WorldWideScience

Sample records for management long-term stewardship

  1. Long-Term Stewardship Baseline Report and Transition Guidance

    Energy Technology Data Exchange (ETDEWEB)

    Kristofferson, Keith

    2001-11-01

    Long-term stewardship consists of those actions necessary to maintain and demonstrate continued protection of human health and the environment after facility cleanup is complete. As the Department of Energy’s (DOE) lead laboratory for environmental management programs, the Idaho National Engineering and Environmental Laboratory (INEEL) administers DOE’s long-term stewardship science and technology efforts. The INEEL provides DOE with technical, and scientific expertise needed to oversee its long-term environmental management obligations complexwide. Long-term stewardship is administered and overseen by the Environmental Management Office of Science and Technology. The INEEL Long-Term Stewardship Program is currently developing the management structures and plans to complete INEEL-specific, long-term stewardship obligations. This guidance document (1) assists in ensuring that the program leads transition planning for the INEEL with respect to facility and site areas and (2) describes the classes and types of criteria and data required to initiate transition for areas and sites where the facility mission has ended and cleanup is complete. Additionally, this document summarizes current information on INEEL facilities, structures, and release sites likely to enter long-term stewardship at the completion of DOE’s cleanup mission. This document is not intended to function as a discrete checklist or local procedure to determine readiness to transition. It is an overarching document meant as guidance in implementing specific transition procedures. Several documents formed the foundation upon which this guidance was developed. Principal among these documents was the Long-Term Stewardship Draft Technical Baseline; A Report to Congress on Long-Term Stewardship, Volumes I and II; Infrastructure Long-Range Plan; Comprehensive Facility Land Use Plan; INEEL End-State Plan; and INEEL Institutional Plan.

  2. Environmental management: Integrating ecological evaluation, remediation, restoration, natural resource damage assessment and long-term stewardship on contaminated lands

    International Nuclear Information System (INIS)

    Burger, Joanna

    2008-01-01

    Ecological evaluation is essential for remediation, restoration, and Natural Resource Damage Assessment (NRDA), and forms the basis for many management practices. These include determining status and trends of biological, physical, or chemical/radiological conditions, conducting environmental impact assessments, performing remedial actions should remediation fail, managing ecosystems and wildlife, and assessing the efficacy of remediation, restoration, and long-term stewardship. The objective of this paper is to explore the meanings of these assessments, examine the relationships among them, and suggest methods of integration that will move environmental management forward. While remediation, restoration, and NRDA, among others, are often conducted separately, it is important to integrate them for contaminated land where the risks to ecoreceptors (including humans) can be high, and the potential damage to functioning ecosystems great. Ecological evaluations can range from inventories of local plants and animals, determinations of reproductive success of particular species, levels of contaminants in organisms, kinds and levels of effects, and environmental impact assessments, to very formal ecological risk assessments for a chemical or other stressor. Such evaluations can range from the individual species to populations, communities, ecosystems or the landscape scale. Ecological evaluations serve as the basis for making decisions about the levels and kinds of remediation, the levels and kinds of restoration possible, and the degree and kinds of natural resource injuries that have occurred because of contamination. Many different disciplines are involved in ecological evaluation, including biologists, conservationists, foresters, restoration ecologists, ecological engineers, economists, hydrologist, and geologists. Since ecological evaluation forms the basis for so many different types of environmental management, it seems reasonable to integrate management options

  3. Long-Term Stewardship Science and Technology Requirements

    International Nuclear Information System (INIS)

    McDonald, J.K.; Nickelson, R.A.

    2002-01-01

    To ensure technology developed for long-term stewardship will meet existing requirements, a review of requirements was performed. In addition to identifying existing science and technology related requirements, gaps and conflicts of requirements were identified

  4. Long-Term Stewardship Program Science and Technology Requirements

    Energy Technology Data Exchange (ETDEWEB)

    Joan McDonald

    2002-09-01

    Many of the United States’ hazardous and radioactively contaminated waste sites will not be sufficiently remediated to allow unrestricted land use because funding and technology limitations preclude cleanup to pristine conditions. This means that after cleanup is completed, the Department of Energy will have long-term stewardship responsibilities to monitor and safeguard more than 100 sites that still contain residual contamination. Long-term stewardship encompasses all physical and institutional controls, institutions, information, and other mechanisms required to protect human health and the environment from the hazards remaining. The Department of Energy Long-Term Stewardship National Program is in the early stages of development, so considerable planning is still required to identify all the specific roles and responsibilities, policies, and activities needed over the next few years to support the program’s mission. The Idaho National Engineering and Environmental Laboratory was tasked with leading the development of Science and Technology within the Long-Term Stewardship National Program. As part of that role, a task was undertaken to identify the existing science and technology related requirements, identify gaps and conflicts that exist, and make recommendations to the Department of Energy for future requirements related to science and technology requirements for long-term stewardship. This work is summarized in this document.

  5. Intergenerational equity and long-term stewardship plans

    International Nuclear Information System (INIS)

    Hocking, E. K.

    2002-01-01

    For an untold number of contaminated sites throughout the world, stewardship will be inevitable. For many such sites, stewardship will be a reasonable approach because of the uncertainties associated with present and future site conditions and site contaminants, the limited performance of available technologies, the nonavailability of technologies, and the risk and cost associated with complete cleanup. Regardless of whether stewardship is a realistic approach to site situations or simply a convenient default, it could be required at most contaminated sites for multiple generations. Because the stewardship plan is required to protect the release of hazardous contaminants to the environment, some use restrictions will be put in place to provide that protection. These use restrictions will limit access to resources for as long as the protection is required. The intergenerational quality of long-term stewardship plans and their inherent limitations on resource use require that they be designed to achieve equity among the affected generations. Intergenerational equity, defined here as the fairness of access to resources across generations, could be achieved through a well-developed stewardship plan that provides future generations with the information they need to make wise decisions about resource use. Developing and implementing such a plan would take into account the failure mechanisms of the plan's components, feature short stewardship time blocks that would allow for periodic reassessments of the site and of the stewardship program's performance, and provide present and future generations with necessary site information

  6. Science and society: the role of long-term studies in environmental stewardship

    Science.gov (United States)

    Charles T. Driscoll; Kathleen F. Lambert; F. Stuart Chapin; David J. Nowak; Thomas A. Spies; Frederick J. Swanson; David B. Kittredge; Clarisse M. Hart

    2012-01-01

    Long-term research should play a crucial role in addressing grand challenges in environmental stewardship. We examine the efforts of five Long Term Ecological Research Network sites to enhance policy, management, and conservation decisions for forest ecosystems. In these case studies, we explore the approaches used to inform policy on atmospheric deposition, public...

  7. Antimicrobial stewardship in long term care facilities: what is effective?

    Science.gov (United States)

    Nicolle, Lindsay E

    2014-02-12

    Intense antimicrobial use in long term care facilities promotes the emergence and persistence of antimicrobial resistant organisms and leads to adverse effects such as C. difficile colitis. Guidelines recommend development of antimicrobial stewardship programs for these facilities to promote optimal antimicrobial use. However, the effectiveness of these programs or the contribution of any specific program component is not known. For this review, publications describing evaluation of antimicrobial stewardship programs for long term care facilities were identified through a systematic literature search. Interventions included education, guidelines development, feedback to practitioners, and infectious disease consultation. The studies reviewed varied in types of facilities, interventions used, implementation, and evaluation. Comprehensive programs addressing all infections were reported to have improved antimicrobial use for at least some outcomes. Targeted programs for treatment of pneumonia were minimally effective, and only for indicators of uncertain relevance for stewardship. Programs focusing on specific aspects of treatment of urinary infection - limiting treatment of asymptomatic bacteriuria or prophylaxis of urinary infection - were reported to be effective. There were no reports of cost-effectiveness, and the sustainability of most of the programs is unclear. There is a need for further evaluation to characterize effective antimicrobial stewardship for long term care facilities.

  8. Long-Term Stewardship At DOE's Hanford Site - 12575

    International Nuclear Information System (INIS)

    Moren, R.J.; Grindstaff, K.D.

    2012-01-01

    The U.S. Department of Energy's (DOE) Hanford Site is located in southeast Washington and consists of 1,518 square kilometers (586 square miles) of land. Established in 1943 as part of the Manhattan Project, Hanford workers produced plutonium for our nation's nuclear defense program until the mid 1980's. Since then, the site has been in cleanup mode that is being accomplished in phases. As we achieve remedial objectives and complete active cleanup, DOE will manage Hanford land under the Long-Term Stewardship (LTS) Program until completion of cleanup and the site becomes ready for transfer to the post cleanup landlord - currently planned for DOE's Office of Legacy Management (LM). We define Hanford's LTS Program in the ''Hanford Long-Term Stewardship Program Plan,'' (DOE/RL-201 0-35)(1), which describes the scope including the relationship between the cleanup projects and the LTS Program. DOE designed the LTS Program to manage and provide surveillance and maintenance (S and M) of institutional controls and associated monitoring of closed waste sites to ensure the protection of human health and the environment. DOE's Richland Operations Office (DOE-RL) and Hanford cleanup and operations contractors collaboratively developed this program over several years. The program's scope also includes 15 key activities that are identified in the DOE Program Plan (DOE/RL-2010-35). The LTS Program will transition 14 land segments through 2016. The combined land mass is approximately 570 square kilometers (220 square miles), with over 1,300 active and inactive waste sites and 3,363 wells. Land segments vary from buffer zone property with no known contamination to cocooned reactor buildings, demolished support facilities, and remediated cribs and trenches. DOE-RL will transition land management responsibilities from cleanup contractors to the Mission Support Contract (MSC), who will then administer the LTS Program for DOE-RL. This process requires an environment of cooperation

  9. Antimicrobial stewardship in long term care facilities: what is effective?

    OpenAIRE

    Nicolle, Lindsay E

    2014-01-01

    Intense antimicrobial use in long term care facilities promotes the emergence and persistence of antimicrobial resistant organisms and leads to adverse effects such as C. difficile colitis. Guidelines recommend development of antimicrobial stewardship programs for these facilities to promote optimal antimicrobial use. However, the effectiveness of these programs or the contribution of any specific program component is not known. For this review, publications describing evaluation of antimicro...

  10. Collaboration in long-term stewardship at DOE Hanford Site

    Energy Technology Data Exchange (ETDEWEB)

    Moren, R. J.; Zeisloft, J. H.; Feist, E. T.; Brown, D.; Grindstaff, K. D.

    2013-01-10

    The U.S. Department of Energy's (DOE) Hanford Site comprises approximately 1,517 km{sup 2} (586 mi{sup 2}) of land in southeastern Washington. The site was established in 1943 as part of the Manhattan Project to produce plutonium for the nation's nuclear weapons program. As the Cold War era came to an end, the mission of the site transitioned from weapons production to environmental cleanup. As the River Corridor area of the site cleanup is completed, the mission for that portion of the site will transition from active cleanup to continued protection of environment through the Long-Term Stewardship (LTS) Program. The key to successful transition from cleanup to LTS is the unique collaboration among three (3) different DOE Programs and three (3) different prime contractors with each contractor having different contracts. The LTS Program at the site is a successful model of collaboration resulting in efficient resolution of issues and accelerated progress that supports DOE's Richland Office 2015 Vision for the Hanford Site. The 2015 Vision for the Hanford Site involves shrinking the active cleanup footprint of the surface area of the site to approximately 20 mi{sup 2} on the Central Plateau. Hanford's LTS Program is defined in DOE's planning document, Hanford Long-Term Stewardship Program Plan, DOE/RL-2010-35 Rev 1. The Plan defines the relationship and respective responsibilities between the federal cleanup projects and the LTS Program along with their respective contractors. The LTS Program involves these different parties (cleanup program and contractors) who must work together to achieve the objective for transition of land parcels. Through the collaborative efforts with the prime contractors on site over the past two years, 253.8 km{sup 2} (98 mi{sup 2}) of property has been successfully transitioned from the cleanup program to the LTS Program upon completion of active surface cleanup. Upcoming efforts in the near term will include transitioning another large

  11. Long term radioactive waste management

    International Nuclear Information System (INIS)

    Lavie, J.M.

    1984-01-01

    In France, waste management, a sensitive issue in term of public opinion, is developing quickly, and due to twenty years of experience, is now reaching maturity. With the launching of the French nuclear programme, the use of radioactive sources in radiotherapy and industry, waste management has become an industrial activity. Waste management is an integrated system dealing with the wastes from their production to the long term disposal, including their identification, sortage, treatment, packaging, collection and transport. This system aims at guaranteing the protection of present and future populations with an available technology. In regard to their long term management, and the design of disposals, radioactive wastes are divided in three categories. This classification takes into account the different radioisotopes contained, their half life and their total activity. Presently short-lived wastes are stored in the shallowland disposal of the ''Centre de la Manche''. Set up within the French Atomic Energy Commission (CEA), the National Agency for waste management (ANDRA) is responsible within the framework of legislative and regulatory provisions for long term waste management in France [fr

  12. Managing Records for the Long Term - 12363

    Energy Technology Data Exchange (ETDEWEB)

    Montgomery, John V. [U.S. Department of Energy, Office of Legacy Management, Morgantown, West Virginia (United States); Gueretta, Jeanie [U.S. Department of Energy, Office of Legacy Management, Grand Junction, Colorado (United States)

    2012-07-01

    The U.S. Department of Energy (DOE) is responsible for managing vast amounts of information documenting historical and current operations. This information is critical to the operations of the DOE Office of Legacy Management. Managing legacy records and information is challenging in terms of accessibility and changing technology. The Office of Legacy Management is meeting these challenges by making records and information management an organizational priority. The Office of Legacy Management mission is to manage DOE post-closure responsibilities at former Cold War weapons sites to ensure the future protection of human health and the environment. These responsibilities include environmental stewardship and long-term preservation and management of operational and environmental cleanup records associated with each site. A primary organizational goal for the Office of Legacy Management is to 'Preserve, Protect, and Share Records and Information'. Managing records for long-term preservation is an important responsibility. Adequate and dedicated resources and management support are required to perform this responsibility successfully. Records tell the story of an organization and may be required to defend an organization in court, provide historical information, identify lessons learned, or provide valuable information for researchers. Loss of records or the inability to retrieve records because of poor records management processes can have serious consequences and even lead to an organisation's downfall. Organizations must invest time and resources to establish a good records management program because of its significance to the organization as a whole. The Office of Legacy Management will continue to research and apply innovative ways of doing business to ensure that the organization stays at the forefront of effective records and information management. DOE is committed to preserving records that document our nation's Cold War legacy, and the

  13. GLAS Long-Term Archive: Preservation and Stewardship for a Vital Earth Observing Mission

    Science.gov (United States)

    Fowler, D. K.; Moses, J. F.; Zwally, J.; Schutz, B. E.; Hancock, D.; McAllister, M.; Webster, D.; Bond, C.

    2012-12-01

    Data Stewardship, preservation, and reproducibility are fast becoming principal parts of a data manager's work. In an era of distributed data and information systems, it is of vital importance that organizations make a commitment to both current and long-term goals of data management and the preservation of scientific data. Satellite missions and instruments go through a lifecycle that involves pre-launch calibration, on-orbit data acquisition and product generation, and final reprocessing. Data products and descriptions flow to the archives for distribution on a regular basis during the active part of the mission. However there is additional information from the product generation and science teams needed to ensure the observations will be useful for long term climate studies. Examples include ancillary input datasets, product generation software, and production history as developed by the team during the course of product generation. These data and information will need to be archived after product data processing is completed. NASA has developed a set of Earth science data and information content requirements for long term preservation that is being used for all the EOS missions as they come to completion. Since the ICESat/GLAS mission was one of the first to end, NASA and NSIDC, in collaboration with the science team, are collecting data, software, and documentation, preparing for long-term support of the ICESat mission. For a long-term archive, it is imperative to preserve sufficient information about how products were prepared in order to ensure future researchers that the scientific results are accurate, understandable, and useable. Our experience suggests data centers know what to preserve in most cases. That is, the processing algorithms along with the Level 0 or Level 1a input and ancillary products used to create the higher-level products will be archived and made available to users. In other cases, such as pre-launch, calibration/validation, and test

  14. Benefits of a Biological Monitoring Program for Assessing Remediation Performance and Long-Term Stewardship - 12272

    Energy Technology Data Exchange (ETDEWEB)

    Peterson, Mark [Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831 (United States)

    2012-07-01

    The Biological Monitoring and Abatement Program (BMAP) is a long-running program that was designed to evaluate biological conditions and trends in waters downstream of Department of Energy (DOE) facilities in Oak Ridge, Tennessee. BMAP monitoring has focused on aquatic pathways from sources to biota, which is consistent with the sites' clean water regulatory focus and the overall cleanup strategy which divided remediation areas into watershed administrative units. Specific programmatic goals include evaluating operational and legacy impacts to nearby streams and the effectiveness of implemented remediation strategies at the sites. The program is characterized by consistent, long-term sampling and analysis methods in a multidisciplinary and quantitative framework. Quantitative sampling has shown conclusively that at most Oak Ridge stream sites, fish and aquatic macro-invertebrate communities have improved considerably since the 1980s. Monitoring of mercury and PCBs in fish has shown that remedial and abatement actions have also improved stream conditions, although in some cases biological monitoring suggests further actions are needed. Follow-up investigations have been implemented by BMAP to identify sources or causes, consistent with an adaptive management approach. Biological monitoring results to date have not only been used to assess regulatory compliance, but have provided additional benefits in helping address other components of the DOE's mission, including facility operations, natural resource, and scientific goals. As a result the program has become a key measure of long-term trends in environmental conditions and of high value to the Oak Ridge environmental management community, regulators, and the public. Some of the BMAP lessons learned may be of value in the design, implementation, and application of other long-term monitoring and stewardship programs, and assist environmental managers in the assessment and prediction of the effectiveness of

  15. Local Government Implementation of Long-Term Stewardship at Two DOE Facilities

    Energy Technology Data Exchange (ETDEWEB)

    John Pendergrass; Roman Czebiniak; Kelly Mott; Seth Kirshenberg; Audrey Eidelman; Zachary Lamb; Erica Pencak; Wendy Sandoz

    2003-08-13

    The Department of Energy (DOE) is responsible for cleaning up the radioactive and chemical contamination that resulted from the production of nuclear weapons. At more than one hundred sites throughout the country DOE will leave some contamination in place after the cleanup is complete. In order to protect human health and the environment from the remaining contamination DOE, U.S. Environmental Protection Agency (EPA), state environmental regulatory agencies, local governments, citizens and other entities will need to undertake long-term stewardship of such sites. Long-term stewardship includes a wide range of actions needed to protect human health in the environment for as long as the risk from the contamination remains above acceptable levels, such as barriers, caps, and other engineering controls and land use controls, signs, notices, records, and other institutional controls. In this report the Environmental Law Institute (ELI) and the Energy Communities Alliance (ECA) examine how local governments, state environmental agencies, and real property professionals implement long-term stewardship at two DOE facilities, Losa Alamos National Laboratory and Oak Ridge Reservation.

  16. Strategic Program Planning Lessons Learned In Developing The Long-Term Stewardship Science and Technology Roadmap

    Energy Technology Data Exchange (ETDEWEB)

    Dixon, B.W.; Hanson, D.J.; Matthern, G.E.

    2003-04-24

    Technology roadmapping is a strategic planning method used by companies to identify and plan the development of technologies necessary for new products. The U.S. Department of Energy's Office of Environmental Management has used this same method to refine requirements and identify knowledge and tools needed for completion of defined missions. This paper describes the process of applying roadmapping to clarify mission requirements and identify enhancing technologies for the Long-Term Stewardship (LTS) of polluted sites after site cleanup has been completed. The nature of some contamination problems is such that full cleanup is not achievable with current technologies and some residual hazards remain. LTS maintains engineered contaminant barriers and land use restriction controls, and monitors residual contaminants until they no longer pose a risk to the public or the environment. Roadmapping was used to clarify the breadth of the LTS mission, to identify capability enhancements needed to improve mission effectiveness and efficiency, and to chart out the research and development efforts to provide those enhancements. This paper is a case study of the application of roadmapping for program planning and technical risk management. Differences between the planned and actual application of the roadmapping process are presented along with lessons learned. Both the process used and lessons learned should be of interest for anyone contemplating a similar technology based planning effort.

  17. A Report to Congress on Long-Term Stewardship. Volume II, Site Summaries

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    2001-01-01

    During World War II and the Cold War, the Federal government developed and operated a vast network of industrial facilities for the research, production, and testing of nuclear weapons, as well as for other scientific and engineering research. These processes left a legacy of radioactive and chemical waste, environmental contamination, and hazardous facilities and materials at well over a 100 sites in 30 States and one U.S. Territory. Hundreds of thousand of acres of residually contaminated soils, contaminated groundwater, surface water and sediment contamination, and contaminated buildings are present at many sites across the country. These sites range in size from less than one acre, containing only a single facility, to large sites spanning over 100,000 acres with huge uranium enrichment plants and plutonium processing canyons. Since 1989, the U.S. Department of Energy’s (DOE) Environmental Management (EM) program has made significant progress in addressing this environmental legacy. Millions of cubic meters of waste have been removed, stabilized, or disposed of, resulting in significant risk and cost reduction. In addition, DOE began disposing of transuranic (i.e., plutonium-contaminated) waste in the nation’s first deep geologic repository – the Waste Isolation Pilot Plant in New Mexico. DOE is now carrying out its long-term stewardship obligations at dozens of sites, including smaller sites where DOE has completed cleanup work for the entire site and many larger sites where DOE has remediated portions of the site.

  18. Strategies and challenges of antimicrobial stewardship in long-term care facilities.

    Science.gov (United States)

    Dyar, O J; Pagani, L; Pulcini, C

    2015-01-01

    As people are living longer the demand for long-term care facilities (LTCFs) continues to rise. For many reasons, antimicrobials are used intensively in LTCFs, with up to a half of this use considered inappropriate or unnecessary. Over-use of antimicrobials can have direct adverse consequences for LTCF residents and promotes the development and spread of resistant bacteria. It is therefore critical that LTCFs are able to engage in antimicrobial stewardship programmes, which have the potential to minimize the antibiotic selective pressure, while improving the quality of care received by LTCF residents. To date, no antimicrobial stewardship guidelines specific to LTCF settings have been published. Here we outline the scale of antimicrobial use in LTCFs and the underlying drivers for antibiotic over-use. We further describe the particular challenges of antimicrobial stewardship in LTCFs, and review the interventional studies that have aimed to improve antibiotic use in these settings. Practical recommendations are then drawn from this research to help guide the development and implementation of antimicrobial stewardship programmes. Copyright © 2014 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  19. Planning for Site Transition to Long-Term Stewardship: Identification of Requirements and Issues

    International Nuclear Information System (INIS)

    Banaee, J.

    2002-01-01

    A systematic methodology is presented and applied for the identification of requirements and issues pertaining to the planning for, and transition to, long term stewardship (LTS). The method has been applied to three of the twelve identified LTS functions. The results of the application of the methodology to contaminated and uncontaminated federal real property in those three functions are presented. The issues that could be seen as impediments to the implementation of LTS are also identified for the three areas under consideration. The identified requirements are significant and in some cases complex to implement. It is clear that early and careful planning is required in all circumstances

  20. Planning for Site Transition to Long-Term Stewardship: Identification of Requirements and Issues

    Energy Technology Data Exchange (ETDEWEB)

    Banaee, J.

    2002-05-16

    A systematic methodology is presented and applied for the identification of requirements and issues pertaining to the planning for, and transition to, long term stewardship (LTS). The method has been applied to three of the twelve identified LTS functions. The results of the application of the methodology to contaminated and uncontaminated federal real property in those three functions are presented. The issues that could be seen as impediments to the implementation of LTS are also identified for the three areas under consideration. The identified requirements are significant and in some cases complex to implement. It is clear that early and careful planning is required in all circumstances.

  1. Planning for Site Transition to Long-Term Stewardship: Identification of Requirements and Issues

    Energy Technology Data Exchange (ETDEWEB)

    Banaee, Jila

    2002-08-01

    A systematic methodology is presented and applied for the identification of requirements and issues pertaining to the planning for, and transition to, long term stewardship (LTS). The method has been applied to three of the twelve identified LTS functions. The results of the application of the methodology to contaminated and uncontaminated federal real property in those three functions are presented. The issues that could be seen as impediments to the implementation of LTS are also identified for the three areas under consideration. The identified requirements are significant and in some cases complex to implement. It is clear that early and careful planning is required in all circumstances.

  2. Biogeochemical Cycling and Environmental Stability of Pu Relevant to Long-Term Stewardship of DOE Sites

    Energy Technology Data Exchange (ETDEWEB)

    Honeyman, Bruce D.

    2006-06-01

    The overall objective of this proposed research is to understand the biogeochemical cycling of Pu in environments of interest to long-term DOE stewardship issues. Central to Pu cycling (transport initiation to immobilization) is the role of microorganisms. The hypothesis underlying this proposal is that microbial activity is the causative agent in initiating the mobilization of Pu in near-surface environments: through the transformation of Pu associated with solid phases, production of extracellular polymeric substances (EPS) carrier phases, and the creation of microenvironments. Also, microbial processes are central to the immobilization of Pu species, through the metabolism of organically complexed Pu species and Pu associated with extracellular carrier phases and the creation of environments favorable for Pu transport retardation.

  3. Biogeochemical Cycling and Environmental Stability of Pu Relevant to Long-Term Stewardship of DOE Sites

    Energy Technology Data Exchange (ETDEWEB)

    Francis, Arokiasamy J.; Santschi, Peter H.; Honeyman, Bruce D.

    2005-06-01

    The overall objective of this proposed research is to understand the biogeochemical cycling of Pu in environments of interest to long-term DOE stewardship issues. Central to Pu cycling (transport initiation to immobilization) is the role of microorganisms. The hypothesis underlying this proposal is that microbial activity is the causative agent in initiating the mobilization of Pu in near-surface environments: through the transformation of Pu associated with solid phases, production of extracellular polymeric substances (EPS) carrier phases, and the creation of microenvironments. Also, microbial processes are central to the immobilization of Pu species, through the metabolism of organically complexed Pu species and Pu associated with extracellular carrier phases and the creation of environments favorable for Pu transport retardation.

  4. Data Stewardship and Long-Term Archive of ICESat Data at the National Snow and Ice Data Center (NSIDC)

    Science.gov (United States)

    Fowler, D. K.; Moses, J. F.; Duerr, R. E.; Webster, D.; Korn, D.

    2010-12-01

    Data Stewardship is becoming a principal part of a data manager’s work at NSIDC. It is vitally important that our organization makes a commitment to both current and long-term goals of data management and the preservation of our scientific data. Data must be available to researchers not only during active missions, but long after missions end. This includes maintaining accurate documentation, data tools, and a knowledgeable user support staff. NSIDC is preparing for long-term support of the ICESat mission data. Though ICESat has seen its last operational day, the data is still being improved and NSIDC is scheduled to archive the final release, Release 33, starting late in 2010. This release will include the final adjustments to the processing algorithms and will produce the best possible products to date. Along with the higher-level data sets, all supporting documentation will be archived at NSIDC. For the long-term archive, it is imperative that there is sufficient information about how products were prepared in order to convince future researchers that the scientific results are reproducible. The processing algorithms along with the Level 0 and ancillary products used to create the higher-level products will be archived and made available to users. This can enable users to examine production history, to derive revised products and to create their own products. Also contained in the long-term archive will be pre-launch, calibration/validation, and test data. These data are an important part of the provenance which must be preserved. For longevity, we’ll need to archive the data and documentation in formats that will be supported in the years to come.

  5. Long term aspects of uranium tailings management

    International Nuclear Information System (INIS)

    Bragg, K.

    1980-05-01

    This paper sets out the background issues which lead to the development of interim close-out criteria for uranium mill tailings. It places the current state-of-the-art for tailings management into both a national and international perspective and shows why such interim criteria are needed now. There are seven specific criteria proposed dealing with the need to have: passive barriers, limits on surface water recharge, durable systems, long term performance guarantees, limits to access, controls on water and airborne releases and finally to have a knowledge of exposure pathways. This paper is intended to serve as a focus for subsequent discussions with all concerned parties. (auth)

  6. Collaboration in Long-Term Stewardship at DOE's Hanford Site - 13019

    International Nuclear Information System (INIS)

    Moren, Rick; Brown, David; Feist, Ella; Grindstaff, Keith; Zeisloft, Jamie

    2013-01-01

    The U.S. Department of Energy's (DOE) Hanford Site comprises approximately 1,517 km 2 (586 mi 2 ) of land in southeastern Washington. The site was established in 1943 as part of the Manhattan Project to produce plutonium for the nation's nuclear weapons program. As the Cold War era came to an end, the mission of the site transitioned from weapons production to environmental cleanup. As the River Corridor area of the site cleanup is completed, the mission for that portion of the site will transition from active cleanup to continued protection of environment through the Long-Term Stewardship (LTS) Program. The key to successful transition from cleanup to LTS is the unique collaboration among three (3) different DOE Programs and three (3) different prime contractors with each contractor having different contracts. The LTS Program at the site is a successful model of collaboration resulting in efficient resolution of issues and accelerated progress that supports DOE's Richland Office 2015 Vision for the Hanford Site. The 2015 Vision for the Hanford Site involves shrinking the active cleanup footprint of the surface area of the site to approximately 20 mi 2 on the Central Plateau. Hanford's LTS Program is defined in DOE's planning document, Hanford Long-Term Stewardship Program Plan [1]. The Plan defines the relationship and respective responsibilities between the federal cleanup projects and the LTS Program along with their respective contractors. The LTS Program involves these different parties (cleanup program and contractors) who must work together to achieve the objective for transition of land parcels. Through the collaborative efforts with the prime contractors on site over the past two years,, 253.8 km 2 (98 mi 2 ) of property has been successfully transitioned from the cleanup program to the LTS Program upon completion of active surface cleanup. Upcoming efforts in the near term will include transitioning another large parcel that includes one of the six (6

  7. Collaboration in Long-Term Stewardship at DOE's Hanford Site - 13019

    Energy Technology Data Exchange (ETDEWEB)

    Moren, Rick; Brown, David [Mission Support Alliance, LLC, Richland, WA (United States); Feist, Ella [Washington Closure Hanford, LLC, Richland WA (United States); Grindstaff, Keith; Zeisloft, Jamie [US Department of Energy, Richland Operations, Richland WA (United States)

    2013-07-01

    The U.S. Department of Energy's (DOE) Hanford Site comprises approximately 1,517 km{sup 2} (586 mi{sup 2}) of land in southeastern Washington. The site was established in 1943 as part of the Manhattan Project to produce plutonium for the nation's nuclear weapons program. As the Cold War era came to an end, the mission of the site transitioned from weapons production to environmental cleanup. As the River Corridor area of the site cleanup is completed, the mission for that portion of the site will transition from active cleanup to continued protection of environment through the Long-Term Stewardship (LTS) Program. The key to successful transition from cleanup to LTS is the unique collaboration among three (3) different DOE Programs and three (3) different prime contractors with each contractor having different contracts. The LTS Program at the site is a successful model of collaboration resulting in efficient resolution of issues and accelerated progress that supports DOE's Richland Office 2015 Vision for the Hanford Site. The 2015 Vision for the Hanford Site involves shrinking the active cleanup footprint of the surface area of the site to approximately 20 mi{sup 2} on the Central Plateau. Hanford's LTS Program is defined in DOE's planning document, Hanford Long-Term Stewardship Program Plan [1]. The Plan defines the relationship and respective responsibilities between the federal cleanup projects and the LTS Program along with their respective contractors. The LTS Program involves these different parties (cleanup program and contractors) who must work together to achieve the objective for transition of land parcels. Through the collaborative efforts with the prime contractors on site over the past two years,, 253.8 km{sup 2} (98 mi{sup 2}) of property has been successfully transitioned from the cleanup program to the LTS Program upon completion of active surface cleanup. Upcoming efforts in the near term will include transitioning another

  8. Collaboration in long-term stewardship at DOE Hanford Site-13019

    International Nuclear Information System (INIS)

    Moren, R. J.; Zeisloft, J. H.; Feist, E. T.; Brown, D.; Grindstaff, K. D.

    2013-01-01

    The U.S. Department of Energy's (DOE) Hanford Site comprises approximately 1,517 km 2 (586 mi 2 ) of land in southeastern Washington. The site was established in 1943 as part of the Manhattan Project to produce plutonium for the nation's nuclear weapons program. As the Cold War era came to an end, the mission of the site transitioned from weapons production to environmental cleanup. As the River Corridor area of the site cleanup is completed, the mission for that portion of the site will transition from active cleanup to continued protection of environment through the Long-Term Stewardship (LTS) Program. The key to successful transition from cleanup to LTS is the unique collaboration among three (3) different DOE Programs and three (3) different prime contractors with each contractor having different contracts. The LTS Program at the site is a successful model of collaboration resulting in efficient resolution of issues and accelerated progress that supports DOE's Richland Office 2015 Vision for the Hanford Site. The 2015 Vision for the Hanford Site involves shrinking the active cleanup footprint of the surface area of the site to approximately 20 mi 2 on the Central Plateau. Hanford's LTS Program is defined in DOE's planning document, Hanford Long-Term Stewardship Program Plan, DOE/RL-2010-35 Rev 1. The Plan defines the relationship and respective responsibilities between the federal cleanup projects and the LTS Program along with their respective contractors. The LTS Program involves these different parties (cleanup program and contractors) who must work together to achieve the objective for transition of land parcels. Through the collaborative efforts with the prime contractors on site over the past two years, 253.8 km 2 (98 mi 2 ) of property has been successfully transitioned from the cleanup program to the LTS Program upon completion of active surface cleanup. Upcoming efforts in the near term will include transitioning another large parcel that includes one

  9. Implementation of the long term stewardship model of decommissioning power reactors. Update on the Zion project

    Energy Technology Data Exchange (ETDEWEB)

    Christian, J.; Hess, J.; Moloney, B.P. [EnergySolutions EU, Swindon (United Kingdom)

    2012-11-01

    Several countries have announced programmes to phase out nuclear power. Many NPPs built in the 1960s-80s are in any case reaching the end of their planned operating lives. Over the next decade, approximately 60-80 reactors worldwide will reach end of useful life and become candidates for decontamination and dismantling (D and D). Utilities will therefore commission over the coming decade a much larger number of decommissioning programmes to discharge their license responsibilities for reactor dismantling and site remediation. One major strategic question for the utilities is whether they regard decommissioning reactors as part of their core business or whether they wish to transfer this burden and risk in part or in whole to a specialised contractor. This paper reviews progress at the first programme in the US where a non-utility company has taken on the full license responsibility from the utility to undertake site remediation and license termination. We call this model ''Long Term Stewardship'' and it is now fully underway at the Zion NPP near Chicago, Illinois. (orig.)

  10. Designing Program Roadmaps to Catalyze Community Formation: A Case Study of the Long-Term Stewardship Science and Technology Roadmapword

    International Nuclear Information System (INIS)

    Dixon, Brent; Hanson, Duane; Matthern, Gretchen

    2003-01-01

    A number of broad perspective technology roadmaps have been developed in the last few years as tools for coordinating nation-wide research in targeted areas. These roadmaps share a common characteristic of coalescing the associated stakeholder groups into a special-interest community that is willing to work cooperatively in achieving the roadmap goals. These communities are key to roadmap implementation as they provide the collaborative energy necessary to obtain the political support and funding required for identified science and technology development efforts. This paper discusses the relationship between roadmaps and special-interest communities, using the recently drafted Department of Energy's Long-Term Stewardship Science and Technology Roadmap as a case study. Specific aspects this roadmap's design facilitated the development of a long-term stewardship community while specific realities during roadmap development impacted the realization of the design

  11. [Perioperative management of long-term medication].

    Science.gov (United States)

    Vogel Kahmann, I; Ruppen, W; Lurati Buse, G; Tsakiris, D A; Bruggisser, M

    2011-01-01

    Anesthesiologists and surgeons are increasingly faced with patients who are under long-term medication. Some of these drugs can interact with anaesthetics or anaesthesia and/or surgical interventions. As a result, patients may experience complications such as bleeding, ischemia, infection or severe circulatory reactions. On the other hand, perioperative discontinuation of medication is often more dangerous. The proportion of outpatient operations has increased dramatically in recent years and will probably continue to increase. Since the implementation of DRGs (pending in Switzerland, introduced in Germany for some time), the patient enters the hospital the day before operation. This means that the referring physician as well as anesthesiologists and surgeons at an early stage must deal with issues of perioperative pharmacotherapy. This review article is about the management of the major drug classes during the perioperative period. In addition to cardiac and centrally acting drugs and drugs that act on hemostasis and the endocrine system, special cases such as immunosuppressants and herbal remedies are mentioned.

  12. Planning for the Transition to Long-Term Stewardship at Three U.S. Department of Energy-Chicago Operations Office Facilities

    International Nuclear Information System (INIS)

    Moos, L. P.; Ditmars, J. D.; Heston, S. L.; Granzen, G. A.; Holzemer, M. J.; Bennett, D. B.

    2003-01-01

    This paper describes a pilot study that resulted in the generation of draft planning documents for the upcoming transition from remediation construction to long-term stewardship at three national laboratories managed by the U.S. Department of Energy (DOE)-Chicago Operations Office (CH). The remediation construction work at these facilities is being completed under the DOE's Office of Environmental Management (EM) Program. Once the remediation is complete, the responsibility for long-term stewardship (LTS) of the closed waste sites is expected to be transferred to the DOE organization responsible for managing each of the three facilities (i.e., the site landlord). To prepare for this transfer, an extensive planning effort is required. This pilot study utilized the DOE guidance in effect at the time to (1) develop a series of documents identifying applicable requirements that the LTS Programs will need to satisfy, issues that need to be resolved before the transfer can proceed, and criteria to be used to determine when active remediation is complete and a given site is ready for transfer to the LTS Program; (2) examine alternate structures for possible LTS Programs; and (3) develop draft LTS Implementation Plans. This advanced planning effort yielded a number of observations and lessons learned that are applicable to any facility approaching the end of its remediation construction phase

  13. Long-Term Stewardship at a Former Uranium Mill Tailings Site in Riverton, Wyoming WM2017-17090

    Energy Technology Data Exchange (ETDEWEB)

    Dam, William [USDOE Office of Legacy Management, Washington, DC (United States); Gil, Dr. April [USDOE Office of Legacy Management, Washington, DC (United States); Johnson, Raymond H. [Navarro Research and Engineering, Oak Ridge, TN (United States); Campbell, Sam [Navarro Research and Engineering, Oak Ridge, TN (United States)

    2017-03-01

    The US Department of Energy Office of Legacy Management (LM) is responsible for maintaining protective public health and environmental conditions at former uranium mill tailings sites nationwide via long-term stewardship. One of these sites, a former uranium mill near Riverton, Wyoming, is within the boundary of the Wind River Indian Reservation and operated from 1958 to 1963. Tailings and contaminated material associated with mill operations were removed and transported to an offsite disposal cell in 1989. The remedial action was completed under Title I of the Uranium Mill Tailings Radiation Control Act of 1978. Milling operations, which included an unlined tailings impoundment and an unlined evaporation pond, contaminated the shallow groundwater, resulting in a downgradient groundwater plume that discharges to the Little Wind River. A natural flushing compliance strategy was implemented in 1998. This strategy allows contaminants of concern to naturally flush from the groundwater, provided that contaminants flush below US Environmental Protection Agency maximum concentration limits within 100 years. As part of the compliance strategy, LM has implemented a groundwater monitoring program along with institutional controls that include the installation of an alternate water supply, continued sampling of private wells, and restrictions on well drilling and gravel pit construction. LM works closely with local stakeholders and community members to ensure that these institutional controls are in place and maintained. The Riverton site provides an interesting case study where contaminant remobilization due to river flooding prompted a reevaluation of the conceptual site model to verify if the current compliance strategy would remain protective of human health and the environment. Concentrations of groundwater contaminants, which include sulfate, molybdenum, and uranium, were transiently elevated following flooding of the Little Wind River in 2010 and 2016. These flood

  14. Core Certification of Data Repositories: Trustworthiness and Long-Term Stewardship

    Science.gov (United States)

    de Sherbinin, A. M.; Mokrane, M.; Hugo, W.; Sorvari, S.; Harrison, S.

    2017-12-01

    Scientific integrity and norms dictate that data created and used by scientists should be managed, curated, and archived in trustworthy data repositories thus ensuring that science is verifiable and reproducible while preserving the initial investment in collecting data. Research stakeholders including researchers, science funders, librarians, and publishers must also be able to establish the trustworthiness of data repositories they use to confirm that the data they submit and use remain useful and meaningful in the long term. Data repositories are increasingly recognized as a key element of the global research infrastructure and the importance of establishing their trustworthiness is recognised as a prerequisite for efficient scientific research and data sharing. The Core Trustworthy Data Repository Requirements are a set of universal requirements for certification of data repositories at the core level (see: https://goo.gl/PYsygW). They were developed by the ICSU World Data System (WDS: www.icsu-wds.org) and the Data Seal of Approval (DSA: www.datasealofapproval.org)—the two authoritative organizations responsible for the development and implementation of this standard to be further developed under the CoreTrustSeal branding . CoreTrustSeal certification of data repositories involves a minimally intensive process whereby repositories supply evidence that they are sustainable and trustworthy. Repositories conduct a self-assessment which is then reviewed by community peers. Based on this review CoreTrustSeal certification is granted by the CoreTrustSeal Standards and Certification Board. Certification helps data communities—producers, repositories, and consumers—to improve the quality and transparency of their processes, and to increase awareness of and compliance with established standards. This presentation will introduce the CoreTrustSeal certification requirements for repositories and offer an opportunity to discuss ways to improve the contribution of

  15. HLW Long-term Management Technology Development

    International Nuclear Information System (INIS)

    Choi, Jong Won; Kang, C. H.; Ko, Y. K.

    2010-02-01

    Permanent disposal of spent nuclear fuels from the power generation is considered to be the unique method for the conservation of human being and nature in the present and future. In spite of spent nuclear fuels produced from power generation, based on the recent trends on the gap between supply and demand of energy, the advance on energy price and reduction of carbon dioxide, nuclear energy is expected to play a role continuously in Korea. It means that a new concept of nuclear fuel cycle is needed to solve problems on spent nuclear fuels. The concept of the advanced nuclear fuel cycle including PYRO processing and SFR was presented at the 255th meeting of the Atomic Energy Commission. According to the concept of the advanced nuclear fuel cycle, actinides and long-term fissile nuclides may go out of existence in SFR. And then it is possible to dispose of short term decay wastes without a great risk bearing. Many efforts had been made to develop the KRS for the direct disposal of spent nuclear fuels in the representative geology of Korea. But in the case of the adoption of Advanced nuclear fuel cycle, the disposal of PYRO wastes should be considered. For this, we carried out the Safety Analysis on HLW Disposal Project with 5 sub-projects such as Development of HLW Disposal System, Radwaste Disposal Safety Analysis, Feasibility study on the deep repository condition, A study on the Nuclide Migration and Retardation Using Natural Barrier, and In-situ Study on the Performance of Engineered Barriers

  16. Strategy for Long-Term Stewardship and Monitoring of Amchitka Island - 12190

    Energy Technology Data Exchange (ETDEWEB)

    Kautsky, Mark; Nguyen, Jason [U.S. Department of Energy Office of Legacy Management (United States); Darr, Paul S. [S.M. Stoller Corporation (United States); Picel, Mary [Argonne National Laboratory (United States)

    2012-07-01

    The Long-Term Surveillance and Maintenance Plan (LTSMP) for Amchitka details how the U.S. Department of Energy (DOE) intends to fulfill its mission to maintain protection of human health and the environment at and around the sites on Amchitka Island. The LTSMP calls for monitoring to be performed every 5 years, at least in the initial phase of the project. The purpose of the monitoring is to develop a baseline of activity concentrations for selected radionuclides in biota, water, and soil, both on Amchitka and at the reference location on Adak Island, approximately 322 km (200 miles) northeast of Amchitka. Data compiled by the Consortium for Risk Evaluation with Stakeholder Participation (CRESP, 2006) are being included as part of the baseline data set. The specific biological, water, and sediment samples collected during the 2011 sampling event were developed through close coordination with the primary stakeholders, including the Alaska Department of Environmental Conservation, the Aleutian Pribilof Island Association, and the U.S. Fish and Wildlife Service (USFWS). Amchitka is managed by the USFWS as part of the Alaska Maritime National Wildlife Refuge. Two plans were developed to address specific needs of the biological- and the terrestrial-monitoring programs. Results from these monitoring programs will help determine whether the environment is being impacted by radionuclide migration and uptake, and if subsistence and commercial-catch seafood is safe for human consumption. The RESRAD-BIOTA code is being used to evaluate ecological health relative to the radionuclide levels determined from this sampling event. The samples were sent to three laboratories for analysis. With the exception of the seawater samples, most of the samples were sent to the Center for Accelerator Mass Spectrometry at the Lawrence Livermore National Laboratory. A smaller subset of rock-weed samples, Star reindeer lichen samples, and soil samples collected from beneath the lichen were sent

  17. ERDA's long-term waste management goals and programs

    International Nuclear Information System (INIS)

    Perge, A.F.; Trice, V.G. Jr.; Walton, R.D. Jr.

    1976-01-01

    This paper presents an overview of the ERDA's major program for the long-term waste management of radioactive waste and provides a perspective for symposium participants with regard to the interrelationship of specific components of the program that are discussed in detail in other ERDA-sponsored papers. Needs, goals, and plans are reviewed for ERDA's management of the commercially generated wastes which are expected to be delivered to ERDA in accordance with Federal regulations. At present, ERDA responsibilities include long-term management of commercial-level wastes. Possible future regulations may give ERDA responsibility for the long-term management of commercial low-level solid wastes contaminated with transuranic nuclides. Primary planning goals and programs for the development of terminal storage facilities and waste processing technology to produce acceptable waste forms for long-term management are reviewed for each of the waste types identified above. The status of development programs for the long-term management of airborne radionuclides, which may be required at some time in the future, is also reviewed. (author)

  18. Issues for the long term management of radioactive waste

    International Nuclear Information System (INIS)

    Schneider, T.; Schieber, C.; Lavelle, S.

    2006-01-01

    High-level radioactive waste are currently managed in interim storage installations, providing an adequate protection of the public and the workers for the short term period. However, the long-term persistence of the radioactivity of the waste gives a new timescale dimension, never experimented by the society for the development of protection systems. In the framework of the European Commission research project 'COWAM-2' (COmmunity WAste Management) dedicated to the governance of radioactive waste management, the issues of 'long term governance' have been addressed by exploring the elements which can contribute to a better integration of the technical and societal time dimensions, taking into account technical, ethical, economic and organizational considerations. The originality of this project is to address the various issues within working groups involving stakeholders from different origins and European countries together with a research team. After a discussion on the time dimensions to be taken into account from the technical and societal perspective, this paper presents, mainly based on the findings of the COWAM-2 project, a brief analysis of the ethical criteria to be considered when future generations are concerned as well as some performance criteria regarding long term governance. Finally, it proposes a discussion on the interest for the radiation protection experts to engage a process with stakeholders concerned by radioactive waste management in order to favour the emergence of a sustainable management responding to the issues at stake and including radiation protection considerations for long term periods. (authors)

  19. Issues for the long term management of radioactive waste

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, T.; Schieber, C. [CEPN, 92 - Fontenay-aux-Roses (France); Lavelle, S. [ICAM, 59 - Lille (France)

    2006-07-01

    High-level radioactive waste are currently managed in interim storage installations, providing an adequate protection of the public and the workers for the short term period. However, the long-term persistence of the radioactivity of the waste gives a new timescale dimension, never experimented by the society for the development of protection systems. In the framework of the European Commission research project 'COWAM-2' (COmmunity WAste Management) dedicated to the governance of radioactive waste management, the issues of 'long term governance' have been addressed by exploring the elements which can contribute to a better integration of the technical and societal time dimensions, taking into account technical, ethical, economic and organizational considerations. The originality of this project is to address the various issues within working groups involving stakeholders from different origins and European countries together with a research team. After a discussion on the time dimensions to be taken into account from the technical and societal perspective, this paper presents, mainly based on the findings of the COWAM-2 project, a brief analysis of the ethical criteria to be considered when future generations are concerned as well as some performance criteria regarding long term governance. Finally, it proposes a discussion on the interest for the radiation protection experts to engage a process with stakeholders concerned by radioactive waste management in order to favour the emergence of a sustainable management responding to the issues at stake and including radiation protection considerations for long term periods. (authors)

  20. San Francisco Bay Long Term Management Strategy for Dredging

    Science.gov (United States)

    The San Francisco Bay Long Term Management Strategy (LTMS) is a cooperative effort to develop a new approach to dredging and dredged material disposal in the San Francisco Bay area. The LTMS serves as the Regional Dredging Team for the San Francisco area.

  1. The long-term consequences of anaesthetic management | Sessler ...

    African Journals Online (AJOL)

    Thus, it is reasonable to ask to what extent anaesthetic management might influence long-term outcomes. The distinction being made here is between the classical definition of anaesthetic complications, which is restricted to the immediate perioperative period, perhaps extending to a few days after surgery, and the ...

  2. Wildfire Mitigation and Private Lands: Managing Long-Term Vulnerabilities

    Science.gov (United States)

    Brian Muller; Stacey Schulte

    2006-01-01

    Long-term management of wildfire vulnerability requires strategies that address complex interactions between fire ecology and human settlement. In this paper, we examine the integration of wildfire mitigation and land use planning in county governments in the western U.S. This research relies on data from two sources. First, we conducted a survey of land use...

  3. FY 2015 - Stockpile Stewardship and Management Plan

    Energy Technology Data Exchange (ETDEWEB)

    None

    2014-04-01

    This Department of Energy’s (DOE) National Nuclear Security Administration (NNSA) Fiscal Year Stockpile Stewardship and Management Plan (SSMP) is a key planning document for the nuclear security enterprise.

  4. FY 2016 - Stockpile Stewardship and Management Plan

    Energy Technology Data Exchange (ETDEWEB)

    None

    2015-03-01

    This Department of Energy’s (DOE) National Nuclear Security Administration (NNSA) Fiscal Year Stockpile Stewardship and Management Plan (SSMP) is a key planning document for the nuclear security enterprise.

  5. Management of long term sickness absence: a systematic realist review.

    Science.gov (United States)

    Higgins, Angela; O'Halloran, Peter; Porter, Sam

    2012-09-01

    The increasing impact and costs of long term sickness absence have been well documented. However, the diversity and complexity of interventions and of the contexts in which these take place makes a traditional review problematic. Therefore, we undertook a systematic realist review to identify the dominant programme theories underlying best practice, to assess the evidence for these theories, and to throw light on important enabling or disabling contextual factors. A search of the scholarly literature from 1950 to 2011 identified 5,576 articles, of which 269 formed the basis of the review. We found that the dominant programme theories in relation to effective management related to: early intervention or referral by employers; having proactive organisational procedures; good communication and cooperation between stakeholders; and workplace-based occupational rehabilitation. Significant contextual factors were identified as the level of support for interventions from top management, the size and structure of the organisation, the level of financial and organisational investment in the management of long-term sickness absence, and the quality of relationships between managers and staff. Consequently, those with responsibility for managing absence should bear in mind the contextual factors that are likely to have an impact on interventions, and do what they can to ensure stakeholders have at least a mutual understanding (if not a common purpose) in relation to their perceptions of interventions, goals, culture and practice in the management of long term sickness absence.

  6. Fire as a long-term stewardship issue for soils contaminated with radionuclides in the western U.S

    International Nuclear Information System (INIS)

    Shafer, David S.; DuBois, David; Etyemezian, Vic; Kavouras, Ilias; Miller, Julianne J.; Nikolich, George; Stone, Mark

    2007-01-01

    On both U.S. Department of Energy (DOE) and U.S. Department of Defense sites in the southwestern United States (U.S.), significant areas of surface soils are contaminated with radionuclides from atmospheric nuclear testing, and with depleted uranium, primarily from military training. At DOE sites in Nevada, the proposed regulatory closure strategy for most sites is to leave contaminants in place with administrative controls and periodic monitoring. Closure-in-place is considered an acceptable strategy because the contaminated sites exist on access-restricted facilities, decreasing the potential risk to public receptor, the high cost and feasibility of excavating contaminated soils over large areas, and the environmental impacts of excavating desert soils that recover very slowly from disturbance. The largest of the contaminated sites on the Tonopah Test Range in Nevada covers over 1,200 hectares. However, a factor that has not been fully investigated in the long-term stewardship of these sites is the potential effects of fires. Because of the long half-lives of some of the contaminants (e.g., 24,100 years for 239 Pu) and changes in land-cover and climatic factors that are increasing the frequency of fires throughout the western U.S., it should be assumed that all of these sites will eventually burn, possibly multiple times, during the time frame when they still pose a risk. Two primary factors are contributing to increased fire frequency. The first is the spread of invasive grasses, particularly cheat grass (Bromus tectorum and Bromus rubens), which have out-competed native annuals and invaded inter-spaces between shrubs, allowing fires to burn easier. The second is a sharp increase in fire frequency and size throughout the western U.S. beginning in the mid-1980's. This second factor appears to correlate with an increase in average spring and summer temperatures, which may be contributing to earlier loss of soil moisture and longer periods of dry plant biomass

  7. Long Term Cost Efficiency through Green Management Control Systems

    OpenAIRE

    Vukania Adda, Nancy; Qin, Xiaochen

    2012-01-01

    Title: Long term cost efficiency through green management control systems.Authors: Nancy Vukania &Xiaochen QinSupervisor: Åsa Karin-EngstrandBackground: The worldwide financial crisis of 2008 has reconfigured the economic turf leading to a more uncertain and turbulent playing field – a greater challenge for business strategy and the quest for optimization- The oil price hike of 2008 (Furlong 2010)1 caused its rippling effect to affect various cost categories including energy, labor and lo...

  8. Chemistry indices for long term plant health management

    International Nuclear Information System (INIS)

    Galt, K.J.; Cerisier, S.D.M.; Caris, N.B.

    1998-01-01

    Eskom's Koeberg Nuclear Power Station has maintained and reported on the WANO Chemistry Performance Index for a number of years. Because of the masking effects of multiple averaging, the value of the Index was questionable. The modified WANO Chemistry Performance Indicator, introduced recently, was considered an improvement. However, it was felt that it is too general to adequately address the long-term plant health management needs of a specific plant; a more tailored, plant-specific indicator is needed. A system of indices for measuring and managing long-term plant health at Eskom's 10 large fossil-fired power stations had been developed in 1996. The major success of these indices in improving plant performance management lay in their inclusion in station performance contracts. The Fossil Chemistry Index was based on the original WANO Chemistry Performance Index and suffered from the same shortcomings. Consequently, a major revision of this index was initiated to address these deficiencies. The objectives set for the revised common indicator were that target and limit values from Eskom Chemistry Standards should be incorporated, that the masking effect of multiple averaging be minimised or eliminated, that weighting factors be introduced to reflect the relative importance of selected parameters, that conditioning chemical effectiveness be monitored, and that ranges of values be accommodated. In tandem with this revision, there was requirement to include Koeberg in the reporting of long term plant health indicators. Instead of developing completely separate chemistry indicators for fossil and nuclear plant. A commonality of approach to Long Term Plant Health indicators was sought. This has resulted in a single indicator determination, with parameter selection, limit values, and target values providing the required plant specificity. (J.P.N.)

  9. Industrial long-term waste management in France

    International Nuclear Information System (INIS)

    Marque, Y.

    1988-01-01

    Long-term industrial management of radioactive waste in France is carried out by the Agence Nationale pour la Gestion des Dechets Radioactifs (ANDRA). ANDRA is in charge of design, siting, construction and operation of disposal centers. The French national program of waste management is running on with the construction of a second near-surface disposal which is expected to be in operation in 1991 and a selection of a site for the construction of an underground laboratory for the qualification of this site for deep disposal

  10. Comparison of Plant Life Management Approaches for Long Term Operations

    International Nuclear Information System (INIS)

    Kang, Kisig

    2012-01-01

    Plant life management can be defined as the integration of ageing and economic planning to maintain a high level of safety and optimize operations. Many Member States have given high priority to long term operation of nuclear power plants beyond the time frame originally anticipated (e. g. 30 or 40 years). Out of a total of 445 (369 GWe) operating nuclear power plants, 349 units (297 GWe) have been in operation for more than 20 years (as of November 2011). The need for engineering support to operation, maintenance, safety review and life management for long term operation as well as education and training in the field is increasingly evident. In addition the Fukushima accident has rendered all stake holders even more attentive to safety concerns and to the provision of beyond safety measures in the preparation and scrutiny of applications for operational design life extensions. In many countries, the safety performance of NPPs is periodically followed and characterized via the periodic safety review (PSR) approach. The regulatory The regulatory review and acceptance of the PSR gives the licensee the permission to operate the plant for up to the end of the next PSR cycle (usually 10 years). In the USA and other countries operating US designed plants, the license renewal application is based on the five pre-requisite requirements and ageing management programme for passive long life system structure and components(SSCs) and active systems is adequately addressed by the maintenance rule (MR) requirements and other established regulatory processes. Other Member States have adopted a combined approach that incorporates elements of both PSR and additional LRA specific requirements primarily focused on time limited ageing analysis. Taking into account this variety of approaches, the international atomic energy agency (IAEA) initiated work for collecting and sharing information among Member States about good practices on plant life management for long term operation in

  11. Long-term surgical-orthodontic management of hemimandibular hyperplasia.

    Science.gov (United States)

    Bennett, Samuel C; Goonewardene, Mithran S

    2016-05-01

    Hemimandibular hyperplasia (HH), also known as hemimandibular hypertrophy, is characterised by excessive unilateral three-dimensional growth of the mandible after birth. Vertical unilateral elongation of the mandible becomes clinically evident as a rare form of vertical facial asymmetry. Aberrant growth of the facial skeleton affects the developing dentition and the dental compensatory mechanism is usually unable to maintain optimal occlusal relationships. The resulting malocclusion is effectively managed by combined surgical-orthodontic care to address the facial, skeletal and dental problems that confront clinicians. Orthodontists are advised to assess patients with HH during the post-treatment retention stage for continuing mandibular growth and assess the stability of treatment outcomes with long-term follow-up and records as required. To present a case of hemimandibular hyperplasia treated successfully by combined surgical-orthodontic care and evaluated for stability over a seven-year follow-up period. Surgical-orthodontic management was accomplished in four stages: 1) pre-surgical orthodontic; 21 surgical; 3) post-surgical orthodontic; and 4) post-treatment orthodontic retention. Complete orthodontic records, including extra- and intra-oral photographs, study models, and cephalograms plus panoramic radiographs were taken at the pretreatment, post-treatment, and seven-year orthodontic retention time-points. Facial, skeletal and dental goals were achieved in the three planes of space and the long-term stability of the treatment results was shown during a post-treatment orthodontic retention period of seven years. Hemimandibular hyperplasia is a true growth anomaly which may be managed effectively. Clinicians may expect successful long-term correction and stability by utilising a comprehensive surgical-orthodontic treatment approach.

  12. Acute and long-term management of food allergy

    DEFF Research Database (Denmark)

    de Silva, D; Geromi, M; Panesar, S S

    2014-01-01

    BACKGROUND: Allergic reactions to food can have serious consequences. This systematic review summarizes evidence about the immediate management of reactions and longer-term approaches to minimize adverse impacts. METHODS: Seven bibliographic databases were searched from their inception to September...... management for non-life-threatening reactions. H1-antihistamines may be of benefit, but this evidence was in part derived from studies on those with cross-reactive birch pollen allergy. Regarding long-term management, avoiding the allergenic food or substituting an alternative was commonly recommended...... helpful, but allergen-specific immunotherapy may be disease modifying and therefore warrants further exploration. CONCLUSIONS: Food allergy can be debilitating and affects a significant number of people. However, the evidence base about acute and longer-term management is weak and needs to be strengthened...

  13. Long Term Management of Spent Fuel from NEK

    International Nuclear Information System (INIS)

    Kegel, L.; Zeleznik, N.; Lokner, V.

    2012-01-01

    In 2008 Slovenian national agency for radioactive waste management ARAO started together with Croatian sister organization APO elaboration of a new revision of Decommissioning, Radioactive waste and Spent fuel management program for NPP Krsko. In scope of this work also new studies for spent fuel storage and disposal were prepared in which technical solutions were analyzed and proposed for specific spent fuel (SF) from NPP Krsko. Time schedules for main activities of SF disposal development were elaborated for two alternative scenarios which correspond to normal NPP Krsko operation and 20 - year lifetime extension. All technical activities were financially assessed and costs estimates of SF storage and geological disposal development provided. The prepared studies were verified by international experts in order to confirm the correctness of technical inputs, proposed solutions, time schedules of activities and costs evaluations. The calculated nominal and discounted costs of spent fuel management served for the recalculation of annuities in the integral scenarios of interrelated activities on NPP Krsko decommissioning, LILW and SF management. Besides new first proposal of long-term management of spent fuel from NPP Krsko the joint work also opened additional questions. One of this is time schedule of proposed activities for long term SF management - what were the criteria used in the determination of actions and are they optimal for both countries. How the process of site selection for SF storage or disposal should be prepared having in mind that it will bring many questions in both countries? Is direct disposal of SF still the best solution in current development of nuclear prospects? The paper will present the current development and solutions for SF management from NPP Krsko and will try to answer questions which need to be solved and future development in the SF management.(author).

  14. High-level Waste Long-term management technology development

    International Nuclear Information System (INIS)

    Choi, Jong Won; Kang, C. H.; Ko, Y. K.

    2012-02-01

    The purpose of this project is to develop a long-term management system(A-KRS) which deals with spent fuels from domestic nuclear power stations, HLW from advanced fuel cycle and other wastes that are not admitted to LILW disposal site. Also, this project demonstrate the feasibility and reliability of the key technologies applied in the A-KRS by evaluating them under in-situ condition such as underground research laboratory and provide important information to establish the safety assessment and long-term management plan. To develop the technologies for the high level radioactive wastes disposal, demonstrate their reliability under in-situ condition and establish safety assessment of disposal system, The major objects of this project are the following: Ο An advanced disposal system including waste containers for HLW from advanced fuel cycle and pyroprocess has been developed. Ο Quantitative assessment tools for long-term safety and performance assessment of a radwaste disposal system has been developed. Ο Hydrological and geochemical investigation and interpretation methods has been developed to evaluate deep geological environments. Ο The THMC characteristics of the engineered barrier system and near-field has been evaluated by in-situ experiments. Ο The migration and retardation of radionuclides and colloid materials in a deep geological environment has been investigated. The results from this project will provide important information to show HLW disposal plan safe and reliable. The knowledge from this project can also contribute to environmental conservation by applying them to the field of oil and gas industries to store their wastes safe

  15. The long-term management of nuclear emergencies: The principles

    International Nuclear Information System (INIS)

    Baverstock, K.; Cherp, A.; Gray, P.

    2004-01-01

    The long-term impact of the Chernobyl accident on the most affected populations in Belarus (Ukraine)) and the Russian Federation is still evident in terms of a continuing elevated level of thyroid cancer, prominent psychosocial effects, a depressed economy and a low level of well being. Some of these impacts are directly and primarily attributable to exposure to ionising radiation, while others have more complex origins and have evolved over the period since the accident. It is argued that although these latter impacts were largely unpredictable at the time of the accident, they could have been minimised had an appropriate management plan been in force. The principles underlying such a management plan for use in future accidents are enumerated. An essential component in further developing such a plan would be a thorough review of the experience of the Chernobyl accident in order to 'learn the lessons' that accident holds. (authors)

  16. Environmental effects of the long term management of wastes

    International Nuclear Information System (INIS)

    Henry, L.C.

    1980-08-01

    Criteria for interim application in uranium mill tailings management, pending the outcome of a thorough investigation of the tailings problem, are outlined. For a closed-out tailings site only passive or natural barriers are to be used to control releases; surface water recharge is to be limited to that from direct natural precipitation, and no permanent water pool will be allowed; all designed systems must be evaluated in terms of their long-term durability; long-term performance and economic guarantees will be required; access must be limited to the maximum extent practical; and pathway analyses should be performed to determine the health, safety and environmental impacts of the expected level of releases. Releases to water should be no greater than those experienced during the operating phase of the facility. Radon emanation should not exceed 2-10 pCi/m 2 .s, and gamma radiation should be reduced to 10-50 μR/hr at 1 metre above the surface. Particulate emissions originating from the tailings material should be virtually non-existent

  17. Plant life time management for safe long term operation

    International Nuclear Information System (INIS)

    Burket, Danes

    2010-01-01

    The topics discussed include LTO (long-term operation) and licensing procedure in general and specifically for the Dukovany NPP, components of an LTO programme, the PLIM (plant life management) concept for Dukovany and Temelin, the LTO implementation project for Dukovany, LTO strategy, LTO risk study, international verification. The Conclusions include the following items: (i) Technical-economic study of Dukovany NPP LTO demonstrates technical feasibility and economic profitability of Dukovany NPP LTO with perspective for up to 60 years of operation. (ii) Safety part of Program for assurance of Dukovany NPP LTO complies with IAEA SALTO recommendations. (iii) Dukovany NPP LTO programme incorporated IAEA SALTO Peer Review Mission recommendations. (iv) LTO Implementation Project for 2009-2015 was approved with major targets to renew operational permission and prepare NPP for operation up to 60 years. (v) Preparation of Temelin NPP LTO programme has been started. (P.A.)

  18. Long-term management of intractable epilepsy in children

    Directory of Open Access Journals (Sweden)

    LIU Yu-jie

    2012-10-01

    Full Text Available Achievement of seizure free is the ultimate goal of patients with epilepsy. Lifelong treatment may be needed in some epileptic children, especially in those with intractable epilepsy. To be more realistic, this goal may be modified to reduce the frequency of more disabling types of seizures. Chronic seizures influence children in social activities, psychology,cognition as well as many other aspects. Therefore, their long-term management requires concerted lifelong care of pediatricians, neurologists and social workers. During the course of treatment, doctors should evaluate the patients regularly, prevent and control the side effects of antiepileptic drugs (AEDs and monitor patients for AEDs-associated adverse events. In addition, doctors should choose the optimal therapeutic regimen for patients with refractory epilepsy, and achieve a balance between benefit and risk in order to improve the quality of life of patients.

  19. Long-term experiences with pluvial flood risk management

    Directory of Open Access Journals (Sweden)

    Fritsch Kathrina

    2016-01-01

    Full Text Available The awareness of pluvial (rain-related flood risk has grown significantly in the past few years but pluvial flooding is not handled with the same intensity throughout Europe. A variety of methods and modelling technologies are used to assess pluvial flood hazard and risk and to develop suggestions for flood mitigation measures. A brief overview of current model approaches is followed by the description of a modelling methodology that has been developed throughout the last 15 years with the focus on processing large scale areas. Experiences from several projects show that only high quality models of whole catchment areas yield results with enough accuracy to gain credibility among stakeholders, planners and the public. As a best practice example shows, the model approach also helps to plan effective decentral flood protection measures. To ensure successful flood risk management, a long-term preservation of flood risk awareness among local authorities and the public is necessary.

  20. Maintenance management during long-term stop of JRR-3

    International Nuclear Information System (INIS)

    Matsui, Yutaka; Suwa, Masayuki; Wada, Shigeru

    2016-01-01

    JRR-3 has been continuing its stop state for more than 5 years as of FY2015 after stopping the use operation of the reactor in November 2010. Different responses are required in the maintenance management for operation resumption, compared with those in normal operation. This paper introduces part of the maintenance managements that are performed during long-term stop. The water qualities of primary coolant and secondary coolant are controlled by measuring pH and conductivity, and the prevention of crevice corrosion of equipment is performed. In the management of pumps for coolant circulation, vibration measurement is performed to confirm that there are no signs of abnormality. As the management of the core structure, the bend measurement of beryllium reflector is performed to confirm that there is no hindrance to operation resumption, and the visual inspection of high burnup fuel elements is performed to confirm that abnormality has not occurred. As for the management of monitoring equipment, the equipment required in shutdown period is subjected to calibration work, and the equipment required in operation period is subjected to soundness check based on the results of cooling system operation. As the functional maintenance of the cooling system, cooling system operating test and 10-day continuous operation of the cooling system are monthly performed to confirm the soundness of equipment. In addition, the competence maintenance and capacity improvement of operators are performed through the cooling system operation and reactor simulator training. (A.O.)

