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. The Systems Biology Markup Language (SBML) Level 3 Package: Qualitative Models, Version 1, Release 1.

    Science.gov (United States)

    Chaouiya, Claudine; Keating, Sarah M; Berenguier, Duncan; Naldi, Aurélien; Thieffry, Denis; van Iersel, Martijn P; Le Novère, Nicolas; Helikar, Tomáš

    2015-09-04

    Quantitative methods for modelling biological networks require an in-depth knowledge of the biochemical reactions and their stoichiometric and kinetic parameters. In many practical cases, this knowledge is missing. This has led to the development of several qualitative modelling methods using information such as, for example, gene expression data coming from functional genomic experiments. The SBML Level 3 Version 1 Core specification does not provide a mechanism for explicitly encoding qualitative models, but it does provide a mechanism for SBML packages to extend the Core specification and add additional syntactical constructs. The SBML Qualitative Models package for SBML Level 3 adds features so that qualitative models can be directly and explicitly encoded. The approach taken in this package is essentially based on the definition of regulatory or influence graphs. The SBML Qualitative Models package defines the structure and syntax necessary to describe qualitative models that associate discrete levels of activities with entity pools and the transitions between states that describe the processes involved. This is particularly suited to logical models (Boolean or multi-valued) and some classes of Petri net models can be encoded with the approach.

  3. 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.

  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. 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

  6. 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)

  7. 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.

  8. 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

  9. A multi-level qualitative analysis of Telehomecare in Ontario: challenges and opportunities.

    Science.gov (United States)

    Hunting, Gemma; Shahid, Nida; Sahakyan, Yeva; Fan, Iris; Moneypenny, Crystal R; Stanimirovic, Aleksandra; North, Taylor; Petrosyan, Yelena; Krahn, Murray D; Rac, Valeria E

    2015-12-09

    Despite research demonstrating the potential effectiveness of Telehomecare for people with Chronic Obstructive Pulmonary Disease and Heart Failure, broad-scale comprehensive evaluations are lacking. This article discusses the qualitative component of a mixed-method program evaluation of Telehomecare in Ontario, Canada. The objective of the qualitative component was to explore the multi-level factors and processes which facilitate or impede the implementation and adoption of the program across three regions where it was first implemented. The study employs a multi-level framework as a conceptual guide to explore the facilitators and barriers to Telehomecare implementation and adoption across five levels: technology, patients, providers, organizations, and structures. In-depth semi-structured interviews and ethnographic observations with program stakeholders, as well as a Telehomecare document review were used to elicit key themes. Study participants (n = 89) included patients and/or informal caregivers (n = 39), health care providers (n = 23), technicians (n = 2), administrators (n = 12), and decision makers (n = 13) across three different Local Health Integration Networks in Ontario. Key facilitators to Telehomecare implementation and adoption at each level of the multi-level framework included: user-friendliness of Telehomecare technology, patient motivation to participate in the program, support for Telehomecare providers, the integration of Telehomecare into broader health service provision, and comprehensive program evaluation. Key barriers included: access-related issues to using the technology, patient language (if not English or French), Telehomecare provider time limitations, gaps in health care provision for patients, and structural barriers to patient participation related to geography and social location. Though Telehomecare has the potential to positively impact patient lives and strengthen models of health care provision, a

  10. 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...

  11. 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

  12. 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

  13. 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)

  14. 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.

  15. 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...

  16. 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.

  17. Junior High School Physics: Using a Qualitative Strategy for Successful Problem Solving

    Science.gov (United States)

    Mualem, Roni; Eylon, Bat Sheva

    2010-01-01

    Students at the junior high school (JHS) level often cannot use their knowledge of physics for explaining and predicting phenomena. We claim that this difficulty stems from the fact that explanations are multi-step reasoning tasks, and students often lack the qualitative problem-solving strategies needed to guide them. This article describes a new…

  18. 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

  19. 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

  20. 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

  1. 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.

  2. Qualitative analysis of the Clock Drawing Test by educational level and cognitive profile

    Directory of Open Access Journals (Sweden)

    Aline Teixeira Fabricio

    2014-04-01

    Full Text Available The use of a qualitative scale for the Clock Drawing Test (CDT may add information about the pattern of errors committed. Objective: To translate and adapt the Modified Qualitative Error Analysis of Rouleau into Brazilian Portuguese and to examine the pattern of errors according to educational level and cognitive profile. Method: 180 adults (47-82 years completed the CDT. Participants were stratified into age and educational levels and separated between those with and without changes in cognitive screening tests (Mini-Mental State Examination, Verbal Fluency. Results: No significant differences were found in CDT scores among age groups. Among participants without cognitive impairment, those with lower education often presented graphic difficulties, conceptual deficits and spatial deficits. Participants with cognitive deficits, demonstrated more frequently conceptual and spatial errors. Conclusion: The qualitative analysis of the CDT may contribute to the identification of cognitive changes. Education level has to be taken into consideration during the analysis.

  3. A multi-level qualitative analysis of Telehomecare in Ontario: challenges and opportunities

    OpenAIRE

    Hunting, Gemma; Shahid, Nida; Sahakyan, Yeva; Fan, Iris; Moneypenny, Crystal R.; Stanimirovic, Aleksandra; North, Taylor; Petrosyan, Yelena; Krahn, Murray D.; Rac, Valeria E.

    2015-01-01

    Background Despite research demonstrating the potential effectiveness of Telehomecare for people with Chronic Obstructive Pulmonary Disease and Heart Failure, broad-scale comprehensive evaluations are lacking. This article discusses the qualitative component of a mixed-method program evaluation of Telehomecare in Ontario, Canada. The objective of the qualitative component was to explore the multi-level factors and processes which facilitate or impede the implementation and adoption of the pro...

  4. 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.

  5. 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

  6. Environmental Risk Communication through Qualitative Risk Assessment

    Directory of Open Access Journals (Sweden)

    Sabre J. Coleman

    2014-06-01

    Full Text Available Environmental analysts are often hampered in communicating the risks of environmental contaminants due to the myriad of regulatory requirements that are applicable. The use of a qualitative, risk-based control banding strategy for assessment and control of potential environmental contaminants provides a standardized approach to improve risk communication. Presented is a model that provides an effective means for determining standardized responses and controls for common environmental issues based on the level of risk. The model is designed for integration within an occupational health and safety management system to provide a multidisciplinary environmental and occupational risk management approach. This environmental model, which utilizes multidisciplinary control banding strategies for delineating risk, complements the existing Risk Level Based Management System, a proven method in a highly regulated facility for occupational health and safety. A simplified environmental risk matrix is presented that is stratified over four risk levels. Examples of qualitative environmental control banding strategies are presented as they apply to United States regulations for construction, research activities, facility maintenance, and spill remediation that affect air, water, soil, and waste disposal. This approach offers a standardized risk communication language for multidisciplinary issues that will improve communications within and between environmental health and safety professionals, workers, and management.

  7. 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

  8. District health manager and mid-level provider perceptions of practice environments in acute obstetric settings in Tanzania: a mixed-method study.

    Science.gov (United States)

    Ng'ang'a, Njoki; Byrne, Mary Woods; Kruk, Margaret E; Shemdoe, Aloisia; de Pinho, Helen

    2016-08-08

    In sub-Saharan Africa, the capacity of human resources for health (HRH) managers to create positive practice environments that enable motivated, productive, and high-performing HRH is weak. We implemented a unique approach to examining HRH management practices by comparing perspectives offered by mid-level providers (MLPs) of emergency obstetric care (EmOC) in Tanzania to those presented by local health authorities, known as council health management teams (CHMTs). This study was guided by the basic strategic human resources management (SHRM) component model. A convergent mixed-method design was utilized to assess qualitative and quantitative data from the Health Systems Strengthening for Equity: The Power and Potential of Mid-Level Providers project. Survey data was obtained from 837 mid-level providers, 83 of whom participated in a critical incident interview whose aim was to elicit negative events in the practice environment that induced intention to leave their job. HRH management practices were assessed quantitatively in 48 districts with 37 members of CHMTs participating in semi-structured interviews. The eight human resources management practices enumerated in the basic SHRM component model were implemented unevenly. On the one hand, members of CHMTs and mid-level providers agreed that there were severe shortages of health workers, deficient salaries, and an overwhelming workload. On the other hand, members of CHMTs and mid-level providers differed in their perspectives on rewards and allocation of opportunities for in-service training. Although written standards of performance and supervision requirements were available in most districts, they did not reflect actual duties. Members of CHMTs reported high levels of autonomy in key HRH management practices, but mid-level providers disputed the degree to which the real situation on the ground was factored into job-related decision-making by CHMTs. The incongruence in perspectives offered by members of CHMTs

  9. Organizational Trust Levels of Elementary Teachers: A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Mukadder BOYDAK ÖZAN

    2013-12-01

    Full Text Available Today, the main feature of a well-functioning organization is trust in the organization. In the research, it is researched which conceptions are needed to ensue organizational trust by the teachers who work in the primary schools and that the effects of the factors of organizational trust formation on the organizational atmosphere. The research is designed qualitatively. The study group of the research consists of 50 teachers working in Elazığ and the centrum of the city boundries. The interview form was prepared by studying on the subject of the research. The validity of the interview forms, content and appearance are provided thanks to be taken the expert opinions of faculty members (n=3. The interview forms are used as a unique data source. In the research , it is evaluated how organizational trust affects on the importantresults in terms of the organization such as organizational commitment, organizational burnout, organizational citizenship, organizational cynicism, identification with the organization, productivity according to the perception of the teachers. As a result, it is observed that organizational trust affects organizational commitment, the organizational burnout and organizational communication levels significantly

  10. 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

  11. 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

  12. The Barriers to High-Quality Inpatient Pain Management: A Qualitative Study.

    Science.gov (United States)

    Lin, Richard J; Reid, M Carrington; Liu, Lydia L; Chused, Amy E; Evans, Arthur T

    2015-09-01

    The current literature suggests deficiencies in the quality of acute pain management among general medical inpatients. The aim of this qualitative study is to identify potential barriers to high-quality acute pain management among general medical inpatients at an urban academic medical center during a 2-year period. Data are collected using retrospective chart reviews, survey questionnaires, and semistructured, open-ended interviews of 40 general medical inpatients who have experienced pain during their hospitalization. Our results confirm high prevalence and disabling impacts of pain and significant patient- and provider-related barriers to high-quality acute pain management. We also identify unique system-related barriers such as time delay and pain management culture. Efforts to improve the pain management experience of general medical inpatients will need to address all these barriers. © The Author(s) 2014.

  13. Factors associated with high-rise evacuation: qualitative results from the World Trade Center Evacuation Study.

    Science.gov (United States)

    Gershon, Robyn R M; Qureshi, Kristine A; Rubin, Marcie S; Raveis, Victoria H

    2007-01-01

    Due to the fact that most high-rise structures (i.e., >75 feet high, or eight to ten stories) are constructed with extensive and redundant fire safety features, current fire safety procedures typically only involve limited evacuation during minor to moderate fire emergencies. Therefore, full-scale evacuation of high-rise buildings is highly unusual and consequently, little is known about how readily and rapidly high-rise structures can be evacuated fully. Factors that either facilitate or inhibit the evacuation process remain under-studied. This paper presents results from the qualitative phase of the World Trade Center Evacuation Study, a three-year, five-phase study designed to improve our understanding of the individual, organizational, and environmental factors that helped or hindered evacuation from the World Trade Center (WTC) Towers 1 and 2, on 11 September 2001. Qualitative data from semi-structured, in-depth interviews and focus groups involving WTC evacuees were collected and analyzed. On the individual level, factors that affected evacuation included perception of risk (formed largely by sensory cues), preparedness training, degree of familiarity with the building, physical condition, health status, and footwear. Individual behavior also was affected by group behavior and leadership. At the organizational level, evacuation was affected by worksite preparedness planning, including the training and education of building occupants, and risk communication. The environmental conditions affecting evacuation included smoke, flames, debris, general condition and degree of crowdedness on staircases, and communication infrastructure systems (e.g., public address, landline, cellular and fire warden's telephones). Various factors at the individual, organizational, and environmental levels were identified that affected evacuation. Interventions that address the barriers to evacuation may improve the full-scale evacuation of other high-rise buildings under extreme

  14. A qualitative study of young people's perspectives of living with type 1 diabetes: do perceptions vary by levels of metabolic control?

    Science.gov (United States)

    Scholes, Cheryl; Mandleco, Barbara; Roper, Susanne; Dearing, Karen; Dyches, Tina; Freeborn, Donna

    2013-06-01

    To explore if young people with higher and lower levels of metabolic control of type 1 diabetes have different perceptions about their lives and illness. Adolescence through emerging adulthood is a developmental stage made more challenging when the person has type 1 diabetes. Little research has investigated if individuals with high and low levels of metabolic control in this age group perceive their disease differently. Qualitative descriptive. In this study, 14 participants, ages 11-22 years were interviewed in 2008 about their perceptions of living with type 1 diabetes. Through a process of induction, major themes were identified. Participants with high and low metabolic control levels reported similar themes related to reactions of others, knowledge about type 1 diabetes, and believed healthcare providers used authoritarian interactions. However, high metabolic control level participants believed type 1 diabetes would be cured; had negative initial responses to being diagnosed; rarely received parental support in managing their diabetes; and were negligent in self-care activities. Participants with low metabolic control levels did not believe a cure was imminent or have negative responses to being diagnosed; received parental support in managing diabetes; and were diligent in self-care activities. Nurses should give information to young people with type 1 diabetes beyond initial diagnosis and help and support this age group learn appropriate ways to manage their disease, develop positive relationships with healthcare professionals, and participate in interactions with others their age successfully managing type 1 diabetes. © 2012 Blackwell Publishing Ltd.

  15. A Qualitative Report of the Ways High School Chemistry Students Attempt to Represent a Chemical Reaction at the Atomic/Molecular Level

    Science.gov (United States)

    Kern, Anne L.; Wood, Nathan B.; Roehrig, Gillian H.; Nyachwaya, James

    2010-01-01

    We report the findings of a large-scale (n = 1,337) qualitative descriptive analysis of U.S. high schools students' particulate representations of a chemical reaction, specifically, the combustion of methane. Data were collected as part of an end of course exam. Student representations were coded into 17 distinct subcategories under one of five…

  16. 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)

  17. 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

  18. 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.

  19. A Qualitative Inquiry of Career Exploration in Highly Implemented Career and Technical Education Programs of Study

    Science.gov (United States)

    Stipanovic, Natalie; Stringfield, Sam

    2013-01-01

    This qualitative study explores career counseling and guidance services as provided to students engaged in career and technical education programs at three sites in the United States. The sites, consisting of high schools and community colleges, were part of the National Research Center for Career and Technical Education's 5-year studies of…

  20. 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

  1. Qualitative Descriptive Methods in Health Science Research.

    Science.gov (United States)

    Colorafi, Karen Jiggins; Evans, Bronwynne

    2016-07-01

    The purpose of this methodology paper is to describe an approach to qualitative design known as qualitative descriptive that is well suited to junior health sciences researchers because it can be used with a variety of theoretical approaches, sampling techniques, and data collection strategies. It is often difficult for junior qualitative researchers to pull together the tools and resources they need to embark on a high-quality qualitative research study and to manage the volumes of data they collect during qualitative studies. This paper seeks to pull together much needed resources and provide an overview of methods. A step-by-step guide to planning a qualitative descriptive study and analyzing the data is provided, utilizing exemplars from the authors' research. This paper presents steps to conducting a qualitative descriptive study under the following headings: describing the qualitative descriptive approach, designing a qualitative descriptive study, steps to data analysis, and ensuring rigor of findings. The qualitative descriptive approach results in a summary in everyday, factual language that facilitates understanding of a selected phenomenon across disciplines of health science researchers. © The Author(s) 2016.

  2. 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

  3. 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.

  4. 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.

  5. 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.

  6. 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)

  7. Providing palliative care in rural Nepal: Perceptions of mid-level health workers

    Directory of Open Access Journals (Sweden)

    Rajesh N Gongal

    2018-01-01

    Full Text Available Introduction: Nepal is beginning to develop palliative care services across the country. Most people live in rural areas, where the Mid-Level Health Workers (MHWs are the major service providers. Their views on providing palliative care are most important in determining how the service is organized and developed.Aim: This study aims to ascertain the perceptions of MHWs about palliative care in their local community, to inform service development.Methods: A> qualitative descriptive design, using focus group discussions, was used to collect data from a rural district of Makwanpur, 1 of the 75 districts of Nepal. Twenty-eight MHWs participated in four focus group discussions. The data were analyzed using content analysis.Result: Four themes emerged from the discussion: (i suffering of patients and families inflicted by life-threatening illness, (ii helplessness and frustration felt when caring for such patients, (iii sociocultural issues at the end of life, and (iv improving care for patients with palliative care needs.Conclusion: MHWs practicing in rural areas reported the suffering of patients inflicted with life-limiting illness and their family due to poverty, poor access, lack of resources, social discrimination, and lack of knowledge and skills of the health workers. While there are clear frustrations with the limited resources, there is a willingness to learn among the health workers and provide care in the community.

  8. 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.

  9. Series: Practical guidance to qualitative research. Part 1: Introduction.

    Science.gov (United States)

    Moser, Albine; Korstjens, Irene

    2017-12-01

    In the course of our supervisory work over the years, we have noticed that qualitative research tends to evoke a lot of questions and worries, so-called Frequently Asked Questions. This journal series of four articles intends to provide novice researchers with practical guidance for conducting high-quality qualitative research in primary care. By 'novice' we mean Master's students and junior researchers, as well as experienced quantitative researchers who are engaging in qualitative research for the first time. This series addresses their questions and provides researchers, readers, reviewers and editors with references to criteria and tools for judging the quality of papers reporting on qualitative research. This first article describes the key features of qualitative research, provides publications for further learning and reading, and gives an outline of the series.

  10. 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...

  11. Qualitative case studies of professional-level workers with traumatic brain injuries: A contextual approach to job accommodation and retention.

    Science.gov (United States)

    Roessler, Richard T; Rumrill, Phillip D; Rumrill, Stuart P; Minton, Deborah L; Hendricks, Deborah J; Sampson, Elaine; Stauffer, Callista; Scherer, Marcia J; Nardone, Amanda; Leopold, Anne; Jacobs, Karen; Elias, Eileen

    2017-09-14

    Traumatic brain injury (TBI) is a multi-systemic disability that causes a wide range of difficulties with personal and social functioning. Four individuals with TBI participated in an evaluation of barriers to their continued employment following graduation from college. A trained interviewer completed the Work Experience Survey (WES) in teleconsultation sessions with each participant. Researchers applied a qualitative case study research design. Participants reported a wide range of difficulties in performing essential functions of their jobs (3 to 24) that have the potential to significantly affect their productivity. Career mastery problems reflected outcomes associated with TBI such as 'believing that others think I do a good job' and 'having the resources (e.g., knowledge, tools, supplies, and equipment) needed to do the job.' Indicative of their wish to continue their current employment, participants reported high levels of job satisfaction. The WES is a cost-effective needs assessment tool to aid health and rehabilitation professionals in providing on-the-job supports to workers with TBI.

  12. Qualitative models for space system engineering

    Science.gov (United States)

    Forbus, Kenneth D.

    1990-01-01

    The objectives of this project were: (1) to investigate the implications of qualitative modeling techniques for problems arising in the monitoring, diagnosis, and design of Space Station subsystems and procedures; (2) to identify the issues involved in using qualitative models to enhance and automate engineering functions. These issues include representing operational criteria, fault models, alternate ontologies, and modeling continuous signals at a functional level of description; and (3) to develop a prototype collection of qualitative models for fluid and thermal systems commonly found in Space Station subsystems. Potential applications of qualitative modeling to space-systems engineering, including the notion of intelligent computer-aided engineering are summarized. Emphasis is given to determining which systems of the proposed Space Station provide the most leverage for study, given the current state of the art. Progress on using qualitative models, including development of the molecular collection ontology for reasoning about fluids, the interaction of qualitative and quantitative knowledge in analyzing thermodynamic cycles, and an experiment on building a natural language interface to qualitative reasoning is reported. Finally, some recommendations are made for future research.

  13. 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...

  14. 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

  15. Creative thinking level of students with high capability in relations and functions by problem-based learning

    Science.gov (United States)

    Nurdyani, F.; Slamet, I.; Sujadi, I.

    2018-03-01

    This research was conducted in order to describe the creative thinking level of students with high capability in relations and functions with Problem Based Learning. The subjects of the research were students with high capability grade VIII at SMPIT Ibnu Abbas Klaten. This research is an qualitative descriptive research. The data were collected using observation, tests and interviews. The result showed that the creative thinking level of students with high capability in relations and functions by Problem Based Learning was at level 4 or very creative because students were able to demonstrate fluency, flexibility, and novelty.

  16. 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

    using a pragmatic meta-aggregative approach and the Joanna Briggs Institute Qualitative Assessment and Review Instrument software. This review included 21 publications from 18 research studies, representing a wide range of countries and healthcare settings. There were 245 findings which were aggregated into 12 categories and five synthesized findings. 1. Nurses/midwives are supportive of provider-initiated HIV testing and counseling if it is perceived to enhance patient care and to align with perceived professional roles. 2. Nurses'/midwives' ability to perform provider-initiated HIV testing and counseling well requires an appropriate infrastructure and adequate human and material resources. 3. At the organizational level, nurses'/midwives' engagement with provider-initiated HIV testing and counseling is facilitated by an inclusive management structure, alongside the provision of ongoing training and clinical supervision. Provider-initiated HIV testing and counseling is hindered by difficulties in fitting it into existing workloads and routines. 4. Nurses/midwives perceive that good quality care in provider-initiated HIV testing and counseling involves finding a balance between public health needs and individual patient needs. Good care requires time and the ability to apply a patient centred approach. 5. The emotional work involved in provider-initiated HIV testing and counseling can be stressful. Nurses/Midwives may require support to deal with complex moral and ethical issues. This review shows that provider-initiated HIV testing and counseling is supported by nurses/midwives who strive to implement it according to principles of good care and a patient centered approach. Nurses/midwives face multiple operational, infra-structural, resource and ethical challenges in the implementation of provider-initiated HIV testing and counseling. The implementation process for provider-initiated HIV testing and counseling would benefit from using a quality improvement framework

  17. 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.

  18. The learner’s perspective in GP teaching practices with multi-level learners: a qualitative study

    Science.gov (United States)

    2014-01-01

    Background Medical students, junior hospital doctors on rotation and general practice (GP) registrars are undertaking their training in clinical general practices in increasing numbers in Australia. Some practices have four levels of learner. This study aimed to explore how multi-level teaching (also called vertical integration of GP education and training) is occurring in clinical general practice and the impact of such teaching on the learner. Methods A qualitative research methodology was used with face-to-face, semi-structured interviews of medical students, junior hospital doctors, GP registrars and GP teachers in eight training practices in the region that taught all levels of learners. Interviews were audio-recorded and transcribed. Qualitative analysis was conducted using thematic analysis techniques aided by the use of the software package N-Vivo 9. Primary themes were identified and categorised by the co-investigators. Results 52 interviews were completed and analysed. Themes were identified relating to both the practice learning environment and teaching methods used. A practice environment where there is a strong teaching culture, enjoyment of learning, and flexible learning methods, as well as learning spaces and organised teaching arrangements, all contribute to positive learning from a learners’ perspective. Learners identified a number of innovative teaching methods and viewed them as positive. These included multi-level learner group tutorials in the practice, being taught by a team of teachers, including GP registrars and other health professionals, and access to a supernumerary GP supervisor (also termed “GP consultant teacher”). Other teaching methods that were viewed positively were parallel consulting, informal learning and rural hospital context integrated learning. Conclusions Vertical integration of GP education and training generally impacted positively on all levels of learner. This research has provided further evidence about the

  19. 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

  20. Provider perceptions of an integrated primary care quality improvement strategy: The PPAQ toolkit.

    Science.gov (United States)

    Beehler, Gregory P; Lilienthal, Kaitlin R

    2017-02-01

    The Primary Care Behavioral Health (PCBH) model of integrated primary care is challenging to implement with high fidelity. The Primary Care Behavioral Health Provider Adherence Questionnaire (PPAQ) was designed to assess provider adherence to essential model components and has recently been adapted into a quality improvement toolkit. The aim of this pilot project was to gather preliminary feedback on providers' perceptions of the acceptability and utility of the PPAQ toolkit for making beneficial practice changes. Twelve mental health providers working in Department of Veterans Affairs integrated primary care clinics participated in semistructured interviews to gather quantitative and qualitative data. Descriptive statistics and qualitative content analysis were used to analyze data. Providers identified several positive features of the PPAQ toolkit organization and structure that resulted in high ratings of acceptability, while also identifying several toolkit components in need of modification to improve usability. Toolkit content was considered highly representative of the (PCBH) model and therefore could be used as a diagnostic self-assessment of model adherence. The toolkit was considered to be high in applicability to providers regardless of their degree of prior professional preparation or current clinical setting. Additionally, providers identified several system-level contextual factors that could impact the usefulness of the toolkit. These findings suggest that frontline mental health providers working in (PCBH) settings may be receptive to using an adherence-focused toolkit for ongoing quality improvement. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  1. 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.

  2. A Mid-Level Dental Provider in Oregon: Dental hygienists' perceptions.

    Science.gov (United States)

    Coplen, Amy E; Bell, Kathryn; Aamodt, Gail L; Ironside, Lynn

    2017-10-01

    Purpose: Many states are exploring alternative provider models and examining the role of the dental hygienist to address access to care challenges as the United States continues to face increasing demands for oral healthcare services. The purpose of this study was to assess dental hygienists' opinions in the state of Oregon regarding the current limitations of dental hygienists' scope of practice, perceived need for a mid-level provider in Oregon, and personal interest in becoming a mid-level provider. Methods: In December 2013 a survey was mailed to a sample of 1,231 dental hygienists registered in Oregon representing 30% of the licentiates. All licentiates holding expanded practice permits (EPP) were included in the sample (n=351). The following categories were included in the 32-question survey: scope of practice, mid-level provider, current practice, and demographics. Results: A total of 440 surveys were returned for a response rate of 36%. Of the EPP holders, 51% responded to the survey. Over half of respondents (59%) believe that a mid-level provider is needed in the state. Respondents holding membership in the American Dental Hygienists' Association, as well as EPP holders, were significantly more likely to respond that a mid-level dental provider was needed in the state (plevel provider was introduced in Oregon, the new provider should be a registered dental hygienist model. Forty-three percent (n=186) of respondents were interested in becoming mid-level providers and 47% (n=203) of respondents believed that the minimum education for a mid-level provider should be a bachelor's degree. The majority, 74% (n=137), of those interested in becoming a mid-level provider indicated a preference in completing their education through online teaching combined with a clinical internship. Conclusion: There is strong support from dental hygienists in Oregon that a need exists for a mid-level dental provider and that this provider model should be dental hygiene based

  3. 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

  4. Qualitative "trial-sibling" studies and "unrelated" qualitative studies contributed to complex intervention reviews.

    Science.gov (United States)

    Noyes, Jane; Hendry, Margaret; Lewin, Simon; Glenton, Claire; Chandler, Jackie; Rashidian, Arash

    2016-06-01

    To compare the contribution of "trial-sibling" and "unrelated" qualitative studies in complex intervention reviews. Researchers are using qualitative "trial-sibling" studies undertaken alongside trials to provide explanations to understand complex interventions. In the absence of qualitative "trial-sibling" studies, it is not known if qualitative studies "unrelated" to trials are helpful. Trials, "trial-sibling," and "unrelated" qualitative studies looking at three health system interventions were identified. We looked for similarities and differences between the two types of qualitative studies, such as participants, intervention delivery, context, study quality and reporting, and contribution to understanding trial results. Reporting was generally poor in both qualitative study types. We detected no substantial differences in participant characteristics. Interventions in qualitative "trial-sibling" studies were delivered using standardized protocols, whereas interventions in "unrelated" qualitative studies were delivered in routine care. Qualitative "trial-sibling" studies alone provided insufficient data to develop meaningful transferrable explanations beyond the trial context, and their limited focus on immediate implementation did not address all phenomena of interest. Together, "trial-sibling" and "unrelated" qualitative studies provided larger, richer data sets across contexts to better understand the phenomena of interest. Findings support inclusion of "trial-sibling" and "unrelated" qualitative studies to explore complexity in complex intervention reviews. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. 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

  6. 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.

  7. 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.

  8. 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...

  9. 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.

  10. Organizational and provider level factors in implementation of trauma-informed care after a city-wide training: an explanatory mixed methods assessment.

