The impact of BWR MK I primary containment failure dynamics on secondary containment integrity

International Nuclear Information System (INIS)

Greene, S.R.

1987-01-01

During the past four years, the ORNL BWRSAT Program has developed a series of increasingly sophisticated BWR secondary containment models. These models have been applied in a variety of studies to evaluate the severe accident mitigation capability of BWR secondary containments. This paper describes the results of a recent ORNL study of the impact of BWR MK I primary containment failure dynamics on secondary containment integrity. A 26-cell MELCOR Browns Ferry secondary containment model is described and the predicted thermodynamic response of the secondary containment to a variety of postulated primary containment failure modes is presented. The effects of primary containment failure location, timing, and ultimate hole size on secondary containment response is investigated, and the potential impact of hydrogen deflagrations on secondary containment integrity is explored

STRUCTURAL AND HIDDEN BARRIERS TO A LOCAL PRIMARY HEALTH CARE INFRASTRUCTURE: AUTONOMY, DECISIONS ABOUT PRIMARY HEALTH CARE, AND THE CENTRALITY AND SIGNIFICANCE OF POWER.

Science.gov (United States)

Freed, Christopher R; Hansberry, Shantisha T; Arrieta, Martha I

2013-09-01

To examine a local primary health care infrastructure and the reality of primary health care from the perspective of residents of a small, urban community in the southern United States. Data derive from 13 semi-structured focus groups, plus three semi-structured interviews, and were analyzed inductively consistent with a grounded theory approach. Structural barriers to the local primary health care infrastructure include transportation, clinic and appointment wait time, and co-payments and health insurance. Hidden barriers consist of knowledge about local health care services, non-physician gatekeepers, and fear of medical care. Community residents have used home remedies and the emergency department at the local academic medical center to manage these structural and hidden barriers. Findings might not generalize to primary health care infrastructures in other communities, respondent perspectives can be biased, and the data are subject to various interpretations and conceptual and thematic frameworks. Nevertheless, the structural and hidden barriers to the local primary health care infrastructure have considerably diminished the autonomy community residents have been able to exercise over their decisions about primary health care, ultimately suggesting that efforts concerned with increasing the access of medically underserved groups to primary health care in local communities should recognize the centrality and significance of power. This study addresses a gap in the sociological literature regarding the impact of specific barriers to primary health care among medically underserved groups.

Bellefonte primary containment structure

International Nuclear Information System (INIS)

Olyniec, J.H.

1981-01-01

Construction of the reactor building primary containment structure at the Bellefonte Nuclear Plant involved several specialized construction techniques. This two unit plant is one of the nine nuclear units at six different sites now under construction by the Tennessee Valley Authority (TVA). The post-Tensioned, cast-in-place interior steel lined containment structure is unique within TVA. Problems during construction were identified at weekly planning meetings, and options were discussed. Close coordination between craft supervisors and on-site engineering personnel drew together ''hands-on''experience and technical background. Details of the construction techniques, problems, and solutions are presented

Clinical Governance in Primary Care; Principles, Prerequisites and Barriers: A Systematic Review

Directory of Open Access Journals (Sweden)

Jaafar Sadeq Tabrizi

2013-07-01

Full Text Available Introduction: Primary care organizations are the entities through which clinical governance is developed at local level. To implement clinical governance in primary care, awareness about principles, prerequisites and barriers of this quality improvement paradigm is necessary. The aim of this study is to pool evidence about implementing clinical governance in primary care organizations. Data sources: The literature search was conducted in July 2012. PubMed, Web of Science, Emerald, Springerlink, and MD Consult were searched using the following MESH keywords; “clinical governance” and “primary care” Study selection: The search was limited to English language journals with no time limitation. Articles that were either quantitative or qualitative on concepts of implementing clinical governance in primary care were eligible for this study. Data extraction: From selected articles, data on principles, prerequisites and barriers of clinical governance in primary health care were extracted and classified in the extraction tables. Results: We classified our findings about principles of clinical governance in primary care in four groups; general principles, principles related to staff, patient and communication. Prerequisites were categorized in eight clusters; same as the seven dimensions of National Health System (NHS models of clinical governance. Barriers were sorted out in five categories as structure and organizing, cultural, resource, theoretical and logistical. Conclusion: Primary care organizations must provide budget holding, incentivized programs, data feedback, peer review, education, human relations, health information technology (HIT support, and resources. Key elements include; enrolled populations, an interdisciplinary team approach, HIT interoperability and access between all providers as well as patients, devolution of hospital based services into the community, inter-sectorial integration, blended payments, and a balance of

Method for contamination control and barrier apparatus with filter for containing waste materials that include dangerous particulate matter

Science.gov (United States)

Pinson, Paul A.

1998-01-01

A container for hazardous waste materials that includes air or other gas carrying dangerous particulate matter has incorporated in barrier material, preferably in the form of a flexible sheet, one or more filters for the dangerous particulate matter sealably attached to such barrier material. The filter is preferably a HEPA type filter and is preferably chemically bonded to the barrier materials. The filter or filters are preferably flexibly bonded to the barrier material marginally and peripherally of the filter or marginally and peripherally of air or other gas outlet openings in the barrier material, which may be a plastic bag. The filter may be provided with a backing panel of barrier material having an opening or openings for the passage of air or other gas into the filter or filters. Such backing panel is bonded marginally and peripherally thereof to the barrier material or to both it and the filter or filters. A coupling or couplings for deflating and inflating the container may be incorporated. Confining a hazardous waste material in such a container, rapidly deflating the container and disposing of the container, constitutes one aspect of the method of the invention. The chemical bonding procedure for producing the container constitutes another aspect of the method of the invention.

Method for contamination control and barrier apparatus with filter for containing waste materials that include dangerous particulate matter

International Nuclear Information System (INIS)

Pinson, P.A.

1998-01-01

A container for hazardous waste materials that includes air or other gas carrying dangerous particulate matter has incorporated barrier material, preferably in the form of a flexible sheet, and one or more filters for the dangerous particulate matter sealably attached to such barrier material. The filter is preferably a HEPA type filter and is preferably chemically bonded to the barrier materials. The filter or filters are preferably flexibly bonded to the barrier material marginally and peripherally of the filter or marginally and peripherally of air or other gas outlet openings in the barrier material, which may be a plastic bag. The filter may be provided with a backing panel of barrier material having an opening or openings for the passage of air or other gas into the filter or filters. Such backing panel is bonded marginally and peripherally thereof to the barrier material or to both it and the filter or filters. A coupling or couplings for deflating and inflating the container may be incorporated. Confining a hazardous waste material in such a container, rapidly deflating the container and disposing of the container, constitutes one aspect of the method of the invention. The chemical bonding procedure for producing the container constitutes another aspect of the method of the invention. 3 figs

Improved HEPA Filter Technology for Flexible and Rigid Containment Barriers

International Nuclear Information System (INIS)

Pinson, Paul Arthur

1998-01-01

Safety and reliability in glovebox operations can be significantly improved and waste packaging efficiencies can be increased by inserting flexible, lightweight, high capacity HEPA filters into the walls of plastic sheet barriers. This HEPA filter/barrier technology can be adapted to a wide variety of applications: disposable waste bags, protective environmental barriers for electronic equipment, single or multiple use glovebag assemblies, flexible glovebox wall elements, and room partitions. These reliable and inexpensive filtered barriers have many uses in fields such as radioactive waste processing, HVAC filter changeout, vapor or grit blasting, asbestos cleanup, pharmaceutical, medical, biological, and electronic equipment containment. The applications can result in significant cost savings, improved operational reliability and safety, and total waste volume reduction. This technology was developed at the Argonne National Laboratory-West (ANL-W) in 1993 and has been used at ANL-W since then at the TRU Waste Characterization Chamber Gloveboxes. Another 1998 AGS Conference paper titled ''TRU Waste Characterization Gloveboxes'', presented by Mr. David Duncan of ANL-W, describes these boxes

Tritium containment in fusion facilities

International Nuclear Information System (INIS)

Anderson, J.L.

1978-01-01

The key environmental control systems that have been identified and are being developed are listed. A brief description of each of the following systems is given: primary process materials, permeation barriers, secondary containment, tritium waste treatment, emergency tritium cleanup, maintenance procedures, and tertiary containment

Requirements for and barriers towards interoperable ehealth technology in primary care

NARCIS (Netherlands)

Oude Nijeweme-d'Hollosy, Wendeline; van Velsen, Lex Stefan; Huygens, Martine; Hermens, Hermanus J.

Despite eHealth technology's rapid growth, eHealth applications are rarely embedded within primary care, mostly because systems lack interoperability. This article identifies requirements for, and barriers towards, interoperable eHealth technology from healthcare professionals' perspective -- the

Barriers to Using Nonpharmacologic Approaches and Reducing Opioid Use in Primary Care.

Science.gov (United States)

Giannitrapani, Karleen F; Ahluwalia, Sangeeta C; McCaa, Matthew; Pisciotta, Maura; Dobscha, Steven; Lorenz, Karl A

2017-10-20

Opioid prescribing for chronic pain, including the potential for over-reliance and misuse, is a public health concern. In the context of Veterans Administration (VA) primary care team-based pain management, we aimed to understand providers' perceptions of barriers to reducing opioid use and improving the use of nonpharmacologic pain management therapies (NPTs) for chronic pain. A semistructured interview elucidated provider experiences with assessing and managing pain. Emergent themes were mapped to known dimensions of VA primary care access. Informants included 60 primary care providers, registered nurses, licensed practical nurses, clerks, psychologists, and social workers at two VA Medical Centers. Nine multidisciplinary focus groups. Provider perceptions of barriers to reducing opioids and improving use of NPTs for patients with chronic pain clustered around availability and access. Barriers to NPT access included the following subthemes: geographical (patient distance from service), financial (out-of-pocket cost to patient), temporal (treatment time delays), cultural (belief that NPTs increased provider workload, perception of insufficient training on NPTs, perceptions of patient resistance to change, confrontation avoidance, and insufficient leadership support), and digital (measure used for pain assessment, older patients hesitant to use technology, providers overwhelmed by information). Decreasing reliance on opioids for chronic pain requires a commitment to local availability and provider-facing strategies that increase efficacy in prescribing NPTs. Policies and interventions for decreasing utilization of opioids and increasing use of NPTs should comprehensively consider access barriers. 2017 American Academy of Pain Medicine. This work is written by US Government employees and is in the public domain in the US.

Demonstration of close-coupled barriers for subsurface containment of buried waste. Conceptual test plan

Energy Technology Data Exchange (ETDEWEB)

Heiser, J. [Brookhaven National Laboratory, Upton, NY (United States); Dwyer, B. [Sandia National Laboratory, Albuquerque, NM (United States)

1995-07-01

Over the past five decades, the US Department of Energy (DOE) Complex sites have experienced numerous loss of confinement failures from underground storage tanks (USTs), piping systems, vaults, landfills, and other structures containing hazardous and mixed wastes. Consequently, efforts are being made to devise technologies that provide interim containment of waste sites while final remediation alternatives are developed. Barrier materials consisting of cement and polymer which will be emplaced beneath a 7500 liter tank. The stresses around the tank shall be evaluated during barrier construction.

Barriers to Maori sole mothers’ primary health care access

Directory of Open Access Journals (Sweden)

Lee R

2013-12-01

Full Text Available INTRODUCTION: International research consistently shows that sole mothers experience poorer health and suboptimal health care access. New Zealand studies on sole mothers' health report similar findings. The aim of this exploratory research was to better understand the experiences of Maori sole mothers' access to health services, particularly primary health care, for personal health needs. METHODS: This qualitative study employed a general inductive design informed by a Kaupapa Maori approach, providing guidance on appropriate cultural protocols for recruiting and engaging Maori participants. Distributing written information and snowballing techniques were used to purposively recruit seven Maori sole mothers. Data collection involved semi-structured interviews which were digitally recorded and transcribed verbatim. Data were analysed using general inductive thematic analysis to identify commonalities and patterns in participants' experiences. FINDINGS: The dominant themes that emerged captured and described participants' experiences in accessing health care. The major barrier to access reported was cost. Compounding cost, transport difficulties and location or scheduling of services were additional barriers to health service accessibility. Child-related issues also posed a barrier, including prioritising children's needs and childcare over personal health needs. CONCLUSION: The findings illuminate Maori sole mothers' experiences of accessing health care and the complex socioeconomic inequalities affecting access options and uptake of services. Further investigation of barriers to access is needed. The study has implications for addressing barriers to access at policy, funding and practice levels to improve health outcomes and equitable health care access for Maori sole mothers.

Barriers to managing child and adolescent mental health problems: a systematic review of primary care practitioners’ perceptions

Science.gov (United States)

O’Brien, Doireann; Harvey, Kate; Howse, Jessica; Reardon, Tessa; Creswell, Cathy

2016-01-01

Background Mental health problems are common and typically have an early onset. Effective treatments for mental health problems in childhood and adolescence are available, yet only a minority of children who are affected access them. This is of serious concern, considering the far-reaching and long-term negative consequences of such problems. Primary care is usually the first port of call for concerned parents so it is important to understand how primary care practitioners manage child and adolescent mental health problems and the barriers they face. Aim To ascertain primary care practitioners’ perceptions of the barriers that prevent effective management of child and adolescent mental health problems. Design and setting A systematic review of qualitative and quantitative literature in a primary care setting. Method A database search of peer-reviewed articles using PsycINFO, MEDLINE®, Embase, and Web of Science, from inception (earliest 1806) until October 2014, was conducted. Additional studies were identified through hand searches and forward-citation searches. Studies needed to have at least one search term in four categories: primary care, childhood/adolescence, mental health, and barriers. Results A total of 4151 articles were identified, of which 43 were included (30 quantitative studies and 13 qualitative studies). The majority of the barriers related to identification, management, and/or referral. Considerable barriers included a lack of providers and resources, extensive waiting lists, and financial restrictions. Conclusion The identification of a broad range of significant barriers highlights the need to strengthen the ability to deal with these common difficulties in primary care. There is a particular need for tools and training to aid accurate identification and management, and for more efficient access to specialist services. PMID:27621291

Barriers to managing child and adolescent mental health problems: a systematic review of primary care practitioners' perceptions.

Science.gov (United States)

O'Brien, Doireann; Harvey, Kate; Howse, Jessica; Reardon, Tessa; Creswell, Cathy

2016-10-01

Mental health problems are common and typically have an early onset. Effective treatments for mental health problems in childhood and adolescence are available, yet only a minority of children who are affected access them. This is of serious concern, considering the far-reaching and long-term negative consequences of such problems. Primary care is usually the first port of call for concerned parents so it is important to understand how primary care practitioners manage child and adolescent mental health problems and the barriers they face. To ascertain primary care practitioners' perceptions of the barriers that prevent effective management of child and adolescent mental health problems. A systematic review of qualitative and quantitative literature in a primary care setting. A database search of peer-reviewed articles using PsycINFO, MEDLINE(®), Embase, and Web of Science, from inception (earliest 1806) until October 2014, was conducted. Additional studies were identified through hand searches and forward-citation searches. Studies needed to have at least one search term in four categories: primary care, childhood/adolescence, mental health, and barriers. A total of 4151 articles were identified, of which 43 were included (30 quantitative studies and 13 qualitative studies). The majority of the barriers related to identification, management, and/or referral. Considerable barriers included a lack of providers and resources, extensive waiting lists, and financial restrictions. The identification of a broad range of significant barriers highlights the need to strengthen the ability to deal with these common difficulties in primary care. There is a particular need for tools and training to aid accurate identification and management, and for more efficient access to specialist services. © British Journal of General Practice 2016.

Employment status, employment functioning, and barriers to employment among VA primary care patients.

Science.gov (United States)

Zivin, Kara; Yosef, Matheos; Levine, Debra S; Abraham, Kristen M; Miller, Erin M; Henry, Jennifer; Nelson, C Beau; Pfeiffer, Paul N; Sripada, Rebecca K; Harrod, Molly; Valenstein, Marcia

2016-03-15

Prior research found lower employment rates among working-aged patients who use the VA than among non-Veterans or Veterans who do not use the VA, with the lowest reported employment rates among VA patients with mental disorders. This study assessed employment status, employment functioning, and barriers to employment among VA patients treated in primary care settings, and examined how depression and anxiety were associated with these outcomes. The sample included 287 VA patients treated in primary care in a large Midwestern VA Medical Center. Bivariate and multivariable analyses were conducted examining associations between socio-demographic and clinical predictors of six employment domains, including: employment status, job search self-efficacy, work performance, concerns about job loss among employed Veterans, and employment barriers and likelihood of job seeking among not employed Veterans. 54% of respondents were employed, 36% were not employed, and 10% were economically inactive. In adjusted analyses, participants with depression or anxiety (43%) were less likely to be employed, had lower job search self-efficacy, had lower levels of work performance, and reported more employment barriers. Depression and anxiety were not associated with perceived likelihood of job loss among employed or likelihood of job seeking among not employed. Single VA primary care clinic; cross-sectional study. Employment rates are low among working-aged VA primary care patients, particularly those with mental health conditions. Offering primary care interventions to patients that address mental health issues, job search self-efficacy, and work performance may be important in improving health, work, and economic outcomes. Published by Elsevier B.V.

Barriers of Chinese primary care attenders to seeking help for psychological distress in Hong Kong.

Science.gov (United States)

Sun, Kai Sing; Lam, Tai Pong; Lam, Kwok Fai; Lo, Tak Lam; Chao, David Vai Kiong; Lam, Edmund Wing Wo

2016-05-15

Most of the previous studies on help seeking for psychological distress were derived from Western countries. This study investigated the barriers to help-seeking for psychological distress among Chinese primary care attenders in Hong Kong. Nine focus groups and 6 individual interviews were conducted among Chinese primary care attenders with/without known distress, patients' significant others and the general public. The identified barriers were investigated in a questionnaire survey with data from 1626 primary care attenders recruited from 13 private clinics and 6 public clinics. Worries about side effects of drugs (79.9%, 95% CI:(77.9%, 81.8%)) and drug dependency (74.7%, 95% CI:(72.5%, 76.8%)) were rated as the top barriers in the survey. Qualitative interviews found both worries and actual experience of the side effects of drugs, which weakened patients' trust in the treatment. Factor analysis on all barrier items suggested three factors: 1) worries of treatment, 2) uncertainties on primary care physicians' capacity, 3) public's limited knowledge on distress and sources of help. Distress level, education level and age were associated with factor 1, whereas distress level and healthcare setting were associated with the other two factors. Qualitative interviews revealed that not having a regular primary care physician in the public setting discouraged disclosure of psychological problems. The findings were based on self-reported data from the respondents. Hong Kong is influenced by a mixed Chinese and Western culture. Relevant public education in a Chinese context should target at reducing patients' worries of drug treatment and strengthening the image of primary care physicians as a feasible source of help. Copyright © 2016 Elsevier B.V. All rights reserved.

In situ construction of horizontal soil containment barrier at Fernald

International Nuclear Information System (INIS)

Ridenour, D.; Pettit, P.J.; Walker, J.

1995-01-01

An innovative method of placing soil barriers to contain vertical flow is being prepared for demonstration by the Fernald Environmental Restoration Management Corporation (FERMCO), working in conjunction with the Department of Energy Office of Technology Development (DOE/OTD) and two principle subcontractors. The method employs proven directional drilling techniques, jet grouting technology and unique placement tooling to form horizontal soil barriers in situ. This is done without disturbance to existing land disposed wastes. This paper is a summary report on the current state of that demonstration, including: a discussion of the construction methods, the results of the initial tool tests, an overview of the Fernald site conditions and, the resulting path of tooling development for the second phase of tool testing

Demonstration of in situ-constructed horizontal soil containment barrier at Fernald

International Nuclear Information System (INIS)

Pettit, P.J.; Ridenour, D.; Walker, J.; Saugier, K.

1994-01-01

A new design of jet grouting tool that can be guided by horizontal well casings and that operates in the horizontal plane has been used for the in situ placement of grout and construction of a prototype horizontal barrier that is free of windows. Jet grouting techniques have been advanced to permit construction of horizontal barriers underneath contaminated soil without having to excavate or disturb the waste. The paper describes progress on the Fernald Environmental Restoration Management Corporation (FERMCO) In Situ Land Containment Project which is sponsored by the US Department of Energy's (DOE) Office of Technology Development (OTD) for DOE's Fernald Environmental Management Project (FEMP). The Fernald project is to demonstrate a novel, enabling technology for the controlled underground placement of horizontal panels of grout, and the joining of adjacent panels to construct practical, extensive barriers. Construction strategy, equipment mechanics and operating details of this new method are described

Disability inclusion in primary health care in Nepal: an explorative study of perceived barriers to access governmental health services.

NARCIS (Netherlands)

Hees, S. van; Cornielje, H.; Wagle, P.; Veldman, E.

2014-01-01

Purpose: Persons with disabilities face additional barriers in accessing primary healthcare services, especially in developing countries. Consequently the prevalence of secondary health conditions is higher among this population. This study aims to explore the perceived barriers to access primary

Exploring primary school headteachers' perspectives on the barriers and facilitators of preventing childhood obesity.

Science.gov (United States)

Howard-Drake, E J; Halliday, V

2016-03-01

Headteachers of primary schools in England are a crucial partner for childhood obesity prevention. Understanding how this works in practice is limited by their views being underrepresented or missing from the evidence base. The aim of this study was to explore primary school headteachers' perspectives on childhood obesity and the perceived barriers and facilitators of prevention. A qualitative study with a purposive sample of 14 primary school headteachers from the Yorkshire and Humber region of England was conducted. Semi-structured interviews were audio-taped, transcribed and analysed using an inductive thematic approach. An extensive range of barriers and facilitators emerged within four key themes; understanding childhood obesity, primary school setting, the role of parents and external partners. A lack of knowledge, awareness and skills to deal with the sensitivity and complexity of childhood obesity across all school stakeholders presents the most significant barrier to effective action. Headteachers recognize primary schools are a crucial setting for childhood obesity prevention; however their school's often do not have the capability, capacity and confidence to make a meaningful and sustainable impact. To increase headteachers' ability and desire to prevent childhood obesity, schools require specialist and tailored training, resources and support from external partners such as public health teams and school nursing services. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Barriers to primary care responsiveness to poverty as a risk factor for health.

Science.gov (United States)

Bloch, Gary; Rozmovits, Linda; Giambrone, Broden

2011-06-29

Poverty is widely recognized as a major determinant of poor health, and this link has been extensively studied and verified. Despite the strong evidentiary link, little work has been done to determine what primary care health providers can do to address their patients' income as a risk to their health. This qualitative study explores the barriers to primary care responsiveness to poverty as a health issue in a well-resourced jurisdiction with near-universal health care insurance coverage. One to one interviews were conducted with twelve experts on poverty and health in primary care in Ontario, Canada. Participants included family physicians, specialist physicians, nurse practitioners, community workers, advocates, policy experts and researchers. The interviews were analysed for anticipated and emergent themes. This study reveals provider- and patient-centred structural, attitudinal, and knowledge-based barriers to addressing poverty as a risk to health. While many of its findings reinforce previous work in this area, this study's findings point to a number of areas front line primary care providers could target to address their patients' poverty. These include a lack of provider understanding of the lived reality of poverty, leading to a failure to collect adequate data about patients' social circumstances, and to the development of inappropriate care plans. Participants also pointed to prejudicial attitudes among providers, a failure of primary care disciplines to incorporate approaches to poverty as a standard of care, and a lack of knowledge of concrete steps providers can take to address patients' poverty. While this study reinforces, in a well-resourced jurisdiction such as Ontario, the previously reported existence of significant barriers to addressing income as a health issue within primary care, the findings point to the possibility of front line primary care providers taking direct steps to address the health risks posed by poverty. The consistent

Containment barrier at Pride Park, Derby, England

International Nuclear Information System (INIS)

Barker, P.; Esnault, A.; Braithwaite, P.

1997-01-01

The Pride Park site at Derby occupies 96ha of derelict land close to the city centre. Approximately one third of the site was a closed landfill with a further third being an old gas works site. The remainder comprised former heavy engineering works and gravel pit workings. The River Derwent bounds the site on two sides. The objectives of the remediation strategy for the site included minimising off-site disposal of contaminated soils and ensuring that contaminants do not migrate into the adjacent river. The eastern part of the site, including the landfill and gasworks sites, was therefore contained by a 600mm wide bentonite cement vertical cut-off wall, with HDPE membrane, sealed by 1m into the underlying mudstone. The cut-off wall is some 3km long and a maximum 10m deep. The works were complicated by the need to construct the wall around 36 existing underground services. The paper briefly covers the background to the remediation of the site, describes the construction process and discusses design considerations in relation to the durability requirements of the containment barrier in the potentially aggressive environment

BARRIERS TO THE UTILIZATION OF PRIMARY CARE SERVICES FOR MENTAL HEALTH PROLEMS

Directory of Open Access Journals (Sweden)

KHAIRANI O

2010-01-01

Full Text Available Objective: To study the barriers toward the utilization of primary care services for mental health problems among adolescents in a secondary school in Hulu Langat, Selangor, Malaysia. Methods: This was a cross-sectional study conducted in July 2008 at a secondary school in Hulu Langat, Selangor. The respondents were selected using randomised cluster sampling among Form Four and Form Five students. Students were given self-administered questionnaire, consisting socio-demographic data and questions on their help-seeking barrier and behaviour. Help-seeking behaviour questions assess the use of medical facility and help-seeking sources. The formal help seeking sources include from teachers, counsellors and doctors. The informal help-seeking sources include from friends,parents and siblings. Results: A total of 175 students were included in the study. None of the students admitted of using the primary health care services for their mental health problems. Majority of the students were not aware of the services availability in the primary health care (97.1%. More than half of them thought the problems were due to their own mistakes (55.4% and the problems were not that serious (49.1%. With regard to perception of the primary health care services, (43.2% of the students were worried about confidentiality, half of them were concerned about other people’s perception especially from their family members(44.6% and friends (48.6%. Minority of them (10.8% thought that nobody can help them. Few of them thought smoking(3.4%, alcohol (3.4% and recreational drugs (1.1% can solve their emotional problems. Conclusion: One of the major barriers identified in the students’ failure to use the health care facilities was their unawarenessof the availability of the service for them in the community. Thus there is a need to promote and increase their awareness onthis issue.

Assessment of primary care services and perceived barriers to care in persons with disabilities.

Science.gov (United States)

Harrington, Amanda L; Hirsch, Mark A; Hammond, Flora M; Norton, H James; Bockenek, William L

2009-10-01

To determine what percentage of persons with disabilities have a primary care provider, participate in routine screening and health maintenance examinations, and identify perceived physical or physician barriers to receiving care. A total of 344 surveys, consisting of 66 questions, were collected from adults with disabilities receiving care at an outpatient rehabilitation clinic. A total of 89.5% (95% CI 86.3%-92.8%) of participants reported having a primary care physician. Younger persons (P brain injury (P use, and safety with relationships at home ranged from 26.6% to 37.5% compared with screening for depression, diet, exercise, and smoking (64.5%-70%). Completion rates of age- and gender-appropriate health maintenance examinations ranged from 42.4% to 90%. A total of 2.67% of participants reported problems with physical access at their physician's office, and 36.4% (95% CI 30.8%-42.1%) of participants reported having to teach their primary care physician about their disability. Most persons with disabilities have a primary care physician. In general, completion rates for routine screening and health maintenance examinations were high. Perceived deficits in primary care physicians' knowledge of disability issues seem more prevalent than physical barriers to care.

Contaminant containment using polymer gel barriers

NARCIS (Netherlands)

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

2004-01-01

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

Performance of engineered barriers

International Nuclear Information System (INIS)

Rajaram, V.; Dean, P.V.; McLellan, S.A.

1997-01-01

Engineered barriers, both vertical and horizontal, have been used to isolate hazardous wastes from contact, precipitation, surface water and groundwater. The primary objective of this study was to determine the performance of subsurface barriers installed throughout the U.S. over the past 20 years to contain hazardous wastes. Evaluation of Resource Conservation and Recovery Act (RCRA) Subtitle C or equivalent caps was a secondary objective. A nationwide search was launched to select hazardous waste sites at which vertical barrier walls and/or caps had been used as the containment method. None of the sites selected had an engineered floor. From an initial list of 130 sites, 34 sites were selected on the basis of availability of monitoring data for detailed analysis of actual field performance. This paper will briefly discuss preliminary findings regarding the design, construction quality assurance/construction quality control (CQA/CQC), and monitoring at the 34 sites. In addition, the short-term performance of these sites (less than 5 years) is presented since very little long-term performance data was available

NucleDyne's passive containment system

International Nuclear Information System (INIS)

Falls, O.B. Jr.; Kleimola, F.W.

1987-01-01

A simple definition of the passive containment system is that it is a total safeguards system for light water reactors designed to prevent and contain any accidental release of radioactivity. Its passive features utilize the natural laws of physics and thermodynamics. The system encompasses three basic containments constructed as one integrated structure on the reactor building foundation. The primary containment encloses the reactor pressure vessel and coolant system and passive engineered safety systems and components. Auxiliary containment enclosures house auxiliary systems and components. Secondary containment (the reactor building), housing the primary and auxiliary containment structures, provides a second containment barrier as added defense-in-depth against leakage of radioactivity for all accidents assumed by the industry. The generic features of the passive containment system are applicable to both the boiling water reactors and the pressurized water reactors as standardized features for all power ranges. These features provide for a zero source term, the industry's ultimate safety goal. This paper relates to a four-loop pressurized water reactor

Improvement of barrier properties of rotomolded PE containers with nanoclay

Energy Technology Data Exchange (ETDEWEB)

Jamshidi, Shadi; Sundararaj, Uttandaraman, E-mail: u.sundararaj@ucalgary.ca [Department of Chemical and Petroleum Engineering, University of Calgary, Calgary, Alberta, T2N 1N4 (Canada)

2015-05-22

Polyethylene (PE) is widely used to make bulk containers in rotational molding process. The challenge in this study is to improve permeation resistance of PE to hydrocarbon solvents and gases. Adding organomodified clay improves the thermal, barrier and mechanical properties of PE. In fact, clay layers create a tortuous path against the permeant, yielding better barrier properties. Due to the non-polar hydrophobic nature of PE and polar hydrophilic structure of clay minerals, the compatibilizer plays a crucial role to enhance the dispersion level of clay in the matrix. In this study High Density Polyethylene (HDPE) and Linear Low Density Polyethylene (LLDPE) layered silicate nanocomposite were melt-compounded with two concentrations of organomodified clay (2 and 4 wt. %). The interaction between nanoclay, compatibilizer and rotomolding grade of PE were examined by using X-ray diffraction, transmission electron microscopy (TEM) and rheology test. Rheology was used to determine the performance of our material at low shear processing condition.

Exploring barriers to primary care for migrants in Greece in times of austerity: Perspectives of service providers.

Science.gov (United States)

Papadakaki, Maria; Lionis, Christos; Saridaki, Aristoula; Dowrick, Christopher; de Brún, Tomas; O'Reilly-de Brún, Mary; O'Donnell, Catherine A; Burns, Nicola; van Weel-Baumgarten, Evelyn; van den Muijsenbergh, Maria; Spiegel, Wolfgang; MacFarlane, Anne

2017-12-01

Migration in Europe is increasing at an unprecedented rate. There is an urgent need to develop 'migrant-sensitive healthcare systems'. However, there are many barriers to healthcare for migrants. Despite Greece's recent, significant experiences of inward migration during a period of economic austerity, little is known about Greek primary care service providers' experiences of delivering care to migrants. To identify service providers' views on the barriers to migrant healthcare. Qualitative study involving six participatory learning and action (PLA) focus group sessions with nine service providers. Data generation was informed by normalization process theory (NPT). Thematic analysis was applied to identify barriers to efficient migrant healthcare. Three main provider and system-related barriers emerged: (a) emphasis on major challenges in healthcare provision, (b) low perceived control and effectiveness to support migrant healthcare, and (c) attention to impoverished local population. The study identified major provider and system-related barriers in the provision of primary healthcare to migrants. It is important for the healthcare system in Greece to provide appropriate supports for communication in cross-cultural consultations for its diversifying population.

Facilitators and barriers of implementing the chronic care model in primary care: a systematic review.

Science.gov (United States)

Kadu, Mudathira K; Stolee, Paul

2015-02-06

The Chronic Care Model (CCM) is a framework developed to redesign care delivery for individuals living with chronic diseases in primary care. The CCM and its various components have been widely adopted and evaluated, however, little is known about different primary care experiences with its implementation, and the factors that influence its successful uptake. The purpose of this review is to synthesize findings of studies that implemented the CCM in primary care, in order to identify facilitators and barriers encountered during implementation. This study identified English-language, peer-reviewed research articles, describing the CCM in primary care settings. Searches were performed in three data bases: Web of Knowledge, Pubmed and Scopus. Article abstracts and titles were read based on whether they met the following inclusion criteria: 1) studies published after 2003 that described or evaluated the implementation of the CCM; 2) the care setting was primary care; 3) the target population of the study was adults over the age of 18 with chronic conditions. Studies were categorized by reference, study design and methods, participants and setting, study objective, CCM components used, and description of the intervention. The next stage of data abstraction involved qualitative analysis of cited barriers and facilitators using the Consolidating Framework for Research Implementation. This review identified barriers and facilitators of implementation across various primary care settings in 22 studies. The major emerging themes were those related to the inner setting of the organization, the process of implementation and characteristics of the individual healthcare providers. These included: organizational culture, its structural characteristics, networks and communication, implementation climate and readiness, presence of supportive leadership, and provider attitudes and beliefs. These findings highlight the importance of assessing organizational capacity and needs prior

Implementing a Lean Management System in Primary Care: Facilitators and Barriers From the Front Lines.

Science.gov (United States)

Hung, Dorothy; Martinez, Meghan; Yakir, Maayan; Gray, Caroline

2015-01-01

Although Lean management techniques are increasingly used in health care to improve quality and reduce costs, lessons about how to successfully implement this approach on the front lines of care delivery are not well documented. In this study, we highlight key facilitators and barriers to implementing Lean among frontline primary care providers. This case study took place at a large, ambulatory care delivery system serving nearly 1 million patients. In-depth interviews were conducted with primary care physicians, staff, and administrators to identify key factors impacting Lean redesigns in primary care. Overall, staff engagement and performance management, sensitivity to the professional values and culture of medicine, and perceived adequacy of organizational resources were critical when introducing Lean changes. Specific drivers of change included empowerment of staff at all levels, visual display of performance metrics, and a culture of innovation and collaboration. Barriers included physician resistance to standardized work, difficulty transferring management responsibilities to non-physician staff, and time and staffing required for participating in improvement efforts. Although Lean offers a new approach to delivering care, the implementation process itself is both complex and crucial to success. Understanding early facilitators and barriers can maximize Lean's, potential to improve health care delivery.

Perceived barriers, benefits, and motives for physical activity: two primary-care physical activity prescription programs.

Science.gov (United States)

Patel, Asmita; Schofield, Grant M; Kolt, Gregory S; Keogh J, W L

2013-01-01

This study examined whether perceived barriers, benefits, and motives for physical activity differed based on allocation to 2 different types of primary-care activity-prescription programs (pedometer-based vs. time-based Green Prescription). Eighty participants from the Healthy Steps study completed a questionnaire that assessed their perceived barriers, benefits, and motives for physical activity. Factor analysis was carried out to identify common themes of barriers, benefits, and motives for physical activity. Factor scores were then used to explore between-groups differences for perceived barriers, benefits, and motives based on group allocation and demographic variables. No significant differences were found in factor scores based on allocation. Demographic variables relating to the existence of chronic health conditions, weight status, and older age were found to significantly influence perceived barriers, benefits, and motives for physical activity. Findings suggest that the addition of a pedometer to the standard Green Prescription does not appear to increase perceived motives or benefits or decrease perceived barriers for physical activity in low-active older adults.

Barriers and facilitators in the integration of oral health into primary care: a scoping review.

Science.gov (United States)

Harnagea, Hermina; Couturier, Yves; Shrivastava, Richa; Girard, Felix; Lamothe, Lise; Bedos, Christophe Pierre; Emami, Elham

2017-09-25

This scoping study has been conducted to map the literature and provide a descriptive synthesis on the barriers and facilitators of the integration of oral health into primary care. Grounded in the Rainbow conceptual model and using the Levac et al six-stage framework, we performed a systematic search of electronic databases, organisational websites and grey literature from 1978 to April 2016. All publications with a focus on the integration of oral health into primary care were included except commentaries and editorials. Thematic analyses were performed to synthesise the results. From a total of 1619 citations, 58 publications were included in the review. Barrier-related themes included: lack of political leadership and healthcare policies; implementation challenges; discipline-oriented education; lack of continuity of care and services and patients' oral healthcare needs. The facilitators of integration were supportive policies and resources allocation, interdisciplinary education, collaborative practices between dental and other healthcare professionals, presence of local strategic leaders and geographical proximity. This work has advanced the knowledge on the barriers and facilitators at each integration domain and level, which may be helpful if the healthcare organisations decide to integrate oral health and dental services into primary care. The scoping review findings could be useful for both dental and medical workforce and allied primary healthcare providers. They could also guide the development of healthcare policies that support collaborative practices and patient-centred care in the field of primary care. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Subsurface barrier verification technologies, informal report

International Nuclear Information System (INIS)

Heiser, J.H.

1994-06-01

One of the more promising remediation options available to the DOE waste management community is subsurface barriers. Some of the uses of subsurface barriers include surrounding and/or containing buried waste, as secondary confinement of underground storage tanks, to direct or contain subsurface contaminant plumes and to restrict remediation methods, such as vacuum extraction, to a limited area. To be most effective the barriers should be continuous and depending on use, have few or no breaches. A breach may be formed through numerous pathways including: discontinuous grout application, from joints between panels and from cracking due to grout curing or wet-dry cycling. The ability to verify barrier integrity is valuable to the DOE, EPA, and commercial sector and will be required to gain full public acceptance of subsurface barriers as either primary or secondary confinement at waste sites. It is recognized that no suitable method exists for the verification of an emplaced barrier's integrity. The large size and deep placement of subsurface barriers makes detection of leaks challenging. This becomes magnified if the permissible leakage from the site is low. Detection of small cracks (fractions of an inch) at depths of 100 feet or more has not been possible using existing surface geophysical techniques. Compounding the problem of locating flaws in a barrier is the fact that no placement technology can guarantee the completeness or integrity of the emplaced barrier. This report summarizes several commonly used or promising technologies that have been or may be applied to in-situ barrier continuity verification

Proactive penicillin allergy testing in primary care patients labeled as allergic: outcomes and barriers.

Science.gov (United States)

Sundquist, Britta K; Bowen, Brady J; Otabor, Uwa; Celestin, Jocelyn; Sorum, Paul C

2017-11-01

To promote penicillin allergy testing in an outpatient setting in patients labeled as penicillin allergic, to determine the number of those who are truly allergic, evaluate patient satisfaction with the testing, and educate both patients and clinicians about testing. Patients with a history of penicillin allergy listed in their EHR were screened and recruited by their primary care office and referred for penicillin allergy testing. The results of allergy testing and patient satisfaction after testing were the main outcomes. We also surveyed the primary care physicians about perceived barriers to recruitment. A total of 82 patients were recruited, although only 37 actually underwent testing. None of these 37 had a positive skin test, and none of 36 had a positive oral challenge (1 refused it). Following testing, 2 patients (5%) had subjective reactions within 24 h. Thirty-one patients (84%) responded to a post-testing follow-up questionnaire; 3 (10%) were subsequently treated with a beta-lactam, and all reported that testing provided important information to their medical history. Providers identified time constraints, either their or their patients lack of time, as the major barrier to recruitment. Penicillin allergy testing safely evaluates patients labeled as penicillin allergic. It is well tolerated, and embraced by the patients who undergo testing. In our study, none of the patients tested had an allergic reaction, but we identified multiple barriers to developing a protocol for testing patients from the primary care setting.

Perceived barriers, resources, and training needs of rural primary care providers relevant to the management of childhood obesity.

Science.gov (United States)

Findholt, Nancy E; Davis, Melinda M; Michael, Yvonne L

2013-08-01

To explore the perceived barriers, resources, and training needs of rural primary care providers in relation to implementing the American Medical Association Expert Committee recommendations for assessment, treatment, and prevention of childhood obesity. In-depth interviews were conducted with 13 rural primary care providers in Oregon. Transcribed interviews were thematically coded. Barriers to addressing childhood obesity fell into 5 categories: barriers related to the practice (time constraints, lack of reimbursement, few opportunities to detect obesity), the clinician (limited knowledge), the family/patient (family lifestyle and lack of parent motivation to change, low family income and lack of health insurance, sensitivity of the issue), the community (lack of pediatric subspecialists and multidisciplinary/tertiary care services, few community resources), and the broader sociocultural environment (sociocultural influences, high prevalence of childhood obesity). There were very few clinic and community resources to assist clinicians in addressing weight issues. Clinicians had received little previous training relevant to childhood obesity, and they expressed an interest in several topics. Rural primary care providers face extensive barriers in relation to implementing recommended practices for assessment, treatment, and prevention of childhood obesity. Particularly problematic is the lack of local and regional resources. Employing nurses to provide case management and behavior counseling, group visits, and telehealth and other technological communications are strategies that could improve the management of childhood obesity in rural primary care settings. © 2013 National Rural Health Association.

Barriers for identification and treatment of problem drinkers in primary care.

Science.gov (United States)

Coloma-Carmona, Ainhoa; Carballo, José Luis; Tirado-González, Sonia

Due to the lack of studies in the Spanish population, this study aims to analyze the barriers perceived by health professionals from different Spanish health centers when attempting to identify and treat problem drinkers and the importance given to this aspect, as well as analyzing the possible differences as a function of the professionals' health teams. We also analyze the psychometric properties of the questionnaire used to assess these barriers. The participants included 107 health professionals: 62.7% belonged to the medical team and 32.4% to the nursing team. After we had reviewed previous studies, collecting the main barriers referred to in them, participants completed an ad hoc questionnaire. The main barriers found were the belief that patients will lie about their actual consumption and will not identify its negative consequences, and the belief that they will reject participating in an intervention for their alcohol consumption. No significant differences between doctors and nurses were found in any of the barriers assessed. The results provide empirical evidence of the reliability of the test for the assessment by both teams of professionals. Studies are needed to examine in greater depth these conclusions, extending the number of variables studied to determine a more complete profile of the health professionals who are reluctant to incorporate the assessment and treatment of problem drinkers in their consultation. This could help to improve the design of programs to facilitate and encourage its implementation in primary care. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Teachers' Perceptions about the Barriers and Catalysts for Effective Practices with ICT in Primary Schools

Science.gov (United States)

Dakich, Eva

This paper presents perceptions of four primary school teachers from two Victorian government primary schools about the barriers and catalyst for effective practices with ICT. Findings of the semi-structured qualitative interviews confirm results of previous studies indicating that access to reliable infrastructure, adequate technical support, and time pressures are still considered to be some of the most significant barriers to successful ICT integration in public schools. Teacher interviews however also reveal that the challenges of integrating ICT in teaching and learning can be counterbalanced by a number of variables, which include: owning a laptop, having access to ongoing professional learning, sharing effective practices, drawing on student expertise and being supported by a whole-school approach to teaching and learning with ICT.

Primary School Teachers' Knowledge, Attitudes and Views on Barriers to Inclusion in Jordan

Science.gov (United States)

Amr, Muna; Al-Natour, Mayada; Al-Abdallat, Bassam; Alkhamra, Hatem

2016-01-01

This study explores teachers' knowledge and attitudes toward the inclusion of students with special education needs (SEN) in mainstream schools in Jordan. It also examines the barriers the teachers perceived to hinder successful inclusions. The study sample consisted of 87 primary school teachers who responded to an open-ended questionnaire asking…

Barriers to patient portal access among veterans receiving home-based primary care: a qualitative study.

Science.gov (United States)

Mishuris, Rebecca G; Stewart, Max; Fix, Gemmae M; Marcello, Thomas; McInnes, D Keith; Hogan, Timothy P; Boardman, Judith B; Simon, Steven R

2015-12-01

Electronic, or web-based, patient portals can improve patient satisfaction, engagement and health outcomes and are becoming more prevalent with the advent of meaningful use incentives. However, adoption rates are low, particularly among vulnerable patient populations, such as those patients who are home-bound with multiple comorbidities. Little is known about how these patients view patient portals or their barriers to using them. To identify barriers to and facilitators of using My HealtheVet (MHV), the United States Department of Veterans Affairs (VA) patient portal, among Veterans using home-based primary care services. Qualitative study using in-depth semi-structured interviews. We conducted a content analysis informed by grounded theory. Fourteen Veterans receiving home-based primary care, surrogates of two of these Veterans, and three home-based primary care (HBPC) staff members. We identified five themes related to the use of MHV: limited knowledge; satisfaction with current HBPC care; limited computer and Internet access; desire to learn more about MHV and its potential use; and value of surrogates acting as intermediaries between Veterans and MHV. Despite their limited knowledge of MHV and computer access, home-bound Veterans are interested in accessing MHV and using it as an additional point of care. Surrogates are also potential users of MHV on behalf of these Veterans and may have different barriers to and benefits from use. © 2014 John Wiley & Sons Ltd.

Closure Welding of Plutonium Bearing Storage Containers

International Nuclear Information System (INIS)

Cannell, G.R.

2002-01-01

A key element in the Department of Energy (DOE) strategy for the stabilization, packaging and storage of plutonium-bearing materials involves closure welding of DOE-STD-3013 Outer Containers (3013 container). The 3013 container provides the primary barrier and pressure boundary preventing release of plutonium-bearing materials to the environment. The final closure (closure weld) of the 3013 container must be leaktight, structurally sound and meet DOE STD 3013 specified criteria. This paper focuses on the development, qualification and demonstration of the welding process for the closure welding of Hanford PFP 3013 outer containers

Possibilities and barriers for e-learning in primary school in Denmark

DEFF Research Database (Denmark)

Alstrup, Stephen; Rootzén, Helle

2016-01-01

How much are we using e-learning in primary school in Denmark? What are the barriers? What are the benefits? Why do we not use e-learning even more? These questions have been the focus for a one year national investigation conducted by ATV, The Danish Academy of Technical Sciences....... The investigation included interviews with Danish researchers, persons from the ministry, teachers, students, and e-learning companies. The overall purpose was to make recommendations on how to accelerate the digital transformation of the Danish primary and high schools education system. In this paper, we combine...... a fear that using Big Data for personalization of the teaching/learning process will be used to stereotype education, or will only be used to save costs...

Barriers in the implementation of a physical activity intervention in primary care settings: lessons learned.

Science.gov (United States)

Josyula, Lakshmi K; Lyle, Roseann M

2013-01-01

Barriers encountered in implementing a physical activity intervention in primary health care settings, and ways to address them, are described in this paper. A randomized comparison trial was designed to examine the impact of health care providers' written prescriptions for physical activity, with or without additional physical activity resources, to adult, nonpregnant patients on preventive care or chronic disease monitoring visits. Following abysmal recruitment outcomes, the research protocol was altered to make it more appealing to all the participants, i.e., health care providers, office personnel, and patients. Various barriers--financial, motivational, and executive--to the implementation of health promotion interventions in primary health care settings were experienced and identified. These barriers have been classified by the different participants in the research process, viz., healthcare providers, administrative personnel, researchers, and patients. Some of the barriers identified were lack of time and reimbursement for health promotion activities, and inadequate practice capacity, for health care providers; increased time and labor demands for administrative personnel; constrained access to participants, and limited funding, for researchers; and superseding commitments, and inaccurate comprehension of the research protocol, for patients. Solutions suggested to overcome these barriers include financial support, e.g., funding for researchers, remuneration for health care organization personnel, reimbursement for providers, payment for participants, and free or subsidized postage, and use of health facilities; motivational strategies such as inspirational leadership, and contests within health care organizations; and partnerships, with other expert technical and creative entities, to improve the quality, efficiency, and acceptability of health promotion interventions.

Mathematical models for diffusive mass transfer from waste package container with multiple perforations

International Nuclear Information System (INIS)

Lee, J.H.; Andrews, R.W.; Chambre, P.L.

1996-01-01

A robust engineered barrier system (EBS) is employed in the current design concept for the potential high-level nuclear waste repository at Yucca Mountain, Nevada, US. The primary component of the EBS is a multi-barrier waste package container. Simplifying the geometry of the cylindrical waste package container and the underlying invert into the equivalent spherical configuration, mathematical models are developed for steady-state and transient diffusive releases from the failed waste container with multiple perforations (or pit penetrations) at the boundary of the invert. Using the models the steady-state and transient diffusive release behaviors form the failed waste container are studied. The analyses show that the number of perforations, the size of perforation, the container wall thickness, the geometry of the waste container and invert, and the adsorption of radionuclide in the invert are the important parameters that control the diffusive release rate. It is emphasized that the failed (or perforated) waste package container can still perform as a potentially important barrier (or diffusion barrier) to radionuclide release

Pre-Primary Education of Roma Children in Serbia: Barriers and Possibilities

Directory of Open Access Journals (Sweden)

Sunčica Macura-Milovanović

2013-01-01

Full Text Available In Serbia, as in the other countries of the Western Balkans and South-Eastern Europe, the most disadvantaged communities belong to the Roma minority. The present paper demonstrates the conditions of Roma preschool children in Serbia: primarily their early education, but also habitation and health in Roma settlements. The data highlight the under-representation of Roma children in pre-primary education, although their growing up in extremely deprived settlements would suggest a need for their earliest possible inclusion in pre-primary services. The paper analyses the following barriers to the access of Roma children to the system of pre-primary education: the poverty of Roma families; discrimination and prejudice towards Roma; the lack of intercultural provision; insufficient inter-sectorial cooperation; the underdeveloped network of preschool institutions; and the absence of kindergartens in Roma settlements. In addition, possible ways to increase the coverage of Roma children in pre-primary education are discussed. As a transitory solution, the paper proposes comprehensivecommunity-based programmes that could contribute to the education, care, health and overall development of young Roma children before their inclusion in desegregated programmes in preschool institutions.

Barriers and enablers of physical activity engagement for patients with COPD in primary care

Directory of Open Access Journals (Sweden)

Kosteli MC

2017-03-01

Full Text Available Maria-Christina Kosteli,1 Nicola R Heneghan,1 Carolyn Roskell,1 Sarah E Williams,1 Peymane Adab,2 Andrew P Dickens,2 Alexandra Enocson,2 David A Fitzmaurice,2 Kate Jolly,2 Rachel Jordan,2 Sheila Greenfield,2 Jennifer Cumming1 1School of Sport, Exercise and Rehabilitation Sciences, 2Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, UK Background: Given that physical activity (PA has a positive impact on COPD symptoms and prognosis, this study examined the factors that both encourage and limit participation in PA for individuals with COPD in a primary care setting from the perspective of social cognitive theory.Methods: A purposive sample of 26 individuals with a range of COPD severity (age range: 50–89 years; males =15 were recruited from primary care to participate in one of four focus groups. Thematic analysis was undertaken to identify key concepts related to their self-efficacy beliefs.Results: Several barriers and enablers closely related to self-efficacy beliefs and symptom severity were identified. The main barriers were health related (fatigue, mobility problems, breathing issues caused by the weather, psychological (embarrassment, fear, frustration/disappointment, attitudinal (feeling in control of their condition, PA perception, older age perception, and motivational. The main enabling factors were related to motivation (autonomous or controlled, attitudes, self-regulation, and performance accomplishments.Clinical implications: When designing interventions for individuals with COPD, it is important to understand the patient-specific social cognitive influences on PA participation. This information can then inform individually tailored management planning. Keywords: COPD, social cognitive theory, self-efficacy, barriers, enablers, primary care

The effect of pH on hydrolysis, cross-linking and barrier properties of starch barriers containing citric acid.

Science.gov (United States)

Olsson, Erik; Menzel, Carolin; Johansson, Caisa; Andersson, Roger; Koch, Kristine; Järnström, Lars

2013-11-06

Citric acid cross-linking of starch for e.g. food packaging applications has been intensely studied during the last decade as a method of producing water-insensitive renewable barrier coatings. We managed to improve a starch formulation containing citric acid as cross-linking agent for industrial paper coating applications by adjusting the pH of the starch solution. The described starch formulations exhibited both cross-linking of starch by citric acid as well as satisfactory barrier properties, e.g. fairly low OTR values at 50% RH that are comparable with EVOH. Furthermore, it has been shown that barrier properties of coated papers with different solution pH were correlated to molecular changes in starch showing both hydrolysis and cross-linking of starch molecules in the presence of citric acid. Hydrolysis was shown to be almost completely hindered at solution pH≥4 at curing temperatures≤105 °C and at pH≥5 at curing temperatures≤150 °C, whereas cross-linking still occurred to some extent at pH≤6.5 and drying temperatures as low as 70 °C. Coated papers showed a minimum in water vapor transmission rate at pH 4 of the starch coating solution, corresponding to the point where hydrolysis was effectively hindered but where a significant degree of cross-linking still occurred. Copyright © 2013 Elsevier Ltd. All rights reserved.

Awareness, Facilitators, and Barriers to Policy Implementation Related to Obesity Prevention for Primary School Children in Malaysia.

Science.gov (United States)

Chan, Camelina; Moy, Foong Ming; Lim, Jennifer N W; Dahlui, Maznah

2018-03-01

To assess the awareness, facilitators, and barriers to policy implementation related to obesity prevention for primary school children. A cross-sectional study administered using an online questionnaire. Conducted in 447 primary schools in a state in Malaysia. One school administrator from each school served as a participant. The questionnaires consisted of 32 items on awareness, policy implementation, and facilitators and barriers to policy implementation. Descriptive analysis was used to describe the awareness, facilitators, and barriers of policies implementation. Association between schools' characteristics and policy implementation was assessed using logistic regression. The majority (90%) of school administrators were aware of the policies. However, only 50% to 70% of schools had implemented the policies fully. Reported barriers were lack of equipment, insufficient training, and limited time to complete implementation. Facilitators of policy implementation were commitment from the schools, staff members, students, and canteen operators. Policy implementation was comparable in all school types and locality; except the policy on "Food and Drinks sold at the school canteens" was implemented by more rural schools compared to urban schools (odds ratio: 1.74, 95% confidence interval: 1.13-2.69). Majority of the school administrators were aware of the existing policies; however, the implementation was only satisfactory. The identified barriers to policy implementation were modifiable and thus, the stakeholders should consider restrategizing plans in overcoming them.

Using Frozen Barriers for Containment of Contaminants

Science.gov (United States)

2017-09-21

barriers are constructed of grout slurry and plastic or steel sheet pilings. Circumferential barriers can be used to completely enclose a source of...2.1.1 Slurry walls A soil-bentonite slurry trench cutoff wall (slurry wall) is excavated and backfilled with grout, cement , or soil-bentonite...installation requires a mixing area, and there is a substantial amount of excavation and the need to dispose of spoil. The advantages of cement -based

Maximum dose angle for oblique incidence on primary beam protective barriers in the design of medical radiation therapy facilities

International Nuclear Information System (INIS)

Fondevila, Damian; Arbiser, Silvio; Sansogne, Rosana; Brunetto, Monica; Dosoretz, Bernardo

2008-01-01

Primary barrier determinations for the shielding of medical radiation therapy facilities are generally made assuming normal beam incidence on the barrier, since this is geometrically the most unfavorable condition for that shielding barrier whenever the occupation line is allowed to run along the barrier. However, when the occupation line (for example, the wall of an adjacent building) runs perpendicular to the barrier (especially roof barrier), then two opposing factors come in to play: increasing obliquity angle with respect to the barrier increases the attenuation, while the distance to the calculation point decreases, hence, increasing the dose. As a result, there exists an angle (α max ) for which the equivalent dose results in a maximum, constituting the most unfavorable geometric condition for that shielding barrier. Based on the usual NCRP Report No. 151 model, this article presents a simple formula for obtaining α max , which is a function of the thickness of the barrier (t E ) and the equilibrium tenth-value layer (TVL e ) of the shielding material for the nominal energy of the beam. It can be seen that α max increases for increasing TVL e (hence, beam energy) and decreases for increasing t E , with a range of variation that goes from 13 to 40 deg for concrete barriers thicknesses in the range of 50-300 cm and most commercially available teletherapy machines. This parameter has not been calculated in the existing literature for radiotherapy facilities design and has practical applications, as in calculating the required unoccupied roof shielding for the protection of a nearby building located in the plane of the primary beam rotation

Maximum dose angle for oblique incidence on primary beam protective barriers in the design of medical radiation therapy facilities.