  1. Effective antimicrobial stewardship in a long-term care facility through an infectious disease consultation service: keeping a LID on antibiotic use.

    Science.gov (United States)

    Jump, Robin L P; Olds, Danielle M; Seifi, Nasim; Kypriotakis, Georgios; Jury, Lucy A; Peron, Emily P; Hirsch, Amy A; Drawz, Paul E; Watts, Brook; Bonomo, Robert A; Donskey, Curtis J

    2012-12-01

    We introduced a long-term care facility (LTCF) infectious disease (ID) consultation service (LID service) that provides on-site consultations to residents of a Veterans Affairs (VA) LTCF. We determined the impact of the LID service on antimicrobial use and Clostridium difficile infections at the LTCF. A 160-bed VA LTCF. Systemic antimicrobial use and positive C. difficile tests at the LTCF were compared for the 36 months before and the 18 months after the initiation of the ID consultation service through segmented regression analysis of an interrupted time series. Relative to that in the preintervention period, total systemic antibiotic administration decreased by 30% (Peffective means to achieve antimicrobial stewardship.

  2. Antimicrobial stewardship in long-term care facilities in Belgium: a questionnaire-based survey of nursing homes to evaluate initiatives and future developments

    Directory of Open Access Journals (Sweden)

    François Kidd

    2016-03-01

    Full Text Available Abstract Background The use of antimicrobials is intense and often inappropriate in long-term care facilities. Antimicrobial resistance has increased in acute and chronic care facilities, including those in Belgium. Evidence is lacking concerning antimicrobial stewardship programmes in chronic care settings. The medical coordinator practicing in Belgian nursing homes is a general practitioner designated to coordinate medical activity. He is likely to be the key position for effective implementation of such programmes. The aim of this study was to evaluate past, present, and future developments of antimicrobial stewardship programmes by surveying medical coordinators working in long-term care facilities in Belgium. Methods We conducted an online questionnaire-based survey of 327 Belgian medical coordinators. The questionnaire was composed of 33 questions divided into four sections: characteristics of the respondents, organisational frameworks for implementation of the antimicrobial stewardship programme, tools to promote appropriate antimicrobial use and priorities of action. Questions were multiple choice, rating scale, or free text. Results A total of 39 medical coordinators (12 % completed the questionnaire. Past or present antimicrobial stewardship initiatives were reported by 23 % of respondents. The possibility of future developments was rated 2.7/5. The proposed key role of medical coordinators was rated <3/5 by 36 % of respondents. General practitioners, nursing staff, and hospital specialists are accepted as important roles. The use of antimicrobial guidelines was reported by only 19 % of respondents. Education was considered the cornerstone for any future developments. Specific diagnostic recommendations were considered useful, but chest x-rays were judged difficult to undertake. The top priority identified was to reduce unnecessary treatment of asymptomatic urinary infections. Conclusions Our study shows that the implementation of

  3. [Outsourcing in long-term care: a risk management approach].

    Science.gov (United States)

    Guimarães, Cristina Machado; Carvalho, José Crespo de

    2012-05-01

    This article seeks to investigate outsourcing decisions in supply chain management of healthcare organizations, namely the motives and constraints behind the decision, the selection criteria for activities to be outsourced to third parties, the type of possible agreements, and the impact of this decision on the organization per se. A case study of the start-up phase of a Long-term Care unit with an innovative approach and high levels of customization was conducted to understand the outsourcing process in a start-up context (not in the standard context of organizational change) and a risk evaluation matrix was created for outsourcing activities in order to define and implement a performance monitoring process. This study seeks to understand how to evaluate and assess the risks of an outsourcing strategy and proposes a monitoring model using risk management tools. It was shown that the risk management approach can be a solution for monitoring outsourcing in the organizational start-up phase. Conclusions concerning dissatisfaction with the results of outsourcing strategies adopted are also presented.

  4. Management challenges faced by managers of New Zealand long-term care facilities.

    Science.gov (United States)

    Madas, E; North, N

    2000-01-01

    This article reports on a postal survey of 78 long-term care managers in one region of New Zealand, of whom 45 (58%) responded. Most long-term care managers (73.2%) were middle-aged females holding nursing but not management qualifications. Most long-term care facilities (69%) tended to be stand-alone facilities providing a single type of care (rest home or continuing care hospital). The most prominent issues facing managers were considered to be inadequate funding to match the growing costs of providing long-term care and occupancy levels. Managers believed that political/regulatory, economic and social factors influenced these issues. Despite a turbulent health care environment and the challenges facing managers, long-term care managers reported they were coping well and valued networking.

  5. Long-term management of chronic spontaneous urticaria with omalizumab.

    Science.gov (United States)

    Pinto Gouveia, M; Gameiro, A; Pinho, A; Gonçalo, M

    2017-10-01

    Clinical trials have shown the efficacy of omalizumabs efficacy in refractory chronic spontaneous urticaria (CSU) and chronic inducible urticaria (CIndU), but real-life management strategies are lacking. To assess the long-term efficacy and safety of omalizumab, and to identify predictive factors and optimum dosage regimens. This was a prospective study of 13 patients (11 women, 2 men) with severe CSU [weekly urticaria activity score (UAS7) > 28] resistant to anti-H1 antihistamines. Patients were started on omalizumab 150 mg subcutaneously every 4 weeks. Dose and interval between administrations were adjusted according to clinical response (189 administrations; treatment duration range 2-38 months). Mean UAS7 was 36.3 ± 5.4. Of the 13 patients, all had experienced angio-oedema, while in addition, 7 had delayed pressure urticaria (DPU) and 1 had solar urticaria (SU). After omalizumab treatment, 4 (30.8%) of the 13 patients had complete response (CR), and the remaining 8 (61.5%) had partial response. CR was achieved with a dose of 150 mg every 4 (n = 2 patients) or 5 (n = 2) weeks. One of these patients remained disease-free after stopping treatment. Partial responses were achieved with 150 mg every 4 weeks (n = 4) and with 300 mg (n = 4) at intervals of 5 weeks (n = 1), 4 weeks (n = 2) or 3 weeks (n = 1). Only one patient (7.7%) did not show significant improvement, despite a dose of 300 mg every 4 weeks. There were no significant differences in epidemiological, clinical and laboratory data between the different response groups. Only two adverse events were observed: one was mild headache and the other was severe angio-oedema and aggravation of urticaria within 6 h of omalizumab administration. Omalizumab dose and interval between administrations could be individualized for long-term management of CSU. © 2017 British Association of Dermatologists.

  6. Diagnosis, management, and long-term outcomes of rectovaginal endometriosis

    Directory of Open Access Journals (Sweden)

    Moawad NS

    2013-11-01

    Full Text Available Nash S Moawad,1 Andrea Caplin21Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, University of Florida, 2University of Florida College of Medicine, Gainesville, FL, USAAbstract: Rectovaginal endometriosis is the most severe form of endometriosis. Clinically, it presents with a number of symptoms including chronic pelvic pain, dysmenorrhea, deep dyspareunia, dyschezia, and rectal bleeding. The gold standard for diagnosis is laparoscopy with histological confirmation; however, there are a number of options for presurgical diagnosis, including clinical examination, transvaginal/transrectal ultrasound, magnetic resonance imagining, colonoscopy, and computed tomography colonography. Treatment can be medical or surgical. Medical therapies include birth control pills, oral progestins, gonadotropin-releasing hormone agonists, danazol, and injectable progestins. Analgesics are often used as well. Surgery improves up to 70% of symptoms. Surgery is either ablative or excisional, and is conducted via transvaginal, laparoscopic, laparotomy, or combined approaches. Common surgical techniques involve shaving of the superficial rectal lesion, laparoscopic anterior discoid resection, and low anterior bowel resection and reanastomosis. Outcomes are generally favorable, but postoperative complications may include intra-abdominal bleeding, anastomotic leaks, rectovaginal fistulas, strictures, chronic constipation, and the need for reoperation. Recurrence of rectal endometriosis is a possibility as well. Other outcomes are improved pain-related symptoms and fertility. Long-term outcomes vary according to the management strategy used. This review will provide the most recent approaches and techniques for the diagnosis and treatment of rectovaginal endometriosis.Keywords: pelvic pain, dyspareunia, bowel resection, endometriosis, rectovaginal

  7. Nurse Case Managers' Experiences on Case Management for Long-term Hospitalization in Korea

    OpenAIRE

    Jinjoo Oh, Ph.D., RN, GNP; Seieun Oh, Ph.D., RN

    2017-01-01

    Purpose: The implementation of case management for long-term hospitalization use has been approved for controlling medical cost increases in other countries. But, introduction of the case management in Korea has created issues that hinder its effective operation. This qualitative study aimed to obtain further understanding of the issues surrounding the management of Medical Aid beneficiaries' use of long-term hospitalization from the case managers' perspectives and to provide suggestions for ...

  8. Digital health system for personalised COPD long-term management.

    Science.gov (United States)

    Velardo, Carmelo; Shah, Syed Ahmar; Gibson, Oliver; Clifford, Gari; Heneghan, Carl; Rutter, Heather; Farmer, Andrew; Tarassenko, Lionel

    2017-02-20

    Recent telehealth studies have demonstrated minor impact on patients affected by long-term conditions. The use of technology does not guarantee the compliance required for sustained collection of high-quality symptom and physiological data. Remote monitoring alone is not sufficient for successful disease management. A patient-centred design approach is needed in order to allow the personalisation of interventions and encourage the completion of daily self-management tasks. A digital health system was designed to support patients suffering from chronic obstructive pulmonary disease in self-managing their condition. The system includes a mobile application running on a consumer tablet personal computer and a secure backend server accessible to the health professionals in charge of patient management. The patient daily routine included the completion of an adaptive, electronic symptom diary on the tablet, and the measurement of oxygen saturation via a wireless pulse oximeter. The design of the system was based on a patient-centred design approach, informed by patient workshops. One hundred and ten patients in the intervention arm of a randomised controlled trial were subsequently given the tablet computer and pulse oximeter for a 12-month period. Patients were encouraged, but not mandated, to use the digital health system daily. The average used was 6.0 times a week by all those who participated in the full trial. Three months after enrolment, patients were able to complete their symptom diary and oxygen saturation measurement in less than 1 m 40s (96% of symptom diaries). Custom algorithms, based on the self-monitoring data collected during the first 50 days of use, were developed to personalise alert thresholds. Strategies and tools aimed at refining a digital health intervention require iterative use to enable convergence on an optimal, usable design. 'Continuous improvement' allowed feedback from users to have an immediate impact on the design of the system (e

  9. Establishing Long Term Data Management Research Priorities via a Data Decadal Survey

    Science.gov (United States)

    Wilson, A.; Uhlir, P.; Meyer, C. B.; Robinson, E.

    2013-12-01

    We live in a time of unprecedented collection of and access to scientific data. Improvements in sensor technologies and modeling capabilities are constantly producing new data sources. Data sets are being used for unexpected purposes far from their point of origin, as research spans projects, discipline domains, and temporal and geographic boundaries. The nature of science is evolving, with more open science, open publications, and changes to the nature of peer review and data "publication". Data-intensive, or computational science, has been identified as a new research paradigm. There is recognition that the creation of a data set can be a contribution to science deserving of recognition comparable to other scientific publications. Federally funded projects are generally expected to make their data open and accessible to everyone. In this dynamic environment, scientific progress is ever more dependent on good data management practices and policies. Yet current data management and stewardship practices are insufficient. Data sets created at great, and often public, expense are at risk of being lost for technological or organizational reasons. Insufficient documentation and understanding of data can mean that the data are used incorrectly or not at all. Scientific results are being scrutinized and questioned, and occasionally retracted due to problems in data management. The volume of data is greatly increasing while funding for data management is meager and generally must be found within existing budgets. Many federal government agencies, including NASA, USGS, NOAA and NSF are already making efforts to address data management issues. Executive memos and directives give substantial impetus to those efforts, such as the May 9 Executive Order directing agencies to implement Open Data Policy requirements and regularly report their progress. However, these distributed efforts risk duplicating effort, lack a unifying, long-term strategic vision, and too often work in

  10. Characteristics of asthma attack with long-term management for bronchial asthma.

    Science.gov (United States)

    Kawahara, Noriko; Hasegawa, Shunji; Hashimoto, Kunio; Matsubara, Tomoyo; Ichiyama, Takashi; Furukawa, Susumu

    2009-10-01

    There have been no reports on the evaluation of the usefulness of long-term asthma management based on the Japanese Pediatric Guideline for the Treatment and Management of Bronchial Asthma 2005 (JPGL 2005). The purpose of the present study was to retrospectively investigate the records of 350 patients admitted to Yamaguchi University Hospital who had asthma attacks from January 2006 to June 2008. There were 149 patients who were treated for more than 3 months in accordance with the guideline (long-term management group) and 201 who were not (non-long-term management group). The patients were divided into three age groups: 100 infants, 159 toddlers, and 91 schoolchildren. The onset age of asthma in the long-term management group was earlier than that in the non-long-term management group in toddlers and schoolchildren. The white blood cell counts and C-reactive protein levels were higher in the non-long-term management group in schoolchildren, suggesting the complication of some infections. The severity of asthma in the long-term management group was greater than that in the non-long-term management group among all three age groups. There were no significant differences, however, in the severity of asthma attack at admission between the long-term and non-long-term management groups in the three age groups. Patients who had severe asthma tended to be treated with long-term management, which suggests that long-term asthma management according to JPGL 2005 may reduce the severity of asthma attack at that admission, because the severity of asthma in patients undergoing long-term management correlates with the severity of asthma attack.

  11. Long term governance for radioactive waste management. Final report of Cowan2 - work package 4

    International Nuclear Information System (INIS)

    Schneider, Th.; Schieber, C.; Lavele, S.

    2006-12-01

    This report aims at identifying key features for the long term governance of radioactive waste. It is proposed by the COWAN2 Work Package 4 the purpose of which was to identify, discuss and analyse the institutional, ethical, economic and legal considerations raised by long term radioactive waste storage or disposal on the three interrelated issues of: responsibility and ownership of radioactive waste on the long term, continuity of local dialogue between stakeholders and monitoring of radioactive waste management facilities, and compensation and sustainable development. The aim is also to propose guidelines in order to better address long term issues in decision-making processes and start long term governance

  12. Long term governance for radioactive waste management. Final report of Cowan2 - work package 4

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, Th.; Schieber, C.; Lavele, S.

    2006-12-15

    This report aims at identifying key features for the long term governance of radioactive waste. It is proposed by the COWAN2 Work Package 4 the purpose of which was to identify, discuss and analyse the institutional, ethical, economic and legal considerations raised by long term radioactive waste storage or disposal on the three interrelated issues of: responsibility and ownership of radioactive waste on the long term, continuity of local dialogue between stakeholders and monitoring of radioactive waste management facilities, and compensation and sustainable development. The aim is also to propose guidelines in order to better address long term issues in decision-making processes and start long term governance

  13. The long-term management of contaminated areas; the principles

    International Nuclear Information System (INIS)

    Baverstock, K.; Cherp, A.; Gray, P.

    2003-01-01

    Full text: There are three primary aspects to be considered in the remediation of areas contaminated by the accidental release of radioactivity, these are: the environment; health and well-being, including the psychological impact on the resident and adjaqent populations; the economic and social status of the affected populations. These aspects cannot be seen as independent of one another. In the case of the Chernobyl accident they have mutually interacted to produce a downward spiral in the quality of life of the affected populations. This paper will discuss the lessons that have emerged from that experience and propose ways in which. There is much, in practical terms, that can be done to manage, in both the short and the long term, the environmental aspects of the contamination, both at the collective and the individual levels. How effectively this is done and is seen to be done, will be a powerful determinant of the success in dealing with the other two primary aspects. Ring fencing the risk into the contaminated areas by the prohibition of processes that disperse the risk to populations outside the affected areas can be counterproductive for the affected population with minimal real detriment for the wider unaffected populations. In the case of the Chernobyl accident it can be argued that health and well-being have been more adversely affected by the psychosocial aspects of the accident than by the direct effects of radiation. A larger than real effect an health is perceived and this leads to the five dimensions of the psychosocial effect, social disruption of communities, illness behaviour, readiness to attribute illness to radiation, changed lifestyle habits, stress related illness. The effects of radiation exposure, if any, will appear after a few to tens of years. Their incidence should be carefully monitored in relation to the previous experience and the experience in comparable populations, in an open and objective way. The perception that health

  14. [Laparoscopic management of ureteroileal stenosis: Long term follow up.

    Science.gov (United States)

    Emiliani, Esteban; Gavrilov, Pavel; Mayordomo, Olga; Salvador, Josep; Palou, Joan; Rosales, Antonio; Villavicencio, Humberto

    2017-05-01

    To describe the laparoscopic approach for uretero-ileal anastomosis strictures and to analyse our long term series. A retrospective review was performed evaluating our series of patients with benign ureteroileal anastomosis strictures treated laparoscopically from 2011 to 2017. Demographics and perioperative data were obtained and analyzed. Complications were described with the Clavien-Dindo classification. The surgical technique was described and a literature review was performed. Eleven procedures were performed in ten patients. Mean blood loss was 180 ml. All the operations were performed laparoscopically without conversion. Mean hospital stay was 10 days (4-23). Early complications were Clavien-Dindo I y II: Two cases of limited anastomosis leakage, one lymphorrea, one paralitic ileum and one accidental descent of the ureteral catheter. Mean follow-up was 56 months (12-179) No late complications have been described. Based on our series with 5 year follow up, the laparoscopic approach for uretero-ileal anastomosis strictures is feasible and safe.

  15. Improvement of Regulatory Framework for Long-Term Operation and Ageing Management of NPPs

    International Nuclear Information System (INIS)

    Kostenko, S.P.

    2015-01-01

    The regulatory framework for long-term operation and ageing management of NPP units in Ukraine was reviewed and deficiencies were identified. The procedure for improving regulatory framework for long-term operation and ageing management is presented. It takes into consideration IAEA recommendations and international practices, as well as experience obtained in long-term operation efforts for Rivne NPP-1, 2 and South Ukraine NPP-1. The paper demonstrates interrelations between standards and technical documents on long-term operation and ageing management. The information is presented regarding the current state of regulatory and legal documentation development and industry-specific standards on long-term operation and ageing management of NPP units in Ukraine

  16. Efficient management vital to large, long-term engineering projects

    International Nuclear Information System (INIS)

    Wolfe, P.L.

    1989-01-01

    This article describes the ways in which firms manage large hazardous waste mitigation projects efficiently. Staffing concerns, control systems and report mechanisms critical to effective and timely management of these large-scale programs are explored

  17. A United States perspective on long-term management of areas contaminated with radioactive materials

    International Nuclear Information System (INIS)

    Jones, C. R.

    2004-01-01

    The US has far-reaching and extensive experience in the long-term management of areas contaminated with radioactive materials. This experience base includes the Dept. of Energy's continued follow-up with Hiroshima and Nagasaki from the 1940's at the Radiological Effects Research Foundation in Hiroshima (Japan)), the long-term management of the Marshall Islands Programme, the clean-up of the US nuclear weapons complex and the ongoing management of accident sites such as in Palomares (Spain)). This paper discusses the lessons learnt and best practices gained from this far-reaching and extensive experience in the long-term management of areas contaminated with radioactive materials. (authors)

  18. Long-term management plan INEL transuranic waste

    International Nuclear Information System (INIS)

    McKinney, J.D.

    1978-12-01

    The Idaho National Engineering Laboratory stores large quantities of transuranic-contaminated waste at its Radioactive Waste Management Complex. This report presents a 10-year plan for management of this transuranic waste and includes descriptions of projects involving nuclear waste storage, retrieval, processing, systems analysis, and environmental science. Detailed project schedules and work breakdown charts are provided to give the reader a clear view of transuranic waste management objectives

  19. Final Programmatic Environmental Impact Statement for stockpile stewardship and management

    International Nuclear Information System (INIS)

    1996-09-01

    The Department of Energy (DOE) has been directed by the President and Congress to maintain the safety and reliability of the reduced nuclear weapons stockpile in the absence of underground nuclear testing. In order to fulfill that responsibility, DOE has developed a Stockpile Stewardship and Management Program to provide a single highly integrated technical program for maintaining the continued safety and reliability of the nuclear stockpile. The Stockpile Stewardship and Management Programmatic Environmental Impact Statement (PEIS) describes and analyzes alternative ways to implement the proposed actions for the Stockpile Stewardship and Management Program. This document contains Volume II which consists of Appendices A through H

  20. The Methodology of Management for Long Term Energy Efficiency Development

    International Nuclear Information System (INIS)

    Zebergs, V.; Kehris, O.; Savickis, J.; Zeltins, N.

    2010-01-01

    The paper has shown that the Member States of the European Union (EU) do what they can in order to accelerate the raising of energy efficiency (EE). In each EU Member State investigations are conducted in the planning and management methods with a view to achieve faster and greater EE gains. In Latvia, which imports almost 70% of the total energy resources consumed, saving of each 'toe' is of great importance. Adaptation of the general policy assessment methodology is being studied for planning and management of the EE process. 12 EE management methods have been analysed and recommendations worked out for the introduction of several most topical methods.(author).

  1. Long term cross asset management of critical structures

    International Nuclear Information System (INIS)

    Wenzel, H.

    2013-01-01

    Conclusions: Asset management requires tools for optimisation. SHM delivers the required information. SHM helps to reduce the uncertainties. Life Cycle methodologies are mature. Life Time Extension can be justified and monitored. Life Cycle Engineering is a must nowadays

  2. Long term industrial management of radioactive wastes in France

    International Nuclear Information System (INIS)

    Lavie, J.

    1981-01-01

    All human activities including energy generation entail the wastes. This definitely applies also to nuclear power generation. Currently the nuclear power program is very extensive, and the plans of fuel reprocessing proceed along this line. In consequence, the Government has decided on tackling the problem of industrial radioactive waste management in earnest. For the purpose, the National Radioactive Waste Management Agency (ANDRA) was created in November, 1979, within the French Atomic Energy Commission (CEA). Its main functions are the design, siting and construction of waste disposal centers and their management, the establishment of waste treatment and disposal standards, and the research and development. The following matters are described: the need for comprehensive industrial approach, the concept of industrial management, ANDRA business program, the industrial policy on waste disposal, and ANDRA financing. (J.P.N.)

  3. Consol structures its management for long-term leadership

    Energy Technology Data Exchange (ETDEWEB)

    Merritt, P; Sanda, A; Sprouls, M

    1988-10-01

    This is a profile of Consolidation Coal which is the second largest coal producer in US. A business strategy has led to the development of a strong management team, to acquisitions and development of new mines, to increased miner productivity and use of innovative mining technologies, and to the application of well-planned, aggressive coal marketing strategies. 23 figs., 4 tabs.

  4. The long-term management of radioactive waste

    International Nuclear Information System (INIS)

    Faussat, A.

    1988-01-01

    After setting out the terms of reference of ANDRA (National agency for the management of radioactive waste), the author describes the current situation and the projects for the surface storage of waste of low and medium activity. He then discusses the work which has started on the construction of an underground laboratory for studying the storage of long life waste [fr

  5. FY 2014 - Stockpile and Stewardship and Management Plan

    Energy Technology Data Exchange (ETDEWEB)

    None

    2013-06-01

    This Department of Energy’s (DOE) National Nuclear Security Administration (NNSA) Fiscal Year Stockpile Stewardship and Management Plan (SSMP) is a key planning document for the nuclear security enterprise.

  6. Community Solutions for Stormwater Management: A Guide for Voluntary Long-Term Planning

    Science.gov (United States)

    This draft guide describes how to develop a comprehensive long-term community stormwater plan that integrates stormwater management with communities’ broader plans for economic development, infrastructure investment and environmental compliance.

  7. Short, medium and long term consequences of inadequate defect fuel management

    International Nuclear Information System (INIS)

    Roberts, J.G.; McQueen, M.; Nashiem, R.; Ma, G.

    2011-01-01

    Defect fuel pencils result in short, medium and long term consequences to the environment within and external to the nuclear power station. The paper will describe these consequences and specify the Defect Fuel Management Practices required to avoid these consequences.

  8. Short, medium and long term consequences of inadequate defect fuel management

    Energy Technology Data Exchange (ETDEWEB)

    Roberts, J.G. [CANTECH Associates Ltd., Burlington, ON (Canada); McQueen, M.; Nashiem, R.; Ma, G. [Bruce Power, Tiverton, ON (Canada)

    2011-07-01

    Defect fuel pencils result in short, medium and long term consequences to the environment within and external to the nuclear power station. The paper will describe these consequences and specify the Defect Fuel Management Practices required to avoid these consequences.

  9. The changing flow of management information systems in long-term care facilities.

    Science.gov (United States)

    Stokes, D F

    1997-08-01

    Over the past three decades, the long-term care community has seen continual increases in the complexity and sophistication of management information systems. These changes have been brought about by the ever-increasing demands on owners and managers to provide accurate and timely data to both regulators and financial investors. The evolution of these systems has increased rapidly in recent years as the nation attempts to reinvent the funding mechanisms for long-term care.

  10. Long term management of wastes contaminated by plutonium

    International Nuclear Information System (INIS)

    Marque, Y.

    1983-01-01

    For the different categories of wastes, the evolution of the cumulated production until the year 2000 is described by curves and the general situation of production points is presented, all that in France. The storage conditions are specified according to the type of wastes, category A, B, or C; the threshold under which the waste is classified in A category being fixed by the safety authorities at 2.10 4 CMA (maximum permissible concentration), that is to say for plutonium 1Ci/m 3 . The knowledge of waste activity is another basic element of the management of such wastes, the fixing of the threshold, above which wastes contaminated by plutonium have to be stored underground, still keeping to be specified [fr

  11. Stepwise Decision Making for Long-Term Radioactive Waste Management

    International Nuclear Information System (INIS)

    Pescatore, Claudio; Vari, Anna

    2003-01-01

    Consideration is increasingly being given, in radioactive waste management (RWM), to concepts such as 'stepwise decision making' and 'adaptive staging' in which the public, and especially the local communities, are also meaningfully involved in the review and planning of developments. The key feature of these concepts is development by steps or stages that are reversible, within the limits of practicability and provided they meet the requirements of an acceptable safety case. Stepwise decisions are designed to provide reassurance that actions can be reversed if experience shows them to have adverse or unwanted effects. Stepwise decision making has thus come to the fore as being especially important for making progress for radioactive waste management in a manner which is acceptable to large sectors of society. Despite its early identification within the RWM community as an important means for reaching decision in which there is broad-based confidence, stepwise decision making has not been widely debated. Accepted guiding principles of any such process have not yet been formulated, its roots in empirical social science research have not been fully reviewed, nor the difficulties of its implementation analysed. This paper reviews the current developments regarding stepwise decision making in RWM with the aim to pinpoint where it stands, to highlight its societal dimension, to analyse its roots in social sciences, and to identify guiding principles and issues in implementation. It is observed that there is convergence between the approach taken by the practitioners of RWM and the indications received from field studies in social research, and that general guiding principles can be proposed at least as a basis for further discussion. A strong basis for dialogue across disciplines thus exists. General methodological issues are also identified. This paper was developed in the framework of the activities of the NEA Forum on Stakeholder Confidence, which is presented in a

  12. Urban Ecological Stewardship: Understanding the Structure, Function and Network of Community-based Urban Land Management

    Directory of Open Access Journals (Sweden)

    Lindsay K. Campbell

    2008-01-01

    Full Text Available Urban environmental stewardship activities are on the rise in cities throughout the Northeast. Groups participating in stewardship activities range in age, size, and geography and represent an increasingly complex and dynamic arrangement of civil society, government and business sectors. To better understand the structure, function and network of these community-based urban land managers, an assessment was conducted in 2004 by the research subcommittee of the Urban Ecology Collaborative. The goal of the assessment was to better understand the role of stewardship organizations engaged in urban ecology initiatives in selected major cities in the Northeastern U.S.: Boston, New Haven, New York City, Pittsburgh, Baltimore, and Washington, D.C. A total of 135 active organizations participated in this assessment. Findings include the discovery of a dynamic social network operating within cities, and a reserve of social capital and expertise that could be better utilized. Although often not the primary land owner, stewardship groups take an increasingly significant responsibility for a wide range of land use types including street and riparian corridors, vacant lots, public parks and gardens, green roofs, etc. Responsibilities include the delivery of public programs as well as daily maintenance and fundraising support. While most of the environmental stewardship organizations operate on staffs of zero or fewer than ten, with small cohorts of community volunteers, there is a significant difference in the total amount of program funding. Nearly all respondents agree that committed resources are scarce and insufficient with stewards relying upon and potentially competing for individual donations, local foundations, and municipal support. This makes it a challenge for the groups to grow beyond their current capacity and to develop long-term programs critical to resource management and education. It also fragments groups, making it difficult for planners and

  13. Policy legitimacy - The key to long term Management of Radioactive Waste

    International Nuclear Information System (INIS)

    Atherton, E.; Dalton, J.; Wild, D.

    2003-01-01

    Experience in the UK has shown that the central theme of delivering a solution is contingent on building a broad base of support for the long term management project. This is multi-layered, both in terms of local, regional and national political actors, but also across societal groups. Legitimacy is the key to success and needs to be understood in three main domains - equity, competence and economics. Finding the appropriate balance is essential for progress in the long term. (authors)

  14. Spent fuel, plutonium and nuclear waste: long-term management; Le combustible use et le plutonium en tant que dechets nucleaires: gestion a long terme

    Energy Technology Data Exchange (ETDEWEB)

    Collard, G

    1998-11-01

    Different options for the management of nuclear waste arising from the nuclear fuel cycle are discussed. Special emphasis is on reprocessing followed by geological disposal, geological disposal of reprocessing waste, direct geological disposal of spent nuclear fuel, long term storage. Particular emphasis is on the management of plutonium including recycling, immobilisation and disposal, partitioning and transmutation.

  15. Taking into account the long term dimension associated with radioactive waste management

    International Nuclear Information System (INIS)

    Schieber, C.; Schneider, T.; Lavelle, S.

    2008-01-01

    Radioactive waste introduces a new time dimension in the field of risk management. This is why, for more than 10 years, there have been reflections on the societal and organisational mechanisms allowing a responsible management over the long term of the risk associated with radioactive waste. These reflections lead one to ask questions regarding interactions between what is at stake for societal and radiation protection criteria, demanding a multidisciplinary approach to the problem. Within the framework of the European project C.O.W.A.M. 2, dedicated to the improvement of governance of radioactive waste management in Europe, a working group involving experts, authorities, waste managers, locally elected representatives and N.G.O.s, discussed the stakes associated with the long term dimension. This article presents the main results of this working group, organised around four themes: meaning of the long term and what is at stake, the ethical dimension regarding long term issues, continuity and sustainability of the surveillance and control of radioactive waste facilities, effectiveness of financing schemes for the long term management of radioactive waste. (authors)

  16. A United States perspective on long-term management of areas contaminated with radioactive materials.

    Science.gov (United States)

    Jones, C Rick

    2004-01-01

    The US has far-reaching and extensive experience in the long-term management of areas contaminated with radioactive materials. This experience base includes the Department of Energy's continued follow-up with Hiroshima and Nagasaki from the 1940s at the Radiological Effects Research Foundation in Hiroshima, Japan, the long-term management of the Marshall Islands Programme, the clean-up of the US nuclear weapons complex and the ongoing management of accident sites such as in Palomares, Spain. This paper discusses the lessons learnt and best practices gained from this far-reaching and extensive experience in the long-term management of areas contaminated with radioactive materials. Copyright 2004 Oxford University Press

  17. Nurse Case Managers' Experiences on Case Management for Long-term Hospitalization in Korea

    Directory of Open Access Journals (Sweden)

    Jinjoo Oh, Ph.D., RN, GNP

    2017-12-01

    Full Text Available Purpose: The implementation of case management for long-term hospitalization use has been approved for controlling medical cost increases in other countries. But, introduction of the case management in Korea has created issues that hinder its effective operation. This qualitative study aimed to obtain further understanding of the issues surrounding the management of Medical Aid beneficiaries' use of long-term hospitalization from the case managers' perspectives and to provide suggestions for successful case management. Methods: Thematic analysis was employed to analyze the data. Medical Aid case managers with 3 or more years of case management experience were recruited from urban, suburban, and rural regions. Data were collected through in-depth interviews: 12 nurse case managers participated in focus group interviews and 11 participated in individual one-on-one interviews. Results: Four major themes emerged: on-site obstacles that hinder work progress; going in an opposite direction; ambiguous position of case managers; and work-related emotions. Eleven subthemes were discovered: chasing potential candidates; becoming an enemy; discharging patients who have nowhere to go; welfare-centered national policies increasing medical costs; Medical Aid Program that encourages hospitalization; misuse of hospitalization; feeling limited; working without authority; fulfilling the expected role; fretting about social criticism; and feeling neglected and unprotected. Conclusion: The findings highlight the complexity and ambiguity of the issues faced by case managers. Successful management of Medical Aid resources requires the orchestrated efforts and collaboration of multiple stakeholders. More systematized support and resources for nurse case managers are essential to fully implement this nursing innovation in Korea. Keywords: case management, focus groups, hospitalization, qualitative research, vulnerable populations

  18. Nurse Case Managers' Experiences on Case Management for Long-term Hospitalization in Korea.

    Science.gov (United States)

    Oh, Jinjoo; Oh, Seieun

    2017-12-01

    The implementation of case management for long-term hospitalization use has been approved for controlling medical cost increases in other countries. But, introduction of the case management in Korea has created issues that hinder its effective operation. This qualitative study aimed to obtain further understanding of the issues surrounding the management of Medical Aid beneficiaries' use of long-term hospitalization from the case managers' perspectives and to provide suggestions for successful case management. Thematic analysis was employed to analyze the data. Medical Aid case managers with 3 or more years of case management experience were recruited from urban, suburban, and rural regions. Data were collected through in-depth interviews: 12 nurse case managers participated in focus group interviews and 11 participated in individual one-on-one interviews. Four major themes emerged: on-site obstacles that hinder work progress; going in an opposite direction; ambiguous position of case managers; and work-related emotions. Eleven subthemes were discovered: chasing potential candidates; becoming an enemy; discharging patients who have nowhere to go; welfare-centered national policies increasing medical costs; Medical Aid Program that encourages hospitalization; misuse of hospitalization; feeling limited; working without authority; fulfilling the expected role; fretting about social criticism; and feeling neglected and unprotected. The findings highlight the complexity and ambiguity of the issues faced by case managers. Successful management of Medical Aid resources requires the orchestrated efforts and collaboration of multiple stakeholders. More systematized support and resources for nurse case managers are essential to fully implement this nursing innovation in Korea. Copyright © 2017. Published by Elsevier B.V.

  19. Long-term management of radioactive waste. Ethics and the environment

    International Nuclear Information System (INIS)

    Pescatore, C.

    1999-01-01

    The protection of the environment and the ethical issues that it raises are important topics in the debate on the long-term management of radioactive waste. An overview of the general ethical principles developed in the wider context of the debate on the environment is presented and the specific case of the management of long-lived radioactive waste is addressed. (author)

  20. Guide to effective research-management collaboration at long-term environmental research sites

    Science.gov (United States)

    Frederick J. Swanson; Steve Eubanks; Mary Beth Adams; John C. Brissette

    2010-01-01

    The Forest Service system of experimental forests and ranges (EFRs) and other sites of long-term silvicultural, watershed, and ecological research have contributed to science and natural resource management for more than a century. An important aspect of the success of EFR programs is strong collaboration between the research and land manager communities. This guide...

  1. Moving Forward with Lessons Learned About Long-term Radioactive Waste Management

    International Nuclear Information System (INIS)

    Atherton, Elizabeth; Dalton, John

    2006-01-01

    A range of lessons have been identified from previous attempts to implement long term radioactive waste management policy in the UK and internationally. Many of these relate to the way the decision-making process is undertaken and the fact that there needs to be an open, transparent process that enables continuous stakeholder involvement. Nirex believes that using the SEA and EIA frameworks will help to incorporate the lessons learned into the future decision-making process relating to long-term radioactive waste management

  2. Moving Forward with Lessons Learned About Long-term Radioactive Waste Management

    Energy Technology Data Exchange (ETDEWEB)

    Atherton, Elizabeth; Dalton, John [UK Nirex Ltd., Harwell (United Kingdom)

    2006-09-15

    A range of lessons have been identified from previous attempts to implement long term radioactive waste management policy in the UK and internationally. Many of these relate to the way the decision-making process is undertaken and the fact that there needs to be an open, transparent process that enables continuous stakeholder involvement. Nirex believes that using the SEA and EIA frameworks will help to incorporate the lessons learned into the future decision-making process relating to long-term radioactive waste management.

  3. Final programmatic environmental impact statement for stockpile stewardship and management

    International Nuclear Information System (INIS)

    1996-09-01

    In response to the end of the Cold War and changes in the world's political regimes, the United States is not producing new-design nuclear weapons. Instead, the emphasis of the U.S. nuclear weapons program is on reducing the size of the Nation's nuclear stockpile by dismantling existing nuclear weapons. The Department of Energy (DOE) has been directed by the President and Congress to maintain the safety and reliability of the reduced nuclear weapons stockpile in the absence of underground nuclear testing. In order to fulfill that responsibility, DOE has developed a Stockpile Stewardship and Management Program to provide a single highly integrated technical program for maintaining the continued safety and reliability of the nuclear stockpile. The Stockpile Stewardship and Management PEIS describes and analyzes alternative ways to implement the proposed actions for the Stockpile Stewardship and Management Program

  4. Organizing and delivering case management services: lessons from the National Long Term Care Channeling Demonstration.

    Science.gov (United States)

    Christianson, J B; Applebaum, R; Carcagno, G; Phillips, B

    1988-01-01

    This article discusses issues relating to the design and internal administration of a case-management agency for community based home care for the elderly. Included in the article are issues relating to screening procedures, assessment and case management activities, cost controls, automated management information systems, and personnel matters. The analysis is based on the experience of the National Long Term Care Demonstration ("Channeling") which established and evaluated ten case management projects nationwide under federal funding.

  5. Emergency Response and Long Term Planning: Two sides of the Coin for Managing Water Resources

    Science.gov (United States)

    Metchis, K.; Beller-Simms, N.

    2014-12-01

    As projected by the US National Climate Assessment and the IPCC, extreme climate and weather events are occurring more frequently and with more intensity across the nation. Communities - and the water resource managers that serve them - are facing difficult choices to increase emergency preparedness, recover from costly impacts, and increase long term resilience. The presentation is based on a recent set of case studies about what happened in six communities that experienced one or more extreme events, focusing on water resource management. Two of the case studies will be presented, revealing that building climate resilience is not just about long term planning - it is also about taking the steps to be prepared for - and to be able to recover from - emergency events. The results of this study have implications for educating local officials on ways to think about resilience to balance both long-term and short-term preparedness.

  6. Long-term management of GERD in the elderly with pantoprazole

    Directory of Open Access Journals (Sweden)

    Carlo Calabrese

    2007-04-01

    Full Text Available Carlo Calabrese, Anna Fabbri, Giulio Di FeboDepartment of Internal Medicine and Gastroenterology, University of Bologna, ItalyAbstract: The prevalence of gastroesophageal reflux disease (GERD increases with age and elderly are more likely to develop severe disease. Older patients often complain of less severe or frequent heartburn than younger patients and they may present with atypical symptoms such as dysphagia, weight loss, or extraesophageal symptoms. Proton pump inhibitors (PPIs are central in the management of GERD and are unchallenged with regards to their efficacy. They are considered safe and more effective than histamine receptor antagonists for healing esophagitis and for preventing its recurrence using a long term maintenance treatment. PPI have minimal side effects and few slight drug interactions and are considered safe for long term treatment. Pantoprazole is significantly effective both for acute and long-term treatment with excellent control of relapse and symptoms. It is well tolerated even for long-term therapy and its tolerability is optimal. Pantoprazole shows to have minimal interactions with other drugs because of a lower affinity for cytocrome P450 than older PPIs. Although the majority of elderly has concomitant illnesses and receive other drugs, this does not adversely effect the efficacy of pantoprazole because of its pharmacokinetics, which are independent of patient age. Clinical practice suggests that a low dose maintenance of PPIs should be used in older patients with GERD.Keywords: GERD, long-term management, pantoprazole, safety, efficacy, tolerability

  7. Analysis on long-term strategy for radwaste management in China

    International Nuclear Information System (INIS)

    Chen Haicheng

    1998-08-01

    Radwaste presents a worldwide issue in the management of environmental protection. Most countries carrying out nuclear programs have developed strategies for their radwastes management. China has been executing its strategy, but the development of nuclear power is representing new challenges for the national radwastes management. This paper tries an analysis on the long-term management of radwastes in China. The exiting system of China's radwastes management is explained. Two important issues on radwastes management i.e. economics and social issues are analyzed. The future issues that will affect China's radwastes management are discussed. A short summary of the national radwastes management in NEA countries is involved in the paper. The analysis indicates that in China the exiting system of radwastes management is comprehensive but remains to be perfected. Improvements of long-term management need to be made in the aspects of economics and social issue. A financing system for long-term management, as a supplement for the exiting system of radwastes management, is expected to be created. (author)

  8. Analysis on long-term strategy for radwaste management in China

    Energy Technology Data Exchange (ETDEWEB)

    Chen Haicheng [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment

    1998-08-01

    Radwaste presents a worldwide issue in the management of environmental protection. Most countries carrying out nuclear programs have developed strategies for their radwastes management. China has been executing its strategy, but the development of nuclear power is representing new challenges for the national radwastes management. This paper tries an analysis on the long-term management of radwastes in China. The exiting system of China`s radwastes management is explained. Two important issues on radwastes management i.e. economics and social issues are analyzed. The future issues that will affect China`s radwastes management are discussed. A short summary of the national radwastes management in NEA countries is involved in the paper. The analysis indicates that in China the exiting system of radwastes management is comprehensive but remains to be perfected. Improvements of long-term management need to be made in the aspects of economics and social issue. A financing system for long-term management, as a supplement for the exiting system of radwastes management, is expected to be created. (author)

  9. Approaches to long-term conditions management and care for older people: similarities or differences?

    Science.gov (United States)

    Tullett, Michael; Neno, Rebecca

    2008-03-01

    In the past few years, there has been an increased emphasis both on the care for older people and the management of long-term conditions within the United Kingdom. Currently, the Department of Health and the Scottish Executive identify and manage these two areas as separate entities. The aim of this article is to examine the current approaches to both of these areas of care and identify commonalities and articulate differences. The population across the world and particularly within the United Kingdom is ageing at an unprecedented rate. The numbers suffering long-term illness conditions has also risen sharply in recent years. As such, nurses need to be engaged at a strategic level in the design of robust and appropriate services for this increasing population group. A comprehensive literature review on long-term conditions and the care of older people was undertaken in an attempt to identify commonalities and differences in strategic and organizational approaches. A policy analysis was conducted to support the paper and establish links that may inform local service development. Proposing service development based on identified needs rather than organizational boundaries after the establishment of clear links between health and social care for those with long-term conditions and the ageing population. Nurse Managers need to be aware of the similarities and differences in political and theoretical approaches to the care for older people and the management of long-term conditions. By adopting this view, creativity in the service redesign and service provision can be fostered and nurtured as well as achieving a renewed focus on partnership working across organizational boundaries. With the current renewed political focus on health and social care, there is an opportunity in the UK to redefine the structure of care. This paper proposes similarities between caring for older people and for those with long-term conditions, and it is proposed these encapsulate the wider

  10. Long-Term Information Management (LTIM) of Safeguards Data at Geological Repositories

    International Nuclear Information System (INIS)

    Haddal, R.; Finch, R.; Baldwin, G.

    2016-01-01

    Full text: The International Atomic Energy Agency (IAEA) has noted that long-term information management (LTIM) of safeguards data at geological repositories will be a significant challenge in the future as information and records management systems evolve and permanent disposal of nuclear materials becomes a high-priority in many countries. Identifying approaches to how information on buried high-level nuclear waste will be managed, handled, organized, archived, read, interpreted, and secured for the long-term (1000 years after repository closure and beyond) will be key to safeguards at repositories). The purpose of this study is to explore various long-term information management systems and how they may or may not be adapted for geological repositories for high-level waste. The study will also examine what types of safeguards-related data should be included in such a system. The study will also consider hypotheses about future needs and analyze the pros and cons of very long-term information management. (author

  11. Legal, administrative and financial aspects of the long-term management of radioactive waste

    International Nuclear Information System (INIS)

    Strohl, P.; Reyners, P.

    1984-01-01

    The paper describes the principal features of a study undertaken by the OECD Nuclear Energy Agency on the institutional problems raised by the long-term management of radioactive waste. The purpose of this study is to provide the competent national authorities with a common approach based on experience. All management operations which may extend over periods of more than 50 years are covered by the study, which analyses the control measures or other institutional measures that must be taken with regard to such operations. It distinguishes between ''active'' and ''passive'' control measures and describes their application ''before closure'' and ''after closure'' of the disposal or storage sites. An attempt is made to evaluate the lifetime of such institutional control measures and it is proposed, on this basis, that a period of several centuries, at most 300 years, should be considered reasonable in view of the need to avoid imposing an excessive burden on future generations. The study also provides a description of relations between governments and industry, stressing the increased responsibility of governments in the context of long-term management of radioactive waste. Specific questions of financing and responsibility for civil nuclear activities which relate to long-term management are also analysed. The general conclusion arrived at is that a long-term management strategy must be based on a viable combination of technological methods and institutional measures. (author)

  12. Engaging aboriginal peoples in Canada's plan for the long-term management of used nuclear fuel

    International Nuclear Information System (INIS)

    Patton, P.

    2011-01-01

    The interests and concerns of Aboriginal peoples are integral to development and implementation of Canada's plans for the long-term management of used nuclear fuel. The Nuclear Waste Management Organization (NWMO) has an ongoing statutory obligation and a commitment to active and meaningful participation with Aboriginal peoples. The organization has worked with Aboriginal organizations and individuals to develop long-term engagement and dialogue processes that respect traditional Aboriginal practices, culture, protocols and approaches to decision-making. Aboriginal peoples were significant participants in the 2003-2005 study that resulted in the recommendation for Adaptive Phased Management (APM). After the Canadian government agreed to proceed with APM, Aboriginal peoples provided valuable input into development of the process for selecting a site for a deep geological repository (DGR) for the long-term management of Canada's used nuclear fuel. The involvement of Aboriginal stakeholders continues to be important as Canada moves into the siting process. Engagement of Aboriginal peoples is guided by principles that respond to the unique interests, perspectives and culture of Aboriginal peoples. These principles recognize and honour the special relationship that Aboriginal peoples have with the natural environment, their unique stewardship responsibilities, and the fact that Aboriginal peoples are holders of Aboriginal Traditional Knowledge (ATK), which brings value to planning processes. The NWMO has been working with Aboriginal Elders and others to learn about ATK and to interweave this knowledge into its work. ATK includes important knowledge about the land, ecology and intergenerational decision-making. The NWMO and Aboriginal peoples have given life to engagement principles and the wisdom of ATK by collaboratively developing a number of programs including agreements with national, regional and local Aboriginal organizations. Additionally, the NWMO has

  13. Quality indicators for the acute and long-term management of anaphylaxis

    DEFF Research Database (Denmark)

    Dhami, Sangeeta; Sheikh, Aadam; Muraro, Antonella

    2017-01-01

    BACKGROUND: The quality of acute and long-term anaphylaxis management is variable and this contributes to the poor outcomes experienced by many patients. Clinical practice guidelines have the potential to improve outcomes, but implementing guideline recommendations in routine practice is challeng...

  14. Canada's plan for the long-term management of used nuclear fuel

    Energy Technology Data Exchange (ETDEWEB)

    Shaver, K. [Nuclear Waste Management Organization, Toronto, ON (Canada)

    2015-07-01

    Our mission is to develop and implement collaboratively with Canadians, a management approach for the long-term care of Canada's used nuclear fuel that is socially acceptable, technically sound, environmentally responsible, and economically feasible. The technical method is for Isolation of used nuclear fuel in deep geological repository with continuous monitoring and potential for retrievability.

  15. Long-term management impacts on carbon storage in Lake States forests

    Science.gov (United States)

    Matthew Powers; Randall Kolka; Brian Palik; Rachel McDonald; Martin. Jurgensen

    2011-01-01

    We examined carbon storage following 50+ years of forest management in two long-term silvicultural studies in red pine and northern hardwood ecosystems of North America’s Great Lakes region. The studies contrasted various thinning intensities (red pine) or selection cuttings, shelterwoods, and diameter-limit cuttings (northern hardwoods) to unmanaged controls of...

  16. PRELIMINARY ANALYSIS OF ALTERNATIVES FOR THE LONG TERM MANAGEMENT OF EXCESS MERCURY

    Science.gov (United States)

    This report describes the use of a systematic method for comparing options for the long term management and retirement of surplus mercury in the U.S. The method chosen is the Analytical Hierarchy Procedure (AHP) as embodied in the Expert Choice 2000 software. The goal, criteria, ...

  17. Short, medium and long term consequences of inadequate defect fuel management

    Energy Technology Data Exchange (ETDEWEB)

    Roberts, J.G. [CANTECH Associates Limited, Burlington, Ontario (Canada); Nashiem, R.; McQueen, M.; Ma, G. [Bruce Power, Tiverton, Ontario (Canada)

    2011-07-01

    Defect fuel pencils result in short, medium and long term consequences to the environment within and external to the nuclear power station. The paper will describe these consequences and specify the Defect Fuel Management Practices required to avoid these consequences. (author)

  18. Short, medium and long term consequences of inadequate defect fuel management

    International Nuclear Information System (INIS)

    Roberts, J.G.; Nashiem, R.; McQueen, M.; Ma, G.

    2011-01-01

    Defect fuel pencils result in short, medium and long term consequences to the environment within and external to the nuclear power station. The paper will describe these consequences and specify the Defect Fuel Management Practices required to avoid these consequences. (author)

  19. Short, medium and long term consequences of inadequate defect fuel management

    Energy Technology Data Exchange (ETDEWEB)

    Roberts, J.G., E-mail: alchemy@tnt21.com [CANTECH Associates Ltd., Burlington, Ontario (Canada); Nashiem, R.; McQueen, M.; Ma, G., E-mail: Rod.nashiem@brucepower.com, E-mail: Maureen.mcqueen@brucepower.com, E-mail: guoping.ma@brucepower.com [Bruce Power, Tiverton (Canada)

    2010-07-01

    Defect fuel pencils result in short, medium and long term consequences to the environment within and external to the nuclear power station. The paper will describe these consequences and specify the Defect Fuel Management Practices required to avoid these consequences. (author)

  20. ANALYSIS OF ALTERNATIVES FOR THE LONG TERM MANAGEMENT OF EXCESS MERCURY

    Science.gov (United States)

    This paper describes a systematic method for comparing options for the long-term management of surplus elemental mercury in the U.S., using the Analytic Hierarchy Process (AHP) as embodied in commercially available Expert Choice software. A limited scope multi-criteria decisionan...

  1. Creature comforts: personal communities, pets and the work of managing a long-term condition.

    Science.gov (United States)

    Brooks, Helen L; Rogers, Anne; Kapadia, Dharmi; Pilgrim, Jack; Reeves, David; Vassilev, Ivaylo

    2013-06-01

    To explore in the context of peoples' personal social networks, the contribution that pets make to 'the work' associated with the management of long-term conditions. Mixed methods survey with nested parallel qualitative study; 300 participants were drawn from diabetes and chronic heart disease registers of General Practices across Greater Manchester in the North West of England. Notions of 'work' were used to describe the illness and everyday activities associated with chronic illness. Nineteen percent of participants identified at least one pet within their network. Pets contributed mostly to managing emotions (emotional work), to enhancing a sense of self identity (biographical work) and to a lesser extent practical tasks (everyday work). There were indicators that pets mediated relationships for people living with a long-term condition through very weak ties with others in domestic and community settings. The findings suggest that pets have unique qualities and are not simply substitutes for human relationships in long-term condition management. The study has potential implications for furthering a social contextual analysis of chronic illness, the understanding of relationships, and the meaning and the role of companion animals in long-term condition management.

  2. Short, medium and long term consequences of inadequate defect fuel management

    International Nuclear Information System (INIS)

    Roberts, J.G.; Nashiem, R.; McQueen, M.; Ma, G.

    2010-01-01

    Defect fuel pencils result in short, medium and long term consequences to the environment within and external to the nuclear power station. The paper will describe these consequences and specify the Defect Fuel Management Practices required to avoid these consequences. (author)

  3. The potential benefits of a new poliovirus vaccine for long-term poliovirus risk management.

    Science.gov (United States)

    Duintjer Tebbens, Radboud J; Thompson, Kimberly M

    2016-12-01

    To estimate the incremental net benefits (INBs) of a hypothetical ideal vaccine with all of the advantages and no disadvantages of existing oral and inactivated poliovirus vaccines compared with current vaccines available for future outbreak response. INB estimates based on expected costs and polio cases from an existing global model of long-term poliovirus risk management. Excluding the development costs, an ideal poliovirus vaccine could offer expected INBs of US$1.6 billion. The ideal vaccine yields small benefits in most realizations of long-term risks, but great benefits in low-probability-high-consequence realizations. New poliovirus vaccines may offer valuable insurance against long-term poliovirus risks and new vaccine development efforts should continue as the world gathers more evidence about polio endgame risks.

  4. Long-term capital planning considering nuclear plant life-cycle management

    International Nuclear Information System (INIS)

    Negin, C.A.; Simpson, J.M.; Hostetler, D.R.

    1992-09-01

    The creation of a Life Cycle Management (LCM) group at utilities to evaluate the long term capital refurbishment needs is gaining favor. Among the functions of such groups can be the responsibility for recommending long term capital planning projects based on results of evaluations of systems, structures, and components that are not only essential to achieving the full current license term of operation, but also to extend the service life of the plant. Making such recommendations, in content and timing, requires the ability to view all recommendations in the context of an overall capital budget and long range outage impacts. This report illustrates an approach for creating a Long-Term Capital Plan with methods for deciding on, compiling, integrating, and presenting projects from the perspective of an LCM program for a nuclear power plant. It also addresses a rationale for capitalization of LCM program activities that would not be allowed under current accounting treatment

  5. RBMK-1500 accident management for loss of long-term core cooling

    International Nuclear Information System (INIS)

    Uspuras, E.; Kaliatka, A.

    2001-01-01

    Results of the Level 1 probabilistic safety assessment of the Ignalina NPP has shown that in topography of the risk, transients dominate above the accidents with LOCAs and failure of the core long-term cooling are the main factors to frequency of the core damage. Previous analyses have shown, that after initial event, as a rule, the reactivity control, as well as short-term and intermediate cooling are provided. However, the acceptance criteria of the long-term cooling are not always carried out. It means that from this point of view the most dangerous accident scenarios are the scenarios related to loss of the core long-term cooling. On the other hand, the transition to the core condition due to loss of the long-term cooling specifies potential opportunities for the management of the accident consequences. Hence, accident management for the mitigation of the accident consequences should be considered and developed. The most likely initiating event, which probably leads to the loss of long term cooling accident, is station blackout. The station blackout is the loss of normal electrical power supply for local needs with an additional failure on start-up of all diesel generators. In the case of loss of electrical power supply MCPs, the circulating pumps of the service water system and MFWPs are switched-off. At the same time, TCV of both turbines are closed. Failure of diesel generators leads to the non-operability of the ECCS long-term cooling subsystem. It means the impossibility to feed MCC by water. The analysis of the station blackout for Ignalina NPP was performed using RELAP5 code. (author)

  6. Plant life management for long term operation of light water reactors. Principles and guidelines

    International Nuclear Information System (INIS)

    2006-01-01

    The subject of this report was originally suggested by the IAEA Technical Working Group on Life Management of Nuclear Power Plants. It was then approved by the IAEA for work to begin in 2004. The participants in the group felt that it was time to address plant life management and ageing issues from the point of view of long term operation and licence renewal. It is believed that the nuclear power industry will only be able to survive if plant economics are favourable and safety is maintained. Therefore, the issue of ageing and obsolescence has to be addressed from an operational and safety standpoint, but also in the context of plant economics in terms of the cost of electricity production, including initial and recurring capital costs. Use of new technologies, such as advanced in-service inspection and condition based maintenance, should be considered, not only to predict the consequences of ageing and guard against them, but also to monitor equipment performance throughout the lifetime of the plant and to help establish replacement schedules for critical systems, structures and components, and to better estimate the optimum end of the operating licence, which means the end of the nuclear power plant's lifetime. The importance of nuclear power plant life management in facilitating the technical and economic goals of long term operation is presented in this report in terms of the requirement to ensure safe long term supplies of electricity in the most economically competitive way. Safe and reliable operation is discussed in terms of the overall economic benefits when plant life management is implemented. Preconditions for plant life management for long term operation are identified and approaches are reviewed. Plant life management should not be associated only with the extension of the operational lifetime of the nuclear power plant, but with an owner's attitude and a rational approach of the operating company towards running the business economically and safely

  7. A United States perspective on long term management of areas contaminated with radioactive materials

    International Nuclear Information System (INIS)

    Jones, C.R.

    2003-01-01

    Full text: The United States has far-reaching experience in the long-term management of areas contaminated with radioactive materials. The events resulting from the atmospheric testing of nuclear weapons in the Marshall Islands, follow-up from Hiroshima and Nagasaki, accidents, and the environmental cleanup of our weapons complex have resulted in an extensive body of lessons learned and best practices. The lack of trust created in the affected population, regardless of cause of the spread of radioactive material, creates the working environment for long-term management of the situation. The extent of advanced planning for such an event will define and bound your ultimate success in reaching a conclusion acceptable to the affected parties. The two key issues to be addressed in the long-term management of areas contaminated with radioactive materials are the two 'T's' - technical and trust. The technical issues to be resolved include: access to the affected area; infrastructure to support operations; local and imported staffing; health care for the affected population; and payment to name a few. In addressing the issue of trust it is critical to establish open, honest and inclusive communications and decision making with the affected population and stakeholders, with clear roles and responsibilities defined. Actions must be sensitive to local cultural issues and agreements reached with affected populations prior to actions being taken. Establishment of an alternative views resolution process helps build trust and allow actions to taken. Government to government relations and agreements must be established with an acceptance and understanding of the long term investment in time and resources needed. Planning ahead for such an eventuality and putting in place procedures, agreements and resources needed to address the technical and trust issues associated with the long-term management of areas contaminated with radioactive materials enhances success. (author)

  8. The Application of Long Term Asset Management (LTAM) Strategy of KHNP

    International Nuclear Information System (INIS)

    Boo, Myung Hwan; Park, Young Sheop

    2007-01-01

    In KHNP, 20 units of Nuclear Power Plants (NPP) are operating and 6 units are under construction. As increase of the number of power plants and operating year, it is needed to develop the integrated cost-effective asset management. Long Term Asset Management (LTAM) strategy is the process by which the nuclear power plants integrate operations, maintenance, engineering, regulatory, and economic planning activities. This paper introduces the application of LTAM strategy of nuclear power plants

  9. Through the Eyes of Nurse Managers in Long-Term Care: Identifying Perceived Competencies and Skills.

    Science.gov (United States)

    Dever, Kathleen H

    2018-05-01

    Nurse managers (NMs) in long-term care supervise health care services for individuals with high acuity levels and numerous comorbidities. There is minimal research identifying NMs' skills and competencies as unit leaders within the long-term care environment. The current mixed-methods study identified NMs' leadership skills and competencies. Nineteen NMs with ≥5 years' long-term care management experience completed the Nurse Manager Inventory Tool and were individually interviewed. They rated their clinical skills at the competent level and their financial/strategic management skills at the novice level. All other skill categories, including leadership reflective practice, diversity, human resource leadership/management, relationship management, performance improvement, and problem solving, were rated at a competent level. Emergent interview qualitative themes included their visibility on the unit, trial and error learning, a sense of "aloneness" due to the absence of other RNs, NM position being a tough job, need for peer support, role modeling, and importance of supporting the resident through their "final journey." [Journal of Gerontological Nursing, 44(5), 32-38.]. Copyright 2018, SLACK Incorporated.

  10. The essential value of long-term experimental data for hydrology and water management

    Science.gov (United States)

    Tetzlaff, D.; Carey, S. K.; McNamara, J. P.; Laudon, H.; Soulsby, C.

    2017-12-01

    Observations and data from long-term experimental watersheds are the foundation of hydrology as a geoscience. They allow us to benchmark process understanding, observe trends and natural cycles, and are pre-requisites for testing predictive models. Long-term experimental watersheds also are places where new measurement technologies are developed. These studies offer a crucial evidence base for understanding and managing the provision of clean water supplies; predicting and mitigating the effects of floods, and protecting ecosystem services provided by rivers and wetlands. They also show how to manage land and water in an integrated, sustainable way that reduces environmental and economic costs. We present a number of compelling examples illustrating how hydrologic process understanding has been generated through comparing hypotheses to data, and how this understanding has been essential for managing water supplies, floods, and ecosystem services today.

  11. Summary of the engineering analysis report for the long-term management of depleted uranium hexafluoride

    International Nuclear Information System (INIS)

    Dubrin, J.W.; Rahm-Crites, L.

    1997-09-01

    The Department of Energy (DOE) is reviewing ideas for the long-term management and use of its depleted uranium hexafluoride. DOE owns about 560,000 metric tons (over a billion pounds) of depleted uranium hexafluoride. This material is contained in steel cylinders located in storage yards near Paducah, Kentucky; Portsmouth, Ohio; and at the East Tennessee Technology Park (formerly the K-25 Site) in Oak Ridge, Tennessee. On November 10, 1994, DOE announced its new Depleted Uranium Hexafluoride Management Program by issuing a Request for Recommendations and an Advance Notice of Intent in the Federal Register (59 FR 56324 and 56325). The first part of this program consists of engineering, costs and environmental impact studies. Part one will conclude with the selection of a long-term management plan or strategy. Part two will carry out the selected strategy

  12. Summary of the engineering analysis report for the long-term management of depleted uranium hexafluoride

    Energy Technology Data Exchange (ETDEWEB)

    Dubrin, J.W., Rahm-Crites, L.

    1997-09-01

    The Department of Energy (DOE) is reviewing ideas for the long-term management and use of its depleted uranium hexafluoride. DOE owns about 560,000 metric tons (over a billion pounds) of depleted uranium hexafluoride. This material is contained in steel cylinders located in storage yards near Paducah, Kentucky; Portsmouth, Ohio; and at the East Tennessee Technology Park (formerly the K-25 Site) in Oak Ridge, Tennessee. On November 10, 1994, DOE announced its new Depleted Uranium Hexafluoride Management Program by issuing a Request for Recommendations and an Advance Notice of Intent in the Federal Register (59 FR 56324 and 56325). The first part of this program consists of engineering, costs and environmental impact studies. Part one will conclude with the selection of a long-term management plan or strategy. Part two will carry out the selected strategy.

  13. Participatory action research in antimicrobial stewardship: a novel approach to improving antimicrobial prescribing in hospitals and long-term care facilities

    NARCIS (Netherlands)

    van Buul, L.W.; Sikkens, J.J.; van Agtmael, M.A.; Kramer, M.H.H.; van der Steen, J.T.; Hertogh, C.M.P.M.

    2014-01-01

    It is challenging to change physicians' antimicrobial prescribing behaviour. Although antimicrobial prescribing is determined by contextual (e.g. a lack of guidelines), cultural (e.g. peer practice) and behavioural (e.g. perceived decision making autonomy) factors, most antimicrobial stewardship

  14. Evolution of safety standards for the long-term management of nuclear waste, and their application in Ontario Power Generation

    International Nuclear Information System (INIS)

    Kempe, T.F.

    2006-01-01

    This paper examines the need to develop current radiation protection methodologies further in order to take account of the special features of long-term waste management. The need to expand the scope and nature of regulatory submissions is also addressed. It is concluded that an international consensus is emerging as to requirements for a safety case for long-term waste management, and on safety assessment approaches and criteria to be applied in the regulation of long-term waste management facilities. The application of some of this methodology in preliminary concept assessments carried out by OPG for long-term waste management facilities is described. (author)

  15. A long-term risk management tool for electricity markets using swarm intelligence

    International Nuclear Information System (INIS)

    Azevedo, F.; Vale, Z.A.; Khodr, H.M.; Oliveira, P.B. Moura

    2010-01-01

    This paper addresses the optimal involvement in derivatives electricity markets of a power producer to hedge against the pool price volatility. To achieve this aim, a swarm intelligence meta-heuristic optimization technique for long-term risk management tool is proposed. This tool investigates the long-term opportunities for risk hedging available for electric power producers through the use of contracts with physical (spot and forward contracts) and financial (options contracts) settlement. The producer risk preference is formulated as a utility function (U) expressing the trade-off between the expectation and the variance of the return. Variance of return and the expectation are based on a forecasted scenario interval determined by a long-term price range forecasting model. This model also makes use of particle swarm optimization (PSO) to find the best parameters allow to achieve better forecasting results. On the other hand, the price estimation depends on load forecasting. This work also presents a regressive long-term load forecast model that make use of PSO to find the best parameters as well as in price estimation. The PSO technique performance has been evaluated by comparison with a Genetic Algorithm (GA) based approach. A case study is presented and the results are discussed taking into account the real price and load historical data from mainland Spanish electricity market demonstrating the effectiveness of the methodology handling this type of problems. Finally, conclusions are dully drawn. (author)

  16. Parameter values for the long-term nuclear waste management food chain model LIMCAL

    International Nuclear Information System (INIS)

    Zach, Reto.

    1982-09-01

    Eighteen parameters of LIMCAL, a comprehensive food chain model for predicting ICRP 26 50-year committed effective dose equivalents to man due to long-term nuclear waste management are reviewed. The parameters are: soil bulk density, plowlayer depth, soil surface layer depth, resusupension factor, atmospheric dust load, deposition velocity, plant interception fraction, plant environmental half-time, translocation factor, time of above-ground exposure, plant yield, holdup time, animals' feed consumption rate, animals' water consumption rate, man's water consumption rate, food type calorie conversion factors, man's total caloric intake rate and food type calorie fractions. LIMCAL has both traditional and unique parameters. The former occur in most of the currently used assessment models for nuclear installations, whereas the latter do not. For each of the parameters of LIMCAL, a suitable generic value for long-term nuclear waste management was determined. Thus, the general literature and the values currently used or recommended by various agencies were reviewed

  17. Long-term radiological aspects of management of wastes from uranium mining and milling

    International Nuclear Information System (INIS)

    1984-09-01

    Due to the contamination of uranium mill tailings by long-lived natural radionuclides, their management presents specific radiation protection aspects in the long term. This report presents several examples of the application of the International Commission of Radiological Protection (ICRP) methodology for the optimisation of radiation protection to these types of waste. The advantages and disadvantages of such an approach are discussed and several important limitations are identified

  18. Hanford long-term high-level waste management program overview

    International Nuclear Information System (INIS)

    Reep, I.E.

