WorldWideScience

Sample records for providing high-level qualitative

  1. a qualitative study of providers' perspectives

    African Journals Online (AJOL)

    Background: Glaucoma management is challenging to patients as well as to the eye care providers.The study is aimed at describing the challenges faced by providers using qualitative methods. Methods: In-depth interviews were conducted with selected Ophthalmologists and resident doctors in ophthalmology at centres ...

  2. Effective factors in providing holistic care: a qualitative study.

    Science.gov (United States)

    Zamanzadeh, Vahid; Jasemi, Madineh; Valizadeh, Leila; Keogh, Brian; Taleghani, Fariba

    2015-01-01

    Holistic care is a comprehensive model of caring. Previous studies have shown that most nurses do not apply this method. Examining the effective factors in nurses' provision of holistic care can help with enhancing it. Studying these factors from the point of view of nurses will generate real and meaningful concepts and can help to extend this method of caring. A qualitative study was used to identify effective factors in holistic care provision. Data gathered by interviewing 14 nurses from university hospitals in Iran were analyzed with a conventional qualitative content analysis method and by using MAXQDA (professional software for qualitative and mixed methods data analysis) software. Analysis of data revealed three main themes as effective factors in providing holistic care: The structure of educational system, professional environment, and personality traits. Establishing appropriate educational, management systems, and promoting religiousness and encouragement will induce nurses to provide holistic care and ultimately improve the quality of their caring.

  3. Scoring methods and results for qualitative evaluation of public health impacts from the Hanford high-level waste tanks. Integrated Risk Assessment Program

    International Nuclear Information System (INIS)

    Buck, J.W.; Gelston, G.M.; Farris, W.T.

    1995-09-01

    The objective of this analysis is to qualitatively rank the Hanford Site high-level waste (HLW) tanks according to their potential public health impacts through various (groundwater, surface water, and atmospheric) exposure pathways. Data from all 149 single-shell tanks (SSTs) and 23 of the 28 double-shell tanks (DSTs) in the Tank Waste Remediation System (TWRS) Program were analyzed for chemical and radiological carcinogenic as well as chemical noncarcinogenic health impacts. The preliminary aggregate score (PAS) ranking system was used to generate information from various release scenarios. Results based on the PAS ranking values should be considered relative health impacts rather than absolute risk values

  4. Effective factors in providing holistic care: A qualitative study

    Directory of Open Access Journals (Sweden)

    Vahid Zamanzadeh

    2015-01-01

    Full Text Available Background: Holistic care is a comprehensive model of caring. Previous studies have shown that most nurses do not apply this method. Examining the effective factors in nurses′ provision of holistic care can help with enhancing it. Studying these factors from the point of view of nurses will generate real and meaningful concepts and can help to extend this method of caring. Materials and Methods: A qualitative study was used to identify effective factors in holistic care provision. Data gathered by interviewing 14 nurses from university hospitals in Iran were analyzed with a conventional qualitative content analysis method and by using MAXQDA (professional software for qualitative and mixed methods data analysis software. Results: Analysis of data revealed three main themes as effective factors in providing holistic care: The structure of educational system, professional environment, and personality traits. Conclusion: Establishing appropriate educational, management systems, and promoting religiousness and encouragement will induce nurses to provide holistic care and ultimately improve the quality of their caring.

  5. Framework development for providing accessibility to qualitative spatial calculi

    OpenAIRE

    Jan, Sahib

    2011-01-01

    Dissertation submitted in partial fulfillment of the requirements for the Degree of Master of Science in Geospatial Technologies. Qualitative spatial reasoning deals with knowledge about an infinite spatial domain using a finite set of qualitative relations without using numerical computation. Qualitative knowledge is relative knowledge where we obtain the knowledge on the basis of comparison of features with in the object domain rather then using some external scales. Reasoning is an inte...

  6. High-level verification

    CERN Document Server

    Lerner, Sorin; Kundu, Sudipta

    2011-01-01

    Given the growing size and heterogeneity of Systems on Chip (SOC), the design process from initial specification to chip fabrication has become increasingly complex. This growing complexity provides incentive for designers to use high-level languages such as C, SystemC, and SystemVerilog for system-level design. While a major goal of these high-level languages is to enable verification at a higher level of abstraction, allowing early exploration of system-level designs, the focus so far for validation purposes has been on traditional testing techniques such as random testing and scenario-based

  7. ALICE High Level Trigger

    CERN Multimedia

    Alt, T

    2013-01-01

    The ALICE High Level Trigger (HLT) is a computing farm designed and build for the real-time, online processing of the raw data produced by the ALICE detectors. Events are fully reconstructed from the raw data, analyzed and compressed. The analysis summary together with the compressed data and a trigger decision is sent to the DAQ. In addition the reconstruction of the events allows for on-line monitoring of physical observables and this information is provided to the Data Quality Monitor (DQM). The HLT can process event rates of up to 2 kHz for proton-proton and 200 Hz for Pb-Pb central collisions.

  8. General Algorithm (High level)

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. General Algorithm (High level). Iteratively. Use Tightness Property to remove points of P1,..,Pi. Use random sampling to get a Random Sample (of enough points) from the next largest cluster, Pi+1. Use the Random Sampling Procedure to approximate ci+1 using the ...

  9. High Level Radioactive Waste Management

    International Nuclear Information System (INIS)

    1991-01-01

    The proceedings of the second annual international conference on High Level Radioactive Waste Management, held on April 28--May 3, 1991, Las Vegas, Nevada, provides information on the current technical issue related to international high level radioactive waste management activities and how they relate to society as a whole. Besides discussing such technical topics as the best form of the waste, the integrity of storage containers, design and construction of a repository, the broader social aspects of these issues are explored in papers on such subjects as conformance to regulations, transportation safety, and public education. By providing this wider perspective of high level radioactive waste management, it becomes apparent that the various disciplines involved in this field are interrelated and that they should work to integrate their waste management activities. Individual records are processed separately for the data bases

  10. High-level radioactive wastes

    International Nuclear Information System (INIS)

    Grissom, M.C.

    1982-10-01

    This bibliography contains 812 citations on high-level radioactive wastes included in the Department of Energy's Energy Data Base from January 1981 through July 1982. These citations are to research reports, journal articles, books, patents, theses, and conference papers from worldwide sources. Five indexes are provided: Corporate Author, Personal Author, Subject, Contract Number, and Report Number

  11. Handling and storage of conditioned high-level wastes

    International Nuclear Information System (INIS)

    1983-01-01

    This report deals with certain aspects of the management of one of the most important wastes, i.e. the handling and storage of conditioned (immobilized and packaged) high-level waste from the reprocessing of spent nuclear fuel and, although much of the material presented here is based on information concerning high-level waste from reprocessing LWR fuel, the principles, as well as many of the details involved, are applicable to all fuel types. The report provides illustrative background material on the arising and characteristics of high-level wastes and, qualitatively, their requirements for conditioning. The report introduces the principles important in conditioned high-level waste storage and describes the types of equipment and facilities, used or studied, for handling and storage of such waste. Finally, it discusses the safety and economic aspects that are considered in the design and operation of handling and storage facilities

  12. Handling and storage of conditioned high-level wastes

    International Nuclear Information System (INIS)

    Heafield, W.

    1984-01-01

    This paper deals with certain aspects of the management of one of the most important radioactive wastes arising from the nuclear fuel cycle, i.e. the handling and storage of conditioned high-level wastes. The paper is based on an IAEA report of the same title published during 1983 in the Technical Reports Series. The paper provides illustrative background material on the characteristics of high-level wastes and, qualitatively, their requirements for conditioning. The principles important in the storage of high-level wastes are reviewed in conjunction with the radiological and socio-political considerations involved. Four fundamentally different storage concepts are described with reference to published information and the safety aspects of particular storage concepts are discussed. Finally, overall conclusions are presented which confirm the availability of technology for constructing and operating conditioned high-level waste storage facilities for periods of at least several decades. (author)

  13. Type 2 diabetes patients' and providers' differing perspectives on medication nonadherence: a qualitative meta-synthesis.

    Science.gov (United States)

    Brundisini, Francesca; Vanstone, Meredith; Hulan, Danielle; DeJean, Deirdre; Giacomini, Mita

    2015-11-23

    Poor adherence to medication regimens increases adverse outcomes for patients with Type 2 diabetes. Improving medication adherence is a growing priority for clinicians and health care systems. We examine the differences between patient and provider understandings of barriers to medication adherence for Type 2 diabetes patients. We searched systematically for empirical qualitative studies on the topic of barriers to medication adherence among Type 2 diabetes patients published between 2002-2013; 86 empirical qualitative studies qualified for inclusion. Following qualitative meta-synthesis methods, we coded and analyzed thematically the findings from studies, integrating and comparing findings across studies to yield a synthetic interpretation and new insights from this body of research. We identify 7 categories of barriers: (1) emotional experiences as positive and negative motivators to adherence, (2) intentional non-compliance, (3) patient-provider relationship and communication, (4) information and knowledge, (5) medication administration, (6) social and cultural beliefs, and (7) financial issues. Patients and providers express different understandings of what patients require to improve adherence. Health beliefs, life context and lay understandings all inform patients' accounts. They describe barriers in terms of difficulties adapting medication regimens to their lifestyles and daily routines. In contrast, providers' understandings of patients poor medication adherence behaviors focus on patients' presumed needs for more information about the physiological and biomedical aspect of diabetes. This study highlights key discrepancies between patients' and providers' understandings of barriers to medication adherence. These misunderstandings span the many cultural and care contexts represented by 86 qualitative studies. Counseling and interventions aimed at improving medication adherence among Type 2 diabetes might become more effective through better integration of

  14. Community and Healthcare Providers' Perspectives on Male Circumcision: A Multi-Centric Qualitative Study in India

    OpenAIRE

    Sahay, Seema; Nagarajan, Karikalan; Mehendale, Sanjay; Deb, Sibnath; Gupta, Abhilasha; Bharat, Shalini; Bhatt, Shripad; Kumar, Athokpam Bijesh; Kanthe, Vidisha; Sinha, Anju; Chandhiok, Nomita

    2014-01-01

    Background Although male circumcision (MC) is recommended as an HIV prevention option, the religious, cultural and biomedical dimensions of its feasibility, acceptability and practice in India have not been explored till date. This study explores beliefs, experiences and understanding of the community and healthcare providers (HCPs) about adult MC as an HIV prevention option in India. Methods This qualitative study covered 134 in-depth interviews from Belgaum, Kolkata, Meerut and Mumbai citie...

  15. High level nuclear wastes

    International Nuclear Information System (INIS)

    Lopez Perez, B.

    1987-01-01

    The transformations involved in the nuclear fuels during the burn-up at the power nuclear reactors for burn-up levels of 33.000 MWd/th are considered. Graphs and data on the radioactivity variation with the cooling time and heat power of the irradiated fuel are presented. Likewise, the cycle of the fuel in light water reactors is presented and the alternatives for the nuclear waste management are discussed. A brief description of the management of the spent fuel as a high level nuclear waste is shown, explaining the reprocessing and giving data about the fission products and their radioactivities, which must be considered on the vitrification processes. On the final storage of the nuclear waste into depth geological burials, both alternatives are coincident. The countries supporting the reprocessing are indicated and the Spanish programm defined in the Plan Energetico Nacional (PEN) is shortly reviewed. (author) 8 figs., 4 tabs

  16. Exploring family physicians' reasons to continue or discontinue providing intrapartum care: Qualitative descriptive study.

    Science.gov (United States)

    Dove, Marion; Dogba, Maman Joyce; Rodríguez, Charo

    2017-08-01

    To examine the reasons why family physicians continue or discontinue providing intrapartum care in their clinical practice. Qualitative descriptive study. Two hospitals located in a multicultural area of Montreal, Que, in November 2011 to June 2012. Sixteen family physicians who were current or former providers of obstetric care. Data were collected using semistructured qualitative interviews. Thematic analysis was used to analyze the interview transcripts. Three overarching themes that help create understanding of why family doctors continue to provide obstetric care were identified: their attraction, often initiated by role models early in their careers, to practising complete continuity of care and accompanying patients in a special moment in their lives; the personal, family, and organizational pressures experienced while pursuing a family medicine career that includes obstetrics; and their ongoing reflection about continuing to practise obstetrics. The practice of obstetrics was very attractive to family physician participants whether they provided intrapartum care or decided to stop. More professional support and incentives might help keep family doctors practising obstetrics. Copyright© the College of Family Physicians of Canada.

  17. Exploring How Lay Rescuers Overcome Barriers to Provide Cardiopulmonary Resuscitation: A Qualitative Study.

    Science.gov (United States)

    Mathiesen, Wenche Torunn; Bjørshol, Conrad Arnfinn; Høyland, Sindre; Braut, Geir Sverre; Søreide, Eldar

    2017-02-01

    Survival rates after out-of-hospital cardiac arrest (OHCA) vary considerably among regions. The chance of survival is increased significantly by lay rescuer cardiopulmonary resuscitation (CPR) before Emergency Medical Services (EMS) arrival. It is well known that for bystanders, reasons for not providing CPR when witnessing an OHCA incident may be fear and the feeling of being exposed to risk. The aim of this study was to gain a better understanding of why barriers to providing CPR are overcome. Using a semi-structured interview guide, 10 lay rescuers were interviewed after participating in eight OHCA incidents. Qualitative content analysis was used. The lay rescuers were questioned about their CPR-knowledge, expectations, and reactions to the EMS and from others involved in the OHCA incident. They also were questioned about attitudes towards providing CPR in an OHCA incident in different contexts. The lay rescuers reported that they were prepared to provide CPR to anybody, anywhere. Comprehending the severity in the OHCA incident, both trained and untrained lay rescuers provided CPR. They considered CPR provision to be the expected behavior of any community citizen and the EMS to act professionally and urgently. However, when asked to imagine an OHCA in an unclear setting, they revealed hesitation about providing CPR because of risk to their own safety. Mutual trust between community citizens and towards social institutions may be reasons for overcoming barriers in providing CPR by lay rescuers. A normative obligation to act, regardless of CPR training and, importantly, without facing any adverse legal reactions, also seems to be an important factor behind CPR provision. Mathiesen WT , Bjørshol CA , Høyland S , Braut GS , Søreide E . Exploring how lay rescuers overcome barriers to provide cardiopulmonary resuscitation: a qualitative study. Prehosp Disaster Med. 2017;32(1):27-32.

  18. A qualitative analysis of job burnout in eating disorder treatment providers.

    Science.gov (United States)

    Warren, Cortney S; Schafer, Kerri J; Crowley, Mary Ellen; Olivardia, Roberto

    2012-01-01

    Although job burnout is common in mental health care settings, almost no research has examined burnout in eating disorder treatment providers. Using qualitative methodology, this study examined a) perceived contributors of burnout, b) efforts to manage burnout, and c) recommendations for avoiding burnout in a sample of professional eating disorder treatment providers. Recruited via professional organizations, 298 participants completed an online questionnaire designed by the authors. Qualitative responses were coded and grouped into themes. Results indicated that almost all participants worried about their patients' health, which frequently resulted in negative affect (e.g., anxiety, sadness). The most frequently cited contributors to burnout were common characteristics of eating pathology (e.g., chronicity, relapse, symptom severity); patient characteristics (e.g., personality conflict); work-related factors (e.g., time demands); and, financial issues (e.g., inadequate compensation). To avoid burnout, over 90% of participants engaged in self-care behaviors (e.g., exercise, social support). Early-career practitioners were encouraged to utilize supervision, create a work/life balance, engage in self-care, and limit caseloads. These results suggest that supervision and training of eating disorder treatment providers should include burnout management.

  19. Health care providers' attitudes towards termination of pregnancy: A qualitative study in South Africa

    Directory of Open Access Journals (Sweden)

    Orner Phyllis

    2009-08-01

    Full Text Available Abstract Background Despite changes to the abortion legislation in South Africa in 1996, barriers to women accessing abortion services still exist including provider opposition to abortions and a shortage of trained and willing abortion care providers. The dearth of abortion providers undermines the availability of safe, legal abortion, and has serious implications for women's access to abortion services and health service planning. In South Africa, little is known about the personal and professional attitudes of individuals who are currently working in abortion service provision. Exploring the factors which determine health care providers' involvement or disengagement in abortion services may facilitate improvement in the planning and provision of future services. Methods Qualitative research methods were used to collect data. Thirty four in-depth interviews and one focus group discussion were conducted during 2006 and 2007 with health care providers who were involved in a range of abortion provision in the Western Cape Province, South Africa. Data were analysed using a thematic analysis approach. Results Complex patterns of service delivery were prevalent throughout many of the health care facilities, and fragmented levels of service provision operated in order to accommodate health care providers' willingness to be involved in different aspects of abortion provision. Related to this was the need expressed by many providers for dedicated, stand-alone abortion clinics thereby creating a more supportive environment for both clients and providers. Almost all providers were concerned about the numerous difficulties women faced in seeking an abortion and their general quality of care. An overriding concern was poor pre and post abortion counselling including contraceptive counselling and provision. Conclusion This is the first known qualitative study undertaken in South Africa exploring providers' attitudes towards abortion and adds to the body of

  20. Effective patient-provider communication about sexual concerns in breast cancer: a qualitative study.

    Science.gov (United States)

    Reese, Jennifer Barsky; Beach, Mary Catherine; Smith, Katherine Clegg; Bantug, Elissa T; Casale, Kristen E; Porter, Laura S; Bober, Sharon L; Tulsky, James A; Daly, Mary B; Lepore, Stephen J

    2017-10-01

    Breast cancer patients commonly experience sexual concerns, yet rarely discuss them with clinicians. The study examined patient and provider experiences and preferences related to communication about breast cancer-related sexual concerns with the goal of informing intervention development. Patient data (n = 28) were derived from focus groups and interviews with partnered and unpartnered women treated for breast cancer reporting sexual concerns. Provider data (n = 11) came from interviews with breast cancer oncologists and nurse practitioners. Patient and provider data were analyzed separately using the framework method of qualitative analysis. Findings revealed individual and institutional barriers to effective communication about sexual concerns and highlighted key communication facilitators (e.g., a positive patient-provider relationship, patient communication as a driver of provider communication, and vice versa). Patients expressed preferences for open, collaborative communication; providers expressed preferences for focused intervention targets (identifying concerns, offering resources/referrals) and convenient format. A model of effective communication of sexual concerns was developed to inform communication interventions. Findings suggest that to improve patient-provider communication about sexual concerns, knowledge and skills-based interventions that activate patients and that equip providers for effective discussions about sexual concerns are needed, as are institutional changes that could incentivize such discussions.

  1. Adolescent Perspectives on Patient-Provider Sexual Health Communication: A Qualitative Study.

    Science.gov (United States)

    Hoopes, Andrea J; Benson, Samantha K; Howard, Heather B; Morrison, Diane M; Ko, Linda K; Shafii, Taraneh

    2017-10-01

    Adolescents in the United States are disproportionately affected by sexually transmitted infections and unintended pregnancy. Adolescent-centered health services may reduce barriers to health care; yet, limited research has focused on adolescents' own perspectives on patient-provider communication during a sexual health visit. Twenty-four adolescents (14-19 years old) seeking care in a public health clinic in Washington State participated in one-on-one qualitative interviews. Interviews explored participants' past experiences with medical providers and their preferences regarding provider characteristics and communication strategies. Interviews revealed that (1) individual patient dynamics and (2) patient-provider interaction dynamics shape the experience during a sexual health visit. Individual patient dynamics included evolving level of maturity, autonomy, and sexual experience. Patient-provider interaction dynamics were shaped by adolescents' perceptions of providers as sources of health information who distribute valued sexual health supplies like contraception and condoms. Participant concerns about provider judgment, power differential, and lack of confidentiality also emerged as important themes. Adolescents demonstrate diverse and evolving needs for sexual health care and interactions with clinicians as they navigate sexual and emotional development.

  2. A qualitative description of service providers' experiences of ethical issues in HIV care.

    Science.gov (United States)

    Sabone, Motshedisi B; Mogobe, Keitshokile Dintle; Matshediso, Ellah; Shaibu, Sheila; Ntsayagae, Esther I; Corless, Inge B; Cuca, Yvette P; Holzemer, William L; Dawson-Rose, Carol; Baez, Solymar S Soliz; Rivero-Mendz, Marta; Webel, Allison R; Eller, Lucille Sanzero; Reid, Paula; Johnson, Mallory O; Kemppainen, Jeanne; Reyes, Darcel; Nokes, Kathleen; Wantland, Dean; Nicholas, Patrice K; Lingren, Teri; Portillo, Carmen J; Sefcik, Elizabeth; Long-Middleton, Ellen

    2018-01-01

    Managing HIV treatment is a complex multi-dimensional task because of a combination of factors such as stigma and discrimination of some populations who frequently get infected with HIV. In addition, patient-provider encounters have become increasingly multicultural, making effective communication and provision of ethically sound care a challenge. This article explores ethical issues that health service providers in the United States and Botswana encountered in their interaction with patients in HIV care. A descriptive qualitative design was used to collect data from health service providers and patients using focused group discussions. This article is based on responses from health service providers only. Participants and context: This article is based on 11 focused group discussions with a total sample of 71 service providers in seven US sites and one Botswana site. Ethical considerations: Ethical review boards at all the study sites reviewed the study protocol and approved it. Ethical review boards of the study's coordinating centers, Rutgers University and the University of California at San Francisco, also approved it. The study participants provided a written informed consent to participate. HIV service providers encountered ethical challenges in all the four Beauchamp and Childress' biomedical ethics of respect for patients' autonomy, beneficence, justice, and nonmaleficence. The finding that HIV service providers encounter ethical challenges in their interaction with patients is supported by prior studies. The ethical challenges are particularly prominent in multicultural care and resource-constrained care environments. Provision of HIV care is fraught with ethical challenges that tend to pose different issues depending on a given care environment. It is important that strong partnerships are developed among key stakeholders in HIV care. In addition, health service providers need to be provided with resources so they can provide quality and ethically sound

  3. Deficiencies in culturally competent asthma care for ethnic minority children: a qualitative assessment among care providers

    Directory of Open Access Journals (Sweden)

    Seeleman Conny

    2012-07-01

    Full Text Available Abstract Background Asthma outcomes are generally worse for ethnic minority children. Cultural competence training is an instrument for improving healthcare for ethnic minority patients. To develop effective training, we explored the mechanisms in paediatric asthma care for ethnic minority patients that lead to deficiencies in the care process. Methods We conducted semi-structured interviews on care for ethnic minority children with asthma (aged 4-10 years with paediatricians (n = 13 and nurses (n = 3 in three hospitals. Interviews were analysed qualitatively with a framework method, using a cultural competence model. Results Respondents mentioned patient non-adherence as the central problem in asthma care. They related non-adherence in children from ethnic minority backgrounds to social context factors, difficulties in understanding the chronic nature of asthma, and parents’ language barriers. Reactions reported by respondents to patients’ non-adherence included retrieving additional information, providing biomedical information, occasionally providing referrals for social context issues, and using informal interpreters. Conclusions This study provides keys to improve the quality of specialist paediatric asthma care to ethnic minority children, mainly related to non-adherence. Care providers do not consciously recognise all the mechanisms that lead to deficiencies in culturally competent asthma care they provide to ethnic minority children (e.g. communicating mainly from a biomedical perspective and using mostly informal interpreters. Therefore, the learning objectives of cultural competence training should reflect issues that care providers are aware of as well as issues they are unaware of.

  4. Swedish healthcare providers' perceptions of preconception expanded carrier screening (ECS)-a qualitative study.

    Science.gov (United States)

    Matar, A; Kihlbom, U; Höglund, A T

    2016-07-01

    Reproductive autonomy, medicalization, and discrimination against disabled and parental responsibility are the main ongoing ethical debates concerning reproductive genetic screening. To examine Swedish healthcare professionals' views on preconception expanded carrier screening (ECS), a qualitative study involving academic and clinical institutions in Sweden was conducted in September 2014 to February 2015. Eleven healthcare professionals including clinicians, geneticists, a midwife, and a genetic counselor were interviewed in depth using a semi-structured interview guide. The questionnaire was constructed after reviewing the main literature and meetings with relevant healthcare providers. The interviews were recorded, transcribed verbatim, and content analyzed for categories and subcategories. Participants nurtured many ethical and non-ethical concerns regarding preconception ECS. Among the ethical concerns were the potential for discrimination, medicalization, concerns with prioritization of healthcare resources, and effects on reproductive freedom. The effects of implementation of preconception ECS, its stakeholders, regulations, and motivation are some of non-ethical concerns. These concerns, if not addressed, may affect the uptake and usage of carrier screening within Swedish healthcare system. As this is a qualitative study with a small non-random sample size, the findings cannot be generalized. The participants had little to no working experience with expanded screening panels. Moreover, the interviews were conducted in English, a second language for the participants, which might have limited the expression of their views. However, the authors claim that the findings may be pertinent to similar settings in other Scandinavian countries.

  5. Iranian women and care providers' perceptions of equitable prenatal care: A qualitative study.

    Science.gov (United States)

    Gheibizadeh, Mahin; Abedi, Heidar Ali; Mohammadi, Easa; Abedi, Parvin

    2016-06-01

    Equity as a basic human right builds the foundation of all areas of primary healthcare, especially prenatal care. However, it is unclear how pregnant women and their care providers perceive the equitable prenatal care. This study aimed to explore Iranian women's and care providers' perceptions of equitable prenatal care. In this study, a qualitative approach was used. Individual in-depth unstructured interviews were conducted with a purposeful sample of pregnant women and their care providers. Data were analyzed using inductive content analysis method. A total of 10 pregnant women and 10 prenatal care providers recruited from six urban health centers across Ahvaz, a south western city in Iran, were participated in the study. The study was approved by the Ethics Committee affiliated to Ahvaz Jundishapur University of Medical Sciences. The ethical principles of voluntary participation, confidentiality, and anonymity were considered. Analysis of participants' interviews resulted in seven themes: guideline-based care, time-saving care, nondiscriminatory care, privacy-respecting care, affordable comprehensive care, effective client-provider relationships, and caregivers' competency. The findings explain the broader and less discussed dimensions of equitable care that are valuable information for the realization of equity in care. Understanding and focusing on these dimensions will help health policy-makers in designing more equitable healthcare services for pregnant women. © The Author(s) 2015.

  6. Healthcare providers' perceptions of barriers in implementing of home telecare in Taiwan: a qualitative study.

    Science.gov (United States)

    Chiang, Kuei-Feng; Wang, Hsiu-Hung; Chien, I-Kuang; Liou, Jhao-Kun; Hung, Chung-Lieh; Huang, Chien-Min; Yang, Feng-Yueh

    2015-04-01

    Telecare has not only brought down medical expenses, but has also become an important tool to address healthcare needs. In recent years, the Taiwanese government has been concerned about this healthcare issue. However, only a few hospitals provide telecare. This study aims at investigating the barriers that healthcare providers face while implementing home telecare in Taiwan. A qualitative research design was employed in this study, with semi-structured in-depth interviews. The sample was obtained from five hospitals, including three medical centers and two regional hospitals. A total of 31 healthcare providers were interviewed, including case managers (n=11), administrators (n=7), physicians (n=7), and nurses (n=6). The results were summarized into five themes, including: (1) unsuitable laws and vague policies, (2) the policy implementation fails to meet public needs, (3) lack of organizational support, (4) lack of quality and convenience of the system, and (5) inadequate public perception and attitudes. Obstacles in policy and regulations are the most fundamental difficulties for telecare implementation, therefore the government should provide a clear direction by planning policies, legislate appropriate regulations, and incorporate telecare into the scope of medical insurance, in order to improve the environment and stimulate the telecare service market. In order to improve the success rate of telecare, administrators should be able to identify an appropriate cost-benefit model to build a humane system to satisfy public needs and to provide staff with resources and support. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  7. User experiences with clinical social franchising: qualitative insights from providers and clients in Ghana and Kenya.

    Science.gov (United States)

    Sieverding, Maia; Briegleb, Christina; Montagu, Dominic

    2015-02-01

    Clinical social franchising is a rapidly growing delivery model in private healthcare markets in low- and middle-income countries. Despite this growth, little is known about providers' perceptions of the benefits and challenges of social franchising or clients' reasons for choosing franchised facilities over other healthcare options. We examine these questions in the context of three social franchise networks in Ghana and Kenya. We conducted in-depth interviews with a purposive sample of providers from the BlueStar Ghana, and Amua and Tunza networks in Kenya. We also conducted qualitative exit interviews with female clients who were leaving franchised facilities after a visit for a reproductive or child health reason. The total sample consists of 47 providers and 47 clients across the three networks. Providers perceived the main benefits of participation in a social franchise network to be training opportunities and access to a consistent supply of low-cost family planning commodities; few providers mentioned branding as a benefit of participation. Although most providers said that client flows for franchised services increased after joining the network, they did not associate this with improved finances for their facility. Clients overwhelmingly cited the quality of the client-provider relationship as their main motivation for attending the franchise facility. Recognition of the franchise brand was low among clients who were exiting a franchised facility. The most important benefit of social franchise programs to both providers and their clients may have more to do with training on business practices, patient counseling and customer service, than with subsidies, technical input, branding or clinical support. This finding may lead to a reconsideration of how franchise programs interact with both their member clinics and the larger health-seeking communities they serve.

  8. Communication Challenges: A Qualitative Look at the Relationship Between Pediatric Hospitalists and Primary Care Providers.

    Science.gov (United States)

    Solan, Lauren G; Sherman, Susan N; DeBlasio, Dominick; Simmons, Jeffrey M

    2016-07-01

    Primary care providers (PCPs) and hospitalists endorse the importance of effective communication yet studies illustrate critical communication problems between these 2 provider types. Our objective was to develop deeper insight into the dimensions of and underlying reasons for communication issues and determine ways to improve communication and remove barriers by eliciting the perspectives of pediatric PCPs and hospitalists. Using qualitative methods, 2 sets of focus groups were held: 1) mix of local PCPs serving diverse populations, and 2) hospitalists from a free-standing, pediatric institution. The open-ended, semistructured question guides included questions about communication experiences, patient care responsibilities, and suggestions for improvement. Using inductive thematic analysis, investigators coded the transcripts, and resolved differences through consensus. Six PCP (n = 27) and 3 hospitalist (n = 15) focus groups were held. Fifty-six percent of PCPs and 14% of hospitalists had been practicing for >10 years. Five major themes were identified: problematic aspects of communication, perceptions of provider roles, push-pull, postdischarge responsibilities/care, and proposed solutions. Aspects of communication included specific problem areas with verbal and written communication. Perceptions of provider roles highlighted the issue of PCPs feeling devalued. Push-pull described conflicting expectations about a counterpart's role and responsibilities. Postdischarge responsibilities/care addressed unclear responsibilities related to patient follow-up. Proposed solutions were suggested for ways to improve communication. Deficiencies in communication hinder successful collaboration and can cause tension between providers in inpatient and outpatient settings. Understanding specific issues that contribute to poor communication like perceptions about provider roles is critical to improving relationships and facilitating combined efforts to improve patient care

  9. A Qualitative Study of Patient and Provider Experiences during Preoperative Care Transitions

    Science.gov (United States)

    MALLEY, ANN; YOUNG, GARY J.

    2017-01-01

    Aims To explore the issues and challenges of care transitions in the preoperative environment. Background Ineffective transitions play a role in a majority of serious medical errors. There is a paucity of research related to the preoperative arena and the multiple inherent transitions in care that occur there. Design Qualitative descriptive design was used. Methods Semi-structured interviews were conducted in a 975 bed academic medical center. Results 30 providers and 10 preoperative patients participated. Themes that arose were: (1) Need for clarity of purpose of preoperative care (2) Care coordination (3) Inter-professional boundaries of care (4) Inadequate time and resources. Conclusion Effective transitions in the preoperative environment require that providers bridge scope of practice barriers to promote good teamwork. Preoperative care that is a product of well-informed providers and patients can improve the entire perioperative care process and potentially influence post-operative patient outcomes. Relevance to Clinical Practice Nurses are well positioned to bridge the gaps within transitions of care and accordingly affect health outcomes. PMID:27706872

  10. CHALLENGES IN THE MANAGEMENT OF GLAUCOMA IN A DEVELOPING COUNTRY; A QUALITATIVE STUDY OF PROVIDERS' PERSPECTIVES.

    Science.gov (United States)

    Adekoya, B J; Adepoju, F G; Moshood, K F; Balarabe, A H

    2015-01-01

    Glaucoma management is challenging to patients as well as to the eye care providers. The study is aimed at describing the challenges faced by providers using qualitative methods. In-depth interviews were conducted with selected Ophthalmologists and resident doctors in ophthalmology at centres offering medical and surgical glaucoma services in Lagos state, Nigeria, according to established qualitative methods. This was done using semi-structured, open ended questions to explore the providers' perspective on glaucoma burden, challenges in the management, surgery for glaucoma, acceptance of glaucoma surgery by patients, and recommendations for improving glaucoma services. The discussions were recorded with the aid of a micro-cassette recorder. Familiarisation was done to identify key ideas in the data, then, the main themes and sub-themes were identified. Quotes that reflect the themes and sub-themes were then identified in the data. In-depth interviews were conducted with a total of 11 ophthalmologists and resident doctors in training. Majority were of the opinion that glaucoma is a significant burden constituting about 35% of outpatient visits. Identified patient related challenges include; late presentation, lack of glaucoma awareness, delay in referral from optometrists, and poor compliance with medications. Shortages in needed equipment were also identified. Availability, affordability and counterfeiting of drugs were the major challenges related to medical treatment. Majority of the participants agreed that surgery should be offered to the patients as soon as the diagnosis of glaucoma is made. However, continuous monitoring of the patient on medical treatment is another line of option for them in early cases; if they are convinced the patients will be compliant. Some respondents considered the current number of glaucoma surgeries as adequate, while some think otherwise. Reasons put forward for reluctance to offer glaucoma surgery include; late presentation, lack

  11. Shared Decision-Making in Oncology - A Qualitative Analysis of Healthcare Providers' Views on Current Practice.

    Science.gov (United States)

    Frerichs, Wiebke; Hahlweg, Pola; Müller, Evamaria; Adis, Christine; Scholl, Isabelle

    2016-01-01

    Despite an increased awareness of shared decision-making (SDM) and its prominent position on the health policy agenda, its implementation in routine care remains a challenge in Germany. In order to overcome this challenge, it is important to understand healthcare providers' views regarding SDM and to take their perspectives and opinions into account in the development of an implementation program. The present study aimed at exploring a) the attitudes of different healthcare providers regarding SDM in oncology and b) their experiences with treatment decisions in daily practice. A qualitative study was conducted using focus groups and individual interviews with different healthcare providers at the University Cancer Center Hamburg, Germany. Focus groups and interviews were audio-recorded, transcribed and analyzed using conventional content analysis and descriptive statistics. N = 4 focus groups with a total of N = 25 participants and N = 17 individual interviews were conducted. Attitudes regarding SDM varied greatly between the different participants, especially concerning the definition of SDM, the attitude towards the degree of patient involvement in decision-making and assumptions about when SDM should take place. Experiences on how treatment decisions are currently made varied. Negative experiences included time and structural constraints, and a lack of (multidisciplinary) communication. Positive experiences comprised informed patients, involvement of relatives and a good physician-patient relationship. The results show that German healthcare providers in oncology have a range of attitudes that currently function as barriers towards the implementation of SDM. Also, their experiences on how decision-making is currently done reveal difficulties in actively involving patients in decision-making processes. It will be crucial to take these attitudes and experiences seriously and to subsequently disentangle existing misconceptions in future implementation programs.

  12. Integration of Health Coaching Concepts and Skills into Clinical Practice Among VHA Providers: A Qualitative Study.

    Science.gov (United States)

    Collins, David A; Thompson, Kirsten; Atwood, Katharine A; Abadi, Melissa H; Rychener, David L; Simmons, Leigh Ann

    2018-01-01

    Although studies of health coaching for behavior change in chronic disease prevention and management are increasing, to date no studies have reported on what concepts and skills providers integrate into their clinical practice following participation in health coaching courses. The purpose of this qualitative study was to assess Veterans Health Administration (VHA) providers' perceptions of the individual-level and system-level changes they observed after participating with colleagues in a 6-day Whole Health Coaching course held in 8 VHA medical centers nationwide. Data for this study were from the follow-up survey conducted with participants 2 to 3 months after completing the training. A total of 142 responses about individual-level changes and 99 responses about system-level changes were analyzed using content analysis. Eight primary themes emerged regarding individual changes, including increased emphasis on Veterans' values, increased use of listening and other specific health coaching skills in their clinical role, and adding health coaching to their clinical practice.Four primary themes emerged regarding system-level changes, including leadership support, increased staff awareness/support/learning and sharing, increased use of health coaching skills or tools within the facility, and organizational changes demonstrating a more engaged workforce, such as new work groups being formed or existing groups becoming more active. Findings suggest that VHA providers who participate in health coaching trainings do perceive positive changes within themselves and their organizations. Health coaching courses that emphasize patient-centered care and promote patient-provider partnerships likely have positive effects beyond the individual participants that can be used to promote desired organizational change.

  13. What do providers want to know about opioid prescribing? A qualitative analysis of their questions.

    Science.gov (United States)

    Cushman, Phoebe A; Liebschutz, Jane M; Hodgkin, Joseph G; Shanahan, Christopher W; White, Julie L; Hardesty, Ilana; Alford, Daniel P

    2017-01-01

    In 2012, the US Food and Drug Administration (FDA) responded to the opioid crisis with a Risk Evaluation and Mitigation Strategy, requiring manufacturers of extended-release/long-acting opioids to fund continuing medical education based on the "FDA Blueprint for Prescriber Education." Topics in the Blueprint are "Assessing Patients for Treatment," "Initiating Therapy, Modifying Dosing, and Discontinuing Use," "Managing Therapy," "Counseling Patients and Caregivers about Safe Use," "General Drug Information," and "Specific Drug Information." Based on the FDA Blueprint, Boston University School of Medicine's "Safe and Competent Opioid Prescribing Education" (SCOPE of Pain) offers live trainings for physicians and other prescribers. During trainings, participants submit written questions about the curriculum and/or their clinical experiences. The objective was to compare themes that arose from questions asked by SCOPE of Pain participants with content of the FDA Blueprint in order to evaluate how well the Blueprint answers prescribers' concerns. The authors conducted qualitative analyses of all 1309 questions submitted by participants in 29 trainings across 16 states from May 2013 to May 2015, using conventional content analysis to code the questions. Themes that emerged from participants' questions were then compared with the Blueprint. Most themes fell into the topic categories of the Blueprint. Five main themes diverged: Participants sought information on (1) safe alternatives to opioids, (2) overcoming barriers to safe opioid prescribing, (3) government regulations of opioid prescribing, (4) the role of marijuana in opioid prescribing, and (5) maintaining a positive provider-patient relationship while prescribing opioids. In addition to learning the mechanics of safe opioid prescribing, providers want to understand government regulations and effective patient communication skills. Aware of the limitations of opioids in managing chronic pain, providers seek advice

  14. Retained in HIV Care But Not on Antiretroviral Treatment: A Qualitative Patient-Provider Dyadic Study.

    Directory of Open Access Journals (Sweden)

    Katerina A Christopoulos

    2015-08-01

    Full Text Available Patients retained in HIV care but not on antiretroviral therapy (ART represent an important part of the HIV care cascade in the United States. Even in an era of more tolerable and efficacious ART, decision making in regards to ART offer and uptake remains complex and calls for exploration of both patient and provider perspectives. We sought to understand reasons for lack of ART usage in patients meeting the Health Resources Services Administration definition of retention as well as what motivated HIV primary care appointment attendance in the absence of ART.We conducted a qualitative study consisting of 70 in-depth interviews with ART-naïve and ART-experienced patients off ART and their primary care providers in two urban safety-net HIV clinics in San Francisco and New York. Twenty patients and their providers were interviewed separately at baseline, and 15 dyads were interviewed again after at least 3 mo and another clinic visit in order to understand any ART use in the interim. We applied dyadic analysis to our data. Nearly all patients were willing to consider ART, and 40% of the sample went on ART, citing education on newer antiretroviral drugs, acceptance of HIV diagnosis, social support, and increased confidence in their ability to adhere as facilitators. However, the strength of the provider recommendation of ART played an important role. Many patients had internalized messages from providers that their health was too good to warrant ART. In addition, providers, while demonstrating patient-centered care through sensitivity to patients experiencing psychosocial instability, frequently muted the offer of ART, at times unintentionally. In the absence of ART, lab monitoring, provider relationships, access to social services, opiate pain medications, and acute symptoms motivated care. The main limitations of this study were that treatment as prevention was not explored in depth and that participants were recruited from academic HIV clinics in

  15. Retained in HIV Care But Not on Antiretroviral Treatment: A Qualitative Patient-Provider Dyadic Study

    Science.gov (United States)

    Christopoulos, Katerina A.; Olender, Susan; Lopez, Andrea M.; Lekas, Helen-Maria; Jaiswal, Jessica; Mellman, Will; Geng, Elvin; Koester, Kimberly A.

    2015-01-01

    Background Patients retained in HIV care but not on antiretroviral therapy (ART) represent an important part of the HIV care cascade in the United States. Even in an era of more tolerable and efficacious ART, decision making in regards to ART offer and uptake remains complex and calls for exploration of both patient and provider perspectives. We sought to understand reasons for lack of ART usage in patients meeting the Health Resources Services Administration definition of retention as well as what motivated HIV primary care appointment attendance in the absence of ART. Methods and Findings We conducted a qualitative study consisting of 70 in-depth interviews with ART-naïve and ART-experienced patients off ART and their primary care providers in two urban safety-net HIV clinics in San Francisco and New York. Twenty patients and their providers were interviewed separately at baseline, and 15 dyads were interviewed again after at least 3 mo and another clinic visit in order to understand any ART use in the interim. We applied dyadic analysis to our data. Nearly all patients were willing to consider ART, and 40% of the sample went on ART, citing education on newer antiretroviral drugs, acceptance of HIV diagnosis, social support, and increased confidence in their ability to adhere as facilitators. However, the strength of the provider recommendation of ART played an important role. Many patients had internalized messages from providers that their health was too good to warrant ART. In addition, providers, while demonstrating patient-centered care through sensitivity to patients experiencing psychosocial instability, frequently muted the offer of ART, at times unintentionally. In the absence of ART, lab monitoring, provider relationships, access to social services, opiate pain medications, and acute symptoms motivated care. The main limitations of this study were that treatment as prevention was not explored in depth and that participants were recruited from academic

  16. Harm reduction interventions in HIV care: a qualitative exploration of patient and provider perspectives

    Directory of Open Access Journals (Sweden)

    Suzanne Carlberg-Racich

    2016-04-01

    Full Text Available Background. A culture of stringent drug policy, one-size-fits-all treatment approaches, and drug-related stigma has clouded clinical HIV practice in the United States. The result is a series of missed opportunities in the HIV care environment. An approach which may address the broken relationship between patient and provider is harm reduction—which removes judgment and operates at the patient’s stage of readiness. Harm reduction is not a routine part of care; rather, it exists outside clinic walls, exacerbating the divide between compassionate, stigma-free services and the medical system. Methods. Qualitative, phenomenological, semi-structured, individual interviews with patients and providers were conducted in three publicly-funded clinics in Chicago, located in areas of high HIV prevalence and drug use and serving African-American patients (N = 38. A deductive thematic analysis guided the process, including: the creation of an index code list, transcription and verification of interviews, manual coding, notation of emerging themes and refinement of code definitions, two more rounds of coding within AtlasTi, calculation of Cohen’s Kappa for interrater reliability, queries of major codes and analysis of additional common themes. Results. Thematic analysis of findings indicated that the majority of patients felt receptive to harm reduction interventions (safer injection counseling, safer stimulant use counseling, overdose prevention information, supply provision from their provider, and expressed anticipated gratitude for harm reduction information and/or supplies within the HIV care visit, although some were reluctant to talk openly about their drug use. Provider results were mixed, with more receptivity reported by advanced practice nurses, and more barriers cited by physicians. Notable barriers included: role-perceptions, limited time, inadequate training, and the patients themselves. Discussion. Patients are willing to receive harm

  17. A qualitative study of the challenges of providing pre-prosthetic rehabilitation in rural South Africa.

    Science.gov (United States)

    Ennion, Liezel; Johannesson, Anton

    2018-04-01

    There is a known shortage of rehabilitation staff in rural settings and a sharp increase in the number of lower limb amputations being performed. A lack of adequate pre-prosthetic rehabilitation will result in worse physical and psychological outcomes for a person with a lower limb amputation, and they will not be eligible to be fitted with a prosthesis. To explore therapists' experiences with providing pre-prosthetic rehabilitation in a rural setting. A qualitative descriptive approach was used to collect and analyse data. Data were collected from 17 purposively sampled therapists in five district hospitals in a rural community in South Africa. Data were collected in two rounds of focus groups to explore the challenges of providing pre-prosthetic rehabilitation in rural South Africa. The main themes identified in the study were (1) a lack of government health system support, (2) poor socioeconomic circumstances of patients and (3) cultural factors that influence rehabilitation. These themes all negatively influence the therapists' ability to follow up patients for pre-prosthetic rehabilitation after discharge from hospital. A lack of adequate pre-prosthetic rehabilitation is a substantial barrier to prosthetic fitting in rural South Africa. Patients who do not receive pre-prosthetic rehabilitation have a poorly shaped residuum or other complications such as knee or hip joint contractures which disqualifies them from being referred to prosthetic services. Therapists involved in this study identified the most important barriers to patients having access to prosthetic services. Clinical relevance Pre-prosthetic rehabilitation provides care of the residuum; maintenance or improvement of physical strength, joint range of motion and referral to a prosthetist. By exploring the challenges known to exist in this service, we can identify potential ways to reduce these barriers and improve the lives of those who use it.

  18. 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

  19. Provider and patient perspectives on opioids and alternative treatments for managing chronic pain: a qualitative study.

    Science.gov (United States)

    Penney, Lauren S; Ritenbaugh, Cheryl; DeBar, Lynn L; Elder, Charles; Deyo, Richard A

    2017-03-24

    Current literature describes the limits and pitfalls of using opioid pharmacotherapy for chronic pain and the importance of identifying alternatives. The objective of this study was to identify the practical issues patients and providers face when accessing alternatives to opioids, and how multiple parties view these issues. Qualitative data were gathered to evaluate the outcomes of acupuncture and chiropractic (A/C) services for chronic musculoskeletal pain (CMP) using structured interview guides among patients with CMP (n = 90) and primary care providers (PCPs) (n = 25) purposively sampled from a managed care health care system as well as from contracted community A/C providers (n = 14). Focus groups and interviews were conducted patients with CMP with varying histories of A/C use. Plan PCPs and contracted A/C providers took part in individual interviews. All participants were asked about their experiences managing chronic pain and experience with and/or attitudes about A/C treatment. Audio recordings were transcribed and thematically coded. A summarized version of the focus group/interview guides is included in the Additional file 1. We identified four themes around opioid use: (1) attitudes toward use of opioids to manage chronic pain; (2) the limited alternative options for chronic pain management; (3) the potential of A/C care as a tool to help manage pain; and (4) the complex system around chronic pain management. Despite widespread dissatisfaction with opioid medications for pain management, many practical barriers challenged access to other options. Most of the participants' perceived A/C care as helpful for short term pain relief. We identified that problems with timing, expectations, and plan coverage limited A/C care potential for pain relief treatment. These results suggest that education about realistic expectations for chronic pain management and therapy options, as well as making A/C care more easily accessible, might lead to more

  20. SIGWX Charts - High Level Significant Weather

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — High level significant weather (SIGWX) forecasts are provided for the en-route portion of international flights. NOAA's National Weather Service Aviation Center...

  1. The use of telehealth for diabetes management: a qualitative study of telehealth provider perceptions

    Directory of Open Access Journals (Sweden)

    Woodbridge Peter A

    2007-05-01

    Full Text Available Abstract Background Monitoring and Messaging Devices (MMDs are telehealth systems used by patients in their homes, and are designed to promote patient self-management, patient education, and clinical monitoring and follow-up activities. Although these systems have been widely promoted by health care systems, including the Veterans Health Administration, very little information is available on factors that facilitate use of the MMD system, or on barriers to use. Methods We conducted in-depth qualitative interviews with clinicians using MMD-based telehealth programs at two Veterans Affairs Medical Centers in the Midwestern United States. Results Findings suggest that MMD program enrollment is limited by both clinical and non-clinical factors, and that patients have varying levels of program participation and system use. Telehealth providers see MMDs as a useful tool for monitoring patients who are interested in working on management of their disease, but are concerned with technical challenges and the time commitment required to use MMDs. Conclusion Telehealth includes a rapidly evolving and potentially promising range of technologies for meeting the growing number of patients and clinicians who face the challenges of diabetes care, and future research should explore the most effective means of ensuring successful program implementation.

  2. Community and Healthcare Providers' Perspectives on Male Circumcision: A Multi-Centric Qualitative Study in India

    Science.gov (United States)

    Sahay, Seema; Nagarajan, Karikalan; Mehendale, Sanjay; Deb, Sibnath; Gupta, Abhilasha; Bharat, Shalini; Bhatt, Shripad; Kumar, Athokpam Bijesh; Kanthe, Vidisha; Sinha, Anju; Chandhiok, Nomita

    2014-01-01

    Background Although male circumcision (MC) is recommended as an HIV prevention option, the religious, cultural and biomedical dimensions of its feasibility, acceptability and practice in India have not been explored till date. This study explores beliefs, experiences and understanding of the community and healthcare providers (HCPs) about adult MC as an HIV prevention option in India. Methods This qualitative study covered 134 in-depth interviews from Belgaum, Kolkata, Meerut and Mumbai cities of India. Of these, 62 respondents were the members of circumcising (CC)/non-circumcising communities (NCC); including medically and traditionally circumcised men, parents of circumcised children, spouses of circumcised men, and religious clerics. Additionally, 58 registered healthcare providers (RHCPs) such as general and pediatric surgeons, pediatricians, skin and venereal disease specialists, general practitioners, and operation theatre nurses were interviewed. Fourteen traditional circumcisers were also interviewed. The data were coded and analyzed in QSR NUD*IST ver. 6.0. The study has not explored the participants' views about neonatal versus adult circumcision. Results Members of CC/NCC, traditional circumcisers and RCHPs expressed sharp religious sensitivities around the issue of MC. Six themes emerged: Male circumcision as the religious rite; Multiple meanings of MC: MC for ‘religious identity/privilege/sacrifice’ or ‘hygiene’; MC inflicts pain and cost; Medical indications outweigh faith; Hesitation exists in accepting ‘foreign’ evidence supporting MC; and communication is the key for acceptance of MCs. Medical indications could make members of NCC accept MC following appropriate counseling. Majority of the RHCPs demanded local in-country evidence. Conclusion HCPs must educate high-risk groups regarding the preventive and therapeutic role of MC. Communities need to discuss and create new social norms about male circumcision for better societal acceptance

  3. Community and healthcare providers' perspectives on male circumcision: a multi-centric qualitative study in India.

    Directory of Open Access Journals (Sweden)

    Seema Sahay

    Full Text Available Although male circumcision (MC is recommended as an HIV prevention option, the religious, cultural and biomedical dimensions of its feasibility, acceptability and practice in India have not been explored till date. This study explores beliefs, experiences and understanding of the community and healthcare providers (HCPs about adult MC as an HIV prevention option in India.This qualitative study covered 134 in-depth interviews from Belgaum, Kolkata, Meerut and Mumbai cities of India. Of these, 62 respondents were the members of circumcising (CC/non-circumcising communities (NCC; including medically and traditionally circumcised men, parents of circumcised children, spouses of circumcised men, and religious clerics. Additionally, 58 registered healthcare providers (RHCPs such as general and pediatric surgeons, pediatricians, skin and venereal disease specialists, general practitioners, and operation theatre nurses were interviewed. Fourteen traditional circumcisers were also interviewed. The data were coded and analyzed in QSR NUD*IST ver. 6.0. The study has not explored the participants' views about neonatal versus adult circumcision.Members of CC/NCC, traditional circumcisers and RCHPs expressed sharp religious sensitivities around the issue of MC. Six themes emerged: Male circumcision as the religious rite; Multiple meanings of MC: MC for 'religious identity/privilege/sacrifice' or 'hygiene'; MC inflicts pain and cost; Medical indications outweigh faith; Hesitation exists in accepting 'foreign' evidence supporting MC; and communication is the key for acceptance of MCs. Medical indications could make members of NCC accept MC following appropriate counseling. Majority of the RHCPs demanded local in-country evidence.HCPs must educate high-risk groups regarding the preventive and therapeutic role of MC. Communities need to discuss and create new social norms about male circumcision for better societal acceptance especially among the NCC. Feasibility

  4. Women's and care providers' perspectives of quality prenatal care: a qualitative descriptive study

    Science.gov (United States)

    2012-01-01

    Background Much attention has been given to the adequacy of prenatal care use in promoting healthy outcomes for women and their infants. Adequacy of use takes into account the timing of initiation of prenatal care and the number of visits. However, there is emerging evidence that the quality of prenatal care may be more important than adequacy of use. The purpose of our study was to explore women's and care providers' perspectives of quality prenatal care to inform the development of items for a new instrument, the Quality of Prenatal Care Questionnaire. We report on the derivation of themes resulting from this first step of questionnaire development. Methods A qualitative descriptive approach was used. Semi-structured interviews were conducted with 40 pregnant women and 40 prenatal care providers recruited from five urban centres across Canada. Data were analyzed using inductive open and then pattern coding. The final step of analysis used a deductive approach to assign the emergent themes to broader categories reflective of the study's conceptual framework. Results The three main categories informed by Donabedian's model of quality health care were structure of care, clinical care processes, and interpersonal care processes. Structure of care themes included access, physical setting, and staff and care provider characteristics. Themes under clinical care processes were health promotion and illness prevention, screening and assessment, information sharing, continuity of care, non-medicalization of pregnancy, and women-centredness. Interpersonal care processes themes were respectful attitude, emotional support, approachable interaction style, and taking time. A recurrent theme woven throughout the data reflected the importance of a meaningful relationship between a woman and her prenatal care provider that was characterized by trust. Conclusions While certain aspects of structure of care were identified as being key dimensions of quality prenatal care, clinical and

  5. Experiences of primary care professionals providing healthcare to recently arrived migrants: a qualitative study.

    Science.gov (United States)

    Lindenmeyer, Antje; Redwood, Sabi; Griffith, Laura; Teladia, Zaheera; Phillimore, Jenny

    2016-09-22

    The main objectives of the study were to explore the experiences of primary care professionals providing care to recent migrants in a superdiverse city and to elicit barriers and facilitators to meeting migrants' care needs. This paper focuses on a strong emergent theme: participants' descriptions and understandings of creating a fit between patients and practices. An exploratory, qualitative study based on the thematic analysis of semistructured interviews. A purposive sample of 10 practices. We interviewed 6 general practitioners, 5 nurses and 6 administrative staff; those based at the same practice opted to be interviewed together. 10 interviewees were from an ethnic minority background; some discussed their own experiences of migration. Creating a fit between patients and practice was complex and could be problematic. Some participants defined this in a positive way (reaching out, creating rapport) while others also focused on ways in which patients did not fit in, for example, different expectations or lack of medical records. A small but vocal minority put the responsibility to fit in on to migrant patients. Some participants believed that practice staff and patients sharing a language could contribute to achieving a fit but others outlined the disadvantages of over-reliance on language concordance. A clearly articulated, team-based strategy to create bridges between practice and patients was often seen as preferable. Although participants agreed that a fit between patients and practice was desirable, some aimed to adapt to the needs of recently arrived migrants, while others thought that it was the responsibility of migrants to adapt to practice needs; a few viewed migrant patients as a burden to the system. Practices wishing to improve fit might consider developing strategies such as introducing link workers and other 'bridging' people; however, they could also aim to foster a general stance of openness to diversity. Published by the BMJ Publishing Group

  6. Lessons learned from implementation of computerized provider order entry in 5 community hospitals: a qualitative study.

    Science.gov (United States)

    Simon, Steven R; Keohane, Carol A; Amato, Mary; Coffey, Michael; Cadet, Bismarck; Zimlichman, Eyal; Bates, David W

    2013-06-24

    Computerized Provider Order Entry (CPOE) can improve patient safety, quality and efficiency, but hospitals face a host of barriers to adopting CPOE, ranging from resistance among physicians to the cost of the systems. In response to the incentives for meaningful use of health information technology and other market forces, hospitals in the United States are increasingly moving toward the adoption of CPOE. The purpose of this study was to characterize the experiences of hospitals that have successfully implemented CPOE. We used a qualitative approach to observe clinical activities and capture the experiences of physicians, nurses, pharmacists and administrators at five community hospitals in Massachusetts (USA) that adopted CPOE in the past few years. We conducted formal, structured observations of care processes in diverse inpatient settings within each of the hospitals and completed in-depth, semi-structured interviews with clinicians and staff by telephone. After transcribing the audiorecorded interviews, we analyzed the content of the transcripts iteratively, guided by principles of the Immersion and Crystallization analytic approach. Our objective was to identify attitudes, behaviors and experiences that would constitute useful lessons for other hospitals embarking on CPOE implementation. Analysis of observations and interviews resulted in findings about the CPOE implementation process in five domains: governance, preparation, support, perceptions and consequences. Successful institutions implemented clear organizational decision-making mechanisms that involved clinicians (governance). They anticipated the need for education and training of a wide range of users (preparation). These hospitals deployed ample human resources for live, in-person training and support during implementation. Successful implementation hinged on the ability of clinical leaders to address and manage perceptions and the fear of change. Implementation proceeded smoothly when institutions

  7. A qualitative study on feedback provided by students in nurse education.

    Science.gov (United States)

    Chan, Zenobia C Y; Stanley, David John; Meadus, Robert J; Chien, Wai Tong

    2017-08-01

    This study aims to help nurse educators/academics understand the perspectives and expectations of students providing their feedback to educators about teaching performance and subject quality. The aim of this study is to reveal students' voices regarding their feedback in nurse education in order to shed light on how the current student feedback practice may be modified. A qualitative study using focus group inquiry. Convenience sampling was adopted and participants recruited from one school of nursing in Hong Kong. A total of 66 nursing students from two pre-registration programs were recruited for seven focus group interviews: one group of Year 1 students (n=21), two groups of Year 3 students (n=27), and four groups of Final Year students (n=18). The interviews were guided by a semi-structured interview guideline and the interview narratives were processed through content analysis. The trustworthiness of this study was guaranteed through peer checking, research meetings, and an audit trail. The participants' privacy was protected throughout the study. Four core themes were discerned based on the narratives of the focus group interviews: (1) "timing of collecting feedback at more than one time point"; (2) "modify the questions being asked in collecting student feedback"; (3) "are electronic means of collecting feedback good enough?; and (4) "what will be next for student feedback?". This study is significant in the following three domains: 1) it contributed to student feedback because it examined the issue from a student's perspective; 2) it explored the timing and channels for collecting feedback from the students' point of view; and 3) it showed the preferred uses of student feedback. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  8. School Transitions: A Qualitative Study of the Supports Provided by Washington State Special Education Administrators

    Science.gov (United States)

    Lewinsohn, Kari

    2013-01-01

    This study investigated the role of special education administrators in the transition planning process for children with disabilities ages 3-21 in selected Washington school districts. A basic qualitative study was selected to construct meaning from a described phenomenon. The study sought to identify and explain how special education…

  9. High-level-waste immobilization

    International Nuclear Information System (INIS)

    Crandall, J.L.

    1982-01-01

    Analysis of risks, environmental effects, process feasibility, and costs for disposal of immobilized high-level wastes in geologic repositories indicates that the disposal system safety has a low sensitivity to the choice of the waste disposal form

  10. High-level Petri Nets

    DEFF Research Database (Denmark)

    various journals and collections. As a result, much of this knowledge is not readily available to people who may be interested in using high-level nets. Within the Petri net community this problem has been discussed many times, and as an outcome this book has been compiled. The book contains reprints...... of some of the most important papers on the application and theory of high-level Petri nets. In this way it makes the relevant literature more available. It is our hope that the book will be a useful source of information and that, e.g., it can be used in the organization of Petri net courses. To make......High-level Petri nets are now widely used in both theoretical analysis and practical modelling of concurrent systems. The main reason for the success of this class of net models is that they make it possible to obtain much more succinct and manageable descriptions than can be obtained by means...

  11. Service provider perceptions of transitioning from audio to video capability in a telehealth system: a qualitative evaluation

    OpenAIRE

    Clay-Williams, Robyn; Baysari, Melissa; Taylor, Natalie; Zalitis, Dianne; Georgiou, Andrew; Robinson, Maureen; Braithwaite, Jeffrey; Westbrook, Johanna

    2017-01-01

    Background Telephone consultation and triage services are increasingly being used to deliver health advice. Availability of high speed internet services in remote areas allows healthcare providers to move from telephone to video telehealth services. Current approaches for assessing video services have limitations. This study aimed to identify the challenges for service providers associated with transitioning from audio to video technology. Methods Using a mixed-method, qualitative approach, w...

  12. High-Level Radioactive Waste.

    Science.gov (United States)

    Hayden, Howard C.

    1995-01-01

    Presents a method to calculate the amount of high-level radioactive waste by taking into consideration the following factors: the fission process that yields the waste, identification of the waste, the energy required to run a 1-GWe plant for one year, and the uranium mass required to produce that energy. Briefly discusses waste disposal and…

  13. Análisis cualitativo de las implicaciones musculares de la escalada deportiva de alto nivel en competición. (Qualitative Study of high level sport climbing muscular involvement in competition.

    Directory of Open Access Journals (Sweden)

    Ana María de Benito

    2013-04-01

    Full Text Available El objetivo de esta investigación fue analizar las acciones musculares ejecutadas por los escaladores de alto nivel en competición. La muestra del estudio está compuesta por 72 varones (nivel técnico medio “a vista” 7C+/8A que participaron en las pruebas de Copa de España de Escalada de Dificultad de 2009 y 2010. Se registraron un total de 7.738 movimientos para su análisis. Se ha utilizado un método de observación validado previamente, siendo las variables de estudio: acción, posición corporal, extremidad ejecutante, tiempo empleado, zona temporal, inicio de movimiento, fin de movimiento y movimiento. Los resultados concluyen que los grupos musculares más importantes para los escaladores de alto nivel son, además de los músculos flexores del tronco, los extensores, aductores y extensores horizontales del hombro, los flexores y pronadores del codo, los extensores, aductores, abductores, rotadores internos y rotadores externos de la cadera y los extensores de rodilla. Ahora bien, el tipo de contracción muscular realizada por cada uno de ellos, dependerá del movimiento requerido. La información aquí presentada puede resultar de gran utilidad a la hora de planificar programas de entrenamiento más personalizados que mejoren el rendimiento del escalador.AbstractThe purpose of the current study was to analyse the muscular contractions carried out by the high level climbers in competition. The sample studied was made up of 72 male subjects (“on sight”-level 5.12c/5.13a who participated in the Spanish Climbing Cup of 2009 and 2010. 7738 movements were registered to analyse them. The observational model used was designed and validated through a previous study. Answer levels were: action, corporal position, limb, time, time zone, start of movement, end of movement and movement. The results obtained establish that the most important muscles for high level climbers are, apart from abdominal muscles, extensors, adductors and

  14. High-level radioactive wastes. Supplement 1

    International Nuclear Information System (INIS)

    McLaren, L.H.

    1984-09-01

    This bibliography contains information on high-level radioactive wastes included in the Department of Energy's Energy Data Base from August 1982 through December 1983. These citations are to research reports, journal articles, books, patents, theses, and conference papers from worldwide sources. Five indexes, each preceded by a brief description, are provided: Corporate Author, Personal Author, Subject, Contract Number, and Report Number. 1452 citations

  15. High-Level Application Framework for LCLS

    Energy Technology Data Exchange (ETDEWEB)

    Chu, P; Chevtsov, S.; Fairley, D.; Larrieu, C.; Rock, J.; Rogind, D.; White, G.; Zalazny, M.; /SLAC

    2008-04-22

    A framework for high level accelerator application software is being developed for the Linac Coherent Light Source (LCLS). The framework is based on plug-in technology developed by an open source project, Eclipse. Many existing functionalities provided by Eclipse are available to high-level applications written within this framework. The framework also contains static data storage configuration and dynamic data connectivity. Because the framework is Eclipse-based, it is highly compatible with any other Eclipse plug-ins. The entire infrastructure of the software framework will be presented. Planned applications and plug-ins based on the framework are also presented.

  16. RPython high-level synthesis

    Science.gov (United States)

    Cieszewski, Radoslaw; Linczuk, Maciej

    2016-09-01

    The development of FPGA technology and the increasing complexity of applications in recent decades have forced compilers to move to higher abstraction levels. Compilers interprets an algorithmic description of a desired behavior written in High-Level Languages (HLLs) and translate it to Hardware Description Languages (HDLs). This paper presents a RPython based High-Level synthesis (HLS) compiler. The compiler get the configuration parameters and map RPython program to VHDL. Then, VHDL code can be used to program FPGA chips. In comparison of other technologies usage, FPGAs have the potential to achieve far greater performance than software as a result of omitting the fetch-decode-execute operations of General Purpose Processors (GPUs), and introduce more parallel computation. This can be exploited by utilizing many resources at the same time. Creating parallel algorithms computed with FPGAs in pure HDL is difficult and time consuming. Implementation time can be greatly reduced with High-Level Synthesis compiler. This article describes design methodologies and tools, implementation and first results of created VHDL backend for RPython compiler.

  17. EAP high-level product architecture

    DEFF Research Database (Denmark)

    Guðlaugsson, Tómas Vignir; Mortensen, Niels Henrik; Sarban, Rahimullah

    2013-01-01

    EAP technology has the potential to be used in a wide range of applications. This poses the challenge to the EAP component manufacturers to develop components for a wide variety of products. Danfoss Polypower A/S is developing an EAP technology platform, which can form the basis for a variety...... of EAP technology products while keeping complexity under control. High level product architecture has been developed for the mechanical part of EAP transducers, as the foundation for platform development. A generic description of an EAP transducer forms the core of the high level product architecture...... the function of the EAP transducers to be changed, by basing the EAP transducers on a different combination of organ alternatives. A model providing an overview of the high level product architecture has been developed to support daily development and cooperation across development teams. The platform approach...

  18. A qualitative study of health care providers' perceptions and experiences of working together to care for children with medical complexity (CMC).