Science.gov (United States)

Fondevila, Damián; Arbiser, Silvio; Sansogne, Rosana; Brunetto, Mónica; Dosoretz, Bernardo

2008-05-01

Primary barrier determinations for the shielding of medical radiation therapy facilities are generally made assuming normal beam incidence on the barrier, since this is geometrically the most unfavorable condition for that shielding barrier whenever the occupation line is allowed to run along the barrier. However, when the occupation line (for example, the wall of an adjacent building) runs perpendicular to the barrier (especially roof barrier), then two opposing factors come in to play: increasing obliquity angle with respect to the barrier increases the attenuation, while the distance to the calculation point decreases, hence, increasing the dose. As a result, there exists an angle (alpha(max)) for which the equivalent dose results in a maximum, constituting the most unfavorable geometric condition for that shielding barrier. Based on the usual NCRP Report No. 151 model, this article presents a simple formula for obtaining alpha(max), which is a function of the thickness of the barrier (t(E)) and the equilibrium tenth-value layer (TVL(e)) of the shielding material for the nominal energy of the beam. It can be seen that alpha(max) increases for increasing TVL(e) (hence, beam energy) and decreases for increasing t(E), with a range of variation that goes from 13 to 40 deg for concrete barriers thicknesses in the range of 50-300 cm and most commercially available teletherapy machines. This parameter has not been calculated in the existing literature for radiotherapy facilities design and has practical applications, as in calculating the required unoccupied roof shielding for the protection of a nearby building located in the plane of the primary beam rotation.

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

Science.gov (United States)

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

2015-12-01

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

Health insurance without provider influence: the limits of cost containment.

Science.gov (United States)

Goldberg, L G; Greenberg, W

1988-01-01

In our previous paper, we showed that market forces can play a significant role in controlling health care costs and that a considerable amount of cost containment effort was pursued by third-party insurers in Oregon in the 1930s and 1940s. Although physicians were able to thwart this cost-control effort, a 1986 Supreme Court decision, FTC v. Indiana Federation of Dentists, found that a boycott of insurers by dentists violated Section 5 of the Federal Trade Commission Act. Further investigation of recent developments, including the recent Wickline v. California decision, indicates that the primary barriers to cost containment today are not obstructive tactics by providers or provider-controlled health insurance plans. Rather, the primary barriers are increases in the development and diffusion of new technology and society's apparent preference for paying for new tests and procedures regardless of economic efficiency.

Primary care physicians′ knowledge and perceived barriers in the management of overweight and obesity

Directory of Open Access Journals (Sweden)

Abdulaziz M Sebiany

2013-01-01

Full Text Available Objectives: To determine the level of knowledge of primary health care physicians and the barriers perceived in the management of overweight and obesity in the Eastern Province of Saudi Arabia. Setting: Primary health care centers in Dammam and Al-Khobar cities, Saudi Arabia. Design: A cross-sectional study. Materials and Methods: One hundred and forty-nine physicians were surveyed. Data were collected with a specially made anonymous, self-administrated, structured questionnaire with a Cronbach alpha reliability of 0.85, and content validity by five experts was used to measure the knowledge and barriers from several different aspects of care provided by primary health care centers to the overweight and obese. Results: One hundred and thirty (87% physicians responded. More than two-thirds of the respondents considered themselves as key players in the management of obesity. However, only one-third believed that they were well prepared to treat obesity. Eighty-three per cent of the respondents had a negative attitude toward the concept of overweight and obesity. It was noted that 76.9% of physicians advised patients to control their weight with sport and exercise together with low calorie diet. Sixty percent of the respondents used body mass index to diagnose obesity. Seventy-two percent of respondents did not use weight reduction medications to treat obesity. Lack of training, poor administrative support, and time constraints were identified as barriers in managing overweight and obesity. Conclusion: Respondents were aware of the magnitude of overweight and obesity as a major public health problem in Saudi Arabia, and they were also aware of the correct definition of overweight and obesity, as well as its effect in increasing mortality. Better training is required to improve some areas of awareness and management of the conditions.

Composition, structure and electrical properties of alumina barrier layers grown in fluoride-containing oxalic acid solutions

Energy Technology Data Exchange (ETDEWEB)

Jagminas, A. [Institute of Chemistry, A. Gostauto 9, LT-01108 Vilnius (Lithuania)], E-mail: jagmin@ktl.mii.lt; Vrublevsky, I. [Department of Microelectricals, Belarusian State University of Informatics and Radioelectricals, 6 Brovka Street, Minsk 220013 (Belarus); Kuzmarskyte, J.; Jasulaitiene, V. [Institute of Chemistry, A. Gostauto 9, LT-01108 Vilnius (Lithuania)

2008-04-15

The composition, structure and electrical properties of alumina barrier layers grown by anodic oxidation in F{sup -}-containing (FC) and F{sup -}-free (FF) oxalic acid solutions were studied using the re-anodizing/dissolution technique, Fourier-transformed infrared and X-ray photoelectron spectroscopy. These results confirmed formation in FC anodizing solutions of films structurally different from ones grown in FF oxalic acid baths. It was found that the barrier layer of FC alumina films is composed of two layers differing in the dissolution rate. These differences are related to the formation in the FC electrolyte of a barrier layer composed of a more microporous outer part and a thin, non-porous and non-scalloped inner part consisting of aluminum oxide and aluminum fluoride.

Characterisation of an in vitro blood-brain barrier model based on primary porcine capillary endothelial cells in monoculture or co-culture with primary rat or porcine astrocytes and pericytes

DEFF Research Database (Denmark)

Thomsen, Louiza Bohn; Larsen, Annette Burkhart; Moos, Torben

to in vivo such as efflux transporters, tight junction proteins, and high transendothelial electric resistance (TEER). Primary BCECs are isolated from a variety of mammals such as rats, mice, cattle and pigs. Often bovine and porcine BCECs are cultured in monoculture or in co-culture with rat astrocytes......In vitro blood-brain barrier (BBB) models based on primary brain capillary endothelial cells (BCECs) in monoculture or in co-culture with primary astrocytes and pericytes are often applied for studying physiology of the BBB. Primary BCECs retain many morphological and biochemical properties similar...... obtained from neonatal rats which have been shown to strengthen the barrier properties of the BCECs. In this study, brain endothelial cells (PBECs), astrocytes and pericytes are isolated from pig brains donated by the local abattoir. The brains are from 6 month old domestic pigs. The availability and high...

Summary report on close-coupled subsurface barrier technology: Initial field trials to full-scale demonstration

International Nuclear Information System (INIS)

Heiser, J.H.

1997-09-01

The primary objective of this project was to develop and demonstrate the installation and measure the performance of a close-coupled barrier for the containment of subsurface waste or contaminant migration. A close-coupled barrier is produced by first installing a conventional, low-cost, cement-grout containment barrier followed by a thin lining of a polymer grout. The resultant barrier is a cement-polymer composite that has economic benefits derived from the cement and performance benefits from the durable and resistant polymer layer. The technology has matured from a regulatory investigation of the issues concerning the use of polymers to laboratory compatibility and performance measurements of various polymer systems to a pilot-scale, single column injection at Sandia to full-scale demonstration. The feasibility of the close-coupled barrier concept was proven in a full-scale cold demonstration at Hanford, Washington and then moved to the final stage with a full-scale demonstration at an actual remediation site at Brookhaven National Laboratory (BNL). At the Hanford demonstration the composite barrier was emplaced around and beneath a 20,000 liter tank. The secondary cement layer was constructed using conventional jet grouting techniques. Drilling was completed at a 45 degree angle to the ground, forming a cone-shaped barrier. The primary barrier was placed by panel jet-grouting with a dual-wall drill stem using a two part polymer grout. The polymer chosen was a high molecular weight acrylic. At the BNL demonstration a V-trough barrier was installed using a conventional cement grout for the secondary layer and an acrylic-gel polymer for the primary layer. Construction techniques were identical to the Hanford installation. This report summarizes the technology development from pilot- to full-scale demonstrations and presents some of the performance and quality achievements attained

Chemical gel barriers as low-cost alternative to containment and in situ cleanup of hazardous wastes to protect groundwater

International Nuclear Information System (INIS)

1997-01-01

Chemical gel barriers are being considered as a low-cost alternative for containment and in situ cleanup of hazardous wastes to protect groundwater. Most of the available gels in petroleum application are non-reactive and relative impermeable, providing a physical barriers for all fluids and contaminants. However, other potential systems can be envisioned. These systems could include gels that are chemically reactive and impermeable such that most phase are captured by the barriers but the contaminants could diffuse through the barriers. Another system that is chemically reactive and permeable could have potential applications in selectivity capturing contaminants while allowing water to pass through the barriers. This study focused on chemically reactive and permeable gel barriers. The gels used in experiment are DuPont LUDOX SM colloidal silica gel and Pfizer FLOPAAM 1330S hydrolyzed polyacrylamide (HPAM) gel

Grounded Theory of Barriers and Facilitators to Mandated Implementation of Mental Health Care in the Primary Care Setting

Directory of Open Access Journals (Sweden)

Justin K. Benzer

2012-01-01

Full Text Available Objective. There is limited theory regarding the real-world implementation of mental health care in the primary care setting: a type of organizational coordination intervention. The purpose of this study was to develop a theory to conceptualize the potential causes of barriers and facilitators to how local sites responded to this mandated intervention to achieve coordinated mental health care. Methods. Data from 65 primary care and mental health staff interviews across 16 sites were analyzed to identify how coordination was perceived one year after an organizational mandate to provide integrated mental health care in the primary care setting. Results. Standardized referral procedures and communication practices between primary care and mental health were influenced by the organizational factors of resources, training, and work design, as well as provider-experienced organizational boundaries between primary care and mental health, time pressures, and staff participation. Organizational factors and provider experiences were in turn influenced by leadership. Conclusions. Our emergent theory describes how leadership, organizational factors, and provider experiences affect the implementation of a mandated mental health coordination intervention. This framework provides a nuanced understanding of the potential barriers and facilitators to implementing interventions designed to improve coordination between professional groups.

Perceptions of Mexican women regarding barriers in mental Heath Services in primary care.

Science.gov (United States)

Galván, Jorge; Saavedra, Nayelhi; Bartolo, Feliciano; Berenzon, Shoshana

2017-08-31

The recent mental health care reforms in Mexico call for the regular evaluation of the services provided. This involves analyzing the opinions of those who utilize them on a daily basis, particularly women, since they are the main health service users. This study explores the barriers to mental health care perceived by a group of women attending primary care centers. A qualitative methodological approach was chosen. The participants were purposively selected, using the snowball technique. Semi-structured interviews were analyzed using the thematic analysis. Three sets of factors representing barriers to care were identified in the participants' discourse. The first is linked to systemic barriers such as a lack of familiarity with the way the service operates, and irregularities in the consultations and appointment schedules that are not always geared to women's needs. The second concerns the social stigma associated with emotional and/or mental disorders and their care while the third involves the characteristics of psychologists and their professional work. In order to overcome some of the barriers identified, users should be given information on the work of mental health professionals, which would help dispel certain misconceptions and sensitize them to the importance of this type of treatment in achieving overall health. There is also a need to make psychologists aware of the living conditions and socio-cultural context of the women who attend these health facilities.

Elder Abuse and Neglect Intervention in the Clinical Setting: Perceptions and Barriers Faced by Primary Care Physicians in Malaysia.

Science.gov (United States)

Mohd Mydin, Fadzilah Hanum; Othman, Sajaratulnisah

2017-08-01

This qualitative study attempts to explore the definition, perceptions, practice experience, and barriers of primary care physicians (PCPs) in identifying and intervening in cases of elder abuse and neglect at the primary care level. Semistructured in-depth interview was conducted among 10 PCPs. Participants were selected by purposive sampling. The interviews were audio recorded, transcribed verbatim, and analyzed using thematic analysis. In general, PCPs showed consistency in defining elder abuse and neglect. PCPs considered that they were optimally positioned to intervene in cases of elder abuse and neglect, but indicated the potential of overlooking such problems. The hurdles faced by PCPs in the identification and intervention of elder abuse were determined to be occurring at three levels: clinical, organizational, and policy. At the clinical level, PCPs recognize that they are lacking both the confidence and knowledge of elder abuse and neglect intervention. PCPs' conflicting personal and professional beliefs create barriers during the clinical practice. Time constraints, patients' other clinical problems, and, in addition, the preservation of a good doctor-patient relationship overshadow the importance of addressing and intervening in elder abuse and neglect issues during the consultation. This is further exacerbated by the barriers perceived by the patients: their nondisclosure and reluctance to accept outside intervention. At the organizational level, the lack of efficient interagency networks or support for the health system poses barriers. At the policy level, the absence of legislation specifically addressing elder abuse also creates considerable difficulties. However, PCPs gave differing responses when asked about a law concerning the elderly and mandatory reporting. Addressing these multilevel barriers is critical for ensuring that opportunities arising at the primary care level for elder maltreatment intervention are correctly utilized.

Ultimate load model test for Sizewell 'B' primary containment

International Nuclear Information System (INIS)

Crowder, R.

1988-01-01

This paper considers the factors influencing the adoption of an ultimate load factor for the Sizewell 'B' PWR primary containment structure. As part of the validation process for the ultimate load analysis method, a proposal has been made by Nuclear Design Associates to build and test a 1/10th scale model of the containment structure, which would proceed following the granting of section 2 consent for Sizewell 'B'. The modelling principles, construction method and test proposals are examined in some detail. The proposal is currently being considered by the CEGB's Project Management Team. (author)

Control of the flanges of the thermal barriers fitting the 900 MWe PWR primary pumps

International Nuclear Information System (INIS)

Cleurennec, M.; Thebault, Y.; Abittan, E.; Pages, C.; Lhote, P.A.; Randrianarivo, L.

1998-01-01

During maintenance visit on 93 D type primary pumps of French 900 MWe nuclear units, cracking has been evidenced on the thermal barrier, first on the flange, on the face of connection of the cooling, water coils, and then on the weld between the housing and the flange. Laboratory examinations have exhibited that this cracking is due to a fatigue phenomenon which is initiated on locations where high residual stresses are present. One pump, in service in a plant, has received an instrumentation in order to determine stress cycling. Measurements of temperature on the surface of the metal have shown the presence of thermal cycling due to the thermohydraulic conditions inside the thermal barrier. A non destructive testing method using ultrasounds has been developed in order to asses the magnitude cracking. Corrective and preventive actions have been implemented for repairing and improving thermal barrier when cracking is detected. (authors)

Barriers and facilitators to providing undergraduate physiotherapy clinical education in the primary care setting: a three-round Delphi study.

Science.gov (United States)

McMahon, S; Cusack, T; O'Donoghue, G

2014-03-01

With the global shift in health care from secondary to primary care, employment opportunities for newly qualified physiotherapists are likely to be in the primary care setting. However, to date, undergraduate physiotherapy clinical education has been centred around secondary care, focusing on acute services in large teaching hospitals. For contemporary physiotherapists to become effective first-contact primary care providers, they need to be exposed to the primary care environment during their undergraduate education. To explore the concept and identify perceived barriers and facilitators to providing physiotherapy undergraduate clinical placements in the primary healthcare setting A three-round Delphi survey was used. Participants were asked to answer open-ended questions with regard to: (i) student preparation for and (ii) provision of primary care placements (Round 1). Content analysis was employed to identify key themes. These themes generated statements for Round 2. In Round 2, participants were asked to rate their level of agreement/disagreement with the generated statements. In Round 3, a final rating process was conducted. Level of consensus was established as ≥70% agreement, with an interquartile range of ≤1. One hundred and ninety-eight primary care physiotherapy staff. Barriers identified included shortage of resources (e.g. staff) and a lack of tradition; in other words, students are not traditionally educated in the primary care setting. Response rates were 60% (120/198), 70% (84/120) and 76% (64/84) for Rounds 1, 2 and 3, respectively. All seven key facilitators identified reached consensus. They included additional support for staff taking students and motivated students. This study revealed that there is support for the provision of physiotherapy clinical education in the primary care setting. Through careful consideration with clear planning and collaboration with all stakeholders, it may be possible to convert the main barriers identified into

Hanford protective barriers program: Status of asphalt barrier studies - FY 1989

International Nuclear Information System (INIS)

Freeman, H.D.; Gee, G.W.

1989-11-01

The Hanford Protective Barrier Program is evaluating alternate barriers to provide a means of meeting stringent water infiltration requirements. One type of alternate barrier being considered is an asphalt-based layer, 1.3 to 15 cm thick. Evaluations of these barriers were initiated in FY 1988, and, based on laboratory studies, two asphalt formulations were selected for further testing in small-tube lysimeters: a hot rubberized asphalt and an admixture of cationic asphalt emulsion and concrete sand containing 24 wt% residual asphalt. Eight lysimeters containing asphalt seals were installed as part of the Small Tube Lysimeter Test Facility on the Hanford Site. Two control lysimeters containing Hanford sand with a surface gravel treatment were also installed for comparison. 5 refs., 13 figs., 1 tab

Barrier and adhesion properties of anti-corrosion coatings based on surfactant-free latexes from anhydride-containing polymers

NARCIS (Netherlands)

Soer, W.J.; Ming, W.; Koning, C.E.; Benthem, van R.A.T.M.; Mol, J.M.C.; Terryn, H.

2009-01-01

We have successfully obtained surfactant-free latexes from anhydride-containing polymers, including poly(styrene-alt-maleic anhydride) (PSMA), maleinized polybutadiene (PBDMA), and poly(octadecene-alt-maleic anhydride) (POMA). Here we report barrier and adhesion properties of the coatings made from

Patient-perceived barriers and facilitators to the implementation of a medication review in primary care: a qualitative thematic analysis.

Science.gov (United States)

Uhl, Mirella Carolin; Muth, Christiane; Gerlach, Ferdinand Michael; Schoch, Goentje-Gesine; Müller, Beate Sigrid

2018-01-05

Although polypharmacy can cause adverse health outcomes, patients often know little about their medication. A regularly conducted medication review (MR) can help provide an overview of a patient's medication, and benefit patients by enhancing their knowledge of their drugs. As little is known about patient attitudes towards MRs in primary care, the objective of this study was to gain insight into patient-perceived barriers and facilitators to the implementation of an MR. We conducted a qualitative study with a convenience sample of 31 patients (age ≥ 60 years, ≥3 chronic diseases, taking ≥5 drugs/d); in Hesse, Germany, in February 2016. We conducted two focus groups and, in order to ensure the participation of elderly patients with reduced mobility, 16 telephone interviews. Both relied on a semi-structured interview guide dealing with the following subjects: patients' experience of polypharmacy, general design of MRs, potential barriers and facilitators to implementation etc. Interviews were audio-recorded, transcribed verbatim, and analysed by two researchers using thematic analysis. Patients' average age was 74 years (range 62-88 years). We identified barriers and facilitators for four main topics regarding the implementation of MRs in primary care: patient participation, GP-led MRs, pharmacist-led MRs, and the involvement of healthcare assistants in MRs. Barriers to patient participation concerned patient autonomy, while facilitators involved patient awareness of medication-related problems. Barriers to GP-led MRs concerned GP's lack of resources while facilitators related to the trusting relationship between patient and GP. Pharmacist-led MRs might be hindered by a lack of patients' confidence in pharmacists' expertise, but facilitated by pharmacies' digital records of the patients' medications. Regarding the involvement of healthcare assistants in MRs, a potential barrier was patients' uncertainty regarding the extent of their training. Patients

Exploring levers and barriers to accessing primary care for marginalised groups and identifying their priorities for primary care provision: a participatory learning and action research study.

Science.gov (United States)

O'Donnell, Patrick; Tierney, Edel; O'Carroll, Austin; Nurse, Diane; MacFarlane, Anne

2016-12-03

The involvement of patients and the public in healthcare has grown significantly in recent decades and is documented in health policy documents internationally. Many benefits of involving these groups in primary care planning have been reported. However, these benefits are rarely felt by those considered marginalised in society and they are often excluded from participating in the process of planning primary care. It has been recommended to employ suitable approaches, such as co-operative and participatory initiatives, to enable marginalised groups to highlight their priorities for care. This Participatory Learning and Action (PLA) research study involved 21 members of various marginalised groups who contributed their views about access to primary care. Using a series of PLA techniques for data generation and co-analysis, we explored barriers and facilitators to primary healthcare access from the perspective of migrants, Irish Travellers, homeless people, drug users, sex workers and people living in deprivation, and identified their priorities for action with regard to primary care provision. Four overarching themes were identified: the home environment, the effects of the 'two-tier' healthcare system on engagement, healthcare encounters, and the complex health needs of many in those groups. The study demonstrates that there are many complicated personal and structural barriers to accessing primary healthcare for marginalised groups. There were shared and differential experiences across the groups. Participants also expressed shared priorities for action in the planning and running of primary care services. Members of marginalised groups have shared priorities for action to improve their access to primary care. If steps are taken to address these, there is scope to impact on more than one marginalised group and to address the existing health inequities.

The blood-brain barrier in vitro using primary culture

DEFF Research Database (Denmark)

Larsen, Annette Burkhart

The brain is protected from the entry of unwanted substances by means of the blood-brain barrier (BBB) formed by the brain microvasculature. This BBB is composed of non-fenestrated brain capillary endothelial cells (BCECs) with their intermingling tight junctions. The presence of the BBB is a huge...... obstacle for the treatment of central nervous system (CNS) diseases, as many potentially CNS active drugs are unable to reach their site of action within the brain. In vitro BBB models are, therefore, being developed to investigate the BBB permeability of a drug early in its development. The first part...... of the thesis involves the establishment and characterization of an in vitro BBB models based on primary cells isolated from the rat brain. Co-culture and triple culture models with astrocytes and pericytes were found to be the superior to mono cultured BCECs with respect to many important BBB characteristics...

Primary human polarized small intestinal epithelial barriers respond differently to a hazardous and an innocuous protein.

Science.gov (United States)

Eaton, A D; Zimmermann, C; Delaney, B; Hurley, B P

2017-08-01

An experimental platform employing human derived intestinal epithelial cell (IEC) line monolayers grown on permeable Transwell ® filters was previously investigated to differentiate between hazardous and innocuous proteins. This approach was effective at distinguishing these types of proteins and perturbation of monolayer integrity, particularly transepithelial electrical resistance (TEER), was the most sensitive indicator. In the current report, in vitro indicators of monolayer integrity, cytotoxicity, and inflammation were evaluated using primary (non-transformed) human polarized small intestinal epithelial barriers cultured on Transwell ® filters to compare effects of a hazardous protein (Clostridium difficile Toxin A [ToxA]) and an innocuous protein (bovine serum albumin [BSA]). ToxA exerted a reproducible decrease on barrier integrity at doses comparable to those producing effects observed from cell line-derived IEC monolayers, with TEER being the most sensitive indicator. In contrast, BSA, tested at concentrations substantially higher than ToxA, did not cause changes in any of the tested variables. These results demonstrate a similarity in response to certain proteins between cell line-derived polarized IEC models and a primary human polarized small intestinal epithelial barrier model, thereby reinforcing the potential usefulness of cell line-derived polarized IECs as a valid experimental platform to differentiate between hazardous and non-hazardous proteins. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

The interaction between contacting barrier materials for containment of radioactive wastes

International Nuclear Information System (INIS)

Chang, Hao-Chun; Wang, Chun-Yao; Huang, Wei-Hsing

2012-01-01

Document available in extended abstract form only. The disposal of low-level radioactive wastes requires multi-barrier facilities to contain the wastes from contamination. Typically, the engineered barrier is composed of a concrete vault backfilled with sand/bentonite mixture. The backfill material is a mixture of bentonite and sand/gravel produced from crushing the rocks excavated at the site. With a great swelling potential, bentonite is expected to serve the sealing function, while the crushed sand/gravel improves the workability of the mixture. Due to the nature of radioactive wastes, the disposal site is designed for a service life of 300 years or more, which is much longer than typical engineering or earth works. With such a long service life, the site is subject to groundwater intrusion and geochemical evolution. The near-field environment evolution can be a complex problem in a disposal site. In the vicinity of the concrete vault in a disposal site, the high-alkali concrete environment can cause changes in the pore solution and alter the nature of backfill materials. Therefore, the interaction between the concrete and the backfill material needs to be assessed, such that the barriers serve the expected functions for a long time. Materials and Methods A locally available Zhishin clay and a bentonite originated from Black Hill, Wyoming, USA were used as raw clay materials in this study. Zhishin clay and Black Hill (BH) bentonite are mixed with Taitung area hard shale to produce the backfill material. An experimental program was conducted analysing the soil properties of these 2 bentonites. And an accelerated migration test was devised to understand the loss of calcium leaching of concrete on characteristics of backfill material. The 2 barrier materials (concrete and backfill) were placed in contact and then an electric gradient applied to accelerate the move of cations between the 2 barriers. Fig. 1 shows a schematic diagram of the accelerated migration test

Social workers' perceptions of barriers to interpersonal therapy implementation for treating postpartum depression in a primary care setting in Israel.

Science.gov (United States)

Bina, Rena; Barak, Adi; Posmontier, Barbara; Glasser, Saralee; Cinamon, Tali

2018-01-01

Research on evidence-based practice (EBP) implementation in social work often neglects to include evaluation of application barriers. This qualitative study examined social workers' perspectives of provider- and organisational-related barriers to implementing a brief eight-session interpersonal therapy (IPT) intervention, a time-limited EBP that addresses reducing depressive symptoms and improving interpersonal functioning. Implementation took place in a primary care setting in Israel and was aimed at treating women who have postpartum depression (PPD) symptoms. Using purposeful sampling, 25 primary care licensed social workers were interviewed between IPT training and implementation regarding their perceived barriers to implementing IPT in practice. Data analysis was facilitated using a phenomenological approach, which entails identifying the shared themes and shared experiences of research participants regarding barriers to implementing IPT. Three themes emerged from the analysis of interviews: Perceived lack of flexibility of IPT intervention in comparison with more familiar methods social workers previously applied, specifically regarding the number of sessions and therapeutic topics included in the IPT protocol; insecurity and hesitance to gain experience with a new method of intervention; and organisational barriers, including difficulties with referrals, the perception of HMOs as health facilities not suitable for therapy, and time constraints. Addressing perceived barriers of social workers toward implementing EBPs, such as IPT for postpartum depression, during the training phase is crucial for enabling appropriate implementation. Future training should include examining practitioners' attitudes toward implementation of EBPs, as part of standardised training protocols. © 2017 John Wiley & Sons Ltd.

The WINCON programme - validation of fast reactor primary containment codes

International Nuclear Information System (INIS)

Sidoli, J.E.A.; Kendall, K.C.

1988-01-01

In the United Kingdom safety studies for the Commercial Demonstration Fast Reactor (CDFR) include an assessment of the capability of the primary containment in providing an adequate containment for defence against the hazards resulting from a hypothetical Whole Core Accident (WCA). The assessment is based on calculational estimates using computer codes supported by measured evidence from small-scale experiments. The hydrodynamic containment code SEURBNUK-EURDYN is capable of representing a prescribed energy release, the sodium coolant and cover gas, and the main containment and safety related internal structures. Containment loadings estimated using SEURBNUK-EURDYN are used in the structural dynamic code EURDYN-03 for the prediction of the containment response. The experiments serve two purposes, they demonstrate the response of the CDFR containment to accident loadings and provide data for the validation of the codes. This paper summarises the recently completed WINfrith CONtainment (WINCON) experiments that studied the response of specific features of current CDFR design options to WCA loadings. The codes have been applied to some of the experiments and a satisfactory prediction of the global response of the model containment is obtained. This provides confidence in the use of the codes in reactor assessments. (author)

Exploring drivers and barriers to sustainability green business practices within small medium sized enterprises: primary findings

Directory of Open Access Journals (Sweden)

Amir Aghelie

2017-03-01

Full Text Available Presently the conducted studies on how SMEs should integrate sustainability align with their core business principle is limited. Most of the discussion on this field is emphasized to address issues for larger organizations and very limited effort on small firms. The drivers and barriers of approaching sustainability practices in SMEs are different from those in large organizations since SMEs lack technical specialist, experience and money required to make such strategy. Since SMEs play a significant role in nation’s economic growth, it is essential to study and find their drivers and barriers toward sustainability business practices constitutes main motivation of this paper. This is a primary finding that aims to understand the SME motivation and barriers that are facing in implementing green sustainable business practices to offer insight look to small firms to find key factors that influence adoption of sustainability business approach within their management practices.

Stability of live attenuated rotavirus vaccine with selected preservatives and primary containers.

Science.gov (United States)

Lal, Manjari; Jarrahian, Courtney; Zhu, Changcheng; Hosken, Nancy A; McClurkan, Chris L; Koelle, David M; Saxon, Eugene; Roehrig, Andrew; Zehrung, Darin; Chen, Dexiang

2016-05-11

Rotavirus infection, which can be prevented by vaccination, is responsible for a high burden of acute gastroenteritis disease in children, especially in low-income countries. An appropriate formulation, packaging, and delivery device for oral rotavirus vaccine has the potential to reduce the manufacturing cost of the vaccine and the logistical impact associated with introduction of a new vaccine, simplify the vaccination procedure, and ensure that the vaccine is safely and accurately delivered to children. Single-dose prefilled presentations can be easy to use; however, they are typically more expensive, can be a bottleneck during production, and occupy a greater volume per dose vis-à-vis supply chain storage and medical waste disposal, which is a challenge in low-resource settings. Multi-dose presentations used thus far have other issues, including increased wastage of vaccine and the need for separate delivery devices. In this study, the goals were to evaluate both the technical feasibility of using preservatives to develop a liquid multi-dose formulation and the primary packaging alternatives for orally delivered, liquid rotavirus vaccines. The feasibility evaluation included evaluation of commonly used preservatives for compatibility with rotavirus vaccines and stability testing of rotavirus vaccine in various primary containers, including Lameplast's plastic tubes, BD's oral dispenser version of Uniject™ (Uniject DP), rommelag's blow-fill-seal containers, and MEDInstill's multi-dose vial and pouch. These presentations were compared to a standard glass vial. The results showed that none of the preservatives tested were compatible with a live attenuated rotavirus vaccine because they had a detrimental effect on the viability of the virus. In the presence of preservatives, vaccine virus titers declined to undetectable levels within 1 month. The vaccine formulation without preservatives maintained a stability profile over 12 months in all primary containers

Barriers and facilitators among health professionals in primary care to prevention of cardiometabolic diseases: a systematic review.

NARCIS (Netherlands)

Wandell, P.E.; Waard, A.K.M. de; Holzmann, M.J.; Gornitzki, C.; Lionis, C.; Wit, N.J. de; Søndergaard, J.; Sønderlund, A.L.; Král, N.; Seifert, B.; Korevaar, J.C.; Schellevis, F.G.; Carlsson, A.C.

2018-01-01

The aim of this study is to identify potential facilitators and barriers for health care professionals to undertake selective prevention of cardiometabolic diseases (CMD) in primary health care. We developed a search string for Medline, Embase, Cinahl and PubMed. We also screened reference lists of

Resolution of the three dimensional structure of components of the glomerular filtration barrier

DEFF Research Database (Denmark)

Arkill, Kenton P; Qvortrup, Klaus; Starborg, Tobias

2014-01-01

The human glomerulus is the primary filtration unit of the kidney, and contains the Glomerular Filtration Barrier (GFB). The GFB had been thought to comprise 3 layers - the endothelium, the basement membrane and the podocyte foot processes. However, recent studies have suggested that at least two...

Perceived Barriers to Implementing Individual Choosing Wisely® Recommendations in Two National Surveys of Primary Care Providers.

Science.gov (United States)

Zikmund-Fisher, Brian J; Kullgren, Jeffrey T; Fagerlin, Angela; Klamerus, Mandi L; Bernstein, Steven J; Kerr, Eve A

2017-02-01

While some research has examined general attitudes about efforts to reduce overutilization of services, such as the Choosing Wisely ® (CW) initiative, little data exists regarding primary care providers' attitudes regarding individual recommendations. We sought to identify whether particular CW recommendations were perceived by primary care providers as difficult to follow, difficult for patients to accept, or both. Two national surveys, one by mail to a random sample of 2000 U.S. primary care physicians in November 2013, and the second electronically to a random sample of 2500 VA primary care providers (PCPs) in October-December 2014. A total of 603 U.S. primary care physicians and 1173 VA primary care providers. Response rates were 34 and 48 %, respectively. PCP ratings of whether 12 CW recommendations for screening, testing and treatments applicable to adult primary care were difficult to follow and difficult for patients to accept; and ratings of potential barriers to reducing overutilization. For four recommendations regarding not screening or testing in asymptomatic patients, less than 20 % of PCPs found the CW recommendations difficult to accept (range 7.2-16.6 %) or difficult for patients to follow (12.2-19.3 %). For five recommendations regarding testing or treatment for symptomatic conditions, however, there was both variation in reported difficulty to follow (9.8-32 %) and a high level of reported difficulty for patients to accept (35.7-87.1 %). The most frequently reported barriers to reducing overuse included malpractice concern, patient requests for services, lack of time for shared decision making, and the number of tests recommended by specialists. While PCPs found many CW recommendations easy to follow, they felt that some, especially those for symptomatic conditions, would be difficult for patients to accept. Overcoming PCPs' perceptions of patient acceptability will require approaches beyond routine physician education, feedback and

Nanoparticles for Protein Sensing in Primary Containers: Interaction Analysis and Application.

Science.gov (United States)

Pérez Medina Martínez, Víctor; Espinosa-de la Garza, Carlos E; Méndez-Silva, Diego A; Bolívar-Vichido, Mariana; Flores-Ortiz, Luis F; Pérez, Néstor O

2018-05-01

Silver nanoparticles (AgNPs) are known to interact with proteins, leading to modifications of the plasmonic absorption that can be used to monitor this interaction, entailing a promising application for sensing adsorption of therapeutic proteins in primary containers. First, transmission electron microscopy in combination with plasmonic absorption and light scattering responses were used to characterize AgNPs and protein-AgNP complexes, including its concentration dependence, using two therapeutic molecules as models: a monoclonal antibody (mAb) and a synthetic copolymer (SC). Upon interaction, a protein corona was formed around AgNPs with the consequent shifting and broadening of their characteristic surface plasmon resonance (SPR) band (400 nm) to 410 nm and longer wavelenghts. Additional studies revealed secondary and three-dimensional structure modifications of model proteins upon interaction with AgNPs by circular dichroism and fluorescence techniques, respectively. Based on the modification of the SPR condition of AgNPs upon interaction with proteins, we developed a novel protein-sensing application of AgNPs in primary containers. This strategy was used to conduct a compatibility assessment of model proteins towards five commercially available prefillable glass syringe (PFS) models. mAb- and SC-exposed PFSs showed that 74 and 94% of cases were positive for protein adsorption, respectively. Interestingly, protein adsorption on 15% of total tested PFSs was negligible (below the nanogram level). Our results highlight the need of a case-by-case compatibility assessment of therapeutic proteins and their primary containers. This strategy has the potential to be easily applied on other containers and implemented during early-stage product development by pharmaceutical companies and for routine use during batch release by packaging manufacturers.

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

Science.gov (United States)

Russo, Brendan J; Savolainen, Peter T

2018-08-01

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

Interprofessional collaboration in primary health care: a review of facilitators and barriers perceived by involved actors.

Science.gov (United States)

Supper, I; Catala, O; Lustman, M; Chemla, C; Bourgueil, Y; Letrilliart, L

2015-12-01

The epidemiological transition calls for redefining the roles of the various professionals involved in primary health care towards greater collaboration. We aimed to identify facilitators of, and barriers to, interprofessional collaboration in primary health care as perceived by the actors involved, other than nurses. Systematic review using synthetic thematic analysis of qualitative research. Articles were retrieved from Medline, Web of science, Psychinfo and The Cochrane library up to July 2013. Quality and relevance of the studies were assessed according to the Dixon-Woods criteria. The following stakeholders were targeted: general practitioners, pharmacists, mental health workers, midwives, physiotherapists, social workers and receptionists. Forty-four articles were included. The principal facilitator of interprofessional collaboration in primary care was the different actors' common interest in collaboration, perceiving opportunities to improve quality of care and to develop new professional fields. The main barriers were the challenges of definition and awareness of one another's roles and competences, shared information, confidentiality and responsibility, team building and interprofessional training, long-term funding and joint monitoring. Interprofessional organization and training based on appropriate models should support collaboration development. The active participation of the patient is required to go beyond professional boundaries and hierarchies. Multidisciplinary research projects are recommended. © The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Development of a cement-polymer close-coupled subsurface barrier technology

International Nuclear Information System (INIS)

Dwyer, B.P.; Heiser, J.; Stewart, W.; Phillips, S.

1997-01-01

The primary objective of this project was to further develop close-coupled barrier technology for the containment of subsurface waste or contaminant migration. A close-coupled barrier is produced by first installing a conventional cement grout curtain followed by a thin inner lining of a polymer grout. The resultant barrier is a cement polymer composite that has economic benefits derived from the cement and performance benefits from the durable and chemically resistant polymer layer. The technology has matured from a regulatory investigation of issues concerning barriers and barrier materials to a pilot-scale, multiple individual column injections at Sandia National Labs (SNL) to full scale demonstration. The feasibility of this barrier concept was successfully proven in a full scale ''cold site'' demonstration at Hanford, WA. Consequently, a full scale deployment of the technology was conducted at an actual environmental restoration site at Brookhaven National Lab (BNL), Long Island, NY. This paper discusses the installation and performance of a technology deployment implemented at OU-1 an Environmental Restoration Site located at BNL

Development of a cement-polymer close-coupled subsurface barrier technology

Energy Technology Data Exchange (ETDEWEB)

Dwyer, B.P. [Sandia National Labs., Albuquerque, NM (United States); Heiser, J. [Brookhaven National Lab., Upton, NY (United States); Stewart, W.; Phillips, S. [Applied Geotechnical Engineering and Construction, Inc., Richland, WA (United States)

1997-02-01

The primary objective of this project was to further develop close-coupled barrier technology for the containment of subsurface waste or contaminant migration. A close-coupled barrier is produced by first installing a conventional cement grout curtain followed by a thin inner lining of a polymer grout. The resultant barrier is a cement polymer composite that has economic benefits derived from the cement and performance benefits from the durable and chemically resistant polymer layer. The technology has matured from a regulatory investigation of issues concerning barriers and barrier materials to a pilot-scale, multiple individual column injections at Sandia National Labs (SNL) to full scale demonstration. The feasibility of this barrier concept was successfully proven in a full scale ``cold site`` demonstration at Hanford, WA. Consequently, a full scale deployment of the technology was conducted at an actual environmental restoration site at Brookhaven National Lab (BNL), Long Island, NY. This paper discusses the installation and performance of a technology deployment implemented at OU-1 an Environmental Restoration Site located at BNL.

Synthesis of studies on primary containers for MLA-VL wastes

International Nuclear Information System (INIS)

Bart, F.; Delassale, F.; Rey, F.; Helie, M.; Levoy, R.; Moitrier, C.; Sicardy, O.; Tiquet, P.

2004-01-01

The aim of this study is the presentation of studies realized on primary containers of medium activity long life level. These studies are realized in the framework of the axis 3 of the law of 1991 on the radioactive waste management. The specificity of this document is the presentation of container for ''random'' wastes chemically corrosive in order to complete the range of possible packages. Thus a special program has been developed to demonstrate a conditioning solution which offers to the waste producers a possibility of conditioning these wastes without a preliminary treatment. (A.L.B.)

Perceived benefits and barriers and self-efficacy affecting the attendance of health education programs among uninsured primary care patients.

Science.gov (United States)

Kamimura, Akiko; Nourian, Maziar M; Jess, Allison; Chernenko, Alla; Assasnik, Nushean; Ashby, Jeanie

2016-12-01

Lifestyle interventions have shown to be effective in improving health status, health behaviors, and self-efficacy. However, recruiting participants to health education programs and ensuring the continuity of health education for underserved populations is often challenging. The goals of this study are: to describe the attendance of health education programs; to identify stages of change to a healthy lifestyle; to determine cues to action; and to specify factors affecting perceived benefits and barriers to healthy food choices and physical activity among uninsured primary care patients. Uninsured primary care patients utilizing a free clinic (N=621) completed a self-administered survey from September to December of 2015. US born English speakers, non-US born English speakers, and Spanish speakers reported different kinds of cues to action in attending health education programs. While self-efficacy increases perceived benefits and decreases perceived barriers for physical activity, it increases both perceived benefits and perceived barriers for healthy food choices. The participants who had attended health education programs did not believe that there were benefits for healthy food choices and physical activity. This study adds to the body of literature on health education for underserved populations. Copyright © 2016 Elsevier Ltd. All rights reserved.

Diabetes and hypertension guidelines and the primary health care practitioner in Barbados: knowledge, attitudes, practices and barriers--a focus group study.

Science.gov (United States)

Adams, O Peter; Carter, Anne O

2010-12-03

Audits have shown numerous deficiencies in the quality of hypertension and diabetes primary care in Barbados, despite distribution of regional guidelines. This study aimed to evaluate the knowledge, attitudes and practices, and the barriers faced by primary care practitioners in Barbados concerning the recommendations of available diabetes and hypertension guidelines. Focus groups using a moderator's manual were conducted at all 8 public sector polyclinics, and 5 sessions were held for private practitioners. Polyclinic sessions were attended by 63 persons (17 physicians, 34 nurses, 3 dieticians, 3 podiatrists, 5 pharmacists, and 1 other), and private sector sessions by 20 persons (12 physicians, 1 nurse, 3 dieticians, 2 podiatrists and 2 pharmacists). Practitioners generally thought they gave a good quality of care. Commonwealth Caribbean Medical Research Council 1995 diabetes and 1998 hypertension guidelines, and the Ministry of Health 2001 diabetes protocol had been seen by 38%, 32% and 78% respectively of polyclinic practitioners, 67%, 83%, and 33% of private physicians, and 25%, 0% and 38% of non-physician private practitioners. Current guidelines were considered by some to be outdated, unavailable, difficult to remember and lacking in advice to tackle barriers. Practitioners thought that guidelines should be circulated widely, promoted with repeated educational sessions, and kept short. Patient oriented versions of the guidelines were welcomed. Patient factors causing barriers to ideal outcome included denial and fear of stigma; financial resources to access an appropriate diet, exercise and monitoring equipment; confusion over medication regimens, not valuing free medication, belief in alternative medicines, and being unable to change habits. System barriers included lack of access to blood investigations, clinic equipment and medication; the lack of human resources in polyclinics; and an uncoordinated team approach. Patients faced cultural barriers with

Managing anemia in low-income toddlers: barriers, challenges and context in primary care.

Science.gov (United States)

Crowell, Rebecca; Pierce, Michelle B; Ferris, Ann M; Slivka, Hilda; Joyce, Patricia; Bernstein, Bruce A; Russell-Curtis, Suzanne

2005-11-01

Iron-deficiency remains a concern among low-income toddlers in the U.S. This formative study describes how primary care providers serving high-risk 1- to 3-year-old children in an urban ambulatory care setting approach anemia. Data collection included a retrospective review of randomly selected medical records (n=264) and semi-structured interviews with clinicians (n=41). Thirty-eight percent of the children presented with anemia (Hgb variable. While providers felt clinically comfortable with anemia, they felt burdened and challenged by follow-up. Communication and system barriers weighed most heavily on perceived treatment outcomes.

Trends in drug delivery through tissue barriers containing tight junctions.

Science.gov (United States)

Tscheik, Christian; Blasig, Ingolf E; Winkler, Lars

2013-04-01

A limitation in the uptake of many drugs is the restricted permeation through tissue barriers. There are two general ways to cross barriers formed by cell layers: by transcytosis or by diffusion through the intercellular space. In the latter, tight junctions (TJs) play the decisive role in the regulation of the barrier permeability. Thus, transient modulation of TJs is a potent strategy to improve drug delivery. There have been extensive studies on surfactant-like absorption enhancers. One of the most effective enhancers found is sodium caprate. However, this modulates TJs in an unspecific fashion. A novel approach would be the specific modulation of TJ-associated marvel proteins and claudins, which are the main structural components of the TJs. Recent studies have identified synthetic peptidomimetics and RNA interference techniques to downregulate the expression of targeted TJ proteins. This review summarizes current progress and discusses the impact on TJs' barrier function.

Systems study on engineered barriers: barrier performance analysis

International Nuclear Information System (INIS)

Stula, R.T.; Albert, T.E.; Kirstein, B.E.; Lester, D.H.

1980-09-01

A performance assessment model for multiple barrier packages containing unreprocessed spent fuel has been modified and applied to several package designs. The objective of the study was to develop information to be used in programmatic decision making concerning engineered barrier package design and development. The assessment model, BARIER, was developed in previous tasks of the System Study on Engineered Barriers (SSEB). The new version discussed in this report contains a refined and expanded corrosion rate data base which includes pitting, crack growth, and graphitization as well as bulk corrosion. Corrosion rates for oxic and anoxic conditions at each of the two temperature ranges are supplied. Other improvements include a rigorous treatment of radionuclide release after package failure which includes resistance of damaged barriers and backfill, refined temperature calculations that account for convection and radiation, a subroutine to calculate nuclear gamma radiation field at each barrier surface, refined stress calculations with reduced conservatism and various coding improvements to improve running time and core usage. This report also contains discussion of alternative scenarios to the assumed flooded repository as well as the impact of water exclusion backfills. The model was used to assess post repository closure performance for several designs which were all variation of basic designs from the Spent Unreprocessed Fuel (SURF) program. Many designs were found to delay the onset of leaching by at least a few hundreds of years in all geologic media. Long delay times for radionuclide release were found for packages with a few inches of sorption backfill. Release of uranium, plutonium, and americium was assessed

Systems study on engineered barriers: barrier performance analysis

Energy Technology Data Exchange (ETDEWEB)

Stula, R.T.; Albert, T.E.; Kirstein, B.E.; Lester, D.H.

1980-09-01

A performance assessment model for multiple barrier packages containing unreprocessed spent fuel has been modified and applied to several package designs. The objective of the study was to develop information to be used in programmatic decision making concerning engineered barrier package design and development. The assessment model, BARIER, was developed in previous tasks of the System Study on Engineered Barriers (SSEB). The new version discussed in this report contains a refined and expanded corrosion rate data base which includes pitting, crack growth, and graphitization as well as bulk corrosion. Corrosion rates for oxic and anoxic conditions at each of the two temperature ranges are supplied. Other improvements include a rigorous treatment of radionuclide release after package failure which includes resistance of damaged barriers and backfill, refined temperature calculations that account for convection and radiation, a subroutine to calculate nuclear gamma radiation field at each barrier surface, refined stress calculations with reduced conservatism and various coding improvements to improve running time and core usage. This report also contains discussion of alternative scenarios to the assumed flooded repository as well as the impact of water exclusion backfills. The model was used to assess post repository closure performance for several designs which were all variation of basic designs from the Spent Unreprocessed Fuel (SURF) program. Many designs were found to delay the onset of leaching by at least a few hundreds of years in all geologic media. Long delay times for radionuclide release were found for packages with a few inches of sorption backfill. Release of uranium, plutonium, and americium was assessed.

[Implementing daily physical education in primary school - potentials and barriers from the involved actor's point of view].

Science.gov (United States)

Sterdt, E; Liersch, S; Henze, V; Röbl, M; Suermann, T; Krauth, C; Walter, U

2015-04-01

The objective was to determine to what extent daily physical education can be implemented in primary schools, what barriers exist and how to overcome the mentioned barriers. Moreover, it was analysed to what extent daily physical education is accepted by teachers, external trainers, parents and students. Semi-structured interviews with parents (n=7), teachers (n=5) and external trainers (n=6) of the intervention schools. The intervention students (n=44) were surveyed within focus groups. All surveyed groups appraised the implementation of daily school sports as successful. The cooperation between the schools and the sports club should be maintained during a comprehensive implementation of daily physical education. Besides an improved lessons quality teachers and external trainers reported an improved social behaviour of the children. Parents perceived positive effects on the child development. All groups believe that daily physical education increases the enjoyment of children in sports. As a certain barrier a lack of resources (e. g., facilities, equipment, financial resources) in the schools were mentioned. The cooperation between the schools and the sports club proved to be an applicable model to implement daily physical education. The combination of teachers and external trainers can contribute to a higher lesson quality. Considering the perceived potentials of daily physical education by all surveyed groups, a comprehensive implementation of systematic daily physical activity promotion in the primary school setting should be tapped more strongly in future. © Georg Thieme Verlag KG Stuttgart · New York.

Tritium permeation characterization of Al{sub 2}O{sub 3}/FeAl coatings as tritium permeation barriers on 321 type stainless steel containers

Energy Technology Data Exchange (ETDEWEB)

Yang, Feilong; Xiang, Xin; Lu, Guangda; Zhang, Guikai, E-mail: zhangguikai@caep.cn; Tang, Tao; Shi, Yan; Wang, Xiaolin

2016-09-15

Accurate tritium transport properties of prospective tritium permeation barriers (TPBs) are essential to tritium systems in fusion reactors. By passing a temperature and rate-controlled sweeping gas over specimen surfaces to carry the permeated tritium to an ion chamber, the gas-driven permeation of tritium has been performed on 321 type stainless steel containers with Al{sub 2}O{sub 3}/FeAl barriers, to determine the T-permeation resistant performance and mechanism of the barrier. The tritium permeability of the Al{sub 2}O{sub 3}/FeAl coated container was reduced by 3 orders of magnitude at 500–700 °C by contrast with that of the bare one, which meets the requirement of the tritium permeation reduction factor (PRF) of TPBs for tritium operating components in the CN-HCCB TBM. The Al{sub 2}O{sub 3}/FeAl barrier resists the tritium permeation by the diffusion in the bulk substrate at a limited number of defect sites with an effective area and thickness, suggesting that the TPB quality is a very important factor for efficient T-permeation resistance. - Highlights: • T-permeation has been measured on bare and coated type 321 SS containers. • Al{sub 2}O{sub 3}/FeAl coating give a reduction of T-permeability of 3 orders of magnitude. • Mechanism of Al{sub 2}O{sub 3}/FeAl barrier resisting T-permeation has obtained. • Quality of TPB is a very important factor for efficient T-permeating reduction.

Insulin initiation status of primary care physicians in Turkey, barriers to insulin initiation and knowledge levels about insulin therapy: A multicenter cross-sectional study.

Science.gov (United States)

Ates, Elif; Set, Turan; Saglam, Zuhal; Tekin, Nil; Karatas Eray, Irep; Yavuz, Erdinc; Sahin, Mustafa Kursat; Selcuk, Engin Burak; Cadirci, Dursun; Cubukcu, Mahcube

2017-10-01

Our aim was to evaluate the insulin initiation status, barriers to insulin initiation and knowledge levels about treatment administered by primary care physicians (PCP). We conducted our study in accordance with a multicenter, cross-sectional design in Turkey, between July 2015 and July 2016. A questionnaire inquiring demographic features, status of insulin initiation, obstacles to insulin initiation and knowledge about therapy of the PCPs was administered during face-to-face interviews. 84 PCPs (19%) (n=446, mean age=41.5±8.4years, 62.9% male and 90.0% ministry certified family physicians) initiated insulin therapy in the past. Most of the stated primary barriers (51.9%, n=230) were due to the physicians. The most relevant barrier was "lack of clinical experience" with a rate of 19% (n=84 of the total). The average total knowledge score was 5.7±2.0 for the family medicine specialist, and 3.8±2.1 for the ministry certified family physicians (p=0.000, maximum knowledge score could be 10). The status of insulin initiation in Turkey by the primary care physicians is inadequate. Medical education programs and health care systems may require restructuring to facilitate insulin initiation in primary care. Copyright © 2017 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

Analysis CFD for the hydrogen transport in the primary containment of a BWR

International Nuclear Information System (INIS)

Jimenez P, D. A.; Del Valle G, E.; Gomez T, A. M.

2014-10-01

This study presents a qualitative and quantitative comparison among the CFD GASFLOW and OpenFOAM codes which are related with the phenomenon of hydrogen transport and other gases in the primary containment of a Boiling Water Reactor (BWR). GASFLOW is a commercial license code that is well validated and that was developed in Germany for the analysis of the gases transport in containments of nuclear reactors. On the other hand, OpenFOAM is an open source code that offers several evaluation solvers for different types of phenomena; in this case, the solver reacting-Foam is used to analyze the hydrogen transport inside the primary containment of the BWR. The results that offer the solver reacting-Foam of OpenFOAM are evaluated in the hydrogen transport calculation and the results are compared with those of the program of commercial license GASFLOW to see if is viable the use of the open source code in the case of the hydrogen transport in the primary containment of a BWR. Of the obtained results so much quantitative as qualitative some differences were identified between both codes, the differences (with a percentage of maximum error of 4%) in the quantitative results are small and they are considered acceptable for this analysis type, also, these differences are attributed mainly to the used transport models, considering that OpenFOAM uses a homogeneous model and GASFLOW uses a heterogeneous model. (Author)

In-situ containment of buried waste at Brookhaven National Laboratory

International Nuclear Information System (INIS)

Dwyer, B.P.; Heiser, J.; Stewart, W.; Phillips, S.

1997-01-01

The primary objective of this project was to further develop close-coupled barrier technology for the containment of subsurface waste or contaminant migration. A close-coupled barrier is produced by first installing a conventional cement grout curtain followed by a thin inner lining of a polymer grout. The resultant barrier is a cement polymer composite that has economic benefits derived from the cement and performance benefits from the durable and chemically resistant polymer layer. The technology has matured from a regulatory investigation of issues concerning barriers and barrier materials to a pilot-scale, multiple individual column injections at Sandia National Labs (SNL) to full scale demonstration. The feasibility of this barrier concept was successfully proven in a full scale 'cold test' demonstration at Hanford, WA. Consequently, a full scale deployment of the technology was conducted at an actual environmental restoration site at Brookhaven National Lab (BNL), Long Island, NY. This paper discusses the installation and performance of a technology deployment implemented at OU-1 an Environmental Restoration Site located at BNL

Diabetes and hypertension guidelines and the primary health care practitioner in Barbados: knowledge, attitudes, practices and barriers-a focus group study

Directory of Open Access Journals (Sweden)

Carter Anne O

2010-12-01

Full Text Available Abstract Background Audits have shown numerous deficiencies in the quality of hypertension and diabetes primary care in Barbados, despite distribution of regional guidelines. This study aimed to evaluate the knowledge, attitudes and practices, and the barriers faced by primary care practitioners in Barbados concerning the recommendations of available diabetes and hypertension guidelines. Methods Focus groups using a moderator's manual were conducted at all 8 public sector polyclinics, and 5 sessions were held for private practitioners. Results Polyclinic sessions were attended by 63 persons (17 physicians, 34 nurses, 3 dieticians, 3 podiatrists, 5 pharmacists, and 1 other, and private sector sessions by 20 persons (12 physicians, 1 nurse, 3 dieticians, 2 podiatrists and 2 pharmacists. Practitioners generally thought they gave a good quality of care. Commonwealth Caribbean Medical Research Council 1995 diabetes and 1998 hypertension guidelines, and the Ministry of Health 2001 diabetes protocol had been seen by 38%, 32% and 78% respectively of polyclinic practitioners, 67%, 83%, and 33% of private physicians, and 25%, 0% and 38% of non-physician private practitioners. Current guidelines were considered by some to be outdated, unavailable, difficult to remember and lacking in advice to tackle barriers. Practitioners thought that guidelines should be circulated widely, promoted with repeated educational sessions, and kept short. Patient oriented versions of the guidelines were welcomed. Patient factors causing barriers to ideal outcome included denial and fear of stigma; financial resources to access an appropriate diet, exercise and monitoring equipment; confusion over medication regimens, not valuing free medication, belief in alternative medicines, and being unable to change habits. System barriers included lack of access to blood investigations, clinic equipment and medication; the lack of human resources in polyclinics; and an uncoordinated

Applicability of JIS SPV 50 steel to primary containment vessels of nuclear power stations

International Nuclear Information System (INIS)

Iida, K.; Ishikawa, K.; Satoh, M.; Soya, I.

1980-01-01

The fracture toughness of JIS SPV 50 steel and its weldment has been examined in order to verify the applicability of these materials to primary containment vessels of nuclear power stations. Test results were evaluated using elastic plastic fracture mechanics through the COD and the J integral concepts for non ductile fracture initiation characteristics. Linear fracture mechanics was employed for propagation arrest characteristics. Results showed that the materials tested here have a sufficient fracture toughness to prevent nonductile fracture and that this steel is a suitable material for use in construction of primary containment vessels of nuclear power stations. (author)

Engineered barriers: current status

International Nuclear Information System (INIS)

Atkinson, A.; Marsh, G.P.

1988-01-01

This report summarises the current state of research relevant to assessing the performance of engineered barriers made of steel and concrete in radioactive waste repositories. The objective of these barriers is to contain the radionuclides within them by providing both physical and chemical impediment to their release. The physical barriers are of most value for highly soluble isotopes with relatively short half-lives (eg 137 Cs), since they can provide containment until a large fraction of the activity has decayed. In addition they can facilitate retrievability for some period after disposal. The chemical barriers operate by beneficial conditioning of the near field groundwater and providing sites for sorption of radionuclides. Both of these reduce the aqueous concentration of radionuclides in the near field. (author)

Assessing the facilitators and barriers of interdisciplinary team working in primary care using normalisation process theory: An integrative review.