    1978-05-01

    The objective is the long-term disposition of the defense high-level radioactive waste which will remain upon completion of the interim waste management program in the mid-1980s, plus any additional high-level defense waste resulting from the future operation of N Reactor and the Purex Plant. The high-level radioactive waste which will exist in the mid-1980s and is addressed by this plan consists of approximately 3,300,000 ft 3 of damp salt cake stored in single-shell and double-shell waste tanks, 1,500,000 ft 3 of damp sludge stored in single-shell and double-shell waste tanks, 11,000,000 gallons of residual liquor stored in double-shell waste tanks, 3,000,000 gallons of liquid wastes stored in double-shell waste tanks awaiting solidification, and 2,900 capsules of 90 SR and 137 Cs compounds stored in water basins. Final quantities of waste may be 5 to 10% greater, depending on the future operation of N Reactor and the Purex Plant and the application of waste treatment techniques currently under study to reduce the inventory of residual liquor. In this report, the high-level radioactive waste addressed by this plan is briefly described, the major alternatives and strategies for long-term waste management are discussed, and a description of the long-term high-level waste management program is presented. Separate plans are being prepared for the long-term management of radioactive wastes which exist in other forms. 14 figures

  19. Environmental and other evaluations of alternatives for long-term management of stored INEL transuranic waste

    International Nuclear Information System (INIS)

    1979-02-01

    This study identifies, develops, and evaluates, in a preliminary manner, alternatives for long-term management of TRU waste stored at the Radioactive Waste Management Complex (RWMC) at the INEL. The evaluations concern waste currently at the RWMC and waste expected to be received by the beginning of the year 1985. The effects of waste that might be received after that date are addressed in an appendix. The technology required for managing the waste, the environmental effects, the risks to the public, the radiological and nonradiological hazards to workers, and the estimated costs are discussed

  20. Estimation of long-term probabilities for inadvertent intrusion into radioactive waste management areas

    International Nuclear Information System (INIS)

    Eedy, W.; Hart, D.

    1988-05-01

    The risk to human health from radioactive waste management sites can be calculated as the product of the probability of accidental exposure (intrusion) times the probability of a health effect from such exposure. This report reviews the literature and evaluates methods used to predict the probabilities for unintentional intrusion into radioactive waste management areas in Canada over a 10,000-year period. Methods to predict such probabilities are available. They generally assume a long-term stability in terms of existing resource uses and society in the management area. The major potential for errors results from the unlikeliness of these assumptions holding true over such lengthy periods of prediction

  1. Environmental and other evaluations of alternatives for long-term management of stored INEL transuranic waste

    International Nuclear Information System (INIS)

    1979-12-01

    This study identifies, develops, and evaluates, in a preliminary manner, alternatives for long-term management of TRU waste stored at the Radioactive Waste Management Complex (RWMC) at the INEL. The evaluations concern waste currently at the RWMC and waste expected to be received by the beginning of the year 1985. The effects of waste that might be received after that data are addressed in an appendix. The technology required for managing the waste, the environmental effects, the risks to the public, the radiological and nonradiological hazards to workers, and the estimated costs are discussed

  2. Environmental and other evaluations of alternatives for long-term management of stored INEL transuranic waste

    Energy Technology Data Exchange (ETDEWEB)

    1979-02-01

    This study identifies, develops, and evaluates, in a preliminary manner, alternatives for long-term management of TRU waste stored at the Radioactive Waste Management Complex (RWMC) at the INEL. The evaluations concern waste currently at the RWMC and waste expected to be received by the beginning of the year 1985. The effects of waste that might be received after that date are addressed in an appendix. The technology required for managing the waste, the environmental effects, the risks to the public, the radiological and nonradiological hazards to workers, and the estimated costs are discussed.

  3. Managing aging effects on used fuel dry cask for very long-term storage - 59067

    International Nuclear Information System (INIS)

    Chopra, Omesh; Diercks, Dwight; Ma, David; Shah, Vikram; Tam, Shiu-Wing; Fabian, Ralph; Liu, Yung; Nutt, Mark

    2012-01-01

    The cancellation of the Yucca Mountain repository program in the Unites States raises the prospect of very long-term storage (i.e., >120 years) and deferred transportation of used fuel at the nuclear power plant sites. While long-term storage of used nuclear fuel in dry cask storage systems (DCSSs) at Independent Spent Fuel Storage Installations (ISFSIs) is already a standard practice among U.S. utilities, recent rule-making activities of the U.S. Nuclear Regulatory Commission (NRC) indicated additional flexibility for the NRC licensees of ISFSIs and certificate holders of the DCSSs to request initial and renewal terms for up to 40 years. The proposed rule also adds a requirement that renewal applicants must provide descriptions of aging management programs (AMPs) and time-limited aging analyses (TLAAs) to ensure that the structures, systems, and components (SSCs) that are important to safety in the DCSSs will perform as designed under the extended license terms. This paper examines issues related to managing aging effects on DCSSs for very long-term storage (VLTS) of used fuels, capitalizing on the extensive knowledge and experience accumulated from the work on aging research and life cycle management at Argonne National Laboratory (ANL) over the last 30 years. The technical basis for acceptable AMPs and TLAAs is described, as are generic AMPs and TLAAs that are being developed by Argonne under the support of the U.S. Department of Energy (DOE) Used Fuel Disposition Campaign for R and D on extended long-term storage and transportation. (authors)

  4. Long-term cost-effectiveness of disease management in systolic heart failure.

    Science.gov (United States)

    Miller, George; Randolph, Stephen; Forkner, Emma; Smith, Brad; Galbreath, Autumn Dawn

    2009-01-01

    Although congestive heart failure (CHF) is a primary target for disease management programs, previous studies have generated mixed results regarding the effectiveness and cost savings of disease management when applied to CHF. We estimated the long-term impact of systolic heart failure disease management from the results of an 18-month clinical trial. We used data generated from the trial (starting population distributions, resource utilization, mortality rates, and transition probabilities) in a Markov model to project results of continuing the disease management program for the patients' lifetimes. Outputs included distribution of illness severity, mortality, resource consumption, and the cost of resources consumed. Both cost and effectiveness were discounted at a rate of 3% per year. Cost-effectiveness was computed as cost per quality-adjusted life year (QALY) gained. Model results were validated against trial data and indicated that, over their lifetimes, patients experienced a lifespan extension of 51 days. Combined discounted lifetime program and medical costs were $4850 higher in the disease management group than the control group, but the program had a favorable long-term discounted cost-effectiveness of $43,650/QALY. These results are robust to assumptions regarding mortality rates, the impact of aging on the cost of care, the discount rate, utility values, and the targeted population. Estimation of the clinical benefits and financial burden of disease management can be enhanced by model-based analyses to project costs and effectiveness. Our results suggest that disease management of heart failure patients can be cost-effective over the long term.

  5. Enabling long-term oceanographic research: Changing data practices, information management strategies and informatics

    Science.gov (United States)

    Baker, Karen S.; Chandler, Cynthia L.

    2008-09-01

    Interdisciplinary global ocean science requires new ways of thinking about data and data management. With new data policies and growing technological capabilities, datasets of increasing variety and complexity are being made available digitally and data management is coming to be recognized as an integral part of scientific research. To meet the changing expectations of scientists collecting data and of data reuse by others, collaborative strategies involving diverse teams of information professionals are developing. These changes are stimulating the growth of information infrastructures that support multi-scale sampling, data repositories, and data integration. Two examples of oceanographic projects incorporating data management in partnership with science programs are discussed: the Palmer Station Long-Term Ecological Research program (Palmer LTER) and the United States Joint Global Ocean Flux Study (US JGOFS). Lessons learned from a decade of data management within these communities provide an experience base from which to develop information management strategies—short-term and long-term. Ocean Informatics provides one example of a conceptual framework for managing the complexities inherent to sharing oceanographic data. Elements are introduced that address the economies-of-scale and the complexities-of-scale pertinent to a broader vision of information management and scientific research.

  6. Termite and earthworm abundance and taxonomic richness under long-term conservation soil management in Saria, Burkina Faso, West Africa

    NARCIS (Netherlands)

    Zida, Z.; Ouedraogo, E.; Mando, A.; Stroosnijder, L.

    2011-01-01

    Unsustainable crop and soil management practices are major causes of soil degradation and declining soil biodiversity in West Africa. Identifying soil management practices that favor macrofauna abundance is highly desirable for long-term soil health. This study investigates the effects of long-term

  7. Application of a Long Term Asset Management Strategy for HP Feedwater Heaters

    International Nuclear Information System (INIS)

    Won, Se Youl; Yun, Eun Sub; Park, Young Sheop

    2008-01-01

    As the commercial operating year of nuclear power plants is increased, it becomes imperative to develop integrated cost-effective asset management and to improve plans for degraded Structures, Systems, and Components (SSCs) in terms of safety and economical consideration. A long-term asset management (LTAM) strategy can improve the condition of nuclear plants, maximize their value, and optimize their operational life by maintaining their safety. This paper presents an optimized LTAM plan for HP feedwater heaters at a specific nuclear power plant

  8. Predicted environmental impacts of long-term waste management at the Savannah River Site

    International Nuclear Information System (INIS)

    Topp, S.V.

    1979-01-01

    This paper describes the different alternative approaches to long-term waste management at SRP, along with their probable relative costs, risks, and uncertainties; the issue of methodology for decision-making in nuclear waste management is also raised. This paper contains a preliminary listing of the SRP alternaties including a simple cost-risk analysis. The alternatives are: glass shipped offsite to Federal repository; air-cooled vault with glass at SRP; liquid waste slurry stored in SRP bedrock cavern; and continued tank farm operation with salt and sludge

  9. Liabilities identification and long-term management - Review of French situation

    International Nuclear Information System (INIS)

    2003-01-01

    In France, long term liabilities due to nuclear activities concern four main operators: Electricite de France (EDF), AREVA (an industrial group created on September 3, 2001 and covering the entire fuel cycle from ore extraction and transformation to the recycling of spent fuel), the Atomic Energy Commission (CEA, the French public research organism in the nuclear sector) and the French Agency for radioactive waste management (ANDRA, in charge with the long term operation of radioactive waste installations). Long term liabilities are due to the financing of both decommissioning of nuclear installations and radioactive waste long term management. In the current French organisational scheme, the different operators must take the responsibility of these long term liabilities. The setting of national policies and the establishment of the legislation are carried out at a national level by the French state. These include the supervision of the three operators through different Ministries and the regulatory control of safety trough the Nuclear Safety Authority (ASN). EDF, AREVA, CEA and ANDRA are responsible for all aspects of the decommissioning (from a technical and financial point of view). Within a safety regulatory frame, they have their own initiative concerning future expenses, based on estimated costs and the expected operational lifetime of the installations. They are responsible of the definition and implementation of the technical options. Through its supervision activities, the French State regularly requires updating studies of these estimated costs, which are conducted by the operators. A general review of the management of these long-term liabilities is also carried out on a four years basis by the French Court of Accounts. Operators are due to constitute provisions during the life cycle of their installations. Provisions are calculated for each installation on the basis of the decommissioning expenses and of the reasonably estimated lifetime. They are re

  10. Long-Term Soil Experiments: A Key to Managing Earth's Rapidly Changing Critical Zones

    Science.gov (United States)

    Richter, D., Jr.

    2014-12-01

    In a few decades, managers of Earth's Critical Zones (biota, humans, land, and water) will be challenged to double food and fiber production and diminish adverse effects of management on the wider environment. To meet these challenges, an array of scientific approaches is being used to increase understanding of Critical Zone functioning and evolution, and one amongst these approaches needs to be long-term soil field studies to move us beyond black boxing the belowground Critical Zone, i.e., to further understanding of processes driving changes in the soil environment. Long-term soil experiments (LTSEs) provide direct observations of soil change and functioning across time scales of decades, data critical for biological, biogeochemical, and environmental assessments of sustainability; for predictions of soil fertility, productivity, and soil-environment interactions; and for developing models at a wide range of temporal and spatial scales. Unfortunately, LTSEs globally are not in a good state, and they take years to mature, are vulnerable to loss, and even today remain to be fully inventoried. Of the 250 LTSEs in a web-based network, results demonstrate that soils and belowground Critical Zones are highly dynamic and responsive to human management. The objective of this study is to review the contemporary state of LTSEs and consider how they contribute to three open questions: (1) can soils sustain a doubling of food production in the coming decades without further impinging on the wider environment, (2) how do soils interact with the global C cycle, and (3) how can soil management establish greater control over nutrient cycling. While LTSEs produce significant data and perspectives for all three questions, there is on-going need and opportunity for reviews of the long-term soil-research base, for establishment of an efficiently run network of LTSEs aimed at sustainability and improving management control over C and nutrient cycling, and for research teams that

  11. Topical nonsteroidal anti-inflammatory drugs for management of osteoarthritis in long-term care patients

    Directory of Open Access Journals (Sweden)

    Argoff CE

    2011-09-01

    Full Text Available Charles E Argoff1, F Michael Gloth2 1Albany Medical College and Comprehensive Pain Center, Albany Medical Center, Albany, NY, USA; 2Johns Hopkins University School of Medicine, Baltimore, MD, USA Abstract: Osteoarthritis is common in patients ≥65 years of age. Although nonsteroidal anti-inflammatory drugs (NSAIDs are often prescribed for osteoarthritis pain, they pose age-related cardiovascular, renal, and gastrointestinal risks. Two topical NSAIDs, diclofenac sodium 1% gel (DSG and diclofenac sodium 1.5% in 45.5% dimethylsulfoxide solution (D-DMSO, are approved in the US for the treatment of osteoarthritis pain. Topical NSAIDs have shown efficacy and safety in knee (DSG, D-DMSO and hand (DSG osteoarthritis. Analyses of data from randomized controlled trials of DSG in hand and knee osteoarthritis demonstrate significant improvement of pain and function in both younger patients (<65 years and older patients (≥65 years and suggest good safety and tolerability. However, long-term safety data in older patients are limited. Topical NSAIDs can ease medication administration and help address barriers to pain management in older patients, such as taking multiple medications and inability to swallow, and are a valuable option for long-term care providers. Keywords: nonsteroidal anti-inflammatory drugs, long-term care, nursing homes, chronic pain, topical analgesics

  12. Simulating long-term effectiveness and efficiency of management scenarios for an invasive grass

    Science.gov (United States)

    Jarnevich, Catherine S.; Holcombe, Tracy R.; Cullinane Thomas, Catherine; Frid, Leonardo; Olsson, Aaryn D.

    2015-01-01

    Resource managers are often faced with trade-offs in allocating limited resources to manage plant invasions. These decisions must often be made with uncertainty about the location of infestations, their rate of spread and effectiveness of management actions. Landscape level simulation tools such as state-and-transition simulation models (STSMs) can be used to evaluate the potential long term consequences of alternative management strategies and help identify those strategies that make efficient use of resources. We analyzed alternative management scenarios for African buffelgrass (Pennisetum ciliare syn. Cenchrus ciliaris) at Ironwood Forest National Monument, Arizona using a spatially explicit STSM implemented in the Tool for Exploratory Landscape Scenario Analyses (TELSA). Buffelgrass is an invasive grass that is spreading rapidly in the Sonoran Desert, affecting multiple habitats and jurisdictions. This invasion is creating a novel fire risk and transforming natural ecosystems. The model used in this application incorporates buffelgrass dispersal and establishment and management actions and effectiveness including inventory, treatment and post-treatment maintenance. We simulated 11 alternative scenarios developed in consultation with buffelgrass managers and other stakeholders. The scenarios vary according to the total budget allocated for management and the allocation of that budget between different kinds of management actions. Scenario results suggest that to achieve an actual reduction and stabilization of buffelgrass populations, management unconstrained by fiscal restrictions and across all jurisdictions and private lands is required; without broad and aggressive management, buffelgrass populations are expected to increase over time. However, results also suggest that large upfront investments can achieve control results that require relatively minimal spending in the future. Investing the necessary funds upfront to control the invasion results in the most

  13. Simulating long-term effectiveness and efficiency of management scenarios for an invasive grass

    Directory of Open Access Journals (Sweden)

    Catherine S. Jarnevich

    2015-05-01

    Full Text Available Resource managers are often faced with trade-offs in allocating limited resources to manage plant invasions. These decisions must often be made with uncertainty about the location of infestations, their rate of spread and effectiveness of management actions. Landscape level simulation tools such as state-and-transition simulation models (STSMs can be used to evaluate the potential long term consequences of alternative management strategies and help identify those strategies that make efficient use of resources. We analyzed alternative management scenarios for African buffelgrass (Pennisetum ciliare syn. Cenchrus ciliaris at Ironwood Forest National Monument, Arizona using a spatially explicit STSM implemented in the Tool for Exploratory Landscape Scenario Analyses (TELSA. Buffelgrass is an invasive grass that is spreading rapidly in the Sonoran Desert, affecting multiple habitats and jurisdictions. This invasion is creating a novel fire risk and transforming natural ecosystems. The model used in this application incorporates buffelgrass dispersal and establishment and management actions and effectiveness including inventory, treatment and post-treatment maintenance. We simulated 11 alternative scenarios developed in consultation with buffelgrass managers and other stakeholders. The scenarios vary according to the total budget allocated for management and the allocation of that budget between different kinds of management actions. Scenario results suggest that to achieve an actual reduction and stabilization of buffelgrass populations, management unconstrained by fiscal restrictions and across all jurisdictions and private lands is required; without broad and aggressive management, buffelgrass populations are expected to increase over time. However, results also suggest that large upfront investments can achieve control results that require relatively minimal spending in the future. Investing the necessary funds upfront to control the invasion

  14. Long-Term Information Management (LTIM) of Safeguards Data at Repositories: Phase II

    International Nuclear Information System (INIS)

    Haddal, Risa N.

    2016-01-01

    One of the challenges of implementing safeguards for geological repositories will be the long-term preservation of safeguards-related data for 100 years or more. While most countries considering the construction and operation of such facilities agree that safeguards information should be preserved, there are gaps with respect to standardized requirements, guidelines, timescales, and approaches. This study analyzes those gaps and explores research to clarify stakeholder needs, identify current policies, approaches, best practices and international standards, and explores existing safeguards information management infrastructure. The study also attempts to clarify what a safeguards data classification system might look like, how long data should be retained, and how information should be exchanged between stakeholders at different phases of a repository's life cycle. The analysis produced a variety of recommendations on what information to preserve, how to preserve it, where to store it, retention options and how to exchange information in the long term. Key findings include the use of the globally recognized international records management standard, ISO15489, for guidance on the development of information management systems, and the development of a Key Information File (KIF). The KIF could be used to identify only the most relevant, high-level safeguards information and the history of decision making about the repository. The study also suggests implementing on-site and off-site records storage in digital and physical form; developing a safeguards data classification system; long-term records retention with periodic reviews every 5 to 10 years during each phase of the repository life cycle; and establishing transition procedures well in advance so that data shepherds and records officers can transfer information with incoming facility managers effectively and efficiently. These and other recommendations are further analyzed in this study.

  15. Long-term management of high-level radioactive waste. The meaning of a demonstration

    International Nuclear Information System (INIS)

    1983-01-01

    The ''demonstration'' of the safe management of high level radioactive waste is a prerequisite for the further development of nuclear energy. It is therefore essential to be clear about both the meaning of the term ''demonstration'' and the practical means to satisfy this request. In the complex sequence of operations necessary to the safe management of high level waste, short term activities can be directly demonstrated. For longer term activities, such as the long term isolation of radioactive waste in deep undergroung structures, demonstration must be indirect. The ''demonstration'' of deep underground disposal for high level radioactive waste involves two steps: one direct, to prove that the system could be built, operated and closed safely and at acceptable costs, and one indirect, to make a convincing evaluation of the system's performance and long term safety on the basis of predictive analyses confirmed by a body of varied technical and scienfic data, much of it deriving from experimental work. The assessment of the evidence collected from current operations, existing experience in related fields and specific research and development activities, calls for specialized scientific expertise. Uncertainties in far future situations and probabilistic events can be taken into account in a scientific assessment. Competent national authorithies will have to satisfy themselves that the proposed waste management solutions can meet long term safety objectives. An element of judgement will always be needed in determining the acceptability of a waste disposal concept. However, the level of confidence in our ability to predict the performance of waste management systems will increase as supporting evidence is collected from current research and development activities and as our predictive techniques improve

  16. Long-Term Information Management (LTIM) of Safeguards Data at Repositories: Phase II

    Energy Technology Data Exchange (ETDEWEB)

    Haddal, Risa N. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2016-10-01

    One of the challenges of implementing safeguards for geological repositories will be the long-term preservation of safeguards-related data for 100 years or more. While most countries considering the construction and operation of such facilities agree that safeguards information should be preserved, there are gaps with respect to standardized requirements, guidelines, timescales, and approaches. This study analyzes those gaps and explores research to clarify stakeholder needs, identify current policies, approaches, best practices and international standards, and explores existing safeguards information management infrastructure. The study also attempts to clarify what a safeguards data classification system might look like, how long data should be retained, and how information should be exchanged between stakeholders at different phases of a repository’s life cycle. The analysis produced a variety of recommendations on what information to preserve, how to preserve it, where to store it, retention options and how to exchange information in the long term. Key findings include the use of the globally recognized international records management standard, ISO15489, for guidance on the development of information management systems, and the development of a Key Information File (KIF). The KIF could be used to identify only the most relevant, high-level safeguards information and the history of decision making about the repository. The study also suggests implementing on-site and off-site records storage in digital and physical form; developing a safeguards data classification system; long-term records retention with periodic reviews every 5 to 10 years during each phase of the repository life cycle; and establishing transition procedures well in advance so that data shepherds and records officers can transfer information with incoming facility managers effectively and efficiently. These and other recommendations are further analyzed in this study.

  17. Final Long-Term Management and Storage of Elemental Mercury Environmental Impact Statement Volume 2

    Energy Technology Data Exchange (ETDEWEB)

    2011-01-01

    Pursuant to the Mercury Export Ban Act of 2008 (P.L. 110-414), DOE was directed to designate a facility or facilities for the long-term management and storage of elemental mercury generated within the United States. Therefore, DOE has analyzed the storage of up to 10,000 metric tons (11,000 tons) of elemental mercury in a facility(ies) constructed and operated in accordance with the Solid Waste Disposal Act, as amended by the Resource Conservation and Recovery Act (74 FR 31723). DOE prepared this Final Mercury Storage EIS in accordance with the National Environmental Policy Act of 1969 (NEPA), as amended (42 U.S.C. 4321 et seq.), the Council on Environmental Quality (CEQ) implementing regulations (40 CFR 1500–1508), and DOE’s NEPA implementing procedures (10 CFR 1021) to evaluate reasonable alternatives for a facility(ies) for the long-term management and storage of elemental mercury. This Final Mercury Storage EIS analyzes the potential environmental, human health, and socioeconomic impacts of elemental mercury storage at seven candidate locations: Grand Junction Disposal Site near Grand Junction, Colorado; Hanford Site near Richland, Washington; Hawthorne Army Depot near Hawthorne, Nevada; Idaho National Laboratory near Idaho Falls, Idaho; Kansas City Plant in Kansas City, Missouri; Savannah River Site near Aiken, South Carolina; and Waste Control Specialists, LLC, site near Andrews, Texas. As required by CEQ NEPA regulations, the No Action Alternative was also analyzed as a basis for comparison. DOE intends to decide (1) where to locate the elemental mercury storage facility(ies) and (2) whether to use existing buildings, new buildings, or a combination of existing and new buildings. DOE’s Preferred Alternative for the long-term management and storage of mercury is the Waste Control Specialists, LLC, site near Andrews, Texas.

  18. Final Long-Term Management and Storage of Elemental Mercury Environmental Impact Statement Volume1

    Energy Technology Data Exchange (ETDEWEB)

    2011-01-01

    Pursuant to the Mercury Export Ban Act of 2008 (P.L. 110-414), DOE was directed to designate a facility or facilities for the long-term management and storage of elemental mercury generated within the United States. Therefore, DOE has analyzed the storage of up to 10,000 metric tons (11,000 tons) of elemental mercury in a facility(ies) constructed and operated in accordance with the Solid Waste Disposal Act, as amended by the Resource Conservation and Recovery Act (74 FR 31723).DOE prepared this Final Mercury Storage EIS in accordance with the National Environmental Policy Act of 1969 (NEPA), as amended (42 U.S.C. 4321 et seq.), the Council on Environmental Quality (CEQ) implementing regulations (40 CFR 1500–1508), and DOE’s NEPA implementing procedures (10 CFR 1021) to evaluate reasonable alternatives for a facility(ies) for the long-term management and storage of elemental mercury. This Final Mercury Storage EIS analyzes the potential environmental, human health, and socioeconomic impacts of elemental mercury storage at seven candidate locations:Grand Junction Disposal Site near Grand Junction, Colorado; Hanford Site near Richland, Washington; Hawthorne Army Depot near Hawthorne, Nevada; Idaho National Laboratory near Idaho Falls, Idaho;Kansas City Plant in Kansas City, Missouri; Savannah River Site near Aiken, South Carolina; and Waste Control Specialists, LLC, site near Andrews, Texas. As required by CEQ NEPA regulations, the No Action Alternative was also analyzed as a basis for comparison. DOE intends to decide (1) where to locate the elemental mercury storage facility(ies) and (2) whether to use existing buildings, new buildings, or a combination of existing and new buildings. DOE’s Preferred Alternative for the long-term management and storage of mercury is the Waste Control Specialists, LLC, site near Andrews, Texas.

  19. Legal, administrative and financial aspects of long term management of radioactive waste

    International Nuclear Information System (INIS)

    Strohl, Pierre.

    1978-01-01

    Radioactive waste management raises technical, political and legal problems. The technical question covers mainly choice of the method and the location for waste disposal or storage: seabed, geologic formations or a disposal facility. The political problem is mainly acceptability by the public of decisions taken or planned by the competent authority. Finally, the legal frame is an important factor in the definition of long-term control. The institutional system to be created requires political consensus and an efficient and credible technique so as to be successful. (NEA) [fr

  20. Stepwise decision making for the long-term management of radioactive waste

    International Nuclear Information System (INIS)

    Pescatore, C.; Vari, A.

    2003-01-01

    The context of long-term radioactive waste management is being shaped by changes in modern society. Values such as health, environmental protection and safety are increasingly important. This changes in turn necessitate new forms of dialogue and decision-making processes that include a large number of stakeholders. This paper deals with the new features of a stepwise decision-making approach, taking into account the public involvement and social learning processes, and showing the complexity of the new situation. (A.L.B.)

  1. Refurbishment implications on long-term waste management strategies at Point Lepreau

    International Nuclear Information System (INIS)

    Hickman, C.

    2011-01-01

    This paper discusses Point Lepreau Generating Station's waste management experiences during the Refurbishment outage. In short, Point Lepreau GS has been challenged during the outage due to the amount of low and intermediate level waste that has been generated compared to that which was expected, which has driven the need to develop a new waste management strategy in the middle of the outage. The paper presents an overview of pre-outage waste handling, what process changes and schedule changes occurred during the outage, and provides a discussion of the operational and financial consequences of those changes. Key issues highlighted by the paper include the need for adequate provision of waste management facilities during large outages, the importance of ensuring that contractors have a stake in waste minimization activities, and long term waste management implications that need to be considered for large outages.

  2. Challenges Associated With Managing Suicide Risk in Long-Term Care Facilities.

    Science.gov (United States)

    O'Riley, Alisa; Nadorff, Michael R; Conwell, Yeates; Edelstein, Barry

    2013-06-01

    Little information about suicidal ideation and behavior in long-term care (LTC) facilities is available. Nonetheless, the implementation of the Minimum Data Set 3.0 requires that LTC facilities screen their residents for suicide risk and have protocols in place to effectively manage residents' responses. In this article, the authors briefly discuss the risk factors of suicide in the elderly and the problems that suicidal ideation and behavior pose in the LTC environment. The authors explain issues that arise when trying to manage suicide risk in the elderly LTC population with general, traditional approaches. These inherent issues make it difficult to develop an effective protocol for managing suicide risk in LTC facilities, leading the authors to propose their own framework for assessing and managing suicide risk in the LTC setting.

  3. Towards sustainable groundwater use: Setting long-term goals, backcasting, and managing adaptively

    Science.gov (United States)

    Gleeson, T.; Alley, W.M.; Allen, D.M.; Sophocleous, M.A.; Zhou, Y.; Taniguchi, M.; Vandersteen, J.

    2012-01-01

    The sustainability of crucial earth resources, such as groundwater, is a critical issue. We consider groundwater sustainability a value-driven process of intra- and intergenerational equity that balances the environment, society, and economy. Synthesizing hydrogeological science and current sustainability concepts, we emphasize three sustainability approaches: setting multigenerational sustainability goals, backcasting, and managing adaptively. As most aquifer problems are long-term problems, we propose that multigenerational goals (50 to 100 years) for water quantity and quality that acknowledge the connections between groundwater, surface water, and ecosystems be set for many aquifers. The goals should be set by a watershed- or aquifer-based community in an inclusive and participatory manner. Policies for shorter time horizons should be developed by backcasting, and measures implemented through adaptive management to achieve the long-term goals. Two case histories illustrate the importance and complexity of a multigenerational perspective and adaptive management. These approaches could transform aquifer depletion and contamination to more sustainable groundwater use, providing groundwater for current and future generations while protecting ecological integrity and resilience. ?? 2011, The Author(s). Ground Water ?? 2011, National Ground Water Association.

  4. Long-term damage management strategies for optimizing steam generator performance

    International Nuclear Information System (INIS)

    Egan, G.R.; Besuner, P.M.; Fox, J.H.; Merrick, E.A.

    1991-01-01

    Minimizing long-term impact of steam generator operating, maintenance, outage, and replacement costs is the goal of all pressurized water reactor utilities. Recent research results have led to deterministic controls that may be implemented to optimize steam generator performance and to minimize damage accumulation. The real dilemma that utilities encounter is the decision process that needs to be made in the face of uncertain data. Some of these decisions involve the frequency and extent of steam generator eddy current tube inspections; the definition of operating conditions to minimize the rate of corrosion reactions (T (hot) , T (cold) ; and the imposition of strict water quality management guidelines. With finite resources, how can a utility decide which damage management strategy provides the most return for its investment? Aptech Engineering Services, Inc. (APTECH) developed a damage management strategy that starts from a deterministic analysis of a current problem- primary water stress corrosion cracking (PWSCC). The strategy involves a probabilistic treatment that results in long-term performance optimization. By optimization, we refer to minimizing the total cost of operating the steam generator. This total includes the present value costs of operations, maintenance, outages, and replacements. An example of the application of this methodology is presented. (author)

  5. Integrated system for long-term radioactive waste management in the UK

    International Nuclear Information System (INIS)

    Dalton, J.; Wisbey, S.

    2003-01-01

    Since the failure of Nirex application to build a Rock Characterisation Facility near Sellafield in 1997, Nirex has been applying lessons learnt from that failure. Some of the issues involved are generic and relate to the process by which legitimate authority can be gained for government policy development, the structure of the nuclear industry and the behaviour of institutions. Transparency must be central to the culture of organisations attempting to win public acceptance. In the UK, the Department for Environment, Food and Rural Affairs (DEFRA) have started a consultation process - stage one completed in March 2002 - to consult about the safe management of radioactive waste. Nirex has modified its approach to long-term waste management, using a concept of phased (stepwise and reversible) geological disposal. Nirex also provides waste producers with advice on, and endorsement of, the packaging and transport of wastes. Through these examples, this paper will demonstrate how Nirex is providing an integrated approach to the long-term management of radioactive wastes in the UK. (orig.)

  6. Technology transfer on long-term radioactive waste management - a feasible option for small nuclear programmes?

    International Nuclear Information System (INIS)

    Mele, I.; Mathieson, J.

    2007-01-01

    The EU project CATT - Co-operation and technology transfer on long-term radioactive waste management for Member States with small nuclear programmes investigated the feasibility of countries with small nuclear programmes implementing long-term radioactive waste management solutions within their national borders, through collaboration on technology transfer with those countries with advanced disposal concepts. The main project objective was to analyse the existing capabilities of technology owning Member States and the corresponding requirements of potential technology acquiring Member States and, based on the findings, to develop a number of possible collaboration models and scenarios that could be used in a technology transfer scheme. The project CATT was performed as a specific support action under the EU sixth framework programme and it brought together waste management organisations from six EU Member States: UK, Bulgaria, Germany, Lithuania, Slovenia and Sweden. In addition, the EC Joint Research Centre from the Netherlands also participated as a full partner. The paper summarises the analyses performed and the results obtained within the project. (author)

  7. Developing and analyzing long-term fuel management strategies for an advanced Small Modular PWR

    Energy Technology Data Exchange (ETDEWEB)

    Hedayat, Afshin, E-mail: ahedayat@aeoi.org.ir

    2017-03-15

    Highlights: • Comprehensive introduction and supplementary concepts as a review paper. • Developing an integrated long-term fuel management strategy for a SMR. • High reliable 3-D core modeling over fuel pins against the traditional LRM. • Verifying the expert rules of large PWRs for an advanced small PWR. • Investigating large numbers of safety parameters coherently. - Abstract: In this paper, long-term fuel management (FM) strategies are introduced and analyzed for a new advanced Pressurized Light Water Reactor (PWR) type of Small Modular Reactors (SMRs). The FM strategies are developed to be safe and practical for implementation as much as possible. Safety performances, economy of fuel, and Quality Assurance (QA) of periodic equilibrium conditions are chosen as the main goals. Flattening power density distribution over fuel pins is the major method to ensure safety performance; also maximum energy output or permissible discharging burn up indicates economy of fuel fabrication costs. Burn up effects from BOC to EOC have been traced, studied, and highly visualized in both of transport lattice cell calculations and diffusion core calculations. Long-term characteristics are searched to gain periodical equilibrium characteristics. They are fissile changes, neutron spectrum, refueling pattern, fuel cycle length, core excess reactivity, average, and maximum burn up of discharged fuels, radial Power Peaking Factors (PPF), total PPF, radial and axial power distributions, batch effects, and enrichment effects for fine regulations. Traditional linear reactivity model have been successfully simulated and adapted via fine core and burn up calculations. Effects of high burnable neutron poison and soluble boron are analyzed. Different numbers of batches via different refueling patterns have been studied and visualized. Expert rules for large type PWRs have been influenced and well tested throughout accurate equilibrium core calculations.

  8. Study of scenarios of long term management of low-activity long-life wastes

    International Nuclear Information System (INIS)

    2012-01-01

    This document reports the study of scenarios for the management of different low-activity long-life radioactive wastes with reference to different French legal texts. After a presentation of the legal and technical context, the report presents different existing and projected storages (description and safety principles for the Cires and Aube centres and for the Cigeo project of deep geological storage centre). It addresses the various aspects of radiferous and graphite waste management on a long term: inventory, parcel, waste peculiarities, management scenarios, assessment of storage in SCR. It also addresses the case of other wastes such as bituminous coated wastes, those presenting a reinforced natural radioactivity or residues of uranium conversion processing. The last part presents the main orientations for the project

  9. Long-term complications of JJ stent and its management: A 5 years review.

    Science.gov (United States)

    Ray, Rajendra Prasad; Mahapatra, Rajkumar Singha; Mondal, Partha Pratim; Pal, Dilip Kumar

    2015-01-01

    To assess the long term complications of JJ stent, the management of complications and the role of endoscopic approach to manage these complications. Nineteen patients with indwelling JJ stent for a duration of more than 6 months were included in this study. Patients were assessed with X-ray KUB, USG KUB, blood urea, creatinine and DTPA renogram. Data were analyzed by Microsoft excel 2007. Out of 19 patients 12 (63.16%) were male and 7 (36.84%) were female. The mean age was 39.78 ± 13.69 years., Mean duration for which the stent was in situ was 29.56 months. The most common complication was broken stent, in 11 cases (57.89%). Other complications were migration in 5 (26.32%), encrustation in 2 (10.52%) and 1 case of (5.26%) stone formation. Eighteen cases were managed by endoscopic approaches. A total of 22 procedures were performed to treat the complications. Eleven cases were managed by a single procedure and 8 patients required multiple procedures. All were managed successfully with no death reported. Post-operative complications were seen in eight cases (42.11%). JJ stent related long-term complications are not uncommon and are usually seen after 6 months of indwelling time. Endourological procedure should be the initial approach with a high success rate. Coordinated use multimodality and technology helps in management of difficult cases. Open surgery is rarely required. Prevention of the complication by judicious use and early removal is the cornerstone.

  10. Long-term climatic change and sustainable ground water resources management

    International Nuclear Information System (INIS)

    Loaiciga, Hugo A

    2009-01-01

    Atmospheric concentrations of greenhouse gases (GHGs), prominently carbon dioxide (CO 2 ), methane (CH 4 ), nitrous oxide (N 2 O), and halocarbons, have risen from fossil-fuel combustion, deforestation, agriculture, and industry. There is currently heated national and international debate about the consequences of such increasing concentrations of GHGs on the Earth's climate, and, ultimately, on life and society in the world as we know it. This paper reviews (i) long-term patterns of climate change, secular climatic variability, and predicted population growth and their relation to water resources management, and, specifically, to ground water resources management, (ii) means available for mitigating and adapting to trends of climatic change and climatic variability and their impacts on ground water resources. Long-term (that is, over hundreds of millions of years), global-scale, climatic fluctuations are compared with more recent (in the Holocene) patterns of the global and regional climates to shed light on the meaning of rising mean surface temperature over the last century or so, especially in regions whose historical hydroclimatic records exhibit large inter-annual variability. One example of regional ground water resources response to global warming and population growth is presented.

  11. Management of bladder dysfunction in Wolfram syndrome with Mitrofanoff appendicovesicostomy: long-term follow-up.

    Science.gov (United States)

    Mozafarpour, Sarah; Kajbafzadeh, Abdol-Mohammad; Mojtahed, Ali; Mojtahed, Mohammad; Mahboubi, Hossein; Shalileh, Keivan

    2015-07-01

    To present the long-term outcomes of appendicovesicostomy using the Mitrofanoff principle for end-stage Wolfram bladder dysfunction as an alternative to clean intermittent self-catheterization (CIC) per urethra mainly following blindness. Twelve Wolfram patients presenting with bilateral hydroureteronephrosis and advanced bladder dysfunction were included in this study. All patients were managed initially by CIC per urethra. All of these patients became blind during follow-up and were unable to perform urethral CIC independently. Out of these patients, six patients agreed to proceed to appendicovesicostomy. Appendicovesicostomy urinary diversion using the Mitrofanoff principle was performed in these six blind patients. The rest of the patients stopped CIC or performed CIC irregularly. Severe hydroureteronephrosis and large bladders were found in all patients prior to intervention. All patients were able to conduct CIC independently through the stoma and maintained overnight bladder free drainage. In all patients with urinary diversion and CIC, the hydroureteronephrosis was reduced and renal function returned to normal. However, the non-intervention group ended with different degrees of progressive renal failure with three mortalities during the follow-up. We suggest appendicovesicostomy as a safe and lifesaving procedure for long-term management of bladder dysfunction in Wolfram syndrome particularly after progression to blindness. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Stakeholder opinions on a transformational model of pain management in long-term care.

    Science.gov (United States)

    Hadjistavropoulos, Thomas; Janzen Claude, Jennifer A; Hadjistavropoulos, Heather; Marchildon, Gregory P; Kaasalainen, Sharon; Gallagher, Romayne; Beattie, B Lynn

    2011-07-01

    Pain in older adults with dementia who reside in long-term care (LTC) facilities tends to be undertreated, despite important guidelines designed to ameliorate this problem. A group of public policy and geriatric pain experts recently concluded that existing guidelines are not being implemented because they fail to take into account policy and resource realities. The group published a set of more feasible guidelines that confront these realities (e.g., a recommendation for very brief pain assessments that can be conducted by nursing staff at least weekly). We asked stakeholders to provide opinions on the possibility of implementation of these guidelines within their LTC facilities. Our results support the feasibility of, interest in, and desirability of implementation. They also support an increased role for nurse leadership in LTC pain management. These results could be used to strengthen advocacy efforts for improvement in pain management. Copyright 2011, SLACK Incorporated.

  13. Special issue on ageing management and long term operation of light water reactors

    International Nuclear Information System (INIS)

    Kashima, Koichi; Kanno, Masanori; Kimura, Itsurou

    2008-01-01

    Ageing management and long term operation of light water reactors became important in Japan and relevant research on physical and materials ageing has been carried out among organizations of government, academia and industry and establishment of technical standards and guideline based on the results is under way. The Japan Energy Policy Institute (JEPI) issued a special number discussing this theme, which consisted of ten reports of experts describing these activities. Main topics were ageing evaluation of reactor components due to neutron irradiation embrittlement and stress corrosion cracking, regulatory evaluation of deteriorations due to ageing with technical information basis, technology development in the area of inspection/monitoring, ageing evaluation and preventive maintenance/repairs, nuclear power plant life management of electric utilities, and advancement of reactor maintenance and inspection. (T. Tanaka)

  14. The long-term functional outcome of type II odontoid fractures managed non-operatively.

    LENUS (Irish Health Repository)

    Butler, J S

    2010-10-01

    Odontoid fractures currently account for 9-15% of all adult cervical spine fractures, with type II fractures accounting for the majority of these injuries. Despite recent advances in internal fixation techniques, the management of type II fractures still remains controversial with advocates still supporting non-rigid immobilization as the definitive treatment of these injuries. At the NSIU, over an 11-year period between 1 July 1996 and 30 June 2006, 66 patients (n = 66) were treated by external immobilization for type II odontoid fractures. The medical records, radiographs and CT scans of all patients identified were reviewed. Clinical follow-up evaluation was performed using the Cervical Spine Outcomes Questionnaire (CSOQ). The objectives of this study were to evaluate the long-term functional outcome of patients suffering isolated type II odontoid fractures managed non-operatively and to correlate patient age and device type with clinical and functional outcome. Of the 66 patients, there were 42 males and 24 females (M:F = 1.75:1) managed non-operatively for type II odontoid fractures. The mean follow-up time was 66 months. Advancing age was highly correlated with poorer long-term functional outcomes when assessing neck pain (r = 0.19, P = 0.1219), shoulder and arm pain (r = 0.41, P = 0.0007), physical symptoms (r = 0.25, P = 0.472), functional disability (r = 0.24, P = 0.0476) and psychological distress (r = 0.41, P = 0.0007). Patients >65 years displayed a higher rate of pseudoarthrosis (21.43 vs. 1.92%) and established non-union (7.14 vs. 0%) than patients <65 years. The non-operative management of type II odontoid fractures is an effective and satisfactory method of treating type II odontoid fractures, particularly those of a stable nature. However, patients of advancing age have been demonstrated to have significantly poorer functional outcomes in the long term. This may be linked to higher rates of non-union.

  15. Comprehensive long-term management program for asthma: effect on outcomes in adult African-Americans.

    Science.gov (United States)

    Kelso, T M; Abou-Shala, N; Heilker, G M; Arheart, K L; Portner, T S; Self, T H

    1996-06-01

    To determine if a comprehensive long-term management program, emphasizing inhaled corticosteroids and patient education, would improve outcomes in adult African-American asthmatics a nonrandomized control trial with a 2-year intervention was performed in a university-based clinic. Inclusion criteria consisted of (> or = 5) emergency department (ED) visits or hospitalizations (> or = 2) during the previous 2 years. Intervention patients were volunteers; a comparable control group was identified via chart review at hospitals within the same area and time period as the intervention patients. Individualized doses of beclomethasone with a spacer, inhaled albuterol "as needed," and crisis prednisone were the primary therapies. Environmental control, peak flow monitoring, and a partnership with the patient were emphasized. Detailed patient education was an integral part of management. Control patients received usual care from local physicians. ED visits and hospitalizations for 2 years before and 2 years during the intervention period were compared. Quality of life (QOL) measurements were made at baseline and every 6 months in the intervention group. Study group (n = 21) had a significant reduction in ED visits (2.3 +/- 0.2 pre-intervention versus 0.6 +/- 0.2 post-intervention; P = 0.0001). Control group (n = 18) did not have a significant change in ED visits during the 2-year post-intervention period (2.6 +/- 0.2 pre-intervention versus 2.0 +/- 0.2 post-intervention; P = 0.11). Both groups had significant reductions in hospitalizations, but the study group had a greater reduction. Sixty-two percent of study patients had complete elimination of ED visits and hospitalizations, whereas no control patients had total elimination of the need for institutional acute care. QOL in the study patients revealed significant improvements for most parameters. A comprehensive long-term management program emphasizing inhaled corticosteroids combined with other state-of-the-art management

  16. Assessing climate change and socio-economic uncertainties in long term management of water resources

    Science.gov (United States)

    Jahanshahi, Golnaz; Dawson, Richard; Walsh, Claire; Birkinshaw, Stephen; Glenis, Vassilis

    2015-04-01

    Long term management of water resources is challenging for decision makers given the range of uncertainties that exist. Such uncertainties are a function of long term drivers of change, such as climate, environmental loadings, demography, land use and other socio economic drivers. Impacts of climate change on frequency of extreme events such as drought make it a serious threat to water resources and water security. The release of probabilistic climate information, such as the UKCP09 scenarios, provides improved understanding of some uncertainties in climate models. This has motivated a more rigorous approach to dealing with other uncertainties in order to understand the sensitivity of investment decisions to future uncertainty and identify adaptation options that are as far as possible robust. We have developed and coupled a system of models that includes a weather generator, simulations of catchment hydrology, demand for water and the water resource system. This integrated model has been applied in the Thames catchment which supplies the city of London, UK. This region is one of the driest in the UK and hence sensitive to water availability. In addition, it is one of the fastest growing parts of the UK and plays an important economic role. Key uncertainties in long term water resources in the Thames catchment, many of which result from earth system processes, are identified and quantified. The implications of these uncertainties are explored using a combination of uncertainty analysis and sensitivity testing. The analysis shows considerable uncertainty in future rainfall, river flow and consequently water resource. For example, results indicate that by the 2050s, low flow (Q95) in the Thames catchment will range from -44 to +9% compared with the control scenario (1970s). Consequently, by the 2050s the average number of drought days are expected to increase 4-6 times relative to the 1970s. Uncertainties associated with urban growth increase these risks further

  17. Ecosystem responses to long-term nutrient management in an urban estuary: Tampa Bay, Florida, USA

    Science.gov (United States)

    Greening, H.; Janicki, A.; Sherwood, E. T.; Pribble, R.; Johansson, J. O. R.

    2014-12-01

    In subtropical Tampa Bay, Florida, USA, we evaluated restoration trajectories before and after nutrient management strategies were implemented using long-term trends in nutrient loading, water quality, primary production, and seagrass extent. Following citizen demands for action, reduction in wastewater nutrient loading of approximately 90% in the late 1970s lowered external total nitrogen (TN) loading by more than 50% within three years. Continuing nutrient management actions from public and private sectors were associated with a steadily declining TN load rate and with concomitant reduction in chlorophyll-a concentrations and ambient nutrient concentrations since the mid-1980s, despite an increase of more than 1 M people living within the Tampa Bay metropolitan area. Water quality (chlorophyll-a concentration, water clarity as indicated by Secchi disk depth, total nitrogen concentration and dissolved oxygen) and seagrass coverage are approaching conditions observed in the 1950s, before the large increases in human population in the watershed. Following recovery from an extreme weather event in 1997-1998, water clarity increased significantly and seagrass is expanding at a rate significantly different than before the event, suggesting a feedback mechanism as observed in other systems. Key elements supporting the nutrient management strategy and concomitant ecosystem recovery in Tampa Bay include: 1) active community involvement, including agreement about quantifiable restoration goals; 2) regulatory and voluntary reduction in nutrient loadings from point, atmospheric, and nonpoint sources; 3) long-term water quality and seagrass extent monitoring; and 4) a commitment from public and private sectors to work together to attain restoration goals. A shift from a turbid, phytoplankton-based system to a clear water, seagrass-based system that began in the 1980s following comprehensive nutrient loading reductions has resulted in a present-day Tampa Bay which looks and

  18. Implementation of a Diabetes Management Flow Sheet in a Long-Term Care Setting.

    Science.gov (United States)

    Williams, Evelyn; Curtis, Ashley

    2015-08-01

    Physicians lack clear guidance about adaptation of clinical practice guidelines for elderly institutionalized patients with diabetes. In a large long-term care facility, a diabetes management flow sheet was trialed to determine which clinical parameters were found useful by clinicians in the management of diabetes in that setting. Clinical practice guidelines for diabetes management were reviewed with attending physicians. Diabetes management flow sheets were distributed for all patients coded as having diabetes on their most recent minimum data sets. After a period of 14 months, flow sheet completion rates were ascertained and physicians were surveyed regarding the utility of the flow sheet. Initial flow sheet data were completed in full or in part for only 57% of the 121 study subjects; 39% of the subjects died within 14 months. Quarterly follow-up data were completed for 58% of the flow sheets. The diabetes management flow sheet was not found to be useful by attending physicians as a chronic-disease management tool. Copyright © 2015 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

  19. Long-term monitoring as aging management component in the NPP Grohnde

    International Nuclear Information System (INIS)

    Reese, Sven H.; Seichter, Johannes

    2009-01-01

    In the frame of aging management of safety relevant mechanical systems, structures and components (SSC) a classification is performed with respect to the safety relevance. For SSC of group M1 integrity has to be assured, i.e. components must not fail. The other safety relevant components are classified as group M2, i.e. failure is admissible as isolated case. SSC of group M1 in the NPP Grohnde are included into the long-term monitoring system, the annual status report ''fatigue'' has to identify the actual usage value and predict the end-of-life usage. The authors describe the used methodology concerning loading evaluation based on temperature cycling data, the thermal hydraulic modeling using finite element methods for fatigue relevant components.

  20. Establishing the long-term fuel management scheme using point reactivity model

    International Nuclear Information System (INIS)

    Park, Yong-Soo; Kim, Jae-Hak; Lee, Young-Ouk; Song, Jae-Woong; Zee, Sung-Kyun

    1994-01-01

    A new approach to establish the long-term fuel management scheme is presented in this paper. The point reactivity model is used to predict the core average reactivity. An attempt to calculate batchwise power fraction is introduced through the two-dimensional nodal power algorithm based on the modified one-group diffusion equation and the number of fuel assemblies on the core periphery. Suggested is an empirical formula to estimate the radial leakage reactivity with ripe core design experience reflected. This approach predicts the cycle lengths and the discharge burnups of individual fuel batches up to an equilibrium core when the proper input data such as batch enrichment, batch size, type and content of burnable poison and reloading strategies are given. Eight benchmark calculations demonstrate that the new approach used in this study is reasonably accurate and highly efficient for the purpose of scoping calculation when compared with design code predictions. (author)

  1. Surgical Management for Destructive Atlantoaxial Spondyloarthropathy in Long-Term Hemodialysis Patients.

    Science.gov (United States)

    Jeong, Je Hoon; Kim, Hee Kyung; Im, Soo Bin

    2017-01-01

    Atlantoaxial spondyloarthropathy most often results from rheumatoid arthritis, cancer metastasis, or basilar invagination. Dialysis-related spondyloarthropathy is a rare cause of spinal deformity and cervical myelopathy at the atlantoaxial joint. We report 2 patients on long-term hemodialysis who presented with atlantoaxial spondyloarthropathy. Two patients with end-stage renal failure presented with a history of progressively worsening neck pain, motion limitation, and gait disturbance. In both patients, radiologic findings showed a bone-destroying soft tissue mass lateral to C1 and C2, compressing the spinal cord and causing atlantoaxial instability. We performed a C1 laminectomy and C12 transarticular screw fixation and biopsied the osteolytic mass. The neck pain, hand numbness, and gait disturbance improved. Although the surgical management of these patients involves many challenges, appropriate decompression and fusion surgery is an effective treatment option. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Long-term experiment with orchard floor management systems: influence on apple yield and chemical composition.

    Science.gov (United States)

    Slatnar, Ana; Licznar-Malanczuk, Maria; Mikulic-Petkovsek, Maja; Stampar, Franci; Veberic, Robert

    2014-05-07

    The study focuses on the response of apple primary and secondary metabolism and some important quality parameters to three living mulch treatments, classical herbicide fallow, and black polypropylene strip application in two apple cultivars. Primary and secondary metabolites were analyzed after 10 years of ground cover experiments. Soluble solids, firmness, and color measurements indicate differences among orchard floor management treatments. Significantly, lower levels of individual sugars have been measured in fruit of different living mulch treatments compared with fruit harvested from trees subjected to the herbicide strip treatment. Total sugar content was higher in fruit of the herbicide strip treatment in both cultivars analyzed. Significantly higher levels of total organic acids were only detected in 'Pinova' fruit of the Festuca ovina L. treatment. Long-term response of both cultivars to living mulch treatments indicated that apples increase the accumulation of almost all analyzed individual phenolic compounds.

  3. Peptide-based anti-PCSK9 vaccines - an approach for long-term LDLc management.

    Directory of Open Access Journals (Sweden)

    Gergana Galabova

    Full Text Available Low Density Lipoprotein (LDL hypercholesterolemia, and its associated cardiovascular diseases, are some of the leading causes of death worldwide. The ability of proprotein convertase subtilisin/kexin 9 (PCSK9 to modulate circulating LDL cholesterol (LDLc concentrations made it a very attractive target for LDLc management. To date, the most advanced approaches for PCSK9 inhibition are monoclonal antibody (mAb therapies. Although shown to lower LDLc significantly, mAbs face functional limitations because of their relatively short in vivo half-lives necessitating frequent administration. Here, we evaluated the long-term efficacy and safety of PCSK9-specific active vaccines in different preclinical models.PCSK9 peptide-based vaccines were successfully selected by our proprietary technology. To test their efficacy, wild-type (wt mice, Ldlr+/- mice, and rats were immunized with highly immunogenic vaccine candidates. Vaccines induced generation of high-affine PCSK9-specific antibodies in all species. Group mean total cholesterol (TC concentration was reduced by up to 30%, and LDLc up to 50% in treated animals. Moreover, the PCSK9 vaccine-induced humoral immune response persisted for up to one year in mice, and reduced cholesterol levels significantly throughout the study. Finally, the vaccines were well tolerated in all species tested.Peptide-based anti-PCSK9 vaccines induce the generation of antibodies that are persistent, high-affine, and functional for up to one year. They are powerful and safe tools for long-term LDLc management, and thus may represent a novel therapeutic approach for the prevention and/or treatment of LDL hypercholesterolemia-related cardiovascular diseases in humans.

  4. Understanding long-term fruit fly (Diptera: Tephritidae) population dynamics: implications for areawide management.

    Science.gov (United States)

    Aluja, Martín; Ordano, Mariano; Guillén, Larissa; Rull, Juan

    2012-06-01

    Fruit flies (Diptera: Tephritidae) are devastating agricultural pests worldwide but studies on their long-term population dynamics are sparse. Our aim was to determine the mechanisms driving long-term population dynamics as a prerequisite for ecologically based areawide pest management. The population density of three pestiferous Anastrepha species [Anastrepha ludens (Loew), Anastrepha obliqua (Macquart), and Anastrepha serpentina (Wiedemann)] was determined in grapefruit (Citrus x paradisi Macfad.), mango (Mangifera indica L.), and sapodilla [Manilkara zapota (L.) P. Royen] orchards in central Veracruz, México, on a weekly basis over an 11-yr period. Fly populations exhibited relatively stable dynamics over time. Population dynamics were mainly driven by a direct density-dependent effect and a seasonal feedback process. We discovered direct and delayed influences that were correlated with both local (rainfall and air temperature) and global climatic variation (El Niño Southern Oscillation [ENSO] and North Atlantic Oscillation [NAO]), and detected differences among species and location of orchards with respect to the magnitude and nature (linear or nonlinear) of the observed effects, suggesting that highly mobile pest outbreaks become uncertain in response to significant climatic events at both global and local levels. That both NAO and ENSO affected Anastrepha population dynamics, coupled with the high mobility of Anastrepha adults and the discovery that when measured as rate of population change, local population fluctuations exhibited stable dynamics over time, suggests potential management scenarios for the species studied lie beyond the local scale and should be approached from an areawide perspective. Localized efforts, from individual growers will probably prove ineffective, and nonsustainable.

  5. Understanding long-term variations in an elephant piosphere effect to manage impacts.

    Directory of Open Access Journals (Sweden)

    Marietjie Landman

    Full Text Available Surface water availability is a key driver of elephant impacts on biological diversity. Thus, understanding the spatio-temporal variations of these impacts in relation to water is critical to their management. However, elephant piosphere effects (i.e. the radial pattern of attenuating impact are poorly described, with few long-term quantitative studies. Our understanding is further confounded by the complexity of systems with elephant (i.e. fenced, multiple water points, seasonal water availability, varying population densities that likely limit the use of conceptual models to predict these impacts. Using 31 years of data on shrub structure in the succulent thickets of the Addo Elephant National Park, South Africa, we tested elephant effects at a single water point. Shrub structure showed a clear sigmoid response with distance from water, declining at both the upper and lower limits of sampling. Adjacent to water, this decline caused a roughly 300-m radial expansion of the grass-dominated habitats that replace shrub communities. Despite the clear relationship between shrub structure and ecological functioning in thicket, the extent of elephant effects varied between these features with distance from water. Moreover, these patterns co-varied with other confounding variables (e.g. the location of neighboring water points, which limits our ability to predict such effects in the absence of long-term data. We predict that elephant have the ability to cause severe transformation in succulent thicket habitats with abundant water supply and elevated elephant numbers. However, these piosphere effects are complex, suggesting that a more integrated understanding of elephant impacts on ecological heterogeneity may be required before water availability is used as a tool to manage impacts. We caution against the establishment of water points in novel succulent thicket habitats, and advocate a significant reduction in water provisioning at our study site

  6. Understanding long-term variations in an elephant piosphere effect to manage impacts.

    Science.gov (United States)

    Landman, Marietjie; Schoeman, David S; Hall-Martin, Anthony J; Kerley, Graham I H

    2012-01-01

    Surface water availability is a key driver of elephant impacts on biological diversity. Thus, understanding the spatio-temporal variations of these impacts in relation to water is critical to their management. However, elephant piosphere effects (i.e. the radial pattern of attenuating impact) are poorly described, with few long-term quantitative studies. Our understanding is further confounded by the complexity of systems with elephant (i.e. fenced, multiple water points, seasonal water availability, varying population densities) that likely limit the use of conceptual models to predict these impacts. Using 31 years of data on shrub structure in the succulent thickets of the Addo Elephant National Park, South Africa, we tested elephant effects at a single water point. Shrub structure showed a clear sigmoid response with distance from water, declining at both the upper and lower limits of sampling. Adjacent to water, this decline caused a roughly 300-m radial expansion of the grass-dominated habitats that replace shrub communities. Despite the clear relationship between shrub structure and ecological functioning in thicket, the extent of elephant effects varied between these features with distance from water. Moreover, these patterns co-varied with other confounding variables (e.g. the location of neighboring water points), which limits our ability to predict such effects in the absence of long-term data. We predict that elephant have the ability to cause severe transformation in succulent thicket habitats with abundant water supply and elevated elephant numbers. However, these piosphere effects are complex, suggesting that a more integrated understanding of elephant impacts on ecological heterogeneity may be required before water availability is used as a tool to manage impacts. We caution against the establishment of water points in novel succulent thicket habitats, and advocate a significant reduction in water provisioning at our study site, albeit with greater

  7. The strategic skills of business continuity managers: putting business continuity management into corporate long-term planning.

    Science.gov (United States)

    Wong, Wei Ning Zechariah

    2009-11-01

    Despite its rapid development in the last two decades, business continuity management (BCM) as a discipline and a profession is still regarded by many as an operational entity of management. Two main issues are discussed in this paper: the role of BCM in strategic management and the strategic skills of business continuity managers. These issues are crucial as they represent the role of BCM in high-level corporate management. The paper discusses the importance of BCM in the long-term planning of organisational success and the preservation of future competitiveness. Finally, salient points that underpin the importance of its role in sustaining organisational performance are addressed.

  8. Hellsgate Winter Range Mitigation Project; Long-term Management Plan, Project Report 1993, Final Draft.

    Energy Technology Data Exchange (ETDEWEB)

    Berger, Matthew T.

    1994-01-01

    A study was conducted on the Hellsgate Winter Range Mitigation Project area, a 4,943 acre ranch purchased for mitigating some habitat losses associated with the original construction of Grand Coulee Dam and innundation of habitat by Lake Roosevelt. A Habitat Evaluation Procedure (HEP) study was used to determine habitat quality and quantity baseline data and future projections. Target species used in the study were sharp-tailed grouse (Tympanuchus phasianellus), mule deer (Odocoileus hemoinus), mink (Mustela vison), spotted sandpiper (Actiius colchicus), bobcat (Felis reufs), blue grouse (Dendragapus obscurus), and mourning dove (Zenaida macroura). From field data collected, limiting life values or HSI's (Habitat Suitability Index's) for each indicator species was determined for existing habitats on project lands. From this data a long term management plan was developed. This report is designed to provide guidance for the management of project lands in relation to the habitat cover types discussed and the indicator species used to evaluate these cover types. In addition, the plan discusses management actions, habitat enhancements, and tools that will be used to enhance, protect and restore habitats to desired conditions. Through planned management actions biodiversity and vegetative structure can be optimized over time to reduce or eliminate, limiting HSI values for selected wildlife on project lands.

  9. Long-term issues associated with spent nuclear power fuel management options

    International Nuclear Information System (INIS)

    Jae-Sol, Lee; Kosaku, Fukuda; Burcl, R.; Bell, M.

    2003-01-01

    Spent fuel management is perceived as one of the crucial issues to be resolved for sustainable utilisation of nuclear power. In the last decades, spent fuel management policies have shown diverging tendencies among the nuclear power production countries - a group has adhered to reprocessing- recycle and another has turned to direct disposal, while the rest of the countries have not taken decision yet, often with ''wait and see'' position. Both the closed and open fuel cycle options for spent fuel management have been subject to a number of debates with pros and cons on various issues such as proliferation risk, environmental impact, etc. The anticipation for better technical solutions that would mitigate those issues has given rise to the renewal of interest in partitioning and transmutation of harmful nuclides to be disposed of, and in a broader context, the recent initiatives for development of innovative nuclear systems. The current trend toward globalization of market economy, which has already brought important impacts on nuclear industry, might have a stimulating effect on regional-international co-operations for cost-effective efforts to mitigate some of those long-term issues associated with spent fuel management. (author)

  10. Congestion management in power systems. Long-term modeling framework and large-scale application

    Energy Technology Data Exchange (ETDEWEB)

    Bertsch, Joachim; Hagspiel, Simeon; Just, Lisa

    2015-06-15

    In liberalized power systems, generation and transmission services are unbundled, but remain tightly interlinked. Congestion management in the transmission network is of crucial importance for the efficiency of these inter-linkages. Different regulatory designs have been suggested, analyzed and followed, such as uniform zonal pricing with redispatch or nodal pricing. However, the literature has either focused on the short-term efficiency of congestion management or specific issues of timing investments. In contrast, this paper presents a generalized and flexible economic modeling framework based on a decomposed inter-temporal equilibrium model including generation, transmission, as well as their inter-linkages. Short and long-term effects of different congestion management designs can hence be analyzed. Specifically, we are able to identify and isolate implicit frictions and sources of inefficiencies in the different regulatory designs, and to provide a comparative analysis including a benchmark against a first-best welfare-optimal result. To demonstrate the applicability of our framework, we calibrate and numerically solve our model for a detailed representation of the Central Western European (CWE) region, consisting of 70 nodes and 174 power lines. Analyzing six different congestion management designs until 2030, we show that compared to the first-best benchmark, i.e., nodal pricing, inefficiencies of up to 4.6% arise. Inefficiencies are mainly driven by the approach of determining cross-border capacities as well as the coordination of transmission system operators' activities.

  11. An assessment method for long-term management of Canada's used nuclear fuel

    International Nuclear Information System (INIS)

    Leiss, W.

    2006-01-01

    The nine-member Assessment Team, assembled by the Nuclear Waste Management Organization in early 2004, reported the results of its work in the NWMO document, 'Assessing the Options: Future Management of Used Nuclear Fuel in Canada (June 2004). The team was responding to the challenge to develop a rigorous and credible evaluation of multiple options, and one which would also satisfy a complex set of objectives: a solution that would be 'socially acceptable, technically sound, environmentally responsible, and economically feasible.' This paper describes the special challenges faced by the Assessment Team in seeking to respond to this multifaceted assignment. I open by discussing the implications of the institutional and legal framework inherited by the NWMO from the Seaborn Panel (including the government's response to the Seaborn Panel report), which in effect set a new standard for the practice of risk management decision making in Canada. I then review the highlights of the Assessment Team's report, including its chosen method, namely, multi-objective utility analysis. I conclude with a discussion of the longer term implications of the assessment work done to date for the next stages in the process of finding a credible solution for the long-term management of used nuclear fuel in Canada. (author)

  12. Mobile phone messaging for facilitating self-management of long-term illnesses.

    Science.gov (United States)

    de Jongh, Thyra; Gurol-Urganci, Ipek; Vodopivec-Jamsek, Vlasta; Car, Josip; Atun, Rifat

    2012-12-12

    Long-term illnesses affect a significant proportion of the population in developed and developing countries. Mobile phone messaging applications, such as Short Message Service (SMS) and Multimedia Message Service (MMS), may present convenient, cost-effective ways of supporting self-management and improving patients' self-efficacy skills through, for instance, medication reminders, therapy adjustments or supportive messages. To assess the effects of mobile phone messaging applications designed to facilitate self-management of long-term illnesses, in terms of impact on health outcomes and patients' capacity to self-manage their condition. Secondary objectives include assessment of: user evaluation of the intervention; health service utilisation and costs; and possible risks and harms associated with the intervention. We searched the Cochrane Central Register of Controlled Trials (CENTRAL,The Cochrane Library 2009, Issue 2), MEDLINE (OvidSP) (January 1993 to June 2009), EMBASE (OvidSP) (January 1993 to June 2009), PsycINFO (OvidSP) (January 1993 to June 2009), CINAHL (EbscoHOST) (January 1993 to June 2009), LILACS (January 1993 to June 2009) and African Health Anthology (January 1993 to June 2009).We also reviewed grey literature (including trial registers) and reference lists of articles. We included randomised controlled trials (RCTs), quasi-randomised controlled trials (QRCTs), controlled before-after (CBA) studies, or interrupted time series (ITS) studies with at least three time points before and after the intervention. We selected only studies where it was possible to assess the effects of mobile phone messaging independent of other technologies or interventions. Two review authors independently assessed all studies against the inclusion criteria, with any disagreements resolved by a third review author. Study design features, characteristics of target populations, interventions and controls, and results data were extracted by two review authors and confirmed by

  13. Impact of short-term severe accident management actions in a long-term perspective. Final Report

    International Nuclear Information System (INIS)

    2000-03-01

    The present systems for severe accident management are focused on mitigating the consequences of special severe accident phenomena and to reach a safe plant state. However, in the development of strategies and procedures for severe accident management, it is also important to consider the long-term perspective of accident management and especially to secure the safe state of the plant. The main reason for this is that certain short-term actions have an impact on the long-term scenario. Both positive and negative effects from short-term actions on the accident management in the long-term perspective have been included in this paper. Short-term actions are accident management measures taken within about 24 hours after the initiating event. The purpose of short-term actions is to reach a stable status of the plant. The main goal in the long-term perspective is to maintain the reactor in a stable state and prevent uncontrolled releases of activity. The purpose of this short Technical Note, deliberately limited in scope, is to draw attention to potential long-term problems, important to utilities and regulatory authorities, arising from the way a severe accident would be managed during the first hours. Its objective is to encourage discussions on the safest - and maybe also most economical - way to manage a severe accident in the long term by not making the situation worse through inappropriate short-term actions, and on the identification of short-term actions likely to make long-term management easier and safer. The Note is intended as a contribution to the knowledge base put at the disposal of Member countries through international collaboration. The scope of the work has been limited to a literature search. Useful further activities have been identified. However, there is no proposal, at this stage, for more detailed work to be undertaken under the auspices of the CSNI. Plant-specific applications would need to be developed by utilities

  14. A long-term perspective on anthropogenic activities and management strategies in a prairie wetland

    Science.gov (United States)

    Hobbs, J. M.; Hobbs, W.; LaFrancois, T.; Edlund, M.; Theissen, K. M.; Zimmer, K.; Hanson, M.