    Science.gov (United States)

    Altman, Lisa; Zurynski, Yvonne; Breen, Christie; Hoffmann, Tim; Woolfenden, Susan

    2018-01-31

    Children with medical complexity (CMC) have a wide range of long term health problems and disabilities that have an adverse impact on their quality of life. They have high levels of family identified health care needs and health care utilisation. There is no Australian literature on the experiences of health care providers working in the Australian tertiary, secondary and primary health care system, whilst managing CMC. This information is essential to inform the design of integrated health care systems for these children. We address this knowledge gap by exploring the perceptions and experiences of health care providers on the provision of health care for CMC aged 0 to 18 years. A qualitative research study was undertaken. Stakeholder forums, group and individual in depth interviews were undertaken using a semi-structured interview guide. The stakeholder forums were audio recorded and transcribed verbatim. Field notes of the stakeholder forums, group and individual interviews were taken. Inductive thematic analysis was undertaken to identify key themes. One hundred and three providers took part in the stakeholder forums and interviews across 3 local health districts, a tertiary paediatric hospital network, and primary health care organisations. Providers expressed concern regarding family capacity to negotiate the system, which was impacted by the medical complexity of the children and psychosocial complexity of their families. Lack of health care provider capacity in terms of their skills, time and availability to manage CMC was also a key problem. These issues occurred within a health system that had impaired capacity in terms of fragmentation of care and limited communication among health care providers. When designing integrated care models for CMC, it is essential to understand and address the challenges experienced by their health care providers. This requires adequate training of providers, additional resources and time for coordination of care, improved

  19. Exploring challenges in the patient's discharge process from the internal medicine service: A qualitative study of patients' and providers' perceptions.

    Science.gov (United States)

    Pinelli, Vincent; Stuckey, Heather L; Gonzalo, Jed D

    2017-09-01

    In hospital-based medicine units, patients have a wide range of complex medical conditions, requiring timely and accurate communication between multiple interprofessional providers at the time of discharge. Limited work has investigated the challenges in interprofessional collaboration and communication during the patient discharge process. In this study, authors qualitatively assessed the experiences of internal medicine providers and patients about roles, challenges, and potential solutions in the discharge process, with a phenomenological focus on the process of collaboration. Authors conducted interviews with 87 providers and patients-41 providers in eight focus-groups, 39 providers in individual interviews, and seven individual patient interviews. Provider roles included physicians, nurses, therapists, pharmacists, care coordinators, and social workers. Interviews were audio-recorded and transcribed verbatim, followed by iterative review of transcripts using qualitative coding and content analysis. Participants identified several barriers related to interprofessional collaboration during the discharge process, including systems insufficiencies (e.g., medication reconciliation process, staffing challenges); lack of understanding others' roles (e.g., unclear which provider should be completing the discharge summary); information-communication breakdowns (e.g., inaccurate information communicated to the primary medical team); patient issues (e.g., patient preferences misaligned with recommendations); and poor collaboration processes (e.g., lack of structured interprofessional rounds). These results provide context for targeting improvement in interprofessional collaboration in medicine units during patient discharges. Implementing changes in care delivery processes may increase potential for accurate and timely coordination, thereby improving the quality of care transitions.

  20. Towards culturally competent paediatric oncology care. A qualitative study from the perspective of care providers.

    Science.gov (United States)

    Suurmond, J; Lieveld, A; van de Wetering, M; Schouten-van Meeteren, A Y N

    2017-11-01

    In order to gain more insight on the influence of ethnic diversity in paediatric cancer care, the perspectives of care providers were explored. Semi-structured interviews were conducted among 12 paediatric oncologists and 13 nurses of two different paediatric oncology wards and were analysed using a framework method. We found that care providers described the contact with Turkish and Moroccan parents as more difficult. They offered two reasons for this: (1) language barriers between care provider and parents hindered the exchange of information; (2) cultural barriers between care provider and parents about sharing the diagnosis and palliative perspective hindered communication. Care providers reported different solutions to deal with these barriers, such as using an interpreter and improving their cultural knowledge about their patients. They, however, were not using interpreters sufficiently and were unaware of the importance of eliciting parents' perspectives. Communication techniques to overcome dilemmas between parents and care providers were not used and care providers were unaware of stereotypes and prejudice. Care providers should be offered insight in cultural barriers they are unaware of. Training in cultural competence might be a possibility to overcome manifest barriers. © 2017 John Wiley & Sons Ltd.

  1. Child Care Providers' Strategies for Supporting Healthy Eating: A Qualitative Approach

    Science.gov (United States)

    Lynch, Meghan; Batal, Malek

    2012-01-01

    Recent research has revealed child care settings and providers to be important influences on children's developing behaviors. Yet most research on children's nutritional development has focused on home settings and parents. Thus, through semistructured interviews with child care providers, this study aimed to develop a better understanding of the…

  2. Exploring Canadian Physicians' Experiences Providing Medical Assistance in Dying: A Qualitative Study.

    Science.gov (United States)

    Khoshnood, Narges; Hopwood, Marie-Clare; Lokuge, Bhadra; Kurahashi, Allison; Tobin, Anastasia; Isenberg, Sarina; Husain, Amna

    2018-05-15

    MAiD allows a practitioner to administer or prescribe medication for the purpose of ending a patient's life. In 2016, Canada was the latest country, following several European countries and American states, to legalize physician-assisted death. Although some studies report on physician attitudes towards MAiD or describe patient characteristics, there are few that explore the professional challenges faced by physicians who provide MAiD. To explore the professional challenges faced by Canadian physicians who provide MAiD. Sixteen physicians from across Canada who provide MAiD completed in-depth, semi-structured telephone interviews. An inductive thematic analysis approach guided data collection and the iterative, interpretive analysis of interview transcripts. Three members of the research team systematically co-coded interview transcripts and the emerging themes were developed with the broader research team. NVivo was used to manage the coded data. Participants described three challenges associated with providing MAiD: 1) their relationships with other MAiD providers were enhanced and relationships with objecting colleagues were sometimes strained, 2) they received inadequate financial compensation for time, and, 3) they experienced increased workload, resulting in sacrifices to personal time. Although these providers did not intend to stop providing MAiD at the time of the interview, they indicated their concerns about whether they would be able to sustain this service over time. Physicians described relationship, financial, and workload challenges to providing MAiD. We provide several recommendations to address these challenges and help ensure the sustainability of MAiD in countries that provide this service. Copyright © 2018. Published by Elsevier Inc.

  3. Expanding the Abortion Provider Workforce: A Qualitative Study of Organizations Implementing a New California Policy.

    Science.gov (United States)

    Battistelli, Molly Frances; Magnusson, Sara; Biggs, M Antonia; Freedman, Lori

    2018-03-01

    Access to abortion care in the United States varies according to multiple factors, including location, state regulation and provider availability. In 2013, California enacted a law that authorized nurse practitioners (NPs), certified nurse-midwives (CNMs) and physician assistants (PAs) to provide first-trimester aspiration abortions; little is known about organizations' experiences in implementing this policy change. Beginning 10 and 24 months after implementation of the new law, semistructured interviews were conducted with 20 administrators whose five organizations trained and employed NPs, CNMs and PAs as providers of aspiration abortions. Interview data on the organizations' experiences were analyzed thematically, and facilitators of and barriers to implementation were identified. Administrators were committed to the provision of aspiration abortions by NPs, CNMs and PAs, and nearly all identified improved access to care and complication management as clear benefits of the policy change. However, integration of the new providers was uneven and depended on a variety of circumstances. Organizational disincentives included financial and logistical costs incurred in trying to deploy and integrate the different types of providers. Some administrators found that increased costs were outweighed by improved patient care, whereas others did not. In general, having a strong administrative champion within the organization made a critical difference. California's expansion of the abortion-providing workforce had a positive impact on patient care in the sampled organizations. However, various organizational obstacles must be addressed to more fully realize the benefits of having NPs, CNMs and PAs provide aspiration abortions. Copyright © 2018 by the Guttmacher Institute.

  4. Provider Experiences with Chronic Care Management (CCM) Services and Fees: A Qualitative Research Study.

    Science.gov (United States)

    O'Malley, Ann S; Sarwar, Rumin; Keith, Rosalind; Balke, Patrick; Ma, Sai; McCall, Nancy

    2017-12-01

    Support for ongoing care management and coordination between office visits for patients with multiple chronic conditions has been inadequate. In January 2015, Medicare introduced the Chronic Care Management (CCM) payment policy, which reimburses providers for CCM activities for Medicare beneficiaries occurring outside of office visits. To explore the experiences, facilitators, and challenges of practices providing CCM services, and their implications going forward. Semi-structured telephone interviews from January to April 2016 with 71 respondents. Sixty billing and non-billing providers and practice staff knowledgeable about their practices' CCM services, and 11 professional society representatives. Practice respondents noted that most patients expressed positive views of CCM services. Practice respondents also perceived several patient benefits, including improved adherence to treatment, access to care team members, satisfaction, care continuity, and care coordination. Facilitators of CCM provision included having an in-practice care manager, patient-centered medical home recognition, experience developing care plans, patient trust in their provider, and supplemental insurance to cover CCM copayments. Most billing practices reported few problems obtaining patients' consent for CCM, though providers felt that CMS could better facilitate consent by marketing CCM's goals to beneficiaries. Barriers reported by professional society representatives and by billing and non-billing providers included inadequacy of CCM payments to cover upfront investments for staffing, workflow modification, and time needed to manage complex patients. Other barriers included inadequate infrastructure for health information exchange with other providers and limited electronic health record capabilities for documenting and updating care plans. Practices owned by hospital systems and large medical groups faced greater bureaucracy in implementing CCM than did smaller, independent practices

  5. How electricity providers communicate price increases – A qualitative analysis of notification letters

    International Nuclear Information System (INIS)

    Pick, Doreén; Zielke, Stephan

    2015-01-01

    In several markets firms are required to explicitly announce price increases by sending customers notification letters. The purpose of this article is to analyze how electricity providers deal with such obligatory price increase communication and to provide a comprehensive overview of communicative arguments used by firms. Data is gathered through a content analysis of 97 price increase mailings. Findings show that electricity providers apply several price communication strategies while other promising strategies for customer retention are mostly ignored (i.e., those related to competitors, offerings and relationship benefits). Further, price increase communication differs between national and local firms. Local firms are more transparent in their price increase communication and refer even less often to offer and relationship benefits. Electricity firms have many options to improve the potential effects of price increase letters, such as referring to the future relationship. This is the first study which examines the content of price increase communication by firms. It structures price communication practices used by electricity providers, analyzes their empirical relevance, summarizes findings in five global propositions, and provides a detailed agenda for future research. Moreover, the study indicates several means for public policy organizations to offer regulations on the content of price increase notifications. - Highlights: • We examine 97 price increase letters from electricity providers in Germany. • We investigate the means how firms deal with price increase communications. • Electricity providers aim to hide price increases towards their customers. • Electricity providers only scarcely use benefit and relationship communication. • Price increase communication differs between types of providers as national firms are more professional.

  6. Influence of Provider Communication on Women's Delivery Expectations and Birth Experience Appraisal: A Qualitative Study.

    Science.gov (United States)

    Ledford, Christy J W; Canzona, Mollie Rose; Womack, Jasmyne J; Hodge, Joshua A

    2016-07-01

    Although current research suggests that patient-provider prenatal communication and expectation-setting affects women's outcomes, more needs to be understood about the kinds of communication experiences that shape women's expectations, the nature of expectations that women hold, and how those expectations influence their appraisal of labor and delivery. The goal of this study is to draw connections between provider communication, birth experience expectations, and birth experience appraisals. Recently delivered mothers (n=36) were recruited at a mid-Atlantic community hospital. Using a grounded theory approach, interviews were systematically analyzed to uncover how participants perceived provider communication during their prenatal care, how participants described their expectations of the birth experience, and how expectations affected appraisals of the experience. Mothers recognize providers' use of patient-centered communication in messages of empowerment, emotional support, explanation, decision making, and elicitation. Findings posit that it is the inflexibility or flexibility of expectations that may determine mothers' appraisals of the birth experience. Mothers continue to rely on providers as partners in health care. Through patient-centered communication, providers can help mothers develop flexible expectations of the birth experience, which in turn can result in positive appraisals of delivery.

  7. Obesity in Pregnancy: A Qualitative Approach to Inform an Intervention for Patients and Providers.

    Science.gov (United States)

    Kominiarek, Michelle A; Gay, Franklin; Peacock, Nadine

    2015-08-01

    To investigate perceptions of minority pregnant women and providers about obesity and gestational weight gain (GWG), and to explore strategies to improve management of obesity in pregnancy with an emphasis on group prenatal care. Sixteen primarily non-Hispanic black pregnant women with a body mass index ≥ 30 kg/m(2) and 19 prenatal care providers participated in focus groups. Discussion topics included GWG goals, body image, health behaviors, and group prenatal care with additional emphasis on provider training needs. Women frequently stated a GWG goal >20 lbs. Women described a body image not in line with clinical recommendations ("200 pounds is not that big."). They avoided the term "obese". They were interested in learning about nutrition and culturally-acceptable healthy cooking. Women would enjoy massage and exercise in group settings, though definitions of "exercise" varied. Family members could help, but generational differences posed challenges. Most had to "encourage myself" and "do this for me and the baby". Providers expressed discomfort discussing GWG and difficulty finding the right words for obesity, which was partially attributed to their own weight. They noted the challenges they faced during prenatal care including time constraints, cultural myths, and system issues. Providers considered a group setting with social support an ideal environment to address health behaviors in obese women. Culturally-tailored programs that use acceptable terms for obesity, provide education regarding healthy eating and safe exercise, and encourage support from social networks may be effective in addressing GWG in obese minority women. Provider training in communication skills is necessary to address obesity in pregnancy.

  8. Multiple sclerosis patients need and want information on exercise promotion from healthcare providers: a qualitative study.

    Science.gov (United States)

    Learmonth, Yvonne C; Adamson, Brynn C; Balto, Julia M; Chiu, Chung-Yi; Molina-Guzman, Isabel; Finlayson, Marcia; Riskin, Barry J; Motl, Robert W

    2017-08-01

    There is growing recognition of the benefits and safety of exercise and its importance in the comprehensive care of persons with multiple sclerosis (MS), yet uptake is low. We explored the needs and wants of patients with MS regarding exercise promotion through healthcare providers. Participants were adults with MS who had mild-or-moderate disability and a range of exercise levels. All participants lived in the Midwest of the United States. Fifty semi-structured interviews were conducted and analysed using thematic analysis. Two themes emerged, namely interactions between patients and healthcare providers and needs and wants of patients. Analysis of participant accounts illustrate that current exercise promotion by healthcare providers does not meet patient needs and wants. The identified needs and wants of persons with MS involved (i) information and knowledge on the benefits of exercise and exercise prescription, (ii) materials to allow home and community exercise and (iii) tools for initiating and maintaining exercise behaviour. Patients with MS frequently interact with healthcare providers and are generally unsatisfied with exercise promotion during interactions. Healthcare providers can address the low uptake of exercise among persons with MS by acting upon the identified unmet needs involving materials, knowledge and behaviour change strategies for exercise. © 2016 The Authors Health Expectations Published by John Wiley & Sons Ltd.

  9. Attitudes, beliefs, and perceptions of caregivers and rehabilitation providers about disabled children's sleep health: a qualitative study.

    Science.gov (United States)

    Chen, Xiaoli; Gelaye, Bizu; Velez, Juan Carlos; Pepper, Micah; Gorman, Sara; Barbosa, Clarita; Zafonte, Ross D; Redline, Susan; Williams, Michelle A

    2014-10-01

    Children with disabilities are more likely to have sleep disturbances than children without disabilities. Identifying attitudes, beliefs, knowledge, and perceptions of caregivers and health professionals is essential in developing effective intervention programs to improve disabled children's sleep health. However, no such qualitative data about adults who have key roles in the life and daytime activities of children with disabilities are available. This qualitative study aimed to understand attitudes, beliefs, knowledge, and perceptions about disabled children's sleep hygiene among caregivers and rehabilitation providers of children with disabilities. Twenty seven adults, including nine primary caregivers and eighteen rehabilitation providers, participated in five focus group discussions between September and December 2012 at the Rehabilitation Center in Punta Arenas, Chile. A trained facilitator guided focus group discussions using a semi-structured script. Audiotapes and transcripts of focus group discussions were reviewed and analyzed for recurrent themes. Participants identified seven themes related to children's sleep hygiene: lifestyle behaviors, family factors, children's disabilities and/or comorbidities, environmental factors, adults' responsibilities for children's sleep, perception of good sleep, and parental distress about children's sleep problems. While both caregivers and rehabilitation providers recognized the importance of sleep for children's health and functioning, they differed in their understanding of how sleep hygiene practices influence sleep. Rehabilitation providers recognized the negative influence of electronics on sleep and the positive influence of sleep routines. In contrast, caregivers reported use of television/movie watching and stimulants as coping strategies for managing children's sleep problems. Caregivers may benefit from better understanding the influence of electronics and stimulant use on child sleep health. Rehabilitation

  10. Family planning providers' perspectives on family planning service delivery in Ibadan and Kaduna, Nigeria: a qualitative study.

    Science.gov (United States)

    Hebert, Luciana Estelle; Schwandt, Hilary Megan; Boulay, Marc; Skinner, Joanna

    2013-01-01

    In Nigeria, fertility continues to be high and contraceptive prevalence remains low. This study was conducted in order to understand the perceptions of, experiences with and challenges of delivering family planning services in two urban areas of Nigeria from the perspectives of family planning service providers. A qualitative study using 59 in-depth interviews was conducted among family planning providers working in hospitals, primary health centres, clinics, pharmacies and patent medicine vendors in Ibadan and Kaduna, Nigeria. Providers support a mix of individuals and organisations involved in family planning provision, including the government of Nigeria. The Nigerian government's role can take a variety of forms, including providing promotional materials for family planning facilities as well as facilitating training and educational opportunities for providers, since many providers lack basic training in family planning provision. Providers often describe their motivation to provide in terms of the health benefits offered by family planning methods. Few providers engage in any marketing of their services and many providers exclude youth and unmarried individuals from their services. The family planning provider community supports a diverse network of providers, but needs further training and support in order to improve the quality of care and market their services. Adolescents, unmarried individuals and women seeking post-abortion care are vulnerable populations that providers need to be better educated about and trained in how to serve. The perspectives of providers should be considered when designing family planning interventions in urban areas of Nigeria.

  11. A qualitative assessment of factors influencing acceptance of a new rotavirus vaccine among health care providers and consumers

    Energy Technology Data Exchange (ETDEWEB)

    Manish M Patel, Alan P Janssen, Richard Tardif, Mark Herring, Umesh Parashar

    2007-10-18

    In 2006, a new rotavirus vaccine (RotaTeq) was licensed in the US and recommended for routine immunization of all US infants. Because a previously licensed vaccine (Rotashield) was withdrawn from the US for safety concerns, identifying barriers to uptake of RotaTeq will help develop strategies to broaden vaccine coverage. Our qualitative assessment provides complementary data to recent quantitative surveys and suggests that physicians and parents are likely to adopt the newly licensed rotavirus vaccine. Increasing parental awareness of the rotavirus disease burden and providing physicians with timely post-marketing surveillance data will be integral to a successful vaccination program.

  12. Oxygen distribution in tumors: A qualitative analysis and modeling study providing a novel Monte Carlo approach

    International Nuclear Information System (INIS)

    Lagerlöf, Jakob H.; Kindblom, Jon; Bernhardt, Peter

    2014-01-01

    end, due to anoxia, but smaller tumors showed undisturbed oxygen distributions. The six different models with correlated parameters generated three classes of oxygen distributions. The first was a hypothetical, negative covariance between vessel proximity and pO 2 (VPO-C scenario); the second was a hypothetical positive covariance between vessel proximity and pO 2 (VPO+C scenario); and the third was the hypothesis of no correlation between vessel proximity and pO 2 (UP scenario). The VPO-C scenario produced a distinctly different oxygen distribution than the two other scenarios. The shape of the VPO-C scenario was similar to that of the nonvariable DOC model, and the larger the tumor, the greater the similarity between the two models. For all simulations, the mean oxygen tension decreased and the hypoxic fraction increased with tumor size. The absorbed dose required for definitive tumor control was highest for the VPO+C scenario, followed by the UP and VPO-C scenarios. Conclusions: A novel MC algorithm was presented which simulated oxygen distributions and radiation response for various biological parameter values. The analysis showed that the VPO-C scenario generated a clearly different oxygen distribution from the VPO+C scenario; the former exhibited a lower hypoxic fraction and higher radiosensitivity. In future studies, this modeling approach might be valuable for qualitative analyses of factors that affect oxygen distribution as well as analyses of specific experimental and clinical situations

  13. A qualitative assessment of ante-natal care provided by auxillary nurse midwives.

    Science.gov (United States)

    Prasad, B; Gupta, V M

    1999-01-01

    Two hundred sixty eight antenatal mothers were observed for the quality of services provided by Auxillary Nurse Midwives (ANMs). History taking was found to be satisfactory in only 2.6% women. Obstetric examination was done unsatisfactorily in majority (52.6%) of the mothers. General physical examination was not done in 69% women. ANMs in all 31 sub-centres were not performing investigation like haemoglobin estimation, urine testing, foetal heart sound monitoring and blood pressure recording.

  14. User experiences with clinical social franchising: qualitative insights from providers and clients in Ghana and Kenya

    OpenAIRE

    Sieverding, Maia; Briegleb, Christina; Montagu, Dominic

    2015-01-01

    Background Clinical social franchising is a rapidly growing delivery model in private healthcare markets in low- and middle-income countries. Despite this growth, little is known about providers? perceptions of the benefits and challenges of social franchising or clients? reasons for choosing franchised facilities over other healthcare options. We examine these questions in the context of three social franchise networks in Ghana and Kenya. Methods We conducted in-depth interviews with a purpo...

  15. A qualitative exploration of psychosocial specialists' experiences of providing support in UK burn care services.

    Science.gov (United States)

    Guest, Ella; Griffiths, Catrin; Harcourt, Diana

    2018-01-01

    A burn can have a significant and long-lasting psychosocial impact on a patient and their family. The National Burn Care Standards (2013) recommend psychosocial support should be available in all UK burn services; however, little is known about how it is provided. The current study aimed to explore experiences of psychosocial specialists working in UK burn care, with a focus on the challenges they experience in their role. Semi-structured telephone interviews with eight psychosocial specialists (two psychotherapists and six clinical psychologists) who worked within UK burn care explored their experiences of providing support to patients and their families. Thematic analysis revealed two main themes: burn service-related experiences and challenges reflected health professionals having little time and resources to support all patients; reduced patient attendance due to them living large distances from service; psychosocial appointments being prioritised below wound-related treatments; and difficulties detecting patient needs with current outcome measures. Therapy-related experiences and challenges outlined the sociocultural and familial factors affecting engagement with support, difficulties treating patients with pre-existing mental health conditions within the burn service and individual differences in the stage at which patients are amenable to support. Findings provide an insight into the experiences of psychosocial specialists working in UK burn care and suggest a number of ways in which psychosocial provision in the NHS burn service could be developed.

  16. Mutual Expectations of Mothers of Hospitalized Children and Pediatric Nurses Who Provided Care: Qualitative Study.

    Science.gov (United States)

    Konuk Şener, Dilek; Karaca, Aysel

    This study attempted to identify the mutual expectations of mothers whose children were hospitalized in the pediatric department of a university hospital and nurses who provided care. A descriptive phenomenological design has been used in this study. Data were obtained through tape-recorded semi-structured interviews. This study was conducted at a pediatric clinic, at a university hospital in a small city in Turkey. Participants comprised five nurses working in the children's clinic and 24 mothers who accompanied their children to the hospital. The six major themes that emerged were mothers' feelings and thoughts about the hospital experience, mothers' expectations for attention and support during hospitalization, mothers' expectations for invasive procedures, issues regarding physical comfort and hospital infrastructure, nurses' feelings and thoughts about working in the pediatric clinic, and nurses' expectations of the mothers. Mothers expected nurses to provide physical support including medication administration, and installing/applying IV and nebulizer treatments; and emotional support in terms of having a friendly, rather than critical attitude, and being approachable and receptive of mothers' questions and anxieties. Nurses stated that they were aware of these expectations but needed mothers to be understanding and tolerant, considering their difficult working conditions. Children's hospitalization is a stressful experience for parents. Open and therapeutic communication and relationships between parents and nurses contribute to improving the quality of care provided to children and their families. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Evaluating beauty care provided by the hospital to women suffering from breast cancer: qualitative aspects.

    Science.gov (United States)

    Amiel, Philippe; Dauchy, Sarah; Bodin, Julie; Cerf, Céline; Zenasni, Franck; Pezant, Elisabeth; Teller, Anne-Marie; André, Fabrice; DiPalma, Mario

    2009-07-01

    Cancer patients are offered more and more access to beauty care during their stay in the hospital. This kind of intervention has not been evaluated yet. Primary objective of our research was to determine what type of evaluation strategy to be implemented (as a supportive care with quality of life and/or medical benefits; as a service providing immediate comfort); intermediate objective was to investigate in scientific terms (psychological, sociological) the experience of beauty care by patients. Sixty patients (all users of beauty care provided by hospital, 58 female, most of them treated for breast cancer, two male, mean age 53 years) and 11 nurses and physicians, from four French cancer centres were included. We used direct observation and semi-structured interviews, conducted by a sociologist and a psychologist; different types of beauty care were concerned. All the interviewed patients were satisfied. Patients appreciated acquiring savoir-faire on how to use make-up and on personal image enhancement. Psychological and social well-being benefits were mentioned. The beauty care was not alleged to be reducing the side effects of the treatments, but it had helped patients to accept or bear the burden of them. Providing care beyond that which is directly curative was appreciated by the patients as a sign that they were treated as a "whole" person. The survey brings valuable clues concerning beauty care experience by cancer patients; it suggests the relevance of quantitative evaluation of the immediate and long-term effects on the quality of life.

  18. Complementary and alternative medicine (CAM) providers' views of chronic low back pain patients' expectations of CAM therapies: a qualitative study.

    Science.gov (United States)

    Schafer, Lisa M; Hsu, Clarissa; Eaves, Emery Rose; Ritenbaugh, Cheryl; Turner, Judith; Cherkin, Daniel C; Sims, Colette; Sherman, Karen J

    2012-11-27

    Some researchers think that patients with higher expectations for CAM therapies experience better outcomes and that enthusiastic providers can enhance treatment outcomes. This is in contrast to evidence suggesting conventional medical providers often reorient patient expectations to better match what providers believe to be realistic. However, there is a paucity of research on CAM providers' views of their patients' expectations regarding CAM therapy and the role of these expectations in patient outcomes. To better understand how CAM providers view and respond to their patients' expectations of a particular therapy, we conducted 32 semi-structured, qualitative interviews with acupuncturists, chiropractors, massage therapists and yoga instructors identified through convenience sampling. Interviews were recorded, transcribed and analyzed thematically using Atlas ti version 6.1. CAM providers reported that they attempt to ensure that their patients' expectations are realistic. Providers indicated they manage their patients' expectations in a number of domains- roles and responsibilities of providers and patients, treatment outcomes, timeframe for improvement, and treatment experience. Providers reported that patients' expectations change over time and that they need to continually manage these expectations to enhance patient engagement and satisfaction with treatment. Providers of four types of CAM therapies viewed patients' expectations as an important component of their experiences with CAM therapy and indicated that they try to align patient expectations with reality. These findings suggest that CAM providers are similar in this respect to conventional medical providers.

  19. The perspective of healthcare providers and patients on health literacy: a systematic review of the quantitative and qualitative studies.

    Science.gov (United States)

    Rajah, Retha; Ahmad Hassali, Mohamed Azmi; Jou, Lim Ching; Murugiah, Muthu Kumar

    2018-03-01

    Health literacy (HL) is a multifaceted concept, thus understanding the perspective of healthcare providers, patients, and the system is vital. This systematic review examines and synthesises the available studies on HL-related knowledge, attitude, practice, and perceived barriers. CINAHL and Medline (via EBSCOhost), Google Scholar, PubMed, ProQuest, Sage Journals, and Science Direct were searched. Both quantitative and/or qualitative studies in the English language were included. Intervention studies and studies focusing on HL assessment tools and prevalence of low HL were excluded. The risk of biasness reduced with the involvement of two reviewers independently assessing study eligibility and quality. A total of 30 studies were included, which consist of 19 quantitative, 9 qualitative, and 2 mixed-method studies. Out of 17 studies, 13 reported deficiency of HL-related knowledge among healthcare providers and 1 among patients. Three studies showed a positive attitude of healthcare providers towards learning about HL. Another three studies demonstrated patients feel shame exposing their literacy and undergoing HL assessment. Common HL communication techniques reported practiced by healthcare providers were the use of everyday language, teach-back method, and providing patients with reading materials and aids, while time constraint was the most reported HL perceived barriers by both healthcare providers and patients. Significant gaps exists in HL knowledge among healthcare providers and patients that needs immediate intervention. Such as, greater effort placed in creating a health system that provides an opportunity for healthcare providers to learn about HL and patients to access health information with taking consideration of their perceived barriers.

  20. Motivation and challenges for use of malaria rapid diagnostic tests among informal providers in Myanmar: a qualitative study.

    Science.gov (United States)

    Sudhinaraset, May; Briegleb, Christina; Aung, Moe; Khin, Hnin Su Su; Aung, Tin

    2015-02-06

    Rapid diagnostic tests (RDTs) for malaria enable proper diagnosis and have been shown to reduce overuse of artemisinin combination therapy. Few studies have evaluated the feasibility and use of RDTs in the private sector in Myanmar. The objectives of the study were to: 1) understand the acceptability of using RDTs in the informal sector in Myanmar; 2) examine motivations for use among informal providers; and, 3) highlight decision-making and knowledge of providers for diagnostic testing and treatment. Qualitative interviews were conducted with 30 informal providers. Purposeful sampling was used to enrol study participants in the Mon and Shan State in Myanmar. All interviews were conducted in Burmese, translated into English, and two researchers coded all interviews using Atlas ti. Major themes identified included: 1) informal provider and outlet characteristics, including demographic and background characteristics; 2) the benefits and challenges of using RDTs according to providers; 3) provider experiences with using RDTs, including motivations for using the RDT; 4) adherence to test results, either positive or negative; and, 5) recommendations from informal providers to promote increased use of RDTs in their communities. This study found that introducing RDTs to informal providers in Myanmar was feasible, resulting in improved provider empowerment and patient-provider relationships. Specific challenges included facility infrastructure to use and dispose RDTs and provider knowledge. This varied across the type of informal provider, with itinerant drug vendors more comfortable and knowledgeable about RDTs compared to general retail sellers and medical drug representatives. This study found informal providers in Myanmar found the introduction of RDTs to be highly acceptable. Providers discussed improvement in service quality including provider empowerment and patient-provider relationships. The study also highlighted a number of challenges that informal providers

  1. High-level radioactive wastes. Supplement 1

    Energy Technology Data Exchange (ETDEWEB)

    McLaren, L.H. (ed.)

    1984-09-01

    This bibliography contains information on high-level radioactive wastes included in the Department of Energy's Energy Data Base from August 1982 through December 1983. These citations are to research reports, journal articles, books, patents, theses, and conference papers from worldwide sources. Five indexes, each preceded by a brief description, are provided: Corporate Author, Personal Author, Subject, Contract Number, and Report Number. 1452 citations.

  2. Communicating about eating behaviors. A qualitative study of Chilean women and their health-care providers.

    Science.gov (United States)

    Gálvez, Patricia; Valencia, Alejandra; Palomino, Ana M; Cataldo, Marjorie; Schwingel, Andiara

    2015-01-01

    Good communication between health care providers (HCPs) and patients is critical in achieving positive health outcomes. The purpose of this article was to compare the perceptions of Chilean woman and their HCPs with respect to determinants of eating behaviors. Semi-structured interviews were conducted with women (n=15) visiting a public health care center in Chile and with their HCPs (n=8) who were in charge of promoting healthy eating behaviors among women. Data from the interviews indicated similarities and inconsistencies in determinants of eating behaviors between the groups. Both mentioned many important factors that influence women's eating behaviors, including food preferences, dietary knowledge, self-control and self-efficacy, family, food cost, and food availability. HCPs appeared to be less aware of the role that personality traits and past experiences play as potential determinants which women mentioned. In contrast, women were less aware of the influence of anxiety and low self-esteem on eating choices, which HCPs noted as key factors. Although it was encouraging to see agreement between women and their HCPs in some areas, it is important to work on increasing understanding among the groups with respect to the important role psychological factors play in influencing eating behavior. We suggest that HCPs should focus on the importance of women's personality traits and past eating behaviors, as well as work on improving women's self-esteem and helping to decrease their anxiety levels. HCPs should be encouraged to develop good communication with each person in order to help them understand the roles that external and internal factors play in eating behaviors.

  3. A qualitative study of diverse providers' behaviour in response to commissioners, patients and innovators in England: research protocol.

    Science.gov (United States)

    Sheaff, Rod; Halliday, Joyce; Exworthy, Mark; Allen, Pauline; Mannion, Russell; Asthana, Sheena; Gibson, Alex; Clark, Jonathan

    2016-05-13

    The variety of organisations providing National Health Service (NHS)-funded services in England is growing. Besides NHS hospitals and general practitioners (GPs), they include corporations, social enterprises, voluntary organisations and others. The degree to which these organisational types vary, however, in the ways they manage and provide services and in the outcomes for service quality, patient experience and innovation, remains unclear. This research will help those who commission NHS services select among the different types of organisation for different tasks. The main research questions are how organisationally diverse NHS-funded service providers vary in their responsiveness to patient choice, NHS commissioning and policy changes; and their patterns of innovation. We aim to assess the implications for NHS commissioning and managerial practice which follow from these differences. Systematic qualitative comparison across a purposive sample (c.12) of providers selected for maximum variety of organisational type, with qualitative studies of patient experience and choice (in the same sites). We focus is on NHS services heavily used by older people at high risk of hospital admission: community health services; out-of-hours primary care; and secondary care (planned orthopaedics or ophthalmology). The expected outputs will be evidence-based schemas showing how patterns of service development and delivery typically vary between different organisational types of provider. We will ensure informants' organisational and individual anonymity when dealing with high profile case studies and a competitive health economy. The frail elderly is a key demographic sector with significant policy and financial implications. For NHS commissioners, patients, doctors and other stakeholders, the main outcome will be better knowledge about the relative merits of different kinds of healthcare provider. Dissemination will make use of strategies suggested by patient and public

  4. Electric heating provides a high level of home comfort - economically

    Energy Technology Data Exchange (ETDEWEB)

    Haapakoski, M.

    1997-11-01

    Research and development at IVO in the area of electric heating boasts a tradition going back almost thirty years. Research aimed at further progress is continuing. IVO and power companies launched the `Electrically heated houses of the century` project four years ago. The first results show that electric heating continues to be very competitive with other heating systems. It is an economical way of heating the home and it also increases the comfort of those living there

  5. Cancer and the LGBTQ Population: Quantitative and Qualitative Results from an Oncology Providers' Survey on Knowledge, Attitudes, and Practice Behaviors.

    Science.gov (United States)

    Tamargo, Christina L; Quinn, Gwendolyn P; Sanchez, Julian A; Schabath, Matthew B

    2017-10-07

    Despite growing social acceptance, the LGBTQ population continues to face barriers to healthcare including fear of stigmatization by healthcare providers, and providers' lack of knowledge about LGBTQ-specific health issues. This analysis focuses on the assessment of quantitative and qualitative responses from a subset of providers who identified as specialists that treat one or more of the seven cancers that may be disproportionate in LGBTQ patients. A 32-item web-based survey was emailed to 388 oncology providers at a single institution. The survey assessed: demographics, knowledge, attitudes, and practice behaviors. Oncology providers specializing in seven cancer types had poor knowledge of LGBTQ-specific health needs, with fewer than half of the surveyed providers (49.5%) correctly answering knowledge questions. Most providers had overall positive attitudes toward LGBTQ patients, with 91.7% agreeing they would be comfortable treating this population, and would support education and/or training on LGBTQ-related cancer health issues. Results suggest that despite generally positive attitudes toward the LGBTQ population, oncology providers who treat cancer types most prevalent among the population, lack knowledge of their unique health issues. Knowledge and practice behaviors may improve with enhanced education and training on this population's specific needs.

  6. Parental experiences of providing skin-to-skin care to their newborn infant—Part 1: A qualitative systematic review

    Directory of Open Access Journals (Sweden)

    Agneta Anderzén-Carlsson

    2014-10-01

    Full Text Available Aim: To describe parental experiences of providing skin-to-skin care (SSC to their newborn infants. Background: SSC care for newborn infants has been reported to have positive physiological and psychological benefits to the infants and their parents. No systematic review regarding parental experiences has been identified. Design: In this first part of a meta-study, the findings of a systematic literature review on parental experience of SSC care are presented. Data sources: Four databases were searched, without year or language limitations, up until December 2013. Manual searches were performed in reference lists and in a bibliography of the topic. Review methods: After a quality-appraisal process, data from the original articles were extracted and analysed using qualitative content analysis. Results: The systematic and manual searches led to the inclusion of 29 original qualitative papers from nine countries, reporting experiences from 401 mothers and 94 fathers. Two themes that characterized the provision of SSC emerged: a restoring experience and an energy-draining experience. Conclusion: This review has added scientific and systematic knowledge about parental experiences of providing SSC. Further research about fathers’ experiences is recommended.

  7. High level waste management in Asia: R and D perspectives

    International Nuclear Information System (INIS)

    Deokattey, Sangeeta; Bhanumurthy, K.

    2010-01-01

    The present work is an attempt to provide an overview, about the status of R and D and current trends in high level radioactive waste management, particularly in Asian countries. The INIS database (for the period 1976 to 2010) was selected for this purpose, as this is the most authoritative global source of information, in the area of Nuclear Science and Technology. Appropriate query formulations on the database, resulted in the retrieval of 4322 unique bibliographic records. Using the content analysis method (which is both a qualitative as well as a quantitative research method), all the records were analyzed. Part One of the analysis details Scientometric R and D indicators, such as the countries and the institutions involved in R and D, the types of publications, and programmes and projects related to High Level Waste management. Part Two is a subject-based analysis, grouped under the following broad categories: I. Waste Processing 1. Partitioning and transmutation (including ADS) II. Waste Immobilization 1. Glass waste forms and 2. Crystalline ceramics and other waste forms III. Waste Disposal 1. Performance assessment and safety evaluation studies 2. Geohydrological studies a. Site selection and characterization, b. In situ underground experiments, c. Rock mechanical characterization 3. Deep geological repositories a. Sorption, migration and groundwater chemistry b. Engineered barrier systems and IV. Waste Packaging Materials. The results of this analysis are summarized in the study. (author)

  8. Optimizing High Level Waste Disposal

    International Nuclear Information System (INIS)

    Dirk Gombert

    2005-01-01

    If society is ever to reap the potential benefits of nuclear energy, technologists must close the fuel-cycle completely. A closed cycle equates to a continued supply of fuel and safe reactors, but also reliable and comprehensive closure of waste issues. High level waste (HLW) disposal in borosilicate glass (BSG) is based on 1970s era evaluations. This host matrix is very adaptable to sequestering a wide variety of radionuclides found in raffinates from spent fuel reprocessing. However, it is now known that the current system is far from optimal for disposal of the diverse HLW streams, and proven alternatives are available to reduce costs by billions of dollars. The basis for HLW disposal should be reassessed to consider extensive waste form and process technology research and development efforts, which have been conducted by the United States Department of Energy (USDOE), international agencies and the private sector. Matching the waste form to the waste chemistry and using currently available technology could increase the waste content in waste forms to 50% or more and double processing rates. Optimization of the HLW disposal system would accelerate HLW disposition and increase repository capacity. This does not necessarily require developing new waste forms, the emphasis should be on qualifying existing matrices to demonstrate protection equal to or better than the baseline glass performance. Also, this proposed effort does not necessarily require developing new technology concepts. The emphasis is on demonstrating existing technology that is clearly better (reliability, productivity, cost) than current technology, and justifying its use in future facilities or retrofitted facilities. Higher waste processing and disposal efficiency can be realized by performing the engineering analyses and trade-studies necessary to select the most efficient methods for processing the full spectrum of wastes across the nuclear complex. This paper will describe technologies being

  9. Lack of patient risk counselling and a broader provider training affect malaria control in remote Somalia Kenya border: Qualitative assessment.

    Science.gov (United States)

    Asgary, Ramin; Grigoryan, Zoya; Naderi, Ramesh; Allan, Richard

    2012-01-01

    Effectiveness of providing health education solely via mass media and the providers' targeted training in malaria control needs further exploration. During pre-epidemic season, we conducted a qualitative study of 40 providers and community leaders using focus groups, comprehensive semi-structured interviews and consultation observations. Interviews were transcribed, coded and analysed for major themes. Community leaders believe that they can acquire malaria from contaminated water, animal products, air or garbage. Consequently, they under-utilise bed nets and other protective measures due to perceived continued exposure to other potential malaria sources. Practitioners do not provide individualised health counselling and risk assessment to patients during sick visits, leading to a range of misconceptions about malaria based on limited knowledge from rumours and mass media, and a strong belief in the curative power of traditional medicine. Providers overdiagnose malaria clinically and underutilise available tests due to time constraints, and the lack of training and resources to correctly diagnose other illnesses. Subsequently, misdiagnoses lead them to question the efficacy of recommended treatments. Promoting counselling during clinical encounters to address patient misconception and change risky behaviour is warranted. Wider-ranging ongoing training could enable providers to properly diagnose and manage differential diagnoses to manage malaria better.

  10. A qualitative assessment of factors influencing acceptance of a new rotavirus vaccine among health care providers and consumers

    Directory of Open Access Journals (Sweden)

    Herring Mark

    2007-10-01

    Full Text Available Abstract Background In 2006, a new rotavirus vaccine (RotaTeq was licensed in the US and recommended for routine immunization of all US infants. Because a previously licensed vaccine (Rotashield was withdrawn from the US for safety concerns, identifying barriers to uptake of RotaTeq will help develop strategies to broaden vaccine coverage. Methods We explored beliefs and attitudes of parents (n = 57 and providers (n = 10 towards rotavirus disease and vaccines through a qualitative assessment using focus groups and in-depth interviews. Results All physicians were familiar with safety concerns about rotavirus vaccines, but felt reassured by RotaTeq's safety profile. When asked about likelihood of using RotaTeq on a scale of one to seven (1 = "absolutely not;" 7 = "absolutely yes" the mean score was 5 (range = 3–6. Physicians expressed a high likelihood of adopting RotaTeq, particularly if recommended by their professional organizations and expressed specific interest in post-marketing safety data. Similarly, consumers found the RotaTeq safety profile to be favorable and would rely on their physician's recommendation for vaccination. However, when asked to rank likelihood of having their child vaccinated against rotavirus (1 = "definitely not get;" 7 = "definitely get", 29% ranked 1 or 2, 36% 3 or 4, and 35% 5 to 7. Conclusion Our qualitative assessment provides complementary data to recent quantitative surveys and suggests that physicians and parents are likely to adopt the newly licensed rotavirus vaccine. Increasing parental awareness of the rotavirus disease burden and providing physicians with timely post-marketing surveillance data will be integral to a successful vaccination program.

  11. A Qualitative Study of Multidisciplinary Providers' Experiences With the Transfer Process for Injured Children and Ideas for Improvement.

    Science.gov (United States)

    Gawel, Marcie; Emerson, Beth; Giuliano, John S; Rosenberg, Alana; Minges, Karl E; Feder, Shelli; Violano, Pina; Morrell, Patricia; Petersen, Judy; Christison-Lagay, Emily; Auerbach, Marc

    2018-02-01

    Most injured children initially present to a community hospital, and many will require transfer to a regional pediatric trauma center. The purpose of this study was 1) to explore multidisciplinary providers' experiences with the process of transferring injured children and 2) to describe proposed ideas for process improvement. This qualitative study involved 26 semistructured interviews. Subjects were recruited from 6 community hospital emergency departments and the trauma and transport teams of a level I pediatric trauma center in New Haven, Conn. Participants (n = 34) included interprofessional providers from sending facilities, transport teams, and receiving facilities. Using the constant comparative method, a multidisciplinary team coded transcripts and collectively refined codes to generate recurrent themes across interviews until theoretical saturation was achieved. Participants reported that the transfer process for injured children is complex, stressful, and necessitates collaboration. The transfer process was perceived to involve numerous interrelated components, including professions, disciplines, and institutions. The 5 themes identified as areas to improve this transfer process included 1) Creation of a unified standard operating procedure that crosses institutions/teams, 2) Enhancing 'shared sense making' of all providers, 3) Improving provider confidence, expertise, and skills in caring for pediatric trauma transfer cases, 4) Addressing organization and environmental factors that may impede/delay transfer, and 5) Fostering institutional and personal relationships. Efforts to improve the transfer process for injured children should be guided by the experiences of and input from multidisciplinary frontline emergency providers.

  12. Insights Into Care Providers' Understandings of Life Story Work With Persons With Dementia: Findings From a Qualitative Study.

    Science.gov (United States)

    Berendonk, Charlotte; Caine, Vera

    2017-08-01

    In Germany, life story work, an approach which acknowledges humans as narrative beings and honors biographies, is required by health authorities to be integrated in care provided in nursing homes. Insufficient attention to life story work could place residents at risk of dehumanization, particularly residents with dementia, who depend on support of others to tell and make meaning of their life experiences. We conducted a qualitative study to gain insights into care providers' perceptions and practices of life story work with persons with dementia. Thirty-six care providers in 7 nursing homes participated in semistructured interviews or group discussions. We derived subjective theories (individual understandings) of care providers and higher-order concept patterns following the principles and processes of grounded theory. We found a great variation in participants' understandings of life story work. Some participants were unsure if and how life story work impacts persons with dementia. Starting points for improving the integration of life story work into practice are discussed. We conclude that care providers need a better understanding of life story work as a nursing intervention. The importance of the notion of humans as narrative beings and the multiple ways in which we story our lives as well as embody life stories needs to be further developed. Knowledge is required about the practical and systemic challenges of integrating life story work in the care of persons with dementia.

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

    Science.gov (United States)

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

    2013-05-01

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

  14. A Qualitative Study Examining Young Adults' Experiences of Disclosure and Nondisclosure of LGBTQ Identity to Health Care Providers.

    Science.gov (United States)

    Rossman, Kinton; Salamanca, Paul; Macapagal, Kathryn

    2017-01-01

    Shifting cultural attitudes and legislation have increased focus on the health care needs of lesbian, gay, bisexual, transgender, and queer (LGBTQ) patients. However, patient nondisclosure of LGBTQ identity creates a barrier to accessing care. This qualitative study examined a diverse sample of LGBTQ young adults and their experiences of disclosure and nondisclosure to medical providers. Participants (n = 206, age range 18-27) completed questionnaires assessing health care access and use as part of a larger study. Participants' responses to open-ended items asking about experiences of LGBTQ identity disclosure to medical providers and reasons for nondisclosure were analyzed thematically. Results revealed intra- and interpersonal factors related to patient disclosure and nondisclosure of LGBTQ identity. Reasons for participant nondisclosure included providers not asking about identity, internalized stigma, and belief that health and LGBTQ identity are not related. When participants did disclose, they experienced reactions ranging from discrimination and disbelief to affirmation and respect. Findings confirm and extend previous research on young adults' identity disclosure and provide avenues for health professionals' continuing education when working with LGBTQ patients.

  15. The trajectory of experience of critical care nurses in providing end-of-life care: A qualitative descriptive study.

    Science.gov (United States)

    Ong, Keh Kiong; Ting, Kit Cheng; Chow, Yeow Leng

    2018-01-01

    To understand the perceptions of critical care nurses towards providing end-of-life care. There has been an increasing interest in end-of-life care in the critical care setting. In Singapore, approximately half of deaths in the hospital occur during critical care. While nurses are well positioned to provide end-of-life care to patients and their family members, they faced barriers to providing end-of-life care. Also, providing end-of-life care has profound positive and negative psychological effects on nurses, with the latter being more prominent. Qualitative descriptive design. Data collection was performed in a medical intensive care unit of a public tertiary hospital in Singapore. Ten registered nurses were purposively sampled and interviewed individually using a semi-structured interview guide. A codebook was developed to guide coding, and data were thematically analysed. Rigour was maintained. Nurses went through a trajectory of experience. They experienced the culture of care and developed dissatisfaction with it. The tension shaped their perception and meaning of life and death, and they developed mechanisms to reach resolution. This study provides insight on nurses' perception as a trajectory of experience and raised several implications on clinical practice, policy and research. There is a need to alleviate the tension nurses face and to facilitate coming to terms with the tension by improving the culture of care and supporting nurses. Nurses could be involved more in decision-making and empowered to start end-of-life care conversations within the team and with family members. Communication with family members and between nurses and doctors could be improved. Support for nurses providing end-of-life care could be enhanced through promoting social networks, education and bereavement support. Further research is needed to explore ways to support and empower nurses to provide end-of-life care in critical care. © 2017 John Wiley & Sons Ltd.

  16. Service Oriented Architecture for High Level Applications

    International Nuclear Information System (INIS)

    Chu, P.

    2012-01-01

    Standalone high level applications often suffer from poor performance and reliability due to lengthy initialization, heavy computation and rapid graphical update. Service-oriented architecture (SOA) is trying to separate the initialization and computation from applications and to distribute such work to various service providers. Heavy computation such as beam tracking will be done periodically on a dedicated server and data will be available to client applications at all time. Industrial standard service architecture can help to improve the performance, reliability and maintainability of the service. Robustness will also be improved by reducing the complexity of individual client applications.

  17. Removing high-level contaminants

    International Nuclear Information System (INIS)

    Wallace, Paula

    2013-01-01

    Full text: Using biomimicry, an Australian cleantech innovation making inroads intoChinas's industrial sector offers multiple benefits to miners and processors in Australia. Stephen Shelley, the executive chairman of Creative Water Technology (CWT), was on hand at a recent trade show to explain how his Melbourne company has developed world-class techniques in zero liquid discharge and fractional crystallization of minerals to apply to a wide range of water treatment and recycling applications. “Most existing technologies operate with high energy distillation, filters or biological processing. CWT's appliance uses a low temperature, thermal distillation process known as adiabatic recovery to desalinate, dewater and/or recycle highly saline and highly contaminated waste water,” said Shelley. The technology has been specifically designed to handle the high levels of contaminant that alternative technologies struggle to process, with proven water quality results for feed water samples with TDS levels over 300,000ppm converted to clean water with less than 20ppm. Comparatively, reverse osmosis struggles to process contaminant levels over 70,000ppm effectively. “CWT is able to reclaim up to 97% clean usable water and up to 100% of the contaminants contained in the feed water,” said Shelley, adding that soluble and insoluble contaminants are separately extracted and dried for sale or re-use. In industrial applications CWT has successfully processed feed water with contaminant levels over 650,000 mg/1- without the use of chemicals. “The technology would be suitable for companies in oil exploration and production, mining, smelting, biofuels, textiles and the agricultural and food production sectors,” said Shelley. When compared to a conventional desalination plant, the CWT system is able to capture the value in the brine that most plants discard, not only from the salt but the additional water it contains. “If you recover those two commodities... then you

  18. Patient-provider interaction from the perspectives of type 2 diabetes patients in Muscat, Oman: a qualitative study

    Directory of Open Access Journals (Sweden)

    Östenson Claes-Göran

    2007-10-01

    Full Text Available Abstract Background Patients' expectations and perceptions of the medical encounter and interactions are important tools in diabetes management. Some problems regarding the interaction during encounters may be related to a lack of communication skills on the part of either the physician or the patient. This study aimed at exploring the perceptions of type 2 diabetes patients regarding the medical encounters and quality of interactions with their primary health-care providers. Methods Four focus group discussions (two women and two men groups were conducted among 27 purposively selected patients (13 men and 14 women from six primary health-care centres in Muscat, Oman. Qualitative content analysis was applied. Results The patients identified some weaknesses regarding the patient-provider communication like: unfriendly welcoming; interrupted consultation privacy; poor attention and eye contact; lack of encouraging the patients to ask questions on the providers' side; and inability to participate in medical dialogue or express concerns on the patients' side. Other barriers and difficulties related to issues of patient-centeredness, organization of diabetes clinics, health education and professional competency regarding diabetes care were also identified. Conclusion The diabetes patients' experiences with the primary health-care providers showed dissatisfaction with the services. We suggest appropriate training for health-care providers with regard to diabetes care and developing of communication skills with emphasis on a patient-centred approach. An efficient use of available resources in diabetes clinics and distributing responsibilities between team members in close collaboration with patients and their families seems necessary. Further exploration of the providers' work situation and barriers to good interaction is needed. Our findings can help the policy makers in Oman, and countries with similar health systems, to improve the quality and

  19. Provider perspectives on drug-resistant tuberculosis and human immunodeficiency virus care in South Africa: a qualitative case study.

    Science.gov (United States)

    Daftary, A; Padayatchi, N

    2016-11-01

    To examine influences on health care workers' (HCWs') capacity to deliver health care for multi- and/or extensively drug-resistant tuberculosis (MDR/XDR-TB) and human immunodeficiency virus (HIV) infection in South Africa. Qualitative data were collected via group and individual interviews with a purposive sample of 17 HCWs at a centralised, tertiary TB facility and analysed using grounded theory. Four themes were identified: 1) personal infection control practices among HCWs may be weakened by a workplace culture comprising low motivation, disparate risk perceptions and practices across workforce hierarchies, physical discomfort, and problems managing patients with treatment-induced hearing loss. 2) Patient-provider interactions are likely stronger among nurses, and in HIV vs. MDR/XDR-TB service delivery, due to greater attention to patient empowerment and support. Stigma associated with MDR/XDR-TB, considered worse than HIV, may be perpetuated within non-specialised facilities less familiar with MDR/XDR-TB. 3) HCWs who struggle with the daily tedium of MDR/XDR-TB treatment supervision are becoming increasingly supportive of treatment literacy and self-administration. 4) Effective integration of HIV and MDR/XDR-TB services may be impeded by administrative restrictions, workplace norms and provider mindsets. Comprehensive, decentralised management of MDR/XDR-TB and HIV coinfection requires the creation of patient-provider trust and treatment literacy in MDR/XDR-TB programmes, and defying workplace norms that could provoke nosocomial TB exposure and fragmented service provision.

  20. Qualitative study investigating the commissioning process for older people's services provided by third sector organisations: SOPRANO study protocol.

    Science.gov (United States)

    Sands, Gina; Chadborn, Neil; Craig, Chris; Gladman, John

    2016-05-18

    The commissioning of third sector services for older people may influence the quality, availability and coordination of services for older people. The SOPRANO study aims to understand the relationships between and processes of commissioning bodies and third sector organisations providing health and social care services for older people. This qualitative study will be based in the East Midlands region of England. An initial scoping survey of commissioners will give an overview of services to maintain the health and well-being of older people in the community that are commissioned. Following this, semistructured interviews will be conducted with 4 sample groups: health and social care commissioners, service provider managers, service provider case workers and older service users. A sample size of 10-15 participants in each of the 4 groups is expected to be sufficient to reach data saturation, resulting in a final expected sample size of 40-60 participants. Informed consent will be gained from all participants, and those unable to provide informed consent will be excluded. The interview data will be analysed by 2 researchers using framework content analysis. Approval for the study has been gained from the University of Nottingham School of Medicine ethical review board, and the relevant approvals have been gained from the National Health Service (NHS) research and development departments for interviewing NHS staff. Early engagement with a wide range of stakeholders will ensure that the research findings are extensively disseminated to relevant stakeholders (including commissioners and third sector providers) in an accessible format using the extensive communication networks available to the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care CLAHRCs (applied health research organisations covering all of England). The study will also be disseminated through academic routes such as conference presentations and

  1. An exploratory qualitative assessment of factors influencing childhood vaccine providers' intention to recommend immunization in the Netherlands

    Directory of Open Access Journals (Sweden)

    Mollema Liesbeth

    2012-02-01

    Full Text Available Abstract Background Under the Dutch national immunization program (NIP, childhood vaccination is not mandatory, but its recommendation by childhood vaccine providers (CVP is important for maintaining high vaccination coverage. We therefore examined factors related to providers' intentions to recommend vaccinations to parents of young children. Methods We conducted four focus group discussions with nurses and physicians who provide vaccines to children 0-4 years old in diverse regions of the Netherlands. Three groups represented CVPs at child welfare centers (CWCs serving the general population, with the fourth representing anthroposophical CWCs. Elements of the Theory of Planned Behaviour (TPB were used to design the groups; thematic analysis was used to structure and analyze the dataset. Results Four main themes emerged, including 1 perceived responsibility: to promote vaccines and discuss pros and cons with parents (although this was usually not done if parents readily accepted the vaccination; 2 attitudes toward the NIP: mainly positive, but doubts as to NIP plans to vaccinate against diseases with a low perceived burden; 3 organizational factors: limited time and information can hamper discussions with parents; 4 relationship with parents: crucial and based mainly on communication to establish trust. Compared to CVPs at standard CWCs, the anthroposophical CWCs spent more time communicating and were more willing to adapt the NIP to individual cases. Conclusions Our qualitative assessment provides an overview of beliefs associated with providers' intention to recommend vaccinations. They were motivated to support the NIP, but their intentions to recommend vaccinations were affected by the perceived relevance of the vaccines, practical issues like limited time and by certain types of resistant parents. These results will inform future studies to test the magnitude and relative impact of these factors.

  2. Community and provider perceptions of traditional and skilled birth attendants providing maternal health care for pastoralist communities in Kenya: a qualitative study.

    Science.gov (United States)

    Byrne, Abbey; Caulfield, Tanya; Onyo, Pamela; Nyagero, Josephat; Morgan, Alison; Nduba, John; Kermode, Michelle

    2016-03-01

    Kenya has a high burden of maternal and newborn mortality. Consequently, the Government of Kenya introduced health system reforms to promote the availability of skilled birth attendants (SBAs) and proscribed deliveries by traditional birth attendants (TBAs). Despite these changes, only 10% of women from pastoralist communities are delivered by an SBA in a health facility, and the majority are delivered by TBAs at home. The aim of this study is to better understand the practices and perceptions of TBAs and SBAs serving the remotely located, semi-nomadic, pastoralist communities of Laikipia and Samburu counties in Kenya, to inform the development of an SBA/TBA collaborative care model. This descriptive qualitative study was undertaken in 2013-14. We conducted four focus group discussions (FGDs) with TBAs, three with community health workers, ten with community women, and three with community men. In-depth interviews were conducted with seven SBAs and eight key informants. Topic areas covered were: practices and perceptions of SBAs and TBAs; rewards and challenges; managing obstetric complications; and options for SBA/TBA collaboration. All data were translated, transcribed and thematically analysed. TBAs are valued and accessible members of their communities who adhere to traditional practices and provide practical and emotional support to women during pregnancy, delivery and post-partum. Some TBA practices are potentially harmful to women e.g., restricting food intake during pregnancy, and participants recognised that TBAs are unable to manage obstetric complications. SBAs are acknowledged as having valuable technical skills and resources that contribute to safe and clean deliveries, especially in the event of complications, but there is also a perception that SBAs mistreat women. Both TBAs and SBAs identified a range of challenges related to their work, and instances of mutual respect and informal collaborations between SBAs and TBAs were described. These findings

  3. In private practice, informed consent is interpreted as providing explanations rather than offering choices: a qualitative study.

    Science.gov (United States)

    Delany, Clare M

    2007-01-01

    How do physiotherapists working in private practice understand and interpret the meaning and significance of informed consent in everyday clinical practice? Qualitative study using semi-structured interviews. Seventeen physiotherapists purposefully recruited from metropolitan private practices where treatment was on a one-on-one basis. Therapists defined informed consent as an implicit component of their routine clinical explanations, rather than a process of providing explicit patient choices. Therapists' primary concern was to provide information that led to a (therapist-determined) beneficial therapeutic outcome, rather than to enhance autonomous patient choice. Explicit patient choice and explicit informed consent were defined as important only if patients requested information or therapists recognised risks associated with the treatment. Physiotherapists defined informed consent within a context of achieving therapeutic outcomes rather than a context of respect for patient autonomy and autonomous choice. Physiotherapy practice guidelines developed to ensure compliance with ethical and legal obligations may therefore be followed only if they fit with therapists' understanding and interpretation of a desired therapeutic outcome.

  4. Understanding Afghan healthcare providers: a qualitative study of the culture of care in a Kabul maternity hospital.

    Science.gov (United States)

    Arnold, R; van Teijlingen, E; Ryan, K; Holloway, I

    2015-01-01

    To analyse the culture of a Kabul maternity hospital to understand the perspectives of healthcare providers on their roles, experiences, values and motivations and the impact of these determinants on the care of perinatal women and their babies. Qualitative ethnographic study. A maternity hospital, Afghanistan. Doctors, midwives and care assistants. Six weeks of observation followed by 22 semi-structured interviews and four informal group discussions with staff, two focus group discussions with women and 41 background interviews with Afghan and non-Afghan medical and cultural experts. The culture of care in an Afghan maternity hospital. A large workload, high proportion of complicated cases and poor staff organisation affected the quality of care. Cultural values, social and family pressures influenced the motivation and priorities of healthcare providers. Nepotism and cronyism created inequality in clinical training and support and undermined the authority of management to improve standards of care. Staff without powerful connections were vulnerable in a punitive inequitable environment-fearing humiliation, blame and the loss of employment. Suboptimal care put the lives of women and babies at risk and was, in part, the result of conflicting priorities. The underlying motivation of staff appeared to be the socio-economic survival of their own families. The hospital culture closely mirrored the culture and core values of Afghan society. In setting priorities for women's health post-2015 Millennium Development Goals, understanding the context-specific pressures on staff is key to more effective programme interventions and sustainability. © 2014 Royal College of Obstetricians and Gynaecologists.

  5. High level white noise generator

    International Nuclear Information System (INIS)

    Borkowski, C.J.; Blalock, T.V.

    1979-01-01

    A wide band, stable, random noise source with a high and well-defined output power spectral density is provided which may be used for accurate calibration of Johnson Noise Power Thermometers (JNPT) and other applications requiring a stable, wide band, well-defined noise power spectral density. The noise source is based on the fact that the open-circuit thermal noise voltage of a feedback resistor, connecting the output to the input of a special inverting amplifier, is available at the amplifier output from an equivalent low output impedance caused by the feedback mechanism. The noise power spectral density level at the noise source output is equivalent to the density of the open-circuit thermal noise or a 100 ohm resistor at a temperature of approximately 64,000 Kelvins. The noise source has an output power spectral density that is flat to within 0.1% (0.0043 db) in the frequency range of from 1 KHz to 100 KHz which brackets typical passbands of the signal-processing channels of JNPT's. Two embodiments, one of higher accuracy that is suitable for use as a standards instrument and another that is particularly adapted for ambient temperature operation, are illustrated in this application

  6. High level white noise generator

    Science.gov (United States)

    Borkowski, Casimer J.; Blalock, Theron V.

    1979-01-01

    A wide band, stable, random noise source with a high and well-defined output power spectral density is provided which may be used for accurate calibration of Johnson Noise Power Thermometers (JNPT) and other applications requiring a stable, wide band, well-defined noise power spectral density. The noise source is based on the fact that the open-circuit thermal noise voltage of a feedback resistor, connecting the output to the input of a special inverting amplifier, is available at the amplifier output from an equivalent low output impedance caused by the feedback mechanism. The noise power spectral density level at the noise source output is equivalent to the density of the open-circuit thermal noise or a 100 ohm resistor at a temperature of approximately 64,000 Kelvins. The noise source has an output power spectral density that is flat to within 0.1% (0.0043 db) in the frequency range of from 1 KHz to 100 KHz which brackets typical passbands of the signal-processing channels of JNPT's. Two embodiments, one of higher accuracy that is suitable for use as a standards instrument and another that is particularly adapted for ambient temperature operation, are illustrated in this application.

  7. How do general practitioners experience providing care to refugees with mental health problems? A qualitative study from Denmark.

    Science.gov (United States)

    Jensen, Natasja Koitzsch; Norredam, Marie; Priebe, Stefan; Krasnik, Allan

    2013-01-28

    Refugees are a particularly vulnerable group in relation to the development of mental illness and many may have been subjected to torture or other traumatic experiences. General practitioners are gatekeepers for access to several parts of the psychiatric system and knowledge of their patients' refugee background is crucial to secure adequate care. The aim of this study is to investigate how general practitioners experience providing care to refugees with mental health problems. The study was conducted as part of an EU project on European Best Practices in Access, Quality and Appropriateness of Health Services for Immigrants in Europe (EUGATE). Semi-structured interviews were carried out with nine general practitioners in the vicinity of Copenhagen purposively selected from areas with a high proportion of immigrants. The analysis of the interviews is inspired by qualitative content analysis. One of the main themes identified in the analysis is communication. This includes the use of professional interpreters and that communication entails more than sharing a common language. Quality of care is another theme that emerges and includes awareness of possible trauma history, limited possibilities for refugees to participate in certain treatments due to language barriers and feelings of hopelessness in the general practitioners. The general practitioners may also choose different referral pathways for refugees and they report that their patients lack understanding regarding the differences between psychological problems and physical symptoms. General practitioners experience that providing care to refugees differs from providing care for patients from the majority population. The different strategies employed by the general practitioners in the health care treatment of refugees may be the result of the great diversity in the organisation of general practice in Denmark and the lack of a national strategy in the health care management of refugees. The findings from this

  8. A qualitative exploration of how Canadian informal caregivers in medical tourism use experiential resources to cope with providing transnational care.

    Science.gov (United States)

    Whitmore, Rebecca; Crooks, Valorie A; Snyder, Jeremy

    2017-01-01

    Canadians travelling abroad for privately arranged surgeries paid for out-of-pocket are engaging in what has come to be known as medical tourism. They are often accompanied by friends or family members, who we call caregiver-companions. Caregiver-companions provide care in and across a variety of formal and informal settings, such as in hotels, airplanes and at home. This qualitative study examines the experiences of informal caregivers in medical tourism to learn more about the lived experiences or 'experiential resources' they draw upon to cope with providing care and avoiding caregiver burden. The care-giving literature has demonstrated that such burden can negatively impact caregivers' well-being. The unique, transnational context of care-giving in medical tourism and recent growth in popularity of this practice means that there are few supports or resources currently in place to assist informal caregivers. In this article, we report on an analysis that sought to detail how caregiver-companions draw upon their previous lived experiences to cope with providing transnational care and to minimise or avoid the onset of caregiver burden. We conducted semi-structured telephone interviews with 20 Canadians who had accompanied their friends or family members abroad for surgery between September 2013 and January 2014. Thematic analysis revealed the ways that participants had developed practical strategies to deal with the challenges they faced in medical tourism. The interviews revealed three important experiential resources drawn upon by participants: (i) previous experiences of international travel; (ii) previous experiences of informal care-giving; and (iii) dimensions of the existing relationship with the care recipient. Differences in access to and use of these experiential resources related to participants' perspectives on medical tourism and the outcomes of the trip. By identifying the experiential resources drawn upon by informal caregivers in medical tourism

  9. Ramifications of defining high-level waste

    International Nuclear Information System (INIS)

    Wood, D.E.; Campbell, M.H.; Shupe, M.W.

