Open string T-duality in double space

International Nuclear Information System (INIS)

Sazdovic, B.

2017-01-01

The role of double space is essential in the new interpretation of T-duality and consequently in an attempt to construct M-theory. The case of the open string is missing in such an approach because until now there has been no appropriate formulation of open string T-duality. In the previous paper (Sazdovic, From geometry to non-geometry via T-duality, arXiv:1606.01938, 2017), we showed how to introduce vector gauge fields A"N_a and A"D_i at the end-points of an open string in order to enable open string invariance under local gauge transformations of the Kalb-Ramond field and its T-dual ''restricted general coordinate transformations''. We demonstrated that gauge fields A"N_a and A"D_i are T-dual to each other. In the present article we prove that all above results can be interpreted as coordinate permutations in double space. (orig.)

Open string T-duality in double space

Energy Technology Data Exchange (ETDEWEB)

Sazdovic, B. [University of Belgrade, Institute of Physics, Belgrade (Serbia)

2017-09-15

The role of double space is essential in the new interpretation of T-duality and consequently in an attempt to construct M-theory. The case of the open string is missing in such an approach because until now there has been no appropriate formulation of open string T-duality. In the previous paper (Sazdovic, From geometry to non-geometry via T-duality, arXiv:1606.01938, 2017), we showed how to introduce vector gauge fields A{sup N}{sub a} and A{sup D}{sub i} at the end-points of an open string in order to enable open string invariance under local gauge transformations of the Kalb-Ramond field and its T-dual ''restricted general coordinate transformations''. We demonstrated that gauge fields A{sup N}{sub a} and A{sup D}{sub i} are T-dual to each other. In the present article we prove that all above results can be interpreted as coordinate permutations in double space. (orig.)

Public evaluation of open space in Illinois: citizen support for natural area acquisition.

Science.gov (United States)

Backlund, Erik A; Stewart, William P; McDonald, Cary; Miller, Craig

2004-11-01

Numerous studies have indicated a broad-based support for open space preservation and protection. Research also has characterized the public values and rationale that underlie the widespread support for open space. In recognition of the widespread public support for open space, various levels of government have implemented programs to provide public access to open space. There are many different types of open space, ranging from golf courses, ball parks, wildlife areas, and prairies, to name a few. This paper addresses questions related to the types of open space that should be prioritized by planners and natural resource managers. The results of this study are based on a stratified random sample of 5000 households in Illinois that were sent a questionnaire related to their support for various types of open space. Through a comparatively simple action grid analysis, the open space types that should be prioritized for public access include forest areas, stream corridors, wildlife habitat, and lakes/ponds. These were the open space types rated of the highest importance, yet were also the open space types rated the lowest in respondent satisfaction. This kind of analysis does not require the technical expertise of other options for land-use prioritizations (e.g., conjoint analysis, contingent valuation), yet provides important policy directives for planners. Although open space funds often allow for purchase of developed sites such as golf courses, ball parks, and community parks, this study indicates that undeveloped (or nature-based) open space lands are most needed in Illinois.

33 CFR 401.89 - Transit refused.

Science.gov (United States)

2010-07-01

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

Universal design of public open spaces

Directory of Open Access Journals (Sweden)

Petra Krajner

2008-01-01

Full Text Available Urban open spaces are public places that must assure access for all users. They should be designed for equal use despite disabilities and special recreational needs. Their design must be functional and must meet user’s special requirements, either everyday functional or special (recreational needs. It is not just about overcoming architectural obstacles by building ramps of suitable slope and size; it is about inclusive, universal landscape design of urban space made for all citizens. For this matter, different ways of public use for each group of users is defined, functional criteria are determined, and examples of good and bad design are assembled to present the differences between technically accomplished ramps, and slope paths that include quality landscape inclusive design. To prove the unsuitability of public open spaces in Ljubljana, various analyses were made, including the measurement of steepness, lengths and wideness of certain urban elements. As an application of results, the universal designing principles are summarized in new proposal for entrance into Tivoli Park.

The Legal Ethical Backbone of Conscientious Refusal

DEFF Research Database (Denmark)

Munthe, Christian; Nielsen, Morten Ebbe Juul

2017-01-01

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

Measuring the quality of public open space using Google Earth.

Science.gov (United States)

Taylor, Bronwen T; Fernando, Peter; Bauman, Adrian E; Williamson, Anna; Craig, Jonathan C; Redman, Sally

2011-02-01

Proximity to public open space, such as parks and other green spaces, has considerable health benefits, and people have been shown to be more likely to use such space for physical activity if it is of high quality. This paper describes a new remote-assessment approach that makes use of Google Earth Pro (the free version of this program is Google Earth) to provide rapid and inexpensive measurement of the quality of public open space. The aim of the study was to assess the correlation between assessments of the quality of public open space using (1) the remote method (making use of Google Earth Pro) and (2) direct observation with a well-established measure of quality, the Public Open Space Tool (POST). Fifty parks selected from the southwest part of Sydney, Australia, were assessed in 2009 with the remote method (using Google Earth Pro), and scores were compared with those obtained from direct observation of the same parks using POST. The time taken to conduct the assessments using each method was also recorded. Raters for each method were blind to scores obtained from using the other method. Analyses were conducted in 2009. The Spearman correlation coefficient between the quality scores obtained for the 50 parks using the remote method and direct observation was 0.9 (pspaces without the need for in-person visits, dramatically reducing the time required for environmental audits of public open space. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Open source IPSEC software in manned and unmanned space missions

Science.gov (United States)

Edwards, Jacob

Network security is a major topic of research because cyber attackers pose a threat to national security. Securing ground-space communications for NASA missions is important because attackers could endanger mission success and human lives. This thesis describes how an open source IPsec software package was used to create a secure and reliable channel for ground-space communications. A cost efficient, reproducible hardware testbed was also created to simulate ground-space communications. The testbed enables simulation of low-bandwidth and high latency communications links to experiment how the open source IPsec software reacts to these network constraints. Test cases were built that allowed for validation of the testbed and the open source IPsec software. The test cases also simulate using an IPsec connection from mission control ground routers to points of interest in outer space. Tested open source IPsec software did not meet all the requirements. Software changes were suggested to meet requirements.

A Mandatory, High-Stakes National Teacher Evaluation System: Perceptions and Attributions of Teachers Who Actively Refuse to Participate

Science.gov (United States)

Tornero, Bernardita; Taut, Sandy

2010-01-01

This study examines why some public elementary school teachers openly refuse participation in a mandatory national, standards-based teacher evaluation program. We describe the perceptions these "rebel" teachers have of the evaluation system, studying their open resistance based on the meanings they construct, and elaborated an…

Cubicle Refusal in Norwegian Dairy Herds

Directory of Open Access Journals (Sweden)

Myren HJ

2001-03-01

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

30 CFR 77.215-4 - Refuse piles; abandonment.

Science.gov (United States)

2010-07-01

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

Public open space for disaster mitigation in Tangerang housing estates

Science.gov (United States)

Winandari, M. I. R.

2018-01-01

Public open space in housing estates plays an important role particularly in disaster mitigation. In some housing, there are indications of shape and use of space changes post-handover to local government. The aim of this study is to explore the relationship between public open space condition and management related to disaster mitigation in Tangerang housing estates. Multiple case study method is used to analyse of 2 housing cases. Aspects of access and boundaries were used to evaluate the cases. The results showed that gated community housing type should have more than 1 access to facilitate evacuation by considering the farthest unit to the housing gate. This is necessary to provide open spaces that are easily accessible from all units as the first evacuation site during and post disaster.

Distribution of green open space in Malang City based on multispectral data

Science.gov (United States)

Hasyim, A. W.; Hernawan, F. P.

2017-06-01

Green open space is one of the land that its existence is quite important in urban areas where the minimum area is set to reach 30% of the total area of the city. Malang which has an area of 110,6 square kilometers, is one of the major cities in East Java Province that is prone to over-land conversion due to development needs. In support of the green space program, calculation of green space is needed precisely so that remote sensing which has high accuracy is now used for measurement of green space. This study aims to analyze the area of green open space in Malang by using Landsat 8 image in 2015. The method used was the vegetation index that is Normalized Difference Vegetation Index (NDVI). From the study obtained the calculation of green open space was better to use the vegetation index method to avoid the occurrence of misclassification of other types of land use. The results of the calculation of green open space using NDVI found that the area of green open space in Malang City in 2015 reached 39% of the total area.

14 CFR 120.11 - Refusal to submit to a drug or alcohol test by a Part 61 certificate holder.

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Refusal to submit to a drug or alcohol test...: CERTIFICATION AND OPERATIONS DRUG AND ALCOHOL TESTING PROGRAM Individuals Certificated Under Parts 61, 63, and 65 § 120.11 Refusal to submit to a drug or alcohol test by a Part 61 certificate holder. (a) This...

14 CFR 120.15 - Refusal to submit to a drug or alcohol test by a Part 65 certificate holder.

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Refusal to submit to a drug or alcohol test...: CERTIFICATION AND OPERATIONS DRUG AND ALCOHOL TESTING PROGRAM Individuals Certificated Under Parts 61, 63, and 65 § 120.15 Refusal to submit to a drug or alcohol test by a Part 65 certificate holder. (a) This...

14 CFR 120.13 - Refusal to submit to a drug or alcohol test by a Part 63 certificate holder.

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Refusal to submit to a drug or alcohol test...: CERTIFICATION AND OPERATIONS DRUG AND ALCOHOL TESTING PROGRAM Individuals Certificated Under Parts 61, 63, and 65 § 120.13 Refusal to submit to a drug or alcohol test by a Part 63 certificate holder. (a) This...

30 CFR 816.83 - Coal mine waste: Refuse piles.

Science.gov (United States)

2010-07-01

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

30 CFR 817.83 - Coal mine waste: Refuse piles.

Science.gov (United States)

2010-07-01

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

The Legal Ethical Backbone of Conscientious Refusal.

Science.gov (United States)

Munthe, Christian; Nielsen, Morten Ebbe Juul

2017-01-01

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

21 CFR 211.50 - Sewage and refuse.

Science.gov (United States)

2010-04-01

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

Numerical Analysis of Thermal Comfort at Open Air Spaces

Science.gov (United States)

Papakonstantinou, K.; Belias, C.; Pantos-Kikkos, S.; Assana, A.

2008-09-01

The present paper refers to the numerical simulation of air velocity at open air spaces and the conducting thermal comfort after the evaluation of the examined space using CFD methods, taking into account bioclimatic principles at the architectural design. More specially, the paper draws attention to the physical procedures governing air movement at an open environment area in Athens (urban park), named "Attiko Alsos," trying to form them in such way that will lead to the thermal comfort of the area's visitors. The study presents a mathematical model, implemented in a general computer code that can provide detailed information on velocity, prevailing in three-dimensional spaces of any geometrical complexity. Turbulent flow is simulated and buoyancy effects are taken into account. This modelling procedure is intended to contribute to the effort towards designing open areas, such as parks, squares or outdoor building environments, using thermal comfort criteria at the bioclimatic design. A computer model of this kind will provide the architects or the environmental engineers with powerful and economical means of evaluating alternative spaces' designs.

Medication Refusal: Resident Rights, Administration Dilemma.

Science.gov (United States)

Haskins, Danielle R; Wick, Jeannette Y

2017-12-01

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

Courts and open spaces in the Late Helladic III Argolid

DEFF Research Database (Denmark)

Siennicka, Malgorzata

2015-01-01

While space remains a neglected subject in research on Mycenaean settlements, archaeological and ethnographical studies devoted to social meaning of places and areas used by the inhabitants of the prehistoric and other communities increase in number. This paper aims to review the use and signific......While space remains a neglected subject in research on Mycenaean settlements, archaeological and ethnographical studies devoted to social meaning of places and areas used by the inhabitants of the prehistoric and other communities increase in number. This paper aims to review the use...... and significance of courts and other open spaces in the Mycenaean settlements in the Argolid during the Palatial and Post-Palatial periods (c. 15th–11th centuries BC). Various categories of areas, like courts, open spaces and open-air areas are discussed, with an emphasis on their functions and status. Courts...

Legal briefing: conscience clauses and conscientious refusal.

Science.gov (United States)

Pope, Thaddeus Mason

2010-01-01

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

OpenSpace: From Data Visualization Research to Planetariums and Classrooms Worldwide

Science.gov (United States)

Emmart, C.; Ynnerman, A.; Bock, A.; Kuznetsova, M. M.; Kinzler, R. J.; Trakinski, V.; Mac Low, M. M.; Ebel, D. S. S.

2016-12-01

"OpenSpace" is a new NASA supported open source software that brings the latest techniques from data visualization research to the planetarium community and general public. The American Museum of Natural History (AMNH), in collaboration with informal science institutions (ISI), academic partners, key vendors that support planetariums worldwide, and NASA mission teams and Subject Matter Experts (SME), is creating OpenSpace to enable STEM education and improve U.S. scientific literacy by engaging a broad spectrum of the American public and STEM learners in cutting-edge NASA science and engineering content. The project's primary focus is the interactive presentation of dynamic data from observations (image sequences), astrophysical simulation (volumetric rendering), and space missions (observation geometry visualization). Development of the software began several years ago in collaboration with NASA Goddard's space weather modeling center and in conjunction with academic support from Linköping University (LiU) in Sweden, and continued last year with visualizations of NASA's New Horizons mission and ESA's Rosetta mission. For the New Horizons Pluto encounter, a dozen sites around the world running OpenSpace networked simultaneously to view the close approach to Pluto as narrated in real time by mission control scientists at NASA's Jet Propulsion Laboratory. Subsequent image data from the Long Range Reconnaissance Imaging (LORRI) camera was released by NASA as it downloaded from the spacecraft in the following months. These images, along with post encounter navigation reconstruction data (NASA SPICE) were then used to update the OpenSpace New Horizons visualization, and create a February 2016 public program in which Deputy Project Scientist, Cathy Olkin, demonstrated these results visualized in OpenSpace to a sold out crowd in the AMNH Hayden Planetarium. As demonstrated with the New Horizons visualization in OpenSpace, the goals of the project are to make visible

Factors related with public open space use among adolescents: a study using GPS and accelerometers.

Science.gov (United States)

Van Hecke, Linde; Verhoeven, Hannah; Clarys, Peter; Van Dyck, Delfien; Van de Weghe, Nico; Baert, Tim; Deforche, Benedicte; Van Cauwenberg, Jelle

2018-01-22

Low physical activity levels and high levels of sedentary time among adolescents call for population wide interventions. Public open spaces can be important locations for adolescents' physical activity. This study aimed to describe the prevalence, frequency and context of public open space visitation and to gain insight into the individual, social and physical environmental factors associated with public open space use among 12- to 16-year-old Flemish (Belgian) adolescents. Global positioning system devices, accelerometers and one-on-one interviews were used to measure location-specific activity levels, time spent at, reasons for using and accompaniment at public open spaces among 173 adolescents. Multilevel hurdle and gamma models were used to estimate the associations between the independent variables (age, gender, ethnicity, education, sport club membership and accompaniment) and the amount of time, sedentary time, light-, moderate- to vigorous- and vigorous-intensity physical activity at public open spaces. Three out of four participants had visited a public open space (for recreational purposes) and participants were most often accompanied by friends/classmates. Mainly public transportation stops/stations were used, and subsequently the most reported reason for public open space use was "to wait for something or someone". Furthermore, boys, younger adolescents, non-western-European adolescents and lower educated adolescents were more likely to use public open spaces. Additionally, boys and younger adolescents were more likely to accumulate physical activity at public open spaces. The only social environmental variable associated with time spent at public open spaces was accompaniment by siblings: adolescents spent more time at public open spaces when accompanied by their siblings. Public open spaces may be effective areas to promote physical activity among groups at risk for physical inactivity (i.e. low educated and non-western-European adolescents

Coal refuse reclamation project

Energy Technology Data Exchange (ETDEWEB)

Zellmer, S.D.

1979-04-06

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

Personal Spaces in Public Repositories as a Facilitator for Open Educational Resource Usage

Science.gov (United States)

Cohen, Anat; Reisman, Sorel; Sperling, Barbra Bied

2015-01-01

Learning object repositories are a shared, open and public space; however, the possibility and ability of personal expression in an open, global, public space is crucial. The aim of this study is to explore personal spaces in a big learning object repository as a facilitator for adoption of Open Educational Resources (OER) into teaching practices…

A strong open mapping theorem for surjections from cones onto Banach spaces

NARCIS (Netherlands)

Jeu, de M.F.E.; Messerschmidt, H.J.M.

2014-01-01

We show that a continuous additive positively homogeneous map from a closed not necessarily proper cone in a Banach space onto a Banach space is an open map precisely when it is surjective. This generalization of the usual Open Mapping Theorem for Banach spaces is then combined with Michael's

Open string fluctuations in AdS space with and without torsion

DEFF Research Database (Denmark)

Larsen, A.L.; Lomholt, Michael Andersen

2003-01-01

The equations of motion and boundary conditions for the fluctuations around a classical open string, in a curved space-time with torsion, are considered in compact and world-sheet covariant form. The rigidly rotating open strings in anti-de Sitter space with and without torsion are investigated...

Open problems in the geometry and analysis of Banach spaces

CERN Document Server

Guirao, Antonio J; Zizler, Václav

2016-01-01

This is a collection of some easily-formulated problems that remain open in the study of the geometry and analysis of Banach spaces. Assuming the reader has a working familiarity with the basic results of Banach space theory, the authors focus on concepts of basic linear geometry, convexity, approximation, optimization, differentiability, renormings, weak compact generating, Schauder bases and biorthogonal systems, fixed points, topology and nonlinear geometry. The main purpose of this work is to help convince young researchers in Functional Analysis that the theory of Banach spaces is a fertile field of research, full of interesting open problems. Inside the Banach space area, the text should help expose young researchers to the depth and breadth of the work that remains, and to provide the perspective necessary to choose a direction for further study. Some of the problems presented herein are longstanding open problems, some are recent, some are more important and some are only "local" problems. Some would ...

76 FR 17474 - Commercial Space Transportation Advisory Committee-Open Meeting

Science.gov (United States)

2011-03-29

... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration Commercial Space Transportation... Commercial Space Transportation Advisory Committee Open Meeting. SUMMARY: Pursuant to Section 10(a)(2) of the... the Commercial Space Transportation Advisory Committee (COMSTAC). The meeting will take place on...

77 FR 16891 - Commercial Space Transportation Advisory Committee-Open Meeting

Science.gov (United States)

2012-03-22

... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration Commercial Space Transportation... Commercial Space Transportation Advisory Committee Open Meeting. SUMMARY: Pursuant to Section 10(a)(2) of the... the Commercial Space Transportation Advisory Committee (COMSTAC). The meeting will take place on...

78 FR 53496 - Commercial Space Transportation Advisory Committee; Open Meeting

Science.gov (United States)

2013-08-29

... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration Commercial Space Transportation... Commercial Space Transportation Advisory Committee Open Meeting. SUMMARY: Pursuant to Section 10(a)(2) of the... the Commercial Space Transportation Advisory Committee (COMSTAC). The meeting will take place on...

76 FR 51461 - Commercial Space Transportation Advisory Committee-Open Meeting

Science.gov (United States)

2011-08-18

... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration Commercial Space Transportation... Commercial Space Transportation Advisory Committee open meeting. SUMMARY: Pursuant to Section 10(a)(2) of the... the Commercial Space Transportation Advisory Committee (COMSTAC). The meeting will take place on...

78 FR 69742 - Commercial Space Transportation Advisory Committee-Open Meeting

Science.gov (United States)

2013-11-20

... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration Commercial Space Transportation... Commercial Space Transportation Advisory Committee Open Meeting. SUMMARY: Pursuant to Section 10(a)(2) of the... the Commercial Space Transportation Advisory Committee (COMSTAC). The meeting will take place on...

77 FR 52108 - Commercial Space Transportation Advisory Committee; Open Meeting

Science.gov (United States)

2012-08-28

... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration Commercial Space Transportation... Commercial Space Transportation Advisory Committee Open Meeting. SUMMARY: Pursuant to Section 10(a)(2) of the... the Commercial Space Transportation Advisory Committee (COMSTAC). The meeting will take place on...

75 FR 54002 - Commercial Space Transportation Advisory Committee-Open Meeting

Science.gov (United States)

2010-09-02

... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration Commercial Space Transportation... Commercial Space Transportation Advisory Committee Open Meeting. SUMMARY: Pursuant to Section 10(a)(2) of the... the Commercial Space Transportation Advisory Committee (COMSTAC). The meeting will take place on...

78 FR 18416 - Commercial Space Transportation Advisory Committee; Open Meeting

Science.gov (United States)

2013-03-26

... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration Commercial Space Transportation... Commercial Space Transportation Advisory Committee Open Meeting. SUMMARY: Pursuant to Section 10(a)(2) of the... the Commercial Space Transportation Advisory Committee (COMSTAC). The meeting will take place on...

75 FR 16901 - Commercial Space Transportation Advisory Committee-Open Meeting

Science.gov (United States)

2010-04-02

... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration Commercial Space Transportation... Commercial Space Transportation Advisory Committee Open meeting. SUMMARY: Pursuant to section 10(a)(2) of the... of the Commercial Space Transportation Advisory Committee (COMSTAC). The meetings will take place on...

Personal values and cancer treatment refusal

NARCIS (Netherlands)

Evert van Leeuwen; Marli Huijer

2000-01-01

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

30 CFR 77.215-1 - Refuse piles; identification.

Science.gov (United States)

2010-07-01

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

30 CFR 77.215-3 - Refuse piles: certification.

Science.gov (United States)

2010-07-01

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

Evaluation of the effects of subgingival injection of Simvastatin on space re-opening after orthodontic space closure in adults.

Science.gov (United States)

Jahanbin, Arezoo; Abtahi, Mostafa; Namdar, Parastoo; Heravi, Farzin; Sadeghi, Fatemeh; Arab, Hamidreza; Shafaee, Hooman

2016-01-01

Background. This clinical trial evaluated the effect of Simvastatin on space re-opening after orthodontic space closure and its effect on the gingival index (GI) and clinical attachment loss (CAL). Methods. 16 females, 25-40 years old, with spaces between anterior mandibular teeth due to chronic periodontitis were participated in this study. The patients were randomly divided into control and experimental groups. In the experimental group, 1.2% Simvastatin gel and in the control group, 0.9% sodium chloride as a placebo was injected into the pocket depth of the six anterior teeth. The amount of space reopening, GI and CAL were measured. Results. No serious complications were observed during interventions and follow-up periods. Space re-opening was significantly reduced in patients receiving Simvastatin (P space re-opening after orthodontic space closure in human anterior teeth.

30 CFR 77.215 - Refuse piles; construction requirements.

Science.gov (United States)

2010-07-01

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

25 CFR 135.23 - Refusal of water delivery.

Science.gov (United States)

2010-04-01

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

25 CFR 135.6 - Refusal of water delivery.

Science.gov (United States)

2010-04-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

1990-03-01

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

School Refusal

Science.gov (United States)

Wimmer, Mary

2008-01-01

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

Open problems in Banach spaces and measure theory | Rodríguez ...

African Journals Online (AJOL)

We collect several open questions in Banach spaces, mostly related to measure theoretic aspects of the theory. The problems are divided into five categories: miscellaneous problems in Banach spaces (non-separable Lp spaces, compactness in Banach spaces, w*-null sequences in dual spaces), measurability in Banach ...

GREEN OPEN SPACE PERFORMANCE AS URBAN RECREASTION RESOURCES IN PEKANBARU

Directory of Open Access Journals (Sweden)

Wahyu Hidayat

2016-01-01

Full Text Available Urban green open space has significant benefits for the condition of urban living and its community. The availability of accessible and attractive green spaces for recreation activities is an integral part of urban quality of life. This research aims to assess the effectiveness of green open space provision as recreation resource for urban citizens in Pekanbaru, Indonesia. This study presents the assessment of two ele-ments which are equity and efficiency. These two elements are analyzed based on numerous independent variables such as number of the facil-ity, distance to house, accessibility and public transportation availability for equity assessment and frequency of usage, attractiveness of fa-cilities and safety level for efficiency assessment. The assessment of those variables is applied in three different subdistricts in Pekanbaru which are City Center, Sail and Tampan that represent different density categories. To achieve the objectives of this study, the method used to con-duct the study is field survey by questionnaire and interview. Stratified random sampling was the method used in data collection through the distribution of questionnaire, and the tool used to analyse data is through the Statistical Package for Social Science (SPSS. The data was analysed using descriptive statistics to obtain frequency distributions, percentage and the level of equity and efficiency. Several types of test in SPSS data analysis are included to attain some significant information in the study such as Chi-Square test of independence and analysis of Correlation. The findings indicate that a majority of respondents were not satisfied with the distribution of green open space. This study also identified that the quality of green open space facilities was perceived by residents as at moderate level. This survey results indicate that there is significant relationship between subdistricts of respondents and the satisfaction level of green open space

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

Science.gov (United States)

2010-04-01

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

Criteria for Public Open Space Enhancement to Achieve Social Interaction: a Review Paper

Science.gov (United States)

Salih, S. A.; Ismail, S.

2017-12-01

A This paper presents a various literatures, studies, transcripts and papers aiming to provide an overview of some theories and existing research on the significance of natural environments and green open spaces to achieve social interaction and outdoor recreation. The main objective of the paper is to identify the factors that affecting social interaction in green open spaces, through proving that an appropriate open spaces is important to enhance social interaction and community. This study employs (qualitative) summarizing content analysis method which mainly focused on collect and summarizing of documentation such as transcripts, articles, papers, and books from more than 25 source, regarding the importance of public open spaces for the community. The summarizing content analysis of this paper is the fundament for a qualitative oriented procedure of text interpretation used to analyse the information gathered. Results of this study confirms that sound social interaction need an appropriate physical space including criteria of: design, activities, access and linkage, administration and maintenance, place attachment and users’ characteristics, also previous studies in this area have a health perspective with measures of physical activity of open spaces in general.

Constructive and Destructive Aspects of Refusal from Communication

Directory of Open Access Journals (Sweden)

Marianna A. Gulyaeva

2016-12-01

Full Text Available The article investigates the phenomenon of refusal from communication in terms of its positive and negative impact, both on the communicative process, and interpersonal relationships in general. It has been analyzed several aspects of the failure to communicate with positive communication position. The identification of constructive or destructive potential was carried out on the basis of three parameters such as productivity/ unproductive conflict resolution with the help of avoiding communication, the choice of an optimum way of non-communication and its role in the communication process on the basis of the functions performed by them. Failure to communicate is often perceived negatively and is considered an inefficient form of communication, so it does not allow to solve interpersonal conflicts. This article discusses the circumstances where refusal from communication advocates an effective way to avoid conflict. In situations where the termination of communication is inevitable, a fundamental factor for the positive, harmonious form of communication acts interrupting the communication process. Functioning in the communicative space, failure to communicate can either destroy an interaction and relationship between the partners, and regulate the communication process by guiding in the right direction, coordinating the behavior of communication.

[Refusal of treatments by an adult cancer patient].

Science.gov (United States)

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

2018-03-01

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

An Open and Holistic Approach for Geo and Space Sciences

Science.gov (United States)

Ritschel, Bernd; Seelus, Christoph; Neher, Günther; Toshihiko, Iyemori; Yatagai, Akiyo; Koyama, Yukinobu; Murayama, Yasuhiro; King, Todd; Hughes, Steve; Fung, Shing; Galkin, Ivan; Hapgood, Mike; Belehaki, Anna

2016-04-01

Geo and space sciences thus far have been very successful, even often an open, cross-domain and holistic approach did not play an essential role. But this situation is changing rapidly. The research focus is shifting into more complex, non-linear and multi-domain specified phenomena, such as e.g. climate change or space environment. This kind of phenomena only can be understood step by step using the holistic idea. So, what is necessary for a successful cross-domain and holistic approach in geo and space sciences? Research and science in general become more and more dependent from a rich fundus of multi-domain data sources, related context information and the use of highly advanced technologies in data processing. Such buzzword phrases as Big Data and Deep Learning are reflecting this development. Big Data also addresses the real exponential growing of data and information produced by measurements or simulations. Deep Learning technology may help to detect new patterns and relationships in data describing high sophisticated natural phenomena. And further on, we should not forget science and humanities are only two sides of the same medal in the continuing human process of knowledge discovery. The concept of Open Data or in particular the open access to scientific data is addressing the free and open availability of -at least publicly founded and generated- data. The open availability of data covers the free use, reuse and redistribution of data which have been established with the formation of World Data Centers already more than 50 years ago. So, we should not forget, the foundation for open data is the responsibility of the individual scientist up until the big science institutions and organizations for a sustainable management of data. Other challenges are discovering and collecting the appropriate data, and preferably all of them or at least the majority of the right data. Therefore a network of individual or even better institutional catalog-based and at least

Public open space, physical activity, urban design and public health: Concepts, methods and research agenda.

Science.gov (United States)

Koohsari, Mohammad Javad; Mavoa, Suzanne; Villanueva, Karen; Sugiyama, Takemi; Badland, Hannah; Kaczynski, Andrew T; Owen, Neville; Giles-Corti, Billie

2015-05-01

Public open spaces such as parks and green spaces are key built environment elements within neighbourhoods for encouraging a variety of physical activity behaviours. Over the past decade, there has been a burgeoning number of active living research studies examining the influence of public open space on physical activity. However, the evidence shows mixed associations between different aspects of public open space (e.g., proximity, size, quality) and physical activity. These inconsistencies hinder the development of specific evidence-based guidelines for urban designers and policy-makers for (re)designing public open space to encourage physical activity. This paper aims to move this research agenda forward, by identifying key conceptual and methodological issues that may contribute to inconsistencies in research examining relations between public open space and physical activity. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

Science.gov (United States)

2010-07-01

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

Evaluation of the effects of subgingival injection of Simvastatin on space re-opening after orthodontic space closure in adults

Directory of Open Access Journals (Sweden)

Arezoo Jahanbin

2016-03-01

Full Text Available Background. This clinical trial evaluated the effect of Simvastatin on space re-opening after orthodontic space closure and its effect on the gingival index (GI and clinical attachment loss (CAL. Methods. 16 females, 25‒40 years old, with spaces between anterior mandibular teeth due to chronic periodontitis were participated in this study. The patients were randomly divided into control and experimental groups. In the experimental group, 1.2% Simvastatin gel and in the control group, 0.9% sodium chloride as a placebo was injected into the pocket depth of the six anterior teeth. The amount of space reopening, GI and CAL were measured. Results. No serious complications were observed during interventions and follow-up periods. Space re-opening was significantly reduced in patients receiving Simvastatin (P < 0.001. Moreover, GI reduction was significantly greater in Sim-vastatin group compared to the control group (P < 0.001. However, CAL did not demonstrate a significant difference between the groups. Conclusion. Simvastatin may decrease space re-opening after orthodontic space closure in human anterior teeth.