    2012-12-01

    Multiple stressors to shallow lake/wetland ecosystems have the ability to control the relative stability of alternative states (clear, macrophyte-dominated or turbid, algal dominated). As a consequence, the use of remedial biomanipulations to induce trophic cascades and shift a turbid lake to a clear state is often only a temporary solution. Here we show the instability of short-term manipulations in the shallow Lake Christina (a Class V wetland in the prairie ecoregion of western Minnesota, USA) is governed by the long-term state following a regime shift in the lake. During the modern, managed period of the lake, three top-down manipulations (fish kills) were undertaken inducing temporary (5-10 years) unstable clear-water states. Paleoecological remains of diatoms, along with proxies of primary production (total chlorophyll a and total organic carbon accumulation rate) and trophic state (total P) from sediment records clearly show a single regime shift in the lake during the early 1950s; following this shift, the functioning of the lake ecosystem is dominated by a persistent turbid state. We find that multiple stressors contributed to the regime shift. First, the lake began to eutrophy (from agricultural land use and/or increased waterfowl populations), leading to a dramatic increase in primary production. Soon after, the construction of a dam in 1936 effectively doubled the depth of the lake, compounded by increases in regional humidity; this resulted in an increase in planktivorous and benthivorous fish reducing phytoplankton grazers. These factors further conspired to increase the stability of a turbid regime during the modern managed period, such that switches to a clear-water state were inherently unstable and the lake consistently returned to a turbid state. We conclude that while top-down manipulations have had measurable impacts on the lake state, they have not been effective in providing a return to an ecosystem similar to the stable historical period

  15. Stepwise decision making for the long-term management of radioactive waste

    International Nuclear Information System (INIS)

    Pescatore, C.; Vari, A.

    2005-01-01

    The context of long-term radioactive waste management is being shaped by changes in modern society. Values such as health, environmental protection and safety are increasingly important, as are trends towards improved forms of participatory democracy that demand new forms of risk governance in dealing with hazardous activities. These changes in turn necessitate new forms of dialogue and decision-making processes that include a large number of stakeholders. The new dynamic of dialogue and decision-making process has been characterised as a shift from a more traditional 'decide, announce and defend' model, focused on technical assurance, to one of 'engage, interact and cooperate', for which both technical assurance and quality of the process are of comparable importance to a constructive outcome. Consequently, the scientific and engineering aspects of waste management safety are no longer of exclusive importance. Organisational ability to communicate and to adapt to the new context has emerged as a critical contributor to public confidence. In the new decision-making context it is clear that (a) any significant decisions regarding the long-term management of radioactive waste will be accompanied by a comprehensive public review with involvement of a diverse range of stakeholders; (b) the public, and especially the local public, are not willing to commit irreversibly to technical choices on which they have insufficient familiarity and understanding; and (c) any management options will take decades to be developed and implemented, which will involve stakeholders who have not yet been born. Thus, a 'decision' no longer means opting for, in one go and for all time, a complete package solution. Instead, a decision is one step in an overall, cautious process of examining and making choices that preserve the safety and well-being of the present generation and the coming ones while not needlessly depriving the latter of their right of choice. Consideration is thus

  16. Evaluation of waste management options in view of long-term maintenance-free landfills

    International Nuclear Information System (INIS)

    Brunner, P.H.; Doeberl, G.; Huber, R.; Eder, M.; Pierrard, R.; Schoenbaeck, W.; Fruehwirth, W.; Hutterer, H.; Woeginger, H.

    2001-01-01

    The present case study compares and evaluates different waste management options with special consideration to their long-term implications. Multiple scenarios of these options were created and investigated as to which of term best fulfilled the goals of the Austrian waste management act (Abfallwirtschaftgesetz, AWG). Serving as a basis for this study, an elaborated model of the Austrian waste management, as described in GUA and IFIP (1998, 'Management of Household and Household-like Waste in Austria'), was used. Alterations to the GUA and IFIP study were done in order to best fulfill the needs of this assessment. Household and household-like waste, as well as municipal sewage sludge have been defined as the system input. The following list of scenarios were investigated against an up-dated status-quo (P0): M1 maximum landfilling of untreated waste; M2a maximum incineration without any after treatment; M2b maximum incineration with cement stabilization of the residual material; M2c maximum high temperature process; M3a maximum mechanical-biological treatment with the light fraction from sorting and splitting processed in a fluidized-bed furnace; M3b maximum mechanical-biological treatment with the light fraction from sorting and splitting processed in a rotary kiln for use in the cement industry; M3c maximum mechanical-biological treatment with the high caloric heavy fraction after decomposition processed in a fluidized-bed furnace; M3d maximum mechanical-biological treatment with the high caloric heavy fraction after decomposition processed in a rotary kiln for use in the cement industry. In order to oblige to the precautionary principle of the AWG, each of the scenarios were investigated, with regards to the short, middle, and long-term landfills behaviors of the deposited residual material. The macro-economical Cost-Benefit-Analysis (CBA) was used in the assessment. Additionally a so-called 'modified-Cost-Effect-Analysis' (MCEA) was developed. Unlike the

  17. Safeguards issues of long-term waste management at DOE sites

    International Nuclear Information System (INIS)

    Pillay, K.K.S.

    1992-06-01

    Waste management at US Department of Energy (DOE) sites is not often regarded as a safeguard-sensitive step in the nuclear fuel cycle because the material concerned is relatively unattractive for diversion or theft. However, the accumulation of large amounts of fissile materials in wastes over a period of time can be a safeguards concern. One estimate shows that high-level and transuranic wastes and some miscellaneous radioactive materials at DOE sites may contain as much as 15 Mt of fissile materials. In the context of present US strategies for the disposal of these radioactive wastes, this study identifies safeguards issues relevant to proposed scenarios for the long-term management and permanent disposal of the above-mentioned waste forms in geologic repositories. This study points out areas of concern and the need to examine the issues before the wastes are processed for geologic disposal. Good waste management practices may offer unique opportunities to address the safeguards issues identified here. A judicious approach to examining the safeguards requirements of waste disposal programs may also contribute to DOE's new effort to establish and maintain public confidence in its environmental restoration programs

  18. Context of the long-term management of low-level short-lived waste

    International Nuclear Information System (INIS)

    Hooft, E.

    2004-01-01

    Until the international moratorium of 1983, Belgium relied on sea disposal for its low-level waste. Since then, ONDRAF/NIRAS, the Belgian radioactive waste management agency, has launched studies to look for land-based solutions. These studies, which are still going on, have gone through various phases. The sometimes harsh reactions in public opinion and the recommendations of independent experts, however, progressively led ONDRAF/NIRAS to question its work methodology. On 16 January 1998 was a milestone in Belgian's nuclear waste management. On that day, the Belgian federal government opted for a final, or potentially final, solution for the long-term management of short-lived, low-level radioactive waste, a solution that also had to be progressive, flexible, and reversible. At the same time, the government entrusted new missions to ONDRAF/NIRAS in particular that of developing methods to enable the integration of final repository project proposals at a local level and restricted the number of potential sites for final disposal to the four existing nuclear sites in Belgium and to possibly interested local districts. The government's decision of 16 January 1998 forced ONDRAF/NIRAS to change its strategy. The agency set up a new work programme and worked out an innovative methodology. This new methodology aims to generate, at the level of the interested towns and villages, draft projects for a final repository supported by a wide public consensus. (author)

  19. Managing long-term polycyclic aromatic hydrocarbon contaminated soils: a risk-based approach.

    Science.gov (United States)

    Duan, Luchun; Naidu, Ravi; Thavamani, Palanisami; Meaklim, Jean; Megharaj, Mallavarapu

    2015-06-01

    Polycyclic aromatic hydrocarbons (PAHs) are a family of contaminants that consist of two or more aromatic rings fused together. Soils contaminated with PAHs pose significant risk to human and ecological health. Over the last 50 years, significant research has been directed towards the cleanup of PAH-contaminated soils to background level. However, this achieved only limited success especially with high molecular weight compounds. Notably, during the last 5-10 years, the approach to remediate PAH-contaminated soils has changed considerably. A risk-based prioritization of remediation interventions has become a valuable step in the management of contaminated sites. The hydrophobicity of PAHs underlines that their phase distribution in soil is strongly influenced by factors such as soil properties and ageing of PAHs within the soil. A risk-based approach recognizes that exposure and environmental effects of PAHs are not directly related to the commonly measured total chemical concentration. Thus, a bioavailability-based assessment using a combination of chemical analysis with toxicological assays and nonexhaustive extraction technique would serve as a valuable tool in risk-based approach for remediation of PAH-contaminated soils. In this paper, the fate and availability of PAHs in contaminated soils and their relevance to risk-based management of long-term contaminated soils are reviewed. This review may serve as guidance for the use of site-specific risk-based management methods.

  20. Transforming long-term care pain management in north america: the policy-clinical interface.

    Science.gov (United States)

    Hadjistavropoulos, Thomas; Marchildon, Gregory P; Fine, Perry G; Herr, Keela; Palley, Howard A; Kaasalainen, Sharon; Béland, François

    2009-04-01

    The undertreatment of pain in older adults who reside in long-term care (LTC) facilities has been well documented, leading to clinical guideline development and professional educational programs designed to foster better pain assessment and management in this population. Despite these efforts, little improvement has occurred, and we postulate that focused attention to public policy and cost implications of systemic change is required to create positive pain-related outcomes. Our goal was to outline feasible and cost-effective clinical and public policy recommendations designed to address the undermanagement of pain in LTC facilities. We arranged a 2-day consensus meeting of prominent United States and Canadian pain and public policy experts. An initial document describing the problem of pain undermanagement in LTC was developed and circulated prior to the meeting. Participants were also asked to respond to a list of relevant questions before arriving. Following formal presentations of a variety of proposals and extensive discussion among clinicians and policy experts, a set of recommendations was developed. We outline key elements of a transformational model of pain management in LTC for the United States and Canada. Consistent with previously formulated clinical guidelines but with attention to readily implementable public policy change in both countries, this transformational model of LTC has important implications for LTC managers and policy makers as well as major quality of life implications for LTC residents.

  1. Infectious Diseases in Older Adults of Long-Term Care Facilities: Update on Approach to Diagnosis and Management.

    Science.gov (United States)

    Jump, Robin L P; Crnich, Christopher J; Mody, Lona; Bradley, Suzanne F; Nicolle, Lindsay E; Yoshikawa, Thomas T

    2018-04-01

    The diagnosis, treatment, and prevention of infectious diseases in older adults in long-term care facilities (LTCFs), particularly nursing facilities, remains a challenge for all health providers who care for this population. This review provides updated information on the currently most important challenges of infectious diseases in LTCFs. With the increasing prescribing of antibiotics in older adults, particularly in LTCFs, the topic of antibiotic stewardship is presented in this review. Following this discussion, salient points on clinical relevance, clinical presentation, diagnostic approach, therapy, and prevention are discussed for skin and soft tissue infections, infectious diarrhea (Clostridium difficile and norovirus infections), bacterial pneumonia, and urinary tract infection, as well as some of the newer approaches to preventive interventions in the LTCF setting. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

  2. Plant life management for long term operation of nuclear power plants

    International Nuclear Information System (INIS)

    2005-01-01

    The world's fleet of Nuclear Power Plants (NPPs) is approximately 20 years old on average, and most plants are believed to be able to operate for 60 years or more. The design life of a NPP is typically 30 to 40 years. This may be extended by 10 to 20 years, or more, provided that the plant can demonstrate by analysis, trending, equipment and system upgrades, increased vigilance, testing, ageing management, and other means that license renewal presents no threat to public health and safety. The basic goal of Plant Life Management (PLiM) is to satisfy requirements for safe long-term supplies of electricity in an economically competitive way. The basic goal of the operating company and the owners to operate as long as economically reasonable and possible from safety point of view. PLiM is a management tool for doing that. PLiM is a system of programmes and procedures to satisfy safety requirements for safe operation and for power production in a competitive way and for time which is rational from technical and economical point of view. PLiM is not only a technical system, it is also an attitude of the operational company to keep the plant in operation as long as possible from safety and business point of view. The common objectives of PLiM assessment is to help and review the pre-conditions for PLiM and long-term operation approaches. PLiM should not be associated with extension of operational life-time of the NPP only. It is an owner's attitude and rational approach of the operating company to run the business economically and safely. The effectiveness of PLiM Programme can be assessed by three complementary kinds of assessment: self-assessment, peer review and comprehensive programme review by the plant owner/ operator. IAEA will provide the assessment service for peer review of PLiM. Preparation for a PLiM Assessment service will be initiated only after the IAEA has been formally approached by a MS and funding (e.g. an existing Technical cooperation project) has

  3. Acute and long-term management of food allergy: systematic review.

    Science.gov (United States)

    de Silva, D; Geromi, M; Panesar, S S; Muraro, A; Werfel, T; Hoffmann-Sommergruber, K; Roberts, G; Cardona, V; Dubois, A E J; Halken, S; Host, A; Poulsen, L K; Van Ree, R; Vlieg-Boerstra, B J; Agache, I; Sheikh, A

    2014-02-01

    Allergic reactions to food can have serious consequences. This systematic review summarizes evidence about the immediate management of reactions and longer-term approaches to minimize adverse impacts. Seven bibliographic databases were searched from their inception to September 30, 2012, for systematic reviews, randomized controlled trials, quasi-randomized controlled trials, controlled clinical trials, controlled before-and-after and interrupted time series studies. Experts were consulted for additional studies. There was no language or geographic restrictions. Two reviewers critically appraised the studies using the appropriate tools. Data were not suitable for meta-analysis due to heterogeneity so were narratively synthesized. Eighty-four studies were included, but two-thirds were at high risk of potential bias. There was little evidence about acute management for non-life-threatening reactions. H1-antihistamines may be of benefit, but this evidence was in part derived from studies on those with cross-reactive birch pollen allergy. Regarding long-term management, avoiding the allergenic food or substituting an alternative was commonly recommended, but apart from for infants with cow's milk allergy, there was little high-quality research on this management approach. To reduce symptoms in children with cow's milk allergy, there was evidence to recommend alternatives such as extensively hydrolyzed formula. Supplements such as probiotics have not proved helpful, but allergen-specific immunotherapy may be disease modifying and therefore warrants further exploration. Food allergy can be debilitating and affects a significant number of people. However, the evidence base about acute and longer-term management is weak and needs to be strengthened as a matter of priority. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. Implementing a balanced scorecard as a strategic management tool in a long-term care organization.

    Science.gov (United States)

    Schalm, Corinne

    2008-01-01

    The Capital Care Group, the largest public sector continuing care organization in Canada, had no ready access to information on its own performance and therefore was limited in its pursuit of evidence-informed decision-making. To remedy this, it was decided to introduce a balanced scorecard. A literature review was conducted together with interviews with 10 other health care organizations which had implemented balanced scorecards. With this information, a workshop was held that resulted in a framework and about 120 potential indicators. Subsequently the number of indicators was reduced to 29, using pre-determined criteria. Development of a corporate balanced scorecard facilitated executive strategic thinking and clarified the organization's strategic direction. In parallel, scorecards were developed at the level of care centres. These had a common core of indicators, plus some site-specific ones. Development of the corporate scorecard took three years and an additional six months for the care centre scorecards. A formal implementation plan has been accepted by the executive team. Key to this is communicating to staff the role of scorecards for strategic management and not just performance measurement. Traditional thinking needs to change from a short-term operational focus to long-term strategy. In addition, champions need to be identified in each care centre and they need to be networked together. Finally, the scorecard is being integrated into existing operational management as a routine component together with resources to support its use. The balanced scorecard has focused on its role as a strategic management tool. The indicators and dimensions need to be customized to the organization. Senior management must be seen to be driving its introduction. It is worth spending sufficient time developing and implementing a scorecard rather than trying to rush its introduction. The scorecard needs to be integrated with existing management processes and sufficient

  5. Current Status of the United Kingdom Programme for Long-Term Radioactive Waste Management

    International Nuclear Information System (INIS)

    Murray, C. H.; Hooper, A. J.; Mathieson, J.

    2002-01-01

    In 1997, the UK programme for the deep disposal of radioactive waste was ''stopped dead in its tracks'' with the refusal by the Secretary of State for the Environment to allow Nirex to go ahead with its plans for an underground Rock Characterisation Facility at Sellafield in north-west England. Since that time a House of Lords' Select Committee has held an inquiry into what went wrong and what the way ahead should be. In addition, Nirex and the nuclear industry players have also been analyzing the past with a view to learning from the experience in taking things forward. In Nirex's view this is essentially an ethical issue; the waste exists and we should deal with it in this generation. Three areas need to be better addressed if a successful program of management of the nation's radioactive waste is to be achieved: the process of how policy development and implementation can be achieved; the structure of the nuclear industry and its relationship to the waste management organization; and the behavior of the players in their interaction with stakeholders. All three are underpinned by the need for transparency. In recognition that developing a policy for managing radioactive waste has to be achieved with the support of all stakeholders, the Government instigated a consultation exercise in September 2001. The initial phase of this initiative is essentially a consultation about consultation and is intended to decide on how the next stages of a six year policy development program should be addressed. In addition to this exercise, the Government is undertaking a fundamental review of the structuring of the United Kingdom Atomic Energy Authority (UKAEA) and British Nuclear Fuels plc (BNFL). They are both shareholders in Nirex and in November 2001 the Government announced the setting up of a Liabilities Management Authority (LMA) to manage the long-term nuclear liabilities that are publicly owned, particularly through those organizations. The future of Nirex will be

  6. Ageing management and knowledge base for safe long-term operation of japanese light water reactors

    International Nuclear Information System (INIS)

    Sekimura, N.

    2008-01-01

    There are 55 operating commercial light water reactor plants (32 BWRs and 23 PWRs) in Japan. Twelve (12) plants have been operating for more than 30 years. Utility companies are required to perform an 'Ageing Management Technical Assessment' be-fore the end of 30 years operation of each plant. The assessments for each plant have been evaluated by the Nuclear and Industry Safety Agency (NISA) of the Ministry of Economy Trade and Industry (WTI) for these 12 plants. The Japan Nuclear Energy Safety Organisation (JNES) has compiled Technical Review Manuals for six major degradation phenomena for the evaluation of Ageing Management Technical Assessment. A 'Road-map for Ageing and Plant Life Management' was established in 2005 by the Special Committee in the Atomic Energy Society of Japan under the commission from the JNES. Within the framework of the road-map, the major research and development fields are divided into the following four categories: 1) engineering information systems; 2) research and development of technologies for inspection, evaluation and repair of the components and materials; 3) development of codes and standards; 4) synthesised maintenance engineering. Continuous revision of the 'Strategy Maps for Ageing Management and Safe Long-term Operation' has been performed under the Coordinating Committee of Ageing Management to promote research and development activities by industries, government and academia, effectively and efficiently. Systematic development of the information basis for database and knowledge-base has been undertaken in addition to the development of codes and standards by academic societies through intensive domestic safety research collaborations and international collaboration. (author)

  7. Long-Term Surveillance and Maintenance Plan for the Gnome-Coach, New Mexico, Site

    Energy Technology Data Exchange (ETDEWEB)

    Kreie, Ken [USDOE Office of Legacy Management, Grand Junction, CO (United States); Findlay, Rick [Navarro Research and Engineering, Inc., Grand Junction, CO (United States)

    2016-06-08

    The U.S. Department of Energy (DOE) Office of Legacy Management (LM) prepared this Long-Term Surveillance and Maintenance Plan (LTSMP) for the Gnome-Coach, New Mexico, Site (the Gnome site). The Gnome site is approximately 25 miles east of Carlsbad in Eddy County, New Mexico (Figure 1). The site was the location of a 3-kiloton-yield underground nuclear test and radioisotope groundwater tracer test. The tests resulted in residual contamination and post-detonation features that require long-term oversight. Long-term responsibility for the site was transferred from the DOE National Nuclear Security Administration Nevada Site Office to LM on October 1, 2006. Responsibilities include surveillance, monitoring, and maintenance of institutional controls (ICs) as part of the long-term stewardship of the site. Long-term stewardship is designed to ensure protection of human health and the environment.

  8. Risk-adapted, long-term management in childhood-onset craniopharyngioma.

    Science.gov (United States)

    Müller, Hermann L

    2017-04-01

    This report is a review of findings on the diagnosis, treatment, clinical course, follow-up, and prognosis of craniopharyngioma patients with special regard to clinical trials and long-term management. Literature search on Pubmed for paper published after 1994. Craniopharyngiomas are rare, embryonic malformations of the sellar/parasellar region with low histological grade. Clinical manifestations are related to increased intracranial pressure, visual impairment, and hypothalamic/pituitary deficiencies. If the tumor is favorably localized, therapy of choice is complete resection, with care taken to preserve hypothalamic and optic functions. In patients with unfavorable tumor location (i.e. involvement of hypothalamic areas), recommended therapy is limited hypothalamus-sparing surgical strategy followed by irradiation. Irradiation has proven effective in treatment of recurrences and progression. Surgical lesions and/or anatomical involvement of posterior hypothalamic areas can result in serious sequelae, mainly hypothalamic syndrome. It is crucial that craniopharyngioma be managed as a frequently chronic disease, providing ongoing care of pediatric and adult patients' by experienced multidisciplinary teams in the context of multicenter trials.

  9. Technology for the long-term management of defense HLW at the Idaho Chemical Processing Plant

    International Nuclear Information System (INIS)

    Staples, B.A.; Berreth, J.R.; Knecht, D.A.

    1986-01-01

    The Defense Waste Management Plan of June 1983 includes a reference plan for the long-term management of Idaho Chemical Processing Plant (ICPP) high-level waste (HLW), with a goal of disposing of the annual output in 500 canisters a year by FY-2008. Based on the current vitrification technology, the ICPP base-glass case would produce 1700 canisters per year after FY-2007. Thus, to meet the DWMP goal processing steps including fuel dissolution, waste treatment, and waste immobilization are being studied as areas where potential modifications could result in HLW volume reductions for repository disposal. It has been demonstrated that ICPP calcined wastes can be densified by hot isostatic pressing to multiphase ceramic forms of high loading and density. Conversion of waste by hot isostatic pressing to these forms has the potential of reducing the annual ICPP waste production to volumes near those of the goal of the DWMP. This report summarizes the laboratory-scale information currently available on the development of these forms

  10. Integrated, long term, sustainable, cost effective biosolids management at a large Canadian wastewater treatment facility.

    Science.gov (United States)

    Leblanc, R J; Allain, C J; Laughton, P J; Henry, J G

    2004-01-01

    The Greater Moncton Sewerage Commission's 115,000 m3/d advanced, chemically assisted primary wastewater treatment facility located in New Brunswick, Canada, has developed an integrated, long term, sustainable, cost effective programme for the management and beneficial utilization of biosolids from lime stabilized raw sludge. The paper overviews biosolids production, lime stabilization, conveyance, and odour control followed by an indepth discussion of the wastewater sludge as a resource programme, namely: composting, mine site reclamation, landfill cover, land application for agricultural use, tree farming, sod farm base as a soil enrichment, topsoil manufacturing. The paper also addresses the issues of metals, pathogens, organic compounds, the quality control program along with the regulatory requirements. Biosolids capital and operating costs are presented. Research results on removal of metals from primary sludge using a unique biological process known as BIOSOL as developed by the University of Toronto, Canada to remove metals and destroy pathogens are presented. The paper also discusses an ongoing cooperative research project with the Université de Moncton where various mixtures of plant biosolids are composted with low quality soil. Integration, approach to sustainability and "cumulative effects" as part of the overall biosolids management strategy are also discussed.

  11. Iron oxides dynamics in a subtropical Brazilian Paleudult under long-term no-tillage management

    Directory of Open Access Journals (Sweden)

    Alberto Vasconcellos Inda

    2013-02-01

    Full Text Available Replacing conventional tillage (CT with no-tillage (NT management alters the pedoenvironment and the rate of topsoil processes, with possible effects on dissolution processes associated with iron oxides and therefore soil mineralogy. This study aimed to determine the effect of NT on the content and distribution of types of iron oxides in a Rhodic Paleudult in southern Brazil. Soil samples were collected at eight depths within the 0.00-0.80 m layer under CT and NT in a long-term experiment (21 years. Mineralogical identification was conducted by X-ray diffraction (XRD, and the Fe content related to specific types of iron oxides determined by selective dissolution and diffuse-reflectance spectroscopy. Kaolinite, quartz, goethite, hematite, and maghemite were identified in the clay fraction. In the NT-managed soil, there was a decrease in the content of crystalline iron oxides and an increase in the content of poorly crystalline iron oxides with increasing proximity to the soil surface. These results suggest that iron oxides are rearranged in this soil by reductive dissolution of the crystalline types and neoformation of metastable ferrihydrite in topsoil layers, which should be assessed further in laboratory studies.

  12. Our experience, technique and long-term outcomes in the management of posterior urethral strictures.

    Science.gov (United States)

    Singh, Amit; Panda, Shasanka Shekhar; Bajpai, Minu; Jana, Manisha; Baidya, Dalim Kumar

    2014-02-01

    To share our experience, technique and long-term outcomes in posterior urethral stricture management. Thirty-seven boys with post-traumatic posterior urethral stricture underwent resection and end-to-end anastomosis through pre-anal coronal approach or in combination with trans-pubic approach from January 2000 to December 2011. Follow up included symptomatic evaluation by micturating cystourethrogram and retrograde urethrogram in all patients, and urethroscopy in patients with voiding symptoms. Pre-anal coronal approach was used in 29 (78%) cases and in 8 (21%) cases it was combined with trans-pubic approach. In 33 (89.1%) patients it was first attempt, while in 4 (10.9%) it was redo surgery. Two patients required buccal mucosal graft to bridge the deficient urethra. Patient age was 5-17 years (mean 10.8 years). Mean follow up was 48.5 months (range 6-132 months). Thirty-two (86%) patients were symptom free. Failed repairs were successfully managed by urethral dilation in 3 and by redo urethroplasty in the remaining 2. All patients were continent. There was no chordee, penile shortening or urethral diverticula. Resection and end-to-end anastomosis of posterior urethral stricture is possible through pre-anal coronal incision; however, if slightest difficulty is envisaged in creating a satisfactory end-to-end anastomosis, extension to trans-pubic approach should be done. Copyright © 2013 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  13. Integrated, long term, sustainable, cost effective biosolids management at a large Canadian wastewater treatment facility

    Energy Technology Data Exchange (ETDEWEB)

    LeBlance, R.J.; Allain, C.J.; Laughton, P.J.; Henry, J.G.

    2003-07-01

    The Greater Moncton Sewerage Commission's 115 000 m{sup 3}/d advanced, chemically assisted primary wastewater treatment facility located in New Brunswick, Canada, has developed an integrated, long term, sustainable, cost effective programme for the management and beneficial utilization of biosolids from lime stabilized raw sludge. The paper overviews biosolids production, lime stabilization, conveyance, and odour control followed by an indepth discussion of the wastewater sludge as a resource programme, namely: composting, mine site reclamation, landfill cover, land application for agricultural use, tree farming, sod farm base as a soil enrichment, topsoil manufacturing. The paper also addresses the issues of metals, pathogens, organic compounds, the quality control program along with the regulatory requirements. Biosolids capital and operating costs are presented. Research results on removal of metals from primary sludge using a unique biological process known as BIOSOL as developed by the University of Toronto, Canada to remove metals and destroy pathogens are presented. The paper also discusses an ongoing cooperative research project with the Universite de Moncton where various mixtures of plant biosolids are composted with low quality soil. Integration, approach to sustainability and ''cumulative effects'' as part of the overall biosolids management strategy is also discussed. (author)

  14. Hypertension management in the oldest old: Findings from a large long-term care facility.

    Science.gov (United States)

    Schwinn, Susan; McKay, Robin; Dinkel, Shirley; Mansfield, Bobbe; Da Cunha, Brooke Faria; Cummins, Savanna; Brunin, Krystal

    2017-03-01

    The purpose of this quality improvement project was to evaluate hypertension (HTN) management in patients 80 years of age and older who reside in a large, long-term care (LTC) facility. A retrospective chart audit was conducted on 75 charts of patients 80 years of age and older and who had a diagnosis of HTN. Using the 2011 American College of Cardiology Foundation/American Heart Association (ACCF/AHA) Expert Consensus Document on Management of Hypertension in the Elderly as a guide, blood pressure readings, significant comorbidities, and antihypertensive medication utilization were analyzed. LTC residents in this sample were often not treated according to expert recommendations. Specifically, analysis revealed overtreatment of uncomplicated HTN and undertreatment of those with comorbid conditions. Additionally, those with diabetes mellitus and chronic kidney disease were infrequently prescribed ace inhibitors/angiotensin receptor blockers, as recommended. Utilizing evidence-based practice (EBP) guidelines affords the best avenue for providing safe and effective treatment of HTN. While expert recommendations are available, researchers seldom recruit frail elders in LTC facilities into treatment investigations. In the absence of population-specific EBP guidelines, nurse practitioners must rely on expert opinion and diagnostic reasoning to individualize HTN treatment to this unique and vulnerable population. ©2016 American Association of Nurse Practitioners.

  15. A strategic approach to short- and long-term irradiated WWER fuel management

    International Nuclear Information System (INIS)

    Wilcox, P.; Conboy, T.M.

    1994-01-01

    A methodology is presented for comparison of alternative options for short-term and long-term irradiated fuel management. The value of this methodology is that all interested parties can take part in the analysis and derive the basis for decision-making. The methodology can answer questions as: When can uranium and plutonium recovered by reprocessing be recycled cost effectively in WWER? If reprocessing is not the short-term option chosen, is storage of irradiated fuel at the original licensed nuclear reactor site preferable to a separate storage-only-site? Are modular vault dry stores and cooling ponds which necessitate significant capital investment prior to deployment, more costly overall than their options? Should the most suitable form of irradiated fuel management be determined only by cost constraints? The key stages of the methodology are: 1) Assessing the current situation; 2) Assessing priorities; 3) Option/possible solutions; 4) Generic storage systems; 5) Cost/funding analysis; 6) Selection criteria; 7) Optioneering/evaluation. The conclusions that can be reached from this methodological approach lead to firm recommendations based on objective assessments. The methodology builds on existing expertise. It is not an imposed solution allowing an excellent exchange of knowledge and skills between the people involved

  16. Short- and Long-Term Management of an Acute Pustular Psoriasis Flare: A Case Report.

    Science.gov (United States)

    Georgakopoulos, Jorge R; Ighani, Arvin; Yeung, Jensen

    Generalised pustular psoriasis (GPP) and acrodermatitis continua of Hallopeau (ACH) are chronic, relapsing variants of pustular psoriasis proven to be remarkably challenging to treat. Due to their uncommon presentation, there are few described cases in literature and scarce evidence for management. Further information is needed to help dermatologists formulate treatment plans for patients presenting with such diseases. We report the case of a 68-year-old man with a 3-year history of psoriasis presenting to our clinic with a severe breakout of GPP and associated ACH. The patient underwent treatment with cyclosporine A (200 mg PO twice daily) for a period of 2 weeks. This provided dramatic improvement in disease symptoms, with clearance of pustules, remarkable reduction of ACH lesions, and absence of pain. The patient was transitioned to infliximab (5 mg/kg intravenous) and apremilast (30 mg PO twice daily), displaying minimal GPP relapse and well-controlled onychodystrophy for several months. This case supports the use of cyclosporine as a first-line agent in providing immediate symptomatic relief for pustular psoriasis flares. Transitioning to infliximab and apremilast combination therapy offers a unique treatment regime for long-term GPP and ACH management.

  17. A strategic approach to short- and long-term irradiated WWER fuel management

    Energy Technology Data Exchange (ETDEWEB)

    Wilcox, P [BNFL International Ltd., Warrington (United Kingdom); Conboy, T M [BNFL Engineering Ltd., Manchester (United Kingdom)

    1994-12-31

    A methodology is presented for comparison of alternative options for short-term and long-term irradiated fuel management. The value of this methodology is that all interested parties can take part in the analysis and derive the basis for decision-making. The methodology can answer questions as: When can uranium and plutonium recovered by reprocessing be recycled cost effectively in WWER? If reprocessing is not the short-term option chosen, is storage of irradiated fuel at the original licensed nuclear reactor site preferable to a separate storage-only-site? Are modular vault dry stores and cooling ponds which necessitate significant capital investment prior to deployment, more costly overall than their options? Should the most suitable form of irradiated fuel management be determined only by cost constraints? The key stages of the methodology are: (1) Assessing the current situation; (2) Assessing priorities; (3) Option/possible solutions; (4) Generic storage systems; (5) Cost/funding analysis; (6) Selection criteria; (7) Optioneering/evaluation. The conclusions that can be reached from this methodological approach lead to firm recommendations based on objective assessments. The methodology builds on existing expertise. It is not an imposed solution allowing an excellent exchange of knowledge and skills between the people involved.

  18. Long term care staff beliefs about evidence based practices for the management of dementia and agitation.

    Science.gov (United States)

    Ayalon, Liat; Arean, Patricia; Bornfeld, Heather; Beard, Renee

    2009-02-01

    Despite a growing literature on effective interventions for Alzheimer's disease (AD) and agitation, the management of these conditions in long term care (LTC) often is inadequate. The goals of the present study were: (a) to evaluate existing beliefs about evidence based practices (EBP) for the management of Alzheimer's disease and agitation among LTC staff; and (b) to evaluate the contribution of demographic and attitudinal variables to LTC staff beliefs about these EBP. A cross sectional study of 371 LTC staff members completed an EBP questionnaire, a short demographic questionnaire, and an attitudinal questionnaire about AD and agitation. Paraprofessional caregivers, those of lower educational level, and ethnic minorities were more likely to be in disagreement with the EBP views examined in this study. Those in disagreement with the EBP views also reported a preference towards not working with residents with AD and agitation and a sense of helplessness associated with such work. Disagreement with EBP views was associated with both normalization and stigmatization of AD and agitation. Paraprofessional caregivers, ethnic minorities, and people of lower educational level are most at need for educational activities about AD and neuropsychiatric symptoms. Educational efforts geared towards changing the belief system of LTC staff should target not only EBP but also information about AD and agitation as conditions that are deviant from the normal aging process, yet non-stigmatizing. It is expected that following EBP will empower staff and improve staff motivation to work with residents with AD and agitation. (c) 2008 John Wiley & Sons, Ltd.

  19. Design of the Long-term Waste Management Facility for Historic LLRW Port Hope Project - 13322

    Energy Technology Data Exchange (ETDEWEB)

    Campbell, Don; Barton, David [Conestoga-Rovers and Associates, 651 Colby Drive, Waterloo, Ontario N2V 1C2 (Canada); Case, Glenn [Atomic Energy of Canada Limited, 115 Toronto Road, Port Hope, Ontario L1A 3S4 (Canada)

    2013-07-01

    The Municipality of Port Hope is located on the northern shores of Lake Ontario approximately 100 km east of Toronto, Ontario, Canada. Starting in the 1930's, radium and later uranium processing by Eldorado Gold Mines Limited (subsequently Eldorado Nuclear Limited) (Eldorado) at their refinery in Port Hope resulted in the generation of process residues and wastes that were disposed of indiscriminately throughout the Municipality until about the mid-1950's. These process residues contained radium (Ra- 226), uranium, arsenic and other contaminants. Between 1944 and 1988, Eldorado was a Federal Crown Corporation, and as such, the Canadian Federal Government has assumed responsibility for the clean-up and long-term management of the historic waste produced by Eldorado during this period. The Port Hope Project involves the construction and development of a new long-term waste management facility (LTWMF), and the remediation and transfer of the historic wastes located within the Municipality of Port Hope to the new LTWMF. The new LTWMF will consist of an engineered above-ground containment mound designed to contain and isolate the wastes from the surrounding environment for the next several hundred years. The design of the engineered containment mound consists of a primary and secondary composite base liner system and composite final cover system, made up of both natural materials (e.g., compacted clay, granular materials) and synthetic materials (e.g., geo-synthetic clay liner, geo-membrane, geo-textiles). The engineered containment mound will cover an area of approximately 13 hectares and will contain the estimated 1.2 million cubic metres of waste that will be generated from the remedial activities within Port Hope. The LTWMF will also include infrastructure and support facilities such as access roads, administrative offices, laboratory, equipment and personnel decontamination facilities, waste water treatment plant and other ancillary facilities

  20. Design of the Long-term Waste Management Facility for Historic LLRW Port Hope Project - 13322

    International Nuclear Information System (INIS)

    Campbell, Don; Barton, David; Case, Glenn

    2013-01-01

    The Municipality of Port Hope is located on the northern shores of Lake Ontario approximately 100 km east of Toronto, Ontario, Canada. Starting in the 1930's, radium and later uranium processing by Eldorado Gold Mines Limited (subsequently Eldorado Nuclear Limited) (Eldorado) at their refinery in Port Hope resulted in the generation of process residues and wastes that were disposed of indiscriminately throughout the Municipality until about the mid-1950's. These process residues contained radium (Ra- 226), uranium, arsenic and other contaminants. Between 1944 and 1988, Eldorado was a Federal Crown Corporation, and as such, the Canadian Federal Government has assumed responsibility for the clean-up and long-term management of the historic waste produced by Eldorado during this period. The Port Hope Project involves the construction and development of a new long-term waste management facility (LTWMF), and the remediation and transfer of the historic wastes located within the Municipality of Port Hope to the new LTWMF. The new LTWMF will consist of an engineered above-ground containment mound designed to contain and isolate the wastes from the surrounding environment for the next several hundred years. The design of the engineered containment mound consists of a primary and secondary composite base liner system and composite final cover system, made up of both natural materials (e.g., compacted clay, granular materials) and synthetic materials (e.g., geo-synthetic clay liner, geo-membrane, geo-textiles). The engineered containment mound will cover an area of approximately 13 hectares and will contain the estimated 1.2 million cubic metres of waste that will be generated from the remedial activities within Port Hope. The LTWMF will also include infrastructure and support facilities such as access roads, administrative offices, laboratory, equipment and personnel decontamination facilities, waste water treatment plant and other ancillary facilities. Preliminary

  1. Eurosafe 2006 radioactive waste management: long term safety requirements and societal expectations

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2006-07-01

    The EUROSAFE Forum is part of the EUROSAFE approach, which consists of two further elements: the EUROSAFE Tribune and the EUROSAFE web site. The general aim of EUROSAFE is to contribute to fostering the convergence of technical nuclear safety practices in a broad European context. This is done by providing technical safety and research organisations, safety authorities, power utilities, the rest of the industry and non-governmental organisations mainly from the European Union and East-European countries, and international organisations with a platform for the presentation of recent analyses and R and D in the field of nuclear safety, to share experiences, exchange technical and scientific opinions, and conduct debates on key issues in the fields of nuclear safety and radiation protection. The EUROSAFE Forum 2006 focuses on 'Radioactive Waste Management: Long Term Safety Requirements and Societal Expectations' from the point of view of the authorities, TSOs and industry and presents the latest work in nuclear installation safety and research, waste management, radiation safety as well as nuclear material and nuclear facilities security carried out by GRS, IRSN, AVN and their partners in the European Union, Switzerland and Eastern Europe. A high level of nuclear safety is a priority for Europe. The technical safety organisations play an important role in contributing to that objective through appropriate approaches to major safety issues as part of their assessments and research activities. The challenges to nuclear safety are international. Changes in underlying technologies such as instrumentation and control, the impact of electricity market deregulation, demands for improved safety and safety management, the ageing of nuclear facilities, waste management, maintaining and improving scientific and technical knowledge, and the need for greater transparency - these are all issues where the value of an international approach is gaining increasing recognition. This

  2. Eurosafe 2006 radioactive waste management: long term safety requirements and societal expectations

    International Nuclear Information System (INIS)

    2006-01-01

    The EUROSAFE Forum is part of the EUROSAFE approach, which consists of two further elements: the EUROSAFE Tribune and the EUROSAFE web site. The general aim of EUROSAFE is to contribute to fostering the convergence of technical nuclear safety practices in a broad European context. This is done by providing technical safety and research organisations, safety authorities, power utilities, the rest of the industry and non-governmental organisations mainly from the European Union and East-European countries, and international organisations with a platform for the presentation of recent analyses and R and D in the field of nuclear safety, to share experiences, exchange technical and scientific opinions, and conduct debates on key issues in the fields of nuclear safety and radiation protection. The EUROSAFE Forum 2006 focuses on 'Radioactive Waste Management: Long Term Safety Requirements and Societal Expectations' from the point of view of the authorities, TSOs and industry and presents the latest work in nuclear installation safety and research, waste management, radiation safety as well as nuclear material and nuclear facilities security carried out by GRS, IRSN, AVN and their partners in the European Union, Switzerland and Eastern Europe. A high level of nuclear safety is a priority for Europe. The technical safety organisations play an important role in contributing to that objective through appropriate approaches to major safety issues as part of their assessments and research activities. The challenges to nuclear safety are international. Changes in underlying technologies such as instrumentation and control, the impact of electricity market deregulation, demands for improved safety and safety management, the ageing of nuclear facilities, waste management, maintaining and improving scientific and technical knowledge, and the need for greater transparency - these are all issues where the value of an international approach is gaining increasing recognition. This

  3. Eurosafe 2006 radioactive waste management: long term safety requirements and societal expectations

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2006-07-01

    The EUROSAFE Forum is part of the EUROSAFE approach, which consists of two further elements: the EUROSAFE Tribune and the EUROSAFE web site. The general aim of EUROSAFE is to contribute to fostering the convergence of technical nuclear safety practices in a broad European context. This is done by providing technical safety and research organisations, safety authorities, power utilities, the rest of the industry and non-governmental organisations mainly from the European Union and East-European countries, and international organisations with a platform for the presentation of recent analyses and R and D in the field of nuclear safety, to share experiences, exchange technical and scientific opinions, and conduct debates on key issues in the fields of nuclear safety and radiation protection. The EUROSAFE Forum 2006 focuses on 'Radioactive Waste Management: Long Term Safety Requirements and Societal Expectations' from the point of view of the authorities, TSOs and industry and presents the latest work in nuclear installation safety and research, waste management, radiation safety as well as nuclear material and nuclear facilities security carried out by GRS, IRSN, AVN and their partners in the European Union, Switzerland and Eastern Europe. A high level of nuclear safety is a priority for Europe. The technical safety organisations play an important role in contributing to that objective through appropriate approaches to major safety issues as part of their assessments and research activities. The challenges to nuclear safety are international. Changes in underlying technologies such as instrumentation and control, the impact of electricity market deregulation, demands for improved safety and safety management, the ageing of nuclear facilities, waste management, maintaining and improving scientific and technical knowledge, and the need for greater transparency - these are all issues where the value of an international approach is gaining increasing recognition

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

    International Nuclear Information System (INIS)

    Li, Zhidong

    2015-01-01

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

  5. Long-term pavement performance ancillary information management system (AIMS) reference guide.

    Science.gov (United States)

    2012-11-01

    This document provides information on the Long-Term Pavement Performance (LTPP) program ancillary information. : Ancillary information includes data, images, reference materials, resource documents, and other information that : support and extend the...

  6. Short- and long-term effects of a quality improvement collaborative on diabetes management

    Directory of Open Access Journals (Sweden)

    Niessen Louis W

    2010-11-01

    Full Text Available Abstract Introduction This study examined the short- and long-term effects of a quality improvement collaborative on patient outcomes, professional performance, and structural aspects of chronic care management of type 2 diabetes in an integrated care setting. Methods Controlled pre- and post-intervention study assessing patient outcomes (hemoglobin A1c, cholesterol, blood pressure, weight, blood lipid levels, and smoking status, professional performance (guideline adherence, and structural aspects of chronic care management from baseline up to 24 months. Analyses were based on 1,861 patients with diabetes in six intervention and nine control regions representing 37 general practices and 13 outpatient clinics. Results Modest but significant improvement was seen in mean systolic blood pressure (decrease by 4.0 mm Hg versus 1.6 mm Hg and mean high density lipoprotein levels (increase by 0.12 versus 0.03 points at two-year follow up. Positive but insignificant differences were found in hemoglobin A1c (0.3%, cholesterol, and blood lipid levels. The intervention group showed significant improvement in the percentage of patients receiving advice and instruction to examine feet, and smaller reductions in the percentage of patients receiving instruction to monitor blood glucose and visiting a dietician annually. Structural aspects of self-management and decision support also improved significantly. Conclusions At a time of heightened national attention toward diabetes care, our results demonstrate a modest benefit of participation in a multi-institutional quality improvement collaborative focusing on integrated, patient-centered care. The effects persisted for at least 12 months after the intervention was completed. Trial number http://clinicaltrials.gov Identifier: NCT 00160017

  7. Enhancing AP1000 reactor accident management capabilities for long term accidents

    International Nuclear Information System (INIS)

    Jiang Pingting; Liu Mengying; Duan Chengjie; Liao Yehong

    2015-01-01

    Passive safety actions are considered as main measures under severe accident in AP1000 power plant. However, risk is still existed. According to PSA, several probable scenarios for AP1000 nuclear power plant are analyzed in this paper with MAAP the severe accident analysis code. According to the analysis results, several deficiencies of AP1000 severe accident management are found. The long term cooling and containment depressurization capability for AP1000 power plant appear to be most important factors under such accidents. Then, several temporary strategies for AP1000 power plant are suggested, including PCCWST temporary water supply strategy after 72h, temporary injection strategy for IRWST, hydrogen relief action in fuel building, which would improve the safety of AP1000 power plant. At last, assessments of effectiveness for these strategies are performed, and the results are compared with analysis without these strategies. The comparisons showed that correct actions of these strategies would effectively prevent the accident process of AP1000 power plant. (author)

  8. Long-Term Metal Retention Performance of Media Filter Drains for Stormwater Management

    Directory of Open Access Journals (Sweden)

    Agathe Thomas

    2015-03-01

    Full Text Available Stormwater runoff, a substantial source of nonpoint pollution, can be treated using Best Management Practices (BMPs, such as the Media Filter Drain (MFD. An MFD is a trench filled with an engineered media mix, usually with a grass overlay, that receives runoff from the paved roadway next to it. The MFD was shown to remove dissolved metals (zinc and copper, typical pollutants from vehicles and urban areas, which might negatively impact aquatic species in receiving waters, but its long-term effectiveness was not known. Existing media filter mixes of different ages were collected from two different sites in the Pacific Northwest of the United States. Columns made with these media mixes received concentrated copper and zinc loading to simulate accelerated aging for estimated total lifespans from 14 to 22 years of copper and zinc loading, with little or no decrease in sorption. Throughout the aging process, some columns were subjected to performance testing with higher levels of typical runoff concentrations and average concentration decreases from influent to effluent were found to be greater than 90% for both copper and zinc. Based on this study, the MFD’s lifespan for zinc and copper treatment is significantly greater than the initial ten-year estimate.

  9. Female urethral strictures: successful management with long-term clean intermittent catheterization after urethral dilatation.

    Science.gov (United States)

    Smith, Ariana L; Ferlise, Victor J; Rovner, Eric S

    2006-07-01

    To report our experience in the diagnosis and treatment of urethral stricture in women. A retrospective review of records and video-urodynamics identified women treated for urethral stricture between 1999 and 2004 at one institution by one surgeon. Urethral stricture was defined as a fixed anatomical narrowing between the bladder neck and distal urethra of or = 30 F. After a period of indwelling catheterization, the women were placed on clean intermittent self-catheterization (CISC) at least once daily, and monitored every 3-6 months. At each follow-up, the urethra was catheterized to exclude recurrence. American Urological Association (AUA) symptom scores were obtained at presentation and at the initial 3 month follow-up. Seven women met the criteria for urethral stricture, and were followed for a mean (range) of 21 (6-34) months. All were initially maintained on daily CISC, and some were gradually reduced to weekly CISC for the duration of follow-up. No patient had a recurrent stricture while on CISC, and none has had a urethral reconstruction to manage their condition. AUA symptom scores improved in all of the women by a mean of 10.7 points. No complications related to catheterization were noted. Urethral stricture is rare in women. Long-term CISC in these women is safe and effective, and can avoid the need for major reconstructive surgery.

  10. The U.S. regulatory framework for long-term management of uranium mill tailings

    International Nuclear Information System (INIS)

    Smythe, C.; Bierley, D.; Bradshaw, M.

    1995-01-01

    The US established the regulatory structure for the management, disposal, and long-term care of uranium mill tailings in 1978 with the passage of the Uranium Mill Tailings Radiation Control Act (UMTRCA) (Pub. L. 95-604). This legislation has governed the cleanup and disposal of uranium tailings at both inactive and active sites. The passage of the UMTRCA established a federal regulatory program for the cleanup and disposal of uranium mill tailings in the US. This program involves the DOE, the NRC, the EPA, various states and tribal governments, private licensees, and the general public. The DOE has completed surface remediation at 14 sites, with the remaining sites either under construction or in planning. The DOE's UMTRA Project has been very successful in dealing with public and agency demands, particularly regarding disposal site selection and transportation issues. The active sites are also being cleaned up, but at a slower pace than the inactive sites, with the first site tentatively scheduled for completion in 1996

  11. Integrating Long-Term Avian Studies with Planning and Adaptive Management: Department of Energy Lands as a Case Study.

    Energy Technology Data Exchange (ETDEWEB)

    Burger, J.

    2000-10-01

    Long-term bio-monitoring of avian communities have been initiated, but they often lack a management component. Integration of the managers needs at an early stage is suggested as a means to increase the use of the data. Variation in community structure is important in understanding impacts. In addition, reference site must be carefully selected.

  12. Identification of liabilities and long-term management of the fund in Hungary

    International Nuclear Information System (INIS)

    Czoch, Ildiko

    2003-01-01

    According to the basic rules, laid down in the Act on Atomic Energy CXVI. of 1996, radioactive waste management shall not impose undue burden on future generations. To satisfy this requirement, the long-term costs of waste disposal and of decommissioning of the plant shall be paid by the generation that enjoys the benefits of nuclear energy production and applications of isotopes. Accordingly, by the Act and its executive orders, a Central Nuclear Financial Fund was established on 1 January 1998 to finance radioactive waste disposal, interim storage and disposal of spent fuel as well as decommissioning of nuclear facilities. The Minister, supervising the Hungarian Atomic Energy Authority is disposing of the Central Nuclear Financial Fund, while the Hungarian Atomic Energy Authority is responsible for its management. The Fund is a separate state fund pursuant to Act XXXVIII of 1992 on Public Finance, exclusively earmarked for financing the construction and operation of disposal facilities for the final disposal of radioactive waste, as well as for the interim storage and final disposal of spent fuel, and the decommissioning of nuclear facilities. A long-term plan (up to the decommissioning of the nuclear facilities), a medium term plan (for five years) and an annual work schedule are to be prepared on the use of the Fund. The preparation of these plans/schedules is within the responsibilities of the Public Agency for Radioactive Waste Management. The long and medium term plans shall be annually reviewed and revised as required. The long and medium term plans and the annual work schedule shall be approved by the Minister supervising the Hungarian Atomic Energy Authority. The payments into the Fund are defined in accordance with these plans. The liabilities of the Paks Nuclear Power Plant for annual payments into the Fund are included in the law on the central budget on the proposal of the Minister supervising the Hungarian Atomic Energy Authority. It is based upon

  13. Risk based requirements for long term stewardship: A proof-of-principle analysis of an analytic method tested on selected Hanford locations

    International Nuclear Information System (INIS)

    Jarvis, T.T.; Andrews, W.B.; Buck, J.W.

    1998-03-01

    Since 1989, the Department of Energy's (DOE) Environmental Management (EM) Program has managed the environmental legacy of US nuclear weapons production, research and testing at 137 facilities in 31 states and one US territory. The EM program has conducted several studies on the public risks posed by contaminated sites at these facilities. In Risks and the Risk Debate [DOE, 1995a], the Department analyzed the risks at sites before, during, and after remediation work by the EM program. The results indicated that aside from a few urgent risks, most hazards present little inherent risk because physical and active site management controls limit both the releases of site contaminants, and public access to these hazards. Without these controls, these sites would pose greater risks to the public. Past risk reports, however, provided little information about post-cleanup risk, primarily because of uncertainty about future site uses and site characteristics at the end of planned cleanup activities. This is of concern because in many cases current cleanup technologies, and remedies, will last a shorter period of time than the waste itself and the resulting contamination will remain hazardous

  14. Risk Based Requirements for Long Term Stewardship: A Proof-of-Principle Analysis of an Analytic Method Tested on Selected Hanford Locations

    Energy Technology Data Exchange (ETDEWEB)

    GM Gelston; JW Buck; LR Huesties; MS Peffers; TB Miley; TT Jarvis; WB Andrews

    1998-12-03

    Since 1989, the Department of Energy's (DOE) Environmental Management (EM) Program has managed the environmental legacy of US nuclear weapons production research and testing at 137 facilities in 31 states and one US territory. The EM program has conducted several studies on the public risks posed by contaminated sites at these facilities. In Risks and the Risk Debate DOE, 1995a, the Department analyzed the risks at sites before, during, and after remediation work by the EM program. The results indicated that aside from a few urgent risks, most hazards present little inherent risk because physical and active site management controls limit both the releases of site contaminants, and public access to these hazards. Without these controls, these sites would pose greater risks to the public. Past risk reports, however, provided little irdiormation about post- cleanup risk, primarily because of uncertainty about fiture site uses and site characteristics at the end of planned cleanup activities. This is of concern because in many cases current cleanup technologies, and remedies, will last a shorter period of time than the waste itself and the resulting contamination will remain hazardous.

  15. Long-term population dynamics of a managed burrowing owl colony

    Science.gov (United States)

    Barclay, John H.; Korfanta, Nicole M.; Kauffman, Matthew J.

    2011-01-01

    We analyzed the population dynamics of a burrowing owl (Athene cunicularia) colony at Mineta San Jose International Airport in San Jose, California, USA from 1990-2007. This colony was managed by using artificial burrows to reduce the occurrence of nesting owls along runways and within major airport improvement projects during the study period. We estimated annual reproduction in natural and artificial burrows and age-specific survival rates with mark-recapture techniques, and we estimated the relative contribution of these vital rates to population dynamics using a life table response experiment. The breeding colony showed 2 distinct periods of change: high population growth from 7 nesting pairs in 1991 to 40 pairs in 2002 and population decline to 17 pairs in 2007. Reproduction was highly variable: annual nesting success (pairs that raised =1 young) averaged 79% and ranged from 36% to 100%, whereas fecundity averaged 3.36 juveniles/pair and ranged from 1.43 juveniles/pair to 4.54 juveniles/pair. We estimated annual adult survival at 0.710 during the period of colony increase from 1996 to 2001 and 0.465 during decline from 2002 to 2007, but there was no change in annual survival of juveniles between the 2 time periods. Long-term population growth rate (lambda) estimated from average vital rates was lambdaa=1.072 with lambdai=1.288 during colony increase and lambdad=0.921 (DELTA lambda=0.368) during decline. A life table response experiment showed that change in adult survival rate during increasing and declining phases explained more than twice the variation in growth rate than other vital rates. Our findings suggest that management and conservation of declining burrowing owl populations should address factors that influence adult survival.

  16. Threshold responses of songbirds to long-term timber management on an active industrial forest

    Science.gov (United States)

    Becker, Douglas A.; Wood, Petra Bohall; Keyser, Patrick D.; Wigley, T. Bently; Dellinger, Rachel; Weakland, Cathy A.

    2011-01-01

    Forest managers often seek to balance economic benefits from timber harvesting with maintenance of habitat for wildlife, ecosystem function, and human uses. Most research on the relationship between avian abundance and active timber management has been short-term, lasting one to two years, creating the need to investigate long-term avian responses and to identify harvest thresholds when a small change in habitat results in a disproportionate response in relative abundance and nest success. Our objectives were to identify trends in relative abundance and nest success and to identify landscape-scale disturbance thresholds for avian species and habitat guilds in response to a variety of harvest treatments (clear-cuts, heavy and light partial harvests) over 14 years. We conducted point counts and monitored nests at an industrial forest in the central Appalachians of West Virginia during 1996–1998, 2001–2003, and 2007–2009. Early successional species increased in relative abundance across all three time periods, whereas interior-edge and forest-interior guilds peaked in relative abundance mid-study after which the forest-interior guild declined. Of 41 species with >10 detections, four (10%) declined significantly, 13 (32%) increased significantly (only three species among all periods), and 9 (22%) peaked in abundance mid-study (over the entire study period, four species had no significant change in abundance, four declined, and one increased). Based on piecewise linear models, forest-interior and interior-edge guilds’ relative abundance harvest thresholds were 28% total harvests (all harvests combined), 10% clear-cut harvests, and 18% light partial harvests, after which abundances declined. Harvest thresholds for the early successional guild were 42% total harvests, 11% clear-cut harvest, and 10% light partial harvests, and relative abundances increased after surpassing thresholds albeit at a reduced rate of increase after the clear-cut threshold. Threshold

  17. Automated telephone communication systems for preventive healthcare and management of long-term conditions.

    Science.gov (United States)

    Posadzki, Pawel; Mastellos, Nikolaos; Ryan, Rebecca; Gunn, Laura H; Felix, Lambert M; Pappas, Yannis; Gagnon, Marie-Pierre; Julious, Steven A; Xiang, Liming; Oldenburg, Brian; Car, Josip

    2016-12-14

    Automated telephone communication systems (ATCS) can deliver voice messages and collect health-related information from patients using either their telephone's touch-tone keypad or voice recognition software. ATCS can supplement or replace telephone contact between health professionals and patients. There are four different types of ATCS: unidirectional (one-way, non-interactive voice communication), interactive voice response (IVR) systems, ATCS with additional functions such as access to an expert to request advice (ATCS Plus) and multimodal ATCS, where the calls are delivered as part of a multicomponent intervention. To assess the effects of ATCS for preventing disease and managing long-term conditions on behavioural change, clinical, process, cognitive, patient-centred and adverse outcomes. We searched 10 electronic databases (the Cochrane Central Register of Controlled Trials; MEDLINE; Embase; PsycINFO; CINAHL; Global Health; WHOLIS; LILACS; Web of Science; and ASSIA); three grey literature sources (Dissertation Abstracts, Index to Theses, Australasian Digital Theses); and two trial registries (www.controlled-trials.com; www.clinicaltrials.gov) for papers published between 1980 and June 2015. Randomised, cluster- and quasi-randomised trials, interrupted time series and controlled before-and-after studies comparing ATCS interventions, with any control or another ATCS type were eligible for inclusion. Studies in all settings, for all consumers/carers, in any preventive healthcare or long term condition management role were eligible. We used standard Cochrane methods to select and extract data and to appraise eligible studies. We included 132 trials (N = 4,669,689). Studies spanned across several clinical areas, assessing many comparisons based on evaluation of different ATCS types and variable comparison groups. Forty-one studies evaluated ATCS for delivering preventive healthcare, 84 for managing long-term conditions, and seven studies for appointment reminders

  18. Defense Nuclear Material Stewardship Integrated Inventory Information Management System (IIIMS).

    Energy Technology Data Exchange (ETDEWEB)

    Aas, Christopher A.; Lenhart, James E.; Bray, Olin H.; Witcher, Christina Jenkin

    2004-11-01

    Sandia National Laboratories was tasked with developing the Defense Nuclear Material Stewardship Integrated Inventory Information Management System (IIIMS) with the sponsorship of NA-125.3 and the concurrence of DOE/NNSA field and area offices. The purpose of IIIMS was to modernize nuclear materials management information systems at the enterprise level. Projects over the course of several years attempted to spearhead this modernization. The scope of IIIMS was broken into broad enterprise-oriented materials management and materials forecasting. The IIIMS prototype was developed to allow multiple participating user groups to explore nuclear material requirements and needs in detail. The purpose of material forecasting was to determine nuclear material availability over a 10 to 15 year period in light of the dynamic nature of nuclear materials management. Formal DOE Directives (requirements) were needed to direct IIIMS efforts but were never issued and the project has been halted. When restarted, duplicating or re-engineering the activities from 1999 to 2003 is unnecessary, and in fact future initiatives can build on previous work. IIIMS requirements should be structured to provide high confidence that discrepancies are detected, and classified information is not divulged. Enterprise-wide materials management systems maintained by the military can be used as overall models to base IIIMS implementation concepts upon.

  19. Flexible bronchoscopic management of benign tracheal stenosis: long term follow-up of 115 patients

    Directory of Open Access Journals (Sweden)

    Fox Benjamin D

    2010-01-01

    Full Text Available Abstract Background Management of benign tracheal stenosis (BTS varies with the type and extent of the disease and influenced by the patient's age and general health status, hence we sought to investigate the long-term outcome of patients with BTS that underwent minimally invasive bronchoscopic treatment. Methods Patients with symptomatic BTS were treated with flexible bronchoscopy therapeutic modalities that included the following: balloon dilatation, laser photo-resection, self-expanding metal stent placement, and High-dose rate endobronchial brachytherapy used in cases of refractory stent-related granulation tissue formation. Results A total of 115 patients with BTS and various cardiac and respiratory co-morbidities with a mean age of 61 (range 40-88 were treated between January 2001 and January 2009. The underlining etiologies for BTS were post - endotracheal intubation (N = 76 post-tracheostomy (N = 30, Wegener's granulomatosis (N = 2, sarcoidosis (N = 2, amyloidosis (N = 2 and idiopathic BTS (N = 3. The modalities used were: balloon dilatation and laser treatment (N = 98. Stent was placed in 33 patients of whom 28 also underwent brachytherapy. Complications were minor and mostly included granulation tissue formation. The overall success rate was 87%. Over a median follow-up of 51 months (range 10-100 months, 30 patients (26% died, mostly due to exacerbation of their underlying conditions. Conclusions BTS in elderly patients with co-morbidities can be safely and effectively treated by flexible bronchoscopic treatment modalities. The use of HDR brachytherapy to treat granulation tissue formation following successful airway restoration is promising.

  20. Minimizing the regrets of long-term urban floodplain management decisions under deeply uncertain climate change

    Science.gov (United States)

    Hecht, J. S.; Kirshen, P. H.; Vogel, R. M.

    2016-12-01

    Making long-term floodplain management decisions under uncertain climate change is a major urban planning challenge of the 21stcentury. To support these efforts, we introduce a screening-level optimization model that identifies adaptation portfolios by minimizing the regrets associated with their flood-control and damage costs under different climate change trajectories that are deeply uncertain, i.e. have probabilities that cannot be specified plausibly. This mixed integer program explicitly considers the coupled damage-reduction impacts of different floodwall designs and property-scale investments (first-floor elevation, wet floodproofing of basements, permanent retreat and insurance), recommends implementation schedules, and assesses impacts to stakeholders residing in three types of homes. An application to a stylized municipality illuminates many nonlinear system dynamics stemming from large fixed capital costs, infrastructure design thresholds, and discharge-depth-damage relationships. If stakeholders tolerate mild damage, floodwalls that fully protect a community from large design events are less cost-effective than portfolios featuring both smaller floodwalls and property-scale measures. Potential losses of property tax revenue from permanent retreat motivate municipal property-tax initiatives for adaptation financing. Yet, insurance incentives for first-floor elevation may discourage locally financed floodwalls, in turn making lower-income residents more vulnerable to severe flooding. A budget constraint analysis underscores the benefits of flexible floodwall designs with low incremental expansion costs while near-optimal solutions demonstrate the scheduling flexibility of many property-scale measures. Finally, an equity analysis shows the importance of evaluating the overpayment and under-design regrets of recommended adaptation portfolios for each stakeholder and contrasts them to single-scenario model results.

  1. Long-term lesser prairie-chicken nest ecology in response to grassland management

    Science.gov (United States)

    Fritts, Sarah R.; Grisham, Blake A.; Haukos, David A.; Boal, Clint W.; Patten, Michael; Wolfe, Don H.; Dixon, Charles; Cox, Robert D.; Heck, Willard R.

    2016-01-01

    Long-term population and range declines from habitat loss and fragmentation caused the lesser prairie-chicken (Tympanuchus pallidicinctus) to be a species of concern throughout its range. Current lesser prairie-chicken range in New Mexico and Texas is partially restricted to sand shinnery oak (Quercus havardii; hereafter shinnery oak) prairies, on which cattle grazing is the main socioeconomic driver for private landowners. Cattle producers within shinnery oak prairies often focus land management on shrub eradication using the herbicide tebuthiuron to promote grass production for forage; however, herbicide application alone, and in combination with grazing, may affect nest site selection and nest survival of lesser prairie-chickens through the reduction of shinnery oak and native grasses. We used a controlled, paired, completely randomized design study to assess the influence of grazing and tebuthiuron application and their combined use on nest site selection and nest survival from 2001 to 2010 in Roosevelt County, New Mexico, USA at 2 spatial scales (i.e., treatment and microhabitat) in 4 treatments: tebuthiuron with grazing, tebuthiuron without grazing, no tebuthiuron with grazing, and a control of no tebuthiuron and no grazing. Grazing treatment was a short-duration system in which plots were grazed once during the dormant season and once during the growing season. Stocking rate was calculated each season based on measured forage production and applied to remove ≤25% of available herbaceous material per season. At the treatment scale, we compared nest site selection among treatments using 1-way χ2 tests and nest survival among treatments using a priori candidate nest survival models in Program MARK. At the microhabitat scale, we identified important habitat predictors of nest site selection and nest survival using logistic regression and a priori candidate nest survival models in Program MARK, respectively. Females typically used treatments as expected and

  2. Strategic Analysis the System of Long-term Management of Enterprise

    Directory of Open Access Journals (Sweden)

    I. T.

    2017-02-01

    Full Text Available he article is devoted research o f role of strategic analysis in management system of enterprise with parallel determination of change ofhim rich in contentfilling, objects, article, tasks and subjects, in the context o f development of social-economic relations. On the basis of analysis of economic literature certainly, that a strategic analysis is, at first, by independent direction of analytical research, that occupies a leading place on each of the stages of strategic management an enterprise and envisages rich in content description of economic subject, exposure o f features, tendencies, possible and impossible directions of its development for the sake of timely and adequate reaction on changes in the environment of its functioning and forming competitive edges that in a long-term prospect will provide increase o f business cost, and, secondly, informative providing, as engulfs the results of actions of all other functions o f management, is based on the facts o f their display, redoes and reproduces new state information and its place activity o f enterprise in an external environment for the sake o f construction o f strategy o f continuity o f activity of subject of menage. Differentiating o f objects, article, tasks and subjects of strategic analysis, is offered after three forms o f display as areas o f scientific knowledges, educational discipline and practical activity, and certainly, that basic setting of strategic analysis as areas of scientific knowledges are providing o f necessities of practice, that is why its article is an improvement and development of methodology. In accordance with the modern understanding of strategic analysis and for complete realization o f his functions the “tree o f tasks” o f strategic analysis activity o f subject of menage with a purpose determination of order of organization and development o f its method, construction of strategy o f development o f enterprise which will allow to form

  3. Nuclear Materials Stewardship Within the DOE Environmental Management Program

    International Nuclear Information System (INIS)

    Bilyeu, J. D.; Kiess, T. E.; Gates, M. L.