    1987-01-01

    The Nuclear Regulatory Commission (NRC) is considering rule making to provide a concentration-based definition of high-level waste (HLW) under authority derived from the Nuclear Waste Policy Act (NWPA) of 1982 and the Low Level Waste Policy Amendments Act of 1985. The Department of Energy (DOE), which has the responsibility to dispose of certain kinds of commercial waste, is supporting development of a risk-based classification system by the Oak Ridge National Laboratory to assist in developing and implementing the NRC rule. The system is two dimensional, with the axes based on the phrases highly radioactive and requires permanent isolation in the definition of HLW in the NWPA. Defining HLW will reduce the ambiguity in the present source-based definition by providing concentration limits to establish which materials are to be called HLW. The system allows the possibility of greater-confinement disposal for some wastes which do not require the degree of isolation provided by a repository. The definition of HLW will provide a firm basis for waste processing options which involve partitioning of waste into a high-activity stream for repository disposal, and a low-activity stream for disposal elsewhere. Several possible classification systems have been derived and the characteristics of each are discussed. The Defense High Level Waste Technology Lead Office at DOE - Richland Operations Office, supported by Rockwell Hanford Operations, has coordinated reviews of the ORNL work by a technical peer review group and other DOE offices. The reviews produced several recommendations and identified several issues to be addressed in the NRC rule making. 10 references, 3 figures

  10. Health-Related Quality of Life after Pediatric Liver Transplantation: A Qualitative Analysis of the Perspectives of Health Care Providers

    Directory of Open Access Journals (Sweden)

    Mar Miserachs

    2017-01-01

    Full Text Available With improved survival outcomes after pediatric liver transplantation (LT, health-related quality of life (HRQoL is an important outcome metric. Understanding the elements contributing to HRQoL after LT in children would enable more targeted strategies towards optimizing best outcomes. This qualitative study aimed to explore health care providers (HCP perceptions about HRQoL after pediatric LT. Thirteen experienced HCP participated in two focus group discussions. Data analysis via a thematic analysis approach revealed 4 major themes: “LT as a facilitator of better HRQoL,” “coping and adapting to LT,” “living with a transplanted liver,” and “the family context.” HCP identified elements that both enhance (improved physical health, peer relationship, and activities of daily living and challenge (need for immunosuppression, transplant follow-up, and restrictions the multidimensional domains of HRQoL. HCP perceived LT to be a stressful life-changing event for children and their families. Patients and their parents’ ability to cope and adjust positively to LT was perceived as a key contributor to better HRQoL. HCP perspective highlights the importance of promoting psychosocial support and a family-centered care delivery model towards the overarching goal of optimizing durable outcomes.

  11. Emergency Nurses' Perceptions of Providing End-of-Life Care in a Hong Kong Emergency Department: A Qualitative Study.

    Science.gov (United States)

    Tse, Johnson Wai Keung; Hung, Maria Shuk Yu; Pang, Samantha Mei Che

    2016-05-01

    Provision of end-of-life (EOL) care in the emergency department has improved globally in recent years and has a different scope of interventions than traditional emergency medicine. In 2010, a regional hospital established the first ED EOL service in Hong Kong. The aim of this study was to understand emergency nurses' perceptions regarding the provision of EOL care in the emergency department. A qualitative approach was used with purposive sampling of 16 nurses who had experience in providing EOL care. Semi-structured, face-to-face interviews were conducted from May to October, 2014. All the interviews were transcribed verbatim for content analysis. Four themes were identified: (1) doing good for the dying patients, (2) facilitating family engagement and involvement, (3) enhancing personal growth and professionalism, and (4) expressing ambiguity toward resource deployment. Provision of EOL care in the emergency department can enhance patients' last moment of life, facilitate the grief and bereavement process of families, and enhance the professional development of staff in emergency department. It is substantiated that EOL service in the emergency department enriches EOL care in the health care system. Findings from this study integrated the perspectives on ED EOL services from emergency nurses. The integration of EOL service in other emergency departments locally and worldwide is encouraged. Copyright © 2016 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  12. A Qualitative Study of Provider Perceptions of Influences on Uptake of Pediatric Hospital Guidelines in Lao PDR.

    Science.gov (United States)

    Gray, Amy Z; Soukaloun, Douangdao; Soumphonphakdy, Bandith

    2017-08-01

    Strategies to improve the quality of hospital care are needed if ongoing gains in child health and survival are to be made. We previously reported on improvements in the quality of case management in hospitals following a guideline-based intervention in Lao PDR, with variation in the degree of change achieved between clinical conditions. This study aims to understand the factors that influenced the uptake of the guideline-based intervention, and its impact on care. This qualitative study was embedded in a mixed-methods evaluation of guideline implementation in nine hospitals in Lao PDR. Focus groups and individual interviews were conducted with 70 health staff from central, provincial, and district hospitals. The interview guide was based on the Theoretical Domains Framework. Inductive content analysis was performed on interview transcripts to identify themes, supported by field notes from the intervention. Findings were triangulated against previously reported quantitative outcomes using driver diagrams. Key influences on guidelines uptake related to the guideline and intervention (filling a void, physical accessibility, comprehensibility, training in guideline use), health staff (behavior regulation, trust in guidelines, and beliefs about consequences), and the environment (social influences particularly consensus and incorporation into clinical norms). The major barrier was family preference for treatments in conflict with guideline recommendations. This study identifies contextual factors that explain, as well as validate previously identified improvements in care following guideline implementation in Lao PDR. It provides novel understanding of why the same intervention may have a differential impact on different clinical conditions.

  13. Qualitative Study of correspondence between Patient Perception of Service Advertisement and Service Provided from Traditional Health Facilities

    Directory of Open Access Journals (Sweden)

    Lusi Kristiana

    2015-01-01

    Full Text Available background: Attractive adses of traditional health services often promises such as certainty of healing, treatment without side effect, experience personnel, exclusive recipes, and testimony of patients who recovered. Ads that this unsubstantiated allegedly played a role in the tendency of people turn to traditional medicine. The aim of the study is to describe the perception of patients about the correspondence between the advertisement and the services provided qualitatively. Methods: The study was conducted in Surabaya for 5 months in 2012. Informants were selected purposively. results: The result shows that most of the information about traditional health services obtained from either advertisement local and national television. Health complaints predominanly degenerative diseases, and most have been treated to modern medicine but because they do not heal, switch to traditional medicine. conclusion: Informants judge ad featuring attractive because advanced equipment, herbal remedies as well as testimonials of patients who have recovered. Much of the promise of the ads is not evident when patients seek treatment, so they seek other traditional treatments. Most of them are less satisfied, but there is a fraction that satisfied because being cured. Traditional health services responsiveness associated with the non-medical aspects assessed either by informants. recomendation:Competent authorities should enforce and socialize media literacy to encourage community.

  14. Using contraceptives to delay first birth: a qualitative study of individual, community and health provider perceptions in southern Tanzania

    Directory of Open Access Journals (Sweden)

    Yovitha Sedekia

    2017-10-01

    Full Text Available Abstract Background Young adolescents and unmarried women in low and middle income countries face challenges in accessing family planning services. One factor likely to limit contraceptive use is the attitude and opinion of local stakeholders such as community leaders and health workers. Much of the existing evidence on this topic focuses on women who have already started childbearing. Using primary qualitative data, we explored individual, community and health provider’s perceptions about using modern contraceptives to delay the first birth in a high fertility setting. Methods A descriptive qualitative study was conducted in Tandahimba district in southern Tanzania between December 2014 and March 2015. We conducted 8 focus group discussions with men and women and 25 in-depth interviews (18 with women, 4 with family planning service providers and 3 with district-level staff. Participants were purposively sampled. Data transcripts were managed and coded using Nvivo 11 software and we employed a thematic framework analysis. Results Three main themes emerged about using modern contraceptives to delay first birth: (1 the social and biological status of the woman (2 the type of contraceptive and (3 non-alignment among national policies for adolescents. Use of modern contraceptives to delay first birth was widely acceptable for women who were students, young, unmarried and women in unstable marriage. But long-acting reversible methods such as implants and intrauterine devices were perceived as inappropriate methods for delaying first birth, partly because of fears around delayed return to fecundity, discontinuation once woman’s marital status changes and permanently limiting future fertility. The support for use of modern contraceptives to delay a first pregnancy was not unanimous. A small number of participants from both rural and urban areas did not approve the use of contraceptive methods before the birth of a first baby at all, not even for

  15. HIV provider and patient perspectives on the Development of a Health Department "Data to Care" Program: a qualitative study.

    Science.gov (United States)

    Dombrowski, Julia C; Carey, James W; Pitts, Nicole; Craw, Jason; Freeman, Arin; Golden, Matthew R; Bertolli, Jeanne

    2016-06-10

    U.S. health departments have not historically used HIV surveillance data for disease control interventions with individuals, but advances in HIV treatment and surveillance are changing public health practice. Many U.S. health departments are in the early stages of implementing "Data to Care" programs to assists persons living with HIV (PLWH) with engaging in care, based on information collected for HIV surveillance. Stakeholder engagement is a critical first step for development of these programs. In Seattle-King County, Washington, the health department conducted interviews with HIV medical care providers and PLWH to inform its Data to Care program. This paper describes the key themes of these interviews and traces the evolution of the resulting program. Disease intervention specialists conducted individual, semi-structured qualitative interviews with 20 PLWH randomly selected from HIV surveillance who had HIV RNA levels >10,000 copies/mL in 2009-2010. A physician investigator conducted key informant interviews with 15 HIV medical care providers. Investigators analyzed de-identified interview transcripts, developed a codebook of themes, independently coded the interviews, and identified codes used most frequently as well as illustrative quotes for these key themes. We also trace the evolution of the program from 2010 to 2015. PLWH generally accepted the idea of the health department helping PLWH engage in care, and described how hearing about the treatment experiences of HIV seropositive peers would assist them with engagement in care. Although many physicians were supportive of the Data to Care concept, others expressed concern about potential health department intrusion on patient privacy and the patient-physician relationship. Providers emphasized the need for the health department to coordinate with existing efforts to improve patient engagement. As a result of the interviews, the Data to Care program in Seattle-King County was designed to incorporate an HIV

  16. National high-level waste systems analysis

    International Nuclear Information System (INIS)

    Kristofferson, K.; O'Holleran, T.P.

    1996-01-01

    Previously, no mechanism existed that provided a systematic, interrelated view or national perspective of all high-level waste treatment and storage systems that the US Department of Energy manages. The impacts of budgetary constraints and repository availability on storage and treatment must be assessed against existing and pending negotiated milestones for their impact on the overall HLW system. This assessment can give DOE a complex-wide view of the availability of waste treatment and help project the time required to prepare HLW for disposal. Facilities, throughputs, schedules, and milestones were modeled to ascertain the treatment and storage systems resource requirements at the Hanford Site, Savannah River Site, Idaho National Engineering Laboratory, and West Valley Demonstration Project. The impacts of various treatment system availabilities on schedule and throughput were compared to repository readiness to determine the prudent application of resources. To assess the various impacts, the model was exercised against a number of plausible scenarios as discussed in this paper

  17. How do general practitioners experience providing care to refugees with mental health problems? A qualitative study from Denmark

    Science.gov (United States)

    2013-01-01

    Background Refugees are a particularly vulnerable group in relation to the development of mental illness and many may have been subjected to torture or other traumatic experiences. General practitioners are gatekeepers for access to several parts of the psychiatric system and knowledge of their patients’ refugee background is crucial to secure adequate care. The aim of this study is to investigate how general practitioners experience providing care to refugees with mental health problems. Methods The study was conducted as part of an EU project on European Best Practices in Access, Quality and Appropriateness of Health Services for Immigrants in Europe (EUGATE). Semi-structured interviews were carried out with nine general practitioners in the vicinity of Copenhagen purposively selected from areas with a high proportion of immigrants. The analysis of the interviews is inspired by qualitative content analysis. Results One of the main themes identified in the analysis is communication. This includes the use of professional interpreters and that communication entails more than sharing a common language. Quality of care is another theme that emerges and includes awareness of possible trauma history, limited possibilities for refugees to participate in certain treatments due to language barriers and feelings of hopelessness in the general practitioners. The general practitioners may also choose different referral pathways for refugees and they report that their patients lack understanding regarding the differences between psychological problems and physical symptoms. Conclusion General practitioners experience that providing care to refugees differs from providing care for patients from the majority population. The different strategies employed by the general practitioners in the health care treatment of refugees may be the result of the great diversity in the organisation of general practice in Denmark and the lack of a national strategy in the health care management

  18. How do general practitioners experience providing care to refugees with mental health problems? A qualitative study from Denmark

    Directory of Open Access Journals (Sweden)

    Jensen Natasja Koitzsch

    2013-01-01

    Full Text Available Abstract Background Refugees are a particularly vulnerable group in relation to the development of mental illness and many may have been subjected to torture or other traumatic experiences. General practitioners are gatekeepers for access to several parts of the psychiatric system and knowledge of their patients’ refugee background is crucial to secure adequate care. The aim of this study is to investigate how general practitioners experience providing care to refugees with mental health problems. Methods The study was conducted as part of an EU project on European Best Practices in Access, Quality and Appropriateness of Health Services for Immigrants in Europe (EUGATE. Semi-structured interviews were carried out with nine general practitioners in the vicinity of Copenhagen purposively selected from areas with a high proportion of immigrants. The analysis of the interviews is inspired by qualitative content analysis. Results One of the main themes identified in the analysis is communication. This includes the use of professional interpreters and that communication entails more than sharing a common language. Quality of care is another theme that emerges and includes awareness of possible trauma history, limited possibilities for refugees to participate in certain treatments due to language barriers and feelings of hopelessness in the general practitioners. The general practitioners may also choose different referral pathways for refugees and they report that their patients lack understanding regarding the differences between psychological problems and physical symptoms. Conclusion General practitioners experience that providing care to refugees differs from providing care for patients from the majority population. The different strategies employed by the general practitioners in the health care treatment of refugees may be the result of the great diversity in the organisation of general practice in Denmark and the lack of a national strategy

  19. Diversity in eMental Health Practice: An Exploratory Qualitative Study of Aboriginal and Torres Strait Islander Service Providers.

    Science.gov (United States)

    Bird, Jennifer; Rotumah, Darlene; Bennett-Levy, James; Singer, Judy

    2017-05-29

    In Australia, mental health services are undergoing major systemic reform with eMental Health (eMH) embedded in proposed service models for all but those with severe mental illness. Aboriginal and Torres Strait Islander service providers have been targeted as a national priority for training and implementation of eMH into service delivery. Implementation studies on technology uptake in health workforces identify complex and interconnected variables that influence how individual practitioners integrate new technologies into their practice. To date there are only two implementation studies that focus on eMH and Aboriginal and Torres Strait Islander service providers. They suggest that the implementation of eMH in the context of Aboriginal and Torres Strait Islander populations may be different from the implementation of eMH with allied health professionals and mainstream health services. The objective of this study is to investigate how Aboriginal and Torres Strait Islander service providers in one regional area of Australia used eMH resources in their practice following an eMH training program and to determine what types of eMH resources they used. Individual semistructured qualitative interviews were conducted with a purposive sample of 16 Aboriginal and Torres Strait Islander service providers. Interviews were co-conducted by one indigenous and one non-indigenous interviewer. A sample of transcripts were coded and thematically analyzed by each interviewer and then peer reviewed. Consensus codes were then applied to all transcripts and themes identified. It was found that 9 of the 16 service providers were implementing eMH resources into their routine practice. The findings demonstrate that participants used eMH resources for supporting social inclusion, informing and educating, assessment, case planning and management, referral, responding to crises, and self and family care. They chose a variety of types of eMH resources to use with their clients, both culturally

  20. High-level language computer architecture

    CERN Document Server

    Chu, Yaohan

    1975-01-01

    High-Level Language Computer Architecture offers a tutorial on high-level language computer architecture, including von Neumann architecture and syntax-oriented architecture as well as direct and indirect execution architecture. Design concepts of Japanese-language data processing systems are discussed, along with the architecture of stack machines and the SYMBOL computer system. The conceptual design of a direct high-level language processor is also described.Comprised of seven chapters, this book first presents a classification of high-level language computer architecture according to the pr

  1. Quality assurance requirements and methods for high level waste package acceptability

    International Nuclear Information System (INIS)

    1992-12-01

    This document should serve as guidance for assigning the necessary items to control the conditioning process in such a way that waste packages are produced in compliance with the waste acceptance requirements. It is also provided to promote the exchange of information on quality assurance requirements and on the application of quality assurance methods associated with the production of high level waste packages, to ensure that these waste packages comply with the requirements for transportation, interim storage and waste disposal in deep geological formations. The document is intended to assist both the operators of conditioning facilities and repositories as well as national authorities and regulatory bodies, involved in the licensing of the conditioning of high level radioactive wastes or in the development of deep underground disposal systems. The document recommends the quality assurance requirements and methods which are necessary to generate data for these parameters identified in IAEA-TECDOC-560 on qualitative acceptance criteria, and indicates where and when the control methods can be applied, e.g. in the operation or commissioning of a process or in the development of a waste package design. Emphasis is on the control of the process and little reliance is placed on non-destructive or destructive testing. Qualitative criteria, relevant to disposal of high level waste, are repository dependent and are not addressed here. 37 refs, 3 figs, 2 tabs

  2. Other-than-high-level waste

    International Nuclear Information System (INIS)

    Bray, G.R.

    1976-01-01

    The main emphasis of the work in the area of partitioning transuranic elements from waste has been in the area of high-level liquid waste. But there are ''other-than-high-level wastes'' generated by the back end of the nuclear fuel cycle that are both large in volume and contaminated with significant quantities of transuranic elements. The combined volume of these other wastes is approximately 50 times that of the solidified high-level waste. These other wastes also contain up to 75% of the transuranic elements associated with waste generated by the back end of the fuel cycle. Therefore, any detailed evaluation of partitioning as a viable waste management option must address both high-level wastes and ''other-than-high-level wastes.''

  3. High-level waste immobilization program: an overview

    International Nuclear Information System (INIS)

    Bonner, W.R.

    1979-09-01

    The High-Level Waste Immobilization Program is providing technology to allow safe, affordable immobilization and disposal of nuclear waste. Waste forms and processes are being developed on a schedule consistent with national needs for immobilization of high-level wastes stored at Savannah River, Hanford, Idaho National Engineering Laboratory, and West Valley, New York. This technology is directly applicable to high-level wastes from potential reprocessing of spent nuclear fuel. The program is removing one more obstacle previously seen as a potential restriction on the use and further development of nuclear power, and is thus meeting a critical technological need within the national objective of energy independence

  4. A qualitative research on Spanish farmers and citizens perceptions of ecosystem services provided by mountain livestock farming

    OpenAIRE

    Bernués Jal, Alberto; Rodríguez Ortega, Tamara; Ripoll Bosch, Raimon; Casasús Pueyo, Isabel

    2013-01-01

    There is a strong debate nowadays on the public goods derived from certain agro-ecosystems and their valuation for establishing payments for ecosystem services (ES). In this context, we carried out a qualitative research on the spontaneous knowledge of ecosystem services and the perceptions of farmers and citizens on relationships between mountain farming and the environment. Five focus groups (2 with farmers and 3 with citizens; n=33) were organized in north-eastern Spain. Discus...

  5. Healthcare providers balancing norms and practice: challenges and opportunities in providing contraceptive counselling to young people in Uganda - a qualitative study.

    Science.gov (United States)

    Paul, Mandira; Näsström, Sara B; Klingberg-Allvin, Marie; Kiggundu, Charles; Larsson, Elin C

    2016-01-01

    Pregnancies among young women force girls to compromise education, resulting in low educational attainment with subsequent poverty and vulnerability. A pronounced focus is needed on contraceptive use, pregnancy, and unsafe abortion among young women. This study aims to explore healthcare providers' (HCPs) perceptions and practices regarding contraceptive counselling to young people. We conducted 27 in-depth interviews with doctors and midwives working in seven health facilities in central Uganda. Interviews were open-ended and allowed the participant to speak freely on certain topics. We used a topic guide to cover areas topics of interest focusing on post-abortion care (PAC) but also covering contraceptive counselling. Transcripts were transcribed verbatim and data were analysed using thematic analysis. The main theme, HCPs' ambivalence to providing contraceptive counselling to sexually active young people is based on two sub-themes describing the challenges of contraceptive counselling: A) HCPs echo the societal norms regarding sexual practice among young people, while at the same time our findings B) highlights the opportunities resulting from providers pragmatic approach to contraceptive counselling to young women. Providers expressed a self-identified lack of skill, limited resources, and inadequate support from the health system to successfully provide appropriate services to young people. They felt frustrated with the consultations, especially when meeting young women seeking PAC. Despite existing policies for young people's sexual and reproductive health in Uganda, HCPs are not sufficiently equipped to provide adequate contraceptive counselling to young people. Instead, HCPs are left in between the negative influence of social norms and their pragmatic approach to address the needs of young people, especially those seeking PAC. We argue that a clear policy supported by a clear strategy with practical guidelines should be implemented alongside in

  6. A Grounded Theory Qualitative Analysis of Interprofessional Providers' Perceptions on Caring for Critically Ill Infants and Children in Pediatric and General Emergency Departments.

    Science.gov (United States)

    Gangadharan, Sandeep; Tiyyagura, Gunjan; Gawel, Marcie; Walsh, Barbara M; Brown, Linda L; Lavoie, Megan; Tay, Khoon-Yen; Auerbach, Marc A

    2016-10-04

    The objective of this study was to explore pediatric emergency department (PED) and general emergency department (GED) providers' perceptions on caring for critically ill infants and children. This study utilized qualitative methods to examine the perceptions of emergency department providers caring for critically ill infants and children. Teams of providers participated in 4 in situ simulation cases followed by facilitated debriefings. Debriefings were recorded and professionally transcribed. The transcripts were reviewed independently and followed by group coding discussions to identify emerging themes. Consistent with grounded theory, the team iteratively revised the debriefing script as new understanding was gained. A total of 188 simulation debriefings were recorded in 24 departments, with 15 teams participating from 8 PEDs and 32 teams from 16 GEDs. Twenty-four debriefings were audiotaped and professionally transcribed verbatim. Thematic saturation was achieved after 20 transcripts. In our iterative qualitative analysis of these transcripts, we observed 4 themes: (1) GED provider comfort with algorithm-based pediatric care and overall comfort with pediatric care in PED, (2) GED provider reliance on cognitive aids versus experience-based recall by PED providers, (3) GED provider discomfort with locating and determining size or dose of pediatric-specific equipment and medications, and (4) PED provider reliance on larger team size and challenges with multitasking during resuscitation. Our qualitative analysis produced several themes that help us to understand providers' perceptions in caring for critically ill children in GEDs and PEDs. These data could guide the development of targeted educational and improvement interventions.

  7. Healthcare providers balancing norms and practice: challenges and opportunities in providing contraceptive counselling to young people in Uganda – a qualitative study

    Directory of Open Access Journals (Sweden)

    Mandira Paul

    2016-05-01

    Full Text Available Background: Pregnancies among young women force girls to compromise education, resulting in low educational attainment with subsequent poverty and vulnerability. A pronounced focus is needed on contraceptive use, pregnancy, and unsafe abortion among young women. Objective: This study aims to explore healthcare providers’ (HCPs perceptions and practices regarding contraceptive counselling to young people. Design: We conducted 27 in-depth interviews with doctors and midwives working in seven health facilities in central Uganda. Interviews were open-ended and allowed the participant to speak freely on certain topics. We used a topic guide to cover areas topics of interest focusing on post-abortion care (PAC but also covering contraceptive counselling. Transcripts were transcribed verbatim and data were analysed using thematic analysis. Results: The main theme, HCPs' ambivalence to providing contraceptive counselling to sexually active young people is based on two sub-themes describing the challenges of contraceptive counselling: A HCPs echo the societal norms regarding sexual practice among young people, while at the same time our findings B highlights the opportunities resulting from providers pragmatic approach to contraceptive counselling to young women. Providers expressed a self-identified lack of skill, limited resources, and inadequate support from the health system to successfully provide appropriate services to young people. They felt frustrated with the consultations, especially when meeting young women seeking PAC. Conclusions: Despite existing policies for young people's sexual and reproductive health in Uganda, HCPs are not sufficiently equipped to provide adequate contraceptive counselling to young people. Instead, HCPs are left in between the negative influence of social norms and their pragmatic approach to address the needs of young people, especially those seeking PAC. We argue that a clear policy supported by a clear strategy

  8. High-level nuclear waste disposal

    International Nuclear Information System (INIS)

    Burkholder, H.C.

    1985-01-01

    The meeting was timely because many countries had begun their site selection processes and their engineering designs were becoming well-defined. The technology of nuclear waste disposal was maturing, and the institutional issues arising from the implementation of that technology were being confronted. Accordingly, the program was structured to consider both the technical and institutional aspects of the subject. The meeting started with a review of the status of the disposal programs in eight countries and three international nuclear waste management organizations. These invited presentations allowed listeners to understand the similarities and differences among the various national approaches to solving this very international problem. Then seven invited presentations describing nuclear waste disposal from different perspectives were made. These included: legal and judicial, electric utility, state governor, ethical, and technical perspectives. These invited presentations uncovered several issues that may need to be resolved before high-level nuclear wastes can be emplaced in a geologic repository in the United States. Finally, there were sixty-six contributed technical presentations organized in ten sessions around six general topics: site characterization and selection, repository design and in-situ testing, package design and testing, disposal system performance, disposal and storage system cost, and disposal in the overall waste management system context. These contributed presentations provided listeners with the results of recent applied RandD in each of the subject areas

  9. Delivering Service Quality in Alcohol Treatment: A Qualitative Comparison of Public and Private Treatment Centres by Service Users and Service Providers

    Science.gov (United States)

    Resnick, Sheilagh M.; Griffiths, Mark D.

    2012-01-01

    In the UK, quality of care has now been placed at the centre of the National Health Service (NHS) modernisation programme. To date, there has been little research on the service quality delivery of alcohol treatment services from the perspective of both the service user and service provider. Therefore, this qualitative study explored the…

  10. High level issues in reliability quantification of safety-critical software

    International Nuclear Information System (INIS)

    Kim, Man Cheol

    2012-01-01

    For the purpose of developing a consensus method for the reliability assessment of safety-critical digital instrumentation and control systems in nuclear power plants, several high level issues in reliability assessment of the safety-critical software based on Bayesian belief network modeling and statistical testing are discussed. Related to the Bayesian belief network modeling, the relation between the assessment approach and the sources of evidence, the relation between qualitative evidence and quantitative evidence, how to consider qualitative evidence, and the cause-consequence relation are discussed. Related to the statistical testing, the need of the consideration of context-specific software failure probabilities and the inability to perform a huge number of tests in the real world are discussed. The discussions in this paper are expected to provide a common basis for future discussions on the reliability assessment of safety-critical software. (author)

  11. Recovering method for high level radioactive material

    International Nuclear Information System (INIS)

    Fukui, Toshiki

    1998-01-01

    Offgas filters such as of nuclear fuel reprocessing facilities and waste control facilities are burnt, and the burnt ash is melted by heating, and then the molten ashes are brought into contact with a molten metal having a low boiling point to transfer the high level radioactive materials in the molten ash to the molten metal. Then, only the molten metal is evaporated and solidified by drying, and residual high level radioactive materials are recovered. According to this method, the high level radioactive materials in the molten ashes are transferred to the molten metal and separated by the difference of the distribution rate of the molten ash and the molten metal. Subsequently, the molten metal to which the high level radioactive materials are transferred is heated to a temperature higher than the boiling point so that only the molten metal is evaporated and dried to be removed, and residual high level radioactive materials are recovered easily. On the other hand, the molten ash from which the high level radioactive material is removed can be discarded as ordinary industrial wastes as they are. (T.M.)

  12. Long-term high-level waste technology program

    International Nuclear Information System (INIS)

    1980-04-01

    The Department of Energy (DOE) is conducting a comprehensive program to isolate all US nuclear wastes from the human environment. The DOE Office of Nuclear Energy - Waste (NEW) has full responsibility for managing the high-level wastes resulting from defense activities and additional responsiblity for providing the technology to manage existing commercial high-level wastes and any that may be generated in one of several alternative fuel cycles. Responsibilities of the Three Divisions of DOE-NEW are shown. This strategy document presents the research and development plan of the Division of Waste Products for long-term immobilization of the high-level radioactive wastes resulting from chemical processing of nuclear reactor fuels and targets. These high-level wastes contain more than 99% of the residual radionuclides produced in the fuels and targets during reactor operations. They include essentially all the fission products and most of the actinides that were not recovered for use

  13. Care provided by the father to the child with cancer under the influence of masculinities: qualitative meta-synthesis

    Directory of Open Access Journals (Sweden)

    Naiara Barros Polita

    Full Text Available ABSTRACT Objective: To synthesize and interpret findings and conclusions of qualitative research addressing the experience of the father in the care of the child with cancer. Method: Meta-synthesis of 16 qualitative studies from six databases, analyzed through taxonomic analysis. Results: Child and adolescent cancer have several repercussions on the daily life of the father, especially related to the stigma around the disease, the fear of the unknown and the social and family role. Faced with the illness and the need to care for the child, the father seeks to recover normality in the family and transitions between hegemonic masculine behaviors and practices culturally recognized as female. Final Considerations: The complex experience of the father, influenced by masculinities, was evidenced. The limitations regard the restricted understanding of the contextual specificities of the experiences, due to the limited characteristics of the parents and children described in the studies. The knowledge produced is useful to promote involvement of fathers in the care of the child, as well as to strengthen and assist him in this task.

  14. DEFENSE HIGH LEVEL WASTE GLASS DEGRADATION

    International Nuclear Information System (INIS)

    Ebert, W.

    2001-01-01

    The purpose of this Analysis/Model Report (AMR) is to document the analyses that were done to develop models for radionuclide release from high-level waste (HLW) glass dissolution that can be integrated into performance assessment (PA) calculations conducted to support site recommendation and license application for the Yucca Mountain site. This report was developed in accordance with the ''Technical Work Plan for Waste Form Degradation Process Model Report for SR'' (CRWMS M andO 2000a). It specifically addresses the item, ''Defense High Level Waste Glass Degradation'', of the product technical work plan. The AP-3.15Q Attachment 1 screening criteria determines the importance for its intended use of the HLW glass model derived herein to be in the category ''Other Factors for the Postclosure Safety Case-Waste Form Performance'', and thus indicates that this factor does not contribute significantly to the postclosure safety strategy. Because the release of radionuclides from the glass will depend on the prior dissolution of the glass, the dissolution rate of the glass imposes an upper bound on the radionuclide release rate. The approach taken to provide a bound for the radionuclide release is to develop models that can be used to calculate the dissolution rate of waste glass when contacted by water in the disposal site. The release rate of a particular radionuclide can then be calculated by multiplying the glass dissolution rate by the mass fraction of that radionuclide in the glass and by the surface area of glass contacted by water. The scope includes consideration of the three modes by which water may contact waste glass in the disposal system: contact by humid air, dripping water, and immersion. The models for glass dissolution under these contact modes are all based on the rate expression for aqueous dissolution of borosilicate glasses. The mechanism and rate expression for aqueous dissolution are adequately understood; the analyses in this AMR were conducted to

  15. The management of high-level radioactive wastes

    International Nuclear Information System (INIS)

    Lennemann, Wm.L.

    1979-01-01

    The definition of high-level radioactive wastes is given. The following aspects of high-level radioactive wastes' management are discussed: fuel reprocessing and high-level waste; storage of high-level liquid waste; solidification of high-level waste; interim storage of solidified high-level waste; disposal of high-level waste; disposal of irradiated fuel elements as a waste

  16. A Qualitative Evaluation of Engagement and Attrition in a Nurse Home Visiting Program: From the Participant and Provider Perspective.

    Science.gov (United States)

    Beasley, Lana O; Ridings, Leigh E; Smith, Tyler J; Shields, Jennifer D; Silovsky, Jane F; Beasley, William; Bard, David

    2018-05-01

    Beginning parenting programs in the prenatal and early postnatal periods have a large potential for impact on later child and maternal outcomes. Home-based parenting programs, such as the Nurse Family Partnership (NFP), have been established to help address this need. Program reach and impact is dependent on successful engagement of expecting mothers with significant risks; however, NFP attrition rates remain high. The current study qualitatively examined engagement and attrition from the perspectives of NFP nurses and mothers in order to identify mechanisms that enhance service engagement. Semi-structured interviews were conducted in focus groups composed of either engaged (27 total mothers) or unengaged (15 total mothers) mothers from the NFP program. NFP nurses (25 total nurses) were recruited for individual semi-structured interviews. Results suggest that understanding engagement in the NFP program requires addressing both initial and sustained engagement. Themes associated with enhanced initial engagement include nurse characteristics (e.g., flexible, supportive, caring) and establishment of a solid nurse-family relationship founded on these characteristics. Factors impacting sustained engagement include nurse characteristics, provision of educational materials on child development, individualized services for families, and available family support. Identified barriers to completing services include competing demands and lack of support. Findings of this study have direct relevance for workforce planning, including hiring and training through integrating results regarding effective nurse characteristics. Additional program supports to enhance parent engagement may be implemented across home-based parenting programs in light of the current study's findings.

  17. PAIRWISE BLENDING OF HIGH LEVEL WASTE

    International Nuclear Information System (INIS)

    CERTA, P.J.

    2006-01-01

    The primary objective of this study is to demonstrate a mission scenario that uses pairwise and incidental blending of high level waste (HLW) to reduce the total mass of HLW glass. Secondary objectives include understanding how recent refinements to the tank waste inventory and solubility assumptions affect the mass of HLW glass and how logistical constraints may affect the efficacy of HLW blending

  18. Materials for high-level waste containment

    International Nuclear Information System (INIS)

    Marsh, G.P.

    1982-01-01

    The function of the high-level radioactive waste container in storage and of a container/overpack combination in disposal is considered. The consequent properties required from potential fabrication materials are discussed. The strategy adopted in selecting containment materials and the experimental programme underway to evaluate them are described. (U.K.)

  19. Current high-level waste solidification technology

    International Nuclear Information System (INIS)

    Bonner, W.F.; Ross, W.A.

    1976-01-01

    Technology has been developed in the U.S. and abroad for solidification of high-level waste from nuclear power production. Several processes have been demonstrated with actual radioactive waste and are now being prepared for use in the commercial nuclear industry. Conversion of the waste to a glass form is favored because of its high degree of nondispersibility and safety

  20. Private healthcare provider experiences with social health insurance schemes: Findings from a qualitative study in Ghana and Kenya.

    Science.gov (United States)

    Sieverding, Maia; Onyango, Cynthia; Suchman, Lauren

    2018-01-01

    Incorporating private healthcare providers into social health insurance schemes is an important means towards achieving universal health coverage in low and middle income countries. However, little research has been conducted about why private providers choose to participate in social health insurance systems in such contexts, or their experiences with these systems. We explored private providers' perceptions of and experiences with participation in two different social health insurance schemes in Sub-Saharan Africa-the National Health Insurance Scheme (NHIS) in Ghana and the National Hospital Insurance Fund (NHIF) in Kenya. In-depth interviews were held with providers working at 79 facilities of varying sizes in three regions of Kenya (N = 52) and three regions of Ghana (N = 27). Most providers were members of a social franchise network. Interviews covered providers' reasons for (non) enrollment in the health insurance system, their experiences with the accreditation process, and benefits and challenges with the system. Interviews were coded in Atlas.ti using an open coding approach and analyzed thematically. Most providers in Ghana were NHIS-accredited and perceived accreditation to be essential to their businesses, despite challenges they encountered due to long delays in claims reimbursement. In Kenya, fewer than half of providers were NHIF-accredited and several said that their clientele were not NHIF enrolled. Understanding of how the NHIF functioned was generally low. The lengthy and cumbersome accreditation process also emerged as a major barrier to providers' participation in the NHIF in Kenya, but the NHIS accreditation process was not a major concern for providers in Ghana. In expanding social health insurance, coordinated efforts are needed to increase coverage rates among underserved populations while also accrediting the private providers who serve those populations. Market pressure was a key force driving providers to gain and maintain accreditation

  1. Private healthcare provider experiences with social health insurance schemes: Findings from a qualitative study in Ghana and Kenya.

    Directory of Open Access Journals (Sweden)

    Maia Sieverding

    Full Text Available Incorporating private healthcare providers into social health insurance schemes is an important means towards achieving universal health coverage in low and middle income countries. However, little research has been conducted about why private providers choose to participate in social health insurance systems in such contexts, or their experiences with these systems. We explored private providers' perceptions of and experiences with participation in two different social health insurance schemes in Sub-Saharan Africa-the National Health Insurance Scheme (NHIS in Ghana and the National Hospital Insurance Fund (NHIF in Kenya.In-depth interviews were held with providers working at 79 facilities of varying sizes in three regions of Kenya (N = 52 and three regions of Ghana (N = 27. Most providers were members of a social franchise network. Interviews covered providers' reasons for (non enrollment in the health insurance system, their experiences with the accreditation process, and benefits and challenges with the system. Interviews were coded in Atlas.ti using an open coding approach and analyzed thematically.Most providers in Ghana were NHIS-accredited and perceived accreditation to be essential to their businesses, despite challenges they encountered due to long delays in claims reimbursement. In Kenya, fewer than half of providers were NHIF-accredited and several said that their clientele were not NHIF enrolled. Understanding of how the NHIF functioned was generally low. The lengthy and cumbersome accreditation process also emerged as a major barrier to providers' participation in the NHIF in Kenya, but the NHIS accreditation process was not a major concern for providers in Ghana.In expanding social health insurance, coordinated efforts are needed to increase coverage rates among underserved populations while also accrediting the private providers who serve those populations. Market pressure was a key force driving providers to gain and maintain

  2. A qualitative study of English community pharmacists' experiences of providing lifestyle advice to patients with cardiovascular disease

    OpenAIRE

    Morton, Kirsty; Pattison, Helen; Langley, Chris; Powell, Rachael

    2015-01-01

    Background - Cardiovascular disease (CVD) progression is modifiable through lifestyle behaviors. Community pharmacists are ideally placed to facilitate self-management of cardiovascular health however research shows varied pharmacist engagement in providing lifestyle advice. Objective - This study explored community pharmacists' experiences and perceptions of providing lifestyle advice to patients with CVD. Methods - Semi-structured interviews were conducted with fifteen pharmacists (1 superm...

  3. A Qualitative Study of Providers' Perception of Adherence of Women Living with HIV/AIDS in Puerto Rico

    Science.gov (United States)

    Rivero-Mendez, Marta; Dawson-Rose, Carol S.; Solis-Baez, Solymar S.

    2010-01-01

    This study examines healthcare providers' perceptions regarding experiences and factors that contribute to adherent and non-adherent behaviors to HIV treatment among women living with HIV infection in Puerto Rico and describes strategies implemented to improve adherence. Providers' accounts revealed that women with HIV infection are living…

  4. Private healthcare provider experiences with social health insurance schemes: Findings from a qualitative study in Ghana and Kenya

    Science.gov (United States)

    Sieverding, Maia; Onyango, Cynthia

    2018-01-01

    Background Incorporating private healthcare providers into social health insurance schemes is an important means towards achieving universal health coverage in low and middle income countries. However, little research has been conducted about why private providers choose to participate in social health insurance systems in such contexts, or their experiences with these systems. We explored private providers’ perceptions of and experiences with participation in two different social health insurance schemes in Sub-Saharan Africa—the National Health Insurance Scheme (NHIS) in Ghana and the National Hospital Insurance Fund (NHIF) in Kenya. Methods In-depth interviews were held with providers working at 79 facilities of varying sizes in three regions of Kenya (N = 52) and three regions of Ghana (N = 27). Most providers were members of a social franchise network. Interviews covered providers’ reasons for (non) enrollment in the health insurance system, their experiences with the accreditation process, and benefits and challenges with the system. Interviews were coded in Atlas.ti using an open coding approach and analyzed thematically. Results Most providers in Ghana were NHIS-accredited and perceived accreditation to be essential to their businesses, despite challenges they encountered due to long delays in claims reimbursement. In Kenya, fewer than half of providers were NHIF-accredited and several said that their clientele were not NHIF enrolled. Understanding of how the NHIF functioned was generally low. The lengthy and cumbersome accreditation process also emerged as a major barrier to providers’ participation in the NHIF in Kenya, but the NHIS accreditation process was not a major concern for providers in Ghana. Conclusions In expanding social health insurance, coordinated efforts are needed to increase coverage rates among underserved populations while also accrediting the private providers who serve those populations. Market pressure was a key force

  5. When parents won't vaccinate their children: a qualitative investigation of australian primary care providers' experiences.

    Science.gov (United States)

    Berry, Nina J; Henry, Alexandra; Danchin, Margie; Trevena, Lyndal J; Willaby, Harold W; Leask, Julie

    2017-01-17

    Increasingly, the experiences and perceptions of parents who decline vaccination are the subject of investigation. However, the experiences of clinicians who encounter these parents in the course of their work has received little academic attention to date. This study aimed to understand the challenges faced and strategies used when general practitioners and immunising nurses encounter parents who choose not to vaccinate their children. Primary care providers were recruited from regions identified through the Australian Childhood Immunisation Register (ACIR) as having higher than national average rates of registered objection to childhood vaccination. Interviews began with an exploration of provider experiences with parents who accept, are hesitant towards, and who decline vaccination. Participants were asked specifically about how they addressed any difficulties they encountered in their interactions. Thematic analysis focused on encounters with parents - challenges and strategies. Twenty-six general practitioners (GPs), community and practice nurses (PNs) were interviewed across two regions in NSW, Australia. Providers' sense of professional identity as health advocates and experts became conflicted in their encounters with vaccine objecting parents. Providers were dissatisfied when such consultations resulted in a 'therapeutic roadblock' whereby provider-parent communication came to a standstill. There were mixed views about being asked to sign forms exempting parents from vaccinating their children. These ranged from a belief that completing the forms rewarded parents for non-conformity to seeing it as a positive opportunity for engagement. Three common strategies were employed by providers to navigate through these challenges; 1) to explore and inform, 2) to mobilise clinical rapport and 3) to adopt a general principle to first do no harm to the therapeutic relationship. Many healthcare providers find consultations with vaccine objecting parents challenging

  6. A qualitative study of English community pharmacists' experiences of providing lifestyle advice to patients with cardiovascular disease.

    Science.gov (United States)

    Morton, Kirsty; Pattison, Helen; Langley, Chris; Powell, Rachael

    2015-01-01

    Cardiovascular disease (CVD) progression is modifiable through lifestyle behaviors. Community pharmacists are ideally placed to facilitate self-management of cardiovascular health however research shows varied pharmacist engagement in providing lifestyle advice. This study explored community pharmacists' experiences and perceptions of providing lifestyle advice to patients with CVD. Semi-structured interviews were conducted with fifteen pharmacists (1 supermarket; 7 multiple; 7 independent) recruited through multiple methods from community pharmacies across the Midlands, England. A thematic analysis was conducted using a Framework approach. Pharmacists categorized patients according to their perceptions of the patients' ability to benefit from advice. Many barriers to providing lifestyle advice were identified. Confidence to provide lifestyle advice varied, with pharmacists most comfortable providing lifestyle advice in conjunction with conversations about medicines. Some pharmacists felt lifestyle advice was an integral part of their role whilst others questioned whether pharmacists should give lifestyle advice at all, particularly when receiving no remuneration for doing so. Pharmacists viewed providing lifestyle advice as important but identified many barriers to doing so. Lifestyle advice provision was influenced by pharmacists' perceptions of patients. Professional identity and associated role conflict appeared to underpin many of the barriers to pharmacists providing lifestyle advice. Pharmacists may benefit from enhanced training to: increase their confidence to provide lifestyle advice; integrate lifestyle advice with regular pharmaceutical practice and challenge their perceptions of some patients' receptiveness to lifestyle advice and behavior change. Changes to the way UK pharmacists are remunerated may increase the provision of lifestyle advice. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  7. Barriers to communication between HIV care providers (HCPs) and women living with HIV about child bearing: A qualitative study.

    Science.gov (United States)

    Ddumba-Nyanzi, Ismael; Kaawa-Mafigiri, David; Johannessen, Helle

    2016-05-01

    In the context of HIV clinical care, open discussion regarding sexual health and reproductive plans has become increasingly relevant. The aim of this paper is to explore barriers to communication between providers and women living with HIV regarding childbearing. In-depth interviews (IDIs) were conducted with 48 HIV infected women receiving ART at 7 different HIV clinics providing comprehensive HIV care services in four districts in Uganda, between July and August 2012. All women were aware of their HIV diagnosis prior to pregnancy or had given birth while living with HIV. Four themes emerged describing barriers to communication, from the HIV-positive women's point of view: (i) provider indifference or opposition to childbearing post HIV diagnosis, (ii) anticipation of negative response from provider, (iii) provider's emphasis on 'scientific' facts, (iv) 'accidental pregnancy'. Existing evidence regarding effective provider-patient communication should be considered for its application for reproductive counseling among HIV infected women. These data demonstrate the need for current counseling guidelines to explore approaches that encourage open, non-judgmental, non-directive discussions with HIV positive individuals around their reproductive desires and intentions in a health care setting. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  8. Coping and compromise: a qualitative study of how primary health care providers respond to health reform in China.

    Science.gov (United States)

    Zhang, Mingji; Wang, Wei; Millar, Ross; Li, Guohong; Yan, Fei

    2017-08-04

    Health reform in China since 2009 has emphasized basic public health services to enhance the function of Community Health Services as a primary health care facility. A variety of studies have documented these efforts, and the challenges these have faced, yet up to now the experience of primary health care (PHC) providers in terms of how they have coped with these changes remains underdeveloped. Despite the abundant literature on psychological coping processes and mechanisms, the application of coping research within the context of human resources for health remains yet to be explored. This research aims to understand how PHC providers coped with the new primary health care model and the job characteristics brought about by these changes. Semi-structured interviews with primary health care workers were conducted in Jinan city of Shandong province in China. A maximum variation sampling method selected 30 PHC providers from different specialties. Thematic analysis was used drawing on a synthesis of theories related to the Job Demands-Resources model, work adjustment, and the model of exit, voice, loyalty and neglect to understand PHC providers' coping strategies. Our interviews identified that the new model of primary health care significantly affected the nature of primary health work and triggered a range of PHC providers' coping processes. The results found that health workers perceived their job as less intensive than hospital medical work but often more trivial, characterized by heavy workload, blurred job description, unsatisfactory income, and a lack of professional development. However, close relationship with community and low work pressure were satisfactory. PHC providers' processing of job demands and resources displayed two ways of interaction: aggravation and alleviation. Processing of job demands and resources led to three coping strategies: exit, passive loyalty, and compromise with new roles and functions. Primary health care providers employed coping

  9. Timing of High-level Waste Disposal

    International Nuclear Information System (INIS)

    2008-01-01

    This study identifies key factors influencing the timing of high-level waste (HLW) disposal and examines how social acceptability, technical soundness, environmental responsibility and economic feasibility impact on national strategies for HLW management and disposal. Based on case study analyses, it also presents the strategic approaches adopted in a number of national policies to address public concerns and civil society requirements regarding long-term stewardship of high-level radioactive waste. The findings and conclusions of the study confirm the importance of informing all stakeholders and involving them in the decision-making process in order to implement HLW disposal strategies successfully. This study will be of considerable interest to nuclear energy policy makers and analysts as well as to experts in the area of radioactive waste management and disposal. (author)

  10. Disposal of high-level radioactive waste

    International Nuclear Information System (INIS)

    Glasby, G.P.

    1977-01-01

    Although controversy surrounding the possible introduction of nuclear power into New Zealand has raised many points including radiation hazards, reactor safety, capital costs, sources of uranium and earthquake risks on the one hand versus energy conservation and alternative sources of energy on the other, one problem remains paramount and is of global significance - the storage and dumping of the high-level radioactive wastes of the reactor core. The generation of abundant supplies of energy now in return for the storage of these long-lived highly radioactive wastes has been dubbed the so-called Faustian bargain. This article discusses the growth of the nuclear industry and its implications to high-level waste disposal particularly in the deep-sea bed. (auth.)

  11. High-Level Waste Melter Study Report

    Energy Technology Data Exchange (ETDEWEB)

    Perez, Joseph M.; Bickford, Dennis F.; Day, Delbert E.; Kim, Dong-Sang; Lambert, Steven L.; Marra, Sharon L.; Peeler, David K.; Strachan, Denis M.; Triplett, Mark B.; Vienna, John D.; Wittman, Richard S.

    2001-07-13

    At the Hanford Site in Richland, Washington, the path to site cleanup involves vitrification of the majority of the wastes that currently reside in large underground tanks. A Joule-heated glass melter is the equipment of choice for vitrifying the high-level fraction of these wastes. Even though this technology has general national and international acceptance, opportunities may exist to improve or change the technology to reduce the enormous cost of accomplishing the mission of site cleanup. Consequently, the U.S. Department of Energy requested the staff of the Tanks Focus Area to review immobilization technologies, waste forms, and modifications to requirements for solidification of the high-level waste fraction at Hanford to determine what aspects could affect cost reductions with reasonable long-term risk. The results of this study are summarized in this report.

  12. Extending Java for High-Level Web Service Construction

    DEFF Research Database (Denmark)

    Christensen, Aske Simon; Møller, Anders; Schwartzbach, Michael Ignatieff

    2003-01-01

    We incorporate innovations from the project into the Java language to provide high-level features for Web service programming. The resulting language, JWIG, contains an advanced session model and a flexible mechanism for dynamic construction of XML documents, in particular XHTML. To support program...

  13. High-Level Overview of Data Needs for RE Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Lopez, Anthony

    2016-12-22

    This presentation provides a high level overview of analysis topics and associated data needs. Types of renewable energy analysis are grouped into two buckets: First, analysis for renewable energy potential, and second, analysis for other goals. Data requirements are similar but and they build upon one another.

  14. High-Level waste process and product data annotated bibliography

    International Nuclear Information System (INIS)

    Stegen, G.E.

    1996-01-01

    The objective of this document is to provide information on available issued documents that will assist interested parties in finding available data on high-level waste and transuranic waste feed compositions, properties, behavior in candidate processing operations, and behavior on candidate product glasses made from those wastes. This initial compilation is only a partial list of available references

  15. An emergency management demonstrator using the high level architecture

    International Nuclear Information System (INIS)

    Williams, R.J.

    1996-12-01

    This paper addresses the issues of simulation interoperability within the emergency management training context. A prototype implementation in Java of a subset of the High Level Architecture (HLA) is described. The use of Web Browsers to provide graphical user interfaces to HLA is also investigated. (au)

  16. High-Level Waste (HLW) Feed Process Control Strategy

    International Nuclear Information System (INIS)

    STAEHR, T.W.

    2000-01-01

    The primary purpose of this document is to describe the overall process control strategy for monitoring and controlling the functions associated with the Phase 1B high-level waste feed delivery. This document provides the basis for process monitoring and control functions and requirements needed throughput the double-shell tank system during Phase 1 high-level waste feed delivery. This document is intended to be used by (1) the developers of the future Process Control Plan and (2) the developers of the monitoring and control system

  17. Evaluation of solidified high-level waste forms

    International Nuclear Information System (INIS)

    1981-01-01

    One of the objectives of the IAEA waste management programme is to coordinate and promote development of improved technology for the safe management of radioactive wastes. The Agency accomplished this objective specifically through sponsoring Coordinated Research Programmes on the ''Evaluation of Solidified High Level Waste Products'' in 1977. The primary objectives of this programme are to review and disseminate information on the properties of solidified high-level waste forms, to provide a mechanism for analysis and comparison of results from different institutes, and to help coordinate future plans and actions. This report is a summary compilation of the key information disseminated at the second meeting of this programme

  18. Aeon: Synthesizing Scheduling Algorithms from High-Level Models

    Science.gov (United States)

    Monette, Jean-Noël; Deville, Yves; van Hentenryck, Pascal

    This paper describes the aeon system whose aim is to synthesize scheduling algorithms from high-level models. A eon, which is entirely written in comet, receives as input a high-level model for a scheduling application which is then analyzed to generate a dedicated scheduling algorithm exploiting the structure of the model. A eon provides a variety of synthesizers for generating complete or heuristic algorithms. Moreover, synthesizers are compositional, making it possible to generate complex hybrid algorithms naturally. Preliminary experimental results indicate that this approach may be competitive with state-of-the-art search algorithms.

  19. Decommissioning high-level waste surface facilities

    International Nuclear Information System (INIS)

    1978-04-01

    The protective storage, entombment and dismantlement options of decommissioning a High-Level Waste Surface Facility (HLWSF) was investigated. A reference conceptual design for the facility was developed based on the designs of similar facilities. State-of-the-art decommissioning technologies were identified. Program plans and cost estimates for decommissioning the reference conceptual designs were developed. Good engineering design concepts were on the basis of this work identified

  20. Key findings: a qualitative assessment of provider and patient perceptions of HIV/AIDS in South Africa.

    Science.gov (United States)

    Ransom, James; Johnson, Anton F

    2009-01-01

    In 1997, at the Davos International Economic Forum, Nelson Mandela stated that "the poor, the vulnerable, the unschooled, the socially marginalized, the women, and the children, those who bear the burden of colonial legacy-these are the sectors of society which bear the burden of AIDS" (Richter, 2001). Nearly a decade later, that statement still holds true, especially in Mr. Mandela's home country. South Africa continues to have one of the world's highest prevalence ratios of HIV infection (UNAIDS, 2002). This paper explores the significance of perceptions, knowledge, practices, and attitudes toward HIV/AIDS in two important groups in South Africa: health care providers based in public health clinics and their patients. This paper will assess the provider-patient interaction from the perspective of members of the South African HIV/AIDS treatment and prevention community. The analysis will examine the results of in-depth interviews and focus group discussions with providers and patients, respectively, in two of South Africa's nine provinces. Between December 2002 and April 2003 in Guateng and KwaZulu-Natal provinces, we conducted (1) in-depth interviews of a spectrum of health care providers at five local public health clinics and (2) focus groups of patients who patronize those clinics. The results show that there are gaps in the HIV/AIDS knowledge of some of the health care providers and that the participants' health beliefs and practices are embedded in the social conditions in which they live and work, which has a ripple effect on their risk behaviors and trumps any intervention messages from their health care providers and larger public health intervention messages.

  1. High-level waste processing and disposal

    International Nuclear Information System (INIS)

    Crandall, J.L.; Krause, H.; Sombret, C.; Uematsu, K.

    1984-01-01

    The national high-level waste disposal plans for France, the Federal Republic of Germany, Japan, and the United States are covered. Three conclusions are reached. The first conclusion is that an excellent technology already exists for high-level waste disposal. With appropriate packaging, spent fuel seems to be an acceptable waste form. Borosilicate glass reprocessing waste forms are well understood, in production in France, and scheduled for production in the next few years in a number of other countries. For final disposal, a number of candidate geological repository sites have been identified and several demonstration sites opened. The second conclusion is that adequate financing and a legal basis for waste disposal are in place in most countries. Costs of high-level waste disposal will probably add about 5 to 10% to the costs of nuclear electric power. The third conclusion is less optimistic. Political problems remain formidable in highly conservative regulations, in qualifying a final disposal site, and in securing acceptable transport routes

  2. Strengthening diabetes retinopathy services in India: Qualitative insights into providers' perspectives: The India 11-city 9-state study

    Directory of Open Access Journals (Sweden)

    Nanda Kishore Kannuri

    2016-01-01

    Full Text Available Context: There is a lack of evidence on the subjective aspects of the provider perspective regarding diabetes and its complications in India. Objectives: The study was undertaken to understand the providers' perspective on the delivery of health services for diabetes and its complications, specifically the eye complications in India. Settings and Design: Hospitals providing diabetic services in government and private sectors were selected in 11 of the largest cities in India, based on geographical distribution and size. Methods: Fifty-nine semi-structured interviews conducted with physicians providing diabetes care were analyzed all interviews were recorded, transcribed, and translated. Nvivo 10 software was used to code the transcripts. Thematic analysis was conducted to analyze the data. Results: The results are presented as key themes: “Challenges in managing diabetes patients,” “Current patient management practices,” and “Strengthening diabetic retinopathy (DR services at the health systems level.” Diabetes affects people early across the social classes. Self-management was identified as an important prerequisite in controlling diabetes and its complications. Awareness level of hospital staff on DR was low. Advances in medical technology have an important role in effective management of DR. A team approach is required to provide comprehensive diabetic care. Conclusions: Sight-threatening DR is an impending public health challenge that needs a concerted effort to tackle it. A streamlined, multi-dimensional approach where all the stakeholders cooperate is important to strengthening services dealing with DR in the existing health care setup.

  3. A qualitative study of patient and provider perspectives on using web-based pain coping skills training to treat persistent cancer pain.

    Science.gov (United States)

    Rini, Christine; Vu, Maihan B; Lerner, Hannah; Bloom, Catherine; Carda-Auten, Jessica; Wood, William A; Basch, Ethan M; Voorhees, Peter M; Reeder-Hayes, Katherine E; Keefe, Francis J

    2018-04-01

    Persistent pain is common and inadequately treated in cancer patients. Behavioral pain interventions are a recommended part of multimodal pain treatments, but they are underused in clinical care due to barriers such as a lack of the resources needed to deliver them in person and difficulties coordinating their use with clinical care. Pain coping skills training (PCST) is an evidence-based behavioral pain intervention traditionally delivered in person. Delivering this training via the web would increase access to it by addressing barriers that currently limit its use. We conducted a patient pilot study of an 8-week web-based PCST program to determine the acceptability of this approach to patients and the program features needed to meet their needs. Focus groups with healthcare providers identified strategies for coordinating the use of web-based PCST in clinical care. Participants included 7 adults with bone pain due to multiple myeloma or metastasized breast or prostate cancer and 12 healthcare providers (4 physicians and 8 advanced practice providers) who treat cancer-related bone pain. Patients completed web-based PCST at home and then took part in an in-depth qualitative interview. Providers attended focus groups led by a trained moderator. Qualitative analyses identified themes in the patient and provider data. Patients reported strongly favorable responses to web-based PCST and described emotional and physical benefits. They offered suggestions for adapting the approach to better fit their needs and to overcome barriers to completion. Focus groups indicated a need to familiarize healthcare providers with PCST and to address concerns about overburdening patients. Providers would recommend the program to patients they felt could benefit. They suggested applying a broad definition of cancer pain and having various types of providers help coordinate program its use with clinical care. Web-based PCST was acceptable to patients and providers. Our findings suggest

  4. Challenges in providing counselling to MSM in highly stigmatized contexts: results of a qualitative study from Kenya.

    Directory of Open Access Journals (Sweden)

    Miriam Taegtmeyer

    Full Text Available The role of men who have sex with men (MSM in the African HIV epidemic is gaining recognition yet capacity to address the HIV prevention needs of this group is limited. HIV testing and counselling is not only a critical entry point for biomedical HIV prevention interventions, such as pre-exposure prophylaxis, rectal microbicides and early treatment initiation, but is also an opportunity for focused risk reduction counselling that can support individuals living in difficult circumstances. For prevention efforts to succeed, however, MSM need to access services and they will only do so if these are non-judgmental, informative, focused on their needs, and of clear benefit. This study aimed to understand Kenyan providers' attitudes towards and experiences with counselling MSM in a research clinic targeting this group for HIV prevention. We used in-depth interviews to explore values, attitudes and cognitive and social constructs of 13 counsellors and 3 clinicians providing services to MSM at this clinic. Service providers felt that despite their growing experience, more targeted training would have been helpful to improve their effectiveness in MSM-specific risk reduction counselling. They wanted greater familiarity with MSM in Kenya to better understand the root causes of MSM risk-taking (e.g., poverty, sex work, substance abuse, misconceptions about transmission, stigma, and sexual desire and felt frustrated at the perceived intractability of some of their clients' issues. In addition, they identified training needs on how to question men about specific risk behaviours, improved strategies for negotiating risk reduction with counselling clients, and improved support supervision from senior counsellors. This paper describes the themes arising from these interviews and makes practical recommendations on training and support supervision systems for nascent MSM HIV prevention programmes in Africa.

  5. Challenges in providing counselling to MSM in highly stigmatized contexts: results of a qualitative study from Kenya.

    Science.gov (United States)

    Taegtmeyer, Miriam; Davies, Alun; Mwangome, Mary; van der Elst, Elisabeth M; Graham, Susan M; Price, Matt A; Sanders, Eduard J

    2013-01-01

    The role of men who have sex with men (MSM) in the African HIV epidemic is gaining recognition yet capacity to address the HIV prevention needs of this group is limited. HIV testing and counselling is not only a critical entry point for biomedical HIV prevention interventions, such as pre-exposure prophylaxis, rectal microbicides and early treatment initiation, but is also an opportunity for focused risk reduction counselling that can support individuals living in difficult circumstances. For prevention efforts to succeed, however, MSM need to access services and they will only do so if these are non-judgmental, informative, focused on their needs, and of clear benefit. This study aimed to understand Kenyan providers' attitudes towards and experiences with counselling MSM in a research clinic targeting this group for HIV prevention. We used in-depth interviews to explore values, attitudes and cognitive and social constructs of 13 counsellors and 3 clinicians providing services to MSM at this clinic. Service providers felt that despite their growing experience, more targeted training would have been helpful to improve their effectiveness in MSM-specific risk reduction counselling. They wanted greater familiarity with MSM in Kenya to better understand the root causes of MSM risk-taking (e.g., poverty, sex work, substance abuse, misconceptions about transmission, stigma, and sexual desire) and felt frustrated at the perceived intractability of some of their clients' issues. In addition, they identified training needs on how to question men about specific risk behaviours, improved strategies for negotiating risk reduction with counselling clients, and improved support supervision from senior counsellors. This paper describes the themes arising from these interviews and makes practical recommendations on training and support supervision systems for nascent MSM HIV prevention programmes in Africa.

  6. Clean delivery practices in rural northern Ghana: a qualitative study of community and provider knowledge, attitudes, and beliefs

    Directory of Open Access Journals (Sweden)

    Moyer Cheryl A

    2012-06-01

    Full Text Available Abstract Background Knowledge, attitudes and practices of community members and healthcare providers in rural northern Ghana regarding clean delivery are not well understood. This study explores hand washing/use of gloves during delivery, delivering on a clean surface, sterile cord cutting, appropriate cord tying, proper cord care following delivery, and infant bathing and cleanliness. Methods In-depth interviews and focus group discussions were audiotaped, transcribed, and analyzed using NVivo 9.0. Results 253 respondents participated, including women with newborn infants, grandmothers, household and compound heads, community leaders, traditional birth attendants, and formally trained health care providers. There is widespread understanding of the need for clean delivery to reduce the risk of infection to both mothers and their babies during and shortly after delivery. Despite this understanding, the use of gloves during delivery and hand washing during and after delivery were mentioned infrequently. The need for a clean delivery surface was raised repeatedly, including explicit discussion of avoiding delivering in the dirt. Many activities to do with cord care involved non-sterile materials and practices: 1 Cord cutting was done with a variety of tools, and the most commonly used were razor blades or scissors; 2 Cord tying utilized a variety of materials, including string, rope, thread, twigs, and clamps; and 3 Cord care often involved applying traditional salves to the cord - including shea butter, ground shea nuts, local herbs, local oil, or “red earth sand.” Keeping babies and their surroundings clean was mentioned repeatedly as an important way to keep babies from falling ill. Conclusions This study suggests a widespread understanding in rural northern Ghana of the need for clean delivery. Nonetheless, many recommended clean delivery practices are ignored. Overarching themes emerging from this study included the increasing use of

  7. Antenatal and obstetric care in Afghanistan--a qualitative study among health care receivers and health care providers.

    Science.gov (United States)

    Rahmani, Zuhal; Brekke, Mette

    2013-05-06

    Despite attempts from the government to improve ante- and perinatal care, Afghanistan has once again been labeled "the worst country in which to be a mom" in Save the Children's World's Mothers' Report. This study investigated how pregnant women and health care providers experience the existing antenatal and obstetric health care situation in Afghanistan. Data were obtained through one-to-one semi-structured interviews of 27 individuals, including 12 women who were pregnant or had recently given birth, seven doctors, five midwives, and three traditional birth attendants. The interviews were carried out in Kabul and the village of Ramak in Ghazni Province. Interviews were taped, transcribed, and analyzed according to the principles of Giorgi's phenomenological analysis. Antenatal care was reported to be underused, even when available. Several obstacles were identified, including a lack of knowledge regarding the importance of antenatal care among the women and their families, financial difficulties, and transportation problems. The women also reported significant dissatisfaction with the attitudes and behavior of health personnel, which included instances of verbal and physical abuse. According to the health professionals, poor working conditions, low salaries, and high stress levels contributed to this matter. Personal contacts inside the hospital were considered necessary for receiving high quality care, and bribery was customary. Despite these serious concerns, the women expressed gratitude for having even limited access to health care, especially treatment provided by a female doctor. Health professionals were proud of their work and enjoyed the opportunity to help their community. This study identified several obstacles which must be addressed to improve reproductive health in Afghanistan. There was limited understanding of the importance of antenatal care and a lack of family support. Financial and transportation problems led to underuse of available care

  8. Toward Optimal Decision Making among Vulnerable Patients Referred for Cardiac Surgery: A Qualitative Analysis of Patient and Provider Perspectives.

    Science.gov (United States)

    Gainer, Ryan A; Curran, Janet; Buth, Karen J; David, Jennie G; Légaré, Jean-Francois; Hirsch, Gregory M

    2017-07-01

    Comprehension of risks, benefits, and alternative treatment options has been shown to be poor among patients referred for cardiac interventions. Patients' values and preferences are rarely explicitly sought. An increasing proportion of frail and older patients are undergoing complex cardiac surgical procedures with increased risk of both mortality and prolonged institutional care. We sought input from patients and caregivers to determine the optimal approach to decision making in this vulnerable patient population. Focus groups were held with both providers and former patients. Three focus groups were convened for Coronary Artery Bypass Graft (CABG), Valve, or CABG +Valve patients ≥ 70 y old (2-y post-op, ≤ 8-wk post-op, complicated post-op course) (n = 15). Three focus groups were convened for Intermediate Medical Care Unit (IMCU) nurses, Intensive Care Unit (ICU) nurses, surgeons, anesthesiologists and cardiac intensivists (n = 20). We used a semi-structured interview format to ask questions surrounding the informed consent process. Transcribed audio data was analyzed to develop consistent and comprehensive themes. We identified 5 main themes that influence the decision making process: educational barriers, educational facilitators, patient autonomy and perceived autonomy, patient and family expectations of care, and decision making advocates. All themes were influenced by time constraints experienced in the current consent process. Patient groups expressed a desire to receive information earlier in their care to allow time to identify personal values and preferences in developing plans for treatment. Both groups strongly supported a formal approach for shared decision making with a decisional coach to provide information and facilitate communication with the care team. Identifying the barriers and facilitators to patient and caretaker engagement in decision making is a key step in the development of a structured, patient-centered SDM approach. Intervention

  9. Providing experiential information on early medical abortion: a qualitative evaluation of an animated personal account, Lara's Story.