Science.gov (United States)

O'Reilly, Pauline; Lee, Siew Hwa; O'Sullivan, Madeleine; Cullen, Walter; Kennedy, Catriona; MacFarlane, Anne

2017-01-01

Interdisciplinary team working is of paramount importance in the reform of primary care in order to provide cost-effective and comprehensive care. However, international research shows that it is not routine practice in many healthcare jurisdictions. It is imperative to understand levers and barriers to the implementation process. This review examines interdisciplinary team working in practice, in primary care, from the perspective of service providers and analyses 1 barriers and facilitators to implementation of interdisciplinary teams in primary care and 2 the main research gaps. An integrative review following the PRISMA guidelines was conducted. Following a search of 10 international databases, 8,827 titles were screened for relevance and 49 met the criteria. Quality of evidence was appraised using predetermined criteria. Data were analysed following the principles of framework analysis using Normalisation Process Theory (NPT), which has four constructs: sense making, enrolment, enactment, and appraisal. The literature is dominated by a focus on interdisciplinary working between physicians and nurses. There is a dearth of evidence about all NPT constructs apart from enactment. Physicians play a key role in encouraging the enrolment of others in primary care team working and in enabling effective divisions of labour in the team. The experience of interdisciplinary working emerged as a lever for its implementation, particularly where communication and respect were strong between professionals. A key lever for interdisciplinary team working in primary care is to get professionals working together and to learn from each other in practice. However, the evidence base is limited as it does not reflect the experiences of all primary care professionals and it is primarily about the enactment of team working. We need to know much more about the experiences of the full network of primary care professionals regarding all aspects of implementation work. International

Barriers to the utilization of primary care services for mental health prolems among adolescents in a secondary school in malaysia.

Science.gov (United States)

Aida, J; Azimah, Mn; Mohd Radzniwan, Ar; Y Iryani, Md; Ramli, M; Khairani, O

2010-01-01

To study the barriers toward the utilization of primary care services for mental health problems among adolescents in a secondary school in Hulu Langat, Selangor, Malaysia. This was a cross-sectional study conducted in July 2008 at a secondary school in Hulu Langat, Selangor. The respondents were selected using randomised cluster sampling among Form Four and Form Five students. Students were given self-administered questionnaire, consisting socio-demographic data and questions on their help-seeking barrier and behaviour. Help-seeking behaviour questions assess the use of medical facility and help-seeking sources. The formal help-seeking sources include from teachers, counsellors and doctors. The informal help-seeking sources include from friends, parents and siblings. A total of 175 students were included in the study. None of the students admitted of using the primary health care services for their mental health problems. Majority of the students were not aware of the services availability in the primary health care (97.1%). More than half of them thought the problems were due to their own mistakes (55.4%) and the problems were not that serious (49.1%). With regard to perception of the primary health care services, (43.2%) of the students were worried about confidentiality, half of them were concerned about other people's perception especially from their family members (44.6%) and friends (48.6%). Minority of them (10.8%) thought that nobody can help them. Few of them thought smoking (3.4%), alcohol (3.4%) and recreational drugs (1.1%) can solve their emotional problems. One of the major barriers identified in the students' failure to use the health care facilities was their unawareness of the availability of the service for them in the community. Thus there is a need to promote and increase their awareness on this issue.

Limited english proficiency, primary language at home, and disparities in children's health care: how language barriers are measured matters.

Science.gov (United States)

Flores, Glenn; Abreu, Milagros; Tomany-Korman, Sandra C

2005-01-01

Approximately 3.5 million U.S. schoolchildren are limited in English proficiency (LEP). Disparities in children's health and health care are associated with both LEP and speaking a language other than English at home, but prior research has not examined which of these two measures of language barriers is most useful in examining health care disparities. Our objectives were to compare primary language spoken at home vs. parental LEP and their associations with health status, access to care, and use of health services in children. We surveyed parents at urban community sites in Boston, asking 74 questions on children's health status, access to health care, and use of health services. Some 98% of the 1,100 participating children and families were of non-white race/ethnicity, 72% of parents were LEP, and 13 different primary languages were spoken at home. "Dose-response" relationships were observed between parental English proficiency and several child and parental sociodemographic features, including children's insurance coverage, parental educational attainment, citizenship and employment, and family income. Similar "dose-response" relationships were noted between the primary language spoken at home and many but not all of the same sociodemographic features. In multivariate analyses, LEP parents were associated with triple the odds of a child having fair/poor health status, double the odds of the child spending at least one day in bed for illness in the past year, and significantly greater odds of children not being brought in for needed medical care for six of nine access barriers to care. None of these findings were observed in analyses of the primary language spoken at home. Individual parental LEP categories were associated with different risks of adverse health status and outcomes. Parental LEP is superior to the primary language spoken at home as a measure of the impact of language barriers on children's health and health care. Individual parental LEP

Primary care physicians' perceived barriers and facilitators to conservative care for older adults with chronic kidney disease: design of a mixed methods study.

Science.gov (United States)

Tam-Tham, Helen; Hemmelgarn, Brenda; Campbell, David; Thomas, Chandra; Quinn, Robert; Fruetel, Karen; King-Shier, Kathryn

2016-01-01

Guideline committees have identified the need for research to inform the provision of conservative care for older adults with stage 5 chronic kidney disease (CKD) who have a high burden of comorbidity or functional impairment. We will use both qualitative and quantitative methodologies to provide a comprehensive understanding of barriers and facilitators to care for these patients in primary care. Our objectives are to (1) interview primary care physicians to determine their perspectives of conservative care for older adults with stage 5 CKD and (2) survey primary care physicians to determine the prevalence of key barriers and facilitators to provision of conservative care for older adults with stage 5 CKD. A sequential exploratory mixed methods design was adopted for this study. The first phase of the study will involve fundamental qualitative description and the second phase will be a cross-sectional population-based survey. The research is conducted in Alberta, Canada. The participants are primary care physicians with experience in providing care for older adults with stage 5 CKD not planning on initiating dialysis. The first objective will be achieved by undertaking interviews with primary care physicians from southern Alberta. Participants will be selected purposively to include physicians with a range of characteristics (e.g., age, gender, and location of clinical practice). Interviews will be recorded, transcribed verbatim, and analyzed using conventional content analysis to generate themes. The second objective will be achieved by undertaking a population-based survey of primary care physicians in Alberta. The questionnaire will be developed based on the findings from the qualitative interviews and pilot tested for face and content validity. Physicians will be provided multiple options to complete the questionnaire including mail, fax, and online methods. Descriptive statistics and associations between demographic factors and barriers and facilitators to

Barriers to implementing the "2008 Mexican Clinical Practice Guideline recommendations for the management of hip and knee osteoarthritis" in primary healthcare practice.

Science.gov (United States)

Loyola-Sanchez, Adalberto; Richardson, Julie; Pelaez-Ballestas, Ingris; Sánchez, José Guadalupe; González, Martha Alicia; Sánchez-Cruz, Juan; Jiménez-Baez, María Valeria; Nolasco-Alonso, Nancy; Alvarado, Idolina; Rodríguez-Amado, Jacqueline; Alvarez-Nemegyei, José; Wilson, Mike G

2014-01-01

To evaluate the implementability of the "2008 Mexican Clinical Practice Guideline for the management of hip and knee osteoarthritis at the primary level of care" within primary healthcare of three Mexican regions using the Guideline Implementability Appraisal methodology version 2 (GLIA.v2). Six family physicians, representing the South, North, and Central Mexico, and one Mexican physiatrist evaluated the 45 recommendations stated by the Mexican guideline. The GLIA.v2 methodology includes the execution of qualitative and semi-quantitative techniques. Reviewers' agreement was between moderate to near complete in most cases. Sixty-nine percent of the recommendations were considered difficult to implement within clinical practice. Eight recommendations did not have an appropriate format. Only 6 recommendations were judged as able to be consistently applied to clinical practice. Barriers related to the context of one or more institutions/regions were identified in 25 recommendations. These barriers are related to health providers/patients' beliefs, processes of care within each institution, and availability of some treatments recommended by the guideline. The guideline presented problems of conciseness and clarity that negatively affect its application within the Mexican primary healthcare context. We identified individual, organizational and system characteristics, which are common to the 3 institutions/regions studied and constitute barriers for implementing the guideline to clinical practice. It is recommended that the 2008-Mexican-CPG-OA be thoroughly revised and restructured to improve the clarity of the actions implied by each recommendation. We propose some strategies to accomplish this and to overcome some of the identified regional/institutional barriers. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

New cooling system of the FRG-1 two barrier system of the primary coolant cycle

International Nuclear Information System (INIS)

Knop, W.; Schreiner, P.

2003-01-01

The GKSS research center operates the swimming pool reactor FRG-1 with a thermal power of 5 MW as national neutron source for neutron scattering experiments and sample irradiation as well. Before changing the primary coolant cycle consisted of the reactor core and the closed piping including pumps, heat exchanger and delay tank. The closed cooling circuit was located underneath the reactor pool, in the so-called radioactive cellar. This piping system served secondary coolant system. Due to the location of the primary coolant cycle below the operation pool a postulated 2-F line break and simultaneous failure of the pool slide gate valve could lead to a falling dry of the total reactor core. the new primary coolant system was built in the beginning 2002 in a partitioned cell all within the radioactive cellar, so that the reactor core remains with water with the assumed incident. Due to the new two barrier-inclusion of the primary circuit only the melting of two fuel plates (from total 252 fuel plates) has to be taken into account. This measure and the core compactness in 2000 with a neutron flux gain of a factor of 2 makes the FRG-1 ready for the next 15 years of reactor operation. (author)

Radiolysis products and sensory properties of electron-beam-irradiated high-barrier food-packaging films containing a buried layer of recycled low-density polyethylene.

Science.gov (United States)

Chytiri, S D; Badeka, A V; Riganakos, K A; Kontominas, M G

2010-04-01

The aim was to study the effect of electron-beam irradiation on the production of radiolysis products and sensory changes in experimental high-barrier packaging films composed of polyamide (PA), ethylene-vinyl alcohol (EVOH) and low-density polyethylene (LDPE). Films contained a middle buried layer of recycled LDPE, while films containing 100% virgin LDPE as the middle buried layer were taken as controls. Irradiation doses ranged between zero and 60 kGy. Generally, a large number of radiolysis products were produced during electron-beam irradiation, even at the lower absorbed doses of 5 and 10 kGy (approved doses for food 'cold pasteurization'). The quantity of radiolysis products increased with irradiation dose. There were no significant differences in radiolysis products identified between samples containing a recycled layer of LDPE and those containing virgin LDPE (all absorbed doses), indicating the 'functional barrier' properties of external virgin polymer layers. Sensory properties (mainly taste) of potable water were affected after contact with irradiated as low as 5 kGy packaging films. This effect increased with increasing irradiation dose.

Barriers and facilitators to HPV vaccination in primary care practices: a mixed methods study using the Consolidated Framework for Implementation Research.

Science.gov (United States)

Garbutt, Jane M; Dodd, Sherry; Walling, Emily; Lee, Amanda A; Kulka, Katharine; Lobb, Rebecca

2018-05-07

In the United States, the effective, safe huma papilloma virus (HPV) vaccine is underused and opportunities to prevent cancer continue to be missed. National guidelines recommend completing the 2-3 dose HPV vaccine series by age 13, well before exposure to the sexually transmitted virus. Accurate characterization of the facilitators and barriers to full implementation of HPV vaccine recommendations in the primary care setting could inform effective implementation strategies. We used the Consolidated Framework for Implementation Research (CFIR) to systematically investigate and characterize factors that influence HPV vaccine use in 10 primary care practices (16 providers) using a concurrent mixed methods design. The CFIR was used to guide collection and analysis of qualitative data collected through in-person semi-structured interviews with the primary care providers. We analyzed HPV vaccine use with data abstracted from medical charts. Constructs that most strongly influenced vaccine use were identified by integrating the qualitative and quantitative data. Of the 72 CFIR constructs assessed, seven strongly distinguished and seven weakly distinguished between providers with higher versus lower HPV vaccine coverage. The majority of strongly distinguishing constructs were facilitators and were related to characteristics of the providers (knowledge and beliefs; self-efficacy; readiness for change), their perception of the intervention (relative advantage of vaccinating younger vs. older adolescents), and their process to deliver the vaccine (executing). Additional weakly distinguishing constructs that were facilitators were from outer setting (peer pressure; financial incentives), inner setting (networks and communications and readiness for implementation) and process (planning; engaging, and reflecting and evaluating). Two strongly distinguishing constructs were barriers to use, one from the intervention (adaptability of the age of initiation) and the other from outer

SU-E-T-273: Radiation Shielding for a Fixed Horizontal-Beam Linac in a Shipping Container and a Conventional Treatment Vault

International Nuclear Information System (INIS)

Hsieh, M; Balter, P; Beadle, B; Chi, P; Stingo, F; Court, L

2014-01-01

Purpose: A fixed horizontal-beam linac, where the patient is treated in a seated position, could lower the overall costs of the treatment unit and room shielding substantially. This design also allows the treatment room and control area to be contained within a reduced space, such as a shipping container. The main application is the introduction of low-cost, high-quality radiation therapy to low- and middle-income regions. Here we consider shielding for upright treatments with a fixed-6MV-beam linac in a shipping container and a conventional treatment vault. Methods: Shielding calculations were done for two treatment room layouts using calculation methods in NCRP Report 151: (1) a shipping container (6m × 2.4m with the remaining space occupied by the console area), and (2) the treatment vault in NCRP 151 (7.8m by 5.4m by 3.4m). The shipping container has a fixed gantry that points in one direction at all times. For the treatment vault, various beam directions were evaluated. Results: The shipping container requires a primary barrier of 168cm concrete (4.5 TVL), surrounded by a secondary barrier of 3.6 TVL. The other walls require between 2.8–3.3 TVL. Multiple shielding calculations were done along the side wall. The results show that patient scatter increases in the forward direction and decreases dramatically in the backward direction. Leakage scatter also varies along the wall, depending largely on the distance between the gantry and the wall. For the treatment room, fixed-beam requires a slightly thicker primary barrier than the conventional linac (0.6 TVL), although this barrier is only needed in the center of one wall. The secondary barrier is different only by 0–0.2 TVL. Conclusion: This work shows that (1) the shipping container option is achievable, using indigenous materials for shielding and (2) upright treatments can be performed in a conventional treatment room with minimal additional shielding. Varian Medical Systems

SU-E-T-273: Radiation Shielding for a Fixed Horizontal-Beam Linac in a Shipping Container and a Conventional Treatment Vault

Energy Technology Data Exchange (ETDEWEB)

Hsieh, M; Balter, P; Beadle, B; Chi, P; Stingo, F; Court, L [The University of Texas MD Anderson Cancer Center, Houston, TX (United States)

2014-06-01

Purpose: A fixed horizontal-beam linac, where the patient is treated in a seated position, could lower the overall costs of the treatment unit and room shielding substantially. This design also allows the treatment room and control area to be contained within a reduced space, such as a shipping container. The main application is the introduction of low-cost, high-quality radiation therapy to low- and middle-income regions. Here we consider shielding for upright treatments with a fixed-6MV-beam linac in a shipping container and a conventional treatment vault. Methods: Shielding calculations were done for two treatment room layouts using calculation methods in NCRP Report 151: (1) a shipping container (6m × 2.4m with the remaining space occupied by the console area), and (2) the treatment vault in NCRP 151 (7.8m by 5.4m by 3.4m). The shipping container has a fixed gantry that points in one direction at all times. For the treatment vault, various beam directions were evaluated. Results: The shipping container requires a primary barrier of 168cm concrete (4.5 TVL), surrounded by a secondary barrier of 3.6 TVL. The other walls require between 2.8–3.3 TVL. Multiple shielding calculations were done along the side wall. The results show that patient scatter increases in the forward direction and decreases dramatically in the backward direction. Leakage scatter also varies along the wall, depending largely on the distance between the gantry and the wall. For the treatment room, fixed-beam requires a slightly thicker primary barrier than the conventional linac (0.6 TVL), although this barrier is only needed in the center of one wall. The secondary barrier is different only by 0–0.2 TVL. Conclusion: This work shows that (1) the shipping container option is achievable, using indigenous materials for shielding and (2) upright treatments can be performed in a conventional treatment room with minimal additional shielding. Varian Medical Systems.

Barriers to Use of Educational Technology in the Learning Process of Primary School Students in District 13 in Tehran

Science.gov (United States)

Doshmanziari, Esfandiar; Mostafavi, Aida

2017-01-01

The aim of this study was to examine the barriers to use of educational technology in the learning process of primary school students in district 13 of Tehran. This research in terms of purpose is practical, in terms of the title characteristics of the research is descriptive, and in terms of data collection method is a field research. The…

JULIA: calculation projection software for primary barriers shielding to X-Rays using barite

International Nuclear Information System (INIS)

Silva, Júlia R.A.S. da; Vieira, José W.; Lima, Fernando R. A.

2017-01-01

The objective was to program a software to calculate the required thicknesses to attenuate X-rays in kilovoltage of 60 kV, 80 kV, 110 kV and 150 kV. The conventional methodological parameters for structural shield calculations established by the NCRP (National Council on Radiation Protection and Measurements) were presented. The descriptive and exploratory methods allowed the construction of the JULIA. In this sense and based on the result obtained, the tool presented is useful for professionals who wish to design structural shielding in radiodiagnostic and/or therapy. The development of calculations in the computational tool corresponds to the accessibility, optimization of time and estimation close to the real. Such heuristic exercise represents improvement of calculations for the estimation of primary barriers with barite

Assessing the facilitators and barriers of interdisciplinary team working in primary care using normalisation process theory: An integrative review

Science.gov (United States)

O’Reilly, Pauline; Lee, Siew Hwa; O’Sullivan, Madeleine; Cullen, Walter; Kennedy, Catriona; MacFarlane, Anne

2017-01-01

Background Interdisciplinary team working is of paramount importance in the reform of primary care in order to provide cost-effective and comprehensive care. However, international research shows that it is not routine practice in many healthcare jurisdictions. It is imperative to understand levers and barriers to the implementation process. This review examines interdisciplinary team working in practice, in primary care, from the perspective of service providers and analyses 1 barriers and facilitators to implementation of interdisciplinary teams in primary care and 2 the main research gaps. Methods and findings An integrative review following the PRISMA guidelines was conducted. Following a search of 10 international databases, 8,827 titles were screened for relevance and 49 met the criteria. Quality of evidence was appraised using predetermined criteria. Data were analysed following the principles of framework analysis using Normalisation Process Theory (NPT), which has four constructs: sense making, enrolment, enactment, and appraisal. The literature is dominated by a focus on interdisciplinary working between physicians and nurses. There is a dearth of evidence about all NPT constructs apart from enactment. Physicians play a key role in encouraging the enrolment of others in primary care team working and in enabling effective divisions of labour in the team. The experience of interdisciplinary working emerged as a lever for its implementation, particularly where communication and respect were strong between professionals. Conclusion A key lever for interdisciplinary team working in primary care is to get professionals working together and to learn from each other in practice. However, the evidence base is limited as it does not reflect the experiences of all primary care professionals and it is primarily about the enactment of team working. We need to know much more about the experiences of the full network of primary care professionals regarding all aspects

One size does not fit all: The impact of primary vaccine container size on vaccine distribution and delivery.

Science.gov (United States)

Haidari, Leila A; Wahl, Brian; Brown, Shawn T; Privor-Dumm, Lois; Wallman-Stokes, Cecily; Gorham, Katie; Connor, Diana L; Wateska, Angela R; Schreiber, Benjamin; Dicko, Hamadou; Jaillard, Philippe; Avella, Melanie; Lee, Bruce Y

2015-06-22

While the size and type of a vaccine container (i.e., primary container) can have many implications on the safety and convenience of a vaccination session, another important but potentially overlooked consideration is how the design of the primary container may affect the distribution of the vaccine, its resulting cost, and whether the vial is ultimately opened. Using our HERMES software platform, we developed a simulation model of the World Health Organization Expanded Program on Immunization supply chain for the Republic of Benin and used the model to explore the effects of different primary containers for various vaccine antigens. Replacing vaccines with presentations containing fewer doses per vial reduced vaccine availability (proportion of people arriving for vaccines who are successfully immunized) by as much as 13% (from 73% at baseline) and raised logistics costs by up to $0.06 per dose administered (from $0.25 at baseline) due to increased bottlenecks, while reducing total costs by as much as $0.15 per dose administered (from $2.52 at baseline) due to lower open vial wastage. Primary containers with a greater number of doses per vial each improved vaccine availability by 19% and reduced logistics costs by $0.05 per dose administered, while reducing the total costs by up to $0.25 per dose administered. Changes in supply chain performance were more extreme in departments with greater constraints. Implementing a vial opening threshold reversed the direction of many of these effects. Our results show that one size may not fit all when choosing a primary vaccine container. Rather, the choice depends on characteristics of the vaccine, the vaccine supply chain, immunization session size, and goals of decision makers. In fact, the optimal vial size may vary among locations within a country. Simulation modeling can help identify tailored approaches to improve availability and efficiency. Copyright © 2015 Elsevier Ltd. All rights reserved.

Arsenic compromises conducting airway epithelial barrier properties in primary mouse and immortalized human cell cultures.

Directory of Open Access Journals (Sweden)

Cara L Sherwood

Full Text Available Arsenic is a lung toxicant that can lead to respiratory illness through inhalation and ingestion, although the most common exposure is through contaminated drinking water. Lung effects reported from arsenic exposure include lung cancer and obstructive lung disease, as well as reductions in lung function and immune response. As part of their role in innate immune function, airway epithelial cells provide a barrier that protects underlying tissue from inhaled particulates, pathogens, and toxicants frequently found in inspired air. We evaluated the effects of a five-day exposure to environmentally relevant levels of arsenic {<4μM [~300 μg/L (ppb] as NaAsO2} on airway epithelial barrier function and structure. In a primary mouse tracheal epithelial (MTE cell model we found that both micromolar (3.9 μM and submicromolar (0.8 μM arsenic concentrations reduced transepithelial resistance, a measure of barrier function. Immunofluorescent staining of arsenic-treated MTE cells showed altered patterns of localization of the transmembrane tight junction proteins claudin (Cl Cl-1, Cl-4, Cl-7 and occludin at cell-cell contacts when compared with untreated controls. To better quantify arsenic-induced changes in tight junction transmembrane proteins we conducted arsenic exposure experiments with an immortalized human bronchial epithelial cell line (16HBE14o-. We found that arsenic exposure significantly increased the protein expression of Cl-4 and occludin as well as the mRNA levels of Cl-4 and Cl-7 in these cells. Additionally, arsenic exposure resulted in altered phosphorylation of occludin. In summary, exposure to environmentally relevant levels of arsenic can alter both the function and structure of airway epithelial barrier constituents. These changes likely contribute to the observed arsenic-induced loss in basic innate immune defense and increased infection in the airway.

Mammography Screening Uptake among Female Health Care Workers in Primary Health Care Centers in Palestine - Motivators and Barriers.

Science.gov (United States)

Nazzal, Zaher; Sholi, Hisham; Sholi, Suha; Sholi, Mohammad; Lahaseh, Rawya

2016-01-01

Early detection remains the cornerstone of breast cancer control in terms of outcome and survival. Thus far the only breast cancer screening method proven effective is mammography. The awareness of female health care workers (HCW) about breast cancer prevention is of vital importance, as their beliefs and behavior may have a major impact on other women. This study was designed to assess mammography screening uptake among female healthcare workers at primary healthcare centers, and to identify the primary motivators and barriers that affect uptake results. A cross sectional study design was used to assess mammography screening by 299 female healthcare workers who completed a self-administered questionnaire that assessed demographics, screening uptake, motivators and barriers. The mean age was 46 years (within age of risk). The majority (95.1%) demonstrated adequate knowledge about breast cancer and mammography screening and 50% of the participants reported having at least one mammogram; however only 21% of them had regularly scheduled mammograms. The most frequent reported motivator was the perceived benefit that early detection of breast cancer is important for its management (89.6%), followed by the belief that mammography can detect breast cancer before its symptoms appear (84.4%). On the other hand, the most frequent barrier reported was being busy (46.7%), followed by the lack of perceived susceptibility (41.5%). Mammography screening was found to be sub-optimal in a population of HCW's with 50 % stating that they received a mammogram at least once, and a minority reported regular screening. There is a pressing need for educational programs aimed at removing the barriers that limit compliance with recommendations for mammography screening, and to emphasize the importance of early detection in breast cancer treatment. Ensuring the availability and accessibility of screening services, particularly for healthcare workers within their work settings are other

Engineered barriers: current status 1989

International Nuclear Information System (INIS)

Atkinson, A.; Marsh, G.B.

1989-06-01

This report summarises the current state of research relevant to assessing the performance of engineered barriers made of steel and concrete in radioactive waste repositories. The objective of these barriers is to contain substantially the radionuclides within them by providing both physical and chemical impediment to their release. The physical barriers are of most value for highly soluble isotopes with relatively short half-lives (eg 137 Cs), since they can provide a measure of containment until a large fraction of the activity has decayed. In addition they can facilitate retrievability for some period after disposal. The chemical barriers operate by beneficial conditioning of the near field groundwater and providing sites for sorption of radionuclides. Both of these reduce the aqueous concentration of radionuclides in the near field. (author)

Origins and Implications of a Primary Crown-of-Thorns Starfish Outbreak in the Southern Great Barrier Reef

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Ian Miller

2015-01-01

Full Text Available The crown-of-thorns starfish (COTS is a major predator of hard corals. Repeated COTS outbreaks in the Cairns and Central sections of the Great Barrier Reef (GBR have been responsible for greater declines in coral cover than any other type of disturbance, including cyclones, disease, and coral bleaching. Knowledge of the precise timing and location of primary outbreaks could reveal the initial drivers of outbreaks and so could indicate possible management measures. In the central GBR, COTS outbreaks appear to follow major flooding events, but despite many years of observations, no primary outbreak has ever been unequivocally identified in the central and northern GBR. Here we locate a primary outbreak of COTS on the southern GBR which is not correlated with flooding. Instead it appears to have been the result of a combination of life history traits of COTS and prevailing oceanographic conditions. The hydrodynamic setting implies that the outbreak could disperse larvae to other reefs in the region.

Overcoming barriers to engaging socio-economically disadvantaged populations in CHD primary prevention: a qualitative study

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Cunningham Heather

2010-07-01

Full Text Available Abstract Background Preventative medicine has become increasingly important in efforts to reduce the burden of chronic disease in industrialised countries. However, interventions that fail to recruit socio-economically representative samples may widen existing health inequalities. This paper explores the barriers and facilitators to engaging a socio-economically disadvantaged (SED population in primary prevention for coronary heart disease (CHD. Methods The primary prevention element of Have a Heart Paisley (HaHP offered risk screening to all eligible individuals. The programme employed two approaches to engaging with the community: a a social marketing campaign and b a community development project adopting primarily face-to-face canvassing. Individuals living in areas of SED were under-recruited via the social marketing approach, but successfully recruited via face-to-face canvassing. This paper reports on focus group discussions with participants, exploring their perceptions about and experiences of both approaches. Results Various reasons were identified for low uptake of risk screening amongst individuals living in areas of high SED in response to the social marketing campaign and a number of ways in which the face-to-face canvassing approach overcame these barriers were identified. These have been categorised into four main themes: (1 processes of engagement; (2 issues of understanding; (3 design of the screening service and (4 the priority accorded to screening. The most immediate barriers to recruitment were the invitation letter, which often failed to reach its target, and the general distrust of postal correspondence. In contrast, participants were positive about the face-to-face canvassing approach. Participants expressed a lack of knowledge and understanding about CHD and their risk of developing it and felt there was a lack of clarity in the information provided in the mailing in terms of the process and value of screening. In

Vegetable and fruit breaks in Australian primary schools: prevalence, attitudes, barriers and implementation strategies.

Science.gov (United States)

Nathan, Nicole; Wolfenden, Luke; Butler, Michelle; Bell, Andrew Colin; Wyse, Rebecca; Campbell, Elizabeth; Milat, Andrew J; Wiggers, John

2011-08-01

School-based vegetable and fruit programs can increase student consumption of vegetables and fruit and have been recommended for adoption by Australian schools since 2005. An understanding of the prevalence and predictors of and the barriers to the adoption of school-based vegetable and fruit programs is necessary to maximize their adoption by schools and ensure that the health benefits of such programs to children are realized. The aim of this study was to determine Australian primary school Principals' attitudes and barriers to the implementation of vegetable and fruit breaks; the prevalence of vegetable and fruit breaks in schools and the implementation strategies used and associated with their recommended adoption (daily in at least 80% of classes). A random sample of 384 school Principals completed a 20-min telephone interview. While Principals were highly supportive of vegetable and fruit breaks, only 44% were implementing these to a recommended level. When controlling for all school characteristics, recommended vegetable and fruit break adoption was 1.9 and 2.2 times greater, respectively, in schools that had parent communication strategies and teachers trained. A substantial opportunity exists to enhance the health of children through the adoption of vegetable and fruit breaks in schools.

Primary care for refugees and newly arrived migrants in Europe: a qualitative study on health needs, barriers and wishes.

Science.gov (United States)

van Loenen, Tessa; van den Muijsenbergh, Maria; Hofmeester, Marrigje; Dowrick, Christopher; van Ginneken, Nadja; Mechili, Enkeleint Aggelos; Angelaki, Agapi; Ajdukovic, Dean; Bakic, Helena; Pavlic, Danica Rotar; Zelko, Erika; Hoffmann, Kathryn; Jirovsky, Elena; Mayrhuber, Elisabeth Sophie; Dückers, Michel; Mooren, Trudy; Gouweloos-Trines, Juul; Kolozsvári, László; Rurik, Imre; Lionis, Christos

2018-02-01

In order to provide effective primary care for refugees and to develop interventions tailored to them, we must know their needs. Little is known of the health needs and experiences of recently arrived refugees and other migrants throughout their journey through Europe. We aimed to gain insight into their health needs, barriers in access and wishes regarding primary health care. In the spring of 2016, we conducted a qualitative, comparative case study in seven EU countries in a centre of first arrival, two transit centres, two intermediate-stay centres and two longer-stay centres using a Participatory Learning and Action research methodology. A total of 98 refugees and 25 healthcare workers participated in 43 sessions. Transcripts and sessions reports were coded and thematically analyzed by local researchers using the same format at all sites; data were synthesized and further analyzed by two other researchers independently. The main health problems of the participants related to war and to their harsh journey like common infections and psychological distress. They encountered important barriers in accessing healthcare: time pressure, linguistic and cultural differences and lack of continuity of care. They wish for compassionate, culturally sensitive healthcare workers and for more information on procedures and health promotion. Health of refugees on the move in Europe is jeopardized by their bad living circumstances and barriers in access to healthcare. To address their needs, healthcare workers have to be trained in providing integrated, compassionate and cultural competent healthcare. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Treatment of EDTA contained reactor coolant using water dielectric barrier discharge plasma

International Nuclear Information System (INIS)

Song, Sang Heon; Kwon, Daniel; Kim, Gon Ho

2005-01-01

EDTA (Ethylene Diamine Tetraacetic Acid) is used as a main absorbent for the metal ion in the secondary loop of the nuclear reactor. Dissolving the wasted EDTA with low cost, therefore, is important issue for the maintenance of the nuclear power reactor and the protection of environment. EDTA is not easily biodegradable, furthermore these methods could make remained another pollutant as complex chemical compounds. Compared to chemical method, the physical methods, using the energetic particles and UVs, are more favorable because they dissociate the bonds of organic compounds directly without the secondary chemical reactions during the treatment. Recently, high energy electron beam, the plasma torch, and the water breakdown by high voltage pulse are applied to treatment of the waste water contained chemicals. Here consideration is narrow down to improve the interaction between the plasma and the chemical bonds of EDTA because the energetic particles; activated radicals, and UVs, are abundant in plasmas. The new method adapted of the water DBD (dielectric barrier discharge) which plasma generates directly on the top of the water contained EDTA is proposed. The application of DBD plasmas has been extended for cleaning the organic compounds from the contaminated surface and also for removing volatile organic chemicals (VOC) such as NO x and SO x from the exhausted gases. Here, the water DBD reactor (SEMTECH, SD-DWG-04-1) is consisted that the one electrode is a ceramic insulator and another one is the water itself. Interestingly, the one electrode, the water, is not the solid dielectric electrode. In this study, therefore, the characteristics with driving frequency are considered and the feasibility of this new method for the DBD treatment of EDTA contained water is demonstrated

Motivators and barriers to mammography screening uptake by female health-care workers in primary health-care centres: a cross-sectional study.

Science.gov (United States)

Nazzal, Zaher; Sholi, Hisham; Sholi, Suha B; Sholi, Mohammad B; Lahaseh, Rawya

2018-02-21

Mammography screening is an effective tool for early detection and management of breast cancer. Female health-care workers' awareness of breast cancer screening is important because their beliefs and behaviours could influence other women. The aim of this study was to assess mammography screening uptake by female health-care workers at primary health-care centres and to identify the primary motivators and barriers that affect uptake. This cross-sectional study included all governmental primary health-care centres in the West Bank. Governorates were grouped into three regions as follows: north West Bank (Nablus, Jenin, Tulkarm, Tubas, Qalqiliya, and Salfit), middle West Bank (Jerusalem, Jericho, and Ramallah), and south West Bank (Hebron, and Bethlehem). The study population included all female health-care workers older than 40 years. Those who performed mammography for a suspected mass or other breast abnormalities were excluded. A self-administered questionnaire was used to collect data on demographic characteristics, knowledge about mammography screening, the extent and regularity of mammography screening, and motivators and barriers influencing their mammography screening uptake. The rate of mammography screening uptake was calculated. χ 2 test and t tests were used to assess screening motivators and barriers. The study was approved by the Institutional Review Board of the An-Najah National University. Participation was voluntary, and written consent was obtained from each participant. 299 female health-care workers completed a self-administered questionnaire. The mean age of the participants was 46 years (SD 4·7). 284 (95%) women had adequate knowledge about breast cancer and mammography screening, and 149 (50%) women reported having had at least one mammogram. 62 (21%) women had had regular scheduled mammograms. The most frequent reported motivators were the perceived benefit that early detection of breast cancer is important for its management (269 [90

Assessment study for multi-barrier system used in radioactive borate waste isolation based on Monte Carlo simulations.

Science.gov (United States)

Bayoumi, T A; Reda, S M; Saleh, H M

2012-01-01

Radioactive waste generated from the nuclear applications should be properly isolated by a suitable containment system such as, multi-barrier container. The present study aims to evaluate the isolation capacity of a new multi-barrier container made from cement and clay and including borate waste materials. These wastes were spiked by (137)Cs and (60)Co radionuclides to simulate that waste generated from the primary cooling circuit of pressurized water reactors. Leaching of both radionuclides in ground water was followed and calculated during ten years. Monte Carlo (MCNP5) simulations computed the photon flux distribution of the multi-barrier container, including radioactive borate waste of specific activity 11.22KBq/g and 4.18KBq/g for (137)Cs and (60)Co, respectively, at different periods of 0, 15.1, 30.2 and 302 years. The average total flux for 100cm radius of spherical cell was 0.192photon/cm(2) at initial time and 2.73×10(-4)photon/cm(2) after 302 years. Maximum waste activity keeping the surface radiation dose within the permissible level was calculated and found to be 56KBq/g with attenuation factors of 0.73cm(-1) and 0.6cm(-1) for cement and clay, respectively. The average total flux was 1.37×10(-3)photon/cm(2) after 302 years. Monte Carlo simulations revealed that the proposed multi-barrier container is safe enough during transportation, evacuation or rearrangement in the disposal site for more than 300 years. Copyright © 2011 Elsevier Ltd. All rights reserved.

Adventitious Carbon on Primary Sample Containment Metal Surfaces

Science.gov (United States)

Calaway, M. J.; Fries, M. D.

2015-01-01

Future missions that return astromaterials with trace carbonaceous signatures will require strict protocols for reducing and controlling terrestrial carbon contamination. Adventitious carbon (AC) on primary sample containers and related hardware is an important source of that contamination. AC is a thin film layer or heterogeneously dispersed carbonaceous material that naturally accrues from the environment on the surface of atmospheric exposed metal parts. To test basic cleaning techniques for AC control, metal surfaces commonly used for flight hardware and curating astromaterials at JSC were cleaned using a basic cleaning protocol and characterized for AC residue. Two electropolished stainless steel 316L (SS- 316L) and two Al 6061 (Al-6061) test coupons (2.5 cm diameter by 0.3 cm thick) were subjected to precision cleaning in the JSC Genesis ISO class 4 cleanroom Precision Cleaning Laboratory. Afterwards, the samples were analyzed by X-ray photoelectron spectroscopy (XPS) and Raman spectroscopy.

Barriers and facilitators for the implementation of primary prevention and health promotion activities in primary care: a synthesis through meta-ethnography.

Directory of Open Access Journals (Sweden)

Maria Rubio-Valera

Full Text Available Evidence supports the implementation of primary prevention and health promotion (PP&HP activities but primary care (PC professionals show resistance to implementing these activities. The aim was to synthesize the available qualitative research on barriers and facilitators identified by PC physicians and nurses in the implementation of PP&HP in adults.A systematic search of three databases was conducted and supported by manual searches. The 35 articles included were translated into each other and a new interpretation of the concepts extracted was generated. The factors affecting the implementation of PP&HP activities in PC according to professionals were fitted into a five-level ecological model: intrapersonal factors, interpersonal processes, institutional factors, community factors and public policy. At the intrapersonal level we find professionals' beliefs about PP&HP, experiences, skills and knowledge, and selfconcept. The attitudes and behavior towards PP&HP of patients, specialists, practice managers and colleagues (interpersonal factors affect the feasibility of implementing PP&HP. Institutional level: PC is perceived as well-placed to implement PP&HP but workload, lack of time and referral resources, and the predominance of the biomedical model (which prioritizes disease treatment hamper the implementation of PP&HP. The effectiveness of financial incentives and tools such as guidelines and alarms/reminders is conditioned by professionals' attitudes to them. Community factors include patients' social and cultural characteristics (religion, financial resources, etc., local referral resources, mass-media messages and pharmaceutical industry campaigns, and the importance given to PP&HP in the curriculum in university. Finally, policies affect the distribution of resources, thus affecting the implementation of PP&HP.Research on barriers and facilitators in the implementation of PP&HP activities in multirisk management is scarce. The conceptual

Barriers to Alcohol Screening Among Hypertensive Patients and the Role of Stigma: Lessons for the Implementation of Screening and Brief Interventions in European Primary Care Settings.

Science.gov (United States)

Hanschmidt, Franz; Manthey, Jakob; Kraus, Ludwig; Scafato, Emanuele; Gual, Antoni; Grimm, Carsten; Rehm, Jürgen

2017-09-01

1. To quantify barriers to alcohol screening among hypertensive patients reported by primary healthcare professionals. 2. To examine whether education and screening frequency measures are associated with stigma-related barriers. A web survey was conducted among 3081 primary healthcare professionals from France, Germany, Italy, Spain and the UK. Participants were asked about perceived barriers to alcohol screening as free-text response. The replies were independently categorized by two raters. Stigma-related barriers were predicted by logistic regressions with education, knowledge on alcohol as risk factor and frequency of alcohol screening. In France and Italy, almost half of the reported barriers were stigma-related, whereas time constraints were cited most commonly in Spain and the UK. In Germany, nearly half of respondents rated the importance of alcohol screening for hypertension as low. Perception that regular screening is inappropriate or associated with too much effort, beliefs that screening is unnecessary, and insufficient knowledge of screening tools were cited as further barriers. Professional education on alcohol use was consistently rated to be poorer than the equivalent education on hypertension, and only a minority of respondents perceived alcohol as important risk factor for hypertension. Stigma-related barriers could not be significantly predicted by education, knowledge or screening frequency in most models. Overall, regular alcohol screening among hypertensive patients seems to be widely accepted, but further education (Germany) and structural support (Spain, UK) could contribute to increase screening rates. In France and Italy, screening uptake could be improved by addressing stigma. Alcohol screening among hypertensive patients was largely accepted among general practitioners from five different European countries. Reported screening barriers varied between countries and included time constraints, stigma and underrated importance of alcohol

Article Including Environmental Barrier Coating System

Science.gov (United States)

Lee, Kang N. (Inventor)

2015-01-01

An enhanced environmental barrier coating for a silicon containing substrate. The enhanced barrier coating may include a bond coat doped with at least one of an alkali metal oxide and an alkali earth metal oxide. The enhanced barrier coating may include a composite mullite bond coat including BSAS and another distinct second phase oxide applied over said surface.

Barriers and facilitators to implementing Decision Boxes in primary healthcare teams to facilitate shared decisionmaking: a study protocol

Directory of Open Access Journals (Sweden)

Giguere Anik

2012-08-01

Full Text Available Abstract Background Decision Boxes are summaries of the most important benefits and harms of health interventions provided to clinicians before they meet the patient, to prepare them to help patients make informed and value-based decisions. Our objective is to explore the barriers and facilitators to using Decision Boxes in clinical practice, more precisely factors stemming from (1 the Decision Boxes themselves, (2 the primary healthcare team (PHT, and (3 the primary care practice environment. Methods/design A two-phase mixed methods study will be conducted. Eight Decision Boxes relevant to primary care, and written in both English and in French, will be hosted on a website together with a tutorial to introduce the Decision Box. The Decision Boxes will be delivered as weekly emails over a span of eight weeks to clinicians of PHTs (family physicians, residents and nurses in five primary care clinics located across two Canadian provinces. Using a web-questionnaire, clinicians will rate each Decision Box with the Information Assessment Method (cognitive impacts, relevance, usefulness, expected benefits and with a questionnaire based on the Theory of Planned Behavior to study the determinants of clinicians’ intention to use what they learned from that Decision Box in their patient encounter (attitude, social norm, perceived behavioral control. Web-log data will be used to monitor clinicians’ access to the website. Following the 8-week intervention, we will conduct semi-structured group interviews with clinicians and individual interviews with clinic administrators to explore contextual factors influencing the use of the Decision Boxes. Data collected from questionnaires, focus groups and individual interviews will be combined to identify factors potentially influencing implementation of Decision Boxes in clinical practice by clinicians of PHTs. Conclusions This project will allow tailoring of Decision Boxes and their delivery to overcome the

Review on experiments relating to primary containment vessel failure

International Nuclear Information System (INIS)

Suzuki, Hiroyuki; Okada, Hidetoshi; Uchida, Sunsuke; Naitoh, Masanori

2015-01-01

Experiments regarding failures of primary containment vessels (PCVs) are reviewed and remained issues to be investigated in the future are discussed. Experiments are categorized as those relating to criteria of PCV failures and to FP releases through breaches on PCV boundaries. In the experiments categorized as those relating to criteria of PCV failures, experiments with full-scale, scale models, and compounds used for sealing are surveyed. Experiments relating to an amount of radioactive fission products (FPs) trapped at breaches on PCV boundaries are also reviewed. As remained issues to be investigated in the future, two items are pointed out: Evaluating degradation behavior of PCV boundaries exposed to temperature and pressure from the failure onset criteria to far above them, and evaluating an amount of FPs trapped at breaches on PCV boundaries. (author)

Overpressurization performance of containment structures

International Nuclear Information System (INIS)

Barr, P.; Bleackley, M.; Harrop, L.P.; Hargreaves, J.; Jowett, J.; Phillips, D.W.

1987-01-01

The containment building of a PWR is the outermost engineered barrier between the reactor and the environment. The most important element of such a containment system is the pressure boundary structure and its associated seals and penetrations. This containment structure is designed deterministically to withstand a number of loads and load combinations of which the dominant one is generally the internal pressure due to the double-ended guillotine break in one of the primary circuit loops. Typically, the design basis large LOCA produces a peak pressure increase in the region of 0.3 MPa in some 10 seconds and with a duration of up to a few tens of seconds. The assessment of overpressure performance of the containment structure is a key component of the PWR safety case, and is usually carried out by estimating a static factor of safety to some failure limit state. These estimates can be made using simple force-balance calculations or complicated finite element calculations, and both approaches have merit. In this paper we examine these approaches and discuss their value in estimating failure pressures and failure modes for a variety of internal pressurization transients. This discussion covers both general design and risk considerations and is illustrated by numerical examples taken from previous and on-going analysis

The in-situ vitrification of subsurface containment barriers: An overview

International Nuclear Information System (INIS)

Murphy, M.; Stottlemyre, J.A.

1990-11-01

In situ vitrification (ISV) is an environmental engineering process in which soil or soil/waste mixtures are melted through the direct application of electrical current and subsequently cooled to a glassy solid. The technology was developed by Pacific Northwest Laboratory (PNL) in the 1980s and has been tested on transuranic, mixed-hazardous, and PCB/organic waste similar to that found at US Department of Energy (DOE) and other facilities nationwide. PNL is conducting a wide range of field tests, expanding the scientific basis of ISV, and assessing its extension into new applications. One such project is ISV--Selective Barriers, an investigation into the construction and performance of ISV--generated, vertical and/or horizontal subsurface barriers to ground-water flow and biogenic intrusion. In some situations, it may be impractical or unnecessary to either excavate or vitrify an entire waste site. Vitrified barriers could minimize the diffusive or fluid transport of hazardous components with either a ground-water diversion wall or an in situ, ''box-like'' structure. During the first year of this project, engineering-scale tests are being conducted between graphite electrodes within a 1.8-m-diameter, 2.4-m-high test cell. Several methods are being tested, including passive metal electrodes, electrode feeding systems, fluxed soil, and fluxed boreholes. In addition, basic data have been collected on the thermal and material properties of ISV melt and solidified glass. 7 refs., 6 figs

Feasibility of permeation grouting for constructing subsurface barriers

International Nuclear Information System (INIS)

Dwyer, B.P.

1994-03-01

The technical feasibility of emplacing a barrier beneath a waste site using directionally drilled boreholes and permeation grouting was investigated. The benefits of this emplacement system are: (1) Directionally drilled boreholes provide access beneath a waste site without disturbing the waste; (2) interim containment of contaminants allows time for the development of remediation options; (3) in the interim, the volume of waste remains fixed; (4) barriers may enhance the effectiveness of in situ remediation actions; and (5) barrier systems may provide permanent waste containment

NEK containment integrated leak rate test at full pressure

International Nuclear Information System (INIS)

Skaler, F.; Planinc, V.; Gregoric, D.; Cicvaric, D.

1999-01-01

NPP Krsko is a Pressure Water Reactor (PWR) Plant which has four barriers to prevent release of radioactive fission products. These four barriers are following: Fuel itself, Fuel Clad, Reactor Coolant System and Containment Building. Containment is the last barrier which can prevent release of fission product when other barriers have been already broken. To find out the real condition of containment vessel and to prove its ability of withstanding increased parameters during accident we have to perform Containment Integrated Leak Rate Test at least three times in every ten years of operation. CILRT 1999 in NPP Krsko was completely performed following regulation of 10CFR50 App. J Option A and ANSI/ANS 56.8-1987. The main goal of CILRT is to prove that the leakage of containment pathways and wall structures are within limits prescribed in Technical Specifications by pressurization of containment building above peak accident pressure Pa and measuring the mass changes of air using Ideal Gas Law.(author)

BSN completion barriers, challenges, incentives, and strategies.

Science.gov (United States)

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

2014-04-01

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

Economic evaluation of closure cap barrier materials study

Energy Technology Data Exchange (ETDEWEB)

Serrato, M.G.; Bhutani, J.S.; Mead, S.M.

1993-09-01

Volume II of the Economic Evaluation of the Closure Cap Barrier Materials, Revision I contains detailed cost estimates for closure cap barrier materials. The cost estimates incorporate the life cycle costs for a generic hazardous waste seepage basin closure cap under the RCRA Post Closure Period of thirty years. The economic evaluation assessed six barrier material categories. Each of these categories consists of several composite cover system configurations, which were used to develop individual cost estimates. The information contained in this report is not intended to be used as a cost estimating manual. This information provides the decision makers with the ability to screen barrier materials, cover system configurations, and identify cost-effective materials for further consideration.

Economic evaluation of closure cap barrier materials study

International Nuclear Information System (INIS)

Serrato, M.G.; Bhutani, J.S.; Mead, S.M.

1993-09-01

Volume II of the Economic Evaluation of the Closure Cap Barrier Materials, Revision I contains detailed cost estimates for closure cap barrier materials. The cost estimates incorporate the life cycle costs for a generic hazardous waste seepage basin closure cap under the RCRA Post Closure Period of thirty years. The economic evaluation assessed six barrier material categories. Each of these categories consists of several composite cover system configurations, which were used to develop individual cost estimates. The information contained in this report is not intended to be used as a cost estimating manual. This information provides the decision makers with the ability to screen barrier materials, cover system configurations, and identify cost-effective materials for further consideration

Performance of the primary containment of a BWR during a severe accident whit the code RELAP/SCDAPSIM

International Nuclear Information System (INIS)

Castillo G, F.

2015-01-01

In this thesis work, it was developed a model of the vacuum breaker valves and down comers for a BWR Mark II primary containment for the code RELAP/SCDAPSIM Mod. 3.4. This code was used to simulate a Station Blackout (Sbo) that evolves to a severe accident scenario. To accomplish this task, the vacuum breaker valves and down comers were included in a simplified model of the primary containment that includes both wet well and dry well, which was coupled with a model of the Nuclear Steam Supply System (NSSS), in order to study the behavior of the primary containment during the evolution of the accident scenario. In the analysis of the results of the simulation, the behavior of the wet well and dry well during the event was particularly monitored, by analyzing the evolution of temperature and pressure profiles in such volumes, this to determine the impact of the inclusion of the breaker vacuum valves and down comers. The results show that the effect of this extension of the model is that more conservative results are obtained, i.e., higher pressures are reached in both wet well and dry well than when it is used a containment model that does not include neither the vacuum valves nor the down comers. The most relevant results obtained show that the Rcic alone is able to keep the core fully covered, but even in such a case, it evaporates about 15% of the initial inventory of liquid water in the Pressure Suppression Pool (Psp). When the Rcic operation is lost, 20% more of the liquid water inventory in the Psp is further reduced within four to twelve hours (approximately), time at which the simulation crashed. Besides, there is a significant increase of pressure in the containment. As the accident evolves, the pressure in the containment continues increasing, but there is still considerable margin to reach the design pressure of the containment. At the end of the simulation, the results show a gauge pressure value of 224,550 Pa in the Psp and 187,482 Pa in the wet well

Peers without fears? Barriers to effective communication among primary care physicians and oncologists about diagnostic delays in cancer.

Science.gov (United States)

Lipitz-Snyderman, Allison; Kale, Minal; Robbins, Laura; Pfister, David; Fortier, Elizabeth; Pocus, Valerie; Chimonas, Susan; Weingart, Saul N

2017-11-01

Relatively little attention has been devoted to the role of communication between physicians as a mechanism for individual and organisational learning about diagnostic delays. This study's objective was to elicit physicians' perceptions about and experiences with communication among physicians regarding diagnostic delays in cancer. Qualitative analysis based on seven focus groups. Fifty-one physicians affiliated with three New York-based academic medical centres participated, with six to nine subjects per group. We used content analysis to identify commonalities among primary care physicians and specialists (ie, medical and surgical oncologists). Perceptions and experiences with physician-to-physician communication about delays in cancer diagnosis. Our analysis identified five major themes: openness to communication, benefits of communication, fears about giving and receiving feedback, infrastructure barriers to communication and overcoming barriers to communication. Subjects valued communication about cancer diagnostic delays, but they had many concerns and fears about providing and receiving feedback in practice. Subjects expressed reluctance to communicate if there was insufficient information to attribute responsibility, if it would have no direct benefit or if it would jeopardise their existing relationships. They supported sensitive approaches to conveying information, as they feared eliciting or being subject to feelings of incompetence or shame. Subjects also cited organisational barriers. They offered suggestions that might facilitate communication about delays. Addressing the barriers to communication among physicians about diagnostic delays is needed to promote a culture of learning across specialties and institutions. Supporting open and honest discussions about diagnostic delays may help build safer health systems. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use

Barriers to and Facilitators of Alcohol Use Disorder Pharmacotherapy in Primary Care: A Qualitative Study in Five VA Clinics.

Science.gov (United States)

Williams, Emily C; Achtmeyer, Carol E; Young, Jessica P; Berger, Douglas; Curran, Geoffrey; Bradley, Katharine A; Richards, Julie; Siegel, Michael B; Ludman, Evette J; Lapham, Gwen T; Forehand, Mark; Harris, Alex H S

2018-03-01

Three medications are FDA-approved and recommended for treating alcohol use disorders (AUD) but they are not offered to most patients with AUD. Primary care (PC) may be an optimal setting in which to offer and prescribe AUD medications, but multiple barriers are likely. This qualitative study used social marketing theory, a behavior change approach that employs business marketing techniques including "segmenting the market," to describe (1) barriers and facilitators to prescribing AUD medications in PC, and (2) beliefs of PC providers after they were segmented into groups more and less willing to prescribe AUD medications. Qualitative, interview-based study. Twenty-four providers from five VA PC clinics. Providers completed in-person semi-structured interviews, which were recorded, transcribed, and analyzed using social marketing theory and thematic analysis. Providers were divided into two groups based on consensus review. Barriers included lack of knowledge and experience, beliefs that medications cannot replace specialty addiction treatment, and alcohol-related stigma. Facilitators included training, support for prescribing, and behavioral staff to support follow-up. Providers more willing to prescribe viewed prescribing for AUD as part of their role as a PC provider, framed medications as a potentially effective "tool" or "foot in the door" for treating AUD, and believed that providing AUD medications in PC might catalyze change while reducing stigma and addressing other barriers to specialty treatment. Those less willing believed that medications could not effectively treat AUD, and that treating AUD was the role of specialty addiction treatment providers, not PC providers, and would require time and expertise they do not have. We identified barriers to and facilitators of prescribing AUD medications in PC, which, if addressed and/or capitalized on, may increase provision of AUD medications. Providers more willing to prescribe may be the optimal target of a

Gelatinous soil barrier for reducing contaminant emissions at waste-disposal sites

International Nuclear Information System (INIS)

Opitz, B.E.; Martin, W.J.; Sherwood, D.R.

1982-09-01

The milling of uranium ore produces large quantities of waste (mill tailings) that are being deposited in earthen pits or repositories. These wastes, which remain potentially hazardous for long time periods, may reach the biosphere at levels greater than those allowed by the Environmental Protection Agency (EPA). For example, the leachates associated with these wastes contain numerous radionuclides and toxic trace metals at levels 10 2 to 10 4 greater than allowable for drinking water based on EPA Primary Drinking Water Standards. As a result, technologies must be developed to ensure that such wastes will not reach the biosphere at hazardous levels. Under sponsorship of the Department of Energy's Uranium Mill Tailings Remedial Action Program (UMTRAP), Pacific Northwest Laboratory (PNL) has investigated the use of engineered barriers for use as liners and covers for waste containment. Results of these investigations have led to the development of a low permeable, multilayer earthen barrier that effectively reduces contaminant loss from waste disposal sites. The multilayer earth barrier was developed as an alternative to clay liner or cover schemes for use in areas where clays were not locally available and must be shipped to the disposal site. The barrier layer is comprised of 90% locally available materials whose liner or cover properties are enhanced by the addition of a gelatinous precipitate which entrains moisture into the cover's air-filled pore spaces, blocking the pathways through which gas would otherwise diffuse into the atmosphere or through which moisture would migrate into the ground. In field verification tests, the earthen seal reduced radon gas emissions by 95 to 99% over prior release rates with measured permeabilities on the order of 10 - 9 cm/s

Enablers and barriers for implementing high-quality hypertension care in a rural primary care setting in Nigeria: perspectives of primary care staff and health insurance managers.

Science.gov (United States)

Odusola, Aina O; Stronks, Karien; Hendriks, Marleen E; Schultsz, Constance; Akande, Tanimola; Osibogun, Akin; van Weert, Henk; Haafkens, Joke A

2016-01-01

Hypertension is a highly prevalent risk factor for cardiovascular diseases in sub-Saharan Africa (SSA) that can be modified through timely and long-term treatment in primary care. We explored perspectives of primary care staff and health insurance managers on enablers and barriers for implementing high-quality hypertension care, in the context of a community-based health insurance programme in rural Nigeria. Qualitative study using semi-structured individual interviews with primary care staff (n = 11) and health insurance managers (n=4). Data were analysed using standard qualitative techniques. Both stakeholder groups perceived health insurance as an important facilitator for implementing high-quality hypertension care because it covered costs of care for patients and provided essential resources and incentives to clinics: guidelines, staff training, medications, and diagnostic equipment. Perceived inhibitors included the following: high staff workload; administrative challenges at facilities; discordance between healthcare provider and insurer on how health insurance and provider payment methods work; and insufficient fit between some guideline recommendations and tools for patient education and characteristics/needs of the local patient population. Perceived strategies to address inhibitors included the following: task-shifting; adequate provider payment benchmarking; good provider-insurer relationships; automated administration systems; and tailoring guidelines/patient education. By providing insights into perspectives of primary care providers and health insurance managers, this study offers information on potential strategies for implementing high-quality hypertension care for insured patients in SSA.