    2002-01-01

    The Department of Energy (DOE) Environmental Management (EM) Program has made significant progress in planning disposition of its excess nuclear materials and has recently completed several noteworthy studies. Since establishment in 1997, the EM Nuclear Material Stewardship Program has developed disposition plans for excess nuclear materials to support facility deactivation. All nuclear materials have been removed from the Miamisburg Environmental Management Project (Mound), and disposition planning is nearing completion for the Fernald Environmental Management Project and the Rocky Flats Environmental Technology Site. Only a few issues remain for materials at the Hanford and Idaho sites. Recent trade studies include the Savannah River Site Canyons Nuclear Materials Identification Study, a Cesium/Strontium Management Alternatives Trade Study, a Liquid Technical Standards Trade Study, an Irradiated Beryllium Reflectors with Tritium study, a Special Performance Assessment Required Trade Study, a Neutron Source Trade Study, and development of discard criteria for uranium. A Small Sites Workshop was also held. Potential and planned future activities include updating the Plutonium-239 storage study, developing additional packaging standards, developing a Nuclear Material Disposition Handbook, determining how to recover or dispose of Pu-244 and U-233, and working with additional sites to define disposition plans for their nuclear materials

  4. The Effectiveness of Self-Management Mobile Phone and Tablet Apps in Long-term Condition Management: A Systematic Review.

    Science.gov (United States)

    Whitehead, Lisa; Seaton, Philippa

    2016-05-16

    Long-term conditions and their concomitant management place considerable pressure on patients, communities, and health care systems worldwide. International clinical guidelines on the majority of long-term conditions recommend the inclusion of self-management programs in routine management. Self-management programs have been associated with improved health outcomes; however, the successful and sustainable transfer of research programs into clinical practice has been inconsistent. Recent developments in mobile technology, such as mobile phone and tablet computer apps, could help in developing a platform for the delivery of self-management interventions that are adaptable, of low cost, and easily accessible. We conducted a systematic review to assess the effectiveness of mobile phone and tablet apps in self-management of key symptoms of long-term conditions. We searched PubMed, Embase, EBSCO databases, the Cochrane Library, and The Joanna Briggs Institute Library for randomized controlled trials that assessed the effectiveness of mobile phone and tablet apps in self-management of diabetes mellitus, cardiovascular disease, and chronic lung diseases from 2005-2016. We searched registers of current and ongoing trials, as well as the gray literature. We then checked the reference lists of all primary studies and review papers for additional references. The last search was run in February 2016. Of the 9 papers we reviewed, 6 of the interventions demonstrated a statistically significant improvement in the primary measure of clinical outcome. Where the intervention comprised an app only, 3 studies demonstrated a statistically significant improvement. Interventions to address diabetes mellitus (5/9) were the most common, followed by chronic lung disease (3/9) and cardiovascular disease (1/9). A total of 3 studies included multiple intervention groups using permutations of an intervention involving an app. The duration of the intervention ranged from 6 weeks to 1 year, and

  5. Multi-generational stewardship of plutonium

    International Nuclear Information System (INIS)

    Pillay, K.K.S.

    1997-01-01

    The post-cold war era has greatly enhanced the interest in the long-term stewardship of plutonium. The management of excess plutonium from proposed nuclear weapons dismantlement has been the subject of numerous intellectual discussions during the past several years. In this context, issues relevant to long-term management of all plutonium as a valuable energy resource are also being examined. While there are differing views about the future role of plutonium in the economy, there is a recognition of the environmental and health related problems and proliferation potentials of weapons-grade plutonium. The long-term management of plutonium as an energy resource will require a new strategy to maintain stewardship for many generations to come

  6. Long-term follow up of children exposed in utero to nifedipine or ritodrine for the management of preterm labour

    NARCIS (Netherlands)

    Houtzager, B. A.; Hogendoorn, S. M.; Papatsonis, D. N. M.; Samsom, J. F.; van Geijn, H. P.; Bleker, O. P.; van Wassenaer, A. G.

    2006-01-01

    OBJECTIVE: To compare the long-term psychosocial and motor effects on children exposed in utero to nifedipine or ritodrine for the management of preterm labour. DESIGN: Randomised controlled trial. SETTING: Multicentre study in two university and one primary hospital in the Netherlands. POPULATION:

  7. APPLICATION OF THE ANALYTIC HIERARCHY PROCESS TO COMPARE ALTERNATIVES FOR THE LONG-TERM MANAGEMENT OF SURPLUS MERCURY

    Science.gov (United States)

    This paper describes a systematic method for comparing options for the long-term management of surplus elemental mercury in the U.S., using the Analytic Hierarchy Process (AHP) as embodied in commercially available Expert Choice software. A limited scope multi-criteria decision-a...

  8. Meso level influences on long term condition self-management: stakeholder accounts of commonalities and differences across six European countries

    NARCIS (Netherlands)

    Rogers, A.; Vassilev, I.; Pumar, M.J.; Todorova, E.; Portillo, M.C.; Foss, C.; Koetsenruijter, J.; Ratsika, N.; Serrano, M.; Knutsen, I.A.; Wensing, M.J.; Roukova, P.; Patelarou, E.; Kennedy, A.; Lionis, C.

    2015-01-01

    BACKGROUND: European countries are increasingly adopting systems of self -care support (SMS) for long term conditions which focus on enhancing individual, competencies, skills, behaviour and lifestyle changes. To date the focus of policy for engendering greater self- management in the population has

  9. Nonsurgical Outpatient Therapies for the Management of Female Stress Urinary Incontinence: Long-Term Effectiveness and Durability

    Directory of Open Access Journals (Sweden)

    G. Willy Davila

    2011-01-01

    Results. Thirty-two clinical trial reports were included. Prospective long-term studies of pelvic floor rehabilitation were limited but indicated significant improvements with treatment adherence for at least 12 months. Poor initial tolerability with duloxetine resulted in substantial discontinuation. Most patients receiving transurethral radiofrequency collagen denaturation or urethral bulking agents reported significant long-term improvements, generally good tolerability, and safety. Conclusions. Conservative therapy is an appropriate initial approach for female SUI, but if therapy fails, radiofrequency collagen denaturation or bulking agents may be an attractive intermediate management step or alternative to surgery.

  10. Long-term response of the mamane forest to feral herbivore management on Mauna Kea, Hawaii

    Science.gov (United States)

    E. Reddy; D. H. Van Vuren; P. G. Scowcroft; J. B. Kauffman; L. Perry

    2012-01-01

    Seven exclosure sites located on Mauna Kea, Hawaii and established in the 1960s and 70s were sampled to characterize long-term response of the mamane (Sophora chrysophylla) forest to protection from feral sheep grazing, and to assess impacts of non-native plant species and recurrent sheep presence on forest recovery. The forest provides essential...

  11. Long-term risks of inadequate management practices on the sustainability of agricultural soils

    NARCIS (Netherlands)

    Vries, de W.; Groenenberg, J.E.; Murányi, A.; Curlík, J.; Sefcík, P.; Römkens, P.F.A.M.; Reinds, G.J.; Bril, J.; Modin, A.K.; Sverdrup, H.U.; Alloway, B.J.

    2003-01-01

    This report describes the major result of a research project funded by the INCO-Copernicus programma of European Commission under Contract number ERB-IC15-CT98-0133. The study focused on the long-term environmental risk of soil acidification on: (i) mobilisation and leaching and (ii) plant uptake of

  12. Final Programmatic Environmental Impact Statement for stockpile stewardship and management: Volume 1

    International Nuclear Information System (INIS)

    1996-09-01

    The Department of Energy (DOE) has been directed by the President and Congress to maintain the safety and reliability of the reduced nuclear weapons stockpile in the absence of underground nuclear testing. In order to fulfill that responsibility, DOE has developed Stockpile Stewardship and Maintenance Program to provide a single highly integrated technical program for maintaining the continued safety and reliability of the nuclear stockpile. The Stockpile Stewardship and Management Program Programmatic Environmental Impact Statement (PEIS) describes and analyzes alternative ways to implement the proposed actions for the Stockpile Stewardship and Management Program. This document contains Volume I of the PEIS

  13. Parents' learning needs and preferences when sharing management of their child's long-term/chronic condition: A systematic review.

    Science.gov (United States)

    Nightingale, Ruth; Friedl, Simone; Swallow, Veronica

    2015-11-01

    This review aimed to (1) identify parents' learning needs and preferences when sharing the management of their child's long-term/chronic (long-term) condition and (2) inform healthcare professional support provided to parents across the trajectory. We conducted a literature search in seven health databases from 1990 to 2013. The quality of included studies was assessed using a critical appraisal tool developed for reviewing the strengths and weaknesses of qualitative, quantitative and mixed methods studies. Twenty-three studies met our criteria and were included in the review. Three themes emerged from synthesis of the included studies: (1) parents' learning needs and preferences (2) facilitators to parents' learning, and (3) barriers to parents' learning. Asking parents directly about their learning needs and preferences may be the most reliable way for healthcare professionals to ascertain how to support and promote individual parents' learning when sharing management of their child's long-term condition. With the current emphasis on parent-healthcare professional shared management of childhood long-term conditions, it is recommended that professionals base their assessment of parents' learning needs and preferences on identified barriers and facilitators to parental learning. This should optimise delivery of home-based care, thereby contributing to improved clinical outcomes for the child. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  14. Strategic Plan for Sustainable Energy Management and Environmental Stewardship for Los Angeles Unified School District

    Energy Technology Data Exchange (ETDEWEB)

    Walker, A.; Beattie, D.; Thomas, K.; Davis, K.; Sim, M.; Jhaveri, A.

    2007-11-01

    This Strategic Plan for Sustainable Energy Management and Environmental Stewardship states goals, measures progress toward goals and how actions are monitored to achieve continuous improvement for the Los Angeles Unified School District.

  15. A Specific Long-Term Plan for Management of U.S. Nuclear Spent Fuel

    International Nuclear Information System (INIS)

    Levy, Salomon

    2006-01-01

    A specific plan consisting of six different steps is proposed to accelerate and improve the long-term management of U.S. Light Water Reactor (LWR) spent nuclear fuel. The first step is to construct additional, centralized, engineered (dry cask) spent fuel facilities to have a backup solution to Yucca Mountain (YM) delays or lack of capacity. The second step is to restart the development of the Integral Fast Reactor (IFR), in a burner mode, because of its inherent safety characteristics and its extensive past development in contrast to Acceleration Driven Systems (ADS). The IFR and an improved non-proliferation version of its pyro-processing technology can burn the plutonium (Pu) and minor actinides (MA) obtained by reprocessing LWR spent fuel. The remaining IFR and LWR fission products will be treated for storage at YM. The radiotoxicity of that high level waste (HLW) will fall below that of natural uranium in less than one thousand years. Due to anticipated increased capital, maintenance, and research costs for IFR, the third step is to reduce the required number of IFRs and their potential delays by implementing multiple recycles of Pu and Neptunium (Np) MA in LWR. That strategy is to use an advanced separation process, UREX+, and the MIX Pu option where the role and degradation of Pu is limited by uranium enrichment. UREX+ will decrease proliferation risks by avoiding Pu separation while the MIX fuel will lead to an equilibrium fuel recycle mode in LWR which will reduce U. S. Pu inventory and deliver much smaller volumes of less radioactive HLW to YM. In both steps two and three, Research and Development (R and D) is to emphasize the demonstration of multiple fuel reprocessing and fabrication, while improving HLW treatment, increasing proliferation resistance, and reducing losses of fissile material. The fourth step is to license and construct YM because it is needed for the disposal of defense wastes and the HLW to be generated under the proposed plan. The

  16. Long-Term Condition Self-Management Support in Online Communities: A Meta-Synthesis of Qualitative Papers

    Science.gov (United States)

    Vassilev, Ivaylo; Kennedy, Anne; Rogers, Anne

    2016-01-01

    Background Recent years have seen an exponential increase in people with long-term conditions using the Internet for information and support. Prior research has examined support for long-term condition self-management through the provision of illness, everyday, and emotional work in the context of traditional offline communities. However, less is known about how communities hosted in digital spaces contribute through the creation of social ties and the mobilization of an online illness “workforce.” Objective The aim was to understand the negotiation of long-term condition illness work in patient online communities and how such work may assist the self-management of long-term conditions in daily life. Methods A systematic search of qualitative papers was undertaken using various online databases for articles published since 2004. A total of 21 papers met the inclusion criteria of using qualitative methods and examined the use of peer-led online communities for those with a long-term condition. A qualitative meta-synthesis was undertaken and the review followed a line of argument synthesis. Results The main themes identified in relation to the negotiation of self-management support were (1) redressing offline experiential information and knowledge deficits, (2) the influence of modeling and learning behaviors from others on self-management, (3) engagement that validates illness and negates offline frustrations, (4) tie formation and community building, (5) narrative expression and cathartic release, and (6) dissociative anonymity and invisibility. These translated into a line of argument synthesis in which four network mechanisms for self-management support in patient online communities were identified. These were (1) collective knowledge and identification through lived experience; (2) support, information, and engagement through readily accessible gifting relationships; (3) sociability that extends beyond illness; and (4) online disinhibition as a facilitator

  17. What factors influence the effectiveness of financial incentives on long-term natural resource management practice change?

    Directory of Open Access Journals (Sweden)

    Emma Swann

    2016-12-01

    Full Text Available Financial incentives are used by natural resource management organisations to encourage landholders to adopt sustainable practices where the outcomes on a farm scale may be negative or marginal. There is a growing body of research aimed at understanding why landholders do or do not agree to participate in financial incentive programs, however research that considers when and how financial incentives work to bring about long-term behaviour change is relatively immature. The purpose of this review is to answer the question ‘What factors influence the effectiveness of financial incentives on long-term natural resource management practice change?’ In synthesising the evidence, it was found that there are numerous characteristics of the practice change itself, along with the program design and implementation, which are important to understand long-term behaviour change. These include whether inexpensive maintenance or long-term funding is available; whether the changes are relatively simple to sustain; whether the program involves structural changes; whether there is land use rigidity; and whether the changes have resulting environmental benefits that are highly observable. Additionally, it is advisable for programs that use financial incentives to include the following program features: ongoing extension support and a focus on building relationship and trust; flexibility in how the practice change is applied; active landholder involvement from planning to evaluation; and contract length that is appropriate for the complexity of the NRM practice. These characteristics can be used to guide policy makers in their natural resource management investment decisions. There is a clear need for greatly increased monitoring and evaluation of existing programs, both during the program and after its conclusion, in order to more fully understand its long-term impacts and ultimate effectiveness. Finally, landholders undertaking a practice change generally

  18. Long-term management of Canada's spent nuclear fuel: the nuclear waste management organizations recommendation to government

    International Nuclear Information System (INIS)

    Shaver, K.

    2006-01-01

    Full text: Like many countries with nuclear power programs, Canada is in the process of addressing the long-term management of its spent fuel. The Nuclear Waste Management Organization (NWMO) was tasked through federal legislation to conduct a three-year study of approaches for the long-term management of spent fuel, and to recommend a preferred approach to the Government of Canada. Legislation required NWMO to compare at least three approaches -approaches based on deep geological disposal in the Canadian Shield, storage at nuclear reactor sites, and centralized storage either above or below ground. In assessing the options, NWMO sought a recommendation that would be socially acceptable, technically sound, environmentally responsible and economically feasible. The study drew on a vast base of social, technical, engineering, and financial research, and included an extensive engagement program with the public and Aboriginal peoples. The recommendation emerged from a collaborative dialogue with specialists and citizens, for an approach that is built on sound science and technology and responsive to citizen values. NWMO submitted its completed options study, with recommendation, to the Government in November 2005. NWMO has proposed an alternative approach, Adaptive Phased Management, which has as its key attributes: central containment and isolation of spent fuel in a deep repository, in an appropriate geological formation; contingency provision for central shallow storage; monitoring and retrievability; and a staged, adaptive process of concept implementation, reflecting the complex nature of the task and the desire of citizens to proceed through cautious, deliberate steps of technical demonstration and social acceptance. This paper will review: 1) the development of the assessment framework for comparing the technical options, which incorporated social and ethical considerations expressed by citizens; 2) findings of the assessment; and 3) features of the proposed

  19. Plant life (PLIM) and ageing management (AM) in German NPPs. Prerequisite for long term operation (LTO)

    International Nuclear Information System (INIS)

    Schuler, X.

    2010-01-01

    dependant) or based on monitoring of relevant parameters (predictive). The results of these procedures are assessed for each SSC, specifically. For both groups of SSC, in addition to the control of (known) damage mechanisms, all significant plant data (e.g. reports of failures, work orders) and the reports from other plants (incl. exchange of knowledge) are assessed regularly in order to be prepared for new damage mechanisms (and to prevent / control them consequently). This is performed by an appropriate software approach. Within this SSC-specific assessment the entity of measures to control degradation effects is reviewed and modified / extended, if necessary. On the basis of good experiences with the AM procedure and driven by the latest political development (nuclear power is an option in energy supply again) the utilities are re-structuring their plant life management (PLIM), actually. PLIM addresses both safety and economical aspects. Consequently, all SSC of a plant and every possible degradation mechanism have to be considered within PLIM - besides other more not-technical aspects. AM is part of the plant life management. Regarding technical equipment, the PLIM procedure is similar to that established in AM. Depending on the requirements it is necessary to - establish quality during design and manufacture - safeguard this quality in operation by appropriate measures - assess procedure / measures and existing quality, regularly. Living an effective PLIM procedure the utilities are kept on the state of the art; on this basis energy production can be safe and economic at any time. This is an essential prerequisite for long term operation (LTO). (orig.)

  20. Methods for Minimization and Management of Variability in Long-Term Groundwater Monitoring Results

    Science.gov (United States)

    2015-12-01

    DECEMBER 2015 Poonam Kulkarni Charles Newell Claire Krebs Thomas McHugh GSI Environmental, Inc. Britt Sanford ProHydro Distribution...based on an understanding of the short-term variability and long-term attenuation rate at a particular site ( McHugh et al., 2015a). The...time is independent of these parameters ( McHugh et al., 2015c). The relative trade-off between monitoring frequency and time required to

  1. FY 2017 Stockpile Stewardship and Management Plan - Biennial Plan Summary

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    2016-03-01

    This year’s summary report updates the Fiscal Year 2016 Stockpile Stewardship and Management Plan (FY 2016 SSMP), the 25-year strategic program of record that captures the plans developed across numerous NNSA programs and organizations to maintain and modernize the scientific tools, capabilities, and infrastructure necessary to ensure the success of NNSA’s nuclear weapons mission. The SSMP is a companion to the Prevent, Counter, and Respond: A Strategic Plan to Reduce Global Nuclear Threats (FY 2017-2021) report, the planning document for NNSA’s nuclear threat reduction mission. New versions of both reports are published each year in response to new requirements and challenges. Much was accomplished in FY 2015 as part of the program of record described in this year’s SSMP. The science-based Stockpile Stewardship Program allowed the Secretaries of Energy and Defense to certify for the twentieth time that the stockpile remains safe, secure, and effective without the need for underground nuclear explosive testing. The talented scientists, engineers, and technicians at the three national security laboratories, the four nuclear weapons production plants, and the national security site are primarily responsible for this continued success. Research, development, test, and evaluation programs have advanced NNSA’s understanding of weapons physics, component aging, and material properties through first-of-a-kind shock physics experiments, along with numerous other critical experiments conducted throughout the nuclear security enterprise. The multiple life extension programs (LEPs) that are under way made progress toward their first production unit dates. The W76-1 LEP is past the halfway point in total production, and the B61-12 completed three development flight tests. Critical to this success is the budget. The Administration’s budget request for NNSA’s Weapons Activities has increased for all but one of the past seven years, resulting in a total increase of

  2. Appropriate zinc addition management into PWR primary coolant after the plant long-term maintenance

    International Nuclear Information System (INIS)

    Hirose, Atsushi; Matsui, Ryo; Imamura, Haruki; Takahashi, Akira; Shimizu, Yuichi; Kogawa, Noritaka; Nagamine, Kunitaka

    2014-01-01

    Zinc addition into the PWR primary coolant is known as an effective method to reduce the radioactivity build up. The reduction effect has been confirmed by actual plant experience of the Genkai Nuclear Power Plant Unit 1 to 4 and the Sendai Nuclear Power Plant Unit 1 to 2 which are operated by Kyushu Electric Power Co. in Japan. Zinc addition is suspended at shut-down, and is resumed after heat up or arrival at full power. In usual maintenance, the period when zinc addition is not applied is short; thus it is considered that suspension of zinc addition does not have practical influence on the corrosion and the radioactivity buildup in the oxide layer of surface for the primary equipment and piping. On the other hand, in case the maintenance period is much longer, the new oxide which does not contain zinc has grown, and then the structure of the oxide layer may be changed. Therefore, it is considered that zinc addition suspension in long-term period has possibilities to deteriorate the dose reduction effect. In order to verify the effect of long-term suspension of zinc addition upon oxide layer, the lab experiment was carried out using TT690 alloy which is the constitution material of the steam generator tubes under the conditions of long-term and the subsequent resuming operations. After the experiment, the specimens were analyzed by IMA and chemical analysis. These measurement results suggest the difference of the oxide layer is little or none between long-term suspension of zinc addition and short-term suspension of zinc suspension. Hence it is considered that influence of long-term maintenance on the oxide layer is small. Furthermore, in this study, in order to evaluate the influence of the suspension of zinc addition in the operation period, specimens of oxide film formed with zinc were carried out the corrosion test in the simulated RCS condition without zinc. These measurement results indicate the effect of reduction of the activity build up will become less

  3. Low-level waste management in the South. Task 4.2 - long-term care requirements

    International Nuclear Information System (INIS)

    1983-01-01

    This paper provides an analysis of the long-term care requirements of low-level radioactive waste disposal facilities. Among the topics considered are the technical requirements for long-term care, the experiences of the three inactive and three active commercial disposal facilities concerning perpetual care and maintenance, and the financial management of a perpetual care fund. In addition, certain recommendations for the establishment of a perpetual care fund are provided. The predominant method of disposing of low-level radioactive wastes is shallow land burial. After studying alternative methods of disposal, the U.S Nuclear Regulatory Commission (NRC) concluded that there are no compelling reasons for abandoning this disposal method. Of the 22 shallow land burial facilities in the U.S., the federal government maintains 14 active and two inactive disposal sites. There are three active (Barnwell, South Carolina; Hanford, Washington; and Beatty, Nevada) and three inactive commercial disposal facilities (Maxey Flats, Kentucky; Sheffield, Illinois; and West Valley, New York). The life of a typical facility can be broken into five phases: preoperational, operational, closure, postclosure observation and maintenance, and institutional control. Long-term care of a shallow land burial facility will begin with the disposal site closure phase and continue through the postclosure observation and maintenance and institutional control phases. Since the postclosure observation and maintenance phase will last about five years and the institutional control phase 100 years, the importance of a well planned long-term care program is apparent. 26 references, 1 table

  4. DBS Electrodes With Single Disconnected Contacts: Long-Term Observation and Implications for the Management.

    Science.gov (United States)

    Allert, Niels; Jusciute, Egle; Quindt, Regina; Lindlau, Alexandra; Nolden, Brit Meike; Daryaeitabar, Mohammadreza; Karbe, Hans

    2018-04-27

    To evaluate the long-term course of quadripolar DBS electrodes with disconnected single contacts that cannot be used for DBS. Quadripolar electrodes with open circuits of single contacts or monopolar impedances >6500 Ω were identified from a cohort of 2082 electrodes from 1044 patients with variable movement disorders. The long-term course was analyzed from follow-up data. Disconnected contacts were found in 58 electrodes (2.8%) from 49 patients (4.7%). The dysfunction was restricted to one contact in 51 electrodes (87.9%), two contacts in 5 electrodes (8.6%), three contacts in 2 electrodes (3.4%). Onset was related to surgery (implantation, impulse generator replacement, or other surgical revision) in 34 electrodes (58.6%), trauma in 2 electrodes, undetermined in 11 electrodes, and occurred spontaneously after previous normal measurements in 11 electrodes (19.0%). Repeated measurements at follow-ups of ≥3 months were available in 39 electrodes. In 16 electrodes (41.0%) abnormal impedances persisted constantly during observations up to 11½ years (47 ± 35 months, median 41 months). In 21 electrodes (53.8%) abnormal impedances remained restricted to the initial contact(s) but varied considerably between measurements during up to six years (39 ± 18 months, median 38 months). Only two electrodes (5.1%) with initially one disconnected contact developed a disconnection of a second contact. Disconnections of single contacts occur with increasing cumulative incidence during long-term DBS. Surgery is the main causative risk factor. In the majority of electrodes, the dysfunction remains restricted to the initial contact(s). © 2018 International Neuromodulation Society.

  5. WIPP Regulatory Compliance Strategy and Management Plan for demonstrating compliance to long-term disposal standards

    International Nuclear Information System (INIS)

    1994-05-01

    The primary purpose of this document is to provide a strategy by which the WIPP will demonstrate its ability to perform as a deep geologic repository. The document communicates the DOE's understanding of the regulations related to long-term repository performance; and provides the most efficient strategy that intergrates WIPP Project elements, ensures the sufficiency of information, and provides flexibility for changes in the TRU waste generation system to facilitate the disposal of defense-generated TRU wastes. In addition, this document forms a focal point between the DOE and its various external regulators as well as other stakeholders for the purpose of arriving at compliance decisions that consider all relevant input

  6. Living Well With a Long-Term Condition: Service Users' Perspectives of a Self-Management Intervention.

    Science.gov (United States)

    Stenberg, Nicola; Furness, Penny J

    2017-03-01

    The outcomes of self-management interventions are commonly assessed using quantitative measurement tools, and few studies ask people with long-term conditions to explain, in their own words, what aspects of the intervention they valued. In this Grounded Theory study, a Health Trainers service in the north of England was evaluated based on interviews with eight service-users. Open, focused, and theoretical coding led to the development of a preliminary model explaining participants' experiences and perceived impact of the service. The model reflects the findings that living well with a long-term condition encompassed social connectedness, changed identities, acceptance, and self-care. Health trainers performed four related roles that were perceived to contribute to these outcomes: conceptualizer, connector, coach, and champion. The evaluation contributes a grounded theoretical understanding of a personalized self-management intervention that emphasizes the benefits of a holistic approach to enable cognitive, behavioral, emotional, and social adjustments.

  7. Monitoring the Long-Term Effectiveness of Integrated Safety Management System (ISMS) Implementation Through Use of a Performance Dashboard Process

    International Nuclear Information System (INIS)

    Kinney, Michael D.; Barrick, William D.

    2008-01-01

    This session will examine a method developed by Federal and Contractor personnel at the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office (NNSA/NSO) to examine long-term maintenance of DOE Integrated Safety Management System (ISMS) criteria, including safety culture attributes, as well as identification of process improvement opportunities. This process was initially developed in the summer of 2000 and has since been expanded to recognize the importance of safety culture attributes, and associated safety culture elements, as defined in DOE M 450.4-1, 'Integrated Safety Management System Manual'. This process has proven to significantly enhance collective awareness of the importance of long-term ISMS implementation as well as support commitments by NNSA/NSO personnel to examine the continued effectiveness of ISMS processes

  8. Antimicrobial Stewardship in Daily Practice: Managing an Important Resource

    Directory of Open Access Journals (Sweden)

    Nicole Le Saux

    2014-01-01

    Full Text Available Antimicrobial stewardship is a recent concept that embodies the practical, judicious use of antimicrobials to decrease adverse outcomes from antimicrobials while optimizing the treatment of bacterial infections to reduce the emergence of resistant pathogens. The objectives of the present statement are to illustrate the principles of antimicrobial stewardship and to offer practical examples of how to make antimicrobial stewardship part of everyday hospital and outpatient practice. Vital components of antimicrobial stewardship include appropriate testing to diagnose whether infections are viral or bacterial, and using clinical follow-up rather than antibiotics in cases in which the child is not very ill and uncertainty exists. Other specific, important actions include questioning whether positive urine cultures are contaminated when there is no evidence of pyuria or inflammatory changes, and obtaining a chest radiograph to support a diagnosis of bacterial pneumonia. Optimizing the choice and dosage of antimicrobials also reduces the probability of clinical failures and subsequent courses of antimicrobials. A list of common clinical scenarios to promote stewardship is included.

  9. Modeled effects of soil acidification on long-term ecological and economic outcomes for managed forests in the Adirondack region (USA)

    Science.gov (United States)

    Caputo, Jesse PhD.; Beier, Colin M.; Sullivan, Timothy J.; Lawrence, Gregory B.

    2016-01-01

    Sugar maple (Acer saccharum) is among the most ecologically and economically important tree species in North America, and its growth and regeneration is often the focus of silvicultural practices in northern hardwood forests. A key stressor for sugar maple (SM) is acid rain, which depletes base cations from poorly-buffered forest soils and has been associated with much lower SM vigor, growth, and recruitment. However, the potential interactions between forest management and soil acidification – and their implications for the sustainability of SM and its economic and cultural benefits – have not been investigated. In this study, we simulated the development of 50 extant SM stands in the western Adirondack region of NY (USA) for 100 years under different soil chemical conditions and silvicultural prescriptions. We found that interactions between management prescription and soil base saturation will strongly shape the ability to maintain SM in managed forests. Below 12% base saturation, SM did not regenerate sufficiently after harvest and was replaced mainly by red maple (Acer rubrum) and American beech (Fagus grandifolia). Loss of SM on acid-impaired sites was predicted regardless of whether the shelterwood or diameter-limit prescriptions were used. On soils with sufficient base saturation, models predicted that SM will regenerate after harvest and be sustained for future rotations. We then estimated how these different post-harvest outcomes, mediated by acid impairment of forest soils, would affect the potential monetary value of ecosystem services provided by SM forests. Model simulations indicated that a management strategy focused on syrup production – although not feasible across the vast areas where acid impairment has occurred – may generate the greatest economic return. Although pollution from acid rain is declining, its long-term legacy in forest soils will shape future options for sustainable forestry and ecosystem stewardship in the northern

  10. Sustaining complex interventions in long-term care: a qualitative study of direct care staff and managers

    OpenAIRE

    Col?n-Emeric, Cathleen; Toles, Mark; Cary, Michael P.; Batchelor-Murphy, Melissa; Yap, Tracey; Song, Yuting; Hall, Rasheeda; Anderson, Amber; Burd, Andrew; Anderson, Ruth A.

    2016-01-01

    Background Little is known about the sustainability of behavioral change interventions in long-term care (LTC). Following a cluster randomized trial of an intervention to improve staff communication (CONNECT), we conducted focus groups of direct care staff and managers to elicit their perceptions of factors that enhance or reduce sustainability in the LTC setting. The overall aim was to generate hypotheses about how to sustain complex interventions in LTC. Methods In eight facilities, we cond...

  11. Novel effects of demand side management data on accuracy of electrical energy consumption modeling and long-term forecasting

    International Nuclear Information System (INIS)

    Ardakani, F.J.; Ardehali, M.M.

    2014-01-01

    Highlights: • Novel effects of DSM data on electricity consumption forecasting is examined. • Optimal ANN models based on IPSO and SFL algorithms are developed. • Addition of DSM data to socio-economic indicators data reduces MAPE by 36%. - Abstract: Worldwide implementation of demand side management (DSM) programs has had positive impacts on electrical energy consumption (EEC) and the examination of their effects on long-term forecasting is warranted. The objective of this study is to investigate the effects of historical DSM data on accuracy of EEC modeling and long-term forecasting. To achieve the objective, optimal artificial neural network (ANN) models based on improved particle swarm optimization (IPSO) and shuffled frog-leaping (SFL) algorithms are developed for EEC forecasting. For long-term EEC modeling and forecasting for the U.S. for 2010–2030, two historical data types used in conjunction with developed models include (i) EEC and (ii) socio-economic indicators, namely, gross domestic product, energy imports, energy exports, and population for 1967–2009 period. Simulation results from IPSO-ANN and SFL-ANN models show that using socio-economic indicators as input data achieves lower mean absolute percentage error (MAPE) for long-term EEC forecasting, as compared with EEC data. Based on IPSO-ANN, it is found that, for the U.S. EEC long-term forecasting, the addition of DSM data to socio-economic indicators data reduces MAPE by 36% and results in the estimated difference of 3592.8 MBOE (5849.9 TW h) in EEC for 2010–2030

  12. Long-term health consequences of premature or early menopause and considerations for management

    Science.gov (United States)

    Faubion, Stephanie S.; Kuhle, Carol L.; Shuster, Lynne T.; Rocca, Walter A.

    2015-01-01

    Aim To review the current evidence concerning the long-term harmful effects of premature or early menopause, and to discuss some of the clinical implications. Material and methods Narrative review of the literature. Results Women undergoing premature or early menopause, either following bilateral salpingo-oophorectomy or because of primary ovarian insufficiency, experience the early loss of estrogen and other ovarian hormones. The long-term consequences of premature or early menopause include adverse effects on cognition, mood, cardiovascular, bone, and sexual health, as well as an increased risk of early mortality. The use of hormone therapy has been shown to lessen some, although not all of these risks. Therefore, multiple medical societies recommend providing hormone therapy at least until the natural age of menopause. It is important to individualize hormone therapy for women with early estrogen deficiency, and higher dosages may be needed to approximate physiological concentrations found in premenopausal women. It is also important to address the psychological impact of early menopause and to review the options for fertility and the potential need for contraception, if the ovaries are intact. Conclusions Women who undergo premature or early menopause should receive individualized hormone therapy and counseling. PMID:25845383

  13. Effects of long-term grassland management on the carbon and nitrogen pools of different soil aggregate fractions.

    Science.gov (United States)

    Egan, Gary; Crawley, Michael J; Fornara, Dario A

    2018-02-01

    Common grassland management practices include animal grazing and the repeated addition of lime and nutrient fertilizers to soils. These practices can greatly influence the size and distribution of different soil aggregate fractions, thus altering the cycling and storage of carbon (C) and nitrogen (N) in grassland soils. So far, very few studies have simultaneously addressed the potential long-term effect that multiple management practices might have on soil physical aggregation. Here we specifically ask whether and how grazing, liming and nutrient fertilization might influence C and N content (%) as well as C and N pools of different soil aggregate fractions in a long-term grassland experiment established in 1991 at Silwood Park, Berkshire, UK. We found that repeated liming applications over 23years significantly decreased the C pool (i.e. gCKg -1 soil) of Large Macro Aggregate (LMA>2mm) fractions and increased C pools within three smaller soil aggregate fractions: Small Macro Aggregate (SMA, 250μm-2mm), Micro Aggregate (MiA, 53-250μm), and Silt Clay Aggregate (SCAfractions was mainly caused by positive liming effects on aggregate fraction mass rather than on changes in soil C (and N) content (%). Liming effects could be explained by increases in soil pH, as this factor was significantly positively related to greater soil C and N pools of smaller aggregate fractions. Long-term grazing and inorganic nutrient fertilization had much weaker effects on both soil aggregate-fraction mass and on soil C and N concentrations, however, our evidence is that these practices could also contribute to greater C and N pools of smaller soil fractions. Overall our study demonstrates how agricultural liming can contribute to increase C pools of small (more stable) soil fractions with potential significant benefits for the long-term C balance of human-managed grassland soils. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Long-term habitat changes in a protected area: Implications for herpetofauna habitat management and restoration.

    Science.gov (United States)

    Markle, Chantel E; Chow-Fraser, Gillian; Chow-Fraser, Patricia

    2018-01-01

    Point Pelee National Park, located at the southern-most tip of Canada's mainland, historically supported a large number of herpetofauna species; however, despite nearly a century of protection, six snake and five amphibian species have disappeared, and remaining species-at-risk populations are thought to be in decline. We hypothesized that long-term changes in availability and distribution of critical habitat types may have contributed to the disappearance of herpetofauna. To track habitat changes we used aerial image data spanning 85 years (1931-2015) and manually digitized and classified image data using a standardized framework. Change-detection analyses were used to evaluate the relative importance of proportionate loss and fragmentation of 17 habitat types. Marsh habitat diversity and aquatic connectivity has declined since 1931. The marsh matrix transitioned from a graminoid and forb shallow marsh interspersed with water to a cattail dominated marsh, altering critical breeding, foraging, and overwintering habitat. Reduced diversity of marsh habitats appears to be linked to the expansion of invasive Phragmites australis, which invaded prior to 2000. Loss of open habitats such as savanna and meadow has reduced availability of high quality thermoregulation habitat for reptiles. Restoration of the northwestern region and tip of Point Pelee National Park to a mixed landscape of shallow wetlands (cattail, graminoid, forb, open water) and eradication of dense Phragmites stands should improve habitat diversity. Our results suggest that long-term landscape changes resulting from habitat succession and invasive species can negatively affect habitat suitability for herpetofauna and protection of land alone does not necessarily equate to protection of sensitive herpetofauna.

  15. Long-term habitat changes in a protected area: Implications for herpetofauna habitat management and restoration.

    Directory of Open Access Journals (Sweden)

    Chantel E Markle

    Full Text Available Point Pelee National Park, located at the southern-most tip of Canada's mainland, historically supported a large number of herpetofauna species; however, despite nearly a century of protection, six snake and five amphibian species have disappeared, and remaining species-at-risk populations are thought to be in decline. We hypothesized that long-term changes in availability and distribution of critical habitat types may have contributed to the disappearance of herpetofauna. To track habitat changes we used aerial image data spanning 85 years (1931-2015 and manually digitized and classified image data using a standardized framework. Change-detection analyses were used to evaluate the relative importance of proportionate loss and fragmentation of 17 habitat types. Marsh habitat diversity and aquatic connectivity has declined since 1931. The marsh matrix transitioned from a graminoid and forb shallow marsh interspersed with water to a cattail dominated marsh, altering critical breeding, foraging, and overwintering habitat. Reduced diversity of marsh habitats appears to be linked to the expansion of invasive Phragmites australis, which invaded prior to 2000. Loss of open habitats such as savanna and meadow has reduced availability of high quality thermoregulation habitat for reptiles. Restoration of the northwestern region and tip of Point Pelee National Park to a mixed landscape of shallow wetlands (cattail, graminoid, forb, open water and eradication of dense Phragmites stands should improve habitat diversity. Our results suggest that long-term landscape changes resulting from habitat succession and invasive species can negatively affect habitat suitability for herpetofauna and protection of land alone does not necessarily equate to protection of sensitive herpetofauna.

  16. Workshop proceedings: Developing the scientific basis for long-term land management of the Idaho National Engineering and Environmental Laboratory

    International Nuclear Information System (INIS)

    Sperber, T.D.; Reynolds, T.D.

    1998-03-01

    Responses to a survey on the INEEL Comprehensive Facility and Land Use Plan (US DOE 1996a) indicated the need for additional discussion on environmental resources, disturbance, and land use issues on the Idaho National Engineering and Environmental Laboratory (INEEL). As a result, in September 1997, a workshop evaluated the existing scientific basis and determined future data needs for long-term land management on the INEEL. This INEEL Long-Term Land Management Workshop examined existing data on biotic, abiotic, and heritage resources and how these resources have been impacted by disturbance activities of the INEEL. Information gained from this workshop will help guide land and facility use decisions, identify data gaps, and focus future research efforts. This report summarizes background information on the INEEL and its long-term land use planning efforts, presentations and discussions at the workshop, and the existing data available at the INEEL. In this document, recommendations for future INEEL land use planning, research efforts, and future workshops are presented. The authors emphasize these are not policy statements, but comments and suggestions made by scientists and others participating in the workshop. Several appendices covering land use disturbance, legal drivers, land use assumptions and workshop participant comments, workshop participants and contributors, and the workshop agenda are also included

  17. The STRATEGY project: decision tools to aid sustainable restoration and long-term management of contaminated agricultural ecosystems.

    Science.gov (United States)

    Howard, B J; Beresford, N A; Nisbet, A; Cox, G; Oughton, D H; Hunt, J; Alvarez, B; Andersson, K G; Liland, A; Voigt, G

    2005-01-01

    The STRATEGY project (Sustainable Restoration and Long-Term Management of Contaminated Rural, Urban and Industrial Ecosystems) aimed to provide a holistic decision framework for the selection of optimal restoration strategies for the long-term sustainable management of contaminated areas in Western Europe. A critical evaluation was carried out of countermeasures and waste disposal options, from which compendia of state-of-the-art restoration methods were compiled. A decision support system capable of optimising spatially varying restoration strategies, that considered the level of averted dose, costs (including those of waste disposal) and environmental side effects was developed. Appropriate methods of estimating indirect costs associated with side effects and of communicating with stakeholders were identified. The importance of stakeholder consultation at a local level and of ensuring that any response is site and scenario specific were emphasised. A value matrix approach was suggested as a method of addressing social and ethical issues within the decision-making process, and was designed to be compatible with both the countermeasure compendia and the decision support system. The applicability and usefulness of STRATEGY outputs for food production systems in the medium to long term is assessed.

  18. The STRATEGY project: decision tools to aid sustainable restoration and long-term management of contaminated agricultural ecosystems

    International Nuclear Information System (INIS)

    Howard, B.J.; Beresford, N.A.; Nisbet, A.; Cox, G.; Oughton, D.H.; Hunt, J.; Alvarez, B.; Andersson, K.G.; Liland, A.; Voigt, G.

    2005-01-01

    The STRATEGY project (Sustainable Restoration and Long-Term Management of Contaminated Rural, Urban and Industrial Ecosystems) aimed to provide a holistic decision framework for the selection of optimal restoration strategies for the long-term sustainable management of contaminated areas in Western Europe. A critical evaluation was carried out of countermeasures and waste disposal options, from which compendia of state-of-the-art restoration methods were compiled. A decision support system capable of optimising spatially varying restoration strategies, that considered the level of averted dose, costs (including those of waste disposal) and environmental side effects was developed. Appropriate methods of estimating indirect costs associated with side effects and of communicating with stakeholders were identified. The importance of stakeholder consultation at a local level and of ensuring that any response is site and scenario specific were emphasised. A value matrix approach was suggested as a method of addressing social and ethical issues within the decision-making process, and was designed to be compatible with both the countermeasure compendia and the decision support system. The applicability and usefulness of STRATEGY outputs for food production systems in the medium to long term is assessed

  19. Long-term intensive management increased carbon occluded in phytolith (PhytOC) in bamboo forest soils

    Science.gov (United States)

    Huang, Zhang-Ting; Li, Yong-Fu; Jiang, Pei-Kun; Chang, Scott X.; Song, Zhao-Liang; Liu, Juan; Zhou, Guo-Mo

    2014-01-01

    Carbon (C) occluded in phytolith (PhytOC) is highly stable at millennium scale and its accumulation in soils can help increase long-term C sequestration. Here, we report that soil PhytOC storage significantly increased with increasing duration under intensive management (mulching and fertilization) in Lei bamboo (Phyllostachys praecox) plantations. The PhytOC storage in 0-40 cm soil layer in bamboo plantations increased by 217 Mg C ha-1, 20 years after being converted from paddy fields. The PhytOC accumulated at 79 kg C ha-1 yr-1, a rate far exceeding the global mean long-term soil C accumulation rate of 24 kg C ha-1 yr-1 reported in the literature. Approximately 86% of the increased PhytOC came from the large amount of mulch applied. Our data clearly demonstrate the decadal scale management effect on PhytOC accumulation, suggesting that heavy mulching is a potential method for increasing long-term organic C storage in soils for mitigating global climate change.

  20. Workshop proceedings: Developing the scientific basis for long-term land management of the Idaho National Engineering and Environmental Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Sperber, T.D.; Reynolds, T.D. [eds.] [Environmental Science and Research Foundation, Inc., Idaho Falls, ID (United States); Breckenridge, R.P. [ed.] [Lockheed Martin Idaho Technologies Co., Idaho Falls, ID (United States)

    1998-03-01

    Responses to a survey on the INEEL Comprehensive Facility and Land Use Plan (US DOE 1996a) indicated the need for additional discussion on environmental resources, disturbance, and land use issues on the Idaho National Engineering and Environmental Laboratory (INEEL). As a result, in September 1997, a workshop evaluated the existing scientific basis and determined future data needs for long-term land management on the INEEL. This INEEL Long-Term Land Management Workshop examined existing data on biotic, abiotic, and heritage resources and how these resources have been impacted by disturbance activities of the INEEL. Information gained from this workshop will help guide land and facility use decisions, identify data gaps, and focus future research efforts. This report summarizes background information on the INEEL and its long-term land use planning efforts, presentations and discussions at the workshop, and the existing data available at the INEEL. In this document, recommendations for future INEEL land use planning, research efforts, and future workshops are presented. The authors emphasize these are not policy statements, but comments and suggestions made by scientists and others participating in the workshop. Several appendices covering land use disturbance, legal drivers, land use assumptions and workshop participant comments, workshop participants and contributors, and the workshop agenda are also included.

  1. Reforming Management of Behavior Symptoms and Psychiatric Conditions in Long-Term Care Facilities: A Different Perspective.

    Science.gov (United States)

    Levenson, Steven A; Desai, Abhilash K

    2017-04-01

    Despite much attention including national initiatives, concerns remain about the approaches to managing behavior symptoms and psychiatric conditions across all settings, including in long-term care settings such as nursing homes and assisted living facilities. One key reason why problems persist is because most efforts to "reform" and "correct" the situation have failed to explore or address root causes and instead have promoted inadequate piecemeal "solutions." Further improvement requires jumping off the bandwagon and rethinking the entire issue, including recognizing and applying key concepts of clinical reasoning and the care delivery process to every situation. The huge negative impact of cognitive biases and rote approaches on related clinical problem solving and decision making and patient outcomes also must be addressed. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  2. Implementation of an antimicrobial stewardship program targeting residents with urinary tract infections in three community long-term care facilities: a quasi-experimental study using time-series analysis.

    Science.gov (United States)

    Doernberg, Sarah B; Dudas, Victoria; Trivedi, Kavita K

    2015-01-01

    Asymptomatic bacteriuria in the elderly commonly results in antibiotic administration and, in turn, contributes to antimicrobial resistance, adverse drug events, and increased costs. This is a major problem in the long-term care facility (LTCF) setting, where residents frequently transition to and from the acute-care setting, often transporting drug-resistant organisms across the continuum of care. The goal of this study was to assess the feasibility and efficacy of antimicrobial stewardship programs (ASPs) targeting urinary tract infections (UTIs) at community LTCFs. This was a quasi-experimental study targeting antibiotic prescriptions for UTI using time-series analysis with 6-month retrospective pre-intervention and 6-month intervention period at three community LTCFs. The ASP team (infectious diseases (ID) pharmacist and ID physician) performed weekly prospective audit and feedback of consecutive prescriptions for UTI. Loeb clinical consensus criteria were used to assess appropriateness of antibiotics; recommendations were communicated to the primary treating provider by the ID pharmacist. Resident outcomes were recorded at subsequent visits. Generalized estimating equations using segmented regression were used to evaluate the impact of the ASP intervention on rates of antibiotic prescribing and antibiotic resistance. One-hundred and four antibiotic prescriptions for UTI were evaluated during the intervention, and recommendations were made for change in therapy in 40 (38 %), out of which 10 (25 %) were implemented. Only eight (8 %) residents started on antibiotics for UTI met clinical criteria for antibiotic initiation. An immediate 26 % decrease in antibiotic prescriptions for UTI during the ASP was identified with a 6 % reduction continuing through the intervention period (95 % Confidence Interval ([CI)] for the difference: -8 to -3 %). Similarly, a 25 % immediate decrease in all antibiotic prescriptions was noted after introduction of the ASP with a

  3. From Cleanup to Stewardship. A companion report to Accelerating Cleanup: Paths to Closure and background information to support the scoping process required for the 1998 PEIS Settlement Study

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    1999-10-01

    Long-term stewardship is expected to be needed at more than 100 DOE sites after DOE's Environmental Management program completes disposal, stabilization, and restoration operations to address waste and contamination resulting from nuclear research and nuclear weapons production conducted over the past 50 years. From Cleanup to stewardship provides background information on the Department of Energy (DOE) long-term stewardship obligations and activities. This document begins to examine the transition from cleanup to long-term stewardship, and it fulfills the Secretary's commitment to the President in the 1999 Performance Agreement to provide a companion report to the Department's Accelerating Cleanup: Paths to Closure report. It also provides background information to support the scoping process required for a study on long-term stewardship required by a 1998 Settlement Agreement.

  4. Management of kyphoscoliosis patients with respiratory failure in the intensive care unit and during long term follow up

    Directory of Open Access Journals (Sweden)

    Adıgüzel Nalan

    2012-09-01

    Full Text Available Abstract Background We aimed to evaluate the ICU management and long-term outcomes of kyphoscoliosis patients with respiratory failure. Methods A retrospective observational cohort study was performed in a respiratory ICU and outpatient clinic from 2002–2011. We enrolled all kyphoscoliosis patients admitted to the ICU and followed-up at regular intervals after discharge. Reasons for acute respiratory failure (ARF, ICU data, mortality, length of ICU stay and outpatient clinic data, non-invasive ventilation (NIV device settings, and compliance were recorded. NIV failure in the ICU and the long term effect of NIV on pulmonary performance were analyzed. Results Sixty-two consecutive ICU kyphoscoliosis patients with ARF were enrolled in the study. NIV was initially applied to 55 patients, 11 (20% patients were intubated, and the majority had sepsis and septic shock (p  Conclusions We strongly discourage the use of NIV in the case of septic shock in ICU kyphoscoliosis patients with ARF. Pulmonary performance improved with NIV during long term follow up.

  5. Paroxetine in panic disorder: clinical management and long-term follow-up.

    Science.gov (United States)

    Dannon, Pinhas N; Lowengrub, Katherine; Iancu, I; Kotler, Moshe

    2004-03-01

    Panic disorder is one of the most common anxiety disorders and has a lifetime prevalence of 3-5%. Panic attacks can begin at any age, but commonly have their onset in early adulthood between the ages of 20 and 40 years. Naturalistic data has shown that panic disorder has a chronic and relapsing course. Panic disorder is reported to be associated with an increased risk of suicidal behavior and comorbid psychiatric diagnoses such as depression and substance abuse. Currently, recommended treatment modalities for panic disorder include the use of antidepressant pharmacotherapy and/or cognitive behavioral therapy. Paroxetine is unique among the selective serotonin reuptake inhibitors since, in addition to its effect on the CNS serotonergic neurotransmission, it also has mild noradrenergic properties demonstrated to be effective in the treatment of anxiety disorders and depression. Paroxetine treatment has the potential to cause weight gain and sexual dysfunction, primarily anorgasmia and ejaculatory dysfunction for the long term. In the short-term, treatment causes nausea, gastrointestinal disturbances, irritability, headaches and eating and sleeping difficulties. Paroxetine is an example of an selective serotonin reuptake inhibitor agent, which has been well studied in the treatment of panic disorder and is efficacious and well-tolerated. Paroxetine pharmacotherapy has been recommended to be continued for 1 year as specified in the treatment guidelines set by the American Psychiatric Association in the treatment of panic disorder.

  6. Management of sexual disorders in long-term of craniocerebral injury within the complex neurorehabilitatione

    Directory of Open Access Journals (Sweden)

    B. G. Dranitsyna

    2015-01-01

    Full Text Available The article describes the importance of the problem of consequences of traumatic brain injury. The study included men with long-term consequences of traumatic brain injury with sexual dysfunction. The study used sexological, psychopathological, psychometric, statistical techniques and additional methods. All patients were divided into three groups depending on the time of the injury. All rehabilitation aimed at restoring lost functions, taking into account the identified sexual dysfunction symptoms. Drug therapy, psychotherapy, logotherapy, massage, physiotherapy effects, acupuncture is used in rehabilitation. Symptomatic treatment was aimed at correcting the underlying psychopathology (affective disorders, asthenic conditions, seizures. Much attention is paid to the psychotherapeutic work, because traumatic brain injury not only leads to a change in the functioning of the human, but also entails a number of social, communication problems, resulting in developing family and sexual disharmony. The basic stages of therapy, taking into account the peculiarities of social functioning, relationships, sexual function of patients and their sexual constitution. The results of evaluation of the effectiveness of the therapy in the study group compared with the control group of patients who were not receiving specific therapy. 

  7. An ethical dimension to sustainable restoration and long-term management of contaminated areas

    International Nuclear Information System (INIS)

    Oughton, Deborah; Forsberg, Ellen-Marie; Bay, Ingrid; Kaiser, Matthias; Howard, Brenda

    2004-01-01

    Experience after the Chernobyl accident has shown that restoration strategies need to consider a wide range of different issues to ensure the long-term sustainability of large and varied contaminated areas. Thus, the criteria by which we evaluate countermeasures need to be extended from simple cost-benefit effectiveness and radiological protection standards to a more integrated, holistic approach, including social and ethical aspects. Within the STRATEGY project, the applicability of many countermeasures is being critically assessed using a wide range of criteria. Attention is being given to issues such as practicability, feasibility, capacity and environmental side-effects, as well as social factors such as public perceptions of risk, communication of information and the need for dialogue and consultation with affected communities, and ethical aspects such as informed consent and the fair distribution of costs and doses. Although such socio-ethical factors are now the subject of a substantial field of research, there has been little attempt to integrate them in a practical context for decision makers. Within this paper, we specifically consider the ethical aspects of restoration strategies and suggest practical means by which these can be taken into account in the decision making process, introducing a value matrix. The paper covers two critical areas: evaluation of individual countermeasures, and use of the matrix to ensure transparent and systematic consideration of values in selection of a restoration strategy

  8. Incorporating Oracle on-line space management with long-term archival technology

    Science.gov (United States)

    Moran, Steven M.; Zak, Victor J.

    1996-01-01

    The storage requirements of today's organizations are exploding. As computers continue to escalate in processing power, applications grow in complexity and data files grow in size and in number. As a result, organizations are forced to procure more and more megabytes of storage space. This paper focuses on how to expand the storage capacity of a Very Large Database (VLDB) cost-effectively within a Oracle7 data warehouse system by integrating long term archival storage sub-systems with traditional magnetic media. The Oracle architecture described in this paper was based on an actual proof of concept for a customer looking to store archived data on optical disks yet still have access to this data without user intervention. The customer had a requirement to maintain 10 years worth of data on-line. Data less than a year old still had the potential to be updated thus will reside on conventional magnetic disks. Data older than a year will be considered archived and will be placed on optical disks. The ability to archive data to optical disk and still have access to that data provides the system a means to retain large amounts of data that is readily accessible yet significantly reduces the cost of total system storage. Therefore, the cost benefits of archival storage devices can be incorporated into the Oracle storage medium and I/O subsystem without loosing any of the functionality of transaction processing, yet at the same time providing an organization access to all their data.

  9. A data management proposal to connect in a hierarchical way nodes of the Spanish Long Term Ecological Research (LTER) network

    Science.gov (United States)

    Fuentes, Daniel; Pérez-Luque, Antonio J.; Bonet García, Francisco J.; Moreno-LLorca, Ricardo A.; Sánchez-Cano, Francisco M.; Suárez-Muñoz, María

    2017-04-01

    The Long Term Ecological Research (LTER) network aims to provide the scientific community, policy makers, and society with the knowledge and predictive understanding necessary to conserve, protect, and manage the ecosystems. LTER is organized into networks ranging from the global to national scale. In the top of network, the International Long Term Ecological Research (ILTER) Network coordinates among ecological researchers and LTER research networks at local, regional and global scales. In Spain, the Spanish Long Term Ecological Research (LTER-Spain) network was built to foster the collaboration and coordination between longest-lived ecological researchers and networks on a local scale. Currently composed by nine nodes, this network facilitates the data exchange, documentation and preservation encouraging the development of cross-disciplinary works. However, most nodes have no specific information systems, tools or qualified personnel to manage their data for continued conservation and there are no harmonized methodologies for long-term monitoring protocols. Hence, the main challenge is to place the nodes in its correct position in the network, providing the best tools that allow them to manage their data autonomously and make it easier for them to access information and knowledge in the network. This work proposes a connected structure composed by four LTER nodes located in southern Spain. The structure is built considering hierarchical approach: nodes that create information which is documented using metadata standards (such as Ecological Metadata Language, EML); and others nodes that gather metadata and information. We also take into account the capacity of each node to manage their own data and the premise that the data and metadata must be maintained where it is generated. The current state of the nodes is a follows: two of them have their own information management system (Sierra Nevada-Granada and Doñana Long-Term Socio-ecological Research Platform) and

  10. The experience of facilitators and participants of long term condition self-management group programmes: A qualitative synthesis.

    Science.gov (United States)

    Hughes, Stephen; Lewis, Sophie; Willis, Karen; Rogers, Anne; Wyke, Sally; Smith, Lorraine

    2017-12-01

    Our aim was to systematically review the qualitative literature about the experiences of both facilitators and participants in a range of group-based programmes to support the self-management of long-term conditions. We searched 7 databases using the terms 'self-management', 'group' and 'qualitative'. Full text articles meeting the inclusion criteria were retrieved for review. A thematic synthesis approach was used to analyse the studies. 2126 articles were identified and 24 were included for review. Group participants valued being with similar others and perceived peer support benefits. Facilitators (HCP and lay) had limited group specific training, were uncertain of purpose and prioritised education and medical conformity over supportive group processes and the promotion of self-management agency and engagement. Overall, studies prioritised positive descriptions. Group programmes' medical self-management focus may reduce their ability to contribute to patient-valued outcomes. Further research is needed to explore this disconnect. This review supports broadening the scope of group-based programmes to foreground shared learning, social support and development of agency. It is of relevance to developers and facilitators of group self-management programmes and their ability to address the burden of long-term conditions. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Simulated biomass, environmental impacts and best management practices for long-term switchgrass systems in a semi-arid region

    International Nuclear Information System (INIS)

    Wang, Limei; Qian, Yaling; Brummer, Joe E.; Zheng, Jiyong; Wilhelm, Sarah; Parton, William J.

    2015-01-01

    Long-term information on switchgrass (Panicum virgatum L.) as a biomass energy crop grown on marginally saline soil and the associated impacts on soil carbon (C) and nitrogen (N) dynamics, greenhouse gas (GHG) emissions, and best management practices (BMPs) are limited. In this study, we employed the DAYCENT model, based on a 4-year switchgrass field experiment, to evaluate the long-term biomass yield potential and environmental impacts, and further to develop BMPs for switchgrass in a semi-arid region. The model showed that long-term (14-year) annual mean biomass yields were 9.6 and 5.2 Mg ha −1 for irrigated and rainfed switchgrass systems, respectively. The simulated biomass yields correlated well with field-measured biomass with r 2 values of 0.99 and 0.89 for irrigated and rainfed systems, respectively. Soil organic carbon (SOC) and soil total nitrogen (STN) accumulated rapidly after switchgrass establishment, with mean accrual rates of 0.99–1.13 Mg C ha −1  yr −1 and 0.04–0.08 Mg N ha −1  yr −1 , respectively. Based on the outputs of numerous long-term model simulations with variable irrigation water supplies and N rates, the irrigation regime and N rate with the highest yield to input ratio were chosen as BMPs. The DAYCENT model predicted-BMP was irrigating every 14 days at 70% potential evapotranspiration combined with an N rate of 67 kg ha −1  yr −1 . Switchgrass established and produced biomass reasonably well in this semi-arid region; however, appropriate irrigation and N fertilization were needed for optimal biomass yield. Switchgrass had a great potential to sequester C into soils with low N 2 O emissions while supplying significant quantities of biomass for biofuel synthesis. - Highlights: • The DAYCENT model reliably simulated the growth of switchgrass on marginal land. • Long-term biomass and environmental impacts were simulated using the DAYCENT model. • Switchgrass produced biomass well on marginal land, but

  12. How long is long-term? reflections based on over 20 years of post-Chernobyl management in Norway

    International Nuclear Information System (INIS)

    Liland, Astrid; Lochard, Jacques; Skuterud, Lavrans

    2009-01-01

    The radiation protection community has only recently started the important work of preparedness for long-term post-accidental management of radioactively contaminated areas, like for instance the EC projects STRATEGY, FARMING and EURANOS and the French authorities' CODIRPA and PAREX programmes. There are, however, different views concerning how long a long-term management might last. Based on the Norwegian and former Soviet Union experience after the Chernobyl accident, it is clear that a nuclear accident can entail decades of necessary management and rehabilitation of living conditions. The time period is dependent on a number of factors, e.g. amount of fallout, type of radionuclides, land use of contaminated area, number and density of people affected and available techniques and resources for implementing countermeasures. This paper discusses the management strategy implemented in Norway after the Chernobyl accident, the need for changing strategy over time and the important involvement of affected groups. Careful planning and reflections should be undertaken before actions are taken in the recovery phase, keeping in mind the possibility of decades with problems.

  13. How long is long-term? reflections based on over 20 years of post-Chernobyl management in Norway

    Energy Technology Data Exchange (ETDEWEB)

    Liland, Astrid [Norwegian Radiation Protection Authority, P.O. Box 55, 1332 Osteras (Norway)], E-mail: astrid.liland@nrpa.no; Lochard, Jacques [CEPN - Nuclear Protection Evaluation Centre, 28 rue de la Redoute, 92260 Fontenay-aux-Roses (France); Skuterud, Lavrans [Norwegian Radiation Protection Authority, P.O. Box 55, 1332 Osteras (Norway); Norwegian Reindeer Husbandry Authority, P.O. Box 121, 7361 Roros (Norway)

    2009-07-15

    The radiation protection community has only recently started the important work of preparedness for long-term post-accidental management of radioactively contaminated areas, like for instance the EC projects STRATEGY, FARMING and EURANOS and the French authorities' CODIRPA and PAREX programmes. There are, however, different views concerning how long a long-term management might last. Based on the Norwegian and former Soviet Union experience after the Chernobyl accident, it is clear that a nuclear accident can entail decades of necessary management and rehabilitation of living conditions. The time period is dependent on a number of factors, e.g. amount of fallout, type of radionuclides, land use of contaminated area, number and density of people affected and available techniques and resources for implementing countermeasures. This paper discusses the management strategy implemented in Norway after the Chernobyl accident, the need for changing strategy over time and the important involvement of affected groups. Careful planning and reflections should be undertaken before actions are taken in the recovery phase, keeping in mind the possibility of decades with problems.

  14. Long-term outcome of visual internal urethrotomy for the management of pediatric urethral strictures.

    Science.gov (United States)

    Hafez, Ashraf T; El-Assmy, Ahmed; Dawaba, Mohamed S; Sarhan, Osama; Bazeed, Mahmoud

    2005-02-01

    We evaluated the long-term results of visual internal urethrotomy for pediatric urethral strictures to evaluate the efficacy and final outcome of this procedure in children and to evaluate the risk factors for stricture recurrence. The computerized surgical records of our hospital were reviewed to identify children who underwent visual internal urethrotomy between 1980 and 2001. Hospital and followup clinical charts were then reviewed. Many variables were analyzed, including age, etiology, length and site of the strictures, and catheter duration. Only patients with a minimum followup of 2 years were included. Regular self-catheterization was not used by any child. A total of 31 patients (mean age 11.2 years, range 2 to 18) were identified. Followup ranged from 2 to 20 years, with a mean of 6.6 years. The most common etiology for stricture formation was failed previous urethroplasty and post instrumentation (35.5% and 32.3%, respectively). The success rate after initial urethrotomy was 35.5% (11 of 31 patients). Mean interval to first recurrence was 26 months. A second urethrotomy improved the success rate of 58.1%. Eight patients required 2 or more urethrotomies, of whom half required open urethroplasty. Among the evaluated variables only stricture length shorter than 1 cm was associated with good results. Visual internal urethrotomy provides a safe first line therapeutic option for pediatric urethral strictures shorter than 1 cm, independent of etiology and location. For patients with more than 1 recurrence or with strictures longer than 1 cm, who are at high risk for recurrence after internal urethrotomy, open urethroplasty remains the treatment of choice.

  15. Mitral valve reconstruction in Barlow disease: long-term echographic results and implications for surgical management.

    Science.gov (United States)

    Jouan, Jérôme; Berrebi, Alain; Chauvaud, Sylvain; Menasché, Philippe; Carpentier, Alain; Fabiani, Jean-Noël

    2012-04-01

    Owing to the complexity of the underlying lesions, Barlow disease remains a challenge for surgeons performing mitral valve repair. We aimed to assess whether our most recent results involving several surgeons were comparable with those of a previous experience in which mitral valve repair was performed by a more limited group of surgeons. From September 2000 to January 2007, 200 patients with Barlow disease (135 men and 65 women; mean age, 56 ± 13 years) were referred to our institution for surgical treatment of their mitral regurgitation. We retrospectively analysed the mitral lesions characteristics, the surgical techniques used, and clinical outcomes. Follow-up echocardiograms were biannually reviewed. Lesions comprised annular dilatation, excess tissue, and leaflet prolapse in all cases. The most frequent prolapsed segments were P2 (88.5%; n = 177) and A2 (55.5%; n = 111). Annular calcifications and restrictive valvular motion were associated in 20% (n = 40). Repair was feasible in 94.7% (n = 179/189) of non-redo interventions. Immediate postoperative echocardiography showed residual mitral regurgitation greater than 1+ in 6 cases; these patients were all reoperated on within the next months. Operative mortality was 1.5% (n = 3). Mean follow-up was 77.5 ± 25.6 months. At 8 years postoperatively, overall survival was 88.6% ± 3.1%, freedom from reintervention was 95.3% ± 1.7%, and freedom from late recurrent moderate mitral regurgitation (>2+) was 90.2% ± 3.1% Provided that the fundamental principles of mitral valve reconstruction are respected, the surgical techniques are highly reproducible with good long-term results, similar to those published during the pioneering phase of this surgery. Copyright © 2012 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  16. Final Long-Term Management and Storage of Elemental Mercury Environmental Impact Statement Summary and Guide for Stakeholders

    Energy Technology Data Exchange (ETDEWEB)

    2011-01-01

    Pursuant to the Mercury Export Ban Act of 2008 (P.L. 110-414), DOE was directed to designate a facility or facilities for the long-term management and storage of elemental mercury generated within the United States. Therefore, DOE has analyzed the storage of up to 10,000 metric tons (11,000 tons) of elemental mercury in a facility(ies) constructed and operated in accordance with the Solid Waste Disposal Act, as amended by the Resource Conservation and Recovery Act (74 FR 31723). DOE prepared this Final Mercury Storage EIS in accordance with the National Environmental Policy Act of 1969 (NEPA), as amended (42 U.S.C. 4321 et seq.), the Council on Environmental Quality (CEQ) implementing regulations (40 CFR 1500–1508), and DOE’s NEPA implementing procedures (10 CFR 1021) to evaluate reasonable alternatives for a facility(ies) for the long-term management and storage of elemental mercury. This Final Mercury Storage EIS analyzes the potential environmental, human health, and socioeconomic impacts of elemental mercury storage at seven candidate locations: Grand Junction Disposal Site near Grand Junction, Colorado; Hanford Site near Richland, Washington; Hawthorne Army Depot near Hawthorne, Nevada; Idaho National Laboratory near Idaho Falls, Idaho; Kansas City Plant in Kansas City, Missouri; Savannah River Site near Aiken, South Carolina; and Waste Control Specialists, LLC, site near Andrews, Texas. As required by CEQ NEPA regulations, the No Action Alternative was also analyzed as a basis for comparison. DOE intends to decide (1) where to locate the elemental mercury storage facility(ies) and (2) whether to use existing buildings, new buildings, or a combination of existing and new buildings. DOE’s Preferred Alternative for the long-term management and storage of mercury is the Waste Control Specialists, LLC, site near Andrews, Texas.

  17. Forest management for mitigation and adaptation: insights from long-term silvicultural experiments

    Science.gov (United States)

    Anthony W. D' Amato; John B. Bradford; Shawn Fraver; Brian J. Palik

    2011-01-01

    Developing management strategies for addressing global climate change has become an increasingly important issue influencing forest management around the globe. Currently, management approaches are being proposed that intend to (1) mitigate climate change by enhancing forest carbon stores and (2) foster adaptation by maintaining compositionally and structurally complex...