    Science.gov (United States)

    Damian, April Joy; Gallo, Joseph; Leaf, Philip; Mendelson, Tamar

    2017-11-21

    While there is increasing support for training youth-serving providers in trauma-informed care (TIC) as a means of addressing high prevalence of U.S. childhood trauma, we know little about the effects of TIC training on organizational culture and providers' professional quality of life. This mixed-methods study evaluated changes in organizational- and provider-level factors following participation in a citywide TIC training. Government workers and nonprofit professionals (N = 90) who participated in a nine-month citywide TIC training completed a survey before and after the training to assess organizational culture and professional quality of life. Survey data were analyzed using multiple regression analyses. A subset of participants (n = 16) was interviewed using a semi-structured format, and themes related to organizational and provider factors were identified using qualitative methods. Analysis of survey data indicated significant improvements in participants' organizational culture and professional satisfaction at training completion. Participants' perceptions of their own burnout and secondary traumatic stress also increased. Four themes emerged from analysis of the interview data, including "Implementation of more flexible, less-punitive policies towards clients," "Adoption of trauma-informed workplace design," "Heightened awareness of own traumatic stress and need for self-care," and "Greater sense of camaraderie and empathy for colleagues." Use of a mixed-methods approach provided a nuanced understanding of the impact of TIC training and suggested potential benefits of the training on organizational and provider-level factors associated with implementation of trauma-informed policies and practices. Future trainings should explicitly address organizational factors such as safety climate and morale, managerial support, teamwork climate and collaboration, and individual factors including providers' compassion satisfaction, burnout, and secondary

  11. Holistic health care: Patients' experiences of health care provided by an Advanced Practice Nurse.

    Science.gov (United States)

    Eriksson, Irene; Lindblad, Monica; Möller, Ulrika; Gillsjö, Catharina

    2018-02-01

    Advanced Practice Nurse (APN) is a fairly new role in the Swedish health care system. To describe patients' experiences of health care provided by an APN in primary health care. An inductive, descriptive qualitative approach with qualitative open-ended interviews was chosen to obtain descriptions from 10 participants regarding their experiences of health care provided by an APN. The data were collected during the spring 2012, and a qualitative approach was used for analyze. The APNs had knowledge and skills to provide safe and secure individual and holistic health care with high quality, and a respectful and flexible approach. The APNs conveyed trust and safety and provided health care that satisfied the patients' needs of accessibility and appropriateness in level of care. The APNs way of providing health care and promoting health seems beneficial in many ways for the patients. The individual and holistic approach that characterizes the health care provided by the APNs is a key aspect in the prevailing change of health care practice. The transfer of care and the increasing number of older adults, often with a variety of complex health problems, call for development of the new role in this context. © 2017 The Authors. International Journal of Nursing Practice Published by John Wiley & Sons Australia, Ltd.

  12. 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

  13. 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.

  14. Cameroon mid-level providers offer a promising public health dentistry model

    Directory of Open Access Journals (Sweden)

    Achembong Leo

    2012-11-01

    Full Text Available Background Oral health services are inadequate and unevenly distributed in many developing countries, particularly those in sub-Saharan Africa. Rural areas in these countries and poorer sections of the population in urban areas often do not have access to oral health services mainly because of a significant shortage of dentists and the high costs of care. We reviewed Cameroon’s experience with deploying a mid-level cadre of oral health professionals and the feasibility of establishing a more formal and predictable role for these health workers. We anticipate that a task-shifting approach in the provision of dental care will significantly improve the uneven distribution of oral health services particularly in the rural areas of Cameroon, which is currently served by only 3% of the total number of dentists. Methods The setting of this study was the Cameroon Baptist Convention Health Board (BCHB, which has four dentists and 42 mid-level providers. De-identified data were collected manually from the registries of 10 Baptist Convention clinics located in six of Cameroon’s 10 regions and then entered into an Excel format before importing into STATA. A retrospective abstraction of all entries for patient visits starting October 2010, and going back in time until 1500 visits were extracted from each clinic. Results This study showed that mid-level providers in BCHB clinics are offering a full scope of dental work across the 10 clinics, with the exception of treatment for major facial injuries. Mid-level providers alone performed 93.5% of all extractions, 87.5% of all fillings, 96.5% of all root canals, 97.5% of all cleanings, and 98.1% of all dentures. The dentists also typically played a teaching role in training the mid-level providers. Conclusions The Ministry of Health in Cameroon has an opportunity to learn from the BCHB model to expand access to oral health care across the country. This study shows the benefits of using a simple, workable, low

  15. 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

  16. 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

  17. 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

  18. A qualitative numerical study of high dimensional dynamical systems

    Science.gov (United States)

    Albers, David James

    Since Poincare, the father of modern mathematical dynamical systems, much effort has been exerted to achieve a qualitative understanding of the physical world via a qualitative understanding of the functions we use to model the physical world. In this thesis, we construct a numerical framework suitable for a qualitative, statistical study of dynamical systems using the space of artificial neural networks. We analyze the dynamics along intervals in parameter space, separating the set of neural networks into roughly four regions: the fixed point to the first bifurcation; the route to chaos; the chaotic region; and a transition region between chaos and finite-state neural networks. The study is primarily with respect to high-dimensional dynamical systems. We make the following general conclusions as the dimension of the dynamical system is increased: the probability of the first bifurcation being of type Neimark-Sacker is greater than ninety-percent; the most probable route to chaos is via a cascade of bifurcations of high-period periodic orbits, quasi-periodic orbits, and 2-tori; there exists an interval of parameter space such that hyperbolicity is violated on a countable, Lebesgue measure 0, "increasingly dense" subset; chaos is much more likely to persist with respect to parameter perturbation in the chaotic region of parameter space as the dimension is increased; moreover, as the number of positive Lyapunov exponents is increased, the likelihood that any significant portion of these positive exponents can be perturbed away decreases with increasing dimension. The maximum Kaplan-Yorke dimension and the maximum number of positive Lyapunov exponents increases linearly with dimension. The probability of a dynamical system being chaotic increases exponentially with dimension. The results with respect to the first bifurcation and the route to chaos comment on previous results of Newhouse, Ruelle, Takens, Broer, Chenciner, and Iooss. Moreover, results regarding the high

  19. Built environment interventions aimed at improving physical activity levels in rural Ontario health units: a descriptive qualitative study.

    Science.gov (United States)

    Coghill, Cara-Lee; Valaitis, Ruta K; Eyles, John D

    2015-05-03

    Few studies to date have explored the relationship between the built environment and physical activity specifically in rural settings. The Ontario Public Health Standards policies mandate that health units in Ontario address the built environment; however, it is unclear how public health practitioners are integrating the built environment into public health interventions aimed at improving physical activity in chronic disease prevention programs. This descriptive qualitative study explored interventions that have or are being implemented which address the built environment specifically related to physical activity in rural Ontario health units, and the impact of these interventions. Data were collected through twelve in-depth semi-structured interviews with rural public health practitioners and managers representing 12 of 13 health units serving rural communities. Key themes were identified using qualitative content analysis. Themes that emerged regarding the types of interventions that health units are employing included: Engagement with policy work at a municipal level; building and working with community partners, committees and coalitions; gathering and providing evidence; developing and implementing programs; and social marketing and awareness raising. Evaluation of interventions to date has been limited. Public health interventions, and their evaluations, are complex. Health units who serve large rural populations in Ontario are engaging in numerous activities to address physical activity levels. There is a need to further evaluate the impact of these interventions on population health.

  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. The Effective Practices and Beliefs of School Principals in High Achieving Hispanic Majority Mid-Level Schools

    Science.gov (United States)

    Briseno, Johnny

    2010-01-01

    This qualitative phenomenological research study used narrative inquiry to investigate the effective practices and beliefs of 10 Texas principals in high achieving majority Hispanic mid-level schools. Participant interviews were analyzed using the Creswell (2007) six step method for analyzing phenomenological studies. Findings from this study…

  2. 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

  3. Factors associated with high stress levels in adults with diabetes mellitus attending a tertiary diabetes care center, Chennai, Tamil Nadu, India

    Directory of Open Access Journals (Sweden)

    Muthappan Sendhilkumar

    2017-01-01

    Full Text Available Objective: We aimed to determine perceived stress levels among adults aged >20 years with type 2 diabetes mellitus (DM in a tertiary care diabetes center, Chennai, Tamil Nadu, India, assess their association with sociodemographic and clinical characteristics and assess the possible risk factors for stress and coping strategies. Methods: A mixed-methods (triangulation design study with quantitative methodology (survey and qualitative methodology (interviews was carried out. Stress levels were assessed among type 2 DM patients attending a diabetes clinic using a 5-point perceived stress scale-10. One-on-one interviews were carried out with 376 participants with DM having high/very high stress levels to understand the reasons for perceived stress and explore their coping mechanisms. Results: The prevalence of high/very high stress was 35% among DM patients. Age 30–40 years, working in professional jobs, and lack of physical activity were factors significantly associated with stress. The perceived major stress inducers were related to family, work, financial issues, and the disease itself. Conclusions: This study showed high levels of stress in more than one-third of DM patients. Potential solutions include regular, formal assessment of stress levels in the clinic, providing integrated counseling and psychological care for DM patients, and promoting physical activity.

  4. Factors associated with high stress levels in adults with diabetes mellitus attending a tertiary diabetes care center, Chennai, Tamil Nadu, India.

    Science.gov (United States)

    Sendhilkumar, Muthappan; Tripathy, Jaya Prasad; Harries, Anthony D; Dongre, Amol R; Deepa, Mohan; Vidyulatha, Ashok; Poongothai, Subramanian; Venkatesan, Ulaganathan; Anjana, Ranjit Mohan; Mohan, Viswanathan

    2017-01-01

    We aimed to determine perceived stress levels among adults aged >20 years with type 2 diabetes mellitus (DM) in a tertiary care diabetes center, Chennai, Tamil Nadu, India, assess their association with sociodemographic and clinical characteristics and assess the possible risk factors for stress and coping strategies. A mixed-methods (triangulation design) study with quantitative methodology (survey) and qualitative methodology (interviews) was carried out. Stress levels were assessed among type 2 DM patients attending a diabetes clinic using a 5-point perceived stress scale-10. One-on-one interviews were carried out with 376 participants with DM having high/very high stress levels to understand the reasons for perceived stress and explore their coping mechanisms. The prevalence of high/very high stress was 35% among DM patients. Age 30-40 years, working in professional jobs, and lack of physical activity were factors significantly associated with stress. The perceived major stress inducers were related to family, work, financial issues, and the disease itself. This study showed high levels of stress in more than one-third of DM patients. Potential solutions include regular, formal assessment of stress levels in the clinic, providing integrated counseling and psychological care for DM patients, and promoting physical activity.

  5. Factors associated with high stress levels in adults with diabetes mellitus attending a tertiary diabetes care center, Chennai, Tamil Nadu, India

    Science.gov (United States)

    Sendhilkumar, Muthappan; Tripathy, Jaya Prasad; Harries, Anthony D.; Dongre, Amol R.; Deepa, Mohan; Vidyulatha, Ashok; Poongothai, Subramanian; Venkatesan, Ulaganathan; Anjana, Ranjit Mohan; Mohan, Viswanathan

    2017-01-01

    Objective: We aimed to determine perceived stress levels among adults aged >20 years with type 2 diabetes mellitus (DM) in a tertiary care diabetes center, Chennai, Tamil Nadu, India, assess their association with sociodemographic and clinical characteristics and assess the possible risk factors for stress and coping strategies. Methods: A mixed-methods (triangulation design) study with quantitative methodology (survey) and qualitative methodology (interviews) was carried out. Stress levels were assessed among type 2 DM patients attending a diabetes clinic using a 5-point perceived stress scale-10. One-on-one interviews were carried out with 376 participants with DM having high/very high stress levels to understand the reasons for perceived stress and explore their coping mechanisms. Results: The prevalence of high/very high stress was 35% among DM patients. Age 30–40 years, working in professional jobs, and lack of physical activity were factors significantly associated with stress. The perceived major stress inducers were related to family, work, financial issues, and the disease itself. Conclusions: This study showed high levels of stress in more than one-third of DM patients. Potential solutions include regular, formal assessment of stress levels in the clinic, providing integrated counseling and psychological care for DM patients, and promoting physical activity. PMID:28217499

  6. Interacting two-level defects as sources of fluctuating high-frequency noise in superconducting circuits

    Energy Technology Data Exchange (ETDEWEB)

    Mueller, Clemens [ARC Centre of Excellence for Engineered Quantum Systems, The University of Queensland, Brisbane (Australia); Lisenfeld, Juergen [Physikalisches Institut, Karlsruhe Institute of Technology, Karlsruhe (Germany); Shnirman, Alexander [Institut fuer Theory der Kondensierten Materie, Karlsruhe Institute of Technology, Karlsruhe (Germany); LD Landau Institute for Theoretical Physics, Moscow (Russian Federation); Poletto, Stefano [IBM TJ Watson Research Centre, Yorktown Heights (United States)

    2016-07-01

    Since the very first experiments, superconducting circuits have suffered from strong coupling to environmental noise, destroying quantum coherence and degrading performance. In state-of-the-art experiments, it is found that the relaxation time of superconducting qubits fluctuates as a function of time. We present measurements of such fluctuations in a 3D-transmon circuit and develop a qualitative model based on interactions within a bath of background two-level systems (TLS) which emerge from defects in the device material. In our model, the time-dependent noise density acting on the qubit emerges from its near-resonant coupling to high-frequency TLS which experience energy fluctuations due to their interaction with thermally fluctuating TLS at low frequencies. We support the model by providing experimental evidence of such energy fluctuations observed in a single TLS in a phase qubit circuit.

  7. Swiss Armed Forces Organizational Level Leader Development: A Qualitative Case Study

    Science.gov (United States)

    2017-06-09

    Merriam, defines a case study as “an in-depth description and analysis of a bounded system.”79 Among the six different qualitative types of research ...80 John W. Creswell, Research Design: Qualitative , Quantitative, and Mixed Methods Approaches (Los Angeles, CA: SAGE, 2014), 201. 81 Ibid...Publishing Group, 1996. Creswell, John W. Research Design: Qualitative , Quantitative, and Mixed Methods Approaches. Los Angeles, CA: SAGE, 2014. Curphy

  8. 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.

  9. 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.

  10. 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

  11. 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

  12. A Qualitative Descriptive Case Study of the Requirements of the IT Industry for Entry-Level IT Positions

    Science.gov (United States)

    Feuerherm, Todd Michael

    2009-01-01

    This qualitative descriptive case study explored the requirements of the IT industry for education, IT certification, and work experience for entry-level IT professionals. Research has shown a growing problem where IT graduates were not able to meet the requirements for entry-level IT jobs. IT enrollment has decreased considerably over the past…

  13. 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...

  14. Organizational and provider level factors in implementation of trauma-informed care after a city-wide training: an explanatory mixed methods assessment

    Directory of Open Access Journals (Sweden)

    April Joy Damian

    2017-11-01

    Full Text Available Abstract Background While there is increasing support for training youth-serving providers in trauma-informed care (TIC as a means of addressing high prevalence of U.S. childhood trauma, we know little about the effects of TIC training on organizational culture and providers’ professional quality of life. This mixed-methods study evaluated changes in organizational- and provider-level factors following participation in a citywide TIC training. Methods Government workers and nonprofit professionals (N = 90 who participated in a nine-month citywide TIC training completed a survey before and after the training to assess organizational culture and professional quality of life. Survey data were analyzed using multiple regression analyses. A subset of participants (n = 16 was interviewed using a semi-structured format, and themes related to organizational and provider factors were identified using qualitative methods. Results Analysis of survey data indicated significant improvements in participants’ organizational culture and professional satisfaction at training completion. Participants’ perceptions of their own burnout and secondary traumatic stress also increased. Four themes emerged from analysis of the interview data, including “Implementation of more flexible, less-punitive policies towards clients,” “Adoption of trauma-informed workplace design,” “Heightened awareness of own traumatic stress and need for self-care,” and “Greater sense of camaraderie and empathy for colleagues.” Conclusion Use of a mixed-methods approach provided a nuanced understanding of the impact of TIC training and suggested potential benefits of the training on organizational and provider-level factors associated with implementation of trauma-informed policies and practices. Future trainings should explicitly address organizational factors such as safety climate and morale, managerial support, teamwork climate and collaboration, and

  15. Dynamin-related protein inhibitor downregulates reactive oxygen species levels to indirectly suppress high glucose-induced hyperproliferation of vascular smooth muscle cells

    Energy Technology Data Exchange (ETDEWEB)

    Maimaitijiang, Alimujiang; Zhuang, Xinyu; Jiang, Xiaofei; Li, Yong, E-mail: 11211220031@fudan.edu.cn

    2016-03-18

    Hyperproliferation of vascular smooth muscle cells is a pathogenic mechanism common in diabetic vascular complications and is a putatively important therapeutic target. This study investigated multiple levels of biology, including cellular and organellar changes, as well as perturbations in protein synthesis and morphology. Quantitative and qualitative analysis was utilized to assess the effect of mitochondrial dynamic changes and reactive oxygen species(ROS) levels on high-glucose-induced hyperproliferation of vascular smooth muscle cells. The data demonstrated that the mitochondrial fission inhibitor Mdivi-1 and downregulation of ROS levels both effectively inhibited the high-glucose-induced hyperproliferation of vascular smooth muscle cells. Downregulation of ROS levels played a more direct role and ROS levels were also regulated by mitochondrial dynamics. Increased ROS levels induced excessive mitochondrial fission through dynamin-related protein (Drp 1), while Mdivi-1 suppressed the sensitivity of Drp1 to ROS levels, thus inhibiting excessive mitochondrial fission under high-glucose conditions. This study is the first to propose that mitochondrial dynamic changes and ROS levels interact with each other and regulate high-glucose-induced hyperproliferation of vascular smooth muscle cells. This finding provides novel ideas in understanding the pathogenesis of diabetic vascular remodeling and intervention. - Highlights: • Mdivi-1 inhibits VSMC proliferation by lowering ROS level in high-glucose condition. • ROS may be able to induce mitochondrial fission through Drp1 regulation. • Mdivi-1 can suppress the sensitivity of Drp1 to ROS.

  16. 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.

  17. Series: Practical guidance to qualitative research. Part 1: Introduction

    OpenAIRE

    Moser, Albine; Korstjens, Irene

    2017-01-01

    In the course of our supervisory work over the years, we have noticed that qualitative research tends to evoke a lot of questions and worries, so-called Frequently Asked Questions. This journal series of four articles intends to provide novice researchers with practical guidance for conducting high-quality qualitative research in primary care. By ‘novice’ we mean Master’s students and junior researchers, as well as experienced quantitative researchers who are engaging in qualitative research ...

  18. Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 2: how to make an overall CERQual assessment of confidence and create a Summary of Qualitative Findings table.

    Science.gov (United States)

    Lewin, Simon; Bohren, Meghan; Rashidian, Arash; Munthe-Kaas, Heather; Glenton, Claire; Colvin, Christopher J; Garside, Ruth; Noyes, Jane; Booth, Andrew; Tunçalp, Özge; Wainwright, Megan; Flottorp, Signe; Tucker, Joseph D; Carlsen, Benedicte

    2018-01-25

    The GRADE-CERQual (Confidence in Evidence from Reviews of Qualitative research) approach has been developed by the GRADE (Grading of Recommendations Assessment, Development and Evaluation) Working Group. The approach has been developed to support the use of findings from qualitative evidence syntheses in decision making, including guideline development and policy formulation. CERQual includes four components for assessing how much confidence to place in findings from reviews of qualitative research (also referred to as qualitative evidence syntheses): (1) methodological limitations, (2) coherence, (3) adequacy of data and (4) relevance. This paper is part of a series providing guidance on how to apply CERQual and focuses on making an overall assessment of confidence in a review finding and creating a CERQual Evidence Profile and a CERQual Summary of Qualitative Findings table. We developed this guidance by examining the methods used by other GRADE approaches, gathering feedback from relevant research communities and developing consensus through project group meetings. We then piloted the guidance on several qualitative evidence syntheses before agreeing on the approach. Confidence in the evidence is an assessment of the extent to which a review finding is a reasonable representation of the phenomenon of interest. Creating a summary of each review finding and deciding whether or not CERQual should be used are important steps prior to assessing confidence. Confidence should be assessed for each review finding individually, based on the judgements made for each of the four CERQual components. Four levels are used to describe the overall assessment of confidence: high, moderate, low or very low. The overall CERQual assessment for each review finding should be explained in a CERQual Evidence Profile and Summary of Qualitative Findings table. Structuring and summarising review findings, assessing confidence in those findings using CERQual and creating a CERQual Evidence

  19. 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

  20. Providing Southern Perspectives on CSR

    DEFF Research Database (Denmark)

    Jeppesen, Søren; Kothuis, Bas

    The article seeks to contribute to the SMEs and CSR literature in developing countries by providing; a) a ‘Southern’ SME perspective, which includes the voices of managers and workers, b) a perspective of CSR, which opens up to informal CSR practices that SMEs undertake, and c) an analysis...... of the key institutional issues affecting the CSR practices of SMEs. It presents perceptions of CSR practices among 21 SMEs in the garment industry in South Africa, based on 40 interviews with managers and 19 interviews with workers through the use of qualitative and quantitative interview frameworks....... It highlights a high degree of similarities between managers and workers, though knowledge of (cognitive level) the concept ‘CSR’ differ considerably. Informal practices are widespread and of key importance to the SMEs, expressed by managers and workers alike. History, industry and manager-workers relations...

  1. CONSIDERATIONS ON THE TREATMENT OF QUALITATIVE CHARACTERISTICS OF ACCOUNTING INFORMATION AT THE INTERNATIONAL LEVEL AND IN VARIOUS NATIONAL ACCOUNTING SYSTEMS

    Directory of Open Access Journals (Sweden)

    Ionela Cristina Breahna Pravat

    2014-07-01

    Full Text Available The qualitative characteristics of accounting information presented by financial-accounting reports represent a concept which was subsequently introduced in the national legal accounting framework and, as a rule, the national conceptual frameworks represent the documents by means of which these quality criteria are established. At a worldwide level, there are more international or national organisms that have an important role in the elaboration of accounting standards in general and more specifically in the formulation of qualitative characteristics of financial reporting. We find two important ones among them, and these are: International Accounting Standards Board, which creates and promotes International Financial Reporting Standards (IFRS, and Financial Accounting Standards Board, which elaborates Generally Accepted Accounting Principles (US GAAP. However, at the level of each country a standardizing authority decides the rules for producing the financial reports and the qualitative characteristics that must be respected by the information contained in these documents. In this context, this paper aims to present a few general considerations concerning the treatment of the qualitative characteristics of the financial-accounting information in different accounting systems, such as the American one, or the British, French, German, Romanian ones, with insistence on the international approach to qualitative characteristics.

  2. 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.

  3. 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.

  4. Measuring teamwork in primary care: Triangulation of qualitative and quantitative data.

    Science.gov (United States)

    Brown, Judith Belle; Ryan, Bridget L; Thorpe, Cathy; Markle, Emma K R; Hutchison, Brian; Glazier, Richard H

    2015-09-01

    This article describes the triangulation of qualitative dimensions, reflecting high functioning teams, with the results of standardized teamwork measures. The study used a mixed methods design using qualitative and quantitative approaches to assess teamwork in 19 Family Health Teams in Ontario, Canada. This article describes dimensions from the qualitative phase using grounded theory to explore the issues and challenges to teamwork. Two quantitative measures were used in the study, the Team Climate Inventory (TCI) and the Providing Effective Resources and Knowledge (PERK) scale. For the triangulation analysis, the mean scores of these measures were compared with the qualitatively derived ratings for the dimensions. The final sample for the qualitative component was 107 participants. The qualitative analysis identified 9 dimensions related to high team functioning such as common philosophy, scope of practice, conflict resolution, change management, leadership, and team evolution. From these dimensions, teams were categorized numerically as high, moderate, or low functioning. Three hundred seventeen team members completed the survey measures. Mean site scores for the TCI and PERK were 3.87 and 3.88, respectively (of 5). The TCI was associated will all dimensions except for team location, space allocation, and executive director leadership. The PERK was associated with all dimensions except team location. Data triangulation provided qualitative and quantitative evidence of what constitutes teamwork. Leadership was pivotal in forging a common philosophy and encouraging team collaboration. Teams used conflict resolution strategies and adapted to the changes they encountered. These dimensions advanced the team's evolution toward a high functioning team. (c) 2015 APA, all rights reserved).

  5. Malaria risk factors and care-seeking behaviour within the private sector among high-risk populations in Vietnam: a qualitative study.

    Science.gov (United States)

    Chen, Ingrid; Thanh, Huong Ngo Thi; Lover, Andrew; Thao, Phung Thi; Luu, Tang Viet; Thang, Hoang Nghia; Thang, Ngo Duc; Neukom, Josselyn; Bennett, Adam

    2017-10-16

    Vietnam has successfully reduced malaria incidence by more than 90% over the past 10 years, and is now preparing for malaria elimination. However, the remaining malaria burden resides in individuals that are hardest to reach, in highly remote areas, where many malaria cases are treated through the informal private sector and are not reported to public health systems. This qualitative study aimed to contextualize and characterize the role of private providers, care-seeking behaviour of individuals at high risk of malaria, as well as risk factors that should be addressed through malaria elimination programmes in Vietnam. Semi-structured qualitative interviews were conducted with 11 key informants in Hanoi, 30 providers, 9 potential patients, and 11 individuals at risk of malaria in Binh Phuoc and Kon Tum provinces. Audio recorded interviews were transcribed and uploaded to Atlas TI™, themes were identified, from which programmatic implications and recommendations were synthesized. Qualitative interviews revealed that efforts for malaria elimination in Vietnam should concentrate on reaching highest-risk populations in remote areas as well their care providers, in particular private pharmacies, private clinics, and grocery stores. Among these private providers, diagnosis is currently based on symptoms, leaving unconfirmed cases that are not reported to public health surveillance systems. Among at-risk individuals, knowledge of malaria was limited, and individuals reported not taking full courses of treatment, a practice that threatens selection for drug resistance. Access to insecticide-treated hammock nets, a potentially important preventive measure for settings with outdoor biting Anopheles vectors, was also limited. Malaria elimination efforts in Vietnam can be accelerated by targeting improved treatment, diagnosis, and reporting practices to private pharmacies, private clinics, and grocery stores. Programmes should also seek to increase awareness and

  6. Ethical issues in using Twitter for population-level depression monitoring: a qualitative study.

    Science.gov (United States)

    Mikal, Jude; Hurst, Samantha; Conway, Mike

    2016-04-14

    Recently, significant research effort has focused on using Twitter (and other social media) to investigate mental health at the population-level. While there has been influential work in developing ethical guidelines for Internet discussion forum-based research in public health, there is currently limited work focused on addressing ethical problems in Twitter-based public health research, and less still that considers these issues from users' own perspectives. In this work, we aim to investigate public attitudes towards utilizing public domain Twitter data for population-level mental health monitoring using a qualitative methodology. The study explores user perspectives in a series of five, 2-h focus group interviews. Following a semi-structured protocol, 26 Twitter users with and without a diagnosed history of depression discussed general Twitter use, along with privacy expectations, and ethical issues in using social media for health monitoring, with a particular focus on mental health monitoring. Transcripts were then transcribed, redacted, and coded using a constant comparative approach. While participants expressed a wide range of opinions, there was an overall trend towards a relatively positive view of using public domain Twitter data as a resource for population level mental health monitoring, provided that results are appropriately aggregated. Results are divided into five sections: (1) a profile of respondents' Twitter use patterns and use variability; (2) users' privacy expectations, including expectations regarding data reach and permanence; (3) attitudes towards social media based population-level health monitoring in general, and attitudes towards mental health monitoring in particular; (4) attitudes towards individual versus population-level health monitoring; and (5) users' own recommendations for the appropriate regulation of population-level mental health monitoring. Focus group data reveal a wide range of attitudes towards the use of public

  7. Validity in Qualitative Evaluation

    Directory of Open Access Journals (Sweden)

    Vasco Lub

    2015-12-01

    Full Text Available This article provides a discussion on the question of validity in qualitative evaluation. Although validity in qualitative inquiry has been widely reflected upon in the methodological literature (and is still often subject of debate, the link with evaluation research is underexplored. Elaborating on epistemological and theoretical conceptualizations by Guba and Lincoln and Creswell and Miller, the article explores aspects of validity of qualitative research with the explicit objective of connecting them with aspects of evaluation in social policy. It argues that different purposes of qualitative evaluations can be linked with different scientific paradigms and perspectives, thus transcending unproductive paradigmatic divisions as well as providing a flexible yet rigorous validity framework for researchers and reviewers of qualitative evaluations.

  8. 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

  9. 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

  10. 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.

  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. High School Football Players and Their Coaches: A Qualitative Study of Their Relationships

    Science.gov (United States)

    Skaza, Robert J.