Explaining the de-prioritization of primary prevention: Physicians' perceptions of their role in the delivery of primary care

Directory of Open Access Journals (Sweden)

Kuo Christina L

2003-05-01

Full Text Available Abstract Background While physicians are key to primary preventive care, their delivery rate is sub-optimal. Assessment of physician beliefs is integral to understanding current behavior and the conceptualization of strategies to increase delivery. Methods A focus group with regional primary care physician (PCP Opinion Leaders was conducted as a formative step towards regional assessment of attitudes and barriers regarding preventive care delivery in primary care. Following the PRECEDE-PROCEED model, the focus group aim was to identify conceptual themes that characterize PCP beliefs and practices regarding preventive care. Seven male and five female PCPs (family medicine, internal medicine participated in the audiotaped discussion of their perceptions and behaviors in delivery of primary preventive care. The transcribed audiotape was qualitatively analyzed using grounded theory methodology. Results The PCPs' own perceived role in daily practice was a significant barrier to primary preventive care. The prevailing PCP model was the "one-stop-shop" physician who could provide anything from primary to tertiary care, but whose provision was dominated by the delivery of immediate diagnoses and treatments, namely secondary care. Conclusions The secondary-tertiary prevention PCP model sustained the expectation of immediacy of corrective action, cure, and satisfaction sought by patients and physicians alike, and, thereby, de-prioritized primary prevention in practice. Multiple barriers beyond the immediate control of PCP must be surmounted for the full integration of primary prevention in primary care practice. However, independent of other barriers, physician cognitive value of primary prevention in practice, a base mediator of physician behavior, will need to be increased to frame the likelihood of such integration.

WWER 440/213 NPP containment from the point of view of IAEA requirements and current European practice

International Nuclear Information System (INIS)

Sabata, M.

2000-01-01

In principle, in a NPP three barriers are used to prevent the release of radioactive substances into the environment: the fuel cladding, the primary circuit boundary, and the containment. The presentation deals with the third barrier - the containment, and explains the philosophy of maximum design accident management in the containment of WWER-440/213 NPPs. This type of containment is shown to be an original and fully functional technical solution. Due to the use of the large reserve of the H 3 BO 3 solution and to the active spray systems, an underpressure can be quickly established, thus minimizing any impact of the accident on the environment. The capability of the bubble condenser system for a maximum design accident has been proven by analyses and by tests performed within the framework of PHARE PH 2.13/95: the condenser system can reduce the pressure in the containment in an effective way. The majority of questions arising so far have been answered and the concern resulting from insufficient verification of the system with regard to western standards has been refuted. The WWER-440/213 is fully consistent with IAEA requirements and with current European practice. (A.K.)

Selection of barrier metals for a waste package in tuff

International Nuclear Information System (INIS)

Russell, E.W.; McCright, R.D.; O'Neal, W.C.

1983-09-01

The Nevada Nuclear Waste Storage Investigation (NNWSI) project under the Civilian Radioactive Waste Management Program is planning a repository at Yucca Mountain at the Nevada Test Site for isolation of high-level nuclear waste. LLNL is developing designs for an engineered barrier system containing several barriers such as the waste form, a canister and/or an overpack, packing, and near field host rock. The selection of metal containment barriers is addressed. 13 references

Transfection of brain capillary endothelial cells in primary culture with defined blood-brain barrier properties.

Science.gov (United States)

Burkhart, Annette; Thomsen, Louiza Bohn; Thomsen, Maj Schneider; Lichota, Jacek; Fazakas, Csilla; Krizbai, István; Moos, Torben

2015-08-07

Primary brain capillary endothelial cells (BCECs) are a promising tool to study the blood-brain barrier (BBB) in vitro, as they maintain many important characteristics of the BBB in vivo, especially when co-cultured with pericytes and/or astrocytes. A novel strategy for drug delivery to the brain is to transform BCECs into protein factories by genetic modifications leading to secretion of otherwise BBB impermeable proteins into the central nervous system. However, a huge challenge underlying this strategy is to enable transfection of non-mitotic BCECs, taking a non-viral approach. We therefore aimed to study transfection in primary, non-mitotic BCECs cultured with defined BBB properties without disrupting the cells' integrity. Primary cultures of BCECs, pericytes and astrocytes were generated from rat brains and used in three different in vitro BBB experimental arrangements, which were characterised based on a their expression of tight junction proteins and other BBB specific proteins, high trans-endothelial electrical resistance (TEER), and low passive permeability to radiolabeled mannitol. Recombinant gene expression and protein synthesis were examined in primary BCECs. The BCECs were transfected using a commercially available transfection agent Turbofect™ to express the red fluorescent protein HcRed1-C1. The BCECs were transfected at different time points to monitor transfection in relation to mitotic or non-mitotic cells, as indicated by fluorescence-activated cell sorting analysis after 5-and 6-carboxylfluorescein diacetate succinidyl ester incorporation. The cell cultures exhibited important BBB characteristics judged from their expression of BBB specific proteins, high TEER values, and low passive permeability. Among the three in vitro BBB models, co-culturing with BCECs and astrocytes was well suited for the transfection studies. Transfection was independent of cell division and with equal efficacy between the mitotic and non-mitotic BCECs. Importantly

Primary care patients' perspectives of barriers and enablers of primary prevention and health promotion-a meta-ethnographic synthesis.

Science.gov (United States)

Moreno-Peral, Patricia; Conejo-Cerón, Sonia; Fernández, Ana; Berenguera, Anna; Martínez-Andrés, María; Pons-Vigués, Mariona; Motrico, Emma; Rodríguez-Martín, Beatriz; Bellón, Juan A; Rubio-Valera, Maria

2015-01-01

Primary care (PC) patients have difficulties in committing to and incorporating primary prevention and health promotion (PP&HP) activities into their long-term care. We aimed to re-interpret, for the first time, qualitative findings regarding factors affecting PC patients' acceptance of PP&HP activities. A meta-ethnographic synthesis was generated following electronic and manual searches that retrieved 29 articles. Papers were reviewed and translated to produce a re-interpretation of the extracted concepts. The factors affecting PC patients' receptiveness to PP&HP activities were framed in a four-level ecological model (intrapersonal, interpersonal, institutional and environment and society). Intrapersonal factors (patients' beliefs/attitudes, knowledge, skills, self-concept, motivation and resources) were the most numerous, with almost 25 different factors. Public health education to modify erroneous beliefs and values regarding PP&HP could encourage a transition to healthier lifestyles. Health care professionals' abilities to communicate and involve patients in the decision-making process can act as facilitators. Biopsychosocial training (with emphasis on communication skills) for health professionals must start with undergraduates. Increased consultation time, the use of reminders, follow-up visits and tools for communicating risk and motivating patients could be applied at the intrapersonal level. Collaborative care involving other health professionals (nutritionists or psychotherapists) and family and community stakeholders (teachers or gym trainers) was important in developing healthier habits. Patients also cited barriers related to the built environment and socioeconomic difficulties that highlighted the need for policies promoting social justice and equity. Encouraging PP&HP using social marketing strategies and regulating media to control its impact on health were also cited. Only the perspectives of PC patients in the context of chronic conditions were

Safety verification of refrigeration containers using barrier certificates

DEFF Research Database (Denmark)

Christensen, Rasmus Lundgaard; Wisniewski, Rafal; Sørensen, Kresten Kjær

2016-01-01

Refrigeration containers make up a large portion of todays global trade, carrying anything from electronics to fresh fruit and vegetables. The containers are transported through varying surrounding temperatures which speeds up the wear and tear of the mechanical parts of the system. It is therefore...... of interest to produce a fault detection scheme, that allows for varying ambient temperature, varying handling standards, varying mechanical state, and accurately predicts if the system is trending towards failure. Lodam Electronics A/S develops control units for refrigeration containers, and are interested...

Utilization of coal/biomass fly ash and bentonite as a low permeability barrier for the containment of acid-generating mine tailings

International Nuclear Information System (INIS)

Penney, K.; Mohamedelhassan, E.; Catalan, L.J.J.

2009-01-01

The control and treatment of acid mine drainage (AMD) in decommissioned mine sites is a major environmental challenge. In general, AMD has a low pH, high acidity, and elevated concentrations of heavy metals. This study investigated the use of coal/biomass fly ash (CBFA) and CBFA/bentonite mixtures as a low permeability seal to contain acid generating mine tailings and treat AMD. Although pure CBFA is effective as a reactive barrier to treat most toxic metals in AMD, its initial hydraulic conductivity exceeds the maximum regulatory requirement of 1 x 10 -7 cm/s. Therefore, 3 cases were investigated, notably CBFA only; CBFA amended with low percentages of bentonite; and layering of CBFA and CBFA amended with bentonite. Practical geoenvironmental applications for low permeability CBFA or bentonite/CBFA mixtures include a cap overlying reactive mine tailings, a containment pond liner, and a core in containment dams and dykes. Mixing 10 per cent by mass bentonite with CBFA decreased the hydraulic conductivity to 1 x 10 -7 cm/s or less throughout the entire permeation by water and AMD. The installation of a layer of pure CBFA upstream of the bentonite/CBFA mixture resulted in a further decrease in hydraulic conductivity over time by preventing the collapse of the bentonite double layer and promoting precipitation of gypsum and ettringite in the CBFA layer. The effluent from all tested bentonite/CBFA barriers met the regulatory requirements for chemical parameters, except for aluminum which was leached from the CBFA. 14 refs., 3 tabs., 10 figs.

Use of vegetable oil in a pilot-scale denitrifying barrier

Science.gov (United States)

Hunter, William J.

2001-12-01

Nitrate in drinking water is a hazard to both humans and animals. Contaminated water can cause methemoglobinemia and may pose a cancer risk. Permeable barriers containing innocuous oils, which stimulate denitrification, can remove nitrate from flowing groundwater. For this study, a sand tank (1.1×2.0×0.085 m in size) containing sand was used as a one-dimensional open-top scale model of an aquifer. A meter-long area near the center of the tank contained sand coated with soybean oil. This region served as a permeable denitrifying barrier. Water containing 20 mg l -1 nitrate-N was pumped through the barrier at a high flow rate, 1112 l week -1, for 30 weeks. During the 30-week study, the barrier removed 39% of the total nitrate-N present in the water. The barrier was most efficient during the first 10 weeks of the study when almost all of the nitrate and nitrogen was removed. Efficiency declined with time so that by week 30 almost no nitrate was removed by the system. Nitrite levels in the effluent water remained low throughout the study. Barriers could be used to protect groundwater from nitrate contamination or for the in situ treatment of contaminated water. At the low flow rates that exist in most aquifers, such barriers should be effective at removing nitrate from groundwater for a much longer period of time.

Containment integrity and leak testing. Procedures applied and experiences gained in European countries

International Nuclear Information System (INIS)

1987-01-01

Containment systems are the ultimate safety barrier for preventing the escape of gaseous, liquid and solid radioactive materials produced in normal operation, not retained in process systems, and for keeping back radioactive materials released by system malfunction or equipment failure. A primary element of the containment shell is therefore its leak-tight design. The report describes the present containment concepts mostly used in European countries. The leak-testing procedures applied and the experiences gained in their application are also discussed. The report refers more particularly to pre-operational testing, periodic testing and extrapolation methods of leak rates measured at test conditions to expected leak rates at calculated accident conditions. The actual problems in periodic containment leak rate testing are critically reviewed. In the appendix to the report a summary is given of the regulations and specifications applied in different member countries

Test plan for buried waste containment system materials

International Nuclear Information System (INIS)

Weidner, J.; Shaw, P.

1997-03-01

The objectives of the FY 1997 barrier material work at the Idaho National Engineering and Environmental Laboratory are to (1) select a waste barrier material and verify that it is compatible with the Buried Waste Containment System Process, and (2) determine if, and how, the Buried Waste Containment System emplacement process affects the material properties and performance (on proof of principle scale). This test plan describes a set of measurements and procedures used to validate a waste barrier material for the Buried Waste Containment System. A latex modified proprietary cement manufactured by CTS Cement Manufacturing Company will be tested. Emplacement properties required for the Buried Waste Containment System process are: slump between 8 and 10 in., set time between 15 and 30 minutes, compressive strength at set of 20 psi minimum, and set temperature less than 100 degrees C. Durability properties include resistance to degradation from carbonate, sulfate, and waste-site soil leachates. A set of baseline barrier material properties will be determined to provide a data base for comparison with the barrier materials when tested in the field. The measurements include permeability, petrographic analysis to determine separation and/or segregation of mix components, and a set of mechanical properties. The measurements will be repeated on specimens from the field test material. The data will be used to determine if the Buried Waste Containment System equipment changes the material. The emplacement properties will be determined using standard laboratory procedures and instruments. Durability of the barrier material will be evaluated by determining the effect of carbonate, sulfate, and waste-site soil leachates on the compressive strength of the barrier material. The baseline properties will be determined using standard ASTM procedures. 9 refs., 1 fig., 2 tabs

RETRAN analysis of inter-system LOCA within the primary coolant pump

International Nuclear Information System (INIS)

Gangadharan, A.; Pratt, G.F.

1992-01-01

One example of an inter-system loss of coolant accident is the failure of the tubing within the primary coolant pump (PCP) thermal barrier heat exchanger. Such a failure would result in the entry of primary coolant into the component cooling water (CCW) system. The primary coolant flowrate through the break would rapidly pressurize the CCW system when the relief valves are too small. The piping in the CCW system at Palisades has a low pressure rating. Failures in this system outside the containment boundary could lead to primary coolant release to the atmosphere. RETRAN-02 was used to perform a simulation of the break in the PCP integral heat exchanger. The model included a detailed nodalization of the Byron-Jackson primary coolant pump internals leading up to the CCW system relief valves. Preliminary studies show the need for increased relief capacity in the CCW system. A case was run using a larger relief valve. Critical flow in the system upstream of the relief valves maintains the pressures in those volumes above the CCW design pressure. The pressures downstream from the relief valves and outside containment will be at or below the design pressure. This paper presents the results of the transient analysis

Enablers and barriers for implementing high-quality hypertension care in a rural primary care setting in Nigeria: perspectives of primary care staff and health insurance managers

Directory of Open Access Journals (Sweden)

Aina O. Odusola

2016-02-01

Full Text Available Background: Hypertension is a highly prevalent risk factor for cardiovascular diseases in sub-Saharan Africa (SSA that can be modified through timely and long-term treatment in primary care. Objective: We explored perspectives of primary care staff and health insurance managers on enablers and barriers for implementing high-quality hypertension care, in the context of a community-based health insurance programme in rural Nigeria. Design: Qualitative study using semi-structured individual interviews with primary care staff (n = 11 and health insurance managers (n=4. Data were analysed using standard qualitative techniques. Results: Both stakeholder groups perceived health insurance as an important facilitator for implementing high-quality hypertension care because it covered costs of care for patients and provided essential resources and incentives to clinics: guidelines, staff training, medications, and diagnostic equipment. Perceived inhibitors included the following: high staff workload; administrative challenges at facilities; discordance between healthcare provider and insurer on how health insurance and provider payment methods work; and insufficient fit between some guideline recommendations and tools for patient education and characteristics/needs of the local patient population. Perceived strategies to address inhibitors included the following: task-shifting; adequate provider payment benchmarking; good provider–insurer relationships; automated administration systems; and tailoring guidelines/patient education. Conclusions: By providing insights into perspectives of primary care providers and health insurance managers, this study offers information on potential strategies for implementing high-quality hypertension care for insured patients in SSA.

A new alternative in vertical barrier wall construction

International Nuclear Information System (INIS)

Rawl, G.F.

1997-01-01

A new proprietary vertical barrier wall system has been developed to revolutionize the construction process by eliminating many of the concerns of conventional installation method's with respect to performance, installation constraints and costs. Vertical barrier walls have been used in the environmental and construction industries for a variety of purposes, usually for cut-off or containment. The typical scenario involves a groundwater contamination problem, in which a vertical barrier wall is utilized to contain or confine the spread of contaminants below the ground surface. Conventional construction techniques have been adequate in many applications, but often fall short of their intended purposes due to physical constraints. In many instances, the economics of these conventional methods have limited the utilization of physical barrier walls. Polywall, the trade name for this new barrier wall technology, was subsequently developed to meet these needs and offer a number of distinct advantages in a variety of scenarios by maximizing confinement and minimizing installation costs. Polywall is constructed from chemically resistant high density polyethylene (HDPE) plastic. It has proven in a half-dozen projects to date to be the most cost-effective and technically sound approach to many containment situations. This paper will cover the development of the technology and will provide a brief synopsis of several installations

Selection of barrier metals for a waste package in tuff

International Nuclear Information System (INIS)

Russell, E.W.; McCright, R.D.; O'Neal, W.C.

1983-10-01

The Nevada Nuclear Waste Storage Investigations (NNWSI) project under the Civilian Radioactive Waste Management Program is planning a repository at Yucca Mountain at the Nevada Test Site for isolation of high-level nuclear waste. Lawrence Livermore National Laboratory is developing designs for an engineered barrier system containing several barriers such as the waste form, a canister and/or an overpack, packing, and near field host rock. In this paper we address the selection of metal containment barriers. 13 references, 4 tables

Barriers to the Integration and Adoption of iPads in Schools

DEFF Research Database (Denmark)

Khalid, Md. Saifuddin; Kilic, Gökce; Christoffersen, Jeanette

2015-01-01

iPad, with its Apple platform and interoperability-dependent material conditions, bring complex barriers in its adoption and integration in secondary education system as a learning tool. In the schools’ context, it is an emerging educational technology for its affordances supporting collaborative...... learning. This systematic literature review on the barriers to the integration of iPad in primary and secondary schools is based on 13 peer-reviewed and full-text articles. The paper discusses what are the challenges in using iPad as a learning tool in primary and secondary educational settings....... The identified barriers are discussed in three broad categories or stages of innovation process in an educational context: basic challenges with the tool, barriers to the integration of the iPad in a school setting, and barriers in the use of the iPad....

Security barriers with automated reconnaissance

Science.gov (United States)

McLaughlin, James O; Baird, Adam D; Tullis, Barclay J; Nolte, Roger Allen

2015-04-07

An intrusion delaying barrier includes primary and secondary physical structures and can be instrumented with multiple sensors incorporated into an electronic monitoring and alarm system. Such an instrumented intrusion delaying barrier may be used as a perimeter intrusion defense and assessment system (PIDAS). Problems with not providing effective delay to breaches by intentional intruders and/or terrorists who would otherwise evade detection are solved by attaching the secondary structures to the primary structure, and attaching at least some of the sensors to the secondary structures. By having multiple sensors of various types physically interconnected serves to enable sensors on different parts of the overall structure to respond to common disturbances and thereby provide effective corroboration that a disturbance is not merely a nuisance or false alarm. Use of a machine learning network such as a neural network exploits such corroboration.

SOLUTIONS TO OVERCOME BARRIERS TO IMPLEMENTATION OF TREATMENT TECHNOLOGIES

Science.gov (United States)

To make treatment a viable option for remediation you must first identify the barriers to implementing treatment. The primary barrier is economics. Treatment options are relatively expensive and there is a lack of funds for treatment. The cost of technologies can be lowered by 1)...

ORIGINAL ARTICLES Barriers to initiating insulin therapy in patients ...

African Journals Online (AJOL)

Nicky

opportunities for continuing medical education (CME) and poor patient ... related to insulin therapy, language barriers between doctor and patients, and fear of ..... of primary health care professionals regarding initiation of insulin in primary ...

Barriers and enablers in primary care clinicians' management of osteoarthritis: protocol for a systematic review and qualitative evidence synthesis.

Science.gov (United States)

Egerton, T; Diamond, L; Buchbinder, R; Bennell, K; Slade, S C

2016-05-27

Osteoarthritis is a highly prevalent and disabling condition. Primary care management of osteoarthritis is generally suboptimal despite evidence for several modestly effective interventions and the availability of high-quality clinical practice guidelines. This report describes a planned study to synthesise the views of primary care clinicians on the barriers and enablers to following recommended management of osteoarthritis, with the aim of providing new interpretations that may facilitate the uptake of recommended treatments, and in turn improve patient care. A systematic review and meta-synthesis of qualitative studies. 5 databases will be searched using key search terms for qualitative research, evidence-based practice, clinical practice guidelines, osteoarthritis, beliefs, perceptions, barriers, enablers and adherence. A priori inclusion/exclusion criteria include availability of data from primary care clinicians, reports on views regarding management of osteoarthritis, and studies using qualitative methods for both data collection and analysis. At least 2 independent reviewers will identify eligible reports, conduct a critical appraisal of study conduct, extract data and synthesise reported findings and interpretations. Synthesis will follow thematic analysis within a grounded theory framework of inductive coding and iterative theme identification. The reviewers plus co-authors will contribute to the meta-synthesis to find new themes and theories. The Confidence in the Evidence from Reviews of Qualitative research (CERQual) approach will be used to determine a confidence profile of each finding from the meta-synthesis. The protocol has been registered on PROSPERO and is reported using the Preferred Reporting Items for Systematic Review and Meta-Analyses Protocols (PRISMA-P) guidelines. Ethical approval is not required. The systematic review will be published in a peer-reviewed journal. The results will help to inform policy and practice and assist in the

Development of a computational model for the calculation of neutron dose equivalent in laminated primary barriers of radiotherapy rooms

International Nuclear Information System (INIS)

Rezende, Gabriel Fonseca da Silva

2015-01-01

Many radiotherapy centers acquire 15 and 18 MV linear accelerators to perform more effective treatments for deep tumors. However, the acquisition of these equipment must be accompanied by an additional care in shielding planning of the rooms that will house them. In cases where space is restricted, it is common to find primary barriers made of concrete and metal. The drawback of this type of barrier is the photoneutron emission when high energy photons (e.g. 15 and 18 MV spectra) interact with the metallic material of the barrier. The emission of these particles constitutes a problem of radiation protection inside and outside of radiotherapy rooms, which should be properly assessed. A recent work has shown that the current model underestimate the dose of neutrons outside the treatment rooms. In this work, a computational model for the aforementioned problem was created from Monte Carlo Simulations and Artificial Intelligence. The developed model was composed by three neural networks, each being formed of a pair of material and spectrum: Pb18, Pb15 and Fe18. In a direct comparison with the McGinley method, the Pb18 network exhibited the best responses for approximately 78% of the cases tested; the Pb15 network showed better results for 100% of the tested cases, while the Fe18 network produced better answers to 94% of the tested cases. Thus, the computational model composed by the three networks has shown more consistent results than McGinley method. (author)

Implementation of renewable energy technology - Opportunities and barriers. Summary of country studies

Energy Technology Data Exchange (ETDEWEB)

Painuly, J.P.; Fenhann, J.V.

2002-07-01

The project was launched to identify barriers to the implementation of renewable energy technologies (RETs) and explore measures to overcome the identified barriers. National institutions in Egypt, Ghana and Zimbabwe carried out the country studies based on the basic methodological framework provided by the UNEP Centre. The objectives of the project included strengthening institutional capacity for analysis and implementation of RET projects in the participating countries and bring out experiences on RETs barriers and removal measures for dissemination so that others can benefit from the knowledge so gained. An important highlight of the studies was involvement of stake holders in the process of identification of barriers and measures to remove them. A preliminary identification of relevant RETs for their countries was done by the country teams in the initial stage of the project. After that, national workshops involving various stake holders were held between July and September 1999 to discuss the RETs and barriers to their implementation. Based on the discussions, a few important RETs were identified for more detailed study. PV systems for rural electrification, solar water heating systems and large-scale biogas system were identified and analysed for barriers in the Egypt country study. Economic, information and policy barriers were identified as major barriers for these technologies. Solar water pumps, biogas and small hydro were the focus of study in Ghana. In this case also, economic, information and policy barriers were found to be the important barriers for the selected technologies. In the case of Zimbabwe, focus was on identification of primary and secondary barriers to RETs dissemination. The primary barriers included lack of capacity to develop proposals, lack of information for policy making and framework for information dissemination. The study concluded that the secondary barriers as seen and experienced by the stake holders are due to primary

Study of the efficiency of the anti-convective thermal barrier of the Super-Phenix vessels inter space

International Nuclear Information System (INIS)

Durin, M.; Mejane, A.

1983-08-01

In the LMFBR Phenix reactor, the junction between the primary vessel and the roof slab is a region of large thermal gradients. In order to limit the gradient in the primary vessel, a thermal barrier has been installed between the primary and the safety vessel. The purpose of this barrier is to prevent the penetration of hot gas in the upper part of the vessels inter space. Experimental results have been obtained on a full scale model representing a 25 0 vessel sector of the reactor. Different geometrical configurations have been tested for a large range of boundary condition: - perfectly tight barrier - no thermal barrier; - simulation of leakages on the barrier [fr

Feasibility study of tank leakage mitigation using subsurface barriers

International Nuclear Information System (INIS)

Treat, R.L.; Peters, B.B.; Cameron, R.J.; McCormak, W.D.; Trenkler, T.; Walters, M.F.; Rouse, J.K.; McLaughlin, T.J.; Cruse, J.M.

1994-01-01

The US Department of Energy (DOE) has established the Tank Waste Remediation System (TWRS) to satisfy manage and dispose of the waste currently stored in the underground storage tanks. The retrieval element of TWRS includes a work scope to develop subsurface impermeable barriers beneath SSTs. The barriers could serve as a means to contain leakage that may result from waste retrieval operations and could also support site closure activities by facilitating cleanup. Three types of subsurface barrier systems have emerged for further consideration: (1) chemical grout, (2) freeze walls, and (3) desiccant, represented in this feasibility study as a circulating air barrier. This report contains analyses of the costs and relative risks associated with combinations retrieval technologies and barrier technologies that from 14 alternatives. Eight of the alternatives include the use of subsurface barriers; the remaining six nonbarrier alternative are included in order to compare the costs, relative risks and other values of retrieval with subsurface barriers. Each alternative includes various combinations of technologies that can impact the risks associated with future contamination of the groundwater beneath the Hanford Site to varying degrees. Other potential risks associated with these alternatives, such as those related to accidents and airborne contamination resulting from retrieval and barrier emplacement operations, are not quantitatively evaluated in this report

ORNL experiments to characterize fuel release from the reactor primary containment in severe LMFBR accidents

International Nuclear Information System (INIS)

Wright, A.L.; Kress, T.S.; Smith, A.M.

1980-01-01

This paper presents results from aerosol source term experiments performed in the ORNL Aerosol Release and Transport (ART) Program sponsored by the US NRC. The tests described were performed to provide information on fuel release from an LMFBR primary containment as a result of a hypothetical core-disruptive accident (HCDA). The release path investigated in these tests assumes that a fuel/sodium bubble is formed after disassembly that transports fuel and fission products through the sodium coolant and cover gas to be relased into the reactor secondary containment. Due to the excellent heat transfer characteristics of the sodium, there is potential for large attenuation of the maximum release

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

Energy Technology Data Exchange (ETDEWEB)

NONE

2001-07-01

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

The disposal of Canada's nuclear fuel waste: engineered barriers alternatives

International Nuclear Information System (INIS)

Johnson, L.H.; Tait, J.C.; Shoesmith, D.W.; Crosthwaite, J.L.; Gray, M.N.

1994-01-01

The concept for disposal of Canada's nuclear fuel waste involves emplacing the waste in a vault excavated at a depth of 500 to 1000 m in plutonic rock of the Canadian Shield. The solid waste would be isolated from the biosphere by a multibarrier system consisting of engineered barriers, including long-lived containers and clay and cement-based sealing materials, and the natural barrier provided by the massive geological formation. The technical feasibility of this concept and its impact on the environment and human health are being documented in an Environmental Impact Statement (EIS), which will be submitted for review under the federal Environmental Assessment and Review Process. This report, one of nine EIS primary references, describes the various alternative designs and materials for engineered barriers that have been considered during the development of the Canadian disposal concept and summarizes engineered barrier concepts being evaluated in other countries. The basis for the selection of a reference engineered barrier system for the EIS is presented. This reference system involves placing used CANDU (Canada Deuterium Uranium) fuel bundles in titanium containers, which would then be emplaced in boreholes drilled in the floor of disposal rooms. Clay-based sealing materials would be used to fill both the space between the containers and the rock and the remaining excavations. In the section on waste forms, the properties of both used-fuel bundles and solidified high-level wastes, which would be produced by treating wastes resulting from the reprocessing of used fuel, are discussed. Methods of solidifying the wastes and the chemical durability of the solidified waste under disposal conditions are reviewed. Various alternative container designs are reviewed, ranging from preliminary conceptual designs to designs that have received extensive prototype testing. Results of structural performance, welding and inspection studies are also summarized. The corrosion of

Prototype Hanford Surface Barrier: Design basis document

International Nuclear Information System (INIS)

Myers, D.R.; Duranceau, D.A.

1994-11-01

The Hanford Site Surface Barrier Development Program (BDP) was organized in 1985 to develop the technology needed to provide a long-term surface barrier capability for the Hanford Site and other arid sites. This document provides the basis of the prototype barrier. Engineers and scientists have momentarily frozen evolving barrier designs and incorporated the latest findings from BDP tasks. The design and construction of the prototype barrier has required that all of the various components of the barrier be brought together into an integrated system. This integration is particularly important because some of the components of the protective barreir have been developed independently of other barreir components. This document serves as the baseline by which future modifications or other barrier designs can be compared. Also, this document contains the minutes of meeting convened during the definitive design process in which critical decisions affecting the prototype barrier's design were made and the construction drawings

Primary Care Patients’ Perspectives of Barriers and Enablers of Primary Prevention and Health Promotion—A Meta-Ethnographic Synthesis

Science.gov (United States)

Moreno-Peral, Patricia; Conejo-Cerón, Sonia; Fernández, Ana; Berenguera, Anna; Martínez-Andrés, María; Pons-Vigués, Mariona; Motrico, Emma; Rodríguez-Martín, Beatriz; Bellón, Juan A.; Rubio-Valera, Maria

2015-01-01

Background Primary care (PC) patients have difficulties in committing to and incorporating primary prevention and health promotion (PP&HP) activities into their long-term care. We aimed to re-interpret, for the first time, qualitative findings regarding factors affecting PC patients' acceptance of PP&HP activities. Methods and Findings A meta-ethnographic synthesis was generated following electronic and manual searches that retrieved 29 articles. Papers were reviewed and translated to produce a re-interpretation of the extracted concepts. The factors affecting PC patients' receptiveness to PP&HP activities were framed in a four-level ecological model (intrapersonal, interpersonal, institutional and environment and society). Intrapersonal factors (patients' beliefs/attitudes, knowledge, skills, self-concept, motivation and resources) were the most numerous, with almost 25 different factors. Public health education to modify erroneous beliefs and values regarding PP&HP could encourage a transition to healthier lifestyles. Health care professionals' abilities to communicate and involve patients in the decision-making process can act as facilitators. Biopsychosocial training (with emphasis on communication skills) for health professionals must start with undergraduates. Increased consultation time, the use of reminders, follow-up visits and tools for communicating risk and motivating patients could be applied at the intrapersonal level. Collaborative care involving other health professionals (nutritionists or psychotherapists) and family and community stakeholders (teachers or gym trainers) was important in developing healthier habits. Patients also cited barriers related to the built environment and socioeconomic difficulties that highlighted the need for policies promoting social justice and equity. Encouraging PP&HP using social marketing strategies and regulating media to control its impact on health were also cited. Only the perspectives of PC patients in the

Primary care patients' perspectives of barriers and enablers of primary prevention and health promotion-a meta-ethnographic synthesis.

Directory of Open Access Journals (Sweden)

Patricia Moreno-Peral

Full Text Available Primary care (PC patients have difficulties in committing to and incorporating primary prevention and health promotion (PP&HP activities into their long-term care. We aimed to re-interpret, for the first time, qualitative findings regarding factors affecting PC patients' acceptance of PP&HP activities.A meta-ethnographic synthesis was generated following electronic and manual searches that retrieved 29 articles. Papers were reviewed and translated to produce a re-interpretation of the extracted concepts. The factors affecting PC patients' receptiveness to PP&HP activities were framed in a four-level ecological model (intrapersonal, interpersonal, institutional and environment and society. Intrapersonal factors (patients' beliefs/attitudes, knowledge, skills, self-concept, motivation and resources were the most numerous, with almost 25 different factors. Public health education to modify erroneous beliefs and values regarding PP&HP could encourage a transition to healthier lifestyles. Health care professionals' abilities to communicate and involve patients in the decision-making process can act as facilitators. Biopsychosocial training (with emphasis on communication skills for health professionals must start with undergraduates. Increased consultation time, the use of reminders, follow-up visits and tools for communicating risk and motivating patients could be applied at the intrapersonal level. Collaborative care involving other health professionals (nutritionists or psychotherapists and family and community stakeholders (teachers or gym trainers was important in developing healthier habits. Patients also cited barriers related to the built environment and socioeconomic difficulties that highlighted the need for policies promoting social justice and equity. Encouraging PP&HP using social marketing strategies and regulating media to control its impact on health were also cited. Only the perspectives of PC patients in the context of chronic

Immunohistochemical expression of stem cell, endothelial cell, and chemosensitivity markers in primary glioma spheroids cultured in serum-containing and serum-free medium

DEFF Research Database (Denmark)

Christensen, Karina; Aaberg-Jessen, Charlotte; Andersen, Claus

2010-01-01

To investigate the influence of serum-free medium (SFM) supplemented with epidermal growth factor and basic fibroblast growth factor compared with conventional serum-containing medium (SCM) on the phenotype of organotypic primary spheroids from seven gliomas.......To investigate the influence of serum-free medium (SFM) supplemented with epidermal growth factor and basic fibroblast growth factor compared with conventional serum-containing medium (SCM) on the phenotype of organotypic primary spheroids from seven gliomas....

Nuclear fuel element and container

International Nuclear Information System (INIS)

Grubb, W.T.; King, L.H.

1981-01-01

The invention is based on the discovery that a substantial reduction in metal embrittlement or stress corrosion cracking from fuel pellet-cladding interaction can be achieved by the use of a copper layer or liner in proximity to the nuclear fuel, and an intermediate zirconium oxide barrier layer between the copper layer and the zirconium cladding substrate. The intermediate zirconia layer is a good copper diffusion barrier; also, if the zirconium cladding surface is modified prior to oxidation, copper can be deposited by electroless plating. A nuclear fuel element is described which comprises a central core of fuel material and an elongated container using the system outlined above. The method for making the container is again described. It comprises roughening or etching the surface of the zirconium or zirconium alloy container, oxidizing the resulting container, activating the oxidized surface to allow for the metallic coating of such surfaces by electroless deposition and further coating the activated-oxidized surface of the zirconium or zirconium alloy container with copper, iron or nickel or an alloy thereof. (U.K.)

Methyllithium-Doped Naphthyl-Containing Conjugated Microporous Polymer with Enhanced Hydrogen Storage Performance.

Science.gov (United States)

Xu, Dan; Sun, Lei; Li, Gang; Shang, Jin; Yang, Rui-Xia; Deng, Wei-Qiao

2016-06-01

Hydrogen storage is a primary challenge for using hydrogen as a fuel. With ideal hydrogen storage kinetics, the weak binding strength of hydrogen to sorbents is the key barrier to obtain decent hydrogen storage performance. Here, we reported the rational synthesis of a methyllithium-doped naphthyl-containing conjugated microporous polymer with exceptional binding strength of hydrogen to the polymer guided by theoretical simulations. Meanwhile, the experimental results showed that isosteric heat can reach up to 8.4 kJ mol(-1) and the methyllithium-doped naphthyl-containing conjugated microporous polymer exhibited an enhanced hydrogen storage performance with 150 % enhancement compared with its counterpart naphthyl-containing conjugated microporous polymer. These results indicate that this strategy provides a direction for design and synthesis of new materials that meet the US Department of Energy (DOE) hydrogen storage target. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Timeliness vaccination of measles containing vaccine and barriers to vaccination among migrant children in East China.

Directory of Open Access Journals (Sweden)

Yu Hu

Full Text Available BACKGROUND: The reported coverage rates of first and second doses of measles containing vaccine (MCV are almost 95% in China, while measles cases are constantly being reported. This study evaluated the vaccine coverage, timeliness, and barriers to immunization of MCV1 and MCV2 in children aged from 8-48 months. METHODS: We assessed 718 children aged 8-48 months, of which 499 children aged 18-48 months in September 2011. Face to face interviews were administered with children's mothers to estimate MCV1 and MCV2 coverage rate, its timeliness and barriers to vaccine uptake. RESULTS: The coverage rates were 76.9% for MCV1 and 44.7% for MCV2 in average. Only 47.5% of surveyed children received the MCV1 timely, which postpone vaccination by up to one month beyond the stipulated age of 8 months. Even if coverage thus improves with time, postponed vaccination adds to the pool of unprotected children in the population. Being unaware of the necessity for vaccination and its schedule, misunderstanding of side-effect of vaccine, and child being sick during the recommended vaccination period were significant preventive factors for both MCV1 and MCV2 vaccination. Having multiple children, mother's education level, household income and children with working mothers were significantly associated with delayed or missing MCV1 immunization. CONCLUSIONS: To avoid future outbreaks, it is crucial to attain high coverage levels by timely vaccination, thus, accurate information should be delivered and a systematic approach should be targeted to high-risk groups.

Barriers to effective management of type 2 diabetes in primary care: qualitative systematic review

Science.gov (United States)

Rushforth, Bruno; McCrorie, Carolyn; Glidewell, Liz; Midgley, Eleanor; Foy, Robbie

2016-01-01

Background Despite the availability of evidence-based guidance, many patients with type 2 diabetes do not achieve treatment goals. Aim To guide quality improvement strategies for type 2 diabetes by synthesising qualitative evidence on primary care physicians’ and nurses’ perceived influences on care. Design and setting Systematic review of qualitative studies with findings organised using the Theoretical Domains Framework. Method Databases searched were MEDLINE, Embase, CINAHL, PsycInfo, and ASSIA from 1980 until March 2014. Studies included were English-language qualitative studies in primary care of physicians’ or nurses’ perceived influences on treatment goals for type 2 diabetes. Results A total of 32 studies were included: 17 address general diabetes care, 11 glycaemic control, three blood pressure, and one cholesterol control. Clinicians struggle to meet evolving treatment targets within limited time and resources, and are frustrated with resulting compromises. They lack confidence in knowledge of guidelines and skills, notably initiating insulin and facilitating patient behaviour change. Changing professional boundaries have resulted in uncertainty about where clinical responsibility resides. Accounts are often couched in emotional terms, especially frustrations over patient compliance and anxieties about treatment intensification. Conclusion Although resources are important, many barriers to improving care are amenable to behaviour change strategies. Improvement strategies need to account for differences between clinical targets and consider tailored rather than ‘one size fits all’ approaches. Training targeting knowledge is necessary but insufficient to bring about major change; approaches to improve diabetes care need to delineate roles and responsibilities, and address clinicians’ skills and emotions around treatment intensification and facilitation of patient behaviour change. PMID:26823263

MENDING THE IN SITU MANIPULATION BARRIER

Energy Technology Data Exchange (ETDEWEB)

PETERSEN, S.W.

2006-02-06

In early 2004, the U.S. Department of Energy (DOE) Richland and Fluor Hanford requested technical assistance from the DOE Headquarters EM-23 Technical Assistance Program to provide a team of technical experts to develop recommendations for mending the In Situ Redox Manipulation (ISRM) Barrier in the 100-D Area of the Hanford Site in Washington State. To accommodate this request, EM-23 provided support to convene a group of technical experts from industry, a national laboratory, and a DOE site to participate in a 2 1/2-day workshop with the objective of identifying and recommending options to enhance the performance of the 100-D Area reactive barrier and of a planned extension to the northeast. This report provides written documentation of the team's findings and recommendations. In 1995, a plume of dissolved hexavalent chromium [Cr(VI)], which resulted from operation of the D/DR Reactors at the Hanford site, was discovered along the Columbia River shoreline and in the 100-D Area. Between 1999 and 2003, a reactive barrier using the In Situ Redox Manipulation (ISRM) technology, was installed a distance of 680 meters along the river to reduce the Cr(VI) in the groundwater. The ISRM technology creates a treatment zone within the aquifer by injection of sodium dithionite, a strong reducing agent that scavenges dissolved oxygen (DO) from the aquifer and reduces ferric iron [Fe(III)], related metals, and oxy-ions. The reduction of Fe(III) to ferrous [Fe(II)] iron provides the primary reduction capacity to reduce Cr(VI) to the +3 state, which is less mobile and less toxic. Bench-scale and field-scale treatability tests were initially conducted to demonstrate proof-of principle and to provide data for estimation of barrier longevity. These calculations estimated barrier longevity in excess of twenty years. However, several years after initial and secondary treatment, groundwater in a number of wells has been found to contain elevated chromium (Cr) concentrations

REVIEW OF MECHANISTIC UNDERSTANDING AND MODELING AND UNCERTAINTY ANALYSIS METHODS FOR PREDICTING CEMENTITIOUS BARRIER PERFORMANCE

Energy Technology Data Exchange (ETDEWEB)

Langton, C.; Kosson, D.

2009-11-30

Cementitious barriers for nuclear applications are one of the primary controls for preventing or limiting radionuclide release into the environment. At the present time, performance and risk assessments do not fully incorporate the effectiveness of engineered barriers because the processes that influence performance are coupled and complicated. Better understanding the behavior of cementitious barriers is necessary to evaluate and improve the design of materials and structures used for radioactive waste containment, life extension of current nuclear facilities, and design of future nuclear facilities, including those needed for nuclear fuel storage and processing, nuclear power production and waste management. The focus of the Cementitious Barriers Partnership (CBP) literature review is to document the current level of knowledge with respect to: (1) mechanisms and processes that directly influence the performance of cementitious materials (2) methodologies for modeling the performance of these mechanisms and processes and (3) approaches to addressing and quantifying uncertainties associated with performance predictions. This will serve as an important reference document for the professional community responsible for the design and performance assessment of cementitious materials in nuclear applications. This review also provides a multi-disciplinary foundation for identification, research, development and demonstration of improvements in conceptual understanding, measurements and performance modeling that would be lead to significant reductions in the uncertainties and improved confidence in the estimating the long-term performance of cementitious materials in nuclear applications. This report identifies: (1) technology gaps that may be filled by the CBP project and also (2) information and computational methods that are in currently being applied in related fields but have not yet been incorporated into performance assessments of cementitious barriers. The various

Review Of Mechanistic Understanding And Modeling And Uncertainty Analysis Methods For Predicting Cementitious Barrier Performance

International Nuclear Information System (INIS)

Langton, C.; Kosson, D.

2009-01-01

Cementitious barriers for nuclear applications are one of the primary controls for preventing or limiting radionuclide release into the environment. At the present time, performance and risk assessments do not fully incorporate the effectiveness of engineered barriers because the processes that influence performance are coupled and complicated. Better understanding the behavior of cementitious barriers is necessary to evaluate and improve the design of materials and structures used for radioactive waste containment, life extension of current nuclear facilities, and design of future nuclear facilities, including those needed for nuclear fuel storage and processing, nuclear power production and waste management. The focus of the Cementitious Barriers Partnership (CBP) literature review is to document the current level of knowledge with respect to: (1) mechanisms and processes that directly influence the performance of cementitious materials (2) methodologies for modeling the performance of these mechanisms and processes and (3) approaches to addressing and quantifying uncertainties associated with performance predictions. This will serve as an important reference document for the professional community responsible for the design and performance assessment of cementitious materials in nuclear applications. This review also provides a multi-disciplinary foundation for identification, research, development and demonstration of improvements in conceptual understanding, measurements and performance modeling that would be lead to significant reductions in the uncertainties and improved confidence in the estimating the long-term performance of cementitious materials in nuclear applications. This report identifies: (1) technology gaps that may be filled by the CBP project and also (2) information and computational methods that are in currently being applied in related fields but have not yet been incorporated into performance assessments of cementitious barriers. The various

A systematic review and evidence synthesis of qualitative studies to identify primary care clinicians' barriers and enablers to the management of osteoarthritis.

Science.gov (United States)

Egerton, T; Diamond, L E; Buchbinder, R; Bennell, K L; Slade, S C

2017-05-01

Primary care management of osteoarthritis (OA) is variable and often inconsistent with clinical practice guidelines (CPGs). This study aimed to identify and synthesize available qualitative evidence on primary care clinicians' views on providing recommended management of OA. Eligibility criteria included full reports published in peer-reviewed journals, with data collected directly from primary care clinicians using qualitative methods for collection and analysis. Five electronic databases (MEDLINE, Cochrane Central Register, EMBASE, CINAHL and PsychInfo) were searched to August 2016. Two independent reviewers identified eligible reports, conducted critical appraisal (based on Critical Appraisal Skills Programme (CASP) criteria), and extracted data. Three reviewers independently, then collaboratively, synthesized and interpreted data through an inductive and iterative process to derive new themes. The Confidence in Evidence from Reviews of Qualitative research (CERQual) approach was used to determine a confidence profile for each finding. Eight studies involving approximately 83 general practitioners (GPs), 24 practice nurses, 12 pharmacists and 10 physical therapists, from Australia, France, United Kingdom, Germany and Mexico were included. Four barriers were identified as themes 1) OA is not that serious, 2) Clinicians are, or perceive they are, under-prepared, 3) Personal beliefs at odds with providing recommended practice, and 4) Dissonant patient expectations. No themes were enablers. Confidence ratings were moderate or low. Synthesising available data revealed barriers that collectively point towards a need to address clinician knowledge gaps, and enhance clinician communication and behaviour change skills to facilitate patient adherence, enable effective conversations and manage dissonant patient expectations. PROSPERO (http://www.crd.york.ac.uk/PROSPERO) [4/11/2015, CRD42015027543]. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

The barriers that women face when choosing food for their primary school children: A case study in the Western Cape Province, South Africa

Directory of Open Access Journals (Sweden)

Y Smit

2017-10-01

Full Text Available Background. Unhealthy food choices made by mothers can impact negatively on child health and may lead to unhealthy eating behaviours that persist into adulthood. Choosing food is a complex process influenced by many factors. Objectives. To determine the factors that influence mothers’ food choices and to investigate barriers to purchasing healthy food. Methods. A cross-sectional, descriptive study, with an analytical component, was conducted. Mothers (N=476 were recruited from three randomly selected primary schools, from a low, middle and high quintile. A self-administered questionnaire was used to collect data on demographics, knowledge, attitude and practices of mothers. Six focus groups (FG (two per school were conducted to investigate the factors that prevent mothers from making healthy dietary decisions. Results. The mean nutrition knowledge score for the group was 68.6%. Nutrition knowledge was significantly lower (p<0.01 in mothers from the lower quintile school (64.0%. Primary factors influencing food purchases were cost (60%, nutritional value (37% and time constraints (29%. Primary sources of nutrition information included magazines and health professionals at 62% and 44%, respectively. Time constraints resulted in mothers purchasing convenience foods more often (p=0.001. The main barriers identified were mixed media messages, the school environments and supermarket layouts. Conclusion. Nutrition education campaigns should include practical advice, e.g. the preparation of economical, wholesome meals. Policymakers should monitor increasing prices of healthy foods. School and supermarket environments, as well as the food industry, can play a pivotal role in facilitating mothers to make healthy food choices

Soil-bentonite design mix for slurry cutoff walls used as containment barriers

International Nuclear Information System (INIS)

Rad, N.S.; Bachus, R.C.; Jacobson, B.D.

1995-01-01

In recent years, soil-bentonite slurry cutoff walls have been increasingly used as containment barriers around contaminated soils to impede or, in some cases, nearly eliminate the off-site migration of contaminated ground water or other potentially hazardous liquids. The paper presents the procedures used and the results obtained during an extensive laboratory testing program performed to select varying soil-bentonite slurry mix components for a soil-bentonite slurry cutoff wall constructed around an old landfill at a former oil refinery. The landfill is underlain to varying depths by a coarse granular soils that has been exposed to oil-products. Compatibility of three commercially available bentonite products with the free oil-products and the oil-contaminated ground water found at some locations in the landfill was initially investigated. Based on the test results, one of the bentonite products was selected for use in the soil-bentonite slurry testing program. A clayey soil from a borrow source, potable water from the site, and subsurface soils from the proposed soil-bentonite slurry wall alignment were used to form different soil-bentonite slurry mixes. Slump tests were performed to evaluate the workability of the mixes. Based on the test results, a single mix was selected for further study, including permeability/compatibility testing. The results of the compatibility testing program are presented and discussed in the paper. A specific design mix methodology for evaluating the chemical compatibility of soil-bentonite slurry mixes with permeants is proposed

Barriers and facilitators influencing self-management among COPD patients: a mixed methods exploration in primary and affiliated specialist care

Directory of Open Access Journals (Sweden)

Hillebregt CF

2016-12-01

Full Text Available Chantal F Hillebregt,1 Auke J Vlonk,1 Marc A Bruijnzeels,1 Onno CP van Schayck,2 Niels H Chavannes3 1Jan van Es Institute (JVEI, Netherlands Expert Center Integrated Primary Care, Almere, 2Department of General Practice, School for Public Health and Primary Care (CAPHRI, Maastricht University Medical Center, Maastricht, 3Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands Abstract: Self-management is becoming increasingly important in COPD health care although it remains difficult to embed self-management into routine clinical care. The implementation of self-management is understood as a complex interaction at the level of patient, health care provider (HCP, and health system. Nonetheless there is still a poor understanding of the barriers and effective facilitators. Comprehension of these determinants can have significant implications in optimizing self-management implementation and give further directions for the development of self-management interventions. Data were collected among COPD patients (N=46 and their HCPs (N=11 in three general practices and their collaborating affiliated hospitals. Mixed methods exploration of the data was conducted and collected by interviews, video-recorded consultations (N=50, and questionnaires on consultation skills. Influencing determinants were monitored by 1 interaction and communication between the patient and HCP, 2 visible and invisible competencies of both the patient and the HCP, and 3 degree of embedding self-management into the health care system. Video observations showed little emphasis on effective behavioral change and follow-up of given lifestyle advice during consultation. A strong presence of COPD assessment and monitoring negatively affects the patient-centered communication. Both patients and HCPs experience difficulties in defining personalized goals. The satisfaction of both patients and HCPs concerning patient centeredness during

Barriers to evidence-based medicine: a systematic review.

Science.gov (United States)

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

2014-12-01

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

Performance characteristics of a self-sealing/self-healing barrier

International Nuclear Information System (INIS)

McGregor, R.G.; Stegemann, J.A.

1997-01-01

Environment Canada and the Netherlands Energy Research Foundation are co-developers of a patented Self-Sealing/Self-Healing (SS/SH) Barrier system for containment of wastes which is licensed to Water Technology International Corporation. The SS/SH Barrier is intended for use as either a liner or cover for landfills, contaminated sites, secondary containment areas, etc., in the industrial, chemical, mining and municipal sectors, and also as a barrier to hydraulic flow for the transportation and construction industry. The SS/SH Barrier's most significant feature is its capability for self-repair in the event of a breach. By contrast, conventional barrier systems, such as clay, geomembrane, or geosynthetic clay liners can not be repaired without laborious excavation and reconstruction. Laboratory investigations have shown that the SS/SH Barrier concept will function with a variety of reactive materials. Self-Sealing/Self-Healing Barriers are cost competitive and consistently exhibit hydraulic conductivities ranging from 10 -9 to 10 -13 m/s, which decrease with time. These measurements meet or exceed the recommended hydraulic conductivity required by EPA for clay liners ( -9 m/s) used in landfills and hazardous waste sites. Results of mineralogical examination of the seal, diffusion testing, hydraulic conductivity measurement, and durability testing, including wet/dry, freeze/thaw cycling and leachate compatibility are also presented

Effect of contact barrier on electron transport in graphene.

Science.gov (United States)

Zhou, Yang-Bo; Han, Bing-Hong; Liao, Zhi-Min; Zhao, Qing; Xu, Jun; Yu, Da-Peng

2010-01-14

The influence of the barrier between metal electrodes and graphene on the electrical properties was studied on a two-electrode device. A classical barrier model was used to analyze the current-voltage characteristics. Primary parameters including barrier height and effective resistance were achieved. The electron transport properties under magnetic field were further investigated. An abnormal peak-valley-peak shape of voltage-magnetoresistance curve was observed. The underlying mechanisms were discussed under the consideration of the important influence of the contact barrier. Our results indicate electrical properties of graphene based devices are sensitive to the contact interface.

Design and construction of a deep slurry trench barrier

International Nuclear Information System (INIS)

Deming, P.W.

1997-01-01

A 24 m (80 ft) deep slurry trench surrounding a former chromium manufacturing facility on the Patapsco River in Baltimore, Maryland was constructed in 1995 to contain groundwater and site Soils, and to reduce the volume of groundwater extracted to maintain an inward gradient. In 1992, an embankment made of crushed stone was constructed in the Patapsco River to make land for barrier construction outboard of the bulkheads, and to protect the barrier. Stability of the slurry-supported trench excavation in the embankment required construction from an elevated work platform. An extended reach backhoe was used to excavate the deep slurry trench and to clean the trench bottom. Soil-Bentonite backfill was prepared at a central mixing area and transported by truck to the perimeter barrier. A synthetic membrane was inserted partially into the backfill for connection to a multimedia cap, and for redundancy and erosion control in the tidal zone. Hydraulic testing of the aquitard contained by the barrier demonstrated excellent performance of the barrier and bottom closure. Detailed definition of subsurface conditions and the closure stratum was necessary for the design and successful construction of the barrier, and is recommended for comparable slurry trench construction projects

Health Barriers to Learning

Directory of Open Access Journals (Sweden)

Delaney Gracy

2014-01-01

Full Text Available This article summarizes the results from a 2013 online survey with 408 principals and assistant principals in New York City public elementary and middle schools. The survey assessed three primary areas: health issues in the school, health issues perceived as barriers to learning for affected students, and resources needed to address these barriers. Eighteen of the 22 health conditions listed in the survey were considered a moderate or serious issue within their schools by at least 10% of respondents. All 22 of the health issues were perceived as a barrier to learning by between 12% and 87% of the respondents. Representatives from schools that serve a higher percentage of low-income students reported significantly higher levels of concern about the extent of health issues and their impact on learning. Respondents most often said they need linkages with organizations that can provide additional services and resources at the school, especially for mental health.

Frozen Soil Barrier. Subsurface Contaminants Focus Area. OST Reference No. 51

International Nuclear Information System (INIS)

1999-01-01

Problem: Hazardous and radioactive materials have historically been disposed of at the surface during operations at Department of Energy facilities. These contaminants have entered the subsurface, contaminating soils and groundwater resources. Remediation of these groundwater plumes using the baseline technology of pump and treat is expensive and takes a long time to complete. Containment of these groundwater plumes can be alternative or an addition to the remediation activities. Standard containment technologies include slurry walls, sheet piling, and grouting. These are permanent structures that once installed are difficult to remove. How It Works: Frozen Soil Barrier technology provides a containment alternative, with the key difference being that the barrier can be easily removed after a period of time, such as after the remediation or removal of the source is completed. Frozen Soil Barrier technology can be used to isolate and control the migration of underground radioactive or other hazardous contaminants subject to transport by groundwater flow. Frozen Soil Barrier technology consists of a series of subsurface heat transfer devices, known as thermoprobes, which are installed around a contaminant source and function to freeze the soil pore water. The barrier can easily be maintained in place until remediation or removal of the contaminants is complete, at which time the barrier is allowed to thaw.

Barriers and enablers that influence sustainable interprofessional education: a literature review.

Science.gov (United States)

Lawlis, Tanya Rechael; Anson, Judith; Greenfield, David

2014-07-01

The effective incorporation of interprofessional education (IPE) within health professional curricula requires the synchronised and systematic collaboration between and within the various stakeholders. Higher education institutions, as primary health education providers, have the capacity to advocate and facilitate this collaboration. However, due to the diversity of stakeholders, facilitating the pedagogical change can be challenging and complex, and brings a degree of uncertainty and resistance. This review, through an analysis of the barriers and enablers investigates the involvement of stakeholders in higher education IPE through three primary stakeholder levels: Government and Professional, Institutional and Individual. A review of eight primary databases using 21 search terms resulted in 40 papers for review. While the barriers to IPE are widely reported within the higher education IPE literature, little is documented about the enablers of IPE. Similarly, the specific identification and importance of enablers for IPE sustainability and the dual nature of some barriers and enablers have not been previously reported. An analysis of the barriers and enablers of IPE across the different stakeholder levels reveals five key "fundamental elements" critical to achieving sustainable IPE in higher education curricula.

Barriers to Providing Health Education During Primary Care Visits at Community Health Centers: Clinical Staff Insights.

Science.gov (United States)

Alicea-Planas, Jessica; Pose, Alix; Smith, Linda

2016-04-01

The rapid increase of diverse patients living in the US has created a different set of needs in healthcare, with the persistence of health disparities continuing to challenge the current system. Chronic disease management has been discussed as a way to improve health outcomes, with quality patient education being a key component. Using a community based participatory research framework, this study utilized a web-based survey and explored clinical staff perceptions of barriers to providing patient education during primary care visits. With a response rate of nearly 42 %, appointment time allotment seemed to be one of the most critical factors related to the delivery of health education and should be considered key. The importance of team-based care and staff training were also significant. Various suggestions were made in order to improve the delivery of quality patient education at community health centers located in underserved areas.

In Situ Remediation Integrated Program: Evaluation and assessment of containment technology

International Nuclear Information System (INIS)

Gerber, M.A.; Fayer, M.J.