  18. Final programmatic environmental impact statement for stockpile stewardship and management. Comment response document. Volume 4

    International Nuclear Information System (INIS)

    1996-09-01

    In response to the end of the Cold War and changes in the world's political regimes, the United States is not producing new-design nuclear weapons. Instead, the emphasis on the U.S. nuclear weapons program is on reducing the size of the Nation's nuclear stockpile by dismantling existing nuclear weapons. The Department of Energy (DOE) has been directed by the President and Congress to maintain the safety and reliability of the reduced nuclear weapons stockpile in the absence of underground nuclear testing. In order to fulfill that responsibility, DOE has developed a Stockpile Stewardship and Management Program to provide a single highly integrated program for maintaining the continued safety and reliability of the nuclear stockpile. The Stockpile Stewardship and Management PEIS describes and analyzes alternative ways to implement the proposed actions for the Stockpile Stewardship and Management Program

  19. Final Programmatic Environmental Impact Statement for stockpile stewardship and management: Volume 3

    International Nuclear Information System (INIS)

    1996-09-01

    The Department of Energy (DOE) has been directed by the President and Congress to maintain the safety and reliability of the reduced nuclear weapons stockpile in the absence of underground nuclear testing. In order to fulfill that responsibility, DOE has developed a Stockpile Stewardship and Management Program to provide a single highly integrated technical program for maintaining the continued safety and reliability of the nuclear stockpile. The Stockpile Stewardship and Management Programmatic Environmental Impact Statement (PEIS) describes and analyzes alternative ways to implement the proposed actions for the Stockpile Stewardship and Management Program. This document consists of Volume III, Appendix I entitled ''National Ignition Facility Project-Specific Analysis,'' which investigates the environmental impacts resulting from constructing and operating the proposed National Ignition Facility

  20. Management of main generator condition during long term plant shut down at Higashidori Nuclear Power Station Unit 1

    International Nuclear Information System (INIS)

    Kato, Seiji

    2014-01-01

    Higashidori Nuclear Power Station Unit 1 shut down on February 6, 2011 to start 4th refuel outage. On March 11, 2011, we keep going refuel outage on this moment a large earthquake occurred and tsunami was generated following it which called 'Great East Japan Earthquake'. Refuel outage takes 3 ∼ 5 months normally but Higashidori NPS still keeping shut down over 3 years due to some issues. In this paper, we introduce about management of Main generator condition during long term plant shut down situation in addition to normal plant shut down situation to keep well. (author)

  1. Technology development for long-term management of Hanford high-level waste. Quarterly report, January 1976--March 1976

    Energy Technology Data Exchange (ETDEWEB)

    Kounts, J S [ed.

    1976-06-01

    This document is the seventh in a series of quarterly reports on work in support of long-term management of Hanford high-level wastes. The work reported here was performed during the period January through March 1976. The specific topics discussed are grouped into the subject areas of: Storage System Integrity and Engineered Improvements; Waste Retrieval; Waste Immobilization and Storage; Contaminated Equipment Volume Reduction; and Analytical Methods Development. Previous reports were published as ARH-ST-110 A through D and ARH-ST-132 A and B.

  2. Long-Term Effect of Different Carbon Management Strategies on Water Flow and Related Processes for Three Loamy Soils

    DEFF Research Database (Denmark)

    Vendelboe, Anders Lindblad; Schjønning, Per; de Jonge, Lis Wollesen

    2013-01-01

    on preferential flow and loss of colloids during heavy irrigation events. The field sites were all under long-term management and therefore represent up to 30 years of pairwise different management strategies. One field in each field pair was managed with a more C-repleting strategy (HighC) than the other (Low......The decline in organic matter of arable land, induced and accelerated by modern agriculture, has been identified as a threat to sustained soil quality. In this article, we studied strategies to counter this decrease by building up soil organic carbon (SOC) levels in the soils using several......C). Only small differences in SOC contents were identified, and none of the management strategies had succeeded in building up SOC pools large enough to saturate the soil with C. Only at one field site was the content of water-dispersible colloids lower in the HighC than the LowC treatment. Preferential...

  3. Modeling framework for representing long-term effectiveness of best management practices in addressing hydrology and water quality problems: Framework development and demonstraton using a Bayesian method

    Science.gov (United States)

    Best management practices (BMPs) are popular approaches used to improve hydrology and water quality. Uncertainties in BMP effectiveness over time may result in overestimating long-term efficiency in watershed planning strategies. To represent varying long-term BMP effectiveness in hydrologic/water q...

  4. Long-term environmental drivers of DOC fluxes: Linkages between management, hydrology and climate in a subtropical coastal estuary

    Science.gov (United States)

    Regier, Peter; Briceño, Henry; Jaffé, Rudolf

    2016-12-01

    Urban and agricultural development of the South Florida peninsula has disrupted historic freshwater flow in the Everglades, a hydrologically connected ecosystem stretching from central Florida to the Gulf of Mexico, USA. Current system-scale restoration efforts aim to restore natural hydrologic regimes to reestablish pre-drainage ecosystem functioning through increased water availability, quality and timing. Aquatic transport of carbon in this ecosystem, primarily as dissolved organic carbon (DOC), plays a critical role in biogeochemical cycling and food-web dynamics, and will be affected both by water management policies and climate change. To better understand DOC dynamics in South Florida estuaries and how hydrology, climate and water management may affect them, 14 years of monthly data collected in the Shark River estuary were used to examine DOC flux dynamics in a broader environmental context. Multivariate statistical methods were applied to long-term datasets for hydrology, water quality and climate to untangle the interconnected environmental drivers that control DOC export at monthly and annual scales. DOC fluxes were determined to be primarily controlled by hydrology but also by seasonality and long-term climate patterns and episodic weather events. A four-component model (salinity, rainfall, inflow, Atlantic Multidecadal Oscillation) capable of predicting DOC fluxes (R2 = 0.84, p water management and salinity.

  5. The problem of the long-term management of nuclear wastes; Le probleme de la gestion a long terme des dechets nucleaires

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-07-01

    The law from December 30, 1991, precisely defines 3 axes of researches for the management of high level and long-lived radioactive wastes: separation/transmutation, surface storage and underground disposal. A global evaluation report about these researches is to be supplied in 2006 by the French government to the Parliament. A first synthesis of the knowledge gained after 14 years of research has led the national commission of the public debate (CNDP) to organize a national debate about the general options of management of high-level and long-lived radioactive wastes before the 2006 date line. The debate comprises 4 public hearings (September 2005: Bar-le-Duc, Saint-Dizier, Pont-du-Gard, Cherbourg), 12 round-tables (October and November 2005: Paris, Joinville, Caen, Nancy, Marseille), a synthesis meeting (December 2005, Dunkerque) and a closing meeting (January 2006, Lyon). This document is the proceedings of the synthesis meeting of Dunkerque. It comprises an introduction which recalls the stakes and modalities of the debate, followed by a talk from the president of the national association of local commissions for nuclear activities information (ANCLI), and three synthesis talks from the particular commission of the public debate, the ministry of industry, and the committee of experts and counter-experts. These proceedings end with some questions and answers with the public. A slide presentation by B. Dessus about the progresses made in the debate on nuclear wastes management is attached to the document. (J.S.)

  6. Defense Virtual Library: Technical Metadata for the Long-Term Management of Digital Materials: Preliminary Guidelines

    National Research Council Canada - National Science Library

    Flynn, Marcy

    2002-01-01

    ... of the digital materials being preserved. This report, prepared by Silver Image Management (SIM), proposes technical metadata elements appropriate for digital objects in the Defense Virtual Library...

  7. Short- and Long-Term Stroke Risk after Urgent Management of Transient Ischaemic Attack: The Bologna TIA Clinical Pathway.

    Science.gov (United States)

    Guarino, Maria; Rondelli, Francesca; Favaretto, Elisabetta; Stracciari, Andrea; Filippini, Massimo; Rinaldi, Rita; Zele, Ivana; Sartori, Michelangelo; Faggioli, Gianluca; Mondini, Susanna; Donti, Andrea; Strocchi, Enrico; Degli Esposti, Daniela; Muscari, Antonio; Veronesi, Maddalena; D'Addato, Sergio; Spinardi, Luca; Faccioli, Luca; Pastore Trossello, Marco; Cirignotta, Fabio

    2015-01-01

    Rapid management can reduce the short stroke risk after transient ischaemic attack (TIA), but the long-term effect is still little known. We evaluated 3-year vascular outcomes in patients with TIA after urgent care. We prospectively enrolled all consecutive patients with TIA diagnosed by a vascular neurologist and referred to our emergency department (ED). Expedited assessment and best secondary prevention was within 24 h. Endpoints were stroke within 90 days, and stroke, myocardial infarction, and vascular death at 12, 24 and 36 months. Between August 2010 and July 2013, we evaluated 686 patients with suspected TIA; 433 (63%) patients had confirmed TIA. Stroke at 90 days was 2.07% (95% confidence interval (CI), 1.1-3.9) compared with the ABCD2-predicted risk of 9.1%. The long-term stroke risk was 2.6% (95% CI, 1.1-4.2), 3.7% (95% CI, 1.6-5.9) and 4.4% (95% CI, 1.9-6.8) at 12, 24 and 36 months, respectively. The composite outcome of stroke, myocardial infarction, and vascular death was 3.5% (95% CI, 1.7-5.1), 4.9% (95% CI, 2.5-7.4), and 5.6% (95% CI, 2.8-8.3) at 12, 24, and 36 months, respectively. TIA expedited management driven by vascular neurologists was associated with a marked reduction in the expected early stroke risk and low long-term risk of stroke and other vascular events. © 2015 S. Karger AG, Basel.

  8. Long-term efficacy and safety of otilonium bromide in the management of irritable bowel syndrome: a literature review

    Directory of Open Access Journals (Sweden)

    Triantafillidis JK

    2014-04-01

    Full Text Available John K Triantafillidis, George Malgarinos Inflammatory Bowel Disease Unit, IASO General Hospital, Athens, Greece Abstract: Irritable bowel syndrome (IBS is a very common functional gastrointestinal disorder characterized by abdominal pain or discomfort and altered bowel habits. The disease affects a large part of the world population. The clinical course is mostly characterized by a cyclic recurrence of symptoms. Therefore, IBS patients should receive, as an initial therapeutic approach, a short course of treatment, and long-term treatment should be reserved for those patients with recurrent symptoms. The available clinical trials show that significant improvement of the symptoms over placebo could be achieved with various drugs, although this improvement is frequently time dependent and with high relapse rates after the cessation of the treatment. In a proportion of patients, clinically obvious relapse could appear long after stopping the treatment. Some of the available pharmacologic agents, including otilonium bromide (OB, are able to significantly prolong the time to the appearance of relapse, compared with placebo. As a consequence, some authors suggest that a cyclic treatment could be of benefit. Antispasmodic drugs have been used for many years in an effort to control the symptoms of IBS. OB is a poorly absorbed spasmolytic drug, exerting significantly greater control of the symptoms of IBS compared with placebo. Recent data suggest that the drug could effectively be used for the long-term management of patients with IBS. The aim of this review is to provide the reader with an evidence-based overview of the efficacy and tolerability of OB in the long-term management of IBS patients, based on the results of the clinical trials published so far. Keywords: irritable bowel syndrome, IBS, treatment, otilonium bromide

  9. Long-term Strategic Planning for a Resilient Metro Colombo: An Economic Case for Wetland Conservation and Management

    Science.gov (United States)

    Rozenberg, J.

    2015-12-01

    Colombo faces recurrent floods that threaten its long-term economic development. Its urban wetlands have been identified by local agencies as a critical component of its flood reduction system, but they have declined rapidly in recent years due to continuous infilling, unmanaged land development and dredging to create lakes. In collaboration with government agencies, NGOs and local universities, the World Bank has carried out a Robust Decision Making analysis to examine the value of Colombo urban wetlands, both in the short-term and long-term, and identify what are the most viable strategies available to increase the city's flood resilience in an unclear future (in terms of climate change and patterns of urban development). This has involved the use of numerous hydrological and socio-economic scenarios as well as the evaluation of some wetlands benefits, like ecosystem services, wastewater treatment, or recreational services. The analysis has determined that if all urban wetlands across the Colombo catchment were lost, in some scenarios the metropolitan area would have to cope with an annual average flood loss of approximately 1% of Colombo GDP in the near future. For long-term strategies, trade-offs between urban development, lake creation and wetland conservation were analyzed and it was concluded that an active management of urban wetlands was the lowest regret option. Finally, the analysis also revealed that in the future, with climate change and fast urban development, wetlands will not be sufficient to protect Colombo against severe floods. Pro-active urban planning and land-use management are therefore necessary, both to protect existing wetlands and to reduce future exposure. The use of many different scenarios, the consideration of several policy options, and the open participatory process ensured policy-makers' buy-in and lead to the decision to actively protect urban wetlands in Colombo.

  10. Long-term effects of grazing management and buffer strips on soil erosion from pastures

    Science.gov (United States)

    High grazing pressure can lead to soil erosion in pastures by compacting soil and increasing runoff and sediment delivery to waterways. Limited information exists on the effects of grazing management and best management practices (BMPs), such as buffer strips, on soil erosion from pastures. The obje...

  11. Perinatal management and long-term cardiac outcome in fetal arrhythmia

    NARCIS (Netherlands)

    Hahurij, N.D.; Blom, N.A.; Lopriore, E.; Aziz, M.I.; Nagel, H.T.; Rozendaal, L.; Vandenbussche, F.P.H.A.

    2011-01-01

    BACKGROUND: cardiac arrhythmias are commonly observed in the fetus, however, may have major consequences for fetal development and post natal life. AIMS: to evaluate the perinatal management and cardiac outcome of fetuses with tachy- or bradyarrhythmia. STUDY DESIGN: perinatal management, outcome

  12. RANGE RAM: a long-term planning method for managing grazing lands

    Science.gov (United States)

    Henricus C. Jansen

    1976-01-01

    Range RAM (Resource Allocation Method) is a computerized planning method designed to assist range managers in developing and selecting alternatives in spatial and temporal allocation of resources. The technique is applicable at the frest or district management levels, or their equivalents. Range RAM can help formulate plans that maximize the production of range outputs...

  13. A risk-based monitoring framework for the long term management of used fuel

    International Nuclear Information System (INIS)

    Garisto, N.C.

    2006-01-01

    The Nuclear Waste Management Organization has a mandate from the Government of Canada to consult with the public and to recommend an approach for managing Canada's used nuclear fuel. Three main fuel management methods are being explored and evaluated by the Nuclear Waste Management Organization: disposal in a Deep Geological Repository (DGR); reactor-site extended storage (RES); and centralized extended storage (CES), either above ground or below ground. The used nuclear fuel management system, whether a DGR or an extended storage system will require monitoring. In this study, a risk-based monitoring framework was developed for the used fuel management program. The proposed approach addresses the unique challenges of used fuel management being implemented in a multi-stakeholder process, including: (i) the complexity of the facilities; (ii) the need to consider both science-based risk and perceived risk in the monitoring plans; and (iii) the difficulty in conducting 'invasive' measurements of sealed systems, particularly over a very long time frame. (author)

  14. Radioactive waste industrial management in France for medium- and long-term

    International Nuclear Information System (INIS)

    Lavie, J.-M.

    1981-01-01

    The context within which the industrial scale management of radioactive wastes takes place is briefly outlined. The regulations already in force or envisaged in France in this field are exposed. Emphasis is given to the activities of the National Agency for the management of radioactive wastes (ANDRA). The reasons why this organization was created are discussed together with the type of work conferred to it, its present workload, the industrial management concepts it applies, its present and future potential, the costs envisaged for waste disposal and the financial solutions adopted. The industrial technical assistance policy of ANDRA is presented [fr

  15. Draft Programmatic Environmental Impact Statement for alternative strategies for the long-term management and use of depleted uranium hexafluoride. Volume 1: Main text

    International Nuclear Information System (INIS)

    1997-12-01

    This PEIS assesses the potential impacts of alternative management of alternative management strategies for depleted uranium hexafluoride (UF 6 ) currently stored at three DOE sites: Paducah site near Paducah, Kentucky; Portsmouth site near Portsmouth, Ohio; and K-25 site on the Oak Ridge Reservation, Oak Ridge, Tennessee. The alternatives analyzed in the PEIS include no action, long-term storage as UF 6 , long-term storage as uranium oxide, use as uranium oxide, use as uranium metal, and disposal. The preferred alternative for the long-term management of depleted UF 6 is to use the entire inventory of material

  16. Draft Programmatic Environmental Impact Statement for alternative strategies for the long-term management and use of depleted uranium hexafluoride. Volume 2: Appendices

    International Nuclear Information System (INIS)

    1997-12-01

    This PEIS assesses the potential impacts of alternative management of alternative management strategies for depleted uranium hexafluoride (UF 6 ) currently stored at three DOE sites: Paducah site near Paducah, Kentucky; Portsmouth site near Portsmouth, Ohio; and K-25 site on the Oak Ridge Reservation, Oak Ridge, Tennessee. The alternatives analyzed in the PEIS include no action, long-term storage as UF 6 , long-term storage as uranium oxide, use as uranium oxide, use as uranium metal, and disposal. The preferred alternative for the long-term management of depleted UF 6 is to use the entire inventory of material. This volume contains the appendices to volume I

  17. Current management strategies and long-term clinical outcomes of upper extremity venous thrombosis

    NARCIS (Netherlands)

    Bleker, S. M.; van Es, N.; Kleinjan, A.; Buller, H. R.; Kamphuisen, P. W.; Aggarwal, A.; Beyer-Westendorf, J.; Camporese, G.; Cosmi, B.; Gary, T.; Ghirarduzzi, A.; Kaasjager, K.; Lerede, T.; Marschang, P.; Meijer, Karina; Otten, H. -M.; Porreca, E.; Righini, M.; Verhamme, P.; van Wissen, S.; Di Nisio, M.

    Background: There is scant information on the optimal management and clinical outcome of deep and superficial vein thrombosis of the upper extremity (UEDVT and UESVT). Objectives: To explore treatment strategies and the incidence of recurrent venous thromboembolism (VTE), mortality, postthrombotic

  18. Long-term evaluation of individualized marketing programs for travel demand management

    Science.gov (United States)

    2010-07-01

    This research examines the use of individualized marketing as a transportation demand : management (TDM) strategy, using the City of Portlands SmartTrips program. This research : project has two specific aims: (1) to evaluate whether the benefits ...

  19. Assessing the effects of early silvicultural management on long-term ...

    African Journals Online (AJOL)

    Eucalyptus is the dominant and most productive planted forest in Brazil, covering ... Usually, a decline of soil quality is caused by management that does not ... preserve crucial physical properties as permeability (root growth, infiltration and ...

  20. Case management after long-term absence from work in China: a case report.

    Science.gov (United States)

    Tang, Dan; Yu, Ignatius Tak Sun; Luo, Xiaoyuan; Liang, Youxin; He, Yonghua

    2011-03-01

    Return-to-work (RTW) after occupational injuries is an important and challenging issue. Case managers are expected to play a vital role in successful RTW. In China, RTW intervention is in its early phase and requires further research and practice. This case report describes Mr. H's RTW process for illustrating the work of a case management team in China. Suggestions on developing and optimizing the process in China are given. After 9 years of absence from work due to severe burn injuries at work, Mr. H was referred for RTW interventions. Mr. H received social and occupational rehabilitation services of 3 months, and the following workplace visits and work trials. After the job placement, the case manager continued the liaison with the worker and employer. Mr. H showed positive changes in occupational and social adjustment after the case management interventions. This was reflected from the shift from the contemplation to action stage on the Lam Assessment of Stages of Employment Readiness. Despite he did not show significant changes on functional capacity and fear avoidance beliefs, Mr. H passed the job credential test and was offered a maintenance technician position at a new company. Both the worker and the employer were satisfied with the outcome of the case management. The RTW interventions carried out by the case managers appeared to be effective within the Chinese system. The results suggested that professional training of case managers, RTW-related policies and technological standards, early integrated interventions should be further developed in China. Disability Adjustment Group Therapy and RTW Support Groups perhaps are useful approaches in workers' returning to work.

  1. Obesity: Risk factors, complications, and strategies for sustainable long-term weight management.

    Science.gov (United States)

    Fruh, Sharon M

    2017-10-01

    The aims of this article are to review the effects of obesity on health and well-being and the evidence indicating they can be ameliorated by weight loss, and consider weight-management strategies that may help patients achieve and maintain weight loss. Narrative review based on literature searches of PubMed up to May 2016 with no date limits imposed. Search included terms such as "obesity," "overweight," "weight loss," "comorbidity," "diabetes," cardiovascular," "cancer," "depression," "management," and "intervention." Over one third of U.S. adults have obesity. Obesity is associated with a range of comorbidities, including diabetes, cardiovascular disease, obstructive sleep apnea, and cancer; however, modest weight loss in the 5%-10% range, and above, can significantly improve health-related outcomes. Many individuals struggle to maintain weight loss, although strategies such as realistic goal-setting and increased consultation frequency can greatly improve the success of weight-management programs. Nurse practitioners have key roles in establishing weight-loss targets, providing motivation and support, and implementing weight-loss programs. With their in-depth understanding of the research in the field of obesity and weight management, nurse practitioners are well placed to effect meaningful changes in weight-management strategies deployed in clinical practice. ©2017 American Association of Nurse Practitioners.

  2. Role of future scenarios in understanding deep uncertainty in long-term air quality management.

    Science.gov (United States)

    Gamas, Julia; Dodder, Rebecca; Loughlin, Dan; Gage, Cynthia

    2015-11-01

    The environment and its interactions with human systems, whether economic, social, or political, are complex. Relevant drivers may disrupt system dynamics in unforeseen ways, making it difficult to predict future conditions. This kind of "deep uncertainty" presents a challenge to organizations faced with making decisions about the future, including those involved in air quality management. Scenario Planning is a structured process that involves the development of narratives describing alternative future states of the world, designed to differ with respect to the most critical and uncertain drivers. The resulting scenarios are then used to understand the consequences of those futures and to prepare for them with robust management strategies. We demonstrate a novel air quality management application of Scenario Planning. Through a series of workshops, important air quality drivers were identified. The most critical and uncertain drivers were found to be "technological development" and "change in societal paradigms." These drivers were used as a basis to develop four distinct scenario storylines. The energy and emissions implications of each storyline were then modeled using the MARKAL energy system model. NOx emissions were found to decrease for all scenarios, largely a response to existing air quality regulations, whereas SO2 emissions ranged from 12% greater to 7% lower than 2015 emissions levels. Future-year emissions differed considerably from one scenario to another, however, with key differentiating factors being transition to cleaner fuels and energy demand reductions. Application of scenarios in air quality management provides a structured means of sifting through and understanding the dynamics of the many complex driving forces affecting future air quality. Further, scenarios provide a means to identify opportunities and challenges for future air quality management, as well as a platform for testing the efficacy and robustness of particular management

  3. Lifetime Management Programs as a basis for the long term operation of nuclear installations

    Energy Technology Data Exchange (ETDEWEB)

    López González, Manuel; Lobato Galeote, Carlos, E-mail: mlopezg@idom.com, E-mail: carlos.lobato@idom.com [IDOM - Consulting, Engineering & Architecture SAU, Madrid (Spain)

    2017-07-01

    From the licensing standpoint there are several approaches worldwide to obtain an authorization to operate a NPP beyond its design life. According to the License Renewal Application (LRA) approach, followed in the United States of America and another countries, plants need to develop a Life Time Management Program (LTMP) with which manage the potential aging processes (corrosion, erosion, erosion-corrosion, radiation and thermally induced embrittlement, fatigue, corrosion fatigue, creep, binding and wear) associated to the Structures, Systems and Components. A LTMP is composed of several tasks which represents a technical challenge for a nuclear installation. (author)

  4. Lifetime Management Programs as a basis for the long term operation of nuclear installations

    International Nuclear Information System (INIS)

    López González, Manuel; Lobato Galeote, Carlos

    2017-01-01

    From the licensing standpoint there are several approaches worldwide to obtain an authorization to operate a NPP beyond its design life. According to the License Renewal Application (LRA) approach, followed in the United States of America and another countries, plants need to develop a Life Time Management Program (LTMP) with which manage the potential aging processes (corrosion, erosion, erosion-corrosion, radiation and thermally induced embrittlement, fatigue, corrosion fatigue, creep, binding and wear) associated to the Structures, Systems and Components. A LTMP is composed of several tasks which represents a technical challenge for a nuclear installation. (author)

  5. Stepwise approach to decision making for long-term radioactive waste management. Experience, issues and guiding principles

    International Nuclear Information System (INIS)

    2004-01-01

    Radioactive waste exists as a result of both past and current practices. One of the most challenging tasks is the management of long-lived waste that must be isolated from the human environment for many thousands, or even hundreds of thousands, of years. Although significant technical progress has been made in developing management schemes that, according to technical experts, would ensure long-term safety (e.g. engineered geologic disposal), the rate of progress towards implementing such solutions has been slower than expected. The contrast between expected and observed rates may be partly attributable to an earlier technical optimism. More significant, however, are the setbacks, which have arisen mainly from an underestimation of the societal and political dimensions. In long-term radioactive waste management, consideration is increasingly being given to concepts such as stepwise decision making and adaptive staging in which the public, and especially the local public, are to be meaningfully involved in the review and planning of developments. The key feature of these concepts is development by steps or stages that are reversible, within the limits of practicability. This is designed to provide reassurance that decisions can be reversed if experience shows them to have adverse or unwanted effects. A stepwise approach to decision making has thus come to the fore as being of value in advancing long-term radioactive waste management solutions in a societally acceptable manner. Despite its early identification within the radioactive waste management community as an important means for reaching solutions and decisions in which there is broad-based confidence, the bases for and application of stepwise decision making has not been widely reviewed. Guiding principles of any such process are still being formulated, its roots in empirical social science research have not been fully reviewed, nor the difficulties of its implementation analysed. The report reviews current

  6. Long-term functioning of a species-rich mountain meadow under different management regimes. Agriculture

    Czech Academy of Sciences Publication Activity Database

    Mašková, Z.; Doležal, J.; Květ, Jan; Zemek, František

    2009-01-01

    Roč. 12, č. 132 (2009), s. 192-202 ISSN 0167-8809 R&D Projects: GA MZe QH92034 Institutional research plan: CEZ:AV0Z60870520 Keywords : Šumava National Park and Biosphere Reserve * grassland management * plant biomass Subject RIV: EF - Botanics Impact factor: 3.130, year: 2009

  7. Long Term Asset Management Strategy for Refurbishment and Replacement of Nuclear Power Plants in Korea

    International Nuclear Information System (INIS)

    Boo, M.H.; Lee, J.G.; Park, J.S.

    2012-01-01

    LTAM strategy was developed for the component level to efficiently manage aging and obsolescence. Systematic monitoring and proactive measures against aging mechanism will reduce unplanned loss due to failure of large components. Also, financial risk for lost power production will be minimized on the basis of fleet-wide LTAM strategies. (author)

  8. Long-term strategies for flood risk management: scenario definition and strategic alternative design

    NARCIS (Netherlands)

    Bruijn, de K.; Klijn, F.; McGahey, C.; Mens, M.; Wolfert, H.P.

    2008-01-01

    This report reviews some mainstream existing methods of scenario development and use, as well as experiences with the design and assessment of strategic alternatives for flood risk management. Next, a procedure and methods are proposed and discussed. Thirdly, the procedure and methods are tried on

  9. Effects of long-term forest management on a regional avifauna

    Science.gov (United States)

    John C. Kilgo; Kathleen E. Franzreb; Sidney A. Gauthreaux; Karl V. Miller; Brian R. Chapman

    2000-01-01

    We compared breeding bird populations on and off of the Savannah River Site, SC, to determine whether management practices have affected abundance and composition of the resident avifauna. We assessed relative abundance by comparing Breeding Bird Survey (BBS) data from six routes off the Savannah River Site with three surrogate routes generated using point-count data...

  10. Modelling long-term water yield effects of forest management in a Norway spruce forest

    Czech Academy of Sciences Publication Activity Database

    Yu, X.; Lamačová, A.; Duffy, Ch.; Krám, P.; Hruška, Jakub; White, T.; Bhatt, G.

    2015-01-01

    Roč. 60, č. 2 (2015), s. 174-191 ISSN 0262-6667 R&D Projects: GA MŠk(CZ) ED1.1.00/02.0073 Institutional support: RVO:67179843 Keywords : Lysina critical zone observatory * PIHM * Norway spruce * forest management Subject RIV: EH - Ecology, Behaviour Impact factor: 2.182, year: 2015

  11. The Biggest Loser Thinks Long-Term: Recency as a Predictor of Success in Weight Management.

    Science.gov (United States)

    Koritzky, Gilly; Rice, Chantelle; Dieterle, Camille; Bechara, Antoine

    2015-01-01

    Only a minority of participants in behavioral weight management lose weight significantly. The ability to predict who is likely to benefit from weight management can improve the efficiency of obesity treatment. Identifying predictors of weight loss can also reveal potential ways to improve existing treatments. We propose a neuro-psychological model that is focused on recency: the reliance on recent information at the expense of time-distant information. Forty-four weight-management patients completed a decision-making task and their recency level was estimated by a mathematical model. Impulsivity and risk-taking were also measured for comparison. Weight loss was measured in the end of the 16-week intervention. Consistent with our hypothesis, successful dieters (n = 12) had lower recency scores than unsuccessful ones (n = 32; p = 0.006). Successful and unsuccessful dieters were similar in their demographics, intelligence, risk taking, impulsivity, and delay of gratification. We conclude that dieters who process time-distant information in their decision making are more likely to lose weight than those who are high in recency. We argue that having low recency facilitates future-oriented thinking, and thereby contributes to behavior change treatment adherence. Our findings underline the importance of choosing the right treatment for every individual, and outline a way to improve weight-management processes for more patients.

  12. The Biggest Loser Thinks Long-Term: Recency as a Predictor of Success in Weight Management

    Directory of Open Access Journals (Sweden)

    Gilly eKoritzky

    2015-12-01

    Full Text Available Only a minority of participants in behavioral weight management lose weight significantly. The ability to predict who is likely to benefit from weight management can improve the efficiency of obesity treatment. Identifying predictors of weight loss can also reveal potential ways to improve existing treatments. We propose a neuro-psychological model that is focused on recency: the reliance on recent information at the expense of time-distant information. Forty-four weight-management patients completed a decision-making task and their recency level was estimated by a mathematical model. Impulsivity and risk-taking were also measured for comparison. Weight loss was measured in the end of the 16-week intervention. Consistent with our hypothesis, successful dieters (n=12 had lower recency scores than unsuccessful ones (n=32; p=0.006. Successful and unsuccessful dieters were similar in their demographics, intelligence, risk taking, impulsivity, and delay of gratification. We conclude that dieters who process time-distant information in their decision making are more likely to lose weight than those who are high in recency. We argue that having low recency facilitates future-oriented thinking, and thereby contributes to behavior change treatment adherence. Our findings underline the importance of choosing the right treatment for every individual, and outline a way to improve weight-management processes for more patients.

  13. Liabilities identification and long-term management decommissioning of nuclear installations in Slovak Republic

    International Nuclear Information System (INIS)

    Burclova, Jana; Konecny, Ladislav

    2003-01-01

    The decommissioning is defined as the safe removal of nuclear facilities from service and reduction of residual radioactivity and/or risk to a level enabling their use for the purpose of another nuclear facility or unrestricted use (site release) and termination of license. The Legal Basis for Decommissioning and Waste Management are described in 4 acts: - 1. Act 130/98 Coll. on peaceful use of nuclear energy (Atomic Act); - 2. The act No 127/1994 Coll. on environmental impact assessment (amended 2000); - 3. The act No 254/1994 Coll. on creation of state found for NPP decommissioning, spent fuel management and disposal investment (amended 2000, 2001); 4. The act No 272/1994 Coll. on protection of public health (amended 1996,2000). The licensing process for radioactive waste management installations as for all nuclear installations is running in following principal steps. The permits for siting, construction, operation including commissioning, individual steps of decommissioning and site release are issued by municipal environmental office on the basis of the Act No 50/1976 Coll. on territorial planning and construction rules and the decisions of the Nuclear regulatory Authority (UJD SR) based on the Atomic Act. The safety documentation shall be prepared by applicant and it is subject of the regulatory bodies approval, for nuclear safety is responsible UJD SR, for radiation protection Ministry of Health, for fire protection Ministry of Interior and for general safety Ministry of Labour, Social Policy and Family. UJD SR issues the permit for each decommissioning phase based on review and approval of safety documentation. Decommissioning Strategy of Slovak Republic was strongly influenced by the changes of Waste Management Strategy. During the last time UJD SR dedicated the great effort to principal improvement of legislation, to cooperation with Ministry of Economy with the aim to create rules for financial sources for decommissioning activities and to enforcement of

  14. Long term management of wastes to be produced by the conversion process. PNGMDR 2013-2015. Study report

    International Nuclear Information System (INIS)

    2015-03-01

    Within the frame of the French national plan for the management of radioactive wastes (PNGMDR), this report addresses the issue of long term management of wastes to be produced by Comurhex installation in Malvesi (the first step of natural uranium processing in France, with purification and transformation into uranium tetrafluoride). The author studied how these wastes could be stored, and also a possible synergy with some uranium-containing or thorium-containing wastes in order to design optimised industrial processes. After a recall of the origin and an inventory of the concerned wastes, this document reports a preliminary acceptability study in a context of very-low-level wastes, and a preliminary acceptability study for a shallow storage

  15. Road Map for Ageing Management and Safe Long Term Operation of Light Water Reactors in Japan

    International Nuclear Information System (INIS)

    Kanno, M.; Sakamoto, H.; Sekimura, N.

    2012-01-01

    The Nuclear Regulatory Authority (tentativename) will be established under the Ministry of Environment, aiming at independent regulatory decision making. Limit of operation to 40 years will be regulated. As an exception, extension of a certain period (<20 years) will be approved only one time when compliance with the regulatory standards is confirmed. It is necessary on a technical information basis to check and evaluate the utilities' activities of the ageing management technical evaluation by the new regulatory organization. Technical information and knowledge-bases for the design, construction, operation and maintenance of nuclear power plants should be utilized comprehensively not only for utilities but also for the regulatory orgnazation. Obsolesce of codes and standards may bring weakness in defense in depth, or higher core damage frequency. Investigation of the aged and thermal material is effective for proactive management and sophistication of codes and standards for ageing managementoflong term operation. (author)

  16. Partnering for long-term management of radioactive waste. Evolution and current practice in thirteen countries

    International Nuclear Information System (INIS)

    2010-01-01

    National radioactive waste management programmes are in various phases of siting facilities and rely on distinct technical approaches for different categories of waste. In all cases, it is necessary for institutional actors and the potential or actual host community to build a meaningful, workable relationship. Partnership approaches are effective in achieving a balance between the requirements of fair representation and competent participation. With host community support, they also help ensure the desirable combination of a licensable site and management concept as well as a balance between compensation, local control and development opportunities. This report provides up-to-date information on experience with local partnership arrangements in 13 countries. The characteristics, advantages and aims of community partnerships are also described in addition to the concept's evolution over the past decade. (authors)

  17. Long-term effects of conservation soil management in Saria, Burkina Faso, West Africa

    OpenAIRE

    Zacharie, Z.

    2011-01-01

    The negative degradation spiral that currently leads to deteriorating soil properties in African drylands is a serious problem that limits food production and threatensthe livelihoods of the people. Nutrient depletion and water and wind erosion are the main factors in soil degradation in Africa. This thesis describes field research conducted from 2006 through 2008 to assess how changes in physical and hydrological soil properties, induced by differences in land management and macro-faunal bi...

  18. MAINTAINING LONG-TERM MANAGEMENT: Herbicide-resistant weeds challenge some signature cropping systems

    Directory of Open Access Journals (Sweden)

    Bradley D. Hanson

    2014-10-01

    Full Text Available Invasive and endemic weeds pose recurring challenges for California land managers. The evolution of herbicide resistance in several species has imposed new challenges in some cropping systems, and these issues are being addressed by UC Cooperative Extension farm advisors, specialists and faculty. There are currently 24 unique herbicide-resistant weed biotypes in the state, dominated by grasses and sedges in flooded rice systems and, more recently, glyphosate-resistant broadleaf and grass weeds in tree and vine systems, roadsides and glyphosate-tolerant field crops. Weed scientists address these complex issues using approaches ranging from basic physiology and genetics research to applied research and extension efforts in grower fields throughout the state. Although solutions to herbicide resistance are not simple and are affected by many biological, economic, regulatory and social factors, California stakeholders need information, training and solutions to address new weed management problems as they arise. Coordinated efforts conducted under the Endemic and Invasive Pests and Disease Strategic Initiative directly address weed management challenges in California's agricultural industries.

  19. The problem of the long-term management of nuclear wastes

    International Nuclear Information System (INIS)

    2005-01-01

    The law from December 30, 1991, precisely defines 3 axes of researches for the management of high level and long-lived radioactive wastes: separation/transmutation, surface storage and underground disposal. A global evaluation report about these researches is to be supplied in 2006 by the French government to the Parliament. A first synthesis of the knowledge gained after 14 years of research has led the national commission of the public debate (CNDP) to organize a national debate about the general options of management of high-level and long-lived radioactive wastes before the 2006 date line. The debate comprises 4 public hearings (September 2005: Bar-le-Duc, Saint-Dizier, Pont-du-Gard, Cherbourg), 12 round-tables (October and November 2005: Paris, Joinville, Caen, Nancy, Marseille), a synthesis meeting (December 2005, Dunkerque) and a closing meeting (January 2006, Lyon). This document is the proceedings of the synthesis meeting of Dunkerque. It comprises an introduction which recalls the stakes and modalities of the debate, followed by a talk from the president of the national association of local commissions for nuclear activities information (ANCLI), and three synthesis talks from the particular commission of the public debate, the ministry of industry, and the committee of experts and counter-experts. These proceedings end with some questions and answers with the public. A slide presentation by B. Dessus about the progresses made in the debate on nuclear wastes management is attached to the document. (J.S.)

  20. Overview of plant life management for long term operation in nuclear power plants

    International Nuclear Information System (INIS)

    Kang, K.S.; Vincze, P.; Bychkov, A.

    2014-01-01

    Many IAEA member states have given high priority to licensing their nuclear power plants to operate for terms longer than the time frame originally anticipated (generally 40 years). The task of managing plant ageing is assigned in most member states to an engineering specialty called 'plant life management' (PLiM) applying a systematic analysis methodology to System Structure Components (SSCs) ageing. In many countries, the safety performance of nuclear power plants is periodically assessed and characterized via the periodic safety review (PSR) process. Regulatory review and acceptance of PSRs constitutes for these countries the licensing requirement for continued operation of the plant to the following PSR cycle (usually 10 years). In the USA and in other countries operating US designed plants, instead of PSR process, a license renewal application (LRA) process is followed, which requires certain prerequisites such as ageing management programs, particularly for passive irreplaceable SSCs. Active components are normally addressed via the maintenance rule (MR) requirements and other established regulatory processes. A third group of member states have adopted a combined approach that incorporates elements of both the PSR process and selected LRA specific requirements, such as time limited ageing analysis. The article ends with some IAEA recommendations for the implementation of national PLiM programs

  1. Antiobesity Pharmacotherapy for Patients with Type 2 Diabetes: Focus on Long-Term Management

    Directory of Open Access Journals (Sweden)

    Won Seon Jeon

    2014-12-01

    Full Text Available Type 2 diabetes and obesity have a complex relationship; obesity is linked to insulin resistance, the precursor to type 2 diabetes. The management of obesity is an important method to delay onset of diabetes and improve the glycemic durability of antidiabetic agents. However, insulin and some of the oral hypoglycemic agents used to treat diabetes cause significant weight gain, and it is difficult for patients with diabetes to reduce and maintain their weight by life-style changes alone. Thus, antiobesity medications or bariatric surgery may be a necessary adjunct for certain obese patients with diabetes. In 2012, the U.S. Food and Drug Administration (FDA approved lorcaserin and phentermine/topiramate extended-release for the management of chronic weight, and approval for naltrexone/bupropion sustained-release as an adjunct to exercise and reduced caloric intake followed in 2014. Liraglutide is pending FDA approval for antiobesity drug. Here we review the efficacy of approved and new promising drugs for the management of obesity.

  2. NOAA's Scientific Data Stewardship Program

    Science.gov (United States)

    Bates, J. J.

    2004-12-01

    The NOAA mission is to understand and predict changes in the Earth's environment and conserve and manage coastal and marine resources to meet the Nation's economic, social and environmental needs. NOAA has responsibility for long-term archiving of the United States environmental data and has recently integrated several data management functions into a concept called Scientific Data Stewardship. Scientific Data Stewardship a new paradigm in data management consisting of an integrated suite of functions to preserve and exploit the full scientific value of NOAA's, and the world's, environmental data These functions include careful monitoring of observing system performance for long-term applications, the generation of authoritative long-term climate records from multiple observing platforms, and the proper archival of and timely access to data and metadata. NOAA has developed a conceptual framework to implement the functions of scientific data stewardship. This framework has five objectives: 1) develop real-time monitoring of all satellite observing systems for climate applications, 2) process large volumes of satellite data extending up to decades in length to account for systematic errors and to eliminate artifacts in the raw data (referred to as fundamental climate data records, FCDRs), 3) generate retrieved geophysical parameters from the FCDRs (referred to as thematic climate data records TCDRs) including combining observations from all sources, 4) conduct monitoring and research by analyzing data sets to uncover climate trends and to provide evaluation and feedback for steps 2) and 3), and 5) provide archives of metadata, FCDRs, and TCDRs, and facilitate distribution of these data to the user community. The term `climate data record' and related terms, such as climate data set, have been used for some time, but the climate community has yet to settle on a concensus definition. A recent United States National Academy of Sciences report recommends using the

  3. Treatment Modalities and Antimicrobial Stewardship Initiatives in the Management of Intra-Abdominal Infections

    Directory of Open Access Journals (Sweden)

    Charles Hoffmann

    2016-02-01

    Full Text Available Antimicrobial stewardship programs (ASPs focus on improving the utilization of broad spectrum antibiotics to decrease the incidence of multidrug-resistant Gram positive and Gram negative pathogens. Hospital admission for both medical and surgical intra-abdominal infections (IAIs commonly results in the empiric use of broad spectrum antibiotics such as fluoroquinolones, beta-lactam beta-lactamase inhibitors, and carbapenems that can select for resistant organisms. This review will discuss the management of uncomplicated and complicated IAIs as well as highlight stewardship initiatives focusing on the proper use of broad spectrum antibiotics.

  4. Efficacy of a Conservative Weight Loss Program in the Long-Term Management of Chronic Upper Airway Obstruction

    Directory of Open Access Journals (Sweden)

    Ryan C. Case

    2009-01-01

    Full Text Available Objective. Obesity is a significant contributor to oxygen demand and dynamic airway obstruction. The objective of the current study is to determine the long-term success of conservative measures directed toward weight reduction on airway management without respect to specific airway disease etiology. Methods. Patients with chronic airway obstruction secondary anatomic lesions or obstructive sleep apnea were recruited and followed prospectively. Demographics, initial and final weights, diagnosis, and followup information were recorded. Patients were referred to a registered dietician, provided counseling, and started on a weight-loss regimen. Outcome measures were change in body mass index (BMI and rate of decannulation from weight loss alone. Results. Of fourteen patients, ten remained tracheostomy-dependent and four had high-grade lesions with the potential for improvement in oxygen demand and dynamic airway collapse with weight loss. The mean follow up period was 25 months. The mean change in BMI was an increase of 1.4 kg/m2 per patient. Conclusions. Conservative measures alone were not effective in achieving weight reduction in the population studied. This may be due to comorbid disease and poor compliance. The promise of decannulation was an insufficient independent motivator for weight loss in this study. Although the theoretical benefits of weight loss support its continued recommendation, the long-term success rate of conservative measures is low. More aggressive facilitated interventions including pharmacotherapy or bariatric surgery should be considered early in the course of treating airway disease complicated by obesity.

  5. Solid Waste Management Units And Areas Of Concern Annual Long-Term Monitoring & Maintenance Report For Calendar Year 2016.

    Energy Technology Data Exchange (ETDEWEB)

    Dotson, Patrick Wells [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Little, Bonnie Colleen [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2017-02-01

    Long-term controls were maintained at 21 Solid Waste Management Units (SWMUs) and Areas of Concern (AOCs) in accordance with the requirements of the “Long-Term Monitoring and Maintenance Plan for SWMUs and AOCs Granted Corrective Action Complete with Controls” in Attachment M of the Resource Conservation and Recovery Act Facility Operating Permit, which took effect February 26, 2015. Maintenance and controls at these SWMUs and AOCs are described and documented in this report. Conditions requiring maintenance or repair activities were not identified for any of the inspected SWMUs or AOCs. Based upon the inspections performed and site conditions observed, the administrative and physical institutional controls in place at the SWMUs and AOCs are effectively providing continued protection of human health and the environment. This report does not present monitoring and maintenance activities for SWMU 76, the Mixed Waste Landfill; those activities adhere to the approved MWL LTMM Plan, Section 4.8.1 requiring a separate annual report which will be submitted to the NMED by June 30, 2017.

  6. Long-Term Management Strategy for Dredged Material Disposal for Naval Facilities at Pearl Harbor, Hawaii Phase III - Analysis of Alternatives and Development of an LTMS

    National Research Council Canada - National Science Library

    Palermo, Michael

    2000-01-01

    This report documents Phase III of a three-phase study to develop a Long-Term Management Study for disposal of dredged material unsuitable for ocean disposal from Pearl Harbor Naval Complex for the next 30 years...

  7. Long-term bladder and bowel management after spinal cord injury: a 20-year longitudinal study.

    Science.gov (United States)

    Savic, Gordana; Frankel, Hans L; Jamous, Mohamed Ali; Soni, Bakulesh M; Charlifue, Susan

    2018-02-16

    Prospective observational. The aim of this study was to analyse changes in bladder and bowel management methods in persons with long-standing spinal cord injury (SCI). Two spinal centres in UK. Data were collected through interviews and examinations between 1990 and 2010 in a sample of persons injured more than 20 years prior to 1990. For the 85 participants who completed the 2010 follow-up, the mean age was 67.7 years and the mean duration of injury was 46.3 years, 80% were male, 37.7% had tetraplegia AIS grade A, B, or C, 44.7% paraplegia AIS A, B, or C, and 17.6% an AIS D grade regardless of level. In all, 50.6% reported having changed their bladder method, 63.1% their bowel method, and 40.5% both methods since they enroled in the study. The reasons for change were a combination of medical and practical. In men, condom drainage remained the most frequent bladder method, and in women, suprapubic catheter replaced straining/expressing as the most frequent method. The use of condom drainage and straining/expressing bladder methods decreased, whereas the use of suprapubic and intermittent catheters increased. Manual evacuation remained the most frequent bowel management method. The percentage of participants on spontaneous/voluntary bowel emptying, straining and medications alone decreased, whereas the use of colostomy and transanal irrigation increased over time. More than half the sample, all living with SCI for more than 40 years, required change in their bladder and bowel management methods, for either medical or practical reasons. Regular follow-ups ensure adequate change of method if/when needed.

  8. Local government involvement in long term resource planning for community energy systems. Demand side management

    Energy Technology Data Exchange (ETDEWEB)

    1992-03-01

    A program was developed to coordinate governmental, research, utility, and business energy savings efforts, and to evaluate future potential actions, based on actual field data obtained during the implementation of Phase I of the State Resource Plan. This has lead to the establishment of a state conservation and energy efficiency fund for the purpose of establishing a DSM Program. By taking a state wide perspective on resource planning, additional savings, including environmental benefits, can be achieved through further conservation and demand management. This effort has already blossomed into a state directive for DSM programs for the natural gas industry.

  9. Ageing Management of the reactor internals in Belgian nuclear units in view of Long Term Operation

    International Nuclear Information System (INIS)

    Gerard, R.; Bertolis, D.; Vissers, S.

    2012-01-01

    The reactor internals support the reactor core, distribute the coolant flow through the core, and guide and protect the rod control cluster assemblies and in-core instrumentation. Their integrity must be guaranteed in all operating and accident conditions. They are exposed to specific degradation mechanisms linked to the intense neutron irradiation, like Irradiation Assisted Stress Corrosion Cracking (IASCC) or potentially void swelling, in addition to more classical mechanisms like fatigue, wear and stress corrosion cracking. A rigorous follow-up of in-service degradation and an effective ageing management is therefore of crucial importance and contributes to the safe and economical operation of nuclear PWR units. (author)

  10. Long-term impact of farm management and crops on soil microorganisms assessed by combined DGGE and PLFA analyses.

    Science.gov (United States)

    Stagnari, Fabio; Perpetuini, Giorgia; Tofalo, Rosanna; Campanelli, Gabriele; Leteo, Fabrizio; Della Vella, Umberto; Schirone, Maria; Suzzi, Giovanna; Pisante, Michele

    2014-01-01

    In the present study, long-term organic and conventional managements were compared at the experimental field of Monsampolo del Tronto (Marche region, Italy) with the aim of investigating soil chemical fertility and microbial community structure. A polyphasic approach, combining soil fertility indicators with microbiological analyses (plate counts, PCR-denaturing gradient gel electrophoresis [DGGE] and phospholipid fatty acid analysis [PLFA]) was applied. Organic matter, N as well as some important macro and micronutrients (K, P, Mg, Mn, Cu, and Zn) for crop growth, were more available under organic management. Bacterial counts were higher in organic management. A significant influence of management system and management x crop interaction was observed for total mesophilic bacteria, nitrogen fixing bacteria and actinobacteria. Interestingly, cultivable fungi were not detected in all analyzed samples. PLFA biomass was higher in the organic and Gram positive bacteria dominated the microbial community in both systems. Even if fungal biomass was higher in organic management, fungal PCR-DGGE fingerprinting revealed that the two systems were very similar in terms of fungal species suggesting that 10 years were not enough to establish a new dynamic equilibrium among ecosystem components. A better knowledge of soil biota and in particular of fungal community structure will be useful for the development of sustainable management strategies.

  11. AECL'S approach to managing long term liabilities at Chalk River Laboratories. Annex II

    International Nuclear Information System (INIS)

    Audet, M.C.

    2006-01-01

    Chalk River Laboratories (CRL) is a large nuclear research and development/ industrial site operated by Atomic Energy of Canada Limited (AECL). Construction of the site started in 1944, and it now includes over 100 buildings/facilities operating in various nuclear fields. A well developed decommissioning programme exists at CRL, with progress being made on decommissioning older redundant buildings, in parallel with ongoing site operations and development. The decommissioning programme is predicated on the assumption that the current nuclear operations will continue over a 100 year operating period, but with a decline towards the end of the period. Although decommissioning and remediation work will be carried out throughout the operational period, residual levels of activity remaining in a few areas will require institutional control (IC) for an assumed period of 300 years. The intention is to complete all necessary active remediation work before the start of the IC period and thereafter rely only on passive means to reduce residual contamination to levels that do not require IC measures. The latter include environmental monitoring, active and passive controls to prevent intrusion, and management controls to prohibit access or development. A formal information and records management programme at CRL has been initiated. (author)

  12. Urethral hydrodistension for management of urethral hypoplasia in prune belly syndrome: long-term results.

    Science.gov (United States)

    Kajbafzadeh, Abdol-Mohammad; Rasouli, Mohammad Reza; Dianat, SeyedSaeid; Nezami, Behtash G; Mahboubi, Amir Hassan; Sina, Alireza

    2010-11-01

    The aim of the study was to evaluate the efficacy and safety of urethral hydrodistension for management of urethral hypoplasia in prune belly syndrome (PBS). During a 10-year period, 7 infants with PBS and urethral hypoplasia presented either with open urachus or surgically created urinary diversion referred to our hospital. Five milliliters of normal saline was pushed via a 22-gauge plastic angiocatheter into the urethra with simultaneous finger pressure on the perineum to occlude the proximal urethra that was repeated with higher volumes of the solution (up to 20 mL). The procedure was continued until a 6F or 8F feeding tube catheter confirmed the urethral patency. Hydrodistension was repeated in 3-month intervals till complete patency was confirmed by imaging. Median age of the infants was 6 (1-8) months. All urethral hydrodistension were successful after 1 to 3 sessions. Follow-up imaging studies showed significant improvement in all patients except one. Natural and surgically created urinary diversions were closed in 6 infants. The hydrodistension create an equal and constant pressure into the urethral wall without any urethral damage. This technique can be considered along with the other available methods for management of urethral hypoplasia in selected cases of PBS. Copyright © 2010 Elsevier Inc. All rights reserved.

  13. UK Regulators Long-term Management of Higher Activity Radioactive Wastes on Nuclear Sites

    International Nuclear Information System (INIS)

    Griffiths, Stephen

    2012-01-01

    There are long time frames from the production of waste to packaging, transport, storage and final disposal in a repository. This entails changing custodians, as the responsible individuals and organisations change. This presentation once again pointed out the importance of a life cycle approach towards RK and M preservation and RWM in general. The traditional focus for the safety case has been examining individual facilities and short term goals (put bluntly, on 'getting the permit'). This approach does not lend itself to forward planning, or a holistic vision of the process. The 'Radioactive waste management case' is an effort to integrate the different individual safety cases, and focus on waste streams rather than facilities, so that the trail of decisions is documented. The concept of 'waste streams' was explained as having been developed in the context of decommissioning, in order to make concrete the idea of 'cradle to grave' life cycle analysis. The importance of creating an 'information management culture' at the level of organisations was underscored. With regard to needing to find a balance between completeness and overload, it was once again pointed out that one needs to wary to avoid a situation of 'Keep everything, find nothing'

  14. Long-term grassland management effects on soil Phosphorus status on rewetted Histosols

    Science.gov (United States)

    Heller, Sebastian; Müller, Jürgen; Kayser, Manfred

    2017-04-01

    Since the Neolithic Period, the cultivation of wetlands has played a significant role for the settlement of Humans northwest Germany. A continuing drainage of the wetlands over the centuries and an intensified soil cultivation during the last decades has caused irreversible peat degradation and led to fundamental changes in the landscape. Nowadays, almost 70 % of the 4345 km2 peatland of Lower Saxony is altered by agriculture. For the revitalization of wetland ecosystems, permanent rewetting is an integral component to preserve the functions of organic soils and achieve resilient, speciesrich wetlands. However, permanent rewetting measures are not always feasible. In our study area at the Osterfeiner Moor, a fen located in the Dümmer lowlands near Osnabrück, intensive forage cropping areas were converted into extensive permanent grasslands accompanied by temporary rewetting during winter. This management practice combined with zero fertilization and a low mowing and grazing intensity aims at mitigating mineralisation of peat layers and creating a habitat for endangered meadow bird species. In this semi-natural ecosystem soil phosphorus (P) dynamics play a crucial role. However, longterm research results on P availability of degraded and rewetted fens are still lacking. Thus, we investigated the interaction of different grassland uses and P dynamics in the soil. We described P depletion of the topsoil over a time scale of 17 years after the implementation of restoration measures. Our study site comprises of 180 ha protected grassland divided into 52 management plots. According to the management system, we divided the plots into meadows, pastures and combinations of cutting and grazing. The soils in our study area can be characterised as drained organic soils, WRB: Rheic Sapric Histosols (Drainic), with drastic degradation properties through moorsh forming processes. Plant-available P (double lactate extraction method: PDL) was analysed from representative topsoil

  15. Angling into the Future: Ten Commandments for Recreational Fisheries Science, Management, and Stewardship in a Good Anthropocene

    Science.gov (United States)

    Elmer, Laura K.; Kelly, Lisa A.; Rivest, Stephanie; Steell, S. Clay; Twardek, William M.; Danylchuk, Andy J.; Arlinghaus, Robert; Bennett, Joseph R.; Cooke, Steven J.

    2017-08-01

    A new geological epoch, the "Anthropocene", has been defined as the period in which humans have had substantial geological and ecological influence on the planet. A positive future for this epoch can be referred to as the "good Anthropocene" and would involve effective management strategies and changes in human behavior that promote the sustainability and restoration of ecosystems. Recreational fisheries hold significant social, cultural, and economic value and can generate many benefits when managed sustainably and thus be an integral part of a "good Anthropocene". Here, we list ten commandments to facilitate persistence and long-term sustainability of recreational fisheries in the "good Anthropocene". This list includes fostering aquatic stewardship, promoting education, using appropriate capture gear, adopting evidence-based management approaches, promoting the concept of resilience, obtaining and using effort data in management, embracing the ecosystem approach, engaging in multilevel collaboration, enhancing accessibility, and embracing optimism. When used singly, or simultaneously, these ten commandments will contribute to the harmonization of sustainable fish populations and angling practices, to create recreational fisheries' "bright spots".

  16. Management of Long-Term Complications of HIV Disease: Focus on Cardiovascular Disease.

    Science.gov (United States)

    Currier, Judith S

    2018-04-01

    HIV-infected individuals on effective antiretroviral therapy experience a number of non-AIDS noncommunicable diseases, such as cardiovascular disease, more frequently than uninfected individuals. Common pathways for such diseases are chronic immune activation and inflammation, including the prolonged inflammation associated with lower nadir CD4+ cell count. Prevention and treatment of non-AIDS conditions include treatment of traditional risk factors, lifestyle interventions, earlier initiation of antiretroviral therapy, and potentially therapies specifically targeting inflammation and immune activation (eg, statins). This article summarizes a presentation by Judith S. Currier, MD, at the IAS-USA continuing education program, Improving the Management of HIV Disease, held in New York, New York, in February 2017.

  17. Long-term efficacy, safety and tolerability of Remoxy for the management of chronic pain.

    Science.gov (United States)

    Pergolizzi, Joseph V; Zampogna, Gianpietro; Taylor, Robert; Raffa, Robert B

    2015-03-01

    Historically, chronic pain generally went under-treated for a variety of objective and subjective reasons, including difficulty to objectively diagnose and manage over a long period of time, potential serious adverse effects of commonly available medications, and patient, healthcare and societal concerns over opioid medications. More recently, in an effort to redress the under-treatment of pain, the number of prescriptions of opioid analgesics has risen dramatically. However, paralleling the increased legitimate use has been a concomitant increase in opioid abuse, misuse and diversion. Pharmaceutical companies have responded by developing a variety of opioid formulations designed to deter abuse by making the products more difficult to tamper with. One such product is Remoxy(®), an extended-release formulation of the strong opioid oxycodone. We review the efficacy, safety and tolerability of this formulation based on the available published literature.

  18. Using Long-Term Removal Data to Manage a Crown-of-Thorns Starfish Population

    Directory of Open Access Journals (Sweden)

    Masako Nakamura

    2016-11-01

    Full Text Available Background: Removal programs are effective strategies for short-term management of Crown-of-Thorns Starfish (Acanthaster spp. populations, especially on a small scale. However, management programs are costly, and, in order to be effective, they must be based on local Acanthaster spp. population dynamics. We have developed simple models to predict the annual number of removable A. cf. solaris along the Onna coast of western central Okinawa Island, where chronic outbreaks have continued for several decades. Methods: The Onna coastal area was divided into five sectors, and annual abundance of small A. cf. solaris individuals was used to predict the total number of removable individuals of a cohort in each sector. Three models were developed, based on size class data collected by the Onna Village Fisheries Cooperative (OVFC for 2003–2015, according to possible patterns of recruitment and adult occurrence. Using the best-fit models selected for each of the five sectors, the number of individuals that potentially escaped removal was calculated. Results: Best-fit models were likely to differ among the five sectors instead of small differences in the coefficients of determination. The models predict differences in the number of residual starfish among sectors; the northernmost sector was predicted to have a high number of residuals and the potential density of A. cf. solaris in the sector exceeded the outbreak criterion. Conclusions: These results suggest how to allocate resources to reduce the population of A. cf. solaris along the Onna coast in 2016. The OVFC implemented a control program for A. cf. solaris based on three model predictions.

  19. Liabilities identification and long-term management at national level (Spain)

    International Nuclear Information System (INIS)

    Espejo Hernandez, Jose Manuel; Gonzalez Gomez, Jose Luis

    2003-01-01

    Radioactive Waste in Spain is due to 9 reactors in operation (7 NPPs) and another one (Vandellos I) under decommissioning, the Juzbado Nuclear Fuel Factory and some 1,300 radioactive installations. From the legal and administrative standpoint, there is an organisation, based on a developed legislative framework in keeping with the evolution of international regulatory requirements, that defines and brings together the main responsibilities of the different parties involved in the process: the Government, through the Ministry of Economy (MECO), responsible for defining policies and awarding the corresponding permits and licenses; the Nuclear Safety Council (CSN), as the sole party responsible for nuclear safety and radiological protection, that reports to the Parliament; ENRESA, a state owned corporation, as the company responsible for radioactive waste management, and the waste producers. From the economic-financial point of view since early 1983, there is a system that covers the financing of radioactive waste management costs, based on the principle of generating funds up-front, throughout the operational lifetime of the nuclear power plants. Those are collected by a fee, consisting of a percentage of the total electricity billing. The income collected through the application of the fee is accumulated in an interest-earning fund for financing of the costs that will normally occur years later. Small producers pay a tariff for the service of collecting and disposing of their waste. The fee is aimed to cover the total costs of managing all types of radioactive waste and spent fuel, as well as of decommissioning of nuclear installations. Although its amount is calculated by summing up the expected costs from all these areas, its collection, and accordingly the rules for it, does not make any distinction of the future destination of the money. ENRESA must evaluate every year the whole life system cost of radioactive waste management. The economical appraisal is

  20. Long-term congestion management by investment in gas-turbine generators : a cost-benefit analysis

    International Nuclear Information System (INIS)

    Tuan, L.A.; Bhattacharya, K.

    2007-01-01

    Load management is one of the most important tasks in the operation of an electric power system. Transmission congestion occurs whenever the grid has one or more violations of the physical, operation, or policy constraints under which it normally operates. In a deregulated electricity market, the independent system operator (ISO) must ensure that contracted power transactions are carried out reliably. Several schemes of congestion management run the risk of increasing electricity prices due to the market power of local generators in congested areas. An alternative is to manage congestion through the installation of reserve gas turbine generators which can be brought online to the system within a short time. The use of gas turbines at different buses in the system can enhance the system in ways of transmission relief during emergency events. This paper proposed a framework for the evaluation of long-term investment by the ISO on gas-turbine generators as a tool for providing transmission congestion relief in the dispatch stage based on cost-benefit analysis. The objective of the framework is to optimally decide the locations and sizes of the generators at different buses in the network in order to minimize the total cost of investment of gas turbines and to minimize total system congestion. A bus-wise cost-benefit analysis was carried out by solving the DC optimal power flow (dc-OPF) model. The CIGRE 32-Bus system was used for the case study. It was shown that network overloading can be significantly reduced with the support of gas turbines at selected buses. The long-term decision of the investment on gas-turbine would depend on the opportunity cost of the gas-turbine with respect to the congestion problem. The gas turbines could also reduce the amount of unserved energy during peak load conditions. 11 refs., 4 tabs., 3 figs

  1. Norway's ongoing, long-term management of Chernobyl affected rural areas

    International Nuclear Information System (INIS)

    Liland, A.

    2004-01-01

    Norway was the country outside the former Soviet Union that received most radioactive fallout from the Chernobyl accident. The deposition was over 100 kBq/m 2 for Cs-137 is the most affected area. In addition, the extended use of unimproved pastures in the food production system resulted in high activity concentrations in foodstuffs. The effective ecological half-times in the Norwegian terrestrial systems have proven longer than earlier anticipated, and the Norwegian authorities still impose countermeasures for livestock at a large scale, even 18 years after the accident. We envisage the need for countermeasures for at least another decade to produce milk and meat that comply with food intervention limits. Specific measures, e.g. dietary advice and whole body counting, are used for the most vulnerable population groups. This talk presents the on-going management of contaminated areas in Norway and topics such as activity concentration levels, countermeasures used, compliance with regulations and financial issues are discussed. (orig.)

  2. Spinal Cord Injury in the Geriatric Population: Risk Factors, Treatment Options, and Long-Term Management.

    Science.gov (United States)

    Ikpeze, Tochukwu C; Mesfin, Addisu

    2017-06-01

    Spinal cord injuries (SCIs) are sustained by more than 12 500 patients per year in the United States and more globally. The SCIs disproportionately affect the elderly, especially men. Approximately 60% of these injuries are sustained traumatically through falls, but nontraumatic causes including infections, tumors, and medication-related epidural bleeding have also been documented. Preexisting conditions such as ankylosing spondylitis and diffuse idiopathic skeletal hyperostosis can render the spine stiff and are risk factors as well as cervical spondylosis and ensuing cervical stenosis. Treatment options vary depending on the severity, location, and complexity of the injury. Surgical management has been growing in popularity over the years and remains an option as it helps reduce spinal cord compression and alleviate pain. Elevating mean arterial pressures to prevent spinal cord ischemia and avoiding the second hit of SCI have become more common as opposed to high dose steroids. Ongoing clinical trials with pharmacological agents such as minocycline and riluzole have shown early, promising results in their ability to reduce cellular damage and facilitate recovery. Though SCI can be life changing, the available treatment options have aimed to reduce pain and minimize complications and maintain quality of life alongside rehabilitative services.

  3. The long term challenges of energy management: keeping all options open

    International Nuclear Information System (INIS)

    Moisan, F.

    2003-01-01

    Before the end of the 21. century, the global energy sector will need to face up to two challenges: climate warming due to greenhouse gas emissions and the increasing scarcity of traditional hydrocarbons. The likely scenarios expected by 2030 demonstrate that we are in the process of witnessing strong growth in the consumption of energy and in CO 2 emissions while at the same time climate experts warn us that we need to achieve a 75 % reduction of emissions in the industrialized nations by 2050. Several technological options may be envisaged in order to meet these challenges including a view generation nuclear power, renewable energy, the storage of carbon dioxide or managing energy consumption, and we need to keep all options open because none of these alone can solve all the problems. The time required for technologies to emerge following research and their penetration into the marketplace can often be several decades. The 2050 deadline is therefore not so at away and we need to stem and reverse the growth in demand from today onwards, something we should da without any misgivings when we consider the considerable uncertainties surrounding supply-side technologies. This profound transformation of our production and consumption methods also involves a change in our lifestyle and our behaviour: our efforts in the field of technological development must be accompanied by a commitment by all citizens to creating a more rational society where energy is concerned. (author)

  4. Long-term changes to flood conditions due to varying management strategies, Rock River, WI

    Science.gov (United States)

    Fredrick, K. C.

    2015-12-01

    The Rock River is a 300-mile tributary of the Mississippi River in southern Wisconsin. Its source is a protected migratory bird habitat called the Horicon National Wildlife Refuge. Below the refuge, the Rock River flows through mostly rural, agricultural areas, with wide floodplain of mixed land use. Between the dam at Horicon and a hydroelectric dam in Watertown, WI, lie the townships of Lebanon, Ashippun, and Ixonia. These rural townships boast productive agricultural lands of mostly corn, soybeans, and alfalfa. Large portions of their land are within the floodplain, underlain by vast expanses of outwash sands and gravels, glaciolacustrine deposits, and tills. Throughout the region, spring floods are common from snowmelt and spring rain. These annual floods may be exacerbated by frozen ground and slow infiltration, making it an accepted part of life for residents. Over the last 8 years, and possibly as many as 20, this segment of the Rock River has seen an increase in flooding both in periodicity and retention of flood waters. Due to the delicate habitat of the wildlife refuge and the commissioned hydroelectric installation at the upper dam in Watertown, the residents and local governments of the Lebanon/Ashippun/Ixonia segment of the river have mostly been left to their own devices to monitor and manage flood events. Lebanon Township has been recording water levels for several years. Recent events at the hydroelectric plant seem to indicate that it may be playing a more important role in the flooding. High water events and flood retention do not correlate well with precipitation for the region. It appears that releases at the dam, or periods of water retention, are driving the long flooding periods upstream. Negative impacts to the region from the flooding include property damage, loss of arable land, and environmental effects.

  5. Persistent genital arousal disorder (PGAD): case report of long-term symptomatic management with electroconvulsive therapy.