Next Generation Space Interconnect Standard (NGSIS): a modular open standards approach for high performance interconnects for space

Science.gov (United States)

Collier, Charles Patrick

2017-04-01

The Next Generation Space Interconnect Standard (NGSIS) effort is a Government-Industry collaboration effort to define a set of standards for interconnects between space system components with the goal of cost effectively removing bandwidth as a constraint for future space systems. The NGSIS team has selected the ANSI/VITA 65 OpenVPXTM standard family for the physical baseline. The RapidIO protocol has been selected as the basis for the digital data transport. The NGSIS standards are developed to provide sufficient flexibility to enable users to implement a variety of system configurations, while meeting goals for interoperability and robustness for space. The NGSIS approach and effort represents a radical departure from past approaches to achieve a Modular Open System Architecture (MOSA) for space systems and serves as an exemplar for the civil, commercial, and military Space communities as well as a broader high reliability terrestrial market.

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

NARCIS (Netherlands)

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

1972-01-01

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

Primary care pediatricians' perceptions of vaccine refusal in europe.

Science.gov (United States)

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

2011-03-01

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

Persian Speakers' Use of Refusal Strategies across Politeness Systems

Science.gov (United States)

Salmani Nodoushan, Mohammad Ali

2016-01-01

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

19 CFR 12.114 - Release or refusal of delivery.

Science.gov (United States)

2010-04-01

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

Remaking Nigeria’s Urbanism: Assessing and Redressing the Dearth of Open Spaces in Benin City

Directory of Open Access Journals (Sweden)

Ndubisi Onwuanyi

2017-05-01

Full Text Available Unplanned land use in most Nigerian cities has meant that all urban land needs are not adequately provided for within their landscapes. Open spaces are either conspicuously missing or inadequate. There is a tendency for existing open spaces to be lost to urban development pressure and a disregard for zoning. This paper identifies available and accessible open spaces in Benin City and assesses their adequacy using as a guide standards established in two selected international jurisdictions, discusses the potential benefits of open space to the city on the one hand and its residents on the other given the incipient impacts of global warming and climate change, and the prospects of mitigation by greening the city even in its already built-up state. Data is sourced from journals, reports, archival records and inspections of the urban environment. The findings confirm a great dearth of open spaces as well as deteriorating urban environmental conditions which have implications for health, well-being and urban sustainability. The recommendations are that future expansions of the city space incorporate adequate provisions for open spaces, whilst within the existing built-up city, solutions be sought in the creation of greenways, green paths, private green spaces, promoting street trees and the conversion of brownfield sites to green areas.

The Impact of Green Open Space on Community Attachment—A Case Study of Three Communities in Beijing

Directory of Open Access Journals (Sweden)

Yuemei Zhu

2017-04-01

Full Text Available With the development of urbanization in China, the quality of urban life and community attachment have attracted increasing attention of the governments and society. Existing research on community attachment has mainly examined how individual characteristics affect community attachment, such as their length of residence and socioeconomic status. However, some scholars have become interested in exploring the effects of green open space on community attachment. This research examined whether the distribution of green open space in communities had significant effects on community attachment, and both the impact and path were also investigated. Through a questionnaire survey, relevant data in three communities of Beijing were collected. The impact of green open space layout on community attachment was evaluated by using hierarchical regression, and the impact path was examined by using a structural equation model. The results showed that green open space in a community had significant effects on the community attachment, with centralized green open space layout having a greater effect than that of dispersed green open space. Moreover, the more complex the shape of green open space is, the greater the impact is. The degree of satisfaction with the green open space had direct effects on the community attachment. The accessibility and perceived area of green open space could indirectly have an impact on the community attachment by affecting the degree of satisfaction with the green open space. Nevertheless, residents’ perceived importance of green open space could affect the community attachment directly and indirectly, as it affects the degree of satisfaction.

Denitrification capacity of bioreactors filled with refuse at different landfill ages

International Nuclear Information System (INIS)

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

2009-01-01

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

36 CFR 1002.14 - Sanitation and refuse.

Science.gov (United States)

2010-07-01

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

Characteristics and Outcomes of Elderly Patients Refused to ICU

Directory of Open Access Journals (Sweden)

María-Consuelo Pintado

2013-01-01

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

36 CFR 2.14 - Sanitation and refuse.

Science.gov (United States)

2010-07-01

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

Refusal of Curative Radiation Therapy and Surgery Among Patients With Cancer

International Nuclear Information System (INIS)

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

2014-01-01

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

Refusal of Curative Radiation Therapy and Surgery Among Patients With Cancer

Energy Technology Data Exchange (ETDEWEB)

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

2014-07-15

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

77 FR 8801 - Request for Applications: The Community Forest and Open Space Conservation Program

Science.gov (United States)

2012-02-15

... DEPARTMENT OF AGRICULTURE Forest Service Request for Applications: The Community Forest and Open Space Conservation Program AGENCY: Forest Service, USDA. ACTION: Request for applications. SUMMARY: The..., requests applications for the Community Forest and Open Space Conservation Program (Community Forest...

Electric equipment for Koto Refuse Incineration Plant; Tokyoto Koto seiso kojo muke denki setsubi

Energy Technology Data Exchange (ETDEWEB)

NONE

1999-03-10

Meidensha Corporation, intending to enter into refuse disposal business, delivered electric equipment to a Koto Refuse Incineration Plant, Koto Ward, Tokyo, and the facilities came into operation in October, 1998. The plant is the largest in Japan in terms of refuse processing capacity (1800t/day), and efforts are exerted to harmonize the plant with the surroundings, which involve pollution measures and a building that images a cruising yacht. The power receiving facility consists of a 66kV nominal two-circuit gas insulated switch and gas insulated transformer arranged in a space saving design. Heat from refuse incineration is fed to a steam turbine generator (yielding 50MW, the largest in Japan, with the surplus offered for sale after 15MW fed to loads in the site) and to neighboring facilities. For the suppression of fluctuations in voltage at the power receiving point, reactive power is subjected to control which is done by controlling the generator magnetic field system. An 11kV distribution system is provided to match the steam turbine generator voltage, and the voltage is stepped down to 6.6kV with the intermediary of a 23MVA gas insulated transformer. The power is fed to high voltage motors such as the one used for the induced draft fan, electric equipment in the buildings, power facilities in the plant, etc. A power monitoring board is provided in the central control room for general supervision over the power related facilities. (NEDO)

Factors related to treatment refusal in Taiwanese cancer patients.

Science.gov (United States)

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

2015-01-01

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

Pervasive refusal syndrome. Three German cases provide further illustration.

Science.gov (United States)

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

2011-09-01

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

Refusal Skill Ability: An Examination of Adolescent Perceptions of Effectiveness

Science.gov (United States)

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

2010-01-01

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

Butterflies Diversity in Brawijaya University, Veteran, Jakarta and Velodrom Green Open Space

Directory of Open Access Journals (Sweden)

Ayu Raisa Khairun Nisa'

2013-05-01

Full Text Available Butterflies have some roles in environmental as pollinator and bioindicator. Habitat is one of important factor to support butterflies growth. The aim of this research was to describe butterflies diversity in some green open spaces in Malang. Direct observations of butterflies diversity, vegetation structures and abiotic factors in Brawijaya University, Veteran, Jakarta and Velodrom Green Open Space were conducted on June 2012. Sampling was took place in each sites using cruising method in three times observation at 07.00, 11.00 a.m. and 3.30 p.m . Data were analyzed by statistical descriptive using Microsoft Excel 2007 and PAST. The result showed that butterflies composition in all sites dominated by Delias sp., Leptosia nina and Eurema venusta. The diversity index of all sites showed moderate rank that indicate communities equilibrium in environment was still good. In this case, Velodrom Green Open Space has the highest one of diversity index, it was about 2,199. Brawijaya University and Jakarta Green Open Space have a high similarity index based on Morisita Index. The highest abundance of butterflies was observed at 11.00-12.30 a.m. Delias sp. and Leptosia nina has temporal spread all day long, while Eurema venusta just in day light.

47 CFR 73.4005 - Advertising-refusal to sell.

Science.gov (United States)

2010-10-01

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

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

Science.gov (United States)

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

2014-07-15

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

Microbial ecology of coal mine refuse

Energy Technology Data Exchange (ETDEWEB)

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

1977-01-01

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

Elemental composition of suspended particles released in refuse incineration

International Nuclear Information System (INIS)

Mamuro, Tetsuo; Mizohata, Akira

1979-01-01

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

Process for producing a fuel suitable for degassing from refuse

Energy Technology Data Exchange (ETDEWEB)

Sulzberger, J

1975-11-20

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

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

OpenAIRE

Wreen, M J

1991-01-01

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

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

Directory of Open Access Journals (Sweden)

Annelize Nienaber

2016-11-01

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

Situation testing: the case of health care refusal.

Science.gov (United States)

Després, C; Couralet, P-E

2011-04-01

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

[Refusal of nursing care, the legal perspective].

Science.gov (United States)

Fisman, Jérôme

2016-10-01

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

Public Open Spaces and Leisure-Time Walking in Brazilian Adults.

Science.gov (United States)

Florindo, Alex Antonio; Barrozo, Ligia Vizeu; Cabral-Miranda, William; Rodrigues, Eduardo Quieroti; Turrell, Gavin; Goldbaum, Moisés; Cesar, Chester Luiz Galvão; Giles-Corti, Billie

2017-05-23

Access to public open space is important to increase leisure-time walking (LTW) in high-income countries, but there is little evidence in middle-income countries. We conducted a cross-sectional analysis to examine the relationship between LTW and the presence of different public open spaces (parks, bike paths, and squares) and the mix of these recreational destinations near the homes of adults participating in the Sao Paulo Health Survey ( n = 3145). LTW was evaluated by a questionnaire. We delineated buffers (500, 1000, and 1500 m) from the geographic coordinates of the adults' residential addresses using a geographic information system. We used multilevel logistic regression taking account of clustering by census tracts and households, and with adjustment for social, demographics, and health characteristics. The main results showed that the presence of at least two recreational destinations within a 500-m buffer of participants' homes were associated with an increased odds of LTW compared with no destinations present (OR = 1.65; 95% CI 1.09-2.55). No associations were found for destinations further away. These results support actions outlined in the new urban plan for Sao Paulo city and could be used to highlight the importance access to a mix of public open spaces to promote physical activity in megacities of middle-income countries.

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

Science.gov (United States)

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

Evaluation of comfort conditions in urban open spaces. Application in the island of Crete

International Nuclear Information System (INIS)

Tsitoura, Marianna; Tsoutsos, Theocharis; Daras, Tryfon

2014-01-01

Highlights: • Outdoor spaces field surveys carried out in four different urban open spaces. • A strong connection between the microclimate and the use of open space. • Human physical and psychological factors can optimize the urban space design. - Abstract: The thermal environment in outdoor public spaces and their level of use are strongly connected. The design of outdoor spaces, especially in urban areas, is very critical in Southern Europe due to their extended use during summertime where the urban heat island phenomenon deteriorates the microclimatic conditions. In this paper the main outcomes of outdoor spaces field surveys are presented, which were carried out in four different urban open spaces in Crete. On site measurements were implemented and a questionnaire was used in order to estimate the thermal comfort of visitors. Thermal indices like Predicted Mean Vote, Physiologically Equivalent Temperature, Standard Effective Temperature, Wet Bulb Globe Temperature are used to evaluate the features of urban microclimate and then are being compared in order to find the most suitable for the Mediterranean microclimate. This suggests another way of approach to the researcher and provides essential tools to the designer

School Refusal: Assessment and Intervention within School Settings.

Science.gov (United States)

Wimmer, Mary B.

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

Risk factors associated with treatment refusal in lung cancer.

Science.gov (United States)

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

2017-09-01

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

A Comparison of Selective Auditory Attention Abilities in Open-Space Versus Closed Classroom Students.

Science.gov (United States)

Reinertsen, Gloria M.

A study compared performances on a test of selective auditory attention between students educated in open-space versus closed classroom environments. An open-space classroom environment was defined as having no walls separating it from hallways or other classrooms. It was hypothesized that the incidence of auditory figure-ground (ability to focus…

Open innovation in the European space sector : existing practices, constraints and opportunities

NARCIS (Netherlands)

van Burg, E.; Giannopapa, C.G.; Reymen, I.M.M.J.

2017-01-01

To enhance innovative output and societal spillover of the European space sector, the open innovation approach is becoming popular. Yet, open innovation, referring to innovation practices that cross borders of individual firms, faces constraints. To explore these constraints and identify

When does food refusal require professional intervention?

OpenAIRE

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

2009-01-01

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

Interactive human behavior analysis in open or public spaces

NARCIS (Netherlands)

Hung, H.; Odobez, J.-M.; Gavrila, D.; Keyson, D.V.; Maher, M.L.; Streitz, N.; Cheok, A.; Augusto, J.C.; Wichert, R.; Englebienne, G.; Aghajan, H.; Kröse, B.J.A.

2011-01-01

In the past years, efforts in surveillance and open space analysis have focused on traditional computer vision problems like scene modeling or object detection and tracking. Research on human behavior recognition have tended to work on predefined simple activities such as running, jumping or left

Public Open Spaces and Leisure-Time Walking in Brazilian Adults

Directory of Open Access Journals (Sweden)

Alex Antonio Florindo

2017-05-01

Full Text Available Access to public open space is important to increase leisure-time walking (LTW in high-income countries, but there is little evidence in middle-income countries. We conducted a cross-sectional analysis to examine the relationship between LTW and the presence of different public open spaces (parks, bike paths, and squares and the mix of these recreational destinations near the homes of adults participating in the Sao Paulo Health Survey (n = 3145. LTW was evaluated by a questionnaire. We delineated buffers (500, 1000, and 1500 m from the geographic coordinates of the adults’ residential addresses using a geographic information system. We used multilevel logistic regression taking account of clustering by census tracts and households, and with adjustment for social, demographics, and health characteristics. The main results showed that the presence of at least two recreational destinations within a 500-m buffer of participants’ homes were associated with an increased odds of LTW compared with no destinations present (OR = 1.65; 95% CI 1.09–2.55. No associations were found for destinations further away. These results support actions outlined in the new urban plan for Sao Paulo city and could be used to highlight the importance access to a mix of public open spaces to promote physical activity in megacities of middle-income countries.

Valuing urban open space using the travel-cost method and the implications of measurement error.

Science.gov (United States)

Hanauer, Merlin M; Reid, John

2017-08-01

Urbanization has placed pressure on open space within and adjacent to cities. In recent decades, a greater awareness has developed to the fact that individuals derive multiple benefits from urban open space. Given the location, there is often a high opportunity cost to preserving urban open space, thus it is important for both public and private stakeholders to justify such investments. The goals of this study are twofold. First, we use detailed surveys and precise, accessible, mapping methods to demonstrate how travel-cost methods can be applied to the valuation of urban open space. Second, we assess the degree to which typical methods of estimating travel times, and thus travel costs, introduce bias to the estimates of welfare. The site we study is Taylor Mountain Regional Park, a 1100-acre space located immediately adjacent to Santa Rosa, California, which is the largest city (∼170,000 population) in Sonoma County and lies 50 miles north of San Francisco. We estimate that the average per trip access value (consumer surplus) is $13.70. We also demonstrate that typical methods of measuring travel costs significantly understate these welfare measures. Our study provides policy-relevant results and highlights the sensitivity of urban open space travel-cost studies to bias stemming from travel-cost measurement error. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

Science.gov (United States)

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

2014-01-01

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

Current status of research on school refusal

Directory of Open Access Journals (Sweden)

Cándido J. Inglés

2015-06-01

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

Refusal to medical interventions.

Science.gov (United States)

Palacios, G; Herreros, B; Pacho, E

2014-10-01

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

Perception of open urban space – Bevk square in Nova Gorica

Directory of Open Access Journals (Sweden)

Nataša Bratina

1997-01-01

Full Text Available In research on perception of open urban space, psychological and structural aspects are important, as well as social use. Social use however is most important, because open urban space and its green surfaces satisfies needs of an urban population. The psychological aspect applies to direct experiencing and perception of space, while the structural aspect proves that public urban places are an important category in the urban structure. On the example of Bevk square, Nova Gorica, three types of analyses were carried out. With the structural analysis and evaluation, development and structure of the place were shown, its problems and qualities. The survey on public opinion utilised the method of cognitive mapping, enabled definition of the image of the square, as perceived by everyday users. With the method of time samples events on the square were observed, in different time slots and days of the week.

Move the Neighborhood: study design of a community-based participatory public open space intervention

DEFF Research Database (Denmark)

Pawlowski, Charlotte Skau; Winge, Laura; Carroll, Sidse

evaluation will be used to gain knowledge of the intervention processes. DISCUSSION: The study presents new methods and approaches in the field of public open space interventions through interdisciplinary collaboration, participatory co-design approach and combination of measurements. Using both effect......BACKGROUND: A limited amount of research has examined the effect of changing public open spaces on active living. This abstract presents the study protocol of an intervention study designed in an interdisciplinary collaboration built on principles of Community-Based Participatory Research (CBPR...... and process evaluations the study will provide unique insights in the role and importance of the interdisciplinary collaboration, participatory processes, tailoring changes in public open space to local needs and wishes. These results can be used to guide urban renewal projects in deprived neighbourhoods...

Refusing The Choice: Balancing Life and Work

Science.gov (United States)

Brooks, J.

2012-12-01

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

Clean Cities Niche Market Overview: Refuse Haulers (Brochure)

Energy Technology Data Exchange (ETDEWEB)

Shea, S.

2011-09-01

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

Open Education as a Way for Space Education in Russia

Science.gov (United States)

Malyshev, V. V.; Karp, K. A.

2002-01-01

low level of state financial support. As a result there is a decreasing education quality. Scientific research was always an integral part of education and an alternative way for education financial support. But today the level of such support is too low as well. High experience of Russian space education system is not useful completely. This paper shows, that at present an open education could be a new step of space education in Russia. discussed in the paper. of students per one professor and also the number of students, which pay for education. New technology based on Internet technology would provide high methodology and technical level of education. The open education guarantees training in different areas and specialties on international standard level. education process, new education technology, new equipment of education system, new ways of financial support, international cooperation in education process, new professors and staffs in education system, increasing the level of salary for staff and comfortable conditions for students are discussed at the first. free education period, both traditional and new education methods are very important on the other side. about 4-5 years. The necessity of international educational system integration has to be taken into account. The international standard request, educational courses in different languages and free market conditions have to be under consideration. The partially ready open space education is discussed also. That system can be started even today.

The Role of Open Space in Urban Neighbourhoods for Health-Related Lifestyle

Science.gov (United States)

Lestan, Katarina Ana; Eržen, Ivan; Golobič, Mojca

2014-01-01

The research reported in this paper addresses the relationship between quality of open space and health related lifestyle in urban residential areas. The research was performed in the residential developments in Ljubljana, Slovenia, dating from the time of political and economic changes in the early nineties. Compared to the older neighborhoods, these are typically single-use residential areas, with small open spaces and poor landscape design. The research is concerned with the quality of life in these areas, especially from the perspective of the vulnerable users, like the elderly and children. Both depend on easily accessible green areas in close proximity to their homes. The hypothesis is that the poor open space quality affects their health-related behavior and their perceived health status. The research has three methodological phases: (1) a comparison between urban residential areas by criteria describing their physical characteristics; (2) behavior observation and mapping and (3) a resident opinion survey. The results confirm differences between open spaces of the selected residential areas as well as their relation with outdoor activities: a lack of outdoor programs correlates with poor variety of outdoor activities, limited to transition type, less time spent outdoors and lower satisfaction with their home environment. The survey also disclosed a strong influence of a set of socio-economic variables such as education and economic status on physical activity and self-perceived health status of people. The results therefore confirm the hypothesis especially for less affluent and educated; i.e., vulnerable groups. PMID:25003173

The Role of Open Space in Urban Neighbourhoods for Health-Related Lifestyle

Directory of Open Access Journals (Sweden)

Katarina Ana Lestan

2014-06-01

Full Text Available The research reported in this paper addresses the relationship between quality of open space and health related lifestyle in urban residential areas. The research was performed in the residential developments in Ljubljana, Slovenia, dating from the time of political and economic changes in the early nineties. Compared to the older neighborhoods, these are typically single-use residential areas, with small open spaces and poor landscape design. The research is concerned with the quality of life in these areas, especially from the perspective of the vulnerable users, like the elderly and children. Both depend on easily accessible green areas in close proximity to their homes. The hypothesis is that the poor open space quality affects their health-related behavior and their perceived health status. The research has three methodological phases: (1 a comparison between urban residential areas by criteria describing their physical characteristics; (2 behavior observation and mapping and (3 a resident opinion survey. The results confirm differences between open spaces of the selected residential areas as well as their relation with outdoor activities: a lack of outdoor programs correlates with poor variety of outdoor activities, limited to transition type, less time spent outdoors and lower satisfaction with their home environment. The survey also disclosed a strong influence of a set of socio-economic variables such as education and economic status on physical activity and self-perceived health status of people. The results therefore confirm the hypothesis especially for less affluent and educated; i.e., vulnerable groups.

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

Science.gov (United States)

Bhandari, Neeraj; Shi, Yunfeng; Jung, Kyoungrae

2016-01-01

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

Generalizations of γ-open set in topological spaces

Energy Technology Data Exchange (ETDEWEB)

Bhattacharya, Baby, E-mail: babybhatt75@gmail.com; Paul, Arnab, E-mail: mrarnabpaul87@gmail.com [Department of Mathematics, NIT Agartala, Jirania, Tripura (India)

2016-06-21

The main aim of this work is to study three generalized forms of γ-open set due to D. Andrijevic (D. Andrijevic, On the Topology Generated by pre-open sets, Presented at the Sixth Prague Topological Symposium, 39 (1987), 367-376)in a topological space. Out of which the dual appearance of one is the stronger form of b-locally closed set in the sense of Arafa A. Nasef (A. A Nasef,On b-locally closed sets and related topics, CHAOS SOLITONS & FRACTALS 12(2001) 1909-1915). Also, we introduce the concept of different types of continuity and study their basic properties by using these newly defined sets. Finally, we establish the interrelationships among themselves together with some already existing generalized forms of continuity.

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

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Owiti, J A; Bowers, L

2011-09-01

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

Transfer closed and transfer open multimaps in minimal spaces

International Nuclear Information System (INIS)

Alimohammady, M.; Roohi, M.; Delavar, M.R.

2009-01-01

This paper is devoted to introduce the concepts of transfer closed and transfer open multimaps in minimal spaces. Also, some characterizations of them are considered. Further, the notion of minimal local intersection property will be introduced and characterized. Moreover, some maximal element theorems via minimal transfer closed multimaps and minimal local intersection property are given.

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

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

2018-01-01

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

[The refusal of nursing care by the families].

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Curchod, Claude; Fisher, Marion

2016-10-01

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

Researching on Hawking Effect in a Kerr Space Time via Open Quantum System Approach

International Nuclear Information System (INIS)

Liu, Wen-Biao; Liu, Xian-Ming

2014-01-01

It has been proposed that Hawking radiation from a Schwarzschild or a de Sitter spacetime can be understood as the manifestation of thermalization phenomena in the framework of an open quantum system. Through examining the time evolution of a detector interacting with vacuum massless scalar fields, it is found that the detector would spontaneously excite with a probability the same as the thermal radiation at Hawking temperature. Following the proposals, the Hawking effect in a Kerr space time is investigated in the framework of an open quantum systems. It is shown that Hawking effect of the Kerr space time can also be understood as the the manifestation of thermalization phenomena via open quantum system approach. Furthermore, it is found that near horizon local conformal symmetry plays the key role in the quantum effect of the Kerr space time

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

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

2014-03-01

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

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

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Wade, Katherine

2014-01-01

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

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

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

2017-07-01

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

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

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

2015-12-01

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

How to Cope with Working in an Open-space Lab?

NARCIS (Netherlands)

Pautasso, Marco; Werf, van der Wopke

2017-01-01

Open-space labs and research environments are increasingly common worldwide. They are supposed to facilitate interactions among researchers, but can be disruptive to those who need to be in a quiet environment in order to concentrate. This problem is increasingly felt across the natural, medical

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

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

2017-10-01

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

Arab Researchers Promotions of Open Archives and Free

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Abd Al-Majid Salih Bu Azza

2006-09-01

Full Text Available A study aiming at measuring the promotion of Arab researches for Open Archives and Free Electronic Journal, contained 60 researches in Sultan Qabus university in Oman, and discovered their opinion about open access resources. It found that 78.8 % of researchers did not publish articles in Free Electronic Journals, and 77.8 % do not aware about the international imitative of Open Access. Also discovered that researchers refuse publishing their articles in e-journals because of electronic articles are not considered in their universities.

Sodium bicarbonate effects on the anaerobic digestion of refuse

Energy Technology Data Exchange (ETDEWEB)

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

1989-01-01

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

Thermal Performance of Housing Open Spaces in the City of Mosul

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Dr. TURKI HASAN ALI ALHADIDI

2012-03-01

Full Text Available The rapid urban growth has lead to an urgent need to increase residential buildings in such a way that requires quick execution of such buildings. The appearance of modern materials such as reinforced concrete has helped in getting fast-constructed houses of a westerly pattern such that excluding the inherited styles that are in harmony with severe environment like that of the Middle East. This has resulted in a modern pattern of buildings lacks the microclimate which was enjoyed by the traditional pattern and which have provided the inhabitant with a relative thermal comfort. ‎This research try to compare different microclimates due to the variation of open architectural spaces patterns in the residential units (traditional ones represented by (the courtyards and Iwan and the modem one represented by the space of (garages and terraces in Summer in Mosul city. ‎ ‎The results showed that the traditional open spaces are the nearest to the thermal comfort zone, although both of them don't represent the ideal state of human comfort in this ‎period of Summer.

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

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

2009-11-01

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

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

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

2010-01-01

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

On the Value of Foregone Open Space in Sprawling Cities

NARCIS (Netherlands)

Vermeulen, W.; Rouwendal, J.

2014-01-01

Foregone benefits of the open space that is sacrificed through urban sprawl are hard to quantify. We obtain a simple benchmark measure by introducing a demand for trips beyond the urban boundary into the monocentric city model. The externality arises from the increase in travel costs that expansion

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

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

1999-01-01

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

Open branes in space-time non-commutative little string theory

International Nuclear Information System (INIS)

Harmark, T.

2001-01-01

We conjecture the existence of two new non-gravitational six-dimensional string theories, defined as the decoupling limit of NS5-branes in the background of near-critical electrical two- and three-form RR fields. These theories are space-time non-commutative Little String Theories with open branes. The theory with (2,0) supersymmetry has an open membrane in the spectrum and reduces to OM theory at low energies. The theory with (1,1) supersymmetry has an open string in the spectrum and reduces to (5+1)-dimensional NCOS theory for weak NCOS coupling and low energies. The theories are shown to be T-dual with the open membrane being T-dual to the open string. The theories therefore provide a connection between (5+1)-dimensional NCOS theory and OM theory. We study the supergravity duals of these theories and we consider a chain of dualities that shows how the T-duality between the two theories is connected with the S-duality between (4+1)-dimensional NCOS theory and OM theory

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

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

2017-11-01

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

Assessment of musculoskeletal load in refuse collectors

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Zbigniew W. Jóźwiak

2013-08-01

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

Geomorphic reclmation of a coal refuse pile

Science.gov (United States)

Hopkinson, L. C.; Quaranta, J.

2017-12-01

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

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

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

2018-01-01

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

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

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

2015-06-01

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

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

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

2005-04-01

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

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

Science.gov (United States)

2011-05-23

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

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

Directory of Open Access Journals (Sweden)

Olajide O Adelugba

2016-01-01

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

Investigating the Impact of Schools' Open Space on Learning and Educational Achievement of Elementary Students

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Abdolreza Gilavand

2016-04-01

Full Text Available Background It is obvious that most of informal learnings of social skills and constructive plays occur in school yards and play-fields where children spend much of their non-official time of teaching. This study aimed to investigate the impact of schools' open space on learning and educational achievement of elementary students in Ahvaz, Southwest of Iran. Materials and Methods At a cross-sectional study, 210 students were selected randomly as sample of study. Data collection tools included Hermance’s achievement motivation questionnaire and researcher-constructed questionnaire (observation checklist to examine the physical parameters of learning schools' open space and interviews with students. Data of study were analyzed in SPSS- 21 software. Results Results of this study showed that schools' open space has a significant impact on learning and academic achievement of elementary school students in Ahvaz- Iran (P

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

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Wreen, M J

1991-09-01

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

Using observational methods to evaluate public open spaces and physical activity in Brazil.

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Hino A A, F; Reis, Rodrigo S; Ribeiro, Isabela C; Parra, Diana C; Brownson, Ross C; Fermino, Rogerio C

2010-07-01

Open public spaces have been identified as important facilities to promote physical activity (PA) at the community level. The main goals of this study are to describe open public spaces user's characteristics and to explore to what extent these characteristics are associated with PA behavior. A system of direct observation was used to evaluate the PA levels on parks and squares (smaller parks) and users's characteristics (gender and age). The 4 parks and 4 squares observed were selected from neighborhoods with different socioeconomic status and environmental characteristics. The settings were observed 3 times a day, 6 days per week, during 2 weeks. More men than women were observed in parks (63.1%) and squares (70.0%) as well as more adults and adolescents than older adults and children. Users were more physically active in parks (men = 34.1%, women = 36.1%) than in squares (men = 25.5%, women 22.8%). The characteristics of public open spaces may affect PA in the observed places. Initiatives to improve PA levels in community settings should consider users' characteristics and preferences to be more effective and reach a larger number of people.

The Role of Stakeholders Related to the Management of Ecological Function of Urban Green Open Space. Case Study: City of Depok, Indonesia

Science.gov (United States)

Mangopa Malik, Andy Anton

2017-12-01

Urban green open space is one of the assets that provide substantial benefits to the urban community. One important function of urban green open space is a function of ecology. This study will provide initial explanation on the various studies related to the ecological function of urban green open space. The study of urban space management approach related to ecological function will explain the extent of the role of stakeholders in the urban areas that will further strengthen the importance of the existence of green open space, especially in city of Depok. With so many problems related to the supply and use of green open space in the city of Depok. This approach was originally applied by the private sector and many applications made a great contribution, so it began to be used by the government in managing public assets there. This study will use descriptive method, at the beginning of the study will explain the existence of the reality of urban green open space as part of the urban space by viewing it from theoretical overview of space, function and role of the various problems that occur in it. The results of this study indicate there are six problems in the management of green open spaces in city of Depok. Using the stages in asset management will provide space for participation of existing stakeholders in the management of green open spaces in city of Depok.

Openly Published Environmental Sensing (OPEnS) | Advancing Open-Source Research, Instrumentation, and Dissemination

Science.gov (United States)

Udell, C.; Selker, J. S.