1994-06-01

Containment technology refers to a broad range of methods that are used to contain waste or contaminated groundwater and to keep uncontaminated water from entering a waste site. The U.S. Department of Energy's (DOE) Office of Technology Development has instituted the In Situ Remediation Integrated Program (ISRIP) to advance the state-of-the-art of innovative technologies that contain or treat, in situ, contaminated media such as soil and groundwater, to the point of demonstration and to broaden the applicability of these technologies to the widely varying site remediation requirements throughout the DOE complex. The information provided here is an overview of the state-of-the-art of containment technology and includes a discussion of ongoing development projects; identifies the technical gaps; discusses the priorities for resolution of the technical gaps; and identifies the site parameters affecting the application of a specific containment method. The containment technology described in this document cover surface caps; vertical barriers such as slurry walls, grout curtains, sheet pilings, frozen soil barriers, and vitrified barriers; horizontal barriers; sorbent barriers; and gravel layers/curtains. Within DOE, containment technology could be used to prevent water infiltration into buried waste; to provide for long-term containment of pits, trenches, and buried waste sites; for the interim containment of leaking underground storage tanks and piping; for the removal of contaminants from groundwater to prevent contamination from migrating off-site; and as an interim measure to prevent the further migration of contamination during the application of an in situ treatment technology such as soil flushing. The ultimate goal is the implementation of containment technology at DOE sites as a cost-effective, efficient, and safe choice for environmental remediation and restoration activities

Vertical barriers with increased sorption capacities

International Nuclear Information System (INIS)

Bradl, H.B.

1997-01-01

Vertical barriers are commonly used for the containment of contaminated areas. Due to the very small permeability of the barrier material which is usually in the order of magnitude of 10-10 m/s or less the advective contaminant transport can be more or less neglected. Nevertheless, there will always be a diffusive contaminant transport through the barrier which is caused by the concentration gradient. Investigations have been made to increase the sorption capacity of the barrier material by adding substances such as organoclays, zeolites, inorganic oxides and fly ashes. The contaminants taken into account where heavy metals (Pb) and for organic contaminants Toluole and Phenantrene. The paper presents results of model calculations and experiments. As a result, barrier materials can be designed 'tailor-made' depending on the individual contaminant range of each site (e.g. landfills, gasworks etc.). The parameters relevant for construction such as rheological properties, compressive strength and permeability are not affected by the addition of the sorbents

Lightweight flywheel containment

Science.gov (United States)

Smith, James R.

2004-06-29

A lightweight flywheel containment composed of a combination of layers of various material which absorb the energy of a flywheel structural failure. The various layers of material act as a vacuum barrier, momentum spreader, energy absorber, and reaction plate. The flywheel containment structure has been experimentally demonstrated to contain carbon fiber fragments with a velocity of 1,000 m/s and has an aerial density of less than 6.5 g/square centimeters. The flywheel containment, may for example, be composed of an inner high toughness structural layer, and energy absorbing layer, and an outer support layer. Optionally, a layer of impedance matching material may be utilized intermediate the flywheel rotor and the inner high toughness layer.

Antibacterial and Barrier Properties of Gelatin Coated by Electrospun Polycaprolactone Ultrathin Fibers Containing Black Pepper Oleoresin of Interest in Active Food Biopackaging Applications

Directory of Open Access Journals (Sweden)

Kelly Johana Figueroa-Lopez

2018-03-01

Full Text Available The present study evaluated the effect of using electrospun polycaprolactone (PCL as a barrier coating and black pepper oleoresin (OR as a natural extract on the morphology, thermal, mechanical, antimicrobial, oxygen, and water vapor barrier properties of solvent cast gelatin (GEL. The antimicrobial activity of the developed multilayer system obtained by the so-called electrospinning coating technique was also evaluated against Staphylococcus aureus strains for 10 days. The results showed that the multilayer system containing PCL and OR increased the thermal resistance, elongated the GEL film, and significantly diminished its permeance to water vapor. Active multilayer systems stored in hermetically closed bottles increased their antimicrobial activity after 10 days by inhibiting the growth of Staphylococcus aureus. This study demonstrates that addition of electrospun PCL ultrathin fibers and OR improved the properties of GEL films, which promoted its potential use in active food packaging applications.

Container Materials, Fabrication And Robustness

International Nuclear Information System (INIS)

Dunn, K.; Louthan, M.; Rawls, G.; Sindelar, R.; Zapp, P.; Mcclard, J.

2009-01-01

The multi-barrier 3013 container used to package plutonium-bearing materials is robust and thereby highly resistant to identified degradation modes that might cause failure. The only viable degradation mechanisms identified by a panel of technical experts were pressurization within and corrosion of the containers. Evaluations of the container materials and the fabrication processes and resulting residual stresses suggest that the multi-layered containers will mitigate the potential for degradation of the outer container and prevent the release of the container contents to the environment. Additionally, the ongoing surveillance programs and laboratory studies should detect any incipient degradation of containers in the 3013 storage inventory before an outer container is compromised.

Frozen soil barriers for hazardous waste confinement

International Nuclear Information System (INIS)

Dash, J.G.; Leger, R.; Fu, H.Y.

1997-01-01

Laboratory and full field measurements have demonstrated the effectiveness of artificial ground freezing for the containment of subsurface hazardous and radioactive wastes. Bench tests and a field demonstration have shown that cryogenic barriers are impenetrable to aqueous and non aqueous liquids. As a result of the successful tests the US Department of Energy has designated frozen ground barriers as one of its top ten remediation technologies

Design of Novel Ophthalmic Formulation Containing Drug Nanoparticles and Its Usefulness as Anti-glaucoma Drugs.

Science.gov (United States)

Nagai, Noriaki

2016-01-01

The ophthalmic application of drugs is the primary route of administration for the therapy of glaucoma; however, in traditional formulations, only small amounts of the administered drug penetrate the cornea to reach the desired intraocular tissue due to corneal barriers. Recently, nanoparticulate drug delivery is expected as a technology to overcome the difficulties in delivering drugs across biological barriers (improvement of bioavailability). In this study, we attempted to establish a new method for preparing solid drug nanoparticles by using a bead mill and various additives, and succeeded in preparing a high quality dispersion containing drug nanoparticles. For a more concrete example, a mean particle size of disulfiram (DSF) treated with bead mill is 183 nm. The corneal penetration and corneal residence time of DSF from the ophthalmic dispersion containing DSF nanoparticles were significantly higher than those from a 2-hydroxypropyl-β-cyclodextrin solution containing DSF (DSF solution). It is known that the administration of DSF has intraocular pressure (IOP)-reducing effects. The IOP-reducing effects of the ophthalmic dispersion containing DSF nanoparticles were significantly greater than those of the DSF solution in rabbits (the IOP was enhanced by placing the rabbits in a dark room for 5 h). In addition, the ophthalmic dispersion containing DSF nanoparticles is better tolerated by corneal epithelial cells than DSF solution. It is possible that dispersions containing DSF nanoparticles provide new possibilities for effectively treating glaucoma, and that ocular drug delivery systems using drug nanoparticles may expand their usage for therapy in the ophthalmologic field.

Comparing the analgesic effect of heat patch containing iron chip and ibuprofen for primary dysmenorrhea: a randomized controlled trial

Directory of Open Access Journals (Sweden)

Navvabi Rigi Shahindokht

2012-08-01

Full Text Available Abstract Background Primary dysmenorrhea is a common and sometimes disabling condition. In recent years, some studies aimed to improve the treatment of dysmenorrhea, and therefore, introduced several therapeutic measures. This study was designed to compare the analgesic effect of iron chip containing heat wrap with ibuprofen for the treatment of primary dysmenorrhea. Methods In this randomized (IRCT201107187038N2 controlled trial, 147 students (18–30 years old with the diagnosis of primary dysmenorrhea were enrolled considering the CONSORT guideline. Screening for primary dysmenorrhea was done by a two-question screening tool. The participants were randomly assigned into one of the intervention groups (heat Patch and ibuprofen. Data regarding the severity and emotional impact of the pain were recorded by a shortened version of McGill Pain Questionnaire (SF-MPQ. Student's t test was used for statistical analysis. Results The maximum and minimum pain severities were observed at 2 and 24 hours in both groups. The severity of sensual pain at 8, 12, and 24 hours was non-significantly less in the heat Patch group. There was also no significant difference between the groups regarding the emotional impact of pain at the first 2, 4, 8, 12 and 12 hours of menstruation. Conclusions Heat patch containing Iron chip has comparable analgesic effects to ibuprofen and can possibly be used for primary dysmenorrhea. Trial registration IRCT201107187038N2

Probable variations of a passive safety containment for a 1700 MWe class PWR with passive safety systems

International Nuclear Information System (INIS)

Sato, Takashi; Fujiki, Yasunobu; Oikawa, Hirohide; Ofstun, Richard P.

2009-01-01

The paper presents probable variations of a passive safety containment for a PWR. The passive safety containment is named Mark P containment tentatively. It is a pressure suppression type containment for a large scale PWR with a BWR type passive containment cooling system (PCCS). More than 3-day grace period can be achieved even for a 1700 MWe class large scale PWR owing to the PCCS. The containment is a reinforced concrete containment vessel (RCCV). The design pressure of the RCCV can be low owing to the suppression pool (S/P) and no prestressed tendon is necessary. It is a single barrier CV that can withstand a large airplane crash by itself. This simple configuration results in good economy and short construction term. The BWR type passive safety systems also include the Passive Cooling and Depressurization System (PCDS). The PCDS has 3-day grace period for the SBO induced by a giant earthquake and can practically eliminate the residual risk of a giant earthquake beyond the design basis earthquake of Ss. It also has a safety function to automatically depressurize the primary system at accidents such as SGTR and eliminate the need for operator actions. It is a large 1700 MWe passive safety PWR that has more than 3-day grace period for extremely severe natural disasters including a giant earthquake, a mega hurricane, tsunami and so on; no containment failure at a SA establishing a no evacuation plant; protection for a large airplane crash with the RCCV single barrier; good economy and short construction term. (author)

Barriers to Beta-Blocker Use and Up-Titration Among Patients with Heart Failure with Reduced Ejection Fraction.

Science.gov (United States)

Levitan, Emily B; Van Dyke, Melissa K; Loop, Matthew Shane; O'Beirne, Ronan; Safford, Monika M

2017-12-01

For patients with heart failure with reduced ejection fraction (HFrEF), guidelines recommend use of beta-blockers with gradual up-titration. However, many patients with HFrEF do not use beta-blockers and up-titration is rare. Our purpose was to identify and rank barriers to beta-blocker use and up-titration from the perspective of primary care physicians. We conducted 4 moderated, structured group discussions among 19 primary care physicians using the nominal group technique; 16 participants also completed a survey. Participants generated lists of barriers to beta-blocker use and up-titration among patients with HFrEF. Each participant had six votes with three votes assigned to the item ranked most important, two to the second most important item, and one to the third most important item. Investigators characterized items into themes. The percentage of available votes was calculated for each theme. Fifteen of 16 participating primary care physicians who completed the survey reported that management of beta-blockers was their responsibility. Treatment/side effects, particularly hypotension, were identified as the most important barrier for beta-blocker use (72% of available votes) followed by polypharmacy (11%), healthcare system barriers (10%), and comorbidities (6%). Barriers to up-titration included treatment/side effects (49% of available votes), patient communication/buy-in (21%), polypharmacy (13%), and healthcare system barriers (8%). Many barriers to guideline concordant use of beta-blockers among patients with HFrEF identified by primary care providers are not readily modifiable. Addressing these barriers may require development, testing, and dissemination of protocols for beta-blocker initiation and up-titration that are safe and appropriate in primary care.

In-situ containment and stabilization of buried waste: Annual report FY 1994

International Nuclear Information System (INIS)

Allan, M.L.; Kukacka, L.E.

1994-10-01

The two landfills of specific interest are the Chemical Waste Landfill (CWL) and the Mixed Waste Landfill (MWL), both located at Sandia National Laboratory. The work is comprised of two subtasks: (1) In-Situ Barriers and (2) In-Situ Stabilization of Contaminated Soils. The main environmental concern at the CWL is a chromium plume resulting from disposal of chromic acid and chromic sulfuric acid into unlined pits. This program has investigated means of in-situ stabilization of chromium contaminated soils and placement of containment barriers around the CWL. The MWL contains a plume of tritiated water. In-situ immobilization of tritiated water with cementitious grouts was not considered to be a method with a high probability of success and was not pursued. This is discussed further in Section 5.0. Containment barriers for the tritium plume were investigated. FY 94 work focused on stabilization of chromium contaminated soil with blast furnace slag modified grouts to bypass the stage of pre-reduction of Cr(6), barriers for tritiated water containment at the MWL, continued study of barriers for the CWL, and jet grouting field trials for CWL barriers at an uncontaminated site at SNL. Cores from the FY 93 permeation grouting field trails were also tested in FY 94

Barriers to accessing urethroplasty.

Science.gov (United States)

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

2016-01-01

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

Containment

International Nuclear Information System (INIS)

Anon.

1987-01-01

The primary mission of the Containment Group is to ensure that underground nuclear tests are satisfactorily contained. The main goal is the development of sound technical bases for containment-related methodology. Major areas of activity include siting, geologic description, emplacement hole stemming, and phenomenological predictions. Performance results of sanded gypsum concrete plugs on the Jefferson, Panamint, Cornucopia, Labquark, and Bodie events are given. Activities are also described in the following areas: computational capabilities site description, predictive modeling, and cavity-pressure measurement. Containment publications are listed. 8 references

Buried waste containment system materials. Final Report

International Nuclear Information System (INIS)

Weidner, J.R.; Shaw, P.G.

1997-10-01

This report describes the results of a test program to validate the application of a latex-modified cement formulation for use with the Buried Waste Containment System (BWCS) process during a proof of principle (POP) demonstration. The test program included three objectives. One objective was to validate the barrier material mix formulation to be used with the BWCS equipment. A basic mix formula for initial trials was supplied by the cement and latex vendors. The suitability of the material for BWCS application was verified by laboratory testing at the Idaho National Engineering and Environmental Laboratory (INEEL). A second objective was to determine if the POP BWCS material emplacement process adversely affected the barrier material properties. This objective was met by measuring and comparing properties of material prepared in the INEEL Materials Testing Laboratory (MTL) with identical properties of material produced by the BWCS field tests. These measurements included hydraulic conductivity to determine if the material met the US Environmental Protection Agency (EPA) requirements for barriers used for hazardous waste sites, petrographic analysis to allow an assessment of barrier material separation and segregation during emplacement, and a set of mechanical property tests typical of concrete characterization. The third objective was to measure the hydraulic properties of barrier material containing a stop-start joint to determine if such a feature would meet the EPA requirements for hazardous waste site barriers

Health care utilization and barriers experienced by individuals with spinal cord injury.

Science.gov (United States)

Stillman, Michael D; Frost, Karen L; Smalley, Craig; Bertocci, Gina; Williams, Steve

2014-06-01

To identify from whom individuals with spinal cord injury (SCI) seek health care, the percentage who receive preventative care screenings, and the frequency and types of barriers they encounter when accessing primary and specialty care services; and to examine how sociodemographic factors affect access to care and receipt of preventative screenings. Cross-sectional, observational study using an Internet-based survey. Internet based. Adults (N=108) with SCI who use a wheelchair as their primary means of mobility in the community. Not applicable. Health care utilization during the past year, barriers encountered when accessing health care facilities, and receipt of routine care and preventative screenings. All but 1 participant had visited a primary care provider within the past 12 months, and 85% had had ≥ 1 visit to specialty care providers. Accessibility barriers were encountered during both primary care (91.1%) and specialty care (80.2%) visits; most barriers were clustered in the examination room. The most prevalent barriers were inaccessible examination tables (primary care=76.9%; specialty care=51.4%) and lack of transfer aids (primary care=69.4%; specialty care=60.8%). Most participants had not been weighed during their visit (89%) and had remained seated in their wheelchair during their examinations (85.2%). Over one third of individuals aged ≥ 50 years had not received a screening colonoscopy, 60% of women aged ≥ 50 years had not had a mammogram within the past year, 39.58% of women had not received a Papanicolaou smear within the previous 3 years, and only 45.37% of respondents had ever received bone density testing. Individuals with SCI face remediable obstacles to care and receive fewer preventative care screenings than their nondisabled counterparts. We recommend that clinics conduct Americans with Disabilities Act self-assessments, ensure that their clinical staff are properly trained in assisting individuals with mobility disabilities, and take

Modelling the endothelial blood-CNS barriers: a method for the production of robust in vitro models of the rat blood-brain barrier and blood-spinal cord barrier.

Science.gov (United States)

Watson, P Marc D; Paterson, Judy C; Thom, George; Ginman, Ulrika; Lundquist, Stefan; Webster, Carl I

2013-06-18

Modelling the blood-CNS barriers of the brain and spinal cord in vitro continues to provide a considerable challenge for research studying the passage of large and small molecules in and out of the central nervous system, both within the context of basic biology and for pharmaceutical drug discovery. Although there has been considerable success over the previous two decades in establishing useful in vitro primary endothelial cell cultures from the blood-CNS barriers, no model fully mimics the high electrical resistance, low paracellular permeability and selective influx/efflux characteristics of the in vivo situation. Furthermore, such primary-derived cultures are typically labour-intensive and generate low yields of cells, limiting scope for experimental work. We thus aimed to establish protocols for the high yield isolation and culture of endothelial cells from both rat brain and spinal cord. Our aim was to optimise in vitro conditions for inducing phenotypic characteristics in these cells that were reminiscent of the in vivo situation, such that they developed into tight endothelial barriers suitable for performing investigative biology and permeability studies. Brain and spinal cord tissue was taken from the same rats and used to specifically isolate endothelial cells to reconstitute as in vitro blood-CNS barrier models. Isolated endothelial cells were cultured to expand the cellular yield and then passaged onto cell culture inserts for further investigation. Cell culture conditions were optimised using commercially available reagents and the resulting barrier-forming endothelial monolayers were characterised by functional permeability experiments and in vitro phenotyping by immunocytochemistry and western blotting. Using a combination of modified handling techniques and cell culture conditions, we have established and optimised a protocol for the in vitro culture of brain and, for the first time in rat, spinal cord endothelial cells. High yields of both CNS

Barriers to and drivers for UK bioenergy development

Energy Technology Data Exchange (ETDEWEB)

Adams, P.W.; Mezzullo, W.G. [Department of Mechanical Engineering, Faculty of Engineering and Design, University of Bath, Claverton Down, Bath BA2 7AY (United Kingdom); Hammond, G.P.; McManus, M.C. [Department of Mechanical Engineering, Faculty of Engineering and Design, University of Bath, Claverton Down, Bath BA2 7AY (United Kingdom); Institute for Sustainable Energy and Environment (I.SEE), University of Bath, Claverton Down, Bath BA2 7AY (United Kingdom)

2011-02-15

Barriers to UK bioenergy development arise from a number of technical, financial, social and other constraints. Likewise, the drivers for using bioenergy are numerous and diverse. A range of these barriers and drivers have been identified through a comprehensive literature and case study review, and then assessed through an online questionnaire, completed by stakeholders from across the UK bioenergy industry: farmers/suppliers, developers/owners of bioenergy projects, primary end-users, and government/policy stakeholders. The results are presented in the form of 'spider web' diagrams. The most critical barriers and drivers relate to economic factors of bioenergy projects. Farmers/suppliers and developers are influenced by production costs and benefits, whilst primary end-users of bioenergy are concerned mainly with the cost of purchasing energy resources. Common drivers for all stakeholders were found to be reducing carbon emissions and the dependency on fossil fuels. In order to satisfy the needs of stakeholders schemes must be both economically attractive and environmentally sustainable for projects to be successful. (author)

The Effect of Free Primary Education Policy on Late School Entry in Urban Primary Schools in Kenya

Science.gov (United States)

Ngware, Moses W.; Oketch, Moses; Ezeh, Alex C.; Mutisya, Maurice

2013-01-01

Late school entry is driven by several factors, one of the key ones being the cost barrier to schooling. Policies such as free primary education (FPE) that advocate for universal coverage are therefore partly aimed at removing the cost barrier. The Kenyan Government, like many in sub-Saharan Africa (SSA), introduced FPE in 2003 with the aim of…

Death following traumatic brain injury in Drosophila is associated with intestinal barrier dysfunction

Science.gov (United States)

Katzenberger, Rebeccah J; Chtarbanova, Stanislava; Rimkus, Stacey A; Fischer, Julie A; Kaur, Gulpreet; Seppala, Jocelyn M; Swanson, Laura C; Zajac, Jocelyn E; Ganetzky, Barry; Wassarman, David A

2015-01-01

Traumatic brain injury (TBI) is a major cause of death and disability worldwide. Unfavorable TBI outcomes result from primary mechanical injuries to the brain and ensuing secondary non-mechanical injuries that are not limited to the brain. Our genome-wide association study of Drosophila melanogaster revealed that the probability of death following TBI is associated with single nucleotide polymorphisms in genes involved in tissue barrier function and glucose homeostasis. We found that TBI causes intestinal and blood–brain barrier dysfunction and that intestinal barrier dysfunction is highly correlated with the probability of death. Furthermore, we found that ingestion of glucose after a primary injury increases the probability of death through a secondary injury mechanism that exacerbates intestinal barrier dysfunction. Our results indicate that natural variation in the probability of death following TBI is due in part to genetic differences that affect intestinal barrier dysfunction. DOI: http://dx.doi.org/10.7554/eLife.04790.001 PMID:25742603

Barrier island facies models and recognition criteria

Science.gov (United States)

Mulhern, J.; Johnson, C. L.

2017-12-01

Barrier island outcrops record transgressive shoreline motion at geologic timescales, providing integral clues to understanding how coastlines respond to rising sea levels. However, barrier island deposits are difficult to recognize. While significant progress has been made in understanding the modern coastal morphodynamics, this insight is not fully leveraged in existing barrier island facies models. Excellent outcrop exposures of the paralic Upper Cretaceous Straight Cliffs Formation of southern Utah provide an opportunity to revise facies models and recognition criteria for barrier island deposits. Preserved barrier islands are composed of three main architectural elements (shorefaces, tidal inlets, and tidal channels) which occur independently or in combination to create larger-scale barrier island deposits. Barrier island shorefaces record progradation, while barrier island tidal inlets record lateral migration, and barrier island tidal channels record aggradation within the tidal inlet. Four facies associations are used to describe and characterize these barrier island architectural elements. Barrier islands occur in association with backarrier fill and internally contain lower and upper shoreface, high-energy upper shoreface, and tidal channel facies. Barrier islands bound lagoons or estuaries, and are distinguished from other shoreface deposits by their internal facies and geometry, association with backbarrier facies, and position within transgressive successions. Tidal processes, in particular tidal inlet migration and reworking of the upper shoreface, also distinguish barrier island deposits. Existing barrier island models highlight the short term heterogeneous and dynamic nature of barrier island systems, yet overlook processes tied to geologic time scales, such as multi-directional motion, erosion, and reworking, and their expressions in preserved barrier island strata. This study uses characteristic outcrop expressions of barrier island successions to

Isotope distributions in primary heat transport and containment systems during a severe accident in CANDU type reactor

International Nuclear Information System (INIS)

Constantin, M.

2005-01-01

The paper is intended to analyse the distribution of the fission products (FPs) in CANDU Primary Heat Transport (PHT) and CANDU Containment Systems by using the ASTEC code. The complexity of the data required by ASTEC and the complexity both of CANDU PHT and Containment System were strong motivation to begin with a simplified model. The data related to the nodes' definitions, temperatures and pressure conditions were chosen as possible as real data from CANDU loss of coolant accident sequence (CATHENA code results). The source term of FPs introduced into the PHT was estimated by ORIGEN code. The FPs distribution in the nodes of the circuit and the FPs mass transfer per isotope and chemical species were obtained by using SOPHAEROS module. The distributions within the containment are obtained by the CPA module (thermalhydraulic calculations in the containment and FPs aerosol transport). The results consist of mass distributions in the nodes of the circuit and the transferred mass to the containment through the break for different species (FPs and chemical species) and mass distributions in the different parts of the containment and different hosts. (authors)

Mobile nuclear reactor containment vessel

International Nuclear Information System (INIS)

Thompson, R.E.; Spurrier, F.R.; Jones, A.R.

1978-01-01

A containment vessel for use in mobile nuclear reactor installations is described. The containment vessel completely surrounds the entire primary system, and is located as close to the reactor primary system components as is possible in order to minimize weight. In addition to being designed to withstand a specified internal pressure, the containment vessel is also designed to maintain integrity as a containment vessel in case of a possible collision accident

Localization of cellular retinol-binding protein and retinol-binding protein in cells comprising the blood-brain barrier of rat and human

International Nuclear Information System (INIS)

MacDonald, P.N.; Ong, D.E.; Bok, D.

1990-01-01

Brain is not generally recognized as an organ that requires vitamin A, perhaps because no obvious histologic lesions have been observed in severely vitamin A-deficient animals. However, brain tissue does contain cellular vitamin A-binding proteins and a nuclear receptor protein for retinoic acid. In the present study, immunohistochemical techniques were used to determine the cell-specific location of cellular retinol-binding protein in human and rat brain tissue. Cellular retinol-binding protein was localized specifically within the cuboidal epithelial cells of the choroid plexus, two primary sites of the mammalian blood-brain barrier. In addition, autoradiographic procedures demonstrated binding sites for serum retinol-binding protein in the choroidal epithelium. These observations suggest that a significant movement of retinol across the blood-brain barrier may occur

Alternative approaches to reliability modeling of a multiple engineered barrier system

International Nuclear Information System (INIS)

Ananda, M.M.A.; Singh, A.K.

1994-01-01

The lifetime of the engineered barrier system used for containment of high-level radioactive waste will significantly impact the total performance of a geological repository facility. Currently two types of designs are under consideration for an engineered barrier system, single engineered barrier system and multiple engineered barrier system. Multiple engineered barrier system consists of several metal barriers and the waste form (cladding). Some recent work show that a significant improvement of performance can be achieved by utilizing multiple engineered barrier systems. Considering sequential failures for each barrier, we model the reliability of the multiple engineered barrier system. Weibull and exponential lifetime distributions are used through out the analysis. Furthermore, the number of failed engineered barrier systems in a repository at a given time is modeled using a poisson approximation

The containment of heavy oil in flowing water

International Nuclear Information System (INIS)

Brown, H.M.; Goodman, R.H.; Nicholson, P.

1992-01-01

Viscous bitumen from Alberta oil sand deposits is diluted with a gas condensate before pipeline transport. Because of its unique properties, the diluent/bitumen mix (dilbit) may require novel containment and recovery techniques in the case of an accidental spill. Preliminary experiments were conducted in a large flowing water channel to determine whether several conventional containment devices could be utilized to trap weathered and emulsified dilbit and bitumen. These devices included a conventional river boom, a nylon fine-weave net, and a low-pressure bubble barrier. The behavior of the oil samples during boom failure was noted in order to understand more completely the mechanisms of failure. The river boom failed to hold viscous floating oil by vortex shedding at flows of under 0.25 m/s. A fine mesh net successfully trapped both floating and mid-channel neutrally buoyant oil but the retention time depends on the oil viscosity. The bubble barrier was not successful in trapping either floating viscous oil or neutrally buoyant oil. At low water velocities, the barrier was able to divert some oils but in an inconsistent manner. The results indicate that conventional barriers need improvement to be effective at higher water velocities and suggest that new concepts in containment should be considered. 9 refs., 3 figs., 2 tabs

Safety barriers to prevent release of hydrocarbons during production of oil and gas

OpenAIRE

Sklet, Snorre; Hauge, Stein

2004-01-01

This report documents a set of scenarios related to release of hydrocarbons during production on oil and gas platforms. For each release scenario, initiating events, barrier functions aimed to prevent loss of containment, and barrier systems that realize these barrier functions are identified and described. Safety barriers to prevent release of hydrocarbons during production of oil and gas

Hanford Permanent Isolation Barrier Program: Asphalt technology development

International Nuclear Information System (INIS)

Freeman, H.D.; Romine, R.A.

1994-11-01

An important component of the Hanford Permanent Isolation Barrier is the use of a two-layer composite asphalt system, which provides backup water diversion capabilities if the primary capillary barrier fails to meet infiltration goals. Because of asphalt's potential to perform to specification over the 1000-year design life criterion, a composite asphalt barrier (HMAC/fluid-applied polymer-modified asphalt) is being considered as an alternative to the bentonite clay/high density poly(ethylene) barriers for the low-permeability component of the Hanford Permanent Isolation Barrier. The feasibility of using asphalt as a long-term barrier is currently being studied. Information that must be known is the ability of asphalt to retain desirable physical properties over a period of 1000 years. This paper presents the approach for performing accelerated aging tests and evaluating the performance of samples under accelerated conditions. The results of these tests will be compared with asphalt artifact analogs and the results of modeling the degradation of the selected asphalt composite to make life-cycle predictions

Experimental Study on the Interaction Between Contacting Barrier Materials for Containment of Radioactive Wastes

Science.gov (United States)

Huang, W. H.; Chang, H. C.

2017-12-01

The disposal of low- and intermediate-level radioactive wastes requires use of multi-barriers for isolation of the wastes from the biosphere. Typically, the engineered barriers are composed of a concrete vault, buffer and backfill materials. Zhishin clay and Black Hill bentonite were used as raw clay material in making buffer and backfill materials in this study. These clays were compacted to make buffer material, or mixed with Taitung area argillite to produce backfill material for potential application as barriers for the disposal of low- and intermediate-level radioactive wastes. The interaction between concrete barrier and the buffer/backfill material is simulated by an accelerated migration test to investigate the effect of contacting concrete on the expected functions of buffer/backfill material. The results show buffer material close to the contact with concrete exhibits significant change in the ratio of calcium/sodium exchange capacity, due to the move of calcium ions released from the concrete. The shorter the distance from the contacting interface, the ratio of the calcium/sodium concentration in buffer/backfill materials increases. The longer the distance from the interface, the effect of the contact on alteration in clays become less significant. Also, some decreases in swelling capacity in the buffer/backfill material near the concrete-backfill interface are noted. Finally, a comparison is made between Zhisin clay and Balck Hill bentonite on the interaction between concrete and the two clays. Black Hill bentonite was found to be influenced more by the interaction, because of the higher content of montmorillonite. On the other hand, being a mixture of clay and sand, backfill material is less affected by the decalsification of concrete at the contact than buffer material.

Design analysis report: high-integrity container for disposal of EPICOR-II prefilter liners

International Nuclear Information System (INIS)

Chapman, R.L.; Reno, H.W.

1983-06-01

A high-integrity container has been developed to (a) immobilize the EPIROC-II prefilter liners from Unit-2 of the Three Mile Island (TMI) Nuclear Power Station, and (b) protect possible future, inadvertent intruders from damaging radiation. The container is designed for disposal depths to 90 feet in either wet or dry subsurface conditions. A built-in vent system for each container will permit the release of gas and function as a water barrier at pressures reaching 45 psig. The container has outside dimensions of 62.5 inches diameter by 84 inches high, and is designed to ensure a 300-year functional life. Its design features multiple barriers that prevent corrosives from penetrating container walls. The multiple-barrier approach provides a 1204-year mean time to total failure, based on an assumed single-event-failure probability of 20%. The multiple-corrosion-barrier concept is supplemented by aluminum hydroxide, which reduces the chemical activity of corrosives potentially arising from chemical decomposition of organic resins in the EPICOR-II prefilter liner. Aluminum hydroxide, an effective amphoteric material, tends to neutralize both acids and bases. An epoxy seal between the lid and container body functions as a barrier against any loss of container contents. Two separate epoxy materials fill the space between the lid and container body; they form a seal, mechanically bonding the lid in place. After curing, this epoxy material has a greater strength than the concrete; thus, the concrete has to fail in order for the lid to loosen

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

Science.gov (United States)

Williams, Brett; Brown, Ted; Costello, Shane

2015-10-24

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

The role of multiple barriers in assuring waste package reliability

International Nuclear Information System (INIS)

Bradford, R.M.

1993-08-01

Yucca Mountain in southwestern Nevada is being studied as a potential repository site for the permanent storage of high-level nuclear waste. Regulators have set performance standards that the potential repository must meet in order to obtain regulatory approval. Nuclear Regulatory Commission (NRC) regulations state that containment of radioactivity must be ''substantially complete'' for the first 1000 years after closure of the facility. Thereafter, the acceptable annual limit on releases is 1/100,000 of each radionuclide remaining in the inventory after 1000 years. To demonstrate that the potential facility is in compliance with the regulations, it is necessary to obtain some understanding of the probability distribution of the cumulative quantity of releases by certain time points. This paper will discuss the probability distribution of waste container lifetimes and how the understanding of this distribution will play a role in finding the distribution of the release quantities over time. It will be shown that, for reasonable assumptions about the process of barrier failure, the reliability of a multiple-barrier container can be achieved and demonstrated much more readily than a container consisting of a single barrier. The discussion will focus primarily on the requirement of substantially complete containment for the first 1000 years

Oscillatory shear response of moisture barrier coatings containing clay of different shape factor.

Science.gov (United States)

Kugge, C; Vanderhoek, N; Bousfield, D W

2011-06-01

Oscillatory shear rheology of barrier coatings based on dispersed styrene-butadiene latex and clay of various shape factors or aspect ratio has been explored. Barrier performance of these coatings when applied to paperboard has been assessed in terms of water vapour transmission rates and the results related to shape factor, dewatering and critical strain. It has been shown that a system based on clay with high shape factor gives a lower critical strain, dewatering and water vapour transmission rate compared with clays of lower shape factor. The dissipated energy, as calculated from an amplitude sweep, indicated no attractive interaction between clay and latex implying a critical strain that appears to be solely dependent on the shape factor at a constant volume fraction. Particle size distribution was shown to have no effect on the critical strain while coatings of high elasticity exhibited high yield strains as expected. The loss modulus demonstrated strain hardening before the elastic to viscous transition. The loss modulus peak was identified by a maximum strain which was significantly lower for a coating based on clay with a high shape factor. The characteristic elastic time was found to vary between 0.6 and 1.3s. The zero shear viscosity of barrier dispersion coatings were estimated from the characteristic elastic time and the characteristic modulus to be of the order of 25-100 Pa s. Copyright © 2011 Elsevier Inc. All rights reserved.

Preparation, crystallization, and preliminary X-ray diffraction study of mutant carboxypeptidase T containing the primary specificity pocket of carboxypeptidase B

International Nuclear Information System (INIS)

Akparov, V. Kh.; Grishin, A. M.; Timofeev, V. I.; Kuranova, I. P.

2010-01-01

Recombinant G215S, A251G, T257A, D260G, T262D mutant carboxypeptidase T from Thermoactinomyces vulgaris containing mutations in the primary specificity pocket was prepared and crystallized. Single crystals with a size of up to 0.3 mm were grown and investigated by X-ray diffraction. Recombinant mutant carboxypeptidase T containing the primary specificity subsite compositionally identical to that of pancreatic carboxypeptidase B crystallizes in the same space group as the natural enzyme. The crystals belong to sp. gr. P6 3 22; the unit-cell parameters are a = b = 157.867 A, c = 104.304 A, α = β = 90 deg., γ = 120 deg. X-ray diffraction data suitable for determining the three-dimensional structure at atomic resolution were collected from one crystal.

Barriers in green lean six sigma product development process

DEFF Research Database (Denmark)

Kumar, Sanjay; Luthra, Sunil; Govindan, Kannan

2016-01-01

In today’s competitive globalised business environment, production cost cutting is a primary issue before operation managers. As a research area, green lean six sigma (GLS) is proposed to have strategic importance in product development towards cutting costs, contributing to optimisation...... experts’ opinions towards developing a hierarchical model structuring these barriers. Twenty-one barriers have been identified and sorted from the review of literature and were then validated through discussions with experts. Relationships (contextual in nature) among these barriers have been realised...... during a brainstorming session. An interpretive structural modelling (ISM) technique has been utilised for developing a hierarchical model of barriers in implementing the GLSPD process in the automobile sector of India. A nine-level structural model has been deduced after application of the ISM technique...

Trends in the development of reactor containments

International Nuclear Information System (INIS)

Turricchia, A.

1977-01-01

The paper presents a review of the technical developments which the containment systems of BWRs, PWRs and HWRs have undergone in the USA, Europe and Canada. The great variety of existing containment systems have been classified for each type of reactor, according to: principle of operation (i.e. dry containment; pressure suppression containment; containment with vacuum building; sub-atmospheric containment; etc.); type and number of the physical barriers provided against the dispersion of fission products to the environment (single containment, double containment, single containment with local collection of the leaks from the most probable leakage paths, or with pressurization of the potential leakage paths, etc.); and structural characteristics of the containment barriers (reinforced concrete, prestressed concrete, metal containment, liners). In the framework of this classification the main features of the various containment systems are illustrated, with special emphasis on the most modern designs. The difference in trend among various countries and various designers are highlighted. A review is also made of the various containment auxiliary systems which would operate in accident conditions (isolation systems, heat removal system, atmosphere control system, etc.). Also for these systems the main design criteria are set forth and present trends are described. Finally, a brief survey is also made of the present trends with regards to the design of containment structures against external events be they of natural origin (earthquake, tornadoes, etc.) or connected with human activities (airplane crash, explosions, etc.) [fr

Utah Youth Suicide Study: Barriers to Mental Health Treatment for Adolescents

Science.gov (United States)

Moskos, Michelle A.; Olson, Lenora; Halbern, Sarah R.; Gray, Doug

2007-01-01

Forty-nine suicide cases were drawn from an original sample of 151 consecutive youth suicide deaths. We used information from 270 interviews with parents and other survivors to evaluate mental health treatment sought for and by the decedent and barriers to mental health treatment. Participants reported the same primary barriers for the decedent:…

Determinants of physical activity in primary school students using the health belief model.

Science.gov (United States)

Ar-Yuwat, Sireewat; Clark, Mary Jo; Hunter, Anita; James, Kathy S

2013-01-01

Thailand is a middle-income country in which two-thirds of children demonstrate an insufficient level of physical activity. Physical inactivity is a major risk factor for obesity and many other health-related consequences in children. Thus, it is important to understand how primary school children perceive things in their daily life as determinants of physical activity. The purpose of this study was to investigate the impact of cues, perceived benefits, and perceived barriers on the level of physical activity among primary school students. A cross-sectional study was conducted in Phitsanulok Province, Thailand, in 2011. Multistage sampling selected a total of 123 primary school students. The Physical Activity Questionnaire for Older Children and the Cues, Perceived Benefits, and Barriers to Physical Activity Questionnaire were used to assess the student levels of physical activity, as well as the perceived benefits, barriers, and cues to action. The association between these factors and the level of physical activity was determined by correlation statistics and confirmed by robust regression. Multivariate analysis of variance compared health belief model determinants: perceived benefits, perceived barriers, and cues to action on physical activity between male and female students. Self-administered questionnaires were validated and tested in a pilot study. The level of activity among primary school children was significantly influenced by perceived barriers, such as fear of strangers when playing outdoors, bad weather, and too much homework. However, activity was not influenced by cues to action or perceived benefits. Perceived benefits, barriers, and cues to physical activity did not differ by gender. A safe environment and fewer barriers, such as amount of homework, could enhance physical activity in primary school children.

DOE UST interim subsurface barrier technologies workshop

International Nuclear Information System (INIS)

1992-09-01

This document contains information which was presented at a workshop regarding interim subsurface barrier technologies that could be used for underground storage tanks, particularly the tank 241-C-106 at the Hanford Reservation

Participant recruitment to FiCTION, a primary dental care trial - survey of facilitators and barriers.

Science.gov (United States)

Keightley, A; Clarkson, J; Maguire, A; Speed, C; Innes, N

2014-11-01

To identify reasons behind a lower than expected participant recruitment rate within the FiCTION trial, a multi-centre paediatric primary dental care randomised controlled trial (RCT). An online survey, based on a previously published tool, consisting of both quantitative and qualitative responses, completed by staff in dental practices recruiting to FiCTION. Ratings from quantitative responses were aggregated to give overall scores for factors related to participant recruitment. Qualitative responses were independently grouped into themes. Thirty-nine anonymous responses were received. Main facilitators related to the support received from the central research team and importance of the research question. The main barriers related to low child eligibility rates and the integration of trial processes within routine workloads. These findings have directed strategies for enhancing participant recruitment at existing practices and informed recruitment of further practices. The results help provide a profile of the features required of practices to successfully screen and recruit participants. Future trials in this setting should consider the level of interest in the research question within practices, and ensure trial processes are as streamlined as possible. Research teams should actively support practices with participant recruitment and maintain enthusiasm among the entire practice team.

General practice integration in Australia. Primary health services provider and consumer perceptions of barriers and solutions.

Science.gov (United States)

Appleby, N J; Dunt, D; Southern, D M; Young, D

1999-08-01

To identify practical examples of barriers and possible solutions to improve general practice integration with other health service providers. Twelve focus groups, including one conducted by teleconference, were held across Australia with GPs and non GP primary health service providers between May and September, 1996. Focus groups were embedded within concept mapping sessions, which were used to conceptually explore the meaning of integration in general practice. Data coding, organising and analysis were based on the techniques documented by Huberman and Miles. Barriers to integration were perceived to be principally due to the role and territory disputes between the different levels of government and their services, the manner in which the GP's role is currently defined, and the system of GP remuneration. Suggestions on ways to improve integration involved two types of strategies. The first involves initiatives implemented 'top down' through major government reform to service structures, including the expansion of the role of divisions of general practice, and structural changes to the GP remuneration systems. The second type of strategy suggested involves initiatives implemented from the 'bottom up' involving services such as hospitals (e.g. additional GP liaison positions) and the use of information technology to link services and share appropriate patient data. The findings support the need for further research and evaluation of initiatives aimed at achieving general practice integration at a systems level. There is little evidence to suggest which types of initiatives improve integration. However, general practice has been placed in the centre of the health care debate and is likely to remain central to the success of such initiatives. Clarification of the future role and authority of general practice will therefore be required if such integrative strategies are to be successful at a wider health system level.

Stochastic simulation of pitting degradation of multi-barrier waste container in the potential repository at Yucca Mountain

International Nuclear Information System (INIS)

Lee, J.H.; Atkins, J.E.; Andrews, R.W.

1995-01-01

A detailed stochastic waste package degradation simulation model was developed incorporating the humid-air and aqueous general and pitting corrosion models for the carbon steel corrosion-allowance outer barrier and aqueous pitting corrosion model for the Alloy 825 corrosion-resistant inner barrier. The uncertainties in the individual corrosion models were also incorporated to capture the variability in the corrosion degradation among waste packages and among pits in the same waste package. Within the scope of assumptions employed in the simulations, the corrosion modes considered, and the near-field conditions from the drift-scale thermohydrologic model, the results of the waste package performance analyses show that the current waste package design appears to meet the 'controlled design assumption' requirement of waste package performance, which is currently defined as having less than 1% of waste packages breached at 1,000 years. It was shown that, except for the waste packages that fail early, pitting corrosion of the corrosion-resistant inner barrier has a greater control on the failure of waste packages and their subsequent degradation than the outer barrier. Further improvement and substantiation of the inner barrier pitting model (currently based on an elicitation) is necessary in future waste package performance simulation model

Measurement and modelling of reactive transport in geological barriers for nuclear waste containment.

Science.gov (United States)

Xiong, Qingrong; Joseph, Claudia; Schmeide, Katja; Jivkov, Andrey P

2015-11-11

Compacted clays are considered as excellent candidates for barriers to radionuclide transport in future repositories for nuclear waste due to their very low hydraulic permeability. Diffusion is the dominant transport mechanism, controlled by a nano-scale pore system. Assessment of the clays' long-term containment function requires adequate modelling of such pore systems and their evolution. Existing characterisation techniques do not provide complete pore space information for effective modelling, such as pore and throat size distributions and connectivity. Special network models for reactive transport are proposed here using the complimentary character of the pore space and the solid phase. This balances the insufficient characterisation information and provides the means for future mechanical-physical-chemical coupling. The anisotropy and heterogeneity of clays is represented using different length parameters and percentage of pores in different directions. Resulting networks are described as mathematical graphs with efficient discrete calculus formulation of transport. Opalinus Clay (OPA) is chosen as an example. Experimental data for the tritiated water (HTO) and U(vi) diffusion through OPA are presented. Calculated diffusion coefficients of HTO and uranium species are within the ranges of the experimentally determined data in different clay directions. This verifies the proposed pore network model and validates that uranium complexes are diffusing as neutral species in OPA. In the case of U(vi) diffusion the method is extended to account for sorption and convection. Rather than changing pore radii by coarse grained mathematical formula, physical sorption is simulated in each pore, which is more accurate and realistic.

Application of two-barrier model of radioactive agent transport in sea water for analyzing artificial radionuclide release from containers with radioactive waste dumped in Kara Sea

Energy Technology Data Exchange (ETDEWEB)

Grishin, Denis S.; Laykin, Andrey I.; Kuchin, Nickolay L.; Platovskikh, Yuri A. [Krylov State Research Center, Saint Petersburg, 44 Moskovskoe shosse, 196158 (Russian Federation)

2014-07-01

Modeling of artificial radionuclide transport in sea water is crucial for prognosis of radioecological situation in regions where dumping of radioactive waste had been made and/or accidents with nuclear submarines had taken place. Distribution of artificial radionuclides in bottom sediments can be a detector of radionuclide release from dumped or sunk objects to marine environment. Proper model can determine the dependence between radionuclide distribution in sediments and radionuclide release. Following report describes two-barrier model of radioactive agent transport in sea water. It was tested on data from 1994 - 2013 expeditions to Novaya Zemlya bays, where regular dumping of solid radioactive waste was practiced by the former USSR from the early 1960's until 1990. Two-barrier model agrees with experimental data and allows more accurate determination of time and intensity of artificial radionuclide release from dumped containers. (authors)

Collaborative care in real-world settings: barriers and opportunities for sustainability

Directory of Open Access Journals (Sweden)

Sanchez K

2017-01-01

Full Text Available Katherine Sanchez1,2 1School of Social Work, The University of Texas at Arlington, Arlington, 2Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA Abstract: Patient-centered care and self-management of chronic disease are optimally characterized by distinct adjunct services such as education, and support for the behavioral and psychosocial elements of managing disease. The collaborative care model for the treatment of depression and anxiety in primary care includes the integration of a behavioral health specialist, in collaboration with the primary care provider, and psychiatric consultation to effectively screen and treat common mental health problems. Dissemination and sustainability of the model have encountered numerous barriers across systems of care. This article represents a discussion of the key barriers to collaborative care and offers a discussion of opportunities for dissemination and sustainability of the model. Keywords: collaborative care, barriers, depression, anxiety, patient preferences

Poster - 11: Radiation barrier thickness calculations for the GammaPod

International Nuclear Information System (INIS)

La Russa, Daniel; Vandervoort, Eric; Wilkins, David

2016-01-01

A consortium of radiotherapy centers in North America is in the process of evaluating a novel new 60 Co teletherapy device, called the GammaPod™ (Xcision Medical Systems, Columbia Maryland), designed specifically for breast SBRT. The GammaPod consists of 36 collimated 60 Co sources with a total activity of 4320 Ci. The sources are housed in a hemispherical source carrier that rotates during treatment to produce a cylindrically symmetric cone of primary beam spanning 16° – 54° degrees from the horizontal. This unique beam geometry presents challenges when designing or evaluating room shielding for the purposes of meeting regulatory requirements, and for ensuring the safety of staff and the public in surrounding areas. Conventional methods for calculating radiation barrier thicknesses have been adapted so that barrier transmission factors for the GammaPod can be determined from a few relevant distances and characteristics of the primary beam. Simple formalisms have been determined for estimating shielding requirements for primary radiation (with a rotating and non-rotating source carrier), patient-scattered radiation, and leakage radiation. When making worst case assumptions, it was found that conventional barrier thicknesses associated with linac treatment suites are sufficient for shielding all sources of radiation from the GammaPod.

Poster - 11: Radiation barrier thickness calculations for the GammaPod

Energy Technology Data Exchange (ETDEWEB)

La Russa, Daniel; Vandervoort, Eric; Wilkins, David [Radiation Medicine Program, The Ottawa Hospital (Canada)

2016-08-15

A consortium of radiotherapy centers in North America is in the process of evaluating a novel new {sup 60}Co teletherapy device, called the GammaPod™ (Xcision Medical Systems, Columbia Maryland), designed specifically for breast SBRT. The GammaPod consists of 36 collimated {sup 60}Co sources with a total activity of 4320 Ci. The sources are housed in a hemispherical source carrier that rotates during treatment to produce a cylindrically symmetric cone of primary beam spanning 16° – 54° degrees from the horizontal. This unique beam geometry presents challenges when designing or evaluating room shielding for the purposes of meeting regulatory requirements, and for ensuring the safety of staff and the public in surrounding areas. Conventional methods for calculating radiation barrier thicknesses have been adapted so that barrier transmission factors for the GammaPod can be determined from a few relevant distances and characteristics of the primary beam. Simple formalisms have been determined for estimating shielding requirements for primary radiation (with a rotating and non-rotating source carrier), patient-scattered radiation, and leakage radiation. When making worst case assumptions, it was found that conventional barrier thicknesses associated with linac treatment suites are sufficient for shielding all sources of radiation from the GammaPod.

Frozen soil barrier technology. Innovative technology summary report

International Nuclear Information System (INIS)

1995-04-01

The technology of using refrigeration to freeze soils has been employed in large-scale engineering projects for a number of years. This technology bonds soils to give load-bearing strength during construction; to seal tunnels, mine shafts, and other subsurface structures against flooding from groundwater; and to stabilize soils during excavation. Examples of modern applications include several large subway, highway, and water supply tunnels. Ground freezing to form subsurface frozen soil barriers is an innovative technology designed to contain hazardous and radioactive contaminants in soils and groundwater. Frozen soil barriers that provide complete containment (open-quotes Vclose quotesconfiguration) are formed by drilling and installing refrigerant piping (on 8-ft centers) horizontally at approximately 45 degrees angles for sides and vertically for ends and then recirculating an environmentally safe refrigerant solution through the piping to freeze the soil porewater. Freeze plants are used to keep the containment structure at subfreezing temperatures. A full-scale containment structure was demonstrated from May 12 to October 10, 1994, at a nonhazardous site on SEG property on Gallaher Road, Oak Ridge, Tennessee

Containment for low temperature district nuclear-heating reactor

International Nuclear Information System (INIS)

He Shuyan; Dong Duo

1992-03-01

Integral arrangement is adopted for Low Temperature District Nuclear-heating Reactor. Primary heat exchangers, control rod drives and spent fuel elements are put in the reactor pressure vessel together with reactor core. Primary coolant flows through reactor core and primary heat exchangers in natural circulation. Primary coolant pipes penetrating the wall of reactor pressure vessel are all of small diameters. The reactor vessel constitutes the main part of pressure boundary of primary coolant. Therefore the small sized metallic containment closed to the wall of reactor vessel can be used for the reactor. Design principles and functions of the containment are as same as the containment for PWR. But the adoption of small sized containment brings about some benefits such as short period of manufacturing, relatively low cost, and easy for sealing. Loss of primary coolant accident would not be happened during the rupture accident of primary coolant pressure boundary inside the containment owing to its intrinsic safety

Engineered barrier development for a nuclear waste repository in basalt

International Nuclear Information System (INIS)

Smith, M.J.

1980-05-01

The BWIP Engineered Barrier Program has been developed to provide an integrated approach to the development of site-specific Engineered Barrier assemblages for a repository located in basalt. The goal of this program is to specify engineered and natural barriers which will ensure that nuclear and non-radioactive hazardous materials emplaced in a repository in basalt do not exceed acceptable rates of release to the biosphere. A wide range of analytical and experimental activities related to the basalt repository environment, waste package environment, waste/barrier/rock interactions, and barrier performance assessment provide the basis for selection of systems capable of meeting licensing requirements. Work has concentrated on specifying and testing natural and man-made materials which can be used to plug boreholes in basalt and which can be used as multiple barriers to surround nuclear waste forms and containers. The Engineered Barriers Program is divided into two major activities: multiple barrier studies and borehole plugging. 8 figures, 4 tables

DEMONSTRATiON OF A SUBSURFACE CONTAINMENT SYSTEM FOR INSTALLATION AT DOE WASTE SITES

Energy Technology Data Exchange (ETDEWEB)

Thomas J. Crocker; Verna M. Carpenter

2003-05-21

Between 1952 and 1970, DOE buried mixed waste in pits and trenches that now have special cleanup needs. The disposal practices used decades ago left these landfills and other trenches, pits, and disposal sites filled with three million cubic meters of buried waste. This waste is becoming harmful to human safety and health. Today's cleanup and waste removal is time-consuming and expensive with some sites scheduled to complete cleanup by 2006 or later. An interim solution to the DOE buried waste problem is to encapsulate and hydraulically isolate the waste with a geomembrane barrier and monitor the performance of the barrier over its 50-yr lifetime. The installed containment barriers would isolate the buried waste and protect groundwater from pollutants until final remediations are completed. The DOE has awarded a contract to RAHCO International, Inc.; of Spokane, Washington; to design, develop, and test a novel subsurface barrier installation system, referred to as a Subsurface Containment System (SCS). The installed containment barrier consists of commercially available geomembrane materials that isolates the underground waste, similar to the way a swimming pools hold water, without disrupting hazardous material that was buried decades ago. The barrier protects soil and groundwater from contamination and effectively meets environmental cleanup standards while reducing risks, schedules, and costs. Constructing the subsurface containment barrier uses a combination of conventional and specialized equipment and a unique continuous construction process. This innovative equipment and construction method can construct a 1000-ft-long X 34-ft-wide X 30-ft-deep barrier at construction rates to 12 Wday (8 hr/day operation). Life cycle costs including RCRA cover and long-term monitoring range from approximately $380 to $590/cu yd of waste contained or $100 to $160/sq ft of placed barrier based upon the subsurface geology surrounding the waste. Project objectives for Phase

Knowledge, attitudes, practices, and barriers reported by patients receiving diabetes and hypertension primary health care in Barbados: a focus group study

Directory of Open Access Journals (Sweden)

Adams O Peter

2011-12-01

Full Text Available Abstract Background Deficiencies in the quality of diabetes and hypertension primary care and outcomes have been documented in Barbados. This study aimed to explore the knowledge, attitudes and practices, and the barriers faced by people with diabetes and hypertension in Barbados that might contribute to these deficiencies. Methods Five structured focus groups were conducted for randomly selected people with diabetes and hypertension. Results Twenty-one patients (5 diabetic, 5 hypertensive, and 11 with both diseases with a mean age of 59 years attended 5 focus group sessions. Patient factors that affected care included the difficulty in maintaining behaviour change. Practitioner factors included not considering the "whole person" and patient expectations, and not showing enough respect for patients. Health care system factors revolved around the amount of time spent accessing care because of long waiting times in public sector clinics and pharmacies. Society related barriers included the high cost and limited availability of appropriate food, the availability of exercise facilities, stigma of disease and difficulty taking time off work. Attendees were not familiar with guidelines for diabetes and hypertension management, but welcomed a patient version detailing a place to record results, the frequency of tests, and blood pressure and blood glucose targets. Appropriate education from practitioners during consultations, while waiting in clinic, through support and education groups, and for the general public through the schools, mass media and billboards were recommended. Conclusions Primary care providers should take a more patient centred approach to the care of those with diabetes and hypertension. The care system should provide better service by reducing waiting times. Patient self-management could be encouraged by a patient version of care guidelines and greater educational efforts.

Determination of radiolysis products in gamma-irradiated multilayer barrier food packaging films containing a middle layer of recycled LDPE

International Nuclear Information System (INIS)

Chytiri, Stavroula; Goulas, Antonios E.; Badeka, Anastasia; Riganakos, Kyriakos A.; Petridis, Dimitrios; Kontominas, Michael G.

2008-01-01

Volatile and non-volatile radiolysis products and sensory changes of five-layer food packaging films have been determined after gamma irradiation (5-60 kGy). Barrier films were based on polyamide (PA) and low-density polyethylene (LDPE). Each film contained a middle buried layer of recycled LDPE or 100% virgin LDPE (control samples). Data showed that a large number of radiolysis products were produced such as hydrocarbons, alcohols, carbonyl compounds, carboxylic acid. These compounds were detected in the food simulant after contact with all films even at the lower absorbed doses of 5 and 10 kGy. The type and concentration of radiolysis products increased progressively with radiation dose, while no new compounds were detected as a result of the presence of recycled LDPE. In addition, irradiation dose appears to influence the sensory properties of table water in contact with films

Functional Anatomy and Oncologic Barriers of the Larynx.

Science.gov (United States)

Mor, Niv; Blitzer, Andrew

2015-08-01

Laryngeal barriers to tumor spread are a product of laryngeal development, anatomic barriers, and enzymatic activity. Supraglottic and glottic/subglottic development is distinct and partially explains the metastatic behavior of laryngeal carcinoma. Dense connective tissues and elastic fibers provide anatomic barriers within the larynx. Laryngeal cartilage contains dense cartilage, enzyme inhibitors, and an intact perichondrium making it relatively resistant to tumor invasion; however, focal areas of vulnerability are created by ossified cartilage and natural interruptions in the perichondrium. Local inflammation and the enzymatic interplay between tumor and host are important factors in the spread of laryngeal tumor. Copyright © 2015 Elsevier Inc. All rights reserved.