    Science.gov (United States)

    Sherman, Sarah; Harden, Jeni; Cattanach, Dawn; Cameron, Sharon T

    2017-10-01

    An animated film has been created to provide information to women requesting early medical abortion (EMA). The 9 min film, Lara's Story , was created using one woman's personal account of her experience. This study evaluated the views of women who had recently undergone EMA on the film and its potential usefulness in providing experiential information to women requesting EMA. Women who had undergone EMA within the past month were recruited. They were shown the film and interviewed in a semi-structured style. Interviews were recorded and transcribed verbatim. They were analysed using cross-sectional indexing and thematic analysis with an inductive approach. 13 women were interviewed. All reported that the film gave a realistic account of EMA and most agreed that they would have wanted to watch it before EMA had it been available. Some said that it might help women who were struggling with decision-making with regard to EMA and all said that there should be unrestricted access to the film from the website of the abortion service. The women commented that the animated style of the film allowed all groups of women to relate to the story. Some commented that Lara's experience of pain, bleeding and side effects such as nausea differed from their own and therefore felt that it would be useful to make more than one woman's account available. The availability of animated audiovisual films recounting women's experiences of EMA might be a valuable adjunct to clinical information for women seeking EMA. © Faculty of Sexual and Reproductive Healthcare of the Royal College of Obstetricians and Gynaecologists (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  10. Cermets for high level waste containment

    International Nuclear Information System (INIS)

    Aaron, W.S.; Quinby, T.C.; Kobisk, E.H.

    1978-01-01

    Cermet materials are currently under investigation as an alternate for the primary containment of high level wastes. The cermet in this study is an iron--nickel base metal matrix containing uniformly dispersed, micron-size fission product oxides, aluminosilicates, and titanates. Cermets possess high thermal conductivity, and typical waste loading of 70 wt % with volume reduction factors of 2 to 200 and low processing volatility losses have been realized. Preliminary leach studies indicate a leach resistance comparable to other candidate waste forms; however, more quantitative data are required. Actual waste studies have begun on NFS Acid Thorex, SRP dried sludge and fresh, unneutralized SRP process wastes

  11. Python based high-level synthesis compiler

    Science.gov (United States)

    Cieszewski, Radosław; Pozniak, Krzysztof; Romaniuk, Ryszard

    2014-11-01

    This paper presents a python based High-Level synthesis (HLS) compiler. The compiler interprets an algorithmic description of a desired behavior written in Python and map it to VHDL. FPGA combines many benefits of both software and ASIC implementations. Like software, the mapped circuit is flexible, and can be reconfigured over the lifetime of the system. FPGAs therefore have the potential to achieve far greater performance than software as a result of bypassing the fetch-decode-execute operations of traditional processors, and possibly exploiting a greater level of parallelism. Creating parallel programs implemented in FPGAs is not trivial. This article describes design, implementation and first results of created Python based compiler.

  12. The CMS High-Level Trigger

    International Nuclear Information System (INIS)

    Covarelli, R.

    2009-01-01

    At the startup of the LHC, the CMS data acquisition is expected to be able to sustain an event readout rate of up to 100 kHz from the Level-1 trigger. These events will be read into a large processor farm which will run the 'High-Level Trigger'(HLT) selection algorithms and will output a rate of about 150 Hz for permanent data storage. In this report HLT performances are shown for selections based on muons, electrons, photons, jets, missing transverse energy, τ leptons and b quarks: expected efficiencies, background rates and CPU time consumption are reported as well as relaxation criteria foreseen for a LHC startup instantaneous luminosity.

  13. The CMS High-Level Trigger

    CERN Document Server

    Covarelli, Roberto

    2009-01-01

    At the startup of the LHC, the CMS data acquisition is expected to be able to sustain an event readout rate of up to 100 kHz from the Level-1 trigger. These events will be read into a large processor farm which will run the "High-Level Trigger" (HLT) selection algorithms and will output a rate of about 150 Hz for permanent data storage. In this report HLT performances are shown for selections based on muons, electrons, photons, jets, missing transverse energy, tau leptons and b quarks: expected efficiencies, background rates and CPU time consumption are reported as well as relaxation criteria foreseen for a LHC startup instantaneous luminosity.

  14. The CMS High-Level Trigger

    Science.gov (United States)

    Covarelli, R.

    2009-12-01

    At the startup of the LHC, the CMS data acquisition is expected to be able to sustain an event readout rate of up to 100 kHz from the Level-1 trigger. These events will be read into a large processor farm which will run the "High-Level Trigger" (HLT) selection algorithms and will output a rate of about 150 Hz for permanent data storage. In this report HLT performances are shown for selections based on muons, electrons, photons, jets, missing transverse energy, τ leptons and b quarks: expected efficiencies, background rates and CPU time consumption are reported as well as relaxation criteria foreseen for a LHC startup instantaneous luminosity.

  15. What are the experiences of seeking, receiving and providing FGM-related healthcare? Perspectives of health professionals and women/girls who have undergone FGM: protocol for a systematic review of qualitative evidence.

    Science.gov (United States)

    Evans, Catrin; Tweheyo, Ritah; McGarry, Julie; Eldridge, Jeanette; McCormick, Carol; Nkoyo, Valentine; Higginbottom, Gina Marie Awoko

    2017-12-14

    Female genital mutilation (FGM) is an issue of global concern. High levels of migration mean that healthcare systems in higher-income western countries are increasingly being challenged to respond to the care needs of affected communities. Research has identified significant challenges in the provision of, and access to, FGM-related healthcare. There is a lack of confidence and competence among health professionals in providing appropriate care, suggesting an urgent need for evidence-based service development in this area. This study will involve two systematic reviews of qualitative evidence to explore the experiences, needs, barriers and facilitators to seeking and providing FGM-related healthcare in high-income (Organisation for Economic Cooperation and Development) countries, from the perspectives of: (1) women and girls who have undergone FGM and (2) health professionals. Twelve databases including MEDLINE, EMBASE, PsycINFO, ASSIA, Web of Science, ERIC, CINAHL, and POPLINE will be searched with no limits on publication year. Relevant grey literature will be identified from digital sources and professional networks.Two reviewers will independently screen, select and critically appraise the studies. Study quality will be assessed using the Joanna Briggs Institute Qualitative Assessment and Review Instrument appraisal tool. Findings will be extracted into NVivo software. Synthesis will involve inductive thematic analysis, including in-depth reading, line by line coding of the findings, development of descriptive themes and re-coding to higher level analytical themes. Confidence in the review findings will be assessed using the CERQual approach. Findings will be integrated into a comprehensive set of recommendations for research, policy and practice. The syntheses will be reported as per the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) statement. Two reviews will be published in peer-reviewed journals and an integrated report

  16. Key successes and challenges in providing mental health care in an urban male remand prison: a qualitative study.

    Science.gov (United States)

    Samele, Chiara; Forrester, Andrew; Urquía, Norman; Hopkin, Gareth

    2016-04-01

    This study aimed to describe the workings of an urban male remand prison mental health service exploring the key challenges and successes, levels of integration and collaboration with other services. A purposive sampling was used to recruit key prison and healthcare professionals for in-depth interviews. A thematic analysis was used to analyse transcripts based on an initial coding frame of several predefined themes. Other key themes were also identified. Twenty-eight interviews were conducted. Prisoners referred to the service had complex, sometimes acute mental illness requiring specialist assessment and treatment. Key successes of the in-reach service included the introduction of an open referral system, locating a mental health nurse at reception to screen all new prisoners and a zoning system to prioritise urgent or non-urgent cases. Achieving an integrated system of healthcare was challenging because of the numerous internal and external services operating across the prison, a highly transient population, limited time and space to deliver services and difficulties with providing inpatient care (e.g., establishing the criteria for admission and managing patient flow). Collaborative working between prison and healthcare staff was required to enable best care for prisoners. The prison mental health in-reach service worked well in assessing and prioritising those who required specialist mental health care. Although the challenges of working within the prison context limited what the in-reach team could achieve. Further work was needed to improve the unit environment and how best to target and deliver inpatient care within the prison.

  17. The ALICE Dimuon Spectrometer High Level Trigger

    CERN Document Server

    Becker, B; Cicalo, Corrado; Das, Indranil; de Vaux, Gareth; Fearick, Roger; Lindenstruth, Volker; Marras, Davide; Sanyal, Abhijit; Siddhanta, Sabyasachi; Staley, Florent; Steinbeck, Timm; Szostak, Artur; Usai, Gianluca; Vilakazi, Zeblon

    2009-01-01

    The ALICE Dimuon Spectrometer High Level Trigger (dHLT) is an on-line processing stage whose primary function is to select interesting events that contain distinct physics signals from heavy resonance decays such as J/psi and Gamma particles, amidst unwanted background events. It forms part of the High Level Trigger of the ALICE experiment, whose goal is to reduce the large data rate of about 25 GB/s from the ALICE detectors by an order of magnitude, without loosing interesting physics events. The dHLT has been implemented as a software trigger within a high performance and fault tolerant data transportation framework, which is run on a large cluster of commodity compute nodes. To reach the required processing speeds, the system is built as a concurrent system with a hierarchy of processing steps. The main algorithms perform partial event reconstruction, starting with hit reconstruction on the level of the raw data received from the spectrometer. Then a tracking algorithm finds track candidates from the recon...

  18. Technetium Chemistry in High-Level Waste

    International Nuclear Information System (INIS)

    Hess, Nancy J.

    2006-01-01

    Tc contamination is found within the DOE complex at those sites whose mission involved extraction of plutonium from irradiated uranium fuel or isotopic enrichment of uranium. At the Hanford Site, chemical separations and extraction processes generated large amounts of high level and transuranic wastes that are currently stored in underground tanks. The waste from these extraction processes is currently stored in underground High Level Waste (HLW) tanks. However, the chemistry of the HLW in any given tank is greatly complicated by repeated efforts to reduce volume and recover isotopes. These processes ultimately resulted in mixing of waste streams from different processes. As a result, the chemistry and the fate of Tc in HLW tanks are not well understood. This lack of understanding has been made evident in the failed efforts to leach Tc from sludge and to remove Tc from supernatants prior to immobilization. Although recent interest in Tc chemistry has shifted from pretreatment chemistry to waste residuals, both needs are served by a fundamental understanding of Tc chemistry

  19. Processing vessel for high level radioactive wastes

    International Nuclear Information System (INIS)

    Maekawa, Hiromichi

    1998-01-01

    Upon transferring an overpack having canisters containing high level radioactive wastes sealed therein and burying it into an underground processing hole, an outer shell vessel comprising a steel plate to be fit and contained in the processing hole is formed. A bury-back layer made of dug earth and sand which had been discharged upon forming the processing hole is formed on the inner circumferential wall of the outer shell vessel. A buffer layer having a predetermined thickness is formed on the inner side of the bury-back layer, and the overpack is contained in the hollow portion surrounded by the layer. The opened upper portion of the hollow portion is covered with the buffer layer and the bury-back layer. Since the processing vessel having a shielding performance previously formed on the ground, the state of packing can be observed. In addition, since an operator can directly operates upon transportation and burying of the high level radioactive wastes, remote control is no more necessary. (T.M.)

  20. Healthcare provider perspectives on managing sexually transmitted infections in HIV care settings in Kenya: A qualitative thematic analysis.

    Directory of Open Access Journals (Sweden)

    Kipruto Chesang

    2017-12-01

    Full Text Available The burden of sexually transmitted infections (STIs has been increasing in Kenya, as is the case elsewhere in sub-Saharan Africa, while measures for control and prevention are weak. The objectives of this study were to (1 describe healthcare provider (HCP knowledge and practices, (2 explore HCP attitudes and beliefs, (3 identify structural and environmental factors affecting STI management, and (4 seek recommendations to improve the STI program in Kenya.Using individual in-depth interviews (IDIs, data were obtained from 87 HCPs working in 21 high-volume comprehensive HIV care centers (CCCs in 7 of Kenya's 8 regions. Transcript coding was performed through an inductive and iterative process, and the data were analyzed using NVivo 10.0. Overall, HCPs were knowledgeable about STIs, saw STIs as a priority, reported high STI co-infection amongst people living with HIV (PLHIV, and believed STIs in PLHIV facilitate HIV transmission. Most used the syndromic approach for STI management. Condoms and counseling were available in most of the clinics. HCPs believed that having an STI increased stigma in the community, that there was STI antimicrobial drug resistance, and that STIs were not prioritized by the authorities. HCPs had positive attitudes toward managing STIs, but were uncomfortable discussing sexual issues with patients in general, and profoundly for anal sex. The main barriers to the management of STIs reported were low commitment by higher levels of management, few recent STI-focused trainings, high stigma and low community participation, and STI drug stock-outs. Solutions recommended by HCPs included formulation of new STI policies that would increase access, availability, and quality of STI services; integrated STI/HIV management; improved STI training; increased supervision; standardized reporting; and community involvement in STI prevention. The key limitations of our study were that (1 participant experience and how much of their workload

  1. Mechanisms of change of a novel weight loss programme provided by a third sector organisation: a qualitative interview study.

    Science.gov (United States)

    McMahon, Naoimh E; Visram, Shelina; Connell, Louise A

    2016-05-10

    There is a need for theory-driven studies that explore the underlying mechanisms of change of complex weight loss programmes. Such studies will contribute to the existing evidence-base on how these programmes work and thus inform the future development and evaluation of tailored, effective interventions to tackle overweight and obesity. This study explored the mechanisms by which a novel weight loss programme triggered change amongst participants. The programme, delivered by a third sector organisation, addressed both diet and physical activity. Over a 26 week period participants engaged in three weekly sessions (education and exercise in a large group, exercise in a small group and a one-to-one education and exercise session). Novel aspects included the intensity and duration of the programme, a competitive selection process, milestone physical challenges (e.g. working up to a 5 K and 10 K walk/run during the programme), alumni support (face-to-face and online) and family attendance at exercise sessions. Data were collected through interviews with programme providers (n = 2) and focus groups with participants (n = 12). Discussions were audio-recorded, transcribed and analysed using NVivo10. Published behaviour change frameworks and behaviour change technique taxonomies were used to guide the coding process. Clients' interactions with components of the weight loss programme brought about a change in their commitment, knowledge, beliefs about capabilities and social and environmental contexts. Intervention components that generated these changes included the competitive selection process, group and online support, family involvement and overcoming milestone challenges over the 26 week programme. The mechanisms by which these components triggered change differed between participants. There is an urgent need to establish robust interventions that can support people who are overweight and obese to achieve a healthy weight and maintain this change. Third

  2. Mechanisms of change of a novel weight loss programme provided by a third sector organisation: a qualitative interview study

    Directory of Open Access Journals (Sweden)

    Naoimh E. McMahon

    2016-05-01

    Full Text Available Abstract Background There is a need for theory-driven studies that explore the underlying mechanisms of change of complex weight loss programmes. Such studies will contribute to the existing evidence-base on how these programmes work and thus inform the future development and evaluation of tailored, effective interventions to tackle overweight and obesity. This study explored the mechanisms by which a novel weight loss programme triggered change amongst participants. The programme, delivered by a third sector organisation, addressed both diet and physical activity. Over a 26 week period participants engaged in three weekly sessions (education and exercise in a large group, exercise in a small group and a one-to-one education and exercise session. Novel aspects included the intensity and duration of the programme, a competitive selection process, milestone physical challenges (e.g. working up to a 5 K and 10 K walk/run during the programme, alumni support (face-to-face and online and family attendance at exercise sessions. Methods Data were collected through interviews with programme providers (n = 2 and focus groups with participants (n = 12. Discussions were audio-recorded, transcribed and analysed using NVivo10. Published behaviour change frameworks and behaviour change technique taxonomies were used to guide the coding process. Results Clients’ interactions with components of the weight loss programme brought about a change in their commitment, knowledge, beliefs about capabilities and social and environmental contexts. Intervention components that generated these changes included the competitive selection process, group and online support, family involvement and overcoming milestone challenges over the 26 week programme. The mechanisms by which these components triggered change differed between participants. Conclusions There is an urgent need to establish robust interventions that can support people who are overweight and

  3. The views and experiences of nurses and midwives in the provision and management of provider-initiated HIV testing and counseling: a systematic review of qualitative evidence.

    Science.gov (United States)

    Evans, Catrin; Nalubega, Sylivia; McLuskey, John; Darlington, Nicola; Croston, Michelle; Bath-Hextall, Fiona

    2016-01-15

    Global progress towards HIV prevention and care is contingent upon increasing the number of those aware of their status through HIV testing. Provider-initiated HIV testing and counseling is recommended globally as a strategy to enhance uptake of HIV testing and is primarily conducted by nurses and midwives. Research shows that provider-initiated HIV testing and counseling implementation is sub-optimal. The reasons for this are unclear. The review aimed to explore nurses' and midwives' views and experiences of the provision and management of provider-initiated HIV testing and counseling. All cadres of nurses and midwives were considered, including those who undertake routine HIV testing as part of a diverse role and those who are specifically trained as HIV counselors. Types of phenomenon of interest: The review sought to understand the views and experiences of the provision and management of provider-initiated HIV testing and counseling (including perceptions, opinions, beliefs, practices and strategies related to HIV testing and its implementation in practice). The review included only provider-initiated HIV testing and counseling. It excluded all other models of HIV testing. The review included all countries and all healthcare settings. Types of studies: This review considered all forms of qualitative study design and methodology. Qualitative elements of a mixed method study were included if they were presented separately within the publication. A three-step search strategy was utilized. Eight databases were searched for papers published from 1996 to October 2014, followed by hand searching of reference lists. Only studies published in the English language were considered. Methodological quality was assessed using the Qualitative Assessment and Review Instrument developed by the Joanna Briggs Institute. Qualitative findings were extracted using the Joanna Briggs Institute Qualitative Assessment and Review Instrument. Qualitative research findings were pooled

  4. Weight and its relationship to adolescent perceptions of their providers (WRAP): a qualitative and quantitative assessment of teen weight-related preferences and concerns.

    Science.gov (United States)

    Cohen, Marc L; Tanofsky-Kraff, Marian; Young-Hyman, Deborah; Yanovski, Jack A

    2005-08-01

    To examine the relationship of body weight to satisfaction with care in adolescents, and to obtain qualitative data on preferences for general and weight-related medical care in normal weight and overweight adolescents. The Weight and its Relationship to Adolescent Perceptions of their Providers survey, a 4-page questionnaire containing previously validated satisfaction scales and open-ended qualitative questions regarding health care preferences, was administered to 62 severely overweight (body mass index [BMI] 38.9 +/- 8.4 kg/m2) and 29 normal weight (BMI 22.5 +/- 4.0 kg/m2) adolescents (age 13.9 +/- 1.7 years; 57% female; 50% Caucasian, 47% African-American, 3% Hispanic). The affective subscale of the medical satisfaction scale was negatively correlated with BMI standard deviation score (r = -.22, p teens. Seventy-nine percent of overweight adolescents stated their health care provider discussed their weight with them; however, only 41% of overweight adolescents desired to discuss their weight. Compared to normal-weight adolescents, overweight teens were more likely to report that their provider raised topics of weight (p teens expressed concerns regarding the public location of their provider's office scale. Satisfaction with affective aspects of the provider-patient relationship is negatively correlated with BMI standard deviation score. Length of experience with one's provider is also a strong predictor of teen satisfaction with their medical care. Teens prefer the term "overweight" for those with high body weight. Sensitivity to confidentiality, privacy, and embarrassment regarding physical examination and weight are important for teen satisfaction.

  5. Non-dental primary care providers' views on challenges in providing oral health services and strategies to improve oral health in Australian rural and remote communities: a qualitative study.

    Science.gov (United States)

    Barnett, Tony; Hoang, Ha; Stuart, Jackie; Crocombe, Len

    2015-10-29

    To investigate the challenges of providing oral health advice/treatment as experienced by non-dental primary care providers in rural and remote areas with no resident dentist, and their views on ways in which oral health and oral health services could be improved for their communities. Qualitative study with semistructured interviews and thematic analysis. Four remote communities in outback Queensland, Australia. 35 primary care providers who had experience in providing oral health advice to patients and four dental care providers who had provided oral health services to patients from the four communities. In the absence of a resident dentist, rural and remote residents did present to non-dental primary care providers with oral health problems such as toothache, abscess, oral/gum infection and sore mouth for treatment and advice. Themes emerged from the interview data around communication challenges and strategies to improve oral health. Although, non-dental care providers commonly advised patients to see a dentist, they rarely communicated with the dentist in the nearest regional town. Participants proposed that oral health could be improved by: enabling access to dental practitioners, educating communities on preventive oral healthcare, and building the skills and knowledge base of non-dental primary care providers in the field of oral health. Prevention is a cornerstone to better oral health in rural and remote communities as well as in more urbanised communities. Strategies to improve the provision of dental services by either visiting or resident dental practitioners should include scope to provide community-based oral health promotion activities, and to engage more closely with other primary care service providers in these small communities. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  6. The ARES High-level Intermediate Representation

    Energy Technology Data Exchange (ETDEWEB)

    Moss, Nicholas David [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-03-03

    The LLVM intermediate representation (IR) lacks semantic constructs for depicting common high-performance operations such as parallel and concurrent execution, communication and synchronization. Currently, representing such semantics in LLVM requires either extending the intermediate form (a signi cant undertaking) or the use of ad hoc indirect means such as encoding them as intrinsics and/or the use of metadata constructs. In this paper we discuss a work in progress to explore the design and implementation of a new compilation stage and associated high-level intermediate form that is placed between the abstract syntax tree and when it is lowered to LLVM's IR. This highlevel representation is a superset of LLVM IR and supports the direct representation of these common parallel computing constructs along with the infrastructure for supporting analysis and transformation passes on this representation.

  7. CAMAC and high-level-languages

    International Nuclear Information System (INIS)

    Degenhardt, K.H.

    1976-05-01

    A proposal for easy programming of CAMAC systems with high-level-languages (FORTRAN, RTL/2, etc.) and interpreters (BASIC, MUMTI, etc.) using a few subroutines and a LAM driver is presented. The subroutines and the LAM driver are implemented for PDP11/RSX-11M and for the CAMAC controllers DEC CA11A (branch controller), BORER type 1533A (single crate controller) and DEC CA11F (single crate controller). Mixed parallel/serial CAMAC systems employing KINETIC SYSTEMS serial driver mod. 3992 and serial crate controllers mod. 3950 are implemented for all mentioned parallel controllers, too. DMA transfers from or to CAMAC modules using non-processor-request controllers (BORER type 1542, DEC CA11FN) are available. (orig.) [de

  8. International high-level radioactive waste repositories

    International Nuclear Information System (INIS)

    Lin, W.

    1996-01-01

    Although nuclear technologies benefit everyone, the associated nuclear wastes are a widespread and rapidly growing problem. Nuclear power plants are in operation in 25 countries, and are under construction in others. Developing countries are hungry for electricity to promote economic growth; industrialized countries are eager to export nuclear technologies and equipment. These two ingredients, combined with the rapid shrinkage of worldwide fossil fuel reserves, will increase the utilization of nuclear power. All countries utilizing nuclear power produce at least a few tens of tons of spent fuel per year. That spent fuel (and reprocessing products, if any) constitutes high-level nuclear waste. Toxicity, long half-life, and immunity to chemical degradation make such waste an almost permanent threat to human beings. This report discusses the advantages of utilizing repositories for disposal of nuclear wastes

  9. Intergenerational ethics of high level radioactive waste

    Energy Technology Data Exchange (ETDEWEB)

    Takeda, Kunihiko [Nagoya Univ., Graduate School of Engineering, Nagoya, Aichi (Japan); Nasu, Akiko; Maruyama, Yoshihiro [Shibaura Inst. of Tech., Tokyo (Japan)

    2003-03-01

    The validity of intergenerational ethics on the geological disposal of high level radioactive waste originating from nuclear power plants was studied. The result of the study on geological disposal technology showed that the current method of disposal can be judged to be scientifically reliable for several hundred years and the radioactivity level will be less than one tenth of the tolerable amount after 1,000 years or more. This implies that the consideration of intergenerational ethics of geological disposal is meaningless. Ethics developed in western society states that the consent of people in the future is necessary if the disposal has influence on them. Moreover, the ethics depends on generally accepted ideas in western society and preconceptions based on racism and sexism. The irrationality becomes clearer by comparing the dangers of the exhaustion of natural resources and pollution from harmful substances in a recycling society. (author)

  10. Management of high level radioactive waste

    International Nuclear Information System (INIS)

    Redon, A.; Mamelle, J.; Chambon, M.

    1977-01-01

    The world wide needs in reprocessing will reach the value of 10.000 t/y of irradiated fuels, in the mid of the 80's. Several countries will have planned, in their nuclear programme, the construction of reprocessing plants with a 1500 t/y capacity, corresponding to 50.000 MWe installed. At such a level, the solidification of the radioactive waste will become imperative. For this reason, all efforts, in France, have been directed towards the realization of industrial plants able of solidifying the fission products as a glassy material. The advantages of this decision, and the reasons for it are presented. The continuing development work, and the conditions and methods of storing the high-level wastes prior to solidification, and of the interim storage (for thermal decay) and the ultimate disposal after solidification are described [fr

  11. Intergenerational ethics of high level radioactive waste

    International Nuclear Information System (INIS)

    Takeda, Kunihiko; Nasu, Akiko; Maruyama, Yoshihiro

    2003-01-01

    The validity of intergenerational ethics on the geological disposal of high level radioactive waste originating from nuclear power plants was studied. The result of the study on geological disposal technology showed that the current method of disposal can be judged to be scientifically reliable for several hundred years and the radioactivity level will be less than one tenth of the tolerable amount after 1,000 years or more. This implies that the consideration of intergenerational ethics of geological disposal is meaningless. Ethics developed in western society states that the consent of people in the future is necessary if the disposal has influence on them. Moreover, the ethics depends on generally accepted ideas in western society and preconceptions based on racism and sexism. The irrationality becomes clearer by comparing the dangers of the exhaustion of natural resources and pollution from harmful substances in a recycling society. (author)

  12. The CMS High Level Trigger System

    CERN Document Server

    Afaq, A; Bauer, G; Biery, K; Boyer, V; Branson, J; Brett, A; Cano, E; Carboni, A; Cheung, H; Ciganek, M; Cittolin, S; Dagenhart, W; Erhan, S; Gigi, D; Glege, F; Gómez-Reino, Robert; Gulmini, M; Gutiérrez-Mlot, E; Gutleber, J; Jacobs, C; Kim, J C; Klute, M; Kowalkowski, J; Lipeles, E; Lopez-Perez, Juan Antonio; Maron, G; Meijers, F; Meschi, E; Moser, R; Murray, S; Oh, A; Orsini, L; Paus, C; Petrucci, A; Pieri, M; Pollet, L; Rácz, A; Sakulin, H; Sani, M; Schieferdecker, P; Schwick, C; Sexton-Kennedy, E; Sumorok, K; Suzuki, I; Tsirigkas, D; Varela, J

    2007-01-01

    The CMS Data Acquisition (DAQ) System relies on a purely software driven High Level Trigger (HLT) to reduce the full Level-1 accept rate of 100 kHz to approximately 100 Hz for archiving and later offline analysis. The HLT operates on the full information of events assembled by an event builder collecting detector data from the CMS front-end systems. The HLT software consists of a sequence of reconstruction and filtering modules executed on a farm of O(1000) CPUs built from commodity hardware. This paper presents the architecture of the CMS HLT, which integrates the CMS reconstruction framework in the online environment. The mechanisms to configure, control, and monitor the Filter Farm and the procedures to validate the filtering code within the DAQ environment are described.

  13. High-level waste processing and disposal

    International Nuclear Information System (INIS)

    Crandall, J.L.; Krause, H.; Sombret, C.; Uematsu, K.

    1984-11-01

    Without reprocessing, spent LWR fuel itself is generally considered an acceptable waste form. With reprocessing, borosilicate glass canisters, have now gained general acceptance for waste immobilization. The current first choice for disposal is emplacement in an engineered structure in a mined cavern at a depth of 500-1000 meters. A variety of rock types are being investigated including basalt, clay, granite, salt, shale, and volcanic tuff. This paper gives specific coverage to the national high level waste disposal plans for France, the Federal Republic of Germany, Japan and the United States. The French nuclear program assumes prompt reprocessing of its spent fuels, and France has already constructed the AVM. Two larger borosilicate glass plants are planned for a new French reprocessing plant at La Hague. France plans to hold the glass canisters in near-surface storage for a forty to sixty year cooling period and then to place them into a mined repository. The FRG and Japan also plan reprocessing for their LWR fuels. Both are currently having some fuel reprocessed by France, but both are also planning reprocessing plants which will include waste vitrification facilities. West Germany is now constructing the PAMELA Plant at Mol, Belgium to vitrify high level reprocessing wastes at the shutdown Eurochemic Plant. Japan is now operating a vitrification mockup test facility and plans a pilot plant facility at the Tokai reprocessing plant by 1990. Both countries have active geologic repository programs. The United State program assumes little LWR fuel reprocessing and is thus primarily aimed at direct disposal of spent fuel into mined repositories. However, the US have two borosilicate glass plants under construction to vitrify existing reprocessing wastes

  14. The high level vibration test program

    International Nuclear Information System (INIS)

    Hofmayer, C.H.; Curreri, J.R.; Park, Y.J.; Kato, W.Y.; Kawakami, S.

    1989-01-01

    As part of cooperative agreements between the US and Japan, tests have been performed on the seismic vibration table at the Tadotsu Engineering Laboratory of Nuclear Power Engineering Test Center (NUPEC) in Japan. The objective of the test program was to use the NUPEC vibration table to drive large diameter nuclear power piping to substantial plastic strain with an earthquake excitation and to compare the results with state-of-the-art analysis of the problem. The test model was subjected to a maximum acceleration well beyond what nuclear power plants are designed to withstand. A modified earthquake excitation was applied and the excitation level was increased carefully to minimize the cumulative fatigue damage due to the intermediate level excitations. Since the piping was pressurized, and the high level earthquake excitation was repeated several times, it was possible to investigate the effects of ratchetting and fatigue as well. Elastic and inelastic seismic response behavior of the test model was measured in a number of test runs with an increasing excitation input level up to the limit of the vibration table. In the maximum input condition, large dynamic plastic strains were obtained in the piping. Crack initiation was detected following the second maximum excitation run. Crack growth was carefully monitored during the next two additional maximum excitation runs. The final test resulted in a maximum crack depth of approximately 94% of the wall thickness. The HLVT (high level vibration test) program has enhanced understanding of the behavior of piping systems under severe earthquake loading. As in other tests to failure of piping components, it has demonstrated significant seismic margin in nuclear power plant piping

  15. Family caregiver learning--how family caregivers learn to provide care at the end of life: a qualitative secondary analysis of four datasets.

    Science.gov (United States)

    Stajduhar, Kelli I; Funk, Laura; Outcalt, Linda

    2013-07-01

    Family caregivers are assuming growing responsibilities in providing care to dying family members. Supporting them is fundamental to ensure quality end-of-life care and to buffer potentially negative outcomes, although family caregivers frequently acknowledge a deficiency of information, knowledge, and skills necessary to assume the tasks involved in this care. The aim of this inquiry was to explore how family caregivers describe learning to provide care to palliative patients. Secondary analysis of data from four qualitative studies (n = 156) with family caregivers of dying people. Data included qualitative interviews with 156 family caregivers of dying people. Family caregivers learn through the following processes: trial and error, actively seeking needed information and guidance, applying knowledge and skills from previous experience, and reflecting on their current experiences. Caregivers generally preferred and appreciated a supported or guided learning process that involved being shown or told by others, usually learning reactively after a crisis. Findings inform areas for future research to identify effective, individualized programs and interventions to support positive learning experiences for family caregivers of dying people.

  16. Weight and its relationship to adolescent perceptions of their providers (WRAP): A qualitative and quantitative assessment of teen weight-related preferences and concerns

    Science.gov (United States)

    Cohen, Marc L.; Tanofsky-Kraff, Marian; Young-Hyman, Deborah; Yanovski, Jack A.

    2008-01-01

    Purpose To examine the relationship of body weight to satisfaction with care in adolescents, and to obtain qualitative data on preferences for general and weight-related medical care in normal weight and overweight adolescents. Methods The Weight and its Relationship to Adolescent Perceptions of their Providers survey, a 4-page questionnaire containing previously validated satisfaction scales and open-ended qualitative questions regarding health care preferences, was administered to 62 severely overweight (body mass index [BMI] 38.9 ± 8.4 kg/m2) and 29 normal weight (BMI 22.5 ± 4.0 kg/m2) adolescents (age 13.9 ± 1.7 years; 57% female; 50% Caucasian, 47% African-American, 3% Hispanic). Results The affective subscale of the medical satisfaction scale was negatively correlated with BMI standard deviation score (r = −.22, p teens. Seventy-nine percent of overweight adolescents stated their health care provider discussed their weight with them; however, only 41% of overweight adolescents desired to discuss their weight. Compared to normal-weight adolescents, overweight teens were more likely to report that their provider raised topics of weight (p teens expressed concerns regarding the public location of their provider’s office scale. Conclusions Satisfaction with affective aspects of the provider-patient relationship is negatively correlated with BMI standard deviation score. Length of experience with one’s provider is also a strong predictor of teen satisfaction with their medical care. Teens prefer the term “overweight” for those with high body weight. Sensitivity to confidentiality, privacy, and embarrassment regarding physical examination and weight are important for teen satisfaction. PMID:16026727

  17. Patient and healthcare provider barriers to hypertension awareness, treatment and follow up: a systematic review and meta-analysis of qualitative and quantitative studies.

    Directory of Open Access Journals (Sweden)

    Rasha Khatib

    Full Text Available BACKGROUND: Although the importance of detecting, treating, and controlling hypertension has been recognized for decades, the majority of patients with hypertension remain uncontrolled. The path from evidence to practice contains many potential barriers, but their role has not been reviewed systematically. This review aimed to synthesize and identify important barriers to hypertension control as reported by patients and healthcare providers. METHODS: Electronic databases MEDLINE, EMBASE and Global Health were searched systematically up to February 2013. Two reviewers independently selected eligible studies. Two reviewers categorized barriers based on a theoretical framework of behavior change. The theoretical framework suggests that a change in behavior requires a strong commitment to change [intention], the necessary skills and abilities to adopt the behavior [capability], and an absence of health system and support constraints. FINDINGS: Twenty-five qualitative studies and 44 quantitative studies met the inclusion criteria. In qualitative studies, health system barriers were most commonly discussed in studies of patients and health care providers. Quantitative studies identified disagreement with clinical recommendations as the most common barrier among health care providers. Quantitative studies of patients yielded different results: lack of knowledge was the most common barrier to hypertension awareness. Stress, anxiety and depression were most commonly reported as barriers that hindered or delayed adoption of a healthier lifestyle. In terms of hypertension treatment adherence, patients mostly reported forgetting to take their medication. Finally, priority setting barriers were most commonly reported by patients in terms of following up with their health care providers. CONCLUSIONS: This review identified a wide range of barriers facing patients and health care providers pursuing hypertension control, indicating the need for targeted multi

  18. Parental experiences of providing skin-to-skin care to their newborn infant--part 2: a qualitative meta-synthesis.

    Science.gov (United States)

    Anderzén-Carlsson, Agneta; Lamy, Zeni C; Tingvall, Maria; Eriksson, Mats

    2014-01-01

    To synthesize and interpret qualitative research findings focusing on parental experiences of skin-to-skin care (SSC) for newborn infants. SSC induces many benefits for newborn infants and their parents. Three meta-analyses have been conducted on physiological outcomes, but no previous qualitative meta-synthesis on parental experiences of SSC has been identified. The present meta-synthesis was guided by the methodology described by Paterson and co-workers. Four databases were searched, without year or language limitations, up until December 2013. Manual searches were also performed. The searches and subsequent quality appraisal resulted in the inclusion of 29 original qualitative papers from 9 countries, reporting experiences from 401 mothers and 94 fathers. The meta-synthesis entails a meta-data analysis, analysis of meta-method, and meta-theory in the included primary studies. Based on the three analyses, the meta-synthesis represents a new interpretation of a phenomenon. The results of the meta-data analysis have been presented as a qualitative systematic review in a separate paper. When synthesizing and interpreting the findings from the included analyses, a theoretical model of Becoming a parent under unfamiliar circumstances emerged. Providing SSC seems to be a restorative as well as an energy-draining experience. A supportive environment has been described as facilitating the restorative experience, whereas obstacles in the environment seem to make the provision of SSC energy-draining for parents. When the process is experienced as positive, it facilitates the growth of parental self-esteem and makes the parents ready to assume full responsibility for their child. The results show that SSC can be interpreted not only as a family-including and important health care intervention but also in terms of actually becoming a parent. The process of becoming a parent in this specific situation is influenced by external factors in three different levels; family and

  19. Parental experiences of providing skin-to-skin care to their newborn infant—Part 2: A qualitative meta-synthesis

    Directory of Open Access Journals (Sweden)

    Agneta Anderzén-Carlsson

    2014-10-01

    Full Text Available Aim: To synthesize and interpret qualitative research findings focusing on parental experiences of skin-to-skin care (SSC for newborn infants. Background: SSC induces many benefits for newborn infants and their parents. Three meta-analyses have been conducted on physiological outcomes, but no previous qualitative meta-synthesis on parental experiences of SSC has been identified. Design: The present meta-synthesis was guided by the methodology described by Paterson and co-workers. Data sources: Four databases were searched, without year or language limitations, up until December 2013. Manual searches were also performed. The searches and subsequent quality appraisal resulted in the inclusion of 29 original qualitative papers from 9 countries, reporting experiences from 401 mothers and 94 fathers. Review methods: The meta-synthesis entails a meta-data analysis, analysis of meta-method, and meta-theory in the included primary studies. Based on the three analyses, the meta-synthesis represents a new interpretation of a phenomenon. The results of the meta-data analysis have been presented as a qualitative systematic review in a separate paper. Results: When synthesizing and interpreting the findings from the included analyses, a theoretical model of Becoming a parent under unfamiliar circumstances emerged. Providing SSC seems to be a restorative as well as an energy-draining experience. A supportive environment has been described as facilitating the restorative experience, whereas obstacles in the environment seem to make the provision of SSC energy-draining for parents. When the process is experienced as positive, it facilitates the growth of parental self-esteem and makes the parents ready to assume full responsibility for their child. Conclusion: The results show that SSC can be interpreted not only as a family-including and important health care intervention but also in terms of actually becoming a parent. The process of becoming a parent in this

  20. Apparatus for Crossflow Filtration Testing of High Level Waste Samples

    International Nuclear Information System (INIS)

    Nash, C.

    1998-05-01

    Remotely-operated experimental apparatuses for verifying crossflow filtration of high level nuclear waste have been constructed at the Savannah River Site (SRS). These units have been used to demonstrate filtration processes at the Savannah River Site, Oak Ridge National Laboratory, the Idaho National Engineering and Environmental Laboratory, and Pacific Northwest National Laboratory. The current work covers the design considerations for experimentation as well as providing results from testing at SRS

  1. High-Level Development of Multiserver Online Games

    Directory of Open Access Journals (Sweden)

    Frank Glinka

    2008-01-01

    Full Text Available Multiplayer online games with support for high user numbers must provide mechanisms to support an increasing amount of players by using additional resources. This paper provides a comprehensive analysis of the practically proven multiserver distribution mechanisms, zoning, instancing, and replication, and the tasks for the game developer implied by them. We propose a novel, high-level development approach which integrates the three distribution mechanisms seamlessly in today's online games. As a possible base for this high-level approach, we describe the real-time framework (RTF middleware system which liberates the developer from low-level tasks and allows him to stay at high level of design abstraction. We explain how RTF supports the implementation of single-server online games and how RTF allows to incorporate the three multiserver distribution mechanisms during the development process. Finally, we describe briefly how RTF provides manageability and maintenance functionality for online games in a grid context with dynamic resource allocation scenarios.

  2. Adult daughters providing post-stroke care to a parent: a qualitative study of the impact that role overload has on lifestyle, participation and family relationships.

    Science.gov (United States)

    Bastawrous, Marina; Gignac, Monique A; Kapral, Moira K; Cameron, Jill I

    2015-06-01

    To qualitatively explore daughters' experiences with and response to holding multiple roles while providing post-stroke care to a parent. Qualitative study using a descriptive approach. Semi-structured interviewing was used. Interviews were recorded, transcribed and analyzed to develop themes. General community of a metropolitan city. Twenty-three adult daughters caring for a community-dwelling parent who had suffered a stroke. Not applicable. Not applicable. Role overload is a salient issue for daughter caregivers. This overload is best captured by the analogy of "juggling" multiple role demands and responsibilities. Two key themes suggest that role overload resulting from parent care affects daughters': 1) valued relationships (e.g. challenges develop in their relationship with children and partner); and 2) ability to participate in valued activities (e.g. reduced involvement in leisure activities and restricted employment). Future support efforts should help daughters manage the caregiving role in light of other responsibilities. This can mitigate overload-related strain in valued relationships and decreased participation in valued activities, thereby contributing to better health and well-being for daughter caregivers. © The Author(s) 2014.

  3. High level waste fixation in cermet form

    International Nuclear Information System (INIS)

    Kobisk, E.H.; Aaron, W.S.; Quinby, T.C.; Ramey, D.W.

    1981-01-01

    Commercial and defense high level waste fixation in cermet form is being studied by personnel of the Isotopes Research Materials Laboratory, Solid State Division (ORNL). As a corollary to earlier research and development in forming high density ceramic and cermet rods, disks, and other shapes using separated isotopes, similar chemical and physical processing methods have been applied to synthetic and real waste fixation. Generally, experimental products resulting from this approach have shown physical and chemical characteristics which are deemed suitable for long-term storage, shipping, corrosive environments, high temperature environments, high waste loading, decay heat dissipation, and radiation damage. Although leach tests are not conclusive, what little comparative data are available show cermet to withstand hydrothermal conditions in water and brine solutions. The Soxhlet leach test, using radioactive cesium as a tracer, showed that leaching of cermet was about X100 less than that of 78 to 68 glass. Using essentially uncooled, untreated waste, cermet fixation was found to accommodate up to 75% waste loading and yet, because of its high thermal conductivity, a monolith of 0.6 m diameter and 3.3 m-length would have only a maximum centerline temperature of 29 K above the ambient value

  4. Tracking at High Level Trigger in CMS

    CERN Document Server

    Tosi, Mia

    2016-01-01

    The trigger systems of the LHC detectors play a crucial role in determining the physics capabili- ties of the experiments. A reduction of several orders of magnitude of the event rate is needed to reach values compatible with detector readout, offline storage and analysis capability. The CMS experiment has been designed with a two-level trigger system: the Level-1 Trigger (L1T), implemented on custom-designed electronics, and the High Level Trigger (HLT), a stream- lined version of the CMS offline reconstruction software running on a computer farm. A software trigger system requires a trade-off between the complexity of the algorithms, the sustainable out- put rate, and the selection efficiency. With the computing power available during the 2012 data taking the maximum reconstruction time at HLT was about 200 ms per event, at the nominal L1T rate of 100 kHz. Track reconstruction algorithms are widely used in the HLT, for the reconstruction of the physics objects as well as in the identification of b-jets and ...

  5. Performance of the CMS High Level Trigger

    CERN Document Server

    Perrotta, Andrea

    2015-01-01

    The CMS experiment has been designed with a 2-level trigger system. The first level is implemented using custom-designed electronics. The second level is the so-called High Level Trigger (HLT), a streamlined version of the CMS offline reconstruction software running on a computer farm. For Run II of the Large Hadron Collider, the increases in center-of-mass energy and luminosity will raise the event rate to a level challenging for the HLT algorithms. The increase in the number of interactions per bunch crossing, on average 25 in 2012, and expected to be around 40 in Run II, will be an additional complication. We present here the expected performance of the main triggers that will be used during the 2015 data taking campaign, paying particular attention to the new approaches that have been developed to cope with the challenges of the new run. This includes improvements in HLT electron and photon reconstruction as well as better performing muon triggers. We will also present the performance of the improved trac...

  6. Vitrification of high-level liquid wastes

    International Nuclear Information System (INIS)

    Varani, J.L.; Petraitis, E.J.; Vazquez, Antonio.

    1987-01-01

    High-level radioactive liquid wastes produced in the fuel elements reprocessing require, for their disposal, a preliminary treatment by which, through a series of engineering barriers, the dispersion into the biosphere is delayed by 10 000 years. Four groups of compounds are distinguished among a great variety of final products and methods of elaboration. From these, the borosilicate glasses were chosen. Vitrification experiences were made at a laboratory scale with simulated radioactive wastes, employing different compositions of borosilicate glass. The installations are described. A series of tests were carried out on four basic formulae using always the same methodology, consisting of a dry mixture of the vitreous matrix's products and a dry simulated mixture. Several quality tests of the glasses were made 1: Behaviour in leaching following the DIN 12 111 standard; 2: Mechanical resistance; parameters related with the facility of the different glasses for increasing their surface were studied; 3: Degree of devitrification: it is shown that devitrification turns the glasses containing radioactive wastes easily leachable. From all the glasses tested, the composition SiO 2 , Al 2 O 3 , B 2 O 3 , Na 2 O, CaO shows the best retention characteristics. (M.E.L.) [es

  7. Ocean disposal of high level radioactive waste

    International Nuclear Information System (INIS)

    1983-01-01

    This study confirms, subject to limitations of current knowledge, the engineering feasibility of free fall penetrators for High Level Radioactive Waste disposal in deep ocean seabed sediments. Restricted sediment property information is presently the principal bar to an unqualified statement of feasibility. A 10m minimum embedment and a 500 year engineered barrier waste containment life are identified as appropriate basic penetrator design criteria at this stage. A range of designs are considered in which the length, weight and cross section of the penetrator are varied. Penetrators from 3m to 20m long and 2t to 100t in weight constructed of material types and thicknesses to give a 500 year containment life are evaluated. The report concludes that the greatest degree of confidence is associated with performance predictions for 75 to 200 mm thick soft iron and welded joints. A range of lengths and capacities from a 3m long single waste canister penetrator to a 20m long 12 canister design are identified as meriting further study. Estimated embedment depths for this range of penetrator designs lie between 12m and 90m. Alternative manufacture, transport and launch operations are assessed and recommendations are made. (author)

  8. Vitrification of high level wastes in France

    International Nuclear Information System (INIS)

    Sombret, C.

    1984-02-01

    A brief historical background of the research and development work conducted in France over 25 years is first presented. Then, the papers deals with the vitrification at (1) the UP1 reprocessing plant (Marcoule) and (2) the UP2 and UP3 reprocessing plants (La Hague). 1) The properties of glass required for high-level radioactive waste vitrification are recalled. The vitrification process and facility of Marcoule are presented. (2) The average characteristics (chemical composition, activity) of LWR fission product solution are given. The glass formulations developed to solidify LWR waste solution must meet the same requirements as those used in the UP1 facility at Marcoule. Three important aspects must be considered with respect to the glass fabrication process: corrosiveness of the molten glass with regard to metals, viscosity of the molten glass, and, volatization during glass fabrication. The glass properties required in view of interim storage and long-term disposal are then largely developed. Two identical vitrification facilities are planned for the site: T7, to process the UP2 throughput, and T7 for the UP3 plant. A prototype unit was built and operated at Marcoule

  9. CMS High Level Trigger Timing Measurements

    International Nuclear Information System (INIS)

    Richardson, Clint

    2015-01-01

    The two-level trigger system employed by CMS consists of the Level 1 (L1) Trigger, which is implemented using custom-built electronics, and the High Level Trigger (HLT), a farm of commercial CPUs running a streamlined version of the offline CMS reconstruction software. The operational L1 output rate of 100 kHz, together with the number of CPUs in the HLT farm, imposes a fundamental constraint on the amount of time available for the HLT to process events. Exceeding this limit impacts the experiment's ability to collect data efficiently. Hence, there is a critical need to characterize the performance of the HLT farm as well as the algorithms run prior to start up in order to ensure optimal data taking. Additional complications arise from the fact that the HLT farm consists of multiple generations of hardware and there can be subtleties in machine performance. We present our methods of measuring the timing performance of the CMS HLT, including the challenges of making such measurements. Results for the performance of various Intel Xeon architectures from 2009-2014 and different data taking scenarios are also presented. (paper)

  10. Decontamination of high-level waste canisters

    International Nuclear Information System (INIS)

    Nesbitt, J.F.; Slate, S.C.; Fetrow, L.K.

    1980-12-01

    This report presents evaluations of several methods for the in-process decontamination of metallic canisters containing any one of a number of solidified high-level waste (HLW) forms. The use of steam-water, steam, abrasive blasting, electropolishing, liquid honing, vibratory finishing and soaking have been tested or evaluated as potential techniques to decontaminate the outer surfaces of HLW canisters. Either these techniques have been tested or available literature has been examined to assess their applicability to the decontamination of HLW canisters. Electropolishing has been found to be the most thorough method to remove radionuclides and other foreign material that may be deposited on or in the outer surface of a canister during any of the HLW processes. Steam or steam-water spraying techniques may be adequate for some applications but fail to remove all contaminated forms that could be present in some of the HLW processes. Liquid honing and abrasive blasting remove contamination and foreign material very quickly and effectively from small areas and components although these blasting techniques tend to disperse the material removed from the cleaned surfaces. Vibratory finishing is very capable of removing the bulk of contamination and foreign matter from a variety of materials. However, special vibratory finishing equipment would have to be designed and adapted for a remote process. Soaking techniques take long periods of time and may not remove all of the smearable contamination. If soaking involves pickling baths that use corrosive agents, these agents may cause erosion of grain boundaries that results in rough surfaces

  11. Consumer providers' experiences of recovery and concerns as members of a psychiatric multidisciplinary outreach team: A qualitative descriptive study from the Japan Outreach Model Project 2011-2014.

    Directory of Open Access Journals (Sweden)

    Yoshifumi Kido

    Full Text Available The objective of this study was to clarify consumer providers (CPs subjective experiences as members of a psychiatric multidisciplinary outreach team that provided services to individuals with a mental illness living in the community.A qualitative descriptive study was conducted through semi-structured interviews. Participants were clients hired as CPs in the Japanese Outreach Model Project from September 2011 until March 2014. Of the seventeen CPs, nine participated in this study. We looked at the CPs' subjective experiences of fulfillment and difficulty.In the process of providing services, CPs experienced both achievements and concerns. They had a sense of achievement by caring for their clients and they experienced that they themselves were recovering. They were also concerned about having inadequate knowledge and skills to provide psychiatric services to their clients. Further, there were concerns about their dual role on the multidisciplinary team and being support staff while they were still using mental health services themselves.The results show that the activities of CPs included fulfillment, recovery, and dilemmas. Clarifications will likely contribute to an increase in understanding and cooperation between CPs and other professionals with whom they work. Further studies are needed to investigate policies related to mental health consumers who are also providers of mental health services.

  12. Solidification of Savannah River Plant high level waste

    International Nuclear Information System (INIS)

    Maher, R.; Shafranek, L.F.; Kelley, J.A.; Zeyfang, R.W.

    1981-11-01

    Authorization for construction of the Defense Waste Processing Facility (DWPF) is expected in FY 83. The optimum time for stage 2 authorization is about three years later. Detailed design and construction will require approximately five years for stage 1, with stage 2 construction completed about two to three years later. Production of canisters of waste glass would begin in 1988, and the existing backlog of high level waste sludge stored at SRP would be worked off by about the year 2000. Stage 2 operation could begin in 1990. The technology and engineering are ready for construction and eventual operation of the DWPF for immobilizing high level radioactive waste at Savannah River Plant (SRP). Proceeding with this project will provide the public, and the leadership of this country, with a crucial demonstration that a major quantity of existing high level nuclear wastes can be safely and permanently immobilized. Early demonstration will both expedite and facilitate rational decision making on this aspect of the nuclear program. Delay in providing these facilities will result in significant DOE expenditures at SRP for new tanks just for continued temporary storage of wastes, and would probably result in dissipation of the intellectual and planning momentum that has built up in developing the project

  13. Handbook of high-level radioactive waste transportation

    International Nuclear Information System (INIS)

    Sattler, L.R.

    1992-10-01

    The High-Level Radioactive Waste Transportation Handbook serves as a reference to which state officials and members of the general public may turn for information on radioactive waste transportation and on the federal government's system for transporting this waste under the Civilian Radioactive Waste Management Program. The Handbook condenses and updates information contained in the Midwestern High-Level Radioactive Waste Transportation Primer. It is intended primarily to assist legislators who, in the future, may be called upon to enact legislation pertaining to the transportation of radioactive waste through their jurisdictions. The Handbook is divided into two sections. The first section places the federal government's program for transporting radioactive waste in context. It provides background information on nuclear waste production in the United States and traces the emergence of federal policy for disposing of radioactive waste. The second section covers the history of radioactive waste transportation; summarizes major pieces of legislation pertaining to the transportation of radioactive waste; and provides an overview of the radioactive waste transportation program developed by the US Department of Energy (DOE). To supplement this information, a summary of pertinent federal and state legislation and a glossary of terms are included as appendices, as is a list of publications produced by the Midwestern Office of The Council of State Governments (CSG-MW) as part of the Midwestern High-Level Radioactive Waste Transportation Project

  14. FPGA based compute nodes for high level triggering in PANDA

    International Nuclear Information System (INIS)

    Kuehn, W; Gilardi, C; Kirschner, D; Lang, J; Lange, S; Liu, M; Perez, T; Yang, S; Schmitt, L; Jin, D; Li, L; Liu, Z; Lu, Y; Wang, Q; Wei, S; Xu, H; Zhao, D; Korcyl, K; Otwinowski, J T; Salabura, P

    2008-01-01

    PANDA is a new universal detector for antiproton physics at the HESR facility at FAIR/GSI. The PANDA data acquisition system has to handle interaction rates of the order of 10 7 /s and data rates of several 100 Gb/s. FPGA based compute nodes with multi-Gb/s bandwidth capability using the ATCA architecture are designed to handle tasks such as event building, feature extraction and high level trigger processing. Data connectivity is provided via optical links as well as multiple Gb Ethernet ports. The boards will support trigger algorithms such us pattern recognition for RICH detectors, EM shower analysis, fast tracking algorithms and global event characterization. Besides VHDL, high level C-like hardware description languages will be considered to implement the firmware

  15. QSPIN: A High Level Java API for Quantum Computing Experimentation

    Science.gov (United States)

    Barth, Tim

    2017-01-01

    QSPIN is a high level Java language API for experimentation in QC models used in the calculation of Ising spin glass ground states and related quadratic unconstrained binary optimization (QUBO) problems. The Java API is intended to facilitate research in advanced QC algorithms such as hybrid quantum-classical solvers, automatic selection of constraint and optimization parameters, and techniques for the correction and mitigation of model and solution errors. QSPIN includes high level solver objects tailored to the D-Wave quantum annealing architecture that implement hybrid quantum-classical algorithms [Booth et al.] for solving large problems on small quantum devices, elimination of variables via roof duality, and classical computing optimization methods such as GPU accelerated simulated annealing and tabu search for comparison. A test suite of documented NP-complete applications ranging from graph coloring, covering, and partitioning to integer programming and scheduling are provided to demonstrate current capabilities.

  16. High-level radioactive waste management

    International Nuclear Information System (INIS)

    Schneider, K.J.; Liikala, R.C.

    1974-01-01

    High-level radioactive waste in the U.S. will be converted to an encapsulated solid and shipped to a Federal repository for retrievable storage for extended periods. Meanwhile the development of concepts for ultimate disposal of the waste which the Federal Government would manage is being actively pursued. A number of promising concepts have been proposed, for which there is high confidence that one or more will be suitable for long-term, ultimate disposal. Initial evaluations of technical (or theoretical) feasibility for the various waste disposal concepts show that in the broad category, (i.e., geologic, seabed, ice sheet, extraterrestrial, and transmutation) all meet the criteria for judging feasibility, though a few alternatives within these categories do not. Preliminary cost estimates show that, although many millions of dollars may be required, the cost for even the most exotic concepts is small relative to the total cost of electric power generation. For example, the cost estimates for terrestrial disposal concepts are less than 1 percent of the total generating costs. The cost for actinide transmutation is estimated at around 1 percent of generation costs, while actinide element disposal in space is less than 5 percent of generating costs. Thus neither technical feasibility nor cost seems to be a no-go factor in selecting a waste management system. The seabed, ice sheet, and space disposal concepts face international policy constraints. The information being developed currently in safety, environmental concern, and public response will be important factors in determining which concepts appear most promising for further development

  17. Implementing Internet-Based Self-Care Programs in Primary Care: Qualitative Analysis of Determinants of Practice for Patients and Providers.

    Science.gov (United States)

    Hermes, Eric; Burrone, Laura; Perez, Elliottnell; Martino, Steve; Rowe, Michael

    2018-05-18

    Access to evidence-based interventions for common mental health conditions is limited due to geographic distance, scheduling, stigma, and provider availability. Internet-based self-care programs may mitigate these barriers. However, little is known about internet-based self-care program implementation in US health care systems. The objective of this study was to identify determinants of practice for internet-based self-care program use in primary care by eliciting provider and administrator perspectives on internet-based self-care program implementation. The objective was explored through qualitative analysis of semistructured interviews with primary care providers and administrators from the Veterans Health Administration. Participants were identified using a reputation-based snowball design. Interviews focused on identifying determinants of practice for the use of internet-based self-care programs at the point of care in Veterans Health Administration primary care. Qualitative analysis of transcripts was performed using thematic coding. A total of 20 physicians, psychologists, social workers, and nurses participated in interviews. Among this group, internet-based self-care program use was relatively low, but support for the platform was assessed as relatively high. Themes were organized into determinants active at patient and provider levels. Perceived patient-level determinants included literacy, age, internet access, patient expectations, internet-based self-care program fit with patient experiences, interest and motivation, and face-to-face human contact. Perceived provider-level determinants included familiarity with internet-based self-care programs, changes to traditional care delivery, face-to-face human contact, competing demands, and age. This exploration of perspectives on internet-based self-care program implementation among Veterans Health Administration providers and administrators revealed key determinants of practice, which can be used to develop

  18. Nurse practitioner perceptions of barriers and facilitators in providing health care for deaf American Sign Language users: A qualitative socio-ecological approach.

    Science.gov (United States)

    Pendergrass, Kathy M; Nemeth, Lynne; Newman, Susan D; Jenkins, Carolyn M; Jones, Elaine G

    2017-06-01

    Nurse practitioners (NPs), as well as all healthcare clinicians, have a legal and ethical responsibility to provide health care for deaf American Sign Language (ASL) users equal to that of other patients, including effective communication, autonomy, and confidentiality. However, very little is known about the feasibility to provide equitable health care. The purpose of this study was to examine NP perceptions of barriers and facilitators in providing health care for deaf ASL users. Semistructured interviews in a qualitative design using a socio-ecological model (SEM). Barriers were identified at all levels of the SEM. NPs preferred interpreters to facilitate the visit, but were unaware of their role in assuring effective communication is achieved. A professional sign language interpreter was considered a last resort when all other means of communication failed. Gesturing, note-writing, lip-reading, and use of a familial interpreter were all considered facilitators. Interventions are needed at all levels of the SEM. Resources are needed to provide awareness of deaf communication issues and legal requirements for caring for deaf signers for practicing and student NPs. Protocols need to be developed and present in all healthcare facilities for hiring interpreters as well as quick access to contact information for these interpreters. ©2017 American Association of Nurse Practitioners.

  19. HIV Care Providers' Attitudes regarding Mobile Phone Applications and Web-Based Dashboards to support Patient Self-Management and Care Coordination: Results from a Qualitative Feasibility Study.

    Science.gov (United States)

    Swendeman, Dallas; Farmer, Shu; Mindry, Deborah; Lee, Sung-Jae; Medich, Melissa

    2016-10-01

    In-depth qualitative interviews were conducted with healthcare providers (HCPs) from five HIV medical care coordination teams in a large Los Angeles County HIV clinic, including physicians, nurses, and psychosocial services providers. HCPs reported on the potential utility, acceptability, and barriers for patient self-monitoring and notifications via mobile phones, and web-based dashboards for HCPs. Potential benefits included: 1) enhancing patient engagement, motivation, adherence, and self-management; and 2) improving provider-patient relationships and HCP care coordination. Newly diagnosed and patients with co-morbidities were highest priorities for mobile application support. Facilitators included universal mobile phone ownership and use of smartphones or text messaging. Patient-level barriers included concerns about low motivation and financial instability for consistent use by some patients. Organizational barriers, cited primarily by physicians, included concerns about privacy protections, easy dashboard access, non-integrated electronic records, and competing burdens in limited appointment times. Psychosocial services providers were most supportive of the proposed mobile tools.

  20. Resilience for family carers of advanced cancer patients-how can health care providers contribute? A qualitative interview study with carers.

    Science.gov (United States)

    Røen, Ingebrigt; Stifoss-Hanssen, Hans; Grande, Gunn; Brenne, Anne-Tove; Kaasa, Stein; Sand, Kari; Knudsen, Anne Kari

    2018-05-01

    Caring for advanced cancer patients affects carers' psychological and physical health. Resilience has been defined as "the process of adapting well in the face of adversity, trauma, tragedy, threats or even significant sources of threat." The aim of this study was to explore factors promoting carer resilience, based on carers' experiences with and preferences for health care provider support. Qualitative, semi-structured, individual interviews with family carers of advanced cancer patients were performed until data saturation. The interviews were recorded, transcribed, and analyzed using systematic text condensation. Carers ( n = 14) of advanced cancer patients, not receiving curative treatment, admitted to an integrated curative and palliative care cancer outpatient clinic or to a university hospital cancer clinic, were included. 14 carers of advanced cancer patients were included; 7 men, 7 women, and mean age of 59 years; 3 were bereaved; 12 were partners; 5 had young and teenage children. Four main resilience factors were identified: (1) being seen and known by health care providers-a personal relation; (2) availability of palliative care; (3) information and communication about illness, prognosis, and death; and (4) facilitating a good carer-patient relation. Health care providers may enhance carers' resilience by a series of simple interventions. Education should address carers' support needs and resilience. Systematic assessment of carers' support needs is recommended. Further investigation is needed into how health care providers can help carers and patients communicate about death.

  1. High-level nuclear waste disposal: Ethical considerations

    International Nuclear Information System (INIS)

    Maxey, M.N.

    1985-01-01

    Popular skepticism about, and moral objections to, recent legislation providing for the management and permanent disposal of high-level radioactive wastes have derived their credibility from two major sources: government procrastination in enacting waste disposal program, reinforcing public perceptions of their unprecedented danger and the inflated rhetoric and pretensions to professional omnicompetence of influential scientists with nuclear expertise. Ethical considerations not only can but must provide a mediating framework for the resolution of such a polarized political controversy. Implicit in moral objections to proposals for permanent nuclear waste disposal are concerns about three ethical principles: fairness to individuals, equitable protection among diverse social groups, and informed consent through due process and participation

  2. Reactions and coping strategies in lay rescuers who have provided CPR to out-of-hospital cardiac arrest victims: a qualitative study.

    Science.gov (United States)

    Mathiesen, Wenche Torunn; Bjørshol, Conrad Arnfinn; Braut, Geir Sverre; Søreide, Eldar

    2016-05-25

    Cardiopulmonary resuscitation (CPR) provided by community citizens is of paramount importance for out-of-hospital cardiac arrest (OHCA) victims' survival. Fortunately, CPR rates by community citizens seem to be rising. However, the experience of providing CPR is rarely investigated. The aim of this study was to explore reactions and coping strategies in lay rescuers who have provided CPR to OHCA victims. This is a qualitative study of 20 lay rescuers who have provided CPR to 18 OHCA victims. We used a semistructured interview guide focusing on their experiences after providing CPR. The study was conducted in the Stavanger region of Norway, an area with very high bystander CPR rates. Three themes emerged from the interview analysis: concern, uncertainty and coping strategies. Providing CPR had been emotionally challenging for all lay rescuers and, for some, had consequences in terms of family and work life. Several lay rescuers experienced persistent mental recurrences of the OHCA incident and had concerns about the outcome for the cardiac arrest victim. Unknown or fatal outcomes often caused feelings of guilt and were particularly difficult to handle. Several reported the need to be acknowledged for their CPR attempts. Health-educated lay rescuers seemed to be less affected than others. A common coping strategy was confiding in close relations, preferably the health educated. However, some required professional help to cope with the OHCA incident. Lay rescuers experience emotional and social challenges, and some struggle to cope in life after providing CPR in OHCA incidents. Experiencing a positive patient outcome and being a health-educated lay rescuer seem to mitigate concerns. Common coping strategies are attempts to reduce uncertainty towards patient outcome and own CPR quality. Further studies are needed to determine whether an organised professional follow-up can mitigate the concerns and uncertainty of lay rescuers. Published by the BMJ Publishing Group

  3. Overview of high-level waste management accomplishments

    International Nuclear Information System (INIS)

    Lawroski, H.; Berreth, J.R.; Freeby, W.A.

    1980-01-01

    Storage of power reactor spent fuel is necessary at present because of the lack of reprocessing operations particularly in the U.S. By considering the above solidification and storage scenario, there is more than reasonable assurance that acceptable, stable, low heat generation rate, solidified waste can be produced, and safely disposed. The public perception of no waste disposal solutions is being exploited by detractors of nuclear power application. The inability to even point to one overall system demonstration lends credibility to the negative assertions. By delaying the gathering of on-line information to qualify repository sites, and to implement a demonstration, the actions of the nuclear power detractors are self serving in that they can continue to point out there is no demonstration of satisfactory high-level waste disposal. By maintaining the liquid and solidified high-level waste in secure above ground storage until acceptable decay heat generation rates are achieved, by producing a compatible, high integrity, solid waste form, by providing a second or even third barrier as a compound container and by inserting the enclosed waste form in a qualified repository with spacing to assure moderately low temperature disposal conditions, there appears to be no technical reason for not progressing further with the disposal of high-level wastes and needed implementation of the complete nuclear power fuel cycle

  4. A descriptive qualitative study of the roles of family members in older men's depression treatment from the perspectives of older men and primary care providers.