2017-12-01

The increasing availability and functionality of Open-Source software and hardware along with 3D printing, low-cost electronics, and proliferation of open-access resources for learning rapid prototyping are contributing to fundamental transformations and new technologies in environmental sensing. These tools invite reevaluation of time-tested methodologies and devices toward more efficient, reusable, and inexpensive alternatives. Building upon Open-Source design facilitates community engagement and invites a Do-It-Together (DIT) collaborative framework for research where solutions to complex problems may be crowd-sourced. However, barriers persist that prevent researchers from taking advantage of the capabilities afforded by open-source software, hardware, and rapid prototyping. Some of these include: requisite technical skillsets, knowledge of equipment capabilities, identifying inexpensive sources for materials, money, space, and time. A university MAKER space staffed by engineering students to assist researchers is one proposed solution to overcome many of these obstacles. This presentation investigates the unique capabilities the USDA-funded Openly Published Environmental Sensing (OPEnS) Lab affords researchers, within Oregon State and internationally, and the unique functions these types of initiatives support at the intersection of MAKER spaces, Open-Source academic research, and open-access dissemination.

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

Science.gov (United States)

2010-07-01

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

What Attracts People to Visit Community Open Spaces? A Case Study of the Overseas Chinese Town Community in Shenzhen, China

Directory of Open Access Journals (Sweden)

Yiyong Chen

2016-06-01

Full Text Available A well-designed open space that encourages outdoor activity and social communication is a community asset that could potentially contribute to the health of local residents and social harmony of the community. Numerous factors may influence the use of each single space and may result in a variety of visitors. Compared with previous studies that focused on accessibility, this study highlights the relationship between the utilization and characteristics of community open spaces in China. The Overseas Chinese Town community in Shenzhen is regarded as an example. The association between the number of visitors and space characteristics is examined with multivariate regression models. Results show that large areas with accessible lawns, well-maintained footpaths, seats, commercial facilities, and water landscapes are important characteristics that could increase the use of community open spaces. However, adding green vegetation, sculptures, and landscape accessories in open spaces has limited effects on increasing the outdoor activities of residents. Thus, to increase the use of community open spaces, landscape designers should focus more on creating user-oriented spaces with facilities that encourage active use than on improving ornamental vegetation and accessories.

What Attracts People to Visit Community Open Spaces? A Case Study of the Overseas Chinese Town Community in Shenzhen, China

Science.gov (United States)

Chen, Yiyong; Liu, Tao; Xie, Xiaohuan; Marušić, Barbara Goličnik

2016-01-01

A well-designed open space that encourages outdoor activity and social communication is a community asset that could potentially contribute to the health of local residents and social harmony of the community. Numerous factors may influence the use of each single space and may result in a variety of visitors. Compared with previous studies that focused on accessibility, this study highlights the relationship between the utilization and characteristics of community open spaces in China. The Overseas Chinese Town community in Shenzhen is regarded as an example. The association between the number of visitors and space characteristics is examined with multivariate regression models. Results show that large areas with accessible lawns, well-maintained footpaths, seats, commercial facilities, and water landscapes are important characteristics that could increase the use of community open spaces. However, adding green vegetation, sculptures, and landscape accessories in open spaces has limited effects on increasing the outdoor activities of residents. Thus, to increase the use of community open spaces, landscape designers should focus more on creating user-oriented spaces with facilities that encourage active use than on improving ornamental vegetation and accessories. PMID:27367713

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

Science.gov (United States)

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

2011-01-01

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

Best Management Practice, Fact Sheet 2. Sheet Flow to Open Space

OpenAIRE

Sample, David; Doumar, Lia

2013-01-01

This publication explains what sheet flow to open space is, where and how it is used, their limitations, routine and nonroutine maintenance, expected costs, and a glossary of terms. This fact sheet is one of a 15-part series on urban stormwater management practices.

Open-bite treatment utilizing clear removable appliances with intermaxillary and intramaxillary elastics.

Science.gov (United States)

Park, Jae Hyun; Kim, Tae Weon

2009-01-01

Clear removable appliances with elastics can be effective and efficient in extruding maxillary teeth during aligner treatment or following a relapse of an open bite. Some patients with open bites refuse to wear conventional fixed appliances. In these individuals, clear aligners with elastics could be a valuable alternative. © 2009 Quintessence Publishing Co, Inc. All Rights Reserved

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

NARCIS (Netherlands)

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

2009-01-01

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

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

African Journals Online (AJOL)

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

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

Directory of Open Access Journals (Sweden)

Luana Sorrenti

2016-08-01

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

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

Science.gov (United States)

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

2001-09-01

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

Public open space as the only urban space for walking: Sumatera Utara experience

Science.gov (United States)

Nasution, A. D.; Zahrah, W.; Ginting, Nurlisa

2018-03-01

One of successful public open space (POS) criteria is the proper pedestrian linkage. Furthermore, a good quality POS should pay attention to pedestrian activities. This will contribute to the physical and mental health of people and enhance their quality of life. The research means to investigate how POS accommodate the pedestrians. The study takes place in twenty small towns in Sumatra Utara province, Indonesia. The analysis is a descriptive, explorative study that collects data about physical elements of POS. The survey also uses a set of questionnaire to get information about the visitors walking tradition. The result of the study shows that most of the citizens approach and get to the POS by vehicle, both cars, and motorcycles. They use their private vehicles although the distance between their houses and the POS is less than one kilometer. There is no pedestrian linkage that connects the POS with the other part of urban space. However, the POS is active by various physical activities, such as walking, playing and exercising. These events occur both in pedestrian ways in the periphery, inside the POS, and in the other spots of the POS, such as grass field or multipurpose plaza. The visitors’ vehicle tradition relates to the whole urban space which is planned in a car-oriented way. Thus, the POS becomes the only space that people can walk and enjoy the environment.

Microbial ecology studies at two coal mine refuse sites in Illinois

Energy Technology Data Exchange (ETDEWEB)

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

1978-01-01

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

An open-source job management framework for parameter-space exploration: OACIS

Science.gov (United States)

Murase, Y.; Uchitane, T.; Ito, N.

2017-11-01

We present an open-source software framework for parameter-space exporation, named OACIS, which is useful to manage vast amount of simulation jobs and results in a systematic way. Recent development of high-performance computers enabled us to explore parameter spaces comprehensively, however, in such cases, manual management of the workflow is practically impossible. OACIS is developed aiming at reducing the cost of these repetitive tasks when conducting simulations by automating job submissions and data management. In this article, an overview of OACIS as well as a getting started guide are presented.

Knowledge-based fault diagnosis system for refuse collection vehicle

International Nuclear Information System (INIS)

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

2015-01-01

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

Knowledge-based fault diagnosis system for refuse collection vehicle

Energy Technology Data Exchange (ETDEWEB)

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

2015-05-15

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

Managing for Multifunctionality in Urban Open Spaces: Approaches for Sustainable Development

Directory of Open Access Journals (Sweden)

Wenzheng Shi

Full Text Available ABSTRACT: Landscape management plays a key role in improving the quality of urban environments and enhancing the multifunctionality of green infrastructure. It works to guide the efficient and effective management of green spaces for sustainability and the well-being of users. However, while most researchers have emphasised spatial planning as a basis for developing green infrastructure to promote new strategic connections in urban green space, they have simultaneously ignored the impact of management. Against this background, this paper argues that if our towns and cities seek to maintain the well-being of citizens while also achieving sustainable environments, they must engage in effective landscape management to improve their green infrastructure. It is not enough to simply design or maintain parks and green spaces so as to keep up their physical condition; rather, green infrastructure work should be adapted to the understanding and implementation of managers, users and stakeholders in an integrated management process in order to provide more services for sustainable development. A selected study in Sheffield investigated the management planning required for sustainable development. It is beneficial to learn the experiences of management planning in Sheffield, a city which has rich management practices for green and open spaces. This study will analyse how management planning helps local authorities and managers to improve multifunctional green and open spaces in the context of sustainable development. As a result, the study also explores the framework of management planning with regard to the transferability of the existing practices in Sheffield. It also attempts to provide a primer for sustainability impact assessments in other cities with a considered knowledge exchange. KEYWORDS: Management planning, green infrastructure, multifunctionality, sustainability, knowledge exchange

Older Adults in Public Open Spaces: Age and Gender Segregation.

Science.gov (United States)

Noon, Rinat Ben; Ayalon, Liat

2018-01-18

There is a substantial body of literature on the importance of the environment in the lives of older adults. Nonetheless, to date, there has been limited research on everyday activities of urban older adults in public open spaces. The present study examined the activities of older adults in public open spaces in Israel with a specific focus on age and gender as potential variables of relevance. Using still photography, we systematically photographed four sessions in two different public outdoor settings attended by older Israelis. Still photographs were converted to narrative descriptions, and then coded, quantified, and compared using descriptive statistics. The majority (311, 97%) of older adults arrived alone to the public setting. Of these, 44% formed a social group of two or more people, whereas the remaining older adults stayed alone. When social interactions occurred, they were primarily gender homogenous (69%); women were more likely to integrate in spontaneous social conversations and men were more likely to participate in common games. Our findings call attention to the important role played by the outdoor environment as a venue for social activities among older adults. The findings further stress the high levels of aloneness experienced by older adults, which do not seem to be alleviated by the mere attendance of public spaces. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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

African Journals Online (AJOL)

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

Sustainability: an Approach in Planning to Raise the Quality of Life Through Open Space Development

Directory of Open Access Journals (Sweden)

Sonal Y. Khobragade

2014-04-01

Full Text Available A presentation of the notion of sustainable development through the eye of a town planner, by elucidating how open space development would change the character of the city and augment towards harmony in the socio-environmental chords of sustainable development. It is an attempt to put forward awareness about the sustainability and environmental risk to ultimately reconcile ecological, social and economic factors of society. It is an attempt to reflect on socio-environmental dimension of the open space planning by addressing urban metamorphosis.

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

Science.gov (United States)

2010-07-01

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

Children with pervasive refusal.

OpenAIRE

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

1991-01-01

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

Chemical reagent and process for refuse disposal

International Nuclear Information System (INIS)

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

1989-01-01

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

49 CFR 219.213 - Unlawful refusals; consequences.

Science.gov (United States)

2010-10-01

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

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

Science.gov (United States)

Kyoso, Masaki

2015-08-01

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

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

NARCIS (Netherlands)

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

2007-01-01

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

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

NARCIS (Netherlands)

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

2007-01-01

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

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

NARCIS (Netherlands)

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

2007-01-01

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

Women's, midwives' and obstetricians' experiences of a structured process to document refusal of recommended maternity care.

Science.gov (United States)

Jenkinson, Bec; Kruske, Sue; Stapleton, Helen; Beckmann, Michael; Reynolds, Maree; Kildea, Sue

2016-12-01

Ethical and professional guidance for midwives and obstetricians emphasises informed consent and respect for patient autonomy; the right to refuse care is well established. However, the existing literature is largely silent on the appropriate clinical responses when pregnant women refuse recommended care, and accounts of disrespectful interactions and conflict are numerous. Policies and processes to support women and maternity care providers are rare and unstudied. To document the perspectives of women, midwives and obstetricians following the introduction of a structured process (Maternity Care Plan; MCP) to document refusal of recommended maternity care in a large tertiary maternity unit. A qualitative, interpretive study involved thematic analysis of in-depth semi-structured interviews with women (n=9), midwives (n=12) and obstetricians (n=9). Four major themes were identified including: 'Reassuring and supporting clinicians'; 'Keeping the door open'; 'Varied awareness, criteria and use of the MCP process' and 'No guarantees'. Clinicians felt protected and reassured by the structured documentation and communication process and valued keeping women engaged in hospital care. This, in turn, protected women's access to maternity care. However, the process could not guarantee favourable responses from other clinicians subsequently involved in the woman's care. Ongoing discussions of risk, perceived by women and some midwives to be pressure to consent to recommended care, were still evident. These limitations may have been attributable to the absence of agreed criteria for initiating the MCP process and fragmented care. Varying awareness and use of the process also diminished women's access to it. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Responding to the refusal of care in the emergency department.

Science.gov (United States)

Nelson, Jennifer; Venkat, Arvind; Davenport, Moira

2014-01-01

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

Evaluation of SPACE code for simulation of inadvertent opening of spray valve in Shin Kori unit 1

International Nuclear Information System (INIS)

Kim, Seyun; Youn, Bumsoo

2013-01-01

SPACE code is expected to be applied to the safety analysis for LOCA (Loss of Coolant Accident) and Non-LOCA scenarios. SPACE code solves two-fluid, three-field governing equations and programmed with C++ computer language using object-oriented concepts. To evaluate the analysis capability for the transient phenomena in the actual nuclear power plant, an inadvertent opening of spray valve in startup test phase of Shin Kori unit 1 was simulated with SPACE code. To evaluate the analysis capability for the transient phenomena in the actual nuclear power plant, an inadvertent opening of spray valve in startup test phase of Shin Kori unit 1 was simulated with SPACE code

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

Science.gov (United States)

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

2014-01-01

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

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

Science.gov (United States)

Bock, Gregory L

2012-11-01

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

Using a Nonaversive Procedure to Decrease Refusals.

Science.gov (United States)

Spooner, Fred; And Others

1990-01-01

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

The Conservation of the Landscape in the Perspective of a Public Open Spaces System in Recife

OpenAIRE

Carneiro, Ana Rita Sá; Duarte, Mirela; Marques, Eliábi A.

2009-01-01

This paper presents the relationship between the study of public open spaces and the urban landscape in Recife, according a systemic vision. This relationship is defined with the historical analysis of the natural ecosystems in the site landscape such as rivers, coast vegetation and mangrove, and the atlantic forest, which was occupied by the time. This method was chosen to understand the morphology of open spaces, its typology and which is preserved as natural and cultural heritage. Nowadays...

Transfusion Refusal and the Shifting Limits of Multicultural Accommodation.

Science.gov (United States)

DeMichelis, Carey

2017-12-01

The refusal of blood products by Jehovah's Witness patients has provoked court proceedings, social science research, and contemporary fiction, all of which emphasize a seemingly intractable conflict between religious and secular ways of being. This article takes a different approach, focusing instead on the space that Witness patients have carved out for their accommodation in a major pediatric research hospital. Using discourse analysis and interview data, I map the way moralizing discourses surrounding Witness families have shifted over the past 70 years alongside advancements in bloodless medicine. I argue that Witnesses have helped to enable their present accommodation and recognition by marshaling particular forms of economic, human, and social capital, and consider whether their success might be attainable by other treatment-resisting patient groups. Thus, this article explores the shifting limits of multicultural accommodation and the conditions that make understanding, collaboration, and compromise possible.

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

Energy Technology Data Exchange (ETDEWEB)

Dugan, P.R.

1987-01-01

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

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

Directory of Open Access Journals (Sweden)

Karine Markosyan

2014-01-01

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

The politics of space - Who owns what? Earth law for space

Science.gov (United States)

Hosenball, S. N.

1983-01-01

Topics of concern in developing space law, i.e., international disagreements, the present status of space law, and requirements for future space activities, are discussed. Factors inhibiting agreements include governments that wish to control specific regions of GEO, the refusal of several countries to permit international DBS television broadcasts over their boundaries, the possibility that weapons may be placed in space, and the lack of international laws governing humans and industries in space. It is noted that any state entering an international agreement has relinquished some of its sovereignty. The Outer Space Treaty has removed celestial bodies from claims of national appropriation. States retain sovereignty over their citizens who travel in space, a problematical concept once internationally-manned settlements in space or on the moon are established. It is recommended that space law develop mainly in reaction to the implementation of new space capabilities in order to avoid hindering space activities.

COSMO: a decision-support system for the central open space, the Netherlands

NARCIS (Netherlands)

Harms, W.B.; Knaapen, J.P.; Roos-Klein-Lankhorst sic, J.

1995-01-01

To evaluate scenarios for nature restoration, a landscape ecological decision-support system has been developed, a knowledge-based system integrated in a geographical information system. The grid-based application in the Central Open Space of the Netherlands (the COSMO model) is presented here. Four

Impact of interventions for patients refusing emergency medical services transport.

Science.gov (United States)

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

1995-06-01

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

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

International Nuclear Information System (INIS)

Anees, M.; Khan, J.A.

2014-01-01

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

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

Science.gov (United States)

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

2018-01-01

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

Refuse-derived fuel as a secondary energy in Taiwan - Using Hotelling space allocation model

International Nuclear Information System (INIS)

Kwodong Wey; Sheueching Hong

2006-01-01

Most Taiwanese farmers usually blend rice straws into the soil after harvest. However, rice straws possess great thermal energy, which can be used to produce refuse-derived fuel (RDF-5). As Taiwan faces energy shortage, the development benefits of the RDF-5 industry are tempting. This study employs the Hotelling model to design the locations and the optimal numbers of RDF-5 plants. From the technology and material supply point of view, turning waste rice straws into RDF-5 is feasible in Taiwan. Nevertheless, from the business operation perspective, even if the RDF-5 plant is willing to lower its profit rate, its selling price is still hard to compete with imported RDF-5. If the Taiwanese government decides to pursue RDF-5 as an alternative energy, they might need to take a step further to subsidize entrepreneurs or provide appropriate tax benefits. Otherwise, the RDF-5 industry is hard to survive in Taiwan. (Author)

Examining public open spaces by neighborhood-level walkability and deprivation.

Science.gov (United States)

Badland, Hannah M; Keam, Rosanna; Witten, Karen; Kearns, Robin

2010-11-01

Public open spaces (POS) are recognized as important to promote physical activity engagement. However, it is unclear how POS attributes, such as activities available, environmental quality, amenities present, and safety, are associated with neighborhood-level walkability and deprivation. Twelve neighborhoods were selected within 1 constituent city of Auckland, New Zealand based on higher (n = 6) or lower (n = 6) walkability characteristics. Neighborhoods were dichotomized as more (n = 7) or less (n = 5) socioeconomically deprived. POS (n = 69) were identified within these neighborhoods and audited using the New Zealand-Public Open Space Tool. Unpaired 1-way analysis of variance tests were applied to compare differences in attributes and overall score of POS by neighborhood walkability and deprivation. POS located in more walkable neighborhoods have significantly higher overall scores when compared with less walkable neighborhoods. Deprivation comparisons identified POS located in less deprived communities have better quality environments, but fewer activities and safety features present when compared with more deprived neighborhoods. A positive relationship existed between presence of POS attributes and neighborhood walkability, but the relationship between POS and neighborhood-level deprivation was less clear. Variation in neighborhood POS quality alone is unlikely to explain poorer health outcomes for residents in more deprived areas.

Mental health consequences of abortion and refused abortion.

Science.gov (United States)

Watter, W W

1980-02-01

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

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

Science.gov (United States)

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

2009-01-01

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

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

Science.gov (United States)

Rajtar, Małgorzata

2013-12-01

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

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

Directory of Open Access Journals (Sweden)

Christopher Sarah

2006-09-01

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

Tidal wetland vegetation and ecotone profiles: The Rush Ranch Open Space Preserve

Science.gov (United States)

The Rush Ranch Open Space Preserve (Rush Ranch) is a component site of the San Francisco Bay National Estuarine Research Reserve (SF Bay NERR) that includes one of the largest undiked tidal wetlands in the San Francisco Estuary. The brackish tidal wetlands grade into transitional vegetation and unde...

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

Science.gov (United States)

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

2015-01-01

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

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

Science.gov (United States)

Davis, John K

2008-03-01

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

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

Science.gov (United States)

Bouvet, R; Le Gueut, M

2013-06-01

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

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

Science.gov (United States)

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

2017-10-01

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

Space closing versus space opening for bilateral missing upper laterals - aesthetic judgments of laypeople: a web-based survey.

Science.gov (United States)

Qadri, Salim; Parkin, Nicola A; Benson, Philip E

2016-06-01

To investigate the opinions of laypeople regarding the aesthetic outcome of treating patients with developmental absence of both maxillary lateral incisors using either orthodontic space closure (OSC) or space opening and prosthetic replacement (PR). Cross sectional, web-based survey. A panel of five orthodontists and five restorative dentists examined post-treatment intra-oral images of 21 patients with developmental absence of both upper lateral incisors. A consensus view was obtained about the 10 most attractive images (5 OSC; 5 PR). The 10 selected images were used in a web-based survey involving staff and students at the University of Sheffield. In the first section, the participants were asked to evaluate the attractiveness of the 10 randomly arranged single images using a 5-point Likert scale. In the second section, an image of OSC was paired with an image of PR according to their attractiveness ranking by the clinician panel, and the participants were asked to indicate which of the two images they preferred. The survey received 959 completed responses with 9590 judgements. The images of OSC were perceived to be more attractive (mean rating 3·34 out of 5; SD 0·56) compared with the images of PR (mean rating 3·14 out of 5; SD 0·58) (mean diff 0·21; P Space closing was perceived to be more attractive than space opening by lay people. The findings have implications for advising patients about the best aesthetic outcome when both maxillary lateral incisors are missing.

8. European sewage and refuse symposium. Documentation

International Nuclear Information System (INIS)

1990-01-01

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

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

Science.gov (United States)

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

2017-06-01

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

Performing coolness: smoking refusal and adolescent identities.

Science.gov (United States)

Plumridge, E W; Fitzgerald, L J; Abel, G M

2002-04-01

The implications of smoking refusal for personal identity style were studied through conversations in six small focus groups or dyads of 13- and 14-year-old non-smokers from an urban New Zealand secondary school. The approach to analyzing their talk was informed by notions of 'performativity' and 'social space' to focus on the connections between identity and social relations. Smoking emerged as a key signifier of power and status. It was salient at both top and bottom ends of the social hierarchy depending upon the competence displayed in smoking as part of a larger ensemble of personal deportment and behavior. Being a non-smoker therefore inevitably carried connotations of being 'average' or 'in the middle', presenting non-smoking adolescents with the problem of accrediting themselves against superior 'smoker cool' groups. A discourse analytic approach was used to examine the resources and strategies participants brought to bear on this 'problem', which was then seen to be solved differently by boys and girls. Boys could establish alternatives to 'smoker cool' through physical activity, girls had little recourse but to accept their inferior status. The implications of this for health education and promotion are discussed.

Open Space Office and it's Influence on Satisfaction of Workers

OpenAIRE

Novotná, Marta

2015-01-01

This bachelor thesis focuses on open space office in relation to satisfaction with employment. It focuses on research of factors of this specific working environment and tries to check hypothesis talking about negative impact on overal satsfacton with job. Through the research conducted within one company this bachelor thesis present evaluation of factos of working environment and show overal impact of these factors on satisfaction with job. This bachelor thesis finds out that noise and disco...

Opening new institutional spaces for grappling with uncertainty: A constructivist perspective

International Nuclear Information System (INIS)

Duncan, Ronlyn

2013-01-01

In the context of an increasing reliance on predictive computer simulation models to calculate potential project impacts, it has become common practice in impact assessment (IA) to call on proponents to disclose uncertainties in assumptions and conclusions assembled in support of a development project. Understandably, it is assumed that such disclosures lead to greater scrutiny and better policy decisions. This paper questions this assumption. Drawing on constructivist theories of knowledge and an analysis of the role of narratives in managing uncertainty, I argue that the disclosure of uncertainty can obscure as much as it reveals about the impacts of a development project. It is proposed that the opening up of institutional spaces that can facilitate the negotiation and deliberation of foundational assumptions and parameters that feed into predictive models could engender greater legitimacy and credibility for IA outcomes. - Highlights: ► A reliance on supposedly objective disclosure is unreliable in the predictive model context in which IA is now embedded. ► A reliance on disclosure runs the risk of reductionism and leaves unexamined the social-interactive aspects of uncertainty. ► Opening new institutional spaces could facilitate deliberation on foundational predictive model assumptions.

Vaccine refusal - what we need to know.

Science.gov (United States)

Succi, Regina Célia de Menezes

2018-04-12

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

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

Science.gov (United States)

2010-04-01

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

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

Science.gov (United States)

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

2016-10-01

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

Scientific competency questions as the basis for semantically enriched open pharmacological space development

DEFF Research Database (Denmark)

Azzaoui, Kamal; Jacoby, Edgar; Senger, Stefan

2013-01-01

Molecular information systems play an important part in modern data-driven drug discovery. They do not only support decision making but also enable new discoveries via association and inference. In this review, we outline the scientific requirements identified by the Innovative Medicines Initiative...... (IMI) Open PHACTS consortium for the design of an open pharmacological space (OPS) information system. The focus of this work is the integration of compound–target–pathway–disease/phenotype data for public and industrial drug discovery research. Typical scientific competency questions provided...

The Effectiveness of Building Permit Regulation for Green Open Space at Housing Estates: Case Study of Kendal Regency, Central Java, Indonesia

Science.gov (United States)

Yulianti, Wiwik; Hadi, Sudharto P.

2018-02-01

Increasing demand for settlements steamed by population growth declines the quality of the environment specifically at urban area. The existing spatial planning could not able to prevent the change of land use for settlement and other infrastructures. The Act no. 26 of 2007 on spatial planning stipulates that green open space must reach 30% of the total area, consisting of 20% public open space and 10% private open space. The existing condition of urban area at Kendal Regency reach 245,6 million m2 with 88.145,5 m2 green open space or 0,036% out of total area. An effort to increase green open space in urban areas taken by the Government of Kendal Regency is by promulgating a local regulation stipulating that each housing developer request a building permit is obliged to provide a green open space at least 10 percent of the total housing area. This paper reviews the effectiveness of building permit regulation, the problems encountered and the concept proposed to make the local regulation work. The area of sample taken is three urban districts out of five urban districts, the resource persons chosen are those from relevant offices (Dinas) involved at the implementation of the local regulation. The data collection techniques employed are the Analytical Hierarchy Process (AHP), Geographic Information System (GIS) technology, social observation and informal interview. The data gathered will be analyzed quantitatively and qualitatively.

The Effectiveness of Building Permit Regulation for Green Open Space at Housing Estates: Case Study of Kendal Regency, Central Java, Indonesia

Directory of Open Access Journals (Sweden)

Yulianti Wiwik

2018-01-01

Full Text Available Increasing demand for settlements steamed by population growth declines the quality of the environment specifically at urban area. The existing spatial planning could not able to prevent the change of land use for settlement and other infrastructures. The Act no. 26 of 2007 on spatial planning stipulates that green open space must reach 30% of the total area, consisting of 20% public open space and 10% private open space. The existing condition of urban area at Kendal Regency reach 245,6 million m2 with 88.145,5 m2 green open space or 0,036% out of total area. An effort to increase green open space in urban areas taken by the Government of Kendal Regency is by promulgating a local regulation stipulating that each housing developer request a building permit is obliged to provide a green open space at least 10 percent of the total housing area. This paper reviews the effectiveness of building permit regulation, the problems encountered and the concept proposed to make the local regulation work. The area of sample taken is three urban districts out of five urban districts, the resource persons chosen are those from relevant offices (Dinas involved at the implementation of the local regulation. The data collection techniques employed are the Analytical Hierarchy Process (AHP, Geographic Information System (GIS technology, social observation and informal interview. The data gathered will be analyzed quantitatively and qualitatively.

9 CFR 93.806 - Animals refused entry.

Science.gov (United States)

2010-01-01

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

Grassland communities of urban open spaces in Bloemfontein, Free State, South Africa

Directory of Open Access Journals (Sweden)

Mamokete N.V. Dingaan

2013-02-01

Full Text Available Natural vegetation in urban environments is greatly impacted by human activities and it is in constant threat of degradation and destruction as a result of urbanisation. This vegetation, although fragmented, serves an important ecological function and needs to be properly managed and conserved. Studies on urban vegetation are lacking in South Africa, with only a handful having been carried out since the end of the last century. This study was initiated to identify, classify and describe the grassland communities of the urban open spaces in Bloemfontein. Relevés were compiled in 61 sample plots, where species present and habitat information were recorded. Care was taken to restrict sample plots to vegetation in pristine condition, wherever possible, and severely degraded stands were avoided. A two-way indicator species analysis (TWINSPAN classification, refined by Braun-Blanquet procedures, revealed two distinct major communities, seven communities and four sub-communities. Both detrended and canonical correspondence analyses indicated the vegetation units to be associated with soil texture and pH, although biotic factors such as overgrazing, burning and mowing also influence the composition of the vegetation. The proper management and conservation of urban open spaces requires in-depth knowledge of the spatial distribution, floristic, structural and functional compositions within the major vegetation types in this environment. The present study further contributed towards formulating ways for the proper management, utilisation and functioning of the open spaces within the Bloemfontein area.Conservation implications: The Grassland Biome of South Africa is poorly conserved, mainly because of its status as an agricultural hub of the country. The preservation of natural and semi-natural forms of urban vegetation is important because such vegetation, although often disturbed and degraded, could form dispersal corridors between peri-urban and rural

Refusal to pay electricity bill is illegal

International Nuclear Information System (INIS)

Hermann, H.P.

1979-01-01

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

Economic analysis of open space box model utilization in spacecraft

Science.gov (United States)

Mohammad, Atif F.; Straub, Jeremy

2015-05-01

It is a known fact that the amount of data about space that is stored is getting larger on an everyday basis. However, the utilization of Big Data and related tools to perform ETL (Extract, Transform and Load) applications will soon be pervasive in the space sciences. We have entered in a crucial time where using Big Data can be the difference (for terrestrial applications) between organizations underperforming and outperforming their peers. The same is true for NASA and other space agencies, as well as for individual missions and the highly-competitive process of mission data analysis and publication. In most industries, conventional opponents and new candidates alike will influence data-driven approaches to revolutionize and capture the value of Big Data archives. The Open Space Box Model is poised to take the proverbial "giant leap", as it provides autonomic data processing and communications for spacecraft. We can find economic value generated from such use of data processing in our earthly organizations in every sector, such as healthcare, retail. We also can easily find retailers, performing research on Big Data, by utilizing sensors driven embedded data in products within their stores and warehouses to determine how these products are actually used in the real world.

Evaluation of speech transmission in open public spaces affected by combined noises.

Science.gov (United States)

Lee, Pyoung Jik; Jeon, Jin Yong

2011-07-01

In the present study, the effects of interference from combined noises on speech transmission were investigated in a simulated open public space. Sound fields for dominant noises were predicted using a typical urban square model surrounded by buildings. Then road traffic noise and two types of construction noises, corresponding to stationary and impulsive noises, were selected as background noises. Listening tests were performed on a group of adults, and the quality of speech transmission was evaluated using listening difficulty as well as intelligibility scores. During the listening tests, two factors that affect speech transmission performance were considered: (1) temporal characteristics of construction noise (stationary or impulsive) and (2) the levels of the construction and road traffic noises. The results indicated that word intelligibility scores and listening difficulty ratings were affected by the temporal characteristics of construction noise due to fluctuations in the background noise level. It was also observed that listening difficulty is unable to describe the speech transmission in noisy open public spaces showing larger variation than did word intelligibility scores. © 2011 Acoustical Society of America

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

Directory of Open Access Journals (Sweden)

Mustafa Yasin Irmak

2016-12-01

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

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

Science.gov (United States)

2010-04-01

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

DAYLIGHTING PERFORMANCE OF HORIZONTAL LIGHT PIPE BRANCHING ON OPEN PLAN OFFICE SPACE

Directory of Open Access Journals (Sweden)

Feny ELSIANA

2015-12-01

Full Text Available For daylighting purpose, office buildings should have a shallow plan and increase the ratio of surface to building’s volume. However, intensive use of air-conditioning drives office building’s plan to be deep with a minimum surface to volume ratio. This leads to the presence of areas that have insufficient daylight level at the work plane. Considering limitations of some daylighting methods in distributing daylight to these areas, Horizontal Light Pipe (HLP was selected. The aim of this research was to evaluate and explain the effect of HLP branching on daylight quantity and distribution inside open plan office space. Experimental with simulation as a tool was used as the research method. HLP branching’s uniformity ratio, illuminance and Daylight Factor were compared with unbranching HLP, simultaneously with daylighting standards. Results showed that office space with HLP-L branching had higher daylight level than HLP-T branching, 296 lux and 295 lux, HLP-L and HLP-T, respectively. However, HLP-T branching distributed daylight more evenly than HLP-L branching, with uniformity ratio as 1.49:1 and 1.50:1, HLP-T and HLP-L, respectively. Both of them met the illuminance target value and uniformity at work plane. Light’s deflection and improvement amount of opening distribution decreased average illuminance and Daylight Factor up to 3.59%. Those also decreased uniformity of daylight inside the space.