    2014-01-01

    This basic qualitative study of high school football coach-player relationships explores the players' perceptions of these relationships, specifically the perceptions the players have of how these relationships influenced their lives. This study allowed the researcher to examine the characteristics of high school football coaches as they relate to…

  13. Research Needs Assessment in the Health Insurance Organization: Level of Health Care Provider

    Directory of Open Access Journals (Sweden)

    Mohammadkarim Bahadori

    2011-12-01

    Full Text Available Objective: Setting research priorities in the research management cycle is a key. It is important to set the research priorities to make optimal use of scarce resources. The aim of this research was to determine the research needs of Health Insurance Organization based on its health care centers research needs.Methods: This is a qualitative, descriptive and cross-sectional study that was conducted in 2011. A purposeful sample of 60 participants from 14 hospitals, seven dispensaries, five dental clinics, two rehabilitation centers, four radiology centers, six medical diagnostic laboratories, 12 pharmacies, and 20 medical offices that were contracted with the Health Insurance Organization in Iran was interviewed. The framework analysis method (a qualitative research method was used for analysis of interviews. Atlas-Ti software was used to analyze quantitative data, respectively. The topics were prioritized using the Analytical Hierarchy Process (AHP method through Expert Choice software.Results: Based on the problems extracted in our qualitative study, 12 research topics were proposed by the experts. Among these “Design of standard treatment protocols,” “Designing model of ranking the health care centers under contract,” and “Pathology of payment system” took the priority ranks of 1 to 3, earning the scores of 0.44, 0.42, and 0.37, respectively.Conclusion: Considering limited resources and unlimited needs and to prevent research resource wasting, conducting research related to health care providers in the Health Insurance Organization can help it achieve its goals.

  14. Influence of High Level Features of HVS on Performance of FSIM

    Directory of Open Access Journals (Sweden)

    P. Dostal

    2013-12-01

    Full Text Available In this paper the influence of information about high level features of Human Visual System (HVS on objective quality assessment is studied. This was done by extending the existing full-reference objective image quality metric – FSIM – where the different importance of certain areas of image is considered using Phase Congruency (PC algorithm. Here, the estimation of Region of Interest (ROI based on this algorithm is complemented by Fixation Density Maps (FDM containing the information about high level features of HVS. Use of another low level features based algorithm (Phase Spectrum of Fourier Transform was also considered and compared to the PC algorithm. The performance was evaluated qualitatively on images reconstructed according to ROI and quantitatively on images from LIVE database. The correlation between subjective and objective tests was calculated using Pearson’s Correlation Coefficient and Spearman’s Rank Order Coefficient. The statistical significance of the difference between correlation coefficients was assessed by Fisher r-to-z transformation. The performance of the metric was also compared to other state-of-the-art image quality metrics (SSIM, MS-SSIM, and FSIM.

  15. Couple perspectives on unintended pregnancy in an area with high HIV prevalence: A qualitative analysis in Rakai, Uganda.

    Science.gov (United States)

    Grilo, Stephanie A; Catallozzi, Marina; Heck, Craig J; Mathur, Sanyukta; Nakyanjo, Neema; Santelli, John S

    2018-03-14

    Understanding how couples perceive a recent unintended pregnancy in the context of HIV infection and high levels of gender inequality may provide insights for prevention of undesired pregnancy. We used data from 24 in-depth interviews with 8 HIV-serodiscordant and 4 seroconcordant couples living in rural Uganda and interviewed separately; between 15 and 49 years and one or both identified the pregnancy as unintended. A dyadic analysis was performed to understand each partner's perspectives on experiences of a specific pregnancy. We used the social-ecological model to guide the analysis. Issues of agency were commonly invoked in describing pregnancy. Women often cited factors that demonstrated a lack of control when making decisions about continuing the pregnancy. Men often expressed a lack of agency or control over preventing their female partner from becoming pregnant. There was much disagreement between partners about intentions regarding the specific pregnancy. Likewise, lack of communication about child spacing and pregnancy intentions was common among couples. HIV serostatus played a role in some discussions of pregnancy intention among serodiscordant couples. This qualitative analysis supports prior quantitative research on the complexity of pregnancy intentions. A lack of agency at the individual level was compounded by a lack of communication between partners.

  16. 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.

  17. 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.

  18. 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.

  19. 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

  20. 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.

  1. 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

  2. Series: Practical guidance to qualitative research. Part 4: Trustworthiness and publishing.

    Science.gov (United States)

    Korstjens, Irene; Moser, Albine

    2018-12-01

    In the course of our supervisory work over the years we have noticed that qualitative research tends to evoke a lot of questions and worries, so-called frequently asked questions (FAQs). This series of four articles intends to provide novice researchers with practical guidance for conducting high-quality qualitative research in primary care. By 'novice' we mean Master's students and junior researchers, as well as experienced quantitative researchers who are engaging in qualitative research for the first time. This series addresses their questions and provides researchers, readers, reviewers and editors with references to criteria and tools for judging the quality of qualitative research papers. The first article provides an introduction to this series. The second article focused on context, research questions and designs. The third article focused on sampling, data collection and analysis. This fourth article addresses FAQs about trustworthiness and publishing. Quality criteria for all qualitative research are credibility, transferability, dependability, and confirmability. Reflexivity is an integral part of ensuring the transparency and quality of qualitative research. Writing a qualitative research article reflects the iterative nature of the qualitative research process: data analysis continues while writing. A qualitative research article is mostly narrative and tends to be longer than a quantitative paper, and sometimes requires a different structure. Editors essentially use the criteria: is it new, is it true, is it relevant? An effective cover letter enhances confidence in the newness, trueness and relevance, and explains why your study required a qualitative design. It provides information about the way you applied quality criteria or a checklist, and you can attach the checklist to the manuscript.

  3. High qualitative and quantitative conservation of alternative splicing in Caenorhabditis elegans and Caenorhabditis briggsae

    DEFF Research Database (Denmark)

    Rukov, Jakob Lewin; Irimia, Manuel; Mørk, Søren

    2007-01-01

    Alternative splicing (AS) is an important contributor to proteome diversity and is regarded as an explanatory factor for the relatively low number of human genes compared with less complex animals. To assess the evolutionary conservation of AS and its developmental regulation, we have investigated...... the qualitative and quantitative expression of 21 orthologous alternative splice events through the development of 2 nematode species separated by 85-110 Myr of evolutionary time. We demonstrate that most of these alternative splice events present in Caenorhabditis elegans are conserved in Caenorhabditis briggsae....... Moreover, we find that relative isoform expression levels vary significantly during development for 78% of the AS events and that this quantitative variation is highly conserved between the 2 species. Our results suggest that AS is generally tightly regulated through development and that the regulatory...

  4. 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

  5. Measuring and managing the work environment of the mid-level provider – the neglected human resource

    Directory of Open Access Journals (Sweden)

    McAuliffe Eilish

    2009-02-01

    Full Text Available Abstract Background Much has been written in the past decade about the health workforce crisis that is crippling health service delivery in many middle-income and low-income countries. Countries having lost most of their highly qualified health care professionals to migration increasingly rely on mid-level providers as the mainstay for health services delivery. Mid-level providers are health workers who perform tasks conventionally associated with more highly trained and internationally mobile workers. Their training usually has lower entry requirements and is for shorter periods (usually two to four years. Our study aimed to explore a neglected but crucial aspect of human resources for health in Africa: the provision of a work environment that will promote motivation and performance of mid-level providers. This paper explores the work environment of mid-level providers in Malawi, and contributes to the validation of an instrument to measure the work environment of mid-level providers in low-income countries. Methods Three districts were purposively sampled from each of the three geographical regions in Malawi. A total of 34 health facilities from the three districts were included in the study. All staff in each of the facilities were included in the sampling frame. A total of 153 staff members consented to be interviewed. Participants completed measures of perceptions of work environment, burnout and job satisfaction. Findings The Healthcare Provider Work Index, derived through Principal Components Analysis and Rasch Analysis of our modification of an existing questionnaire, constituted four subscales, measuring: (1 levels of staffing and resources; (2 management support; (3 workplace relationships; and (4 control over practice. Multivariate analysis indicated that scores on the Work Index significantly predicted key variables concerning motivation and attrition such as emotional exhaustion, job satisfaction, satisfaction with the profession

  6. Conceptual model for dietary behaviour change at household level: a 'best-fit' qualitative study using primary data.

    Science.gov (United States)

    Daivadanam, Meena; Wahlström, Rolf; Ravindran, T K Sundari; Thankappan, K R; Ramanathan, Mala

    2014-06-09

    Interventions having a strong theoretical basis are more efficacious, providing a strong argument for incorporating theory into intervention planning. The objective of this study was to develop a conceptual model to facilitate the planning of dietary intervention strategies at the household level in rural Kerala. Three focus group discussions and 17 individual interviews were conducted among men and women, aged between 23 and 75 years. An interview guide facilitated the process to understand: 1) feasibility and acceptability of a proposed dietary behaviour change intervention; 2) beliefs about foods, particularly fruits and vegetables; 3) decision-making in households with reference to food choices and access; and 4) to gain insights into the kind of intervention strategies that may be practical at community and household level. The data were analysed using a modified form of qualitative framework analysis, which combined both deductive and inductive reasoning. A priori themes were identified from relevant behaviour change theories using construct definitions, and used to index the meaning units identified from the primary qualitative data. In addition, new themes emerging from the data were included. The associations between the themes were mapped into four main factors and its components, which contributed to construction of the conceptual model. Thirteen of the a priori themes from three behaviour change theories (Trans-theoretical model, Health Belief model and Theory of Planned Behaviour) were confirmed or slightly modified, while four new themes emerged from the data. The conceptual model had four main factors and its components: impact factors (decisional balance, risk perception, attitude); change processes (action-oriented, cognitive); background factors (personal modifiers, societal norms); and overarching factors (accessibility, perceived needs and preferences), built around a three-stage change spiral (pre-contemplation, intention, action). Decisional

  7. 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

  8. Series: Practical guidance to qualitative research: part 4: trustworthiness and publishing

    OpenAIRE

    Korstjens, Irene; Moser, Albine

    2017-01-01

    In the course of our supervisory work over the years we have noticed that qualitative research tends to evoke a lot of questions and worries, so-called frequently asked questions (FAQs). This series of four articles intends to provide novice researchers with practical guidance for conducting high-quality qualitative research in primary care. By ‘novice’ we mean Master’s students and junior researchers, as well as experienced quantitative researchers who are engaging in qualitative research fo...

  9. 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

  10. 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.

  11. 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

  12. High-risk respiratory patients' experiences of bronchoscopy with conscious sedation and analgesia: A qualitative study.

    Science.gov (United States)

    Saxon, Catherine; Fulbrook, Paul; Fong, Kwun M; Ski, Chantal F

    2017-10-20

    To understand the experiences of high-risk respiratory patients undergoing bronchoscopy with conscious sedation. Due to possible complications, high-risk respiratory patients are usually given smaller, cautious doses of sedation and analgesia for bronchoscopy. Described as "conscious sedation," this facilitates depression of the patient's consciousness without causing respiratory compromise. Previously, studies have investigated patient experience using quantitative methods. This is the first study that has explored the patient experience during bronchoscopy from a qualitative perspective. Qualitative, phenomenological approach as described by Van Manen. The setting was an endoscopy unit within an Australian tertiary hospital. Unstructured interviews were conducted with 13 patients with chronic obstructive pulmonary disease who underwent day-case bronchoscopy. All participants received conscious sedation. They were interviewed twice, within a week, postprocedure. Interviews were transcribed verbatim and analysed using Van Manen's interpretive approach. Participants had varying experiences. Five themes emerged from the analysis: Frustration and fear; Comfort and safety; Choking and coughing; Being aware; and Consequences. Whilst not all participants experienced procedural awareness or remembered it, for those who did it was a significant event. Overall, experiences were found to be negative; however, participants accepted and tolerated them, perceiving them as necessary to obtain a diagnostic result. The findings demonstrate that often patients are aware during the procedure and their experience may be uncomfortable and distressing. These findings have implications for patient preparation pre- and post-bronchoscopy in terms of what they might expect, and to discuss what has happened after the procedure. Some practices of the bronchoscopy team during the procedure may need modification. For example, in anticipation of the possibility that the patient may be aware

  13. 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.

  14. 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...

  15. Qualitative research methods for medical educators.

    Science.gov (United States)

    Hanson, Janice L; Balmer, Dorene F; Giardino, Angelo P

    2011-01-01

    This paper provides a primer for qualitative research in medical education. Our aim is to equip readers with a basic understanding of qualitative research and prepare them to judge the goodness of fit between qualitative research and their own research questions. We provide an overview of the reasons for choosing a qualitative research approach and potential benefits of using these methods for systematic investigation. We discuss developing qualitative research questions, grounding research in a philosophical framework, and applying rigorous methods of data collection, sampling, and analysis. We also address methods to establish the trustworthiness of a qualitative study and introduce the reader to ethical concerns that warrant special attention when planning qualitative research. We conclude with a worksheet that readers may use for designing a qualitative study. Medical educators ask many questions that carefully designed qualitative research would address effectively. Careful attention to the design of qualitative studies will help to ensure credible answers that will illuminate many of the issues, challenges, and quandaries that arise while doing the work of medical education. Copyright © 2011 Academic Pediatric Association. All rights reserved.

  16. Dating Violence among High-Risk Young Women: A Systematic Review Using Quantitative and Qualitative Methods

    Science.gov (United States)

    Joly, Lauren E.; Connolly, Jennifer

    2016-01-01

    Our systematic review identified 21 quantitative articles and eight qualitative articles addressing dating violence among high risk young women. The groups of high-risk young women in this review include street-involved, justice-involved, pregnant or parenting, involved with Child Protective Services, and youth diagnosed with a mental health issue. Our meta-analysis of the quantitative articles indicated that 34% (CI = 0.24–0.45) of high-risk young women report that they have been victims of physical dating violence and 45% (CI = 0.31–0.61) of these young women report perpetrating physical dating violence. Significant moderator variables included questionnaire and timeframe. Meta-synthesis of the qualitative studies revealed that high-risk young women report perpetrating dating violence to gain power and respect, whereas women report becoming victims of dating violence due to increased vulnerability. PMID:26840336

  17. Dating Violence among High-Risk Young Women: A Systematic Review Using Quantitative and Qualitative Methods

    Directory of Open Access Journals (Sweden)

    Lauren E. Joly

    2016-01-01

    Full Text Available Our systematic review identified 21 quantitative articles and eight qualitative articles addressing dating violence among high risk young women. The groups of high-risk young women in this review include street-involved, justice-involved, pregnant or parenting, involved with Child Protective Services, and youth diagnosed with a mental health issue. Our meta-analysis of the quantitative articles indicated that 34% (CI = 0.24–0.45 of high-risk young women report that they have been victims of physical dating violence and 45% (CI = 0.31–0.61 of these young women report perpetrating physical dating violence. Significant moderator variables included questionnaire and timeframe. Meta-synthesis of the qualitative studies revealed that high-risk young women report perpetrating dating violence to gain power and respect, whereas women report becoming victims of dating violence due to increased vulnerability.

  18. 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

  19. 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.

  20. How theory is used and articulated in qualitative research: development of a new typology.

    Science.gov (United States)

    Bradbury-Jones, Caroline; Taylor, Julie; Herber, Oliver

    2014-11-01

    There is a long tradition within qualitative research of theory being central and of critical importance. Qualitative research theory often equates with the methodologies used but this is a complex relationship, plagued by lack of consensus among scholars regarding how theory and methodology are related. This article furthers the debates on how theories are used in qualitative research, how they might influence a study and how they are articulated in publications. The aim is to provide a framework through which the relationship between theory and qualitative research can be understood. We propose a five-point typology on the levels of theoretical visibility, testing this against a range of published research from five key international health, medicine and social science journals. The typology captures a range of visibility--from seemingly absent through to highly visible and applied throughout. There was a clear gradient in this assessment--only a minority appeared to use theory consistently throughout a study. We outline several challenges to consistently applying theory in qualitative research and suggest potential solutions. This article is based on the argument that lack of theory in qualitative research undermines its quality. The typology is offered to assist researchers in applying theory in their own research and critiquing its use in the work of others. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. 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.

  2. Qualitative and quantitative determination of ubiquinones by the method of high-efficiency liquid chromatography

    International Nuclear Information System (INIS)

    Yanotovskii, M.T.; Mogilevskaya, M.P.; Obol'nikova, E.A.; Kogan, L.M.; Samokhvalov, G.I.

    1986-01-01

    A method has been developed for the qualitative and quantitative determination of ubiquinones CoQ 6 -CoQ 10 , using high-efficiency reversed-phase liquid chromatography. Tocopherol acetate was used as the internal standard

  3. Qualitative Research Methods in Visual Communication. Case Study: Visual Networks in the Promotional Videos of the European Year of Volunteering

    Directory of Open Access Journals (Sweden)

    Camelia Cmeciu

    2013-05-01

    Full Text Available European Years are a means of promoting European issues at a macro and micro-level. The objective of this paper is to provide the visual differences in the framing of the issue of volunteering at a European and national level. The approach focuses on a blending of two qualitative research methods in visual communication: ATLAS.ti (computer assisted/ aided qualitative data analysis software and social semiotics. The results of our analysis highlight two network views on volunteering promoted through videos, a salience of transactional processes in the implementation of volunteering at a European and national level, and a classification of various types of social practices specific to Romania. This study provides an insight into the way in which two different qualitative methods may be combined in order to provide a visual representation and interpretation to a European issue.

  4. QUALITATIVE ANALYSIS REGARDING THE DECISION-MAKERS IN TERMS OF TOURISM PROMOTION

    Directory of Open Access Journals (Sweden)

    Ariadna-Ioana GAVRA JURAVLE

    2015-04-01

    Full Text Available The aim of this paper was to obtain qualitative information from the decision-makers in Bucovina in order to identify their attitude in terms of tourism promotion and their level of information regarding promotion, tourism and tourists. We set four objectives: analyzing the level of awareness regarding the benefits provided by tourism for the municipality and the locality; identifying the level of information regarding the range of services available for tourists in the localities where the mayors carry out their activities; determining the attitude of the decision-makers vis-à-vis promotion and identifying the perceptions of the interviewees regarding the place of promotion in tourism development. The research method we used is qualitative research, namely the in-depth interview.

  5. 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…

  6. Validity in Qualitative Evaluation

    OpenAIRE

    Vasco Lub

    2015-01-01

    This article provides a discussion on the question of validity in qualitative evaluation. Although validity in qualitative inquiry has been widely reflected upon in the methodological literature (and is still often subject of debate), the link with evaluation research is underexplored. Elaborating on epistemological and theoretical conceptualizations by Guba and Lincoln and Creswell and Miller, the article explores aspects of validity of qualitative research with the explicit objective of con...

  7. 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.

  8. Evaluating the Implementation of Home-Based Videoconferencing for Providing Mental Health Services.

    Science.gov (United States)

    Interian, Alejandro; King, Arlene R; St Hill, Lauren M; Robinson, Claire H; Damschroder, Laura J

    2018-01-01

    The Veterans Health Administration (VHA) has recently implemented video-to-home (V2H) telehealth as part of a strategy to improve access to mental health treatment. Implementation research of this modality is needed, given that V2H telehealth transforms the traditional face-to-face delivery of mental health services. To address this need, V2H implementation was evaluated by examining barriers and facilitators that were associated with level of staff V2H experience and factors that differentiated facilities with various levels of V2H performance. Semistructured interviews with VHA personnel (N=33) from three facilities were conducted. The facilities were selected by overall number of mental health V2H visits during fiscal year (FY) 2015 as well as by growth in number of visits from FY 2014 through FY 2015. Factors influencing implementation were identified through qualitative analyses that contrasted responses by groups of participants with three different levels of V2H experience (no experience, limited experience, most experience) as well as three facilities that differed in V2H productivity (high visit count, high visit growth, and low visit count and low visit growth). Providers seemed to encounter different barriers and facilitators depending on their level of experience with V2H. Site-level analyses illustrated the importance of logistical support, especially for providers who are newly adopting the technology. Other factors that differentiated the facilities were also identified and described. Key factors related to implementation of V2H telehealth pertained to provider buy-in and logistical support. Facility-level strategies that address these factors may enhance provider progression from nonuse to sustained use.

  9. 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.

  10. 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

  11. 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

  12. 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

  13. 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

  14. Psilocybin impairs high-level but not low-level motion perception.

    Science.gov (United States)

    Carter, Olivia L; Pettigrew, John D; Burr, David C; Alais, David; Hasler, Felix; Vollenweider, Franz X

    2004-08-26

    The hallucinogenic serotonin(1A&2A) agonist psilocybin is known for its ability to induce illusions of motion in otherwise stationary objects or textured surfaces. This study investigated the effect of psilocybin on local and global motion processing in nine human volunteers. Using a forced choice direction of motion discrimination task we show that psilocybin selectively impairs coherence sensitivity for random dot patterns, likely mediated by high-level global motion detectors, but not contrast sensitivity for drifting gratings, believed to be mediated by low-level detectors. These results are in line with those observed within schizophrenic populations and are discussed in respect to the proposition that psilocybin may provide a model to investigate clinical psychosis and the pharmacological underpinnings of visual perception in normal populations.

  15. 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.

  16. 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

  17. Database searches for qualitative research

    OpenAIRE

    Evans, David

    2002-01-01

    Interest in the role of qualitative research in evidence-based health care is growing. However, the methods currently used to identify quantitative research do not translate easily to qualitative research. This paper highlights some of the difficulties during searches of electronic databases for qualitative research. These difficulties relate to the descriptive nature of the titles used in some qualitative studies, the variable information provided in abstracts, and the differences in the ind...

  18. Conceptual model for dietary behaviour change at household level: a ‘best-fit’ qualitative study using primary data

    Science.gov (United States)

    2014-01-01

    Background Interventions having a strong theoretical basis are more efficacious, providing a strong argument for incorporating theory into intervention planning. The objective of this study was to develop a conceptual model to facilitate the planning of dietary intervention strategies at the household level in rural Kerala. Methods Three focus group discussions and 17 individual interviews were conducted among men and women, aged between 23 and 75 years. An interview guide facilitated the process to understand: 1) feasibility and acceptability of a proposed dietary behaviour change intervention; 2) beliefs about foods, particularly fruits and vegetables; 3) decision-making in households with reference to food choices and access; and 4) to gain insights into the kind of intervention strategies that may be practical at community and household level. The data were analysed using a modified form of qualitative framework analysis, which combined both deductive and inductive reasoning. A priori themes were identified from relevant behaviour change theories using construct definitions, and used to index the meaning units identified from the primary qualitative data. In addition, new themes emerging from the data were included. The associations between the themes were mapped into four main factors and its components, which contributed to construction of the conceptual model. Results Thirteen of the a priori themes from three behaviour change theories (Trans-theoretical model, Health Belief model and Theory of Planned Behaviour) were confirmed or slightly modified, while four new themes emerged from the data. The conceptual model had four main factors and its components: impact factors (decisional balance, risk perception, attitude); change processes (action-oriented, cognitive); background factors (personal modifiers, societal norms); and overarching factors (accessibility, perceived needs and preferences), built around a three-stage change spiral (pre

  19. Series: Practical guidance to qualitative research. Part 2: Context, research questions and designs.

    Science.gov (United States)

    Korstjens, Irene; Moser, Albine

    2017-12-01

    In the course of our supervisory work over the years, we have noticed that qualitative research tends to evoke a lot of questions and worries, so-called frequently asked questions (FAQs). This series of four articles intends to provide novice researchers with practical guidance for conducting high-quality qualitative research in primary care. By 'novice' we mean Master's students and junior researchers, as well as experienced quantitative researchers who are engaging in qualitative research for the first time. This series addresses their questions and provides researchers, readers, reviewers and editors with references to criteria and tools for judging the quality of qualitative research papers. This second article addresses FAQs about context, research questions and designs. Qualitative research takes into account the natural contexts in which individuals or groups function to provide an in-depth understanding of real-world problems. The research questions are generally broad and open to unexpected findings. The choice of a qualitative design primarily depends on the nature of the research problem, the research question(s) and the scientific knowledge one seeks. Ethnography, phenomenology and grounded theory are considered to represent the 'big three' qualitative approaches. Theory guides the researcher through the research process by providing a 'lens' to look at the phenomenon under study. Since qualitative researchers and the participants of their studies interact in a social process, researchers influence the research process. The first article described the key features of qualitative research, the third article will focus on sampling, data collection and analysis, while the last article focuses on trustworthiness and publishing.

  20. Commentary: Writing and evaluating qualitative research reports

    Science.gov (United States)

    An overview of qualitative methods is provided, particularly for reviewers and authors who may be less familiar with qualitative research. A question and answer format is used to address considerations for writing and evaluating qualitative research. When producing qualitative research, individuals ...

  1. 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

  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. Inequality and adolescent cannabis use: A qualitative comparative analysis of the link at national level

    OpenAIRE

    Stevens, Alex

    2016-01-01

    Aim: This article explores the link between income inequality and adolescent cannabis use at the national level, in the context of other relevant social conditions, in developed countries. Methods and data: Fuzzy set qualitative comparative analysis is applied to two data sets that contain information on the national prevalence of past year cannabis use among 15 and 16 year olds, taken from the ESPAD and HBSC surveys, with supplementary data from the MtF and ASSAD surveys for the USA and Aust...

  4. Combination and Integration of Qualitative and Quantitative Analysis

    Directory of Open Access Journals (Sweden)

    Philipp Mayring

    2001-02-01

    Full Text Available In this paper, I am going to outline ways of combining qualitative and quantitative steps of analysis on five levels. On the technical level, programs for the computer-aided analysis of qualitative data offer various combinations. Where the data are concerned, the employment of categories (for instance by using qualitative content analysis allows for combining qualitative and quantitative forms of data analysis. On the individual level, the creation of types and the inductive generalisation of cases allow for proceeding from individual case material to quantitative generalisations. As for research design, different models can be distinguished (preliminary study, generalisation, elaboration, triangulation which combine qualitative and quantitative steps of analysis. Where the logic of research is concerned, it can be shown that an extended process model which combined qualitative and quantitative research can be appropriate and thus lead to an integration of the two approaches. URN: urn:nbn:de:0114-fqs010162

  5. Reporting Qualitative Research: Standards, Challenges, and Implications for Health Design.

    Science.gov (United States)

    Peditto, Kathryn

    2018-04-01

    This Methods column describes the existing reporting standards for qualitative research, their application to health design research, and the challenges to implementation. Intended for both researchers and practitioners, this article provides multiple perspectives on both reporting and evaluating high-quality qualitative research. Two popular reporting standards exist for reporting qualitative research-the Consolidated Criteria for Reporting Qualitative Research (COREQ) and the Standards for Reporting Qualitative Research (SRQR). Though compiled using similar procedures, they differ in their criteria and the methods to which they apply. Creating and applying reporting criteria is inherently difficult due to the undefined and fluctuating nature of qualitative research when compared to quantitative studies. Qualitative research is expansive and occasionally controversial, spanning many different methods of inquiry and epistemological approaches. A "one-size-fits-all" standard for reporting qualitative research can be restrictive, but COREQ and SRQR both serve as valuable tools for developing responsible qualitative research proposals, effectively communicating research decisions, and evaluating submissions. Ultimately, tailoring a set of standards specific to health design research and its frequently used methods would ensure quality research and aid reviewers in their evaluations.

  6. 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...

  7. Qualitative and Quantitative Integrated Modeling for Stochastic Simulation and Optimization

    Directory of Open Access Journals (Sweden)

    Xuefeng Yan

    2013-01-01

    Full Text Available The simulation and optimization of an actual physics system are usually constructed based on the stochastic models, which have both qualitative and quantitative characteristics inherently. Most modeling specifications and frameworks find it difficult to describe the qualitative model directly. In order to deal with the expert knowledge, uncertain reasoning, and other qualitative information, a qualitative and quantitative combined modeling specification was proposed based on a hierarchical model structure framework. The new modeling approach is based on a hierarchical model structure which includes the meta-meta model, the meta-model and the high-level model. A description logic system is defined for formal definition and verification of the new modeling specification. A stochastic defense simulation was developed to illustrate how to model the system and optimize the result. The result shows that the proposed method can describe the complex system more comprehensively, and the survival probability of the target is higher by introducing qualitative models into quantitative simulation.

  8. 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.

  9. Series: Practical guidance to qualitative research: part 2: context, research questions and designs

    OpenAIRE

    Moser, Albine; Korstjens, Irene

    2017-01-01

    In the course of our supervisory work over the years, we have noticed that qualitative research tends to evoke a lot of questions and worries, so-called frequently asked questions (FAQs). This series of four articles intends to provide novice researchers with practical guidance for conducting high-quality qualitative research in primary care. By ‘novice’ we mean Master’s students and junior researchers, as well as experienced quantitative researchers who are engaging in qualitative research f...

  10. 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.

  11. 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...

  12. Generation method of educational materials using qualitative reasoning

    International Nuclear Information System (INIS)

    Yoshimura, Seiichi; Yamada, Shigeo; Fujisawa, Noriyoshi.

    1992-01-01

    Central Research Institute of Electric Power Industry has developed a nuclear power plant educational system in which educational materials for several events are included. The system effectively teaches operators by tailoring the event explanations to their knowledge levels of understanding. The preparation of the educational materials, however, is laborious and this becomes one of the problems in the practical use of the system. Discussed in the present paper is a basic explanation generation method using qualitative reasoning. This has been developed to solve the problem. Qualitative equations describing a recirculation pumps trip were transformed into production rules. These were stored in the knowledge base of an event explanation generation system together with explanation sentences. When an operator selects a certain variable's time-interval in which he wants to know the reasons for a variable change, the inference engine searches for the rule which satisfies both the qualitative value and qualitative differential value concerned with this time-interval. Then the event explanation generation section provides explanations by combining the explanation sentences attached to the rules. This paper demonstrates that it is possible to apply qualitative reasoning to such complex reactor systems, and also that explanations can be generated using the simulation results from a transient analysis code. (author)

  13. 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.