    Science.gov (United States)

    Hinton, Ladson; Apesoa-Varano, Ester Carolina; Unützer, Jürgen; Dwight-Johnson, Megan; Park, Mijung; Barker, Judith C

    2015-05-01

    The aim of this study is to describe the roles of family members in older men's depression treatment from the perspectives of older men and primary care physicians (PCPs). Cross-sectional, descriptive qualitative study conducted from 2008-2011 in primary care clinics in an academic medical center and a safety-net county teaching hospital in California's Central Valley. Participants in this study were the following: (1) 77 age ≥ 60, noninstitutionalized men with a 1-year history of clinical depression and/or depression treatment who were identified through screening in primary care clinics and (2) a convenience sample of 15 PCPs from the same recruitment sites. Semi-structured and in-depth qualitative interviews were conducted and audiotaped then transcribed and analyzed thematically. Treatment-promoting roles of family included providing an emotionally supportive home environment, promoting depression self-management and facilitating communication about depression during primary care visits. Treatment-impeding roles of family included triggering or worsening men's depression, hindering depression care during primary care visits, discouraging depression treatment and being unavailable to assist men with their depression care. Overall, more than 90% of the men and the PCPs described one or more treatment-promoting roles of family and over 75% of men and PCPs described one or more treatment-impeding roles of family. Families play important roles in older men's depression treatment with the potential to promote as well as impede care. Interventions and services need to carefully assess the ongoing roles and attitudes of family members and to tailor treatment approaches to build on the positive aspects and mitigate the negative aspects of family support. Copyright © 2014 John Wiley & Sons, Ltd.

  5. “Completely out-at-sea” with “two-gender medicine”: A qualitative analysis of physician-side barriers to providing healthcare for transgender patients

    Directory of Open Access Journals (Sweden)

    Snelgrove John W

    2012-05-01

    Full Text Available Abstract Background Members of the transgender community have identified healthcare access barriers, yet a corresponding inquiry into healthcare provider perspectives has lagged. Our aim was to examine physician perceptions of barriers to healthcare provision for transgender patients. Methods This was a qualitative study with physician participants from Ontario, Canada. Semi-structured interviews were used to capture a progression of ideas related to barriers faced by physicians when caring for trans patients. Qualitative data were then transcribed verbatim and analysed with an emergent grounded theory approach. Results A total of thirteen (13 physician participants were interviewed. Analysis revealed healthcare barriers that grouped into five themes: Accessing resources, medical knowledge deficits, ethics of transition-related medical care, diagnosing vs. pathologising trans patients, and health system determinants. A centralising theme of “not knowing where to go or who to talk to” was also identified. Conclusions The findings of this study show that physicians perceive barriers to the care of trans patients, and that these barriers are multifactorial. Access barriers impede physicians when referring patients to specialists or searching for reliable treatment information. Clinical management of trans patients is complicated by a lack of knowledge, and by ethical considerations regarding treatments—which can be unfamiliar or challenging to physicians. The disciplinary division of responsibilities within medicine further complicates care; few practitioners identify trans healthcare as an interest area, and there is a tendency to overemphasise trans status in mental health evaluations. Failure to recognise and accommodate trans patients within sex-segregated healthcare systems leads to deficient health policy. The findings of this study suggest potential solutions to trans healthcare barriers at the informational level—with increased

  6. Defense High Level Waste Disposal Container System Description Document

    International Nuclear Information System (INIS)

    Pettit, N. E.

    2001-01-01

    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. US 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 inserted in the center and/or one or more DOE SNF canisters displacing a HLW 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

  7. Meeting psychosocial needs for persons with dementia in home care services - a qualitative study of different perceptions and practices among health care providers.

    Science.gov (United States)

    Hansen, Anette; Hauge, Solveig; Bergland, Ådel

    2017-09-11

    The majority of persons with dementia are home-dwelling. To enable these persons to stay in their own homes as long as possible, a holistic, individual and flexible care is recommended. Despite a requirement for meeting psychological, social and physical needs, home care services seem to focus on patients' physical needs. Accordingly, the aim of this study was to explore how the psychosocial needs of home-dwelling, older persons with dementia were perceived, emphasized and met by home care services. A descriptive, qualitative approach was used. Data were collected through semi-structured focus group interviews with 24 health care providers in home care services from four municipalities. Data were analysed using systematic text condensation. This study showed major differences in how health care providers perceived the psychosocial needs of older home-dwelling persons with dementia and how they perceived their responsibilities for meeting those psychosocial needs. The differences in the health care providers' perceptions seemed to significantly influence the provided care. Three co-existing logics of care were identified: the physical need-oriented logic, the renouncement logic and the integrated logic. The differences in how health care providers perceived the psychosocial needs of persons with dementia and their responsibilities for meeting those needs, influenced how the psychosocial needs were met. These differences indicates a need for a clarification of how psychosocial needs should be conceptualized and who should be responsible for meeting these needs. Further, increased competence and increased consciousness of psychosocial needs and how those needs can be met, are essential for delivering high-quality holistic care that enables persons with dementia to live in their own home for as long as possible.

  8. Service provider perceptions of telerehabilitation as an additional service delivery option within an Australian neurosurgical and orthopaedic physiotherapy screening clinic: A qualitative study.

    Science.gov (United States)

    Cottrell, Michelle A; Hill, Anne J; O'Leary, Shaun P; Raymer, Maree E; Russell, Trevor G

    2017-12-01

    The Neurosurgical & Orthopaedic Physiotherapy Screening Clinic and Multidisciplinary Service (N/OPSC&MDS) originated as a complementary, non-surgical pathway for patients referred to public neurosurgical and orthopaedic specialist services. Patient access to the N/OPSC&MDS could potentially be improved with the implementation of telerehabilitation as an additional method of service delivery. To evaluate service provider's views on (1) current barriers to patients' accessing N/OPSC & MD services, and (2) the implementation of telerehabilitation within the N/OPSC&MDS. Qualitative descriptive study design. Healthcare providers (n = 26) were recruited from six N/OPSC&MD services located throughout Queensland, Australia. Semi-structured interviews were conducted to explore service providers' views with respect to existing barriers to patients accessing the N/OPSC&MDS, and if telerehabilitation could be feasibly adopted to address current barriers. Template analysis resulted in six themes: (1) barriers to some patients' accessing current N/OPSC&MD services are complex & multifaceted; (2) telerehabilitation could improve patient access to appropriate management for their musculoskeletal condition; (3) telerehabilitation may have limitations when compared to face-to-face healthcare; (4) the delivery of telerehabilitation needs to be flexible; (5) perceived barriers, and (6) facilitators to the successful implementation of telerehabilitation within the N/OPSC&MDS. This study represents a critical step in determining the readiness of service providers for the implementation of telerehabilitation within the N/OPSC&MDS. Although cautious, service providers are overall accepting of the implementation of telerehabilitation, acknowledging that it could eliminate several current barriers, subsequently achieving more equitable access to the service. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  9. Experiences and meanings of integration of TCAM (Traditional, Complementary and Alternative Medical) providers in three Indian states: results from a cross-sectional, qualitative implementation research study.

    Science.gov (United States)

    Nambiar, D; Narayan, V V; Josyula, L K; Porter, J D H; Sathyanarayana, T N; Sheikh, K

    2014-11-25

    -level individual integrative efforts, and are fostered by high-level political will are recommended. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  10. Hyperloop Commercial Feasibility Analysis : High Level Overview

    Science.gov (United States)

    2016-07-01

    Hyperloop is a concept for very highspeed, fixedguideway, intercity surface transportation, using capsulelike vehicles that operate in sealed partialvacuum tubes. This report provide a highlevel evaluation of hyperloop in terms of its ...

  11. Qualitative evaluation of primary care providers experiences of a training programme to offer brief behaviour change counselling on risk factors for non-communicable diseases in South Africa.

    Science.gov (United States)

    Malan, Zelra; Mash, Robert; Everett-Murphy, Katherine

    2015-08-19

    The global epidemic of non-communicable disease (NCDs) has been linked with four modifiable risky lifestyle behaviours, namely smoking, unhealthy diet, physical inactivity and alcohol abuse. Primary care providers (PCPs) can play an important role in changing patient's risky behaviours. It is recommended that PCPs provide individual brief behaviour change counselling (BBCC) as part of everyday primary care. This study is part of a larger project that re-designed the current training for PCPs in South Africa, to offer a standardized approach to BBCC based on the 5 As and a guiding style. This article reports on a qualitative sub-study, which explored whether the training intervention changed PCPs perception of their confidence in their ability to offer BBCC, whether they believed that the new approach could overcome the barriers to implementation in clinical practice and be sustained, and their recommendations on future training and integration of BBCC into curricula and clinical practice. This was a qualitative study that used verbal feedback from participants at the beginning and end of the training course, and twelve individual in-depth interviews with participants once they had returned to their clinical practice. Although PCP's confidence in their ability to counselling improved, and some thought that time constraints could be overcome, they still reported that understaffing, lack of support from within the facility and poor continuity of care were barriers to counselling. However, the current organisational culture was not congruent with the patient-centred guiding style of BBCC. Training should be incorporated into undergraduate curricula of PCPs for both nurses and doctors, to ensure that counselling skills are embedded from the start. Existing PCPs should be offered training as part of continued professional development programmes. This study showed that although training changed PCPs perception of their ability to offer BBCC, and increased their confidence

  12. Palliative sedation challenging the professional competency of health care providers and staff: a qualitative focus group and personal written narrative study.

    Science.gov (United States)

    Leboul, Danièle; Aubry, Régis; Peter, Jean-Michel; Royer, Victor; Richard, Jean-François; Guirimand, Frédéric

    2017-04-11

    Despite recent advances in palliative medicine, sedating a terminally ill patient is regarded as an indispensable treatment to manage unbearable suffering. With the prospect of widespread use of palliative sedation, the feelings and representations of health care providers and staff (carers) regarding sedation must be carefully explored if we are to gain a better understanding of its impact and potential pitfalls. The objective of the study was to provide a comprehensive description of the opinions of carers about the use of sedation practices in palliative care units (PCU), which have become a focus of public attention following changes in legislation. Data were collected using a qualitative study involving multi-professional focus groups with health care providers and staff as well as personal narratives written by physicians and paramedical staff. A total of 35 medical and paramedical providers volunteered to participate in focus group discussions in three Palliative Care Units in two French hospitals and to write personal narratives. Health care provider and staff opinions had to do with their professional stance and competencies when using midazolam and practicing sedation in palliative care. They expressed uncertainty regarding three aspects of the comprehensive care: biomedical rigour of diagnosis and therapeutics, quality of the patient/provider relationship and care to be provided. Focusing on the sedative effect of midazolam and continuous sedation until death, the interviewed health care providers examined the basics of their professional competency as well as the key role played by the health care team in terms of providing support and minimizing workplace suffering. Nurses were subject to the greatest misgivings about their work when they were called upon to sedate patients. The uncertainty experienced by the carers with regard to the medical, psychosocial and ethical justification for sedation is a source of psychological burden and moral distress

  13. "I Am Ready and Willing to Provide the Service … Though My Religion Frowns on Abortion"-Ghanaian Midwives' Mixed Attitudes to Abortion Services: A Qualitative Study.

    Science.gov (United States)

    Oppong-Darko, Prince; Amponsa-Achiano, Kwame; Darj, Elisabeth

    2017-12-04

    Unsafe abortion is a major preventable public health problem and contributes to high mortality among women. Ghana has ratified international conventions to prevent unwanted pregnancies and provide safe abortion services, legally authorizing midwives to provide induced abortion services in certain circumstances. The aim of the study was to understand midwives' readiness to be involved in legal induced abortions, should the law become less restricted in Ghana. A qualitative study design, with a topic guide for individual in-depth interviews of selected midwives, was adopted. The interviews were tape-recorded and analyzed using content analysis. Participants emphasized their willingness to reduce maternal mortalities, their experiences of maternal deaths, and their passion for the health of pregnant women. Knowledge of Ghana's abortion law was generally low. Different views were expressed regarding readiness to engage in abortion services. Some expressed it as being sinful and against their religion to assist in abortion care, whilst others felt it was good to save the lives of women. The midwives made it clear that unsafe abortions are common, stigmatizing and contributing to maternal mortality, issues that must be addressed. They made various suggestions to reduce this preventable tragedy.

  14. A qualitative study of barriers to enrollment into free HIV care: perspectives of never-in-care HIV-positive patients and providers in Rakai, Uganda.

    Science.gov (United States)

    Nakigozi, Gertrude; Atuyambe, Lynn; Kamya, Moses; Makumbi, Fredrick E; Chang, Larry W; Nakyanjo, Neema; Kigozi, Godfrey; Nalugoda, Fred; Kiggundu, Valerian; Serwadda, David; Wawer, Maria; Gray, Ronald

    2013-01-01

    Early entry into HIV care is low in Sub-Saharan Africa. In Rakai, about a third (31.5%) of HIV-positive clients who knew their serostatus did not enroll into free care services. This qualitative study explored barriers to entry into care from HIV-positive clients who had never enrolled in care and HIV care providers. We conducted 48 in-depth interviews among HIV-infected individuals aged 15-49 years, who had not entered care within six months of result receipt and referral for free care. Key-informant interviews were conducted with 12 providers. Interviews were audio-recorded and transcripts subjected to thematic content analysis based on the health belief model. Barriers to using HIV care included fear of stigma and HIV disclosure, women's lack of support from male partners, demanding work schedules, and high transport costs. Programmatic barriers included fear of antiretroviral drug side effects, long waiting and travel times, and inadequate staff respect for patients. Denial of HIV status, belief in spiritual healing, and absence of AIDS symptoms were also barriers. Targeted interventions to combat stigma, strengthen couple counseling and health education programs, address gender inequalities, and implement patient-friendly and flexible clinic service hours are needed to address barriers to HIV care.

  15. Reconciling patient and provider priorities for improving the care of critically ill patients: A consensus method and qualitative analysis of decision making.

    Science.gov (United States)

    McKenzie, Emily; Potestio, Melissa L; Boyd, Jamie M; Niven, Daniel J; Brundin-Mather, Rebecca; Bagshaw, Sean M; Stelfox, Henry T

    2017-12-01

    Providers have traditionally established priorities for quality improvement; however, patients and their family members have recently become involved in priority setting. Little is known about how to reconcile priorities of different stakeholder groups into a single prioritized list that is actionable for organizations. To describe the decision-making process for establishing consensus used by a diverse panel of stakeholders to reconcile two sets of quality improvement priorities (provider/decision maker priorities n=9; patient/family priorities n=19) into a single prioritized list. We employed a modified Delphi process with a diverse group of panellists to reconcile priorities for improving care of critically ill patients in the intensive care unit (ICU). Proceedings were audio-recorded, transcribed and analysed using qualitative content analysis to explore the decision-making process for establishing consensus. Nine panellists including three providers, three decision makers and three family members of previously critically ill patients. Panellists rated and revised 28 priorities over three rounds of review and reached consensus on the "Top 5" priorities for quality improvement: transition of patient care from ICU to hospital ward; family presence and effective communication; delirium screening and management; early mobilization; and transition of patient care between ICU providers. Four themes were identified as important for establishing consensus: storytelling (sharing personal experiences), amalgamating priorities (negotiating priority scope), considering evaluation criteria and having a priority champion. Our study demonstrates the feasibility of incorporating families of patients into a multistakeholder prioritization exercise. The approach described can be used to guide consensus building and reconcile priorities of diverse stakeholder groups. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

  16. Understanding Postpartum Healthcare Services and Exploring the Challenges and Motivations of Maternal Health Service Providers in the Philippines: a Qualitative Study.

    Science.gov (United States)

    Yamashita, Tadashi; Suplido, Sherri Ann; Llave, Cecilia; Tuliao, Maria Teresa R; Tanaka, Yuko; Matsuo, Hiroya

    2015-06-01

    Given the shortage of medical professionals in the Philippines, Barangay Health Workers (BHWs) may play a role in providing postpartum healthcare services. However, as there are no reports regarding BHW activities in postpartum healthcare, we conducted this study to understand postpartum healthcare services and to explore the challenges and motivations of maternal health service providers. Focus group interview (FGI) of 13 participants was conducted as qualitative research methodology at Muntinlupa City. The results were analyzed according to the interview guide. The proceedings of the FGI were transcribed verbatim, and researchers read and coded the transcripts. The codes were then used to construct categories. Four important activities were highlighted among 11 analysis codes. These activities were "Assessment of postpartum women's conditions," "Recommendation to visit a health facility," "Measurement of blood-pressure and vitamin intake," and "Providing postpartum health information." Among five analysis codes, we identified three challenges that BHWs face, which were "No current information regarding postpartum care," "Some postpartum women do not want to receive healthcare services from BHW," and "Too many assigned postpartum women." Among five analysis codes, we identified two reasons for continuing BHW activities, which were "Hospitality to help postpartum women and their family in the community" and "Performance of mission in providing BHW services." This study is the first to evaluate BHW activities in postpartum healthcare services. Our results indicate that BHWs play a potentially important role in evaluating postpartum women's physical and mental conditions through home-visiting services. However, several difficulties adversely affected their activities, and these must be addressed to maximize the contributions of BHWs to the postpartum healthcare system.

  17. The ATLAS high level trigger region of interest builder

    International Nuclear Information System (INIS)

    Blair, R.; Dawson, J.; Drake, G.; Haberichter, W.; Schlereth, J.; Zhang, J.; Ermoline, Y.; Pope, B.; Aboline, M.; High Energy Physics; Michigan State Univ.

    2008-01-01

    This article describes the design, testing and production of the ATLAS Region of Interest Builder (RoIB). This device acts as an interface between the Level 1 trigger and the high level trigger (HLT) farm for the ATLAS LHC detector. It distributes all of the Level 1 data for a subset of events to a small number of (16 or less) individual commodity processors. These processors in turn provide this information to the HLT. This allows the HLT to use the Level 1 information to narrow data requests to areas of the detector where Level 1 has identified interesting objects

  18. Managing the nation's commercial high-level radioactive waste

    International Nuclear Information System (INIS)

    1985-03-01

    This report presents the findings and conclusions of OTA's analysis of Federal policy for the management of commercial high-level radioactive waste. It is intended to contribute to the implementation of Nuclear Waste Policy Act of 1982 (NWPA). The major conclusion of that review is that NWPA provides sufficient authority for developing and operating a waste management system based on disposal in geologic repositories. Substantial new authority for other facilities will not be required unless major unexpected problems with geologic disposal are encountered. OTA also concludes that DOE's Draft Mission Plan published in 1984 falls short of its potential for enhancing the credibility and acceptability of the waste management program

  19. A critically educated public explores high level radioactive waste management

    International Nuclear Information System (INIS)

    Blum, J.E.

    1994-01-01

    It is vital to the citizens of Nevada that they and their children are given an opportunity to explore all sides of the characterization of Yucca Mountain as a potential repository site for spent nuclear fuel. The state-wide, national and international implications demand a reasoned and complete approach to this issue, which has become emotionally and irrationally charged and fueled by incomplete perception and information. The purpose of this paper is to provide curriculum suggestions and recommend concomitant policy developments that will lead to the implementation of a Critical Thinking (CT) approach to High Level Radioactive Waste Management

  20. Cermet high level waste forms: a pregress report

    International Nuclear Information System (INIS)

    Aaron, W.S.; Quinby, T.C.; Kobisk, E.H.

    1978-06-01

    The fixation of high level radioactive waste from both commercial and DOE defense sources as cermets is currently under study. This waste form consists of a continuous iron-nickel base metal matrix containing small particles of fission product oxides. Preliminary evaluations of cermets fabricated from a variety of simulated wastes indicate they possess properties providing advantages over other waste forms presently being considered, namely thermal conductivity, waste loading levels, and leach resistance. This report describes the progress of this effort, to date, since its initiation in 1977

  1. Characterizing speed-independence of high-level designs

    DEFF Research Database (Denmark)

    Kishinevsky, Michael; Staunstrup, Jørgen

    1994-01-01

    This paper characterizes the speed-independence of high-level designs. The characterization is a condition on the design description ensuring that the behavior of the design is independent of the speeds of its components. The behavior of a circuit is modeled as a transition system, that allows data...... types, and internal as well as external non-determinism. This makes it possible to verify the speed-independence of a design without providing an explicit realization of the environment. The verification can be done mechanically. A number of experimental designs have been verified including a speed-independent...

  2. Spanish high level radioactive waste management system issues

    International Nuclear Information System (INIS)

    Espejo, J.M.; Beceiro, A.R.

    1992-01-01

    The Empresa Nacional de Residuos Radiactivos, S.A. (ENRESA) has been limited liability company to be responsible for the management of all kind of radioactive wastes in Spain. This paper provides an overview of the strategy and main lines of action stated in the third General Radioactive Waste Plan, currently in force, for the management of spent nuclear fuel and high - level wastes, as well as an outline of the main related projects, either being developed or foreseen. Aspects concerning the organizational structure, the economic and financing system and the international cooperation are also included

  3. Spanish high level radioactive waste management system issues

    International Nuclear Information System (INIS)

    Ulibarri, A.; Veganzones, A.

    1993-01-01

    The Empresa Nacional de Residuous Radiactivos, S.A. (ENRESA) was set up in 1984 as a state-owned limited liability company to be responsible for the management of all kinds of radioactive wastes in Spain. This paper provides an overview of the strategy and main lines of action stated in the third General Radioactive Waste Plan, currently in force, for the management of spent nuclear fuel and high-level wastes, as well as an outline of the main related projects, either being developed or foreseen. Aspects concerning the organizational structure, the economic and financing system and the international co-operational are also included

  4. Very-high-level neutral-beam control system

    International Nuclear Information System (INIS)

    Elischer, V.; Jacobson, V.; Theil, E.

    1981-10-01

    As increasing numbers of neutral beams are added to fusion machines, their operation can consume a significant fraction of a facility's total resources. LBL has developed a very high level control system that allows a neutral beam injector to be treated as a black box with just 2 controls: one to set the beam power and one to set the pulse duration. This 2 knob view allows simple operation and provides a natural base for implementing even higher level controls such as automatic source conditioning

  5. Developing a Shared Patient-Centered, Web-Based Medication Platform for Type 2 Diabetes Patients and Their Health Care Providers: Qualitative Study on User Requirements.

    Science.gov (United States)

    Bernhard, Gerda; Mahler, Cornelia; Seidling, Hanna Marita; Stützle, Marion; Ose, Dominik; Baudendistel, Ines; Wensing, Michel; Szecsenyi, Joachim

    2018-03-27

    Information technology tools such as shared patient-centered, Web-based medication platforms hold promise to support safe medication use by strengthening patient participation, enhancing patients' knowledge, helping patients to improve self-management of their medications, and improving communication on medications among patients and health care professionals (HCPs). However, the uptake of such platforms remains a challenge also due to inadequate user involvement in the development process. Employing a user-centered design (UCD) approach is therefore critical to ensure that user' adoption is optimal. The purpose of this study was to identify what patients with type 2 diabetes mellitus (T2DM) and their HCPs regard necessary requirements in terms of functionalities and usability of a shared patient-centered, Web-based medication platform for patients with T2DM. This qualitative study included focus groups with purposeful samples of patients with T2DM (n=25), general practitioners (n=13), and health care assistants (n=10) recruited from regional health care settings in southwestern Germany. In total, 8 semistructured focus groups were conducted. Sessions were audio- and video-recorded, transcribed verbatim, and subjected to a computer-aided qualitative content analysis. Appropriate security and access methods, supported data entry, printing, and sending information electronically, and tracking medication history were perceived as the essential functionalities. Although patients wanted automatic interaction checks and safety alerts, HCPs on the contrary were concerned that unspecific alerts confuse patients and lead to nonadherence. Furthermore, HCPs were opposed to patients' ability to withhold or restrict access to information in the platform. To optimize usability, there was consensus among participants to display information in a structured, chronological format, to provide information in lay language, to use visual aids and customize information content, and align

  6. Conceptual high-level framework of cyberterrorism

    CSIR Research Space (South Africa)

    Veerasamy, N

    2009-04-01

    Full Text Available elements for only total certainty of belief (or total moral relativism) provides justification for taking lives. According to the Israeli political scientist, Ehud Sprinzak, right wing terrorism is characterised by the process of “split... driving terrorism today. Social factors A core underlying factor impacting the acts of terrorists in general stems from various social issues. Jenkins (2006) states that terrorism is generally derived from concepts of morality, law, and the rules...

  7. Dilemmas in providing resilience-enhancing social services to long-term social assistance clients. A qualitative study of Swedish social workers

    Directory of Open Access Journals (Sweden)

    Marttila Anneli

    2012-07-01

    Full Text Available Abstract Background Long-term recipients of social assistance face barriers to social and economic inclusion, and have poorer health and more limited opportunities for improving their health than many other groups in the population. During recent decades there have been changes in Swedish social policy, with cutbacks in public benefits and a re-emphasis on means-tested policies. In this context, it is important to investigate the necessary conditions for social workers to offer social assistance and services, as well as the mediating role of social workers between public policies and their clients. Swedish social services aim to promote social inclusion by strengthening the individual´s own resources. We investigated the issues that arise when providing social services to long-term social assistance clients within the framework of resilience, which focuses on the processes leading to positive functioning in adverse conditions. Methods Interviews were conducted with 23 social workers in Stockholm and analysed by qualitative content analysis. Results The main theme to emerge from the interviews concerned the constraints that the social workers faced in providing social services to social assistance clients. The first subtheme focused on dilemmas in the interaction between social workers and clients resulting from the dual role of exercising authority and supporting and building trust with clients. Working conditions of social workers also played a crucial role. The second subtheme addressed the impact of the societal context, such as labour market opportunities and coordination between authorities. Conclusions Overall, we found that social workers to a great extent tried to find individual solutions to structural problems. To provide resilience-enhancing social services to long-term social assistance clients with varying obstacles and needs requires a constructive working environment, supportive societal structures and inter-sectoral cooperation

  8. Supporting family carers providing end-of-life home care: a qualitative study on the impact of a hospice at home service.

    Science.gov (United States)

    Jack, Barbara A; O'Brien, Mary R; Scrutton, Joyce; Baldry, Catherine R; Groves, Karen E

    2015-01-01

    To explore bereaved family carers' perceptions and experiences of a hospice at home service. The increasing demand for the development of home-based end-of-life services is not confined to the western world; such services are also emerging in resource-poor countries where palliative care services are developing with limited inpatient facilities. Despite this growing trend, studies show a variety of interrelated factors, with an emphasis on the availability of informal carers and their ability to cope, which can influence whether terminally ill patients actually remain at home. A hospice at home service was developed to meet patients' and families' needs by providing individually tailored resources. A qualitative study. Data were collected by semi-structured, digitally recorded interviews from 20 family carers who had experienced the service. Interviews were transcribed verbatim and a thematic approach adopted for analysis. All participants reported a personal positive impact of the service. Family carers commented the service provided a valued presence, they felt in good hands and importantly it helped in supporting normal life. The impact of an individualised, targeted, hospice at home service using dedicated, palliative care trained, staff, is perceived positively by family carers and importantly, supportive of those with additional caring or employment commitments. The emergence of hospice at home services has resulted in more options for patients and their families, when the increased amount of care a family member has to provide in these circumstances needs to be adequately supported, with the provision of a flexible service tailored to individual needs and delivered by appropriately trained staff. © 2014 The Authors. Journal of Clinical Nursing Published by John Wiley & Sons Ltd.

  9. Dilemmas in providing resilience-enhancing social services to long-term social assistance clients. A qualitative study of Swedish social workers.

    Science.gov (United States)

    Marttila, Anneli; Johansson, Eva; Whitehead, Margaret; Burström, Bo

    2012-07-12

    Long-term recipients of social assistance face barriers to social and economic inclusion, and have poorer health and more limited opportunities for improving their health than many other groups in the population. During recent decades there have been changes in Swedish social policy, with cutbacks in public benefits and a re-emphasis on means-tested policies. In this context, it is important to investigate the necessary conditions for social workers to offer social assistance and services, as well as the mediating role of social workers between public policies and their clients. Swedish social services aim to promote social inclusion by strengthening the individual's own resources. We investigated the issues that arise when providing social services to long-term social assistance clients within the framework of resilience, which focuses on the processes leading to positive functioning in adverse conditions. Interviews were conducted with 23 social workers in Stockholm and analysed by qualitative content analysis. The main theme to emerge from the interviews concerned the constraints that the social workers faced in providing social services to social assistance clients. The first subtheme focused on dilemmas in the interaction between social workers and clients resulting from the dual role of exercising authority and supporting and building trust with clients. Working conditions of social workers also played a crucial role. The second subtheme addressed the impact of the societal context, such as labour market opportunities and coordination between authorities. Overall, we found that social workers to a great extent tried to find individual solutions to structural problems. To provide resilience-enhancing social services to long-term social assistance clients with varying obstacles and needs requires a constructive working environment, supportive societal structures and inter-sectoral cooperation between different authorities.

  10. Statistics of high-level scene context.

    Science.gov (United States)

    Greene, Michelle R

    2013-01-01

    CONTEXT IS CRITICAL FOR RECOGNIZING ENVIRONMENTS AND FOR SEARCHING FOR OBJECTS WITHIN THEM: contextual associations have been shown to modulate reaction time and object recognition accuracy, as well as influence the distribution of eye movements and patterns of brain activations. However, we have not yet systematically quantified the relationships between objects and their scene environments. Here I seek to fill this gap by providing descriptive statistics of object-scene relationships. A total of 48, 167 objects were hand-labeled in 3499 scenes using the LabelMe tool (Russell et al., 2008). From these data, I computed a variety of descriptive statistics at three different levels of analysis: the ensemble statistics that describe the density and spatial distribution of unnamed "things" in the scene; the bag of words level where scenes are described by the list of objects contained within them; and the structural level where the spatial distribution and relationships between the objects are measured. The utility of each level of description for scene categorization was assessed through the use of linear classifiers, and the plausibility of each level for modeling human scene categorization is discussed. Of the three levels, ensemble statistics were found to be the most informative (per feature), and also best explained human patterns of categorization errors. Although a bag of words classifier had similar performance to human observers, it had a markedly different pattern of errors. However, certain objects are more useful than others, and ceiling classification performance could be achieved using only the 64 most informative objects. As object location tends not to vary as a function of category, structural information provided little additional information. Additionally, these data provide valuable information on natural scene redundancy that can be exploited for machine vision, and can help the visual cognition community to design experiments guided by statistics

  11. Understanding the health and wellbeing challenges of the food banking system: A qualitative study of food bank users, providers and referrers in London.

    Science.gov (United States)

    Thompson, C; Smith, D; Cummins, S

    2018-05-16

    In the UK, food poverty has been associated with conditions such as obesity, malnutrition, hypertension, iron deficiency, and impaired liver function. Food banks, the primary response to food poverty on the ground, typically rely on community referral and distribution systems that involve health and social care professionals and local authority public health teams. The perspectives of these key stakeholders remain underexplored. This paper reports on a qualitative study of the health and wellbeing challenges of food poverty and food banking in London. An ethnographic investigation of food bank staff and users was carried out alongside a series of healthcare stakeholder interviews. A total of 42 participants were interviewed. A Critical Grounded Theory (CGT) analysis revealed that contemporary lived experiences of food poverty are embedded within and symptomatic of extreme marginalisation, which in turn impacts upon health. Specifically, food poverty was conceptualised by participants to: firstly, be a barrier to providing adequate care and nutrition for young children; secondly, be exacerbated by lack of access to adequate fresh food, food storage and cooking facilities; and thirdly, amplify existing health and social problems. Further investigation of the local government structures and professional roles that both rely upon and serve to further embed the food banking system is necessary in order to understand the politics of changing welfare landscapes. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  12. Regulating the for-profit private healthcare providers towards universal health coverage: A qualitative study of legal and organizational framework in Mongolia.

    Science.gov (United States)

    Tsevelvaanchig, Uranchimeg; Narula, Indermohan S; Gouda, Hebe; Hill, Peter S

    2018-01-01

    Regulating the behavior of private providers in the context of mixed health systems has become increasingly important and challenging in many developing countries moving towards universal health coverage including Mongolia. This study examines the current regulatory architecture for private healthcare in Mongolia exploring its role for improving accessibility, affordability, and quality of private care and identifies gaps in policy design and implementation. Qualitative research methods were used including documentary review, analysis, and in-depth interviews with 45 representatives of key actors involved in and affected by regulations in Mongolia's mixed health system, along with long-term participant observation. There has been extensive legal documentation developed regulating private healthcare, with specific organizations assigned to conduct health regulations and inspections. However, the regulatory architecture for healthcare in Mongolia is not optimally designed to improve affordability and quality of private care. This is not limited only to private care: important regulatory functions targeted to quality of care do not exist at the national level. The imprecise content and details of regulations in laws inviting increased political interference, governance issues, unclear roles, and responsibilities of different government regulatory bodies have contributed to failures in implementation of existing regulations. Copyright © 2017 John Wiley & Sons, Ltd.

  13. Self-administered versus provider-directed sampling in the Anishinaabek Cervical Cancer Screening Study (ACCSS): a qualitative investigation with Canadian First Nations women.

    Science.gov (United States)

    Zehbe, Ingeborg; Wakewich, Pamela; King, Amy-Dee; Morrisseau, Kyla; Tuck, Candace

    2017-09-01

    While (Pap)anicolaou screening has helped to decrease cervical cancer incidence in Canada, First Nations women continue to have a higher burden and mortality relative to mainstream populations. Many First Nations women may feel uncomfortable with the invasiveness of this test, contributing to this statistic. Implemented from 2009 to 2015 in 10 Northwest Ontario First Nations communities, the Anishinaabek Cervical Cancer Screening Study (ACCSS) uniquely addressed this Indigenous health inequity through a mixed methods approach. Our goal was to offer an alternative test which the women could do themselves: human papillomavirus (HPV) testing based on self-sampling. We investigated whether First Nations women preferred HPV self-sampling over healthcare provider (HCP)-administered Pap screening. Participatory action researchinformed by the ethical space concept has guided all stages of the ACCSS. We conducted qualitative interviews with 16 HCPs and 8 focus group discussions with 69 female community members followed by a cluster-randomised controlled trial (RCT). Here, we draw on the qualitative field data and an end-of-study community update gathering to disseminate and contextualise research findings. Informant data were evaluated using thematic analysis. We discuss factors influencing participants' strong preference for HPV self-sampling over physician-conducted Pap screening. Key arguments included enhanced accessibility and more personal control, less physical and emotional discomfort and fewer concerns regarding privacy of test results. For future implementation of HPV self-sampling, study participants emphasised the need for more culturally sensitive education addressed to community members of all genders, starting at school, clarifying that HPV causes cervical cancer. Further, HPV infection should be de-stigmatised by accentuating that it affects men and women alike. Here we show that self-sampling in conjunction with community engagement and culturally sensitive

  14. Spent Fuel and High-Level Radioactive Waste Transportation Report

    International Nuclear Information System (INIS)

    1992-03-01

    This publication is intended to provide its readers with an introduction to the issues surrounding the subject of transportation of spent nuclear fuel and high-level radioactive waste, especially as those issues impact the southern region of the United States. It was originally issued by SSEB in July 1987 as the Spent Nuclear Fuel and High-Level Radioactive Waste Transportation Primer, a document patterned on work performed by the Western Interstate Energy Board and designed as a ''comprehensive overview of the issues.'' This work differs from that earlier effort in that it is designed for the educated layman with little or no background in nuclear waste Issues. In addition. this document is not a comprehensive examination of nuclear waste issues but should instead serve as a general introduction to the subject. Owing to changes in the nuclear waste management system, program activities by the US Department of Energy and other federal agencies and developing technologies, much of this information is dated quickly. While this report uses the most recent data available, readers should keep in mind that some of the material is subject to rapid change. SSEB plans periodic updates in the future to account for changes in the program. Replacement pages will be supplied to all parties in receipt of this publication provided they remain on the SSEB mailing list

  15. Spent fuel and high-level radioactive waste transportation report

    Energy Technology Data Exchange (ETDEWEB)

    1989-11-01

    This publication is intended to provide its readers with an introduction to the issues surrounding the subject of transportation of spent nuclear fuel and high-level radioactive waste, especially as those issues impact the southern region of the United States. It was originally issued by the Southern States Energy Board (SSEB) in July 1987 as the Spent Nuclear Fuel and High-Level Radioactive Waste Transportation Primer, a document patterned on work performed by the Western Interstate Energy Board and designed as a ``comprehensive overview of the issues.`` This work differs from that earlier effort in that it is designed for the educated layman with little or no background in nuclear waste issues. In addition, this document is not a comprehensive examination of nuclear waste issues but should instead serve as a general introduction to the subject. Owing to changes in the nuclear waste management system, program activities by the US Department of Energy and other federal agencies and developing technologies, much of this information is dated quickly. While this report uses the most recent data available, readers should keep in mind that some of the material is subject to rapid change. SSEB plans periodic updates in the future to account for changes in the program. Replacement pages sew be supplied to all parties in receipt of this publication provided they remain on the SSEB mailing list.

  16. Spent fuel and high-level radioactive waste transportation report

    International Nuclear Information System (INIS)

    1989-11-01

    This publication is intended to provide its readers with an introduction to the issues surrounding the subject of transportation of spent nuclear fuel and high-level radioactive waste, especially as those issues impact the southern region of the United States. It was originally issued by the Southern States Energy Board (SSEB) in July 1987 as the Spent Nuclear Fuel and High-Level Radioactive Waste Transportation Primer, a document patterned on work performed by the Western Interstate Energy Board and designed as a ''comprehensive overview of the issues.'' This work differs from that earlier effort in that it is designed for the educated layman with little or no background in nuclear waste issues. In addition, this document is not a comprehensive examination of nuclear waste issues but should instead serve as a general introduction to the subject. Owing to changes in the nuclear waste management system, program activities by the US Department of Energy and other federal agencies and developing technologies, much of this information is dated quickly. While this report uses the most recent data available, readers should keep in mind that some of the material is subject to rapid change. SSEB plans periodic updates in the future to account for changes in the program. Replacement pages sew be supplied to all parties in receipt of this publication provided they remain on the SSEB mailing list

  17. Spent fuel and high-level radioactive waste transportation report

    International Nuclear Information System (INIS)

    1990-11-01

    This publication is intended to provide its readers with an introduction to the issues surrounding the subject of transportation of spent nuclear fuel and high-level radioactive waste, especially as those issues impact the southern region of the United States. It was originally issued by the Southern States Energy Board (SSEB) in July 1987 as the Spent Nuclear Fuel and High-Level Radioactive Waste Transportation Primer, a document patterned on work performed by the Western Interstate Energy Board and designed as a ''comprehensive overview of the issues.'' This work differs from that earlier effort in that it is designed for the educated layman with little or no background in nuclear waste issues. In addition, this document is not a comprehensive examination of nuclear waste issues but should instead serve as a general introduction to the subject. Owing to changes in the nuclear waste management system, program activities by the US Department of Energy and other federal agencies and developing technologies, much of this information is dated quickly. While this report uses the most recent data available, readers should keep in mind that some of the material is subject to rapid change. SSEB plans periodic updates in the future to account for changes in the program. Replacement pages will be supplied to all parties in receipt of this publication provided they remain on the SSEB mailing list

  18. HIV provider and patient perspectives on the Development of a Health Department “Data to Care” Program: a qualitative study

    Directory of Open Access Journals (Sweden)

    Julia C. Dombrowski

    2016-06-01

    Full Text Available Abstract Background U.S. health departments have not historically used HIV surveillance data for disease control interventions with individuals, but advances in HIV treatment and surveillance are changing public health practice. Many U.S. health departments are in the early stages of implementing “Data to Care” programs to assists persons living with HIV (PLWH with engaging in care, based on information collected for HIV surveillance. Stakeholder engagement is a critical first step for development of these programs. In Seattle-King County, Washington, the health department conducted interviews with HIV medical care providers and PLWH to inform its Data to Care program. This paper describes the key themes of these interviews and traces the evolution of the resulting program. Methods Disease intervention specialists conducted individual, semi-structured qualitative interviews with 20 PLWH randomly selected from HIV surveillance who had HIV RNA levels >10,000 copies/mL in 2009–2010. A physician investigator conducted key informant interviews with 15 HIV medical care providers. Investigators analyzed de-identified interview transcripts, developed a codebook of themes, independently coded the interviews, and identified codes used most frequently as well as illustrative quotes for these key themes. We also trace the evolution of the program from 2010 to 2015. Results PLWH generally accepted the idea of the health department helping PLWH engage in care, and described how hearing about the treatment experiences of HIV seropositive peers would assist them with engagement in care. Although many physicians were supportive of the Data to Care concept, others expressed concern about potential health department intrusion on patient privacy and the patient-physician relationship. Providers emphasized the need for the health department to coordinate with existing efforts to improve patient engagement. As a result of the interviews, the Data to Care

  19. Healthcare service providers' and facility administrators' perspectives of the free maternal healthcare services policy in Malindi District, Kenya: a qualitative study.

    Science.gov (United States)

    Lang'at, Evaline; Mwanri, Lillian

    2015-06-27

    Globally, there are increasing efforts to improve maternal health outcomes including the reduction in maternal mortality rates. Improved access to skilled care utilisation during pregnancy and delivery has been one of the strategies employed to improve maternal health outcomes. In Kenya, more than half of the women deliver without the assistance of a skilled attendant and this has contributed to high maternal mortality rates. The free maternal healthcare services policy in all public facilities was initiated as a strategy to improve access to skilled care and reduce poor maternal health outcomes. This study aimed to explore the perspectives of the service providers and facility administrators of the free maternal health care service policy that was introduced in Kenya in 2013. A qualitative inquiry using semi-structured one-on-one interviews was conducted in Malindi District, Kenya. The participants included maternal health service providers and facility administrators recruited from five different healthcare facilities. Data were analysed using a thematic framework analysis. Free maternal healthcare service provision was perceived to boost skilled care utilisation during pregnancy and delivery. However, challenges including; delays in the reimbursement of funds by the government to the facilities, stock outs of essential commodities in the facilities to facilitate service provision, increased workload amidst staff shortage and lack of consultation and sensitisation of key stakeholders were perceived as barriers to effective implementation of this policy. Free maternal healthcare services can be one of the strategies to improve a range of maternal health outcomes. However, the implementation of this policy would be more effective if; the healthcare facilities were upgraded, equipped with adequate supplies, funds and staff; the community are continually sensitized on the importance of seeking skilled care during pregnancy and delivery; and inclusivity and

  20. Lung cancer, caring for the caregivers. A qualitative study of providing pro-active social support targeted to the carers of patients with lung cancer.

    Science.gov (United States)

    Ryan, P J; Howell, V; Jones, J; Hardy, E J

    2008-04-01

    Carers of patients with lung cancer often have a short time to access the support they require. The Macmillan Carers Project (MCP) was set up to provide non-clinical social support targeted in the community to the carers of patients with lung cancer and this study describes its evaluation. Prospective case study using interviews with the carers, project workers and health and social care professionals to obtain qualitative data for thematic analysis. 81 patients' carers received support from the MCP; 20 carers, 2 MCP workers and their manager and 10 other professionals (chest consultant physician, lung cancer clinical nurse specialist, GP, four Macmillan nurses, hospice social worker and two community social workers) were interviewed. Patients were predominantly male (62%), mean age 71 years and carers were predominantly female (70%) mean age 63 years. Carers identified the MCP as providing emotional support, more time, practical help, financial advice, information and back-up for a myriad of problems. Although there was some overlap with other services, the MCP was valued by carers and professionals as filling a gap in social care. The unique aspect of this study was support targeted to the carers of a single cancer site (lung) rather than generic cancer support. As lung cancer may progress rapidly, patients and their carers have a short time to gather new information, access services and adjust to their new circumstances and roles. By focusing on the needs of carers from the time of lung cancer diagnosis, we have shown that the MCP was a valued additional service, well received by carers, patients and professionals.

  1. Progress in the High Level Trigger Integration

    CERN Multimedia

    Cristobal Padilla

    2007-01-01

    During the week from March 19th to March 23rd, the DAQ/HLT group performed another of its technical runs. On this occasion the focus was on integrating the Level 2 and Event Filter triggers, with a much fuller integration of HLT components than had been done previously. For the first time this included complete trigger slices, with a menu to run the selection algorithms for muons, electrons, jets and taus at the Level-2 and Event Filter levels. This Technical run again used the "Pre-Series" system (a vertical slice prototype of the DAQ/HLT system, see the ATLAS e-news January issue for details). Simulated events, provided by our colleagues working in the streaming tests, were pre-loaded into the ROS (Read Out System) nodes. These are the PC's where the data from the detector is stored after coming out of the front-end electronics, the "first part of the TDAQ system" and the interface to the detectors. These events used a realistic beam interaction mixture and had been subjected to a Level-1 selection. The...

  2. High-level waste management technology program plan

    International Nuclear Information System (INIS)

    Harmon, H.D.

    1995-01-01

    The purpose of this plan is to document the integrated technology program plan for the Savannah River Site (SRS) High-Level Waste (HLW) Management System. The mission of the SRS HLW System is to receive and store SRS high-level wastes in a see and environmentally sound, and to convert these wastes into forms suitable for final disposal. These final disposal forms are borosilicate glass to be sent to the Federal Repository, Saltstone grout to be disposed of on site, and treated waste water to be released to the environment via a permitted outfall. Thus, the technology development activities described herein are those activities required to enable successful accomplishment of this mission. The technology program is based on specific needs of the SRS HLW System and organized following the systems engineering level 3 functions. Technology needs for each level 3 function are listed as reference, enhancements, and alternatives. Finally, FY-95 funding, deliverables, and schedules are s in Chapter IV with details on the specific tasks that are funded in FY-95 provided in Appendix A. The information in this report represents the vision of activities as defined at the beginning of the fiscal year. Depending on emergent issues, funding changes, and other factors, programs and milestones may be adjusted during the fiscal year. The FY-95 SRS HLW technology program strongly emphasizes startup support for the Defense Waste Processing Facility and In-Tank Precipitation. Closure of technical issues associated with these operations has been given highest priority. Consequently, efforts on longer term enhancements and alternatives are receiving minimal funding. However, High-Level Waste Management is committed to participation in the national Radioactive Waste Tank Remediation Technology Focus Area. 4 refs., 5 figs., 9 tabs

  3. High-level waste management technology program plan

    Energy Technology Data Exchange (ETDEWEB)

    Harmon, H.D.

    1995-01-01

    The purpose of this plan is to document the integrated technology program plan for the Savannah River Site (SRS) High-Level Waste (HLW) Management System. The mission of the SRS HLW System is to receive and store SRS high-level wastes in a see and environmentally sound, and to convert these wastes into forms suitable for final disposal. These final disposal forms are borosilicate glass to be sent to the Federal Repository, Saltstone grout to be disposed of on site, and treated waste water to be released to the environment via a permitted outfall. Thus, the technology development activities described herein are those activities required to enable successful accomplishment of this mission. The technology program is based on specific needs of the SRS HLW System and organized following the systems engineering level 3 functions. Technology needs for each level 3 function are listed as reference, enhancements, and alternatives. Finally, FY-95 funding, deliverables, and schedules are s in Chapter IV with details on the specific tasks that are funded in FY-95 provided in Appendix A. The information in this report represents the vision of activities as defined at the beginning of the fiscal year. Depending on emergent issues, funding changes, and other factors, programs and milestones may be adjusted during the fiscal year. The FY-95 SRS HLW technology program strongly emphasizes startup support for the Defense Waste Processing Facility and In-Tank Precipitation. Closure of technical issues associated with these operations has been given highest priority. Consequently, efforts on longer term enhancements and alternatives are receiving minimal funding. However, High-Level Waste Management is committed to participation in the national Radioactive Waste Tank Remediation Technology Focus Area. 4 refs., 5 figs., 9 tabs.

  4. High-Level Synthesis: Productivity, Performance, and Software Constraints

    Directory of Open Access Journals (Sweden)

    Yun Liang

    2012-01-01

    Full Text Available FPGAs are an attractive platform for applications with high computation demand and low energy consumption requirements. However, design effort for FPGA implementations remains high—often an order of magnitude larger than design effort using high-level languages. Instead of this time-consuming process, high-level synthesis (HLS tools generate hardware implementations from algorithm descriptions in languages such as C/C++ and SystemC. Such tools reduce design effort: high-level descriptions are more compact and less error prone. HLS tools promise hardware development abstracted from software designer knowledge of the implementation platform. In this paper, we present an unbiased study of the performance, usability and productivity of HLS using AutoPilot (a state-of-the-art HLS tool. In particular, we first evaluate AutoPilot using the popular embedded benchmark kernels. Then, to evaluate the suitability of HLS on real-world applications, we perform a case study of stereo matching, an active area of computer vision research that uses techniques also common for image denoising, image retrieval, feature matching, and face recognition. Based on our study, we provide insights on current limitations of mapping general-purpose software to hardware using HLS and some future directions for HLS tool development. We also offer several guidelines for hardware-friendly software design. For popular embedded benchmark kernels, the designs produced by HLS achieve 4X to 126X speedup over the software version. The stereo matching algorithms achieve between 3.5X and 67.9X speedup over software (but still less than manual RTL design with a fivefold reduction in design effort versus manual RTL design.

  5. Heat transfer in high-level waste management

    International Nuclear Information System (INIS)

    Dickey, B.R.; Hogg, G.W.

    1979-01-01

    Heat transfer in the storage of high-level liquid wastes, calcining of radioactive wastes, and storage of solidified wastes are discussed. Processing and storage experience at the Idaho Chemical Processing Plant are summarized for defense high-level wastes; heat transfer in power reactor high-level waste processing and storage is also discussed

  6. Conceptualization of a hypothetical high-level nuclear waste repository site in unsaturated, fractured tuff

    International Nuclear Information System (INIS)

    Parsons, A.M.; Olague, N.E.; Gallegos, D.P.

    1991-01-01

    Under the sponsorship of the US Nuclear Regulatory Commission (NRC), Sandia National Laboratories (SNL) is developing a performance assessment methodology for the analysis of long-term disposal and isolation of high-level nuclear wastes (HLW) in alternative geologic media. As part of this exercise, SNL created a conceptualization of ground-water flow and radionuclide transport in the far field of a hypothetical HLW repository site located in unsaturated, fractured tuff formations. This study provides a foundation for the development of conceptual mathematical, and numerical models to be used in this performance assessment methodology. This conceptualization is site specific in terms of geometry, the regional ground-water flow system, stratigraphy, and structure in that these are based on information from Yucca Mountain located on the Nevada Test Site. However, in terms of processes in unsaturated, fractured, porous media, the model is generic. This report also provides a review and evaluation of previously proposed conceptual models of unsaturated and saturated flow and solute transport. This report provides a qualitative description of a hypothetical HLW repository site in fractured tuff. However, evaluation of the current knowledge of flow and transport at Yucca Mountain does not yield a single conceptual model. Instead, multiple conceptual models are possible given the existing information

  7. Conceptualization of a hypothetical high-level nuclear waste repository site in unsaturated, fractured tuff

    Energy Technology Data Exchange (ETDEWEB)

    Parsons, A.M.; Olague, N.E.; Gallegos, D.P. [Sandia National Labs., Albuquerque, NM (USA)

    1991-01-01

    Under the sponsorship of the US Nuclear Regulatory Commission (NRC), Sandia National Laboratories (SNL) is developing a performance assessment methodology for the analysis of long-term disposal and isolation of high-level nuclear wastes (HLW) in alternative geologic media. As part of this exercise, SNL created a conceptualization of ground-water flow and radionuclide transport in the far field of a hypothetical HLW repository site located in unsaturated, fractured tuff formations. This study provides a foundation for the development of conceptual mathematical, and numerical models to be used in this performance assessment methodology. This conceptualization is site specific in terms of geometry, the regional ground-water flow system, stratigraphy, and structure in that these are based on information from Yucca Mountain located on the Nevada Test Site. However, in terms of processes in unsaturated, fractured, porous media, the model is generic. This report also provides a review and evaluation of previously proposed conceptual models of unsaturated and saturated flow and solute transport. This report provides a qualitative description of a hypothetical HLW repository site in fractured tuff. However, evaluation of the current knowledge of flow and transport at Yucca Mountain does not yield a single conceptual model. Instead, multiple conceptual models are possible given the existing information.

  8. Alternatives Generation and Analysis for Heat Removal from High Level Waste Tanks

    Energy Technology Data Exchange (ETDEWEB)

    WILLIS, W.L.

    2000-06-15

    This document addresses the preferred combination of design and operational configurations to provide heat removal from high-level waste tanks during Phase 1 waste feed delivery to prevent the waste temperature from exceeding tank safety requirement limits. An interim decision for the preferred method to remove the heat from the high-level waste tanks during waste feed delivery operations is presented herein.

  9. Alternatives Generation and Analysis for Heat Removal from High Level Waste Tanks

    International Nuclear Information System (INIS)

    WILLIS, W.L.

    2000-01-01

    This document addresses the preferred combination of design and operational configurations to provide heat removal from high-level waste tanks during Phase 1 waste feed delivery to prevent the waste temperature from exceeding tank safety requirement limits. An interim decision for the preferred method to remove the heat from the high-level waste tanks during waste feed delivery operations is presented herein

  10. A high-level language for rule-based modelling.

    Science.gov (United States)

    Pedersen, Michael; Phillips, Andrew; Plotkin, Gordon D

    2015-01-01

    Rule-based languages such as Kappa excel in their support for handling the combinatorial complexities prevalent in many biological systems, including signalling pathways. But Kappa provides little structure for organising rules, and large models can therefore be hard to read and maintain. This paper introduces a high-level, modular extension of Kappa called LBS-κ. We demonstrate the constructs of the language through examples and three case studies: a chemotaxis switch ring, a MAPK cascade, and an insulin signalling pathway. We then provide a formal definition of LBS-κ through an abstract syntax and a translation to plain Kappa. The translation is implemented in a compiler tool which is available as a web application. We finally demonstrate how to increase the expressivity of LBS-κ through embedded scripts in a general-purpose programming language, a technique which we view as generally applicable to other domain specific languages.

  11. High-level radioactive-waste-disposal investigations in Texas

    International Nuclear Information System (INIS)

    Smith, R.D.

    1983-01-01

    The Texas Energy and Natural Resources Advisory Council (TENRAC) was designated in 1980 to coordinate the interaction between the State of Texas and the federal government relating to the high-level radioactive waste disposal issue. This report was prepared to summarize the many aspects of that issue with particular emphasis on the activities in Texas. The report is intended to provide a comprehensive introduction for individuals with little or no previous exposure to the issue and to provide a broader perspective for those individuals who have addressed specific aspects of the issue but have not had the opportunity to study it in a broader context. Following the introduction, contents of this report are as follows: (1) general status of major repository siting investigations in the US; (2) detailed review of Texas studies; (3) possible facilities to be sited in Texas; (4) current Texas policy; (5) federal regulations; and (6) federal legislation. 9 figures, 2 tables

  12. A qualitative study on knowledge, perceptions, and attitudes of mothers and health care providers toward pneumococcal conjugate vaccine in Bandung, West Java, Indonesia.

    Science.gov (United States)

    Harjaningrum, Agnes Tri; Kartasasmita, Cissy; Orne-Gliemann, Joanna; Jutand, Marthe-Aline; Goujon, Nicolas; Koeck, Jean-Louis

    2013-03-01

    Due to the high burden of pneumonia in Indonesia, the inclusion of pneumococcal conjugate vaccine (PCV) into Indonesia's National Immunization Program (NIP) is recommended by World Health Organization. Prior to the introduction of new vaccines, it is imperative to assess the perceptions of the public and medical community about the disease and the vaccine. The purpose of this qualitative study was to explore the knowledge, perceptions, and attitudes of mothers and health care providers (HCPs) toward PCV in Bandung, West Java, Indonesia. Fifty-five respondents (26 mothers and 29 HCPs) were interviewed at public and private health care facilities in Bandung using semi-structured interviews in May-June 2011. Data were analyzed manually according to pre-defined themes. Although most mothers had low knowledge about PCV, did not perceive themselves as susceptible to the disease, perceived that cost was the main barrier to PCV access, and obtained little information on PCV, they considered pneumonia as a severe disease and a priority health problem, perceived benefits of the vaccine, and were likely to adopt it. Similarly, knowledge about PCV among most HCPs was limited. Despite perceiving cost as the main barrier, most HCPs perceived benefits of the vaccine, susceptibility and severity of the disease, regarded pneumonia as a priority health problem, and were likely to suggest the new vaccination. Despite the poor knowledge of mothers and HCPs about PCV, they are aware of the high burden of pneumonia and the need for a vaccine in the NIP. Perceived severity and benefits among mothers, and, additionally, perceived susceptibility among HCPs were manifested in the willingness to accept PCV. The findings would contribute to better understanding the factors, which could support decision-making about vaccine introduction, and be utilized for developing suitable messages for mothers and HCPs. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. Tanzanian farmers' knowledge and attitudes to GM biotechnology and the potential use of GM crops to provide improved levels of food security. A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Herron Caroline M

    2010-07-01

    Full Text Available Abstract Background Genetically Modified (GM crops have been championed as one possible method to improve food security and individual nutritional status in sub Saharan Africa. Understanding and acceptability of GM crop technology to farmers and consumers have not been assessed. We developed a qualitative research study involving farmers as both producers and consumers to gauge the understanding of GM crop technology, its acceptability, and identifying issues of concern. Methods Nineteen individual interviews (10 male and 9 female and five mixed gender focus group discussions with local farmers were conducted in 3 regions in Tanzania. Analysis took place concurrently with data collection. Following initial interviews, subsequent questions were adjusted based on emerging themes. Results Understanding, awareness and knowledge of GM crop technology and terminology and its potential risks and benefits was very poor in all regions. Receptivity to the potential use of GM crops was, however, high. Respondents focused on the potential benefits of GM crops rather than any potential longer term health risks. A number of factors, most significantly field trial data, would influence farmers' decisions regarding the introduction of GM crop varieties into their farming practice. Understanding of the potential improved health provision possible by changes in agricultural practice and food-related decision making, and the health benefits of a diet containing essential vitamins, minerals and micronutrients is also poor in these communities. Conclusion This study forms a basis from which further research work can be undertaken. It is important to continue to assess opinions and attitudes of farmers and consumers in sub Saharan Africa towards potential use of GM technologies whilst highlighting the importance of the relationship between agriculture, health and development. This will allow people in the region to make accurate, informed decisions about whether they

  14. Tanzanian farmers' knowledge and attitudes to GM biotechnology and the potential use of GM crops to provide improved levels of food security. A Qualitative Study.

    Science.gov (United States)

    Lewis, Christopher P; Newell, James N; Herron, Caroline M; Nawabu, Haidari

    2010-07-12

    Genetically Modified (GM) crops have been championed as one possible method to improve food security and individual nutritional status in sub Saharan Africa. Understanding and acceptability of GM crop technology to farmers and consumers have not been assessed. We developed a qualitative research study involving farmers as both producers and consumers to gauge the understanding of GM crop technology, its acceptability, and identifying issues of concern. Nineteen individual interviews (10 male and 9 female) and five mixed gender focus group discussions with local farmers were conducted in 3 regions in Tanzania. Analysis took place concurrently with data collection. Following initial interviews, subsequent questions were adjusted based on emerging themes. Understanding, awareness and knowledge of GM crop technology and terminology and its potential risks and benefits was very poor in all regions. Receptivity to the potential use of GM crops was, however, high. Respondents focused on the potential benefits of GM crops rather than any potential longer term health risks. A number of factors, most significantly field trial data, would influence farmers' decisions regarding the introduction of GM crop varieties into their farming practice. Understanding of the potential improved health provision possible by changes in agricultural practice and food-related decision making, and the health benefits of a diet containing essential vitamins, minerals and micronutrients is also poor in these communities. This study forms a basis from which further research work can be undertaken. It is important to continue to assess opinions and attitudes of farmers and consumers in sub Saharan Africa towards potential use of GM technologies whilst highlighting the importance of the relationship between agriculture, health and development. This will allow people in the region to make accurate, informed decisions about whether they believe use of GM biotechnology is an appropriate way in which

  15. Barriers and Benefits in Telemedicine Arising Between a High-Technology Hospital Service Provider and Remote Public Healthcare Units: A Qualitative Study in Brazil.

    Science.gov (United States)

    de Souza, Carlos Henrique Amaral; Morbeck, Renata Albaladejo; Steinman, Milton; Hors, Cora Pereira; Bracco, Mario Maia; Kozasa, Elisa H; Leão, Eliseth Ribeiro

    2017-06-01

    In Brazil, the Program for Institutional Development of the Unified Healthcare System (PROADI-SUS) has implemented a telemedicine service for urgent situations and emergencies. It is delivered by a high-technology (HT) hospital to 15 remote healthcare units (RUs) in 11 different Brazilian states. The aim of this study was to investigate possible barriers and benefits in telemedicine service among these units. We performed a qualitative study on the perceptions of physicians involved in telemedicine service in their role as providers and consultants. An individual, semistructured recorded interview was conducted with 28 physicians (17 HT; 11 RU) encompassing telemedicine resources and interaction among HT and RU physicians. Data analysis was performed by Discourse of Collective Subject. We identified the following barriers in the telemedicine service: (1) lack of experience in the use of technology or the quality of the internet signal; (2) the multiplicity of different telemedicine platforms; (3) the quality of the image sent to the HT hospital; (4) the misunderstanding that telemedicine is a time-consuming technology instead of a resource that may help to save lives; (5) not feeling comfortable exposing doubts to other HT colleagues; (6) problems in the management of telemedicine use in the RUs; and (7) political and legal issues. However, important benefits in telemedicine service were also described. The structural barriers should be the target of hospital managers. Development of standard remote care protocols may increase the use of telemedicine and create new work routines. Given the relationship difficulties among the RU and HT doctors during telemedicine consultations, other meetings should be organized to allow more interpersonal interactions. These meetings may also have the goal of sharing outcome indicators of their joint activity in telemedicine to stimulate and make them aware of the benefits of their interaction.

  16. Why do we not want to recommend influenza vaccination to young children? A qualitative study of Australian parents and primary care providers.

    Science.gov (United States)

    Biezen, Ruby; Grando, Danilla; Mazza, Danielle; Brijnath, Bianca

    2018-02-01

    Influenza vaccination has been shown to be safe and effective against influenza and in the prevention of complicating secondary respiratory illnesses. However, its uptake in young children remains low. This study explored the views, attitudes and practices of parents and primary care providers (PCPs) on their knowledge and acceptance of influenza vaccination in children under 5. Using a cross-sectional qualitative research design, we conducted 30 in-depth interviews with PCPs (i.e., general practitioners, practice nurses, maternal and child health nurses, and pharmacists) and five focus groups with parents (n = 50) between June 2014 and July 2015 in Melbourne, Australia. Data were thematically analysed. Parents thought the vaccine could cause influenza, and influenza vaccination was not necessary for their children as they needed to build their own 'immunity'. Parents said that they would consider vaccinating their children if recommended by their GP and if the influenza vaccine was part of the immunisation schedule. PCPs also expressed concerns regarding the efficacy of the vaccine as well as out-of-pocket costs incurred by families, and uncertainty regarding the mortality and morbidity of influenza in otherwise healthy children. However, they said they would recommend the vaccine to high-risk groups (e.g. children with chronic disease(s), and asthma). Despite the established safety of influenza vaccines, barriers to uptake include concerns regarding the iatrogenic effects of vaccination, its administration schedule, and knowledge of influenza severity. Updated information on influenza and the efficacy of the vaccine, and incorporating influenza vaccination into the immunisation schedule may overcome some of these barriers to increase influenza vaccination in this vulnerable cohort. Copyright © 2018 Elsevier Ltd. All rights reserved.

  17. On risk assessment of high level radioactive waste disposal

    International Nuclear Information System (INIS)

    Smith, C.F.; Kastenberg, W.E.

    1976-01-01

    One of the major concerns with the continued growth of the nuclear power industry is the production of the high level radioactive wastes. The risks associated with the disposal of these wastes derives from the potential for release of radioactive materials into the environment. The development of a methodology for risk analysis is carried out. The methodology suggested involves the probabilistic analysis of a general accident consequence distribution. In this analysis, the frequency aspect of the distribution is treated separately from the normalized probability function. In the final stage of the analysis, the frequency and probability characteristics of the distribution are recombined to provide an estimate of the risk. The characterization of the radioactive source term is accomplished using the ORIGEN computer code. Calculations are carried out for various reactor types and fuel cycles, and the overall waste hazard for a projected 35 year nuclear power program is determined. An index of relative nuclide hazard appropriate to problems involving the management of high level radioactive wastes is developed. As an illustration of the methodology, risk analyses are made for two proposed methods for waste management: extraterrestrial disposal and interim surface storage. The results of these analyses indicate that, within the assumptions used, the risks of these management schemes are small compared with natural background radiation doses. (Auth.)

  18. Hip Arthroscopy in High-Level Baseball Players.

    Science.gov (United States)

    Byrd, J W Thomas; Jones, Kay S

    2015-08-01

    To report the results of hip arthroscopy among high-level baseball players as recorded by outcome scores and return to baseball. All patients undergoing hip arthroscopy were prospectively assessed with the modified Harris Hip Score. On review of all procedures performed over a 12-year period, 44 hips were identified among 41 intercollegiate or professional baseball players who had achieved 2-year follow-up. Among the 41 players, follow-up averaged 45 months (range, 24 to 120 months), with a mean age of 23 years (range, 18 to 34 years). There were 23 collegiate (1 bilateral) and 18 professional (2 bilateral) baseball players, including 10 Major League Baseball players. Of the 8 Major League Baseball pitchers, 6 (75%) also underwent ulnar collateral ligament elbow surgery. Improvement in the modified Harris Hip Score averaged 13 points (from 81 points preoperatively to 94 points postoperatively); a paired-samples t test determined that this mean improvement of 13 points was statistically significant (P arthroscopy. This study supports the idea that arthroscopic treatment for a variety of hip pathologies in high-level baseball players provides a successful return to sport and improvement in functional outcome scores. Level IV, therapeutic case series. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  19. Risk assessments for the disposal of high level radioactive wastes

    International Nuclear Information System (INIS)

    Smith, C.F.

    1975-01-01

    The risks associated with the disposal of high level wastes derive from the potential for release of radioactive materials into the environment. The assessment of these risks requires a methodology for risk analysis, an identification of the radioactive sources, and a method by which to express the relative hazard of the various radionuclides that comprise the high level waste. The development of a methodology for risk analysis is carried out after a review of previous work in the area of probabilistic risk assessment. The methodology suggested involves the probabilistic analysis of a general accident consequence distribution. In this analysis, the frequency aspect of the distribution is treated separately from the normalized probability function. At the final stage of the analysis, the frequency and probability characteristics of the distribution are recombined to provide an estimate of the risk. The characterization of the radioactive source term is accomplished using the ORIGEN computer code. Calculations are carried out for various reactor types and fuel cycles, and the overall waste hazard for a projected thirty-five year nuclear power program is determined

  20. Permitting plan for the high-level waste interim storage

    International Nuclear Information System (INIS)

    Deffenbaugh, M.L.