Airway Epithelial Barrier Dysfunction in Chronic Obstructive Pulmonary Disease : Role of Cigarette Smoke Exposure

NARCIS (Netherlands)

Aghapour, Mahyar; Raee, Pourya; Moghaddam, Seyed Javad; Hiemstra, Pieter S.; Heijink, Irene H.

The epithelial lining of the airway forms the first barrier against environmental insults, such as inhaled cigarette smoke, which is the primary risk factor for the development of chronic obstructive pulmonary disease (COPD). The barrier is formed by airway epithelial junctions, which are

In vitro models of the blood-brain barrier

DEFF Research Database (Denmark)

Helms, Hans Christian Cederberg; Abbott, N Joan; Burek, Malgorzata

2016-01-01

The endothelial cells lining the brain capillaries separate the blood from the brain parenchyma. The endothelial monolayer of the brain capillaries serves both as a crucial interface for exchange of nutrients, gases, and metabolites between blood and brain, and as a barrier for neurotoxic...... components of plasma and xenobiotics. This "blood-brain barrier" function is a major hindrance for drug uptake into the brain parenchyma. Cell culture models, based on either primary cells or immortalized brain endothelial cell lines, have been developed, in order to facilitate in vitro studies of drug...... transport to the brain and studies of endothelial cell biology and pathophysiology. In this review, we aim to give an overview of established in vitro blood-brain barrier models with a focus on their validation regarding a set of well-established blood-brain barrier characteristics. As an ideal cell culture...

Physical Activity Promotion, Beliefs, and Barriers Among Australasian Oncology Nurses.

Science.gov (United States)

Keogh, Justin W L; Pühringer, Petra; Olsen, Alicia; Sargeant, Sally; Jones, Lynnette M; Climstein, Mike

2017-03-01

To describe the physical activity (PA) promotion practices, beliefs, and barriers of Australasian oncology nurses and gain preliminary insight into how PA promotion practices may be affected by the demographics of the nurses.
. Cross-sectional survey.
. Australia and New Zealand.
. 119 registered oncology nurses.
. Self-reported online survey completed once per participant.
. Questions assessed the PA promotion beliefs (e.g., primary healthcare professionals responsible for PA promotion, treatment stage), PA benefits (e.g., primary benefits, evidence base), and PA promotion barriers of oncology nurses.
. Oncology nurses believed they were the major providers of PA advice to their patients. They promoted PA prior to, during, and post-treatment. The three most commonly cited benefits of PA for their patients were improved quality of life, mental health, and activities of daily living. Lack of time, lack of adequate support structures, and risk to patient were the most common barriers to PA promotion. Relatively few significant differences in the oncology nurses' PA promotion practices, beliefs, and barriers were observed based on hospital location or years of experience.
. Despite numerous barriers, Australasian oncology nurses wish to promote PA to their patients with cancer across multiple treatment stages because they believe PA is beneficial for their patients.
. Hospitals may need to better support oncology nurses in promoting PA to their patients and provide better referral pathways to exercise physiologists and physiotherapists.

3. Workshop for IAEA ICSP on Integral PWR Design Natural Circulation Flow Stability and Thermo-hydraulic Coupling of Containment and Primary System during Accidents. Presentations

International Nuclear Information System (INIS)

2012-04-01

Most advanced nuclear power plant designs adopted several kinds of passive systems. Natural circulation is used as a key driving force for many passive systems and even for core heat removal during normal operation such as NuScale, CAREM, ESBWR and Indian AHWR designs. Simulation of natural circulation phenomena is very challenging since the driving force of it is weak compared to forced circulation and involves a coupling between primary system and containment for integral type reactor. The IAEA ICSP (International Collaborative Standard Problem) on 'Integral PWR Design Natural Circulation Flow Stability and Thermo-hydraulic Coupling of Containment and Primary System during Accidents' was proposed within the CRP on 'Natural Circulation Phenomena, Modelling, and Reliability of Passive Systems that utilize Natural Circulation'. Oregon State University (OSU) of USA offered to host this ICSP. This ICSP plans to conduct the following experiments and blind/open simulations with system codes: 1. Quasi-steady state operation with different core power levels: Conduct quasi-steady state operation with step-wise increase of core power level in order to observe single phase natural circulation flow according to power level. The experimental facility and operating conditions for an integral PWR will be used. 2. Thermo-hydraulic Coupling between Primary system and Containment: Conduct a loss of feedwater transient with subsequent ADS blowdown and long term cooling to determine the progression of a loss of feedwater transient by natural circulation through primary and containment systems. These tests would examine the blowdown phase as well as the long term cooling using sump natural circulation by coupling the primary to containment systems. This data could be used for the evaluation of system codes to determine if they model specific phenomena in an accurate manner. OSU completed planned two ICSP tests in July 2011 and real initial and boundary conditions measured from the

Project Guarantee 1985. Final repository for low- and intermediate-level radioactive wastes: The system of safety barriers

International Nuclear Information System (INIS)

Anon.

1985-01-01

The safety barrier system for the type B repository for low- and intermediate-level waste is described. The barrier parameters which are relevant for safety analysis are quantified and associated error limits and data scatter are given. The aim of the report is to give a summary documentation of the safety analysis input data and their scientific background. For secure containment of radioactive waste safety barriers are used which effectively limit the release of radioactive material from the repository (release barriers) and effectively retard the entry of the original radioactive material into the biosphere (time barriers). In the case of low- and intermediate-level waste the technical safety barrier system comprises: waste solidification matrix (cement, bitumen and resin), immobilisation of the waste packages in containers using liquid cement, concrete repository containers, backfilling of remaining vacant storage space with special concrete, concrete lining of the repository caverns, sealing of access tunnels on final closure of the repository. Natural geological safety barriers - host rock and overlying formations - have the following important functions. Because of its stability, the host rock in the repository zone protects the technical safety barrier system from destruction caused by climatic effects and erosion for a sufficient length of time. It also provides for low water flow and favourable chemistry (reducing conditions)

Barriers to Colorectal Cancer Screening in Primary Care Settings: Attitudes and Knowledge of Nurses and Physicians

Directory of Open Access Journals (Sweden)

Joshua Kanaabi Muliira

2016-01-01

Full Text Available Objective: Healthcare providers (HCPs play a critical role in reducing colorectal cancer (CRC related morbidity and mortality. This study aimed at exploring the attitudes and knowledge of nurses and physicians working in primary care settings regarding CRC screening. Methods: A total of 142 HCPs (57.7% nurses and 42.3% physicians participated in a cross-sectional survey. Data were collected using a Self-administered Questionnaire. The participants were clinically experienced (mean = 9.39 years; standard deviation [SD] = 6.13, regularly taking care of adults eligible for CRC screening (62% and had positive attitudes toward CRC screening (83.1%. Most participants (57% had low levels of knowledge about CRC screening (mean = 3.23; SD = 1.50. The participants were most knowledgeable about the recommended age for initiating screening (62.7% and the procedures not recommended for screening (90.8%. Results: More than 55% did not know the frequency of performing specific screening procedures, the upper age limit at which screening is not recommended, and the patients at high-risk for CRC. There were no significant differences between nurses′ and physicians′ attitudes and knowledge. The participants′ perceptions about professional training (odds ratio [OR] = 2.17, P = 0.003, colonoscopy (OR = 2.60, P = 0.014, and double-contrast barium enema (OR = 0.53, P = 0.041, were significantly associated with knowledge about CRC screening. Conclusions: The inadequate knowledge levels among nurses and physicians may be one of the barriers affecting CRC screening. Enhancing HCPs knowledge about CRC screening should be considered a primary intervention in the efforts to promote CRC screening and prevention.

Barriers to Mammography Screening: How to Overcome Them

Directory of Open Access Journals (Sweden)

Yasmin Hassoun

2015-10-01

Full Text Available Background: Screening mammography is an established intervention that leads to early breast cancer detection and reduced mortality. The Lebanese Ministry of Health has initiated yearly awareness campaigns and provided free mammography in multiple centers around the country. Methods: The study took place in two major areas of Lebanon - Beirut and South Lebanon. This cross-sectional survey aimed to assess knowledge about breast cancer screening and screening behaviors in the Lebanese population. The primary outcome of the study was to assess the reasons that prevented women from performing screening mammography based on our categories of questions: lack of knowledge about breast cancer, lack of access to screening facilities, failure of primary care physician to encourage screening behavior, and other reasons. Results: The major barriers to seek screening that had statistically significant P-values, in order of prevalence, included: lack of knowledge about breast cancer, followed by social reasons and lack of access. Conclusion: Given the prevalence of breast cancer in our population, it is important to understand the pitfalls that we experience in promoting awareness. Our study is the first study to reach out to the community to assess perceived barriers against screening and provide solutions for such barriers.

Study on vibration behaviors of engineered barrier system

International Nuclear Information System (INIS)

Mikoshiba, Tadashi; Ogawa, Nobuyuki; Minowa, Chikahiro

1998-01-01

High-level radioactive wastes have been buried underground by packing into a strong sealed container made from carbon steel (over-pack) with buffer material (bentonite). The engineered barrier system constructed with an overpack and buffer materials must be resistant to earthquakes as well as invasion of groundwater for a long period. Therefore, seismic evaluation of barrier system for earthquakes is indispensable especially in Japan to keep its structural safety. Here, the effects of earthquake vibration on the engineered barrier systems were investigated experimentally. Random-wave vibration and practical seismic wave one were loaded for the systems and fundamental data were obtained. For the former vibration the response characteristics of both engineered barrier models constructed with overpack and bentonite were non-linear. For the latter one, the stress in bentonite was increased in proportion to the vibration level. (M.N.)

Perturbation of baseline thermal stress in the Mound 9516 Shipping Package primary containment vessel

International Nuclear Information System (INIS)

Sansalone, K.H.F.

1995-01-01

Full-capacity loading of heat sources into the Mound 9516 Shipping Package primary containment vessel (PCV) results in temperature gradients which are symmetric, due to the axisymmetry of the package design. Concern over the change in thermal gradients (and therefore, stress) in the PCV due to sub-capacity loading led to the analytical examination of this phenomenon. The PCVs are cylindrical in shape and are loaded into the package such that they and all containment components are concentrically arranged along a common longitudinal axis. If the design full-capacity loading of the PCVs in this package assumes the axisymmetric (or more precisely, cyclicly symmetric) arrangement of its heat-producing contents, then sub-capacity loading implies that in many cases, the load arrangement could be asymmetric with respect to the longitudinal axis. It is then feasible that the departure from heat load axisymmetry could perturb the nominal thermal gradients so that thermally-induced stress within the PCV might increase to levels deemed unacceptable. This study applies Finite Element analysis (FEA) to the problem and demonstrates that no such unacceptable thermal stress increase occurs in the PCV material due to the asymmetric arrangement of contents. copyright 1995 American Institute of Physics

Strain-dependent augmentation of tight-junction barrier function in human primary epidermal keratinocytes by Lactobacillus and Bifidobacterium lysates.

Science.gov (United States)

Sultana, Reshma; McBain, Andrew J; O'Neill, Catherine A

2013-08-01

In this study, we investigated whether probiotic lysates can modify the tight-junction function of human primary keratinocytes. The keratinocytes were grown on cell culture inserts and treated with lysates from Bifidobacterium longum, Lactobacillus plantarum, Lactobacillus reuteri, Lactobacillus fermentum, or Lactobacillus rhamnosus GG. With the exception of L. fermentum (which decreased cell viability), all strains markedly enhanced tight-junction barrier function within 24 h, as assessed by measurements of transepithelial electrical resistance (TEER). However, B. longum and L. rhamnosus GG were the most efficacious, producing dose-dependent increases in resistance that were maintained for 4 days. These increases in TEER correlated with elevated expression of tight-junction protein components. Neutralization of Toll-like receptor 2 abolished both the increase in TEER and expression of tight-junction proteins induced by B. longum, but not L. rhamnosus GG. These data suggest that some bacterial strains increase tight-junction function via modulation of protein components but the different pathways involved may vary depending on the bacterial strain.

Deconstructing barriers: perceptions of students labeled with learning disabilities in higher education.

Science.gov (United States)

Denhart, Hazel

2008-01-01

This phenomenological study investigated barriers to higher education faced by 11 college students labeled with learning disabilities (LD) using their voice as the primary data. Data were analyzed and interpreted through a disability theory perspective revealing barriers stemmed largely from external social causes rather than individual pathology. Barriers included being misunderstood by faculty, being reluctant to request accommodations for fear of invoking stigma, and having to work considerably longer hours than nonlabeled peers. Findings indicated barriers could be overcome through raising faculty awareness about LD issues, engaging the assistance of the college LD specialist, and participation in a LD democratic empowerment community on campus.

Natural analogues for containment-providing barriers for a HLW repository in salt

Energy Technology Data Exchange (ETDEWEB)

Wolf, J.; Noseck, U.

2015-06-15

In 2005, a German research project was started to develop a novel approach to prove safety for a HLW repository in a salt formation, to refine the safety concept, to identify open scientific issues and to define necessary R&D work. This project aimed at identifying the key information for a HLW repository in salt. One important question is how this information may be best fulfilled by natural analogue studies. This question is answered by starting a review of the required key information needs of the safety case (post-closure phase) in order to assess whether or not these requirements can be supported by natural analogues information. In order to structure the review and to address the key elements of the safety concepts, three types of natural analogues are distinguished: (i) natural analogues for the integrity of the geological barrier, (ii) natural analogues for the integrity of the geotechnical barriers and (iii) natural analogues for release scenarios. For the safety case in salt type (i) and (ii) are of highest importance and are treated in this paper. The assessment documented in this paper on the one hand indicates the high potential benefit of natural analogues for a safety case in salt and on the other hand helps to focus the available human and financial resources for the safety case on the most safety-relevant aspects. (authors)

Attitudinal Barriers to Analgesic Use among Patients with Substance Use Disorders

Directory of Open Access Journals (Sweden)

Leah Zallman

2012-01-01

Full Text Available Attitudinal barriers towards analgesic use among primary care patients with chronic pain and substance use disorders (SUDs are not well understood. We evaluated the prevalence of moderate to significant attitudinal barriers to analgesic use among 597 primary care patients with chronic pain and current analgesic use with 3 subscales from the Barriers Questionaire II: concern about side effects, fear of addiction, and worry about reporting pain to physicians. Concern about side effects was a greater barrier for those with opioid use disorders (OUDs and non-opioid SUDs than for those with no SUD (OR (95% CI: 2.30 (1.44–3.68, P<0.001 and 1.64 (1.02–2.65, P=0.041, resp.. Fear of addiction was a greater barrier for those with OUDs as compared to those with non-opioid SUDs (OR (95% CI: 2.12 (1.04–4.30, P=0.038 and no SUD (OR (95% CI: 2.69 (1.44–5.03, P=0.002. Conversely, participants with non-opioid SUDs reported lower levels of worry about reporting pain to physicians than those with no SUD (OR (95% CI: 0.43 (0.24–0.76, P=0.004. Participants with OUDs reported higher levels of worry about reporting pain than those with non-opioid SUDs (OR (95% CI: 1.91 (1.01–3.60, P=0.045. Concerns about side effects and fear of addiction can be barriers to analgesic use, moreso for people with SUDs and OUDs.

Primary care providers' experiences caring for complex patients in primary care: a qualitative study.

Science.gov (United States)

Loeb, Danielle F; Bayliss, Elizabeth A; Candrian, Carey; deGruy, Frank V; Binswanger, Ingrid A

2016-03-22

Complex patients are increasingly common in primary care and often have poor clinical outcomes. Healthcare system barriers to effective care for complex patients have been previously described, but less is known about the potential impact and meaning of caring for complex patients on a daily basis for primary care providers (PCPs). Our objective was to describe PCPs' experiences providing care for complex patients, including their experiences of health system barriers and facilitators and their strategies to enhance provision of effective care. Using a general inductive approach, our qualitative research study was guided by an interpretive epistemology, or way of knowing. Our method for understanding included semi-structured in-depth interviews with internal medicine PCPs from two university-based and three community health clinics. We developed an interview guide, which included questions on PCPs' experiences, perceived system barriers and facilitators, and strategies to improve their ability to effectively treat complex patients. To focus interviews on real cases, providers were asked to bring de-identified clinical notes from patients they considered complex to the interview. Interview transcripts were coded and analyzed to develop categories from the raw data, which were then conceptualized into broad themes after team-based discussion. PCPs (N = 15) described complex patients with multidimensional needs, such as socio-economic, medical, and mental health. A vision of optimal care emerged from the data, which included coordinating care, preventing hospitalizations, and developing patient trust. PCPs relied on professional values and individual care strategies to overcome local and system barriers. Team based approaches were endorsed to improve the management of complex patients. Given the barriers to effective care described by PCPs, individual PCP efforts alone are unlikely to meet the needs of complex patients. To fulfill PCP's expressed concepts of

Investigation of anodizing parameter effect on barrier layer of anodic zirconium oxide

International Nuclear Information System (INIS)

Kharchenko, Eh.P.

1979-01-01

Effect of fluoride concentration and forming direction upon kinetics of barrier layer transformations in the process of preparation of phase anodic zirconium oxide in acid fluorine-containing solutions is considered. Suppositions are made on the mechanism of barrier layer transformation under the effect of the parameters mentioned. The thickness of the barrier layer is determined by two methods and it is shown that coefficient of the layer thickess growth at the voltage increase by 1 V is much lower than during formation of the barrier films in non-agressive electrolytes

Homogeneous Reactor Experiment (HRE) Pond cryogenic barrier technology demonstration: Pre-barrier subsurface hydrology and contaminant transport investigation

International Nuclear Information System (INIS)

Moline, G.R.

1998-03-01

The Homogeneous Reactor Experiment (HRE) Pond is the site of a former impoundment for radioactive wastes that has since been drained, filled with soil, and covered with an asphalt cap. The site is bordered to the east and south by a tributary that empties into Melton Branch Creek and that contains significant concentrations of radioactive contaminants, primarily 90 Sr. Because of the proximity of the tributary to the HRE disposal site and the probable flow of groundwater from the site to the tributary, it is hypothesized that the HRE Pond is a source of contamination to he creek. As a means for temporary containment of contaminants within the impoundment, a cryogenic barrier technology demonstration was initiated in FY96 with a background hydrologic investigation that continued through FY97. Cryogenic equipment installation was completed in FY97, and freezing was initiated in September of 1997. This report documents the results of a hydrologic and geologic investigation of the HRE Pond/cryogenic barrier site. The purpose of this investigation is to evaluate the hydrologic conditions within and around the impoundment in order to meet the following objectives: (1) to provide a pre-barrier subsurface hydrologic baseline for post-barrier performance assessment; (2) to confirm that the impoundment is hydraulically connected to the surrounding sediments; and (3) to determine the likely contaminant exit pathways from the impoundment. The methods of investigation included water level and temperature monitoring in a network of wells and standpipes in and surrounding the impoundment, a helium tracer test conducted under ambient flow conditions, and geologic logging during the drilling of boreholes for installation of cryogenic probes and temperature monitoring wells

Generation of primary cultures of bovine brain endothelial cells and setup of cocultures with rat astrocytes

DEFF Research Database (Denmark)

Helms, Hans C; Brodin, Birger

2014-01-01

-brain barrier. The present protocol describes the setup of an in vitro coculture model based on primary cultures of endothelial cells from bovine brain microvessels and primary cultures of rat astrocytes. The model displays a high electrical tightness and expresses blood-brain barrier marker proteins....

Barriers to Distance Education in Rural Schools

Science.gov (United States)

Irvin, Matthew J.; Hannum, Wallace H.; Varre, Claire de la; Farmer, Thomas W.

2010-01-01

The primary purpose of the current study was to examine barriers to the use of distance education and explore related factors in small and low-income rural schools. Data were collected via a telephone survey with administrators or other qualified personnel. The sample involved 417 randomly selected small and low-income rural school districts…

INCOME AND PRICE AS A BARRIER TO ORGANIC FOOD CHOICE

OpenAIRE

Aschemann-Witzel, Jessica; Zielke, Stephan; Thøgersen, John

2014-01-01

From the barriers said to potentially hamper the further development of the sector, the consumer demand side and herein the high prices are handled as crucial. We reviewed the literature since 2000 regarding the role of perceived price and income. We find that self-report based studies nearly unequivocally find price is the primary barrier to choice, deviations from this appear to occur when researching organic consumers and developed organic markets. There are mixed findings regarding income...

HRE-Pond Cryogenic Barrier Technology Demonstration: Pre- and Post-Barrier Hydrologic Assessment

International Nuclear Information System (INIS)

Moline, G.R.

1999-01-01

The Homogeneous Reactor Experiment (HRE) Pond is the site of a former impoundment for radioactive wastes on the Oak Ridge Reservation (ORR) in east Tennessee. The pond received radioactive wastes from 1957 to 1962, and was subsequently drained, filled with soil, and covered with an asphalt cap. The site is bordered to the east and south by an unnamed stream that contains significant concentrations of radioactive contaminants, primarily 90 Sr. Because of the proximity of the stream to the HRE disposal site and the probable flow of groundwater from the site to the stream, it was hypothesized that the HRE Pond has been a source of contamination to the creek. The HRE-Pond was chosen as the site of a cryogenic barrier demonstration to evaluate this technology as a means for rapid, temporary isolation of contaminants in the type of subsurface environment that exists on the ORR. The cryogenic barrier is created by the circulation of liquid CO 2 through a system of thermoprobes installed in boreholes which are backfilled with sand. The probes cool the subsurface, creating a vertical ice wall by freezing adjacent groundwater, effectively surrounding the pond on four sides. The purpose of this investigation was to evaluate the hydrologic conditions within and around the pond prior to, during, and after the cryogenic barrier emplacement. The objectives were (1) to provide a hydrologic baseline for post-banner performance assessment, (2) to confirm that the pond is hydraulically connected to the surrounding sediments, (3) to determine the likely contaminant exit pathways from the pond, and (4) to measure changes in hydrologic conditions after barrier emplacement in order to assess the barrier performance. Because relatively little information about the subsurface hydrology and the actual configuration of the pond existed, data from multiple sources was required to reconstruct this complex system

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

Science.gov (United States)

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

2011-08-01

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

Barriers to medication adherence for the secondary prevention of stroke: a qualitative interview study in primary care.

Science.gov (United States)

Jamison, James; Graffy, Jonathan; Mullis, Ricky; Mant, Jonathan; Sutton, Stephen

2016-08-01

Medications are highly effective at reducing risk of recurrent stroke, but success is influenced by adherence to treatment. Among survivors of stroke and transient ischaemic attack (TIA), adherence to medication is known to be suboptimal. To identify and report barriers to medication adherence for the secondary prevention of stroke/TIA. A qualitative interview study was conducted within general practice surgeries in the East of England, UK. Patients were approached by letter and invited to take part in a qualitative research study. Semi-structured interviews were undertaken with survivors of stroke, caregivers, and GPs to explore their perspectives and views around secondary prevention and perceived barriers to medication adherence. Key themes were identified using a grounded theory approach. Verbatim quotes describing the themes are presented here. In total, 28 survivors of stroke, including 14 accompanying caregivers and five GPs, were interviewed. Two key themes were identified. Patient level barriers included ability to self-care, the importance people attach to a stroke event, and knowledge of stroke and medication. Medication level barriers included beliefs about medication and beliefs about how pills work, medication routines, changing medications, and regimen complexity and burden of treatment. Patients who have had a stroke are faced with multiple barriers to taking secondary prevention medications in UK general practice. This research suggests that a collaborative approach between caregivers, survivors, and healthcare professionals is needed to address these barriers and facilitate medication-taking behaviour. © British Journal of General Practice 2016.

Information barriers

International Nuclear Information System (INIS)

Fuller, J.L.; Wolford, J.

2001-01-01

Full text: An information barrier (IB) consists of procedures and technology that prevent the release of sensitive information during a joint inspection of a sensitive nuclear item, and provides confidence that the measurement system into which it has been integrated functions exactly as designed and constructed. Work in the U.S. on radiation detection system information barriers dates back at least to 1990, even though the terminology is more recent. In January 1999 the Joint DoD-DOE Information Barrier Working Group was formed in the United States to help coordinate technical efforts related to information barrier R and D. This paper presents an overview of the efforts of this group, by its Chairs, as well as recommendations for further information barrier R and D. Progress on the demonstration of monitoring systems containing IBs is also provided. From the U.S. perspective, the basic, top-level functional requirements for the information barrier portion of an integrated radiation signature-information barrier inspection system are twofold: The host must be assured that his classified information is protected from disclosure to the inspecting party; and The inspecting party must be confident that the integrated inspection system measures, processes, and presents the radiation-signature-based measurement conclusion in an accurate and reproducible manner. It is the position of the United States that in the absence of any agreement to share classified nuclear weapons design information in the conduct of an inspection regime, the requirement to protect host country classified warhead design information is paramount and admits no tradeoff versus the confidence provided to the inspecting party in the accuracy and reproducibility of the measurements. The U.S. has reached an internal consensus on several critical design elements that define a general standard for radiation signature information barrier design. These criteria have stood the test of time under intense

Disposal/storage container development experience

International Nuclear Information System (INIS)

Morrow, R.W. Jr.; Van Hoesen, S.D.; Fowler, E.; Barreira, D.G.; Emmett, R.W.

1988-01-01

Developmental work is currently underway at the Oak Ridge National Laboratory to design and manufacture a radioactive waste container suitable for both storage and disposal of radioactive wastes. The container is designed to fulfill the Department of Energy and Nuclear Regulatory Commission requirements for on-site storage, as well as the Nuclear Regulatory Commission's requirements for high integrity containers. The project also involves meeting the strict design and manufacturing ANSI/ASME NQA-1 guidelines. Special provisions of the container include a double containment system, with the inner barrier being corrosion resistant, the capability to monitor the internal cavity of the container, and off-gas venting capability. Further, yet related developmental work includes evaluating the cask for other varied uses, such as a processing cask, an ALARA shield, and even the possibility of Department of Transportation approval for an over-the-road transport cask

A composite vacuum barrier for the LHC short straight section

International Nuclear Information System (INIS)

Jenny, B.; Rohmig, P.; Uriarte, J.M.

1996-01-01

The lattice of the CERN Large Hadron Collider (LHC) will contain 384 Short Straight Section (SSS) units, one in every 53 m half-cell. The SSS is composed of a twin aperture high-field superconducting quadrupole and of two combined-function corrector magnets operating in pressurized helium at 1.9 K. The SSS cryostat contains also a barrier for sectorisation of the insulation vacuum. The vacuum barrier is mounted between the helium vessel and the vacuum enclosure. Its functions are to limit the extent of eventual helium leaks and to facilitate the leak detection and the pumping-down from atmospheric pressure. During installation of the LHC, the vacuum barrier permits independent testing of the half-cells, thus enabling higher installation rates. In parallel to a conventional barrier made out of austenitic stainless steel, a barrier of composite material was developed, taking advantage of the lower thermal conductivity of glass fibre reinforced epoxy resin, and with the aim of reducing costs for LHC. The thermo-mechanical design together with the conception and the moulding techniques used for the manufacture of the prototype are described. Bonding techniques for the leak tight stainless steel composite interfaces are presented and test results shown. Results on the mechanical performance and on the helium tests carried out on the prototype are given

Barriers to Implementation of Primary Percutaneous Coronary Intervention in Europe

DEFF Research Database (Denmark)

Laut, Kristina Grønborg; Pedersen, Alma Becic; Lash, Timothy

2011-01-01

Primary percutaneous coronary intervention (PPCI) is the recommended treatment for patients with acute ST-segment elevation myocardial infarction (STEMI). Despite substantial evidence of its effectiveness, only 40–45% of European STEMI patients are currently treated with PPCI and there are large ...... is needed. Keywords Primary percutaneous coronary intervention, acute ST-elevation myocardial infarction, implementation, practice variation, registry data......Primary percutaneous coronary intervention (PPCI) is the recommended treatment for patients with acute ST-segment elevation myocardial infarction (STEMI). Despite substantial evidence of its effectiveness, only 40–45% of European STEMI patients are currently treated with PPCI and there are large...... the diffusion of PPCI in Europe. The lack of complete implementation and large national and regional differences arise from the interplay between technology, patients, policy makers, culture and resources. Explanations for the variation in treatment access still remain a puzzle and access to valid data...

Determinants of physical activity in primary school students using the health belief model

Directory of Open Access Journals (Sweden)

Ar-yuwat S

2013-03-01

Full Text Available Sireewat Ar-yuwat,1,2 Mary Jo Clark,2 Anita Hunter,3 Kathy S James2 1Boromarajonani College of Nursing Nakhon Lampang (BCNLP, Lampang, Thailand; 2Hahn School of Nursing and Health Science, University of San Diego, San Diego, CA, 3Department of Nursing, Dominican University of California, San Rafael, CA, USA Background: Thailand is a middle-income country in which two-thirds of children demonstrate an insufficient level of physical activity. Physical inactivity is a major risk factor for obesity and many other health-related consequences in children. Thus, it is important to understand how primary school children perceive things in their daily life as determinants of physical activity. The purpose of this study was to investigate the impact of cues, perceived benefits, and perceived barriers on the level of physical activity among primary school students. Methods: A cross-sectional study was conducted in Phitsanulok Province, Thailand, in 2011. Multistage sampling selected a total of 123 primary school students. The Physical Activity Questionnaire for Older Children and the Cues, Perceived Benefits, and Barriers to Physical Activity Questionnaire were used to assess the student levels of physical activity, as well as the perceived benefits, barriers, and cues to action. The association between these factors and the level of physical activity was determined by correlation statistics and confirmed by robust regression. Multivariate analysis of variance compared health belief model determinants: perceived benefits, perceived barriers, and cues to action on physical activity between male and female students. Self-administered questionnaires were validated and tested in a pilot study. Results: The level of activity among primary school children was significantly influenced by perceived barriers, such as fear of strangers when playing outdoors, bad weather, and too much homework. However, activity was not influenced by cues to action or perceived

Groundwater protection from cadmium contamination by permeable reactive barriers

Energy Technology Data Exchange (ETDEWEB)

Di Natale, F. [Dipartimento di Ingegneria chimica, Universita di Federico II, P.le Tecchio, 80-80125 Naples (Italy)], E-mail: fdinatal@unina.it; Di Natale, M.; Greco, R. [Centro Interdipartimentale di Ricerca in Ingegneria Ambientale (CIRIAM), Dipartimento di Ingegneria Civile, Seconda Universita di Napoli, via Roma 29-81031 Aversa (Caserta) (Italy); Lancia, A. [Dipartimento di Ingegneria chimica, Universita di Federico II, P.le Tecchio, 80-80125 Naples (Italy); Laudante, C.; Musmarra, D. [Centro Interdipartimentale di Ricerca in Ingegneria Ambientale (CIRIAM), Dipartimento di Ingegneria Civile, Seconda Universita di Napoli, via Roma 29-81031 Aversa (Caserta) (Italy)

2008-12-30

This work studies the reliability of an activated carbon permeable reactive barrier in removing cadmium from a contaminated shallow aquifer. Laboratory tests have been performed to characterize the equilibrium and kinetic adsorption properties of the activated carbon in cadmium-containing aqueous solutions. A 2D numerical model has been used to describe pollutant transport within a groundwater and the pollutant adsorption on the permeable adsorbing barrier (PRB). In particular, it has been considered the case of a permeable adsorbing barrier (PAB) used to protect a river from a Cd(II) contaminated groundwater. Numerical results show that the PAB can achieve a long-term efficiency by preventing river pollution for several months.

SURFACE-ALTERED ZEOLITES AS PERMEABLE BARRIERS FOR IN SITU TREATMENT OF CONTAMINATED GROUNDWATER

International Nuclear Information System (INIS)

Bowman, Robert S.; Li, Zhaohui; Roy, Stephen J.; Burt, Todd; Johnson, Timothy L.; Johnson, Richard L.

1999-01-01

The overall objective of this effort is to develop and test a zeolite-based permeable barrier system for containing and remediating contaminated groundwater. The projected product is an engineered and tested permeable barrier system that can be adopted by the commercial sector

SURFACE-ALTERED ZEOLITES AS PERMEABLE BARRIERS FOR IN SITU TREATMENT OF CONTAMINATED GROUNDWATER

Energy Technology Data Exchange (ETDEWEB)

Robert S. Bowman; Zhaohui Li; Stephen J. Roy; Todd Burt; Timothy L. Johnson; Richard L. Johnson

1999-08-30

The overall objective of this effort is to develop and test a zeolite-based permeable barrier system for containing and remediating contaminated groundwater. The projected product is an engineered and tested permeable barrier system that can be adopted by the commercial sector.

Impact of changed fuel performances on safety barrier effectiveness at normal operation of NPP with WWER

International Nuclear Information System (INIS)

Zhurbenko, A. V.; Semchenkov, Y. M.; Slavyagin, P.D.

2007-01-01

The paper presents the analysis of adopted safety barriers against propagation of fission product released from WWER core of active power plants. Relationship between system and equipment performances and safety barriers is demonstrated. The fundamental principles of methodological approach to the operational limit determination based on the assessment of iodine-131 specific activity in the primary circuit are discussed. Problems of substantiating the operational limit for primary coolant activity are analyzed for conditions of growing burnup (Authors)

Accessibility and use of primary healthcare for immigrants living in the Niagara Region.

Science.gov (United States)

Lum, Irene D; Swartz, Rebecca H; Kwan, Matthew Y W

2016-05-01

Although the challenges of accessing and using primary healthcare for new immigrants to Canada have been fairly well documented, the focus has primarily been on large cities with significant immigrant populations. The experiences of immigrants living in smaller, less diverse urban centres remain largely unknown. The purpose of this study was to examine the lived experiences of immigrants living in a small urban centre with regards to the primary healthcare system. A total of 13 immigrants living in the Greater Niagara Region participated in semi-structured interviews. All interviews were recorded, transcribed, and then coded and analyzed for emergent themes using NVivo. Five factors were found to impact primary care access and use: lack of social contacts, lack of universal healthcare coverage during their initial arrival, language as a barrier, treatment preferences, and geographic distance to primary care. Overall findings suggest that immigrants moving to smaller areas such as the Niagara Region face similar barriers to primary care as those moving into large cities. Some barriers, however, appear to be specific to the context of smaller urban centres, further exacerbated by living in a small city due to a smaller immigrant population, fewer services for immigrants, and less diversity in practicing physicians. More research is required to understand the contextual factors inhibiting primary care access and use among immigrants moving to smaller urban centres, and determine effective strategies to overcome these barriers. Copyright © 2016 Elsevier Ltd. All rights reserved.

Modeling the long-term durability of concrete barriers in the context of low-activity waste storage

Directory of Open Access Journals (Sweden)

Samson E.

2013-07-01

Full Text Available The paper investigates the long-term durability of concrete barriers in contact with a cementitious wasteform designed to immobilize low-activity nuclear waste. The high-pH pore solution of the wasteform contains high concentration level of sulfate, nitrate, nitrite and alkalis. The multilayer concrete/wasteform system was modeled using a multiionic reactive transport model accounting for coupling between species, dissolution/ precipitation reactions, and feedback effect. One of the primary objectives was to investigate the risk associated with the presence of sulfate in the wasteform on the durability of concrete. Simulation results showed that formation of expansive phases, such as gypsum and ettringite, into the concrete barrier was not extensive. Based on those results, it was not possible to conclude that concrete would be severely damaged, even after 5,000 years. Lab work was performed to provide data to validate the modeling results. Paste samples were immersed in sulfate contact solutions and analyzed to measure the impact of the aggressive environment on the material. The results obtained so far tend to confirm the numerical simulations.

Reclamation of mercury from primary cell waste and from other mercury-containing residue. Rueckgewinnung von Quecksilber aus Primaerzellenschrott und anderen quecksilberhaltigen Rueckstaenden

Energy Technology Data Exchange (ETDEWEB)

Frankenbach, P P

1984-09-01

In the course of carrying out this R+D project, the Elwenn + Frankenbach firm developed a practicable and economical method for reclaiming mercury from primary cell waste. Methods for processing mercury-containing organic materials were examined, but led to no practicable solution. Workable procedures for processing mercury-containing, sulphur-laden activated carbon were found. The distillation facility was further developed and reconstructed, resulting in increased safety in operation, improved industrial safety, and reduced emission.

Progress in forming bottom barriers under waste sites

International Nuclear Information System (INIS)

Carter, E.E.

1997-01-01

The paper describes an new method for the construction, verification, and maintenance of underground vaults to isolate and contain radioactive burial sites without excavation or drilling in contaminated areas. The paper begins with a discussion of previous full-scale field tests of horizontal barrier tools which utilized high pressure jetting technology. This is followed by a discussion of the TECT process, which cuts with an abrasive cable instead of high pressure jets. The new method is potentially applicable to more soil types than previous methods and can form very thick barriers. Both processes are performed from the perimeter of a site and require no penetration or disturbance of the active waste area. The paper also describes long-term verification methods to monitor barrier integrity passively

Field Soil Water Retention of the Prototype Hanford Barrier and Its Variability with Space and Time

Energy Technology Data Exchange (ETDEWEB)

Zhang, Z. F.

2015-08-14

Engineered surface barriers are used to isolate underlying contaminants from water, plants, animals, and humans. To understand the flow processes within a barrier and the barrier’s ability to store and release water, the field hydraulic properties of the barrier need to be known. In situ measurement of soil hydraulic properties and their variation over time is challenging because most measurement methods are destructive. A multiyear test of the Prototype Hanford Barrier (PHB) has yielded in situ soil water content and pressure data for a nine-year period. The upper 2 m layer of the PHB is a silt loam. Within this layer, water content and water pressure were monitored at multiple depths at 12 water balance stations using a neutron probe and heat dissipation units. Valid monitoring data from 1995 to 2003 for 4 depths at 12 monitoring stations were used to determine the field water retention of the silt loam layer. The data covered a wide range of wetness, from near saturation to the permanent wilt point, and each retention curve contained 51 to 96 data points. The data were described well with the commonly used van Genuchten water retention model. It was found that the spatial variation of the saturated and residual water content and the pore size distribution parameter were relatively small, while that of the van Genuchten alpha was relatively large. The effects of spatial variability of the retention properties appeared to be larger than the combined effects of added 15% w/w pea gravel and plant roots on the properties. Neither of the primary hydrological processes nor time had a detectible effect on the water retention of the silt loam barrier.

Fission products distributions in Candu primary heat transport and Candu containment systems during a severe accident

International Nuclear Information System (INIS)

Constantin, Marin; Rizoiu, Andrei

2005-01-01

The paper is intended to analyse the distribution of the fission products (FPs) in CANDU Primary Heat Transport (PHT) and CANDU Containment Systems by using the ASTEC code (Accident Source Term Evaluation Code). The complexity of the data required by ASTEC and the complexity both of CANDU PHT and Containment System were strong motivations to begin with a simplified geometry in order to avoid the introducing of unmanageable errors at the level of input deck. Thus only 1/4 of the PHT circuit was simulated and a simplified FPs inventory, some simplifications in the feeders geometry and containment were used. The circuit consists of 95 horizontal fuel channels connected to 95 horizontal out-feeders, then through vertical feeders to the outlet-header (a big pipe that collects the water from feeders); the circuit continues from the outlet-header with a riser and then with the steam generator and a pump. After this pump, the circuit was broken; in this point the FPs are transferred to the containment. The containment model consists of 4 rooms connected between by 6 links. The data related to the nodes' definitions, temperatures and pressure conditions were chosen as possible as real data from CANDU NPP loss of coolant accident sequence. Temperature and pressure conditions in the time of the accident were calculated by the CATHENA code and the source term of FPs introduced into the PHT was estimated by the ORIGEN code. The FPs distribution in the nodes of the circuit and the FPs mass transfer per isotope and chemical species are obtained by using SOPHAEROS module of ASTEC code. The distributions into the containment are obtained by the CPA module of ASTEC code (thermalhydraulics calculations in the containment and FPs aerosol transport). The results consist of mass distributions in the nodes of the circuit and the transferred mass to the containment through the break for different species (FPs and chemical species) and mass distributions in the different parts and

Barriers and Misperceptions Limiting Widespread Use of Intrauterine Contraception Among Canadian Women.

Science.gov (United States)

Hauck, Brian; Costescu, Dustin

2015-07-01

Unintended pregnancy is a major social and public health problem with adverse effects on neonatal and developmental outcomes, as well as maternal health and wellbeing. Traditionally, family planning policies have focused on increasing contraceptive uptake in non-users; however, rates of non-use are low in many developed nations. A high proportion of unintended pregnancies are attributable to contraceptive failure, particularly when using barrier and short-acting hormonal contraceptives. Intrauterine contraceptive devices (IUCDs) are highly effective and have been shown to reduce unintended pregnancy rates. Despite this, global utilization rates are low, and IUCD uptake in Canada has been particularly low. In this review we explore why IUCDs are not more widely used, and specifically focus on barriers and misperceptions that may influence IUCD uptake, particularly in Canada. We reviewed relevant articles published in English between 1990 and 2014, through searches of PubMed and Medline, including primary studies of any design containing information on the knowledge and attitudes of health care providers and women. Providing education to care providers, women, and policy makers may help overcome misperceptions about the use of IUCDs, and may facilitate greater use. Increased support from federal and provincial health programs may also encourage the use of IUCDs in Canadian women, and help to reduce unintended pregnancy rates.

Photocured epoxy/graphene nanocomposites with enhanced water vapor barrier properties

Science.gov (United States)

Periolatto, M.; Sangermano, M.; Spena, P. Russo

2016-05-01

A transparent, water vapor barrier film made of an epoxy resin and graphene oxide (GO) was synthesized by photopolymerization process. The epoxy/GO film with just 0.05 wt% GO gives a 93% WVTR reduction with respect to the pristine polymer, reaching barrier properties better than other polymer composites containing higher amounts of graphene. The excellent water vapor barrier is attributed to the good dispersion of GO in the polymer matrix. Moreover, GO significantly enhances the toughness and the damping capacity of the epoxy resins. The hybrid film can have potential applications in anticorrosive coatings, electronic devices, pharmaceuticals and food packaging.

Photocured epoxy/graphene nanocomposites with enhanced water vapor barrier properties

Energy Technology Data Exchange (ETDEWEB)

Periolatto, M.; Spena, P. Russo [Faculty of Science and Technology, Free University of Bozen-Bolzano, Piazza Università 5, Bolzano (Italy); Sangermano, M. [Dipartimento di Scienza Applicata e Tecnologia, Politecnico di Torino, C.so Duca degli Abruzzi 24, Torino (Italy)

2016-05-18

A transparent, water vapor barrier film made of an epoxy resin and graphene oxide (GO) was synthesized by photopolymerization process. The epoxy/GO film with just 0.05 wt% GO gives a 93% WVTR reduction with respect to the pristine polymer, reaching barrier properties better than other polymer composites containing higher amounts of graphene. The excellent water vapor barrier is attributed to the good dispersion of GO in the polymer matrix. Moreover, GO significantly enhances the toughness and the damping capacity of the epoxy resins. The hybrid film can have potential applications in anticorrosive coatings, electronic devices, pharmaceuticals and food packaging.

Photocured epoxy/graphene nanocomposites with enhanced water vapor barrier properties

International Nuclear Information System (INIS)

Periolatto, M.; Spena, P. Russo; Sangermano, M.

2016-01-01

A transparent, water vapor barrier film made of an epoxy resin and graphene oxide (GO) was synthesized by photopolymerization process. The epoxy/GO film with just 0.05 wt% GO gives a 93% WVTR reduction with respect to the pristine polymer, reaching barrier properties better than other polymer composites containing higher amounts of graphene. The excellent water vapor barrier is attributed to the good dispersion of GO in the polymer matrix. Moreover, GO significantly enhances the toughness and the damping capacity of the epoxy resins. The hybrid film can have potential applications in anticorrosive coatings, electronic devices, pharmaceuticals and food packaging.

Barriers to initiating antiretroviral therapy during pregnancy: a ...

African Journals Online (AJOL)

In this qualitative study, 28 HIV-positive pregnant or postpartum women, who either had initiated ART or were eligible for ART, and 21 service providers were interviewed in Cape Town, South Africa, to investigate these barriers. Prevention of vertical transmission of HIV was often the primary motivation for starting treatment.

Reliability and Validity of a Treatment Barriers Scale for Individuals With Alcohol Use Disorder.

Science.gov (United States)

Possemato, Kyle; Funderburk, Jennifer; Spinola, Suzanne; Hutchison, Dezarie; Maisto, Stephen A; Lantinga, Larry J; Oslin, David W

2016-01-01

Few studies have measured addiction-specific barriers to treatment. A measurement of barriers with psychometric support that has been tested in diverse samples and that assesses multiple components of addiction treatment barriers is needed to inform providers and treatment programs. This paper aims to provide an initial psychometric investigation of a measure of barriers to seeking addictions treatment. Data were collected from 196 Veterans Affairs primary care patients with Alcohol Use Disorder that participated in a randomized clinical trial. A Principal Components Analysis revealed that the 32-item Treatment Barriers Scale (TBS) can be reduced to 14 items, measuring 4 factors: stigma, dislike of the treatment process, alcohol problem identification, and logistical concerns. Acceptable internal consistent reliability (α = .64-.76) and excellent precision of alpha (α = 0.001-0.009) was found for each subscale. Support for the measure's concurrent validity was found, for example, participants who reported more motivation to reduce their drinking perceived significantly fewer barriers to care. Support for the measure's predictive validity was also found, including that more barriers were related to future drinking among all participants and less mental health and addictions treatment visits among participants in one treatment condition. Conclusions/ Importance: Our results provide initial support for the utility of the TBS-14 among primary care patients with Alcohol Use Disorder. Use of the TBS-14 could enable healthcare providers to better understand patient-specific treatment barriers, provide corrective information on treatment misconceptions, and inform individualized treatment plans that increase patient engagement in addiction services.

School Administrator Perceptions of Cyberbullying Facilitators and Barriers to Preventive Action: A Qualitative Study.

Science.gov (United States)

Young, Rachel; Tully, Melissa; Ramirez, Marizen

2017-06-01

Schools are often held responsible for preventing or addressing cyberbullying, yet little is known about school administrator perceptions of cyberbullying and the challenges they face in addressing this public health issue. The goal of this study is to examine school administrators' perceptions of the facilitators of cyberbullying and barriers to primary and secondary prevention strategies. Public school administrators ( N = 36) participated in in-depth interviews about bullying and discussed their experiences with cyberbullying and their perceptions of cyberbullying facilitators and barriers to prevention. Three main themes arose from the analysis: (1) cyberbullying as a major challenge; (2) facilitators of cyberbullying and barriers to preventive action, including parents and technology; and (3) prevention efforts, including unclear jurisdiction for action, primary versus secondary prevention efforts, and technology attributes that facilitate school response to bullying. Although administrators perceive cyberbullying as a major challenge facing their schools, they are often unsure about appropriate primary and secondary prevention efforts. Relationships with parents and police complicate response and prevention as schools attempt to navigate unclear jurisdiction. Additionally, technology presents a challenge to schools because it is seen as an enabler of cyberbullying, a facilitator of prevention, and a necessary part of education efforts. Lack of research on prevention strategies, parents' knowledge and attitudes, and confusion about responsibility for addressing cyberbullying are barriers to action. Findings suggest administrators could benefit from additional clarity on which strategies are most effective for primary prevention of cyberbullying, and that prevention strategies should proactively involve parents to promote effective collaboration with schools.

The barriers that women face when choosing food for their primary ...

African Journals Online (AJOL)

The mean nutrition knowledge score for the group was 68.6%. Nutrition knowledge was significantly lower (p<0.01) in mothers from the lower quintile school (64.0%). Primary factors influencing food purchases were cost (60%), nutritional value (37%) and time constraints (29%). Primary sources of nutrition information ...

Project Guarantee 1985. Final repository for high-level radioactive wastes: The system of safety barriers

International Nuclear Information System (INIS)

Anon.

1985-01-01

Final disposal of radioactive waste involves preventing the waste from returning from the repository location into the biosphere by means of successively arranged containment measures known as safety barriers. In the present volume NGB 85-04 of the series of reports for Project 'Guarantee' 1985, the safety barrier system for the type C repository for high-level waste is described. The barrier parameters which are relevant for safety analysis are quantified and associated error limits and data scatter are given. The aim of the report is to give a summary documentation of the safety analysis input data and their scientific background. For secure containment of radioactive waste safety barriers are used which effectively limit the release of radioactive material from the repository (release barriers) and effectively retard the entry of the original radioactive material into the biosphere (time barriers). Safety barriers take the form of both technically constructed containment measures and the siting of the repository in suitable geological formations. The technical safety barrier system in the case of high-level waste comprises: the waste solidification matrix (borosilicate glass), massive steel canisters, encasement of the waste canisters, encasement of the waste canisters in highly compacted bentonite, sealing of vacant storage space and access routes on repository closure. The natural geological safety barriers - the host rock and overlying formations provide sufficiently long deep groundwater flow times from the repository location to the earth's surface and for additional lengthening of radionuclide migration times by means of various chemical and physical retardation mechanisms. The stability of the geological formations is so great that hydrogeological system is protected for a sufficient length of time from deterioration caused, in particular, by erosion. Observations in the final section of the report indicate that input data for the type C repository safety

EDITORIAL: Special issue containing papers presented at the 12th International Workshop on H-mode Physics and Transport Barriers Special issue containing papers presented at the 12th International Workshop on H-mode Physics and Transport Barriers

Science.gov (United States)

Hahm, T. S.

2010-06-01

The 12th International Workshop on H-mode Physics and Transport Barriers was held at the Princeton Plasma Physics Laboratory, Princeton, New Jersey, USA between September 30 and October 2, 2009. This meeting was the continuation of a series of previous meetings which was initiated in 1987 and has been held bi-annually since then. Following the recent tradition at the last few meetings, the program was sub- divided into six sessions. At each session, an overview talk was presented, followed by two or three shorter oral presentations which supplemented the coverage of important issues. These talks were followed by discussion periods and poster sessions of contributed papers. The sessions were: Physics of Transition to/from Enhanced Confinement Regimes, Pedestal and Edge Localized Mode Dynamics, Plasma Rotation and Momentum Transport, Role of 3D Physics in Transport Barriers, Transport Barriers: Theory and Simulations and High Priority ITER Issues on Transport Barriers. The diversity of the 90 registered participants was remarkable, with 22 different nationalities. US participants were in the majority (36), followed by Japan (14), South Korea (7), and China (6). This special issue of Nuclear Fusion consists of a cluster of 18 accepted papers from submitted manuscripts based on overview talks and poster presentations. The paper selection procedure followed the guidelines of Nuclear Fusion which are essentially the same as for regular articles with an additional requirement on timeliness of submission, review and revision. One overview paper and five contributed papers report on the H-mode pedestal related results which reflect the importance of this issue concerning the successful operation of ITER. Four papers address the rotation and momentum transport which play a crucial role in transport barrier physics. The transport barrier transition condition is the main focus of other four papers. Finally, four additional papers are devoted to the behaviour and control of

Development of an automated remote inspection system for the interior of the primary containment vessel of a nuclear power plant

International Nuclear Information System (INIS)

Senoo, Makoto; Yoshida, Tomiharu; Omote, Tatsuyuki; Tanaka, Keiji; Koga, Kazunori

1996-01-01

An automated remote inspection system has been developed for the interior of the primary containment vessel of a nuclear power plant. This system consists of an inspection robot and an operator's console. The inspection robot travels along a monorail provided in the interior of the primary containment vessel. The operator's console is located in the central control room of the power plant. We have made efforts to downsize the robot and automate the inspection and monitoring machinery. As for downsizing the robot, a 152 mm wide, 290 mm high cross-sectional area and 15 kg weight can be realized using commercially available small sensors and rearranging the parts in those sensors. As for automating the inspection and monitoring, several monitoring functions are developed using image processing, frequency analysis and other techniques applied to signals from sensors such as an ITV camera, an infrared camera and a microphone, which are mounted on the robot. Endurance tests show resistance of the robot to radiational and thermal conditions is adequate for actual use in actual power plants. (author)

Inclusions and Exclusions in Rural Tanzanian Primary Schools: Material Barriers, Teacher Agency and Disability Equality

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Susie Miles

2018-03-01

Full Text Available This article begins with the assumption that the argument for the inclusion of children with disabilities in mainstream schools, championed by Sustainable Development Goal 4 and Article 24 of the UN Convention on the Rights of Persons with Disabilities, has largely been accepted nationally and internationally by policy makers, and is increasingly being accepted by teachers. In interrogating the complex craft of developing inclusive and equal learning environments for children with disabilities, this article draws upon Kershner’s ‘core aspects of teachers’ knowledge and knowing’, and in particular, ‘the school as a site for the development of teaching expertise and the creation of knowledge’. Data is presented from in-depth interviews following videoed lesson observations with experienced teachers in 15 rural, urban and coastal primary schools in four districts in Tanzania. Findings indicate that the teachers’ practice is moving unevenly towards disability equality, and involves processes of inclusions and exclusions. This involves teacher autonomy, agency and reflective practice in the context of material, attitudinal, structural, pedagogic and curricular barriers. The teachers’ expertise has potential to inform national and international policy developments, and so reduce the evident rhetoric-reality gap. In conclusion, it is argued that inclusive education needs to grapple with disability as a social construct, and lessons are drawn for the further fulfilment of the rights of children with disabilities to equal participation in education.

Identifying Areas of Primary Care Shortage in Urban Ohio

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Hsin-Chung Liao

Full Text Available ABSTRACT: This study considers both spatial and a-spatial variables in examining accessibility to primary healthcare in the three largest urban areas of Ohio (Cleveland, Columbus, and Cincinnati. Spatial access emphasizes the importance of geographic barriers between individuals and primary care physicians, while a-spatial variables include non-geographic barriers or facilitators such as age, sex, race, income, social class, education, living conditions and language skills. Population and socioeconomic data were obtained from the 2000 Census, and primary care physician data for 2008 was provided by the Ohio Medical Board. We first implemented a two-step method based on a floating catchment area using Geographic Information Systems to measure spatial accessibility in terms of 30-minute travel times. We then used principal component analysis to group various socio-demographic variables into three groups: (1 socioeconomic disadvantages, (2 living conditions, and (3 healthcare needs. Finally, spatial and a-spatial variables were integrated to identify areas with poor access to primary care in Cleveland, Columbus, and Cincinnati. KEYWORDS: Geographic information systems, healthcare access, spatial accessibility, primary care shortage areas

Barriers and facilitators to implementing electronic prescription: a systematic review of user groups' perceptions.

Science.gov (United States)

Gagnon, Marie-Pierre; Nsangou, Édith-Romy; Payne-Gagnon, Julie; Grenier, Sonya; Sicotte, Claude

2014-01-01

We conducted a systematic review identifying users groups' perceptions of barriers and facilitators to implementing electronic prescription (e-prescribing) in primary care. We included studies following these criteria: presence of an empirical design, focus on the users' experience of e-prescribing implementation, conducted in primary care, and providing data on barriers and facilitators to e-prescribing implementation. We used the Donabedian logical model of healthcare quality (adapted by Barber et al) to analyze our findings. We found 34 publications (related to 28 individual studies) eligible to be included in this review. These studies identified a total of 594 elements as barriers or facilitators to e-prescribing implementation. Most user groups perceived that e-prescribing was facilitated by design and technical concerns, interoperability, content appropriate for the users, attitude towards e-prescribing, productivity, and available resources. This review highlights the importance of technical and organizational support for the successful implementation of e-prescribing systems. It also shows that the same factor can be seen as a barrier or a facilitator depending on the project's own circumstances. Moreover, a factor can change in nature, from a barrier to a facilitator and vice versa, in the process of e-prescribing implementation. This review summarizes current knowledge on factors related to e-prescribing implementation in primary care that could support decision makers in their design of effective implementation strategies. Finally, future studies should emphasize on the perceptions of other user groups, such as pharmacists, managers, vendors, and patients, who remain neglected in the literature.

Development of engineered barrier

Energy Technology Data Exchange (ETDEWEB)

Chun, Kwan Sik; Cho, Won Jin; Lee, Jae Owan; Kim, Seung Soo; Kang, Mu Ja

1999-03-01

Engineered barrier development was carried out into the three research fields : waste form, disposal container, and buffer. The waste form field dealt with long-term leaching tests with borosilicate waste glasses surrounded by compacted bentonite. The leach rate decreased with increasing time, and was higher for the waste specimen rich in U and Na. In the container field, preliminary concepts of disposal containers were recommended by conducting structural analysis, thermal analysis, and shielding analysis, and major properties of stainless steel, copper, and titanium as a container material were surveyed. The sensitization degrees of SUS 316 and316L were lower than those of SUS 304 and 304L, respectively. The crevice corrosion of sensitized stainless steel was sensitive to the content of salt. Researches into the buffer included establishment of its performance criteria followed by investigating major properties of buffer using potential material in Korea. Experiments were made for measuring hydraulic conductivities, swelling properties, mechanical properties, thermal conductivities, pore-water chemistry properties, and adsorption properties was also investigated. (author)

Development of engineered barrier

International Nuclear Information System (INIS)

Chun, Kwan Sik; Cho, Won Jin; Lee, Jae Owan; Kim, Seung Soo; Kang, Mu Ja

1999-03-01

Engineered barrier development was carried out into the three research fields : waste form, disposal container, and buffer. The waste form field dealt with long-term leaching tests with borosilicate waste glasses surrounded by compacted bentonite. The leach rate decreased with increasing time, and was higher for the waste specimen rich in U and Na. In the container field, preliminary concepts of disposal containers were recommended by conducting structural analysis, thermal analysis, and shielding analysis, and major properties of stainless steel, copper, and titanium as a container material were surveyed. The sensitization degrees of SUS 316 and 316L were lower than those of SUS 304 and 304L, respectively. The crevice corrosion of sensitized stainless steel was sensitive to the content of salt. Researches into the buffer included establishment of its performance criteria followed by investigating major properties of buffer using potential material in Korea. Experiments were made for measuring hydraulic conductivities, swelling properties, mechanical properties, thermal conductivities, pore-water chemistry properties, and adsorption properties was also investigated. (author)

Passive containment system

International Nuclear Information System (INIS)

Kleimola, F.W.