Promoting Productive Urban Green Open Space Towards Food Security: Case Study Taman Sari, Bandung

Science.gov (United States)

Ridwan, M.; Sinatra, Fran; Natalivan, Petrus

2017-10-01

The common trend of urban population has been growing significantly in Indonesia for decades, are affected by urban green space conversion. Generally, this area is utilized for urban infrastructures and residences. Furthermore, urban area has grown uncontrollably that could enhance the phenomenon of urban sprawl. The conversion of green urban area and agricultural area will significantly decrease urban food security and quality of urban environment. This problem becomes a serious issue for urban sustainability. Bandung is a city with dense population where there are many poor inhabitants. Families living in poverty are subjected to food insecurity caused by the rise of food prices. Based on the urgency of urban food security and urban environment quality the local government has to achieve comprehensive solutions. This research aims to formulate the policy of productive green open space towards food security for poor people in Bandung. This research not only examines the role played by productive green open space to supply food for the urban poor but also how to govern urban areas sustainably and ensure food security. This research uses descriptive explanatory methodology that describes and explains how to generate policy and strategic planning for edible landscape to promote urban food security. Taman Sari is the location of this research, this area is a populous area that has amount of poor people and has a quite worse quality of urban environment. This study shows that urban green open space has the potential to be utilized as an urban farming land, which poor inhabitants could be main actors to manage urban agriculture to provide their food. Meanwhile, local government could contribute to subsidize the financial of urban farming activities.

Present condition and theme of the planning standards of parks and open space planning. Koen ryokuchi keikaku gijutsu hyojun no genjo to kadai

Energy Technology Data Exchange (ETDEWEB)

Takanashi, M. (Kanagawa Prefectural Government, Kanagawa (Japan))

1992-08-06

With the dramatic progress of urbanization, the rapid decrease of the green area and the open space, which is basis for ensuring the safety and the comfort of city life and formation of a good city environment, lead to the worsen of city environment. For the basic purpose of achieving the harmony between development and environment by considering the preservation of the green area and the open space, the green master plan is a representative example, and was made as the constitution of from a ground plan to the various plans such as region, city and nation based on the space unit of developing the human action. One of the important planning approach for the green area plan from conception to implementation is the planning standards of park and open space planning. This paper introduced the change of the system about the planning standards of park and open space planning, and explained necessarily the present state of greens master plan about preservation of the national environment and adjustment the park and open space. 1tab.

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

Science.gov (United States)

2010-10-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2012-10-15

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

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

International Nuclear Information System (INIS)

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

2012-01-01

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

Rotary furnace for pyrolysis of refuse. Rotationstrommelofen zur Pyrolyse von Muell

Energy Technology Data Exchange (ETDEWEB)

Siepmann, H A

1983-11-17

The invention concerns a rotary furnace for the pyrolysis of refuse, in which the material to be treated passes through a rotating drum heated from outside. The drum rotating around a vertical axis, cone-shaped downwards, is situated at right angles to a combustion chamber surrounding the drum, through the upper and lower walls of which it passes, where the sealing at these walls is done by labyrinth seals carrying a liquid concentric to the axis of rotation. Inside the rotating drum a helical insert matched to the conical shape of the drum is situated spaced from its wall, which narrows in the upper section and to the hollow space of which pieces of pipe provided with slots are connected at the top and bottom, by which the insert is held inside the drum. A cylindrical degasification shaft may be connected to the upper end of the rotating drum which is connected to the degasification chamber and is also sealed by a labyrinth seal carrying a liquid, which a lower furnace chamber is connected to the lower end of the drum, in which a transport device for drawing off the material leaving the rotating drum is situated.

GeneLab: NASA's Open Access, Collaborative Platform for Systems Biology and Space Medicine

Science.gov (United States)

Berrios, Daniel C.; Thompson, Terri G.; Fogle, Homer W.; Rask, Jon C.; Coughlan, Joseph C.

2015-01-01

NASA is investing in GeneLab1 (http:genelab.nasa.gov), a multi-year effort to maximize utilization of the limited resources to conduct biological and medical research in space, principally aboard the International Space Station (ISS). High-throughput genomic, transcriptomic, proteomic or other omics analyses from experiments conducted on the ISS will be stored in the GeneLab Data Systems (GLDS), an open-science information system that will also include a biocomputation platform with collaborative science capabilities, to enable the discovery and validation of molecular networks.

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

Science.gov (United States)

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

2002-10-01

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

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

Science.gov (United States)

2010-07-01

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

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

Science.gov (United States)

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

2016-01-01

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

Analysis of fouling in refuse waste incinerators

NARCIS (Netherlands)

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

2001-01-01

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

Use for refuse of shale carbonization

Energy Technology Data Exchange (ETDEWEB)

1917-09-25

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

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

Directory of Open Access Journals (Sweden)

Ibrahim Fathi Huwari

2015-02-01

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

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

Directory of Open Access Journals (Sweden)

S J Thaker

2015-01-01

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

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

Science.gov (United States)

Bouaziz, Nora; Titia Rizzi, Alice

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

Natural woodland vegetation and plant species richness of the urban open spaces in Gauteng, South Africa

Directory of Open Access Journals (Sweden)

C.H. Grobler

2002-01-01

Full Text Available It is estimated that approximately 60 % of the world’s population will be living in urban areas by 2025. In Gauteng, the most densely populated province in South Africa, the natural open spaces are continually under threat from development. Vegetation is the most physical representation of the environment on which all animals are ultimately dependent. In order to evaluate an areas potential for development or conservation it is necessary to make a thorough inventory of the plant communities and their associated habitats. A survey of the natural woodlands was undertaken as part of a project describing the vegetation of the natural open spaces within the Gauteng region. Relevés were compiled in 73 stratified random sample plots in selected open spaces within the study area. A TWINSPAN classification, refined by Braun-Blanquet procedures, indicated six woodland communities that can be grouped into two major woodland communities. A classification and description of these communities as well as their species richness are presented. The results indicate that there are still patches of well-preserved natural vegetation within the study area and contribute to the limited knowledge that presently exists for the vegetation of the area.

Understanding Excessive School Absenteeism as School Refusal Behavior

Science.gov (United States)

Dube, Shanta R.; Orpinas, Pamela

2009-01-01

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

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

Science.gov (United States)

Lee, Marcella I.; Miltenberger, Raymond G.

1996-01-01

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

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

Science.gov (United States)

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

2016-01-01

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

Open Space between Residential Buildings as a Factor of Sustainable Development - Case Studies in Brno (Czech Republic) and Vienna (Austria)

Science.gov (United States)

Kilnarová, Pavla; Wittmann, Maxmilian

2017-12-01

The characteristics of open spaces between residential buildings have, as authors suppose, an impact on the sustainable development of urban areas. Spatial arrangement and accessibility of these spaces, the type and height of surrounding buildings, the quantity and character of greenery, and many more characteristics influence the quality of environment, and the quality of life of local residents. These and further characteristics of the open spaces between residential buildings influence the ecological stability of the area, its hygienic qualities, the intensity and way of using by various social groups, and also the prices of real estates. These qualities indicate the environmental, social and economic sustainability of the urban area. The proposed research methodology assessed specific indicators of sustainability within a range from 0 to 10 points. 5 points correspond to the general standard in the area, 0 points indicate degradation, and 10 points indicate the highest contribution to sustainable development. Observation methods, questionnaire survey, statistical analyses, and methods of measurement were used to determine the values of the given indicators. The paper analyses the impact of the open spaces between residential buildings on sustainability via the case studies performed in the Central European cities of Brno, Czech Republic and Vienna, Austria. Two forms of residential urban structures in the City of Brno in the Czech Republic were selected for the analysis: the closed courtyards in the urban block from the 19th century and the open spaces in the housing estates constructed under socialism in the 20th century. The question is, if the different forms of spaces between residential buildings influence the sustainability of urban area and satisfaction of inhabitants in different ways. A complementary case study in Vienna indicates that inhabitants of a housing estate in Vienna, as well as inhabitants of housing estates in Brno, highly appreciate the

Opened athletic-educational space - the condition of professional development of future teacher of physical culture is needed

Directory of Open Access Journals (Sweden)

Dragnev Y.V.

2012-04-01

Full Text Available It is shown that the opening of the sports and educational space is determined by the whole space, where the interaction of the activity of the pedagogical university with different educational institutions on the basis of integration, continuity of the educational process, aimed at physical education, the development of children and young people take place. It is revealed the importance of awareness of such concepts as the world educational space, the international educational space, the European higher education area, European space of higher education and educational space of the CIS countries.

77 FR 13261 - Request for Applications: The Community Forest and Open Space Conservation Program

Science.gov (United States)

2012-03-06

... DEPARTMENT OF AGRICULTURE Forest Service Request for Applications: The Community Forest and Open Space Conservation Program AGENCY: Forest Service. ACTION: Notice; Correction. SUMMARY: The Department..., published a document in the Federal Register of February 15, 2011, concerning requests for applications for...

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

Science.gov (United States)

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

2009-11-01

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

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

Directory of Open Access Journals (Sweden)

Melissa B Gilkey

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

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

Science.gov (United States)

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

2018-01-01

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

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

Science.gov (United States)

Magrane, Diane; And Others

1994-01-01

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

Consent and assessment of capacity to decide or refuse treatment.

Science.gov (United States)

Simpson, Owena

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

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

Science.gov (United States)

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

2011-12-01

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

Combustion products of plastics as indicators for refuse burning in the atmosphere.

Science.gov (United States)

Simoneit, Bernd R T; Medeiros, Patricia M; Didyk, Borys M

2005-09-15

Despite all of the economic problems and environmental discussions on the dangers and hazards of plastic materials, plastic production worldwide is growing at a rate of about 5% per year. Increasing techniques for recycling polymeric materials have been developed during the last few years; however, a large fraction of plastics are still being discarded in landfills or subjected to intentional or incidental open-fire burning. To identify specific tracer compounds generated during such open-fire combustion, both smoke particles from burning and plastic materials from shopping bags, roadside trash, and landfill garbage were extracted for gas chromatography-mass spectrometry analyses. Samples were collected in Concón, Chile, an area frequently affected by wildfire incidents and garbage burning, and the United States for comparison. Atmospheric samples from various aerosol sampling programs are also presented as supportive data. The major components of plastic extracts were even-carbon-chain n-alkanes (C16-C40), the plasticizer di-2-ethylhexyl phthalate, and the antioxidants and lubricants/antiadhesives Irganox 1076, Irgafos 168, and its oxidation product tris(2,4-di-tertbutylphenyl) phosphate. Major compounds in smoke from burning plastics include the non-source-specific n-alkanes (mainly even predominance), terephthalic acid, phthalates, and 4-hydroxybenzoic acid, with minor amounts of polycyclic aromatic hydrocarbons (including triphenylbenzenes) and tris(2,4-di-tert-butylphenyl)phosphate. 1,3,5-Triphenylbenzene and tris(2,4-di-tert-butylphenyl)- phosphate were found in detectable amounts in atmospheric samples where plastics and refuse were burned in open fires, and thus we propose these two compounds as specific tracers for the open-burning of plastics.

NREL Evaluates Performance of Hydraulic Hybrid Refuse Vehicles

Energy Technology Data Exchange (ETDEWEB)

2015-09-01

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

Community members’ initiatives in public open spaces: two case studies from Slovenia

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Sabina Jelenc Krašovec

2017-10-01

Full Text Available The paper deals with public spaces as open, everyday arenas where people share experiences beyond their immediate circle of friends, family and age group. Public space is understood as a forum for social and personal change (Harvey, 2011; Lefebvre, 2013; Arendt, 1996; Habermas, 1989; 2001. Questions are analysed from the point of view of community members, who are strongly attached to the space and who are interested in belonging and in proactive changes in their living environment (Iecovich, 2014; Kohn 2004; Mean and Tims, 2005. The paper is based on the presumptions that public space has an important role in generating ideas and activities of community members and that it is an important venue for community members’ informal learning. Ethnomethodological research in two public spaces (the Tabor community in Ljubljana and a small community in the coastal town of Izola show that there are differences between both public spaces regarding top-down initiatives and bottom-up, self-organized activities. However, although the activity initiators were in one case different associations rooted in the community, and in the other the local people themselves, most of the activities were conducted by people living in the selected communities/public spaces themselves as is typical of grassroots activities. It was confirmed that learning was not often mentioned by members of either community and was mostly a hidden activity, resulting in tacit knowledge.

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

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

2018-05-01

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

B→τν: Opening up the charged Higgs parameter space with R-parity violation

International Nuclear Information System (INIS)

Bose, Roshni; Kundu, Anirban

2012-01-01

The theoretically clean channel B + →τ + ν shows a close to 3σ discrepancy between the Standard Model prediction and the data. This in turn puts a strong constraint on the parameter space of a two-Higgs doublet model, including R-parity conserving supersymmetry. The constraint is so strong that it almost smells of fine-tuning. We show how the parameter space opens up with the introduction of suitable R-parity violating interactions, and release the tension between data and theory.

Magnetometric Studies of Catalyst Refuses in Nanocarbon Materials

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Eklund Peter

2008-01-01

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

[Refusal of personal hygiene care and nursing responsibility].

Science.gov (United States)

Peyé, Anne

2013-03-01

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

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

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

2016-01-20

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

The Experience of Psychiatric Care of Adolescents with Anxiety-based School Refusal and of their Parents: A Qualitative Study.

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Sibeoni, Jordan; Orri, Massimiliano; Podlipski, Marc-Antoine; Labey, Mathilde; Campredon, Sophie; Gerardin, Priscille; Revah-Levy, Anne

2018-01-01

Anxiety-based school refusal in adolescence is a complex, sometimes difficult to treat disorder that can have serious academic and psychiatric consequences. The objective of this qualitative study was to explore how teens with this problem and their parents experience the psychiatric care received. This qualitative multicenter study took place in France, where we conducted semi-structured interviews with adolescents receiving psychiatric care for anxiety-based school refusal and with their parents. Data collection by purposive sampling continued until we reached theoretical sufficiency. Data analysis was thematic. This study included 20 adolescents aged 12 to 18 years and 21 parents. Two themes emerged from the analysis: (1) the goals of psychiatric care with two sub-themes, " self-transformation " and problem solving ; and, (2) the therapeutic levers identified as effective with two sub-themes: time and space and relationships . Our results show a divergence between parents and teens in their representations of care and especially of its goals. Therapeutic and research implications about the terms of return to school within psychiatric care and also the temporality of care are discussed.

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

International Nuclear Information System (INIS)

Ripp, B.J.

1997-01-01

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

Refuses and delays in the transportation by ship of radioactive material

International Nuclear Information System (INIS)

Xavier, Clarice; Sobreira, Ana Celia

2011-01-01

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

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

Science.gov (United States)

2010-04-01

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

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

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Shohreh Shahpouri Arani

2013-05-01

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

Othermotherwork: "Testimonio" and the Refusal of Historical Trauma

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Vega, Christine

2018-01-01

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

The return of "Gasoline station-park" status into green-open space in DKI Jakarta Province

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Kautsar, L. H. R.; Waryono, T.; Sobirin

2017-07-01

The development of gasoline stations in 1970 increased drastically due to the Government support through DKT Jaya Official Note (DKT Jakarta), resulting in a great number of the parks (green open space or RTH - Ruang Terbuka Hijau) converted into a gasoline station. Currently, to meet the RTH target (13.94 % RTH based RTRW [(Rencana Tata Ruang Wilayah) DKT Jakarta 2010], the policy was changed by Decree No.728 year 2009 and Governor Tnstruction No.75 year 2009. Land function of 27 gasoline stations unit must be returned. This study is to determine the appropriateness of gasoline Station-Park conversion into RTH based site and situation approach. The scope of this study was limited only to gasoline stations not converted into RTH. The methodology was the combination of AHP (Analytical Hierarchy Process) and ranking method. Site variables were meant for prone to flooding, the width of land for gasoline station, land status. Situation variables were meant for other public space, availability of other gasoline stations, gasoline stations service, road segments, and the proportions of built space. Analysis study used quantitative descriptive analysis. The results were three of the five gasoline stations were congruence to be converted into a green open space (RTH).

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

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Filippello Pina

2018-01-01

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

Audible vision for the blind and visually impaired in indoor open spaces.

Science.gov (United States)

Yu, Xunyi; Ganz, Aura

2012-01-01

In this paper we introduce Audible Vision, a system that can help blind and visually impaired users navigate in large indoor open spaces. The system uses computer vision to estimate the location and orientation of the user, and enables the user to perceive his/her relative position to a landmark through 3D audio. Testing shows that Audible Vision can work reliably in real-life ever-changing environment crowded with people.

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

Science.gov (United States)

Shapiro, Michael

2018-06-01

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

[Professionals' training and refusal of nursing care].

Science.gov (United States)

Bay, Corinne

2016-10-01

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

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

Science.gov (United States)

Sobo, Elisa J

2015-09-01

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

Weak openness and almost openness

Directory of Open Access Journals (Sweden)

David A. Rose

1984-01-01

Full Text Available Weak openness and almost openness for arbitrary functions between topological spaces are defined as duals to the weak continuity of Levine and the almost continuity of Husain respectively. Independence of these two openness conditions is noted and comparison is made between these and the almost openness of Singal and Singal. Some results dual to those known for weak continuity and almost continuity are obtained. Nearly almost openness is defined and used to obtain an improved link from weak continuity to almost continuity.

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

Directory of Open Access Journals (Sweden)

Mitra Khalili

2016-01-01

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

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

International Nuclear Information System (INIS)

Mafi, S.; Stehouwer, R.C.

1996-01-01

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

Features of public open spaces and physical activity among children: findings from the CLAN study.

Science.gov (United States)

Timperio, Anna; Giles-Corti, Billie; Crawford, David; Andrianopoulos, Nick; Ball, Kylie; Salmon, Jo; Hume, Clare

2008-11-01

To examine associations between features of public open spaces, and children's physical activity. 163 children aged 8-9 years and 334 adolescents aged 13-15 years from Melbourne, Australia participated in 2004. A Geographic Information System was used to identify all public open spaces (POS) within 800 m of participants' homes and their closest POS. The features of all POS identified were audited in 2004/5. Accelerometers measured moderate-to-vigorous physical activity (MVPA) after school and on weekends. Linear regression analyses examined associations between features of the closest POS and participants' MVPA. Most participants had a POS within 800 m of their home. The presence of playgrounds was positively associated with younger boys' weekend MVPA (B=24.9 min/day; pPOS were associated with participants' MVPA, although mixed associations were evident. Further research is required to clarify these complex relationships.

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

Science.gov (United States)

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

2013-11-01

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

Suspicious Behavior Detection System for an Open Space Parking Based on Recognition of Human Elemental Actions

Science.gov (United States)

Inomata, Teppei; Kimura, Kouji; Hagiwara, Masafumi

Studies for video surveillance applications for preventing various crimes such as stealing and violence have become a hot topic. This paper proposes a new video surveillance system that can detect suspicious behaviors such as a car break-in and vandalization in an open space parking, and that is based on image processing. The proposed system has the following features: it 1)deals time series data flow, 2)recognizes “human elemental actions” using statistic features, and 3)detects suspicious behavior using Subspace method and AdaBoost. We conducted the experiments to test the performance of the proposed system using open space parking scenes. As a result, we obtained about 10.0% for false positive rate, and about 4.6% for false negative rate.

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

Energy Technology Data Exchange (ETDEWEB)

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

2014-09-15

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

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

International Nuclear Information System (INIS)

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

2014-01-01

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

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

Science.gov (United States)

Blanchard, Karine; Ménard, Rachel; Corvol, Aline

2016-10-01

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

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

Science.gov (United States)

Frescura, Marina

1997-01-01

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

Mapping urban green open space in Bontang city using QGIS and cloud computing

Science.gov (United States)

Agus, F.; Ramadiani; Silalahi, W.; Armanda, A.; Kusnandar

2018-04-01

Digital mapping techniques are available freely and openly so that map-based application development is easier, faster and cheaper. A rapid development of Cloud Computing Geographic Information System makes this system can help the needs of the community for the provision of geospatial information online. The presence of urban Green Open Space (GOS) provide great benefits as an oxygen supplier, carbon-binding agent and can contribute to providing comfort and beauty of city life. This study aims to propose a platform application of GIS Cloud Computing (CC) of Bontang City GOS mapping. The GIS-CC platform uses the basic map available that’s free and open source. The research used survey method to collect GOS data obtained from Bontang City Government, while application developing works Quantum GIS-CC. The result section describes the existence of GOS Bontang City and the design of GOS mapping application.

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

Science.gov (United States)

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

2015-04-01

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

Conscientious refusals and reason-giving.

Science.gov (United States)

Marsh, Jason

2014-07-01

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

7 CFR 319.8-26 - Material refused entry.

Science.gov (United States)

2010-01-01

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

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

Science.gov (United States)

2013-01-01

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

Refuse derived fuel incineration: Fuel gas monitoring and analysis

International Nuclear Information System (INIS)

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

1993-11-01

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

Invitation Refusals in Cameroon French and Hexagonal French

Science.gov (United States)

Farenkia, Bernard Mulo

2015-01-01

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

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

Science.gov (United States)

Gurmu, Eshetu; Endale, Senait

2017-03-16

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

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

NARCIS (Netherlands)

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

2013-01-01

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

ACCESS TO PUBLIC OPEN SPACE: IS DISTRIBUTION EQUITABLE ACROSS DIFFERENT SOCIO-ECONOMIC AREAS

Directory of Open Access Journals (Sweden)

Mohammad Javad Koohsari

2011-12-01

Full Text Available During the past decade, the role of the built environment on physical activity has been well investigated by public health, transportation and urban design scholars and it has been shown that different aspects of the built environment can influence physical activity Public open spaces (POS like parks have many health benefits and they can be important settings and destinations for having physical activity. Inequality in access to POS which may influence the amount of physical activity can be a reason for lower physical activity among deprived neighbourhoods. This paper aims to examine whether objective access to public open spaces (POS like parks is equally across the different socio-economic status (SES areas in the City of Melbourne. Objective access to POS was measured in network distance using geographic information systems (GIS and area SES was obtained using the SEIFA (Socio-Economic Indexes for Areas index. The results showed there was a significant difference in access to POS according to the SES areas. There was a significant negative correlation between the access to POS and the SES areas in which lower SES areas had poorer access to POS in comparison with the higher ones.

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

Science.gov (United States)

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

2011-12-29

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

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

International Nuclear Information System (INIS)

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

1999-01-01

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

An Experimental Study on the Influence of Soundscapes on People's Behaviour in an Open Public Space

OpenAIRE

Aletta, F.; Lepore, F.; Kostara-Konstantinou, E.; Kang, J.; Astolfi, A.

2016-01-01

Several studies have investigated how environmental sounds and music can modulate people’s behaviours, particularly in marketing research. However, there are relatively few examples of research about such relationships with a focus on the management of urban public spaces. The current study investigated an open public space used mainly as a pedestrian crossing to analyse the relationship between the audio stimuli and peoples’ behaviours. An experiment relying on covert behavioural observation...

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

Energy Technology Data Exchange (ETDEWEB)

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

1995-09-01

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

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

Science.gov (United States)

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

2015-01-01

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

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

Science.gov (United States)

2010-01-01

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

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

Science.gov (United States)

2010-01-28

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

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

Science.gov (United States)

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

1992-11-01

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

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

Energy Technology Data Exchange (ETDEWEB)

Sullivan, K M

1977-06-01

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

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

International Nuclear Information System (INIS)

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

1996-01-01

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

Maximum opening of the mouth by mouth prop during dental procedures increases the risk of upper airway constriction

Directory of Open Access Journals (Sweden)

Hiroshi Ito

2010-05-01

Full Text Available Hiroshi Ito1, Hiroyoshi Kawaai1, Shinya Yamazaki1, Yosuke Suzuki21Division of Systemic Management, Department of Oral Function, 2Division of Radiology and Diagnosis, Department of Medical Sciences, Ohu University, Post Graduate School of Dentistry, Koriyama City, Fukushima Prefecture, JapanAbstract: From a retrospective evaluation of data on accidents and deaths during dental procedures, it has been shown that several patients who refused dental treatment died of asphyxia during dental procedures. We speculated that forcible maximum opening of the mouth by using a mouth prop triggers this asphyxia by affecting the upper airway. Therefore, we assessed the morphological changes of the upper airway following maximal opening of the mouth. In 13 healthy adult volunteers, the sagittal diameter of the upper airway on lateral cephalogram was measured between the two conditions; closed mouth and maximally open mouth. The dyspnea in each state was evaluated by a visual analog scale. In one subject, a computed tomograph (CT was taken to assess the three-dimensional changes in the upper airway. A significant difference was detected in the mean sagittal diameter of the upper airway following use of the prop (closed mouth: 18.5 ± 3.8 mm, maximally open mouth: 10.4 ± 3.0 mm. All subjects indicated upper airway constriction and significant dyspnea when their mouth was maximally open. Although a CT scan indicated upper airway constriction when the mouth was maximally open, muscular compensation was admitted. Our results further indicate that the maximal opening of the mouth narrows the upper airway diameter and leads to dyspnea. The use of a prop for the patient who has communication problems or poor neuromuscular function can lead to asphyxia. When the prop is used for patient refusal in dentistry, the respiratory condition should be monitored strictly, and it should be kept in mind that the “sniffing position” is effective for avoiding upper airway

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

OpenAIRE

Dugan, Patrick R.; Apel, William A.

1983-01-01

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

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

Science.gov (United States)

Azodo, Clement Chinedu; Umoh, Agnes O

2015-09-15

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

Multimegawatt space nuclear power open-cycle MHD-facility

International Nuclear Information System (INIS)

Pavshuk, V.A.; Panchenko, V.P.

2008-01-01

Paper presents the results of the efforts to calculate the characteristics, the layout and the engineering design of the open cycle space power propulsion on the basis of the high-temperature nuclear reactor for a nuclear rocket engine and the Faraday 20 MW capacity MHD-generator. The IVG-1 heterogeneous channel-vessel reactor ensuring in the course of the experiments hydrogen heating up to 3100 K, up to 5 MPa pressure at the reactor core outlet, up to 5 kg/s flowsheet, up to 220 MW thermal power served as a reactor is considered. One determined the MHD-generator basic parameters, namely: the portion of Cs dope was equal to 20%, the outlet stagnation pressure - 2 MPa, the electric conductivity - ≅30 S/m, the Mach number - ≅0.7, the magnetic field induction - 6 T, the capacity - 20 MW, the specific power removal - ∼4 MJ/kg. Paper describes the design of the MHD-facility with the working fluid momentless discharge and its basic characteristics [ru

Project Startup: Evaluating the Performance of Hydraulic Hybrid Refuse Vehicles

Energy Technology Data Exchange (ETDEWEB)

2015-09-01

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

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

Science.gov (United States)

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

2012-05-28

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

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

Directory of Open Access Journals (Sweden)

Chandran Thoovakkunon

2012-05-01

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

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

Science.gov (United States)

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

2014-01-01

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

Implementation of the Forest Service Open Space Conservation Strategy in Washington State: Exploring the Role of the National Forest System

Science.gov (United States)

Richard J. Pringle; Lee K. Cerveny; Gordon A. Bradley

2015-01-01

The loss of open space was declared one of the “four threats to the health of our nation’s forests” by former USDA Forest Service Chief Dale Bosworth in 2004. Since then, the agencywide Open Space Conservation Strategy (OSCS) was released and the “four threats” were incorporated into the agency’s National Strategic Plan. These actions indicate that the OSCS is in the...

The social aspects of landscape change: protecting open space under the pressure of development

Science.gov (United States)

Paul H. Gobster; Susan I. Stewart; David N. Bengston

2004-01-01

The extent of developed land in many parts of the world has increased rapidly in recent decades, posing significant challenges to the protection of forests, agricultural lands, and other natural and culturally modified green areas in urban and rural settings. Sustaining these open spaces has long been seen as a critical issue economically, and it is now increasingly...

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

Science.gov (United States)

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

2008-05-01

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

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

Science.gov (United States)

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

2009-06-01

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

Emissions from co-combustion of wood and household refuse

International Nuclear Information System (INIS)

Zhang, X.J.; Peterson, F.

1996-01-01

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

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

Science.gov (United States)

Dugan, Patrick R.; Apel, William A.

1983-01-01

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

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

Science.gov (United States)

Clarke, Kyra

2016-01-01

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

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

Science.gov (United States)

Manson, Neil C

2015-02-01

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

Powerful and large regional authorities are needed to preserve green open space for urban agglomerations

Directory of Open Access Journals (Sweden)

Carmen Aalbers

2013-10-01

Full Text Available Identification and assessment of strategies for the conservation and multifunctional development of green open space in the urban fringe of European urban regions is a challenge to both the academic and the real life world. Within the EU funded research project PLUREL – Peri-urban land use relationships – ‘Strategies and sustainability assessment tools for urban rural linkages’, we developed a methodology for international comparison of regional strategies that considers the policy context at supra-regional level. This methodology helped to explain the reported impacts of strategies. For this we further elaborated the theoretical concept of policy arrangements and policy dimensions by Van Tatenhove et al. (2000 and Arts et al. (2006. Strategies and policy contexts referred to are from Montpellier Agglomeration, a formal coalition of now 31 municipalities, Leipzig-Halle region, a functional urban region (FUR with governance coalitions around green open space preservation strategies, and Hangzhou in China, a very large city with hierarchical formal government. Results showed how the means of influence from different government levels can complement and reinforce each other and raise the effectiveness of the strategies. A combination of hierarchical government with a horizontal coalition between local authorities covering the full FUR can be very effective for managing the land use developments in the urban fringe, even when private business, CSOs or other NGOs are not included in the coalition. Supra-regional authorities do not have to possess the land resources, but setting the Rules of the Game is a powerful means of influence to coerce local municipalities to preserve green open space in the urban fringe.