  14. 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

  15. 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.

  16. Experiences of High School Students about the Predictors of Tobacco Use: a Directed Qualitative Content Analysis

    Directory of Open Access Journals (Sweden)

    Mahmoud Ghasemi

    2015-12-01

    Full Text Available Background and Objectives: Tobacco use is one of the most important risk factors that increases the burden of diseases worldwide. Based on the increasing speed of tobacco use, the aim of the present study was to explain the experiences of high school students about the determiners of use and non-use of tobacco (cigarettes and hookah based on the theory of protection motivation. Materials and Methods: The present study is a qualitative study based on content analysis that has been carried out for five months from 22, November of 2014 to 20, April of 2015 on male high schools in Noshahr. Data were collected in the form of semi-structured interviews from 21 male high school students of whom 7 smoked cigarettes, 7 used hookah and 7 of them did not use any type of tobacco. Data analysis was carried out through the use of directed qualitative content analysis. Results: Data analysis led to the extraction of 99 primary codes that were categorized into 9 predetermined levels of protection motivation theory including perceived sensitivity, perceived intensity, fear, perceived self-efficacy, response expense, efficiency of the perceived answer, external perceived reward, internal perceived reward, protection motivation. The findings of the study showed that the most important predictors for the use of tobacco were the structures of response expense and high perceived rewards and the most important predictors for non-use of tobacco were perceived sensitivity, perceived intensity and high self-efficacy of students. Conclusions: the findings of the present study showed that the pressure from peers, being present in a group using tobacco and the absence of alternative recreational activities are among the most important factors of using tobacco. So, it is suggested that planners of the health department take the comprehensive interventions to improve effective individual and environmental factors of using tobacco so that they could reduce smoking cigarettes

  17. Levels of reconstruction as complementarity in mixed methods research: a social theory-based conceptual framework for integrating qualitative and quantitative research.

    Science.gov (United States)

    Carroll, Linda J; Rothe, J Peter

    2010-09-01

    Like other areas of health research, there has been increasing use of qualitative methods to study public health problems such as injuries and injury prevention. Likewise, the integration of qualitative and quantitative research (mixed-methods) is beginning to assume a more prominent role in public health studies. Likewise, using mixed-methods has great potential for gaining a broad and comprehensive understanding of injuries and their prevention. However, qualitative and quantitative research methods are based on two inherently different paradigms, and their integration requires a conceptual framework that permits the unity of these two methods. We present a theory-driven framework for viewing qualitative and quantitative research, which enables us to integrate them in a conceptually sound and useful manner. This framework has its foundation within the philosophical concept of complementarity, as espoused in the physical and social sciences, and draws on Bergson's metaphysical work on the 'ways of knowing'. Through understanding how data are constructed and reconstructed, and the different levels of meaning that can be ascribed to qualitative and quantitative findings, we can use a mixed-methods approach to gain a conceptually sound, holistic knowledge about injury phenomena that will enhance our development of relevant and successful interventions.

  18. Leaders' Experiences with High School-College Writing Center Collaborations: A Qualitative Multiple-Case Study

    Science.gov (United States)

    Story, Julie A.

    2014-01-01

    The purpose of this qualitative multiple-case study was to explore academic leaders' experiences with the organizational elements of their own high school-college writing center collaborations. Conjoining theories framed this study: collaborative leadership theory, Kenneth Bruffee's notion of social constructionism and collaborative learning…

  19. 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

  20. Qualitative data analysis: conceptual and practical considerations.

    Science.gov (United States)

    Liamputtong, Pranee

    2009-08-01

    Qualitative inquiry requires that collected data is organised in a meaningful way, and this is referred to as data analysis. Through analytic processes, researchers turn what can be voluminous data into understandable and insightful analysis. This paper sets out the different approaches that qualitative researchers can use to make sense of their data including thematic analysis, narrative analysis, discourse analysis and semiotic analysis and discusses the ways that qualitative researchers can analyse their data. I first discuss salient issues in performing qualitative data analysis, and then proceed to provide some suggestions on different methods of data analysis in qualitative research. Finally, I provide some discussion on the use of computer-assisted data analysis.

  1. 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

  2. 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.

  3. 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

  4. Qualitative interpretation of high resolution aeromagnetic (HRAM ...

    African Journals Online (AJOL)

    ... the implication of the above findings towards hydrocarbon exploration within the offshore Niger Delta of the study area. The original raster map, obtained from the Nigeria Geological Survey Agency (NGSA) in half degree sheet, was subjected to qualitative data analysis using the WingLink geophysical and visualization ...

  5. Scope of physician procedures independently billed by mid-level providers in the office setting.

    Science.gov (United States)

    Coldiron, Brett; Ratnarathorn, Mondhipa

    2014-11-01

    Mid-level providers (nurse practitioners and physician assistants) were originally envisioned to provide primary care services in underserved areas. This study details the current scope of independent procedural billing to Medicare of difficult, invasive, and surgical procedures by medical mid-level providers. To understand the scope of independent billing to Medicare for procedures performed by mid-level providers in an outpatient office setting for a calendar year. Analyses of the 2012 Medicare Physician/Supplier Procedure Summary Master File, which reflects fee-for-service claims that were paid by Medicare, for Current Procedural Terminology procedures independently billed by mid-level providers. Outpatient office setting among health care providers. The scope of independent billing to Medicare for procedures performed by mid-level providers. In 2012, nurse practitioners and physician assistants billed independently for more than 4 million procedures at our cutoff of 5000 paid claims per procedure. Most (54.8%) of these procedures were performed in the specialty area of dermatology. The findings of this study are relevant to safety and quality of care. Recently, the shortage of primary care clinicians has prompted discussion of widening the scope of practice for mid-level providers. It would be prudent to temper widening the scope of practice of mid-level providers by recognizing that mid-level providers are not solely limited to primary care, and may involve procedures for which they may not have formal training.

  6. 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

  7. 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

  8. Ecological Applications of Qualitative Reasoning

    NARCIS (Netherlands)

    Bredeweg, B.; Salles, P.; Neumann, M.; Recknagel, F.

    2006-01-01

    Representing qualitative ecological knowledge is of great interest for ecological modelling. QR provides means to build conceptual models and to make qualitative knowledge explicit, organized and manageable by means of symbolic computing. This chapter discusses the main characteristics of QR using

  9. Hermeneutic Constructivism: An Ontology for Qualitative Research.

    Science.gov (United States)

    Peck, Blake; Mummery, Jane

    2018-02-01

    Qualitative research is entirely an operation with language, in language, and occasionally on language. This article suggests a tension between theoretical recognition of a multiplicity of human experience on one hand and a reliance upon practices of thematic representation that prioritize the common or the general over individualized experience. The fulcrum of this tension is the nature of language itself and its role in human experience and meaning-making. This article sets out the theoretical foundations of Hermeneutic Constructivism as one proposed approach to redress this problematic within many qualitative frameworks and open up an opportunity for a deeper and more nuanced understanding of human being. Within Hermeneutic Constructivism, a Fundamental Postulate and 11 elaborative corollaries detail a cogent relationship between language and the structures and processes of mental activity that support the human comportment toward understanding. The authors argue that this theoretical position is able to inform a model for qualitative research that makes possible an exploration of a person's experience at a deeper level of abstraction and that may provide an avenue for overcoming this identified tension.

  10. 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

  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. Examining Data Repository Guidelines for Qualitative Data Sharing.

    Science.gov (United States)

    Antes, Alison L; Walsh, Heidi A; Strait, Michelle; Hudson-Vitale, Cynthia R; DuBois, James M

    2018-02-01

    Qualitative data provide rich information on research questions in diverse fields. Recent calls for increased transparency and openness in research emphasize data sharing. However, qualitative data sharing has yet to become the norm internationally and is particularly uncommon in the United States. Guidance for archiving and secondary use of qualitative data is required for progress in this regard. In this study, we review the benefits and concerns associated with qualitative data sharing and then describe the results of a content analysis of guidelines from international repositories that archive qualitative data. A minority of repositories provide qualitative data sharing guidelines. Of the guidelines available, there is substantial variation in whether specific topics are addressed. Some topics, such as removing direct identifiers, are consistently addressed, while others, such as providing an anonymization log, are not. We discuss the implications of our study for education, best practices, and future research.

  13. Impact of CRM on the competitiveness level of ICT services in Croatian service providers

    Directory of Open Access Journals (Sweden)

    Dražen Alerić

    2007-07-01

    Full Text Available This paper proves a higher competitiveness of ICT service providers who utilize CRM versus the providers who do not. The study of observed participating ICT service providers in Croatia proves that the value added of the services incorporating CRM is more competitive than the same services but without CRM. There is also stronger demand from clients for the services enriched with CRM. Increased service competitiveness generated by CRM utilization raises the company’s general competitiveness. A systematic application of CRM creates a long-lasting relationship between clients and providers and thus enables high-quality long-term term solutions to client demands. CRM represents the value added that raises the level of service competitiveness and makes the service provider unique and recognizable among numerous competitors. Consequently, the satisfaction of clients with the provider and their preference for the same provider result in higher client loyalty. A service company that incorporates CRM in its practices has a higher success rate in fulfilling its mission and attaining goals in accordance with the marketing philosophy.

  14. The Estuary Guide. Level 3: High School. Draft.

    Science.gov (United States)

    Alexander, Glen; And Others

    Estuaries are marine systems that serve as nurseries for animals, links in the migratory pathways, and habitat for a complex community of organisms. This curriculum guide intended for use at the high school level seeks to teach what estuaries are; provide opportunities to practice decision-making that affects estuaries; and encourage students to…

  15. Analyzing the Qualitative Data Analyst: A Naturalistic Investigation of Data Interpretation

    Directory of Open Access Journals (Sweden)

    Wolff-Michael Roth

    2015-07-01

    Full Text Available Much qualitative research involves the analysis of verbal data. Although the possibility to conduct qualitative research in a rigorous manner is sometimes contested in debates of qualitative/quantitative methods, there are scholarly communities within which qualitative research is indeed data driven and enacted in rigorous ways. How might one teach rigorous approaches to analysis of verbal data? In this study, 20 sessions were recorded in introductory graduate classes on qualitative research methods. The social scientist thought aloud while analyzing transcriptions that were handed to her immediately prior the sessions and for which she had no background information. The students then assessed, sometimes showing the original video, the degree to which the analyst had recovered (the structures of the original events. This study provides answers to the broad question: "How does an analyst recover an original event with a high degree of accuracy?" Implications are discussed for teaching qualitative data analysis. URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs1503119

  16. Application of four-dimension criteria to assess rigour of qualitative research in emergency medicine.

    Science.gov (United States)

    Forero, Roberto; Nahidi, Shizar; De Costa, Josephine; Mohsin, Mohammed; Fitzgerald, Gerry; Gibson, Nick; McCarthy, Sally; Aboagye-Sarfo, Patrick

    2018-02-17

    The main objective of this methodological manuscript was to illustrate the role of using qualitative research in emergency settings. We outline rigorous criteria applied to a qualitative study assessing perceptions and experiences of staff working in Australian emergency departments. We used an integrated mixed-methodology framework to identify different perspectives and experiences of emergency department staff during the implementation of a time target government policy. The qualitative study comprised interviews from 119 participants across 16 hospitals. The interviews were conducted in 2015-2016 and the data were managed using NVivo version 11. We conducted the analysis in three stages, namely: conceptual framework, comparison and contrast and hypothesis development. We concluded with the implementation of the four-dimension criteria (credibility, dependability, confirmability and transferability) to assess the robustness of the study, RESULTS: We adapted four-dimension criteria to assess the rigour of a large-scale qualitative research in the emergency department context. The criteria comprised strategies such as building the research team; preparing data collection guidelines; defining and obtaining adequate participation; reaching data saturation and ensuring high levels of consistency and inter-coder agreement. Based on the findings, the proposed framework satisfied the four-dimension criteria and generated potential qualitative research applications to emergency medicine research. We have added a methodological contribution to the ongoing debate about rigour in qualitative research which we hope will guide future studies in this topic in emergency care research. It also provided recommendations for conducting future mixed-methods studies. Future papers on this series will use the results from qualitative data and the empirical findings from longitudinal data linkage to further identify factors associated with ED performance; they will be reported

  17. 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

  18. [Advantages and disadvantages of incorporating qualitative methodology in the evaluation of health services. A practical case: evaluation of a high-resolution clinic].

    Science.gov (United States)

    Alvarez Del Arco, D; Rodríguez Rieiro, C; Sanchidrián De Blás, C; Alejos, B; Plá Mestre, R

    2012-01-01

    We examined the usefulness of incorporating a qualitative phase in the evaluation of the quality of care in a high-resolution medical service carried out with quantitative methods. A quantitative research was performed using a structured questionnaire and selecting interviewees by systematic randomized sampling methods (n=320). In addition, a qualitative research was carried on through semi-structured interviews with patients selected by convenience criteria (n=11), observations in the care assistance circuit, and a group interview with health professionals working in the service. A multidisciplinary research team conducted an individual analysis of the information collected in both quantitative and qualitative phases. Subsequently, three meetings based on group brainstorming techniques were held to identify the diverse contributions of each of the methodologies employed to the research, using affinity graphs to analyse the different results obtained in both phases and evaluate possible bias arising from the use of qualitative methods. Qualitative research allowed examining specific aspects of the health care service that had been collected in the quantitative phase, harmonizing the results obtained in the previous phase, giving in-depth data on the reasons for patient dissatisfaction with specific aspects, such as waiting times and available infrastructures, and identifying emerging issues of the service which had not been previously assessed. Overall, the qualitative phase enriched the results of the research. It is appropriate and recommendable to incorporate this methodological approach in research aimed at evaluating the quality of the service in specific health care settings, since it is provided first hand, by the voice of the customer. Copyright © 2011 SECA. Published by Elsevier Espana. All rights reserved.

  19. 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...

  20. Qualitative research in nutrition and dietetics: data analysis issues.

    Science.gov (United States)

    Fade, S A; Swift, J A

    2011-04-01

    Although much of the analysis conducted in qualitative research falls within the broad church of thematic analysis, the wide scope of qualitative enquiry presents the researcher with a number of choices regarding data analysis techniques. This review, the third in the series, provides an overview of a number of techniques and practical steps that can be taken to provide some structure and focus to the intellectual work of thematic analysis in nutrition and dietetics. Because appropriate research methods are crucial to ensure high-quality research, it also describes a process for choosing appropriate analytical methods that considers the extent to which they help answer the research question(s) and are compatible with the philosophical assumptions about ontology, epistemology and methodology that underpin the overall design of a study. Other reviews in this series provide a model for embarking on a qualitative research project in nutrition and dietetics, an overview of the principal techniques of data collection, sampling and quality assessment of this kind of research and some practical advice relevant to nutrition and dietetics, along with glossaries of key terms. © 2010 The Authors. Journal compilation © 2010 The British Dietetic Association Ltd.

  1. Qualitative Research David Silverman Qualitative Research Sage Publications £26.99 464pp 9781849204170 1849204179 [Formula: see text].

    Science.gov (United States)

    2012-01-26

    DAVID SILVERMAN'S latest book builds on previous editions to provide up-to-date development in qualitative research and offers an overview of theoretical and practical considerations. Unlike many other qualitative research methodology books there is an emphasis on the function of qualitative research to articulate meaning.

  2. 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

  3. 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

  4. 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.

  5. 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.

  6. Levels of Interaction Provided by Online Distance Education Models

    Science.gov (United States)

    Alhih, Mohammed; Ossiannilsson, Ebba; Berigel, Muhammet

    2017-01-01

    Interaction plays a significant role to foster usability and quality in online education. It is one of the quality standard to reveal the evidence of practice in online distance education models. This research study aims to evaluate levels of interaction in the practices of distance education centres. It is aimed to provide online distance…

  7. Selection mechanisms underlying high impact biomedical research--a qualitative analysis and causal model.

    Directory of Open Access Journals (Sweden)

    Hilary Zelko

    Full Text Available BACKGROUND: Although scientific innovation has been a long-standing topic of interest for historians, philosophers and cognitive scientists, few studies in biomedical research have examined from researchers' perspectives how high impact publications are developed and why they are consistently produced by a small group of researchers. Our objective was therefore to interview a group of researchers with a track record of high impact publications to explore what mechanism they believe contribute to the generation of high impact publications. METHODOLOGY/PRINCIPAL FINDINGS: Researchers were located in universities all over the globe and interviews were conducted by phone. All interviews were transcribed using standard qualitative methods. A Grounded Theory approach was used to code each transcript, later aggregating concept and categories into overarching explanation model. The model was then translated into a System Dynamics mathematical model to represent its structure and behavior. Five emerging themes were found in our study. First, researchers used heuristics or rules of thumb that came naturally to them. Second, these heuristics were reinforced by positive feedback from their peers and mentors. Third, good communication skills allowed researchers to provide feedback to their peers, thus closing a positive feedback loop. Fourth, researchers exhibited a number of psychological attributes such as curiosity or open-mindedness that constantly motivated them, even when faced with discouraging situations. Fifth, the system is dominated by randomness and serendipity and is far from a linear and predictable environment. Some researchers, however, took advantage of this randomness by incorporating mechanisms that would allow them to benefit from random findings. The aggregation of these themes into a policy model represented the overall expected behavior of publications and their impact achieved by high impact researchers. CONCLUSIONS: The proposed

  8. Qualitative interviewing: methodological challenges in Arab settings.

    Science.gov (United States)

    Hawamdeh, Sana; Raigangar, Veena

    2014-01-01

    To explore some of the main methodological challenges faced by interviewers in Arab settings, particularly during interviews with psychiatric nurses. Interviews are a tool used commonly in qualitative research. However, the cultural norms and practices of interviewees must be considered to ensure that an appropriate interviewing style is used, a good interviewee-interviewer relationship formed and consent for participation obtained sensitively. A study to explore the nature of psychiatric nurses' practices that used unstructured interviews. This is a methodology paper that discusses a personal experience of addressing many challenges that are specific to qualitative interviewing in Arab settings, supported by literature on the topic. Suggestions for improving the interview process to make it more culturally sensitive are provided and recommendations for future research are made. Openness, flexibility and a reflexive approach by the researcher can help manage challenges in Arab settings. Researchers should allow themselves to understand the cultural elements of a population to adapt interviewing methods with the aim of generating high quality qualitative research.

  9. A qualitative analysis of multi-level barriers to HIV testing among women in Lebanon.

    Science.gov (United States)

    Clark, Kirsty A; Keene, Danya E; Pachankis, John E; Fattal, Omar; Rizk, Nesrine; Khoshnood, Kaveh

    2017-09-01

    While the number of HIV cases in the Middle East and North Africa region is low compared to other regions, recent studies show that incidence is increasing especially among high-risk populations; in particular, little is known about women and HIV in the region. Through semi-structured interviews with sexual healthcare providers and staff at non-governmental organisations, we sought to understand barriers to HIV testing among women in Lebanon. Using snowball sampling, key informants were recruited from greater Beirut (12 physicians, 9 non-governmental organisation staff). Data were analysed using a grounded theory framework. Findings identified barriers to HIV testing among women at each level of an adapted social-ecological model (i.e. social-cultural barriers, policy barriers, interpersonal healthcare provider barriers and intrapersonal barriers). Primary findings include the culture of sex as taboo; lack of sexual health education among women; fear of disclosing HIV testing and diagnosis; financial barriers linked to stigmatising insurance policies; and provider attitudes towards women. Findings can be used to inform HIV-related sexual health interventions at multiple levels for women in Lebanon and the greater region.

  10. Process of Argumentation in High School Biology Class: A Qualitative Analysis

    Science.gov (United States)

    Ramli, M.; Rakhmawati, E.; Hendarto, P.; Winarni

    2017-02-01

    Argumentation skill can be nurtured by designing a lesson in which students are provided with the opportunity to argue. This research aims to analyse argumentation process in biology class. The participants were students of three biology classes from different high schools in Surakarta Indonesia. One of the classroom was taught by a student teacher, and the rest were instructed by the assigned teachers. Through a classroom observation, oral activities were noted, audio-recorded and video-taped. Coding was done based on the existence of claiming-reasoning-evidence (CRE) process by McNeill and Krajcik. Data was analysed qualitatively focusing on the role of teachers to initiate questioning to support argumentation process. The lesson design of three were also analysed. The result shows that pedagogical skill of teachers to support argumentation process, such as skill to ask, answer, and respond to students’ question and statements need to be trained intensively. Most of the argumentation found were only claiming, without reasoning and evidence. Teachers have to change the routine of mostly posing open-ended questions to students, and giving directly a correct answer to students’ questions. Knowledge and skills to encourage student to follow inquiry-based learning have to be acquired by teachers.

  11. 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

  12. 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

  13. 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...

  14. FACTOR ANALYSIS ABOUT EXCLUSIVE BREASTFEEDING ACHIEVEMENT LEVEL AMONG MOTHERS WHO PROVIDE BREASTMILK TO THEIR CHILDREN

    Directory of Open Access Journals (Sweden)

    Tiyas Kusumaningrum

    2017-04-01

    Full Text Available Introduction: The number of mother who breastfeed their babies exclusively in Indonesia is low. It caused by many factors such as high intensity of formula milk advertisement, lack of awareness about the importance of breastfeeding, working mother, social culture, family support and the role of health care provider. The purpose of this research was to analyze factors related with successfulness level of exclusive breastfeeding. Method: Design used in this research was analytic retrospective. The population were all mothers at Pacarkeling Public Health Center area. Sample obtained through purposive sampling. Total sample was 61 respondents. Independent variables were knowledge, information and promotion, family support, social cultural, role of health provider, work/occupation, education and breast physiology anatomy. The dependent variable was exclusive breastfeeding. Result: The result indicated that exclusive breastfeeding achievement level was related with information and promotion (r = 0.271, family support (r = 373, health care provider role (r = 231, mother occupation (r = 251, anatomy and physiology of breast (r = 293, while the knowledge (r = 108, social cultural (r = 180 and education (r = 093 not significantly related. Discussion: In conclusion, there was a positive correlation between information and promotion, family support, health care provider role, mother’s occupation, anatomy and physiology of breast with successfulness level of exclusive breastfeeding. While the knowledge, social cultural and education did not indicate significant result. Therefore it is suggested to increase the quantity and quality of information and promotion about exclusive breastfeeding to the society, health care provider and pregnant and breastfeeding mother.

  15. 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)

  16. Employing a Qualitative Description Approach in Health Care Research.

    Science.gov (United States)

    Bradshaw, Carmel; Atkinson, Sandra; Doody, Owen

    2017-01-01

    A qualitative description design is particularly relevant where information is required directly from those experiencing the phenomenon under investigation and where time and resources are limited. Nurses and midwives often have clinical questions suitable to a qualitative approach but little time to develop an exhaustive comprehension of qualitative methodological approaches. Qualitative description research is sometimes considered a less sophisticated approach for epistemological reasons. Another challenge when considering qualitative description design is differentiating qualitative description from other qualitative approaches. This article provides a systematic and robust journey through the philosophical, ontological, and epistemological perspectives, which evidences the purpose of qualitative description research. Methods and rigor issues underpinning qualitative description research are also appraised to provide the researcher with a systematic approach to conduct research utilizing this approach. The key attributes and value of qualitative description research in the health care professions will be highlighted with the aim of extending its usage.

  17. Examining the Highs and Lows of the Collaborative Relationship Between Technical Assistance Providers and Prevention Implementers.

    Science.gov (United States)

    Chilenski, Sarah M; Welsh, Janet; Olson, Jonathan; Hoffman, Lesa; Perkins, Daniel F; Feinberg, Mark E

    2018-02-01

    The PROSPER model uses a three-tiered community partnership, university researcher, and Cooperative Extension-based technical assistance system to support the delivery of evidence-based interventions in communities. This study examines the trajectory and predictors of the collaborative relationship between technical assistance providers and community teams across the three phases of organization, implementation, and sustainability. Members of 14 PROmoting School-university-community Partnerships to Enhance Resilience (PROSPER) community teams and directors of local agencies rated communities' levels of readiness and adolescent substance use norms. Technical assistance providers rated their collaborative relationship with their teams at 14 occasions across 4.5 years. Results from mixed models show that levels of collaboration were stable until the sustainability phase, when they increased significantly. Team differences in change were significant during the implementation phase. Community readiness predicted levels of the collaborative relationship over time: high community readiness was associated with a high level of collaboration during organization, but a decline in collaboration during implementation. These results provide a more nuanced understanding of the relationship between technical assistance provision and community prevention teams and lead to recommendations to improve dissemination models to achieve a greater public health impact.

  18. Levels of valence

    Directory of Open Access Journals (Sweden)

    Vera eShuman

    2013-05-01

    Full Text Available The distinction between the positive and the negative is fundamental in our emotional life. In appraisal theories, in particular in the component process model of emotion (Scherer, 1984, 2010, qualitatively different types of valence are proposed based on appraisals of (unpleasantness, goal obstructiveness/conduciveness, low or high power, self- (incongruence, and moral badness/goodness. This multifaceted conceptualization of valence is highly compatible with the frequent observation of mixed feelings in real life. However, it seems to contradict the one-dimensional conceptualization of valence often encountered in psychological theories, and the notion of valence as a common currency used to explain choice behavior. Here, we propose a framework to integrate the seemingly disparate conceptualizations of multifaceted valence and one-dimensional valence by suggesting that valence should be conceived at different levels, micro and macro. Micro-valences correspond to qualitatively different types of evaluations, potentially resulting in mixed feelings, whereas one-dimensional macro-valence corresponds to an integrative common currency to compare alternatives for choices. We propose that conceptualizing levels of valence may focus research attention on the mechanisms that relate valence at one level (micro to valence at another level (macro, leading to new hypotheses and addressing various concerns that have been raised about the valence concept, such as the valence-emotion relation.

  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. 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

  1. A Multi-Center Assessment of Nutrient Levels and Foods Provided by Hospital Patient Menus

    Directory of Open Access Journals (Sweden)

    Susan Trang

    2015-11-01

    Full Text Available Diets of high nutritional quality can aid in the prevention and management of malnutrition in hospitalized patients. This study evaluated the nutritional quality of hospital patient menus. At three large acute care hospitals in Ontario, Canada, 84 standard menus were evaluated, which included regular and carbohydrate-controlled diets and 3000 mg and 2000 mg sodium diets. Mean levels of calories, macronutrients and vitamins and minerals provided were calculated. Comparisons were made with the Dietary Reference Intakes (DRI and Canada’s Food Guide (CFG recommendations. Calorie levels ranged from 1281 to 3007 kcal, with 45% of menus below 1600 kcal. Protein ranged from 49 to 159 g (0.9–1.1 g/kg/day. Energy and protein levels were highest in carbohydrate-controlled menus. All regular and carbohydrate-controlled menus provided macronutrients within the Acceptable Macronutrient Distribution Ranges. The proportion of regular diet menus meeting the DRIs: 0% for fiber; 7% for calcium; 57% for vitamin C; and 100% for iron. Compared to CFG recommended servings, 35% met vegetables and fruit and milk and alternatives, 11% met grain products and 8% met meat and alternatives. These data support the need for frequent monitoring and evaluation of menus, food procurement and menu planning policies and for sufficient resources to ensure menu quality.

  2. A Multi-Center Assessment of Nutrient Levels and Foods Provided by Hospital Patient Menus.

    Science.gov (United States)

    Trang, Susan; Fraser, Jackie; Wilkinson, Lori; Steckham, Katherine; Oliphant, Heather; Fletcher, Heather; Tzianetas, Roula; Arcand, JoAnne

    2015-11-11

    Diets of high nutritional quality can aid in the prevention and management of malnutrition in hospitalized patients. This study evaluated the nutritional quality of hospital patient menus. At three large acute care hospitals in Ontario, Canada, 84 standard menus were evaluated, which included regular and carbohydrate-controlled diets and 3000 mg and 2000 mg sodium diets. Mean levels of calories, macronutrients and vitamins and minerals provided were calculated. Comparisons were made with the Dietary Reference Intakes (DRI) and Canada's Food Guide (CFG) recommendations. Calorie levels ranged from 1281 to 3007 kcal, with 45% of menus below 1600 kcal. Protein ranged from 49 to 159 g (0.9-1.1 g/kg/day). Energy and protein levels were highest in carbohydrate-controlled menus. All regular and carbohydrate-controlled menus provided macronutrients within the Acceptable Macronutrient Distribution Ranges. The proportion of regular diet menus meeting the DRIs: 0% for fiber; 7% for calcium; 57% for vitamin C; and 100% for iron. Compared to CFG recommended servings, 35% met vegetables and fruit and milk and alternatives, 11% met grain products and 8% met meat and alternatives. These data support the need for frequent monitoring and evaluation of menus, food procurement and menu planning policies and for sufficient resources to ensure menu quality.