    1997-01-01

    This document addresses the environmental permitting requirements for the transportation and interim storage of solidified high-level waste (HLW) produced during Phase 1 of the Hanford Site privatization effort. Solidified HLW consists of canisters containing vitrified HLW (glass) and containers that hold cesium separated during low-level waste pretreatment. The glass canisters and cesium containers will be transported to the Canister Storage Building (CSB) in a U.S. Department of Energy (DOE)-provided transportation cask via diesel-powered tractor trailer. Tri-Party Agreement (TPA) Milestone M-90 establishes a new major milestone, and associated interim milestones and target dates, governing acquisition and/or modification of facilities necessary for: (1) interim storage of Tank Waste Remediation Systems (TWRS) immobilized HLW (IHLW) and other canistered high-level waste forms; and (2) interim storage and disposal of TWRS immobilized low-activity tank waste (ILAW). An environmental requirements checklist and narrative was developed to identify the permitting path forward for the HLW interim storage (HLWIS) project (See Appendix B). This permitting plan will follow the permitting logic developed in that checklist

  1. Qualitative study to explore the health and well-being impacts on adults providing informal support to female domestic violence survivors.

    Science.gov (United States)

    Gregory, Alison; Feder, Gene; Taket, Ann; Williamson, Emma

    2017-03-24

    Domestic violence (DV) is hazardous to survivors' health, from injuries sustained and from resultant chronic physical and mental health problems. Support from friends and relatives is significant in the lives of DV survivors; research shows associations between positive support and the health, well-being and safety of survivors. Little is known about how people close to survivors are impacted. The aim of this study was exploratory, with the following research question: what are the health and well-being impacts on adults who provide informal support to female DV survivors? A qualitative study using semistructured interviews conducted face to face, by telephone or using Skype. A thematic analysis of the narratives was carried out. Community-based, across the UK. People were eligible to take part if they had had a close relationship (either as friend, colleague or family member) with a woman who had experienced DV, and were aged 16 or over during the time they knew the survivor. Participants were recruited via posters in community venues, social media and radio advertisement. 23 participants were recruited and interviewed; the majority were women, most were white and ages ranged from mid-20s to 80. Generated themes included: negative impacts on psychological and emotional well-being of informal supporters, and related physical health impacts. Some psychological impacts were over a limited period; others were chronic and had the potential to be severe and enduring. The impacts described suggested that those providing informal support to survivors may be experiencing secondary traumatic stress as they journey alongside the survivor. Friends and relatives of DV survivors experience substantial impact on their own health and well-being. There are no direct services to support this group. These findings have practical and policy implications, so that the needs of informal supporters are legitimised and met. Published by the BMJ Publishing Group Limited. For permission to

  2. Midwestern High-Level Radioactive Waste Transportation Project

    International Nuclear Information System (INIS)

    Dantoin, T.S.

    1990-12-01

    For more than half a century, the Council of State Governments has served as a common ground for the states of the nation. The Council is a nonprofit, state-supported and -directed service organization that provides research and resources, identifies trends, supplies answers and creates a network for legislative, executive and judicial branch representatives. This List of Available Resources was prepared with the support of the US Department of Energy, Cooperative Agreement No. DE-FC02-89CH10402. However, any opinions, findings, conclusions, or recommendations expressed herein are those of the author(s) and do not necessarily reflect the views of DOE. The purpose of the agreement, and reports issued pursuant to it, is to identify and analyze regional issues pertaining to the transportation of high-level radioactive waste and to inform Midwestern state officials with respect to technical issues and regulatory concerns related to waste transportation

  3. FADO 2. 0: A high level tagging language

    Energy Technology Data Exchange (ETDEWEB)

    Werner, C.M.L. (European Organization for Nuclear Research, Geneva (Switzerland). EP-Div.); Pimenta, M.; Varela, J. (LIP, Lisbon (Portugal)); Souza, J. (Rio de Janeiro Univ. (Brazil). Coordenacao dos Programas de Pos-graduacao de Engenharia)

    1989-12-01

    FADO 2.0 is a high level language, developed in the context of the 4th level trigger of the DELPHI data acquisition project at CERN, that provides a simple and concise way to define physics criteria for event tagging. Its syntax is based on mathematical logic and set theory, as it was found the most appropriate framework to describe the properties of single HEP events. The language is one of the components of the FADO tagging system. The system also implements implicitly a mechanism to selectively reconstruct the event data that are needed to fulfil the physics criteria, following the speed requirements of the online data-acquisition system. A complete programming environment is now under development, which will include a syntax directed editor, and incremental compiler, a debugger and a configurer. This last tool can be used to transport the system into the context of other HEP applications, namely offline event selection and filtering. (orig.).

  4. Glass formulation for phase 1 high-level waste vitrification

    International Nuclear Information System (INIS)

    Vienna, J.D.; Hrma, P.R.

    1996-04-01

    The purpose of this study is to provide potential glass formulations for prospective Phase 1 High-Level Waste (HLW) vitrification at Hanford. The results reported here will be used to aid in developing a Phase 1 HLW vitrification request for proposal (RFP) and facilitate the evaluation of ensuing proposals. The following factors were considered in the glass formulation effort: impact on total glass volume of requiring the vendor to process each of the tank compositions independently versus as a blend; effects of imposing typical values of B 2 O 3 content and waste loading in HLW borosilicate glasses as restrictions on the vendors (according to WAPS 1995, the typical values are 5--10 wt% B 2 O 3 and 20--40 wt% waste oxide loading); impacts of restricting the processing temperature to 1,150 C on eventual glass volume; and effects of caustic washing on any of the selected tank wastes relative to glass volume

  5. Conceptual process for conversion of high level waste to glass

    International Nuclear Information System (INIS)

    1975-01-01

    During a ten-year period highly radioactive wastes amounting to 22 million gallons of salt cake and 5 million gallons of wet sludge are to be converted to 1.2 million gallons of glass and 24 million gallons of decontaminated salt cake and placed in the new storage facilities which will provide high assurance of containment with minimal reliance on maintenance and surveillance. The glass will contain nearly all of the radioactivity in a form that is highly resistant to leaching and dispersion. The salt cake will contain a small amount of residual radioactivity. The process is shown in Figure 1 and the facilities may be arranged in seven modules to accomplish seven tasks, (1) remove wastes from tanks, (2) separate sludge and salt, (3) decontaminate salt, (4) solidify and package sludge and 137 Cs, (5) solidify and package decontaminated salt, (6) store high level waste, and (7) store decontaminated salt cake

  6. Monitoring of geological repositories for high level radioactive waste

    International Nuclear Information System (INIS)

    2001-04-01

    Geological repositories for disposal of high level radioactive waste are designed to provide isolation of the waste from human environment for many thousands of years. This report discusses the possible purposes for monitoring geological repositories at the different stages of a repository programme, the use that may be made of the information obtained and the techniques that might be applied. This report focuses on the different objectives that monitoring might have at various stages of a programme, from the initiation of work on a candidate site, to the period after repository closure. Each objective may require somewhat different types of information, or may use the same information in different ways. Having evaluated monitoring requirements, the report concludes with a brief evaluation of available monitoring techniques

  7. The development of a high level radioactive waste management strategy

    International Nuclear Information System (INIS)

    Beale, H.

    1979-11-01

    The management of high level radioactive waste, from the removal of spent fuel from reactors to final disposal of vitrified waste, involves a complex choice of operational variables which interact one with another. If the various operations are designed and developed in isolation it will almost certainly lead to suboptimal choice. Management of highly active waste should therefore be viewed as a complete system and analysed in such a way that account is taken of the interactions between the various operations. This system must have clearly defined and agreed objectives as well as criteria against which performance can be judged. A thorough analysis of the system will provide a framework within which the necessary research and development can be carried out in a co-ordinated fashion and lead to an optimised strategy for managing highly active wastes. (author)

  8. High level waste (HLW) steam reducing station evaluation

    International Nuclear Information System (INIS)

    Gannon, R.E.

    1993-01-01

    Existing pressure equipment in High Level Waste does not have a documented technical baseline. Based on preliminary reviews, the existing equipment seems to be based on system required capacity instead of system capability. A planned approach to establish a technical baseline began September 1992 and used the Works Management System preventive maintenance schedule. Several issues with relief valves being undersized on steam reducing stations created a need to determine the risk of maintaining the steam in service. An Action Plan was developed to evaluate relief valves that did not have technical baselines and provided a path forward for continued operation. Based on Action Plan WER-HLE-931042, the steam systems will remain in service while the designs are being developed and implemented

  9. Risk assessment methodology for Hanford high-level waste tanks

    International Nuclear Information System (INIS)

    Bott, T.F.; Mac Farlane, D.R.; Stack, D.W.; Kindinger, J.

    1992-01-01

    A methodology is presented for applying Probabilistic Safety Assessment techniques to quantification of the health risks posed by the high-level waste (HLW) underground tanks at the Department of Energy's Hanford reservation. This methodology includes hazard screening development of a list of potential accident initiators, systems fault trees development and quantification, definition of source terms for various release categories, and estimation of health consequences from the releases. Both airborne and liquid pathway releases to the environment, arising from aerosol and spill/leak releases from the tanks, are included in the release categories. The proposed methodology is intended to be applied to a representative subset of the total of 177 tanks, thereby providing a baseline risk profile for the HLW tank farm that can be used for setting clean-up/remediation priorities. Some preliminary results are presented for Tank 101-SY

  10. High-level radioactive waste glass and storage canister design

    International Nuclear Information System (INIS)

    Slate, S.C.; Ross, W.A.

    1979-01-01

    Management of high-level radioactive wastes is a primary concern in nuclear operations today. The main objective in managing these wastes is to convert them into a solid, durable form which is then isolated from man. A description is given of the design and evaluation of this waste form. The waste form has two main components: the solidified waste and the storage canister. The solid waste form discussed in this study is glass. Waste glasses have been designed to be inert to water attack, physically rugged, low in volatility, and stable over time. Two glass-making processes are under development at PNL. The storage canister is being designed to provide high-integrity containment for solidified wastes from processing to terminal storage. An outline is given of the steps in canister design: material selection, stress and thermal analyses, quality verification, and postfill processing. Examples are given of results obtained from actual nonradioactive demonstration tests. 14 refs

  11. Supervision of the ATLAS High Level Trigger System

    CERN Document Server

    Wheeler, S.; Meessen, C.; Qian, Z.; Touchard, F.; Negri, France A.; Zobernig, H.; CHEP 2003 Computing in High Energy Physics; Negri, France A.

    2003-01-01

    The ATLAS High Level Trigger (HLT) system provides software-based event selection after the initial LVL1 hardware trigger. It is composed of two stages, the LVL2 trigger and the Event Filter. The HLT is implemented as software tasks running on large processor farms. An essential part of the HLT is the supervision system, which is responsible for configuring, coordinating, controlling and monitoring the many hundreds of processes running in the HLT. A prototype implementation of the supervision system, using tools from the ATLAS Online Software system is presented. Results from scalability tests are also presented where the supervision system was shown to be capable of controlling over 1000 HLT processes running on 230 nodes.

  12. National high-level waste systems analysis plan

    International Nuclear Information System (INIS)

    Kristofferson, K.; Oholleran, T.P.; Powell, R.H.; Thiel, E.C.

    1995-05-01

    This document details the development of modeling capabilities that can provide a system-wide view of all US Department of Energy (DOE) high-level waste (HLW) treatment and storage systems. This model can assess the impact of budget constraints on storage and treatment system schedules and throughput. These impacts can then be assessed against existing and pending milestones to determine the impact to the overall HLW system. A nation-wide view of waste treatment availability will help project the time required to prepare HLW for disposal. The impacts of the availability of various treatment systems and throughput can be compared to repository readiness to determine the prudent application of resources or the need to renegotiate milestones

  13. Impact of a nationwide study for surveillance of maternal near-miss on the quality of care provided by participating centers: a quantitative and qualitative approach

    Science.gov (United States)

    2014-01-01

    Background The Brazilian Network for Surveillance of Severe Maternal Morbidity was established in 27 centers in different regions of Brazil to investigate the frequency of severe maternal morbidity (near-miss and potentially life-threatening conditions) and associated factors, and to create a collaborative network for studies on perinatal health. It also allowed interventions aimed at improving the quality of care in the participating institutions. The objective of this study was to evaluate the perception of the professionals involved regarding the effect of participating in such network on the quality of care provided to women. Methods A mixed quantitative and qualitative study interviewed coordinators, investigators and managers from all the 27 obstetric units that had participated in the network. Following verbal informed consent, data were collected six and twelve months after the surveillance period using structured and semi-structured interviews that were conducted by telephone and recorded. A descriptive analysis for the quantitative and categorical data, and a thematic content analysis for the answers to the open questions were performed. Results The vast majority (93%) of interviewees considered it was important to have participated in the network and 95% that their ability to identify cases of severe maternal morbidity had improved. They also considered that the study had a positive effect, leading to changes in how cases were identified, better organization/standardization of team activities, changes in routines/protocols, implementation of auditing for severe cases, dissemination of knowledge at local/regional level and a contribution to local and/or national identification of maternal morbidity. After 12 months, interviewees mentioned the need to improve prenatal care and the scientific importance of the results. Some believed that there had been little or no impact due to the poor dissemination of information and the resistance of professionals to

  14. Too few staff, too many patients: a qualitative study of the impact on obstetric care providers and on quality of care in Malawi.

    Science.gov (United States)

    Bradley, Susan; Kamwendo, Francis; Chipeta, Effie; Chimwaza, Wanangwa; de Pinho, Helen; McAuliffe, Eilish

    2015-03-21

    Shortages of staff have a significant and negative impact on maternal outcomes in low-income countries, but the impact on obstetric care providers in these contexts is less well documented. Despite the government of Malawi's efforts to increase the number of human resources for health, maternal mortality rates remain persistently high. Health workers' perceptions of insufficient staff or time to carry out their work can predict key variables concerning motivation and attrition, while the resulting sub-standard care and poor attitudes towards women dissuade women from facility-based delivery. Understanding the situation from the health worker perspective can inform policy options that may contribute to a better working environment for staff and improved quality of care for Malawi's women. A qualitative research design, using critical incident interviews, was used to generate a deep and textured understanding of participants' experiences. Eligible participants had performed at least one of the emergency obstetric care signal functions (a) in the previous three months and had experienced a demotivating critical incident within the same timeframe. Data were analysed using NVivo software. Eighty-four interviews were conducted. Concerns about staff shortages and workload were key factors for over 40% of staff who stated their intention to leave their current post and for nearly two-thirds of the remaining health workers who were interviewed. The main themes emerging were: too few staff, too many patients; lack of clinical officers/doctors; inadequate obstetric skills; undermining performance and professionalism; and physical and psychological consequences for staff. Underlying factors were inflexible scheduling and staff allocations that made it impossible to deliver quality care. This study revealed the difficult circumstances under which maternity staff are operating and the professional and emotional toll this exacts. Systems failures and inadequate human resource

  15. Evaluation of radionuclide concentrations in high-level radioactive wastes

    International Nuclear Information System (INIS)

    Fehringer, D.J.

    1985-10-01

    This report describes a possible approach for development of a numerical definition of the term ''high-level radioactive waste.'' Five wastes are identified which are recognized as being high-level wastes under current, non-numerical definitions. The constituents of these wastes are examined and the most hazardous component radionuclides are identified. This report suggests that other wastes with similar concentrations of these radionuclides could also be defined as high-level wastes. 15 refs., 9 figs., 4 tabs

  16. High-Level Management of Communication Schedules in HPF-like Languages

    National Research Council Canada - National Science Library

    Benkner, Siegfried

    1997-01-01

    ..., providing the users with a high-level language interface for programming scalable parallel architectures and delegating to the compiler the task of producing an explicitly parallel message-passing program...

  17. Managing commercial high-level radioactive waste: summary

    International Nuclear Information System (INIS)

    1982-04-01

    This summary presents the findings and conclusions of OTA's analysis of Federal policy for the management of commercial high-level radioactive waste - an issue that has been debated over the last decade and that now appears to be moving toward major congressional action. After more than 20 years of commercial nuclear power, the Federal Government has yet to develop a broadly supported policy for fulfilling its legal responsibility for the final isolation of high-level radioactive waste. OTA's study concludes that until such a policy is adopted in law, there is a substantial risk that the false starts, shifts of policy, and fluctuating support that have plagued the final isolation program in the past will continue. The continued lack of final isolation facilities has raised two key problems that underlie debates about radioactive waste policy. First, some question the continued use of nuclear power until it is shown that safe final isolation for the resulting wastes can and will be accomplished, and argue that the failure to develop final isolation facilities is evidence that it may be an insoluble problem. Second, because there are no reprocessing facilities or federal waste isolation facilities to accept spent fuel, existing reactors are running out of spent fuel storage space, and by 1986 some may face a risk of shutting down for some period. Most of the 72,000 metric tons of spent fuel expected to be generated by the year 2000 will still be in temporary storage at that time. While it is possible that utilities could provide all necessary additional storage at reactor sites before existing basins are filled, some supplemental storage may be needed if there are delays in their efforts

  18. Managing the nation's commercial high-level radioactive waste

    International Nuclear Information System (INIS)

    Cotton, T.

    1985-01-01

    With the passage of the Nuclear Waste Policy Act of 1982 (NWPA), Congress for the first time established in law a comprehensive Federal policy for commercial high-level radioactive waste management, including interim storage and permanent disposal. NWPA provides sufficient authority for developing and operating a high-level radioactive waste management system based on disposal in mined geologic repositories. Authorization for other types of waste facilities will not be required unless major problems with geologic disposal are discovered, and studies to date have identified no insurmountable technical obstacles to developing geologic repositories. The NWPA requires the Department of Energy (DOE) to submit to Congress three key documents: (1) a Mission Plan, containing both a waste management plan with a schedule for transferring waste to Federal facilities and an implementation program for choosing sites and developing technologies to carry out that plan; (2) a monitored retrievable storage (MRS) proposal, to include a site-specific design for a long-term federal storage facility, an evaluation of whether such an MRS facility is needed and feasible, and an analysis of how an MRS facility would be integrated with the repository program if authorized by Congress; and (3) a study of alternative institutional mechanisms for financing and managing the radioactive waste system, including the option of establishing an independent waste management organization outside of DOE. The Mission Plan and the report on alternative institutional mechanisms were submitted to the 99th US Congress in 1985. The MRS proposal is to be submitted in early 1986. Each of these documents is discussed following an overview of the Nuclear Waste Policy Act of 1982

  19. High Level Information Fusion (HLIF) with nested fusion loops

    Science.gov (United States)

    Woodley, Robert; Gosnell, Michael; Fischer, Amber

    2013-05-01

    Situation modeling and threat prediction require higher levels of data fusion in order to provide actionable information. Beyond the sensor data and sources the analyst has access to, the use of out-sourced and re-sourced data is becoming common. Through the years, some common frameworks have emerged for dealing with information fusion—perhaps the most ubiquitous being the JDL Data Fusion Group and their initial 4-level data fusion model. Since these initial developments, numerous models of information fusion have emerged, hoping to better capture the human-centric process of data analyses within a machine-centric framework. 21st Century Systems, Inc. has developed Fusion with Uncertainty Reasoning using Nested Assessment Characterizer Elements (FURNACE) to address challenges of high level information fusion and handle bias, ambiguity, and uncertainty (BAU) for Situation Modeling, Threat Modeling, and Threat Prediction. It combines JDL fusion levels with nested fusion loops and state-of-the-art data reasoning. Initial research has shown that FURNACE is able to reduce BAU and improve the fusion process by allowing high level information fusion (HLIF) to affect lower levels without the double counting of information or other biasing issues. The initial FURNACE project was focused on the underlying algorithms to produce a fusion system able to handle BAU and repurposed data in a cohesive manner. FURNACE supports analyst's efforts to develop situation models, threat models, and threat predictions to increase situational awareness of the battlespace. FURNACE will not only revolutionize the military intelligence realm, but also benefit the larger homeland defense, law enforcement, and business intelligence markets.

  20. Estimation of minimum sample size for identification of the most important features: a case study providing a qualitative B2B sales data set

    OpenAIRE

    Marko Bohanec; Mirjana Kljajić Borštnar; Marko Robnik-Šikonja

    2017-01-01

    An important task in machine learning is to reduce data set dimensionality, which in turn contributes to reducing computational load and data collection costs, while improving human understanding and interpretation of models. We introduce an operational guideline for determining the minimum number of instances sufficient to identify correct ranks of features with the highest impact. We conduct tests based on qualitative B2B sales forecasting data. The results show that a relatively small inst...

  1. Tanzanian farmers' knowledge and attitudes to GM biotechnology and the potential use of GM crops to provide improved levels of food security. A Qualitative Study

    OpenAIRE

    Herron Caroline M; Newell James N; Lewis Christopher P; Nawabu Haidari

    2010-01-01

    Abstract Background Genetically Modified (GM) crops have been championed as one possible method to improve food security and individual nutritional status in sub Saharan Africa. Understanding and acceptability of GM crop technology to farmers and consumers have not been assessed. We developed a qualitative research study involving farmers as both producers and consumers to gauge the understanding of GM crop technology, its acceptability, and identifying issues of concern. Methods Nineteen ind...

  2. 40 CFR 227.30 - High-level radioactive waste.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 24 2010-07-01 2010-07-01 false High-level radioactive waste. 227.30...-level radioactive waste. High-level radioactive waste means the aqueous waste resulting from the operation of the first cycle solvent extraction system, or equivalent, and the concentrated waste from...

  3. Discovery of high-level tasks in the operating room

    NARCIS (Netherlands)

    Bouarfa, L.; Jonker, P.P.; Dankelman, J.

    2010-01-01

    Recognizing and understanding surgical high-level tasks from sensor readings is important for surgical workflow analysis. Surgical high-level task recognition is also a challenging task in ubiquitous computing because of the inherent uncertainty of sensor data and the complexity of the operating

  4. Characteristics of solidified high-level waste products

    International Nuclear Information System (INIS)

    1979-01-01

    The object of the report is to contribute to the establishment of a data bank for future preparation of codes of practice and standards for the management of high-level wastes. The work currently in progress on measuring the properties of solidified high-level wastes is being studied

  5. Process for solidifying high-level nuclear waste

    Science.gov (United States)

    Ross, Wayne A.

    1978-01-01

    The addition of a small amount of reducing agent to a mixture of a high-level radioactive waste calcine and glass frit before the mixture is melted will produce a more homogeneous glass which is leach-resistant and suitable for long-term storage of high-level radioactive waste products.

  6. 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

  7. Linear devices in combined high-level radiation environments

    International Nuclear Information System (INIS)

    van Vonno, N.W.

    1987-01-01

    The design of precision analog integrated circuits for use in combined high-level radiation environments has traditionally been on a full-custom basis. The use of semicustom design methods has become prevalent in digital devices, with standard cell libraries and gate arrays readily available from multiple vendors. This paper addresses the application of semicustom design techniques to analog parts. In all cases the emphasis is on bipolar technology, since this provides an optimal combination of precision and radiation hardness. A mixed mode analog/digital (A/D) cell family for implementing semicustom designs is described, together with the fabrication process used. Specific processing and design methods are used to provide circuit hardness against neutron, total gamma dose, and transient gamma environments. Semicustom mixed analog/digital design is seen as an appropriate methodology for implementation of medium-performance mixed mode functions for radiation-hardened applications. This leads to trade-offs in process complexity and performance. Full custom design remains necessary for demanding applications such as high-speed A/D conversion and associated sample/hold functions. An A/D cell family optimized for hardness is described, together with the bipolar process used to implement it

  8. Auto Detection For High Level Water Content For Oil Well

    Science.gov (United States)

    Janier, Josefina Barnachea; Jumaludin, Zainul Arifin B.

    2010-06-01

    Auto detection of high level water content for oil well is a system that measures the percentage of water in crude oil. This paper aims to discuss an auto detection system for measuring the content of water level in crude oil which is applicable for offshore and onshore oil operations. Data regarding water level content from wells can be determined by using automation thus, well with high water level can be determined immediately whether to be closed or not from operations. Theoretically the system measures the percentage of two- fluid mixture where the fluids have different electrical conductivities which are water and crude oil. The system made use of grid sensor which is a grid pattern like of horizontal and vertical wires. When water occupies the space at the intersection of vertical and horizontal wires, an electrical signal is detected which proved that water completed the circuit path in the system. The electrical signals are counted whereas the percentage of water is determined from the total electrical signals detected over electrical signals provided. Simulation of the system using the MultiSIM showed that the system provided the desired result.

  9. Options for the disposal of high-level radioactive waste

    International Nuclear Information System (INIS)

    Mitchell, N.T.; Laughton, A.S.; Webb, G.A.M.

    1977-01-01

    The management of radioactive waste within the fuel cycle, especially the high-level wastes from reprocessing of nuclear fuel, is currently a matter of particular concern. In the short term (meaning a timescale of tens of years) management by engineered storage is considered to provide a satisfactory solution. Beyond this, however, the two main alternative options which are considered in the paper are: (a) disposal by burial into geologic formations on land; and (b) disposal by emplacement into or onto the seabed. Status of our present knowledge on the land and seabed disposal options is reviewed together with an assessment of the extent to which their reliability and safety can be judged on presently available information. Further information is needed on the environmental behaviour of radioactivity in the form of solidified waste in both situations in order to provide a more complete, scientific assessment. Work done so far has clarified the areas where further research is most needed - for instance modelling of the environmental transfer processes associated with the seabed option. This is discussed together with an indication of the research programmes which are now being pursued

  10. PLUTONIUM/HIGH-LEVEL VITRIFIED WASTE BDBE DOSE CALCULATION

    Energy Technology Data Exchange (ETDEWEB)

    J.A. Ziegler

    2000-11-20

    The purpose of this calculation is to provide a dose consequence analysis of high-level waste (HLW) consisting of plutonium immobilized in vitrified HLW to be handled at the proposed Monitored Geologic Repository at Yucca Mountain for a beyond design basis event (BDBE) under expected conditions using best estimate values for each calculation parameter. In addition to the dose calculation, a plutonium respirable particle size for dose calculation use is derived. The current concept for this waste form is plutonium disks enclosed in cans immobilized in canisters of vitrified HLW (i.e., glass). The plutonium inventory at risk used for this calculation is selected from Plutonium Immobilization Project Input for Yucca Mountain Total Systems Performance Assessment (Shaw 1999). The BDBE examined in this calculation is a nonmechanistic initiating event and the sequence of events that follow to cause a radiological release. This analysis will provide the radiological releases and dose consequences for a postulated BDBE. Results may be considered in other analyses to determine or modify the safety classification and quality assurance level of repository structures, systems, and components. This calculation uses best available technical information because the BDBE frequency is very low (i.e., less than 1.0E-6 events/year) and is not required for License Application for the Monitored Geologic Repository. The results of this calculation will not be used as part of a licensing or design basis.

  11. Estimation of minimum sample size for identification of the most important features: a case study providing a qualitative B2B sales data set

    Directory of Open Access Journals (Sweden)

    Marko Bohanec

    2017-01-01

    Full Text Available An important task in machine learning is to reduce data set dimensionality, which in turn contributes to reducing computational load and data collection costs, while improving human understanding and interpretation of models. We introduce an operational guideline for determining the minimum number of instances sufficient to identify correct ranks of features with the highest impact. We conduct tests based on qualitative B2B sales forecasting data. The results show that a relatively small instance subset is sufficient for identifying the most important features when rank is not important.

  12. National high-level waste systems analysis report

    Energy Technology Data Exchange (ETDEWEB)

    Kristofferson, K.; Oholleran, T.P.; Powell, R.H.

    1995-09-01

    This report documents the assessment of budgetary impacts, constraints, and repository availability on the storage and treatment of high-level waste and on both existing and pending negotiated milestones. The impacts of the availabilities of various treatment systems on schedule and throughput at four Department of Energy sites are compared to repository readiness in order to determine the prudent application of resources. The information modeled for each of these sites is integrated with a single national model. The report suggests a high-level-waste model that offers a national perspective on all high-level waste treatment and storage systems managed by the Department of Energy.

  13. National high-level waste systems analysis report

    International Nuclear Information System (INIS)

    Kristofferson, K.; Oholleran, T.P.; Powell, R.H.

    1995-09-01

    This report documents the assessment of budgetary impacts, constraints, and repository availability on the storage and treatment of high-level waste and on both existing and pending negotiated milestones. The impacts of the availabilities of various treatment systems on schedule and throughput at four Department of Energy sites are compared to repository readiness in order to determine the prudent application of resources. The information modeled for each of these sites is integrated with a single national model. The report suggests a high-level-waste model that offers a national perspective on all high-level waste treatment and storage systems managed by the Department of Energy

  14. Decision Document for Heat Removal from High-Level Waste Tanks

    International Nuclear Information System (INIS)

    WILLIS, W.L.

    2000-01-01

    This document establishes the combination of design and operational configurations that will be used to provide heat removal from high-level waste tanks during Phase 1 waste feed delivery to prevent the waste temperature from exceeding tank safety requirement limits. The chosen method--to use the primary and annulus ventilation systems to remove heat from the high-level waste tanks--is documented herein

  15. Generation of Efficient High-Level Hardware Code from Dataflow Programs

    OpenAIRE

    Siret , Nicolas; Wipliez , Matthieu; Nezan , Jean François; Palumbo , Francesca

    2012-01-01

    High-level synthesis (HLS) aims at reducing the time-to-market by providing an automated design process that interprets and compiles high-level abstraction programs into hardware. However, HLS tools still face limitations regarding the performance of the generated code, due to the difficulties of compiling input imperative languages into efficient hardware code. Moreover the hardware code generated by the HLS tools is usually target-dependant and at a low level of abstraction (i.e. gate-level...

  16. Immobilized high-level waste interim storage alternatives generation and analysis and decision report

    International Nuclear Information System (INIS)

    CALMUS, R.B.

    1999-01-01

    This report presents a study of alternative system architectures to provide onsite interim storage for the immobilized high-level waste produced by the Tank Waste Remediation System (TWRS) privatization vendor. It examines the contract and program changes that have occurred and evaluates their impacts on the baseline immobilized high-level waste (IHLW) interim storage strategy. In addition, this report documents the recommended initial interim storage architecture and implementation path forward

  17. Natural analogues for processes affecting disposal of high-level radioactive waste in the vadose zone

    Science.gov (United States)

    Stuckless, J. S.

    2003-04-01

    Natural analogues can contribute to understanding and predicting the performance of subsystems and processes affecting a mined geologic repository for high-level radioactive waste in several ways. Most importantly, analogues provide tests for various aspects of systems of a repository at dimensional scales and time spans that cannot be attained by experimental study. In addition, they provide a means for the general public to judge the predicted performance of a potential high-level nuclear waste repository in familiar terms such that the average person can assess the anticipated long-term performance and other scientific conclusions. Hydrologists working on the Yucca Mountain Project (currently the U.S. Department of Energy's Office of Repository Development) have modeled the flow of water through the vadose zone at Yucca Mountain, Nevada and particularly the interaction of vadose-zone water with mined openings. Analogues from both natural and anthropogenic examples confirm the prediction that most of the water moving through the vadose zone will move through the host rock and around tunnels. This can be seen both quantitatively where direct comparison between seepage and net infiltration has been made and qualitatively by the excellent degree of preservation of archaeologic artifacts in underground openings. The latter include Paleolithic cave paintings in southwestern Europe, murals and artifacts in Egyptian tombs, painted subterranean Buddhist temples in India and China, and painted underground churches in Cappadocia, Turkey. Natural analogues also suggest that this diversion mechanism is more effective in porous media than in fractured media. Observations from natural analogues are also consistent with the modeled decrease in the percentage of infiltration that becomes seepage with a decrease in amount of infiltration. Finally, analogues, such as tombs that have ben partially filled by mud flows, suggest that the same capillary forces that keep water in the

  18. The ATLAS High Level Trigger Infrastructure, Performance and Future Developments

    CERN Document Server

    The ATLAS collaboration

    2009-01-01

    The ATLAS High Level Trigger (HLT) is a distributed real-time software system that performs the final online selection of events produced during proton-proton collisions at the Large Hadron Collider (LHC). It is designed as a two-stage event filter running on a farm of commodity PC hardware. Currently the system consists of about 850 multi-core processing nodes that will be extended incrementally following the increasing luminosity of the LHC to about 2000 nodes depending on the evolution of the processor technology. Due to the complexity and similarity of the algorithms a large fraction of the software is shared between the online and offline event reconstruction. The HLT Infrastructure serves as the interface between the two domains and provides common services for the trigger algorithms. The consequences of this design choice will be discussed and experiences from the operation of the ATLAS HLT during cosmic ray data taking and first beam in 2008 will be presented. Since the event processing time at the HL...

  19. Glass formulation for phase 1 high-level waste vitrification

    Energy Technology Data Exchange (ETDEWEB)

    Vienna, J.D.; Hrma, P.R.

    1996-04-01

    The purpose of this study is to provide potential glass formulations for prospective Phase 1 High-Level Waste (HLW) vitrification at Hanford. The results reported here will be used to aid in developing a Phase 1 HLW vitrification request for proposal (RFP) and facilitate the evaluation of ensuing proposals. The following factors were considered in the glass formulation effort: impact on total glass volume of requiring the vendor to process each of the tank compositions independently versus as a blend; effects of imposing typical values of B{sub 2}O{sub 3} content and waste loading in HLW borosilicate glasses as restrictions on the vendors (according to WAPS 1995, the typical values are 5--10 wt% B{sub 2}O{sub 3} and 20--40 wt% waste oxide loading); impacts of restricting the processing temperature to 1,150 C on eventual glass volume; and effects of caustic washing on any of the selected tank wastes relative to glass volume.

  20. Synroc - a multiphase ceramic for high level nuclear waste immobilisation

    International Nuclear Information System (INIS)

    Reeve, K.D.; Vance, E.R.; Hart, K.P.; Smith, K.L.; Lumpkin, G.R.; Mercer, D.J.

    1992-01-01

    Many natural minerals - particularly titanates - are very durable geochemically, having survived for millions of years with very little alteration. Moreover, some of these minerals have quantitatively retained radioactive elements and their daughter products over this time. The Synroc concept mimics nature by providing an all-titanate synthetic mineral phase assemblage to immobilise high level waste (HLW) from nuclear fuel reprocessing operations for safe geological disposal. In principle, many chemically hazardous inorganic wastes arising from industry could also be immobilised in highly durable ceramics and disposed of geologically, but in practice the cost structure of most industries is such that lower cost waste management solutions - for example, the development of reusable by-products or the use of cements rather than ceramics - have to be devised. In many thousands of aqueous leach tests at ANSTO, mostly at 70-90 deg C, Synroc has been shown to be exceptionally durable. The emphases of the recent ANSTO program have been on tailoring of the Synroc composition to varying HLW compositions, leach testing of Synroc containing radioactive transuranic actinides, study of leaching mechanisms by SEM and TEM, and the development and costing of a conceptual fully active Synroc fabrication plant design. A summary of recent results on these topics will be presented. 29 refs., 4 figs

  1. Hanford high-level waste melter system evaluation data packages

    International Nuclear Information System (INIS)

    Elliott, M.L.; Shafer, P.J.; Lamar, D.A.; Merrill, R.A.; Grunewald, W.; Roth, G.; Tobie, W.

    1996-03-01

    The Tank Waste Remediation System is selecting a reference melter system for the Hanford High-Level Waste vitrification plant. A melter evaluation was conducted in FY 1994 to narrow down the long list of potential melter technologies to a few for testing. A formal evaluation was performed by a Melter Selection Working Group (MSWG), which met in June and August 1994. At the June meeting, MSWG evaluated 15 technologies and selected six for more thorough evaluation at the Aug. meeting. All 6 were variations of joule-heated or induction-heated melters. Between the June and August meetings, Hanford site staff and consultants compiled data packages for each of the six melter technologies as well as variants of the baseline technologies. Information was solicited from melter candidate vendors to supplement existing information. This document contains the data packages compiled to provide background information to MSWG in support of the evaluation of the six technologies. (A separate evaluation was performed by Fluor Daniel, Inc. to identify balance of plant impacts if a given melter system was selected.)

  2. ATW system impact on high-level waste

    International Nuclear Information System (INIS)

    Arthur, E.D.

    1992-01-01

    This report discusses the Accelerator Transmutation of Waste (ATW) concept which aims at destruction of key long-lived radionuclides in high-level nuclear waste (HLW), both fission products and actinides. This focus makes it different from most other transmutation concepts which concentrate primarily on actinide burning. The ATW system uses an accelerator-driven, sub-critical assembly to create an intense thermal neutron environment for radionuclide transmutation. This feature allows rapid transmutation under low-inventory system conditions, which in turn, has a direct impact on the size of chemical separations and materials handling components of the system. Inventories in ATW are factors of eight to thirty times smaller than reactor systems of equivalent thermal power. Chemical separations systems are relatively small in scale and can be optimized to achieve high decontamination factors and minimized waste streams. The low-inventory feature also directly impacts material amounts remaining in the system at its end of life. In addition to its low-inventory operation, the accelerator-driven neutron source features of ATW are key to providing a sufficient level of neutrons to allow transmutation of long-lived fission products

  3. Site suitability criteria for solidified high level waste repositories

    International Nuclear Information System (INIS)

    Heckman, R.A.; Holdsworth, T.; Isherwood, D.; Towse, D.F.; Dayem, N.L.

    1979-01-01

    The NRC is developing a framework of regulations, criteria, and standards. Lawrence Livermore Laboratory provides broad technical support to the NRC for developing this regulatory framework, part of which involves site suitability criteria for solidified high-level wastes (SHLW). Both the regulatory framework and the technical base on which it rests have evolved in time. This document is the second report of the technical support project. It was issued as a draft working paper for a programmatic review held at LLL from August 16 to 18, 1977. It was printed and distributed solely as a briefing document on preliminary methodology and initial findings for the purpose of critical review by those in attendance. These briefing documents are being reprinted now in their original formats as UCID-series reports for the sake of the historical record. Analysis results have evolved as both the models and data base have changed. As a result, the methodology, models, and data base in this document are severely outmoded

  4. Technical career opportunities in high-level radioactive waste management

    International Nuclear Information System (INIS)

    1993-01-01

    Technical career opportunities in high-level radioactive waste management are briefly described in the areas of: Hydrology; geology; biological sciences; mathematics; engineering; heavy equipment operation; and skilled labor and crafts

  5. Glasses used for the high level radioactive wastes storage

    International Nuclear Information System (INIS)

    Sombret, C.

    1983-06-01

    High level radioactive wastes generated by the reprocessing of spent fuels is an important concern in the conditioning of radioactive wastes. This paper deals with the status of the knowledge about glasses used for the treatment of these liquids [fr

  6. Thermo-aeraulics of high level waste storage facilities

    International Nuclear Information System (INIS)

    Lagrave, Herve; Gaillard, Jean-Philippe; Laurent, Franck; Ranc, Guillaume; Duret, Bernard

    2006-01-01

    subsurface facilities; - Design study of a concrete shell; - Perspectives: shaft experimental program; - Conclusion. To summarize, one underlines that the studies and the experiments carried out by the CEA have provided evidence of the technical feasibility of long-term interim storage for long-lived high-level radioactive waste. The feasibility of the natural ventilation (thermo aeraulics aspects) and mechanical strength (concrete structures aspects) of these storage facilities has been demonstrated. Nevertheless, the design would have to be optimised according to the selected site

  7. Thermo-aeraulics of high level waste storage facilities

    Energy Technology Data Exchange (ETDEWEB)

    Lagrave, Herve; Gaillard, Jean-Philippe; Laurent, Franck; Ranc, Guillaume [CEA/Valrho, B.P. 17171, F-30207 Bagnols-sur-Ceze (France); Duret, Bernard [CEA Grenoble, 17 rue des Martyrs, 38054 Grenoble cedex 9 (France)

    2006-07-01

    structures; - GALATEE subsurface facilities; - Design study of a concrete shell; - Perspectives: shaft experimental program; - Conclusion. To summarize, one underlines that the studies and the experiments carried out by the CEA have provided evidence of the technical feasibility of long-term interim storage for long-lived high-level radioactive waste. The feasibility of the natural ventilation (thermo aeraulics aspects) and mechanical strength (concrete structures aspects) of these storage facilities has been demonstrated. Nevertheless, the design would have to be optimised according to the selected site.

  8. Nutritional strategies of high level natural bodybuilders during competition preparation.

    Science.gov (United States)

    Chappell, A J; Simper, T; Barker, M E

    2018-01-01

    Competitive bodybuilders employ a combination of resistance training, cardiovascular exercise, calorie reduction, supplementation regimes and peaking strategies in order to lose fat mass and maintain fat free mass. Although recommendations exist for contest preparation, applied research is limited and data on the contest preparation regimes of bodybuilders are restricted to case studies or small cohorts. Moreover, the influence of different nutritional strategies on competitive outcome is unknown. Fifty-one competitors (35 male and 16 female) volunteered to take part in this project. The British Natural Bodybuilding Federation (BNBF) runs an annual national competition for high level bodybuilders; competitors must qualify by winning at a qualifying events or may be invited at the judge's discretion. Competitors are subject to stringent drug testing and have to undergo a polygraph test. Study of this cohort provides an opportunity to examine the dietary practices of high level natural bodybuilders. We report the results of a cross-sectional study of bodybuilders competing at the BNBF finals. Volunteers completed a 34-item questionnaire assessing diet at three time points. At each time point participants recorded food intake over a 24-h period in grams and/or portions. Competitors were categorised according to contest placing. A "placed" competitor finished in the top 5, and a "Non-placed" (DNP) competitor finished outside the top 5. Nutrient analysis was performed using Nutritics software. Repeated measures ANOVA and effect sizes (Cohen's d ) were used to test if nutrient intake changed over time and if placing was associated with intake. Mean preparation time for a competitor was 22 ± 9 weeks. Nutrient intake of bodybuilders reflected a high-protein, high-carbohydrate, low-fat diet. Total carbohydrate, protein and fat intakes decreased over time in both male and female cohorts ( P  preparation (5.1 vs 3.7 g/kg BW) than DNP competitors ( d  = 1.02, 95% CI

  9. Development of melt compositions for sulphate bearing high level waste

    International Nuclear Information System (INIS)

    Jahagirdar, P.B.; Wattal, P.K.

    1997-09-01

    The report deals with the development and characterization of vitreous matrices for sulphate bearing high level waste. Studies were conducted in sodium borosilicate and lead borosilicate systems with the introduction of CaO, BaO, MgO etc. Lead borosilicate system was found to be compatible with sulphate bearing high level wastes. Detailed product evaluation carried on selected formulations is also described. (author)

  10. Properties and characteristics of high-level waste glass

    International Nuclear Information System (INIS)

    Ross, W.A.

    1977-01-01

    This paper has briefly reviewed many of the characteristics and properties of high-level waste glasses. From this review, it can be noted that glass has many desirable properties for solidification of high-level wastes. The most important of these include: (1) its low leach rate; (2) the ability to tolerate large changes in waste composition; (3) the tolerance of anticipated storage temperatures; (4) its low surface area even after thermal shock or impact

  11. High-Level Waste System Process Interface Description

    International Nuclear Information System (INIS)

    D'Entremont, P.D.

    1999-01-01

    The High-Level Waste System is a set of six different processes interconnected by pipelines. These processes function as one large treatment plant that receives, stores, and treats high-level wastes from various generators at SRS and converts them into forms suitable for final disposal. The three major forms are borosilicate glass, which will be eventually disposed of in a Federal Repository, Saltstone to be buried on site, and treated water effluent that is released to the environment

  12. Physical modeling of joule heated ceramic glass melters for high level waste immobilization

    International Nuclear Information System (INIS)

    Quigley, M.S.; Kreid, D.K.

    1979-03-01

    This study developed physical modeling techniques and apparatus suitable for experimental analysis of joule heated ceramic glass melters designed for immobilizing high level waste. The physical modeling experiments can give qualitative insight into the design and operation of prototype furnaces and, if properly verified with prototype data, the physical models could be used for quantitative analysis of specific furnaces. Based on evaluation of the results of this study, it is recommended that the following actions and investigations be undertaken: It was not shown that the isothermal boundary conditions imposed by this study established prototypic heat losses through the boundaries of the model. Prototype wall temperatures and heat fluxes should be measured to provide better verification of the accuracy of the physical model. The VECTRA computer code is a two-dimensional analytical model. Physical model runs which are isothermal in the Y direction should be made to provide two-dimensional data for more direct comparison to the VECTRA predictions. The ability of the physical model to accurately predict prototype operating conditions should be proven before the model can become a reliable design tool. This will require significantly more prototype operating and glass property data than were available at the time of this study. A complete set of measurements covering power input, heat balances, wall temperatures, glass temperatures, and glass properties should be attempted for at least one prototype run. The information could be used to verify both physical and analytical models. Particle settling and/or sludge buildup should be studied directly by observing the accumulation of the appropriate size and density particles during feeding in the physical model. New designs should be formulated and modeled to minimize the potential problems with melter operation identifed by this study

  13. Health care providers' perceptions of and attitudes towards induced abortions in sub-Saharan Africa and Southeast Asia : a systematic literature review of qualitative and quantitative data.

    OpenAIRE

    Rehnström Loi, Ulrika; Gemzell-Danielsson, Kristina; Faxelid, Elisabeth; Klingberg-Allvin, Marie

    2015-01-01

    Background Unsafe abortions are a serious public health problem and a major human rights issue. In low-income countries, where restrictive abortion laws are common, safe abortion care is not always available to women in need. Health care providers have an important role in the provision of abortion services. However, the shortage of health care providers in low-income countries is critical and exacerbated by the unwillingness of some health care providers to provide abortion services. The aim...

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

    International Nuclear Information System (INIS)

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

    2012-02-01

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

  15. Overview: Defense high-level waste technology program

    International Nuclear Information System (INIS)

    Shupe, M.W.; Turner, D.A.

    1987-01-01

    Defense high-level waste generated by atomic energy defense activities is stored on an interim basis at three U.S. Department of Energy (DOE) operating locations; the Savannah River Plant in South Carolina, the Hanford Site in Washington, and the Idaho National Engineering Laboratory in Idaho. Responsibility for the permanent disposal of this waste resides with DOE's Office of Defense Waste and Transportation Management. The objective of the Defense High-Level Wast Technology Program is to develop the technology for ending interim storage and achieving permanent disposal of all U.S. defense high-level waste. New and readily retrievable high-level waste are immobilized for disposal in a geologic repository. Other high-level waste will be stabilized in-place if, after completion of the National Environmental Policy Act (NEPA) process, it is determined, on a site-specific basis, that this option is safe, cost effective and environmentally sound. The immediate program focus is on implementing the waste disposal strategy selected in compliance with the NEPA process at Savannah River, while continuing progress toward development of final waste disposal strategies at Hanford and Idaho. This paper presents an overview of the technology development program which supports these waste management activities and an assessment of the impact that recent and anticipated legal and institutional developments are expected to have on the program

  16. Providers' perspectives of factors influencing implementation of evidence-based treatments in a community mental health setting: A qualitative investigation of the training-practice gap.

    Science.gov (United States)

    Marques, Luana; Dixon, Louise; Valentine, Sarah E; Borba, Christina P C; Simon, Naomi M; Wiltsey Stirman, Shannon

    2016-08-01

    This study aims to elucidate relations between provider perceptions of aspects of the consolidated framework for implementation research (Damschroder et al., 2009) and provider attitudes toward the implementation of evidence-based treatments (EBTs) in an ethnically diverse community health setting. Guided by directed content analysis, we analyzed 28 semistructured interviews that were conducted with providers during the pre-implementation phase of a larger implementation study for cognitive processing therapy for posttraumatic stress disorder (Resick et al., 2008). Our findings extend the existing literature by also presenting provider-identified client-level factors that contribute to providers' positive and negative attitudes toward EBTs. Provider-identified client-level factors include the following: client motivation to engage in treatment, client openness to EBTs, support networks of family and friends, client use of community and government resources, the connection and relationship with their therapist, client treatment adherence, client immediate needs or crises, low literacy or illiteracy, low levels of education, client cognitive limitations, and misconceptions about therapy. These results highlight the relations between provider perceptions of their clients, provider engagement in EBT training, and subsequent adoption of EBTs. We present suggestions for future implementation research in this area. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  17. Exploring the context in which different close-to-community sexual and reproductive health service providers operate in Bangladesh: a qualitative study.

    Science.gov (United States)

    Mahmud, Ilias; Chowdhury, Sadia; Siddiqi, Bulbul Ashraf; Theobald, Sally; Ormel, Hermen; Biswas, Salauddin; Jahangir, Yamin Tauseef; Sarker, Malabika; Rashid, Sabina Faiz

    2015-09-01

    A range of formal and informal close-to-community (CTC) health service providers operate in an increasingly urbanized Bangladesh. Informal CTC health service providers play a key role in Bangladesh's pluralistic health system, yet the reasons for their popularity and their interactions with formal providers and the community are poorly understood. This paper aims to understand the factors shaping poor urban and rural women's choice of service provider for their sexual and reproductive health (SRH)-related problems and the interrelationships between these providers and communities. Building this evidence base is important, as the number and range of CTC providers continue to expand in both urban slums and rural communities in Bangladesh. This has implications for policy and future programme interventions addressing the poor women's SRH needs. Data was generated through 24 in-depth interviews with menstrual regulation clients, 12 focus group discussions with married men and women in communities and 24 semi-structured interviews with formal and informal CTC SRH service providers. Data was collected between July and September 2013 from three urban slums and one rural site in Dhaka and Sylhet, Bangladesh. Atlas.ti software was used to manage data analysis and coding, and a thematic analysis was undertaken. Poor women living in urban slums and rural areas visit a diverse range of CTC providers for SRH-related problems. Key factors influencing their choice of provider include the following: availability, accessibility, expenses and perceived quality of care, the latter being shaped by notions of trust, respect and familiarity. Informal providers are usually the first point of contact even for those clients who subsequently access SRH services from formal providers. Despite existing informal interactions between both types of providers and a shared understanding that this can be beneficial for clients, there is no effective link or partnership between these providers for

  18. Review of high-level waste form properties. [146 bibliographies

    Energy Technology Data Exchange (ETDEWEB)

    Rusin, J.M.

    1980-12-01

    This report is a review of waste form options for the immobilization of high-level-liquid wastes from the nuclear fuel cycle. This review covers the status of international research and development on waste forms as of May 1979. Although the emphasis in this report is on waste form properties, process parameters are discussed where they may affect final waste form properties. A summary table is provided listing properties of various nuclear waste form options. It is concluded that proposed waste forms have properties falling within a relatively narrow range. In regard to crystalline versus glass waste forms, the conclusion is that either glass of crystalline materials can be shown to have some advantage when a single property is considered; however, at this date no single waste form offers optimum properties over the entire range of characteristics investigated. A long-term effort has been applied to the development of glass and calcine waste forms. Several additional waste forms have enough promise to warrant continued research and development to bring their state of development up to that of glass and calcine. Synthetic minerals, the multibarrier approach with coated particles in a metal matrix, and high pressure-high temperature ceramics offer potential advantages and need further study. Although this report discusses waste form properties, the total waste management system should be considered in the final selection of a waste form option. Canister design, canister materials, overpacks, engineered barriers, and repository characteristics, as well as the waste form, affect the overall performance of a waste management system. These parameters were not considered in this comparison.

  19. Review of high-level waste form properties

    International Nuclear Information System (INIS)

    Rusin, J.M.

    1980-12-01

    This report is a review of waste form options for the immobilization of high-level-liquid wastes from the nuclear fuel cycle. This review covers the status of international research and development on waste forms as of May 1979. Although the emphasis in this report is on waste form properties, process parameters are discussed where they may affect final waste form properties. A summary table is provided listing properties of various nuclear waste form options. It is concluded that proposed waste forms have properties falling within a relatively narrow range. In regard to crystalline versus glass waste forms, the conclusion is that either glass of crystalline materials can be shown to have some advantage when a single property is considered; however, at this date no single waste form offers optimum properties over the entire range of characteristics investigated. A long-term effort has been applied to the development of glass and calcine waste forms. Several additional waste forms have enough promise to warrant continued research and development to bring their state of development up to that of glass and calcine. Synthetic minerals, the multibarrier approach with coated particles in a metal matrix, and high pressure-high temperature ceramics offer potential advantages and need further study. Although this report discusses waste form properties, the total waste management system should be considered in the final selection of a waste form option. Canister design, canister materials, overpacks, engineered barriers, and repository characteristics, as well as the waste form, affect the overall performance of a waste management system. These parameters were not considered in this comparison

  20. Solidification of high-level radioactive wastes. Final report

    International Nuclear Information System (INIS)

    1979-06-01

    A panel on waste solidification was formed at the request of the Nuclear Regulatory Commission to study the scientific and technological problems associated with the conversion of liquid and semiliquid high-level radioactive wastes into a stable form suitable for transportation and disposition. Conclusions reached and recommendations made are as follows. Many solid forms described in this report could meet standards as stringent as those currently applied to the handling, storage, and transportation of spent fuel assemblies. Solid waste forms should be selected only in the context of the total radioactive waste management system. Many solid forms are likely to be satisfactory for use in an appropriately designed system, The current United States policy of deferring the reprocessing of commercial reactor fuel provides additional time for R and D solidification technology for this class of wastes. Defense wastes which are relatively low in radioactivity and thermal power density can best be solidified by low-temperature processes. For solidification of fresh commercial wastes that are high in specific activity and thermal power density, the Panel recommends that, in addition to glass, the use of fully-crystalline ceramics and metal-matrix forms be actively considered. Preliminary analysis of the characteristics of spent fuel pins indicates that they may be eligible for consideration as a waste form. Because the differences in potential health hazards to the public resulting from the use of various solid form and disposal options are likely to be small, the Panel concludes that cost, reliability, and health hazards to operating personnel will be major considerations in choosing among the options that can meet safety requiremens. The Panel recommends that responsibility for all radioactive waste management operations (including solidification R and D) should be centralized

  1. The precautionary principle and high-level nuclear waste policy

    International Nuclear Information System (INIS)

    Frishman, S.

    1999-01-01

    The 'Precautionary Principle' has grown from the broadening observation that there is compelling evidence that damage to humans and the world-wide environment is of such a magnitude and seriousness that new principles for conducting human activities are necessary. One of the various statements of the Precautionary Principle is: when an activity raises threats of harm to human health or the environment, precautionary measures should be taken even if some cause and effect relationships are not fully established scientifically. The use of a precautionary principle was a significant recommendation emerging from the 1992 United Nations Conference on Environment and Development, held in Rio de Janeiro, Brazil, and it is gaining acceptance in discussions ranging from global warming to activities that affect the marine environment, and far beyond. In the US high-level nuclear waste policy, there is a growing trend on the part of geologic repository proponents and regulators to shift the required safety evaluation from a deterministic analysis of natural and engineered barriers and their interactions to risk assessments and total system waste containment and isolation performance assessment. This is largely a result of the realisation that scientific 'proof' of safety cannot be demonstrated to the level repository proponents have led the American public to expect. Therefore, they are now developing other methods in an attempt to effectively lower the repository safety expectations of the public. Implicit in this shift in demonstration of 'proof' is that levels of uncertainty far larger than those generally taken as scientifically acceptable must be accepted in repository safety, simply because greater certainty is either too costly, in time and money, or impossible to achieve at the potential Yucca Mountain repository site. In the context of the Precautionary Principle, the repository proponent must bear the burden of providing 'Acceptable' proof, established by an open

  2. High-level radioactive waste disposal in the deep ocean

    International Nuclear Information System (INIS)

    Hill, H.W.

    1977-01-01

    A joint programme has begun between the Fisheries Laboratory, Lowestoft and the Institute of Oceanographic Sciences, Wormley to study the dispersion of radioactivity in the deep ocean arising from the possible dumping of high level waste on the sea bed in vitrified-glass form which would permit slow leakage over a long term scale. The programme consists firstly of the development of a simple diffusion/advection model for the dispersion of radioactivity in a closed and finite ocean, which overcomes many of the criticisms of the earlier model proposed by Webb and Morley. Preliminary results from this new model are comparable to those of the Webb-Morley model for radio isotopes with half-lives of 10-300 years but are considerably more restrictive outside this range, particularly for those which are much longer-lived. The second part of the programme, towards which the emphasis is directed, concerns the field programme planned to measure the advection and diffusion parameters in the deeper layers of the ocean to provide realistic input parameters to the model and increase our fundamental understanding of the environment in which the radioactive materials may be released. The first cruises of the programme will take place in late 1976 and involve deep current meter deployments and float dispersion experiments around the present NEA dump site with some sediment sampling, so that adsorption experiments can be started on typical deep sea sediments. The programme will expand the number of long-term deep moored stations over the next five years and include further float experiments, CTD profiling, and other physical oceanography. In the second half of the 5-year programme, attempts will be made to measure diffusion parameters in the deeper layers of the ocean using radioactive tracers

  3. Managing the nation's commercial high-level radioactive waste

    International Nuclear Information System (INIS)

    1985-03-01

    This report presents the findings and conclusions of OTA's analysis of Federal policy for the management of commercial high-level radioactive waste. It represents a major update and expansion of the Analysis presented to Congress in our summary report, Managing Commercial High-Level Radioactive Waste, published in April of 1982 (NWPA). This new report is intended to contribute to the implementation of NWPA, and in particular to Congressional review of three major documents that DOE will submit to the 99th Congress: a Mission Plan for the waste management program; a monitored retrievable storage (MRS) proposal; and a report on mechanisms for financing and managing the waste program. The assessment was originally focused on the ocean disposal of nuclear waste. OTA later broadened the study to include all aspects of high-level waste disposal. The major findings of the original analysis were published in OTA's 1982 summary report

  4. Techniques for the solidification of high-level wastes

    International Nuclear Information System (INIS)

    1977-01-01

    The problem of the long-term management of the high-level wastes from the reprocessing of irradiated nuclear fuel is receiving world-wide attention. While the majority of the waste solutions from the reprocessing of commercial fuels are currently being stored in stainless-steel tanks, increasing effort is being devoted to developing technology for the conversion of these wastes into solids. A number of full-scale solidification facilities are expected to come into operation in the next decade. The object of this report is to survey and compare all the work currently in progress on the techniques available for the solidification of high-level wastes. It will examine the high-level liquid wastes arising from the various processes currently under development or in operation, the advantages and disadvantages of each process for different types and quantities of waste solutions, the stages of development, the scale-up potential and flexibility of the processes

  5. Spent fuel and high-level radioactive waste storage

    International Nuclear Information System (INIS)

    Trigerman, S.

    1988-06-01

    The subject of spent fuel and high-level radioactive waste storage, is bibliographically reviewed. The review shows that in the majority of the countries, spent fuels and high-level radioactive wastes are planned to be stored for tens of years. Sites for final disposal of high-level radioactive wastes have not yet been found. A first final disposal facility is expected to come into operation in the United States of America by the year 2010. Other final disposal facilities are expected to come into operation in Germany, Sweden, Switzerland and Japan by the year 2020. Meanwhile , stress is placed upon the 'dry storage' method which is carried out successfully in a number of countries (Britain and France). In the United States of America spent fuels are stored in water pools while the 'dry storage' method is still being investigated. (Author)

  6. The ATLAS High-Level Calorimeter Trigger in Run-2

    CERN Document Server

    Wiglesworth, Craig; The ATLAS collaboration

    2018-01-01

    The ATLAS Experiment uses a two-level triggering system to identify and record collision events containing a wide variety of physics signatures. It reduces the event rate from the bunch-crossing rate of 40 MHz to an average recording rate of 1 kHz, whilst maintaining high efficiency for interesting collision events. It is composed of an initial hardware-based level-1 trigger followed by a software-based high-level trigger. A central component of the high-level trigger is the calorimeter trigger. This is responsible for processing data from the electromagnetic and hadronic calorimeters in order to identify electrons, photons, taus, jets and missing transverse energy. In this talk I will present the performance of the high-level calorimeter trigger in Run-2, noting the improvements that have been made in response to the challenges of operating at high luminosity.

  7. Production and properties of solidified high-level waste

    International Nuclear Information System (INIS)

    Brodersen, K.

    1980-08-01

    Available information on production and properties of solidified high-level waste are presented. The review includes literature up to the end of 1979. The feasibility of production of various types of solidified high-level wast is investigated. The main emphasis is on borosilicate glass but other options are also mentioned. The expected long-term behaviour of the materials are discussed on the basis of available results from laboratory experiments. Examples of the use of the information in safety analysis of disposal in salt formations are given. The work has been made on behalf of the Danish utilities investigation of the possibilities of disposal of high-level waste in salt domes in Jutland. (author)

  8. Evaluation of high-level waste pretreatment processes with an approximate reasoning model

    International Nuclear Information System (INIS)

    Bott, T.F.; Eisenhawer, S.W.; Agnew, S.F.

    1999-01-01

    The development of an approximate-reasoning (AR)-based model to analyze pretreatment options for high-level waste is presented. AR methods are used to emulate the processes used by experts in arriving at a judgment. In this paper, the authors first consider two specific issues in applying AR to the analysis of pretreatment options. They examine how to combine quantitative and qualitative evidence to infer the acceptability of a process result using the example of cesium content in low-level waste. They then demonstrate the use of simple physical models to structure expert elicitation and to produce inferences consistent with a problem involving waste particle size effects

  9. Hydrological evaluation of five sedimentary rocks for high-level waste disposal

    International Nuclear Information System (INIS)

    Lomenick, T.F.; Kanehiro, B.Y.

    1986-01-01

    Utilizing performance criteria that are based upon siting guidelines issued by DOE for postclosure as well as preclosure conditions, a preliminary hydrologic evaluation and ranking is being conducted to determine the suitability of five sedimentary rocks as potential host rocks for a high-level radioactive waste repository. Based upon both quantitative and qualitative considerations, the hydrological ranking of the rocks in order of their potential as a host rock for the disposal of radioactive wastes would be shale, anhydrock, sandstone, chalk, and carbonates, with the first three rocks being significantly better than the remaining two types

  10. High Level Waste plant operation and maintenance concepts. Final report, March 27, 1995

    International Nuclear Information System (INIS)

    Janicek, G.P.

    1995-01-01

    The study reviews and evaluates worldwide High Level Waste (HLW) vitrification operating and maintenance (O ampersand M) philosophies, plant design concepts, and lessons learned with an aim towards developing O ampersand M recommendations for either, similar implementation or further consideration in a HLW vitrification facility at Hanford. The study includes a qualitative assessment of alternative concepts for a variety of plant and process systems and subsystems germane to HLW vitrification, such as, feed materials handling, melter configuration, glass form, canister handling, failed equipment handling, waste handling, and process control. Concept evaluations and recommendations consider impacts to Capital Cost, O ampersand M Cost, ALARA, Availability, and Reliability

  11. High level radioactive waste management facility design criteria

    International Nuclear Information System (INIS)

    Sheikh, N.A.; Salaymeh, S.R.

    1993-01-01

    This paper discusses the engineering systems for the structural design of the Defense Waste Processing Facility (DWPF) at the Savannah River Site (SRS). At the DWPF, high level radioactive liquids will be mixed with glass particles and heated in a melter. This molten glass will then be poured into stainless steel canisters where it will harden. This process will transform the high level waste into a more stable, manageable substance. This paper discuss the structural design requirements for this unique one of a kind facility. A special emphasis will be concentrated on the design criteria pertaining to earthquake, wind and tornado, and flooding

  12. Development of technical information database for high level waste disposal

    International Nuclear Information System (INIS)

    Kudo, Koji; Takada, Susumu; Kawanishi, Motoi

    2005-01-01

    A concept design of the high level waste disposal information database and the disposal technologies information database are explained. The high level waste disposal information database contains information on technologies, waste, management and rules, R and D, each step of disposal site selection, characteristics of sites, demonstration of disposal technology, design of disposal site, application for disposal permit, construction of disposal site, operation and closing. Construction of the disposal technologies information system and the geological disposal technologies information system is described. The screen image of the geological disposal technologies information system is shown. User is able to search the full text retrieval and attribute retrieval in the image. (S.Y. )

  13. Final report on cermet high-level waste forms

    International Nuclear Information System (INIS)

    Kobisk, E.H.; Quinby, T.C.; Aaron, W.S.

    1981-08-01

    Cermets are being developed as an alternate method for the fixation of defense and commercial high level radioactive waste in a terminal disposal form. Following initial feasibility assessments of this waste form, consisting of ceramic particles dispersed in an iron-nickel base alloy, significantly improved processing methods were developed. The characterization of cermets has continued through property determinations on samples prepared by various methods from a variety of simulated and actual high-level wastes. This report describes the status of development of the cermet waste form as it has evolved since 1977. 6 tables, 18 figures

  14. Managing the high level waste nuclear regulatory commission licensing process

    International Nuclear Information System (INIS)

    Baskin, K.P.

    1992-01-01

    This paper reports that the process for obtaining Nuclear Regulatory Commission permits for the high level waste storage facility is basically the same process commercial nuclear power plants followed to obtain construction permits and operating licenses for their facilities. Therefore, the experience from licensing commercial reactors can be applied to the high level waste facility. Proper management of the licensing process will be the key to the successful project. The management of the licensing process was categorized into four areas as follows: responsibility, organization, communication and documentation. Drawing on experience from nuclear power plant licensing and basic management principles, the management requirement for successfully accomplishing the project goals are discussed

  15. High-level trigger system for the LHC ALICE experiment

    CERN Document Server

    Bramm, R; Lien, J A; Lindenstruth, V; Loizides, C; Röhrich, D; Skaali, B; Steinbeck, T M; Stock, Reinhard; Ullaland, K; Vestbø, A S; Wiebalck, A

    2003-01-01

    The central detectors of the ALICE experiment at LHC will produce a data size of up to 75 MB/event at an event rate less than approximately equals 200 Hz resulting in a data rate of similar to 15 GB/s. Online processing of the data is necessary in order to select interesting (sub)events ("High Level Trigger"), or to compress data efficiently by modeling techniques. Processing this data requires a massive parallel computing system (High Level Trigger System). The system will consist of a farm of clustered SMP-nodes based on off- the-shelf PCs connected with a high bandwidth low latency network.

  16. Treatment technologies for non-high-level wastes (USA)

    International Nuclear Information System (INIS)

    Cooley, C.R.; Clark, D.E.