Active living : the impact of renovating urban open spaces on increasing the level of physical activity among social groups

NARCIS (Netherlands)

Wiggers, Hiske; Shokoohi, Roya

2017-01-01

Introduction The provision of active parks/public open space is the key factor in promoting active living, because people and specially low-income and elderlies are being more interested in doing non-organized/informal, and no-cost sports/physical activities in outdoor spaces in recent decades

Lime helps establish crownvetch on coal-breaker refuse

Science.gov (United States)

Miroslaw M. Czapowskyj; Edward A. Sowa

1976-01-01

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

[Refusal of care and respect of the body].

Science.gov (United States)

Bernard, Marie-Fleur

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

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

Science.gov (United States)

Setse, Rosanna W; Maxwell, Celia J

2014-05-01

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

Factors Influencing Visitors to Suburban Open Space Areas near a Northern Japanese City

Directory of Open Access Journals (Sweden)

Yasushi Shoji

2012-04-01

Full Text Available Visitor information often serves as the basis for the management plan of parks. However, there exist few scientific and fundamental surveys for parks and open spaces in Japan. We analyzed the correlation between the number of visitors and the various factors in a suburban open space in a northern Japanese city, Takino Park. To explain the fluctuations in the number of visitors in Takino Park, multiple regression analyses with the stepwise method were conducted. The analyses employed social factors and meteorological factors, such as the day of the week, school vacations, temperature and the weather. The results show that the most influential factor is the day of the week, i.e., Sundays and holidays. The weather is also influential as the number of visitors decreases on rainy and snowy days. Comparing different seasons of the year, we found that influential factors varied from one season to the other. A key distinguishing finding of our results is that the weather conditions at the departure site and the weather forecast are also determining factors. These findings will help park managers understand the current situations and examine future management strategies to maintain and enhance visitor satisfaction, and improve information services.

Expose-R experiment on effects of open space condition on survivorship in dormant stages of aquatic invertebrates

Science.gov (United States)

Alekseev, Victor; Novikova, Nataliya; Levinskikh, Margarita; Sychev, Vladimir; Yusoff, Fatimah; Azuraidi, Osman

2012-07-01

Dormancy protects animals and plants in harsh environmental conditions from months up to hundred years. This phenomenon is perspective for space researches especially for interplanetary missions. Direct experiments in open space BYORYSK supported in principle the fact of survivorship of bacteria, fungi spores, seed of plants and crustacean dormant cysts. Even though the rate of survivorship in long-term treatments was low but good enough to conclude that biological invasion even to Mars is a real danger. As soon as the BYORYSK lunch was made of metal the possibility for resting stages to survive under UV treatment in vacuum without some protection was not clear. To test it an ESA and RSA equipment titled EXPOSE-R was applied. The EXPOSE-R facility was an external facility attached to the outside of the Zvezda Service Module in ISS in the end of November 2008. It had glace windows transparent for UV-radiation and possibility to measure temperature, space- and UV-radiation. Among a number of experiments requiring exposure to the open space environment it had a biological launch containing resting stages of terrestrial and aquatic organisms. These stages included dried ephippia of cladoceran Daphnia magna differentiated on size, dormant eggs of ostracode Eucypris ornate, cysts of fair-shrimp Streptocephalus torvicornis ( all from hemi desert Caspian area) and Artemis salina from salt lake Crimean populations. All dormant stages were kept in transparent to UV plastic bags placed in three layers. After about two years of exposing in open space dormant stages of 3 species A. salina, D. magna, S. torvicornis successfully survived at different scales but in second and third layers only . The highest level of survivorship was found in A. salina cysts. In preliminary land experiments that imitated land EXPOSE imitation of outside space station UV and vacuum conditions survivorship in resting eggs of D .magna, S. torvicornis and E. ornate was tested also. The total UV dose of

Regional assessment of urban impacts on landcover and open space finds a smart urban growth policy performs little better than business as usual.

Science.gov (United States)

Thorne, James H; Santos, Maria J; Bjorkman, Jacquelyn H

2013-01-01

Assessment of landscape change is critical for attainment of regional sustainability goals. Urban growth assessments are needed because over half the global population now lives in cities, which impact biodiversity, ecosystem structure and ecological processes. Open space protection is needed to preserve these attributes, and provide the resources humans need. The San Francisco Bay Area, California, is challenged to accommodate a population increase of 3.07 million while maintaining the region's ecosystems and biodiversity. Our analysis of 9275 km² in the Bay Area links historic trends for three measures: urban growth, protected open space, and landcover types over the last 70 years to future 2050 projections of urban growth and open space. Protected open space totaled 348 km² (3.7% of the area) in 1940, and expanded to 2221 km² (20.2%) currently. An additional 1038 km² of protected open space is targeted (35.1%). Urban area historically increased from 396.5 km² to 2239 km² (24.1% of the area). Urban growth during this time mostly occurred at the expense of agricultural landscapes (62.9%) rather than natural vegetation. Smart Growth development has been advanced as a preferred alternative in many planning circles, but we found that it conserved only marginally more open space than Business-as-usual when using an urban growth model to portray policies for future urban growth. Scenarios to 2050 suggest urban development on non-urban lands of 1091, 956, or 179 km², under Business-as-usual, Smart Growth and Infill policy growth scenarios, respectively. The Smart Growth policy converts 88% of natural lands and agriculture used by Business-as-usual, while Infill used only 40% of those lands. Given the historic rate of urban growth, 0.25%/year, and limited space available, the Infill scenario is recommended. While the data may differ, the use of an historic and future framework to track these three variables can be easily applied to other metropolitan areas.

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

Science.gov (United States)

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

2013-01-01

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

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

Science.gov (United States)

Popper-Giveon, Ariela; Keshet, Yael

2018-04-01

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

An Experimental Study on the Influence of Soundscapes on People’s Behaviour in an Open Public Space

OpenAIRE

Francesco Aletta; Federica Lepore; Eirini Kostara-Konstantinou; Jian Kang; Arianna Astolfi

2016-01-01

Several studies have investigated how environmental sounds and music can modulate people’s behaviours, particularly in marketing research. However, there are relatively few examples of research about such relationships with a focus on the management of urban public spaces. The current study investigated an open public space used mainly as a pedestrian crossing to analyse the relationship between the audio stimuli and peoples’ behaviours. An experiment relying on covert behavioural observation...

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

OpenAIRE

Borel , Marie; Veber , Benoit; Villette-Baron , Karen; Hariri , S.; Dureuil , Bertrand; Hervé , Christian

2009-01-01

International audience; It is not a question of going towards a systematic admission in intensive care of any patient proposed, but to make sure that so if there is a refusal, it is carried out according to a step ethically acceptable.

The moderating role of risk-taking tendency and refusal assertiveness on social influences in alcohol use among inner-city adolescents.

Science.gov (United States)

Epstein, Jennifer A; Botvin, Gilbert J

2002-07-01

Many etiological models of adolescent alcohol use concentrate on the main effects of risk and protective factors. This study examined the moderating influence of risk-taking tendency and refusal assertiveness on perceived friends' drinking as associated with alcohol use among inner-city adolescents. Participants (N = 2,400; 54% female) completed questionnaires that included measures of risk-taking tendency, refusal assertiveness, perceived friends' drinking and alcohol use (drinking frequency, drinking amount and drunkenness). Main effects for perceived friends' drinking, risk-taking tendency and refusal assertiveness were found for all three drinking measures, consistent with prior work. Furthermore, significant interactions were found between (1) risk-taking tendency and perceived friends' drinking and (2) refusal assertiveness and perceived friends' drinking. High risk-taking tendency and low refusal assertiveness increased the impact of perceived friends' drinking on alcohol use among inner-city adolescents. This suggests that these factors are important components in preventing alcohol use.

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

Science.gov (United States)

Salam, Asma Abdus; Afshan, Gauhar

2016-01-01

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

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

Science.gov (United States)

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

2014-09-01

Refuse trucks play an important role in the waste collection process. Due to their typical driving cycle, these vehicles are characterized by large fuel consumption, which strongly affects the overall waste disposal costs. Hybrid hydraulic refuse vehicles offer an interesting alternative to conventional diesel trucks, because they are able to recuperate, store and reuse braking energy. However, the expected fuel savings can vary strongly depending on the driving cycle and the operational mode. Therefore, in order to assess the possible fuel savings, a typical driving cycle was measured in a conventional vehicle run by the waste authority of the City of Stuttgart, and a dynamical model of the considered vehicle was built up. Based on the measured driving cycle and the vehicle model including the hybrid powertrain components, simulations for both the conventional and the hybrid vehicle were performed. Fuel consumption results that indicate savings of about 20% are presented and analyzed in order to evaluate the benefit of hybrid hydraulic vehicles used for refuse collection. Copyright © 2014 Elsevier Ltd. All rights reserved.

[Anorexia and refusal to eat in the elderly].

Science.gov (United States)

Hazif-Thomas, Cyril; Thomas, Philippe

2016-01-01

The question of the links between anorexia and the refusal to eat in the elderly is often the cause of major difficulties with regard to therapeutic strategies within caregiving teams. Likewise, few studies have been carried out into the diachronic links between teenage anorexia and that of the elderly. The role of the multi-disciplinary team is essential. Copyright © 2015. Published by Elsevier Masson SAS.

Ways to Say No: Refusal Skill Strategies among Urban Adolescents

Science.gov (United States)

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

2006-01-01

Objectives: To examine associations among adolescents' generated verbal strategies (ie, Simple No, Declarative Statements, Excuse, Alternatives) and underlying nonverbal assertiveness in 2 refusal situations: smoking and shoplifting. Methods: Sixth-grade urban minority students (N = 454) participated in videotaped role-play assessments of peer…

Urban open spaces: the relationship of uses within the neighborhood scale

Directory of Open Access Journals (Sweden)

Wilza Gomes Reis Lopes

2007-06-01

Full Text Available In the urban habitacionais areas the population needs areas with which they can be identified, of free spaces that reflect the identity of its inhabitants. Thus, the square is had as public good of the cities, opened to all and endowed with functions, that supply the physical and mental necessities of its inhabitants. This work had as objective to present the diverse joined uses and the way as the users if they appropriate of the squares in the Mocambinho quarter located in the zone north of the city of Teresina, its Inter-relations in the context where they are inserted.

An Experimental Study on the Influence of Soundscapes on People’s Behaviour in an Open Public Space

OpenAIRE

Aletta, F.; Lepore, F.; Kostara-Konstantinou, E.; Kang, J.; Astolfi, A.

2016-01-01

Several studies have investigated how environmental sounds and music can modulate\\ud people’s behaviours, particularly in marketing research. However, there are relatively few examples\\ud of research about such relationships with a focus on the management of urban public spaces.\\ud The current study investigated an open public space used mainly as a pedestrian crossing to analyse\\ud the relationship between the audio stimuli and peoples’ behaviours. An experiment relying on\\ud covert behaviou...

Carbon-13 nuclear magnetic resonance spectroscopic characterization of humic substances from municipal refuse decomposing in a landfill

International Nuclear Information System (INIS)

Newman, R.H.; Theng, B.K.G.; Filip, Z.

1987-01-01

Municipal refuse was disposed of in simulated landfills and left for periods of more than 20 months. Three different 40 m 3 systems of disposals were studied, namely (i) where the refuse was compacted, (ii) where it was mixed with sewage sludge and left uncompacted, and (iii) where it was compacted with sewage sludge. At 2, 6, 12 and 20 months, the humic substances were extracted from each system, purified, and characterised by cross-polarisation 13 C NMR spectroscopy with 'magic-angle' sample spinning. The areas under the various signals were related to carbon percentages in different structural categories. The aromaticity of the humic acids increased with time of decomposition; those from refuse mixed with sewage sludge were particularly high in phenolic content. A signal at 174 p.p.m., assigned primarily to secondary amide linkages, reached maximum strength after 6 to 12 months decomposition. The carbohydrate contents of the humic acids showed only small variations as decomposition progressed. Polymethylene chains in lipids, particularly for the uncompacted system, accounted for a diminishing fraction of total carbon as time of refuse disposal increased. The spectrum of a soil humic acid showed features similar to those observed in spectra of humic acids derived from refuse, but the signals were less well resolved. 19 refs.; 8 figs.; 3 tabs

The impact of urban open space and 'lift-up' building design on building intake fraction and daily pollutant exposure in idealized urban models.

Science.gov (United States)

Sha, Chenyuan; Wang, Xuemei; Lin, Yuanyuan; Fan, Yifan; Chen, Xi; Hang, Jian

2018-08-15

Sustainable urban design is an effective way to improve urban ventilation and reduce vehicular pollutant exposure to urban residents. This paper investigated the impacts of urban open space and 'lift-up' building design on vehicular CO (carbon monoxide) exposure in typical three-dimensional (3D) urban canopy layer (UCL) models under neutral atmospheric conditions. The building intake fraction (IF) represents the fraction of total vehicular pollutant emissions inhaled by residents when they stay at home. The building daily CO exposure (E t ) means the extent of human beings' contact with CO within one day indoor at home. Computational fluid dynamics (CFD) simulations integrating with these two concepts were performed to solve turbulent flow and assess vehicular CO exposure to urban residents. CFD technique with the standard k-ε model was successfully validated by wind tunnel data. The initial numerical UCL model consists of 5-row and 5-column (5×5) cubic buildings (building height H=street width W=30m) with four approaching wind directions (θ=0°, 15°, 30°, 45°). In Group I, one of the 25 building models is removed to attain urban open space settings. In Group II, the first floor (Lift-up1), or second floor (Lift-up2), or third floor (Lift-up3) of all buildings is elevated respectively to create wind pathways through buildings. Compared to the initial case, urban open space can slightly or significantly reduce pollutant exposure for urban residents. As θ=30° and 45°, open space settings are more effective to reduce pollutant exposure than θ=0° and 15°.The pollutant dilution near or surrounding open space and in its adjacent downstream regions is usually enhanced. Lift-up1 and Lift-up2 experience much greater pollutant exposure reduction in all wind directions than Lift-up3 and open space. Although further investigations are still required to provide practical guidelines, this study is one of the first attempts for reducing urban pollutant exposure by

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

Science.gov (United States)

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

2015-04-01

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

Refusal of recommended maternity care: Time to make a pact with women?

Science.gov (United States)

Jenkinson, Bec; Kruske, Sue; Kildea, Sue

2018-03-28

The right to refuse medical treatment can be contentious in maternity care. Professional guidance for midwives and obstetricians emphasises informed consent and respect for patient autonomy, but there is little guidance available to clinicians about the appropriate clinical responses when women decline recommended care. We propose a comprehensive, woman-centred, systems-level framework for documentation and communication with the goal of supporting women, clinicians and health services in situations of maternal refusal. We term this the Personalised Alternative Care and Treatment framework. The Personalised Alternative Care and Treatment framework addresses Australian policy, practice, education and professional issues to underpin woman-centred care in the context of maternal refusal. It embeds Respectful Maternity Care in system-level maternity care policy; highlights the woman's role as decision maker about her maternity care; documents information exchanged with women; creates a 'living' plan that respects the woman's birth intentions and can be reviewed as circumstances change; enables communication between clinicians; permits flexible initiation pathways; provides for professional education for clinicians, and incorporates a mediation role to act as a failsafe. The Personalised Alternative Care and Treatment framework has the potential to meet the needs of women, clinicians and health services when pregnant women decline recommended maternity care. Copyright © 2018. Published by Elsevier Ltd.

Socializing in an open drug scene: the relationship between access to private space and drug-related street disorder.

Science.gov (United States)

Debeck, Kora; Wood, Evan; Qi, Jiezhi; Fu, Eric; McArthur, Doug; Montaner, Julio; Kerr, Thomas

2012-01-01

Limited attention has been given to the potential role that the structure of housing available to people who are entrenched in street-based drug scenes may play in influencing the amount of time injection drug users (IDU) spend on public streets. We sought to examine the relationship between time spent socializing in Vancouver's drug scene and access to private space. Using multivariate logistic regression we evaluated factors associated with socializing (three+ hours each day) in Vancouver's open drug scene among a prospective cohort of IDU. We also assessed attitudes towards relocating socializing activities if greater access to private indoor space was provided. Among our sample of 1114 IDU, 43% fit our criteria for socializing in the open drug scene. In multivariate analysis, having limited access to private space was independently associated with socializing (adjusted odds ratio: 1.80, 95% confidence interval: 1.28-2.55). In further analysis, 65% of 'socializers' reported positive attitudes towards relocating socializing if they had greater access to private space. These findings suggest that providing IDU with greater access to private indoor space may reduce one component of drug-related street disorder. Low-threshold supportive housing based on the 'housing first' model that include safeguards to manage behaviors associated with illicit drug use appear to offer important opportunities to create the types of private spaces that could support a reduction in street disorder. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Quantum mechanics on the moduli space from the quantum geometrodynamics of the open topological membrane

International Nuclear Information System (INIS)

Kogan, I.I.

1991-01-01

The quantum geometrodynamics of the open topological membrane is described in terms of 2+1 topologically massive gravity (TMG) where the inverse graviton mass is proportional to the 2D central charge and thus is the measure of the off-criticality. The hamiltonian quantization of TMG on Riemann surfaces is considered and the moduli space appears as the subspace of the quantum-mechanical configuration space containing, besides the moduli, the first-order time derivatives of half of the moduli. The appearance of the first-order time derivatives as coordinates, not momenta, is due to the third-order derivative in the TMG lagrangian. The hamiltonian for the latter leads us to the discrete levels picture which looks like the topologically massive gauge theory (TMGT) case, where we also get the Landau levels picture and the lowest Landau level corresponds to the Hilbert space of the Chern-Simons theory (CST). The connection between the positivity of the energy and the complex structure on the moduli space is discussed. (orig.)

the development of new generation of solid waste refuse incinerators

African Journals Online (AJOL)

Apart from town refuse, there are wastes from agriculturally based industries especially ... depends on careful control of the 3T's (time, temperature and turbulence). ... These activities cause serious public health risks ... The modifications to the old bottle incinerators were developed by carefully assessing the failure modes.

9 CFR 351.19 - Refusal of certification for specific lots.

Science.gov (United States)

2010-01-01

... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Refusal of certification for specific lots. 351.19 Section 351.19 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE AGENCY ORGANIZATION AND TERMINOLOGY; MANDATORY MEAT AND POULTRY PRODUCTS INSPECTION...

Free to become martyrs? The right to refuse medical treatment on religious grounds in a comparative perspective

Directory of Open Access Journals (Sweden)

Vincenzo Pacillo

2016-09-01

 ABSTRACT: This study focuses on the right of patients to refuse medical treatments on religious grounds and on the (supposed right to the parents to refuse medical treatments on behalf of their children, emphasizing the links and connections between the freedom of religion, the right to self-determination and the right to refuse medical treatment based on religious motivations. After a comparison between the norms devoted to rule the exercise of these rights in the English (and Welsh and Italian legal systems, the article suggests that the approach of medical staff towards a Refusal of Medical Treatment on Religious Grounds ought to start an intercultural process. This process ought to be a cross-cultural dialogue devoted not only to translate medical language in a language which can be fully understood by the patient, but also to create a reciprocal comprehension between the (mainstream ethnocultural communication codes and instances of the staff and the (nondominant ethnocultural (and religious communication codes and instances of the patient (or of his/her parents.

Energy from refuse by bioconversion, fermentation and residue disposal processes

Energy Technology Data Exchange (ETDEWEB)

Pfeffer, J T; Liebman, J C

1976-01-01

Bioconversion of organic refuse to CH/sub 4/ by anaerobic fermentation is 1 mechanism by which the energy in urban waste can be reclaimed. Laboratory studies were made to determine the rate and amount of gas production at various operating temperatures. The dewatering characteristics of the spent fermentation slurry were evaluated. The spent solids can be dewatered to a sufficiently low moisture content such that incineration is self-sustaining. The incineration system was evaluated to determine the possible energy recovery from the spent cake. A process for treating the liquid blowdown from the system was developed. A mathematical simulation of the total system was constructed to evaluate performance under various operating conditions. A plant processing 908 tons of refuse/day will produce 3905 m/sup 3/ CH/sub 4//hr. Recovery of just CH/sub 4/ provides a 32.6% efficiency of energy recovery. This efficiency can be increased to 63.4% if steam from the incinerator can be sold.

Right of a patient to refuse medical treatment: justification for judicial ...

African Journals Online (AJOL)

Nnamdi Azikiwe University Journal of International Law and Jurisprudence ... This paper discusses the right of a patient to refuse medical treatment and juxtaposes ... This is achieved by an expository review of relevant case law and scholarly ...

When is it permissible to dismiss a family who refuses vaccines? Legal, ethical and public health perspectives.

Science.gov (United States)

Halperin, Beth; Melnychuk, Ryan; Downie, Jocelyn; Macdonald, Noni

2007-12-01

Although immunization is one of the most important health interventions of the 20th century, cases of infectious disease continue to occur. There are parents who refuse immunization for their children, creating a dilemma for the primary care physician who must consider the best interest of the individual child as well as that of the community. Some physicians, when faced with parents who refuse immunization on behalf of their children, choose to dismiss these families from their practice. Given the existing shortage of primary care physicians across Canada, this decision to dismiss families based on vaccine refusal has far-reaching implications. The present article explores this issue in the Canadian context from a legal, ethical and public health perspective.

Individual- and regional-level determinants of human papillomavirus (HPV) vaccine refusal: the Ontario Grade 8 HPV vaccine cohort study.

Science.gov (United States)

Remes, Olivia; Smith, Leah M; Alvarado-Llano, Beatriz E; Colley, Lindsey; Lévesque, Linda E

2014-10-08

Studies on the determinants of human papillomavirus (HPV) vaccine use have generally focused on individual-level characteristics, despite the potentially important influence of regional-level characteristics. Therefore, we undertook a population-based, retrospective cohort study to identify individual- and regional-level determinants of HPV vaccine refusal (non-receipt) in Ontario's (Canada) Grade 8 HPV Immunization Program. Ontario's administrative health and immunization databases were used to identify girls eligible for free HPV vaccination in 2007-2011 and to ascertain individual-level characteristics of cohort members (socio-demographics, vaccination history, health care utilization, medical history). The social and material characteristics of the girl's region (health unit) were derived from the 2006 Canadian Census. Generalized estimating equations (binomial distribution, logit link) were used to estimate the population-average effects of individual- and regional-level characteristics on HPV vaccine refusal. Our cohort consisted of 144,047 girls, 49.3% of whom refused HPV vaccination. Factors associated with refusal included a previous diagnosis of Down's syndrome (OR = 1.37, 95% CI 1.16-1.63) or autism (OR = 1.60, 95% CI 1.34-1.90), few physician visits (OR = 1.45, 95% CI 1.35-1.55), and previous refusal of mandatory (OR = 2.23, 95% CI 2.07-2.40) and optional (OR = 3.96, 95% CI 3.87-4.05) vaccines. Refusal was highest among the lowest and highest income levels. Finally, a previous diagnosis of obesity and living in an area of high deprivation were associated with lower refusal (OR = 0.87, 95% CI 0.83-0.92 and OR = 0.82 95%, CI 0.79-0.86, respectively). Studies on HPV vaccine determinants should consider regional-level factors. Efforts to increase HPV vaccine acceptance should include vulnerable populations (such as girls of low income) and girls with limited contact with the healthcare system.

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

Science.gov (United States)

Umotong, Eno

2016-12-01

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

An open-loop system design for deep space signal processing applications

Science.gov (United States)

Tang, Jifei; Xia, Lanhua; Mahapatra, Rabi

2018-06-01

A novel open-loop system design with high performance is proposed for space positioning and navigation signal processing. Divided by functions, the system has four modules, bandwidth selectable data recorder, narrowband signal analyzer, time-delay difference of arrival estimator and ANFIS supplement processor. A hardware-software co-design approach is made to accelerate computing capability and improve system efficiency. Embedded with the proposed signal processing algorithms, the designed system is capable of handling tasks with high accuracy over long period of continuous measurements. The experiment results show the Doppler frequency tracking root mean square error during 3 h observation is 0.0128 Hz, while the TDOA residue analysis in correlation power spectrum is 0.1166 rad.

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

African Journals Online (AJOL)

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

A quality of life quandary: a framework for navigating parental refusal of treatment for co-morbidities in infants with underlying medical conditions.

Science.gov (United States)

Kunz, Sarah N; McAdams, Ryan M; Diekema, Douglas S; Opel, Douglas J

2015-01-01

Parental refusal of a recommended treatment is not an uncommon scenario in the neonatal intensive care unit. These refusals may be based upon the parents' perceptions of their child's projected quality of life. The inherent subjectivity of quality of life assessments, however, can exacerbate disagreement between parents and healthcare providers. We present a case of parental refusal of surgical intervention for necrotizing enterocolitis in an infant with Bartter syndrome and develop an ethical framework in which to consider the appropriateness of parental refusal based upon an infant's projected quality of life. Copyright 2015 The Journal of Clinical Ethics. All rights reserved.

Soft ideal topological space and mixed fuzzy soft ideal topological space

Directory of Open Access Journals (Sweden)

Manash Borah

2019-01-01

Full Text Available In this paper we introduce fuzzy soft ideal and mixed fuzzy soft ideal topological spaces and some properties of this space. Also we introduce fuzzy soft $I$-open set, fuzzy soft $\\alpha$-$I$-open set, fuzzy soft pre-$I$-open set, fuzzy soft semi-$I$-open set and fuzzy soft $\\beta$-$I$-open set and discuss some of their properties.

The use of coal refuse as construction aggregates; Utilizacion de los Esteriles de Carbon como Aridos en Construccion

Energy Technology Data Exchange (ETDEWEB)

NONE

2000-07-01

The objective of this project was to carry out a study which would allow us to determine the nature and properties of coal refuse for its possible use as construction aggregates: roadbeds concrete, bituminous meagres, etc. and to establish criteria of acceptability, placing, and quality control. Two types of refuse, considered to be representative, were chosen (one black and one red) and various trials were performed at a grinding and classifying plant for the obtention of granular materials. The results of these trials determined the most appropriate plant treatment for each type of refuse and established the margin of acceptability, criteria of acceptability, and quality control tests to be applied to the materials obtained from coal refuse for use as construction aggregates. Laboratory testing with both types of refuse mixed with binders (cement, emulsions) were carried out. At the same time, real scale tests, through the construction of concrete slabs in local roads and in trial areas, using the proportions of aggregates and cement that are customary in the area, and also by varying the cement content, substituting it for airborne ash from the thermal La Pereda power station were also performed. From the results obtained, it can be deduced that coal refuse can be used as granular material for roadbeds in different ways: stabilised as gravel-cement, in the form of gravel emulsion, as gravel slag, or by itself. As far as its use in concrete manufacture, it is limited to marginal works. With regard to its decorative use in gardening, it is being used in various town halls in Asturias and Cantabria. (Author)

Patient-related factors and circumstances surrounding decisions to forego life-sustaining treatment, including intensive care unit admission refusal.

Science.gov (United States)

Reignier, Jean; Dumont, Romain; Katsahian, Sandrine; Martin-Lefevre, Laurent; Renard, Benoit; Fiancette, Maud; Lebert, Christine; Clementi, Eva; Bontemps, Frederic

2008-07-01

To assess decisions to forego life-sustaining treatment (LST) in patients too sick for intensive care unit (ICU) admission, comparatively to patients admitted to the ICU. Prospective observational cohort study. A medical-surgical ICU. Consecutive patients referred to the ICU during a one-yr period. None. Of 898 triaged patients, 147 were deemed too well to benefit from ICU admission. Decisions to forego LST were made in 148 of 666 (22.2%) admitted patients and in all 85 patients deemed too sick for ICU admission. Independent predictors of decisions to forego LST at ICU refusal rather than after ICU admission were: age; underlying disease; living in an institution; preexisting cognitive impairment; admission for medical reasons; and acute cardiac failure, acute central neurologic illness, or sepsis. Hospital mortality after decisions to forego LST was not significantly different in refused and admitted patients (77.5% vs. 86.5%; p = .1). Decisions to forego LST were made via telephone in 58.8% of refused patients and none of the admitted patients. Nurses caring for the patient had no direct contact with the ICU physicians for 62.3% of the decisions in refused patients, whereas meetings between nurses and physicians occurred in 70.3% of decisions to forego LST in the ICU. Patients or relatives were involved in 28.2% of decisions to forego LST at ICU refusal compared with 78.4% of decisions to forego LST in ICU patients (p refused patients (vs. none of admitted patients) and were associated with less involvement of nurses and relatives compared with decisions in admitted patients. Further work is needed to improve decisions to forego LST made under the distinctive circumstances of triage.

Understanding Treatment Refusal Among Adults Presenting for HIV-Testing in Soweto, South Africa: A Qualitative Study

OpenAIRE

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

2015-01-01

HIV treatment initiatives have focused on increasing access to antiretroviral therapy (ART). There is growing evidence, however, that treatment availability alone is insufficient to stop the epidemic. In South Africa, only one third of individuals living with HIV are actually on treatment. Treatment refusal has been identified as a phenomenon among people who are asymptomatic, however, factors driving refusal remain poorly understood. We interviewed 50 purposively sampled participants who pre...

Open Data and Open Science for better Research in the Geo and Space Domain

Science.gov (United States)

Ritschel, B.; Seelus, C.; Neher, G.; Iyemori, T.; Koyama, Y.; Yatagai, A. I.; Murayama, Y.; King, T. A.; Hughes, S.; Fung, S. F.; Galkin, I. A.; Hapgood, M. A.; Belehaki, A.

2015-12-01

Main open data principles had been worked out in the run-up and finally adopted in the Open Data Charta at the G8 summit in Lough Erne, Northern Ireland in June 2013. Important principles are also valid for science data, such as Open Data by Default, Quality and Quantity, Useable by All, Releasing Data for Improved Governance, Releasing Data for Innovation. There is also an explicit relationship to such areas of high values as earth observation, education and geospatial data. The European union implementation plan of the Open Data Charta identifies among other things objectives such as making data available in an open format, enabling semantic interoperability, ensuring quality, documentation and where appropriate reconciliation across different data sources, implementing software solutionsallowing easy management, publication or visualization of datasets and simplifying clearance of intellectual property rights.Open Science is not just a list of already for a longer time known principles but stands for a lot of initiatives and projects around a better handling of scientific data and openly shared scientific knowledge. It is also about transparency in methodology and collection of data, availability and reuse of scientific data, public accessibility to scientific communication and using of social media to facility scientific collaboration. Some projects are concentrating on open sharing of free and open source software and even further hardware in kind of processing capabilities. In addition question about the mashup of data and publication and an open peer review process are addressed.Following the principles of open data and open science the newest results of the collaboration efforts in mashing up the data servers related to the Japanese IUGONET, the European Union ESPAS and the GFZ ISDC semantic Web projects will be presented here. The semantic Web based approach for the mashup is focusing on the design and implementation of a common but still distributed data

The Spaces of Open-Source Politics

DEFF Research Database (Denmark)

Husted, Emil; Plesner, Ursula

The recent proliferation of Web 2.0 technologies and their role in contemporary political life has inspired the coining of the term ‘open-source politics’. This article analyzes how open-source politics is organized in the case of a young radical political party called The Alternative. Inspired...... processes, but may provide both closure and disconnection between the party’s universal body and its particular body. In conclusion, we propose that such a disconnection might be a precondition for success when institutionalizing radical politics, as it allows parties like The Alternative to maintain...