  3. Patient and referring health care provider satisfaction with a physiotherapy spinal triage assessment service.

    Science.gov (United States)

    Bath, Brenna; Janzen, Bonnie

    2012-01-01

    To evaluate participant and referring care provider satisfaction associated with a spinal triage assessment service delivered by physiotherapists in collaboration with orthopedic surgeons. People with low back-related complaints were recruited from those referred to a spinal triage assessment program delivered by physiotherapists. Measures of patient and provider satisfaction were completed at approximately 4 weeks after the assessment. The satisfaction surveys were analyzed quantitatively with descriptive statistics and qualitatively with an inductive thematic approach of open and axial coding. A total of 108/115 participants completed the posttest satisfaction survey. Sixty-six percent of participants were "very satisfied" with the service and 55% were "very satisfied" with the recommendations that were made. Only 18% of referring care providers completed the satisfaction survey and 90.5% of those were "very satisfied" with the recommendations. Sixty-one participants and 14 care providers provided comments which revealed a diverse range of themes which were coded into positive (ie, understanding the problem, communication, customer service, efficiency, and management direction), negative (ie, lack of detail, time to follow-up, cost) and neutral related to the triage service, and an "other" category unrelated to the service (ie, chronic symptoms, comorbidities, and limited access to health care.) The quantitative results of the participant survey demonstrated very high levels of satisfaction with the service and slightly less satisfaction with the recommendations that were made. Satisfaction of referring care providers with the recommendations and report was also high, but given the low response rate, these results should be interpreted with caution. Qualitative analysis of participant and provider comments revealed a diverse range of themes. These other issues may be important contextual factors that have the potential to impact patient relevant outcomes.

  4. Ensuring validity in qualitative international business research

    DEFF Research Database (Denmark)

    Andersen, Poul Houman; Skaates, Maria Anne

    2002-01-01

    The purpose of this paper is to provide an account of how the validity issue related to qualitative research strategies within the IB field may be grasped from an at least partially subjectivist point of view. In section two, we will first assess via the aforementioned literature review the extent...... to which the validity issue has been treated in qualitative research contributions published in six leading English-language journals which publish IB research. Thereafter, in section three, we will discuss our findings and relate them to (a) various levels of a research project and (b) the existing...... literature on potential validity problems from a more subjectivist point of view. As a part of this step, we will demonstrate that the assumptions of objectivist and subjectivist ontologies and their corresponding epistemologies merit different canons for assessing research validity. In the subsequent...

  5. 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

  6. 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

  7. Water security at local government level in South Africa: a qualitative interview-based analysis

    Directory of Open Access Journals (Sweden)

    Richard Meissner, DPhil

    2018-05-01

    Full Text Available Background: As one of the 40 driest countries in the world with an annual average rainfall of 497 mm, South Africa is a water-scarce country. Additionally, South Africa's rate of economic development is closely linked to its water security. Thus, increasing water stress, supply variability, flooding, and water pollution levels and inadequate access to safe drinking water and sanitation are slowing economic growth. Despite the high premium placed on South Africa's water resources, no commonly shared understanding of water security exists. The aim of this study was to research, using qualitative social scientific methods, how people in two South African localities understand water security. Methods: We used interviews and qualitative analyses to establish and compare how people from different lifestyles perceive water security in the Greater Sekhukhune District and the eThekwini Metropolitan Municipalities of South Africa. The inland Sekhukhune has a drier climate and more rural socioeconomic profile than the coastal, urbanised eThekwini with its complex economy and diverse socioeconomic structure. We did face-to-face structured interviews with a diverse stakeholder group consisting of community members, traditional leaders, municipal officials, researchers, business people, and farmers in each municipality and focus groups in two communities of each municipality: Leeuwfontein and Motetema (Sekhukhune and Inanda and Ntshongweni (eThekwini. Each interview lasted 40–60 min, and focus group discussions lasted 90–120 min. We asked the respondents about their understanding of the concept of water security and whether they believe that, at the local and national level, the authorities had achieved water security for all. Findings: Following a qualitative analysis, we found that water security is a state of mind based on context-specific (ie, localised and individualised perceptions held by an individual of water-related threats and how it influences

  8. 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.

  9. Quantitative and qualitative retinal microvascular characteristics and blood pressure.

    Science.gov (United States)

    Cheung, Carol Y; Tay, Wan T; Mitchell, Paul; Wang, Jie J; Hsu, Wynne; Lee, Mong L; Lau, Qiangfeng P; Zhu, Ai L; Klein, Ronald; Saw, Seang M; Wong, Tien Y

    2011-07-01

    The present study examined the effects of blood pressure on a spectrum of quantitative and qualitative retinal microvascular signs. Retinal photographs from the Singapore Malay Eye Study, a population-based cross-sectional study of 3280 (78.7% response) persons aged 40-80 years, were analyzed. Quantitative changes in the retinal vasculature (branching angle, vascular tortuosity, fractal dimension, and vascular caliber) were measured using a semi-automated computer-based program. Qualitative signs, including focal arteriolar narrowing (FAN), arteriovenous nicking (AVN), opacification of the arteriolar wall (OAW), and retinopathy (e.g., microaneurysms, retinal hemorrhages), were assessed from photographs by trained technicians. After excluding persons with diabetes and ungradable photographs, 1913 persons provided data for this analysis. In multivariable linear regression models controlling for age, sex, BMI, use of antihypertensive medication, and other factors, retinal arteriolar branching asymmetry ratio, arteriolar tortuosity, venular tortuosity, fractal dimension, arteriolar caliber, venular caliber, FAN, AVN, and retinopathy were independently associated with mean arterial blood pressure. In contrast, arteriolar/venular branching angle, venular branching asymmetry ratio and OAW were not related to blood pressure. Retinal arteriolar caliber (sβ = -0.277) and FAN (sβ = 0.170) had the strongest associations with mean arterial blood pressure, and higher blood pressure levels were associated with increasing number of both quantitative and qualitative retinal vascular signs (P trend qualitative retinal vascular signs, with the number of signs increasing with higher blood pressure levels.

  10. High estradiol levels improve false memory rates and meta-memory in highly schizotypal women.

    Science.gov (United States)

    Hodgetts, Sophie; Hausmann, Markus; Weis, Susanne

    2015-10-30

    Overconfidence in false memories is often found in patients with schizophrenia and healthy participants with high levels of schizotypy, indicating an impairment of meta-cognition within the memory domain. In general, cognitive control is suggested to be modulated by natural fluctuations in oestrogen. However, whether oestrogen exerts beneficial effects on meta-memory has not yet been investigated. The present study sought to provide evidence that high levels of schizotypy are associated with increased false memory rates and overconfidence in false memories, and that these processes may be modulated by natural differences in estradiol levels. Using the Deese-Roediger-McDermott paradigm, it was found that highly schizotypal participants with high estradiol produced significantly fewer false memories than those with low estradiol. No such difference was found within the low schizotypy participants. Highly schizotypal participants with high estradiol were also less confident in their false memories than those with low estradiol; low schizotypy participants with high estradiol were more confident. However, these differences only approached significance. These findings suggest that the beneficial effect of estradiol on memory and meta-memory observed in healthy participants is specific to highly schizotypal individuals and might be related to individual differences in baseline dopaminergic activity. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  11. Employing a Qualitative Description Approach in Health Care Research

    Science.gov (United States)

    Bradshaw, Carmel; Atkinson, Sandra; Doody, Owen

    2017-01-01

    A qualitative description design is particularly relevant where information is required directly from those experiencing the phenomenon under investigation and where time and resources are limited. Nurses and midwives often have clinical questions suitable to a qualitative approach but little time to develop an exhaustive comprehension of qualitative methodological approaches. Qualitative description research is sometimes considered a less sophisticated approach for epistemological reasons. Another challenge when considering qualitative description design is differentiating qualitative description from other qualitative approaches. This article provides a systematic and robust journey through the philosophical, ontological, and epistemological perspectives, which evidences the purpose of qualitative description research. Methods and rigor issues underpinning qualitative description research are also appraised to provide the researcher with a systematic approach to conduct research utilizing this approach. The key attributes and value of qualitative description research in the health care professions will be highlighted with the aim of extending its usage. PMID:29204457

  12. Electronic circuit provides automatic level control for liquid nitrogen traps

    Science.gov (United States)

    Turvy, R. R.

    1968-01-01

    Electronic circuit, based on the principle of increased thermistor resistance corresponding to decreases in temperature provides an automatic level control for liquid nitrogen cold traps. The electronically controlled apparatus is practically service-free, requiring only occasional reliability checks.

  13. High potassium level

    Science.gov (United States)

    ... level is very high, or if you have danger signs, such as changes in an ECG . Emergency ... Seifter JL. Potassium disorders. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine . 25th ed. Philadelphia, PA: ...

  14. 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...

  15. Determinants of the Level of Care Provided for Various Types and Sizes of Dogs in New Providence, The Bahamas

    Directory of Open Access Journals (Sweden)

    Fielding, William J.

    2010-01-01

    Full Text Available This paper reports the level of care offered 424 dogs, classified as small dogs, large dogs, pit bulls and potcakes (the colloquial name for the local mongrel in New Providence, The Bahamas. Levels of care that meet the legal minimum –food water and shelter– as well as care considered essential and enriched in The Bahamas were less common for large dogs than small dogs. Small dogs tended to get more care than other dogs and so were at lowest risk of being neglected.It is suggested that the size of the dog is an important factor which determines the level of care provided. Pit bulls generally received similar care to potcakes which are often considered neglected. Large dogs were more likely to be kept outside and less likely to be allowed inside the home than small dogs. It is conjectured that in many instances the level of care offered constitutes partial abandonment due to a lack of interaction between caregivers and their dogs.

  16. Synthesizing qualitative and quantitative evidence on non-financial access barriers: implications for assessment at the district level.

    Science.gov (United States)

    O'Connell, Thomas S; Bedford, K Juliet A; Thiede, Michael; McIntyre, Di

    2015-06-09

    A key element of the global drive to universal health coverage is ensuring access to needed health services for everyone, and to pursue this goal in an equitable way. This requires concerted efforts to reduce disparities in access through understanding and acting on barriers facing communities with the lowest utilisation levels. Financial barriers dominate the empirical literature on health service access. Unless the full range of access barriers are investigated, efforts to promote equitable access to health care are unlikely to succeed. This paper therefore focuses on exploring the nature and extent of non-financial access barriers. We draw upon two structured literature reviews on barriers to access and utilization of maternal, newborn and child health services in Ghana, Bangladesh, Vietnam and Rwanda. One review analyses access barriers identified in published literature using qualitative research methods; the other in published literature using quantitative analysis of household survey data. We then synthesised the key qualitative and quantitative findings through a conjoint iterative analysis. Five dominant themes on non-financial access barriers were identified: ethnicity; religion; physical accessibility; decision-making, gender and autonomy; and knowledge, information and education. The analysis highlighted that non-financial factors pose considerable barriers to access, many of which relate to the acceptability dimension of access and are challenging to address. Another key finding is that quantitative research methods, while yielding important findings, are inadequate for understanding non-financial access barriers in sufficient detail to develop effective responses. Qualitative research is critical in filling this gap. The analysis also indicates that the nature of non-financial access barriers vary considerably, not only between countries but also between different communities within individual countries. To adequately understand access barriers as a

  17. 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)

  18. 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.

  19. Qualitative identification of chaotic systems behaviours

    International Nuclear Information System (INIS)

    Vicha, T.; Dohnal, M.

    2008-01-01

    There are only three qualitative values positive, negative and zero. This means that there is a maximal number of qualitatively distinguishable scenarios, prescribed by the number of variables and the highest qualitative derivative taken into consideration. There are several chaos related tasks, which can be solved with great difficulties on the numerical level if multidimensional problems are studied. One of them is the identification of all qualitatively different behaviours. To make sure that all distinctive qualitative scenarios are identified a qualitative interpretation of a classical quantitative phase portrait is used. The highest derivatives are usually the second derivatives as it is not possible to safely identify higher derivatives if tasks related to ecology or economics are studied. Two classical models are discussed - Damped oscillation (non chaotic) and Lorenz model (chaotic). There are 191 scenarios of the Lorenz model if only the second derivatives are considered. If the third derivatives are taken into consideration then the number of scenarios is 2619. Complete qualitative results are given in details

  20. Women's motivations for choosing a high risk birth setting against medical advice in the Netherlands: a qualitative analysis.

    Science.gov (United States)

    Hollander, Martine; de Miranda, Esteriek; van Dillen, Jeroen; de Graaf, Irene; Vandenbussche, Frank; Holten, Lianne

    2017-12-16

    Home births in high risk pregnancies and unassisted childbirth seem to be increasing in the Netherlands. Until now there were no qualitative data on women's motivations for these choices in the Dutch maternity care system where integrated midwifery care and home birth are regular options in low risk pregnancies. We aimed to examine women's motivations for birthing outside the system in order to provide medical professionals with insight and recommendations regarding their interactions with women who have birth wishes that go against medical advice. An exploratory qualitative research design with a constructivist approach and a grounded theory method were used. In-depth interviews were performed with 28 women on their motivations for going against medical advice in choosing a high risk childbirth setting. Open, axial and selective coding of the interview data was done in order to generate themes. A focus group was held for a member check of the findings. Four main themes were found: 1) Discrepancy in the definition of superior knowledge, 2) Need for autonomy and trust in the birth process, 3) Conflict during negotiation of the birth plan, and 4) Search for different care. One overarching theme emerged that covered all other themes: Fear. This theme refers both to the participants' fear (of interventions and negative consequences of their choices) and to the providers' fear (of a bad outcome). Where for some women it was a positive choice, for the majority of women in this study the choice for a home birth in a high risk pregnancy or an unassisted childbirth was a negative one. Negative choices were due to previous or current negative experiences with maternity care and/or conflict surrounding the birth plan. The main goal of working with women whose birthing choices do not align with medical advice should not be to coerce them into the framework of protocols and guidelines but to prevent negative choices. Recommendations for maternity caregivers can be summarized as

  1. Qualitative Secondary Analysis: A Case Exemplar.

    Science.gov (United States)

    Tate, Judith Ann; Happ, Mary Beth

    Qualitative secondary analysis (QSA) is the use of qualitative data that was collected by someone else or was collected to answer a different research question. Secondary analysis of qualitative data provides an opportunity to maximize data utility, particularly with difficult-to-reach patient populations. However, qualitative secondary analysis methods require careful consideration and explicit description to best understand, contextualize, and evaluate the research results. In this article, we describe methodologic considerations using a case exemplar to illustrate challenges specific to qualitative secondary analysis and strategies to overcome them. Copyright © 2017 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

  2. Exploring Treatment Needs and Expectations for People Living with HIV in South Africa: A Qualitative Study.

    Science.gov (United States)

    Earnshaw, Valerie A; Bogart, Laura M; Courtney, Ingrid; Zanoni, Holly; Bangsberg, David R; Orrell, Catherine; Goggin, Kathy; Katz, Ingrid T

    2018-04-04

    The UNAIDS 90-90-90 treatment targets aim to dramatically increase the number of people who initiate antiretroviral therapy (ART) by 2020. Greater understanding of barriers to ART initiation in high prevalence countries like South Africa is critical. Qualitative semi-structured interviews were conducted with 30 participants in Gugulethu Township, South Africa, including 10 healthcare providers and 20 people living with HIV (PLWH) who did not initiate ART. Interviews explored barriers to ART initiation and acceptability of theory-based intervention strategies to optimize ART initiation. An inductive content analytic approach was applied to the data. Consistent with the Theory of Triadic Influence, barriers to ART initiation were identified at the individual, social, and structural levels. Results suggested high acceptability for intervention strategies involving trained HIV-positive peers among South African PLWH and healthcare providers. Research is needed to evaluate their feasibility and efficacy in high HIV prevalence countries.

  3. Integrating qualitative and quantitative characterization of traditional Chinese medicine injection by high-performance liquid chromatography with diode array detection and tandem mass spectrometry.

    Science.gov (United States)

    Xie, Yuan-yuan; Xiao, Xue; Luo, Juan-min; Fu, Chan; Wang, Qiao-wei; Wang, Yi-ming; Liang, Qiong-lin; Luo, Guo-an

    2014-06-01

    The present study aims to describe and exemplify an integrated strategy of the combination of qualitative and quantitative characterization of a multicomponent mixture for the quality control of traditional Chinese medicine injections with the example of Danhong injection (DHI). The standardized chemical profile of DHI has been established based on liquid chromatography with diode array detection. High-performance liquid chromatography coupled with time-of-flight mass spectrometry and high-performance liquid chromatography with electrospray multistage tandem ion-trap mass spectrometry have been developed to identify the major constituents in DHI. The structures of 26 compounds including nucleotides, phenolic acids, and flavonoid glycosides were identified or tentatively characterized. Meanwhile, the simultaneous determination of seven marker constituents, including uridine, adenosine, danshensu, protocatechuic aldehyde, p-coumaric acid, rosmarinic acid, and salvianolic acid B, in DHI was performed by multiwavelength detection based on high-performance liquid chromatography with diode array detection. The integrated qualitative and quantitative characterization strategy provided an effective and reliable pattern for the comprehensive and systematic characterization of the complex traditional Chinese medicine system. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  4. The challenges of developing an instrument to assess health provider motivation at primary care level in rural Burkina Faso, Ghana, and Tanzania

    Directory of Open Access Journals (Sweden)

    Helen Prytherch

    2012-10-01

    Full Text Available Background: The quality of health care depends on the competence and motivation of the health workers that provide it. In the West, several tools exist to measure worker motivation, and some have been applied to the health sector. However, none have been validated for use in sub-Saharan Africa. The complexity of such tools has also led to concerns about their application at primary care level. Objective: To develop a common instrument to monitor any changes in maternal and neonatal health (MNH care provider motivation resulting from the introduction of pilot interventions in rural, primary level facilities in Ghana, Burkina Faso, and Tanzania. Design: Initially, a conceptual framework was developed. Based upon this, a literature review and preliminary qualitative research, an English-language instrument was developed and validated in an iterative process with experts from the three countries involved. The instrument was then piloted in Ghana. Reliability testing and exploratory factor analysis were used to produce a final, parsimonious version. Results and discussion: This paper describes the actual process of developing the instrument. Consequently, the concepts and items that did not perform well psychometrically at pre-test are first presented and discussed. The final version of the instrument, which comprises 42 items for self-assessment and eight for peer-assessment, is then shown. This is followed by a presentation and discussion of the findings from first use of the instrument with MNH providers from 12 rural, primary level facilities in each of the three countries. Conclusions: It is possible to undertake work of this nature at primary health care level, particularly if the instruments are kept as straightforward as possible and well introduced. However, their development requires very lengthy preparatory periods. The effort needed to adapt such instruments for use in different countries within the region of sub-Saharan Africa should not

  5. The challenges of developing an instrument to assess health provider motivation at primary care level in rural Burkina Faso, Ghana and Tanzania

    Science.gov (United States)

    Prytherch, Helen; Leshabari, Melkidezek T.; Wiskow, Christiane; Aninanya, Gifty A.; Kakoko, Deodatus C.V.; Kagoné, Moubassira; Burghardt, Juliane; Kynast-Wolf, Gisela; Marx, Michael; Sauerborn, Rainer

    2012-01-01

    Background The quality of health care depends on the competence and motivation of the health workers that provide it. In the West, several tools exist to measure worker motivation, and some have been applied to the health sector. However, none have been validated for use in sub-Saharan Africa. The complexity of such tools has also led to concerns about their application at primary care level. Objective To develop a common instrument to monitor any changes in maternal and neonatal health (MNH) care provider motivation resulting from the introduction of pilot interventions in rural, primary level facilities in Ghana, Burkina Faso, and Tanzania. Design Initially, a conceptual framework was developed. Based upon this, a literature review and preliminary qualitative research, an English-language instrument was developed and validated in an iterative process with experts from the three countries involved. The instrument was then piloted in Ghana. Reliability testing and exploratory factor analysis were used to produce a final, parsimonious version. Results and discussion This paper describes the actual process of developing the instrument. Consequently, the concepts and items that did not perform well psychometrically at pre-test are first presented and discussed. The final version of the instrument, which comprises 42 items for self-assessment and eight for peer-assessment, is then shown. This is followed by a presentation and discussion of the findings from first use of the instrument with MNH providers from 12 rural, primary level facilities in each of the three countries. Conclusions It is possible to undertake work of this nature at primary health care level, particularly if the instruments are kept as straightforward as possible and well introduced. However, their development requires very lengthy preparatory periods. The effort needed to adapt such instruments for use in different countries within the region of sub-Saharan Africa should not be underestimated. PMID

  6. 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.

  7. Ensuring validity in qualitative International Business Research

    DEFF Research Database (Denmark)

    Andersen, Poul Houman

    2004-01-01

    The purpose of this paper is to provide an account for how the validity issue may be gasped within a qualitative apporach to the IB field......The purpose of this paper is to provide an account for how the validity issue may be gasped within a qualitative apporach to the IB field...

  8. 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

  9. High-dose benzodiazepine dependence: a qualitative study of patients' perception on cessation and withdrawal.

    Science.gov (United States)

    Liebrenz, Michael; Gehring, Marie-Therese; Buadze, Anna; Caflisch, Carlo

    2015-05-13

    Benzodiazepine withdrawal syndrome has been reported following attempts to withdraw even from low or therapeutic doses and has been compared to barbiturate and alcohol withdrawal. This experience is known to deter patients from future cessation attempts. Research on other psychotropic substances shows that the reasons and motivations for withdrawal attempts - as well as the experiences surrounding those attempts - at least partially predict future efforts at discontinuation as well as relapse. We therefore aimed to qualitatively explore what motivates patients to discontinue this medication as well as to examine their experiences surrounding previous and current withdrawal attempts and treatment interventions in order to positively influence future help-seeking behavior and compliance. To understand these patients better, we conducted a series of 41 unstructured, narrative, in-depth interviews among adult Swiss patients with a long-term dependent use of benzodiazepines in doses equivalent to more than 40 mg diazepam per day and/or otherwise problematic use (mixing benzodiazepines, escalating dosage, recreational use or illegal purchase). Mayring's qualitative content analysis was used to evaluate findings. These high-dose benzodiazepine-dependent patients decision to change consumption patterns were affected by health concerns, the feeling of being addicted and social factors. Discontinuation attempts were frequent and not very successful with fast relapse. Withdrawal was perceived to be a difficult, complicated, and highly unpredictable process. The first attempt at withdrawal occurred at home and typically felt better than at the clinic. Inpatient treatment was believed to be more effective with long term treatment (approaches) than short term. Patients preferred gradual reduction of usage to abrupt cessation (and had experienced both). While no clear preferences for withdrawal were found for benzodiazepines with specific pharmacokinetic properties, participants

  10. '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

  11. 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

  12. 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.

  13. 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.

  14. Views of People With High and Low Levels of Health Literacy About a Digital Intervention to Promote Physical Activity for Diabetes: A Qualitative Study in Five Countries.

    Science.gov (United States)

    Rowsell, Alison; Muller, Ingrid; Murray, Elizabeth; Little, Paul; Byrne, Christopher D; Ganahl, Kristin; Müller, Gabriele; Gibney, Sarah; Lyles, Courtney R; Lucas, Antonia; Nutbeam, Don; Yardley, Lucy

    2015-10-12

    Low health literacy is associated with poor health-related knowledge, illness self-management, health service use, health, and survival, and thus addressing issues related to low health literacy has been highlighted as a pressing international priority. To explore views of a digital health promotion intervention designed to be accessible to people with lower levels of health literacy, in particular examining reactions to the interactive and audiovisual elements of the intervention. Qualitative think-aloud interviews were carried out with 65 adults with type 2 diabetes in the UK, Ireland, USA, Germany, and Austria, with purposive sampling to ensure representation of people with lower levels of health literacy. Inductive thematic analysis was used to identify common themes. We then systematically compared views in subgroups based on country, health literacy level, age, gender, and time since diagnosis. Most participants from the chosen countries expressed positive views of most elements and features of the intervention. Some interactive and audiovisual elements required modification to increase their usability and perceived credibility and relevance. There were some differences in views based on age and gender, but very few differences relating to health literacy level or time since diagnosis. In general, participants found the intervention content and format accessible, appropriate, engaging, and motivating. Digital interventions can and should be designed to be accessible and engaging for people with a wide range of health literacy levels.

  15. Qualitative research study of high-achieving females' life experiences impacting success

    Science.gov (United States)

    Butcher, Ann Patrice

    2003-07-01

    This qualitative study investigated the life experiences of five academically gifted female students in math and science in reflection of their elementary learning prior to enrollment at a prestigious science and mathematics high school. The elite high school limits admission to the state of Illinois' top students. The purpose of this study is to unfold the story of five academically gifted females in attendance at the elite high school reflecting on their life experiences in elementary school that contributed to their current academic success. Twelve female students, who at the time of this study were currently in their senior year (12th grade) of high school, were solicited from the top academic groups who are regarded by their teachers as highly successful in class. Students were selected as part of the study based on academic status, survey completion and interest in study, Caucasian and Asian ethnicity, locale of elementary school with preference given to the variety of school demographics---urban, suburban, and rural---further defined the group to the core group of five. All female participants were personally interviewed and communicated via Internet with the researcher. Parents and teachers completing surveys as well met the methodological requirements of triangulation. An emergent theme of paternal influence came from the research. Implications supported in the research drawn from this study to increase achievement of academically gifted females include: (a) proper early identification of learner strengths plays a role; (b) learning with appropriate intellectual peers is more important than learning with their age group; (c) teachers are the greatest force for excellent instruction; (d) effective teaching strategies include cooperative learning, multi-sensory learning, problem-based learning, and hands-on science; (e) rigor in math is important; (f) gender and stereotypes need not be barriers; (g) outside interests and activities are important for self

  16. 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

  17. 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

  18. 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

  19. Investigations on the long-term behaviour of high level waste forms

    International Nuclear Information System (INIS)

    Lemmens, K.

    2009-01-01

    The Belgian Nuclear Research Centre (SCK-CEN) has a long-standing expertise in research concerning the compatibility of waste forms with the final disposal environment, in collaboration with NIRAS/ONDRAS. For high level waste, most attention goes to two waste forms that are relevant for Belgium, namely (1) vitrified HLW (High Level Waste) from the reprocessing of spent fuel, and (2) spent fuel as such, referring to the direct disposal scenario. The expertise lies especially in the study of the chemical interactions between the waste forms and the disposal environment. This is done by laboratory experiments, supported by modeling. Until 2004, the reference disposal design for HLW glass and spent fuel in Belgium was based on the use of a bentonite buffer. The experiments performed in that period therefore involved mostly the study of the influence of clay on the waste form behaviour. Since 2004 the Supercontainer design with Ordinary Portland Cement as buffer material (without bentonite) has been selected as the reference. The experiments related to this new design are therefore predominant now. Clay based disposal designs are still the reference in several other European countries. For this reason, the study of clay-waste interactions was not completely abandoned in the period 2004-2008, but continued in the framework of EC programmes. The first experiments focused on the Supercontainer design were started in 2006 (HLW) and 2007 (spent fuel). The first results are available now for HLW glass. Most results generated recently are, however, still related to the bentonite concept. The objectives of the present study were to evaluate the minimum guaranteed durability of the waste form, which will be used as input in the safety assessment. The objective is not to obtain an absolute value for the durability or an interval of values, which will always be subject to caution, but rather to determine a lower limit for the life time of the waste form, which is conservative

  20. 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.

  1. 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

  2. Qualitative Research in Palliative Care: Applications to Clinical Trials Work.

    Science.gov (United States)

    Lim, Christopher T; Tadmor, Avia; Fujisawa, Daisuke; MacDonald, James J; Gallagher, Emily R; Eusebio, Justin; Jackson, Vicki A; Temel, Jennifer S; Greer, Joseph A; Hagan, Teresa; Park, Elyse R

    2017-08-01

    While vast opportunities for using qualitative methods exist within palliative care research, few studies provide practical advice for researchers and clinicians as a roadmap to identify and utilize such opportunities. To provide palliative care clinicians and researchers descriptions of qualitative methodology applied to innovative research questions relative to palliative care research and define basic concepts in qualitative research. Body: We describe three qualitative projects as exemplars to describe major concepts in qualitative analysis of early palliative care: (1) a descriptive analysis of clinician documentation in the electronic health record, (2) a thematic content analysis of palliative care clinician focus groups, and (3) a framework analysis of audio-recorded encounters between patients and clinicians as part of a clinical trial. This study provides a foundation for undertaking qualitative research within palliative care and serves as a framework for use by other palliative care researchers interested in qualitative methodologies.

  3. Resource-level QoS metric for CPU-based guarantees in cloud providers

    OpenAIRE

    Goiri Presa, Íñigo; Julià Massó, Ferran; Fitó, Josep Oriol; Macías Lloret, Mario; Guitart Fernández, Jordi

    2010-01-01

    Success of Cloud computing requires that both customers and providers can be confident that signed Service Level Agreements (SLA) are supporting their respective business activities to their best extent. Currently used SLAs fail in providing such confidence, especially when providers outsource resources to other providers. These resource providers typically support very simple metrics, or metrics that hinder an efficient exploitation of their resources. In this paper, we propose a re...