    1976-06-01

    Non-high-level waste arising from operations at nuclear reactors, fuel fabrication facilities, and reprocessing facilities can be treated using one of several technical alternatives prior to storage. Each alternative and the associated experience and status of development are summarized. The technology for treating non-high-level wastes is generally available for industrial use. Improved techniques applicable to the commercial nuclear fuel cycle are being developed and demonstrated to reduce the volume of waste and to immobilize it for storage. 36 figures, 59 references

  17. High-level radioactive waste disposal type and theoretical analyses

    International Nuclear Information System (INIS)

    Lu Yingfa; Wu Yanchun; Luo Xianqi; Cui Yujun

    2006-01-01

    Study of high-level radioactive waste disposal is necessary for the nuclear electrical development; the determination of nuclear waste depository type is one of importance safety. Based on the high-level radioactive disposal type, the relative research subjects are proposed, then the fundamental research characteristics of nuclear waste disposition, for instance: mechanical and hydraulic properties of rock mass, saturated and unsaturated seepage, chemical behaviors, behavior of special soil, and gas behavior, etc. are introduced, the relative coupling equations are suggested, and a one dimensional result is proposed. (authors)

  18. Sterilization, high-level disinfection, and environmental cleaning.

    Science.gov (United States)

    Rutala, William A; Weber, David J

    2011-03-01

    Failure to perform proper disinfection and sterilization of medical devices may lead to introduction of pathogens, resulting in infection. New techniques have been developed for achieving high-level disinfection and adequate environmental cleanliness. This article examines new technologies for sterilization and high-level disinfection of critical and semicritical items, respectively, and because semicritical items carry the greatest risk of infection, the authors discuss reprocessing semicritical items such as endoscopes and automated endoscope reprocessors, endocavitary probes, prostate biopsy probes, tonometers, laryngoscopes, and infrared coagulation devices. In addition, current issues and practices associated with environmental cleaning are reviewed. Copyright © 2011. Published by Elsevier Inc.

  19. Leveraging the private sector for child health: a qualitative examination of caregiver and provider perspectives on private sector care for childhood pneumonia in Uttar Pradesh, India.

    Science.gov (United States)

    Brunie, Aurélie; Lenzi, Rachel; Lahiri, Anamika; Izadnegahdar, Rasa

    2017-02-22

    The private health sector is a primary source of curative care for childhood illnesses in many low- and middle-income countries. Therefore ensuring appropriate private sector care is an important step towards improving outcomes from illnesses like pneumonia, which is the leading infectious cause of childhood mortality worldwide. This study aimed to provide evidence on private sector care for childhood pneumonia in Uttar Pradesh, India, by simultaneously exploring providers' knowledge and practices and caregivers' experiences. We conducted in-depth interviews with a purposive sample of 36 practitioners and 34 caregivers in two districts. Practitioners included allopathic doctors, AYUSH providers, and drug sellers. Caregivers were mothers of children under the age of five with symptoms consistent with pneumonia who had seen one of those practitioners. Interview transcripts were analyzed thematically. Caregivers were generally prompt in seeking care outside the home, but many initially favored local informal providers based on access and cost. Drug sellers were not commonly consulted for treatment. Formal providers had imperfect, but reasonable, knowledge of pneumonia and followed appropriate steps for diagnosis, though some gaps were noticed that were primarily related to lack of (or failure to use) diagnostic tools. Most practitioners prescribed antibiotics and supportive symptomatic treatment. Relational and structural factors encouraged overuse of antibiotics and treatment interruption. Caregivers often had a limited understanding of treatment but wanted rapid symptomatic improvements, frequently leading to sequentially consulting multiple providers and interrupting treatment when symptoms improved. Providers were confronted with these expectations and care-seeking patterns. This study contributes in-depth evidence on private sector care for childhood pneumonia in UP. Achieving appropriate care requires an enriched perspective that simultaneously considers the

  20. Perceptions of users and providers on barriers to utilizing skilled birth care in mid- and far-western Nepal: a qualitative study

    OpenAIRE

    Sharad Onta; Bishnu Choulagai; Binjwala Shrestha; Narayan Subedi; Gajananda P. Bhandari; Alexandra Krettek

    2014-01-01

    Background: Although skilled birth care contributes significantly to the prevention of maternal and newborn morbidity and mortality, utilization of such care is poor in mid- and far-western Nepal. This study explored the perceptions of service users and providers regarding barriers to skilled birth care.Design: We conducted 24 focus group discussions, 12 each with service users and service providers from different health institutions in mid- and far-western Nepal. All discussions examined the...

  1. When human immunodeficiency virus (HIV) treatment goals conflict with guideline-based opioid prescribing: A qualitative study of HIV treatment providers.

    Science.gov (United States)

    Starrels, Joanna L; Peyser, Deena; Haughton, Lorlette; Fox, Aaron; Merlin, Jessica S; Arnsten, Julia H; Cunningham, Chinazo O

    2016-01-01

    Human immunodeficiency virus (HIV)-infected patients have a high prevalence of chronic pain and opioid use, making HIV care a critical setting for improving the safety of opioid prescribing. Little is known about HIV treatment providers' perspectives about opioid prescribing to patients with chronic pain. The authors administered a questionnaire and conducted semistructured telephone interviews with 18 HIV treatment providers (infectious disease specialists, general internists, family medicine physicians, nurse practitioners, and physician assistants) in Bronx, NY. Open-ended interview questions focused on providers' experiences, beliefs, and attitudes about opioid prescribing and about the use of guideline-based opioid prescribing practices (conservative prescribing, and monitoring for and responding to misuse). Transcripts were thematically analyzed using a modified grounded theory approach. Eighteen HIV treatment providers included 13 physicians, four nurse practitioners, and one physician assistant. They were 62% female, 56% white, and practiced as HIV treatment providers for a mean of 14.6 years. Most reported always or almost always using opioid treatment agreements (56%) and urine drug testing (61%) with their patients on long-term opioid therapy. HIV treatment providers tended to view opioid prescribing for chronic pain within the "HIV paradigm," a set of priorities and principles defined by three key themes: (1) primacy of HIV goals, (2) familiarity with substance use, and (3) the clinician as ally. The HIV paradigm sometimes supported, and sometimes conflicted with, guideline-based opioid prescribing practices. For HIV treatment providers, perceived alignment with the HIV paradigm determined whether and how guideline-based opioid prescribing practices were adopted. For example, the primacy of HIV goals superseded conservative opioid prescribing when providers prescribed opioids with the goal of retaining patients in HIV care. These findings highlight

  2. A qualitative study of provider thoughts on implementing pre-exposure prophylaxis (PrEP in clinical settings to prevent HIV infection.

    Directory of Open Access Journals (Sweden)

    Emily A Arnold

    Full Text Available A recent clinical trial demonstrated that a daily dose tenofovir disoproxil fumarate and emtricitabrine (TDF-FTC can reduce HIV acquisition among men who have sex with men (MSM and transgender (TG women by 44%, and up to 90% if taken daily. We explored how medical and service providers understand research results and plan to develop clinical protocols to prescribe, support and monitor adherence for patients on PrEP in the United States.Using referrals from our community collaborators and snowball sampling, we recruited 22 healthcare providers in San Francisco, Oakland, and Los Angeles for in-depth interviews from May-December 2011. The providers included primary care physicians seeing high numbers of MSM and TG women, HIV specialists, community health clinic providers, and public health officials. We analyzed interviews thematically to produce recommendations for setting policy around implementing PrEP. Interview topics included: assessing clinician impressions of PrEP and CDC guidance, considerations of cost, office capacity, dosing schedules, and following patients over time.Little or no demand for PrEP from patients was reported at the time of the interviews. Providers did not agree on the most appropriate patients for PrEP and believed that current models of care, which do not involve routine frequent office visits, were not well suited for prescribing PrEP. Providers detailed the need to build capacity and were concerned about monitoring side effects and adherence. PrEP was seen as potentially having impact on the epidemic but providers also noted that community education campaigns needed to be tailored to effectively reach specific vulnerable populations.While PrEP may be a novel and clinically compelling prevention intervention for MSM and TG women, it raises a number of important implementation challenges that would need to be addressed. Nonetheless, most providers expressed optimism that they eventually could prescribe and monitor Pr

  3. A qualitative study of provider thoughts on implementing pre-exposure prophylaxis (PrEP) in clinical settings to prevent HIV infection.

    Science.gov (United States)

    Arnold, Emily A; Hazelton, Patrick; Lane, Tim; Christopoulos, Katerina A; Galindo, Gabriel R; Steward, Wayne T; Morin, Stephen F

    2012-01-01

    A recent clinical trial demonstrated that a daily dose tenofovir disoproxil fumarate and emtricitabrine (TDF-FTC) can reduce HIV acquisition among men who have sex with men (MSM) and transgender (TG) women by 44%, and up to 90% if taken daily. We explored how medical and service providers understand research results and plan to develop clinical protocols to prescribe, support and monitor adherence for patients on PrEP in the United States. Using referrals from our community collaborators and snowball sampling, we recruited 22 healthcare providers in San Francisco, Oakland, and Los Angeles for in-depth interviews from May-December 2011. The providers included primary care physicians seeing high numbers of MSM and TG women, HIV specialists, community health clinic providers, and public health officials. We analyzed interviews thematically to produce recommendations for setting policy around implementing PrEP. Interview topics included: assessing clinician impressions of PrEP and CDC guidance, considerations of cost, office capacity, dosing schedules, and following patients over time. Little or no demand for PrEP from patients was reported at the time of the interviews. Providers did not agree on the most appropriate patients for PrEP and believed that current models of care, which do not involve routine frequent office visits, were not well suited for prescribing PrEP. Providers detailed the need to build capacity and were concerned about monitoring side effects and adherence. PrEP was seen as potentially having impact on the epidemic but providers also noted that community education campaigns needed to be tailored to effectively reach specific vulnerable populations. While PrEP may be a novel and clinically compelling prevention intervention for MSM and TG women, it raises a number of important implementation challenges that would need to be addressed. Nonetheless, most providers expressed optimism that they eventually could prescribe and monitor PrEP in their

  4. Fuzzy distributions in probabilistic environmental impact assessment: application to a high-level waste repository

    International Nuclear Information System (INIS)

    Datta, D.; Joshi, M.L.

    2006-01-01

    Environmental modeling with a satisfaction levels of the end user in relation to a defined parameter coupled with imprecision that stems from the field data is a key issue. In the context of this issue success of possibility theory based on fuzzy sets has high visibility in comparison with conventional probability theory. Environmental impact assessments of a high level waste repository is focused using the new approach because the problems under consideration includes a number of qualitative uncertainties at different levels, apart from being quite complex; decision-maker's need to have a transparent assessment result that will enable him to understand underlying assumptions and to judge resulting doses. Fuzzy distributions have been tried to resolve the issues related to the safety of environment from the waste repository. Paper describes the details of fuzzy distribution, fuzzy logic and its possible application to deal the qualitative and quantitative uncertainty in connection with waste repository. (author)

  5. Process Design Concepts for Stabilization of High Level Waste Calcine

    Energy Technology Data Exchange (ETDEWEB)

    T. R. Thomas; A. K. Herbst

    2005-06-01

    The current baseline assumption is that packaging ¡§as is¡¨ and direct disposal of high level waste (HLW) calcine in a Monitored Geologic Repository will be allowed. The fall back position is to develop a stabilized waste form for the HLW calcine, that will meet repository waste acceptance criteria currently in place, in case regulatory initiatives are unsuccessful. A decision between direct disposal or a stabilization alternative is anticipated by June 2006. The purposes of this Engineering Design File (EDF) are to provide a pre-conceptual design on three low temperature processes under development for stabilization of high level waste calcine (i.e., the grout, hydroceramic grout, and iron phosphate ceramic processes) and to support a down selection among the three candidates. The key assumptions for the pre-conceptual design assessment are that a) a waste treatment plant would operate over eight years for 200 days a year, b) a design processing rate of 3.67 m3/day or 4670 kg/day of HLW calcine would be needed, and c) the performance of waste form would remove the HLW calcine from the hazardous waste category, and d) the waste form loadings would range from about 21-25 wt% calcine. The conclusions of this EDF study are that: (a) To date, the grout formulation appears to be the best candidate stabilizer among the three being tested for HLW calcine and appears to be the easiest to mix, pour, and cure. (b) Only minor differences would exist between the process steps of the grout and hydroceramic grout stabilization processes. If temperature control of the mixer at about 80„aC is required, it would add a major level of complexity to the iron phosphate stabilization process. (c) It is too early in the development program to determine which stabilizer will produce the minimum amount of stabilized waste form for the entire HLW inventory, but the volume is assumed to be within the range of 12,250 to 14,470 m3. (d) The stacked vessel height of the hot process vessels

  6. Modeling pitting corrosion damage of high-level radioactive-waste containers, with emphasis on the stochastic approach

    Energy Technology Data Exchange (ETDEWEB)

    Henshall, G.A.; Halsey, W.G.; Clarke, W.L.; McCright, R.D.

    1993-01-01

    Recent efforts to identify methods of modeling pitting corrosion damage of high-level radioactive-waste containers are described. The need to develop models that can provide information useful to higher level system performance assessment models is emphasized, and examples of how this could be accomplished are described. Work to date has focused upon physically-based phenomenological stochastic models of pit initiation and growth. These models may provide a way to distill information from mechanistic theories in a way that provides the necessary information to the less detailed performance assessment models. Monte Carlo implementations of the stochastic theory have resulted in simulations that are, at least qualitatively, consistent with a wide variety of experimental data. The effects of environment on pitting corrosion have been included in the model using a set of simple phenomenological equations relating the parameters of the stochastic model to key environmental variables. The results suggest that stochastic models might be useful for extrapolating accelerated test data and for predicting the effects of changes in the environment on pit initiation and growth. Preliminary ideas for integrating pitting models with performance assessment models are discussed. These ideas include improving the concept of container ``failure``, and the use of ``rules-of-thumb`` to take information from the detailed process models and provide it to the higher level system and subsystem models. Finally, directions for future work are described, with emphasis on additional experimental work since it is an integral part of the modeling process.

  7. Modeling pitting corrosion damage of high-level radioactive-waste containers, with emphasis on the stochastic approach

    International Nuclear Information System (INIS)

    Henshall, G.A.; Halsey, W.G.; Clarke, W.L.; McCright, R.D.

    1993-01-01

    Recent efforts to identify methods of modeling pitting corrosion damage of high-level radioactive-waste containers are described. The need to develop models that can provide information useful to higher level system performance assessment models is emphasized, and examples of how this could be accomplished are described. Work to date has focused upon physically-based phenomenological stochastic models of pit initiation and growth. These models may provide a way to distill information from mechanistic theories in a way that provides the necessary information to the less detailed performance assessment models. Monte Carlo implementations of the stochastic theory have resulted in simulations that are, at least qualitatively, consistent with a wide variety of experimental data. The effects of environment on pitting corrosion have been included in the model using a set of simple phenomenological equations relating the parameters of the stochastic model to key environmental variables. The results suggest that stochastic models might be useful for extrapolating accelerated test data and for predicting the effects of changes in the environment on pit initiation and growth. Preliminary ideas for integrating pitting models with performance assessment models are discussed. These ideas include improving the concept of container ''failure'', and the use of ''rules-of-thumb'' to take information from the detailed process models and provide it to the higher level system and subsystem models. Finally, directions for future work are described, with emphasis on additional experimental work since it is an integral part of the modeling process

  8. Motivation and incentives of rural maternal and neonatal health care providers: a comparison of qualitative findings from Burkina Faso, Ghana and Tanzania.

    Science.gov (United States)

    Prytherch, Helen; Kagoné, Moubassira; Aninanya, Gifty A; Williams, John E; Kakoko, Deodatus C V; Leshabari, Melkidezek T; Yé, Maurice; Marx, Michael; Sauerborn, Rainer

    2013-04-25

    In Burkina Faso, Ghana and Tanzania strong efforts are being made to improve the quality of maternal and neonatal health (MNH) care. However, progress is impeded by challenges, especially in the area of human resources. All three countries are striving not only to scale up the number of available health staff, but also to improve performance by raising skill levels and enhancing provider motivation. In-depth interviews were used to explore MNH provider views about motivation and incentives at primary care level in rural Burkina Faso, Ghana and Tanzania. Interviews were held with 25 MNH providers, 8 facility and district managers, and 2 policy-makers in each country. Across the three countries some differences were found in the reasons why people became health workers. Commitment to remaining a health worker was generally high. The readiness to remain at a rural facility was far less, although in all settings there were some providers that were willing to stay. In Burkina Faso it appeared to be particularly difficult to recruit female MNH providers to rural areas. There were indications that MNH providers in all the settings sometimes failed to treat their patients well. This was shown to be interlinked with differences in how the term 'motivation' was understood, and in the views held about remuneration and the status of rural health work. Job satisfaction was shown to be quite high, and was particularly linked to community appreciation. With some important exceptions, there was a strong level of agreement regarding the financial and non-financial incentives that were suggested by these providers, but there were clear country preferences as to whether incentives should be for individuals or teams. Understandings of the terms and concepts pertaining to motivation differed between the three countries. The findings from Burkina Faso underline the importance of gender-sensitive health workforce planning. The training that all levels of MNH providers receive in

  9. Licensing information needs for a high-level waste repository

    International Nuclear Information System (INIS)

    Wright, R.J.; Greeves, J.T.; Logsdon, M.J.

    1985-01-01

    The information needs for licensing findings during the development of a repository for high-level waste (HLW) are described. In particular, attention is given to the information and needs to demonstrate, for construction authorization purposes: repository constructibility, waste retrievability, waste containment, and waste isolation

  10. Site suitability criteria for solidified high level waste repositories

    International Nuclear Information System (INIS)

    Heckman, R.A.; Holdsworth, T.; Towse, D.F.

    1979-01-01

    Activities devoted to development of regulations, criteria, and standards for storage of solidified high-level radioactive wastes are reported. The work is summarized in sections on site suitability regulations, risk calculations, geological models, aquifer models, human usage model, climatology model, and repository characteristics. Proposed additional analytical work is also summarized

  11. Answers to your questions on high-level nuclear waste

    International Nuclear Information System (INIS)

    1987-11-01

    This booklet contains answers to frequently asked questions about high-level nuclear wastes. Written for the layperson, the document contains basic information on the hazards of radiation, the Nuclear Waste Management Program, the proposed geologic repository, the proposed monitored retrievable storage facility, risk assessment, and public participation in the program

  12. The ATLAS Data Acquisition and High Level Trigger system

    International Nuclear Information System (INIS)

    2016-01-01

    This paper describes the data acquisition and high level trigger system of the ATLAS experiment at the Large Hadron Collider at CERN, as deployed during Run 1. Data flow as well as control, configuration and monitoring aspects are addressed. An overview of the functionality of the system and of its performance is presented and design choices are discussed.

  13. High-level radioactive waste repositories site selection plan

    International Nuclear Information System (INIS)

    Castanon, A.; Recreo, F.

    1985-01-01

    A general vision of the high level nuclear waste (HLNW) and/or nuclear spent fuel facilities site selection processes is given, according to the main international nuclear safety regulatory organisms quidelines and the experience from those countries which have reached a larger development of their national nuclear programs. (author)

  14. High-level waste-form-product performance evaluation

    International Nuclear Information System (INIS)

    Bernadzikowski, T.A.; Allender, J.S.; Stone, J.A.; Gordon, D.E.; Gould, T.H. Jr.; Westberry, C.F. III.

    1982-01-01

    Seven candidate waste forms were evaluated for immobilization and geologic disposal of high-level radioactive wastes. The waste forms were compared on the basis of leach resistance, mechanical stability, and waste loading. All forms performed well at leaching temperatures of 40, 90, and 150 0 C. Ceramic forms ranked highest, followed by glasses, a metal matrix form, and concrete. 11 tables

  15. High level waste canister emplacement and retrieval concepts study

    International Nuclear Information System (INIS)

    1975-09-01

    Several concepts are described for the interim (20 to 30 years) storage of canisters containing high level waste, cladding waste, and intermediate level-TRU wastes. It includes requirements, ground rules and assumptions for the entire storage pilot plant. Concepts are generally evaluated and the most promising are selected for additional work. Follow-on recommendations are made

  16. High-level manpower movement and Japan's foreign aid.

    Science.gov (United States)

    Furuya, K

    1992-01-01

    "Japan's technical assistance programs to Asian countries are summarized. Movements of high-level manpower accompanying direct foreign investments by private enterprise are also reviewed. Proposals for increased human resources development include education and training of foreigners in Japan as well as the training of Japanese aid experts and the development of networks for information exchange." excerpt

  17. Reachability Trees for High-level Petri Nets

    DEFF Research Database (Denmark)

    Jensen, Kurt; Jensen, Arne M.; Jepsen, Leif Obel

    1986-01-01

    the necessary analysis methods. In other papers it is shown how to generalize the concept of place- and transition invariants from place/transition nets to high-level Petri nets. Our present paper contributes to this with a generalization of reachability trees, which is one of the other important analysis...

  18. High-level lipase production by Aspergillus candidus URM 5611 ...

    African Journals Online (AJOL)

    The current study evaluated lipase production by Aspergillus candidus URM 5611 through solid state fermentation (SSF) by using almond bran licuri as a new substrate. The microorganism produced high levels of the enzyme (395.105 U gds-1), thus surpassing those previously reported in the literature. The variable ...

  19. High level of CA 125 due to large endometrioma.

    Science.gov (United States)

    Phupong, Vorapong; Chen, Orawan; Ultchaswadi, Pornthip

    2004-09-01

    CA 125 is a tumor-associated antigen. Its high levels are usually associated with ovarian malignancies, whereas smaller increases in the levels were associated with benign gynecologic conditions. The authors report a high level of CA 125 in a case of large ovarian endometrioma. A 45-year-old nulliparous Thai woman, presented with an increase of her abdominal girth for 7 months. Transabdominal ultrasonogram demonstrated a large ovarian cyst and multiple small leiomyoma uteri, and serum CA 125 level was 1,006 U/ml. The preoperative diagnosis was ovarian cancer with leiomyoma uteri. Exploratory laparotomy was performed. There were a large right ovarian endometrioma, small left ovarian endometrioma and multiple small leiomyoma. Total abdominal hysterectomy and bilateral salpingo-oophorectomy was performed and histopathology confirmed the diagnosis of endometrioma and leiomyoma. The serum CA 125 level declined to non-detectable at the 4th week. She was well at discharge and throughout her 4th week follow-up period Although a very high level of CA 125 is associated with a malignant process, it can also be found in benign conditions such as a large endometrioma. The case emphasizes the association of high levels of CA 125 with benign gynecologic conditions.

  20. The 2011 United Nations High-Level Meeting on Non ...

    African Journals Online (AJOL)

    The 2011 United Nations High-Level Meeting on Non- Communicable Diseases: The Africa agenda calls for a 5-by-5 approach. ... The Political Declaration issued at the meeting focused the attention of world leaders and the global health community on the prevention and control of noncommunicable diseases (NCDs).

  1. Providing Family Planning Services at Primary Care Organizations after the Exclusion of Planned Parenthood from Publicly Funded Programs in Texas: Early Qualitative Evidence.

    Science.gov (United States)

    White, Kari; Hopkins, Kristine; Grossman, Daniel; Potter, Joseph E

    2017-10-20

    To explore organizations' experiences providing family planning during the first year of an expanded primary care program in Texas. Between November 2014 and February 2015, in-depth interviews were conducted with program administrators at 30 organizations: 7 women's health organizations, 13 established primary care contractors (e.g., community health centers, public health departments), and 10 new primary care contractors. Interviews addressed organizational capacities to expand family planning and integrate services with primary care. Interview transcripts were analyzed using a theme-based approach. Themes were compared across the three types of organizations. Established and new primary care contractors identified several challenges expanding family planning services, which were uncommon among women's health organizations. Clinicians often lacked training to provide intrauterine devices and contraceptive implants. Organizations often recruited existing clients into family planning services, rather than expanding their patient base, and new contractors found family planning difficult to integrate because of clients' other health needs. Primary care contractors frequently described contraceptive provision protocols that were not evidence-based. Many primary care organizations in Texas initially lacked the capacity to provide evidence-based family planning services that women's health organizations already provided. © Health Research and Educational Trust.

  2. Perceptions of users and providers on barriers to utilizing skilled birth care in mid- and far-western Nepal: a qualitative study

    Directory of Open Access Journals (Sweden)

    Sharad Onta

    2014-08-01

    Full Text Available Background: Although skilled birth care contributes significantly to the prevention of maternal and newborn morbidity and mortality, utilization of such care is poor in mid- and far-western Nepal. This study explored the perceptions of service users and providers regarding barriers to skilled birth care. Design: We conducted 24 focus group discussions, 12 each with service users and service providers from different health institutions in mid- and far-western Nepal. All discussions examined the perceptions and experiences of service users and providers regarding barriers to skilled birth care and explored possible solutions to overcoming such barriers. Results: Our results determined that major barriers to skilled birth care include inadequate knowledge of the importance of services offered by skilled birth attendants (SBAs, distance to health facilities, unavailability of transport services, and poor availability of SBAs. Other barriers included poor infrastructure, meager services, inadequate information about services/facilities, cultural practices and beliefs, and low prioritization of birth care. Moreover, the tradition of isolating women during and after childbirth decreased the likelihood that women would utilize delivery care services at health facilities. Conclusions: Service users and providers perceived inadequate availability and accessibility of skilled birth care in remote areas of Nepal, and overall utilization of these services was poor. Therefore, training and recruiting locally available health workers, helping community groups establish transport mechanisms, upgrading physical facilities and services at health institutions, and increasing community awareness of the importance of skilled birth care will help bridge these gaps.

  3. Perceptions of users and providers on barriers to utilizing skilled birth care in mid- and far-western Nepal: a qualitative study.

    Science.gov (United States)

    Onta, Sharad; Choulagai, Bishnu; Shrestha, Binjwala; Subedi, Narayan; Bhandari, Gajananda P; Krettek, Alexandra

    2014-01-01

    Although skilled birth care contributes significantly to the prevention of maternal and newborn morbidity and mortality, utilization of such care is poor in mid- and far-western Nepal. This study explored the perceptions of service users and providers regarding barriers to skilled birth care. We conducted 24 focus group discussions, 12 each with service users and service providers from different health institutions in mid- and far-western Nepal. All discussions examined the perceptions and experiences of service users and providers regarding barriers to skilled birth care and explored possible solutions to overcoming such barriers. Our results determined that major barriers to skilled birth care include inadequate knowledge of the importance of services offered by skilled birth attendants (SBAs), distance to health facilities, unavailability of transport services, and poor availability of SBAs. Other barriers included poor infrastructure, meager services, inadequate information about services/facilities, cultural practices and beliefs, and low prioritization of birth care. Moreover, the tradition of isolating women during and after childbirth decreased the likelihood that women would utilize delivery care services at health facilities. Service users and providers perceived inadequate availability and accessibility of skilled birth care in remote areas of Nepal, and overall utilization of these services was poor. Therefore, training and recruiting locally available health workers, helping community groups establish transport mechanisms, upgrading physical facilities and services at health institutions, and increasing community awareness of the importance of skilled birth care will help bridge these gaps.

  4. High-Level Waste Vitrification Facility Feasibility Study

    International Nuclear Information System (INIS)

    D. A. Lopez

    1999-01-01

    A ''Settlement Agreement'' between the Department of Energy and the State of Idaho mandates that all radioactive high-level waste now stored at the Idaho Nuclear Technology and Engineering Center will be treated so that it is ready to be moved out of Idaho for disposal by a compliance date of 2035. This report investigates vitrification treatment of the high-level waste in a High-Level Waste Vitrification Facility based on the assumption that no more New Waste Calcining Facility campaigns will be conducted after June 2000. Under this option, the sodium-bearing waste remaining in the Idaho Nuclear Technology and Engineering Center Tank Farm, and newly generated liquid waste produced between now and the start of 2013, will be processed using a different option, such as a Cesium Ion Exchange Facility. The cesium-saturated waste from this other option will be sent to the Calcine Solids Storage Facilities to be mixed with existing calcine. The calcine and cesium-saturated waste will be processed in the High-Level Waste Vitrification Facility by the end of calendar year 2035. In addition, the High-Level Waste Vitrification Facility will process all newly-generated liquid waste produced between 2013 and the end of 2035. Vitrification of this waste is an acceptable treatment method for complying with the Settlement Agreement. This method involves vitrifying the waste and pouring it into stainless-steel canisters that will be ready for shipment out of Idaho to a disposal facility by 2035. These canisters will be stored at the Idaho National Engineering and Environmental Laboratory until they are sent to a national geologic repository. The operating period for vitrification treatment will be from the end of 2015 through 2035

  5. High-Level Waste Vitrification Facility Feasibility Study

    Energy Technology Data Exchange (ETDEWEB)

    D. A. Lopez

    1999-08-01

    A ''Settlement Agreement'' between the Department of Energy and the State of Idaho mandates that all radioactive high-level waste now stored at the Idaho Nuclear Technology and Engineering Center will be treated so that it is ready to be moved out of Idaho for disposal by a compliance date of 2035. This report investigates vitrification treatment of the high-level waste in a High-Level Waste Vitrification Facility based on the assumption that no more New Waste Calcining Facility campaigns will be conducted after June 2000. Under this option, the sodium-bearing waste remaining in the Idaho Nuclear Technology and Engineering Center Tank Farm, and newly generated liquid waste produced between now and the start of 2013, will be processed using a different option, such as a Cesium Ion Exchange Facility. The cesium-saturated waste from this other option will be sent to the Calcine Solids Storage Facilities to be mixed with existing calcine. The calcine and cesium-saturated waste will be processed in the High-Level Waste Vitrification Facility by the end of calendar year 2035. In addition, the High-Level Waste Vitrification Facility will process all newly-generated liquid waste produced between 2013 and the end of 2035. Vitrification of this waste is an acceptable treatment method for complying with the Settlement Agreement. This method involves vitrifying the waste and pouring it into stainless-steel canisters that will be ready for shipment out of Idaho to a disposal facility by 2035. These canisters will be stored at the Idaho National Engineering and Environmental Laboratory until they are sent to a national geologic repository. The operating period for vitrification treatment will be from the end of 2015 through 2035.

  6. The invisible work of personal health information management among people with multiple chronic conditions: qualitative interview study among patients and providers.

    Science.gov (United States)

    Ancker, Jessica S; Witteman, Holly O; Hafeez, Baria; Provencher, Thierry; Van de Graaf, Mary; Wei, Esther

    2015-06-04

    A critical problem for patients with chronic conditions who see multiple health care providers is incomplete or inaccurate information, which can contribute to lack of care coordination, low quality of care, and medical errors. As part of a larger project on applications of consumer health information technology (HIT) and barriers to its use, we conducted a semistructured interview study with patients with multiple chronic conditions (MCC) with the objective of exploring their role in managing their personal health information. Semistructured interviews were conducted with patients and providers. Patients were eligible if they had multiple chronic conditions and were in regular care with one of two medical organizations in New York City; health care providers were eligible if they had experience caring for patients with multiple chronic conditions. Analysis was conducted from a grounded theory perspective, and recruitment was concluded when saturation was achieved. A total of 22 patients and 7 providers were interviewed; patients had an average of 3.5 (SD 1.5) chronic conditions and reported having regular relationships with an average of 5 providers. Four major themes arose: (1) Responsibility for managing medical information: some patients perceived information management and sharing as the responsibility of health care providers; others—particularly those who had had bad experiences in the past—took primary responsibility for information sharing; (2) What information should be shared: although privacy concerns did influence some patients' perceptions of sharing of medical data, decisions about what to share were also heavily influenced by their understanding of health and disease and by the degree to which they understood the health care system; (3) Methods and tools varied: those patients who did take an active role in managing their records used a variety of electronic tools, paper tools, and memory; and (4) Information management as invisible work

  7. The car manufacturer (CM) and third party logistics provider (TPLP) relationship in the outbound delivery channel: A qualitative study of the Malaysian automotive industry

    OpenAIRE

    Abdul Rahman, Nor Aida

    2012-01-01

    This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University. This research studies the relationship between car manufacturers (CM) and third party logistics providers (TPLP), also known as the logistics partnership, in the outbound delivery channel in the Malaysian automotive industry. It focuses specifically on the dyad perspective, and demonstrates that several critical success factors are required for a successful relationship between these two part...

  8. Culturally Sensitive Approaches to Identification and Treatment of Depression among HIV Infected African American Adults: A Qualitative Study of Primary Care Providers' Perspectives.

    Science.gov (United States)

    Le, Huynh-Nhu; Hipolito, Maria Mananita S; Lambert, Sharon; Terrell-Hamilton, Flora; Rai, Narayan; McLean, Charlee; Kapetanovic, Suad; Nwulia, Evaristus

    2016-04-01

    Major depressive disorder (MDD) is highly prevalent among HIV-infected (HIV+) individuals, and is associated with non-adherence to antiretroviral therapy (ART), and accelerated disease progression. MDD is underdiagnosed and undertreated among low-income African Americans, who are disproportionately impacted by the HIV epidemic. To improve detection and treatment of depression among African Americans living with HIV/AIDS, it is important to understand culturally and contextually relevant aspects of MDD and attitudes about mental health treatment. A focus group session was conducted with seven providers and staff at a primary care center that serves a largely African-American community heavily impacted by the HIV epidemic in Washington, DC. Data were analyzed using an inductive approach to distill prominent themes, perspectives, and experiences among participating providers. Five themes emerged to characterize the lived experiences of HIV+ African-American patients: (a) Changes in perceptions of HIV over time; (b) HIV is comorbid with mental illness, particularly depression and substance abuse; (c) Stigma is associated with both HIV and depression; (d) Existing mental health services vary and are insufficient and (e) Suggestions for optimal treatment for comorbid HIV and depression. This study reflects the views of providers from one clinic in this community. Substantial economic disadvantage, pervasive childhood adversity, limited education and limited resources jointly put members of this community at risk for acquisition of HIV and for development of depression and addictions. These contextual factors provide an important reminder that any patient-level depression identification or intervention in this community will have to be mindful of such circumstances.

  9. A qualitative study exploring midwives' perceptions and knowledge of maternal obesity: Reflecting on their experiences of providing healthy eating and weight management advice to pregnant women.

    Science.gov (United States)

    McCann, Mary T; Newson, Lisa; Burden, Catriona; Rooney, Jane S; Charnley, Margaret S; Abayomi, Julie C

    2018-04-01

    Midwives are responsible for providing advice regarding the complex issues of healthy eating and weight management during pregnancy. This study utilised an inductive data-driven thematic approach in order to determine midwives' perceptions, knowledge, and experiences of providing healthy eating and weight management advice to pregnant women. Semistructured interviews with 17 midwives were transcribed verbatim and data subjected to thematic analysis. The findings offer insight into the challenges facing midwives in their role trying to promote healthy eating and appropriate weight management to pregnant women. Three core themes were identified: (a) "If they eat healthily it will bring their weight down": Midwives Misunderstood; (b) "I don't think we are experienced enough": Midwives Lack Resources and Expertise; and (c) "BMI of 32 wouldn't bother me": Midwives Normalised Obesity. The midwives recognised the importance of providing healthy eating advice to pregnant women and the health risks associated with poor diet and obesity. However, they reported the normalisation of obesity in pregnant women and suggested that this, together with their high workload and lack of expertise, explained the reasons why systematic advice was not in standard antenatal care. In addition, the current lack of UK clinical guidance, and thus, possibly lack of clinical leadership are also preventing delivery of tailored advice. Implementation literature on understanding the barriers to optimal health care delivery and informing clinical practice through research evidence needs to be further investigated in this field. This study has recommendations for policy makers, commissioners, service providers, and midwives. © 2017 John Wiley & Sons Ltd.

  10. The Adoption of Roles by Primary Care Providers during Implementation of the New Chronic Disease Guidelines in Urban Mongolia: A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Oyun Chimeddamba

    2016-04-01

    Full Text Available (1 Background: In 2011, new chronic disease guidelines were introduced across Mongolia. No formal advice was provided regarding role delineation. This study aimed to analyse the roles that different primary care providers adopted, and the variations in these, in the implementation of the guidelines in urban Mongolia; (2 Methods: Ten group interviews with nurses and ten individual interviews each with practice doctors and practice directors were conducted. Data was analysed using a thematic approach based on the identified themes relevant to role delineation; (3 Results: There was some variability and flexibility in role delineation. Factors involving teamwork, task rotation and practice flexibility facilitated well the guideline implementation. However, factors including expectations and decision making, nursing shortage, and training gaps adversely influenced in the roles and responsibilities. Some role confusion and dissatisfaction was identified, often associated with a lack of training or staff turnover; (4 Conclusions: Findings suggest that adequate ongoing training is required to maximize the range of roles particular provider types, especially primary care nurses, are competent to perform. Ensuring that role delineation is specified in guidelines could remove confusion and enhance implementation of such guidelines.

  11. Factors influencing health care and service providers' and their respective "at risk" populations' adoption of the Air Quality Health Index (AQHI): a qualitative study.

    Science.gov (United States)

    Radisic, Sally; Newbold, K Bruce

    2016-03-31

    The Air Quality Health Index (AQHI) provides air quality and health information such that the public can implement health protective behaviours (reducing and/or rescheduling outdoor activity) and decrease exposure to outdoor air pollution. The AQHI's health messages account for increased risk associated with "at risk" populations (i.e. young children, elderly and those with pre-existing respiratory and/or cardiovascular conditions) who rely on health care and service providers for guidance. Using Rogers' Diffusion of Innovations theory, our objective with respect to health care and service providers and their respective "at risk" populations was to explore: 1) level of AQHI knowledge; 2) factors influencing AQHI adoption and; 3) strategies that may increase uptake of AQHI, according to city divisions and socioeconomic status (SES). Semi-structured face-to-face interviews with health care (Registered Nurses and Certified Respiratory Educators) and service providers (Registered Early Childhood Educators) and focus groups with their respective "at risk" populations explored barriers and facilitators to AQHI adoption. Participants were selected using purposive sampling. Each transcript was analyzed using an Interpretive Description approach to identify themes. Analyses were informed by Rogers' Diffusion of Innovations theory. Fifty participants (6 health care and service providers, 16 parents, 13 elderly, 15 people with existing respiratory conditions) contributed to this study. AQHI knowledge, AQHI characteristics and perceptions of air quality and health influenced AQHI adoption. AQHI knowledge centred on numerical reliance and health protective intent but varied with SES. More emphasis on AQHI relevance with respect to health benefits was required to stress relative advantage over other indices and reduce index confusion. AQHI reporting at a neighbourhood scale was recognized as addressing geographic variability and uncertainty in perceived versus measured air

  12. Qualitative methods textbooks

    OpenAIRE

    Barndt, William

    2003-01-01

    Over the past few years, the number of political science departments offering qualitative methods courses has grown substantially. The number of qualitative methods textbooks has kept pace, providing instructors with an overwhelming array of choices. But how to decide which text to choose from this exhortatory smorgasbord? The scholarship desperately needs evaluated. Yet the task is not entirely straightforward: qualitative methods textbooks reflect the diversity inherent in qualitative metho...

  13. Exploring Working Relationships in Mental Health Care via an E-Recovery Portal: Qualitative Study on the Experiences of Service Users and Health Providers.

    Science.gov (United States)

    Strand, Monica; Gammon, Deede; Eng, Lillian Sofie; Ruland, Cornelia

    2017-11-14

    The quality of working relationships between service users and health providers is fundamental in the processes of recovery in mental health. How Internet-based interventions will influence these relationships for persons with long-term care needs, and the measures that can be taken to maintain and enhance working relationships through Internet, is still not well understood. The aim of this study was to gain insights into how service users and health providers experience their working relationships when they are offered the option of supplementing ongoing collaboration with an e-recovery portal. In this exploratory and descriptive study, an e-recovery portal was used by service users and their health providers in 2 mental health communities in Norway for at least 6 months and at most 12 months (2015-2016). The portal consists of secure messaging, a peer support forum, and a toolbox of resources for working with life domains including status, goals and activities, network map, crisis plan, and exercises. The portal was owned and managed by the service user while health providers could remotely access parts of the service user-generated content. The participants could use the portal in whatever way they wished, to suit their collaboration. Data from 6 focus groups, 17 individual interviews, and an interview with 1 dyad about their experiences of use of the portal over the study period were inductively coded and thematically analyzed. The thematic analysis resulted in 2 main themes: (1) new relational avenues and (2) out of alignment, illustrated by 8 subthemes. The first main theme is about dyads who reported new and enriching ways of working together through the portal, particularly related to written communication and use of the goal module. Illustrative subthemes are ownership, common ground, goals and direction, and sense of presence and availability. The second main theme illuminates the difficulties that arose when service users' and health providers

  14. DOUBLE SHELL TANK INTEGRITY PROJECT HIGH LEVEL WASTE CHEMISTRY OPTIMIZATION

    International Nuclear Information System (INIS)

    WASHENFELDER DJ

    2008-01-01

    The U.S. Department of Energy's Office (DOE) of River Protection (ORP) has a continuing program for chemical optimization to better characterize corrosion behavior of High-Level Waste (HLW). The DOE controls the chemistry in its HLW to minimize the propensity of localized corrosion, such as pitting, and stress corrosion cracking (SCC) in nitrate-containing solutions. By improving the control of localized corrosion and SCC, the ORP can increase the life of the Double-Shell Tank (DST) carbon steel structural components and reduce overall mission costs. The carbon steel tanks at the Hanford Site are critical to the mission of safely managing stored HLW until it can be treated for disposal. The DOE has historically used additions of sodium hydroxide to retard corrosion processes in HLW tanks. This also increases the amount of waste to be treated. The reactions with carbon dioxide from the air and solid chemical species in the tank continually deplete the hydroxide ion concentration, which then requires continued additions. The DOE can reduce overall costs for caustic addition and treatment of waste, and more effectively utilize waste storage capacity by minimizing these chemical additions. Hydroxide addition is a means to control localized and stress corrosion cracking in carbon steel by providing a passive environment. The exact mechanism that causes nitrate to drive the corrosion process is not yet clear. The SCC is less of a concern in the newer stress relieved double shell tanks due to reduced residual stress. The optimization of waste chemistry will further reduce the propensity for SCC. The corrosion testing performed to optimize waste chemistry included cyclic potentiodynamic volarization studies. slow strain rate tests. and stress intensity factor/crack growth rate determinations. Laboratory experimental evidence suggests that nitrite is a highly effective:inhibitor for pitting and SCC in alkaline nitrate environments. Revision of the corrosion control

  15. Patient–Provider Communication and Counseling about Gestational Weight Gain and Physical Activity: A Qualitative Study of the Perceptions and Experiences of Latinas Pregnant with their First Child

    Directory of Open Access Journals (Sweden)

    Ana Cristina Lindsay

    2017-11-01

    Full Text Available Latina women in the United States (U.S. are disproportionately affected by obesity and are more likely to begin pregnancy overweight and gain excessive weight during pregnancy. The prenatal care period represents a window of opportunity for women to access the healthcare system and receive preventive services, education, nutritional support, and other social services to improve pregnancy outcomes. Excessive gestational weight gain (GWG has numerous negative short- and long-term consequences for both the mother and newborn. We explored nulliparous Latina women’s perceptions about their experiences communicating with their primary healthcare provider about GWG and physical activity (PA to identify possible intervention targets using in-depth, semi-structured interviews. Bilingual, trained research staff conducted 23 interviews with first-time pregnant Latinas between 22 and 36 weeks of gestation. Interviews were transcribed verbatim and analyzed using content analysis. Salient text passages were extracted, shortened, coded, and grouped into categories. Women, including those who self-identified as being overweight or obese prior to pregnancy, reported receiving limited or no advice from their healthcare providers about GWG or PA. Additionally, analysis revealed that although participants value information received from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC program counselors, they would like to receive more information from their primary healthcare providers about adequate GWG. Furthermore, study findings indicate that some participants received conflicting information regarding PA during pregnancy. Study findings suggest the need for increased integration of communication and counseling about GWG and PA into prenatal care services to promote healthy weight gain and PA among low-income Latina women.

  16. Study on high-level waste geological disposal metadata model

    International Nuclear Information System (INIS)

    Ding Xiaobin; Wang Changhong; Zhu Hehua; Li Xiaojun

    2008-01-01

    This paper expatiated the concept of metadata and its researches within china and abroad, then explain why start the study on the metadata model of high-level nuclear waste deep geological disposal project. As reference to GML, the author first set up DML under the framework of digital underground space engineering. Based on DML, a standardized metadata employed in high-level nuclear waste deep geological disposal project is presented. Then, a Metadata Model with the utilization of internet is put forward. With the standardized data and CSW services, this model may solve the problem in the data sharing and exchanging of different data form A metadata editor is build up in order to search and maintain metadata based on this model. (authors)

  17. In-situ nitrite analysis in high level waste tanks

    International Nuclear Information System (INIS)

    O'Rourke, P.E.; Prather, W.S.; Livingston, R.R.

    1992-01-01

    The Savannah River Site produces special nuclear materials used in the defense of the United States. Most of the processes at SRS are primarily chemical separations and purifications. In-situ chemical analyses help improve the safety, efficiency and quality of these operations. One area where in situ fiberoptic spectroscopy can have a great impact is the management of high level radioactive waste. High level radioactive waste at SRS is stored in more than 50 large waste tanks. The waste exists as a slurry of nitrate salts and metal hydroxides at pH's higher than 10. Sodium Nitrite is added to the tanks as a corrosion inhibitor. In-situ fiberoptic probes are being developed to measure the nitrate, nitrite and hydroxide concentrations in both liquid and solid fractions. Nitrite levels can be measured between 0.01M and 1M in a 1mm pathlength optical cell

  18. Glass-solidification method for high level radioactive liquid waste

    International Nuclear Information System (INIS)

    Kawamura, Kazuhiro; Kometani, Masayuki; Sasage, Ken-ichi.

    1996-01-01

    High level liquid wastes are removed with precipitates mainly comprising Mo and Zr, thereafter, the high level liquid wastes are mixed with a glass raw material comprising a composition having a B 2 O 3 /SiO 2 ratio of not less than 0.41, a ZnO/Li 2 O ratio of not less than 1.00, and an Al 2 O 3 /Li 2 O ratio of not less than 2.58, and they are melted and solidified into glass-solidification products. The liquid waste content in the glass-solidification products can be increased up to about 45% by using the glass raw material having such a predetermined composition. In addition, deposition of a yellow phase does not occur, and a leaching rate identical with that in a conventional case can be maintained. (T.M.)

  19. Nondestructive examination of DOE high-level waste storage tanks

    International Nuclear Information System (INIS)

    Bush, S.; Bandyopadhyay, K.; Kassir, M.; Mather, B.; Shewmon, P.; Streicher, M.; Thompson, B.; van Rooyen, D.; Weeks, J.

    1995-01-01

    A number of DOE sites have buried tanks containing high-level waste. Tanks of particular interest am double-shell inside concrete cylinders. A program has been developed for the inservice inspection of the primary tank containing high-level waste (HLW), for testing of transfer lines and for the inspection of the concrete containment where possible. Emphasis is placed on the ultrasonic examination of selected areas of the primary tank, coupled with a leak-detection system capable of detecting small leaks through the wall of the primary tank. The NDE program is modelled after ASME Section XI in many respects, particularly with respects to the sampling protocol. Selected testing of concrete is planned to determine if there has been any significant degradation. The most probable failure mechanisms are corrosion-related so that the examination program gives major emphasis to possible locations for corrosion attack

  20. Evaluation and selection of candidate high-level waste forms

    International Nuclear Information System (INIS)

    1982-03-01

    Seven candidate waste forms being developed under the direction of the Department of Energy's National High-Level Waste (HLW) Technology Program, were evaluated as potential media for the immobilization and geologic disposal of high-level nuclear wastes. The evaluation combined preliminary waste form evaluations conducted at DOE defense waste-sites and independent laboratories, peer review assessments, a product performance evaluation, and a processability analysis. Based on the combined results of these four inputs, two of the seven forms, borosilicate glass and a titanate based ceramic, SYNROC, were selected as the reference and alternative forms for continued development and evaluation in the National HLW Program. Both the glass and ceramic forms are viable candidates for use at each of the DOE defense waste-sites; they are also potential candidates for immobilization of commercial reprocessing wastes. This report describes the waste form screening process, and discusses each of the four major inputs considered in the selection of the two forms

  1. Storage of High Level Nuclear Waste in Germany

    Directory of Open Access Journals (Sweden)

    Dietmar P. F. Möller

    2007-01-01

    Full Text Available Nuclear energy is very often used to generate electricity. But first the energy must be released from atoms what can be done in two ways: nuclear fusion and nuclear fission. Nuclear power plants use nuclear fission to produce electrical energy. The electrical energy generated in nuclear power plants does not produce polluting combustion gases but a renewable energy, an important fact that could play a key role helping to reduce global greenhouse gas emissions and tackling global warming especially as the electricity energy demand rises in the years ahead. This could be assumed as an ideal win-win situation, but the reverse site of the medal is that the production of high-level nuclear waste outweighs this advantage. Hence the paper attempt to highlight the possible state-of-art concepts for the safe and sustaining storage of high-level nuclear waste in Germany.

  2. Radiation transport in high-level waste form

    International Nuclear Information System (INIS)

    Arakali, V.S.; Barnes, S.M.

    1992-01-01

    The waste form selected for vitrifying high-level nuclear waste stored in underground tanks at West Valley, NY is borosilicate glass. The maximum radiation level at the surface of a canister filled with the high-level waste form is prescribed by repository design criteria for handling and disposition of the vitrified waste. This paper presents an evaluation of the radiation transport characteristics for the vitreous waste form expected to be produced at West Valley and the resulting neutron and gamma dose rates. The maximum gamma and neutron dose rates are estimated to be less than 7500 R/h and 10 mRem/h respectively at the surface of a West Valley canister filled with borosilicate waste glass

  3. Multipurpose optimization models for high level waste vitrification

    International Nuclear Information System (INIS)

    Hoza, M.

    1994-08-01

    Optimal Waste Loading (OWL) models have been developed as multipurpose tools for high-level waste studies for the Tank Waste Remediation Program at Hanford. Using nonlinear programming techniques, these models maximize the waste loading of the vitrified waste and optimize the glass formers composition such that the glass produced has the appropriate properties within the melter, and the resultant vitrified waste form meets the requirements for disposal. The OWL model can be used for a single waste stream or for blended streams. The models can determine optimal continuous blends or optimal discrete blends of a number of different wastes. The OWL models have been used to identify the most restrictive constraints, to evaluate prospective waste pretreatment methods, to formulate and evaluate blending strategies, and to determine the impacts of variability in the wastes. The OWL models will be used to aid in the design of frits and the maximize the waste in the glass for High-Level Waste (HLW) vitrification

  4. Chromosome Aberration on High Level Background Natural Radiation Areas

    International Nuclear Information System (INIS)

    Yanti-Lusiyanti; Zubaidah-Alatas

    2001-01-01

    When the body is irradiated, all cells can suffer cytogenetic damage that can be seen as structural damage of chromosome in the lymphocytes. People no matter where they live in world are exposed to background radiation from natural sources both internal and external such as cosmic radiation, terrestrial radiation, cosmogenic radiation radon and thoron. Level of area natural ionizing radiation is varies depending on the altitude, the soil or rock conditions, particular food chains and the building materials and construction features. Level of normal areas of background exposure is annual effective dose 2.4 mSv and the high level areas of background exposure 20 mSv. This paper discuses the frequency of aberration chromosome especially dysenteries in several countries having high level radiation background. It seems that frequency of chromosome aberrations increase, generally with the increase of age of the people and the accumulated dose received. (author)

  5. Safety of geologic disposal of high level radioactive waste

    International Nuclear Information System (INIS)

    Zaitsu, Tomohisa; Ishiguro, Katsuhiko; Masuda, Sumio

    1992-01-01

    This article introduces current concepts of geologic disposal of high level radioactive waste and its safety. High level radioactive waste is physically stabilized by solidifying it in a glass form. Characteristics of deep geologic layer are presented from the viewpoint of geologic disposal. Reconstruction of multi-barrier system receives much attention to secure the safety of geologic disposal. It is important to research performance assessment of multi-barrier system for preventing dissolution or transfer of radionuclides into the ground water. Physical and chemical modeling for the performance assessment is outlined in the following terms: (1) chemical property of deep ground water, (2) geochemical modeling of artificial barrier spatial water, (3) hydrology of deep ground water, (4) hydrology of the inside of artificial barrier, and (5) modeling of radionuclide transfer from artificial barrier. (N.K.)

  6. Development of high-level waste solidification technology 1

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Joon Hyung; Kim, Hwan Young; Kim, In Tae [and others

    1999-02-01

    Spent nuclear fuel contains useful nuclides as valuable resource materials for energy, heat and catalyst. High-level wastes (HLW) are expected to be generated from the R and D activities and reuse processes. It is necessary to develop vitrification or advanced solidification technologies for the safe long-term management of high level wastes. As a first step to establish HLW vitrification technology, characterization of HLWs that would arise at KAERI site, glass melting experiments with a lab-scale high frequency induction melter, and fabrication and property evaluation of base-glass made of used HEPA filter media and additives were performed. Basic study on the fabrication and characterization of candidate ceramic waste form (Synroc) was also carried out. These HLW solidification technologies would be directly useful for carrying out the R and Ds on the nuclear fuel cycle and waste management. (author). 70 refs., 29 tabs., 35 figs.

  7. Economic considerations/comparisons for the disposal of defense high-level waste

    International Nuclear Information System (INIS)

    Leclaire, D.B.; Lazur, E.G.

    1985-01-01

    This paper provides a summary, in a generic sense, of the economic considerations and comparisons of permanent isolation of defense high-level waste (DHLW) in a licensed geologic repository. Topics considered include underground disposal, economic analysis, comparative evaluations, national defense, radioactive waste facilities, and licensing

  8. SymexTRON: Symbolic Execution of High-Level Transformation Languages

    DEFF Research Database (Denmark)

    Al-Sibahi, Ahmad Salim; Dimovski, Aleksandar; Wasowski, Andrzej

    2016-01-01

    Transformations form an important part of developing domain specific languages, where they are used to provide semantics for typing and evaluation. Yet, few solutions exist for verifying transformations written in expressive high-level transformation languages. We take a step towards that goal, b...

  9. IAEA coordinated research program on the evaluation of solidified high-level radioactive waste products

    International Nuclear Information System (INIS)

    Grover, J.R.; Schneider, K.J.

    1979-01-01

    A coordinated research program on the evaluation of solidified high-level radioactive waste products has been active with the IAEA since 1976. The program's objectives are to integrate research and to provide a data bank on an international basis in this subject area. Results and considerations to date are presented

  10. Using depleted uranium to shield vitrified high-level waste packages

    International Nuclear Information System (INIS)

    Yoshimura, H.R.; Gildea, P.D.; Bernard, E.A.

    1995-01-01

    The underlying report for this paper evaluates options for using depleted uranium as shielding materials for transport systems for disposal of vitrified high-level waste (VHLW). In addition, economic analyses are presented to compare costs associated with these options to costs, associated with existing and proposed storage, transport, and diposal capabilities. A more detailed evaluation is provided elsewhere. (Yoshimura et al. 1995.)

  11. Radionuclide compositions of spent fuel and high level waste from commercial nuclear reactors

    International Nuclear Information System (INIS)

    Goodill, D.R.; Tymons, B.J.

    1984-10-01

    This report provides information on radionuclide compositions of spent fuel and high level waste produced during reprocessing. The reactor types considered are Magnox, AGR, PWR and CFR. The activities of the radionuclides are calculated using the FISPIN code. The results are presented in a form suitable for radioactive waste management calculations. (author)

  12. The Evolution of Power System Planning with High Levels of Variable Renewable Generation

    Energy Technology Data Exchange (ETDEWEB)

    Katz, Jessica [National Renewable Energy Lab. (NREL), Golden, CO (United States); Milligan, Michael [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2016-09-01

    Greening the Grid provides technical assistance to energy system planners, regulators, and grid operators to overcome challenges associated with integrating variable renewable energy into the grid. This document, part of the Greening the Grid introduces the evolution of power system planning with high levels of variable renewable generation.

  13. Insect cell transformation vectors that support high level expression and promoter assessment in insect cell culture

    Science.gov (United States)

    A somatic transformation vector, pDP9, was constructed that provides a simplified means of producing permanently transformed cultured insect cells that support high levels of protein expression of foreign genes. The pDP9 plasmid vector incorporates DNA sequences from the Junonia coenia densovirus th...

  14. Adapting high-level language programs for parallel processing using data flow

    Science.gov (United States)

    Standley, Hilda M.

    1988-01-01

    EASY-FLOW, a very high-level data flow language, is introduced for the purpose of adapting programs written in a conventional high-level language to a parallel environment. The level of parallelism provided is of the large-grained variety in which parallel activities take place between subprograms or processes. A program written in EASY-FLOW is a set of subprogram calls as units, structured by iteration, branching, and distribution constructs. A data flow graph may be deduced from an EASY-FLOW program.

  15. Development of a geoscience database for preselecting China's high level radioactive waste disposal sites

    International Nuclear Information System (INIS)

    Li Jun; Fan Ai; Huang Shutao; Wang Ju

    1998-01-01

    Taking the development of a geoscience database for China's high level waste disposal sites: Yumen Town, Gansu Province, northwest of China, as an example, the author introduces in detail the application of Geographical Information System (GIS) to high level waste disposal and analyses its application prospect in other fields. The development of GIS provides brand-new thinking for administrators and technicians at all levels. At the same time, the author also introduces the administration of maps and materials by using Geographical Information System

  16. Development of a geoscience database for preselecting China's high level radioactive waste disposal sites

    International Nuclear Information System (INIS)

    Li Jun; Fan Ai; Huang Shutao; Wang Ju

    2004-01-01

    Taking the development of a geoscience database for China's high level waste disposal sites: Yumen Town, Guansu province, northwest of China, as an example, this paper introduces in detail the application of Geographical Information System (GIS) to high level waste disposal and analyses its application prospect in other fields. The development of GIS provides brand-new thinking for administrators and technicians at all levels. At the same time, this paper also introduces the administration of maps and materials by using Geographical Information System. (author)

  17. Leaching behavior of simulated high-level waste glass

    International Nuclear Information System (INIS)

    Kamizono, Hiroshi

    1987-03-01

    The author's work in the study on the leaching behavior of simulated high-level waste (HLW) glass were summarized. The subjects described are (1) leach rates at high temperatures, (2) effects of cracks on leach rates, (3) effects of flow rate on leach rates, and (4) an in-situ burial test in natural groundwater. In the following section, the leach rates obtained by various experiments were summarized and discussed. (author)

  18. The tracking of high level waste shipments-TRANSCOM system

    International Nuclear Information System (INIS)

    Johnson, P.E.; Joy, D.S.; Pope, R.B.

    1995-01-01

    The TRANSCOM (transportation tracking and communication) system is the U.S. Department of Energy's (DOE's) real-time system for tracking shipments of spent fuel, high-level wastes, and other high-visibility shipments of radioactive material. The TRANSCOM system has been operational since 1988. The system was used during FY1993 to track almost 100 shipments within the US.DOE complex, and it is accessed weekly by 10 to 20 users

  19. High-level Component Interfaces for Collaborative Development: A Proposal

    Directory of Open Access Journals (Sweden)

    Thomas Marlowe

    2009-12-01

    Full Text Available Software development has rapidly moved toward collaborative development models where multiple partners collaborate in creating and evolving software intensive systems or components of sophisticated ubiquitous socio-technical-ecosystems. In this paper we extend the concept of software interface to a flexible high-level interface as means for accommodating change and localizing, controlling and managing the exchange of knowledge and functional, behavioral, quality, project and business related information between the partners and between the developed components.

  20. Mixing Processes in High-Level Waste Tanks - Final Report

    International Nuclear Information System (INIS)

    Peterson, P.F.

    1999-01-01

    The mixing processes in large, complex enclosures using one-dimensional differential equations, with transport in free and wall jets is modeled using standard integral techniques. With this goal in mind, we have constructed a simple, computationally efficient numerical tool, the Berkeley Mechanistic Mixing Model, which can be used to predict the transient evolution of fuel and oxygen concentrations in DOE high-level waste tanks following loss of ventilation, and validate the model against a series of experiments

  1. Status of the French nuclear high level waste disposal

    International Nuclear Information System (INIS)

    Sombret, C.

    1985-09-01

    French research on high level waste processing has led to the development of industrial vitrification facilities. Borosilicate glass is still being investigated for its long-term storage properties, since it is itself a component of the containment system. The other constituents of this system, the engineered barriers, are also being actively investigated. The geological barrier is now being assessed using a methodology applicable to various types of geological formations, and final site qualification should be possible before the end of 1992

  2. Soil-structure interaction effects on high level waste tanks

    International Nuclear Information System (INIS)

    Miller, C.A.; Costantino, C.J.; Heymsfeld, E.

    1991-01-01

    High Level Waste Tanks consist of steel tanks located in concrete vaults which are usually completely embedded in the soil. Many of these tanks are old and were designed to seismic standards which are not compatible with current requirements. The objective if this paper is to develop simple methods of modeling SSI effects for such structures and to obtain solutions for a range of parameters that can be used to identify significant aspects of the problem

  3. High-level neutron coincidence counter (HLNCC): users' manual

    International Nuclear Information System (INIS)

    Krick, M.S.; Menlove, H.O.

    1979-06-01

    This manual describes the portable High-Level Neutron Coincidence Counter (HLNCC) developed at the Los Alamos Scientific Laboratory (LASL) for the assay of plutonium, particularly by inspectors of the International Atomic Energy Agency (IAEA). The counter is designed for the measurement of the effective 240 Pu mass in plutonium samples which may have a high plutonium content. The following topics are discussed: principle of operation, description of the system, operating procedures, and applications

  4. Development of cermets for high-level radioactive waste fixation

    International Nuclear Information System (INIS)

    Aaron, W.S.; Quinby, T.C.; Kobisk, E.H.

    1979-01-01

    A method is currently under development for the solidification and fixation of commercial and defense high-level radioactive wastes in the form of ceramic particles encapsulated by metal, i.e., a cermet. The chemical and physical processing techniques which have been developed and the properties of the resulting cermet bodies are described in this paper. These cermets have the advantages of high thermal conductivity and low leach rates

  5. Research on high level radioactive waste repository seismic design criteria

    International Nuclear Information System (INIS)

    Jing Xu

    2012-01-01

    Review seismic hazard analysis principle and method in site suitable assessment process of Yucca Mountain Project, and seismic design criteria and seismic design basis in primary design process. Demonstrated spatial character of seismic hazard by calculated regional seismic hazard map. Contrasted different level seismic design basis to show their differences and relation. Discussed seismic design criteria for preclosure phrase of high level waste repository and preference goal under beyond design basis ground motion. (author)

  6. The tracking of high level waste shipments - TRANSCOM system

    International Nuclear Information System (INIS)

    Johnson, P.E.; Joy, D.S.; Pope, R.B.; Thomas, T.M.; Lester, P.B.

    1994-01-01

    The TRANSCOM (transportation tracking and communication) system is the US Department of Energy's (DOE's) real-time system for tracking shipments of spent fuel, high-level wastes, and other high-visibility shipments of radioactive material. The TRANSCOM system has been operational since 1988. The system was used during FY 1993 to track almost 100 shipments within the US DOE complex, and it is accessed weekly by 10 to 20 users

  7. A High Level Model of a Conscious Embodied Agent

    Czech Academy of Sciences Publication Activity Database

    Wiedermann, Jiří

    2010-01-01

    Roč. 2, č. 3 (2010), s. 62-78 ISSN 1942-9045 R&D Projects: GA ČR GAP202/10/1333 Institutional research plan: CEZ:AV0Z10300504 Keywords : embodied agent * internal world models * higher cognitive function Subject RIV: IN - Informatics, Computer Science http://www.igi-global.com/article/high-level-model-conscious-embodied/46147

  8. Production and utilization of high level and long duration shocks

    International Nuclear Information System (INIS)

    Labrot, R.

    1978-01-01

    In order to verify the behaviour of equipments under extreme environmental conditions (propulsion, falls, impacts...), it is necessary to create 'high level and long duration shocks'. For these shocks, the velocity variation ΔV, which is equal to the area under the accelerogram γ (t), can reach several hundred meters per second. These velocity variations cannot be performed via classical free fall shock machine (ΔV [fr

  9. Developing a gender-based approach to chronic conditions and women's health: a qualitative investigation of community-dwelling women and service provider perspectives.

    Science.gov (United States)

    DiGiacomo, Michelle; Green, Anna; Rodrigues, Emma; Mulligan, Kathryn; Davidson, Patricia M

    2015-11-21

    Chronic conditions contribute to over 70 % of Australia's total disease burden, and this is set to increase to 80 % by 2020. Women's greater longevity means that they are more likely than men to live with disability and have unique health concerns related to their gender based roles in society. Cultural and social issues can impact on women's health and are important to consider in health services planning and research. In this study, we aimed to identify barriers and facilitators to providing a gender-based approach to chronic conditions and women's health in an eastern metropolitan region of Australia. Focus groups were used to engage both community-dwelling women who had chronic conditions and relevant professional stakeholders in the target area. Recorded proceedings underwent thematic analysis. Five focus groups were conducted with professional stakeholders and women community members in February and March 2014. Resultant themes included: women's disempowerment through interactions with health systems; social and economic constraints and caregiving roles act to exclude women from participating in self-care and society; and empowerment can be achieved through integrated models of care that facilitate voice and enable communication and engagement. This study underscores the importance of including perspectives of sex and gender in health care services planning. Tailoring services to socio-demographic and cultural groups is critical in promoting access to health care services. Unique epidemiological trends, particularly the ageing of women and new migrant groups, require particular attention.

  10. Using peer advocates to improve access to services among hard-to-reach populations with hepatitis C: a qualitative study of client and provider relationships.

    Science.gov (United States)

    MacLellan, Jennifer; Surey, Julian; Abubakar, Ibrahim; Stagg, Helen R; Mannell, Jenevieve

    2017-11-28

    Peer support programmes use individuals with specific experiences to improve engagement and outcomes among new clients. However, the skills and techniques used to achieve this engagement have not been mapped. This potentially restricts the development and replication of successful peer advocate models of care. This study explored how a group of peer advocates with experience of homelessness, alcohol and drug misuse made and sustained relationships with their client group. For the purposes of this project, the client group were located among a hepatitis C-positive cohort of people who have a history of injecting drug use and homelessness. Five self-selecting advocates gave a narrative interview lasting 40-90 min. These interviews were double transcribed using both thematic analysis and narrative analysis in order to triangulate the data and provide a robust set of findings about the unique skills of peer advocates in creating and sustaining relationships with clients from hard-to-reach populations. Peer advocates build rapport with clients through disclosing personal details about their lives. While this runs counter to assumptions about the need to maintain distance in client-patient relationships, the therapeutic benefits appear to outweigh the potential costs of this engagement. We conclude the therapeutic benefits of self-disclosure between peer advocates and their clients offer a moral grounding for self-disclosure as a means of building relationships with key hard-to-reach populations.

  11. The other 23 hours: a qualitative study of fitness provider perspectives on social support for health promotion for adults with mental illness.