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

Science.gov (United States)

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

2011-02-01

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

Evaluation of low-level solid radioactive waste generated by a large hospital and disposed of with ordinary refuse

International Nuclear Information System (INIS)

Conte, L.; Pedroli, G.; Monciardini, M.; Bianchi, L.; Novario, R.; Beretta, A.

1996-01-01

In the Lombardy region some hospitals have recently been reported to the local authorities because of the presence of radioactivity in hospital refuse sent to the municipal tips for incineration. On various occasions the refuse collectors coming from the hospitals had to return with their refuse as traces of radioactivity were detected at the entrance to the tips equipped with monitoring systems. Hospitals administering radioactive substances for diagnostic or therapeutic purposes produce radioactive waste mainly in solid and liquid form. This waste is principally present in patient excreta and in contaminated materials. Radioactive waste present in patient excreta is normally disposed of through the sewage system provided that the concentration limits and annual activity stipulated by law are respected. The contaminated materials coming from the departments that carry out radioisotopic investigations and therapy with unsealed sources can be collected separately and sent to a tip after a period of storage to permit radioactive decay. However, part of the radioactive waste escapes all checks and inevitably mixes with normal refuse or with special hospital refuse that is not considered radioactive. This occurs in the case of: 1. excreta from patients who are not hospitalised after a radioisotopic investigation and materials contaminated by the excreta; 2. excreta from hospitalised patients which are eliminated outside the nuclear medicine and radiotherapy departments; 3. contaminated materials produced with unsealed sources in hospital departments other than those of nuclear medicine and radiotherapy; The waste indicated in point 1 is probably the main problem in ecological terms as the patients who are not hospitalised eliminate radioactive excreta into domestic sewage systems and can also contaminate materials that are disposed of with normal household refuse. In this case any solution to the problem would seriously affect diagnostic activities carried out in the

[A patient who refused treatment after self-poisoning with paracetamol

NARCIS (Netherlands)

Kramers, C.; Jansman, F.G.A.; Droogleever Fortuyn, H.A.

2006-01-01

Two patients, a 20-year-old man and a 33-year-old woman, were admitted with paracetamol poisoning. Both patients refused treatment initially but eventually complied. The man had a paracetamol concentration of 47.5 mg/l 2.5-5.0 h after ingestion, so antidote treatment was not considered necessary.

Refuse Dumps And The Environment: A Case Study Of Some ...

African Journals Online (AJOL)

Refuse Dumps And The Environment: A Case Study Of Some Selected Cities In Nigeria. ... International Journal of Emotional Psychology and Sport Ethics ... This study assessed the level of environmental pollution in the nation by focusing on the degree of accumulation of house – hold wastes, industrial scraps or wastes, ...

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

Science.gov (United States)

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

2017-05-01

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

Confusing criminal and civil law: when may a hospital refuse to release a dead body?

Science.gov (United States)

Gallagher, Steven B

2014-12-01

A United Kingdom bereavement advice group has expressed concern that hospitals in Britain may be acting "illegally" in refusing to release dead bodies to relatives unless they provide evidence that funeral arrangements have been made. In some cases, hospitals may have refused to release a body to anyone other than an undertaker. The charity argues that this behaviour constitutes the common law offence of preventing the lawful burial of a body. This article considers the confusion that may occur between this offence and interference with the right to possession of a body for lawful burial. The conclusion is that it is extremely unlikely a hospital or its employees would fall foul of the criminal law in refusing to release a dead body and may be liable in the civil courts if they release a body to someone who does not have the duty and consequent right to possession of the body for lawful burial.

Informed, advance refusals of treatment by people with severe mental illness in a randomised controlled trial of joint crisis plans: demand, content and correlates.

Science.gov (United States)

Henderson, Claire; Farrelly, Simone; Flach, Clare; Borschmann, Rohan; Birchwood, Max; Thornicroft, Graham; Waheed, Waquas; Szmukler, George

2017-11-24

In the UK, crisis planning for mental health care should acknowledge the right to make an informed advance treatment refusal under the Mental Capacity Act 2005. Our aims were to estimate the demand for such treatment refusals within a sample of service users who had had a recent hospital admission for psychosis or bipolar disorder, and to examine the relationship between refusals, and service user characteristics. To identify refusals we conducted content analysis of Joint Crisis Plans, which are plans formulated by service users and their clinical team with involvement from an external facilitator, and routine care plans in sub-samples from a multi-centre randomised controlled trial of Joint Crisis Plans (plus routine mental health care) versus routine care alone (CRIMSON) in England. Factors hypothesised to be associated with refusals were identified using the trial data collected through baseline interviews of service users and clinicians and collection of routine clinical data. Ninety-nine of 221 (45%) of the Joint Crisis Plans contained a treatment refusal compared to 10 of 424 (2.4%) baseline routine care plans. No Joint Crisis Plans recorded disagreement with refusals on the part of clinicians. Among those with completed Joint Crisis Plans, adjusted analyses indicated a significant association between treatment refusals and perceived coercion at baseline (odds ratio = 1.21, 95% CI 1.02-1.43), but not with baseline working alliance or a past history of involuntary admission. We demonstrated significant demand for written treatment refusals in line with the Mental Capacity Act 2005, which had not previously been elicited by the process of treatment planning. Future treatment/crisis plans should incorporate the opportunity for service users to record a treatment refusal during the drafting of such plans. ISRCTN11501328 Registered 13th March 2008.

Open string model building

International Nuclear Information System (INIS)

Ishibashi, Nobuyuki; Onogi, Tetsuya

1989-01-01

Consistency conditions of open string theories, which can be a powerful tool in open string model building, are proposed. By making use of these conditions and assuming a simple prescription for the Chan-Paton factors, open string theories in several backgrounds are studied. We show that 1. there exist a large number of consistent bosonic open string theories on Z 2 orbifolds, 2. SO(32) type I superstring is the unique consistent model among fermionic string theories on the ten-dimensional flat Minkowski space, and 3. with our prescription for the Chan-Paton factors, there exist no consistent open superstring theories on (six-dimensional Minkowski space-time) x (Z 2 orbifold). (orig.)

38 CFR 17.100 - Refusal of treatment by unnecessarily breaking appointments.

Science.gov (United States)

2010-07-01

... and satisfactory reasons are advanced for breaking the appointment and circumstances were such that... unnecessarily breaking appointments. 17.100 Section 17.100 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Breaking Appointments § 17.100 Refusal of treatment by unnecessarily breaking...

Staff attitude and experience in dealing with rational nursing home patients who refuse to eat and drink.

Science.gov (United States)

Mattiasson, A C; Andersson, L

1994-11-01

This paper describes the personal attitudes of nursing home staff and their experience of coping with rational nursing home patients who refused to eat and drink. Professional caregivers in 13 nursing homes and nursing home units in the county of Stockholm, Sweden, were asked to judge an ethical conflict involving a situation in which a patient of sound mind refused to eat and drink. Two questions were raised: (a) What would your unit's decision be in this case? (b) What is your personal opinion in this case? Answers to question (a) showed that 20% believed that the patient's autonomy would be respected, i.e. the patient would be allowed to die without medical intervention. Concerning question (b), the results showed that approximately 50% believed that the patient's wishes regarding food refusal must be respected. Furthermore, the results suggested that both professional category and number of years' service made a difference to the staff views on patient autonomy. Finally, the findings indicated that the nursing homes included in the study did not show any distinct policy with regard to the autonomy of elderly nursing home patients in refusing to eat and drink.

Trans*+ing Classrooms: The Pedagogy of Refusal as Mediator for Learning

Directory of Open Access Journals (Sweden)

sj Miller

2016-07-01

Full Text Available Gender and sexuality norms, conscribed under cis/heteropatriarchy, have established violent and unstable social and educational climates for the millennial generation of lesbian, gay, bisexual, transgender, intersex, agender/asexual, gender creative, and questioning youth. While strides have been made to make schools more supportive and queer inclusive, schools still struggle to include lesbian, gay, bisexual, transgender*+, intersex, agender/asexual, gender creative, queer and questioning (LGBT*+IAGCQQ-positive curricula. While extensive studies must be done on behalf of all queer youth, this work specifically focuses on how to support classroom teachers to uptake and apply a pedagogy of refusal that attends to the most vulnerabilized population of queer youth to date, those that are trans*+. A pedagogy of refusal will be explored through an evolving theory of trans*+ness, then demonstrated through a framework for classroom application, followed by recommendations for change.

Frequent fliers, school phobias, and the sick student: school health personnel's perceptions of students who refuse school.

Science.gov (United States)

Torrens Armstrong, Anna M; McCormack Brown, Kelli R; Brindley, Roger; Coreil, Jeannine; McDermott, Robert J

2011-09-01

This study explored school personnel's perceptions of school refusal, as it has been described as a "common educational and public health problem" that is less tolerated due to increasing awareness of the potential socioeconomic consequences of this phenomenon. In-depth interviews were conducted with school personnel at the middle school (N = 42), high school (N = 40), and district levels (N = 10). The findings focus on emergent themes from interviews with school health personnel (N = 12), particularly those themes related to their perceptions of and role in working with school-refusing students. Personnel, especially school health services staff, constructed a typification of the school-refusing student as "the sick student," which conceptualized student refusal due to reasons related to illness. Personnel further delineated sick students by whether they considered the illness legitimate. School health personnel referenced the infamous "frequent fliers" and "school phobics" within this categorization of students. Overarching dynamics of this typification included parental control, parental awareness, student locus of control, blame, and victim status. These typifications influenced how personnel reacted to students they encountered, particularly in deciding which students need "help" versus "discipline," thus presenting implications for students and screening of students. Overall, findings suggest school health personnel play a pivotal role in screening students who are refusing school as well as keeping students in school, underscoring policy that supports an increased presence of school health personnel. Recommendations for school health, prevention, and early intervention include the development of screening protocols and staff training. © 2011, American School Health Association.

45 CFR 286.150 - Can a family, with a child under age 6, be penalized because a parent refuses to work because (s...

Science.gov (United States)

2010-10-01

... arrangements are unavailable. (b) Refusal to work when an acceptable form of child care is available is not... penalized because a parent refuses to work because (s)he cannot find child care? 286.150 Section 286.150... a parent refuses to work because (s)he cannot find child care? (a) If the individual is a single...

Heavy Metal Contamination of Foods by Refuse Dump Sites in Awka, Southeastern Nigeria

Directory of Open Access Journals (Sweden)

J. K. C. Nduka

2008-01-01

Full Text Available The impact of heavy metals from refuse dumps on soil, food, and water qualities in Awka, Nigeria was studied. Soil samples (top and 1.35 m deep were collected from five refuse dumps digested with conc. HNO3 and HClO4. The heavy metals (lead, manganese, arsenic, chromium, cadmium, and nickel in vegetables (spinach, fluted pumpkin, root crop (cocoyam, and surface and ground water were determined using an atomic absorption spectrophotometer (AAS. Chemical properties of the soil and bacteria were determined. Heavy metals were found to be more concentrated at a depth of 1.35 m. Manganese was high in shallow wells and borehole water samples with the highest levels as 0.538 and 0.325 mg/l, respectively. Nickel levels in the borehole sample ranged from 0.001 to 0.227 mg/l, whereas the highest level of lead was 0.01 mg/l. The Obibia stream had the highest levels of manganese and lead. Linear regression analyses showed that the relationship between soil heavy metals and farm produce heavy metals was strong. Taken together, we may conclude that the consumption of leafy vegetables and crops produced on contaminated soils may pose a health risk to those that reside around the refuse dumps.

Open coil traction system.

Science.gov (United States)

Vibhute, Pavankumar Janardan

2012-01-01

Sliding mechanics have become a popular method for space closure, with the development of preadjusted edgewise appliances. Furthermore, various space closing auxiliaries have been developed and extensively evaluated for their clinical efficiency. Their effectiveness is enhanced with optimum force magnitude and low load deflection rate/force decay. With the advent of nickel-titanium (Ni-Ti) springs in orthodontics, load deflection rates have been markedly reduced. To use Ni-Ti springs, clinicians have to depend upon prefabricated closed coil springs. The open coil traction system, or open coil retraction spring, is developed utilizing Ni-Ti open coil springs for orthodontic space closure. This article describes the fabrication and clinical application of the open coil traction system, which has a number of advantages. It sustains a low load deflection rate with optimum force magnitude, and its design is adjustable for a desired length and force level. It is fail-safe for both activation and deactivation (ie, it cannot be overactivated, and the decompression limit of the open coil is controlled by the operator). The open coil traction system can be offset from the mucosa to help reduce soft tissue impingement.

Utilization of washery dirt and mine refuse

Energy Technology Data Exchange (ETDEWEB)

Leininger, D; Schieder, T

1975-10-02

Washery dirt and mine refuse may be used without processing as road ballast, embankments and dykes, and for filling gravel pits and subsidence areas. The properties required in road ballast are outlined. For the top portions of embankments and for frost protection layers, washery dirt must be processed to remove particles of the wrong size. Methods of heat treatment are listed, and the chemical composition of the dirt is discussed. Because of its different chemical composition, large particles are preferable to fine dirt for some applications, even if they have to be crushed. Tree planting experiments on spoilbanks are described.

Determinants for refusal of HIV testing among women attending for antenatal care in Gambella Region, Ethiopia.

Science.gov (United States)

Fanta, Wondimagegn; Worku, Alemayehu

2012-07-26

In Gambella region, inhabitants owe socio-cultural factors that might favor refusal for HIV testing service utilization among Antenatal Care attendees. To assess determinants for refusal of HIV testing service utilization among ANC attendees in Gambella Region. A comparative cross sectional study was conducted among ANC attendees from March 2008 to May 2008 in four selected health facilities of Gambella region. Sample size of 332 participants (83 who refused HIV testing and 249 who accepted HIV testing) were taken for the study. The study was supplemented with four focus group discussions. Multivariate binary logistic regression was employed to control for confounding factors. When adjusted with other factors pregnant women with 2-3 live births in the past; who claimed divorce as a perceived response of their husband following HIV positive test result; who had not sought agreement from their husband for testing; disclosure of test for husband and being from certain ethnic group (E.g. Mejenger) were independent predictors for refusal of HIV testing among ANC attendees. Based on the findings, the following recommendations were forwarded: Provision of innovative information and education on the pre-test session for those pregnant women having two or more children; community involvement to tackle stigma; women empowerment; designing couple friendly counseling service; and fighting harmful traditional practices related with decision of HIV testing.

Modular Open System Architecture for Reducing Contamination Risk in the Space and Missile Defense Supply Chain

Science.gov (United States)

Seasly, Elaine

2015-01-01

To combat contamination of physical assets and provide reliable data to decision makers in the space and missile defense community, a modular open system architecture for creation of contamination models and standards is proposed. Predictive tools for quantifying the effects of contamination can be calibrated from NASA data of long-term orbiting assets. This data can then be extrapolated to missile defense predictive models. By utilizing a modular open system architecture, sensitive data can be de-coupled and protected while benefitting from open source data of calibrated models. This system architecture will include modules that will allow the designer to trade the effects of baseline performance against the lifecycle degradation due to contamination while modeling the lifecycle costs of alternative designs. In this way, each member of the supply chain becomes an informed and active participant in managing contamination risk early in the system lifecycle.

Do features of public open spaces vary according to neighbourhood socio-economic status?

Science.gov (United States)

Crawford, David; Timperio, Anna; Giles-Corti, Billie; Ball, Kylie; Hume, Clare; Roberts, Rebecca; Andrianopoulos, Nick; Salmon, Jo

2008-12-01

This study examined the relations between neighbourhood socio-economic status and features of public open spaces (POS) hypothesised to influence children's physical activity. Data were from the first follow-up of the Children Living in Active Neighbourhoods (CLAN) Study, which involved 540 families of 5-6 and 10-12-year-old children in Melbourne, Australia. The Socio-Economic Index for Areas Index (SEIFA) of Relative Socio-economic Advantage/Disadvantage was used to assign a socioeconomic index score to each child's neighbourhood, based on postcode. Participant addresses were geocoded using a Geographic Information System. The Open Space 2002 spatial data set was used to identify all POS within an 800 m radius of each participant's home. The features of each of these POS (1497) were audited. Variability of POS features was examined across quintiles of neighbourhood SEIFA. Compared with POS in lower socioeconomic neighbourhoods, POS in the highest socioeconomic neighbourhoods had more amenities (e.g. picnic tables and drink fountains) and were more likely to have trees that provided shade, a water feature (e.g. pond, creek), walking and cycling paths, lighting, signage regarding dog access and signage restricting other activities. There were no differences across neighbourhoods in the number of playgrounds or the number of recreation facilities (e.g. number of sports catered for on courts and ovals, the presence of other facilities such as athletics tracks, skateboarding facility and swimming pool). This study suggests that POS in high socioeconomic neighbourhoods possess more features that are likely to promote physical activity amongst children.

Aspects of Cultural Landscape Application on Classical Stage Art. Ballet Performance in the Open Space as a Significant Element of the Cultural Landscape

Directory of Open Access Journals (Sweden)

Jelena Lebedeva

2016-04-01

Full Text Available The article examines the applications aspects of cultural landscape for the preparation of the classical performing arts staging. Research findings highlighted that the cultural landscape (parks, estates, castles, bastions, etc. objects occupies an increasingly important role in public recreation and classical art development programs. At the same time it is noted that event’s aesthetic and emotional quality suffers due to the fact that no specific attention was given for the preparation of the event space. More methodological materials are necessary for preparation of this type of design spaces. In Lithuania classical performing arts events in cultural landscape open spaces are based on XVI–XVII century tradition and has good prospects for modern development. A review of some of the classical art events installations, based on the importance of quality of open spaces influence on the emotional impact, that should be an integral part of the cultural event. The author summarizes his experience of ballet events in open spaces in the cultural landscape – Klaipėda, Trakai. Presented is Tchaikovsky's ballet “Swan Lake” construction in Klaipėda John Hill project that includes infrastructure and environmental design concept: audience space, stage design, stage design performance solutions. Analogous key decisions are later adapted to the ballet performance in the natural environment of the lake Trakai. Experience of this project dictated the necessity of deeper understanding and methodological basis for the classical performing arts analysis and design.

Disposable containers as larval habitats for Aedes aegypti in a city with regular refuse collection: a study in Marília, São Paulo State, Brazil.

Science.gov (United States)

Mazine, C A; Macoris, M L; Andrighetti, M T; Yasumaro, S; Silva, M E; Nelson, M J; Winch, P J

1996-09-01

In Marília, Brazil, refuse is collected at least every other day, yet non-useful, non-returnable containers such as cans, plastic bottles and tires account for almost half of the container habitats found positive for the Aedes aegypti mosquito. A study was therefore conducted to investigate why these containers exist despite regular refuse collection and a high level of awareness of dengue prevention, and how the control program could most effectively respond. Differing community perceptions as to what constitutes refuse were found to lead people to store a variety of containers in their yard. Other dimensions of the problem include the presence of informal refuse collectors in search of saleable materials, and dumping of refuse in vacant lots and along roads. An intervention based on these data will involve the informal refuse collectors in implementation of a community-based recycling project.

Risky procedures by nurses in hospitals: problems and (contemplated) refusals of orders by physicians, and views of physicians and nurses

NARCIS (Netherlands)

de Bie, J.; Cuperus-Bosma, J.M.; van der Jagt, M.A.; Gevers, J.K.M.; van der Wal, G.

2005-01-01

Occurrence of problems with, refusals of orders and contemplated refusals of orders for risky procedures by nurses in Dutch hospitals and views on the safety of performance was studied using postal questionnaires (600 physicians and 3200 nurses, response 60-71%). Of the respondents, 11-30%

Higher refusal rates for organ donation among older potential donors in the Netherlands: impact of the donor register and relatives.

NARCIS (Netherlands)

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

2010-01-01

BACKGROUND: The availability of donor organs is considerably reduced by relatives refusing donation after death. There is no previous large-scale evaluation of the influence of the Donor Register (DR) consultation and the potential donor's age on this refusal in The Netherlands. METHODS: This study

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

African Journals Online (AJOL)

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

Refusal of implant supported mandibular overdentures by elderly patients.

Science.gov (United States)

Ellis, Janice S; Levine, Alissa; Bedos, Christophe; Mojon, Phillippe; Rosberger, Zeer; Feine, Jocelyne; Thomason, J Mark

2011-03-01

  The aim of this study was to gain greater in-depth understanding of why elderly patients who are currently dissatisfied with conventional dentures decline implant treatment.   There is strong evidence from high-quality randomised controlled trials to support the use of implant-supported overdentures for the restoration of the edentulous mandible. However, whilst recruiting for randomised clinical trials, researchers have found that a high proportion of potential subjects decline participation, despite the removal of financial constraints.   The study adopted a qualitative approach to provide a rich and deep understanding of people's reasons for refusal. Data were collected through focus group interviews in a two-centre study based in Montreal, Canada and Newcastle, UK. A semi-structured interview schedule was used and iteratively developed as analysis identified themes from previous focus groups. Transcripts of focus groups were coded and emergent themes determined.   Two main themes emerged; patients' fear and anxiety (relating to the pain of surgery, complications of the procedure and immediate post-surgical denture use), and the appropriateness of the procedure in an elderly person.   Fears of pain, complications and social embarrassment, exacerbated by age, are important factors that help explain refusal of implants by elderly patients. © 2010 The Gerodontology Society and John Wiley & Sons A/S.

Belém’s built form and its developments to the formation of a system of open spaces accessible to population

Directory of Open Access Journals (Sweden)

Ana Claudia Duarte Cardoso

2016-07-01

Full Text Available This paper presents a characterization of the built space of Belém highlighting, its estuarine condition, physical geography and its economic, social and spacial development. It is based on Quapá-SEL Workshop conclusions held in Belém, in May 2015, in which teachers and students from São Paulo and Pará Federal Universities assessed the conditions of urban open spaces of the city. The results highlight a disarticulation between real estate agents strategies and of urban management towards structuring an Open Spaces System (SEL in Portuguese, as well as its limited appropriation by the population. There is a remarkable differentiation between the landscapes of central area in opposition / contraposition to that at the city’s expansion area. This debate showed how much permanent preservation areas on the banks of inland rivers and islands (the main green spaces of the city and main linkage with the Amazonian biome, with its landscape potentials, have been unevenly appropriated in the city, through gentrification.

Observations of parent-child co-shoppers in supermarkets: children's involvement in food selections, parental yielding, and refusal strategies.

Science.gov (United States)

O'Dougherty, Maureen; Story, Mary; Stang, Jamie

2006-01-01

The study aimed to collect descriptive information on the decision-making processes of adult shoppers around food purchases when young children are present. Anthropological field observations were conducted on adult-child grocery shoppers. Eleven supermarkets in the Minneapolis-St. Paul metropolitan region. A convenience sample (n = 142) of adult-child shoppers at 8 budget and 3 deluxe supermarkets located in diverse urban and suburban areas. Observations registered adult-child interactions over food selections, including parental yielding or refusal strategies and child engagement in shopping. Means and frequencies were calculated for food items considered. In 67 (50.4%) of the total 133 observations, a child initiated a request. Half (55.2%) of the requests were for sweets or snacks. Nearly half (47.8%) of adults yielded to the child's request. Brands and marketing techniques appeared to be a factor in 28.6% of selections. The most frequent adult refusals either provided an explanation or ignored the request. Adults yield to children's requests for sweets and snacks nearly as often as they refuse them. However, effective refusal strategies are used by many adults. Opportunities exist in the grocery store for adults to reinforce young children's interest in food and nutrition.

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

Science.gov (United States)

Utt, Sandra H.; Pasternack, Steve

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

Open Innovation Drug Discovery (OIDD): a potential path to novel therapeutic chemical space.

Science.gov (United States)

Alvim-Gaston, Maria; Grese, Timothy; Mahoui, Abdelaziz; Palkowitz, Alan D; Pineiro-Nunez, Marta; Watson, Ian

2014-01-01

The continued development of computational and synthetic methods has enabled the enumeration or preparation of a nearly endless universe of chemical structures. Nevertheless, the ability of this chemical universe to deliver small molecules that can both modulate biological targets and have drug-like physicochemical properties continues to be a topic of interest to the pharmaceutical industry and academic researchers alike. The chemical space described by public, commercial, in-house and virtual compound collections has been interrogated by multiple approaches including biochemical, cellular and virtual screening, diversity analysis, and in-silico profiling. However, current drugs and known chemical probes derived from these efforts are contained within a remarkably small volume of the predicted chemical space. Access to more diverse classes of chemical scaffolds that maintain the properties relevant for drug discovery is certainly needed to meet the increasing demands for pharmaceutical innovation. The Lilly Open Innovation Drug Discovery platform (OIDD) was designed to tackle barriers to innovation through the identification of novel molecules active in relevant disease biology models. In this article we will discuss several computational approaches towards describing novel, biologically active, drug-like chemical space and illustrate how the OIDD program may facilitate access to previously untapped molecules that may aid in the search for innovative pharmaceuticals.

Fiscal 2000 report on the development of high-efficiency refuse-fueled power generation technology; Kokoritsu haikibutsu hatsuden gijutsu kaihatsu 2000 nendo hokokusho

Energy Technology Data Exchange (ETDEWEB)

NONE

2001-03-01

Efforts were made to develop a refuse gasification/fusion power generation technology to contribute to the effective utilization of unexploited energy and to reduction in greenhouse gas emissions. Developed in the technology of elevating steam temperature were the evaluation of high-temperature corrosion of SH materials and a high temperature dust removing system, dechlorination technology for the thermolysis process, and a ceramic-made high-temperature air heater. For the avoidance of exhaust gas reheating, development was carried out for a low-temperature denitration unit, stable refuse feeding system for reduction in the self-heat melting critical calorific value, waste plastic injection technology for reduction in the amount of external fuel injection, and so forth. The effect of the developed element technologies were evaluated and a detailed feasibility study was conducted for a refuse gas conversion power generation system using gas engine power generation for minor-scale general waste treatment facilities. In the survey of the trend of refuse-fueled power generation technologies, trend in Japan and advanced refuse-fueled power generation systems and their introduction in Europe and America were investigated. (NEDO)

The People Are Missing: Cramped Space, Social Relations, and the Mediators of Politics

OpenAIRE

Thoburn, Nicholas

2016-01-01

This article investigates the place of social relations in Deleuze and Guattari’s figure of ‘cramped space’, a figure integral to their ‘minor politics’. Against social and political theories that seek the source of political practice in a collective identity, the theory of cramped space contends that politics arises among those who lack and refuse coherent identity, in their encounter with the impasses, limits, or impossibilities of individual and collective subjectivity. Cramped space, as D...

St. Louis demonstration final report: refuse processing plant equipment, facilities, and environmental evaluations

Energy Technology Data Exchange (ETDEWEB)

Fiscus, D.E.; Gorman, P.G.; Schrag, M.P.; Shannon, L.J.

1977-09-01

The results are presented of processing plant evaluations of the St. Louis-Union Electric Refuse Fuel Project, including equipment and facilities as well as assessment of environmental emissions at both the processing and the power plants. Data on plant material flows and operating parameters, plant operating costs, characteristics of plant material flows, and emissions from various processing operations were obtained during a testing program encompassing 53 calendar weeks. Refuse derived fuel (RDF) is the major product (80.6% by weight) of the refuse processing plant, the other being ferrous metal scrap, a marketable by-product. Average operating costs for the entire evaluation period were $8.26/Mg ($7.49/ton). The average overall processing rate for the period was 168 Mg/8-h day (185.5 tons/8-h day) at 31.0 Mg/h (34.2 tons/h). Future plants using an air classification system of the type used at the St. Louis demonstration plant will need an emissions control device for particulates from the large de-entrainment cyclone. Also in the air exhaust from the cyclone were total counts of bacteria and viruses several times higher than those of suburban ambient air. No water effluent or noise exposure problems were encountered, although landfill leachate mixed with ground water could result in contamination, given low dilution rates.

"To My Relations": Writing and Refusal toward an Indigenous Epistolary Methodology

Science.gov (United States)

Cisneros, Nora Alba

2018-01-01

In this article, the author presents an Indigenous Epistolary Methodology (IEM) to reflect on what it means for Indigenous women to engage the notion of refusal in traditional writing methods and qualitative research. The author proposes that an IEM, nestled within her familial genealogies, Indigenous Knowledges and Chicana Feminist Epistemology…

Factors Associated with Participation, Active Refusals and Reasons for Not Taking Part in a Mortality Followback Survey Evaluating End-of-Life Care.

Directory of Open Access Journals (Sweden)

Natalia Calanzani

Full Text Available Examination of factors independently associated with participation in mortality followback surveys is rare, even though these surveys are frequently used to evaluate end-of-life care. We aimed to identify factors associated with 1 participation versus non-participation and 2 provision of an active refusal versus a silent refusal; and systematically examine reasons for refusal in a population-based mortality followback survey.Postal survey about the end-of-life care received by 1516 people who died from cancer (aged ≥18, identified through death registrations in London, England (response rate 39.3%. The informant of death (a relative in 95.3% of cases was contacted 4-10 months after the patient died. We used multivariate logistic regression to identify factors associated with participation/active refusals and content analysis to examine refusal reasons provided by 205 nonparticipants.The odds of partaking were higher for patients aged 90+ (AOR 3.48, 95%CI: 1.52-8.00, ref: 20-49yrs and female informants (AOR 1.70, 95%CI: 1.33-2.16. Odds were lower for hospital deaths (AOR 0.62, 95%CI: 0.46-0.84, ref: home and proxies other than spouses/partners (AORs 0.28 to 0.57. Proxies of patients born overseas were less likely to provide an active refusal (AOR 0.49; 95% CI: 0.32-0.77. Refusal reasons were often multidimensional, most commonly study-related (36.0%, proxy-related and grief-related (25.1% each. One limitation of this analysis is the large number of nonparticipants who did not provide reasons for refusal (715/920.Our survey better reached proxies of older patients while those dying in hospitals were underrepresented. Proxy characteristics played a role, with higher participation from women and spouses/partners. More information is needed about the care received by underrepresented groups. Study design improvements may guide future questionnaire development and help develop strategies to increase response rates.