  4. Macintosh support is provided at the level of the Service Desk

    CERN Multimedia

    2011-01-01

    Since September 2010 the Apple laptops & desktops with Mac OS are recognized and supported at CERN by the IT department. Therefore, the “Macintosh support” procedure now follows the same ITIL*) schema as for all IT services, i.e.: All CERN users must address any request for support on Macintosh PCs to the Service Desk. The Service Desk will move on questions or problems they cannot solve to “IT 2nd level” support people, provided by the “computing support” contract managed by IT department. Mac OS being officially supported by the IT department, a 3rd level support is provided by CERN IT staff; they may give specialized expert assistance, within the scope described at the ITUM-2 presentation, for all incidents or requests which can be neither resolved nor fulfilled by the Service Desk (1st level) and the 2nd level support people. Therefore, users who have problems related to Mac OS should simply fill-in the appropriate form from th...

  5. Coastal barrier stratigraphy for Holocene high-resolution sea-level reconstruction.

    Science.gov (United States)

    Costas, Susana; Ferreira, Óscar; Plomaritis, Theocharis A; Leorri, Eduardo

    2016-12-08

    The uncertainties surrounding present and future sea-level rise have revived the debate around sea-level changes through the deglaciation and mid- to late Holocene, from which arises a need for high-quality reconstructions of regional sea level. Here, we explore the stratigraphy of a sandy barrier to identify the best sea-level indicators and provide a new sea-level reconstruction for the central Portuguese coast over the past 6.5 ka. The selected indicators represent morphological features extracted from coastal barrier stratigraphy, beach berm and dune-beach contact. These features were mapped from high-resolution ground penetrating radar images of the subsurface and transformed into sea-level indicators through comparison with modern analogs and a chronology based on optically stimulated luminescence ages. Our reconstructions document a continuous but slow sea-level rise after 6.5 ka with an accumulated change in elevation of about 2 m. In the context of SW Europe, our results show good agreement with previous studies, including the Tagus isostatic model, with minor discrepancies that demand further improvement of regional models. This work reinforces the potential of barrier indicators to accurately reconstruct high-resolution mid- to late Holocene sea-level changes through simple approaches.

  6. Qualitative tools and experimental philosophy

    Science.gov (United States)

    Andow, James

    2016-01-01

    Abstract Experimental philosophy brings empirical methods to philosophy. These methods are used to probe how people think about philosophically interesting things such as knowledge, morality, and freedom. This paper explores the contribution that qualitative methods have to make in this enterprise. I argue that qualitative methods have the potential to make a much greater contribution than they have so far. Along the way, I acknowledge a few types of resistance that proponents of qualitative methods in experimental philosophy might encounter, and provide reasons to think they are ill-founded. PMID:28392629

  7. High-performance work systems in health care management, part 2: qualitative evidence from five case studies.

    Science.gov (United States)

    McAlearney, Ann Scheck; Garman, Andrew N; Song, Paula H; McHugh, Megan; Robbins, Julie; Harrison, Michael I

    2011-01-01

    : A capable workforce is central to the delivery of high-quality care. Research from other industries suggests that the methodical use of evidence-based management practices (also known as high-performance work practices [HPWPs]), such as systematic personnel selection and incentive compensation, serves to attract and retain well-qualified health care staff and that HPWPs may represent an important and underutilized strategy for improving quality of care and patient safety. : The aims of this study were to improve our understanding about the use of HPWPs in health care organizations and to learn about their contribution to quality of care and patient safety improvements. : Guided by a model of HPWPs developed through an extensive literature review and synthesis, we conducted a series of interviews with key informants from five U.S. health care organizations that had been identified based on their exemplary use of HPWPs. We sought to explore the applicability of our model and learn whether and how HPWPs were related to quality and safety. All interviews were recorded, transcribed, and subjected to qualitative analysis. : In each of the five organizations, we found emphasis on all four HPWP subsystems in our conceptual model-engagement, staff acquisition/development, frontline empowerment, and leadership alignment/development. Although some HPWPs were common, there were also practices that were distinctive to a single organization. Our informants reported links between HPWPs and employee outcomes (e.g., turnover and higher satisfaction/engagement) and indicated that HPWPs made important contributions to system- and organization-level outcomes (e.g., improved recruitment, improved ability to address safety concerns, and lower turnover). : These case studies suggest that the systematic use of HPWPs may improve performance in health care organizations and provide examples of how HPWPs can impact quality and safety in health care. Further research is needed to specify

  8. How do stakeholders from multiple hierarchical levels of a large provincial health system define engagement? A qualitative study.

    Science.gov (United States)

    Norris, Jill M; White, Deborah E; Nowell, Lorelli; Mrklas, Kelly; Stelfox, Henry T

    2017-08-01

    Engaging stakeholders from varied organizational levels is essential to successful healthcare quality improvement. However, engagement has been hard to achieve and to measure across diverse stakeholders. Further, current implementation science models provide little clarity about what engagement means, despite its importance. The aim of this study was to understand how stakeholders of healthcare improvement initiatives defined engagement. Participants (n = 86) in this qualitative thematic study were purposively sampled for individual interviews. Participants included leaders, core members, frontline clinicians, support personnel, and other stakeholders of Strategic Clinical Networks in Alberta Health Services, a Canadian provincial health system with over 108,000 employees. We used an iterative thematic approach to analyze participants' responses to the question, "How do you define engagement?" Regardless of their organizational role, participants defined engagement through three interrelated themes. First, engagement was active participation from willing and committed stakeholders, with levels that ranged from information sharing to full decision-making. Second, engagement centered on a shared decision-making process about meaningful change for everyone "around the table," those who are most impacted. Third, engagement was two-way interactions that began early in the change process, where exchanges were respectful and all stakeholders felt heard and understood. This study highlights the commonalities of how stakeholders in a large healthcare system defined engagement-a shared understanding and terminology-to guide and improve stakeholder engagement. Overall, engagement was an active and committed decision-making about a meaningful problem through respectful interactions and dialog where everyone's voice is considered. Our results may be used in conjunction with current implementation models to provide clarity about what engagement means and how to engage various

  9. 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

  10. Levels of Valence

    Science.gov (United States)

    Shuman, Vera; Sander, David; Scherer, Klaus R.

    2013-01-01

    The distinction between the positive and the negative is fundamental in our emotional life. In appraisal theories, in particular in the component process model of emotion (Scherer, 1984, 2010), qualitatively different types of valence are proposed based on appraisals of (un)pleasantness, goal obstructiveness/conduciveness, low or high power, self-(in)congruence, and moral badness/goodness. This multifaceted conceptualization of valence is highly compatible with the frequent observation of mixed feelings in real life. However, it seems to contradict the one-dimensional conceptualization of valence often encountered in psychological theories, and the notion of valence as a common currency used to explain choice behavior. Here, we propose a framework to integrate the seemingly disparate conceptualizations of multifaceted valence and one-dimensional valence by suggesting that valence should be conceived at different levels, micro and macro. Micro-valences correspond to qualitatively different types of evaluations, potentially resulting in mixed feelings, whereas one-dimensional macro-valence corresponds to an integrative “common currency” to compare alternatives for choices. We propose that conceptualizing levels of valence may focus research attention on the mechanisms that relate valence at one level (micro) to valence at another level (macro), leading to new hypotheses, and addressing various concerns that have been raised about the valence concept, such as the valence-emotion relation. PMID:23717292

  11. What "price" means when buying food: insights from a multisite qualitative study with Black Americans.

    Science.gov (United States)

    DiSantis, Katherine Isselmann; Grier, Sonya A; Odoms-Young, Angela; Baskin, Monica L; Carter-Edwards, Lori; Young, Deborah Rohm; Lassiter, Vikki; Kumanyika, Shiriki K

    2013-03-01

    We explored the role of price in the food purchasing patterns of Black adults and youths. We analyzed qualitative data from interviews and focus groups with socioeconomically diverse, primarily female, Black adults or parents (n = 75) and youths (n = 42) in 4 US cities. Interview protocols were locality specific, but all were designed to elicit broad discussion of food marketing variables. We performed a conventional qualitative content analysis by coding and analyzing data from each site to identify common salient themes. Price emerged as a primary influence on food purchases across all sites. Other value considerations (e.g., convenience, food quality, healthfulness of product, and family preferences) were discussed, providing a more complex picture of how participants considered the price of a product. Food pricing strategies that encourage consumption of healthful foods may have high relevance for Black persons across income or education levels. Accounting for how price intersects with other value considerations may improve the effectiveness of these strategies.

  12. 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.

  13. 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.

  14. 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

  15. 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

  16. 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/

  17. Are we ready to accept the challenge? Addressing the shortcomings of contemporary qualitative health research.

    Science.gov (United States)

    Lau, Sofie Rosenlund; Traulsen, Janine M

    Qualitative approaches represent an important contributor to health care research. However, several researchers argue that contemporary qualitative research does not live up to its full potential. By presenting a snapshot of contemporary qualitative research in the field of social and administrative pharmacy, this study challenges contributors to the field by asking: Are we ready to accept the challenge and take qualitative research one step further? The purpose of this study was to initiate a constructive dialogue on the need for increased transparency in qualitative data analysis, including explicitly reflecting upon theoretical perspectives affecting the research process. Content analysis was used to evaluate levels of theoretical visibility and analysis transparency in selected qualitative research articles published in Research in Social and Administrative Pharmacy between January 2014 and January 2015. In 14 out of 21 assessed papers, the use of theory was found to be Seemingly Absent (lowest level of theory use), and the data analyses did not include any interpretive endeavors. Only two papers consistently applied theory throughout the entire study and clearly took the data analyses from a descriptive to an interpretive level. It was found that the aim of the majority of assessed papers was to change or modify a given practice, which however, resulted in a lack of both theoretical underpinnings and analysis transparency. This study takes the standpoint that theory and high-quality analysis go hand-in-hand. Based on the content analysis, articles that were deemed to be high in quality were explicit about the theoretical framework of their study and transparent in how they analyzed their data. It was found that theory contributed to the transparency of how the data were analyzed and interpreted. Two ways of improving contemporary qualitative research in the field of social and administrative pharmacy are discussed: engaging with social theory and establishing

  18. 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.

  19. 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

  20. 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

  1. Commentary: Writing and Evaluating Qualitative Research Reports

    Science.gov (United States)

    Thompson, Deborah; Aroian, Karen J.; McQuaid, Elizabeth L.; Deatrick, Janet A.

    2016-01-01

    Objective To provide an overview of qualitative methods, particularly for reviewers and authors who may be less familiar with qualitative research. Methods A question and answer format is used to address considerations for writing and evaluating qualitative research. Results and Conclusions When producing qualitative research, individuals are encouraged to address the qualitative research considerations raised and to explicitly identify the systematic strategies used to ensure rigor in study design and methods, analysis, and presentation of findings. Increasing capacity for review and publication of qualitative research within pediatric psychology will advance the field’s ability to gain a better understanding of the specific needs of pediatric populations, tailor interventions more effectively, and promote optimal health. PMID:27118271

  2. 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.

  3. 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

  4. “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

  5. Conducting qualitative research in audiology: a tutorial.

    Science.gov (United States)

    Knudsen, Line V; Laplante-Lévesque, Ariane; Jones, Lesley; Preminger, Jill E; Nielsen, Claus; Lunner, Thomas; Hickson, Louise; Naylor, Graham; Kramer, Sophia E

    2012-02-01

    Qualitative research methodologies are being used more frequently in audiology as it allows for a better understanding of the perspectives of people with hearing impairment. This article describes why and how international interdisciplinary qualitative research can be conducted. This paper is based on a literature review and our recent experience with the conduction of an international interdisciplinary qualitative study in audiology. We describe some available qualitative methods for sampling, data collection, and analysis and we discuss the rationale for choosing particular methods. The focus is on four approaches which have all previously been applied to audiologic research: grounded theory, interpretative phenomenological analysis, conversational analysis, and qualitative content analysis. This article provides a review of methodological issues useful for those designing qualitative research projects in audiology or needing assistance in the interpretation of qualitative literature.

  6. Successful qualitative research: A practical guide for beginners

    OpenAIRE

    Clarke, V.; Braun, V.

    2013-01-01

    For Chapter 1: This chapter introduces qualitative research to a reader new to the area, and sets the scene for the rest of the book. It clearly specifies what defines qualitative research, and differentiates the use of a whole qualitative paradigm, or Big Q approach, with the more limited use of qualitative data within a more positivist paradigm. It contextualises qualitative research – within psychology – by providing a brief history of the approach, and by locating it within the learning-c...

  7. Highly dissipative Hénon map behavior in the four-level model of the CO 2 laser with modulated losses

    Science.gov (United States)

    Pando L., C. L.; Acosta, G. A. Luna; Meucci, R.; Ciofini, M.

    1995-02-01

    We show that the four-level model for the CO 2 laser with modulated losses behaves in a qualitatively similar way as the highly dissipative Hénon map. The ubiquity of elements of the universal sequence, their related symbolic dynamics, and the presence of reverse bifurcations of chaotic bands in the model are reminiscent of the logistic map which is the limit of the Hénon map when the Jacobian equals zero. The coexistence of attractors, its dynamics related to contraction of volumes in phase space and the associated return maps can be correlated with those of the highly dissipative Hénon map.

  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. Critical Issues in the Funding of Qualitative Research

    Science.gov (United States)

    Bourgeault, Ivy Lynn

    2012-01-01

    Qualitative research has moved from the margins to the mainstream in many domains of scholarship. Yet, biases against how qualitative methods can best address important research questions still persist. The present article provides reflections regarding my experiences of proposing and reviewing both qualitative and quantitative research grants for…

  10. Origins, Methods and Advances in Qualitative Meta-Synthesis

    Science.gov (United States)

    Nye, Elizabeth; Melendez-Torres, G. J.; Bonell, Chris

    2016-01-01

    Qualitative research is a broad term encompassing many methods. Critiques of the field of qualitative research argue that while individual studies provide rich descriptions and insights, the absence of connections drawn between studies limits their usefulness. In response, qualitative meta-synthesis serves as a design to interpret and synthesise…

  11. 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

  12. High performance gamma measurements of equipment retrieved from Hanford high-level nuclear waste tanks

    International Nuclear Information System (INIS)

    Troyer, G.L.

    1997-01-01

    The cleanup of high level defense nuclear waste at the Hanford site presents several progressive challenges. Among these is the removal and disposal of various components from buried active waste tanks to allow new equipment insertion or hazards mitigation. A unique automated retrieval system at the tank provides for retrieval, high pressure washing, inventory measurement, and containment for disposal. Key to the inventory measurement is a three detector HPGe high performance gamma spectroscopy system capable of recovering data at up to 90% saturation (200,000 counts per second). Data recovery is based on a unique embedded electronic pulser and specialized software to report the inventory. Each of the detectors have different shielding specified through Monte Carlo simulation with the MCNP program. This shielding provides performance over a dynamic range of eight orders of magnitude. System description, calibration issues and operational experiences are discussed

  13. High performance gamma measurements of equipment retrieved from Hanford high-level nuclear waste tanks

    Energy Technology Data Exchange (ETDEWEB)

    Troyer, G.L.

    1997-03-17

    The cleanup of high level defense nuclear waste at the Hanford site presents several progressive challenges. Among these is the removal and disposal of various components from buried active waste tanks to allow new equipment insertion or hazards mitigation. A unique automated retrieval system at the tank provides for retrieval, high pressure washing, inventory measurement, and containment for disposal. Key to the inventory measurement is a three detector HPGe high performance gamma spectroscopy system capable of recovering data at up to 90% saturation (200,000 counts per second). Data recovery is based on a unique embedded electronic pulser and specialized software to report the inventory. Each of the detectors have different shielding specified through Monte Carlo simulation with the MCNP program. This shielding provides performance over a dynamic range of eight orders of magnitude. System description, calibration issues and operational experiences are discussed.

  14. 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.

  15. Providing instrumental social support is more beneficial to reduce mortality risk among the elderly with low educational level in Taiwan: a 12-year follow-up national longitudinal study.

    Science.gov (United States)

    Liao, C C; Yeh, C J; Lee, S H; Liao, W C; Liao, M Y; Lee, M C

    2015-04-01

    To evaluate whether the effects of providing or receiving social support are more beneficial to reduce mortality risk among the elderly with different educational levels. In this long-term prospective cohort study, data were retrieved from the Taiwan Longitudinal Study on Aging. This study was initiated from 1996 until 2007. The complete data from 1492 males and 1177 females aged ≥67 years were retrieved. Participants received financial, instrumental, and emotional support, and they actively provided instrumental and emotional support to others and involved in social engagement. Education attainment was divided into two levels: high and low. The low education level included illiterate and elementary school. The high education level included junior high school to senior high school and above college. Cox regression analysis was used to examine the association between providing or receiving social support on mortality with different educational levels. The average age of the participants in 1996 was 73.0 (IQR=8.0) years, and the median survival following years (1996-2007) of participants was 10.3 (IQR=6.7) years. Most participants were low educational level including illiterate (39.3%) and elementary school (41.2%). Participants with high educational level tend to be younger and more male significantly. On the contrary, participants with low educational level tend to have significant more poor income, more depression, more cognition impairment, more with IADL and ADL disability than high educational level. Most participants received instrumental support from others (95.5%) and also provided emotional support to others (97.7%). Providing instrumental support can reduce 17% of mortality risk among the elderly with a low level of education after adjusting several covariates [Hazard ratio (HR) = 0.83; 95% confidence interval (CI) = 0.70-0.99; p = 0.036]. Providing instrumental social support to others confer benefits to the giver and prolong life expectancy among the

  16. 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

  17. 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...

  18. Qualitative data collection and analysis methods: the INSTINCT trial.

    Science.gov (United States)

    Meurer, William J; Frederiksen, Shirley M; Majersik, Jennifer J; Zhang, Lingling; Sandretto, Annette; Scott, Phillip A

    2007-11-01

    Patient care practices often lag behind current scientific evidence and professional guidelines. The failure of such knowledge translation (KT) efforts may reflect inadequate assessment and management of specific barriers confronting both physicians and patients at the point of treatment level. Effective KT in this setting may benefit from the use of qualitative methods to identify and overcome these barriers. Qualitative methodology allows in-depth exploration of the barriers involved in adopting practice change and has been infrequently used in emergency medicine research. The authors describe the methodology for qualitative analysis within the INcreasing Stroke Treatment through INteractive behavioral Change Tactics (INSTINCT) trial. This includes processes for valid data collection and reliable analysis of the textual data from focus group and interview transcripts. INSTINCT is a 24-hospital, randomized, controlled study that is designed to evaluate a system-based barrier assessment and interactive educational intervention to increase appropriate tissue plasminogen activator (tPA) use in ischemic stroke. Intervention hospitals undergo baseline barrier assessment using both qualitative as well as quantitative (survey) techniques. Investigators obtain data on local barriers to tPA use, as well as information on local attitudes, knowledge, and beliefs regarding acute stroke treatment. Targeted groups at each site include emergency physicians, emergency nurses, neurologists, radiologists, and hospital administrators. Transcript analysis using NVivo7 with a predefined barrier taxonomy is described. This will provide both qualitative insight on thrombolytic use and importance of specific barrier types for each site. The qualitative findings subsequently direct the form of professional education efforts and system interventions at treatment sites.

  19. Co-creation of a pedagogical space to support qualitative inquiry: An advanced qualitative collective.

    Science.gov (United States)

    Abboud, Sarah; Kim, Su Kyung; Jacoby, Sara; Mooney-Doyle, Kim; Waite, Terease; Froh, Elizabeth; Sefcik, Justine S; Kim, Hyejin; Sowicz, Timothy Joseph; Kelly, Terri-Ann; Kagan, Sarah

    2017-03-01

    Situated in a research-intensive School of Nursing, the Advanced Qualitative Collective (AQC) provides an innovative educational forum for the study of qualitative research by doctoral and postdoctoral scholars. This long-standing collective is guided by a faculty facilitator using a collaborative co-learning approach to address individual and group needs, from the conception of research projects through dissemination of completed qualitative research. This article describes the dynamics of the AQC and the ways a co-created pedagogical entity supports professional development among its diverse members. The informal, participatory style, and dynamic content used by the AQC resists a course structure typical of doctoral education in health sciences, and promotes engagement and self-direction. The AQC provides opportunities for members to examine theoretical frameworks and methodologies rarely addressed within a positivism-dominant learning environment while simultaneously serving as an alternative exemplar for the pedagogy of research. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Incentives and compensation: providing resources for communities hosting low-level waste facilities

    International Nuclear Information System (INIS)

    Anon.

    1982-01-01

    State responsibility for the management of low-level radioactive waste necessitates the selection of candidate locations for a disposal facility. Concern over potential impacts can be expected from segments of the citizenry neighboring a proposed site. A number of national organizations comprising state and local officials have recommended the use of incentives and compensation to help offset the negative local impacts. This document explores that concept. Discussion provides background information on potential local impacts from a low-level waste facility and considers the nature and types of incentives and compensation benefits that could be provided. The document then examines realistic options for planning and implementing the benefit program. This information is intended, primarily, to assist state officials - executive, legislative, and agency - in planning for and managing low-level waste disposal facilities

  1. Handling Imprecision in Qualitative Data Warehouse: Urban Building Sites Annoyance Analysis Use Case

    Science.gov (United States)

    Amanzougarene, F.; Chachoua, M.; Zeitouni, K.

    2013-05-01

    Data warehouse means a decision support database allowing integration, organization, historisation, and management of data from heterogeneous sources, with the aim of exploiting them for decision-making. Data warehouses are essentially based on multidimensional model. This model organizes data into facts (subjects of analysis) and dimensions (axes of analysis). In classical data warehouses, facts are composed of numerical measures and dimensions which characterize it. Dimensions are organized into hierarchical levels of detail. Based on the navigation and aggregation mechanisms offered by OLAP (On-Line Analytical Processing) tools, facts can be analyzed according to the desired level of detail. In real world applications, facts are not always numerical, and can be of qualitative nature. In addition, sometimes a human expert or learned model such as a decision tree provides a qualitative evaluation of phenomenon based on its different parameters i.e. dimensions. Conventional data warehouses are thus not adapted to qualitative reasoning and have not the ability to deal with qualitative data. In previous work, we have proposed an original approach of qualitative data warehouse modeling, which permits integrating qualitative measures. Based on computing with words methodology, we have extended classical multidimensional data model to allow the aggregation and analysis of qualitative data in OLAP environment. We have implemented this model in a Spatial Decision Support System to help managers of public spaces to reduce annoyances and improve the quality of life of the citizens. In this paper, we will focus our study on the representation and management of imprecision in annoyance analysis process. The main objective of this process consists in determining the least harmful scenario of urban building sites, particularly in dense urban environments.

  2. [Qualitative translational science in clinical practice].

    Science.gov (United States)

    Mu, Pei-Fan

    2013-10-01

    Qualitative translational research refers to the "bench-to-bedside" enterprise of harnessing knowledge from the basic sciences to produce new treatment options or nursing interventions for patients. Three evidence-based translational problems related to qualitative translational research discussed this year address the interfaces among the nursing paradigm, the basic sciences, and clinical nursing work. This article illustrates the definition of translational science and translational blocks of evidence-based practice; discusses the qualitative research perspective in evidence synthesis, evidence translation and evidence utilization; and discusses the research questions that must be answered to solve the problems of the three translational gaps from the qualitative research perspective. Qualitative inquiry has an essential role to play in efforts to improve current healthcare-provider nursing interventions, experiences, and contexts. Thus, it is vital to introduce qualitative perspectives into evidence-based practice from the knowledge discovery through to the knowledge implementation process.

  3. 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.

  4. Geographical distribution of drinking-water with high iodine level and association between high iodine level in drinking-water and goitre: a Chinese national investigation.

    Science.gov (United States)

    Shen, Hongmei; Liu, Shoujun; Sun, Dianjun; Zhang, Shubin; Su, Xiaohui; Shen, Yanfeng; Han, Hepeng

    2011-07-01

    Excessive iodine intake can cause thyroid function disorders as can be caused by iodine deficiency. There are many people residing in areas with high iodine levels in drinking-water in China. The main aim of the present study was to map the geographical distribution of drinking-water with high iodine level in China and to determine the relationship between high iodine level in drinking-water and goitre prevalence. Iodine in drinking-water was measured in 1978 towns of eleven provinces in China, with a total of 28,857 water samples. We randomly selected children of 8-10 years old, examined the presence of goitre and measured their urinary iodine in 299 towns of nine provinces. Of the 1978 towns studied, 488 had iodine levels between 150 and 300 μg/l in drinking-water, and in 246 towns, the iodine level was >300 μg/l. These towns are mainly distributed along the original Yellow River flood areas, the second largest river in China. Of the 56 751 children examined, goitre prevalence was 6.3 % in the areas with drinking-water iodine levels of 150-300 μg/l and 11.0 % in the areas with drinking-water iodine >300 μg/l. Goitre prevalence increased with water and urinary iodine levels. For children with urinary iodine >1500 μg/l, goitre prevalence was 3.69 times higher than that for those with urinary iodine levels of 100-199 μg/l. The present study suggests that drinking-water with high iodine levels is distributed in eleven provinces of China. Goitre becomes more prevalent with the increase in iodine level in drinking-water. Therefore, it becomes important to prevent goitre through stopping the provision of iodised salt and providing normal drinking-water iodine through pipelines in these areas in China.

  5. A new high-voltage level-shifting circuit for half-bridge power ICs

    International Nuclear Information System (INIS)

    Kong Moufu; Chen Xingbi

    2013-01-01

    In order to reduce the chip area and improve the reliability of HVICs, a new high-voltage level-shifting circuit with an integrated low-voltage power supply, two PMOS active resistors and a current mirror is proposed. The integrated low-voltage power supply not only provides energy for the level-shifting circuit and the logic circuit, but also provides voltage signals for the gates and sources of the PMOS active resistors to ensure that they are normally-on. The normally-on PMOS transistors do not, therefore, need to be fabricated in the depletion process. The current mirror ensures that the level-shifting circuit has a constant current, which can reduce the process error of the high-voltage devices of the circuit. Moreover, an improved RS trigger is also proposed to improve the reliability of the circuit. The proposed level-shifting circuit is analyzed and confirmed by simulation with MEDICI, and the simulation results show that the function is achieved well. (semiconductor integrated circuits)

  6. Cultural Competence among Maternal Healthcare Providers in Bahir Dar City Administration, Northwest Ethiopia: Cross sectional Study.

    Science.gov (United States)

    Aragaw, Amanu; Yigzaw, Tegbar; Tetemke, Desalegn; G/Amlak, Wubalem

    2015-09-24

    Cultural competency is now a core requirement for maternal health providers working in multicultural society. However, it has not yet received due attention in Ethiopia. This study aimed to determine the level of cultural competence and its associated factors among maternal health care providers in Bahir Dar City Administration, Northwest Ethiopia. Institution based cross-sectional study was carried out using both quantitative and qualitative methods. Maternal health care providers from all health facilities were our study participants. Structured Questionnaire with some modification of Campinha Bacote's tool was used to collect quantitative data from health workers and semi structured guide line was used for qualitative data among women. While quantitative data analysis was done using SPSS, qualitative data was analyzed using open code software. P-value of less than 0.05 was taken to determine statistical significance. Cronbach's alpha was used to test internal reliability and a factor loading of 0.3 or greater was the criterion used to retain items. Two hundred seventy four health workers and seven women were involved in the study. The overall competency level was 57.3 % thought vary in different subscales or stages. Of the cultural competent health workers near to three fourth (73.0 %) were in awareness stage which is the earliest stage of competence in which individuals were aware only their own culture but not the world view of their clients. The voices of mothers in the qualitative assessment also showed discordance in cultural competence with their healthcare providers. Female health workers almost six times [AOR,5.5; 2.71, 11.30] more competent than male providers and those who got in-service training related to maternal care provided services more culturally competent than their counter parts with [AOR,3.5; 1.4, 8.64]. Reliability Cronbach's α coefficient value of cultural competence subscales showed 0.672,0 .719, 0.658, 0.714, and 0.631 for cultural

  7. L1Track: A fast Level 1 track trigger for the ATLAS high luminosity upgrade

    International Nuclear Information System (INIS)

    Cerri, Alessandro

    2016-01-01

    With the planned high-luminosity upgrade of the LHC (HL-LHC), the ATLAS detector will see its collision rate increase by approximately a factor of 5 with respect to the current LHC operation. The earliest hardware-based ATLAS trigger stage (“Level 1”) will have to provide a higher rejection factor in a more difficult environment: a new improved Level 1 trigger architecture is under study, which includes the possibility of extracting with low latency and high accuracy tracking information in time for the decision taking process. In this context, the feasibility of potential approaches aimed at providing low-latency high-quality tracking at Level 1 is discussed. - Highlights: • HL-LH requires highly performing event selection. • ATLAS is studying the implementation of tracking at the very first trigger level. • Low latency and high-quality seem to be achievable with dedicated hardware and adequate detector readout architecture.

  8. 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

  9. 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)

  10. 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

  11. Pediatric providers and radiology examinations: knowledge and comfort levels regarding ionizing radiation and potential complications of imaging.