1977-01-01

Disclosed is a containment system that provides complete protection entirely by passive means for the loss of coolant accident in a nuclear power plant and wherein all stored energy released in the coolant blowdown is contained and absorbed while the nuclear fuel is prevented from over-heating by a high containment back-pressure and a reactor vessel refill system. The primary containment vessel is restored to a high sub-atmospheric pressure within a few minutes after accident initiation and the decay heat is safely transferred to the environment while radiolytic hydrogen is contained by passive means. 20 claims, 14 figures

Barriers and facilitators to the dissemination of DECISION+, a continuing medical education program for optimizing decisions about antibiotics for acute respiratory infections in primary care: A study protocol

Directory of Open Access Journals (Sweden)

Gagnon Marie-Pierre

2011-01-01

Full Text Available Abstract Background In North America, acute respiratory infections are the main reason for doctors' visits in primary care. Family physicians and their patients overuse antibiotics for treating acute respiratory infections. In a pilot clustered randomized trial, we showed that DECISION+, a continuing medical education program in shared decision making, has the potential to reduce the overuse of antibiotics for treating acute respiratory infections. DECISION+ learning activities consisted of three interactive sessions of three hours each, reminders at the point of care, and feedback to doctors on their agreement with patients about comfort with the decision whether to use antibiotics. The objective of this study is to identify the barriers and facilitators to physicians' participation in DECISION+ with the goal of disseminating DECISION+ on a larger scale. Methods/design This descriptive study will use mixed methods and retrospective and prospective components. All analyses will be based on an adapted version of the Ottawa Model of Research Use. First, we will use qualitative methods to analyze the following retrospective data from the pilot study: the logbooks of eight research assistants, the transcriptions of 15 training sessions, and 27 participant evaluations of the DECISION+ training sessions. Second, we will collect prospective data in semi-structured focus groups composed of family physicians to identify barriers and facilitators to the dissemination of a future training program similar to DECISION+. All 39 family physicians exposed to DECISION+ during the pilot project will be eligible to participate. We will use a self-administered questionnaire based on Azjen's Theory of Planned Behaviour to assess participants' intention to take part in future training programs similar to DECISION+. Discussion Barriers and facilitators identified in this project will guide modifications to DECISION+, a continuing medical education program in shared

Barriers to Effective Teamwork Relating to Pediatric Resuscitations: Perceptions of Pediatric Emergency Medicine Staff.

Science.gov (United States)

Sherman, Joshua M; Chang, Todd P; Ziv, Nurit; Nager, Alan L

2017-10-09

In the pediatric emergency department (PED), resuscitations require medical teams form ad hoc, rarely communicating beforehand. Literature has shown that the medical community has deficiencies in communication and teamwork. However, we as medical providers do not know or understand the perceived barriers of our colleagues. Physicians may perceive a barrier that is different from nurses, respiratory therapists, pharmacists, or technicians. Perhaps we do not know in which area of teamwork and communication we are deficient. Only when we understand the perceptions of our fellow coworkers can we take steps toward improvement in quality resuscitations and therefore patient safety. The primary objectives of this study were to describe and understand the perceived barriers to effective communication and teamwork among different disciplines forming spontaneous resuscitation teams at a tertiary urban PED and to determine if providers of different disciplines perceived these barriers differently. This was a mixed-methods study conducted in a single, tertiary care freestanding children's hospital emergency department. Survey questions were iteratively developed to measure the construct of barriers and best practices within resuscitation teamwork, which was administered to staff among 5 selected roles: physicians, nurses, respiratory technicians, PED technicians, and PED pharmacists. It contained open-ended questions to provide statements on specific barriers or goals in effective teamwork, as well as a priority ranking on 25 different statements on teamwork extracted from the literature. From the participant data, 9 core themes related to resuscitation teamwork were coalesced using affinity diagramming by the authors. All statements from the survey were coded to the 9 core themes by 2 authors, with high reliability (κ = 0.93). Descriptive statistics were used to summarize the prevalence of themes mentioned by survey participants. A χ test was used to determine differences

Toward a Unified Integration Approach: Uniting Diverse Primary Care Strategies Under the Primary Care Behavioral Health (PCBH) Model.

Science.gov (United States)

Sandoval, Brian E; Bell, Jennifer; Khatri, Parinda; Robinson, Patricia J

2017-12-12

Primary care continues to be at the center of health care transformation. The Primary Care Behavioral Health (PCBH) model of service delivery includes patient-centered care delivery strategies that can improve clinical outcomes, cost, and patient and primary care provider satisfaction with services. This article reviews the link between the PCBH model of service delivery and health care services quality improvement, and provides guidance for initiating PCBH model clinical pathways for patients facing depression, chronic pain, alcohol misuse, obesity, insomnia, and social barriers to health.

Radioactive waste containment - a literature study

International Nuclear Information System (INIS)

Mohiuddin, G.

1985-01-01

One of the basic requirements of safe radioactive waste disposal is isolation of the radioactive substances to prevent leakage into the biosphere. The multi-barrier concept has been developed to meet this requirement. Within the framework of the concept, barriers can be either natural or man-made. Natural barriers, i.e. geologic formations,have been investigated for their suitability, with host rock and their different properties being determined and compared. It has been found that the qualification of a proposed repository medium cannot be defined on the basis of physical, chemical, and mineralogical criteria alone, but that these data have to be completed by a global evaluation of the entire system consisting of waste products and waste forms, host rock, and surrounding rock. The study in hand reviews the reports and also lists the studies made on engineered barriers, as e.g. immobilisation barriers, container and package barriers, of various waste forms. A review of the studies dealing with the various waste disposal techniques shows that the sub-surface waste disposal and the deep underground disposal in mines are the best developed techniques currently. A review of ultimate disposal concepts adopted abroad shows that most countries favour the mining technology approach, with the exception of Denmark where R and D work in this field is focused on deep well disposal. (orig./HP) [de

Artifacts Generated During Azoalkane Peroxy Radical Oxidative Stress Testing of Pharmaceuticals Containing Primary and Secondary Amines.

Science.gov (United States)

Nefliu, Marcela; Zelesky, Todd; Jansen, Patrick; Sluggett, Gregory W; Foti, Christopher; Baertschi, Steven W; Harmon, Paul A

2015-12-01

We report artifactual degradation of pharmaceutical compounds containing primary and secondary amines during peroxy radical-mediated oxidative stress carried out using azoalkane initiators. Two degradation products were detected when model drug compounds dissolved in methanol/water were heated to 40°C with radical initiators such as 2,2'-azobis(2-methylpropionitrile) (AIBN). The primary artifact was identified as an α-aminonitrile generated from the reaction of the amine group of the model drug with formaldehyde and hydrogen cyanide, generated as byproducts of the stress reaction. A minor artifact was generated from the reaction between the amine group and isocyanic acid, also a byproduct of the stress reaction. We report the effects of pH, initiator/drug molar ratio, and type of azoalkane initiator on the formation of these artifacts. Mass spectrometry and nuclear magnetic resonance were used for structure elucidation, whereas mechanistic studies, including stable isotope labeling experiments, cyanide analysis, and experiments exploring the effects of butylated hydroxyanisole addition, were employed to support the degradation pathways. © 2015 Wiley Periodicals, Inc. and the American Pharmacists Association.

Modulating the skin barrier function by DMSO: molecular dynamics simulations of hydrophilic and hydrophobic transmembrane pores

NARCIS (Netherlands)

den Otter, Wouter K.; Notman, R.; Anwar, J.; Noro, M.G.; Briels, Willem J.

2008-01-01

The dense lipid bilayers at the outer surface of the skin represent the primary barrier to molecules penetrating the human skin. One approach to overcome this barrier, with promising applications in administering medicinal drugs to the body, is to employ chemical permeability enhancers. How these

Barriers to Asthma Management for School Nurses: An Integrative Review.

Science.gov (United States)

Hanley Nadeau, Ellen; Toronto, Coleen E

2016-04-01

Childhood asthma is a growing health concern. Asthma is the most common chronic illness of childhood and a leading cause of emergency room visits, hospitalizations, and school absenteeism. School nurses play a valuable role in asthma management. The purpose of this integrative review is to examine barriers to asthma management for school nurses in the school setting. Findings revealed multiple barriers school nurses encounter in managing asthma. Six themes emerged that included lack of resources and support, insufficient time, communication challenges, limited knowledge, and lack of awareness of school nurses' expertise. Students, parents, primary care physicians, school administration, staff, and school nurses themselves all play a role in constructing barriers to asthma management. There is a need for school nurses and school nurse leaders to focus efforts to develop strategies to overcome barriers to ensure evidence-based, best practice management of asthma in the school setting. © The Author(s) 2015.

Leakage evaluation in the PCV (Primary Containment Vessel) using chemical and radiochemical data

International Nuclear Information System (INIS)

Maeda, Katsuji; Nagasawa, Katsumi

1998-01-01

Keeping the reliability of nuclear power plant operation, the primary coolant leakage in the PCV is strictly restricted by the Technical Specifications. It is very important to detect an indication of leakage and estimate the source of leakage to provide countermeasures. Usually the indication of leakage will be detected by increase of drain flow in the PCV sump. There are some possibilities of leakage sources in the PCV, such as reactor water, main steam, condensate, feedwater and closed cooling water. The leakage source contain different chemical and radiochemical species. This means that the leakage source can be presumed and detected by using chemical information from the PCV atmosphere and sump water. To detect the leakage indication and the source quickly and exactly, the PCV Leakage Detection Expert System has been developed. This paper describes how to evaluate the leakage indication and source in the PCV by using chemical and radiochemical data. (author)

Sensing of EGTA Mediated Barrier Tissue Disruption with an Organic Transistor

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Scherrine Tria

2013-01-01

Full Text Available Barrier tissue protects the body against external factors by restricting the passage of molecules. The gastrointestinal epithelium is an example of barrier tissue with the primary purpose of allowing the passage of ions and nutrients, while restricting the passage of pathogens and toxins. It is well known that the loss of barrier function can be instigated by a decrease in extracellular calcium levels, leading to changes in protein conformation and an increase in paracellular transport. In this study, ethylene glycol-bis(beta-aminoethyl ether-N,N,N',N'-tetra acetic acid (EGTA, a calcium chelator, was used to disrupt the gastrointestinal epithelial barrier. The effect of EGTA on barrier tissue was monitored by a novel label-free method based on an organic electrochemical transistor (OECT integrated with living cells and validated against conventional methods for measuring barrier tissue integrity. We demonstrate that the OECT can detect breaches in barrier tissue upon exposure to EGTA with the same sensitivity as existing methods but with increased temporal resolution. Due to the potential of low cost processing techniques and the flexibility in design associated with organic electronics, the OECT has great potential for high-throughput, disposable sensing and diagnostics.

Enablers and barriers to implementing collaborative care for anxiety and depression

DEFF Research Database (Denmark)

Overbeck, Gritt; Davidsen, Annette Sofie; Kousgaard, Marius Brostrøm

2016-01-01

shown significant positive effects for patients suffering from depression, but since collaborative care is a complex intervention, it is important to understand the factors which affect its implementation. We present a qualitative systematic review of the enablers and barriers to implementing...... employed the normalization process theory (NPT). RESULTS: We included 17 studies in our review of which 11 were conducted in the USA, five in the UK, and one in Canada. We identified several barriers and enablers within the four major analytical dimensions of NPT. Securing buy-in among primary care...... collaborative care interventions: effective educational programs, especially for care managers; issues of reimbursement in relation to primary care providers; good systems for communication and monitoring; and promoting face-to-face interaction between care managers and physicians, preferably through co...

Bentonite. Geotechnical barrier and source for microbial life

International Nuclear Information System (INIS)

Matschiavelli, Nicole; Kluge, Sindy; Cherkouk, Andrea; Steglich, Jennifer

2017-01-01

Due to their properties, namely a high swelling capacity and a low hydraulic conductivity, Bentonites fulfil as geotechnical barrier a sealing and buffering function in the nuclear waste repository. Depending on the mineral composition Bentonites contain many suitable electron-donors and -acceptors, enabling potential microbial life. For the potential repository of highly radioactive waste the microbial mediated transformation of Bentonite could influence its properties as a barrier material. Microcosms were set up containing Bentonite and anaerobic synthetic Opalinus-clay-pore water solution under an N_2/CO_2-atmosphere to elucidate the microbial potential within selected Bentonites. Substrates like acetate and lactate were supplemented to stimulate potential microbial activity. First results show that bentonites represent a source for microbial life, demonstrated by the consumption of lactate and the formation of pyruvate. Furthermore, microbial iron-reduction was determined, which plays a crucial role in Betonite-transformation.

Bentonite. Geotechnical barrier and source for microbial life

Energy Technology Data Exchange (ETDEWEB)

Matschiavelli, Nicole; Kluge, Sindy; Cherkouk, Andrea [Helmholtz-Zentrum Dresden-Rossendorf e.V., Dresden (Germany). HZDR Young Investigator Group; Steglich, Jennifer

2017-06-01

Due to their properties, namely a high swelling capacity and a low hydraulic conductivity, Bentonites fulfil as geotechnical barrier a sealing and buffering function in the nuclear waste repository. Depending on the mineral composition Bentonites contain many suitable electron-donors and -acceptors, enabling potential microbial life. For the potential repository of highly radioactive waste the microbial mediated transformation of Bentonite could influence its properties as a barrier material. Microcosms were set up containing Bentonite and anaerobic synthetic Opalinus-clay-pore water solution under an N{sub 2}/CO{sub 2}-atmosphere to elucidate the microbial potential within selected Bentonites. Substrates like acetate and lactate were supplemented to stimulate potential microbial activity. First results show that bentonites represent a source for microbial life, demonstrated by the consumption of lactate and the formation of pyruvate. Furthermore, microbial iron-reduction was determined, which plays a crucial role in Betonite-transformation.

Concrete containers in radioactive waste management: a review

Energy Technology Data Exchange (ETDEWEB)

Tavares, Bárbara L.; Tello, Clédola Cássia O. de, E-mail: barbaralacerdat@gmail.com [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte/MG (Brazil)

2017-07-01

Nuclear power is considered a clean energy, because it does not produce the gases responsible for greenhouse effect. However, like all human activities, it is susceptible to waste generation. With increasing demand for energy in Brazil, the use of nuclear power is being expanded, as a result, the implementation of correct treatment and disposal are a necessity, in order to ensure the non-contamination of the public or environment and that exposure doses are lower than limits by legislation. Most of waste produced in Brazil are classified as low and intermediate radiation level; consequently, the national repository will be near surface, in accordance with the legislation. Considering the multi-barrier concept for the repository, the radioactive waste product is the first barrier. To have a qualified radioactive waste product, it should be solid or solidified using an inert material. With the intention of standardize the disposal process, all radioactive waste products will be placed in concrete containers. These containers will be settled in a concrete cell, the final engineered barrier of the repository. The state of the art is the first part of the study of the concrete containers and its specific criteria acceptation. Since the repository’s operational and surveillance period is 60 and 300 years, respectively, tests still need to be fulfilled in order to ensure the stability and resistance of the material. (author)

Concrete containers in radioactive waste management: a review

International Nuclear Information System (INIS)

Tavares, Bárbara L.; Tello, Clédola Cássia O. de

2017-01-01

Nuclear power is considered a clean energy, because it does not produce the gases responsible for greenhouse effect. However, like all human activities, it is susceptible to waste generation. With increasing demand for energy in Brazil, the use of nuclear power is being expanded, as a result, the implementation of correct treatment and disposal are a necessity, in order to ensure the non-contamination of the public or environment and that exposure doses are lower than limits by legislation. Most of waste produced in Brazil are classified as low and intermediate radiation level; consequently, the national repository will be near surface, in accordance with the legislation. Considering the multi-barrier concept for the repository, the radioactive waste product is the first barrier. To have a qualified radioactive waste product, it should be solid or solidified using an inert material. With the intention of standardize the disposal process, all radioactive waste products will be placed in concrete containers. These containers will be settled in a concrete cell, the final engineered barrier of the repository. The state of the art is the first part of the study of the concrete containers and its specific criteria acceptation. Since the repository’s operational and surveillance period is 60 and 300 years, respectively, tests still need to be fulfilled in order to ensure the stability and resistance of the material. (author)

Developments in permeable and low permeability barriers

International Nuclear Information System (INIS)

Jefferis, S.A.; Norris, G.H.; Thomas, A.O.

1997-01-01

The concept of the reactive treatment zone whereby pollutants are attenuated as they move along a pathway in the ground has enabled a re-thinking of many of the concepts of containment. In particular it offers the potential for the control of the flux from a contaminated area by controlling the contaminant concentration in the pathway(s) as well as or instead of using a low permeability barrier. The paper outlines the basic concepts of the reactive treatment zone and the use of permeable and low permeability reactive systems. The paper then gives a case history of the installation of a permeable barrier using an in-situ reaction chamber

Improvements in or relating to thermal barrier systems

International Nuclear Information System (INIS)

Birch, W.; Pearson, R.

1976-01-01

Reference is made to thermal barrier systems for the internal surface of gas cooled reactor prestressed concrete pressure vessels. Provision has to be made to anchor the thermal barrier system to a metal limit within the pressure vessel, and the object of the arrangement described is to provided a suitable attachment means. The thermal barrier may consist of a number of plates arranged in overlapped fashion or having flexible joint portions. A problem that arises concerns anchoring of the hot plates to the cold pressure vessel by a rigid attachment, and the design must be such as to ensure adequate bending and axial strength compatible with a minimum heat conduction area and allowable thermal stress. The arrangement must also allow easy installation. The arrangement described also provides for a 'fail-safe' structure. It comprises a metal stud with a hollow body; two or more helical channels are provided through the side walls of the body. The body portion expands or contracts to accommodate axial temperature gradient stress set up by the temperature difference between the pressure vessel and the thermal barrier. The space between the thermal barrier and the pressure vessel may contain solid insulating material. (U.K.)

ANALYSIS OF FLEXIBLE BARRIERS USED AS SAFETY PROTECTION IN WOODWORKING

Directory of Open Access Journals (Sweden)

Ana Pavlovic

2016-03-01

Full Text Available Machine tools use physical barriers, made by flexible thermoplastic materials, to protect the environment and the operators against the projections of wood chips and parts of cutting tools. These barriers constitute a partial closure and allow the passage of the workpiece, being simultaneously able to contain sharp fragments projected at high speed. The present research was conducted with the aim to evaluate the real effectiveness of these barriers, to investigate their dynamic behaviour by numerical simulations. Results showed that these barriers, if properly considered, could retain heavier masses and higher speeds. The research also allowed, in fact, to investigate the influence of several factors in design, selection and use, as material, shape, position, assemblages and many others, highlighting weaknesses and identifying possible measures to increase its effectiveness.

Dimensional Analysis of Psychosocial Barriers to Prevention of Early Childhood Caries Among Recent Immigrants

Directory of Open Access Journals (Sweden)

Arnaldo Perez

2014-06-01

Full Text Available The objective of this article is to define the underlying dimensions of psychosocial barriers to obtaining and providing dental care for young children among recent immigrants. Fifteen focus groups were conducted with 99 primary caregivers from African, South Asian, and Chinese recent immigrants. A secondary analysis of identified barriers using dimensional analysis methodology was performed to determine dimensions and properties of barriers. The analysis continued until irreducible properties were found or emerging dimensions were not relevant to the study. Identified dimensions were associated with barriers and individuals. Type, number, level, objectiveness, nature, and impact were barrier-related; awareness and controllability were individual-related dimensions. Type refers to barriers themselves. Number and level indicate the amount and location of barriers, respectively. Objectiveness refers to the extent that perceived barrier reflects reality and nature indicates its intrinsic characteristic. Impact concerns behaviors, goals, and outcomes compromised by barriers. Awareness alludes to the extent that individuals are aware of the barriers and controllability explains how much control people perceive to have over barriers. Identified dimensions are useful for better understanding and addressing existing barriers to children’s optimal oral health.

Improving Communication About Serious Illness in Primary Care: A Review.

Science.gov (United States)

Lakin, Joshua R; Block, Susan D; Billings, J Andrew; Koritsanszky, Luca A; Cunningham, Rebecca; Wichmann, Lisa; Harvey, Doreen; Lamey, Jan; Bernacki, Rachelle E

2016-09-01

The Institute of Medicine recently called for systematic improvements in clinician-led conversations about goals, values, and care preferences for patients with serious and life-threatening illnesses. Studies suggest that these conversations are associated with improved outcomes for patients and their families, enhanced clinician satisfaction, and lower health care costs; however, the role of primary care clinicians in driving conversations about goals and priorities in serious illness is not well defined. To present a review of a structured search of the evidence base about communication in serious illness in primary care. MEDLINE was searched, via PubMed, on January 19, 2016, finding 911 articles; 126 articles were reviewed and selected titles were added from bibliography searches. Review of the literature informed 2 major topic areas: the role of primary care in communication about serious illness and clinician barriers and system failures that interfere with effective communication. Literature regarding the role that primary care plays in communication focused primarily on the ambiguity about whether primary care clinicians or specialists are responsible for initiating conversations, the benefits of primary care clinicians and specialists conducting conversations, and the quantity and quality of discussions. Timely and effective communication about serious illness in primary care is hampered by key clinician barriers, which include deficits in knowledge, skills, and attitudes; discomfort with prognostication; and lack of clarity about the appropriate timing and initiation of conversations. Finally, system failures in coordination, documentation, feedback, and quality improvement contribute to lack of conversations. Clinician and system barriers will challenge primary care clinicians and institutions to meet the needs of patients with serious illness. Ensuring that conversations about goals and values occur at the appropriate time for seriously ill patients will

Sprache als Barriere (Language as a Barrier)

Science.gov (United States)

Mattheier, Klaus

1974-01-01

The concept of language barrier has its derivations in the fields of dialectology, sociology and psychology. In contemporary usage however, the concept has two meanings i.e. regional-cultural barrier and socio-cultural barrier. (Text is in German.) (DS)

(18)F-Fluorodeoxyglucose PET/Computed Tomography for Primary Brain Tumors

DEFF Research Database (Denmark)

Antonsen Segtnan, Eivind; Hess, Søren; Grupe, Peter

2015-01-01

Structural imaging with computed tomography (CT) and MR imaging is the mainstay in primary diagnosis of primary brain tumors, but these modalities depend on morphologic appearance and an intact blood-brain barrier, and important aspects of tumor biology are not addressed. Such issues may...

SH2 domain-containing protein tyrosine phosphatase 2 and focal adhesion kinase protein interactions regulate pulmonary endothelium barrier function.

Science.gov (United States)

Chichger, Havovi; Braza, Julie; Duong, Huetran; Harrington, Elizabeth O

2015-06-01

Enhanced protein tyrosine phosphorylation is associated with changes in vascular permeability through formation and dissolution of adherens junctions and regulation of stress fiber formation. Inhibition of the protein tyrosine phosphorylase SH2 domain-containing protein tyrosine phosphatase 2 (SHP2) increases tyrosine phosphorylation of vascular endothelial cadherin and β-catenin, resulting in disruption of the endothelial monolayer and edema formation in the pulmonary endothelium. Vascular permeability is a hallmark of acute lung injury (ALI); thus, enhanced SHP2 activity offers potential therapeutic value for the pulmonary vasculature in diseases such as ALI, but this has not been characterized. To assess whether SHP2 activity mediates protection against edema in the endothelium, we assessed the effect of molecular activation of SHP2 on lung endothelial barrier function in response to the edemagenic agents LPS and thrombin. Both LPS and thrombin reduced SHP2 activity, correlated with decreased focal adhesion kinase (FAK) phosphorylation (Y(397) and Y(925)) and diminished SHP2 protein-protein associations with FAK. Overexpression of constitutively active SHP2 (SHP2(D61A)) enhanced baseline endothelial monolayer resistance and completely blocked LPS- and thrombin-induced permeability in vitro and significantly blunted pulmonary edema formation induced by either endotoxin (LPS) or Pseudomonas aeruginosa exposure in vivo. Chemical inhibition of FAK decreased SHP2 protein-protein interactions with FAK concomitant with increased permeability; however, overexpression of SHP2(D61A) rescued the endothelium and maintained FAK activity and FAK-SHP2 protein interactions. Our data suggest that SHP2 activation offers the pulmonary endothelium protection against barrier permeability mediators downstream of the FAK signaling pathway. We postulate that further studies into the promotion of SHP2 activation in the pulmonary endothelium may offer a therapeutic approach for patients

Design of double containment canister cask storage system

International Nuclear Information System (INIS)

Asami, M.; Matsumoto, T.; Oohama, T.; Kuriyama, K.; Kawakami, K.

2004-01-01

Spent fuels discharged from Japanese LWR will be stored as recycled-fuel-resources in interim storage facilities. The concrete cask storage system is one of important forms for the spent fuel interim storage. In Japan, the interim storage facility will be located near the coast, therefore it is important to prevent SCC (Stress Corrosion Cracking) caused by sea salt particles and to assure the containment integrity of the canister which contains spent fuels. KEPCO, NFT and OCL have designed the double containment canister cask storage system that can assure the long-term containment integrity and monitor the containment performance without storage capacity decrease. Major features of the combined canister cask system are shown as follows: This system can survey containment integrity of dual canisters by monitoring the pressure of the gap between canisters. The primary canister has dual lids sealed by welding. The secondary canister has single lid tightened by bolts and sealed by metallic gaskets. The primary canister is contained in the transport cask during transportation, and the gap between the primary canister and the transport cask is filled with He gas. Under storage condition in the concrete cask, the primary canister is contained in the secondary canister, and the gap between these canisters is filled with helium gas. Hence this system can prevent the primary canister to contact sea salt particle in the air and from SCC. Decrease of cooling performance because of the double canister is compensated by fins fitted on the secondary canister surface. Then, this system can prevent the decrease of storage capacity determined by the fuel temperature limit. This system can assure that the primary canister will keep intact for long term storage. Therefore, in the case of pressure down of the gap between canisters, it can be considered that the secondary canister containment is damaged, and the primary canister will be transferred to another secondary canister at the

Electroconvulsive therapy: Promoting awareness among primary care physicians.

Science.gov (United States)

Sicher, Sarah; Gedzior, Joanna

2016-04-01

This article aims to promote awareness among primary care providers and support electroconvulsive therapy as a generally well-tolerated, effective therapeutic modality to treat specific psychiatric conditions in appropriately selected patients. There seem to be several potential barriers to treatment with electroconvulsive therapy including stigma, lack of providers who preform it, and lack of awareness among providers referring patients who may be appropriate candidates. The article provides a brief overview of electroconvulsive therapy principles and topics and includes a case report to illustrate clinical utility. The article proposes the concept that a potential way to overcome barriers to treatment with electroconvulsive therapy may be to promote education and awareness of it as a viable treatment modality among primary care providers. © The Author(s) 2016.

Understanding barriers to commercial-scale carbon capture and sequestration in the United States: An empirical assessment

International Nuclear Information System (INIS)

Davies, Lincoln L.; Uchitel, Kirsten; Ruple, John

2013-01-01

Although a potentially useful climate change mitigation tool, carbon capture and sequestration (CCS) efforts in the United States remain mired in demonstration and development. Prior studies suggest numerous reasons for this stagnation. This article empirically assesses those claims. Using an anonymous opinion survey completed by 229 CCS experts, we identified four primary barriers to CCS commercialization: (1) cost and cost recovery, (2) lack of a price signal or financial incentive, (3) long-term liability risks, and (4) lack of a comprehensive regulatory regime. These results give empirical weight to previous studies suggesting that CCS cost (and cost recovery) and liability risks are primary barriers to the technology. However, the need for comprehensive rather than piecemeal CCS regulation represents an emerging concern not previously singled out in the literature. Our results clearly show that the CCS community sees fragmented regulation as one of the most significant barriers to CCS deployment. Specifically, industry is united in its preference for a federal regulatory floor that is subject to state-level administration and sensitive to local conditions. Likewise, CCS experts share broad confidence in the technology's readiness, despite continued calls for commercial-scale demonstration projects before CCS is widely deployed. - Highlights: • We developed and distributed a unique CCS opinion survey. • Our analysis confirmed cost and liability as primary barriers to CCS deployment. • We identified regulatory barriers to CCS not previously singled out in the literature. • We address the need for comprehensive rather than piecemeal CCS regulation

Greatest barrier is retaining young scientists

Science.gov (United States)

Chandler, Mark; Hopper, John

The National Science Foundation's top priorities as listed by director Neal Lane in Eos (November 9) are to strengthen NSF and its support of scientific research and education, to better articulate to the public why it is so important that support of science and engineering be strengthened, and to continue to lower barriers that discourage young people from choosing careers in science.While we firmly support the first two priorities, we are concerned about the underlying assumptions and implications of the third. Barriers discouraging women and minorities from considering careers in math and science do exist within our educational system, and there is now abundant statistical evidence showing these groups are under-represented in most fields of science. However, as stated in the Eos article, solving these problems and leveling the playing field is not the primary goal of the NSF policy.

How reliable does the waste package containment have to be

International Nuclear Information System (INIS)

Wick, E.A.

1985-01-01

The final rule (10 CFR Part 60) for Disposal of High-Level Radioactive Wastes in Geologic Repositories specifies that the engineered barrier system shall be designed so that, assuming anticipated processes and events, containment of high-level radioactive wastes (HLW) will be substantially complete during the period when radiation and thermal conditions in the engineered barrier system are dominated by fission product decay. This requirement leads to the Nuclear Regulatory Commission (NRC) being asked the following questions: What is meant by ''substantially complete''. How reliable does waste package containment have to be. How many waste packages can fail. Although the NRC has not defined quantitatively the term ''substantially complete'', a numerical concept for acceptable release during the containment period is discussed. The number of containment failures that could be tolerated under the rule would depend upon the acceptable release, the time at which failure occurs and the rate of release from a failed package

Development of backfill material as an engineered barrier in the waste package system. Interim topical report

International Nuclear Information System (INIS)

Wheelwright, E.J.; Hodges, F.N.; Bray, L.A.; Westsik, J.H. Jr.; Lester, D.H.; Nakai, T.L.; Spaeth, M.E.; Stula, R.T.

1981-09-01

A backfill barrier, emplaced between the containerized waste and the host rock, can both protect the other engineered barriers and act as a primary barrier to the release of radionuclides from the waste package. Attributes that a backfill should provide in order to carry out its required function have been identified. Primary attributes are those that have a direct effect upon the release and transport of radionuclides from the waste package. Supportive attributes do not directly affect radionuclide release but are necessary to support the primary attributes. The primary attributes, in order of importance, are: minimize (retard or exclude) the migration of ground water between the host rock and the waste canister system; retard the migration of selected chemical species (corrosive species and radionuclides) in the ground water; control the Eh and pH of the ground water within the waste-package environment. The supportive attributes are: self-seal any cracks or discontinuities in the backfill or interfacing host geology; retain performance properties at all repository temperatures; retain peformance properties during and after receiving repository levels of gamma radiation; conduct heat from the canister system to the host geology; retain mechanical properties and provide resistance to applied mechanical forces; retain morphological stability and compatibility with structural barriers and with the host geology for required period of time. Screening and selection of candidate backfill materials has resulted in a preliminary list of materials for testing. Primary emphasis has been placed on sodium and calcium bentonites and zeolites used in conjunction with quartz sand or crushed host rock. Preliminary laboratory studies have concentrated on permeability, sorption, swelling pressure, and compaction properties of candidate backfill materials

What are the barriers and facilitators to implementing Collaborative Care for depression? A systematic review.

Science.gov (United States)

Wood, Emily; Ohlsen, Sally; Ricketts, Thomas

2017-05-01

Collaborative Care is an evidence-based approach to the management of depression within primary care services recommended within NICE Guidance. However, uptake within the UK has been limited. This review aims to investigate the barriers and facilitators to implementing Collaborative Care. A systematic review of the literature was undertaken to uncover what barriers and facilitators have been reported by previous research into Collaborative Care for depression in primary care. The review identified barriers and facilitators to successful implementation of Collaborative Care for depression in 18 studies across a range of settings. A framework analysis was applied using the Collaborative Care definition. The most commonly reported barriers related to the multi-professional approach, such as staff and organisational attitudes to integration, and poor inter-professional communication. Facilitators to successful implementation particularly focussed on improving inter-professional communication through standardised care pathways and case managers with clear role boundaries and key underpinning personal qualities. Not all papers were independent title and abstract screened by multiple reviewers thus limiting the reliability of the selected studies. There are many different frameworks for assessing the quality of qualitative research and little consensus as to which is most appropriate in what circumstances. The use of a quality threshold led to the exclusion of six papers that could have included further information on barriers and facilitators. Although the evidence base for Collaborative Care is strong, and the population within primary care with depression is large, the preferred way to implement the approach has not been identified. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Containment response and radiological release for a TMLB' accident sequence in a large dry containment

International Nuclear Information System (INIS)

Gasser, R.D.; Bieniarz, P.P.; Tills, J.L.

1987-01-01

An analysis has been performed for the Bellefonte Pressurized Water Reactor (PWR) Unit 1 to determine the containment loading and the radiological releases into the environment from a station blackout accident. A number of issues have been addressed in this analysis, which include the effects of direct heating on containment loading and the effects of fission product heating and natural convection on releases from the primary system. The results indicate that direct heating, which involves more than about 50% of the core, may fail the Bellefonte containment, but natural convection in the Reactor Coolant System (RCS) may lead to overheating and failure of the primary system piping before core slump, thus, eliminating or mitigating direct heating. Releases from the primary system are significantly increased before vessel breach, due to natural circulation, and after vessel breach, due to reevolution of retained fission products by fission product heating of RCS structures. (orig.)

Evaluation of neutron doses beyond of primary shielding of rooms housing clinical linear accelerators

International Nuclear Information System (INIS)

Rezende, Gabriel Fonseca da Silva

2011-01-01

The growing need to build radiotherapy rooms in places with lack of available space leads to the necessity of unconventional solutions for the shielding projects. In most cases, adding metals to the primary barriers is the best way to shield the rooms properly. However, when photons with energies equal to or great than 10 MeV interact with nuclei of materials with high atomic number, neutrons are ejected and can result in a problem of radioprotection both inside and outside the room. Currently, the only empirical formula existing in the literature to assess the dose equivalent due to neutrons beyond the laminated barriers works only under very specific conditions, and a validation of this formula had not yet been done. In this work, the Monte Carlo code MCNPX was used to verify the validity of the above formula for cases of primary barriers containing lead or iron sheets in rooms that house linear accelerators with 10, 15 and 18 MV. Moreover, such a code was used to evaluate the coefficient of neutron production and tenth-value layer for neutrons in concrete, both parameters that directly influence the equation studied. The study results showed that over 90% of the values compared between the formula and the simulations present discrepancies above 100%, which led to conclude that the formula from the literature produces values that do not match the reality. In addition, there were inconsistencies in the parameters that make up the formula, leading to a need to review this formula in order to build a new model that will better represent the real case. (author)

Method of estimating the leakage of multiple barriers in a radioactive materials shipping package

International Nuclear Information System (INIS)

Towell, R.H.; Kapoor, A.; Oras, J.J.

1997-01-01

This paper presents the results of a theoretical study of the performance of multiple leaky barriers in containing radioactive materials in a shipping package. The methods used are reasoned analysis and finite element modeling barriers. The finite element model is developed and evaluated with parameters set to bracket 6M configurations with three to six nested plastic jars, food-pack cans, and plastic bags inside Department of Transportation (DOT) Specification 2R inner containers with pipe thread closures. The results show that nested barriers reach the regulatory limit of 1x10 -6 A 2 /hr in 11 to 52 days, even though individually the barriers would exceed the regulatory limit by a factor of as much as 370 instantaneously. These times are within normal shipping times. The finite element model is conservative because it does not consider the deposition and sticking of the leaking radioactive material on the surfaces inside each boundary

Barriers perceived by teachers at work, coping strategies, self-efficacy and burnout.

Science.gov (United States)

Doménech Betoret, Fernando; Gómez Artiga, Amparo

2010-11-01

This study examines the relationships among stressors, coping strategies, self-efficacy and burnout in a sample of 724 Spanish primary and secondary teachers. We understood stressors as barriers perceived by teachers that interfere with their work meeting learning objectives and which cause them stress and burnout. An analysis of teacher responses using hierarchical regression revealed that pedagogical barriers had significant positive effects on the burnout dimensions. Furthermore, the results show not only the moderator role played by coping strategies in the pedagogical barriers-burnout dimensions relationship, but also the association between self-efficacy and the coping strategies used by teachers. Practical implications are discussed.

Tunnel magnetoresistance in alumina, magnesia and composite tunnel barrier magnetic tunnel junctions

International Nuclear Information System (INIS)

Schebaum, Oliver; Drewello, Volker; Auge, Alexander; Reiss, Guenter; Muenzenberg, Markus; Schuhmann, Henning; Seibt, Michael; Thomas, Andy

2011-01-01

Using magnetron sputtering, we have prepared Co-Fe-B/tunnel barrier/Co-Fe-B magnetic tunnel junctions with tunnel barriers consisting of alumina, magnesia, and magnesia-alumina bilayer systems. The highest tunnel magnetoresistance ratios we found were 73% for alumina and 323% for magnesia-based tunnel junctions. Additionally, tunnel junctions with a unified layer stack were prepared for the three different barriers. In these systems, the tunnel magnetoresistance ratios at optimum annealing temperatures were found to be 65% for alumina, 173% for magnesia, and 78% for the composite tunnel barriers. The similar tunnel magnetoresistance ratios of the tunnel junctions containing alumina provide evidence that coherent tunneling is suppressed by the alumina layer in the composite tunnel barrier. - Research highlights: → Transport properties of Co-Fe-B/tunnel barrier/Co-Fe-B magnetic tunnel junctions. → Tunnel barrier consists of MgO, Al-Ox, or MgO/Al-Ox bilayer systems. → Limitation of TMR-ratio in composite barrier tunnel junctions to Al-Ox values. → Limitation indicates that Al-Ox layer is causing incoherent tunneling.

Barrier mechanisms in the Drosophila blood-brain barrier

Directory of Open Access Journals (Sweden)

Samantha Jane Hindle

2014-12-01

Full Text Available The invertebrate blood-brain barrier field is growing at a rapid pace and, in recent years, studies have shown a physiologic and molecular complexity that has begun to rival its vertebrate counterpart. Novel mechanisms of paracellular barrier maintenance through GPCR signaling were the first demonstrations of the complex adaptive mechanisms of barrier physiology. Building upon this work, the integrity of the invertebrate blood-brain barrier has recently been shown to require coordinated function of all layers of the compound barrier structure, analogous to signaling between the layers of the vertebrate neurovascular unit. These findings strengthen the notion that many blood-brain barrier mechanisms are conserved between vertebrates and invertebrates, and suggest that novel findings in invertebrate model organisms will have a significant impact on the understanding of vertebrate BBB functions. In this vein, important roles in coordinating localized and systemic signaling to dictate organism development and growth are beginning to show how the blood-brain barrier can govern whole animal physiologies. This includes novel functions of blood-brain barrier gap junctions in orchestrating synchronized neuroblast proliferation, and of blood-brain barrier secreted antagonists of insulin receptor signaling. These advancements and others are pushing the field forward in exciting new directions. In this review, we provide a synopsis of invertebrate blood-brain barrier anatomy and physiology, with a focus on insights from the past 5 years, and highlight important areas for future study.

Primary angle closure glaucoma (PACG) susceptibility gene PLEKHA7 encodes a novel Rac1/Cdc42 GAP that modulates cell migration and blood-aqueous barrier function.

Science.gov (United States)

Lee, Mei-Chin; Shei, William; Chan, Anita S; Chua, Boon-Tin; Goh, Shuang-Ru; Chong, Yaan-Fun; Hilmy, Maryam H; Nongpiur, Monisha E; Baskaran, Mani; Khor, Chiea-Chuen; Aung, Tin; Hunziker, Walter; Vithana, Eranga N

2017-10-15

PLEKHA7, a gene recently associated with primary angle closure glaucoma (PACG), encodes an apical junctional protein expressed in components of the blood aqueous barrier (BAB). We found that PLEKHA7 is down-regulated in lens epithelial cells and in iris tissue of PACG patients. PLEKHA7 expression also correlated with the C risk allele of the sentinel SNP rs11024102 with the risk allele carrier groups having significantly reduced PLEKHA7 levels compared to non-risk allele carriers. Silencing of PLEKHA7 in human immortalized non-pigmented ciliary epithelium (h-iNPCE) and primary trabecular meshwork cells, which are intimately linked to BAB and aqueous humor outflow respectively, affected actin cytoskeleton organization. PLEKHA7 specifically interacts with GTP-bound Rac1 and Cdc42, but not RhoA, and the activation status of the two small GTPases is linked to PLEKHA7 expression levels. PLEKHA7 stimulates Rac1 and Cdc42 GTP hydrolysis, without affecting nucleotide exchange, identifying PLEKHA7 as a novel Rac1/Cdc42 GAP. Consistent with the regulatory role of Rac1 and Cdc42 in maintaining the tight junction permeability, silencing of PLEKHA7 compromises the paracellular barrier between h-iNPCE cells. Thus, downregulation of PLEKHA7 in PACG may affect BAB integrity and aqueous humor outflow via its Rac1/Cdc42 GAP activity, thereby contributing to disease etiology. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Process and electrolyte for applying barrier layer anodic coatings

International Nuclear Information System (INIS)

Dosch, R.G.; Prevender, T.S.

1975-01-01

Various metals may be anodized, and preferably barrier anodized, by anodizing the metal in an electrolyte comprising quaternary ammonium compound having a complex metal anion in a solvent containing water and a polar, water soluble organic material. (U.S.)

The rodent research animal holding facility as a barrier to environmental contamination

Science.gov (United States)

Savage, P. D., Jr.; Jahns, G. C.; Dalton, B. P.; Hogan, R. P.; Wray, A. E.

1989-01-01

The rodent Research Animal Holding Facility (RAHF), developed by NASA Ames Research Center (ARC) to separately house rodents in a Spacelab, was verified as a barrier to environmental contaminants during a 12-day biocompatibility test. Environmental contaminants considered were solid particulates, microorganisms, ammonia, and typical animal odors. The 12-day test conducted in August 1988 was designed to verify that the rodent RAHF system would adequately support and maintain animal specimens during normal system operations. Additional objectives of this test were to demonstrate that: (1) the system would capture typical particulate debris produced by the animal; (2) microorganisms would be contained; and (3) the passage of animal odors was adequately controlled. In addition, the amount of carbon dioxide exhausted by the RAHF system was to be quantified. Of primary importance during the test was the demonstration that the RAHF would contain particles greater than 150 micrometers. This was verified after analyzing collection plates placed under exhaust air ducts and rodent cages during cage maintenance operations, e.g., waste tray and feeder changeouts. Microbiological testing identified no additional organisms in the test environment that could be traced to the RAHF. Odor containment was demonstrated to be less than barely detectable. Ammonia could not be detected in the exhaust air from the RAHF system. Carbon dioxide levels were verified to be less than 0.35 percent.

Tracer verification and monitoring of containment systems

International Nuclear Information System (INIS)

Lowry, W.; Dunn, S.D.; Williams, C.

1996-01-01

In-situ barrier emplacement techniques and materials for the containment of high-risk contaminants in soils are currently being developed by the Department of Energy (DOE). Because of their relatively high cost, the barriers are intended to be used in cases where the risk is too great to remove the contaminants, the contaminants are too difficult to remove with current technologies, or the potential for movement of the contaminants to the water table is so high that immediate action needs to be taken to reduce health risks. Consequently, barriers are primarily intended for use in high-risk sites where few viable alternatives exist to stop the movement of contaminants in the near term. Assessing the integrity of the barrier once it is emplaced, and during its anticipated life, is a very difficult but necessary requirement. Existing surface-based and borehole geophysical techniques do not provide the degree of resolution required to assure the formation of an integral in-situ barrier. Science and Engineering Associates, Inc., (SEA) and Sandia National Laboratories (SNL) are developing a quantitative subsurface barrier assessment system using gaseous tracers. Called SEAtrace trademark, this system integrates an autonomous, multipoint soil vapor sampling and analysis system with a global optimization modeling methodology to pinpoint leak sources and sizes in real time. SEAtrace trademark is applicable to impermeable barrier emplacements above the water table, providing a conservative assessment of barrier integrity after emplacement, as well as a long term integrity monitoring function. The SEAtrace trademark system is being developed under funding by the DOE-EM Subsurface Contaminant Focus Area

Barriers to the implementation of research perceived by nurses from Osakidetza.

Science.gov (United States)

Cidoncha-Moreno, M Ángeles; Ruíz de Alegría-Fernandez de Retana, Begoña

To understand the barriers to implementing nursing research findings into practice, as perceived by the nurses working in Osakidetza and to analyze if the workplace factor and time worked affect the perception of these barriers. Cross-sectional study. BARRIERS Scale questionnaire was given to a representative sample of 1,572 Basque Health Service nurses, stratified and randomized, according to scope of work and job responsibility (response rate: 43.76%). According to the research results, the first important barrier was "insufficient time on the job to implement new ideas". Nurses have perceived the organizational factor as the most important barrier in their practice. Nurses in "Special hospital departments" perceived more barriers in the "quality of research" factor than those working in "Primary Care". Years of service showed a slight influence. The nurses stated that external factors related to the organization principally interfered in implementing results into clinical practice. They placed lack of critical reading training second. Working environment and seniority mark differences in the perception of barriers. This study may help to develop strategies for planning training programs to facilitate the use of research in clinical practice, in order to provide quality care. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Emotional Barriers to Successful Reemployment: Implications for Counselors.

Science.gov (United States)

Guindon, Mary H.; Smith, Barrett

2002-01-01

Common responses to job loss include stress reactions, depression and anxiety, and lowered self-esteem. This article describes these common reactions to job loss and unemployment, explains how to recognize their symptoms, and discusses ways counselors can address these emotional barriers to finding meaningful employment. (Contains 50 references.)…

Synthesis of the IRSN report related to the containment of double walled enclosures of the operated fleet

International Nuclear Information System (INIS)

2013-01-01

This report presents the IRSN's analysis on studies and modifications planned by EDF within the frame of the VD3-1300 safety re-examination which more particularly concern the third containment barrier of a reactor and of its extensions, as well as the containment of some surrounding buildings. The addressed topics are: the approach associated with the 'containment' safety function, the condition, behaviour and control of the double walled enclosure, the system of suction and filtration of the space between enclosures, the extension of the third containment barrier, the containment of building surrounding the reactor building, the risk of bypass containment, the EDF organisation with respect to the containment safety function

Verification of the integrity of barriers using gas diffusion

International Nuclear Information System (INIS)

Ward, D.B.; Williams, C.V.

1997-06-01

In-situ barrier materials and designs are being developed for containment of high risk contamination as an alternative to immediate removal or remediation. The intent of these designs is to prevent the movement of contaminants in either the liquid or vapor phase by long-term containment, essentially buying time until the contaminant depletes naturally or a remediation can be implemented. The integrity of the resultant soil-binder mixture is typically assessed by a number of destructive laboratory tests (leaching, compressive strength, mechanical stability with respect to wetting and freeze-thaw cycles) which as a group are used to infer the likelihood of favorable long-term performance of the barrier. The need exists for a minimally intrusive yet quantifiable methods for assessment of a barrier's integrity after emplacement, and monitoring of the barrier's performance over its lifetime. Here, the authors evaluate non-destructive measurements of inert-gas diffusion (specifically, SF 6 ) as an indicator of waste-form integrity. The goals of this project are to show that diffusivity can be measured in core samples of soil jet-grouted with Portland cement, validate the experimental method through measurements on samples, and to calculate aqueous diffusivities from a series of diffusion measurements. This study shows that it is practical to measure SF 6 diffusion rates in the laboratory on samples of grout (Portland cement and soil) typical of what might be used in a barrier. Diffusion of SF 6 through grout (Portland cement and soil) is at least an order of magnitude slower than through air. The use of this tracer should be sensitive to the presence of fractures, voids, or other discontinuities in the grout/soil structure. Field-scale measurements should be practical on time-scales of a few days

In-situ containment and stabilization of buried waste

International Nuclear Information System (INIS)

Allan, M.L.; Kukacka, L.E.

1993-10-01

In FY 1993 research continued on development and testing of grout materials for in-situ containment and stabilization of buried waste. Specifically, the work was aimed at remediation of the Chemical Waste Landfill (CWL) at Sandia National Laboratories (SNL) in Albuquerque, New Mexico as part of the Mixed Waste Landfill Integrated Demonstration (MWLID). The work on grouting materials was initiated in FY 1992 and the accomplishments for that year are documented in the previous annual report (Allan, Kukacka and Heiser, 1992). The remediation plan involves stabilization of the chromium plume, placement of impermeable vertical and horizontal barriers to isolate the landfill and installation of a surface cap. The required depth of subsurface barriers is approximately 33 m (100 ft). The work concentrated on optimization of grout formulations for use as grout and soil cement barriers and caps. The durability of such materials was investigated, in addition to shrinkage cracking resistance, compressive and flexural strength and permeability. The potential for using fibers in grouts to control cracking was studied. Small scale field trials were conducted to test the practicality of using the identified formulations and to measure the long term performance. Large scale trials were conducted at Sandia as part of the Subsurface Barrier Emplacement Technology Program. Since it was already determined in FY 1992 that cementitious grouts could effectively stabilize the chromium plume at the CWL after pre-treatment is performed, the majority of the work was devoted to the containment aspect

Tunnel barrier and noncollinear magnetization effects on shot noise in ferromagnetic/semiconductor/ferromagnetic heterojunctions

International Nuclear Information System (INIS)

An Xingtao; Liu Jianjun

2008-01-01

Based on the scattering approach, we investigate transport properties of electrons in a one-dimensional waveguide that contains a ferromagnetic/semiconductor/ferromagnetic heterojunction and tunnel barriers in the presence of Rashba and Dresselhaus spin-orbit interactions. We simultaneously consider significant quantum size effects, quantum coherence, Rashba and Dresselhaus spin-orbit interactions and noncollinear magnetizations. It is found that the tunnel barrier plays a decisive role in the transmission coefficient and shot noise of the ballistic spin electron transport through the heterojunction. When the small tunnel barriers are considered, the transport properties of electrons are quite different from those without tunnel barriers

Reducing barriers to energy efficiency in the German brewing sector. Final report

Energy Technology Data Exchange (ETDEWEB)

Schleich, J; Boede, U; Ostertag, K; Radgen, P

2000-12-01

This report describes the empirical research into barriers to energy efficiency in the German brewing sector. It is one of nine such reports in the BARRIERS project. The report contains description and analysis of five case studies of energy management in German breweries. The results are analysed using the theoretical framework developed for the BARRIERS project. The report also provides brief recommendations on how these barriers to the rational use of energy (RUE) may be overcome and how energy efficiency within the brewing sector may be improved. The results of the study for the brewing sector in Germany are summarised in this executive summary under the following headings: - Characterising the brewing sector - Case studies of energy management in the German brewing sector; - Evidence of barriers in the German brewing sector; - The role of energy service companies in the brewing sector; - Policy implications. (orig.)

Reducing barriers to energy efficiency in the German brewing sector. Executive Summary

Energy Technology Data Exchange (ETDEWEB)

Schleich, J.; Boede, U.; Ostertag, K.; Radgen, P.

2000-12-01

This report describes the empirical research into barriers to energy efficiency in the German brewing sector. It is one of nine such reports in the BARRIERS project. The report contains description and analysis of five case studies of energy management in German breweries. The results are analysed using the theoretical framework developed for the BARRIERS project. The report also provides brief recommendations on how these barriers to the rational use of energy (RUE) may be overcome and how energy efficiency within the brewing sector may be improved. The results of the study for the brewing sector in Germany are summarised in this executive summary under the following headings: - Characterising the brewing sector; - Case studies of energy management in the German brewing sector; - Evidence of barriers in the German brewing sector; - The role of energy service companies in the brewing sector; - Policy implications. (orig.)

Determining the Coefficient of Discharge for a Draining Container

Science.gov (United States)

Hicks, Ashley; Slaton, William

2014-01-01

The flow of fluids through open containers is a topic studied frequently in introductory physics classes. A fluid mechanics class delves deeper into the topic of fluid flow through open containers with holes or barriers. The flow of a fluid jet out of a sharp-edged orifice rarely has the same area as the orifice due to a fluid flow phenomenon…

77 FR 74827 - Working Group on Access to Information on Prescription Drug Container Labels

Science.gov (United States)

2012-12-18

... on Prescription Drug Container Labels AGENCY: Architectural and Transportation Barriers Compliance... information on prescription drug container labels accessible to people who are blind or visually impaired. The... stakeholder working group to develop best practices for making information on prescription drug container...

[Motivation and barriers in the consumption of five daily servings of fruit and vegetables by mothers of school age children and primary school teachers].

Science.gov (United States)

Olivares, Sonia; Lera, Lydia; Mardones, María Angélica; Araneda, Jacqueline; Olivares, María Antonieta; Colque, Maria Ester

2009-06-01

As a baseline for the promotion of health and the design of educational interventions, the benefits, barriers and stages of change related to the consumption of five daily servings of fruit and vegetables were studied in 463 mothers of school age children from different socioeconomic levels (SEL) and 412 primary school teachers in 3 cities in Chile. These groups were selected because of their influence over children's eating habits. For the evaluation of stages changes, a questionnaire designed by the American Institute for Cancer Research was adapted and applied. The questionnaire was answered voluntarily by the participants. 58% of the mothers and 60% of the teachers ate 1-2 servings of fruit and vegetables daily; 29.4 and 32.3% ate 3-4 servings and only 10 and 4% respectively ate 5 servings. Benefits reported from fruit and vegetable consumption in both groups were pleasure, wellness, a sense of well being and weight management. Barriers mentioned were forgetfulness, time constraints, nonsatisfaction of appetite and lack of motivation. The price of fruit and vegetables was considered high by 15.1% of mothers of medium high SEL and by 26.4% of medium low SEL (p motivation for eating more fruit and vegetables and to thus support this healthy eating habit in children.

Corrosion evaluation of metallic HLW/spent fuel disposal containers - review

International Nuclear Information System (INIS)

Kursten, B.; Smailos, E.; Azkarate, I.; Werme, L.; Smart, N.R.; Marx, G.; Cunado, M.A.; Santarini, G.

2004-01-01

Over the years a lot of investigations have been performed to choose suitable container materials and to characterize their long-term corrosion behaviour in contact with their potential disposal environments, i.e. salt, clay, and granite. Carbon steels, stainless steels, nickel-based alloys, titanium-based alloys, and copper have been widely investigated as potential container materials depending on the studied host rock formation. The results obtained in salt environments indicate that the passively corroding Ti99.8-Pd is the primary choice for the thin-walled corrosion-resistant concept, since its general corrosion rate is negligible and it is highly resistant to localized corrosion and stress corrosion cracking (SCC) in salt brines. The TStE 355 carbon steel is the first candidate for the corrosion-allowance concept because it is resistant to pitting corrosion and SCC and its general corrosion rates are sufficiently low to provide corrosion allowance acceptable for thick-walled containers. Stainless steels, Ni-based alloys, and Ti-based alloys are the most important candidate container materials in clay for the thin-walled concept, while carbon steel is considered the main choice for the thick-walled corrosion-allowance concept. Studies performed in granite seem to indicate that copper containers provide an excellent corrosion barrier with an estimated lifetime exceeding 100,000 years. The TStE 355 carbon steel is also a valid option for a thick-walled container concept in granite. In this paper, some relevant corrosion data of carbon steel and stainless steel in cementitious environments are given in addition because large amounts of concrete will be used as structural materials in most of the envisaged repository design concepts. This paper also provides recommendations for future studies. (authors)

Comparison of a Rat Primary Cell-Based Blood-Brain Barrier Model With Epithelial and Brain Endothelial Cell Lines: Gene Expression and Drug Transport

Directory of Open Access Journals (Sweden)

Szilvia Veszelka

2018-05-01

Full Text Available Cell culture-based blood-brain barrier (BBB models are useful tools for screening of CNS drug candidates. Cell sources for BBB models include primary brain endothelial cells or immortalized brain endothelial cell lines. Despite their well-known differences, epithelial cell lines are also used as surrogate models for testing neuropharmaceuticals. The aim of the present study was to compare the expression of selected BBB related genes including tight junction proteins, solute carriers (SLC, ABC transporters, metabolic enzymes and to describe the paracellular properties of nine different culture models. To establish a primary BBB model rat brain capillary endothelial cells were co-cultured with rat pericytes and astrocytes (EPA. As other BBB and surrogate models four brain endothelial cells lines, rat GP8 and RBE4 cells, and human hCMEC/D3 cells with or without lithium treatment (D3 and D3L, and four epithelial cell lines, native human intestinal Caco-2 and high P-glycoprotein expressing vinblastine-selected VB-Caco-2 cells, native MDCK and MDR1 transfected MDCK canine kidney cells were used. To test transporter functionality, the permeability of 12 molecules, glucopyranose, valproate, baclofen, gabapentin, probenecid, salicylate, rosuvastatin, pravastatin, atorvastatin, tacrine, donepezil, was also measured in the EPA and epithelial models. Among the junctional protein genes, the expression level of occludin was high in all models except the GP8 and RBE4 cells, and each model expressed a unique claudin pattern. Major BBB efflux (P-glycoprotein or ABCB1 and influx transporters (GLUT-1, LAT-1 were present in all models at mRNA levels. The transcript of BCRP (ABCG2 was not expressed in MDCK, GP8 and RBE4 cells. The absence of gene expression of important BBB efflux and influx transporters BCRP, MRP6, -9, MCT6, -8, PHT2, OATPs in one or both types of epithelial models suggests that Caco-2 or MDCK models are not suitable to test drug candidates which

Impact of vertical barriers on performance of pump-and-treat systems

International Nuclear Information System (INIS)

Russell, K.; Rabideau, A.