Factors Associated with Participation, Active Refusals and Reasons for Not Taking Part in a Mortality Followback Survey Evaluating End-of-Life Care

Science.gov (United States)

Calanzani, Natalia; Higginson, Irene J; Koffman, Jonathan; Gomes, Barbara

2016-01-01

Background Examination of factors independently associated with participation in mortality followback surveys is rare, even though these surveys are frequently used to evaluate end-of-life care. We aimed to identify factors associated with 1) participation versus non-participation and 2) provision of an active refusal versus a silent refusal; and systematically examine reasons for refusal in a population-based mortality followback survey. Methods Postal survey about the end-of-life care received by 1516 people who died from cancer (aged ≥18), identified through death registrations in London, England (response rate 39.3%). The informant of death (a relative in 95.3% of cases) was contacted 4–10 months after the patient died. We used multivariate logistic regression to identify factors associated with participation/active refusals and content analysis to examine refusal reasons provided by 205 nonparticipants. Findings The odds of partaking were higher for patients aged 90+ (AOR 3.48, 95%CI: 1.52–8.00, ref: 20–49yrs) and female informants (AOR 1.70, 95%CI: 1.33–2.16). Odds were lower for hospital deaths (AOR 0.62, 95%CI: 0.46–0.84, ref: home) and proxies other than spouses/partners (AORs 0.28 to 0.57). Proxies of patients born overseas were less likely to provide an active refusal (AOR 0.49; 95% CI: 0.32–0.77). Refusal reasons were often multidimensional, most commonly study-related (36.0%), proxy-related and grief-related (25.1% each). One limitation of this analysis is the large number of nonparticipants who did not provide reasons for refusal (715/920). Conclusions Our survey better reached proxies of older patients while those dying in hospitals were underrepresented. Proxy characteristics played a role, with higher participation from women and spouses/partners. More information is needed about the care received by underrepresented groups. Study design improvements may guide future questionnaire development and help develop strategies to increase

Do pharmacists have a right to refuse to fill prescriptions for abortifacient drugs?

Science.gov (United States)

Weinstein, B D

1992-01-01

Some pharmacists opposed to abortion on moral ground are concerned by having to fill prescriptions for abortifacient drugs like mifepristone (RU-486). The issue of the right of pharmacists to refuse to fill such prescriptions depends on the model of the physician-pharmacist-patient relationship. The libertarian model of pharmacy practice holds that physicians, pharmacists, and patients are bound only by the contract that they freely negotiate with one another, thus the pharmacist has no moral obligation to fill a prescription for mifepristone unless he or she has expressly contracted to do so. The American Pharmaceutical Association's 1981 Code of Ethics does not specify what a pharmacist ought to do in particular circumstances. The right to refuse is strongly supported by the principles of nonmaleficence and respect for autonomy. These are principles of the libertarian model of the pharmacist-patient relationship but are also present in the guild or societal models stressing the duty to avoid harming others. Justification for pharmacists right of refusal appeals to their autonomy rights as members of the moral community rather than the profession of pharmacy. Since the professional right to autonomy is not absolute, moral consideration circumscribe it: it is difficult to argue that a pharmacist who believes that homosexuality is immoral has the right to refuse to fill a prescription for AZT. Even if a person who presents such a prescription is homosexual there is no causal relationship between filling a prescription for AZT and participating in a homosexual act. At the opposite end the libertarians reject the notion of even a basic right to health care. A woman in the above situation would not have a right to the abortifacient drug, so a pharmacist has no duty to dispense it. According to the technician model of professionalism, the pharmacist's personal values do not matter, so a pharmacist has a duty to provide the service.

30 CFR 780.25 - Reclamation plan: Siltation structures, impoundments, and refuse piles.

Science.gov (United States)

2010-07-01

... is capable of being done after consideration of cost, logistics, and available technology. The fact... COAL EXPLORATION SYSTEMS UNDER REGULATORY PROGRAMS SURFACE MINING PERMIT APPLICATIONS-MINIMUM..., and refuse piles. (a) General. Each application must include a general plan and a detailed design plan...

30 CFR 784.16 - Reclamation plan: Siltation structures, impoundments, and refuse piles.

Science.gov (United States)

2010-07-01

... of being done after consideration of cost, logistics, and available technology. The fact that one... COAL EXPLORATION SYSTEMS UNDER REGULATORY PROGRAMS UNDERGROUND MINING PERMIT APPLICATIONS-MINIMUM..., and refuse piles. (a) General. Each application must include a general plan and a detailed design plan...

OpenSubspace

DEFF Research Database (Denmark)

Müller, Emmanuel; Assent, Ira; Günnemann, Stephan

2009-01-01

Subspace clustering and projected clustering are recent research areas for clustering in high dimensional spaces. As the field is rather young, there is a lack of comparative studies on the advantages and disadvantages of the different algorithms. Part of the underlying problem is the lack...... of available open source implementations that could be used by researchers to understand, compare, and extend subspace and projected clustering algorithms. In this paper, we discuss the requirements for open source evaluation software. We propose OpenSubspace, an open source framework that meets...... these requirements. OpenSubspace integrates state-of-the-art performance measures and visualization techniques to foster research in subspace and projected clustering....

At the Intersection of Faith, Culture, and Family Dynamics: A Complex Case of Refusal of Treatment for Childhood Cancer.

Science.gov (United States)

Brown, Amy E Caruso

2017-01-01

Refusing treatment for potentially curable childhood cancers engenders much discussion and debate. I present a case in which the competent parents of a young Amish child with acute myeloid leukemia deferred authority for decision making to the child's maternal grandfather, who was vocal in his opposition to treatment. I analyze three related concerns that distinguish this case from other accounts of refused treatment. First, I place deference to grandparents as decision makers in the context of surrogate decision making more generally. Second, the maternal grandfather's ardent refusal of treatment and his rationale appeared to be inconsistent with the beliefs expressed by other family members and by members of the same Amish community, leading members of the medical team to question whether refusal of treatment should be treated differently when it appears to be based on the idiosyncratic beliefs of an individual rather than on community-wide values. Third, the medical team perceived tension and dissension between the nonverbal behavior of some family members and the verbal statements made by the maternal grandfather, leading the team to question the parents' true wishes and debate how to weigh nonverbal and indirect forms of communication. Finally, building upon the conclusions of these queries, I explore whether, if the child's prognosis was less favorable or if he were to relapse later, the maternal grandfather should have been permitted to drive a decision to refuse further treatment. Copyright 2017 The Journal of Clinical Ethics. All rights reserved.

Exploring the relationship between postmigratory stressors and mental health for asylum seekers and refused asylum seekers in the UK.

Science.gov (United States)

Morgan, Gareth; Melluish, Steve; Welham, Alice

2017-01-01

Numerous studies have linked the high rates of traumatic events experienced by refugees to the elevated rate of mental health problems in these populations. A growing body of evidence has also highlighted the importance of considering postmigratory stressors when making sense of displaced person distress. This study explored the relationship between mental health and postmigratory stress for asylum seekers and refused asylum seekers in Britain. The study further examined if those refused asylum experienced elevated distress and postmigratory stress compared to those awaiting the outcome of asylum applications. Results indicated that participants ( N = 97) had endured a range of pre- and postmigratory stressors and had high scores on measures of anxiety, depression, and PTSD. A postmigratory factor comprising items associated with isolation, restrictive policies, and stressors associated with having an insecure immigration status, was significantly associated with PTSD scores. This relationship remained when controlling for the variance accounted for by premigratory trauma predictors. Being refused asylum was the strongest predictor of depression and anxiety. Those refused asylum scored higher on a factor associated with barriers to accessing services. Social materialist theories of distress are drawn upon to contextualise the heightened vulnerability of those refused asylum. The paper concludes by emphasising the problems associated with taking an exclusively trauma-focussed approach when working with asylum seekers and argues for community orientated interventions to support displaced people to cope with the various stressors endured in exile.

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

Science.gov (United States)

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

2017-11-01

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

[Granted, undecided, withdrawn and refused requests for euthanasia and physician-assisted suicide in the Netherlands; 2000-2002].

Science.gov (United States)

Onwuteaka-Philipsen, B D; Jansen-Van der Weide, M C; Van der Wal, G

2006-02-04

To determine the characteristics of patients who request euthanasia or physician-assisted suicide and whether these characteristics differ among those whose request is granted, those who die before the procedure, those who die before completion of the approval process, those who withdraw their request, and lastly, those whose request is refused by the physician. Questionnaire study. All general practitioners in 18 of the 23 Dutch general practitioner districts received a written questionnaire in which they were asked to describe the most recent request for euthanasia or physician-assisted suicide that they had received (response 60%, n=3614). Of all explicit requests, 44% resulted in euthanasia or physician-assisted suicide. Thirteen percent of patients died before the procedure, 13% died before completion of the approval process, 13% withdrew their request and 12% were refused by the physician. The most prominent symptoms were 'feeling bad', 'tiredness', and 'lack of appetite'. The most frequently mentioned reasons for requesting euthanasia or physician-assisted suicide were 'pointless suffering', 'loss of dignity', and 'general weakness'. The patients' situation met the official requirements for accepted practice best in the group of requests that resulted in euthanasia or physician-assisted suicide and least in the group of refused requests. A lesser degree of competence and less unbearable and hopeless suffering had the strongest associations with the refusal of a request. The complexity of euthanasia or physician-assisted suicide decision-making is reflected in the fact that, besides granting and refusing a request, 3 other situations could be distinguished. The decisions physicians made, the reasons for their decisions and the way they arrived at their decisions appeared to be based on patient evaluations and on the official requirements for accepted practice.

Wastes disposal on board a ship. Crushing and volume reducing apparatus for combustible and non-combustible refuses; Senjo no haikibutsu shori. Kanen funen gomi no hasai gen`yo shori sochi

Energy Technology Data Exchange (ETDEWEB)

Kishida, Y. [Hitachi Zosen Corp., Osaka (Japan)

1996-07-25

This paper introduces a refuse crushing apparatus to reduce for storage the volume of refuses produced on board a ship by crushing. Refuses to be crushed are solid wastes including solid combustible refuses such as paper, wood pieces, and cloths, non-combustible refuses such as empty cans, metals and glass, and refuses unsuitable for combustion, such as plastics and stylofoam. Crushing methods include impact system, compression system and shearing system. The shearing system shears and crushes refuses by using blades rotating at a low speed. The system has a wide range of crush ability and excellent versatility, generates low levels of dust, noise and vibration, and is suitable as a marine use refuse disposing apparatus. However, empty cans and PET bottles are more difficult of getting into cutting blades requiring a large amount of time for crushing. Therefore, it is more suitable to reduce volume of refuses by using a compressor or the like apparatuses, and then crush them by using a double-axial shearing crusher. Stylofoam causes its crushed pieces to be electrically charged and deposited onto the apparatus, hence it is more suitable to reduce the volume of refuses and make them brittle by heating, and then crush them by using the double-axial crusher. 2 figs.

Overcoming healthcare workers vaccine refusal--competition between egoism and altruism.

Science.gov (United States)

Betsch, C

2014-12-04

Vaccination reduces the risk of becoming infected with and transmitting pathogens. The role of healthcare workers (HCWs) in controlling and limiting nosocomial infections has been stressed repeatedly. This has also been recognised at a political level, leading the European Council of Ministers in 2009 to encourage coverage of 75% seasonal influenza vaccine in HCWs. Although there are policies, recommendations and well-tolerated vaccines, still many HCWs refuse to get vaccinated. This article uses literature from psychology and behavioural economics to understand vaccination decisions and the specific situation of HCWs. HCWs are expected to be highly motivated to protect others. However, their individual vaccination decisions follow the same principles (of weighting individual risks) as everyone else’s vaccination decisions. This will lead to decisional conflict in a typical social dilemma situation, in which individual interests are at odds with collective interests. Failure to get vaccinated may be the result. If we understand the motivations and mechanisms of HCWs’ vaccine refusal, interventions and campaigns may be designed more effectively. Strategies to increase HCWs’ vaccine uptake should be directed towards correcting skewed risk perceptions and activating pro-social motivation in HCWs.

Monte Carlo simulation of second-generation open-type PET ''single-ring OpenPET'' implemented with DOI detectors

International Nuclear Information System (INIS)

Tashima, Hideaki; Yamaya, Taiga; Hirano, Yoshiyuki; Yoshida, Eiji; Kinouch, Shoko; Watanabe, Mitsuo; Tanaka, Eiichi

2013-01-01

At the National Institute of Radiological Sciences, we are developing OpenPET, an open-type positron emission tomography (PET) geometry with a physically open space, which allows easy access to the patient during PET studies. Our first-generation OpenPET system, dual-ring OpenPET, which consisted of two detector rings, could provide an extended axial field of view (FOV) including the open space. However, for applications such as in-beam PET to monitor the dose distribution in situ during particle therapy, higher sensitivity concentrated on the irradiation field is required rather than a wide FOV. In this report, we propose a second-generation OpenPET geometry, single-ring OpenPET, which can efficiently improve sensitivity while providing the required open space. When the proposed geometry was realized with block detectors, position-dependent degradation of the spatial resolution was expected because it was necessary to arrange the detector blocks in ellipsoidal rings stacked and shifted relative to one another. However, we found by Monte Carlo simulation that the use of depth-of-interaction (DOI) detectors made it feasible to achieve uniform spatial resolution in the FOV. (author)

Influence of Music on the Behaviors of Crowd in Urban Open Public Spaces.

Science.gov (United States)

Meng, Qi; Zhao, Tingting; Kang, Jian

2018-01-01

Sound environment plays an important role in urban open spaces, yet studies on the effects of perception of the sound environment on crowd behaviors have been limited. The aim of this study, therefore, is to explore how music, which is considered an important soundscape element, affects crowd behaviors in urban open spaces. On-site observations were performed at a 100 m × 70 m urban leisure square in Harbin, China. Typical music was used to study the effects of perception of the sound environment on crowd behaviors; then, these behaviors were classified into movement (passing by and walking around) and non-movement behaviors (sitting). The results show that the path of passing by in an urban leisure square with music was more centralized than without music. Without music, 8.3% of people passing by walked near the edge of the square, whereas with music, this percentage was zero. In terms of the speed of passing by behavior, no significant difference was observed with the presence or absence of background music. Regarding the effect of music on walking around behavior in the square, the mean area and perimeter when background music was played were smaller than without background music. The mean speed of those exhibiting walking around behavior with background music in the square was 0.296 m/s slower than when no background music was played. For those exhibiting sitting behavior, when background music was not present, crowd density showed no variation based on the distance from the sound source. When music was present, it was observed that as the distance from the sound source increased, crowd density of those sitting behavior decreased accordingly.

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

Science.gov (United States)

Chavkin, Wendy; Leitman, Liddy; Polin, Kate

2013-12-01

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

Using OpenTarget to Generate Potential Countermeasures for Long-Term Space Exposure from Data Available on GeneLab

Science.gov (United States)

Beheshti, Afshin

2018-01-01

GeneLab as a general tool for the scientific community; Utilizing GeneLab datasets to generate hypothesis and determining potential biological targets against health risks due to long-term space missions; How can OpenTarget be used to discover novel drugs to test as countermeasures that can be utilized by astronauts.

The role of positive/negative outcome expectancy and refusal self-efficacy of Internet use on Internet addiction among college students in Taiwan.

Science.gov (United States)

Lin, Min-Pei; Ko, Huei-Chen; Wu, Jo Yung-Wei

2008-08-01

Based on Bandura's social cognitive theory, this study was designed to examine positive and negative outcome expectancy and refusal self-efficacy of Internet use and their contribution to Internet addiction among college students by using hierarchical multiple regression analyses in a cross-sectional study design. Schools were first stratified into technical or nontechnical colleges and then into seven majors. A cluster random sampling by department was further applied to randomly choose participants from each major. A representative sample of 4,456 college students participated in this study. The Outcome Expectancy and Refusal Self-Efficacy of Internet Use Questionnaire and the Chen Internet Addiction Scale were used to assess the cognitive factors and the levels of Internet addiction. Results showed that both positive outcome expectancy and negative outcome expectancy were significantly and positively correlated with Internet addiction, and refusal self-efficacy of Internet use was significantly and negatively related to Internet addiction. Further analyses revealed that refusal self-efficacy of Internet use directly and negatively predicted Internet addiction. Moreover, we discovered that positive outcome expectancy positively predicted Internet addiction via refusal self-efficacy of Internet use; however, surprisingly, negative outcome expectancy had both a direct and indirect positive relationship in predicting Internet addiction via the refusal self-efficacy of Internet use. These results give empirical evidence to verify the theoretical effectiveness of the three cognitive factors to Internet addiction and should be incorporated when designing prevention programs and strategies for Internet addicted college students.

When a Wife Says "No": Wife Sexual Refusal as a Factor in Husband-Wife Homicides in Ghana.

Science.gov (United States)

Adinkrah, Mensah

2017-11-01

In Ghana, wife sexual refusal is a key factor in uxoricides or husband-to-wife murders. Despite this, there is a dearth of systematic research that examines sexual strife as a precipitant of domestic violence and spousal murder. The present article addresses the current lack of research by systematically examining 25 cases of homicides and attempted homicides where wives were lethally and nonlethally assaulted by their husbands following the former's refusal to engage in husband-initiated sexual intercourse. A content analysis was conducted of all print and electronic media news items where a wife's refusal of sexual intercourse with a husband triggered lethal or aggravated violence. The results showed that the victims were aged 23 to 55 years old and were generally of low socioeconomic status. The assailants were aged 28 to 60 years old. Assailants used machetes, knives, and personal weapons to perpetrate the crimes, and extreme violence was a frequent feature of both lethal and nonlethal acts.

A Virtual Reality Curriculum for Pediatric Residents Decreases Rates of Influenza Vaccine Refusal.

Science.gov (United States)

Real, Francis J; DeBlasio, Dominick; Beck, Andrew F; Ollberding, Nicholas J; Davis, David; Cruse, Bradley; Samaan, Zeina; McLinden, Daniel; Klein, Melissa D

Influenza vaccine hesitancy is common in the primary care setting. Though physicians can affect caregivers' attitudes toward vaccination, physicians report uneasiness discussing vaccine hesitancy. Few studies have targeted physician-patient communication training as a means to decrease vaccination refusal. An immersive virtual reality (VR) curriculum was created to teach pediatric residents communication skills when discussing influenza vaccine hesitancy. This pilot curriculum consisted of 3 VR simulations during which residents counseled graphical character representatives (avatars) who expressed vaccine hesitancy. Participants were randomized to the intervention (n = 24) or control (n = 21) group. Only residents in the intervention group underwent the VR curriculum. Impact of the curriculum was assessed through difference in influenza vaccine refusal rates between the intervention and control groups in the 3 months after the VR curriculum. Participants included postgraduate level (PL) 2 and PL3 pediatric residents. All eligible residents (n = 45) participated; the survey response rate was 100%. In patients aged 6 to 59 months, residents in the intervention group had a decreased rate of influenza vaccination refusal in the postcurriculum period compared to the control group (27.8% vs 37.1%; P = .03). Immersive VR may be an effective modality to teach communication skills to medical trainees. Next steps include evaluation of the curriculum in a larger, multisite trial. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Thermal Comfort Assessment in The Open Space in Bandung Case Study Dago Street and Riau Street

Science.gov (United States)

Sugangga, M.; Janesonia, K. I.; Illiyin, D. F.; Donny Koerniawan, M.

2018-05-01

Bandung’s temperature has been higher since last years. This phenomenon affects the level of thermal comfort in open space. One indicator that determines the thermal comfort level is the type of activity performed by the open space user. Riau Street and Dago Street are corridors that are often used by the people for strolling, jogging, shopping. Dago Street has special event every Sunday namely car free day. Both corridors have different orientation; Dago Street is North to South corridor while Riau Street’s is West to East. The goal of the study is to compare people’s perception of thermal comfort in both corridors. This research uses two methods, namely qualitative method and quantitative method. Based on the results of qualitative analysis found that the thermal conditions in Dago Street more comfortable than the Riau Street. The result of quantitative analysis found that the average PET (thermal comfort indices) value of Dago Street was at 27.5 °C PET and Riau Street 28.6 °C PET. Dago Street is considered more convenient because it has a lower PET value than Riau Street. The people perception of thermal comfort is very important to start the steps for designing the orientation of street in urban design.

CO-COMBUSTION OF REFUSE DERIVED FUEL WITH COAL IN A FLUIDISED BED COMBUSTOR

Directory of Open Access Journals (Sweden)

W. A. WAN AB KARIM GHANI

2009-03-01

Full Text Available Power generation from biomass is an attractive technology which utilizes municipal solid waste-based refused derived fuel. In order to explain the behavior of biomass-fired fluidized bed incinerator, biomass sources from refuse derived fuel was co-fired with coal in a 0.15 m diameter and 2.3 m high fluidized bed combustor. The combustion efficiency and carbon monoxide emissions were studied and compared with those from pure coal combustion. This study proved that the blending effect had increased the carbon combustion efficiency up to 12% as compared to single MSW-based RDF. Carbon monoxide levels fluctuated between 200-1600 ppm were observed when coal is added. It is evident from this research that efficient co-firing of biomass with coal can be achieved with minimum modification of existing coal-fired boilers.

Graduated Exposure and Compliance Training Intervention for Blood Draw Avoidance and Refusal in a Woman with Intellectual Disability and Schizoaffective Disorder

Science.gov (United States)

Cromartie, R. Samuel; Flood, William A.; Luiselli, James K.

2014-01-01

This case report concerns a woman with intellectual disability, schizoaffective disorder, and avoidance and refusal of having her blood drawn. She required but refused blood draws to properly monitor the therapeutic dose of a necessary psychotropic medication. During intervention at a community-based habilitation setting and under simulated…

Finding industrial space

DEFF Research Database (Denmark)

Riesto, Svava

2011-01-01

Spaces marked by industrial rationalities are easily overseen or rejected without further consideration during urban redevelopment processes. This is striking in an era where urban space is often seen as a cornerstone for the future city. This article investigates different concepts of open space...... that have been operative in the redevelopment of the so-called Carlsberg Square in Copenhagen between 2006-2009. It concludes with general remarcs on dealing with the complex matter open space in the practices of design and heritage management in urban redevelopment processes....

Parent Refusal of Topical Fluoride for Their Children: Clinical Strategies and Future Research Priorities to Improve Evidence-Based Pediatric Dental Practice.

Science.gov (United States)

Chi, Donald L

2017-07-01

A growing number of parents are refusing topical fluoride for their children during preventive dental and medical visits. This nascent clinical and public health problem warrants attention from dental professionals and the scientific community. Clinical and community-based strategies are available to improve fluoride-related communications with parents and the public. In terms of future research priorities, there is a need to develop screening tools to identify parents who are likely to refuse topical fluoride and diagnostic instruments to uncover the reasons for topical fluoride refusal. This knowledge will lead to evidence-based strategies that can be widely disseminated into clinical practice. Copyright © 2017 Elsevier Inc. All rights reserved.

The impact of a multiple intelligences teaching approach drug education programme on drug refusal skills of Nigerian pupils.

Science.gov (United States)

Nwagu, Evelyn N; Ezedum, Chuks E; Nwagu, Eric K N

2015-09-01

The rising incidence of drug abuse among youths in Nigeria is a source of concern for health educators. This study was carried out on primary six pupils to determine the effect of a Multiple Intelligences Teaching Approach Drug Education Programme (MITA-DEP) on pupils' acquisition of drug refusal skills. A programme of drug education based on the Multiple Intelligences Teaching Approach (MITA) was developed. An experimental group was taught using this programme while a control group was taught using the same programme but developed based on the Traditional Teaching Approach. Pupils taught with the MITA acquired more drug refusal skills than those taught with the Traditional Teaching Approach. Urban pupils taught with the MITA acquired more skills than rural pupils. There was no statistically significant difference in the mean refusal skills of male and female pupils taught with the MITA. © The Author(s) 2014.

Bioaerosol exposure during refuse collection: results of field studies in the real-life situation.

Science.gov (United States)

Neumann, H D; Balfanz, J; Becker, G; Lohmeyer, M; Mathys, W; Raulf-Heimsoth, M

2002-07-03

To determine the bioaerosol exposure of refuse collectors, field measurements were performed under real working conditions within the framework of a research project. Influencing variables such as different types of refuse, community structure, collection interval and season were taken into account. Overall, 1612 samples were taken in towns of Westfalia, Germany. With workplace levels on a scale of 10(3) to less than 10(4) CFU/m3 for the loader, the results show a surprisingly low total fungi concentration in comparison with earlier studies. Total bacteria concentrations, in contrast, were largely on a scale of 10(4) CFU/m3, with 10(5) CFU/m3 being registered sporadically, especially in apartment-block districts. Endotoxin levels were high especially in the summer months, occasionally reaching values of more than 50 EU/m3, whereas they were normally below 10 EU/m3 in autumn and winter. Inside the cab, the exposure level for the entire spectrum was at least one power of ten lower. The factors believed to account primarily for the low total fungi concentration were workplace hygiene, the prevailing 1-week collection interval, and the low in-process exposure time resulting from the effective deployment of automatic lifting devices. In contrast, the type of refuse was not found to have a significant influence.

Psychosocial Interventions for School Refusal with Primary and Secondary School Students: A Systematic Review

Directory of Open Access Journals (Sweden)

Brandy Maynard

2015-05-01

Full Text Available BACKGROUND School refusal is a psychosocial problem characterized by a student’s difficulty attending school and, in many cases, substantial absence from school (Heyne & Sauter, 2013. It is often distinguished from truancy, in part because of the severe emotional distress associated with having to attend school and the absence of severe antisocial behavior. Truancy, on the other hand, is not typically associated with emotional distress and is commonly associated with severe externalizing behavior. The emotional distress associated with school refusal is often in the form of fear or anxiety, and sometimes in the form of depression. School refusal occurs for about 1-2% of young people, and estimates among clinically referred youth are considerably higher. There is substantial heterogeneity in both the presentation of school refusal and its associated risk factors. Significant adverse consequences may occur in the short- and long-term, including school dropout and problems with social adjustment. Family members and school staff are also affected by school refusal. The most commonly studied interventions for school refusal are behavioral approaches and cognitive-behavioral therapy (CBT. The overarching aim of these interventions is the reduction of the young person’s emotional distress and an increase in school attendance to help the young person follow a normal developmental pathway (Heyne & Sauter, 2013. Behavioral interventions include exposure-based interventions, relaxation training, and/or social skills training with the student, and contingency management procedures with the parents and school staff. CBT manuals additionally focus attention on the identification and modification of maladaptive cognition that may maintain the young person’s emotional distress and absenteeism. In some instances parent cognition is also targeted. Other interventions have been used to treat school refusal (e.g., psychodynamic treatment, family therapy

Topology of actions and homogeneous spaces

International Nuclear Information System (INIS)

Kozlov, Konstantin L

2013-01-01

Topologization of a group of homeomorphisms and its action provide additional possibilities for studying the topological space, the group of homeomorphisms, and their interconnections. The subject of the paper is the use of the property of d-openness of an action (introduced by Ancel under the name of weak micro-transitivity) in the study of spaces with various forms of homogeneity. It is proved that a d-open action of a Čech-complete group is open. A characterization of Polish SLH spaces using d-openness is given, and it is established that any separable metrizable SLH space has an SLH completion that is a Polish space. Furthermore, the completion is realized in coordination with the completion of the acting group with respect to the two-sided uniformity. A sufficient condition is given for extension of a d-open action to the completion of the space with respect to the maximal equiuniformity with preservation of d-openness. A result of van Mill is generalized, namely, it is proved that any homogeneous CDH metrizable compactum is the only G-compactification of the space of rational numbers for the action of some Polish group. Bibliography: 39 titles.

Models of anxiety: responses of mice to novelty and open spaces in a 3D maze.

Science.gov (United States)

Ennaceur, A; Michalikova, S; van Rensburg, R; Chazot, P L

2006-11-01

The present report describes the emotional responses of different strains of mice to exposure to a novel open space model of anxiety using a 3D spatial navigation task. The 3D maze is modification of the radial maze with flexible arms that can be raised above or lowered below the horizontal level of a central platform. To access the arms animals need to cross a bridge linking the arms to the central platform. In this model, mice are exposed to novelty in an unfamiliar open space setting with no safe alternative. Fear from novelty is compounded with the need to explore. The drive to escape and the drive to approach are intermingled making this open space model radically different from the current models of anxiety which provide animals with the choice between safe and anxiogenic spaces. In a series of experiments, we examined the behaviour of different groups of mice from C57, C3H, CD1 and Balb/c strains. In the first experiment, different groups of C57 mice were tested in one of the three arms configurations. In the second experiment, C57 mice were compared to C3H mice. In the third experiment, C57 mice were compared to CD1 and Balb/c mice in the raised arm configuration over three successive sessions. In the fourth experiment, we examined the behaviour of C57 mice in the lowered arm configuration with an open and an enclosed central. In the final experiment, we examined the difference between C57 and C3H mice of both genders. Using several spatio-temporal parameters of the transition responses between central platform, bridges and arms, we have been able to show consistent results demonstrating significant differences between C57 and C3H mice, and between Balb/c and both C57 and CD1 mice. C3H appear more anxious than C57 mice, and Balb/c mice seem more anxious than C57 and CD1 mice. We also observed significant differences between sexes in C3H mice but not in C57 mice. C3H male mice appear more anxious than C3H female mice and than both C57 male and female mice

The use of coal refuse bike substratoun in cultivate techniques without soils; Utilizacion de los Esteriles de Carbon como Sustratos en Cultivos sin Suelo 2 Fase

Energy Technology Data Exchange (ETDEWEB)

NONE

1999-11-01

Coal refuse poses several problems as regards both their storage and environmental impact: landscape alteration, pollution, high costs, an increasing difficulty in finding appropriate places for storage, etc. Therefore, the companies HUMOSA, HORPLASA and the C. S. I. C. Centre for Environmental Sciences carried out a joint study financed by OCICARBON. This study, completing other ones carried out previously, was aimed at determining the use as both a soilless medium for growing other vegetables than tomatoes and a basic component for container gardening. Then, based on previous experiments, two types of coal refuse were selected: coal refuse from dumps and burnt coal refuse. The characterization of the coal refuse was carried out and the investigation-line was established: (I) the adaption of techniques and know-how obtained up to that moment to the production of kidney beans faba de la granja, green beans and pepper; (II) to study the possibilities of coal refuse as basic components of substrates for container gardening of decorative outdoor plants different from the already investigated conifers in order examine thoroughly the cultivation techniques and, in particular, the methods of fertilization by irrigation. Exhaustive controls were carried out with both types of cultivation using as reference other cultivations with conventional substrates. The results obtained proved that coal refuse can be used as soilles growing medium for vegetables and for container gardening of decorative plants.

Mothers' reasons for refusing to give consent to HIV testing and the ...

African Journals Online (AJOL)

under-five mortality rate by more than half since 1990. ... children in sub-Saharan Africa. ... In Limpopo Province, South Africa, the prevention of mother-to-child ... had attended antenatal care, 28 (93%) stated that their HIV results were negative ... (16%) mothers signed refusal of hospital treatment, three (12%) started ARV ...

ÁREAS VERDES URBANAS, ESPAÇOS LIVRES PARA O LAZER / Urban green areas, open spaces for leisure

Directory of Open Access Journals (Sweden)

Kátia MAZZEI Mazzei

2007-06-01

Full Text Available The creation and the management of Conservation Units in urban areas, as in the category ofintegral protection as of sustainable use, aims to improve the quality of life of the urban citizenat the same time that it promotes an improvement in the urban environment quality, endowingthe urban space with vegetal covering and fundamental green areas to the reproduction of thenatural cycle and maintenance of the dynamic balance. In the urban environment, the differentcategories of open spaces and the indexes of green area per inhabitant intend to offer optionsto the leisure and recreation activities, besides of characterizing as strategic instruments forthe municipal planning, integrating the characteristics and the limits of the environment to theurban expansion.