    Science.gov (United States)

    Wildman-Tobriner, Benjamin; Parente, Victoria M; Maxfield, Charles M

    2017-12-01

    Pediatric providers should understand the basic risks of the diagnostic imaging tests they order and comfortably discuss those risks with parents. Appreciating providers' level of understanding is important to guide discussions and enhance relationships between radiologists and pediatric referrers. To assess pediatric provider knowledge of diagnostic imaging modalities that use ionizing radiation and to understand provider concerns about risks of imaging. A 6-question survey was sent via email to 390 pediatric providers (faculty, trainees and midlevel providers) from a single academic institution. A knowledge-based question asked providers to identify which radiology modalities use ionizing radiation. Subjective questions asked providers about discussions with parents, consultations with radiologists, and complications of imaging studies. One hundred sixty-nine pediatric providers (43.3% response rate) completed the survey. Greater than 90% of responding providers correctly identified computed tomography (CT), fluoroscopy and radiography as modalities that use ionizing radiation, and ultrasound and magnetic resonance imaging (MRI) as modalities that do not. Fewer (66.9% correct, Pionizing radiation. A majority of providers (82.2%) believed that discussions with radiologists regarding ionizing radiation were helpful, but 39.6% said they rarely had time to do so. Providers were more concerned with complications of sedation and cost than they were with radiation-induced cancer, renal failure or anaphylaxis. Providers at our academic referral center have a high level of basic knowledge regarding modalities that use ionizing radiation, but they are less aware of ionizing radiation use in nuclear medicine studies. They find discussions with radiologists helpful and are concerned about complications of sedation and cost.

  12. 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.

  13. Robotic Prostatectomy on the Web: A Cross-Sectional Qualitative Assessment.

    Science.gov (United States)

    Borgmann, Hendrik; Mager, René; Salem, Johannes; Bründl, Johannes; Kunath, Frank; Thomas, Christian; Haferkamp, Axel; Tsaur, Igor

    2016-08-01

    Many patients diagnosed with prostate cancer search for information on robotic prostatectomy (RobP) on the Web. We aimed to evaluate the qualitative characteristics of the mostly frequented Web sites on RobP with a particular emphasis on provider-dependent issues. Google was searched for the term "robotic prostatectomy" in Europe and North America. The mostly frequented Web sites were selected and classified as physician-provided and publically-provided. Quality was measured using Journal of the American Medical Association (JAMA) benchmark criteria, DISCERN score, and addressing of Trifecta surgical outcomes. Popularity was analyzed using Google PageRank and Alexa tool. Accessibility, usability, and reliability were investigated using the LIDA tool and readability was assessed using readability indices. Twenty-eight Web sites were physician-provided and 15 publically-provided. For all Web sites, 88% of JAMA benchmark criteria were fulfilled, DISCERN quality score was high, and 81% of Trifecta outcome measurements were addressed. Popularity was average according to Google PageRank (mean 2.9 ± 1.5) and Alexa Traffic Rank (median, 49,109; minimum, 7; maximum, 8,582,295). Accessibility (85 ± 7%), usability (92 ± 3%), and reliability scores (88 ± 8%) were moderate to high. Automated Readability Index was 7.2 ± 2.1 and Flesch-Kincaid Grade Level was 9 ± 2, rating the Web sites as difficult to read. Physician-provided Web sites had higher quality scores and lower readability compared with publically-provided Web sites. Websites providing information on RobP obtained medium to high ratings in all domains of quality in the current assessment. In contrast, readability needs to be significantly improved so that this content can become available for the populace. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Qualitative research in travel behavior studies

    Energy Technology Data Exchange (ETDEWEB)

    Mars Aicart, M.L.; Ruiz Sanchez, T.; Arroyo Lopez, M.R.

    2016-07-01

    Qualitative methodology is extensively used in a wide range of scientific areas, such as Sociology and Psychology, and it is been used to study individual and household decision making processes. However, in the Transportation Planning and Engineering domain it is still infrequent to find in the travel behavior literature studies using qualitative techniques to explore activity-travel decisions. The aim of this paper is first, to provide an overview of the types of qualitative techniques available and to explore how to correctly implement them. Secondly, to highlight the special characteristics of qualitative methods that make them appropriate to study activity-travel decision processes. Far from been an unempirical or intuitive methodology, using qualitative methods properly implies a strong foundation on theoretical frameworks, a careful design of data collection and a deep data analysis. For such a purpose, a review of the scarce activity-travel behavior literature using qualitative methods, or a combination of qualitative and quantitative approaches, is presented. The use of qualitative techniques can play a role of being a supplementary way of obtaining information related to activity-travel decisions which otherwise it would be extremely difficult to find. This work ends with some conclusions about how qualitative research could help in making progress on activity-travel behavior studies. (Author)

  15. Level set methods for detonation shock dynamics using high-order finite elements

    Energy Technology Data Exchange (ETDEWEB)

    Dobrev, V. A. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Grogan, F. C. [Univ. of California, San Diego, CA (United States); Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Kolev, T. V. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Rieben, R [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Tomov, V. Z. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2017-05-26

    Level set methods are a popular approach to modeling evolving interfaces. We present a level set ad- vection solver in two and three dimensions using the discontinuous Galerkin method with high-order nite elements. During evolution, the level set function is reinitialized to a signed distance function to maintain ac- curacy. Our approach leads to stable front propagation and convergence on high-order, curved, unstructured meshes. The ability of the solver to implicitly track moving fronts lends itself to a number of applications; in particular, we highlight applications to high-explosive (HE) burn and detonation shock dynamics (DSD). We provide results for two- and three-dimensional benchmark problems as well as applications to DSD.

  16. How College Students Understand Their Self-Control Development: A Qualitative Analysis

    Science.gov (United States)

    Cliburn Allen, Cara; Glanzer, Perry

    2017-01-01

    Recent research has shown the importance of the positive benefits of high-levels of self-control for both individuals and society. Yet, we know only a limited amount about how college students understand and apply self-control. This qualitative study examined how a national sample of 75 students defined self-control, whether or not they believed…

  17. Patient and referring health care provider satisfaction with a physiotherapy spinal triage assessment service

    Directory of Open Access Journals (Sweden)

    Bath B

    2011-12-01

    Full Text Available Brenna Bath1, Bonnie Janzen21School of Physical Therapy, College of Medicine, University of Saskatchewan, 2Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, CanadaPurpose: To evaluate participant and referring care provider satisfaction associated with a spinal triage assessment service delivered by physiotherapists in collaboration with orthopedic surgeons.Methods: People with low back-related complaints were recruited from those referred to a spinal triage assessment program delivered by physiotherapists. Measures of patient and provider satisfaction were completed at approximately 4 weeks after the assessment. The satisfaction surveys were analyzed quantitatively with descriptive statistics and qualitatively with an inductive thematic approach of open and axial coding.Results: A total of 108/115 participants completed the posttest satisfaction survey. Sixty-six percent of participants were “very satisfied” with the service and 55% were “very satisfied” with the recommendations that were made. Only 18% of referring care providers completed the satisfaction survey and 90.5% of those were “very satisfied” with the recommendations. Sixty-one participants and 14 care providers provided comments which revealed a diverse range of themes which were coded into positive (ie, understanding the problem, communication, customer service, efficiency, and management direction, negative (ie, lack of detail, time to follow-up, cost and neutral related to the triage service, and an “other” category unrelated to the service (ie, chronic symptoms, comorbidities, and limited access to health care.Conclusion: The quantitative results of the participant survey demonstrated very high levels of satisfaction with the service and slightly less satisfaction with the recommendations that were made. Satisfaction of referring care providers with the recommendations and report was also high, but given

  18. Comparative qualitative research in Cultural Psychology

    DEFF Research Database (Denmark)

    Demuth, Carolin; Fatigante, Marilena

    2012-01-01

    The present paper aims to provide an approach that allows to study the interplay of culture and psychological human functioning in comparative study designs. Starting out with a brief overview of how qualitative, cultural, and comparative research is addressed in the field of psychology we...... will take a Cultural Psychology approach to suggest that the unit of analysis for comparative research needs to be situated social interaction. We will then suggest an integrative approach that allows us to study social interaction both on a micro- and on a macro-level by combining discourse analysis...... some criteria of validity that particularly apply to the field of comparative research in Cultural Psychology....

  19. DUACS: Toward High Resolution Sea Level Products

    Science.gov (United States)

    Faugere, Y.; Gerald, D.; Ubelmann, C.; Claire, D.; Pujol, M. I.; Antoine, D.; Desjonqueres, J. D.; Picot, N.

    2016-12-01

    The DUACS system produces, as part of the CNES/SALP project, and the Copernicus Marine Environment and Monitoring Service, high quality multimission altimetry Sea Level products for oceanographic applications, climate forecasting centers, geophysic and biology communities... These products consist in directly usable and easy to manipulate Level 3 (along-track cross-calibrated SLA) and Level 4 products (multiple sensors merged as maps or time series) and are available in global and regional version (Mediterranean Sea, Arctic, European Shelves …).The quality of the products is today limited by the altimeter technology "Low Resolution Mode" (LRM), and the lack of available observations. The launch of 2 new satellites in 2016, Jason-3 and Sentinel-3A, opens new perspectives. Using the global Synthetic Aperture Radar mode (SARM) coverage of S3A and optimizing the LRM altimeter processing (retracking, editing, ...) will allow us to fully exploit the fine-scale content of the altimetric missions. Thanks to this increase of real time altimetry observations we will also be able to improve Level-4 products by combining these new Level-3 products and new mapping methodology, such as dynamic interpolation. Finally these improvements will benefit to downstream products : geostrophic currents, Lagrangian products, eddy atlas… Overcoming all these challenges will provide major upgrades of Sea Level products to better fulfill user needs.

  20. 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

  1. 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

  2. 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.

  3. The qualitative orientation in medical education research.

    Science.gov (United States)

    Cleland, Jennifer Anne

    2017-06-01

    Qualitative research is very important in educational research as it addresses the "how" and "why" research questions and enables deeper understanding of experiences, phenomena and context. Qualitative research allows you to ask questions that cannot be easily put into numbers to understand human experience. Getting at the everyday realities of some social phenomenon and studying important questions as they are really practiced helps extend knowledge and understanding. To do so, you need to understand the philosophical stance of qualitative research and work from this to develop the research question, study design, data collection methods and data analysis. In this article, I provide an overview of the assumptions underlying qualitative research and the role of the researcher in the qualitative process. I then go on to discuss the type of research objectives which are common in qualitative research, then introduce the main qualitative designs, data collection tools, and finally the basics of qualitative analysis. I introduce the criteria by which you can judge the quality of qualitative research. Many classic references are cited in this article, and I urge you to seek out some of these further reading to inform your qualitative research program.

  4. Qualitative description – the poor cousin of health research?

    OpenAIRE

    Sondergaard Jens; Andersen Rikke; Olesen Frede; Neergaard Mette

    2009-01-01

    Abstract Background The knowledge and use of qualitative description as a qualitative research approach in health services research is limited. The aim of this article is to discuss the potential benefits of a qualitative descriptive approach, to identify its strengths and weaknesses and to provide examples of use. Discussion Qualitative description is a useful qualitative method in much medical research if you keep the limitations of the approach in mind. It is especially relevant in mixed m...

  5. 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.

  6. Theoretical Coalescence: A Method to Develop Qualitative Theory: The Example of Enduring.

    Science.gov (United States)

    Morse, Janice M

    Qualitative research is frequently context bound, lacks generalizability, and is limited in scope. The purpose of this article was to describe a method, theoretical coalescence, that provides a strategy for analyzing complex, high-level concepts and for developing generalizable theory. Theoretical coalescence is a method of theoretical expansion, inductive inquiry, of theory development, that uses data (rather than themes, categories, and published extracts of data) as the primary source for analysis. Here, using the development of the lay concept of enduring as an example, I explore the scientific development of the concept in multiple settings over many projects and link it within the Praxis Theory of Suffering. As comprehension emerges when conducting theoretical coalescence, it is essential that raw data from various different situations be available for reinterpretation/reanalysis and comparison to identify the essential features of the concept. The concept is then reconstructed, with additional inquiry that builds description, and evidence is conducted and conceptualized to create a more expansive concept and theory. By utilizing apparently diverse data sets from different contexts that are linked by certain characteristics, the essential features of the concept emerge. Such inquiry is divergent and less bound by context yet purposeful, logical, and with significant pragmatic implications for practice in nursing and beyond our discipline. Theoretical coalescence is a means by which qualitative inquiry is broadened to make an impact, to accommodate new theoretical shifts and concepts, and to make qualitative research applied and accessible in new ways.

  7. Qualitative research and the modern library

    CERN Document Server

    Goodman, Valeda Dent

    2011-01-01

    Qualitative Research and the Modern Library examines the present-day role and provides suggestions for areas that might be suited to this type of research for the purposes of evaluation. The author discusses how the results from such research might be applied, and the overall impact of using this type of research to inform development of a more user-centred organisation. The book provides a thoughtful look at the implications of using qualitative research to inform decision-making processes within libraries and is written by an author and library researcher with international experience in var

  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. Pediatric providers and radiology examinations. Knowledge and comfort levels regarding ionizing radiation and potential complications of imaging

    Energy Technology Data Exchange (ETDEWEB)

    Wildman-Tobriner, Benjamin; Maxfield, Charles M. [Duke University Hospital, Department of Radiology, Durham, NC (United States); Parente, Victoria M. [Duke University Hospital, Department of Pediatrics, Durham, NC (United States)

    2017-12-15

    Pediatric providers should understand the basic risks of the diagnostic imaging tests they order and comfortably discuss those risks with parents. Appreciating providers' level of understanding is important to guide discussions and enhance relationships between radiologists and pediatric referrers. To assess pediatric provider knowledge of diagnostic imaging modalities that use ionizing radiation and to understand provider concerns about risks of imaging. A 6-question survey was sent via email to 390 pediatric providers (faculty, trainees and midlevel providers) from a single academic institution. A knowledge-based question asked providers to identify which radiology modalities use ionizing radiation. Subjective questions asked providers about discussions with parents, consultations with radiologists, and complications of imaging studies. One hundred sixty-nine pediatric providers (43.3% response rate) completed the survey. Greater than 90% of responding providers correctly identified computed tomography (CT), fluoroscopy and radiography as modalities that use ionizing radiation, and ultrasound and magnetic resonance imaging (MRI) as modalities that do not. Fewer (66.9% correct, P<0.001) knew that nuclear medicine utilizes ionizing radiation. A majority of providers (82.2%) believed that discussions with radiologists regarding ionizing radiation were helpful, but 39.6% said they rarely had time to do so. Providers were more concerned with complications of sedation and cost than they were with radiation-induced cancer, renal failure or anaphylaxis. Providers at our academic referral center have a high level of basic knowledge regarding modalities that use ionizing radiation, but they are less aware of ionizing radiation use in nuclear medicine studies. They find discussions with radiologists helpful and are concerned about complications of sedation and cost. (orig.)

  11. Using a theory-driven conceptual framework in qualitative health research.

    Science.gov (United States)

    Macfarlane, Anne; O'Reilly-de Brún, Mary

    2012-05-01

    The role and merits of highly inductive research designs in qualitative health research are well established, and there has been a powerful proliferation of grounded theory method in the field. However, tight qualitative research designs informed by social theory can be useful to sensitize researchers to concepts and processes that they might not necessarily identify through inductive processes. In this article, we provide a reflexive account of our experience of using a theory-driven conceptual framework, the Normalization Process Model, in a qualitative evaluation of general practitioners' uptake of a free, pilot, language interpreting service in the Republic of Ireland. We reflect on our decisions about whether or not to use the Model, and describe our actual use of it to inform research questions, sampling, coding, and data analysis. We conclude with reflections on the added value that the Model and tight design brought to our research.

  12. [Qualitative Research in Health Services Research - Discussion Paper, Part 3: Quality of Qualitative Research].

    Science.gov (United States)

    Stamer, M; Güthlin, C; Holmberg, C; Karbach, U; Patzelt, C; Meyer, T

    2015-12-01

    The third and final discussion paper of the German Network of Health Services Research's (DNVF) "Qualitative Methods Working Group" demonstrates methods for the evaluation and quality of qualitative research in health services research. In this paper we discuss approaches described in evaluating qualitative studies, including: an orientation to the general principles of empirical research, an approach-specific course of action, as well as procedures based on the research-process and criteria-oriented approaches. Divided into general and specific aspects to be considered in a qualitative study quality evaluation, the central focus of the discussion paper undertakes an extensive examination of the process and criteria-oriented approaches. The general aspects include the participation of relevant groups in the research process as well as ethical aspects of the research and data protection issues. The more specific aspects in evaluating the quality of qualitative research include considerations about the research interest, research questions, and the selection of data collection methods and types of analyses. The formulated questions are intended to guide reviewers and researchers to evaluate and to develop qualitative research projects appropriately. The intention of this discussion paper is to ensure a transparent research culture, and to reflect on and discuss the methodological and research approach of qualitative studies in health services research. With this paper we aim to initiate a discussion on high quality evaluation of qualitative health services research. © Georg Thieme Verlag KG Stuttgart · New York.

  13. The Urban Adaptation and Adaptation Process of Urban Migrant Children: A Qualitative Study

    Science.gov (United States)

    Liu, Yang; Fang, Xiaoyi; Cai, Rong; Wu, Yang; Zhang, Yaofang

    2009-01-01

    This article employs qualitative research methods to explore the urban adaptation and adaptation processes of Chinese migrant children. Through twenty-one in-depth interviews with migrant children, the researchers discovered: The participant migrant children showed a fairly high level of adaptation to the city; their process of urban adaptation…

  14. Commentary: Writing and Evaluating Qualitative Research Reports.

    Science.gov (United States)

    Wu, Yelena P; Thompson, Deborah; Aroian, Karen J; McQuaid, Elizabeth L; Deatrick, Janet A

    2016-06-01

    To provide an overview of qualitative methods, particularly for reviewers and authors who may be less familiar with qualitative research. A question and answer format is used to address considerations for writing and evaluating qualitative research. When producing qualitative research, individuals are encouraged to address the qualitative research considerations raised and to explicitly identify the systematic strategies used to ensure rigor in study design and methods, analysis, and presentation of findings. Increasing capacity for review and publication of qualitative research within pediatric psychology will advance the field's ability to gain a better understanding of the specific needs of pediatric populations, tailor interventions more effectively, and promote optimal health. © The Author 2016. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  15. Curriculum-Level Strategies That U.S. Occupational Therapy Programs Use to Address Occupation: A Qualitative Study.

    Science.gov (United States)

    Hooper, Barb; Krishnagiri, Sheama; Price, Pollie; Taff, Steven D; Bilics, Andrea

    This study's objective was to describe curriculum-level strategies used to convey occupation to occupational therapy students. The study used a descriptive qualitative research design. Fifteen occupational therapy and 10 occupational therapy assistant programs participated in interviews, submitted curriculum artifacts such as syllabi and assignments, and recorded teaching sessions. Data were coded both inductively and deductively and then categorized into themes. Occupational therapy programs designed strategies on two levels of the curriculum, infrastructure and implementation, to convey knowledge of occupation to students. The degree to which strategies explicitly highlighted occupation and steered instruction fluctuated depending on how differentiated occupation was from other concepts and skills. Two arguments are presented about the degree to which occupation needs to be infused in all curricular elements. To guide curriculum design, it is critical for educators to discuss beliefs about how ubiquitous occupation is in a curriculum and whether curricular elements portray occupation to the extent preferred. Copyright © 2018 by the American Occupational Therapy Association, Inc.

  16. Qualitative and quantitative combined nonlinear dynamics model and its application in analysis of price, supply–demand ratio and selling rate

    International Nuclear Information System (INIS)

    Zhu, Dingju

    2016-01-01

    The qualitative and quantitative combined nonlinear dynamics model proposed in this paper fill the gap in nonlinear dynamics model in terms of qualitative and quantitative combined methods, allowing the qualitative model and quantitative model to perfectly combine and overcome their weaknesses by learning from each other. These two types of models use their strengths to make up for the other’s deficiencies. The qualitative and quantitative combined models can surmount the weakness that the qualitative model cannot be applied and verified in a quantitative manner, and the high costs and long time of multiple construction as well as verification of the quantitative model. The combined model is more practical and efficient, which is of great significance for nonlinear dynamics. The qualitative and quantitative combined modeling and model analytical method raised in this paper is not only applied to nonlinear dynamics, but can be adopted and drawn on in the modeling and model analysis of other fields. Additionally, the analytical method of qualitative and quantitative combined nonlinear dynamics model proposed in this paper can satisfactorily resolve the problems with the price system’s existing nonlinear dynamics model analytical method. The three-dimensional dynamics model of price, supply–demand ratio and selling rate established in this paper make estimates about the best commodity prices using the model results, thereby providing a theoretical basis for the government’s macro-control of price. Meanwhile, this model also offer theoretical guidance to how to enhance people’s purchasing power and consumption levels through price regulation and hence to improve people’s living standards.

  17. 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

  18. University-Level Research Projects for High School Students

    Science.gov (United States)

    McConnell, Mark L.

    2000-01-01

    The goal of this project was to provide an opportunity for high school students to participate in university-level research projects. In this case, students from Pinkerton Academy (Derry, New Hampshire) were invited to participate in efforts to catalog data from the COMPTEL experiment on NASA's Compton Gamma-Ray Observatory (CGRO). These activities were part of a senior level honors course at Pinkerton. Although the success of this particular program was rather limited, we feel that the general concept is a sound one. In principle, the concept of partnerships between local schools and university researchers is one that could be especially attractive to soft money researchers. Programs can be carefully designed to benefit both the students and the research program.

  19. 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.

  20. Conducting qualitative research in mental health: Thematic and content analyses.

    Science.gov (United States)

    Crowe, Marie; Inder, Maree; Porter, Richard

    2015-07-01

    The objective of this paper is to describe two methods of qualitative analysis - thematic analysis and content analysis - and to examine their use in a mental health context. A description of the processes of thematic analysis and content analysis is provided. These processes are then illustrated by conducting two analyses of the same qualitative data. Transcripts of qualitative interviews are analysed using each method to illustrate these processes. The illustration of the processes highlights the different outcomes from the same set of data. Thematic and content analyses are qualitative methods that serve different research purposes. Thematic analysis provides an interpretation of participants' meanings, while content analysis is a direct representation of participants' responses. These methods provide two ways of understanding meanings and experiences and provide important knowledge in a mental health context. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  1. 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.)

  2. 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

  3. 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

  4. Optimizing lay counsellor services for chronic care in South Africa: a qualitative systematic review.

    Science.gov (United States)

    Petersen, Inge; Fairall, Lara; Egbe, Catherine O; Bhana, Arvin

    2014-05-01

    To conduct a qualitative systematic review on the use of lay counsellors in South Africa to provide lessons on optimizing their use for psychological and behavioural change counselling for chronic long-term care in scare-resource contexts. A qualitative systematic review of the literature on lay counsellor services in South Africa. Twenty-nine studies met the inclusion criteria. Five randomized control trials and two cohort studies reported that lay counsellors can provide behaviour change counselling with good outcomes. One multi-centre cohort study provided promising evidence of improved anti-retroviral treatment adherence and one non-randomized controlled study provided promising results for counselling for depression. Six studies found low fidelity of lay counsellor-delivered interventions in routine care. Reasons for low fidelity include poor role definition, inconsistent remuneration, lack of standardized training, and poor supervision and logistical support. Within resource-constrained settings, adjunct behaviour change and psychological services provided by lay counsellors can be harnessed to promote chronic care at primary health care level. Optimizing lay counsellor services requires interventions at an organizational level that provide a clear role definition and scope of practice; in-service training and formal supervision; and sensitization of health managers to the importance and logistical requirements of counselling. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  5. Qualitative Research on Emergency Medicine Physicians

    DEFF Research Database (Denmark)

    Paltved, Charlotte; Musaeus, Peter

    2012-01-01

    Aim: This study aims to systematically review the qualitative research studying Emergency Medicine (EM) physicians in Emergency Departments (ED). Background: Qualitative research aims to study complex social phenomena. EM is a highly complex medical and social environment that can be investigated...... with qualitative research. Methods: Electronic databases of English peer-reviewed articles were searched from 1971 to 2012 using Medline through PubMed and PsychINFO. This search was supplemented with hand-searches of Academic Emergency Medicine and Emergency Medicine Journal from 1999 to 2012 and cross references...... and training, communication, professional roles, and organizational factors, and into 12 sub-themes. Conclusion: The strength of qualitative research is its ability to grasp and operationalize complex relations within EM. Although qualitative research methodologies have gained in rigour in recent years and few...

  6. Review: Lyn Richards (2005. Handling Qualitative Data: A Practical Guide

    Directory of Open Access Journals (Sweden)

    Robert L. Miller

    2006-03-01

    Full Text Available Handling Qualitative Data: A Practical Guide is an introductory textbook covering all stages of qualitative research from the initial conceptualisation of a project, through data collection and analysis, to writing up. The author, Lyn RICHARDS, is a well-known developer of two key qualitative software analysis packages, NUD*IST and NVivo. While RICHARDS clearly advocates the use of qualitative analysis software, the text is "generic" and could be used in tandem with any qualitative software package. The book concentrates on practical advice about the use of software to manage and analyse qualitative data, and provides insights in these areas. The consideration of issues around team-based qualitative research is another strong point. However, due in part to its short length, the overall coverage of topics tends to be superficial. In itself, the book does not provide sufficient detailed support for a student who would like to use it as her/his main source of guidance for carrying out a qualitative research project. URN: urn:nbn:de:0114-fqs0602244

  7. Assessment of studies and researches on warehousing - High-level and intermediate-level-long-lived radioactive wastes - December 2012

    International Nuclear Information System (INIS)

    2013-01-01

    This large report first presents the approach adopted for the study and research on the warehousing of high-level and intermediate-level-long-lived radioactive wastes. It outlines how reversible storage and warehousing are complementary, discusses the lessons learned from researches performed by the CEA on long duration warehousing, presents the framework of studies and researches performed since 2006, and presents the scientific and technical content of studies and researches (warehousing need analysis, search for technical options providing complementarity with storage, extension or creation of warehousing installations). The second part addresses high-level and intermediate-level-long-lived radioactive waste parcels, indicates their origins and quantities. The third part proposes an analysis of warehousing capacities: existing capacities, French industrial experience in waste parcel warehousing, foreign experience in waste warehousing. The fourth part addresses reversible storage in deep geological formation: storage safety functions, storage reversibility, storage parcels, storage architecture, chronicle draft. The fifth part proposes an inventory of warehousing needs in terms of additional capacities for the both types of wastes (high-level, and intermediate-level-long-lived), and discusses warehousing functionalities and safety objectives. The sixth and seventh parts propose a detailed overview of design options for warehousing installations, respectively for high-level and for intermediate-level-long-lived waste parcels: main technical issues, feasibility studies of different concepts or architecture shapes, results of previous studies and introduction to studies performed since 2011, possible evolutions of the HA1, HA2 and MAVL concepts. The eighth chapter reports a phenomenological analysis of warehousing and the optimisation of material selection and construction arrangements. The last part discusses the application of researches to the extension of the

  8. RWebData: A High-Level Interface to the Programmable Web

    Directory of Open Access Journals (Sweden)

    Ulrich Matter

    2018-02-01

    Full Text Available The rise of the programmable web offers new opportunities for the empirically driven sciences. The access to, compilation and preparation of data from the programmable web for statistical analysis can, however, involve substantial up-front costs for the practical researcher. The 'R'-package RWebData provides a high-level framework that allows data to be easily collected from the programmable web in a format that can be used directly for statistical analysis in 'R' without bothering about the data’s initial format and nesting structure. It was developed specifically for users who have no experience with web technologies and merely use 'R' as statistics software. This paper provides an overview of the high-level functions, explains the basic architecture of the package, illustrates the implemented data mapping algorithm, and discusses RWebData’s further development and reuse potential.   Funding statement: The author acknowledges financial support from the University of Basel Research Fund as well as support from the Swiss National Science Foundation (grant 168848.

  9. Understanding Qualitative Research: A School Nurse Perspective

    Science.gov (United States)

    Broussard, Lisa

    2006-01-01

    More school nurses are engaging in the generation of research, and their studies increasingly are using qualitative methods to describe various areas of practice. This article provides an overview of 4 major qualitative methods: ethnography, phenomenology, grounded theory, and historical research. Examples of school nursing research studies that…

  10. Directions in low-level radioactive-waste management. Incentives and compensation: providing resources for communities hosting low-level waste facilities

    International Nuclear Information System (INIS)

    1982-10-01

    State responsibility for the management of low-level radioactive waste necessitates the selection of candidate locations for a disposal facility. Concern over potential impacts can be expected from segments of the citizenry neighboring a proposed site. A number of national organizations comprising state and local officials have recommended the use of incentives and compensation to help offset the negative local impacts. This document explores that concept. Discussion provides background information on potential local impacts from a low-level waste facility and considers the nature and types of incentives and compensation benefits that could be provided. The document then examines realistic options for planning and implementing the benefit program. This information is intended, primarily, to assist state officials - executive, legislative, and agency - in planning for and managing low-level waste disposal facilities

  11. 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

  12. Tank waste remediation system high-level waste vitrification system development and testing requirements

    International Nuclear Information System (INIS)

    Calmus, R.B.