    Science.gov (United States)

    Korda, Joanna B; Pfaus, James G; Kellner, Charles H; Goldstein, Irwin

    2009-10-01

    This is the second case report of a woman with bipolar disorder type I who noted the onset of persistent genital arousal disorder (PGAD) symptoms after abrupt cessation of paroxetine. With the worsening of PGAD symptoms, she developed severe depression and suicidal thoughts, resulting in her undergoing electroconvulsive therapy (ECT) as management. To describe a case of PGAD and develop hypotheses to explain the beneficial actions of ECT on PGAD based on 4 years of ECT administration. Patient self-report after obtaining consent, as well as literature review. After the fourth ECT, the patient's PGAD symptoms abated serendipitously. She was placed on ECT on demand for the treatment of her PGAD. With each ECT treatment, PGAD symptoms immediately disappeared, relapsing slowly over time until the next ECT was administered. The patient has, thus far, received a total of 30 treatments of ECT. Side effects continue to be minimal and include brief short-term memory loss, headache, and muscle aches. ECT is known to induce cerebral excitatory and inhibitory neurotransmitter changes after acute and chronic administration. Sexual arousal is stimulated by the action of hypothalamic and limbic dopamine, noradrenaline, melanocortin, and oxytocin, and inhibited by serotonin, cerebral opioids, and endocannabinoids. Based on the patient's bipolar disorder, the mechanism of action of ECT and the observation of ECT effectiveness on her PGAD, we hypothesize the following: (i) bipolar disorder led to central hyperactive dopamine release, an important component in the pathophysiology of her PGAD; (ii) central serotonin deficiency after selective serotonin-reuptake inhibitor (SSRI) withdrawal resulted in a lack of inhibition of sexual excitement; (iii) ECT resulted in lowering of the hyperstimulated central dopamine release; and (iv) ECT led to an increase in sexual inhibition by stimulating serotonin activity. Further research in the central control of sexual arousal is needed.

  6. Long-term outcomes for women versus men with unstable angina/non-ST-segment elevation myocardial infarction managed medically without revascularization

    DEFF Research Database (Denmark)

    Clemmensen, Peter; Roe, Matthew T.; Hochman, Judith S.

    2015-01-01

    BACKGROUND: Women with acute coronary syndromes (ACS) are less likely to undergo invasive revascularization than men, but sex-specific differences in long-term outcomes and platelet reactivity among medically managed ACS patients remain uncertain. We examined sex-specific differences in long......-term ischemic and bleeding outcomes and platelet reactivity for medically managed ACS patients randomized to prasugrel versus clopidogrel plus aspirin. METHODS: Data from 9,326 patients enrolled in TRILOGY ACS were analyzed to determine differences in long-term ischemic and bleeding outcomes between women (n....... There were no sex-specific, treatment-related differences in 30-day platelet reactivity. CONCLUSIONS: Long-term ischemic and bleeding outcomes in medically managed ACS patients were similar for women versus men, as was treatment-related platelet reactivity. Women had a higher baseline risk profile and, after...

  7. Analysis of long term options in the management of closed uranium mining sites in France: a pluralistic expertise experience

    International Nuclear Information System (INIS)

    Marignac, Yves; Barbey, Pierre; Catelinois, Olivier; Crochon, Philippe; Petitfrere, Michael; Guillaumont, Robert

    2008-01-01

    Full text: Palaiseau Public demand and new regulations call for a growing stakeholder involvement in the protection of the public and the environment. On complex technical subjects prone to controversy, a useful advise to decision making processes can be provided by the pluralistic examination of the issues by a group of institutional and non-institutional experts. The French ministers for the environment, health, and industry created in 2005 a pluralistic expert group (GEP), started in mid-2006, to focus on the remediated uranium mines in the Limousin region of France. This group, which receives public funding, brings together experts with varied skills and backgrounds (from institutions, associations and industry, including independent and foreign experts). AREVA NC (COGEMA) the mine owner for the Haute Vienne sites has provided, on request of the administration, documents to assess the situation of the sites, and the French Institute for Radiological Protection and Nuclear Safety (IRSN) has been commissioned to produce a global expertise of this assessment. The GEP has been given the task of contributing this critical analysis and participating in the direction of the global expertise, with the aim to provide the authorities and the operator with recommendations on long-term management and monitoring options for the facilities. The group has also the duty to report to local stakeholders and to inform the general public. Work has been developed in three complementary areas: Improving the assessment of the source term and releases of transfer to the natural environment, including hydrogeological and geochemical studies as well as the characterisation of exhalations of radon; Developing a more thorough assessment of health and environmental impacts, including radiological and chemical risks. This includes, in addition to traditional methods, the first-of-a-kind application of an innovative methodology to assess radio-ecological impacts; - strengthening the

  8. Social Impact of Recharging Activity in Long-Term HRI and Verbal Strategies to Manage User Expectations During Recharge

    Directory of Open Access Journals (Sweden)

    Amol Deshmukh

    2018-04-01

    Full Text Available Social robots perform tasks to help humans in their daily activities. However, if they fail to fulfill expectations this may affect their acceptance. This work investigates the service degradation caused by recharging, during which the robot is socially inactive. We describe two studies conducted in an ecologically valid office environment. In the first long-term study (3 weeks, we investigated the service degradation caused by the recharging behavior of a social robot. In the second study, we explored the social strategies used to manage users’ expectations during recharge. Our findings suggest that the use of verbal strategies (transparency, apology, and politeness can make robots more acceptable to users during recharge.

  9. The role of long-term geologic changes in the regulation of the Canadian nuclear fuel waste management program

    International Nuclear Information System (INIS)

    Flavelle, P.

    1996-01-01

    It is recognized that the geosphere is a dynamic system over the long time frames of nuclear fuel waste disposal. This paper describes how consideration of a dynamic geosphere has impacted upon the evolving regulatory environment in Canada, and how the approach taken to comply with the regulatory requirements can affect the evaluation of long-term geologic changes. AECB staff opinion is that if the maximum possible effect of geologic changes can be demonstrated to have negligible impact on the safety of a nuclear fuel waste repository, then further consideration of a dynamic geosphere is unnecessary for the current review of the Canadian Nuclear Fuel Waste Management Program. (authors). 7 refs., 4 figs

  10. OBRA: a European project to create an observatory for long-term governance on radioactive waste management

    International Nuclear Information System (INIS)

    Martell, Meritxell; Duro, Lara; Bruno, Jordi; Kopetz, Irene

    2007-01-01

    Available in abstract form only. Full text of publication follows: This paper introduces a number of topics that will be addressed by the 'OBRA' project. The OBRA project (2006-2008) is a 2-year Coordination Action under the 6. EURATOM Framework Program (FP) which started on 1. November 2006 and will finish on 31. October 2008. The project aims to assess the feasibility of creating an Observatory for Long-term Governance on Radioactive Waste Management in Europe. OBRA will devise an Observatory to promote appropriate forms of interaction between stakeholders, mainly local and regional communities and experts. The focus and value of OBRA lies on the development of a concrete tool to promote governance processes. With respect to this objective, the paper introduces the project and some of the key questions that have been addressed in the first creative workshop and which will be the focus of OBRA in the following months. (authors)

  11. Life Cycle Management Considerations of Remotely Sensed Geospatial Data and Documentation for Long Term Preservation

    Science.gov (United States)

    Khayat, Mohammad G.; Kempler, Steven J.

    2015-01-01

    As geospatial missions age, one of the challenges for the usability of data is the availability of relevant and updated metadata with sufficient documentation that can be used by future generations of users to gain knowledge from the original data. Given that remote sensing data undergo many intermediate processing steps, for example, an understanding of the exact algorithms employed and the quality of that data produced, could be key considerations for these users. As interest in global climate data is increasing, documentation about older data, their origins, and provenance are valuable to first time users attempting to perform historical climate research or comparative analysis of global change. Incomplete or missing documentation could be what stands in the way of a new researcher attempting to use the data. Therefore, preservation of documentation and related metadata is sometimes just as critical as the preservation of the original observational data. The Goddard Earth Sciences - Data and Information Service Center (GES DISC), a NASA Earth science Distributed Active Archive Center (DAAC), that falls under the management structure of the Earth Science Data and Information System (ESDIS), is actively pursuing the preservation of all necessary artifacts needed by future users. In this paper we will detail the data custodial planning and the data lifecycle process developed for content preservation, our implementation of a Preservation System to safeguard documents and associated artifacts from legacy (older) missions, as well as detail lessons learned regarding access rights and confidentiality of information issues. We also elaborate on key points that made our preservation effort successful; the primary points being: the drafting of a governing baseline for historical data preservation from satellite missions, and using the historical baseline as a guide to content filtering of what documents to preserve. The Preservation System currently archives

  12. Between Participation and Collective Action—From Occasional Liaisons towards Long-Term Co-Management for Urban Resilience

    Directory of Open Access Journals (Sweden)

    Elisabeth Schauppenlehner-Kloyber

    2016-07-01

    Full Text Available For resilience building, cities need to foster learning and innovation processes among all actors in order to develop transformative capacities of urban governance regimes to manage extraordinary situations as well as continuous change. A close collaboration of urban governmental actors and citizens is, therefore, of high importance. This paper explores two different discourses on urban governance: participation and self-organized collective action for the management of the commons. Both address the involvement of citizens into governance, albeit from different perspectives: on the one hand from the viewpoint of the government, selectively handing some of its power over to citizens, on the other hand from the perspective of citizens who self-organize for a collective management of urban commons. Based on experiences in the Austrian city of Korneuburg, it is argued that the collective action literature may help overcome some of the self-criticisms and shortcomings of the participation discourse. More specifically, Elinor Ostrom’s design principles for the management of the commons provide valuable input to overcome restrictions in thinking about citizen participation and to effectively design institutions for long-term urban co-management.

  13. Long-term monitoring of UK river basins: the disconnections between the timescales of hydrological processes and watershed management planning

    Science.gov (United States)

    Howden, N. J. K.; Burt, T.; Worrall, F.

    2016-12-01

    The UK has a wealth of hydrological monitoring data that has both good coverage in space since the early 1970s, and also a few locations where records have been kept continuously for almost 150 years. Such datasets offer unique opportunities for the hydrologist to consider how the concepts of stationarity, change, and definitions of "baseline" resources should be used to shape how we build models of these systems, and how we devise appropriate and sustainable watershed management strategies. In this paper we consider some of the UK's longest hydrological and biogeochemical records, to explore how long records can be used to shape such understanding and, in some cases, how they can be used to identify new modes of behaviour that need to be incorporated into management planning, from the scale of individual watersheds right up to the national scale. We also consider how key timescales of hydrological responses that are evident within the data may pose major problems for watershed management unless appropriate attention is paid to the potential impacts of processes that work over decadal timescales - much longer than sub-decadal water industry investment cycles or short-term projects for watershed management planning. We use our long-term records to show how key processes can be identified, and to illustrate how careful interpretation of shorter term records will improve decision-making for water resource management.

  14. Analyzing and modelling the effect of long-term fertilizer management on crop yield and soil organic carbon in China.

    Science.gov (United States)

    Zhang, Jie; Balkovič, Juraj; Azevedo, Ligia B; Skalský, Rastislav; Bouwman, Alexander F; Xu, Guang; Wang, Jinzhou; Xu, Minggang; Yu, Chaoqing

    2018-06-15

    This study analyzes the influence of various fertilizer management practices on crop yield and soil organic carbon (SOC) based on the long-term field observations and modelling. Data covering 11 years from 8 long-term field trials were included, representing a range of typical soil, climate, and agro-ecosystems in China. The process-based model EPIC (Environmental Policy Integrated Climate model) was used to simulate the response of crop yield and SOC to various fertilization regimes. The results showed that the yield and SOC under additional manure application treatment were the highest while the yield under control treatment was the lowest (30%-50% of NPK yield) at all sites. The SOC in northern sites appeared more dynamic than that in southern sites. The variance partitioning analysis (VPA) showed more variance of crop yield could be explained by the fertilization factor (42%), including synthetic nitrogen (N), phosphorus (P), potassium (K) fertilizers, and fertilizer NPK combined with manure. The interactive influence of soil (total N, P, K, and available N, P, K) and climate factors (mean annual temperature and precipitation) determine the largest part of the SOC variance (32%). EPIC performs well in simulating both the dynamics of crop yield (NRMSE = 32% and 31% for yield calibration and validation) and SOC (NRMSE = 13% and 19% for SOC calibration and validation) under diverse fertilization practices in China. EPIC can assist in predicting the impacts of different fertilization regimes on crop growth and soil carbon dynamics, and contribute to the optimization of fertilizer management for different areas in China. Copyright © 2018. Published by Elsevier B.V.

  15. Total pancreatectomy and islet autotransplantation in children for chronic pancreatitis: indication, surgical techniques, postoperative management, and long-term outcomes.

    Science.gov (United States)

    Chinnakotla, Srinath; Bellin, Melena D; Schwarzenberg, Sarah J; Radosevich, David M; Cook, Marie; Dunn, Ty B; Beilman, Gregory J; Freeman, Martin L; Balamurugan, A N; Wilhelm, Josh; Bland, Barbara; Jimenez-Vega, Jose M; Hering, Bernhard J; Vickers, Selwyn M; Pruett, Timothy L; Sutherland, David E R

    2014-07-01

    Describe the surgical technique, complications, and long-term outcomes of total pancreatectomy and islet autotransplantation (TP-IAT) in a large series of pediatric patients. Surgical management of childhood pancreatitis is not clear; partial resection or drainage procedures often provide transient pain relief, but long-term recurrence is common due to the diffuse involvement of the pancreas. Total pancreatectomy (TP) removes the source of the pain, whereas islet autotransplantation (IAT) potentially can prevent or minimize TP-related diabetes. Retrospective review of 75 children undergoing TP-IAT for chronic pancreatitis who had failed medical, endoscopic, or surgical treatment between 1989 and 2012. Pancreatitis pain and the severity of pain statistically improved in 90% of patients after TP-IAT (P Puestow procedure (P = 0.018), lower body surface area (P = 0.048), higher islet equivalents (IEQ) per kilogram body weight (P = 0.001), and total IEQ (100,000) (P = 0.004) were associated with insulin independence. By multivariate analysis, 3 factors were associated with insulin independence after TP-IAT: (1) male sex, (2) lower body surface area, and (3) higher total IEQ per kilogram body weight. Total IEQ (100,000) was the single factor most strongly associated with insulin independence (odds ratio = 2.62; P < 0.001). Total pancreatectomy and islet autotransplantation provides sustained pain relief and improved quality of life. The β-cell function is dependent on islet yield. Total pancreatectomy and islet autotransplantation is an effective therapy for children with painful pancreatitis that failed medical and/or endoscopic management.

  16. Modeling framework for representing long-term effectiveness of best management practices in addressing hydrology and water quality problems: Framework development and demonstration using a Bayesian method

    Science.gov (United States)

    Liu, Yaoze; Engel, Bernard A.; Flanagan, Dennis C.; Gitau, Margaret W.; McMillan, Sara K.; Chaubey, Indrajeet; Singh, Shweta

    2018-05-01

    Best management practices (BMPs) are popular approaches used to improve hydrology and water quality. Uncertainties in BMP effectiveness over time may result in overestimating long-term efficiency in watershed planning strategies. To represent varying long-term BMP effectiveness in hydrologic/water quality models, a high level and forward-looking modeling framework was developed. The components in the framework consist of establishment period efficiency, starting efficiency, efficiency for each storm event, efficiency between maintenance, and efficiency over the life cycle. Combined, they represent long-term efficiency for a specific type of practice and specific environmental concern (runoff/pollutant). An approach for possible implementation of the framework was discussed. The long-term impacts of grass buffer strips (agricultural BMP) and bioretention systems (urban BMP) in reducing total phosphorus were simulated to demonstrate the framework. Data gaps were captured in estimating the long-term performance of the BMPs. A Bayesian method was used to match the simulated distribution of long-term BMP efficiencies with the observed distribution with the assumption that the observed data represented long-term BMP efficiencies. The simulated distribution matched the observed distribution well with only small total predictive uncertainties. With additional data, the same method can be used to further improve the simulation results. The modeling framework and results of this study, which can be adopted in hydrologic/water quality models to better represent long-term BMP effectiveness, can help improve decision support systems for creating long-term stormwater management strategies for watershed management projects.

  17. Short and Long-Term Disability and Workers' Compensation Health Care Programs: Management Project at Georgetown University Hospital

    National Research Council Canada - National Science Library

    Whippen, Thomas

    2000-01-01

    .... Recent acquisition discussions between Georgetown University medical Center and MedStar provide an opportunity to reengineer the Workers' Compensation and Short and Long-Term Disability Programs...

  18. Immediate endoscopic management of complete iatrogenic anterior urethral injuries: A case series with long-term results

    Directory of Open Access Journals (Sweden)

    Maheshwari Pankaj N

    2005-11-01

    Full Text Available Abstract Background Urethral injury produces partial or complete disruption of the urethral integrity. Advances in endourology have made endoscopic management of most of these injuries feasible without greatly compromising the final result. We report our institutional experience of immediate endoscopic realignment of complete iatrogenic anterior urethral injury. Methods From May 1997 to May 2003, seven patients with complete anterior urethral disruption were managed by immediate endoscopy guided splinting of urethra. Retrograde urethroscopy, combined with fluoroscopic guidance and in some cases antegrade cystoscopy through a suprapubic stab cystostomy was performed. A guide wire was negotiated across the disruption. Later, a 16 F Foley catheter was placed for 1–3 weeks. Patients were followed up at 1, 3, 6 and 12 months and then yearly to assess the long-term outcome of endoscopic management. Results Immediate endoscopic realignment was achieved in all patients. Three patients developed recurrence at six months; that was treated by optical urethrotomy. Only one patient developed multiple recurrences over an average follow-up of 49.2 months (range 7 to 74 months. He was offered open end-to-end urethroplasty at twenty months after third recurrence. Thus immediate endoscopic realignment avoided any further intervention in four patients (57.14%; while after an additional optical urethrotomy, urethroplasty could be avoided in six patients (87.2%. Conclusion Immediate endoscopic realignment of traumatic urethral disruption is a feasible, safe and effective treatment modality for management of patients with iatrogenic complete anterior urethral injuries.

  19. The long-term management of information and records on radioactive waste packages in the United Kingdom

    International Nuclear Information System (INIS)

    Upshall, I.R.; Wisbey, S.J.

    2002-01-01

    It is generally accepted that information associated with the creation, conditioning and packaging of radioactive waste must be maintained for a considerable period of time. During the retention period not only must the storage media be preserved, but the data must remain accessible and in a form that can be interpreted with minimum 'processing'. This will ensure, as far as practicable, that the information accurately represents the nature of the waste and its packaging, that the media employed is suitable for long-term storage and that the storage conditions provide a stable environment. Careful consideration must be given to the type and form of the retained information and the threats to its continued integrity. United Kingdom Nirex Limited (Nirex), in association with experts in records media and management, has undertaken a programme of work to consider the range of media currently available, the threats to media integrity and the implications of a general move towards 'electronic' records. The results of this study are being used to develop an information management system strategy, capable of retaining data for all future phases of radioactive waste management. (author)

  20. Holistic countermeasures evaluation and the sustainable restoration and long-term management of contaminated rural, urban and industrial ecosystems

    International Nuclear Information System (INIS)

    Beresford, N.A.; Wright, S.M.; Barnett, C.L.; Howard, B.J.; Cox, G.; Crout, N.M.J.

    2002-01-01

    Emergency planning as conducted by most national authorities is often focussed upon short-term response (few days - weeks) and addresses issues such as the need for evacuation, problems associated with 1 31I and immediate requirements for restrictions on food and water. There is limited systematic consideration of the long-term management of contaminated areas to ensure their sustainability. Experience following the Chernobyl accident, most especially within the countries of the former Soviet Union (fSU) but also in Scandinavia and the United Kingdom, have demonstrated that countermeasures may have to be employed for a number of decades. The evaluation criteria for the many countermeasures which have been developed needs to be extended from simply effectiveness and radiological protection criteria to a more integrated, holistic approach. Specifically, there needs to be an assessment as to whether countermeasures: can be practically applied; incur considerable direct or side-effect costs; have significant environmental side-effects; and are acceptable to society. In addition, suitable approaches for successfully communicating with a wide range of stake holders must be explored. This is an essential step in developing a decision framework and avoiding problems previously experienced in emergency management. This paper presents results from an ongoing project (see www.strategy-ec.org.uk) to develop a framework for the identification of strategies for the sustainable management of contaminated urban, rural and industrial areas

  1. Dietary and Behavioral Adjustments to Manage Bowel Dysfunction After Surgery in Long-Term Colorectal Cancer Survviors

    Science.gov (United States)

    Sun, Virginia; Grant, Marcia; Wendel, Christopher S.; McMullen, Carmit K.; Bulkley, Joanna E.; Altschuler, Andrea; Ramirez, Michelle; Baldwin, Carol M.; Herrinton, Lisa J.; Hornbrook, Mark C.; Krouse, Robert S.

    2015-01-01

    BACKGROUND Bowel dysfunction is a known complication of colorectal cancer (CRC) surgery. Poor bowel control has a detrimental impact on survivors’ health-related quality of life (HRQOL). This analysis describes the dietary and behavioral adjustments used by CRC survivors to manage bowel dysfunction and compares adjustments used by survivors with permanent ostomy to those with anastomosis. METHODS This mixed-methods analysis included pooled data from several studies that assessed HRQOL in CRC survivors. In all studies, CRC survivors with or without permanent ostomies (N=856) were surveyed using the City of Hope Quality of Life Colorectal Cancer tool. Dietary adjustments were compared by ostomy status and by overall HRQOL score (high versus low). Qualitative data from 13 focus groups and 30 interviews were analyzed to explore specific strategies used by survivors to manage bowel dysfunction. RESULTS CRC survivors made substantial, permanent dietary and behavioral adjustments after surgery, regardless of ostomy status. Survivors who took longer after surgery to become comfortable with their diet or regain their appetite were more likely to report worse HRQOL. Adjustments to control bowel function were divided into four major strategies: dietary adjustments, behavioral adjustments, exercise, and medication use. CONCLUSIONS CRC survivors struggled with unpredictable bowel function and may fail to find a set of management strategies to achieve regularity. Understanding the myriad adjustments used by CRC survivors may lead to evidence-based interventions to foster positive adjustments after surgery and through long-term survivorship. PMID:26159443

  2. Dietary and Behavioral Adjustments to Manage Bowel Dysfunction After Surgery in Long-Term Colorectal Cancer Survivors.

    Science.gov (United States)

    Sun, Virginia; Grant, Marcia; Wendel, Christopher S; McMullen, Carmit K; Bulkley, Joanna E; Altschuler, Andrea; Ramirez, Michelle; Baldwin, Carol M; Herrinton, Lisa J; Hornbrook, Mark C; Krouse, Robert S

    2015-12-01

    Bowel dysfunction is a known complication of colorectal cancer (CRC) surgery. Poor bowel control has a detrimental impact on survivors' health-related quality of life (HRQOL). This analysis describes the dietary and behavioral adjustments used by CRC survivors to manage bowel dysfunction and compares adjustments used by survivors with permanent ostomy to those with anastomosis. This mixed-methods analysis included pooled data from several studies that assessed HRQOL in CRC survivors. In all studies, CRC survivors with or without permanent ostomies (N = 856) were surveyed using the City of Hope Quality of Life Colorectal Cancer tool. Dietary adjustments were compared by ostomy status and by overall HRQOL score (high vs. low). Qualitative data from 13 focus groups and 30 interviews were analyzed to explore specific strategies used by survivors to manage bowel dysfunction. CRC survivors made substantial, permanent dietary, and behavioral adjustments after surgery, regardless of ostomy status. Survivors who took longer after surgery to become comfortable with their diet or regain their appetite were more likely to report worse HRQOL. Adjustments to control bowel function were divided into four major strategies: dietary adjustments, behavioral adjustments, exercise, and medication use. CRC survivors struggled with unpredictable bowel function and may fail to find a set of management strategies to achieve regularity. Understanding the myriad adjustments used by CRC survivors may lead to evidence-based interventions to foster positive adjustments after surgery and through long-term survivorship.

  3. Meso level influences on long term condition self-management: stakeholder accounts of commonalities and differences across six European countries.

    Science.gov (United States)

    Rogers, Anne; Vassilev, Ivaylo; Pumar, Maria J Jesús; Todorova, Elka; Portillo, Mari Carmen; Foss, Christina; Koetsenruijter, Jan; Ratsika, Nikoleta; Serrano, Manuel; Knutsen, Ingrid A Ruud; Wensing, Michel; Roukova, Poli; Patelarou, Evridiki; Kennedy, Anne; Lionis, Christos

    2015-07-08

    European countries are increasingly adopting systems of self -care support (SMS) for long term conditions which focus on enhancing individual, competencies, skills, behaviour and lifestyle changes. To date the focus of policy for engendering greater self- management in the population has been focused in the main on the actions and motivations of individuals. Less attention has been paid to how the broader influences relevant to SMS policy and practice such as those related to food production, distribution and consumption and the structural aspects and economics relating to physical exercise and governance of health care delivery systems might be implicated in the populations ability to self- manage. This study aimed to identify key informants operating with knowledge of both policy and practice related to SMS in order to explore how these influences are seen to impact on the self-management support environment for diabetes type 2. Ninety semi-structured interviews were conducted with key stakeholder informants in Bulgaria, Spain, Greece, Norway, Netherlands and UK. Interviews were transcribed and analysed using thematic and textual analysis. Stakeholders in the six countries identified a range of influences which shaped diabetes self-management (SM). The infrastructure and culture for supporting self- management practice is viewed as driven by political decision-makers, the socio-economic and policy environment, and the ethos and delivery of chronic illness management in formal health care systems. Three key themes emerged during the analysis of data. These were 1) social environmental influences on diabetes self-management 2) reluctance or inability of policy makers to regulate processes and environments related to chronic illness management 3) the focus of healthcare system governance and gaps in provision of self-management support (SMS). Nuances in the salience and content of these themes between partner countries related to the presence and articulation of

  4. Sandia National Laboratories performance assessment methodology for long-term environmental programs : the history of nuclear waste management.

    Energy Technology Data Exchange (ETDEWEB)

    Marietta, Melvin Gary; Anderson, D. Richard; Bonano, Evaristo J.; Meacham, Paul Gregory (Raytheon Ktech, Albuquerque, NM)

    2011-11-01

    Sandia National Laboratories (SNL) is the world leader in the development of the detailed science underpinning the application of a probabilistic risk assessment methodology, referred to in this report as performance assessment (PA), for (1) understanding and forecasting the long-term behavior of a radioactive waste disposal system, (2) estimating the ability of the disposal system and its various components to isolate the waste, (3) developing regulations, (4) implementing programs to estimate the safety that the system can afford to individuals and to the environment, and (5) demonstrating compliance with the attendant regulatory requirements. This report documents the evolution of the SNL PA methodology from inception in the mid-1970s, summarizing major SNL PA applications including: the Subseabed Disposal Project PAs for high-level radioactive waste; the Waste Isolation Pilot Plant PAs for disposal of defense transuranic waste; the Yucca Mountain Project total system PAs for deep geologic disposal of spent nuclear fuel and high-level radioactive waste; PAs for the Greater Confinement Borehole Disposal boreholes at the Nevada National Security Site; and PA evaluations for disposal of high-level wastes and Department of Energy spent nuclear fuels stored at Idaho National Laboratory. In addition, the report summarizes smaller PA programs for long-term cover systems implemented for the Monticello, Utah, mill-tailings repository; a PA for the SNL Mixed Waste Landfill in support of environmental restoration; PA support for radioactive waste management efforts in Egypt, Iraq, and Taiwan; and, most recently, PAs for analysis of alternative high-level radioactive waste disposal strategies including repositories deep borehole disposal and geologic repositories in shale and granite. Finally, this report summarizes the extension of the PA methodology for radioactive waste disposal toward development of an enhanced PA system for carbon sequestration and storage systems

  5. Report: Ongoing Management Improvements and Further Evaluation Vital to EPA Stewardship and Voluntary Programs

    Science.gov (United States)

    Report #2005-P-00007, February 17, 2005. We asked stakeholders to define stewardship, list motivators and obstacles to participating in stewardship programs, and outline key roles for EPA to play to foster participating in environmental stewardship.

  6. Conceptual costing study for the long-term management of the Port Hope area low-level radioactive wastes

    International Nuclear Information System (INIS)

    1989-12-01

    Comparative conceptual cost estimates for several possible options for the long-term management of the Port Hope area low-level radioactive wastes have been developed. Five potentially applicable concepts were considered in the study: shallow land burial, using either unlined trenches, lined trenches or concrete canisters; engineered storage mounds; above-ground concrete vaults; below-ground concrete vaults; and intermediate-depth caverns using either open stopes or shrinkage mining. The objective was to develop comparative estimates. The differences in costs between concepts reflect the differences in handling methodology or costs of additional engineered barriers around the stored waste. An in situ waste volume of 805 000 m 3 , relatively favorable site conditions, a four-year disposal schedule and a consistent costing basis were assumed for each concept. Limited effort was made to optimize specific facility designs or disposal operations. The projected disposal costs vary from $68/m 3 of waste for shallow land burial in unlined trenches, to $312/m 3 of waste disposal in concrete canisters in trenches. The results of this study are reasonably consistent with previous estimates prepared for the low-level Radioactive Waste Management Office

  7. Increasing the Frequency and Timeliness of Pain Assessment and Management in Long-Term Care: Knowledge Transfer and Sustained Implementation

    Directory of Open Access Journals (Sweden)

    Thomas Hadjistavropoulos

    2016-01-01

    Full Text Available Background. Although feasible protocols for pain assessment and management in long-term care (LTC have been developed, these have not been implemented on a large-scale basis. Objective. To implement a program of regular pain assessment in two LTC facilities, using implementation science principles, and to evaluate the process and success of doing so. Methods. The implementation protocol included a pain assessment workshop and the establishment of a nurse Pain Champion. Quality indicators were tracked before and after implementation. Focus groups and interviews with staff were also conducted. Results. The implementation effort was successful in increasing and regularizing pain assessments. This was sustained during the follow-up period. Staff members reported enthusiasm about the protocol at baseline and positive results following its implementation. Despite the success in increasing assessments, we did not identify changes in the percentages of patients reported as having moderate-to-severe pain. Discussion. It is our hope that our feasibility demonstration will encourage more facilities to improve their pain assessment/management practices. Conclusions. It is feasible to implement regular and systematic pain assessment in LTC. Future research should focus on ensuring effective clinical practices in response to assessment results, and determination of longer-term sustainability.

  8. Determinants of turnover among low wage earners in long term care: the role of manager-employee relationships.

    Science.gov (United States)

    Matthews, Michael; Carsten, Melissa K; Ayers, Douglas J; Menachemi, Nir

    2018-02-27

    The demand for Long-Term Care (LTC) is steadily increasing as Baby Boomers age and enter retirement. High turnover rates among employees in LTC creates challenges for supervisors and administrators, and can negatively impact quality of care. This study examines manager-subordinate relationship quality using Leader-Member Exchange Theory (LMX) as an antecedent to turnover among low-wage earners in the LTC environment. Survey data measuring LMX, job satisfaction, and demographic information was collected at time 1, and turnover data was collected 18 months later at time 2. The results reveal that all four LMX dimensions were rated significantly different among subordinates who left versus those who stayed, however, only the LMX dimension of supervisor loyalty was a significant predictor of turnover among low wage earners. Our study adds a more nuanced view of the reasons low-wage employees turnover, and presents implications for clinical managers and LTC organizations more broadly. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. The effectiveness of a nurse practitioner-led pain management team in long-term care: A mixed methods study.

    Science.gov (United States)

    Kaasalainen, Sharon; Wickson-Griffiths, Abigail; Akhtar-Danesh, Noori; Brazil, Kevin; Donald, Faith; Martin-Misener, Ruth; DiCenso, Alba; Hadjistavropoulos, Thomas; Dolovich, Lisa

    2016-10-01

    Considering the high rates of pain as well as its under-management in long-term care (LTC) settings, research is needed to explore innovations in pain management that take into account limited resource realities. It has been suggested that nurse practitioners, working within an inter-professional model, could potentially address the under-management of pain in LTC. This study evaluated the effectiveness of implementing a nurse practitioner-led, inter-professional pain management team in LTC in improving (a) pain-related resident outcomes; (b) clinical practice behaviours (e.g., documentation of pain assessments, use of non-pharmacological and pharmacological interventions); and, (c) quality of pain medication prescribing practices. A mixed method design was used to evaluate a nurse practitioner-led pain management team, including both a quantitative and qualitative component. Using a controlled before-after study, six LTC homes were allocated to one of three groups: 1) a nurse practitioner-led pain team (full intervention); 2) nurse practitioner but no pain management team (partial intervention); or, 3) no nurse practitioner, no pain management team (control group). In total, 345 LTC residents were recruited to participate in the study; 139 residents for the full intervention group, 108 for the partial intervention group, and 98 residents for the control group. Data was collected in Canada from 2010 to 2012. Implementing a nurse practitioner-led pain team in LTC significantly reduced residents' pain and improved functional status compared to usual care without access to a nurse practitioner. Positive changes in clinical practice behaviours (e.g., assessing pain, developing care plans related to pain management, documenting effectiveness of pain interventions) occurred over the intervention period for both the nurse practitioner-led pain team and nurse practitioner-only groups; these changes did not occur to the same extent, if at all, in the control group

  10. Sustaining complex interventions in long-term care: a qualitative study of direct care staff and managers.

    Science.gov (United States)

    Colón-Emeric, Cathleen; Toles, Mark; Cary, Michael P; Batchelor-Murphy, Melissa; Yap, Tracey; Song, Yuting; Hall, Rasheeda; Anderson, Amber; Burd, Andrew; Anderson, Ruth A

    2016-07-16

    Little is known about the sustainability of behavioral change interventions in long-term care (LTC). Following a cluster randomized trial of an intervention to improve staff communication (CONNECT), we conducted focus groups of direct care staff and managers to elicit their perceptions of factors that enhance or reduce sustainability in the LTC setting. The overall aim was to generate hypotheses about how to sustain complex interventions in LTC. In eight facilities, we conducted 15 focus groups with 83 staff who had participated in at least one intervention session. Where possible, separate groups were conducted with direct care staff and managers. An interview guide probed for staff perceptions of intervention salience and sustainability. Framework analysis of coded transcripts was used to distill insights about sustainability related to intervention features, organizational context, and external supports. Staff described important factors for intervention sustainability that are particularly challenging in LTC. Because of the tremendous diversity in staff roles and education level, interventions should balance complexity and simplicity, use a variety of delivery methods and venues (e.g., group and individual sessions, role-play/storytelling), and be inclusive of many work positions. Intervention customizability and flexibility was particularly prized in this unpredictable and resource-strapped environment. Contextual features noted to be important include addressing the frequent lack of trust between direct care staff and managers and ensuring that direct care staff directly observe manager participation and support for the program. External supports suggested to be useful for sustainability include formalization of changes into facility routines, using "train the trainer" approaches and refresher sessions. High staff turnover is common in LTC, and providing materials for new staff orientation was reported to be important for sustainability. When designing or

  11. Management of Diabetes in Long-term Care and Skilled Nursing Facilities: A Position Statement of the American Diabetes Association.

    Science.gov (United States)

    Munshi, Medha N; Florez, Hermes; Huang, Elbert S; Kalyani, Rita R; Mupanomunda, Maria; Pandya, Naushira; Swift, Carrie S; Taveira, Tracey H; Haas, Linda B

    2016-02-01

    Diabetes is more common in older adults, has a high prevalence in long-term care (LTC) facilities, and is associated with significant disease burden and higher cost. The heterogeneity of this population with regard to comorbidities and overall health status is critical to establishing personalized goals and treatments for diabetes. The risk of hypoglycemia is the most important factor in determining glycemic goals due to the catastrophic consequences in this population. Simplified treatment regimens are preferred, and the sole use of sliding scale insulin (SSI) should be avoided. This position statement provides a classification system for older adults in LTC settings, describes how diabetes goals and management should be tailored based on comorbidities, delineates key issues to consider when using glucose-lowering agents in this population, and provides recommendations on how to replace SSI in LTC facilities. As these patients transition from one setting to another, or from one provider to another, their risk for adverse events increases. Strategies are presented to reduce these risks and ensure safe transitions. This article addresses diabetes management at end of life and in those receiving palliative and hospice care. The integration of diabetes management into LTC facilities is important and requires an interprofessional team approach. To facilitate this approach, acceptance by administrative personnel is needed, as are protocols and possibly system changes. It is important for clinicians to understand the characteristics, challenges, and barriers related to the older population living in LTC facilities as well as the proper functioning of the facilities themselves. Once these challenges are identified, individualized approaches can be designed to improve diabetes management while lowering the risk of hypoglycemia and ultimately improving quality of life. © 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly

  12. Combined management of retroperitoneal sarcoma with dose intensification radiotherapy and resection: Long-term results of a prospective trial.

    LENUS (Irish Health Repository)

    Smith, Myles J F

    2014-01-07

    Late failure is a challenging problem following resection of retroperitoneal sarcoma (RPS). We investigated the effects of preoperative XRT plus dose escalation with early postoperative brachytherapy (BT) on long-term survival and recurrence in RPS.

  13. Securing the long-term financing of decommissioning and radioactive waste management - From cost estimates to a comprehensive financing system

    International Nuclear Information System (INIS)

    Aebersold, Michael

    2003-01-01

    One of the most important issues in the area of waste disposal concerns the long-term securing of the necessary financing. Large amounts of money will have to be invested, managed and subsequently spent at the appropriate time, over an extended period of 100 years or more. In an electricity market that is opening up across Europe and is characterised by complicated legal structures, a focus on a handful of major groups and cost pressure due to increased competition, it will be necessary to create the corresponding background conditions. The anticipated costs for decommissioning and disposal will have to be calculated or estimated on the basis of available know-how and criteria. The required funds will then have to be collected and invested on the domestic and international money markets, which given the current situation on the stock markets will by no means be an easy task. But the assurance that enough money will be available is essential for public confidence. Using Switzerland as an example, the author wishes to demonstrate which steps are necessary in order to calculate the potential decommissioning and waste disposal costs based on a defined disposal concept and programme, determine the annual contributions to be paid in by operators, and establish a suitable system for securing the necessary funding. This paper deals with the following issues: 1. Political background and legislative framework in Switzerland; 2. Swiss radioactive waste management policy and programmes; 3. Calculating the decommissioning and waste management costs; 4. Calculating the contributions to the Funds; 5. Financing system

  14. Long-term engagement with a mobile self-management system for people with type 2 diabetes.

    Science.gov (United States)

    Tatara, Naoe; Arsand, Eirik; Skrøvseth, Stein Olav; Hartvigsen, Gunnar

    2013-03-27

    In a growing number of intervention studies, mobile phones are used to support self-management of people with Type 2 diabetes mellitus (T2DM). However, it is difficult to establish knowledge about factors associated with intervention effects, due to considerable differences in research designs and outcome measures as well as a lack of detailed information about participants' engagement with the intervention tool. To contribute toward accumulating knowledge about factors associated with usage and usability of a mobile self-management application over time through a thorough analysis of multiple types of investigation on each participant's engagement. The Few Touch application is a mobile-phone-based self-management tool for patients with T2DM. Twelve patients with T2DM who have been actively involved in the system design used the Few Touch application in a real-life setting from September 2008 until October 2009. During this period, questionnaires and semistructured interviews were conducted. Recorded data were analyzed to investigate usage trends and patterns. Transcripts from interviews were thematically analyzed, and the results were further analyzed in relation to the questionnaire answers and the usage trends and patterns. The Few Touch application served as a flexible learning tool for the participants, responsive to their spontaneous needs, as well as supporting regular self-monitoring. A significantly decreasing (Pmanual entry; intuitive and informative feedback; and rich learning materials, especially about foods. Many grounded design implications were identified through a thorough analysis of results from multiple types of investigations obtained through a year-long field trial of the Few Touch application. The study showed the importance and value of involving patient-users in a long-term trial of a tool to identify factors influencing usage and usability over time. In addition, the study confirmed the importance of detailed analyses of each participant

  15. LIMCAL: a comprehensive food chain model for predicting radiation exposure to man in long-term nuclear waste management

    International Nuclear Information System (INIS)

    Zach, Reto.

    1982-08-01

    A food chain model, LIMCAL, has been designed to aid in the assessment of the effects of long-term nuclear waste management on man far into the future. LIMCAL is particularly suited to the evaluation of an underground vault. Energy budgets, a basic feature of food chains, have been introduced in LIMCAL to help overcome uncertainties imposed by long time spans. LIMCAL includes all the ingestion pathways leading to man, which comprise terrestrial, fresh-water and saltwater food types and man's and animals' drinking water. The terrestrial pathways include both root uptake and leaf deposition. The basic input terms for LIMCAL are annual average radionuclide concentrations in soil, fresh water and saltwater. Annual average air concentrations can be calculated from soil concentrations by using the resuspension factor or the mass-loading approach. Many of the equations in LIMCAL are similar to those in FOOD II and NEPTUN, existing food chain models for contemporary assessments. The basic output of LIMCAL consists of radionculide concentrations in various food types and drinking water, and the resulting ICRP 26 50-year committed effective dose equivalents for infant and adult man. Dose/ concentration ratios can also be calculated readily by LIMCAL. LIMCAL is best described as a deterministic generic quasi-equilibrium assessment model of the linear-chain type. The parameters of LIMCAL have been reviewed in detail in a separate document

  16. On The Ubiquity of Nonstationary Fluvial Suspended Sediment Dynamics: A Call for Long Term Monitoring and Dynamical Sediment Management Strategies

    Science.gov (United States)

    Gray, A. B.

    2017-12-01

    Watersheds with sufficient monitoring data have been predominantly found to display nonstationary suspended sediment dynamics, whereby the relationship between suspended sediment concentration and discharge changes over time. Despite the importance of suspended sediment as a keystone of geophysical and biochemical processes, and as a primary mediator of water quality, stationary behavior remains largely assumed in the context of these applications. This study presents an investigation into the time dependent behavior of small mountainous rivers draining the coastal ranges of the western continental US over interannual to interdecadal time scales. Of the 250+ small coastal (drainage area systems. Temporal patterns of non-stationary behavior provided some evidence for spatial coherence, which may be related to synoptic hydro-metrological patterns and regional scale changes in land use patterns. However, the results also highlight the complex, integrative nature of watershed scale fluvial suspended sediment dynamics. This underscores the need for in-depth, forensic approaches for initial processes identification, which require long term, high resolution monitoring efforts in order to adequately inform management. The societal implications of nonstationary sediment dynamics and their controls were further explored through the case of California, USA, where over 150 impairment listings have resulted in more than 50 sediment TMDLs, only 3 of which are flux based - none of which account for non-stationary behavior.

  17. Alternatives for long-term management of defense high-level radioactive waste, Hanford Reservations, Richland, Washington

    International Nuclear Information System (INIS)

    1977-09-01

    The objective of this document is to provide information or alternatives that are being considered for the long-term management of defense high-level radioactive waste stored at Hanford in underground tanks and in stainless steel-lined concrete basins. For purposes of basic programmatic decision making, four major alternatives based on disposal location are considered. The steps leading to placement of the waste in the following locations are illustrated: existing waste tanks; onsite engineered surface facilities; onsite geologic repository; and offsite geologic repository. The four major disposal alternatives are expanded into 27 alternative plans by considering: (1) variations in the final form of the high-level fraction (with radionuclide removal) to include glass, concrete, and powder; (2) variations in the final form of the dehydrated waste product to include glass, calcined clay, and powder; and (3) variations in the treatment and handling of encapsulated waste to include packaging of capsules in canisters and conversion of the strontium fluoride and cesium chloride to glass; canisters stored in sealed casks on the surface are disposed of in a surface vault after the radionuclides have decayed sufficiently to avoid a heat-transfer problem. A description of the technology, a preliminary risk assessment, and preliminary cost estimates for each of these 27 plans are presented. The technology required to implement any of the 27 alternative plans has not been developed to the point where any plan can be considered completely technically sound and feasible

  18. Immediate and long-term outcomes of bronchial and non-bronchial systemic artery embolisation for the management of haemoptysis

    Energy Technology Data Exchange (ETDEWEB)

    Chun, Joo-Young; Belli, Anna-Maria [St. George' s Hospital, Department of Radiology, London (United Kingdom)

    2010-03-15

    To evaluate the immediate and long-term results of arterial embolisation in the management of haemoptysis and to identify factors influencing outcome. A retrospective analysis was carried out of the medical records and angiograms of 50 patients who underwent transarterial embolisation for haemoptysis. The most frequent causes of haemoptysis included bronchiectasis (16%), active tuberculosis (12%) and aspergilloma (12%). A total of 126 bronchial and non-bronchial systemic arteries were embolised in 62 procedures. Immediate cessation of haemoptysis was achieved in 43 patients (86%). Haemoptysis was controlled in 36 patients (72%), recurred in 14 (28%) and 11 (22%) required repeat embolisation. The worst outcomes were observed in patients with aspergilloma: all six suffered recurrent bleeding and three (50%) died from massive haemoptysis. Aspergilloma was also associated with an increased risk of haemoptysis recurrence (p<0.05). A good clinical outcome was achieved in those with active tuberculosis and malignancy. Complication rates were low and included transient chest pain, false aneurysm and one case of lower limb weakness. Bronchial artery embolisation (BAE) is an effective and safe procedure for haemoptysis control in most cases. However, high recurrence and mortality rates are associated with aspergilloma. Early intervention with repeat embolisation is recommended in these patients and elective surgery should be considered. (orig.)

  19. GMDPtoolbox: A Matlab library for designing spatial management policies. Application to the long-term collective management of an airborne disease.

    Science.gov (United States)

    Cros, Marie-Josée; Aubertot, Jean-Noël; Peyrard, Nathalie; Sabbadin, Régis

    2017-01-01

    Designing management policies in ecology and agroecology is complex. Several components must be managed together while they strongly interact spatially. Decision choices must be made under uncertainty on the results of the actions and on the system dynamics. Furthermore, the objectives pursued when managing ecological systems or agroecosystems are usually long term objectives, such as biodiversity conservation or sustainable crop production. The framework of Graph-Based Markov Decision Processes (GMDP) is well adapted to the qualitative modeling of such problems of sequential decision under uncertainty. Spatial interactions are easily modeled and integrated control policies (combining several action levers) can be designed through optimization. The provided policies are adaptive, meaning that management actions are decided at each time step (for instance yearly) and the chosen actions depend on the current system state. This framework has already been successfully applied to forest management and invasive species management. However, up to now, no "easy-to-use" implementation of this framework was available. We present GMDPtoolbox, a Matlab toolbox which can be used both for the design of new management policies and for comparing policies by simulation. We provide an illustration of the use of the toolbox on a realistic crop disease management problem: the design of long term management policy of blackleg of canola using an optimal combination of three possible cultural levers. This example shows how GMDPtoolbox can be used as a tool to support expert thinking.

  20. SALTO guidelines. Guidelines for peer review of long term operation and ageing management of nuclear power plants

    International Nuclear Information System (INIS)

    2008-01-01

    The average age of nuclear power plants (NPPs) connected to the grid worldwide is increasing. About 20% of all the power reactors operating worldwide have been in operation for more than 30 years, and almost 50% have been in operation for 20 to 30 years, while a rather limited number of new NPPs are being put into operation. In view of this trend, many countries are giving a high priority to continuing the operation of NPPs beyond the time frame originally anticipated (e.g. 30 or 40 years). Long term operation (LTO) for NPPs is operation beyond the established time frame originally set forth by the license term, design limits, standards or regulations. LTO needs to be justified by a safety assessment considering life limiting processes and features for structures, systems and components. Proper and safe LTO is based on the experience and practices of various countries in areas such as plant license renewal, life extension, continued operation and life management. Other activities, including periodic safety review, ageing management and plant modification, are also relevant to LTO. Ageing management of an NPP is an important activity that must be considered before and in conjunction with the decision to enter LTO. Ageing management of NPPs deals with the physical ageing of structures, systems and components (SSCs) that can result in the degradation of their performance characteristics. Thus ageing management helps ensure that SSCs important to safety remain capable of performing their required safety functions. An effective ageing management programme (AMP) is a key element of the safe and reliable operation of NPPs during the originally planned time frame originally planned for their operation, as well as for the period of LTO. In order to assist Member States in managing ageing effectively, the IAEA is developing related safety standards and guidance publications. International peer review is a useful tool for Member States to exchange experience, learn from each

  1. Embedding Data Stewardship in Geoscience Australia

    Science.gov (United States)

    Bastrakova, I.; Fyfe, S.

    2013-12-01

    Ten years of technological innovation now enable vast amounts of data to be collected, managed, processed and shared. At the same time, organisations have witnessed government legislative and policy requirements for open access to public sector data, and a demand for flexibility in access to data by both machine-to-machine and human consumption. Geoscience Australia (GA) has adopted Data Stewardship as an organisation-wide initiative to improve the way we manage and share our data. The benefits to GA including: - Consolidated understanding of GA's data assets and their value to the Agency; - Recognition of the significant role of data custodianship and data management; - Well-defined governance, policies, standards, practices and accountabilities that promote the accessibility, quality and interoperability of GA's data; - Integration of disparate data sets into cohesive information products available online in real time and equally accessible to researchers, government, industry and the public. Although the theory behind data stewardship is well-defined and accepted and the benefits are generally well-understood, practical implementation requires an organisation to prepare for a long-term commitment of resources, both financial and human. Fundamentally this involves: 1. Raising awareness in the organisation of the need for data stewardship and the challenges this entails; 2. Establishing a data stewardship framework including a data governance office to set policy and drive organisational change; and 3. Embedding the functions and a culture of data stewardship into business as usual operations. GA holds a vast amount of data ranging from petabytes of Big Data to significant quantities of relatively small ';long tail' geoscientific observations and measurements. Over the past four years, GA has undertaken strategic activities that prepare us for Data Stewardship: - Organisation-wide audits of GA's data holdings and identification of custodians for each dataset

  2. The long-term prospects of citizens managing urban green space: From place making to place-keeping? : Special feature:TURFGRASS

    NARCIS (Netherlands)

    Mattijssen, T.J.M.; van der Jagt, A.P.N.; Buijs, A.E.; Elands, B.H.M.; Erlwein, S.; Lafortezza, R.

    2017-01-01

    Abstract This paper discusses the long-term management or ‘place-keeping’ of urban green space by citizens and highlights enabling and constraining factors that play a crucial role in this continuity. While authorities have historically been in charge of managing public green spaces, there is an

  3. Long-term impact of reduced tillage and residue management on soil carbon stabilization: Implications for conservation agriculture on contrasting soil

    NARCIS (Netherlands)

    Chivenge, P.P.; Murwira, H.K.; Giller, K.E.; Mapfumo, P.; Six, J.

    2007-01-01

    Residue retention and reduced tillage are both conservation agricultural management options that may enhance soil organic carbon (SOC) stabilization in tropical soils. Therefore, we evaluated the effects of long-term tillage and residue management on SOC dynamics in a Chromic Luvisol (red clay soil)

  4. Long-term integrated river basin planning and management of water quantity and water quality in mining impacted catchments

    Science.gov (United States)

    Pohle, Ina; Zimmermann, Kai; Claus, Thomas; Koch, Hagen; Gädeke, Anne; Uhlmann, Wilfried; Kaltofen, Michael; Müller, Fabian; Redetzky, Michael; Schramm, Martina; Schoenheinz, Dagmar; Grünewald, Uwe

    2015-04-01

    During the last decades, socioeconomic change in the catchment of the Spree River, a tributary of the Elbe, has been to a large extent associated with lignite mining activities and the rapid decrease of these activities in the 1990s. There are multiple interconnections between lignite mining and water management both in terms of water quantity and quality. During the active mining period a large-scale groundwater depression cone has been formed while river discharges have been artificially increased. Now, the decommissioned opencast mines are being transformed into Europe's largest man-made lake district. However, acid mine drainage causes low pH in post mining lakes and high concentrations of iron and sulphate in post mining lakes and the river system. Next to potential changes in mining activities, also the potential impacts of climate change (increasing temperature and decreasing precipitation) on water resources of the region are of major interest. The fundamental question is to what extent problems in terms of water quantity and water quality are exacerbated and whether they can be mitigated by adaptation measures. In consequence, long term water resource planning in the region has to formulate adaptation measures to climate change and socioeconomic change in terms of mining activities which consider both, water quantity and water quality aspects. To assess potential impacts of climate and socioeconomic change on water quantity and water quality of the Spree River catchment up to the Spremberg reservoir in the scenario period up to 2052, we used a model chain which consists of (i) the regional climate model STAR (scenarios with a further increase in temperature of 0 and 2 K), (ii) mining scenarios (mining discharges, cooling water consumption of thermal power plants), (iii) the ecohydrological model SWIM (natural water balance), (iv) the long term water management model WBalMo (managed discharges, withdrawal of water users, reservoir operation) and (v) the

  5. Implementation of an antimicrobial stewardship program targeting residents with urinary tract infections in three community long-term care facilities: a quasi-experimental study using time-series analysis

    OpenAIRE

    Doernberg, Sarah B.; Dudas, Victoria; Trivedi, Kavita K.

    2015-01-01

    Background Asymptomatic bacteriuria in the elderly commonly results in antibiotic administration and, in turn, contributes to antimicrobial resistance, adverse drug events, and increased costs. This is a major problem in the long-term care facility (LTCF) setting, where residents frequently transition to and from the acute-care setting, often transporting drug-resistant organisms across the continuum of care. The goal of this study was to assess the feasibility and efficacy of antimicrobial s...

  6. Predictors of Short- and Long-Term Attrition From the Parents as Agents of Change Randomized Controlled Trial for Managing Pediatric Obesity.

    Science.gov (United States)

    Spence, Nicholas D; Newton, Amanda S; Keaschuk, Rachel A; Ambler, Kathryn A; Jetha, Mary M; Holt, Nicholas L; Rosychuk, Rhonda J; Spence, John C; Sharma, Arya M; Ball, Geoff D C

    Attrition in pediatric weight management is a substantial problem. This study examined factors associated with short- and long-term attrition from a lifestyle and behavioral intervention for parents of children with overweight or obesity. Fifty-two families with children ages 6 to 12 years old and body mass index at or above the 85th percentile participated in a randomized controlled trial focused on parents, comparing parent-based cognitive behavioral therapy with parent-based psychoeducation for pediatric weight management. We examined program attrition using two clinical phases of the intervention: short-term and long-term attrition, modeled using the general linear model. Predictors included intervention type, child/parent weight status, sociodemographic factors, and health of the family system. Higher self-assessed health of the family system was associated with lower short-term attrition; higher percentage of intervention sessions attended by parents was associated with lower long-term attrition. Different variables were significant in our short- and long-term models. Attrition might best be conceptualized based on short- and long-term phases of clinical, parent-based interventions for pediatric weight management. Copyright © 2016 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

  7. Degradation of Alloy 800 steam generator tubing and its long-term behaviour predictions for plant life management

    International Nuclear Information System (INIS)

    Lu, Y.C.; Tapping, R.L.; Pandey, M.D.

    2009-01-01

    results imply that Alloy 800 SG tubing may experience measurable aging after many years of service. Although these preliminary results require further confirmation, special attention should be paid to manage the SG tubing degradation in a proactive and predictable manner. Electric Power Research Institute (EPRI) and Dominion Engineering, Inc. (DEI) have developed probabilistic approaches using a degradation free lifetime Weibull distribution based on the OPEX of Alloy 600 SG tubing and a concept of materials improvement factors (MIFs) to 'predict' the long-term service behaviour of other SG tubing. In this paper, a new concept, 'corrosion stress cycle analysis' (CSCA) based on the concept of 'Fatigue Usage Factor' used in mechanical design, is proposed here as a guide for predictive and proactive SG life management. The CSCA approach assumes that an alloy can tolerate a certain number of corrosion stress cycles, i.e., excursions due to off-specification (assuming that the specifications are appropriate) chemistry conditions and SG transients etc. Using the in-service experience, the number of stress cycles that occurred in the history of a SG and in the future can be estimated and the Alloy 800 SG tubing long-term degradation can then be predicted. (author)

  8. Long term fluctuations of groundwater mine pollution in a sulfide mining district with dry Mediterranean climate: Implications for water resources management and remediation.

    Science.gov (United States)

    Caraballo, Manuel A; Macías, Francisco; Nieto, José Miguel; Ayora, Carlos

    2016-01-01

    Water resources management and restoration strategies, and subsequently ecological and human life quality, are highly influenced by the presence of short and long term cycles affecting the intensity of a targeted pollution. On this respect, a typical acid mine drainage (AMD) groundwater from a sulfide mining district with dry Mediterranean climate (Iberian Pyrite Belt, SW Spain) was studied to unravel the effect of long term weather changes in water flow rate and metal pollutants concentration. Three well differentiated polluting stages were observed and the specific geochemical, mineralogical and hydrological processes involved (pyrite and enclosing rocks dissolution, evaporitic salts precipitation-redisolution and pluviometric long term fluctuations) were discussed. Evidencing the importance of including longer background monitoring stage in AMD management and restoration strategies, the present study strongly advise a minimum 5-years period of AMD continuous monitoring previous to the design of any AMD remediation system in regions with dry Mediterranean climate. Copyright © 2015 Elsevier B.V. All rights reserved.

  9. Stakeholder-led science: engaging resource managers to identify science needs for long-term management of floodplain conservation lands

    Science.gov (United States)

    Bouska, Kristin L.; Lindner, Garth; Paukert, Craig P.; Jacobson, Robert B.

    2016-01-01

    Floodplains pose challenges to managers of conservation lands because of constantly changing interactions with their rivers. Although scientific knowledge and understanding of the dynamics and drivers of river-floodplain systems can provide guidance to floodplain managers, the scientific process often occurs in isolation from management. Further, communication barriers between scientists and managers can be obstacles to appropriate application of scientific knowledge. With the coproduction of science in mind, our objectives were the following: (1) to document management priorities of floodplain conservation lands, and (2) identify science needs required to better manage the identified management priorities under nonstationary conditions, i.e., climate change, through stakeholder queries and interactions. We conducted an online survey with 80 resource managers of floodplain conservation lands along the Upper and Middle Mississippi River and Lower Missouri River, USA, to evaluate management priority, management intensity, and available scientific information for management objectives and conservation targets. Management objectives with the least information available relative to priority included controlling invasive species, maintaining respectful relationships with neighbors, and managing native, nongame species. Conservation targets with the least information available to manage relative to management priority included pollinators, marsh birds, reptiles, and shore birds. A follow-up workshop and survey focused on clarifying science needs to achieve management objectives under nonstationary conditions. Managers agreed that metrics of inundation, including depth and extent of inundation, and frequency, duration, and timing of inundation would be the most useful metrics for management of floodplain conservation lands with multiple objectives. This assessment provides guidance for developing relevant and accessible science products to inform management of highly

  10. Spatiotemporal variation of long-term drought propensity through reliability-resilience-vulnerability based Drought Management Index

    Science.gov (United States)

    Chanda, Kironmala; Maity, Rajib; Sharma, Ashish; Mehrotra, Rajeshwar

    2014-10-01

    This paper characterizes the long-term, spatiotemporal variation of drought propensity through a newly proposed, namely Drought Management Index (DMI), and explores its predictability in order to assess the future drought propensity and adapt drought management policies for a location. The DMI was developed using the reliability-resilience-vulnerability (RRV) rationale commonly used in water resources systems analysis, under the assumption that depletion of soil moisture across a vertical soil column is equivalent to the operation of a water supply reservoir, and that drought should be managed not simply using a measure of system reliability, but should also take into account the readiness of the system to bounce back from drought to a normal state. Considering India as a test bed, 5 year long monthly gridded (0.5° Lat × 0.5° Lon) soil moisture data are used to compute the RRV at each grid location falling within the study domain. The Permanent Wilting Point (PWP) is used as the threshold, indicative of transition into water stress. The association between resilience and vulnerability is then characterized through their joint probability distribution ascertained using Plackett copula models for four broad soil types across India. The joint cumulative distribution functions (CDF) of resilience and vulnerability form the basis for estimating the DMI as a five-yearly time series at each grid location assessed. The status of DMI over the past 50 years indicate that drought propensity is consistently low toward northern and north eastern parts of India but higher in the western part of peninsular India. Based on the observed past behavior of DMI series on a climatological time scale, a DMI prediction model comprising deterministic and stochastic components is developed. The predictability of DMI for a lead time of 5 years is found to vary across India, with a Pearson correlation coefficient between observed and predicted DMI above 0.6 over most of the study area

  11. United States Department of Energy Nuclear Materials Stewardship

    International Nuclear Information System (INIS)

    Newton, J. W.

    2002-01-01

    The Department of Energy launched the Nuclear Materials Stewardship Initiative in January 2000 to accelerate the work of achieving integration and cutting long-term costs associated with the management of the Department's nuclear materials, with the principal focus on excess materials. Management of nuclear materials is a fundamental and enduring responsibility that is essential to meeting the Department's national security, nonproliferation, energy, science, and environmental missions into the distant future. The effective management of nuclear materials is important for a set of reasons: (1) some materials are vital to our national defense; (2) the materials pose physical and security risks; (3) managing them is costly; and (4) costs are likely to extend well into the future. The Department currently manages nuclear materials under eight programs, with offices in 36 different locations. Through the Nuclear Materials Stewardship Initiative, progress was during calendar year 20 00 in achieving better coordination and integration of nuclear materials management responsibilities and in evaluating opportunities to further coordinate and integrate cross-program responsibilities for the treatment, storage, and disposition of excess nuclear materials. During CY 2001 the Departmental approach to nuclear materials stewardship changed consistent with the business processes followed by the new administration. This paper reports on the progress of the Nuclear Materials Stewardship Initiative in evaluating and implementing these opportunities, and the remaining challenges in integrating the long-term management of nuclear materials

  12. Depleted Uranium Hexafluoride Management Program. The technology assessment report for the long-term management of depleted uranium hexafluoride. Volume 1

    Energy Technology Data Exchange (ETDEWEB)

    Zoller, J.N.; Rosen, R.S.; Holliday, M.A. [and others

    1995-06-30

    With the publication of a Request for Recommendations and Advance Notice of Intent in the November 10, 1994 Federal Register, the Department of Energy initiated a program to assess alternative strategies for the long-term management or use of depleted uranium hexafluoride. This Request was made to help ensure that, by seeking as many recommendations as possible, Department management considers reasonable options in the long-range management strategy. The Depleted Uranium Hexafluoride Management Program consists of three major program elements: Engineering Analysis, Cost Analysis, and an Environmental Impact Statement. This Technology Assessment Report is the first part of the Engineering Analysis Project, and assesses recommendations from interested persons, industry, and Government agencies for potential uses for the depleted uranium hexafluoride stored at the gaseous diffusion plants in Paducah, Kentucky, and Portsmouth, Ohio, and at the Oak Ridge Reservation in Tennessee. Technologies that could facilitate the long-term management of this material are also assessed. The purpose of the Technology Assessment Report is to present the results of the evaluation of these recommendations. Department management will decide which recommendations will receive further study and evaluation. These Appendices contain the Federal Register Notice, comments on evaluation factors, independent technical reviewers resumes, independent technical reviewers manual, and technology information packages.

  13. Depleted Uranium Hexafluoride Management Program. The technology assessment report for the long-term management of depleted uranium hexafluoride. Volume 1

    International Nuclear Information System (INIS)

    Zoller, J.N.; Rosen, R.S.; Holliday, M.A.

    1995-01-01

    With the publication of a Request for Recommendations and Advance Notice of Intent in the November 10, 1994 Federal Register, the Department of Energy initiated a program to assess alternative strategies for the long-term management or use of depleted uranium hexafluoride. This Request was made to help ensure that, by seeking as many recommendations as possible, Department management considers reasonable options in the long-range management strategy. The Depleted Uranium Hexafluoride Management Program consists of three major program elements: Engineering Analysis, Cost Analysis, and an Environmental Impact Statement. This Technology Assessment Report is the first part of the Engineering Analysis Project, and assesses recommendations from interested persons, industry, and Government agencies for potential uses for the depleted uranium hexafluoride stored at the gaseous diffusion plants in Paducah, Kentucky, and Portsmouth, Ohio, and at the Oak Ridge Reservation in Tennessee. Technologies that could facilitate the long-term management of this material are also assessed. The purpose of the Technology Assessment Report is to present the results of the evaluation of these recommendations. Department management will decide which recommendations will receive further study and evaluation. These Appendices contain the Federal Register Notice, comments on evaluation factors, independent technical reviewers resumes, independent technical reviewers manual, and technology information packages

  14. Depleted Uranium Hexafluoride Management Program. The technology assessment report for the long-term management of depleted uranium hexafluoride. Volume 2

    Energy Technology Data Exchange (ETDEWEB)

    Zoller, J.N.; Rosen, R.S.; Holliday, M.A. [and others

    1995-06-30

    With the publication of a Request for Recommendations and Advance Notice of Intent in the November 10, 1994 Federal Register, the Department of Energy initiated a program to assess alternative strategies for the long-term management or use of depleted uranium hexafluoride. This Request was made to help ensure that, by seeking as many recommendations as possible, Department management considers reasonable options in the long-range management strategy. The Depleted Uranium Hexafluoride Management Program consists of three major program elements: Engineering Analysis, Cost Analysis, and an Environmental Impact Statement. This Technology Assessment Report is the first part of the Engineering Analysis Project, and assesses recommendations from interested persons, industry, and Government agencies for potential uses for the depleted uranium hexafluoride stored at the gaseous diffusion plants in Paducah, Kentucky, and Portsmouth, Ohio, and at the Oak Ridge Reservation in Tennessee. Technologies that could facilitate the long-term management of this material are also assessed. The purpose of the Technology Assessment Report is to present the results of the evaluation of these recommendations. Department management will decide which recommendations will receive further study and evaluation.

  15. Depleted Uranium Hexafluoride Management Program. The technology assessment report for the long-term management of depleted uranium hexafluoride. Volume 2

    International Nuclear Information System (INIS)

    Zoller, J.N.; Rosen, R.S.; Holliday, M.A.

    1995-01-01

    With the publication of a Request for Recommendations and Advance Notice of Intent in the November 10, 1994 Federal Register, the Department of Energy initiated a program to assess alternative strategies for the long-term management or use of depleted uranium hexafluoride. This Request was made to help ensure that, by seeking as many recommendations as possible, Department management considers reasonable options in the long-range management strategy. The Depleted Uranium Hexafluoride Management Program consists of three major program elements: Engineering Analysis, Cost Analysis, and an Environmental Impact Statement. This Technology Assessment Report is the first part of the Engineering Analysis Project, and assesses recommendations from interested persons, industry, and Government agencies for potential uses for the depleted uranium hexafluoride stored at the gaseous diffusion plants in Paducah, Kentucky, and Portsmouth, Ohio, and at the Oak Ridge Reservation in Tennessee. Technologies that could facilitate the long-term management of this material are also assessed. The purpose of the Technology Assessment Report is to present the results of the evaluation of these recommendations. Department management will decide which recommendations will receive further study and evaluation

  16. Impacts of weather on long-term patterns of plant richness and diversity vary with location and management.

    Science.gov (United States)

    Jonas, Jayne L; Buhl, Deborah A; Symstad, Amy J

    2015-09-01

    Better understanding the influence of precipitation and temperature on plant assemblages is needed to predict the effects of climate change. Many studies have examined the relationship between plant productivity and weather (primarily precipitation), but few have directly assessed the relationship between plant richness or diversity and weather despite their increased use as metrics of ecosystem condition. We focus on the grasslands of central North America, which are characterized by high temporal climatic variability. Over the next 100 years, these grasslands are predicted to experience further increased variability in growing season precipitation, as well as increased temperatures, due to global climate change. We assess the portion of interannual variability of richness and diversity explained by weather, how relationships between these metrics and weather vary among plant assemblages, and which aspects of weather best explain temporal variability. We used an information-theoretic approach to assess relationships between long-term plant richness and diversity patterns and a priori weather covariates using six data sets from four grasslands. Weather explained up to 49% and 63% of interannual variability in total plant species richness and diversity, respectively. However, richness and diversity responses to specific weather variables varied both among sites and among experimental treatments within sites. In general, we found many instances in which temperature was of equal or greater importance as precipitation, as well as evidence of the importance of lagged effects and precipitation or temperature variability. Although precipitation has been shown to be a key driver of productivity in grasslands, our results indicate that increasing temperatures alone, without substantial changes in precipitation patterns, could have measurable effects on Great Plains grassland plant assemblages and biodiversity metrics. Our results also suggest that richness and diversity

  17. Are Established Methods of Physiotherapeutic Management for Long-term Neurological Conditions Applicable to 'Orphan' Conditions such as Syringomyelia?