The use of town refuse ash in urban agriculture around Jos, Nigeria: health and environmental risks.

Science.gov (United States)

Pasquini, M W

2006-01-15

This paper reports on a study that examines the health and environmental risks of using town refuse ash in urban vegetable production in Jos, Nigeria, in terms of heavy metal accumulation in the food chain. Soil and crop samples, collected from five study farms, and samples of the river water used for irrigation, were analysed for seven heavy metals Fe, Mn, Zn, Cu, Ni, Cd and Pb. On the basis of the field data the paper discusses: (1) the potential soil deficiencies and toxicities; (2) the probable links between soil heavy metal levels and fertilisation practices; (3) the heavy metal concentrations in crop tissue in relation to crop growth and human health. The findings suggest that soil concentrations of the seven metals fall within 'typical' soil levels, and that there should not be any problems of either toxicities or deficiencies for crop growth. There was evidence of slight accumulation of Zn, Cu and Cd on some of the farms with a history of town refuse ash use. However, in all farms lettuce crops contained very large concentrations of Fe, and Pb concentrations that were 20 to 40 times higher than the WHO/FAO maximum recommended level in leafy vegetables for human consumption. The Cd content of carrot tissue was 10 times higher than the WHO/FAO recommended limit. The relatively small number of soil and crop samples precluded any formal attempt at correlating the concentrations of heavy metals found in the vegetable crops with the farm levels. Nevertheless, the data suggested that these were not linked. The paper goes on to consider various potential sources of the metals found in the crops, including irrigation water, town refuse ash and air-borne dust, and discusses additional health and environmental risks pertaining to the use of town refuse ash. Undoubtedly, the heavy Pb and Cd contamination of certain crops indicates the urgent need for future studies to ascertain the precise source of these metals, and although the practice of using town refuse ash does

Abandoned coal mine refuse areas: their reclamation and use

Energy Technology Data Exchange (ETDEWEB)

Zellmer, S. D.; Carter, R. P.

1977-01-01

There are over 4,000 abandoned deep coal mine refuse areas in Illinois ranging in size from a few acres to as large as 160 acres. These sites produce quantities of pollutants which affect the environment, have no real land value, and are a scar on the landscape. The Staunton 1 Site Reclamation Demonstration Project addressess these problems. It also is developing and evaluating new cost-effective methods for reclaiming refuse areas of this type. The program involved determining the final land use for the site, development of detailed engineering plans and specifications for the reclamation effort, a prereclamation environmental inventory, and implementation. Post-construction evaluation is now in process to determine the effectiveness of the reclamation effort. Detailed investigations are being conducted to determine surface water quality improvement, the amount of suitable surface cover and amendments required for revegetation, and field evaluation of candidate vegetation species for revegetation. Other research is examining soil microbial populations, soil fauna reactions, and changes in surface material characteristics at the reclamation site. Surveys are being conducted on groundwater quality, effects on the aquatic ecosystem, and wildlife use of the area. An economic evaluation is underway to determine the cost effectiveness of the total effort and of individual reclamation procedures. Preliminary results from the first year's environmental evaluation of various method tested will be described in detail. An economic assessment, including cost effectiveness, of the first year's work is given.

The stigma of "mental" illness: end stage anorexia and treatment refusal.

Science.gov (United States)

Campbell, Amy T; Aulisio, Mark P

2012-07-01

To answer the questions of whether psychiatric patients should ever be allowed to refuse life-sustaining treatment in favor of comfort care for a condition that is caused by a psychiatric disorder, and if so, under what conditions. Case discussion and normative ethical and legal analysis. We argue that psychiatric patients should sometimes be allowed to refuse life-sustaining treatment in favor of comfort care for a condition that is caused by that psychiatric disorder and articulate the core considerations that should be taken into account when such a case arises. We also suggest that unwillingness among many, especially mental health professionals, to consider seriously both of these questions risks perpetuating stigmatization of persons with psychiatric disorders, i.e., that the "mentally" ill should not be allowed to make significant decisions for themselves-a-a stigmatization that can result in persons with mental disorders both being prevented from exercising autonomous choice even when they are capable of it, and being denied good comfort care at the end of life--care which would be offered to patients with similarly life-threatening conditions that were not deemed to be the result of "mental" illness. Copyright © 2012 Wiley Periodicals, Inc.

Impact of Location of the Central Activities on Development of Open Public Space in the City Centers of Small Cities

Directory of Open Access Journals (Sweden)

Volgemut, Mateja

2016-10-01

Full Text Available Urban areas of the central activities with mixed land use are crucial for the development of city center, even in small cities. In the last decades or two the attention is drawn on the retail and service activities that are usually located outside of cities near main roads. Municipalities had already detected this problem, but they are not implementing any of the measures (Rebernik, 2010. The purpose of this paper is to demonstrate that the central activities in small cities in Slovenia are located in freestanding buildings, which is most appropriate in terms of forming the open public space in the city center. In this research we compared ten central activities (Vrišer, 1988, 1990, Kokole, 1971 in 34 small cities. We selected only those small cities (Prosen et al, 2008 which have among other activities a county court. The results showed the differences and commonalities of the central activities in selected small cities according to the indicators. Litija, Domžale and Sevnica are small cities, where activities that could articulate open public space are located in the larger building complexes. The phenomenon is similar to a modern machine, where action in it and indirectly the insight into the functioning of the society is invisible to the observer (Kos, 2008. We found out that in these tree cities the central activities are not forming the open public spaces in front of the public buildings (Vertelj Nared, 2014. The result is problematic image of the city and changed forces of the city life.

Comment on 'Relation between space charge limited current and power loss in open drift tubes' [Phys. Plasmas 13, 073101 (2006)

International Nuclear Information System (INIS)

Swanekamp, S. B.; Schumer, J. W.

2007-01-01

In Phys Plasmas 13, 073101 (2006), the drop in the space-charge-limited (SCL) current for a beam injected into a space with an open boundary is analyzed with an electromagnetic particle-in-cell code. The authors explained the power loss observed at the open boundary as the loss of electromagnetic radiation created from the deceleration of electrons in the gap, and they developed an effective voltage theory to predict the drop in the SCL current observed in the simulations. In this Comment, we show that, provided the current remains below the SCL value, the electric and magnetic fields are constant in time so that power loss from the open boundary is a dc phenomenon with no rf power leaving through the boundary. We show that the electric and magnetic fields are static in time and static fields DO NOT RADIATE. Instead, the electron beam charges the collector plate, which causes a real electrostatic electric field to develop. The electron energy loss is not due to radiation but rather to the work done by this electrostatic field on the electrons as they move across the gap. This is precisely the energy dissipated in the matched resistance across the open boundary, which is a consequence of the boundary condition. Furthermore, since a real electrostatic potential develops, the voltage drop is real and there is no need to call the voltage drop an effective voltage

Children with food refusal: an assessment of parental eating attitudes and their styles of coping with stress.

Science.gov (United States)

Tan, Seda; Yilmaz, Ayse Esra; Karabel, Musemma; Kara, Semra; Aldemir, Seçil; Karabel, Duran

2012-05-01

In this study, we aimed to assess the eating attitudes and stress coping styles of parents whose children presented to the clinic complaining of food refusal. The parents of 31 children aged ≥3 years, presented to the clinic with the complaint of food refusal. The control group consisted of 30 healthy children with no prior history of food refusal, and their parents. In both groups, birth features, body mass indexes (BMIs), eating attitudes and stress coping styles of the parents were assessed. The parents of both groups were studied, in part utilizing the eating attitudes test (EAT), and the coping styles of stress scale (CSSS). Our study found that body weights and BMI values of the fathers in the study group were significantly lower than fathers in the control group. There was no significant difference in EAT scores between the two groups; however, where the children's body weight and height for age percentile was under 25%, the parents had significantly lower EAT scores. When CSSS scores were assessed, the optimistic approach score of the mother and the self-confident score of the father were found to be significantly high in both groups. The parental perception and definition of eating problems does not necessarily indicate the presence of an eating disorder in a child. In fact, the eating attitudes of the fathers were related to the low percentile weight and height values of the children, and a child's food refusal was not dependent on the stress coping style used by the parent. Copyright © 2012. Published by Elsevier B.V.

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

Science.gov (United States)

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

2010-03-29

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

Space Sustainment: A New Approach for America in Space

Science.gov (United States)

2014-12-01

international community toward promoting market incentives in international space law. This would open up the competitive space for new entrants ...announces- new -space-situational-awareness-satellite-program.aspx. 29. Gruss, “U.S. Space Assets Face Growing Threat .” 30. McDougall, Heavens and the...November–December 2014 Air & Space Power Journal | 117 SCHRIEVER ESSAY WINNER SECOND PLACE Space Sustainment A New Approach for America in Space Lt

Psychological Factors behind Truancy, School Phobia, and School Refusal: A Literature Study

Science.gov (United States)

Ek, Hans; Eriksson, Rikard

2013-01-01

Truancy is a problem that normally leads to treatment interventions within different organizations. Within these organizations different perspectives on the causes and consequences of the above problem can be found. The purpose of this literature study is to map out and describe the current state of research within the fields of school refusal,…

War Memories and the Refusal of Male Dominance in Shakir's "Oh, Lebanon"

Science.gov (United States)

Al-Momani, Hassan Ali Abdullah

2017-01-01

This study investigates the role of the war memories in the construction of the female gender identity in Evelyin Shakir's "Oh, Lebanon," in which the female protagonist refuses to belong to her Arab identity when she lives in the United States because of the brutal war memories she witnesses in Lebanon. Such memories make the…

A discrete-space urban model with environmental amenities

Science.gov (United States)

Liaila Tajibaeva; Robert G. Haight; Stephen Polasky

2008-01-01

This paper analyzes the effects of providing environmental amenities associated with open space in a discrete-space urban model and characterizes optimal provision of open space across a metropolitan area. The discrete-space model assumes distinct neighborhoods in which developable land is homogeneous within a neighborhood but heterogeneous across neighborhoods. Open...

Risky procedures by nurses in hospitals: problems and (contemplated) refusals of orders by physicians, and views of physicians and nurses: a questionnaire survey

NARCIS (Netherlands)

de Bie, J.; Cuperus-Bosma, J.M.; van der Jagt, M.A.; Gevers, J.K.M.; van der Wal, G.

2005-01-01

Occurrence of problems with, refusals of orders and contemplated refusals of orders for risky procedures by nurses in Dutch hospitals and views on the safety of performance was studied using postal questionnaires (600 physicians and 3200 nurses, response 60-71%). Of the respondents, 11-30%

The Right of Psychiatric Patients to Refuse Medication: Where Should Social Workers Stand?

Science.gov (United States)

Bentley, Kia J.

1993-01-01

Addresses differences among competence, commitment, and mental illness; the right to privacy; and the prohibition against cruel and unusual punishment. Reviews professional motivations in relation to both sides of controversy over rights of psychiatric patients to refuse medication. Presents position for social work profession that stands for…

Research and Development of a New Silica-Alumina Based Cementitious Material Largely Using Coal Refuse for Mine Backfill, Mine Sealing and Waste Disposal Stabilization

Energy Technology Data Exchange (ETDEWEB)

Henghu Sun; Yuan Yao

2012-06-29

Coal refuse and coal combustion byproducts as industrial solid waste stockpiles have become great threats to the environment. To activate coal refuse is one practical solution to recycle this huge amount of solid waste as substitute for Ordinary Portland Cement (OPC). The central goal of this project is to investigate and develop a new silica-alumina based cementitious material largely using coal refuse as a constituent that will be ideal for durable construction, mine backfill, mine sealing and waste disposal stabilization applications. This new material is an environment-friendly alternative to Ordinary Portland Cement. The main constituents of the new material are coal refuse and other coal wastes including coal sludge and coal combustion products (CCPs). Compared with conventional cement production, successful development of this new technology could potentially save energy and reduce greenhouse gas emissions, recycle vast amount of coal wastes, and significantly reduce production cost. A systematic research has been conducted to seek for an optimal solution for enhancing pozzolanic reactivity of the relatively inert solid waste-coal refuse in order to improve the utilization efficiency and economic benefit as a construction and building material.

Augmenting Cognitive Behavior Therapy for School Refusal with Fluoxetine: A Randomized Controlled Trial.

Science.gov (United States)

Melvin, Glenn A; Dudley, Amanda L; Gordon, Michael S; Klimkeit, Ester; Gullone, Eleonora; Taffe, John; Tonge, Bruce J

2017-06-01

This study investigates whether the augmentation of cognitive behavior therapy (CBT) with fluoxetine improves outcomes in anxious school refusing adolescents (11-16.5 years). Sixty-two participants were randomly allocated to CBT alone, CBT + fluoxetine or CBT + placebo. All treatments were well tolerated; with one suicide-attempt in the CBT + placebo group. All groups improved significantly on primary (school attendance) and secondary outcome measures (anxiety, depression, self-efficacy and clinician-rated global functioning); with gains largely maintained at 6-months and 1-year. Few participants were anxiety disorder free after acute treatment. During the follow-up period anxiety and depressive disorders continued to decline whilst school attendance remained stable, at around 54 %. The only significant between-group difference was greater adolescent-reported treatment satisfaction in the CBT + fluoxetine group than the CBT alone group. These results indicate the chronicity of school refusal, and the need for future research into how to best improve school attendance rates.

The rights of the dying: the refusal of medical treatments in Argentine courts

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Juan Pedro Alonso

2016-10-01

Full Text Available This paper addresses the judicialization of end of life medical decision-making, as part of the advance of the justice system in the regulation of medical practice and the rise of recognition of patient autonomy. The article analyzes, from a sociological standpoint, legal decisions regarding treatment refusal at the end of life produced by the Argentine courts between 1975 and 2015. Based on a qualitative design, 38 sentences collected from jurisprudential databases using key terms were analyzed. First, judicialized cases during the period are described; these are characterized by a high proportion of claims presented by health institutions, a pro-treatment bias in the legal actions requested, and a high percentage of unnecessary litigation in the absence of conflicts or in situations that do not require court intervention. Second, legal and extralegal factors affecting the justiciability of decisions to refuse or withdraw medical treatments, such as changes in the law and processes of politicization of claims, are analyzed.

The Second Space Race

Science.gov (United States)

Fawkes, S.

This paper compares and contrasts the characteristics of the first space race, which ran from the late 1950s to the late 1990s, and the second space race that began with the successful space flight of SpaceShipOne in 2004. The first space race was between superpowers seeking to establish geo-political dominance in the Cold War. The second space race will be between competing companies seeking to establish low cost access to space for ordinary people. The first space race achieved its geo- political objectives but did not open up low cost access to space but rather restricted access to a select few, highly trained astronauts and cosmonauts. The second space race, driven by the size and growth of the travel and tourism industry, promises to open up access to space to millions of space tourists.

SpacePy - a Python-based library of tools for the space sciences

International Nuclear Information System (INIS)

Morley, Steven K.; Welling, Daniel T.; Koller, Josef; Larsen, Brian A.; Henderson, Michael G.

2010-01-01

Space science deals with the bodies within the solar system and the interplanetary medium; the primary focus is on atmospheres and above - at Earth the short timescale variation in the the geomagnetic field, the Van Allen radiation belts and the deposition of energy into the upper atmosphere are key areas of investigation. SpacePy is a package for Python, targeted at the space sciences, that aims to make basic data analysis, modeling and visualization easier. It builds on the capabilities of the well-known NumPy and MatPlotLib packages. Publication quality output direct from analyses is emphasized. The SpacePy project seeks to promote accurate and open research standards by providing an open environment for code development. In the space physics community there has long been a significant reliance on proprietary languages that restrict free transfer of data and reproducibility of results. By providing a comprehensive, open-source library of widely used analysis and visualization tools in a free, modern and intuitive language, we hope that this reliance will be diminished. SpacePy includes implementations of widely used empirical models, statistical techniques used frequently in space science (e.g. superposed epoch analysis), and interfaces to advanced tools such as electron drift shell calculations for radiation belt studies. SpacePy also provides analysis and visualization tools for components of the Space Weather Modeling Framework - currently this only includes the BATS-R-US 3-D magnetohydrodynamic model and the RAM ring current model - including streamline tracing in vector fields. Further development is currently underway. External libraries, which include well-known magnetic field models, high-precision time conversions and coordinate transformations are wrapped for access from Python using SWIG and f2py. The rest of the tools have been implemented directly in Python. The provision of open-source tools to perform common tasks will provide openness in the

Effects from different types of construction refuse in the soil on electrodialytic remediation

DEFF Research Database (Denmark)

Ottosen, Lisbeth M.; Eriksson, Thomas; Hansen, Henrik K.

2002-01-01

At abandoned industrial sites some of the previous buildings are often left behind. If the soil at such site is polluted with heavy metals and is to be remediated by an electrochemical method, the construction refuse within the soil matrix will influence the remediation action. The influence of d...

PATIENT’S CONSCIOUS REFUSAL OF TREATMENT AND REQUEST FOR ACTIVETREATMENT WHEN RECOVERY IS NOT POSSIBLE

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Peter Černoga

2008-01-01

General practitioner and a specialist doctor are faced with difficult dilemma when there isa case of a competent but unwilling to consent patient refusing the timely treatment inspite of the predicted fatal consequences

The geoarchaeology of urban wastes: from refuses to activities and towns organisation (France, 6th c. BC - 10th c. aD)

Science.gov (United States)

Borderie, Q.; Cammas, C.; Petit, C.

2012-04-01

In an urban context, geoarchaeological study of man-environment interaction is often neglected, although recent studies of urbic anthrosols and human induced processes show that it can provide a great amount of data. The sedimentary matrix of the archaeological layers, especially its organic and heavy metal contents (phosphore, organic carbon, lead…) and the pedo-sedimentary processes (such as bioturbation, percolation, decay of organic matter…), are evidence of ancient lifestyle and waste disposal habits. This data are even more useful when archaeological evidence is rare or inefficient, such as in the early medieval Dark Earth. This paper is based on several geoarchaeological studies undertaken since the 1990 in French towns ranging from the Iron Age to the early Middle Ages (Paris, Beauvais, Bayeux, Noyon, Macon, Metz, Lattara…), mainly from rescue excavations. Multi-scale, 3D and fine scale analyses of archaeological stratigraphy are combined with micromorphological studies of undisturbed samples and grain size as well as geochemical analysis of bulk samples (CaCO3, C/N, Fe, Pb, Zn, Cu…). Spatial sampling reveals complex pattern of activities in finely stratified and well defined architectural context like Lattara (Iron Age). Organic refuses were found mainly in specific urban spaces like courtyards or squares and animal housing areas could be delineate. In more undifferentiated stratigraphy (early medieval Dark Earth), bioturbation is one of the main formation process and seems to have obliterated others. Thus, we analysed the 3D pattern of macro-artefacts on field, combined with micromorphology, geochemical and semi quantitative counting of micro-artefacts on thin sections. It allowed us to characterise Dark Earth by the type of activity refuses, in relation with the pedo-sedimentary context and the uses of the areas. It also allowed us to assess the characters induced by in situ activities and those due to the local background. Moreover, in Metz

Developmentally sensitive cognitive behavioral therapy for adolescent school refusal: rationale and case illustration.

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Heyne, David; Sauter, Floor M; Ollendick, Thomas H; Van Widenfelt, Brigit M; Westenberg, P Michiel

2014-06-01

School refusal can be difficult to treat and the poorest treatment response is observed among older school refusers. This poor response may be explained, in part, by the impact of developmental transitions and tasks upon the young person, their family, and the treatment process. This paper describes and illustrates the @school program, a cognitive behavioral therapy (CBT) designed to promote developmental sensitivity when planning and delivering treatment for adolescent school refusal. Treatment is modularized and it incorporates progress reviews, fostering a planned yet flexible approach to CBT. The treatment is illustrated in the case of Allison, a 16-year-old female presenting with major depressive disorder and generalized anxiety disorder. A case formulation guided the selection, sequencing, and pacing of modules targeting predisposing, precipitating, perpetuating, and protective factors. Treatment comprised 16 sessions with Allison (interventions addressing depression, anxiety, and school attendance) and 15 concurrent sessions with her mother (strategies to facilitate an adolescent's school attendance), including two sessions with Allison and mother together (family communication and problem solving to reduce parent-adolescent conflict). Two treatment-related consultations were also conducted with Allison's homeroom teacher. Allison's school attendance improved during the course of treatment. By post-treatment, there was a decrease in internalizing behavior, an increase in self-efficacy, and remission of depressive disorder and anxiety disorder. Clinically significant treatment gains were maintained at 2-month follow-up. Factors influencing outcome may include those inherent to the @school program together with less specific factors. Special consideration is given to parents' use of both authoritative and autonomy-granting approaches when helping an adolescent to attend school.

Critical Spaces for Critical Times: Global Conversations in Literacy Research as an Open Professional Development and Practices Resource

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Peggy Albers

2015-09-01

Full Text Available This paper reflects an OER (Open Educational Resources critical literacy project, Global Conversations in Literacy Research (GCLR, (www.globalconversationsinliteracy.wordpress.com, now in its fourth year. GCLR annually hosts seven web seminars presented by internationally recognized literacy and education scholars. We outline key dimensions of GCLR not only as an OER but as an open educational practice (OEP (Andrade et al., 2011 that through its design, not only provides open access to scholarship, but also understands the critical nexus among resources, practices and theory. Informed by data from a longitudinal study, this paper situates these dimensions within professional development literature, and outlines GCLR as a critical space designed for critical times, and the importance of intentionality when accessing OER. Like scholars before us, we argue that that availability is not the only consideration when using OER (Andrade et al., 2011; OER must be considered in relation to pedagogical considerations and how OER are used as a critical component to online professional development.

Psychosocial factors influencing parental decision to allow or refuse potentially lifesaving enucleation in children with retinoblastoma

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Rolando Enrique D. Domingo

2017-01-01

Full Text Available Objective: Retinoblastoma is the most common malignancy of the eye and ocular adnexa in the Philippines. It is curable when treated early, but delay in enucleation is common due to the parental refusal of surgery for varied reasons. The aim of this study is to identify the psychosocial barriers and facilitating factors for accepting versus refusing enucleation as treatment for retinoblastoma. Methods: This is a cross-sectional descriptive study utilizing structured interviews and a questionnaire. It was conducted at the Retinoblastoma Clinic of the Philippine General Hospital. A questionnaire using the Likert scale was constructed after performing key informant interviews and focus group discussions. It was pretested and revised before parents of patients with retinoblastoma were invited to participate in the study. Descriptive statistics, quantitative item analyses using inter-item correlations and item-total correlations was performed. Results: Factors that correlate with refusal to enucleate are the beliefs that cancer is a fatal illness, the fear of unacceptable esthetic outcome of the surgery, and the cost of treatment. Favorable factors include value of life, high regard for the opinion of medical practitioners, and appreciation of the efficacy of treatment. Conclusions: There are several favorable factors and barriers that health practitioners must consider in facilitating parental decision-making toward enucleation for retinoblastoma.

Public policies for managing urban growth and protecting open space: policy instruments and lessons learned in the United States

Science.gov (United States)

David N. Bengston; Jennifer O. Fletcher

2003-01-01

The public sector in the United States has responded to growing concern about the social and environmental costs of sprawling development patterns by creating a wide range of policy instruments designed to manage urban growth and protect open space. These techniques have been implemented at the local, regional, state and, to a limited extent, national levels. This...

Open-Coil Retraction Spring

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Pavankumar Janardan Vibhute

2011-01-01

Full Text Available Sliding mechanic has become a popular method for space closure with developments in preadjusted edgewise appliance. Furthermore, various space closing auxiliaries have been developed and evaluated extensively for their clinical efficiency. Their effectiveness enhanced with optimum force magnitude and low-load deflection rate (LDR/force decay. With the advent of NiTi springs in orthodontics, LDRs have been markedly reduced. For use of NiTi, clinician has to depend upon prefabricated closed coil springs. “Open Coil Retraction Spring (OCRS” is developed utilizing NiTi open-coil spring for orthodontic space closure. This paper describes fabrication and clinical application of OCRS which have number of advantages. It sustains low LDR with optimum force magnitude. Its design is adjustable for desired length and force level. It is fail-safe for both activation and deactivation (i.e., it cannot be over activated, and decompression limit of open coil is also controlled by the operator, resp.. A possibility to offset the OCRS away from mucosa helps to reduce its soft-tissue impingement.

[Effect of axial stress stimulation on tibial and fibular open fractures healing after Taylor space stent fixation].

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Ge, Qihang; Wan, Chunyou; Liu, Yabei; Ji, Xu; Ma, Jihai; Cao, Haikun; Yong, Wei; Liu, Zhao; Zhang, Ningning

2017-08-01

To investigate the effect of axial stress stimulation on tibial and fibular open fractures healing after Taylor space stent fixation. The data of 45 cases with tibial and fibular open fractures treated by Taylor space stent fixation who meet the selection criteria between January 2015 and June 2016 were retrospectively analysed. The patients were divided into trial group (23 cases) and control group (22 cases) according to whether the axial stress stimulation was performed after operation. There was no significant difference in gender, age, affected side, cause of injury, type of fracture, and interval time from injury to operation between 2 groups ( P >0.05). The axial stress stimulation was performed in trial group after operation. The axial load sharing ratio was tested, and when the value was less than 10%, the external fixator was removed. The fracture healing time, full weight-bearing time, and external fixator removal time were recorded and compared. After 6 months of external fixator removal, the function of the limb was assessed by Johner-Wruhs criteria for evaluation of final effectiveness of treatment of tibial shaft fractures. There were 2 and 3 cases of needle foreign body reaction in trial group and control group, respectively, and healed after symptomatic anti allergic treatment. All the patients were followed up 8-12 months with an average of 10 months. All the fractures reached clinical healing, no complication such as delayed union, nonunion, or osteomyelitis occurred. The fracture healing time, full weight-bearing time, and external fixator removal time in trial group were significantly shorter than those in control group ( P good in 6 cases, fair in 3 cases, and poor in 1 case in trial group, with an excellent and good rate of 82.6%; and was excellent in 5 cases, good in 10 cases, fair in 4 cases, and poor in 3 cases in control group, with an excellent and good rate of 68.2%, showing significant difference between 2 groups ( Z =-2.146, P =0

Drinking Refusal Self-Efficacy and Intended Alcohol Consumption During a Mass-Attended Youth Event.

Science.gov (United States)

Jongenelis, Michelle I; Pettigrew, Simone; Biagioni, Nicole

2018-04-16

Mass-attended youth events represent a substantial public health challenge due to high levels of alcohol consumption and corresponding high rates of alcohol-related harm. Although previous research has documented the protective effect of high drinking refusal self-efficacy (DRSE) on alcohol consumption in general, there is a lack of research examining the role of DRSE in reducing consumption during mass-attended youth events and the factors associated with DRSE in these contexts. This study aimed to identify potentially modifiable factors that influence DRSE and drinking intentions to inform interventions designed to reduce alcohol-related harm during mass-attended events. Australian secondary school students (n = 586; 70% female) in their final two years of high school completed an online survey assessing their alcohol consumption intentions for Schoolies, their perceived degree of DRSE, and other individual and environmental factors. Path analysis was used to assess a mediational model examining factors associated with DRSE and alcohol consumption intentions. DRSE was found to be significantly associated with intended alcohol consumption during Schoolies. Specifically, leavers who believed they would not be able to refuse others' offers of alcoholic drinks reported significantly greater alcohol consumption intentions. Results also revealed that DRSE was enhanced in those respondents who believed there would be a variety of non-drinking activities and non-alcoholic beverages available to them during Schoolies. Results suggest the need to increase leavers' confidence in their ability to refuse unwanted alcoholic beverages and highlight the importance of providing celebration options that do not involve alcohol consumption.

[Behavioural psychotherapy for encopresis shown on a girl with chronic "toilet-refusal-syndrome"].

Science.gov (United States)

Hansen, Berit; Lehmkuhl, Ulrike

2007-01-01

Encopresis is one of the areas of the psychiatric diseases in childhood and adolescence that has been less researched. There is not much literature on the treatment of encopresis. The article describes a standard behavioural therapy including a case report on a 7, 9 year old girl with chronic "toilet-refusal-syndrome".

The Open

Directory of Open Access Journals (Sweden)

Saitya Brata Das

2009-12-01

Full Text Available In the Open darkness and light, remembrance and oblivion, coming into existence and disappearing in death play their originary co-belonging, or co-figuration. Existence belongs to this opening and is exposed to its coming to presence: it is on the basis of this originary opening, this originary historical which is revealed to this mortal being called ‘man,’ on the basis of this revelation, man founds something like politics and history. There thus comes into existence out of this freedom, out of this “play space”2, this field called ‘polis’3 where there takes place war and festival, where historical revolutions tear apart history, brings ruptures and discontinuities in the very mode of his existence, where man seeks the foundation of his own foundation (which is his metaphysical task , where occurs the dialectics of negativity between man and man, where man puts at stake his own death, his own dissolution, and by the power of his own dissolution stands in relation to the total world that he seeks to dominate. This means that man’s attempts to metaphysically found his own political and historical existence must presuppose a far more originary non-foundation, the differentiating revealing of the open, the ungrounded spacing play, or playing space of natality and mortality.

Hospital wastes management containing in radioactive refusals

International Nuclear Information System (INIS)

Campi, F.

1999-01-01

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

Toilet refusal syndrome in preschool children: do different subtypes exist?

Science.gov (United States)

Niemczyk, Justine; Equit, Monika; El Khatib, Diana; von Gontard, Alexander

2014-03-01

Toilet refusal syndrome (TRS) is a common, benign disorder in toddlers defined by the use of diapers and refusal of toilet for defaecation, but has not been described systematically in preschool children yet. The aim of the study was to analyse and identify possible subgroups of TRS. Retrospective analysis of all of the consecutive children with TRS presented as outpatients in a clinic for elimination disorders. Patients had received a detailed paediatric and child psychiatric assessment, including the Child Behavior Checklist questionnaire. Three typical case vignettes are presented of TRS with constipation, oppositional defiant disorder, and sibling rivalry. Twenty-five children (10 boys) with a mean age of 5.2 (3.4-7.3) years were included-representing 2.5% of all of the children (n = 1001) presented. They had high rates of constipation (60%) and elimination disorders (24%-44%). Child psychiatric International Classification of Diseases-10th Edition disorders were common (40%) and heterogeneous, with significantly more boys affected, but no differences between children with and without constipation. This study shows that TRS occurs also in older preschool (and even school) children. At this later age, it is associated with constipation and behavioural disorders. The case vignettes show differences in therapy and may represent different subgroups of TRS. TRS is associated with constipation, elimination disorders, and psychiatric disorders. Owing to this variety of comorbid disorders, different therapeutic approaches are needed. A general screening for behavioural symptoms is recommended.

Rationality, religion and refusal of treatment in an ambulance revisited.

Science.gov (United States)

McMahon-Parkes, Kate