1997-01-01

Although aquifer remediation by Pump-and-treat (PAT) is widely practiced, it is generally implemented as an effective means of plume containment, rather than as an efficient means of contaminant mass removal. The use of slurry cutoff walls has been recognized as a means of improving the performance of PAT with respect to hydraulic control. As part of a study on the use of decision analysis in the design of aquifer remediation systems, the economic tradeoffs between capital costs and risk reduction were compared for several alternative PAT strategies. This work included an evaluation of the use of vertical barriers as components of PAT systems, using numerical experiments to examine the impacts of vertical barriers on PAT reliability. The results indicated that the use of vertical barriers in conjunction with PAT can significantly improve the simulated system performance, but that the magnitude of the predicted enhancement and cost-effectiveness of the barrier system are dependent on site characteristics, barrier placement, and modeling assumptions

A Multiple Indicators Multiple Causes (MIMIC) model of internal barriers to drug treatment in China.

Science.gov (United States)

Qi, Chang; Kelly, Brian C; Liao, Yanhui; He, Haoyu; Luo, Tao; Deng, Huiqiong; Liu, Tieqiao; Hao, Wei; Wang, Jichuan

2015-03-01

Although evidence exists for distinct barriers to drug abuse treatment (BDATs), investigations of their inter-relationships and the effect of individual characteristics on the barrier factors have been sparse, especially in China. A Multiple Indicators Multiple Causes (MIMIC) model is applied for this target. A sample of 262 drug users were recruited from three drug rehabilitation centers in Hunan Province, China. We applied a MIMIC approach to investigate the effect of gender, age, marital status, education, primary substance use, duration of primary drug use, and drug treatment experience on the internal barrier factors: absence of problem (AP), negative social support (NSS), fear of treatment (FT), and privacy concerns (PC). Drug users of various characteristics were found to report different internal barrier factors. Younger participants were more likely to report NSS (-0.19, p=0.038) and PC (-0.31, p<0.001). Compared to other drug users, ice users were more likely to report AP (0.44, p<0.001) and NSS (0.25, p=0.010). Drug treatment experiences related to AP (0.20, p=0.012). In addition, differential item functioning (DIF) occurred in three items when participant from groups with different duration of drug use, ice use, or marital status. Individual characteristics had significant effects on internal barriers to drug treatment. On this basis, BDAT perceived by different individuals could be assessed before tactics were utilized to successfully remove perceived barriers to drug treatment. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Swedish nurses encounter barriers when promoting healthy habits in children.

Science.gov (United States)

Ljungkrona-Falk, Lena; Brekke, Hilde; Nyholm, Maria

2014-12-01

To increase the understanding of difficulties in promoting healthy habits to parents, we explore barriers in health-care provision. The aim of this study is to describe nurses' perceived barriers when discussing with parents regarding healthy food habits, physical activity and their child's body weight. A mixed method approach was chosen. Nurses (n = 76) working at 29 different Child Health Care Centers' in an area in west Sweden were included in the study. Three focus group interviews were conducted and 17 nurses were selected according to maximum variation. Data were categorized and qualitative content analysis was the chosen analysis method. In the second method, data were obtained from a questionnaire distributed to all 76 nurses. The latent content was formulated into a theme: even with encouragement and support, the nurses perceive barriers of both an external and internal nature. The results identified four main barriers: experienced barriers in the workplace-internal and external; the nurse's own fear and uncertainty; perceived obstacles in nurse-parent interactions and modern society impedes parents' ability to promote healthy habits. The nurses' perceived barriers were confirmed by the results from 62 of the nurses who completed the questionnaire. Despite education and professional support, the health professionals perceived both external and internal barriers in promoting healthy habits to parents when implementing a new method of health promotion in primary care. Further qualitative studies are needed to gain deeper understanding of the perceived barriers when promoting healthy habits to parents. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Practice Patterns, Attitudes, and Barriers to Palliative Care Consultation by Gynecologic Oncologists.

Science.gov (United States)

Buckley de Meritens, Alexandre; Margolis, Benjamin; Blinderman, Craig; Prigerson, Holly G; Maciejewski, Paul K; Shen, Megan J; Hou, June Y; Burke, William M; Wright, Jason D; Tergas, Ana I

2017-09-01

We sought to describe practice patterns, attitudes, and barriers to the integration of palliative care services by gynecologic oncologists. Members of the Society of Gynecologic Oncology were electronically surveyed regarding their practice of incorporating palliative care services and to identify barriers for consultation. Descriptive statistics were used, and two-sample z-tests of proportions were performed to compare responses to related questions. Of the 145 respondents, 71% were attending physicians and 58% worked at an academic medical center. The vast majority (92%) had palliative care services available for consultation at their hospital; 48% thought that palliative care services were appropriately used, 51% thought they were underused, and 1% thought they were overused. Thirty percent of respondents thought that palliative care services should be incorporated at first recurrence, whereas 42% thought palliative care should be incorporated when prognosis for life expectancy is ≤ 6 months. Most participants (75%) responded that palliative care consultation is reasonable for symptom control at any stage of disease. Respondents were most likely to consult palliative care services for pain control (53%) and other symptoms (63%). Eighty-three percent of respondents thought that communicating prognosis is the primary team's responsibility, whereas the responsibilities for pain and symptom control, resuscitation status, and goals of care discussions were split between the primary team only and both teams. The main barrier for consulting palliative care services was the concern that patients and families would feel abandoned by the primary oncologist (73%). Ninety-seven percent of respondents answered that palliative care services are useful to improve patient care. The majority of gynecologic oncologists perceived palliative care as a useful collaboration that is underused. Fear of perceived abandonment by the patient and family members was identified as a

Barriers to Electronic Health Record Adoption: a Systematic Literature Review.

Science.gov (United States)

Kruse, Clemens Scott; Kristof, Caitlin; Jones, Beau; Mitchell, Erica; Martinez, Angelica

2016-12-01

Federal efforts and local initiatives to increase adoption and use of electronic health records (EHRs) continue, particularly since the enactment of the Health Information Technology for Economic and Clinical Health (HITECH) Act. Roughly one in four hospitals not adopted even a basic EHR system. A review of the barriers may help in understanding the factors deterring certain healthcare organizations from implementation. We wanted to assemble an updated and comprehensive list of adoption barriers of EHR systems in the United States. Authors searched CINAHL, MEDLINE, and Google Scholar, and accepted only articles relevant to our primary objective. Reviewers independently assessed the works highlighted by our search and selected several for review. Through multiple consensus meetings, authors tapered articles to a final selection most germane to the topic (n = 27). Each article was thoroughly examined by multiple authors in order to achieve greater validity. Authors identified 39 barriers to EHR adoption within the literature selected for the review. These barriers appeared 125 times in the literature; the most frequently mentioned barriers were regarding cost, technical concerns, technical support, and resistance to change. Despite federal and local incentives, the initial cost of adopting an EHR is a common existing barrier. The other most commonly mentioned barriers include technical support, technical concerns, and maintenance/ongoing costs. Policy makers should consider incentives that continue to reduce implementation cost, possibly aimed more directly at organizations that are known to have lower adoption rates, such as small hospitals in rural areas.

Advanced containment research for the Canadian Nuclear Fuel Waste Management Program

International Nuclear Information System (INIS)

Onofrei, M.; Mathew, P.M.; McKay, P.; Hosaluk, L.J.; Oscarson, D.W.

1986-09-01

This document outlines the program on the development of advanced containment systems for the disposal of used fuel in a vault deep in plutonic rock. Possible advanced containment concepts, the strategy adopted in selecting potential container materials, and experimental programs currently underway or planned are presented. Most effort is currently directed toward developing long-term containment systems based on non-metallic materials and massive metal containers. The use of additional independent barriers to extend the lifetime of simple containment systems is also being evaluated. 58 refs

Why are IPTp coverage targets so elusive in sub-Saharan Africa? A systematic review of health system barriers.

Science.gov (United States)

Thiam, Sylla; Kimotho, Victoria; Gatonga, Patrick

2013-10-03

Use of intermittent preventive treatment (IPTp) is a proven cost-effective intervention for preventing malaria in pregnancy. However, despite the roll-out of IPTp policies across Africa more than ten years ago, utilization levels remain low. This review sought to consolidate scattered evidence as to the health system barriers for IPTp coverage in the continent. Relevant literature from Africa was systematically searched, reviewed and synthesized. Only studies containing primary data were considered. Studies reveal that: (i) poor leadership and governance contribute to slow decentralization of programme management, lack of harmonized guidelines, poor accountability mechanisms, such as robust monitoring and evaluation systems; (ii) low budgetary allocation towards policy implementation slows scale-up, while out-of-pocket expenditure deters women from seeking antenatal services that include IPTp; (iii) there are rampant human resource challenges including low staff motivation levels attributed to such factors as incorrect knowledge of IPTp recommendations and inadequate staffing; (iv) implementation of IPTp policies is hampered by prevailing service delivery barriers, such as long waiting time, long distances to health facilities and poor service provider/client relations; and (v) drug stock-outs and poor management of information and supply chains impair sustained availability of drugs for IPTp. For successful IPTp policy implementation, it is imperative that malaria control programmes target health system barriers that result in low coverage and hence programme ineffectiveness.

Barriers and enablers for the development and implementation of allied health clinical practice guidelines in South African primary healthcare settings: a qualitative study.

Science.gov (United States)

Dizon, J M; Grimmer, K; Louw, Q; Machingaidze, S; Parker, H; Pillen, H

2017-09-15

The South African allied health (AH) primary healthcare (PHC) workforce is challenged with the complex rehabilitation needs of escalating patient numbers. The application of evidence-based care using clinical practice guidelines (CPGs) is one way to make efficient and effective use of resources. Although CPGs are common for AH in high-income countries, there is limited understanding of how to do this in low- to middle-income countries. This paper describes barriers and enablers for AH CPG uptake in South African PHC. Semi-structured individual interviews were undertaken with 25 South African AH managers, policymakers, clinicians and academics to explore perspectives on CPGs. Interviews were conducted by researcher dyads, one being familiar with South African AH PHC practice and the other with CPG expertise. Rigour and transparency of data collection was ensured. Interview transcripts were analysed by structuring content into codes, categories and themes. Exemplar quotations were extracted to support themes. CPGs were generally perceived to be relevant to assist AH providers to address the challenges of consistently providing evidence-based care in South African PHC settings. CPGs were considered to be tools for managing clinical, social and economic complexities of AH PHC practice, particularly if CPG recommendations were contextusalised. CPG uptake was one way to deal with increasing pressures to make efficient use of scarce financial resources, and to demonstrate professional legitimacy. Themes comprised organisational infrastructures and capacities for CPG uptake, interactions between AH actors and interaction with broader political structures, the nature of AH evidence in CPGs, and effectively implementing CPGs into practice. CPGs contextualised to local circumstances offer South African PHC AH services with an efficient vehicle for putting evidence into practice. There are challenges to doing this, related to local barriers such as geography, AH training

Primary care professional's perspectives on treatment decision making for depression with African Americans and Latinos in primary care practice.

Science.gov (United States)

Patel, Sapana R; Schnall, Rebecca; Little, Virna; Lewis-Fernández, Roberto; Pincus, Harold Alan

2014-12-01

Increasing interest has been shown in shared decision making (SDM) to improve mental health care communication between underserved immigrant minorities and their providers. Nonetheless, very little is known about this process. The following is a qualitative study of fifteen primary care providers at two Federally Qualified Health Centers in New York and their experience during depression treatment decision making. Respondents described a process characterized in between shared and paternalistic models of treatment decision making. Barriers to SDM included discordant models of illness, stigma, varying role expectations and decision readiness. Respondents reported strategies used to overcome barriers including understanding illness perceptions and the role of the community in the treatment process, dispelling stigma using cultural terms, orienting patients to treatment and remaining available regarding the treatment decision. Findings from this study have implications for planning SDM interventions to guide primary care providers through treatment engagement for depression.

Role of Primary Care Providers in Tobacco Cessation, Tobacco Dependence Treatment

Directory of Open Access Journals (Sweden)

Rohini Ruhil

2015-03-01

Full Text Available Background: Tobacco use is very common among Indian society. In fact, tobacco use is responsible for majority of morbidity and mortality in India and worldwide. Tobacco has been identified as “addictive” and tobacco dependence has been defined as a health problem in ICD-10. Aims & Objectives: This review article aims to emphasize the role of primary health care providers in tobacco cessation and to give recommendations after identifying barriers and exploring the present scenario. Material Methods: Several studies, journals and web-based articles have been referred to support the evidence that a brief tobacco cessation advice from physicians could help the patient quit. Result: Studies show that there is lack of participation from primary health care providers for tobacco cessation. Several barriers have been identified in many studies and also there exist some solutions to these barriers. Conclusion: It has been concluded in the article that primary health care providers should be trained and supported with all possible resources so that they can screen tobacco use in patients and could help them quit.

Containment Loads Analysis for CANDU6 Reactor using CONTAIN 2.0

International Nuclear Information System (INIS)

Kim, Tae H.; Yang, Chae Y.

2013-01-01

The containment plays an important role to limit the release of radioactive materials to the environment during design basis accidents (DBAs). Therefore, the containment has to maintain its integrity under DBA conditions. Generally, a containment functional DBA evaluation includes calculations of the key containment loads, i. e., pressure and temperature effects associated with a postulated large rupture of the primary or secondary coolant system piping. In this paper, the behavior of containment pressure and temperature was evaluated for loss of coolant accidents (LOCAs) of the Wolsong unit 1 in order to assess the applicability of CONTAIN 2.0 code for the containment loads analysis of the CANDU6 reactor. The containment pressure and temperature of the Wolsong unit 1 were evaluated using the CONTAIN 2.0 code and the results were compared with the CONTEMPT4 code. The peak pressure and temperature calculated by CONTAIN 2.0 agreed well with those of CONTEMPT4 calculation. The overall result of this analysis shows that the CONTAIN 2.0 code can apply to the containment loads analysis for the CANDU6 reactor

Barriers to physical activity between adults with stroke and their care partners.

Science.gov (United States)

Zalewski, Kathryn R; Dvorak, Leah

2011-10-01

Healthy living includes meeting daily physical activity guidelines. This study compares daily physical activity rates and barriers to physical activity for people with stroke and their partners (spouse or significant other). Physical abilities, energy expenditure, daily steps, and barriers to physical activity are evaluated in people who have completed stroke rehabilitation and their partners. Twenty pairs of adults (mean age 69.7 years) participated. Participants with stroke were classified as sedentary, averaging 2,990 (± 2,488) steps per day. Their partners are classified as low active, averaging 6,378 (± 2,149) steps per day. For stroke survivors, physical abilities were positively correlated to daily activity rates. The number of steps walked per day was moderately correlated to 6-minute walk tests (r = 0.550, P physical abilities were not correlated to daily physical activity. People with stroke report lack of skill as a primary barrier; their partners report lack of time. The relationship between physical ability and physical activity is reinforced with this study. The impact of stroke on the family, particularly on time demands of the primary caregiver, suggests the needs of the care partner may not be adequately addressed in the rehabilitation process.

Barriers and facilitators to the integration of mental health services into primary health care: a systematic review protocol.

Science.gov (United States)

Wakida, Edith K; Akena, Dickens; Okello, Elialilia S; Kinengyere, Alison; Kamoga, Ronald; Mindra, Arnold; Obua, Celestino; Talib, Zohray M

2017-08-25

Mental health is an integral part of health and well-being and yet health systems have not adequately responded to the burden of mental disorders. Integrating mental health services into primary health care (PHC) is the most viable way of closing the treatment gap and ensuring that people get the mental health care they need. PHC was formally adapted by the World Health Organization (WHO), and they have since invested enormous amounts of resources across the globe to ensure that integration of mental health services into PHC works. This review will use the SPIDER (Sample, Phenomenon of Interest, Design, Evaluation, Research type) framework approach to identify experiences of mental health integration into PHC; the findings will be reported using the "Best fit" framework synthesis. PubMed, EMBASE, PsycINFO, and Cochrane Central Register of Controlled trials (CENTRAL) will be searched including other sources like the WHO website and OpenGrey database. Assessment of bias and quality will be done at study level using two separate tools to check for the quality of evidence presented. Data synthesis will take on two synergistic approaches (qualitative and quantitative studies). Synthesizing evidence from countries across the globe will provide useful insights into the experiences of integrating mental health services into PHC and how the barriers and challenges have been handled. The findings will be useful to a wide array of stakeholders involved in the implementation of the mental health integration into PHC. The SPIDER framework has been chosen for this review because of its suitable application to qualitative and mixed methods research and will be used as a guide when selecting articles for inclusion. Data extracted will be synthesized using the "Best fit" framework because it has been used before and proved its suitability in producing new conceptual models for explaining decision-making and possible behaviors. Synthesizing evidence from countries across the globe

Investigating Primary Source Literacy

Science.gov (United States)

Archer, Joanne; Hanlon, Ann M.; Levine, Jennie A.

2009-01-01

Primary source research requires students to acquire specialized research skills. This paper presents results from a user study testing the effectiveness of a Web guide designed to convey the concepts behind "primary source literacy". The study also evaluated students' strengths and weaknesses when conducting primary source research. (Contains 3…

Barriers to the use of hydrotherapy in labor.

Science.gov (United States)

Stark, Mary Ann; Miller, Michael G

2009-01-01

To determine nurses' perceived barriers to the use of hydrotherapy in labor. While effective in relieving pain, reducing anxiety, encouraging relaxation, and promoting a sense of control, hydrotherapy is rarely used during labor. Comparative descriptive survey design. A national convention and perinatal listserves. Intrapartum nurses (N=401) attending a national convention (Association of Women's Health, Obstetric, and Neonatal Nurses, 2007; n=225) and members of perinatal listserves (n=176) were recruited. A questionnaire was designed for this study (Nurses' Perception of the Use of Hydrotherapy in Labor). The questionnaire was available in paper format and online. Institutional but not individual characteristics (age, education, and role) were associated with Nurses' Perception of the Use of Hydrotherapy in Labor. Nurses who reported higher epidural rates (r=.45, p=.000) and Cesarean section rates (r=.30, p=.000) reported more barriers. There was no difference in perception of barriers for nurses at hospitals providing different levels of care; there were significant differences when primary care providers were considered. Intrapartum nurses in facilities where certified nurse-midwives do most deliveries reported significantly fewer barriers than nurses who worked in facilities where physicians attended most deliveries (F=6.84, df=2, p=.000). The culture of the birthing unit in which nurses provide care influences perception of barriers to the use of hydrotherapy in labor. Providing hydrotherapy requires a supportive environment, adequate nursing policies and staffing, and collaborative relationships among the health care team.

NATURAL BARRIERS TARGETED THRUST FY 2004 PROJECTS

International Nuclear Information System (INIS)

NA

2005-01-01

This booklet contains project descriptions of work performed by the Department of Energy (DOE), Office of Civilian Radioactive Waste Management (OCRWM), Office of Science and Technology and International's (OSTandI) Natural Barriers Targeted Thrust during Fiscal Year (FY) 2004. The Natural Barriers Targeted Thrust is part of OSTandI's Science and Technology Program which supports the OCRWM mission to manage and dispose of high-level radioactive waste and spent nuclear fuel in a manner that protects health, safety, and the environment; enhances national and energy security; and merits public confidence. In general, the projects described will continue beyond FY 2004 assuming that the technical work remains relevant to the proposed Yucca Mountain Repository and sufficient funding is made available to the Science and Technology Program

Regulatory barriers to hazardous waste technology innovation

International Nuclear Information System (INIS)

Kuusinen, T.L.; Siegel, M.R.

1991-02-01

The primary federal regulatory programs that influence the development of new technology for hazardous waste are the Resource Conservation and Recovery Act (RCRA) and the Comprehensive Environmental Response, Compensation and Liability Act (CERCLA, also commonly known as Superfund). Two important aspects of RCRA that can create barriers to hazardous waste technology innovation are technology-based waste pre-treatment standards and a cumbersome permitting program. By choosing a technology-based approach to the RCRA land disposal restrictions program, the US Environmental Protection Agency (EPA) has simultaneously created tremendous demand for the technologies specified in its regulations, while at the same time significantly reduced incentives for technology innovation that might have otherwise existed. Also, the RCRA hazardous waste permitting process can take years and cost hundreds of thousands of dollars. The natural tendency of permit writers to be cautious of unproven (i.e., innovative) technology also can create a barrier to deployment of new technologies. EPA has created several permitting innovations, however, to attempt to mitigate this latter barrier. Understanding the constraints of these permitting innovations can be important to the success of hazardous waste technology development programs. 3 refs

Barrier Coatings for Refractory Metals and Superalloys

Energy Technology Data Exchange (ETDEWEB)

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

2006-02-23

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

Motivators and barriers for paediatricians discharging patients.

Science.gov (United States)

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

2017-07-01

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

Barrier Coatings for Refractory Metals and Superalloys

International Nuclear Information System (INIS)

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

2006-01-01

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

Sendai virosomal infusion of an adeno-associated virus-derived construct containing neuropeptide Y into primary rat brain cultures.

Science.gov (United States)

Wu, P; de Fiebre, C M; Millard, W J; Elmstrom, K; Gao, Y; Meyer, E M

1995-05-05

A novel neuronal gene-delivery system was investigated in primary neuron-enriched cultures with respect to driving the expression of neuropeptide Y (NPY). This delivery system consists of an adeno-associated virus-derived (AAV) plasmid, pJDT95npy, encapsulated in reconstituted Sendai virosomes. pJDT95npy contains full length rat NPY cDNA inserted downstream from the P40 promoter in a cap-gene deleted AAV-derived construct. The rep-sequences under control of the P5 and P19 promoters are intact. Virosomally encapsulated pJDT95npy drove the expression of NPY mRNAs, predominantly by P40. Total cellular NPY immunoreactivity and release in the presence of depolarization increased following pJDT95npy-transfection. Neither empty virosomes nor virosomes containing pJDT95 affected NPY mRNA expression or immunoreactivity. This study demonstrates that an AAV-derived plasmid can drive exogenous gene expression in intact neurons after infusion by Sendai virosomes.

Overcoming barriers to public understanding of nuclear waste management

International Nuclear Information System (INIS)

Wilder, M.; Hall, S.

1987-01-01

Communication with the public to promote public understanding of, and participation in, nuclear waste issues is crucial. However, such communication with the public is falling short. One of the major reasons for this failure is that the public feels it cannot trust the motivations or actions of USDOE. The biggest barrier to public involvement in nuclear waste issues is the lack of trust in those who invite us to be involved. Many methods could be employed to increase communication and public involvement in complex and technical nuclear matters. This paper discusses the authors' observations of how USDOE's loss of credibility has affected the high-level nuclear waste repository siting process and suggests methods to overcome this primary barrier

105K West Isolation Barrier Acceptance Test results

International Nuclear Information System (INIS)

McCracken, K.J.; Irwin, J.J.

1995-01-01

The objective of this document is to report and interpret the findings of the isolation barrier acceptance tests performed in 105KW/100K. The tests were performed in accordance with the test plan and acceptance test procedure. The test report contains the test data. This document compares the test data against the criteria. A discussion of the leak rate analytical characterization describes how the flow characteristics flow rate will be determined using the test data from the test report. Two modes of water loss were considered; basin and/or discharge chute leakage, and evaporation. An initial test established baseline leakage data and instrumentation performance. Test 2 evaluated the sealing performance of the isolation barrier by inducing an 11 in. (27.9 cm) level differential across the barrier. The leak rate at this 11 in. (27.9 cm) level is extrapolated to the 16 ft. (4.9 m) level differential postulated in the DBE post seismic event. If the leak rate, adjusted for evaporation and basin leakage (determined from Test 1), is less than the SAR limit of 1,500 gph (5,680 lph) at a 16 ft (4.9 m) level differential, the barriers pass the acceptance test

Primary care nurses struggle with lifestyle counseling in diabetes care: a qualitative analysis

Directory of Open Access Journals (Sweden)

Elwyn Glyn

2010-05-01

Full Text Available Abstract Background Patient outcomes are poorly affected by lifestyle advice in general practice. Promoting lifestyle behavior change require that nurses shift from simple advice giving to a more counseling-based approach. The current study examines which barriers nurses encounter in lifestyle counseling to patients with type 2 diabetes. Based on this information we will develop an implementation strategy to improve lifestyle behavior change in general practice. Method In a qualitative semi-structured study, twelve in-depth interviews took place with nurses in Dutch general practices involved in diabetes care. Specific barriers in counseling patients with type 2 diabetes about diet, physical activity, and smoking cessation were addressed. The nurses were invited to reflect on barriers at the patient and practice levels, but mainly on their own roles as counselors. All interviews were audio-recorded and transcribed. The data were analyzed with the aid of a predetermined framework. Results Nurses felt most barriers on the level of the patient; patients had limited knowledge of a healthy lifestyle and limited insight into their own behavior, and they lacked the motivation to modify their lifestyles or the discipline to maintain an improved lifestyle. Furthermore, nurses reported lack of counseling skills and insufficient time as barriers in effective lifestyle counseling. Conclusions The traditional health education approach is still predominant in primary care of patients with type 2 diabetes. An implementation strategy based on motivational interviewing can help to overcome 'jumping ahead of the patient' and promotes skills in lifestyle behavioral change. We will train our nurses in agenda setting to structure the consultation based on prioritizing the behavior change and will help them to develop social maps that contain information on local exercise programs.

Passive Barriers to Inadvertent Human Intrusion for Use at the Nevada Test Site

International Nuclear Information System (INIS)

NSTec Environmental Management

2007-01-01

In July1996, BN transmitted Passive Barriers to Inadvertent Human Intrusion for Use at the Nevada Test Site to the United States Department of Energy, under Contract DE-AC08-91NV10833. The 1996 paper had a limited distribution and was not reviewed for public release. In 2007, National Security Technologies LLC (NSTec) made minor revisions to conform to current editorial standards of the NNSA/NSO and to meet current security requirements for public release. The primary purpose of this study was to identify types of engineered passive barriers that could deter future intrusion into buried low-level radioactive waste, particularly intrusion by drilling water wells. The study considered drilling technology, many natural and man-made materials, and both underground and above-ground barriers. Based on cost and effectiveness, the report recommended underground barriers consisting of a layer of rubble or tires. An aboveground barrier mound might also prove effective, but would cost more, and may become an attractive nuisance (e.g., might, after their purpose has been forgotten, encourage exploration for the sake of satisfying curiosity). Advances in drilling technology could render any engineered barriers ineffective if there is motivation to penetrate the barriers

Workplace barriers encountered by employed persons with systemic sclerosis.

Science.gov (United States)

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

2016-01-01

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

Health information technology workforce needs of rural primary care practices.

Science.gov (United States)

Skillman, Susan M; Andrilla, C Holly A; Patterson, Davis G; Fenton, Susan H; Ostergard, Stefanie J

2015-01-01

This study assessed electronic health record (EHR) and health information technology (HIT) workforce resources needed by rural primary care practices, and their workforce-related barriers to implementing and using EHRs and HIT. Rural primary care practices (1,772) in 13 states (34.2% response) were surveyed in 2012 using mailed and Web-based questionnaires. EHRs or HIT were used by 70% of respondents. Among practices using or intending to use the technology, most did not plan to hire new employees to obtain EHR/HIT skills and even fewer planned to hire consultants or vendors to fill gaps. Many practices had staff with some basic/entry, intermediate and/or advanced-level skills, but nearly two-thirds (61.4%) needed more staff training. Affordable access to vendors/consultants who understand their needs and availability of community college and baccalaureate-level training were the workforce-related barriers cited by the highest percentages of respondents. Accessing the Web/Internet challenged nearly a quarter of practices in isolated rural areas, and nearly a fifth in small rural areas. Finding relevant vendors/consultants and qualified staff were greater barriers in small and isolated rural areas than in large rural areas. Rural primary care practices mainly will rely on existing staff for continued implementation and use of EHR/HIT systems. Infrastructure and workforce-related barriers remain and must be overcome before practices can fully manage patient populations and exchange patient information among care system partners. Efforts to monitor adoption of these skills and ongoing support for continuing education will likely benefit rural populations. © 2014 National Rural Health Association.

Plan for metal barrier selection and testing for NNWSI

International Nuclear Information System (INIS)

Halsey, W.G.; McCright, R.D.

1987-12-01

The Department of Energy's Nevada Nuclear Waste Storage Investigations (NNWSI) Project is evaluating a site at Yucca Mountain in Nevada as a geological repository for the storage of high-level nuclear waste. The Nuclear Waste Management Projects (NWMP) at Lawrence Livermore National Laboratory (LLNL) has the responsibility for design, testing, and performance analysis of the NNWSI waste packages. One portion of this work is the selection and testing of the material for container construction. The anticipated container design is for this material to be a corrosion resistant metal called the metal barrier. This document is the publication version of the Scientific Investigation Plan (SIP) for the Metal Barrier Selection and Testing Task. The SIP serves as a formal planning document for the investigation and is used to assign quality assurance levels to the activities of the task. This document is an informal version for information distribution and has the sections on ''Schedule and Milestones'' and the ''Quality Assurance Level Assignment Sheets'' removed

Corrosion of barrier materials in seawater environments

International Nuclear Information System (INIS)

Heiser, J.H.; Soo, P.

1995-07-01

A brief review has been carried out on the performance of barrier materials for low-level radioactive wastes in seawater environments. The environments include those for shallower coastal waters as well as the deep ocean (down to 3800 m). The review is mainly focused on metallic materials since they are the most common for seawater service and they have the largest data base. Information from the literature is usually pertinent to shallower coastal locations, but there is a valuable source of corrosion data obtained from several studies of metallic specimens exposed to ocean-bed conditions. In addition, the corrosion of carbon steel barriers has been evaluated for actual waste containers that were retrieved from previously-used disposal sites in the Atlantic and Pacific Oceans. Of the metallic materials studied, carbon steel showed the least corrosion resistance. Failure by non-uniform attack in a typical waste container could occur in as little as 25 y in some ocean environments ' Penetration by local attack, such as pitting and crevice corrosion resistance was also observed for more expensive materials such as low-alloy steels, stainless steels, titanium alloys, zirconium alloys, copper alloys, nickel alloys, aluminum alloys, and lead alloys

Sub-barrier fusion: An experimental review

International Nuclear Information System (INIS)

Betts, R.R.

1991-01-01

This paper contains a review of the current status of the experimental study of heavy-ion fusion at sub-barrier energies. Emphasis is placed on the comparison of the experimentally observed quantities with theoretical expectations. Results of measurements of the spin distributions of the composite systems formed following fusion are critically examined with a view to understanding the large discrepancies between theory and experiment which exist for some systems. 20 refs., 14 figs

The application of containment technologies on landfills and contaminated sites in Europe

International Nuclear Information System (INIS)

Melchior, S.

1997-01-01

Remedial action on contaminated sites may include ex-situ or in-situ treatment of contaminants (extraction of solids, liquids and gases or in-situ decontamination) as well as the application of containment technologies. Rumer ampersand Ryan (1995) define containment technology as open-quotes the construction of low-permeability barriers around the source zone [of contaminated sites] to contain contaminants combined with manipulation of hydraulic gradientsclose quotes. The technical focus areas of the 1997 International Containment Technology Conference and Exhibition include vertical, bottom and surface barriers as well as technologies like permeable barriers and stabilization ampersand solidification. Contaminant transport modeling, the test and choice of materials, quality assurance and control, cost and performance criteria, and long-term performance monitoring are integral and essential parts of the technologies and their application. The extent of their use depends on the technology applied as well as on the hazard of the site. This paper will focus on a description of the systems used to construct walls, floors, and caps on European landfills and contaminated sites. The application of walls, floors, and caps, however, is not only a question of the best available technology but also is strongly governed by the priority of the problem to be solved. Therefore this paper will give a short overview on some environmental, socio-economical and political factors, which influence the application of containment technologies, before short profiles of the currently applied technologies will be presented

Defense High Level Waste Disposal Container System Description Document

International Nuclear Information System (INIS)

2000-01-01

The Defense High Level Waste Disposal Container System supports the confinement and isolation of waste within the Engineered Barrier System of the Monitored Geologic Repository (MGR). Disposal containers are loaded and sealed in the surface waste handling facilities, transferred to the underground through the accesses using a rail mounted transporter, and emplaced in emplacement drifts. The defense high level waste (HLW) disposal container provides long-term confinement of the commercial HLW and defense HLW (including immobilized plutonium waste forms (IPWF)) placed within disposable canisters, and withstands the loading, transfer, emplacement, and retrieval loads and environments. U.S. Department of Energy (DOE)-owned spent nuclear fuel (SNF) in disposable canisters may also be placed in a defense HLW disposal container along with commercial HLW waste forms, which is known as 'co-disposal'. The Defense High Level Waste Disposal Container System provides containment of waste for a designated period of time, and limits radionuclide release. The disposal container/waste package maintains the waste in a designated configuration, withstands maximum handling and rockfall loads, limits the individual canister temperatures after emplacement, resists corrosion in the expected handling and repository environments, and provides containment of waste in the event of an accident. Defense HLW disposal containers for HLW disposal will hold up to five HLW canisters. Defense HLW disposal containers for co-disposal will hold up to five HLW canisters arranged in a ring and one DOE SNF canister in the ring. Defense HLW disposal containers also will hold two Multi-Canister Overpacks (MCOs) and two HLW canisters in one disposal container. The disposal container will include outer and inner cylinders, outer and inner cylinder lids, and may include a canister guide. An exterior label will provide a means by which to identify the disposal container and its contents. Different materials

Meeting the challenge of constructing a uniquely difficult barrier wall

International Nuclear Information System (INIS)

Stamnes, R.L.; Orlean, H.M.; Thompson, N.E.

1997-01-01

A soil-bentonite vertical barrier wall with intersecting and round corners was constructed in complex geology and steep terrain to enclose and dewater a 1.4 hectare (3.5 acre) area once used for hazardous waste lagoons and landfills at the Queen City Farms (QCF) Superfund site in Maple Valley, Washington. The barrier system, including cap and barrier wall, was designed to contain light non-aqueous phase liquid (LNAPL), in addition to subsurface soil and ground water contaminated with chromium, polychlorinated biphenyls, polyaromatic hydrocarbons, trichloroethylene, dichloroethylene and vinyl chloride in the dissolved-phase. These contaminants threaten a drinking water aquifer beneath the site. Constructing the vertical barrier was a challenge due to steep slopes of 20 percent along the alignment (19.2 meter elevation change in the top of the wall), a 22.5 meter (75 foot) design wall depth, heavily consolidated clays and silts, open works gravels (gravel without finer soils), and geologic discontinuity. The barrier wall is keyed into either a glacial till or thin clayey-silt aquitard. Extensive earth moving, stepped walls and many construction techniques were used to enable construction of this barrier wall. Commonly accepted constructability criteria would have discouraged the construction of this wall

State of R and D of radioactive waste disposal (5). R and D of low level radioactive waste disposal. Engineered barrier: evaluation of barrier materials

International Nuclear Information System (INIS)

Hironaga, Michihiko

2008-01-01

The Central Research Institute of Electric Power Industry (CRIEPI) has researched and developed the long-term durability evaluation of engineered barrier materials for the facility of sub-surface disposal at intermediate depth. The important functions of engineered barrier are mechanical stability of construction, low hydraulic conductivity and diffusivity, and absorption of nuclide. A natural barrier plays an important part in nuclide transfer. Some examples of researches on the engineered barrier with cement and bentonite are reported. They contained the leaching test of hardened cement paste using X-ray microanalysis, relation between the dissociation rate of montmorillonite and pH from 15 to 70 deg C, and the mechanism of gas permeability of dense bentonite. The results of leaching test showed that the modified underground water leached smaller amount of ions than the ion exchanged water. The sediment was found on the surface of hardened paste. The dissociation rate of smectite under alkaline conditions showed almost the same values as neutral conditions at 15 deg C. (S.Y.)

Smart parking barrier

KAUST Repository

Alharbi, Abdulrazaq M.

2016-05-06

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

Teachers' Readiness to Implement Nutrition Education Programs: Beliefs, Attitudes, and Barriers

Science.gov (United States)

Perikkou, Anastasia; Kokkinou, Eleni; Panagiotakos, Demosthenes B.; Yannakoulia, Mary

2015-01-01

Teachers' attitudes about school food environments and their readiness to implement school-based nutrition programs were investigated. A total of 1,436 primary-school teachers filled out a questionnaire on their demographic and professional characteristics and their attitudes, beliefs, and barriers for implementing health educational programs. The…

Work Barriers Experienced and Job Accommodations Used by Persons with Arthritis and Other Rheumatic Diseases.

Science.gov (United States)

Allaire, Saralynn H.; Li, Wei; LaValley, Michael P.

2003-01-01

Many people with arthritis become work disabled, but little is known about the types of work barriers they experience and their use of job accommodations. This article describes work barriers and use of accommodations and examines factors associated with accommodation use in persons with arthritis at risk for work disability. (Contains 30…

Value engineering study for seletion of verticle barrier technology at a Superfund site

International Nuclear Information System (INIS)

Bryan, E.E.; Guglielmetti, J.L.; Butler, P.B.; Brill, M.P.

1997-01-01

A value engineering (VE) study was conducted to identify and evaluate vertical barrier technologies and alignments for a Superfund project in New Castle County, Delaware. The objective was to select and recommend the most appropriate vertical barrier(s) for two separate landfills and a portion of the manufacturing plant on the site. A VE team was assembled to identify and evaluate site specific issues related to effectiveness, constructability and cost for numerous vertical barrier technologies. Several cost-effective alternatives were identified that met project objectives. The VE study concluded that a composite vertical barrier system consisting of a soil-bentonite slurry trench and steel sheet piles would provide effective containment of the North Landfill. Additionally, the geologic confining unit specified in the Record of Decision (ROD) was found to be unsuitable as a vertical barrier key and a more suitable, shallow confining unit was discovered. This paper describes the value engineering process and results of the VE study for one of the landfills

Language, culture and emotions: exploring ethnic minority patients' emotional expressions in primary healthcare consultations.

Science.gov (United States)

De Maesschalck, Stéphanie; Deveugele, Myriam; Willems, Sara

2011-09-01

This study explores ethnic minority patients' expression of emotional cues and concerns in primary healthcare, and examines relationships with patient, provider and consultation attributes. 191 video-recorded consultations were analyzed using the VR-CoDES. Patients were interviewed before the consultation. Generalized Estimating Equations models (GEE) were used to test for associations. Psychosocial versus bio-medically oriented encounters contained significantly more cues (p≤0.05). Patients with poor versus good language proficiency expressed significantly less cues (p≤0.001). No significant correlations were found with patients' cultural values, patients' or physicians' gender or the presence of an interpreter. Female patients express more concerns (p≤0.05), female physicians have a higher number of concerns expressed by patients (p≤0.02). This study shows that independent of physician and diagnosis, patients' language proficiency has a more important impact on the number of cues expressed by the patient than cultural difference. Medical schools and Continuing Medical Education should focus on training programs for recognizing and handling linguistic barriers between physicians and patients. Patient education programs should encourage patients who experience language barriers to open up to physicians. In situations where language is a barrier, physicians and patients should be encouraged to use interpreters to enhance the expression of emotions. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Chaotic correlations in barrier billiards with arbitrary barriers

International Nuclear Information System (INIS)

Osbaldestin, A H; Adamson, L N C

2013-01-01

We study autocorrelation functions in symmetric barrier billiards for golden mean trajectories with arbitrary barriers. Renormalization analysis reveals the presence of a chaotic invariant set and thus that, for a typical barrier, there are chaotic correlations. The chaotic renormalization set is the analogue of the so-called orchid that arises in a generalized Harper equation. (paper)

Reactor container

International Nuclear Information System (INIS)

Kojima, Yoshihiro; Hosomi, Kenji; Otonari, Jun-ichiro.

1997-01-01

In the present invention, a catalyst for oxidizing hydrogen to be disposed in a reactor container upon rupture of pipelines of a reactor primary coolant system is prevented from deposition of water droplets formed from a reactor container spray to suppress elevation of hydrogen concentration in the reactor container. Namely, a catalytic combustion gas concentration control system comprises a catalyst for oxidizing hydrogen and a support thereof. In addition, there is also disposed a water droplet deposition-preventing means for preventing deposition of water droplets in a reactor pressure vessel on the catalyst. Then, the effect of the catalyst upon catalytic oxidation reaction of hydrogen can be kept high. The local elevation of hydrogen concentration can be prevented even upon occurrence of such a phenomenon that various kinds of mobile forces in the container such as dry well cooling system are lost. (I.S.)

Expression and deposition of basement membrane proteins by brain capillary endothelial cells in a primary murine model of the blood-brain barrier

DEFF Research Database (Denmark)

Thomsen, Maj Schneider; Birkelund, Svend; Larsen, Annette Burkhart

2016-01-01

The blood-brain barrier (BBB) represents the interface between the blood and the brain parenchyma and consists of endothelial cells which are tightly sealed together by tight junction proteins. The endothelial cells are in addition supported by pericytes, which are embedded in the vascular basement...... of the present study was to create four different in vitro constructs of the murine BBB to characterise if the expression and secretion of basement membrane proteins by the murine brain capillary endothelial cells (mBCECs) was affected by co-culturing with pericytes, mixed glial cells, or both. Primary m......BCECs and pericytes were isolated from brains of adult mice. Mixed glial cells were prepared from cerebral cortices of newborn mice. The mBCECs were grown as mono-culture, or co-cultured with pericytes, mixed glial cells, or both. To study the expression of basement membrane proteins RT-qPCR, mass spectrometry...

A field test of a waste containment technology using a new generation of injectable barrier liquids

International Nuclear Information System (INIS)

Moridis, G.; Apps, J.; Persoff, P.; Myer, L.; Muller, S.; Pruess, K.; Yen, P.

1996-08-01

A first stage field injection of a new generation of barrier liquids was successfully completed. Two types of barrier liquids, colloidal silica (CS) and polysiloxane (PSX), were injected into heterogeneous unsaturated deposits of sand, silt, and gravel typical of many of the arid DOE cleanup sites and particularly analogous to the conditions of the Hanford Site. Successful injection by commercially available chemical grouting equipment and the tube-a-manchette technique was demonstrated. Excavation of the grout bulbs permitted visual evaluation of the soil permeation by the grout, as well as sample collection. Both grouts effectively permeated all of the formation. The PSX visually appeared to perform better, producing a more uniform and symmetric permeation regardless of heterogeneity, filling large as well as small pores and providing more structural strength than the CS. Numerical simulation of the injection tests incorporated a stochastic field to represent site heterogeneity and was able to replicate the general test behavior. Tiltmeters were used successfully to monitor surface displacements during grout injection

Response of a thermal barrier system to acoustic excitation in a gas turbine nuclear reactor

International Nuclear Information System (INIS)

Betts, W.S. Jr.; Blevins, R.D.

1980-11-01

A gas turbine located within a High-Temperature Gas-Cooled Reactor (HTGR) induces high acoustic sound pressure levels into the primary coolant (helium). This acoustic loading induces high cycle fatigue stresses which may control the design of the thermal barrier system. This study examines the dynamic response of a thermal barrier configuration consisting of a fibrous insulation compressed against the reactor vessel by a coverplate which is held in position by a central attachment fixture. The results of dynamic vibration analyses indicate the effect of the plate size and curvature and the attachment size on the response of the thermal barrier

Smart parking barrier

KAUST Repository

Alharbi, Abdulrazaq M.

2016-01-01

positioning of the movable parking barrier, and a parking controller configured to initiate movement of the parking barrier, via the barrier drive. The movable parking barrier can be positioned between a first position that restricts access to the parking

Spallation impact analysis of plutonium storage container at K-Area

International Nuclear Information System (INIS)

Gong, C.

2000-01-01

A 100-pound concrete block falls 55-foot from ceiling spallation upon the top of the 9975 shipping package. This finite element analysis aims to evaluate the dynamic impact from the spallation upon the packaging. The geometric configuration of the packaging is meticulously modeled in detail. However, the drum is eliminated and the fiberboard with radius greater than 5.6 inches is conservatively omitted. The primary containment vessel and 3013 container were not included to simplify the model. The concrete block is modeled as a rigid body. The material properties are conservatively selected. The final results indicate that the secondary containment vessel is intact during this spallation impact. Consequently the primary containment vessel and 3013 container would not experience damage and containment is maintained. The secondary containment vessel protects the primary containment vessel from the dynamic impact. The top fiberboard is compressed from 3.5 inches to 0.875 inches will eventually recover to 1.8 inches according to tests performed at Savannah River Technology Center (SRTC)

Deep disposal of high activity radioactive wastes: the study of engineered and geological barriers behaviour

International Nuclear Information System (INIS)

Yu Jun; Cui; Delage, P.; Laure, E. de; Behrouz, Gatmiri; Sulem, J.; Anh Minh, Tang

2008-09-01

One option for the isolation of high activity and long lived radioactive wastes is the disposal of the vitrified waste containers in galleries dug inside impermeable rocks of the deep underground (granite, argillite, salt). The multi-barrier isolation concept is based on the use of successive barriers to avoid the migration of radionuclides towards the biosphere (container envelope, engineered barrier made of compacted swelling clay, and host rock). In parallel to the works carried out in underground laboratories, experiments and simulation works are performed in order to understand the behaviour of storage facilities and barriers under the effects of constraints, water fluxes and temperature changes. In this context, the UR Navier geotechnical team (CERMES), a joint research unit of Ecole des Ponts ParisTech and LCPC, has been working for more than 15 years on this topic for various contractors. These works are based on original experimental devices allowing to identify the thermo-hydro-mechanical phenomena and thereafter to model them. This dossier presents a summary of these works. (J.S.)

Utilisation of fly ash for the management of heavy metal containing primary chemical sludge generated in a leather manufacturing industry

Energy Technology Data Exchange (ETDEWEB)

Sekaran, G.; Rao, B.P.; Ghanamani, A.; Rajamani, S. [Central Leather Research Institute, Chennai (India). Dept. of Environmental Technology

2003-07-01

The present study aims at disposal of primary chemical sludge generated in the tanning industry by solidification and stabilization process using flyash generated from thermal power plant along with binders and also on evaluating the leachability of heavy metal from the solidified product. The primary chemical sludge containing heavy metals iron and chromium were obtained from a garment leather manufacturing company at Chennai in India. The sludge was dried in open environment and it was powdered to fine size in a grinder. Binding increases stabilization of heavy metal in calcined sludge with refractory binders such as clay, fly ash, lime and ordinary Portland cement. Fly ash can be considered as the additional binder for producing stronger bricks, with high metal fixation efficiency, and minimum rate of removal of heavy metal and minimum diffusion co-efficient. 15 refs., 5 figs., 5 tabs.

NATURAL BARRIERS TARGETED THRUST FY 2004 PROJECTS

Energy Technology Data Exchange (ETDEWEB)

NA

2005-07-27

This booklet contains project descriptions of work performed by the Department of Energy (DOE), Office of Civilian Radioactive Waste Management (OCRWM), Office of Science and Technology and International's (OST&I) Natural Barriers Targeted Thrust during Fiscal Year (FY) 2004. The Natural Barriers Targeted Thrust is part of OST&I's Science and Technology Program which supports the OCRWM mission to manage and dispose of high-level radioactive waste and spent nuclear fuel in a manner that protects health, safety, and the environment; enhances national and energy security; and merits public confidence. In general, the projects described will continue beyond FY 2004 assuming that the technical work remains relevant to the proposed Yucca Mountain Repository and sufficient funding is made available to the Science and Technology Program.

Immobilization of chromate from coal fly ash leachate using an attenuating barrier containing zero-valent iron

DEFF Research Database (Denmark)

Astrup, Thomas; Stipp, S. L. S.; Christensen, Thomas Højlund

2000-01-01

The purpose of this investigation was (i) to test the effectiveness of a barrier engineered to remove Cr(VI) from leachates of higher pH and salinity typical of coal burning ashes and (ii) to determine which geochemical processes control Cr immobilization. Laboratory column and batch desorption e...

Spiritual beliefs and barriers among managed care practitioners.

Science.gov (United States)

McCauley, Jeanne; Jenckes, Mollie W; Tarpley, Margaret J; Koenig, Harold G; Yanek, Lisa R; Becker, Diane M

2005-01-01

Ninety percent of American adults believe in God and 82% pray weekly. A majority wants their physicians to address spirituality during their health care visit. However, clinicians incorporate spiritual discussion in less than 20% of visits. Our objectives were to measure clinician beliefs and identify perceived barriers to integrating spirituality into patient care in a statewide, primary care, managed care group. Practitioners completed a 30-item survey including demographics and religious involvement (DUREL), spirituality in patient care (SPC), and barriers (BAR). We analyzed data using frequencies, means, standard deviations, and ANOVA. Clinicians had a range of religious denominations (67% Christian, 14% Jewish, 11% Muslim, Hindu or Buddhist, 8% agnostic), were 57% female and 24% had training in spirituality. Sixty-six percent reported experiencing the divine. Ninety-five percent felt that a patient's spiritual outlook was important to handling health difficulties and 68% percent agreed that addressing spirituality was part of the physician's role. Ninety-five percent of our managed care group noted 'lack of time' as an important barrier, 'lack of training' was indicated by 69%, and 21% cited 'fear of response from administration'. Managed care practitioners in a time constrained setting were spiritual themselves and believed this to be important to patients. Respondents indicated barriers of time and training to implementing these beliefs. Comparing responses from our group to those in other published surveys on clinician spirituality, we find similar concerns. Clinician education may overcome these barriers and improve ability to more fully meet their patients' expressed needs regarding spirituality and beliefs.

International medical graduate-patient communication: a qualitative analysis of perceived barriers.

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Dorgan, Kelly A; Lang, Forrest; Floyd, Michael; Kemp, Evelyn

2009-11-01

International medical graduates (IMGs) represent a substantial portion of all medical residents in the United States. Yet, IMGs may be disadvantaged in their communications with U.S. patients for a variety of reasons. The authors conducted a qualitative study to examine IMGs' perceptions of the barriers to their communication with patients. A convenience sample of 12 IMGs participated in interviews that lasted 1 to 1.5 hours. Residents from the Caribbean, Colombia, Denmark, India, Iran, Pakistan, and Peru participated in individual interviews conducted on-site at one of three clinics. Interviews were transcribed and then coded independently and jointly. The authors used a qualitative analysis of interview transcripts to identify primary and secondary themes. IMGs' perceptions of the barriers to communication with their Appalachian patients fit into two broad themes: educational barriers and interpersonal barriers. Within each of these themes, the authors identified secondary themes: education-related barriers were science immersion and lack of communication training, and interpersonally related barriers were unfamiliar dialects, new power dynamics, and different rapport-building expectations. The analysis of the interview data yielded several important findings that residency programs should consider when designing orientations, training curricula, and communication interventions. Programs may need to address challenges related to regional dialect and "informal" English use, as well as communication barriers associated with cross-cultural differences in norms, values, and beliefs. Programs also need to draw on multilayered interventions to address the multidimensional challenges of cross-cultural physician-patient communication.

Airway Epithelial Barrier Dysfunction in Chronic Obstructive Pulmonary Disease: Role of Cigarette Smoke Exposure.

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Aghapour, Mahyar; Raee, Pourya; Moghaddam, Seyed Javad; Hiemstra, Pieter S; Heijink, Irene H

2018-02-01

The epithelial lining of the airway forms the first barrier against environmental insults, such as inhaled cigarette smoke, which is the primary risk factor for the development of chronic obstructive pulmonary disease (COPD). The barrier is formed by airway epithelial junctions, which are interconnected structures that restrict permeability to inhaled pathogens and environmental stressors. Destruction of the epithelial barrier not only exposes subepithelial layers to hazardous agents in the inspired air, but also alters the normal function of epithelial cells, which may eventually contribute to the development of COPD. Of note, disruption of epithelial junctions may lead to modulation of signaling pathways involved in differentiation, repair, and proinflammatory responses. Epithelial barrier dysfunction may be particularly relevant in COPD, where repeated injury by cigarette smoke exposure, pathogens, inflammatory mediators, and impaired epithelial regeneration may compromise the barrier function. In the current review, we discuss recent advances in understanding the mechanisms of barrier dysfunction in COPD, as well as the molecular mechanisms that underlie the impaired repair response of the injured epithelium in COPD and its inability to redifferentiate into a functionally intact epithelium.

Primary Culture of Choroid Plexuses from Neonate Rats Containing Progenitor Cells Capable of Differentiation

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Sheng-Li Huang

2013-12-01

Full Text Available Background: The choroid plexuses, which could secrete a number of neurotrophins, have recently been used in transplantation in central nervous system diseases. Aims: To study the mechanism of nerve regeneration in the central nervous system by grafting choroid plexus tissues. Study Design: Animal experimentation. Methods: The choroid plexuses from the lateral ventricles of neonatal rats were cultured in adherent culture, and immunocytochemical methods were used to analyse the progenitor cells on days 2, 6, and 10 after seeding. Results: Expression of both nestin and glial fibrillary acidic protein was observed in small cell aggregates on day 2 in primary culture. Most of the nestin-positive cells on day 6 were immunoreactive to glial fibrillary acidic protein antibody. No cells expressing nestin or glial fibrillary acidic protein were seen on day 10. Conclusion: These experimental results indicate that the choroid plexus contains a specific cell population – progenitor cells. Under in vitro experimental conditions, the progenitor cells differentiated into choroid plexus epithelial cells but did not form neurons or astrocytes.

The connection between the primary care and the physical activity sector: professionals’ perceptions

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Karlijn E. F. Leenaars

2016-09-01

Full Text Available Abstract Background To stimulate physical activity (PA and guide primary care patients towards local PA facilities, Care Sport Connectors (CSC, to whom a broker role has been ascribed, were introduced in 2012 in the Netherlands. The aim of this study is to assess perceptions of primary care, welfare, and sport professionals towards the CSC role and the connection between the primary care and the PA sector. Methods Nine focus groups were held with primary care, welfare and sport professionals within the CSC network. In these focus groups the CSC role and the connection between the sectors were discussed. Both top-down and bottom-up codes were used to analyse the focus groups. Results Professionals ascribed three roles to the CSC: 1 broker role, 2 referral, 3 facilitator. Professionals were enthusiastic about how the current connection was established. However, barriers relating to their own sector were currently hindering the connection: primary care professionals’ lack of time, money and knowledge, and the lack of suitable PA activities and instructors for the target group. Conclusions This study provides further insight into the CSC role and the connection between the sectors from the point of view of primary care, welfare, and sport professionals. Professionals found the CSC role promising, but barriers are currently hindering the collaboration between both sectors. More time for the CSC and changes in the way the primary care and PA sector are organized seem to be necessary to overcome the identified barriers and to make a success of the connection. Trial registration Dutch Trial register NTR4986 . Registered 14 December 2014.

Scientific Opinion on the safety and efficacy of straight-chain primary aliphatic alcohols/aldehydes/acids, acetals and esters with esters containing saturated alcohols and acetals containing saturated aldehydes (chemical group 1) when used as flavourings for all animal species

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EFSA Panel on Additives and Products or Substances used in Animal Feed (FEEDAP)

2013-01-01

Chemical group 1 (CG 1) consists of straight-chain primary aliphatic alcohols/aldehydes/acids, acetals and esters with esters containing saturated alcohols and acetals containing saturated aldehydes of which 86 are currently authorised for use as flavours in food. The FEEDAP Panel was unable to perform an assessment of ethyl oleate because of its insufficient purity. The following compounds are considered to be safe for all animal species at the use level proposed for feed flavourings: formic...