    Science.gov (United States)

    Smith, Rebecca; Jones, Gareth; Curtis, Alexandra; Murphy, Hollie; Flint, Graham

    2016-03-01

    Syringomyelia is a rare or 'orphan' condition with the potential to cause significant disability and detrimental effects to quality of life. Syringomyelia shares similar symptoms to those common in other long-term neurological conditions, including spinal cord injury and multiple sclerosis. In these more prevalent conditions, physiotherapy is utilized widely and is effective in optimizing physical, psychological and social parameters. Therefore, we theorized that physiotherapy might be transferable to, and beneficial to syringomyelia patients. As a paucity of literature exists in this area, we aimed to evaluate the existing uptake and perceived efficacy of physiotherapy. An exploratory, mixed methodology was selected to derive sufficient qualitative data for analysis. Specifically designed questionnaires and semi-structured interviews yielded data on uptake and perceived physiotherapy efficacy. One hundred patients from a National Health Service tertiary syringomyelia service were invited to participate. The questionnaire and interviews were completed by 49 and 20 patients, respectively. Of the small number of patients receiving physiotherapy, the majority reported beneficial effects on pain modulation and quality of life. Stretching and hydrotherapy were deemed effective for relief of pain and stiffness. Additionally, physiotherapy was reported to provide similar benefits to surgical intervention. Syringomyelia patients report physiotherapy to provide benefits for symptom management and quality of life. Such findings suggest that established rehabilitation techniques in more common conditions may be transferable to those less prevalent. Uptake of physiotherapy was limited, seemingly because of inadequate information, knowledge and resources. To address these deficiencies, further studies should be planned investigating the effectiveness of physiotherapy modalities, such as hydrotherapy, in parallel or in conjunction with surgery and/or pharmacology. Additionally

  18. Long-term modeling of the forest-grassland ecotone in the French Alps: implications for land management and conservation.

    Science.gov (United States)

    Carlson, Bradley Z; Renaud, Julien; Biron, Pierre Eymard; Choler, Philippe

    2014-07-01

    Understanding decadal-scale land-cover changes has the potential to inform current conservation policies. European mountain landscapes that include numerous protected areas provide a unique opportunity to weigh the long-term influences of land-use practices and climate on forest-grassland ecotone dynamics. Aerial photographs from four dates (1948, 1978, 1993, and 2009) were used to quantify the extent of forest and grassland cover at 5-m resolution across a 150-km2 area in a protected area of the southwestern French Alps. The study area included a grazed zone and a nongrazed zone that was abandoned during the 1970s. We estimated time series of a forestation index (FI) and analyzed the effects of elevation and grazing on FI using a hierarchical linear mixed effect model. Forest extent (composed primarily of mountain pine, Pinus uncinata) expanded from 50.6 km2 in 1948 to 85.5 km2 in 2009, i.e., a 23% increase in relative cover at the expense of grassland communities. Over the sixty-year period, the treeline rose by 118 m, from 1564 to 1682 m. Rapid forest expansion within the nongrazed zone followed the cessation of logging activities and was likely accelerated by climate warming during the 1980s. Within the grazed zone, the maintained presence of sheep did not fully counteract mountain pine expansion and led to highly contrasting rates of land-cover change based on the location of shepherds' cabins and water sources. Projections of FI for 2030 showed remnant patches of intensively used grasslands interspersed in a densely forested matrix. Our analysis of mountain land-cover dynamics provided strong evidence for forest encroachment into grassland habitat despite consistent grazing pressure. This pattern may be attributed to the disappearance of traditional land-use practices such as shrub burning and removal. Our findings prompt land managers to reconsider their initial conservation priority (i.e., the protection of a renowned mountain pine forest) and to implement

  19. Long-term management of wastes resulting from dismantling operations. Storing the very low-level activity wastes at Morvilliers

    International Nuclear Information System (INIS)

    Duret, F.; Dutzer, M.; Beranger, V.; Lecoq, P.

    2003-01-01

    Extension of dismantling operations in France in the years to come poses the question of availability of long-term waste facility. Large amount of such wastes will be produced after progressive shutdown of the 58 pressurized water reactors now in operation, not before 2010. However, France is already confronted with dismantling of 9 power reactors (6 of which of gas cooled graphite type), the first reprocessing plant at Marcoule, as well as, dismantling of other installations, for instance the CEA reactors or laboratories. The systems of processing the dismantling waste are not different from those used for wastes resulting from nuclear operations. For the high-level or long-term intermediate level activity disposal the debates must start by 2006, as based on the results of the research conducted according to different provisions of the December 30, 1991 law. These wastes represent however small amounts from the dismantling (around 2000 t for the 9 reactors at shutdown) and they will be stored until a decision will be made. A specific storing system should be implemented by 2008-2010 for the graphite wastes (around 23,000 t) which contain significant amount of long-lived radioelements, although their gross activity is low. But the most significant amount will come from low-level or intermediate-level of short lifetime or from wastes of very low activity. The first category is stored at Storage Center at Aube (CSA), its capacity being of 1,000,000 m 3 of drums. The total volume stored by the end of 2002 amounted 136,500 m 3 with an annual delivering of 12-15,000 m 3 at design rate of 30,000 m 3 /y. This center will be able to absorb the flux increase resulting from dismantling of the decommissioned nuclear installations (around 50,000 t from the dismantling of the 9 power reactor). The Center at Aube can be also adapted for storing wastes of large sizes as for instance the lid of the reactor vessel. According to the French regulation, the wastes produced within a

  20. Are we missing the boat? Current uses of long-term biological monitoring data in the evaluation and management of marine protected areas.

    Science.gov (United States)

    Addison, P F E; Flander, L B; Cook, C N

    2015-02-01

    Protected area management agencies are increasingly using management effectiveness evaluation (MEE) to better understand, learn from and improve conservation efforts around the globe. Outcome assessment is the final stage of MEE, where conservation outcomes are measured to determine whether management objectives are being achieved. When quantitative monitoring data are available, best-practice examples of outcome assessments demonstrate that data should be assessed against quantitative condition categories. Such assessments enable more transparent and repeatable integration of monitoring data into MEE, which can promote evidence-based management and improve public accountability and reporting. We interviewed key informants from marine protected area (MPA) management agencies to investigate how scientific data sources, especially long-term biological monitoring data, are currently informing conservation management. Our study revealed that even when long-term monitoring results are available, management agencies are not using them for quantitative condition assessment in MEE. Instead, many agencies conduct qualitative condition assessments, where monitoring results are interpreted using expert judgment only. Whilst we found substantial evidence for the use of long-term monitoring data in the evidence-based management of MPAs, MEE is rarely the sole mechanism that facilitates the knowledge transfer of scientific evidence to management action. This suggests that the first goal of MEE (to enable environmental accountability and reporting) is being achieved, but the second and arguably more important goal of facilitating evidence-based management is not. Given that many MEE approaches are in their infancy, recommendations are made to assist management agencies realize the full potential of long-term quantitative monitoring data for protected area evaluation and evidence-based management. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Short- and Long-Term Theory-Based Predictors of Physical Activity in Women Who Participated in a Weight-Management Program

    Science.gov (United States)

    Wasserkampf, A.; Silva, M. N.; Santos, I. C.; Carraça, E. V.; Meis, J. J. M.; Kremers, S. P. J.; Teixeira, P. J.

    2014-01-01

    This study analyzed psychosocial predictors of the Theory of Planned Behavior (TPB) and Self-Determination Theory (SDT) and evaluated their associations with short- and long-term moderate plus vigorous physical activity (MVPA) and lifestyle physical activity (PA) outcomes in women who underwent a weight-management program. 221 participants (age…

  2. Ex post and ex ante evaluation of the long term management plan for sole and plaice in the North Sea (part 1): ex post

    NARCIS (Netherlands)

    Miller, D.C.M.; Poos, J.J.

    2009-01-01

    This report describes the first part of an ex post and ex ante evaluation of the long term management plan for sole and plaice in the North Sea as laid out in Council Regulation (EC) No 676/2007. This plan has been in place since 2007. The plan aims to ensure, in its first stage, that the stocks of

  3. Commissioning of self-management support for people with long-term conditions: an exploration of commissioning aspirations and processes.

    Science.gov (United States)

    Reidy, Claire; Kennedy, Anne; Pope, Catherine; Ballinger, Claire; Vassilev, Ivo; Rogers, Anne

    2016-07-15

    To explore how self-management support (SMS) is considered and conceptualised by Clinical Commissioning Groups (CCGs) and whether this is reflected in strategic planning and commissioning. SMS is an essential element of long-term condition (LTC) management and CCGs are responsible for commissioning services that are coordinated, integrated and link into patient's everyday lives. This focus provides a good test and exemplar for how commissioners communicate with their local population to find out what they need. A multisite, quasi-ethnographic exploration of 9 CCGs. National Health Service (NHS) CCGs in southern England, representing varied socioeconomic status, practice sizes and rural and urban areas. Content analysis of CCG forward plans for mention of SMS. Semistructured interviews with commissioners (n=10) explored understanding of SMS and analysed thematically. The practice of commissioning explored through the observations of Service User Researchers (n=5) attending Governing Body meetings (n=10, 30 hours). Observations illuminate the relative absence of SMS and gateways to active engagement with patient and public voices. Content analysis of plans point to tensions between local aspirations and those identified by NHS England for empowering patients by enhancing SMS services ('person-centred', whole systems). Interview data highlight disparities in the process of translating the forward plans into practice. Commissioners reference SMS as a priority yet details of local initiatives are notably absent with austerity (cost-containment) and nationally measured biomedical outcomes taking precedence. Commissioners conceptualise locally sensitive SMS as a means to improve health and reduce service use, but structural and financial constraints result in prioritisation of nationally driven outcome measures and payments relating to biomedical targets. Ultimately, there is little evidence of local needs driving SMS in CCGs. CCGs need to focus more on early strategic

  4. Percutaneous-endoscopic rendezvous procedure for the management of bile duct injuries after cholecystectomy: short- and long-term outcomes

    NARCIS (Netherlands)

    Schreuder, Anne Marthe; Booij, Klaske A. C.; de Reuver, Philip R.; van Delden, Otto M.; van Lienden, Krijn P.; Besselink, Marc G.; Busch, Olivier R.; Gouma, Dirk J.; Rauws, Erik A. J.; van Gulik, Thomas M.

    2018-01-01

    Bile duct injury (BDI) remains a daunting complication of laparoscopic cholecystectomy. In patients with complex BDI, a percutaneous-endoscopic rendezvous procedure may be required to establish bile duct continuity. The aim of this study was to assess short- and long-term outcomes of the rendezvous

  5. Efficacy and safety of pimecrolimus cream in the long-term management of atopic dermatitis in children

    NARCIS (Netherlands)

    Wahn, Ulrich; Bos, Jan D.; Goodfield, Mark; Caputo, Ruggero; Papp, Kim; Manjra, Ahmed; Dobozy, Attila; Paul, Carle; Molloy, Stephen; Hultsch, Thomas; Graeber, Michael; Cherill, Robert; de Prost, Yves

    2002-01-01

    OBJECTIVE: Pimecrolimus cream (SDZ ASM 981), a nonsteroid inhibitor of inflammatory cytokines, is effective in atopic dermatitis (AD). We assessed whether early treatment of AD signs/symptoms with pimecrolimus could influence long-term outcome by preventing disease flares. METHODS: Early

  6. Integrated Weed Control for Land Stewardship at Legacy Management's Rocky Flats Site in Colorado - 13086

    International Nuclear Information System (INIS)

    Nelson, Jody K.

    2013-01-01

    Land stewardship is one of nine sustainability programs in the U.S. Department of Energy's Environmental Management System. Land stewardship includes maintaining and improving ecosystem health. At the Rocky Flats Site near Westminster, Colorado, land stewardship is an integral component of the Office of Legacy Management's post-closure monitoring and management at the site. Nearly 263 hectares (650 acres) were disturbed and re-vegetated during site cleanup and closure operations. Proactive management of revegetation areas is critical to the successful reestablishment of native grasslands, wetlands, and riparian communities. The undisturbed native plant communities that occur at the site also require active management to maintain the high-quality wetlands and other habitats that are home to numerous species of birds and other wildlife such as elk and deer, rare plant communities, and the federally listed threatened Preble's meadow jumping mouse. Over the past several decades, an increase of Noxious weeds has impacted much of Colorado's Front Range. As a result, weed control is a key component of the land stewardship program at Rocky Flats. Thirty-three species of state-listed Noxious weeds are known to occur in the Central and Peripheral Operable Units at Rocky Flats, along with another five species that are considered invasive at the site. Early detection and rapid response to control new invasive species is crucial to the program. An integrated weed control/vegetation management approach is key to maintaining healthy, sustainable plant communities that are able to resist Noxious weed invasions. Weed mapping, field surveys, and field-staff training sessions (to learn how to identify new potential problem species) are conducted to help detect and prevent new weed problems. The integrated approach at Rocky Flats includes administrative and cultural techniques (prevention), mechanical controls, biological controls, and chemical controls. Several species of biocontrol

  7. Long-term collections

    CERN Multimedia

    Collectes à long terme

    2007-01-01

    The Committee of the Long Term Collections (CLT) asks for your attention for the following message from a young Peruvian scientist, following the earthquake which devastated part of her country a month ago.

  8. Long-term impact of reduced tillage and residue management on soil carbon stabilization: Implications for conservation agriculture on contrasting soils

    OpenAIRE

    Chivenge, P.P.; Murwira, H.K.; Giller, K.E.; Mapfumo, P.; Six, J.

    2007-01-01

    Metadata only record The long-term effects of tillage system and residue management on soil organic carbon stabilization are studied in two tropical soils in Zimbabwe, a red clay and a sandy soil. The four tillage systems evaluated were conventional tillage (CT), mulch ripping (MR), clean ripping (CR) and tied ridging (TR). Soil organic carbon (SOC) content was measured for each size fraction as well as total SOC. Based on the findings, the authors conclude that residue management - mainta...

  9. Managing treatment fatigue in patients with multiple sclerosis on long-term therapy: the role of multiple sclerosis nurses

    Directory of Open Access Journals (Sweden)

    Crawford A

    2014-08-01

    Full Text Available Ann Crawford, Sally Jewell,* Holly Mara, Laura McCatty, Regina Pelfrey The Lash Group; Frisco, TX, USA *Sally Jewell is now retired Abstract: This article discusses the many ways that nurses can address the factors that lead to treatment fatigue in patients with multiple sclerosis (MS on long-term disease-modifying therapy, ultimately helping to preserve the patient’s health and quality of life. Patients with MS on long-term therapy may suffer from treatment fatigue and poor adherence due to a variety of different factors, including difficulties with injections, anxiety/depression, financial problems, and inaccurate beliefs about the MS disease process. Because MS nurses have regular interactions with patients, they are ideally situated to help patients cope with these and other factors that may limit adherence. Keywords: multiple sclerosis, disease-modifying therapy, injection, nurse

  10. A long-term optimization method for reservoir management in a market oriented hydro-dominated power systems

    International Nuclear Information System (INIS)

    Sultovic, E.; Sarajcev, I.; Majstrovic, M.

    2001-01-01

    This paper presents an optimization-based method for the long-term scheduling of hydrothermal power system. The proposed method maximizes the profit of hydroelectric production in power system based on monthly energy requirement of the system and unit commitment calculations. The method allows precise hydro chain modeling with numerous restrictions as well as computation for multiple-reservoir river systems with multiple-purpose operation. The method has been implemented in a computer program and tested on power system, which is very similar to Croatian Power System in the year 2000. Several testing results are given. Presented method can be applicable for long-term planning in a competitive electricity market due to possibility of unit commitment calculations with different electrical energy price during scheduling horizon. (authors)

  11. Fluoroscopically guided caudal epidural steroid injection for management of degenerative lumbar spinal stenosis: short-term and long-term results

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Joon Woo; Myung, Jae Sung; Kang, Heung Sik [Seoul National University Bundang Hospital, Department of Radiology, Seong Nam, Gyeongi-do (Korea); Park, Kun Woo; Yeom, Jin S. [Seoul National University Bundang Hospital, Department of Orthopaedic Surgery, Seong Nam, Gyeongi-do (Korea); Kim, Ki-Jeong; Kim, Hyun-Jib [Seoul National University Bundang Hospital, Department of Neurosurgery, Seong Nam, Gyeongi-do (Korea)

    2010-07-15

    To evaluate the short-term and long-term effects of fluoroscopically guided caudal epidural steroid injection (ESI) for the management of degenerative lumbar spinal stenosis (DLSS) and to analyze outcome predictors. All patients who underwent caudal ESI in 2006 for DLSS were included in the study. Response was based on chart documentation (aggravated, no change, slightly improved, much improved, no pain). In June 2009 telephone interviews were conducted, using formatted questions including the North American Spine Society (NASS) patient satisfaction scale. For short-term and long-term effects, age difference was evaluated by the Mann-Whitney U test, and gender, duration of symptoms, level of DLSS, spondylolisthesis, and previous operations were evaluated by Fisher's exact test. Two hundred and sixteen patients (male: female = 75:141; mean age 69.2 years; range 48{proportional_to}91 years) were included in the study. Improvements (slightly improved, much improved, no pain) were seen in 185 patients (85.6%) after an initial caudal ESI and in 189 patients (87.5%) after a series of caudal ESIs. Half of the patients (89/179, 49.8%) replied positively to the NASS patient satisfaction scale (1 or 2). There were no significant outcome predictors for either the short-term or the long-term responses. Fluoroscopically guided caudal ESI was effective for the management of DLSS (especially central canal stenosis) with excellent short-term and good long-term results, without significant outcome predictors. (orig.)

  12. Megavoltage pituitary irradiation in the management of Cushing's disease and Nelson's syndrome: long-term follow-up

    International Nuclear Information System (INIS)

    Howlett, T.A.; Plowman, P.N.; Wass, J.A.H.; Rees, L.H.; Jones, A.E.; Besser, G.M.

    1989-01-01

    The authors report the long-term follow-up (up to 17.3 years) of the clinical and biochemical effects of megavoltage pituitary irradiation (radiotherapy;RT), administered as primary or secondary therapy, for pituitary Cushing's disease and Nelson's syndrome in 52 patients. Irradiation was administered, from a 4-15 MeV linear accelerator, via a three-field technique, to a total dose of 4500 cGy (rad) in 25 fractions over 35 days. (author)

  13. Educational Needs of Health Care Providers Working in Long-Term Care Facilities with Regard to Pain Management

    Directory of Open Access Journals (Sweden)

    Yannick Tousignant-Laflamme

    2012-01-01

    Full Text Available BACKGROUND: The prevalence of chronic pain ranges from 40% to 80% in long-term care facilities (LTCF, with the highest proportion being found among older adults and residents with dementia. Unfortunately, pain in older adults is underdiagnosed, undertreated, inadequately treated or not treated at all. A solution to this problem would be to provide effective and innovative interdisciplinary continuing education to health care providers (HCPs.

  14. An assessment of the long term suitability of present and proposed methods for the management of uranium mill tailings

    International Nuclear Information System (INIS)

    1979-07-01

    Proposals for safe, long-term containment of conventional tailings include 1) storage under water, 2) storage in active, abandoned or specially created underground mines and, 3) storage in open pits, with subsequent flooding or covering with overburden. The underwater proposal can meet most of the requirements of long term containment; however, extensive study of existing tailings deposits in deep water locations will be needed. Underground mines cannot provide sufficient storage capacity, since the tailings bulk during mill operation can occupy twice the volume of the original ore. It is possible to reduce the hazard by reducing the radium and thorium content of the tailings. Proposals for such an undertaking include ore beneficiation with rejection of the relatively innocuous fraction, radium-thorium removal in the mill, and significant changes in both ore processing and treatment of tailings. It is concluded that surface-stored tailings are vulnerable over the long term to dispersion by leaching and water erosion, and that access to a tailings site cannot be prevented, while only a major climatic or seismic event could disturb tailings stored in suitable underwater or underground mine sites. The criteria for determining suitability for each method, however, will need to be identified, tested, and accepted through the normal process of modeling, pilot plant evaluation, monitoring and evaluation. (author)

  15. Efficacy and safety of pimecrolimus cream in the long-term management of atopic dermatitis in children.

    Science.gov (United States)

    Wahn, Ulrich; Bos, Jan D; Goodfield, Mark; Caputo, Ruggero; Papp, Kim; Manjra, Ahmed; Dobozy, Attila; Paul, Carle; Molloy, Stephen; Hultsch, Thomas; Graeber, Michael; Cherill, Robert; de Prost, Yves

    2002-07-01

    between treatment groups in response to recall antigens in those patients who remained on study for 12 months. Treatment of early AD signs/symptoms with pimecrolimus was effective in preventing progression to flares in more than half the patients, reducing or eliminating the need for topical corticosteroids. The benefits were consistently seen at 6 months across important disease severity subgroups and with respect to the various predefined efficacy endpoints. Furthermore, these benefits were sustained for 12 months, providing evidence that long-term treatment with pimecrolimus leads to better control of AD. Treatment with pimecrolimus was well tolerated and was not associated with clinically relevant adverse events compared with the conventional treatment group. The results reported here offer the prospect of effective long-term management of AD with reduced need for topical corticosteroids.

  16. Emerging concepts and requirements for the long-term management of non-radioactive hazardous wastes - would geological disposal be an appropriate solution for some of these wastes

    International Nuclear Information System (INIS)

    Rein, K. von

    1994-01-01

    This work deals with the emerging concepts and requirements for the long-term management of non-radioactive hazardous wastes. After some generalities on the pollution of natural environment and the legislations taken by the swedish government the author tries to answer to the question : would geological disposal be an appropriate solution for the non-radioactive hazardous wastes? Then is given the general discussion of the last three articles concerning the background to current environmental policies and their implementation and more particularly the evolution and current thoughts about environmental policies, the managing hazardous activities and substances and the emerging concepts and requirements for the long-term management of non-radioactive hazardous wastes. Comments and questions concerning the similarity or otherwise between the present position of radioactive waste disposal and the background to current environmental policies are indicated. (O.L.)

  17. Coordination of short-term and long-term mitigation measures of hydro-meteorological risks: the importance of establishing a link between emergency management and spatial planning

    Science.gov (United States)

    Prenger-Berninghoff, Kathrin; Cortes, V. Juliette; Aye, Zar Chi; Sprague, Teresa

    2013-04-01

    The management of natural hazards involves, as generally known, the four stages of the risk management cycle: Prevention, preparedness, response and recovery. Accordingly, the mitigation of disasters can be performed in terms of short-term and long-term purposes. Whereas emergency management or civil protection helps to strengthen a community's capacity to be better prepared for natural hazards and to better respond in case a disaster strikes, thus addressing the short-term perspective, spatial planning serves long-term planning goals and can therefore implement long-term prevention measures. A purposefully applied risk mitigation strategy requires coordination of short-term and long-term mitigation measures and thus an effective coordination of emergency management and spatial planning. Several actors are involved in risk management and should consequently be linked throughout the whole risk management cycle. However, these actors, partly because of a historically fragmented administrative system, are hardly connected to each other, with spatial planning only having a negligible role compared to other actors1, a problem to which Young (2002) referred to as the "problem of interplay". In contrast, information transfer and decision-taking happen at the same time and are not coordinated among different actors. This applies to the prevention and preparedness phase as well as to the recovery phase, which basically constitutes the prevention phase for the next disaster2. Since investments in both risk prevention and emergency preparedness and response are considered necessary, a better coordination of the two approaches is required. In this regard, Decision Support Systems (DSS) can be useful in order to provide support in the decision-making aspect of risk management. The research work currently undertaken examines the problem of interplay in the four case study areas of the Marie Curie ITN, CHANGES3. The link between different risk management actors will be explored

  18. Social networks, work and network-based resources for the management of long-term conditions: a framework and study protocol for developing self-care support

    Directory of Open Access Journals (Sweden)

    Kapadia Dharmi

    2011-05-01

    Full Text Available Abstract Background Increasing the effective targeting and promotion of self-care support for long-term conditions requires more of a focus on patient contexts and networks. The aim of this paper is to describe how within a programme of research and implementation, social networks are viewed as being centrally involved in the mobilisation and deployment of resources in the management of a chronic condition. This forms the basis of a novel approach to understanding, designing, and implementing new forms of self-management support. Methods Drawing on evidence syntheses about social networks and capital and the role of information in self-management, we build on four conceptual approaches to inform the design of our research on the implementation of self-care support for people with long-term conditions. Our approach takes into consideration the form and content of social networks, notions of chronic illness work, normalisation process theory (NPT, and the whole systems informing self-management engagement (WISE approach to self-care support. Discussion The translation and implementation of a self-care agenda in contemporary health and social context needs to acknowledge and incorporate the resources and networks operating in patients' domestic and social environments and everyday lives. The latter compliments the focus on healthcare settings for developing and delivering self-care support by viewing communities and networks, as well as people suffering from long-term conditions, as a key means of support for managing long-term conditions. By focusing on patient work and social-network provision, our aim is to open up a second frontier in implementation research, to translate knowledge into better chronic illness management, and to shift the emphasis towards support that takes place outside formal health services.

  19. Carbon stewardship: land management decisions and the potential for carbon sequestration in Colorado, USA

    International Nuclear Information System (INIS)

    Failey, Elisabeth L; Dilling, Lisa

    2010-01-01

    Land use and its role in reducing greenhouse gases is a key element of policy negotiations to address climate change. Calculations of the potential for enhanced terrestrial sequestration have largely focused on the technical characteristics of carbon stocks, such as vegetation type and management regime, and to some degree, on economic incentives. However, the actual potential for carbon sequestration critically depends on who owns the land and additional land management decision drivers. US land ownership patterns are complex, and consequently land use decision making is driven by a variety of economic, social and policy incentives. These patterns and incentives make up the 'carbon stewardship landscape'-that is, the decision making context for carbon sequestration. We examine the carbon stewardship landscape in the US state of Colorado across several public and private ownership categories. Achieving the full potential for land use management to help mitigate carbon emissions requires not only technical feasibility and financial incentives, but also effective implementing mechanisms within a suite of often conflicting and hard to quantify factors such as multiple-use mandates, historical precedents, and non-monetary decision drivers.

  20. Sharing Responsibility for Data Stewardship Between Scientists and Curators

    Science.gov (United States)

    Hedstrom, M. L.

    2012-12-01

    Data stewardship is becoming increasingly important to support accurate conclusions from new forms of data, integration of and computation across heterogeneous data types, interactions between models and data, replication of results, data governance and long-term archiving. In addition to increasing recognition of the importance of data management, data science, and data curation by US and international scientific agencies, the National Academies of Science Board on Research Data and Information is sponsoring a study on Data Curation Education and Workforce Issues. Effective data stewardship requires a distributed effort among scientists who produce data, IT staff and/or vendors who provide data storage and computational facilities and services, and curators who enhance data quality, manage data governance, provide access to third parties, and assume responsibility for long-term archiving of data. The expertise necessary for scientific data management includes a mix of knowledge of the scientific domain; an understanding of domain data requirements, standards, ontologies and analytical methods; facility with leading edge information technology; and knowledge of data governance, standards, and best practices for long-term preservation and access that rarely are found in a single individual. Rather than developing data science and data curation as new and distinct occupations, this paper examines the set of tasks required for data stewardship. The paper proposes an alternative model that embeds data stewardship in scientific workflows and coordinates hand-offs between instruments, repositories, analytical processing, publishers, distributors, and archives. This model forms the basis for defining knowledge and skill requirements for specific actors in the processes required for data stewardship and the corresponding educational and training needs.

  1. Long-term management of radioactive waste - will the Price-Anderson system work for third party liability issues arising from the Nuclear Waste Policy Act of 1982

    International Nuclear Information System (INIS)

    Kuznick, S.K.

    1985-01-01

    Two pieces of legislation have been enacted in the United States to provide a framework for the management of radioactive waste and spent nuclear fuel: the Low-level Radioactive Waste Policy Act (1980) and the Nuclear Waste Policy Act of 1982. Neither of these statutes provide a means for resolving third party liability issues arising out of radioactive waste management. However, the Price Anderson Act (originally enacted in 1957) provides a system of financial protection that can be applied to waste management activities and that can resolve most issues pertaining to liability for nuclear damage that may result from long-term management of radioactive waste and spent nuclear fuel. (NEA) [fr

  2. New maintenance strategy of Tokyo Electric Power Company and Fukushima Dai-ichi Nuclear Power Plant for effective ageing management and safe long-term operation

    International Nuclear Information System (INIS)

    Inagaki, Takeyuki; Yamashita, Norimichi

    2009-01-01

    Fukushima Dai-ichi Nuclear Power Plant is the oldest among three nuclear power plants owned and operated by Tokyo Electric Power Company, which consists of six boiling water reactor units. The commercial operation of Unit 1 was commenced in 1971 (37 years old) and Unit 6 in 1978 (29 years old). Currently ageing degradations of systems, structures and components are managed through maintenance programs, component replacement/refurbishment programs and long-term maintenance plans. The long-term maintenance plans are established through ageing management component replacement/refurbishment programs reviews performed before the 30th year of operation and they are for safe and reliable operation after 30 years (long-term operation). However the past maintenance actions and past component replacement/refurbishment programs were not always proactive and past operational experience and maintenance practices suggest that effective/proactive ageing management programs be introduced in earlier stage of the plant operation. In this circumstance, Tokyo Electric Power Company and Fukushima Dai-ichi Nuclear Power Plant are setting up a new maintenance strategy that includes 1) improving the normal maintenance programs by using ageing degradation data, 2) effective use of information on internal/external operational experience and maintenance practices related to ageing, and 3) proactive component/equipment refurbishment programs during a refreshment outage for safe and reliable long-term operation. To accomplish the goal of this strategy, strengthening engineering capability of plant staff members is a crucial required for the plant. The objective of this paper is to briefly explain main results ageing management reviews, past and current significant ageing issues and management programs against them, and the new maintenance strategy established by Tokyo Electric Power Company and Fukushima Dai-ichi Nuclear Power Plant. (author)

  3. Long-term management of the existing radioactive wastes and residues at the Niagara Falls Storage Site. Draft Environmental Impact Statement

    International Nuclear Information System (INIS)

    1984-08-01

    The statement assesses and compares several alternatives for long-term management of the existing radioactive wastes and residues at the Niagara Falls Storage Site (NFSS), Lewiston, New York. The alternatives include: (1) no action (continued interim storage at NFSS within a diked and capped containment area), (2) long-term management at NFSS (improved containment, with or without modified form of the residues), (3) long-term management at other DOE sites (Hanford, Washington, or Oak Ridge, Tennessee), and (4) offsite management of the residues at Hanford or Oak Ridge and either leaving the wastes at NFSS or removing them for disposal in the ocean. In addition to alternatives analyzed in depth, several options are also considered, including: other modifications of residue form, modification of the basic conceptual designs, other containment design options, transportation routes, and transportation modes. The radiological health effects (primarily increased risk of cancer) associated with long-term management of the wastes and residues are expected to be smaller than the nonradiological risks of occupational and transportation-related injuries and deaths. During the action period, the risk is highest for workers if all wastes and residues are moved to Hanford. The risk is highest for the general public if the residues are moved to Hanford and the wastes are moved to the ocean. Dispersal of the slightly contaminated wastes in the ocean is not expected to result in any significant impacts on the ocean environment or pose any significant radiological risk to humans. For all alternatives, if controls ceased, there would be eventual dispersion of the radioactive materials to the environment. If it is assumed that all controls cease, predicted time for loss of covers over the buried materials ranges from several hundred years to more than two million years, depending on the use of the land surface

  4. The Role of the Government and the Public in the Planning of Long Term Management for Nuclear Fuel Wastes in Canada

    International Nuclear Information System (INIS)

    Diah Hidayanti; Yudi Pramono

    2007-01-01

    The generation of electricity from nuclear power has the consequence of producing some wastes that are radioactive, especially in the form of spent fuels which are classified as high level nuclear wastes. Nuclear fuel wastes must be managed properly in order to protect public and environment from its big potential hazard. One type of long term management for nuclear fuel wastes is the final disposal in a permanent storage. Because of the importance of safety aspects for final disposal, it needs the involvement of government and the public to determine the reliability and the acceptance of final disposal concept. Those involvements can be implemented in some aspects such as regulation aspect, review and assessment process, and the public feedback. The evaluation on the plan of long term management for nuclear fuel wastes in Canada provides Indonesia an overview of its long term management plans for all radioactive materials, including nuclear fuel wastes generated from the nuclear power plant which is planned to be in service by 2016. (author)

  5. Analysis of streamflow distribution of non-point source nitrogen export from long-term urban-rural catchments to guide watershed management in the Chesapeake Bay watershed

    Science.gov (United States)

    Duncan, J. M.; Band, L. E.; Groffman, P.

    2017-12-01

    Discharge, land use, and watershed management practices (stream restoration and stormwater control measures) have been found to be important determinants of nitrogen (N) export to receiving waters. We used long-term water quality stations from the Baltimore Ecosystem Study Long-Term Ecological Research (BES LTER) Site to quantify nitrogen export across streamflow conditions at the small watershed scale. We calculated nitrate and total nitrogen fluxes using methodology that allows for changes over time; weighted regressions on time, discharge, and seasonality. Here we tested the hypotheses that a) while the largest N stream fluxes occur during storm events, there is not a clear relationship between N flux and discharge and b) N export patterns are aseasonal in developed watersheds where sources are larger and retention capacity is lower. The goal is to scale understanding from small watersheds to larger ones. Developing a better understanding of hydrologic controls on nitrogen export is essential for successful adaptive watershed management at societally meaningful spatial scales.

  6. Desirable Components for a Customized, Home-Based, Digital Care-Management App for Children and Young People With Long-Term, Chronic Conditions: A Qualitative Exploration

    OpenAIRE

    Nightingale, Ruth; Hall, Andrew; Gelder, C; Friedl, S; Brennan, E; Swallow, Veronica

    2017-01-01

    Background: Mobile apps for mobile phones and tablet devices are widely used by children and young people aged 0-18 years with long-term health conditions, such as chronic kidney disease (CKD), and their healthy peers for social networking or gaming. They are also poised to become a major source of health guidance. However, app development processes that are coproduced, rigorously developed, and evaluated to provide tailored, condition-specific, practical advice on day-to-day care management ...

  7. Dancing the Two-Step in Ontario's Long-term Care Sector: More Deterrence-oriented Regulation = Ownership and Management Consolidation.

    Science.gov (United States)

    Daly, Tamara

    2015-03-01

    This paper explores shifts in public and private delivery over time through an analysis of Ontario's approach to LTC funding and regulation in relation to other jurisdictions in Canada and abroad. The case of Ontario's long-term care (LTC) policy evolution - from the 1940s until early 2013 -- shows how moving from compliance to deterrence oriented regulation can support consolidation of commercial providers' ownership and increase the likelihood of non-profit and public providers outsourcing their management.

  8. Long-Term Weight-Loss Maintenance by a Meal Replacement Based Weight Management Program in Primary Care.

    Science.gov (United States)

    Kruschitz, Renate; Wallner-Liebmann, Sandra; Lothaller, Harald; Luger, Maria; Ludvik, Bernhard

    2017-01-01

    Structured obesity treatment programs at primary care level are becoming increasingly important. However, evidence from current treatment approaches in the long term is lacking. In view of this fact we evaluated a standardized, meal replacement-based weight loss program (myLINE®; AENGUS, Graz, Austria) according to the currently applicable guidelines. Data of overweight and obese individuals (n = 70) who participated at least 36 months in the program were analyzed. Data were collected at baseline (T0) as well as after 1, 3, 6, 12, 24, and 36 (T1-T36) months. Body composition was measured by conventional anthropometry and bioelectrical impedance analysis. Compared to T0, a maximum weight, BMI, fat mass, absolute body cell mass (BCM) reduction and an increase of relative BCM could be seen at T6. Subsequently, the findings reveal a significant reduction of body weight and body fat and a satisfying development of body cell mass during the observation period of 36 months. The evaluated program complies with national and international guidelines for the therapy of obesity in adults and is efficient and meaningful for a long-term therapeutic use in primary care.. © 2017 The Author(s) Published by S. Karger GmbH, Freiburg.

  9. Long-Term Weight-Loss Maintenance by a Meal Replacement Based Weight Management Program in Primary Care

    Directory of Open Access Journals (Sweden)

    Renate Kruschitz

    2017-04-01

    Full Text Available Objective: Structured obesity treatment programs at primary care level are becoming increasingly important. However, evidence from current treatment approaches in the long term is lacking. In view of this fact we evaluated a standardized, meal replacement-based weight loss program (myLINE®; AENGUS, Graz, Austria according to the currently applicable guidelines. Methods: Data of overweight and obese individuals (n = 70 who participated at least 36 months in the program were analyzed. Data were collected at baseline (T0 as well as after 1, 3, 6, 12, 24, and 36 (T1-T36 months. Body composition was measured by conventional anthropometry and bioelectrical impedance analysis. Results: Compared to T0, a maximum weight, BMI, fat mass, absolute body cell mass (BCM reduction and an increase of relative BCM could be seen at T6. Subsequently, the findings reveal a significant reduction of body weight and body fat and a satisfying development of body cell mass during the observation period of 36 months. Conclusion: The evaluated program complies with national and international guidelines for the therapy of obesity in adults and is efficient and meaningful for a long-term therapeutic use in primary care..

  10. Long-term safety, efficacy, and patient acceptability of teriparatide in the management of glucocorticoid-induced osteoporosis

    Directory of Open Access Journals (Sweden)

    Dore RK

    2013-05-01

    Full Text Available Robin K DoreDavid Geffen School of Medicine, University of California, Los Angeles, CA, USAAbstract: Glucocorticoids are commonly prescribed medications to treat multiple diseases across many medical specialties. One of the most common yet largely unappreciated side effect of glucocorticoid use is increased risk of fracture. Many different therapies are indicated to prevent and treat this condition; many guidelines exist that suggest appropriate use of both glucocorticoids and the medications approved to prevent this common side effect of glucocorticoid therapy. Nevertheless, 30%–50% of patients on long-term glucocorticoid therapy sustain a fracture. Teriparatide, recombinant human parathyroid hormone (1–34, is a daily self-injectable therapy for 24 months approved for use in patients taking long-term glucocorticoids. Teriparatide has been shown to increase bone mineral density and reduce vertebral fracture risk in glucocorticoid-treated patients. Glucocorticoids have many adverse effects on bone that teriparatide has been shown to prevent or negate. Given the fact that preventive therapy for glucocorticoid-induced osteoporosis is often not prescribed, one wonders whether a daily self-injectable therapy for this condition would be prescribed by physicians and accepted by patients. This article reviews the epidemiology, pathophysiology, treatment, guidelines, and persistence data (when available for patients with glucocorticoid-induced osteoporosis treated with teriparatide.Keywords: glucocorticoid-induced osteoporosis, teriparatide, anabolic, PTH, parathyroid hormone

  11. Long-Term Collections

    CERN Multimedia

    Comité des collectes à long terme

    2011-01-01

    It is the time of the year when our fireman colleagues go around the laboratory for their traditional calendars sale. A part of the money of the sales will be donated in favour of the long-term collections. We hope that you will welcome them warmly.

  12. A broader view of stewardship to achieve conservation and sustainability goals in South Africa

    Directory of Open Access Journals (Sweden)

    Jaco Barendse

    2016-05-01

    Full Text Available Stewardship is a popular term for the principles and actions aimed at improving sustainability and resilience of social-ecological systems at various scales and in different contexts. Participation in stewardship is voluntary, and is based on values of altruism and long-term benefits. At a global scale, "earth stewardship" is viewed as a successor to earlier natural resource management systems. However, in South Africa, stewardship is narrowly applied to biodiversity conservation agreements on private land. Using a broader definition of stewardship, we identify all potentially related schemes that may contribute to sustainability and conservation outcomes. Stewardship schemes and actors are represented as a social network and placed in a simple typology based on objectives, mechanisms of action and operational scales. The predominant type was biodiversity stewardship programmes. The main actors were environmental non-governmental organisations participating in prominent bioregional landscape partnerships, together acting as important "bridging organisations" within local stewardship networks. This bridging enables a high degree of collaboration between non-governmental and governmental bodies, especially provincial conservation agencies via mutual projects and conservation objectives. An unintended consequence may be that management accountability is relinquished or neglected by government because of inadequate implementation capacity. Other stewardship types, such as market-based and landscape initiatives, complemented primarily biodiversity ones, as part of national spatial conservation priorities. Not all schemes related to biodiversity, especially those involving common pool resources, markets and supply chains. Despite an apparent narrow biodiversity focus, there is evidence of diversification of scope to include more civic and community-level stewardship activities, in line with the earth stewardship metaphor.

  13. Development of a Collaborative Practice Agreement Template to Promote the Role of the Pharmacist in Managing Urinary Tract Infections in Long-term Care Residents

    Science.gov (United States)

    Fehrenbacher, Lynne; McDevitt, Kimberly; Palmer, Matthew; Traynor, Laura; Boero, Joe; Crnich, Christopher

    2017-01-01

    Abstract Background One of the CDC core elements of antimicrobial stewardship in nursing homes emphasizes the promotion of clinical practice change and integration of the dispensing and consultant pharmacist to improve antibiotic use. An opportunity to support this element is via collaborative practice agreements (CPA). A CPA is a voluntary agreement between one or more prescribers and pharmacists which delegates physician authority under defined conditions and/or limitations toward a common goal. The Wisconsin Healthcare-Associated Infections (HAI) in Long-term Care (LTC) Coalition aims to reduce and eliminate HAIs among LTC residents. A coalition emphasis has been to educate caregivers about appropriate evaluation and treatment of suspected urinary tract infection (UTI). Given this focus, we targeted the same cohort for CPA design. Methods A literature review resulted in no report of CPAs being applied to LTC residents on antibiotics for UTI. Recognizing the dispensing and consultant pharmacist role varies by organization, we drafted a multi-layered CPA that can be customized by facility. The draft was reviewed by physicians, pharmacists, and nurses with expertise in infectious diseases, LTC, and CPAs. Through frequent meetings and collaborative editing, consensus was achieved. The final CPA includes antibiotic renal dose adjustment, discontinuation of antibiotics in asymptomatic patients with negative urinalysis or culture, and oral antibiotic modification based on organism susceptibility. Results The CPA template is supported by the WI HAI in LTC Coalition. It has been presented at the state level and is available for use by LTC facilities and pharmacists that may apply any/all level(s) of the CPA. An organization policy template and initial CPA competency for pharmacists have been designed to support implementation. Committed pilot sites have been identified. Conclusion A CPA is an innovative approach to expand the role of the dispensing and consultant

  14. Long-term Outcome of Argon Laser Peripheral Iridoplasty in the Management of Plateau Iris Syndrome Eyes.

    Science.gov (United States)

    Peterson, Jeffrey R; Anderson, John W; Blieden, Lauren S; Chuang, Alice Z; Feldman, Robert M; Bell, Nicholas P

    2017-09-01

    To report long-term (>5 y) outcomes of plateau iris syndrome patients treated with argon laser peripheral iridoplasty (ALPI). A retrospective chart review was performed on all patients with plateau iris syndrome treated with ALPI from 1996 to 2007. The study included 22 eyes from 22 patients with plateau iris after peripheral iridotomy that were followed for at least 1 year after ALPI. The primary outcome was incidence of needing any intraocular pressure (IOP)-lowering medications or surgery (either a filtering procedure or phacoemulsification). Demographic and baseline clinical data were summarized by mean (±SD) or frequency (percentage). Snellen best-corrected visual acuity was converted to logMAR. The paired t test was used to compare IOP changes, number of IOP-lowering medications, and best-corrected visual acuity from baseline to annual follow-up. Mean follow-up was 76 months. Only 2 (9%) eyes maintained an IOPiris in our patient population.

  15. Percutaneous-endoscopic rendezvous procedure for the management of bile duct injuries after cholecystectomy: short- and long-term outcomes.

    Science.gov (United States)

    Schreuder, Anne Marthe; Booij, Klaske A C; de Reuver, Philip R; van Delden, Otto M; van Lienden, Krijn P; Besselink, Marc G; Busch, Olivier R; Gouma, Dirk J; Rauws, Erik A J; van Gulik, Thomas M

    2018-01-19

     Bile duct injury (BDI) remains a daunting complication of laparoscopic cholecystectomy. In patients with complex BDI, a percutaneous-endoscopic rendezvous procedure may be required to establish bile duct continuity. The aim of this study was to assess short- and long-term outcomes of the rendezvous procedure.  All consecutive patients with BDI referred to our tertiary referral center between 1995 and 2016 were analyzed. A rendezvous procedure was performed when endoscopic or radiologic intervention failed, and when deemed feasible by a dedicated multidisciplinary team including hepatopancreaticobiliary surgeons, gastrointestinal endoscopists, and interventional radiologists. Classification of BDI, technical success of the rendezvous procedure, procedure-related adverse events, and outcomes were assessed.  Among a total of 812 patients, rendezvous was performed in 47 (6 %), 31 (66 %) of whom were diagnosed with complete transection of the bile duct (Amsterdam type D/Strasberg type E injury). The primary success rate of rendezvous was 94 % (44 /47 patients). Overall morbidity was 18 % (10 /55 procedures). No life-threatening adverse events or 90-day mortality occurred. After a median follow-up of 40 months (interquartile range 23 - 54 months), rendezvous was the final successful treatment in 26 /47 patients (55 %). In 14 /47 patients (30 %), rendezvous acted as a bridge to surgery, with hepaticojejunostomy being chosen either primarily or secondarily to treat refractory or relapsing stenosis. In experienced hands, rendezvous was a safe procedure, with a long-term success rate of 55 %. When endoscopic or transhepatic interventions fail to restore bile duct continuity in patients with BDI, rendezvous should be considered, either as definitive treatment or as a bridge to elective surgery. © Georg Thieme Verlag KG Stuttgart · New York.

  16. Final programmatic environmental impact statement for alternative strategies for the long-term management and use of depleted uranium hexafluoride. Summary

    International Nuclear Information System (INIS)

    1999-04-01

    This PEIS assesses the potential impacts of alternative management strategies for depleted uranium hexafluoride (UF 6 ) currently stored at three DOE sites: Paducah site near Paducah, Kentucky, Portsmouth site near Portsmouth, Ohio; and K-25 site on the Oak Ridge Reservation, Oak Ridge, Tennessee. The alternatives analyzed in the PEIS include no action, long-term storage as UF 6 , long-term storage as uranium oxide, use as uranium oxide, use as uranium metal, and disposal. DOE's preferred alternative is to begin conversion of the depleted UF 6 inventory as soon as possible, either to uranium oxide, uranium metal, or a combination of both, while allowing for use of as much of this inventory as possible

  17. Final programmatic environmental impact statement for alternative strategies for the long-term management and use of depleted uranium hexafluoride. Volume 1: Main text

    International Nuclear Information System (INIS)

    1999-04-01

    This PEIS assesses the potential impacts of alternative management strategies for depleted uranium hexafluoride (UF 6 ) currently stored at three DOE sites: Paducah site near Paducah, Kentucky, Portsmouth site near Portsmouth, Ohio; and K-25 site on the Oak Ridge Reservation, Oak Ridge, Tennessee. The alternatives analyzed in the PEIS include no action, long-term storage as UF 6 , long-term storage as uranium oxide, use as uranium oxide, use as uranium metal, and disposal. DOE's preferred alternative is to begin conversion of the depleted UF 6 inventory as soon as possible, either to uranium oxide, uranium metal, or a combination of both, while allowing for use of as much of this inventory as possible

  18. Final programmatic environmental impact statement for alternative strategies for the long-term management and use of depleted uranium hexafluoride. Volume 2: Appendices

    International Nuclear Information System (INIS)

    1999-04-01

    This PEIS assesses the potential impacts of alternative management strategies for depleted uranium hexafluoride (UF 6 ) currently stored at three DOE sites: Paducah site near Paducah, Kentucky, Portsmouth site near Portsmouth, Ohio; and K-25 site on the Oak Ridge Reservation, Oak Ridge, Tennessee. The alternatives analyzed in the PEIS include no action, long-term storage as UF 6 , long-term storage as uranium oxide, use as uranium oxide, use as uranium metal, and disposal. DOE's preferred alternative is to begin conversion of the depleted UF 6 inventory as soon as possible, either to uranium oxide, uranium metal, or a combination of both, while allowing for use of as much of this inventory as possible. This volume contains Appendices A--O

  19. Similar long-term survival of consecutive in-hospital and out-of-hospital cardiac arrest patients treated with targeted temperature management

    DEFF Research Database (Denmark)

    Engsig, Magaly; Søholm, Helle; Folke, Fredrik

    2016-01-01

    OBJECTIVE: The long-term survival of in-hospital cardiac arrest (IHCA) patients treated with targeted temperature management (TTM) is poorly described. The aim of this study was to compare the outcomes of consecutive IHCA with out-of-hospital cardiac arrest (OHCA) patients treated with TTM. DESIGN...... SETTING AND PATIENTS: Retrospectively collected data on all consecutive adult patients treated with TTM at a university tertiary heart center between 2005 and 2011 were analyzed. MEASUREMENTS: Primary endpoints were survival to hospital discharge and long-term survival. Secondary endpoint was neurological...... time to return of spontaneous circulation (ROSC). Survival to hospital discharge was 54% for OHCA and 53% for IHCA (adjusted odds ratio 0.98 [95% confidence interval {CI}; 0.43-2.24]). Age ≤60 years, bystander CPR, time to ROSC ≤10 min, and shockable rhythm at presentation were associated with survival...

  20. Long-Term Spatial Data Preservation and Archiving: What Are the Issues?

    International Nuclear Information System (INIS)

    BLEAKLY, DENISE R.

    2002-01-01

    The Department of Energy (DOE) is moving towards Long-Term Stewardship (LTS) of many environmental restoration sites that cannot be released for unrestricted use. One aspect of information management for LTS is geospatial data archiving. This report discusses the challenges facing the DOE LTS program concerning the data management and archiving of geospatial data. It discusses challenges in using electronic media for archiving, overcoming technological obsolescence, data refreshing, data migration, and emulation. It gives an overview of existing guidance and policy and discusses what the United States Geological Service (USGS), National Oceanic and Atmospheric Administration (NOAA) and the Federal Emergency Management Agency (FEMA) are doing to archive the geospatial data that their agencies are responsible for. In the conclusion, this report provides issues for further discussion around long-term spatial data archiving

  1. Mobile Phone and Tablet Apps to Support Young People's Management of Their Physical Long-Term Conditions: A Systematic Review Protocol.

    Science.gov (United States)

    Majeed-Ariss, Rabiya; Hall, Andrew G; McDonagh, Janet; Fallon, Deborah; Swallow, Veronica

    2015-04-07

    The prevalence of long-term or chronic conditions that limit activity and reduce quality of life in young people aged 10-24 years is rising. This group has distinct health care needs and requires tailored support strategies to facilitate increasing personal responsibility for the management of their condition wherever possible, as they mature. Mobile phone and tablet mobile technologies featuring software program apps are already well used by young people for social networking or gaming. They have also been utilized in health care to support personal condition management, using condition-specific and patient-tailored software. Such apps have much potential, and there is an emerging body of literature on their use in a health context making this review timely. The objective of this paper is to develop a systematic review protocol focused on identifying and assessing the effectiveness of mobile phone and tablet apps that support young people's management of their chronic conditions. The search strategy will include a combination of standardized indexed search terms and free-text terms related to the key concepts of young people; long-term conditions and mobile technology. Peer-reviewed journal articles published from 2003 that meet the inclusion and exclusion criteria will be identified through searching the generated hits from 5 bibliographical databases. Two independent reviewers will screen the titles and abstracts to determine which articles focus on testing interventions identified as a mobile phone or tablet apps, and that have been designed and delivered to support the management of long-term conditions in young people aged 10-24 years. Data extraction and quality assessment tools will be used to facilitate consistent analysis and synthesis. It is anticipated that several studies will meet the selection criteria but that these are likely to be heterogeneous in terms of study design, reported outcomes, follow-up times, participants' age, and health condition

  2. Environmental evaluation of alternatives for long-term management of Defense high-level radioactive wastes at the Idaho Chemical Processing Plant

    Energy Technology Data Exchange (ETDEWEB)

    1982-09-01

    The U.S. Department of Energy (DOE) is considering the selection of a strategy for the long-term management of the defense high-level wastes at the Idaho Chemical Processing Plant (ICPP). This report describes the environmental impacts of alternative strategies. These alternative strategies include leaving the calcine in its present form at the Idaho National Engineering Laboratory (INEL), or retrieving and modifying the calcine to a more durable waste form and disposing of it either at the INEL or in an offsite repository. This report addresses only the alternatives for a program to manage the high-level waste generated at the ICPP. 24 figures, 60 tables.

  3. Environmental evaluation of alternatives for long-term management of Defense high-level radioactive wastes at the Idaho Chemical Processing Plant

    International Nuclear Information System (INIS)

    1982-09-01

    The U.S. Department of Energy (DOE) is considering the selection of a strategy for the long-term management of the defense high-level wastes at the Idaho Chemical Processing Plant (ICPP). This report describes the environmental impacts of alternative strategies. These alternative strategies include leaving the calcine in its present form at the Idaho National Engineering Laboratory (INEL), or retrieving and modifying the calcine to a more durable waste form and disposing of it either at the INEL or in an offsite repository. This report addresses only the alternatives for a program to manage the high-level waste generated at the ICPP. 24 figures, 60 tables

  4. VISIONARY THINKER: LEADERSHIP AND MANAGEMENT IN WORKS OF MARY P. FOLLETT – LONG-TERM PERSPECTIVE IN THE COMPANIES OF THE REPUBLIC OF SERBIA

    Directory of Open Access Journals (Sweden)

    Srdjan Nikezic

    2014-06-01

    Full Text Available In her lectures, Mary P. Follett pointed to key moments of leadership, management, group membership, coordination and participation as relevant elements for the exploration of human relations that are of interest today in the same way as they were eighty years ago. Model of thinking applied by Mary P. Follett is deeply linked to current strong needs for the creation of leadership and management professions that are linked to changes and long term strategic goals of big companies and world economy as a whole.

  5. Long-Term Nuclear Knowledge Management (NKM) on Nuclear Production of Hydrogen - A Case Study of the Japan Atomic Energy Research Institute (JAERI)

    International Nuclear Information System (INIS)

    Yanagisawa, Kazuaki

    2007-01-01

    In Japan, so-called a formal nuclear policy; The Framework for Nuclear Energy Policy is built up by Japan Atomic Energy Commission at every 5-year, in which not only a conventional light water reactor (LWR) but also a fast breeder reactor (FBR), HTGR and a fusion reactor (FR) is referred as a prominent candidate of long-term (<100 years) nuclear energy source. The policy makers might have multi-purpose scenarios for a future of innovated nuclear energy systems through results of various discussions at their level. According to long-term nuclear knowledge management, the author made ex ante evaluation of HTGR known as the intellectual assets of JAERI 1, from the viewpoint of hypothetical benefits under conditions of substantial uncertainty. Nuclear knowledge management (NKM) is an integrated, systematic approach to identifying, managing and sharing an organization's nuclear knowledge, and enabling persons to create new nuclear knowledge collectively and thereby helping achieve the objectives. NKM identifies, optimizes, and actively manages intellectual assets either in the form of explicit knowledge held in intangible products or tacit knowledge possessed by individuals or communities in the nuclear fields. In the present study the authors wish not only to show the validity of long-term NKM as a key factor of HTGR but also to assess their hypothetical benefits through the year 2050 under conditions of substantial uncertainty. It should be stressed that those factors are important intellectual assets of JAERI developed to date. Additionally, in the Framework for Nuclear Energy Policy constructed up by the Japan Atomic Energy Commission, a LWR, a fast breeder reactor (FBR), a HTGR, and a fusion reactor (FR) are all defined as eligible and prominent candidates for long-term nuclear energy sources. In this sense, we estimate here a direct market creation of (1) hydrogen energy production and (2) electricity generation, by commercialized HTGR through the year 2050 with

  6. Responses of bacterial and archaeal ammonia oxidizers to soil organic and fertilizer amendments under long-term management

    Energy Technology Data Exchange (ETDEWEB)

    Wessen, E.; Nyberg, K.; Jansson, J.K.; Hallin, S.

    2010-05-01

    Ammonia-oxidizing bacteria (AOB) and ammonia-oxidizing archaea (AOA) co-exist in soil, but their relative distribution may vary depending on the environmental conditions. Effects of changes in soil organic matter and nutrient content on the AOB and AOA are poorly understood. Our aim was to compare effects of long-term soil organic matter depletion and amendments with labile (straw) and more recalcitrant (peat) organic matter, with and without easily plant-available nitrogen, on the activities, abundances and community structures of AOB and AOA. Soil was sampled from a long-term field site in Sweden that was established in 1956. The potential ammonia oxidation rates, the AOB and AOA amoA gene abundances and the community structures of both groups based on T-RFLP of amoA genes were determined. Straw amendment during 50 years had not altered any of the measured soil parameters, while the addition of peat resulted in a significant increase of soil organic carbon as well as a decrease in pH. Nitrogen fertilization alone resulted in a small decrease in soil pH, organic carbon and total nitrogen, but an increase in primary production. Type and amount of organic matter had an impact on the AOB and AOA community structures and the AOA abundance. Our findings confirmed that AOA are abundant in soil, but showed that under certain conditions the AOB dominate, suggesting niche differentiation between the two groups at the field site. The large differences in potential rates between treatments correlated to the AOA community size, indicating that they were functionally more important in the nitrification process than the AOB. The AOA abundance was positively related to addition of labile organic carbon, which supports the idea that AOA could have alternative growth strategies using organic carbon. The AOB community size varied little in contrast to that of the AOA. This indicates that the bacterial ammonia oxidizers as a group have a greater ecophysiological diversity and

  7. A Long-term Plan for Kalk

    DEFF Research Database (Denmark)

    2017-01-01

    In this case, the author demonstrates together with the owner-manager of KALK A/S, Mr Rasmus Jorgensen, how to use the Family Business Map to frame a constructive discussion about long-term planning. The Family Business Map is a tool for long-term planning in family firms developed by Professor...

  8. Economic comparison of long-term nuclear fuel cycle management scenarios: The influence of the discount rate

    International Nuclear Information System (INIS)

    Le Dars, Aude; Loaec, Christine

    2007-01-01

    This article presents some main economic results obtained by the CEA in the DERECO project, which aimed to evaluate the global cost of contrasted and long-term nuclear fuel cycle scenarios. The scenarios have been studied for the period 2000-2150 in the French context. They all assume a sustainable nuclear development. These scenarios must not be considered as forecasts and do not reflect any industrial strategy. The article focuses on the comparison of five scenarios including the Generation IV fast reactors and their associated fuel cycles. Common trends as well as specific features can be identified. The article describes the scenarios with the replacement of the nuclear power and the associated fuel cycle. It details the main technical and economic assumptions common to all the scenarios, and exposes some main key results, concerning the flows and inventories as well as concerning economic evaluation. Economic results are given in a comparative manner due to the level of uncertainties at this time horizon. The key economic elements described in the article deal with the sensitivity of the results to the choice of the discount rate

  9. Evaluation of nurses’ changing perceptions when trained to implement a self-management programme for dual sensory impaired older adults in long-term care: a qualitative study

    Science.gov (United States)

    Roets-Merken, Lieve M; Vernooij-Dassen, Myrra J F J; Zuidema, Sytse U; Dees, Marianne K; Hermsen, Pieter G J M; Kempen, Gertrudis I J M; Graff, Maud J L

    2016-01-01

    Objectives To gain insights into the process of nurses’ changing perceptions when trained to implement a self-management programme for dual sensory impaired older adults in long-term care, and into the factors that contributed to these changes in their perceptions. Design Qualitative study alongside a cluster randomised controlled trial. Setting 17 long-term care homes spread across the Netherlands. Participants 34 licensed practical nurses supporting 54 dual sensory impaired older adults. Intervention A 5-month training programme designed to enable nurses to support the self-management of dual sensory impaired older adults in long-term care. Primary outcomes Nurses’ perceptions on relevance and feasibility of the self-management programme collected from nurses’ semistructured coaching diaries over the 5-month training and intervention period, as well as from trainers’ reports. Results Nurses’ initial negative perceptions on relevance and feasibility of the intervention changed to positive as nurses better understood the concept of autonomy. Through interactions with older adults and by self-evaluations of the effect of their behaviour, nurses discovered that their usual care conflicted with client autonomy. From that moment, nurses felt encouraged to adapt their behaviour to the older adults’ autonomy needs. However, nurses’ initial unfamiliarity with conversation techniques required a longer exploration period than planned. Once client autonomy was understood, nurses recommended expanding the intervention as a generic approach to all their clients, whether dual sensory impaired or not. Conclusions Longitudinal data collection enabled exploration of nurses’ changes in perceptions when moving towards self-management support. The training programme stimulated nurses to go beyond ‘protocol thinking’, discovering client autonomy and exploring the need for their own behavioural adaptations. Educational programmes for practical nurses should offer

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

    International Nuclear Information System (INIS)

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

    2009-01-01

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

  11. Nursing home manager's knowledge, attitudes and beliefs about advance care planning for people with dementia in long-term care settings: a cross-sectional survey.

    Science.gov (United States)

    Beck, Esther-Ruth; McIlfatrick, Sonja; Hasson, Felicity; Leavey, Gerry

    2017-09-01

    To examine nursing home managers' knowledge, attitudes, beliefs and current practice regarding advance care planning for people with dementia in long-term care settings informed by the theory of planned behaviour. Internationally, advance care planning is advocated for people with dementia. However, evidence suggests that discussions with people with dementia are rare, particularly in long-term care settings. Whilst nursing home managers can be considered central to implementation in this setting, there is a dearth of research that has examined their perspective. This study reports on their role with regard to advance care planning and the perceived factors which influence this. A cross-sectional postal survey was carried out as part of a larger scale sequential explanatory mixed-methods study between January-March 2015. Nursing home managers in a region in the UK (n = 178). A response rate of 66% (n = 116) was achieved. Nursing home managers demonstrated a lack of knowledge of advance care planning, with negative attitudes underpinned by concerns regarding the capacity and lack of perceived benefits to the person with dementia. Currently, they do not view advance care planning as part of their role, with lack of ownership impacting upon current practice behaviours. Whilst nursing home managers recognise the potential benefits of advance care planning, barriers and challenges create a reluctance to facilitate. Targeted training to address the knowledge deficit is required, with the wider components of advance care planning promoted. There is a need for greater role clarification to ensure nurses in long-term care settings identify with the process in the future. A gap between rhetoric and reality of implementation is evident; therefore, long-term care settings must critically examine system, organisational and individual factors for failure to implement advance care planning for people with dementia. Increased cognisance of the context in which advance care

  12. Surgical Management and Long-Term Seizure Outcome After Surgery for Temporal Lobe Epilepsy Associated with Cerebral Cavernous Malformations.

    Science.gov (United States)

    Yang, Peng-Fan; Pei, Jia-Sheng; Jia, Yan-Zeng; Lin, Qiao; Xiao, Hui; Zhang, Ting-Ting; Zhong, Zhong-Hui

    2018-02-01

    Operative strategies for cerebral cavernous malformation (CCM)-associated temporal lobe epilepsy and timing of surgical intervention continue to be debated. This study aimed to establish an algorithm to evaluate the efficacy of surgical intervention strategies, to maximize positive surgical outcomes and minimize postsurgical neurologic deficits. 47 patients having undergone operation for CCM-associated temporal lobe epilepsy were retrospectively reviewed. They had received a diagnostic series for seizure localization, including long-term video electroencephalography (vEEG), high-resolution magnetic resonance imaging (MRI), and positron emission tomography-computed tomography (PET-CT). In patients with mesial temporal lobe CCMs, the involved structures (amygdala, hippocampus, or parahippocampal gyrus) were resected in addition to the lesions. Patients with neocortical epileptogenic CCM underwent extended lesionectomy guided by intraoperative electrocorticography; further performance of amygdalohippocampectomy depended on the extent of hippocampal epileptogenicity. The study cohort contained 28 patients with drug-resistant epilepsy (DRE), 12 with chronic epilepsy (CE), and 7 with sporadic seizure (SS). Normal temporal lobe metabolism was seen in 7/7 patients of the SS group. Hypometabolism was found in all patients with chronic disease except for those with posterior inferior and middle temporal gyrus cavernous malformations (CMs). Of the 31 patients with superficial neocortical CCM, 7 had normal PET without hippocampal sclerosis, 14 had ipsilateral temporal lobe hypometabolism without hippocampal sclerosis, and 10 had obvious hippocampal sclerosis and hypometabolism. Seizure freedom in DRE, CE, and SS was 82.1%, 75%, and 100%, respectively. A significant difference was found between lesion laterality and postoperative seizure control; the rate was lower in left-sided cases because of less aggressive resection. Our study demonstrates that the data from the

  13. Management of post-biopsy renal allograft arteriovenous fistulas with selective arterial embolization: immediate and long-term outcomes

    International Nuclear Information System (INIS)

    Loffroy, R.; Guiu, B.; Lambert, A.; Mousson, C.; Tanter, Y.; Martin, L.; Cercueil, J.-P.; Krause, D.

    2008-01-01

    Aim: To evaluate the outcomes after transcatheter embolization of percutaneous biopsy-related arteriovenous fistulas in renal allografts. Materials and methods: All post-biopsy renal-transplant vascular injuries referred for embolization between June 1999 and October 2006 were reviewed retrospectively. There were six male and six female patients with a mean age of 49.8 years (range 25-67 years); nine patients were symptomatic, three asymptomatic. Colour Doppler ultrasound (CDUS) and angiography showed one intra-renal arteriovenous fistula in 10 patients and two in two patients, combined with a pseudoaneurysm in six patients. Superselective embolization using a single catheter or coaxial microcatheter was performed with 0.035'' coils or 0.018''microcoils, respectively, in all 12 cases. 24-h creatinine clearance values before (the day of biopsy) and after (7-14 days; 3 months) the procedure were compared using the Wilcoxon signed-rank test. Physical examination and CDUS were performed after 1, 6, and 12 months, and yearly thereafter. Mean follow-up was 33.6 months. Results: Complete definitive occlusion of the fistula was achieved consistently with a single procedure. No procedure-related complications occurred. Renal infarction was minor in all patients (0-10% in nine and 10-20% in three). Symptoms resolved completely. Creatinine clearance values obtained before and after embolization were not statistically different (p = 0.168;.889 respectively). No late recurrences were reported. Conclusion: Transcatheter embolization with coaxial or single-catheter techniques was effective and safe for treating post-biopsy arteriovenous fistulas in renal transplants. The loss of renal parenchyma was minimal and no mid-term deterioration of allograft function was noted. The long-term survival of the renal allograft seemed to be not affected by embolization

  14. A New Framework for Adaptive Sampling and Analysis During Long-Term Monitoring and Remedial Action Management

    International Nuclear Information System (INIS)

    Minsker, Barbara

    2004-01-01