    Science.gov (United States)

    Aschbrenner, Kelly; Mueser, Kim; Bartels, Stephen; Carpenter-Song, Elizabeth; Pratt, Sarah; Barre, Laura; Naslund, John; Kinney, Allison

    2015-05-01

    Current efforts to reduce the increased risk of premature death from preventable cardiovascular disease among adults with serious mental illness (SMI) through lifestyle change have had limited success. Engaging informal support systems to promote healthy behaviors in everyday life may increase the effectiveness of health promotion interventions targeting this at-risk population. In-depth semistructured interviews were conducted with 10 fitness trainers serving adults with SMI in a health promotion program at community mental health centers to explore their perspectives on the potential of enlisting support from significant others for health behavior change. Trainers reported that the majority of participants had a relative or significant other who influenced their health behaviors, and they saw potential value in involving them in efforts to improve health outcomes by extending support into participants' daily lives. They did not feel qualified to work with families of individuals with mental illness, but they were willing to partner with providers who had experience in this area. Social workers who practice with families could play a critical role on health promotion teams addressing cardiovascular risk in adults with SMI by using their skills and experiences to engage families in supporting a relative through the process of health behavior change.

  12. Evaluation of conditioned high-level waste forms

    International Nuclear Information System (INIS)

    Mendel, J.E.; Turcotte, R.P.; Chikalla, T.D.; Hench, L.L.

    1983-01-01

    The evaluation of conditioned high-level waste forms requires an understanding of radiation and thermal effects, mechanical properties, volatility, and chemical durability. As a result of nuclear waste research and development programs in many countries, a good understanding of these factors is available for borosilicate glass containing high-level waste. The IAEA through its coordinated research program has contributed to this understanding. Methods used in the evaluation of conditioned high-level waste forms are reviewed. In the US, this evaluation has been facilitated by the definition of standard test methods by the Materials Characterization Center (MCC), which was established by the Department of Energy (DOE) in 1979. The DOE has also established a 20-member Materials Review Board to peer-review the activities of the MCC. In addition to comparing waste forms, testing must be done to evaluate the behavior of waste forms in geologic repositories. Such testing is complex; accelerated tests are required to predict expected behavior for thousands of years. The tests must be multicomponent tests to ensure that all potential interactions between waste form, canister/overpack and corrosion products, backfill, intruding ground water and the repository rock, are accounted for. An overview of the status of such multicomponent testing is presented

  13. High level cognitive information processing in neural networks

    Science.gov (United States)

    Barnden, John A.; Fields, Christopher A.

    1992-01-01

    Two related research efforts were addressed: (1) high-level connectionist cognitive modeling; and (2) local neural circuit modeling. The goals of the first effort were to develop connectionist models of high-level cognitive processes such as problem solving or natural language understanding, and to understand the computational requirements of such models. The goals of the second effort were to develop biologically-realistic model of local neural circuits, and to understand the computational behavior of such models. In keeping with the nature of NASA's Innovative Research Program, all the work conducted under the grant was highly innovative. For instance, the following ideas, all summarized, are contributions to the study of connectionist/neural networks: (1) the temporal-winner-take-all, relative-position encoding, and pattern-similarity association techniques; (2) the importation of logical combinators into connection; (3) the use of analogy-based reasoning as a bridge across the gap between the traditional symbolic paradigm and the connectionist paradigm; and (4) the application of connectionism to the domain of belief representation/reasoning. The work on local neural circuit modeling also departs significantly from the work of related researchers. In particular, its concentration on low-level neural phenomena that could support high-level cognitive processing is unusual within the area of biological local circuit modeling, and also serves to expand the horizons of the artificial neural net field.

  14. Final disposal of high levels waste and spent nuclear fuel

    International Nuclear Information System (INIS)

    Gelin, R.

    1984-05-01

    Foreign and international activities on the final disposal of high-level waste and spent nuclear fuel have been reviewed. A considerable research effort is devoted to development of acceptable disposal options. The different technical concepts presently under study are described in the report. Numerous studies have been made in many countries of the potential risks to future generations from radioactive wastes in underground disposal repositories. In the report the safety assessment studies and existing performance criteria for geological disposal are briefly discussed. The studies that are being made in Canada, the United States, France and Switzerland are the most interesting for Sweden as these countries also are considering disposal into crystalline rocks. The overall time-tables in different countries for realisation of the final disposal are rather similar. Normally actual large-scale disposal operations for high-level wastes are not foreseen until after year 2000. In the United States the Congress recently passed the important Nuclear Waste Policy Act. It gives a rather firm timetable for site-selection and construction of nuclear waste disposal facilities. According to this act the first repository for disposal of commercial high-level waste must be in operation not later than in January 1998. (Author)

  15. High level radioactive wastes: Considerations on final disposal

    International Nuclear Information System (INIS)

    Ciallella, Norberto R.

    2000-01-01

    When at the beginnings of the decade of the 80 the National Commission on Atomic Energy (CNEA) in Argentina decided to study the destination of the high level radioactive wastes, was began many investigations, analysis and multidisciplinary evaluations that be origin to a study of characteristics never before carried out in Argentina. For the first time in the country was faced the study of an environmental eventual problem, several decades before that the problem was presented. The elimination of the high level radioactive wastes in the technological aspects was taken in advance, avoiding to transfer the problems to the future generations. The decision was based, not only in technical evaluations but also in ethical premises, since it was considered that the future generations may enjoy the benefits of the nuclear energy and not should be solve the problem. The CNEA in Argentina in 1980 decided to begin a feasibility study and preliminary engineering project for the construction of the final disposal of high level radioactive wastes

  16. Standards for high level waste disposal: A sustainability perspective

    International Nuclear Information System (INIS)

    Dougherty, W.W.; Powers, V.; Johnson, F.X.; Cornland, D.

    1999-01-01

    Spent reactor fuel from commercial power stations contains high levels of plutonium, other fissionable actinides, and fission products, all of which pose serious challenges for permanent disposal because of the very long half-lives of some isotopes. The 'nuclear nations' have agreed on the use of permanent geologic repositories for the ultimate disposal of high-level nuclear waste. However, it is premature to claim that a geologic repository offers permanent isolation from the biosphere, given high levels of uncertainty, nascent risk assessment frameworks for the time periods considered, and serious intergenerational equity issues. Many have argued for a broader consideration of disposal options that include extended monitored retrievable storage and accelerator-driven transmutation of wastes. In this paper we discuss and compare these three options relative to standards that emerge from the application of sustainable development principles, namely long-lasting technical viability, intergenerational equity, rational resource allocation, and rights of future intervention. We conclude that in order to maximise the autonomy of future generations, it is imperative to leave future options more open than does permanent disposal

  17. Materials Science of High-Level Nuclear Waste Immobilization

    International Nuclear Information System (INIS)

    Weber, William J.; Navrotsky, Alexandra; Stefanovsky, S. V.; Vance, E. R.; Vernaz, Etienne Y.

    2009-01-01

    With the increasing demand for the development of more nuclear power comes the responsibility to address the technical challenges of immobilizing high-level nuclear wastes in stable solid forms for interim storage or disposition in geologic repositories. The immobilization of high-level nuclear wastes has been an active area of research and development for over 50 years. Borosilicate glasses and complex ceramic composites have been developed to meet many technical challenges and current needs, although regulatory issues, which vary widely from country to country, have yet to be resolved. Cooperative international programs to develop advanced proliferation-resistant nuclear technologies to close the nuclear fuel cycle and increase the efficiency of nuclear energy production might create new separation waste streams that could demand new concepts and materials for nuclear waste immobilization. This article reviews the current state-of-the-art understanding regarding the materials science of glasses and ceramics for the immobilization of high-level nuclear waste and excess nuclear materials and discusses approaches to address new waste streams

  18. The immobilization of High Level Waste Into Glass

    International Nuclear Information System (INIS)

    Aisyah; Martono, H.

    1998-01-01

    High level liquid waste is generated from the first step extraction in the nuclear fuel reprocessing. The waste is immobilized with boro-silicate glass. A certain composition of glass is needed for a certain type of waste, so that the properties of waste glass would meet the requirement either for further process or for disposal. The effect of waste loading on either density, thermal expansion, softening point and leaching rate has been studied. The composition of the high level liquid waste has been determined by ORIGEN 2 and the result has been used to prepare simulated high level waste. The waste loading in the waste glass has been set to be 19.48; 22.32; 25.27; and 26.59 weight percent. The result shows that increasing the waste loading has resulted in the higher density with no thermal expansion and softening point significant change. The increase in the waste loading increase that leaching rate. The properties of the waste glass in this research have not shown any deviation from the standard waste glass properties

  19. US program for the immobilization of high-level nuclear wastes

    International Nuclear Information System (INIS)

    Crandall, J.L.

    1979-01-01

    A program has been developed for long-term management of high-level nuclear waste. The Savannah River Operations Office of the US Department of Energy is acting as the lead office for this program with technical advice from the E.I. du Pont de Nemours and Company. The purpose of the long-term program is to immobilize the DOE high-level waste in forms that act as highly efficient barriers against radionuclide release to the disposal site and to provide technology for similar treatment of commercial high-level waste in case reprocessing of commercial nuclear fuels is ever resumed. Descriptions of existing DOE and commercial wastes, program strategy, program expenditures, development of waste forms, evaluation and selection of waste forms, regulatory aspects of waste form selection, project schedules, and cost estimates for immobilization facilities are discussed

  20. Synthetic hydrogeological study on Beishan preselected area for high-level radioactive waste repository in China

    International Nuclear Information System (INIS)

    Guo Yonghai; Su Rui; Ji Ruili; Wang Hailong; Liu Shufen; Zong Zihua; Dong Jiannan; Zhang Ming

    2014-01-01

    On the basis of large scale field hydrogeological investigation, synthetic hydrogeological studies related to groundwater system characteristics, permeability of rock bodies, groundwater dynamic, hydrogeochemistry, isotopic hydrology, CFC's of groundwater and groundwater flow field simulation were carried out for Beishan area, Gansu province. According to analysis on a large amount of hydrogeological data, the characteristics of groundwater circulation, groundwater hydrodynamics and hydrgeochemistry were described and the suitability of Beishan area as the potential area of high-level radioactive waste disposal was evaluated in the paper. Through this study, the hydrogeological study and evaluation methods in the siting of China's high level radioactive waste repository were set up. Furthermore, the important hydrogeological scientific evidence was provided for optimal site filtration of China's high-level radioactive waste repository in Beishan area. (authors)

  1. High-level radioactive waste management in the United States. Background and status: 1996

    International Nuclear Information System (INIS)

    Dyer, J.R.

    1996-01-01

    The US high-level radioactive waste disposal program is investigating a site at Yucca Mountain, Nevada, to determine whether or not it is a suitable location for the development of a deep mined geologic repository. At this time, the US program is investigating a single site, although in the past, the program involved successive screening and comparison of alternate locations. The United States civilian reactor programs do not reprocess spent fuel; the high-level waste repository will be designed for the emplacement or spent fuel and a limited amount of vitrified high-level wastes from previous reprocessing in the US. The legislation enabling the US program also contains provisions for a Monitored Retrievable Storage facility, which could provide temporary storage of spent fuel accepted for disposal, and improve the flexibility of the repository development schedule

  2. High-level waste processing at the Savannah River Site: An update

    International Nuclear Information System (INIS)

    Marra, J.E.; Bennett, W.M.; Elder, H.H.; Lee, E.D.; Marra, S.L.; Rutland, P.L.

    1997-01-01

    The Defense Waste Processing Facility (DWPF) at the Savannah River Site (SRS) in Aiken, SC mg began immobilizing high-level radioactive waste in borosilicate glass in 1996. Currently, the radioactive glass is being produced as a ''sludge-only'' composition by combining washed high-level waste sludge with glass frit. The glass is poured in stainless steel canisters which will eventually be disposed of in a permanent, geological repository. To date, DWPF has produced about 100 canisters of vitrified waste. Future processing operations will, be based on a ''coupled'' feed of washed high-level waste sludge, precipitated cesium, and glass frit. This paper provides an update of the processing activities completed to date, operational/flowsheet problems encountered, and programs underway to increase production rates

  3. Advanced High-Level Waste Glass Research and Development Plan

    Energy Technology Data Exchange (ETDEWEB)

    Peeler, David K. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Vienna, John D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Schweiger, Michael J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Fox, Kevin M. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

    2015-07-01

    The U.S. Department of Energy Office of River Protection (ORP) has implemented an integrated program to increase the loading of Hanford tank wastes in glass while meeting melter lifetime expectancies and process, regulatory, and product quality requirements. The integrated ORP program is focused on providing a technical, science-based foundation from which key decisions can be made regarding the successful operation of the Hanford Tank Waste Treatment and Immobilization Plant (WTP) facilities. The fundamental data stemming from this program will support development of advanced glass formulations, key process control models, and tactical processing strategies to ensure safe and successful operations for both the low-activity waste (LAW) and high-level waste (HLW) vitrification facilities with an appreciation toward reducing overall mission life. The purpose of this advanced HLW glass research and development plan is to identify the near-, mid-, and longer-term research and development activities required to develop and validate advanced HLW glasses and their associated models to support facility operations at WTP, including both direct feed and full pretreatment flowsheets. This plan also integrates technical support of facility operations and waste qualification activities to show the interdependence of these activities with the advanced waste glass (AWG) program to support the full WTP mission. Figure ES-1 shows these key ORP programmatic activities and their interfaces with both WTP facility operations and qualification needs. The plan is a living document that will be updated to reflect key advancements and mission strategy changes. The research outlined here is motivated by the potential for substantial economic benefits (e.g., significant increases in waste throughput and reductions in glass volumes) that will be realized when advancements in glass formulation continue and models supporting facility operations are implemented. Developing and applying advanced

  4. 'I am treated well if I adhere to my HIV medication': putting patient-provider interactions in context through insights from qualitative research in five sub-Saharan African countries.

    Science.gov (United States)

    Ondenge, Ken; Renju, Jenny; Bonnington, Oliver; Moshabela, Mosa; Wamoyi, Joyce; Nyamukapa, Constance; Seeley, Janet; Wringe, Alison; Skovdal, Morten

    2017-07-01

    The nature of patient-provider interactions and communication is widely documented to significantly impact on patient experiences, treatment adherence and health outcomes. Yet little is known about the broader contextual factors and dynamics that shape patient-provider interactions in high HIV prevalence and limited-resource settings. Drawing on qualitative research from five sub-Saharan African countries, we seek to unpack local dynamics that serve to hinder or facilitate productive patient-provider interactions. This qualitative study, conducted in Kisumu (Kenya), Kisesa (Tanzania), Manicaland (Zimbabwe), Karonga (Malawi) and uMkhanyakude (South Africa), draws upon 278 in-depth interviews with purposively sampled people living with HIV with different diagnosis and treatment histories, 29 family members of people who died due to HIV and 38 HIV healthcare workers. Data were collected using topic guides that explored patient testing and antiretroviral therapy treatment journeys. Thematic analysis was conducted, aided by NVivo V.8.0 software. Our analysis revealed an array of inter-related contextual factors and power dynamics shaping patient-provider interactions. These included (1) participants' perceptions of roles and identities of 'self' and 'other'; (2) conformity or resistance to the 'rules of HIV service engagement' and a 'patient-persona'; (3) the influence of significant others' views on service provision; and (4) resources in health services. We observed that these four factors/dynamics were located in the wider context of conceptualisations of power, autonomy and structure. Patient-provider interaction is complex, multidimensional and deeply embedded in wider social dynamics. Multiple contextual domains shape patient-provider interactions in the context of HIV in sub-Saharan Africa. Interventions to improve patient experiences and treatment adherence through enhanced interactions need to go beyond the existing focus on patient-provider communication

  5. Barriers and facilitators to providing primary care-based weight management services in a patient centered medical home for Veterans: a qualitative study.

    Science.gov (United States)

    Jay, Melanie; Chintapalli, Sumana; Squires, Allison; Mateo, Katrina F; Sherman, Scott E; Kalet, Adina L

    2015-11-14

    Obesity is highly prevalent among Veterans. In the United States, the Veterans Health Administration (VHA) offers a comprehensive weight management program called MOVE!. Yet, fewer than 10 % of eligible patients ever attend one MOVE! visit. The VHA has a patient-centered medical home (PCMH) model of primary care (PC) called Patient-Aligned Care Teams (PACT) at all Veterans Affairs (VA) Medical Centers. PACT teamlets conduct obesity screening, weight management counseling, and refer to MOVE!. As part of a needs assessment to improve delivery of weight management services, the purpose of this study was to assess PACT teamlet and MOVE! staff: 1) current attitudes and perceptions regarding obesity care; 2) obesity-related counseling practices 3) experiences with the MOVE! program; and 4) targets for interventions to improve implementation of obesity care in the PC setting. We recruited 25 PACT teamlet members from a single VA study site-11 PC physicians, 5 registered nurses, 5 licensed practical nurses, 1 clerical assistant, and 3 MOVE! staff (2 dietitians, 1 psychologist)-for individual interviews using a combination of convenience and snowball sampling. Audio recorded interviews were professionally transcribed and iteratively coded by two independent reviewers. The analytic process was guided by discourse analysis in order to discover how the participants perceived and provided weight management care and what specific attitudes affected their practices, all as bounded within the organization. Emerging themes included: 1) role perceptions, 2) anticipated outcomes of weight management counseling and programs, and 3) communication and information dissemination. Perceived role among PCPs was influenced by training, whereas personal experience with their own weight management impacted role perception among LPNs/RNs. Attitudes about whether or not they could impact patients' weight outcomes via counseling or referral to MOVE! varied. System-level communication about VHA

  6. The data module, the missing link in high level control languages

    International Nuclear Information System (INIS)

    Crowley-Milling, M.C.

    1979-01-01

    In order to be able to use the full power and simplicity of a high level language for writing plant control programs, it must be possible to use the plant variables in the same manner as program variables, completely transparent to the address structure of the hardware and interface. Some of the high level languages provide facilities for writing procedures or subroutines to make this possible. However, most of the facilities provided share a number of disadvantages: they are usually relatively complicated for the user, involving passing many parameters which the programmer has to specify at each call; they usually have restrictions on the data types that can be used, and the data bases are normally organised to suit the interface system. However, the high level programmer is interested in the equipment to be controlled such as motors, pumps, power supplies, valves, etc., rather than the means of interfacing the equipment, and it greatly simplifies his task if he can call for actions on these items, using simple mnemonic names and a simple format. The design of the control system for the CERN 400 GeV proton accelerator, using a network of some thirty computers, provided the opportunity to try out a different approach, using an interpreter for the high-level control language NODAL, together with special functions which are called 'data modules'. The use of the data module and interpreter are described. (author)

  7. High Level Competence: A Tool for Coping with Organizational Change

    Science.gov (United States)

    Heilmann, Pia

    2007-01-01

    Purpose: The purpose of this paper is to find out and understand the different competence development needs of managers and their ways of learning. The examined managers work in middle management in Finnish information and communication technology sector (ICT) and paper business sector. Design/methodology/approach: The research was qualitative by…

  8. Criticality Safety Evaluation of Hanford Site High Level Waste Storage Tanks

    Energy Technology Data Exchange (ETDEWEB)

    ROGERS, C.A.

    2000-02-17

    This criticality safety evaluation covers operations for waste in underground storage tanks at the high-level waste tank farms on the Hanford site. This evaluation provides the bases for criticality safety limits and controls to govern receipt, transfer, and long-term storage of tank waste. Justification is provided that a nuclear criticality accident cannot occur for tank farms operations, based on current fissile material and operating conditions.

  9. Criticality Safety Evaluation of Hanford Site High-Level Waste Storage Tanks

    International Nuclear Information System (INIS)

    ROGERS, C.A.

    2000-01-01

    This criticality safety evaluation covers operations for waste in underground storage tanks at the high-level waste tank farms on the Hanford site. This evaluation provides the bases for criticality safety limits and controls to govern receipt, transfer, and long-term storage of tank waste. Justification is provided that a nuclear criticality accident cannot occur for tank farms operations, based on current fissile material and operating conditions

  10. The IAEA's high level radioactive waste management programme

    International Nuclear Information System (INIS)

    Saire, D.E.

    1994-01-01

    This paper presents the different activities that are performed under the International Atomic Energy Agency's (IAEA) high level radioactive waste management programme. The Agency's programme is composed of five main activities (information exchange, international safety standards, R ampersand D activities, advisory services and special projects) which are described in the paper. Special emphasis is placed on the RADioactive WAste Safety Standards (RADWASS) programme which was implemented in 1991 to document international consensus that exists on the safe management of radioactive waste. The paper also raises the question about the need for regional repositories to serve certain countries that do not have the resources or infrastructure to construct a national repository

  11. Corrosion and failure processes in high-level waste tanks

    International Nuclear Information System (INIS)

    Mahidhara, R.K.; Elleman, T.S.; Murty, K.L.

    1992-11-01

    A large amount of radioactive waste has been stored safely at the Savannah River and Hanford sites over the past 46 years. The aim of this report is to review the experimental corrosion studies at Savannah River and Hanford with the intention of identifying the types and rates of corrosion encountered and indicate how these data contribute to tank failure predictions. The compositions of the High-Level Wastes, mild steels used in the construction of the waste tanks and degradation-modes particularly stress corrosion cracking and pitting are discussed. Current concerns at the Hanford Site are highlighted

  12. Global tracker for the ALICE high level trigger

    International Nuclear Information System (INIS)

    Vik, Thomas

    2006-01-01

    This thesis deals with two main topics. The first is the implementation and testing of a Kalman filter algorithm in the HLT (High Level Trigger) reconstruction code. This will perform the global tracking in the HLT, that is merging tracklets and hits from the different sub-detectors in the central barrel detector. The second topic is a trigger mode of the HLT which uses the global tracking of particles through the TRD (Transition Radiation Detector), TPC (Time Projection Chamber) and the ITS (Inner Tracking System): The dielectron trigger. Global tracking: The Kalman filter algorithm has been introduced to the HLT tracking scheme. (Author)

  13. Market Designs for High Levels of Variable Generation: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Milligan, M.; Holttinen, H.; Kiviluoma, J.; Orths, A.; Lynch, M.; Soder, L.

    2014-10-01

    Variable renewable generation is increasing in penetration in modern power systems, leading to higher variability in the supply and price of electricity as well as lower average spot prices. This raises new challenges, particularly in ensuring sufficient capacity and flexibility from conventional technologies. Because the fixed costs and lifetimes of electricity generation investments are significant, designing markets and regulations that ensure the efficient integration of renewable generation is a significant challenge. This papers reviews the state of play of market designs for high levels of variable generation in the United States and Europe and considers new developments in both regions.

  14. The high level and long lived radioactive wastes

    International Nuclear Information System (INIS)

    2005-01-01

    This report presents the main conclusions of 15 years of researches managed by the CEA. This report is the preliminary version of the 2005 final report. It presents the main conclusions of the actions on the axis 1 and 3 of the law of the 30 December 1991. The synthesis report on the axis 1 concerns results obtained on the long lived radionuclides separation and transmutation in high level and long lived radioactive wastes. the synthesis report on the axis 3 presents results obtained by the processes of conditioning and of ground and underground long term storage. (A.L.B.)

  15. High level waste at Hanford: Potential for waste loading maximization

    International Nuclear Information System (INIS)

    Hrma, P.R.; Bailey, A.W.

    1995-09-01

    The loading of Hanford nuclear waste in borosilicate glass is limited by phase-related phenomena, such as crystallization or formation of immiscible liquids, and by breakdown of the glass structure because of an excessive concentration of modifiers. The phase-related phenomena cause both processing and product quality problems. The deterioration of product durability determines the ultimate waste loading limit if all processing problems are resolved. Concrete examples and mass-balance based calculations show that a substantial potential exists for increasing waste loading of high-level wastes that contain a large fraction of refractory components

  16. Solidification of Savannah River Plant high-level waste

    International Nuclear Information System (INIS)

    Maher, R.; Shafranek, L.F.; Stevens, W.R. III.

    1983-01-01

    The Department of Energy, in accord with recommendations from the Du Pont Company, has started construction of a Defense Waste Processing Facility (DWPF) at the Savannah River Plant. The facility should be completed by the end of 1988, and full-scale operation should begin in 1990. This facility will immobilize in borosilicate glass the large quantity of high-level radioactive waste now stored at the plant plus the waste to be generated from continued chemical reprocessing operations. The existing wastes at the Savannah River Plant will be completely converted by about 2010. 21 figures

  17. Treatment of High-Level Waste Arising from Pyrochemical Processes

    International Nuclear Information System (INIS)

    Lizin, A.A.; Kormilitsyn, M.V.; Osipenko, A.G.; Tomilin, S.V.; Lavrinovich, Yu.G.

    2013-01-01

    JSC “SSC RIAR” has been performing research and development activities in support of closed fuel cycle of fast reactor since the middle of 1960s. Fuel cycle involves fabrication and reprocessing of spent nuclear fuel (SNF) using pyrochemical methods of reprocessing in molten alkali metal chlorides. At present pyrochemical methods of SNF reprocessing in molten chlorides has reached such a level in their development that makes it possible to compare their competitiveness with classic aqueous methods. Their comparative advantage lies in high safety, compactness, high protectability as to nonproliferation of nuclear materials, and reduction of high level waste volume

  18. Development and evaluation of candidate high-level waste forms

    International Nuclear Information System (INIS)

    Bernadzikowski, T.A.

    1981-01-01

    Some seventeen candidate waste forms have been investigated under US Department of Energy programs as potential media for the immobilization and geologic disposal of the high-level radioactive wastes (HLW) resulting from chemical processing of nuclear reactor fuels and targets. Two of these HLW forms were selected at the end of fiscal year (FY) 1981 for intensive development if FY 1982 to 1983. Borosilicate glass was continued as the reference form. A crystalline ceramic waste form, SYNROC, was selected for further product formulation and process development as the alternative to borosilicate glass. This paper describes the bases on which this decision was made

  19. High-level waste canister envelope study: structural analysis

    International Nuclear Information System (INIS)

    1977-11-01

    The structural integrity of waste canisters, fabricated from standard weight Type 304L stainless steel pipe, was analyzed for sizes ranging from 8 to 24 in. diameter and 10 to 16 feet long under normal, abnormal, and improbable life cycle loading conditions. The canisters are assumed to be filled with vitrified high-level nuclear waste, stored temporarily at a fuel reprocessing plant, and then transported for storage in an underground salt bed or other geologic storage. In each of the three impact conditions studies, the resulting impact force is far greater than the elastic limit capacity of the material. Recommendations are made for further study

  20. High-level neutron coincidence counter maintenance manual

    International Nuclear Information System (INIS)

    Swansen, J.; Collinsworth, P.

    1983-05-01

    High-level neutron coincidence counter operational (field) calibration and usage is well known. This manual makes explicit basic (shop) check-out, calibration, and testing of new units and is a guide for repair of failed in-service units. Operational criteria for the major electronic functions are detailed, as are adjustments and calibration procedures, and recurrent mechanical/electromechanical problems are addressed. Some system tests are included for quality assurance. Data on nonstandard large-scale integrated (circuit) components and a schematic set are also included

  1. High level trigger system for the ALICE experiment

    International Nuclear Information System (INIS)

    Frankenfeld, U.; Roehrich, D.; Ullaland, K.; Vestabo, A.; Helstrup, H.; Lien, J.; Lindenstruth, V.; Schulz, M.; Steinbeck, T.; Wiebalck, A.; Skaali, B.

    2001-01-01

    The ALICE experiment at the Large Hadron Collider (LHC) at CERN will detect up to 20,000 particles in a single Pb-Pb event resulting in a data rate of ∼75 MByte/event. The event rate is limited by the bandwidth of the data storage system. Higher rates are possible by selecting interesting events and subevents (High Level trigger) or compressing the data efficiently with modeling techniques. Both require a fast parallel pattern recognition. One possible solution to process the detector data at such rates is a farm of clustered SMP nodes, based on off-the-shelf PCs, and connected by a high bandwidth, low latency network

  2. FPGA Co-processor for the ALICE High Level Trigger

    CERN Document Server

    Grastveit, G.; Lindenstruth, V.; Loizides, C.; Roehrich, D.; Skaali, B.; Steinbeck, T.; Stock, R.; Tilsner, H.; Ullaland, K.; Vestbo, A.; Vik, T.

    2003-01-01

    The High Level Trigger (HLT) of the ALICE experiment requires massive parallel computing. One of the main tasks of the HLT system is two-dimensional cluster finding on raw data of the Time Projection Chamber (TPC), which is the main data source of ALICE. To reduce the number of computing nodes needed in the HLT farm, FPGAs, which are an intrinsic part of the system, will be utilized for this task. VHDL code implementing the Fast Cluster Finder algorithm, has been written, a testbed for functional verification of the code has been developed, and the code has been synthesized

  3. A high-level product representation for automatic design reasoning

    Energy Technology Data Exchange (ETDEWEB)

    Kroll, E.; Qamar, Z.; Mohammad, R. [Texas A and M Univ., College Station, TX (United States). Mechanical Engineering Dept.

    1994-12-31

    A high-level product representation has been developed and implemented, using features for part description and mating conditions between features for the relationships among parts. The underlying ideas are that features are necessary for effective design representation; that spatial and functional relationships among parts of an assembly are best expressed through mating conditions; that assembly features of a part may, at times, be different from its manufacturing features; and that a good representation should be natural, intelligent, comprehensive, and integrated with a visual display. Some new mating conditions have been defined and classified. Several problems concerning the use of features with mating conditions are discussed.

  4. High-level wastes: DOE names three sites for characterization

    International Nuclear Information System (INIS)

    Anon.

    1986-01-01

    DOE announced in May 1986 that there will be there site characterization studies made to determine suitability for a high-level radioactive waste repository. The studies will include several test drillings to the proposed disposal depths. Yucca Mountain, Nevada; Deaf Smith Country, Texas, and Hanford, Washington were identified as the study sites, and further studies for a second repository site in the East were postponed. The affected states all filed suits in federal circuit courts because they were given no advance warning of the announcement of their selection or the decision to suspend work on a second repository. Criticisms of the selection process include the narrowing or DOE options

  5. High-level neutron coincidence counter maintenance manual

    Energy Technology Data Exchange (ETDEWEB)

    Swansen, J.; Collinsworth, P.

    1983-05-01

    High-level neutron coincidence counter operational (field) calibration and usage is well known. This manual makes explicit basic (shop) check-out, calibration, and testing of new units and is a guide for repair of failed in-service units. Operational criteria for the major electronic functions are detailed, as are adjustments and calibration procedures, and recurrent mechanical/electromechanical problems are addressed. Some system tests are included for quality assurance. Data on nonstandard large-scale integrated (circuit) components and a schematic set are also included.

  6. Ionization chamber for measurements of high-level tritium gas

    International Nuclear Information System (INIS)

    Carstens, D.H.W.; David, W.R.

    1980-01-01

    The construction and calibration of a simple ionization-chamber apparatus for measurement of high level tritium gas is described. The apparatus uses an easily constructed but rugged chamber containing the unknown gas and an inexpensive digital multimeter for measuring the ion current. The equipment after calibration is suitable for measuring 0.01 to 100% tritium gas in hydrogen-helium mixes with an accuracy of a few percent. At both the high and low limits of measurements deviations from the predicted theoretical current are observed. These are briefly discussed

  7. Safe disposal of high-level radioactive wastes

    Energy Technology Data Exchange (ETDEWEB)

    Ringwood, A E [Australian National Univ., Canberra. Research School of Earth Sciences

    1980-10-01

    Current strategies in most countries favour the immobilisation of high-level radioactive wastes in borosilicate glasses, and their burial in large, centralised, mined repositories. Strong public opposition has been encountered because of concerns over safety and socio-political issues. The author develops a new disposal strategy, based on immobilisation of wastes in an extremely resistant ceramic, SYNROC, combined with burial in an array of widely dispersed, very deep drill holes. It is demonstrated that the difficulties encountered by conventional disposal strategies can be overcome by this new approach.

  8. Efficient handling of high-level radioactive cell waste in a vitrification facility analytical laboratory

    International Nuclear Information System (INIS)

    Roberts, D.W.; Collins, K.J.

    1998-01-01

    The Savannah River Site''s (SRS) Defense Waste Processing Facility (DWPF) near Aiken, South Carolina, is the world''s largest and the United State''s first high level waste vitrification facility. For the past 1.5 years, DWPF has been vitrifying high level radioactive liquid waste left over from the Cold War. The vitrification process involves the stabilization of high level radioactive liquid waste into borosilicate glass. The glass is contained in stainless steel canisters. DWPF has filled more than 200 canisters 3.05 meters (10 feet) long and 0.61 meters (2 foot) diameter. Since operations began at DWPF in March of 1996, high level radioactive solid waste continues to be generated due to operating the facility''s analytical laboratory. The waste is referred to as cell waste and is routinely removed from the analytical laboratories. Through facility design, engineering controls, and administrative controls, DWPF has established efficient methods of handling the high level waste generated in its laboratory facility. These methods have resulted in the prevention of undue radiation exposure, wasted man-hours, expenses due to waste disposal, and the spread of contamination. This level of efficiency was not reached overnight, but it involved the collaboration of Radiological Control Operations and Laboratory personnel working together to devise methods that best benefited the facility. This paper discusses the methods that have been incorporated at DWPF for the handling of cell waste. The objective of this paper is to provide insight to good radiological and safety practices that were incorporated to handle high level radioactive waste in a laboratory setting

  9. Michigan high-level radioactive waste program. Technical progress report for 1985

    International Nuclear Information System (INIS)

    1986-01-01

    In 1985, five crystalline rock formations located in Michigan's Upper Peninsula were under consideration in the regional phase of the Department of Energy's (DOE) search for the site of the nation's second high-level radioactive waste repository. The Michigan Department of Public Health has been designated by the Governor as lead state agency in matters related to high-level radioactive waste (HLRW). Mr. Lee E. Jager, Chief of the Department's Bureau of Environmental and Occupational Health, has been designated as the state contact person in this matter, and the Bureau's Division of Radiological Health, Office of Radioactive Waste Management (ORWM), has been designated to provide staff support. Recognizing that adequate state involvement in the various aspects of the Federal high-level radioactive waste (HLRW) programs would require a range of expertise beyond the scope of any single state agency, Governor Blanchard established the High-Level Radioactive Waste Task Force in 1983. In support of the Task Force efforts concerning the implementation of its change, the Department negotiated and concluded an agreement with the DOE, under which federal funds are provided to support state HLRW activities. This report outlines state activities for the calendar year 1985, funded under that agreement

  10. Health professionals’ perceptions of the barriers and facilitators to providing smoking cessation advice to women in pregnancy and during the post-partum period: a systematic review of qualitative research

    Directory of Open Access Journals (Sweden)

    Kate Flemming

    2016-03-01

    Full Text Available Abstract Background Reducing smoking in pregnancy is a policy priority in many countries and as a result there has been a rise in the development of services to help pregnant women to quit. A wide range of professionals are involved in providing these services, with midwives playing a particularly pivotal role. Understanding professionals’ experiences of providing smoking cessation support in pregnancy can help to inform the design of interventions as well as to improve routine care. Methods A synthesis of qualitative research of health professionals’ perceptions of the barriers and facilitators to providing smoking cessation advice to women in pregnancy and the post-partum period was conducted using meta-ethnography. Searches were undertaken from 1990 to January 2015 using terms for maternity health professionals and smoking cessation advisors, pregnancy, post-partum, smoking, and qualitative in seven electronic databases. The review was reported in accordance with the ‘Enhancing transparency in reporting the synthesis of qualitative research’ (ENTREQ statement. Results Eight studies reported in nine papers were included, reporting on the views of 190 health professionals/key informants, including 85 midwives and health visitors. The synthesis identified that both the professional role of participants and the organisational context in which they worked could act as either barriers or facilitators to an individual’s ability to provide smoking cessation support to pregnant or post-partum women. Underpinning these factors was an acknowledgment that the association between maternal smoking and social disadvantage was a considerable barrier to addressing and supporting smoking cessation Conclusions The review identifies a role for professional education, both pre-qualification and in continuing professional development that will enable individuals to provide smoking cessation support to pregnant women. Key to the success of this education

  11. Engineering materials for high level radioactive waste repository

    International Nuclear Information System (INIS)

    Wen Zhijian

    2009-01-01

    Radioactive wastes can arise from a wide range of human activities and have different physical and chemical forms with various radioactivity. The high level radioactive wastes (HLW)are characterized by nuclides of very high initial radioactivity, large thermal emissivity and the long life-term. The HLW disposal is highly concerned by the scientists and the public in the world. At present, the deep geological disposal is regarded as the most reasonable and effective way to safely dispose high-level radioactive wastes in the world. The conceptual model of HLW geological disposal in China is based on a multi-barrier system that combines an isolating geological environment with an engineering barrier system(EBS). The engineering materials in EBS include the vitrified HLW, canister, overpack, buffer materials and backfill materials. Referring to progress in the world, this paper presents the function, the requirement for material selection and design, and main scientific projects of R and D of engineering materials in HLW repository. (authors)

  12. Space augmentation of military high-level waste disposal

    International Nuclear Information System (INIS)

    English, T.; Lees, L.; Divita, E.

    1979-01-01

    Space disposal of selected components of military high-level waste (HLW) is considered. This disposal option offers the promise of eliminating the long-lived radionuclides in military HLW from the earth. A space mission which meets the dual requirements of long-term orbital stability and a maximum of one space shuttle launch per week over a period of 20-40 years, is a heliocentric orbit about halfway between the orbits of earth and Venus. Space disposal of high-level radioactive waste is characterized by long-term predicability and short-term uncertainties which must be reduced to acceptably low levels. For example, failure of either the Orbit Transfer Vehicle after leaving low earth orbit, or the storable propellant stage failure at perihelion would leave the nuclear waste package in an unplanned and potentially unstable orbit. Since potential earth reencounter and subsequent burn-up in the earth's atmosphere is unacceptable, a deep space rendezvous, docking, and retrieval capability must be developed

  13. High level waste forms: glass marbles and thermal spray coatings

    International Nuclear Information System (INIS)

    Treat, R.L.; Oma, K.H.; Slate, S.C.

    1982-01-01

    A process that converts high-level waste to glass marbles and then coats the marbles has been developed at Pacific Northwest Laboratory (PNL) under sponsorship of the US Department of Energy. The process consists of a joule-heated glass melter, a marble-making device based on a patent issued to Corning Glass Works, and a coating system that includes a plasma spray coater and a marble tumbler. The process was developed under the Alternative Waste Forms Program which strived to improve upon monolithic glass for immobilizing high-level wastes. Coated glass marbles were found to be more leach-resistant, and the marbles, before coating were found to be very homogeneous, highly impact resistant, and conductive to encapsulation in a metal matric for improved heat transfer and containment. Marbles are also ideally suited for quality assurance and recycling. However, the marble process is more complex, and marbles require a larger number of canisters for waste containment and have a higher surface area than do glass monoliths

  14. Midwestern High-Level Radioactive Waste Transportation Project

    International Nuclear Information System (INIS)

    1993-01-01

    On February 17,1989, the Midwestern Office of The Council of State Governments and the US Department of Energy entered into a cooperative agreement authorizing the initiation of the Midwestern High-Level Radioactive Waste Transportation Project. The transportation project continued to receive funding from DOE through amendments to the original cooperative agreement, with December 31, 1993, marking the end of the initial 5-year period. This progress report reflects the work completed by the Midwestern Office from February 17,1989, through December 31,1993. In accordance with the scopes of work governing the period covered by this report, the Midwestern Office of The Council of State Governments has worked closely with the Midwestern High-Level Radioactive Waste Committee. Project staff have facilitated all eight of the committee's meetings and have represented the committee at meetings of DOE's Transportation Coordination Group (TCG) and Transportation External Coordination Working Group (TEC/WG). Staff have also prepared and submitted comments on DOE activities on behalf of the committee. In addition to working with the committee, project staff have prepared and distributed 20 reports, including some revised reports (see Attachment 1). Staff have also developed a library of reference materials for the benefit of committee members, state officials, and other interested parties. To publicize the library, and to make it more accessible to potential users, project staff have prepared and distributed regular notices of resource availability

  15. Immobilisation of high level nuclear reactor wastes in SYNROC

    Energy Technology Data Exchange (ETDEWEB)

    Ringwood, A E; Kesson, S E; Ware, N G; Hibberson, W; Major, A [Australian National Univ., Canberra. Inst. of Advanced Studies

    1979-03-15

    It is stated that the elements occurring in high-level nuclear reactor wastes can be safely immobilised by incorporating them within the crystal lattices of the constituent minerals of a synthetic rock (SYNROC). The preferred form of SYNROC can accept up to 20% of high level waste calcine to form dilute solid solutions. The constituent minerals, or close structural analogues, have survived in a wide range of geochemical environments for periods of 20 to 2,000 Myr whilst immobilising the same elements present in nuclear wastes. SYNROC is unaffected by leaching for 24 hours in pure water or 10 wt % NaCl solution at high temperatures and pressure whereas borosilicate glasses completely decompose in a few hours in much less severe hydrothermal conditions. The combination of these leaching results with the geological evidence of long-term stability indicates that SYNROC would be vastly superior to glass in its capacity to safely immobilise nuclear wastes, when buried in a suitable geological repository. A dense, compact, mechanically strong form of SYNROC suitable for geological disposal can be produced by a process as economical as that which incorporates radioactive waste in borosilicate glasses.

  16. Risk communication system for high level radioactive waste disposal

    International Nuclear Information System (INIS)

    Kugo, Akihide; Uda, Akinobu; Shimoda, Hirosi; Yoshikawa, Hidekazu; Ito, Kyoko; Wakabayashi, Yasunaga

    2005-01-01

    In order to gain a better understanding and acceptance of the task of implementing high level radioactive waste disposal, a study on new communication system about social risk information has been initiated by noticing the rapid expansion of Internet in the society. First, text mining method was introduced to identify the core public interest, examining public comments on the technical report of high level radioactive waste disposal. Then we designed the dialog-mode contents based on the theory of norm activation by Schwartz. Finally, the discussion board was mounted on the web site. By constructing such web communication system which includes knowledge base contents, introspective contents, and interactive discussion board, we conducted the experiment for verifying the principles such as that the basic technical knowledge and trust, and social ethics are indispensable in this process to close the perception gap between nuclear specialists and the general public. The participants of the experiment increased their interest in the topics with which they were not familiar and actively posted their opinions on the BBS. The dialog-mode contents were significantly more effective than the knowledge-based contents in promoting introspection that brought people into a greater awareness of problems such as social dilemma. (author)

  17. Design concepts of definitive disposal for high level radioactive wastes

    International Nuclear Information System (INIS)

    Badillo A, V.E.; Alonso V, G.

    2007-01-01

    It is excessively known the importance about finding a solution for the handling and disposition of radioactive waste of all level. However, the polemic is centered in the administration of high level radioactive waste and the worn out fuel, forgetting that the more important volumes of waste its are generated in the categories of low level wastes or of very low level. Depending on the waste that will be confined and of the costs, several technological modalities of definitive disposition exist, in function of the depth of the confinement. The concept of deep geologic storage, technological option proposed more than 40 years ago, it is a concept of isolation of waste of long half life placed in a deep underground installation dug in geologic formations that are characterized by their high stability and their low flow of underground water. In the last decades, they have registered countless progresses in technical and scientific aspects of the geologic storage, making it a reliable technical solution supported with many years of scientific work carried out by numerous institutions in the entire world. In this work the design concepts that apply some countries for the high level waste disposal that its liberate heat are revised and the different geologic formations that have been considered for the storage of this type of wastes. (Author)

  18. Radiolytic gas formation in high-level liquid waste solutions

    International Nuclear Information System (INIS)

    Brodda, B.-G.; Dix, Siegfried; Merz, E.R.

    1989-01-01

    High-level fission product waste solutions originating from the first-cycle raffinate stream of spent fast breeder reactor fuel reprocessing have been investigated gas chromatographically for their radiolytic and chemical gas production. The solutions showed considerable formation of hydrogen, carbon dioxide and dinitrogen oxide, whereas atmospheric oxygen was consumed completely within a short time. In particular, carbon dioxide resulted from the radiolytic degradation of entrained organic solvent. After nearly complete degradation of the organic solvent, the influence of hydrazine and nitrogen dioxide on hydrogen formation was investigated. Hydrazinium hydroxide led to the formation of dinitrogen oxide and nitrogen. After 60 d, the concentration of dinitrogen oxide had reduced to zero, whereas the amount of nitrogen formed had reached a maximum. This may be explained by simultaneous chemical and radiolytic reactions leading to the formation of dinitrogen oxide and nitrogen and photolytic fission of dinitrogen oxide. Addition of sodium nitrite resulted in the rapid formation of dinitrogen oxide. The rate of hydrogen production was not changed significantly after the addition of hydrazine or nitrite. The results indicate that under normal operating conditions no dangerous hydrogen radiolysis yields should develop in the course of reprocessing and high-level liquid waste tank storage. Organic entrainment may lead to enhanced radiolytic decomposition and thus to considerable hydrogen production rates and pressure build-up in closed systems. (author)

  19. Disposal of high level and intermediate level radioactive wastes

    International Nuclear Information System (INIS)

    Flowers, R.H.

    1991-01-01

    The waste products from the nuclear industry are relatively small in volume. Apart from a few minor gaseous and liquid waste streams, containing readily dispersible elements of low radiotoxicity, all these products are processed into stable solid packages for disposal in underground repositories. Because the volumes are small, and because radioactive wastes are latecomers on the industrial scene, a whole new industry with a world-wide technological infrastructure has grown up alongside the nuclear power industry to carry out the waste processing and disposal to very high standards. Some of the technical approaches used, and the Regulatory controls which have been developed, will undoubtedly find application in the future to the management of non-radioactive toxic wastes. The repository site outlined would contain even high-level radioactive wastes and spent fuels being contained without significant radiation dose rates to the public. Water pathway dose rates are likely to be lowest for vitrified high-level wastes with spent PWR fuel and intermediate level wastes being somewhat higher. (author)

  20. The principal radionuclides in high level radioactive waste management

    International Nuclear Information System (INIS)

    Mulyanto

    1998-01-01

    The principal radionuclides in high level radioactive waste management. The selection of the principal radionuclides in the high level waste (HLW) management was developed in order to improve the disposal scenario of HLW. In this study the unified criteria for selection of the principal radionuclides were proposed as; (1) the value of hazard index estimated by annual limit of intake (ALI) for long-term tendency,(2) the relative dose factor related to adsorbed migration rate transferred by ground water, and (3) heat generation in the repository. From this study it can be concluded that the principal radionuclides in the HLW management were minor actinide (MA=Np, Am, Cm, etc), Tc, I, Cs and Sr, based on the unified basic criteria introduced in this study. The remaining short-lived fission product (SLFPs), after the selected nuclides are removed, should be immobilized and solidified in a glass matrix. Potential risk due to the remaining SLFPs can be lower than that of uranium ore after about 300 year. (author)

  1. Non-dental primary care providers’ views on challenges in providing oral health services and strategies to improve oral health in Australian rural and remote communities: a qualitative study

    Science.gov (United States)

    Barnett, Tony; Hoang, Ha; Stuart, Jackie; Crocombe, Len

    2015-01-01

    Objectives To investigate the challenges of providing oral health advice/treatment as experienced by non-dental primary care providers in rural and remote areas with no resident dentist, and their views on ways in which oral health and oral health services could be improved for their communities. Design Qualitative study with semistructured interviews and thematic analysis. Setting Four remote communities in outback Queensland, Australia. Participants 35 primary care providers who had experience in providing oral health advice to patients and four dental care providers who had provided oral health services to patients from the four communities. Results In the absence of a resident dentist, rural and remote residents did present to non-dental primary care providers with oral health problems such as toothache, abscess, oral/gum infection and sore mouth for treatment and advice. Themes emerged from the interview data around communication challenges and strategies to improve oral health. Although, non-dental care providers commonly advised patients to see a dentist, they rarely communicated with the dentist in the nearest regional town. Participants proposed that oral health could be improved by: enabling access to dental practitioners, educating communities on preventive oral healthcare, and building the skills and knowledge base of non-dental primary care providers in the field of oral health. Conclusions Prevention is a cornerstone to better oral health in rural and remote communities as well as in more urbanised communities. Strategies to improve the provision of dental services by either visiting or resident dental practitioners should include scope to provide community-based oral health promotion activities, and to engage more closely with other primary care service providers in these small communities. PMID:26515687

  2. Breast ultrasound image segmentation: an optimization approach based on super-pixels and high-level descriptors

    Science.gov (United States)

    Massich, Joan; Lemaître, Guillaume; Martí, Joan; Mériaudeau, Fabrice

    2015-04-01

    Breast cancer is the second most common cancer and the leading cause of cancer death among women. Medical imaging has become an indispensable tool for its diagnosis and follow up. During the last decade, the medical community has promoted to incorporate Ultra-Sound (US) screening as part of the standard routine. The main reason for using US imaging is its capability to differentiate benign from malignant masses, when compared to other imaging techniques. The increasing usage of US imaging encourages the development of Computer Aided Diagnosis (CAD) systems applied to Breast Ultra-Sound (BUS) images. However accurate delineations of the lesions and structures of the breast are essential for CAD systems in order to extract information needed to perform diagnosis. This article proposes a highly modular and flexible framework for segmenting lesions and tissues present in BUS images. The proposal takes advantage of optimization strategies using super-pixels and high-level descriptors, which are analogous to the visual cues used by radiologists. Qualitative and quantitative results are provided stating a performance within the range of the state-of-the-art.

  3. A High-Level Petri Net Framework for Genetic Regulatory Networks

    Directory of Open Access Journals (Sweden)

    Banks Richard

    2007-12-01

    Full Text Available To understand the function of genetic regulatory networks in the development of cellular systems, we must not only realise the individual network entities, but also the manner by which they interact. Multi-valued networks are a promising qualitative approach for modelling such genetic regulatory networks, however, at present they have limited formal analysis techniques and tools. We present a flexible formal framework for modelling and analysing multi-valued genetic regulatory networks using high-level Petri nets and logic minimization techniques. We demonstrate our approach with a detailed case study in which part of the genetic regulatory network responsible for the carbon starvation stress response in Escherichia coli is modelled and analysed. We then compare and contrast this multivalued model to a corresponding Boolean model and consider their formal relationship.

  4. Interaction of cementitious materials with high-level waste

    International Nuclear Information System (INIS)

    Lemmens, Karel; Cachoir, Christelle; Ferrand, Karine; Mennecart, Thierry; Gielen, Ben; Vercauter, Regina

    2012-01-01

    Document available in abstract form only: Since a few years, the Belgian agency for radioactive waste (ONDRAF/NIRAS) has selected the Supercontainer design with an Ordinary Portland Cement (OPC) buffer as the reference design for geological disposal of High-Level Waste (HLW) and Spent Fuel (SF) in the Boom Clay formation. The Boom Clay beneath the Mol-Dessel nuclear zone is a reference methodological site for supporting R and D. Compared to the previous bentonite based reference design, described in detail in the final SAFIR 2 report, the supercontainer will provide a highly alkaline chemical environment allowing the passivation of the surface of the overpack and the inhibition of its corrosion. The Supercontainer will contribute to the containment of radionuclides, but it will also have an effect on the retardation of radionuclide release from the waste and it will retard the migration of the released radionuclides. In the Supercontainer design, the canisters of HLW or SF will be enclosed by a 30 mm thick carbon steel overpack and a concrete buffer about 700 mm thick. The overpack will prevent contact with the (cementitious) pore water during the thermal phase. On the other hand, once the overpack will be locally perforated, the high pH of the incoming water may have an impact on the lifetime of the vitrified waste or spent fuel. The behaviour of these waste forms in disposal conditions has been studied for several decades, but the vast majority of published data is related to the interaction with backfill or host rock materials at near-neutral pH. Very few studies have been reported for alkaline media, at pH >11. Hence, a research programme including new experiments, was started at the Belgian Nuclear Research Centre (SCK.CEN) and at INE (FZK) to assess the rate at which the radionuclides are released by the vitrified waste and spent fuel in such an environment. The presence of concrete will have an impact on the behaviour of the vitrified HLW and spent fuel. For

  5. High-level waste repository-induced effects

    Energy Technology Data Exchange (ETDEWEB)

    Leupin, O.X.; Marschall, P.; Johnson, L.; Cloet, V.; Schneider, J. [National Cooperative for the Disposal of Radioactive Waste (NAGRA), Wettingen (Switzerland); Smith, P. [Safety Assessment Management Ltd, Henley-On-Thames, Oxfordshire (United Kingdom); Savage, D. [Savage Earth Associates Ltd, Bournemouth, Dorset (United Kingdom); Senger, R. [Intera Inc., Ennetbaden (Switzerland)

    2016-10-15

    This status report aims at describing and assessing the interactions of the radioactive waste emplaced in a high-level waste (HLW) repository with the engineered materials and the Opalinus Clay host rock. The Opalinus Clay has a thickness of about 100 m in the proposed siting regions. Among other things the results are used to steer the RD and D programme of NAGRA. The repository-induced effects considered in this report are of the following broad types: - Thermal effects: i.e. effects on the host rock and engineered barriers arising principally from the heat generated by the waste. - Rock-mechanical effects: i.e. effects arising from the mechanical disturbance to the rock caused by the excavation of the emplacement rooms and other underground structures. - Hydraulic and gas-related effects: i.e. the effects of repository resaturation and of gas generation, e.g. due to the corrosion of metals within the repository, on the host rock and engineered barriers. - Chemical effects: i.e. chemical interactions between the waste, the engineered materials and the host rock, with a focus on chemical effects of the waste and engineered materials on the host rock. The assessment of the repository-induced effects shows that detrimental chemical and mechanical impacts are largely confined to the rock immediately adjacent to the excavations, thermal impacts are controllable by limiting the heat load and gas effects are limited by ensuring acceptably low gas production rates and by the natural tendency of the gas to escape along the excavations and the excavation damaged zone (EDZ) rather than through the undisturbed rock. Specific measures that are part of the current reference design are discussed in relation to their significance with respect to repository-induced effects. The SF/HLW emplacement rooms (emplacement drifts) are designed, constructed, operated and finally backfilled in such a way that formation of excavation damaged zones is limited. Specifically this is achieved

  6. High-level waste repository-induced effects

    International Nuclear Information System (INIS)

    Leupin, O.X.; Marschall, P.; Johnson, L.; Cloet, V.; Schneider, J.; Smith, P.; Savage, D.; Senger, R.

    2016-10-01

    This status report aims at describing and assessing the interactions of the radioactive waste emplaced in a high-level waste (HLW) repository with the engineered materials and the Opalinus Clay host rock. The Opalinus Clay has a thickness of about 100 m in the proposed siting regions. Among other things the results are used to steer the RD and D programme of NAGRA. The repository-induced effects considered in this report are of the following broad types: - Thermal effects: i.e. effects on the host rock and engineered barriers arising principally from the heat generated by the waste. - Rock-mechanical effects: i.e. effects arising from the mechanical disturbance to the rock caused by the excavation of the emplacement rooms and other underground structures. - Hydraulic and gas-related effects: i.e. the effects of repository resaturation and of gas generation, e.g. due to the corrosion of metals within the repository, on the host rock and engineered barriers. - Chemical effects: i.e. chemical interactions between the waste, the engineered materials and the host rock, with a focus on chemical effects of the waste and engineered materials on the host rock. The assessment of the repository-induced effects shows that detrimental chemical and mechanical impacts are largely confined to the rock immediately adjacent to the excavations, thermal impacts are controllable by limiting the heat load and gas effects are limited by ensuring acceptably low gas production rates and by the natural tendency of the gas to escape along the excavations and the excavation damaged zone (EDZ) rather than through the undisturbed rock. Specific measures that are part of the current reference design are discussed in relation to their significance with respect to repository-induced effects. The SF/HLW emplacement rooms (emplacement drifts) are designed, constructed, operated and finally backfilled in such a way that formation of excavation damaged zones is limited. Specifically this is achieved

  7. Safe immobilization of high-level nuclear reactor wastes

    International Nuclear Information System (INIS)

    Ringwood, A.; Kesson, S.; Ware, N.; Hibberson, W.; Major, A.

    1979-01-01

    The advantages and disadvantages of methods of immobilizing high-level radioactive wastes are discussed. Problems include the devitrification of glasses and the occurrence of radiation damage. An alternative method of radioctive waste immobilization is described in which the waste is incorporated in the constituent minerals of a synthetic rock, Synroc. Synroc is immune from devitrification and is composed of phases which possess crystal structures identical to those of minerals which are known to have retained radioactive elements in geological environments at elevated pressures and tempertures for long periods. The composition and mineralogy of Synroc is given and the process of immobilizing wastes in Synroc is described. Accelerated leaching tests at elevated pressures and temperatures are also described

  8. Reprogrammable Controller Design From High-Level Specification

    Directory of Open Access Journals (Sweden)

    M. Benmohammed

    2003-10-01

    Full Text Available Existing techniques in high-level synthesis mostly assume a simple controller architecture model in the form of a single FSM. However, in reality more complex controller architectures are often used. On the other hand, in the case of programmable processors, the controller architecture is largely defined by the available control-flow instructions in the instruction set. With the wider acceptance of behavioral synthesis, the application of these methods for the design of programmable controllers is of fundamental importance in embedded system technology. This paper describes an important extension of an existing architectural synthesis system targeting the generation of ASIP reprogrammable architectures. The designer can then generate both style of architecture, hardwired and programmable, using the same synthesis system and can quickly evaluate the trade-offs of hardware decisions.

  9. Tree-indexed processes: a high level crossing analysis

    Directory of Open Access Journals (Sweden)

    Mark Kelbert

    2003-01-01

    Full Text Available Consider a branching diffusion process on R1 starting at the origin. Take a high level u>0 and count the number R(u,n of branches reaching u by generation n. Let Fk,n(u be the probability P(R(u,n

  10. Thermal characteristics of rocks for high-level waste repository

    International Nuclear Information System (INIS)

    Shimooka, Kenji; Ishizaki, Kanjiro; Okamoto, Masamichi; Kumata, Masahiro; Araki, Kunio; Amano, Hiroshi

    1980-12-01

    Heat released by the radioactive decay of high-level waste in an underground repository causes a long term thermal disturbance in the surrounding rock mass. Several rocks constituting geological formations in Japan were gathered and specific heat, thermal conductivity, thermal expansion coefficient and compressive strength were measured. Thermal analysis and chemical analysis were also carried out. It was found that volcanic rocks, i.e. Andesite and Basalt had the most favorable thermal characteristics up to around 1000 0 C and plutonic rock, i.e. Granite had also favorable characteristics under 573 0 C, transition temperature of quartz. Other igneous rocks, i.e. Rhyolite and Propylite had a problem of decomposition at around 500 0 C. Sedimentary rocks, i.e. Zeolite, Tuff, Sandstone and Diatomite were less favorable because of their decomposition, low thermal conductivity and large thermal expansion coefficient. (author)

  11. High level radioactive waste vitrification process equipment component testing

    International Nuclear Information System (INIS)

    Siemens, D.H.; Heath, W.O.; Larson, D.E.; Craig, S.N.; Berger, D.N.; Goles, R.W.

    1985-04-01

    Remote operability and maintainability of vitrification equipment were assessed under shielded-cell conditions. The equipment tested will be applied to immobilize high-level and transuranic liquid waste slurries that resulted from plutonium production for defense weapons. Equipment tested included: a turntable for handling waste canisters under the melter; a removable discharge cone in the melter overflow section; a thermocouple jumper that extends into a shielded cell; remote instrument and electrical connectors; remote, mechanical, and heat transfer aspects of the melter glass overflow section; a reamer to clean out plugged nozzles in the melter top; a closed circuit camera to view the melter interior; and a device to retrieve samples of the glass product. A test was also conducted to evaluate liquid metals for use in a liquid metal sealing system

  12. Separation processes for high-level radioactive waste treatment

    International Nuclear Information System (INIS)

    Sutherland, D.G.

    1992-11-01

    During World War II, production of nuclear materials in the United States for national defense, high-level waste (HLW) was generated as a byproduct. Since that time, further quantities of HLW radionuclides have been generated by continued nuclear materials production, research, and the commercial nuclear power program. In this paper HLW is defined as the highly radioactive material resulting from the processing of spent nuclear fuel. The HLW is the liquid waste generated during the recovery of uranium and plutonium in a fuel processing plant that generally contains more than 99% of the nonvolatile fission products produced during reactor operation. Since this paper deals with waste separation processes, spent reactor fuel elements that have not been dissolved and further processed are excluded

  13. Powder technological vitrification of simulated high-level waste

    International Nuclear Information System (INIS)

    Gahlert, S.

    1988-03-01

    High-level waste simulate from the reprocessing of light water reactor and fast breeder fuel was vitrified by powder technology. After denitration with formaldehyde, the simulated HLW is mixed with glass frit and simultaneously dried in an oil-heated mixer. After 'in-can calcination' for at least 24 hours at 850 or 950 K (depending on the type of waste and glass), the mixture is hot-pressed in-can for several hours at 920 or 1020 K respectively, at pressures between 0.4 and 1.0 MPa. The technology has been demonstrated inactively up to diameters of 30 cm. Leach resistance is significantly enhanced when compared to common borosilicate glasses by the utilization of glasses with higher silicon and aluminium content and lower sodium content. (orig.) [de

  14. Fluidized bed system for calcination of high level radioactive waste

    Energy Technology Data Exchange (ETDEWEB)

    Pande, D P; Prasad, T L; Yadgiri, N K; Theyyunni, T K [Process Engineering and Systems Development Division, Bhabha Atomic Research Centre, Mumbai (India)

    1994-06-01

    During the operation of nuclear facilities significant quantities of radiochemical liquid effluents of different concentrations and varying chemical compositions are generated. These effluents contain activated radionuclides, corrosion products and fission products. The advantage of feeding the waste in solid form into the vitrifying equipment are multifold. Efforts are therefore made in many countries to calcine the high level waste, and obtain waste in the oxide form before the same is mixed with glass forming additives and fed into the melter unit. An experimental rig for fluidized bed calcination is constructed for carrying out the detailed investigation of this process, in order to adopt the same for plant scale application. To achieve better gas-solid contact and avoid raining down of solids, a distributor of bubble cap type was designed. A review of existing experience at various laboratories and design of new experimental facility for development of calciners are given. (author). 11 refs., 5 figs.

  15. Intermittent Testing and Training for High-Level Football Players

    DEFF Research Database (Denmark)

    Ingebrigtsen, Jørgen

    Football is the most popular sport in the world, played by over 400 million men and women. In addition to the wide range of sport-specific technical and tactical skills needed, several physical components have been shown to be necessary to perform at a high level. The present PhD thesis is based...... on four articles that focus on physical testing and training for elite and sub-elite football players.The first article (Study I) aims to identify and establish aerobic capacities and anthropometric characteristics of elite female football players with the use of laboratory tests, and to examine whether...... systematic differences between the playing positions can be detected. Lately, field tests have become more frequently used in football than the laboratory tests used in Study I. Study II therefore aims to assess the validity of one of them, the Yo-Yo Intermittent Recovery test level 2 (Yo-Yo IR2). Along...

  16. Electropolishing decontamination system for high-level waste canisters

    International Nuclear Information System (INIS)

    Larson, D.E.; Berger, D.N.; Allen, R.P.; Bryan, G.H.; Place, B.G.

    1988-10-01

    As part of a US Department of Energy (DOE) project agreement with the Federal Ministry for Research and Technology (BMFT) in the Federal Republic of Germany (FRG). The Nuclear Waste Treatment Program at the Pacific Northwest Laboratory (PNL) is preparing 30 radioactive canisters containing borosilicate glass for use in high-level waste repository related tests at the Asse Salt Mine. After filling, the canisters will be welded closed and decontaminated in preparation for shipping to the FRG. Electropolishing was selected as the primary decontamination approach, and an electropolishing system with associated canister inspection equipment has been designed and fabricated for installation in a large hot cell. This remote electropolishing system, which is currently undergoing preliminary testing, is described in this report. 3 refs., 3 figs., 1 tab

  17. Remote ignitability analysis of high-level radioactive waste

    International Nuclear Information System (INIS)

    Lundholm, C.W.; Morgan, J.M.; Shurtliff, R.M.; Trejo, L.E.

    1992-09-01

    The Idaho Chemical Processing Plant (ICPP), was used to reprocess nuclear fuel from government owned reactors to recover the unused uranium-235. These processes generated highly radioactive liquid wastes which are stored in large underground tanks prior to being calcined into a granular solid. The Resource Conservation and Recovery Act (RCRA) and state/federal clean air statutes require waste characterization of these high level radioactive wastes for regulatory permitting and waste treatment purposes. The determination of the characteristic of ignitability is part of the required analyses prior to calcination and waste treatment. To perform this analysis in a radiologically safe manner, a remoted instrument was needed. The remote ignitability Method and Instrument will meet the 60 deg. C. requirement as prescribed for the ignitability in method 1020 of SW-846. The method for remote use will be equivalent to method 1020 of SW-846

  18. High-level waste description, inventory and hazard

    International Nuclear Information System (INIS)

    Crandall, J.; Hennelly, E.J.; McElroy, J.L.

    1983-01-01

    High-level nuclear waste (HLW), including its origin, is described and the current differences in definitions discussed. Quantities of defense and commercial radioactive HLW, both volume and curie content, are given. Current waste handling, which is interimin nature, is described for the several sites. The HLW hazard is defined by the times during which various radionuclides are the dominant contributors. The hazard is also compared to that of the ore. Using ICRP-2, which is the legal reference in the US, the hazard of the waste reduces to a level equal to the ore in about 300 years. The disposal plans are summarized and it is shown that regulatory requirements will probably govern disposal operations in such a conservative manner that the risk (product of hazard times probability of release) may well be lower than for any other wastes in existence or perhaps lower than those for any other human endeavor

  19. Using the CMS high level trigger as a cloud resource

    International Nuclear Information System (INIS)

    Colling, David; Huffman, Adam; Bauer, Daniela; McCrae, Alison; Cinquilli, Mattia; Gowdy, Stephen; Coarasa, Jose Antonio; Ozga, Wojciech; Chaze, Olivier; Lahiff, Andrew; Grandi, Claudio; Tiradani, Anthony; Sgaravatto, Massimo

    2014-01-01

    The CMS High Level Trigger is a compute farm of more than 10,000 cores. During data taking this resource is heavily used and is an integral part of the experiment's triggering system. However, outside of data taking periods this resource is largely unused. We describe why CMS wants to use the HLT as a cloud resource (outside of data taking periods) and how this has been achieved. In doing this we have turned a single-use cluster into an agile resource for CMS production computing. While we are able to use the HLT as a production cloud resource, there is still considerable further work that CMS needs to carry out before this resource can be used with the desired agility. This report, therefore, represents a snapshot of this activity at the time of CHEP 2013.