    1995-01-01

    This document provides the fiscal year (FY) 1995 recommended high-level waste melter system development and testing (D and T) requirements. The first phase of melter system testing (FY 1995) will focus on the feasibility of high-temperature operation of recommended high-level waste melter systems. These test requirements will be used to establish the basis for defining detailed testing work scope, cost, and schedules. This document includes a brief summary of the recommended technologies and technical issues associated with each technology. In addition, this document presents the key D and T activities and engineering evaluations to be performed for a particular technology or general melter system support feature. The strategy for testing in Phase 1 (FY 1995) is to pursue testing of the recommended high-temperature technologies, namely the high-temperature, ceramic-lined, joule-heated melter, referred to as the HTCM, and the high-frequency, cold-wall, induction-heated melter, referred to as the cold-crucible melter (CCM). This document provides a detailed description of the FY 1995 D and T needs and requirements relative to each of the high-temperature technologies

  13. Do cervical epidural injections provide long-term relief in neck and upper extremity pain? A systematic review.

    Science.gov (United States)

    Manchikanti, Laxmaiah; Nampiaparampil, Devi E; Candido, Kenneth D; Bakshi, Sanjay; Grider, Jay S; Falco, Frank J E; Sehgal, Nalini; Hirsch, Joshua A

    2015-01-01

    The high prevalence of chronic persistent neck pain not only leads to disability but also has a significant economic, societal, and health impact. Among multiple modalities of treatments prescribed in the management of neck and upper extremity pain, surgical, interventional and conservative modalities have been described. Cervical epidural injections are also common modalities of treatments provided in managing neck and upper extremity pain. They are administered by either an interlaminar approach or transforaminal approach. To determine the long-term efficacy of cervical interlaminar and transforaminal epidural injections in the treatment of cervical disc herniation, spinal stenosis, discogenic pain without facet joint pain, and post surgery syndrome. The literature search was performed from 1966 to October 2014 utilizing data from PubMed, Cochrane Library, US National Guideline Clearinghouse, previous systematic reviews, and cross-references. The evidence was assessed based on best evidence synthesis with Level I to Level V. There were 7 manuscripts meeting inclusion criteria. Of these, 4 assessed the role of interlaminar epidural injections for managing disc herniation or radiculitis, and 3 assessed these injections for managing central spinal stenosis, discogenic pain without facet joint pain, and post surgery syndrome. There were 4 high quality manuscripts. A qualitative synthesis of evidence showed there is Level II evidence for each etiology category. The evidence is based on one relevant, high quality trial supporting the efficacy of cervical interlaminar epidural injections for each particular etiology. There were no randomized trials available assessing the efficacy of cervical transforaminal epidural injections. Paucity of available literature, specifically conditions other than disc herniation. This systematic review with qualitative best evidence synthesis shows Level II evidence for the efficacy of cervical interlaminar epidural injections with local

  14. Using Discursis to enhance the qualitative analysis of hospital pharmacist-patient interactions.

    Directory of Open Access Journals (Sweden)

    Bernadette A M Chevalier

    Full Text Available Pharmacist-patient communication during medication counselling has been successfully investigated using Communication Accommodation Theory (CAT. Communication researchers in other healthcare professions have utilised Discursis software as an adjunct to their manual qualitative analysis processes. Discursis provides a visual, chronological representation of communication exchanges and identifies patterns of interactant engagement.The aim of this study was to describe how Discursis software was used to enhance previously conducted qualitative analysis of pharmacist-patient interactions (by visualising pharmacist-patient speech patterns, episodes of engagement, and identifying CAT strategies employed by pharmacists within these episodes.Visual plots from 48 transcribed audio recordings of pharmacist-patient exchanges were generated by Discursis. Representative plots were selected to show moderate-high and low- level speaker engagement. Details of engagement were investigated for pharmacist application of CAT strategies (approximation, interpretability, discourse management, emotional expression, and interpersonal control.Discursis plots allowed for identification of distinct patterns occurring within pharmacist-patient exchanges. Moderate-high pharmacist-patient engagement was characterised by multiple off-diagonal squares while alternating single coloured squares depicted low engagement. Engagement episodes were associated with multiple CAT strategies such as discourse management (open-ended questions. Patterns reflecting pharmacist or patient speaker dominance were dependant on clinical setting.Discursis analysis of pharmacist-patient interactions, a novel application of the technology in health communication, was found to be an effective visualisation tool to pin-point episodes for CAT analysis. Discursis has numerous practical and theoretical applications for future health communication research and training. Researchers can use the software to

  15. Using Discursis to enhance the qualitative analysis of hospital pharmacist-patient interactions.

    Science.gov (United States)

    Chevalier, Bernadette A M; Watson, Bernadette M; Barras, Michael A; Cottrell, William N; Angus, Daniel J

    2018-01-01

    Pharmacist-patient communication during medication counselling has been successfully investigated using Communication Accommodation Theory (CAT). Communication researchers in other healthcare professions have utilised Discursis software as an adjunct to their manual qualitative analysis processes. Discursis provides a visual, chronological representation of communication exchanges and identifies patterns of interactant engagement. The aim of this study was to describe how Discursis software was used to enhance previously conducted qualitative analysis of pharmacist-patient interactions (by visualising pharmacist-patient speech patterns, episodes of engagement, and identifying CAT strategies employed by pharmacists within these episodes). Visual plots from 48 transcribed audio recordings of pharmacist-patient exchanges were generated by Discursis. Representative plots were selected to show moderate-high and low- level speaker engagement. Details of engagement were investigated for pharmacist application of CAT strategies (approximation, interpretability, discourse management, emotional expression, and interpersonal control). Discursis plots allowed for identification of distinct patterns occurring within pharmacist-patient exchanges. Moderate-high pharmacist-patient engagement was characterised by multiple off-diagonal squares while alternating single coloured squares depicted low engagement. Engagement episodes were associated with multiple CAT strategies such as discourse management (open-ended questions). Patterns reflecting pharmacist or patient speaker dominance were dependant on clinical setting. Discursis analysis of pharmacist-patient interactions, a novel application of the technology in health communication, was found to be an effective visualisation tool to pin-point episodes for CAT analysis. Discursis has numerous practical and theoretical applications for future health communication research and training. Researchers can use the software to support

  16. An examination of endoparasites and fecal testosterone levels in flying squirrels (Glaucomys spp.) using high performance liquid chromatography-ultra-violet (HPLC-UV).

    Science.gov (United States)

    Waksmonski, Sarah N; Huffman, Justin M; Mahan, Carolyn G; Steele, Michael A

    2017-08-01

    The immuno-competence hypothesis proposes that higher levels of testosterone increases the susceptibility to parasitism. Here we examined the testosterone levels in two species of flying squirrels ( Glaucomys ): one known to regularly host a nematode species ( Strongyloides robustus ) without ill effects ( G. volans ) and a closely related species that is considered negatively affected by the parasite. We quantified fecal testosterone levels in northern and southern flying squirrels ( G. sabrinus, G. volans ) with high-performance liquid chromatography-ultraviolet spectroscopy (HPLC-UV), and compared levels to endoparasites detected in individual squirrels. Qualitatively, we found highest levels of testosterone in male northern flying squirrels infected with Strongyloides robustus . This analytical approach represents an alternative and equally reliable method to using enzyme-linked immunosorbent assay (ELISA), for detecting and quantifying fecal testosterone levels.

  17. An examination of endoparasites and fecal testosterone levels in flying squirrels (Glaucomys spp. using high performance liquid chromatography-ultra-violet (HPLC-UV

    Directory of Open Access Journals (Sweden)

    Sarah N. Waksmonski

    2017-08-01

    Full Text Available The immuno-competence hypothesis proposes that higher levels of testosterone increases the susceptibility to parasitism. Here we examined the testosterone levels in two species of flying squirrels (Glaucomys: one known to regularly host a nematode species (Strongyloides robustus without ill effects (G. volans and a closely related species that is considered negatively affected by the parasite. We quantified fecal testosterone levels in northern and southern flying squirrels (G. sabrinus, G. volans with high-performance liquid chromatography-ultraviolet spectroscopy (HPLC-UV, and compared levels to endoparasites detected in individual squirrels. Qualitatively, we found highest levels of testosterone in male northern flying squirrels infected with Strongyloides robustus. This analytical approach represents an alternative and equally reliable method to using enzyme-linked immunosorbent assay (ELISA, for detecting and quantifying fecal testosterone levels.

  18. 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

  19. Transitioning HIV-infected adolescents to adult care at 14 clinics across the United States: using adolescent and adult providers' insights to create multi-level solutions to address transition barriers.

    Science.gov (United States)

    Philbin, Morgan M; Tanner, Amanda E; Chambers, Brittany D; Ma, Alice; Ware, Samuella; Lee, Sonia; Fortenberry, J Dennis; The Adolescent Trials Network

    2017-10-01

    HIV-infected adolescents have disproportionately low rates of care retention and viral suppression. Approximately half disengage from care while transitioning to adult clinics, in part due to fragmented care systems and lack of streamlined protocols. We conducted 58 qualitative interviews with social service and health care providers across 14 Adolescent Trials Network clinics (n = 28) and 20 adult clinics that receive transitioning adolescents (n = 30) from August 2015-June 2016. We used the constant comparative approach to examine processes, barriers, and facilitators of adult care transition. Transition barriers coalesced around three levels. Structural: insurance eligibility, transportation, and HIV-related stigma; Clinical: inter-clinic communication, differences in care cultures, and resource/personnel limitations; and Individual: adolescents' transition readiness and developmental capacity. Staff-initiated solutions (e.g., grant-funded transportation) were often unsustainable and applied individual-level solutions to structural-level barriers. Comprehensive initiatives, which develop collaborative policies and protocols that support providers' ability to match the solution and barrier level (i.e., structural-to-structural), are sorely needed. These initiatives should also support local systematic planning to facilitate inter-clinic structures and communication. Such approaches will help HIV-infected adolescents transition to adult care and improve long-term health outcomes.

  20. Variations in levels of care within a hospital provided to acute ...

    African Journals Online (AJOL)

    Variations in levels of care within a hospital provided to acute trauma patients. ... A scoring system was devised to classify the quality of the observations that each patient received in the different ... Observations in the intensive care unit (ICU) and operating theatre were uniformly excellent. In the ... HOW TO USE AJOL.

  1. 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.

  2. A High-Voltage Level Tolerant Transistor Circuit

    NARCIS (Netherlands)

    Annema, Anne J.; Geelen, Godefridus Johannes Gertrudis Maria

    2001-01-01

    A high-voltage level tolerant transistor circuit, comprising a plurality of cascoded transistors, including a first transistor (T1) operatively connected to a high-voltage level node (3) and a second transistor (T2) operatively connected to a low-voltage level node (2). The first transistor (T1)

  3. High-level intuitive features (HLIFs) for intuitive skin lesion description.

    Science.gov (United States)

    Amelard, Robert; Glaister, Jeffrey; Wong, Alexander; Clausi, David A

    2015-03-01

    A set of high-level intuitive features (HLIFs) is proposed to quantitatively describe melanoma in standard camera images. Melanoma is the deadliest form of skin cancer. With rising incidence rates and subjectivity in current clinical detection methods, there is a need for melanoma decision support systems. Feature extraction is a critical step in melanoma decision support systems. Existing feature sets for analyzing standard camera images are comprised of low-level features, which exist in high-dimensional feature spaces and limit the system's ability to convey intuitive diagnostic rationale. The proposed HLIFs were designed to model the ABCD criteria commonly used by dermatologists such that each HLIF represents a human-observable characteristic. As such, intuitive diagnostic rationale can be conveyed to the user. Experimental results show that concatenating the proposed HLIFs with a full low-level feature set increased classification accuracy, and that HLIFs were able to separate the data better than low-level features with statistical significance. An example of a graphical interface for providing intuitive rationale is given.

  4. Qualitative Robustness in Estimation

    Directory of Open Access Journals (Sweden)

    Mohammed Nasser

    2012-07-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Times New Roman","serif";} Qualitative robustness, influence function, and breakdown point are three main concepts to judge an estimator from the viewpoint of robust estimation. It is important as well as interesting to study relation among them. This article attempts to present the concept of qualitative robustness as forwarded by first proponents and its later development. It illustrates intricacies of qualitative robustness and its relation with consistency, and also tries to remove commonly believed misunderstandings about relation between influence function and qualitative robustness citing some examples from literature and providing a new counter-example. At the end it places a useful finite and a simulated version of   qualitative robustness index (QRI. In order to assess the performance of the proposed measures, we have compared fifteen estimators of correlation coefficient using simulated as well as real data sets.

  5. Advancing the Science of Qualitative Research to Promote Health Equity.

    Science.gov (United States)

    Griffith, Derek M; Shelton, Rachel C; Kegler, Michelle

    2017-10-01

    Qualitative methods have long been a part of health education research, but how qualitative approaches advance health equity has not been well described. Qualitative research is an increasingly important methodologic tool to use in efforts to understand, inform, and advance health equity. Qualitative research provides critical insight into the subjective meaning and context of health that can be essential for understanding where and how to intervene to inform health equity research and practice. We describe the larger context for this special theme issue of Health Education & Behavior, provide brief overviews of the 15 articles that comprise the issue, and discuss the promise of qualitative research that seeks to contextualize and illuminate answers to research questions in efforts to promote health equity. We highlight the critical role that qualitative research can play in considering and incorporating a diverse array of contextual information that is difficult to capture in quantitative research.

  6. Bracketing as a skill in conducting unstructured qualitative interviews.

    Science.gov (United States)

    Sorsa, Minna Anneli; Kiikkala, Irma; Åstedt-Kurki, Päivi

    2015-03-01

    To provide an overview of bracketing as a skill in unstructured qualitative research interviews. Researchers affect the qualitative research process. Bracketing in descriptive phenomenology entails researchers setting aside their pre-understanding and acting non-judgementally. In interpretative phenomenology, previous knowledge is used intentionally to create new understanding. A literature search of bracketing in phenomenology and qualitative research. This is a methodology paper examining the researchers' impact in creating data in creating data in qualitative research. Self-knowledge, sensitivity and reflexivity of the researcher enable bracketing. Skilled and experienced researchers are needed to use bracketing in unstructured qualitative research interviews. Bracketing adds scientific rigour and validity to any qualitative study.

  7. 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

  8. High throughput octal alpha/gamma spectrometer for low level bioassay estimations

    International Nuclear Information System (INIS)

    Bhasin, B.D.; Shirke, S.H.; Suri, M.M.; Vaidya, P.P.; Ghodgaonkar, M.D.

    1995-01-01

    The present paper describes the development of a high throughput octal alpha spectrometry system specially developed for the estimation of low levels of actinides in bioassay and environmental samples. The system processes simultaneously the outputs coming from eight independent detectors. It can be configured to simultaneously record low level alpha and gamma spectra. The high throughput is achieved by using a prioritised multiplexer router. The prioritised multiplexing and routing coupled with fast 8K ADC (conversion time 20 μsec) allow simultaneous acquisition of multiple spectra without any significant loss in counts. The dual (8K, 24bit) port memory facilitates easy online viewing of spectrum buildup. A menu driven user friendly software makes the operating system convenient to use. A specially developed software provides built-in routines for processing the spectra and estimating the isotopic activity. The interactive mode of software provides easy identification of isotopes compatible with the separation chemistry of different actinides. (author). 6 refs., 2 figs

  9. 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.

  10. Handbook of Qualitative Research in Communication Disorders

    Science.gov (United States)

    Ball, Martin J., Ed.; Müller, Nicole, Ed.; Nelson, Ryan L., Ed.

    2013-01-01

    This volume provides a comprehensive and in-depth handbook of qualitative research in the field of communication disorders. It introduces and illustrates the wide range of qualitative paradigms that have been used in recent years to investigate various aspects of communication disorders. The first part of the Handbook introduces in some detail the…

  11. 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

  12. "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.

  13. Qualitative versus quantitative methods in psychiatric research.

    Science.gov (United States)

    Razafsha, Mahdi; Behforuzi, Hura; Azari, Hassan; Zhang, Zhiqun; Wang, Kevin K; Kobeissy, Firas H; Gold, Mark S

    2012-01-01

    Qualitative studies are gaining their credibility after a period of being misinterpreted as "not being quantitative." Qualitative method is a broad umbrella term for research methodologies that describe and explain individuals' experiences, behaviors, interactions, and social contexts. In-depth interview, focus groups, and participant observation are among the qualitative methods of inquiry commonly used in psychiatry. Researchers measure the frequency of occurring events using quantitative methods; however, qualitative methods provide a broader understanding and a more thorough reasoning behind the event. Hence, it is considered to be of special importance in psychiatry. Besides hypothesis generation in earlier phases of the research, qualitative methods can be employed in questionnaire design, diagnostic criteria establishment, feasibility studies, as well as studies of attitude and beliefs. Animal models are another area that qualitative methods can be employed, especially when naturalistic observation of animal behavior is important. However, since qualitative results can be researcher's own view, they need to be statistically confirmed, quantitative methods. The tendency to combine both qualitative and quantitative methods as complementary methods has emerged over recent years. By applying both methods of research, scientists can take advantage of interpretative characteristics of qualitative methods as well as experimental dimensions of quantitative methods.

  14. Justification for Selecting Level A vs. Level B Personal Protective Equipment to Remediate a Room Containing Concentrated Acids, Bases and Radiological Constituents

    International Nuclear Information System (INIS)

    Hylko, J. M.; Thompson, A. L.; Walter, J. F.; Deecke, T. A.

    2002-01-01

    Selecting the appropriate personal protective equipment (PPE) is based on providing an adequate level of employee protection relative to the task-specific conditions and hazards. PPE is categorized into four ensembles, based on the degree of protection afforded; e.g., Levels A (most restrictive), B, C, and D (least restrictive). What is often overlooked in preparing an ensemble is that the PPE itself can create significant worker hazards; i.e., the greater the level of PPE, the greater the associated risks. Furthermore, there is confusion as to whether a more ''conservative approach'' should always be taken since Level B provides the same level of respiratory protection as Level A but less skin protection. This paper summarizes the Occupational Safety and Health Administration regulations addressing Level A versus Level B, and provides justification for selecting Level B over Level A without under-protecting the employee during a particular remediation scenario. The scenario consisted of an entry team performing (1) an initial entry into a room containing concentrated acids (e.g., hydrofluoric acid), bases, and radiological constituents; (2) sampling and characterizing container contents; and (3) retrieving characterized containers. The invasive nature of the hydrofluoric acid sampling and characterization scenario created a high potential for splash, immersion, and exposure to hazardous vapors, requiring additional skin protection. The hazards associated with this scenario and the chemical nature of hydrofluoric acid provided qualitative evidence to justify Level A. Once the hydrofluoric acid was removed from the room, PPE performance was evaluated against the remaining chemical inventory. If chemical breakthrough from direct contact was not expected to occur and instrument readings confirmed the absence of any hazardous vapors, additional skin protection afforded by wearing a vapor-tight, totally-encapsulated suit was not required. Therefore, PPE performance and

  15. Extension Trial of Qigong for Fibromyalgia: A Quantitative and Qualitative Study

    Directory of Open Access Journals (Sweden)

    Jana Sawynok

    2013-01-01

    Full Text Available This extension trial is an open-label observational trial of 20 subjects with fibromyalgia who undertook level 2 Chaoyi Fanhuan Qigong (CFQ training following an earlier controlled trial of level 1 CFQ. Subjects practiced 60 min/day for 8 weeks and continued some daily practice for 6 months. Quantitative measures, assessed at baseline, 8 weeks, 4 and 6 months, were of pain, impact, sleep, physical and mental functions, and practice time. Qualitative comments also were recorded. Compared to baselines, CFQ practice led to significant improvements in pain, impact, sleep, and physical function in the 13 subjects (65% who completed the trial; changes were present at 8 weeks and were maintained for the 6-month trial duration. A highly motivated subgroup of N=5, who practiced the most, had the best outcomes in terms of end symptomology, and qualitative comments indicated health benefits in other domains as well. Qualitative comments by the remaining N=8 trial completers and N=7 withdrawals indicate different experiences with the practice. This extension trial indicates that diligent CFQ practice over time produces significant health gains in fibromyalgia in a subset of individuals. Future studies will need to address factors that might predispose to favourable outcomes.

  16. Scenario development, qualitative causal analysis and system dynamics

    Directory of Open Access Journals (Sweden)

    Michael H. Ruge

    2009-02-01

    Full Text Available The aim of this article is to demonstrate that technology assessments can be supported by methods such as scenario modeling and qualitative causal analysis. At Siemens, these techniques are used to develop preliminary purely qualitative models. These or parts of these comprehensive models may be extended to system dynamics models. While it is currently not possible to automatically generate a system dynamics models (or vice versa, obtain a qualitative simulation model from a system dynamics model, the two thechniques scenario development and qualitative causal analysis provide valuable indications on how to proceed towards a system dynamics model. For the qualitative analysis phase, the Siemens – proprietary prototype Computer – Aided Technology Assessment Software (CATS supportes complete cycle and submodel analysis. Keywords: Health care, telecommucations, qualitative model, sensitivity analysis, system dynamics.

  17. 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

  18. TF.Learn: TensorFlow's High-level Module for Distributed Machine Learning

    OpenAIRE

    Tang, Yuan

    2016-01-01

    TF.Learn is a high-level Python module for distributed machine learning inside TensorFlow. It provides an easy-to-use Scikit-learn style interface to simplify the process of creating, configuring, training, evaluating, and experimenting a machine learning model. TF.Learn integrates a wide range of state-of-art machine learning algorithms built on top of TensorFlow's low level APIs for small to large-scale supervised and unsupervised problems. This module focuses on bringing machine learning t...

  19. Telemanagement of hypertension: A qualitative assessment of patient and physician preferences

    Science.gov (United States)

    Halifax, Nancy VD; Cafazzo, Joseph A; Irvine, M Jane; Hamill, Melinda; Rizo, Carlos A; McIsaac, Warren J; Rossos, Peter G; Logan, Alexander G

    2007-01-01

    BACKGROUND: Prevalence surveys have consistently found that the blood pressure control rate among people with hypertension is less than 25%. Studies of telemedicine as a means of providing care to hypertensive patients have shown that this approach is effective in lowering blood pressure. Major design flaws and high operating costs, however, have hindered its adoption by physicians and patients. OBJECTIVES: In the present commentary, the field of telemedicine, as it pertains to hypertension management, is reviewed, and the investigators’ experiences in developing a new telemedicine system are outlined. METHODS: An applied qualitative case study approach was used to determine the information needs for the design of a telemedicine system. Opinions were elicited separately from type 2 diabetic patients with hypertension (n=24) and family practitioners in active clinical practice (n=18). RESULTS: Physician and patient focus group meetings provided key information that led to changes in the prototype system. The low level of computer and Internet use by patients in everyday life and by physicians in practice-related activities precluded their inclusion in the design of the system for information retrieval and receiving clinical alerts. For patients, the mobile phone appeared to be an acceptable alternative. The only practical, automated means to disseminate reports and alerts to physicians was by fax, which was the most universally available device in a doctor’s office. CONCLUSION: This tightly focused qualitative study led to the development of design principles for a prototype system, increasing the likelihood of user acceptance and improving its effectiveness. PMID:17534469

  20. A Qualitative Study of the Relationship between a Banking IT Troubled Project and the Executive Project Sponsor's Project Management Maturity Level

    Science.gov (United States)

    Northcraft, Terry G.

    2017-01-01

    This qualitative study examined the effect the level of project management maturity a banking IT project sponsor has on project success. Project management maturity is gauged by the amount of modern project management training, knowledge and organizational skills an individual or organization has and applies to their project lifecycle experiences.…

  1. Polarity-specific high-level information propagation in neural networks.

    Science.gov (United States)

    Lin, Yen-Nan; Chang, Po-Yen; Hsiao, Pao-Yueh; Lo, Chung-Chuan

    2014-01-01

    Analyzing the connectome of a nervous system provides valuable information about the functions of its subsystems. Although much has been learned about the architectures of neural networks in various organisms by applying analytical tools developed for general networks, two distinct and functionally important properties of neural networks are often overlooked. First, neural networks are endowed with polarity at the circuit level: Information enters a neural network at input neurons, propagates through interneurons, and leaves via output neurons. Second, many functions of nervous systems are implemented by signal propagation through high-level pathways involving multiple and often recurrent connections rather than by the shortest paths between nodes. In the present study, we analyzed two neural networks: the somatic nervous system of Caenorhabditis elegans (C. elegans) and the partial central complex network of Drosophila, in light of these properties. Specifically, we quantified high-level propagation in the vertical and horizontal directions: the former characterizes how signals propagate from specific input nodes to specific output nodes and the latter characterizes how a signal from a specific input node is shared by all output nodes. We found that the two neural networks are characterized by very efficient vertical and horizontal propagation. In comparison, classic small-world networks show a trade-off between vertical and horizontal propagation; increasing the rewiring probability improves the efficiency of horizontal propagation but worsens the efficiency of vertical propagation. Our result provides insights into how the complex functions of natural neural networks may arise from a design that allows them to efficiently transform and combine input signals.

  2. 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.)

  3. Teaching Qualitative Research: Using Theory to Inform Practice

    Science.gov (United States)

    Sallee, Margaret W.

    2010-01-01

    This article considers how theories of instructional scaffolding--which call for a skilled expert to teach a novice a new task by breaking it into smaller pieces--might be employed in graduate-level qualitative methods courses. The author discusses how she used instructional scaffolding in the design and delivery of a qualitative methods course…

  4. 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

  5. Qualitative methods in pharmacy practice research

    DEFF Research Database (Denmark)

    Kaae, Susanne; Traulsen, Janine Marie

    2015-01-01

    Qualitative research within pharmacy practice is concerned with understanding the behavior of actors such as pharmacy staff, pharmacy owners, patients, other healthcare professionals, and politicians to explore various types of existing practices and beliefs in order to improve them. As qualitative...... research attempts to answer the “why” questions, it is useful for describing, in rich detail, complex phenomena that are situated and embedded in local contexts. Typical methods include interviews, observation, document analysis, and netnography. Qualitative research has to live up to a set of rigid...... quality criteria of research conduct to provide trustworthy results that contribute to the further development of the area....

  6. Soldier Readiness: Insights from Qualitative Interviews

    Science.gov (United States)

    2018-01-10

    domains interact and influence performance. From January to May 2016, the research team conducted three qualitative studies with Soldiers including... Research Questions UNCLASSIFIED 9 • From January to May 2016, the research team conducted a series of qualitative studies with Soldiers from the 82nd...that the Army’s current approach for providing these types of training is not always ideal. Specifically, the train-the-trainer method or use of

  7. What “Price” Means When Buying Food: Insights From a Multisite Qualitative Study With Black Americans

    Science.gov (United States)

    DiSantis, Katherine Isselmann; Grier, Sonya A.; Odoms-Young, Angela; Baskin, Monica L.; Carter-Edwards, Lori; Young, Deborah Rohm; Lassiter, Vikki

    2013-01-01

    Objectives. We explored the role of price in the food purchasing patterns of Black adults and youths. Methods. We analyzed qualitative data from interviews and focus groups with socioeconomically diverse, primarily female, Black adults or parents (n = 75) and youths (n = 42) in 4 US cities. Interview protocols were locality specific, but all were designed to elicit broad discussion of food marketing variables. We performed a conventional qualitative content analysis by coding and analyzing data from each site to identify common salient themes. Results. Price emerged as a primary influence on food purchases across all sites. Other value considerations (e.g., convenience, food quality, healthfulness of product, and family preferences) were discussed, providing a more complex picture of how participants considered the price of a product. Conclusions. Food pricing strategies that encourage consumption of healthful foods may have high relevance for Black persons across income or education levels. Accounting for how price intersects with other value considerations may improve the effectiveness of these strategies. PMID:23327261

  8. High levels of Porphyromonas gingivalis-induced immunoglobulin G2 are associated with lower high-density lipoprotein levels in chronic periodontitis.

    Science.gov (United States)

    Ardila, Carlos M; Guzmán, Isabel C

    2016-11-01

    To investigate the association between the presence of Porphyromonas gingivalis-induced immunoglobulin G antibodies and the high-density lipoprotein (HDL) level. A total of 108 individuals were examined. The presence of P. gingivalis was detected using primers designed to target the 16S rRNA gene sequence. Peripheral blood was collected from each subject to determine the levels of P. gingivalis-induced IgG1 and IgG2 serum antibodies. The HDL levels were determined using fully enzymatic methods. A higher proportion of periodontitis patients had high levels of P. gingivalis-induced IgG1 and IgG2, and the proportion of subjects with a HDL level of chronic periodontitis patients. In the unadjusted regression model, the presence of high levels of P. gingivalis-induced IgG2 was associated with a HDL level of periodontitis patients with high levels of P. gingivalis-induced IgG2 showed 3.2 more chances of having pathological HDL levels (odds ratio = 3.2, 95% confidence interval = 1.2-9.8). High levels of P. gingivalis-induced IgG2 were associated with low HDL concentrations in patients with periodontitis, which suggests that the response of the host to periodontal infection may play an important role in the pathogenesis of cardiovascular diseases. © 2015 Wiley Publishing Asia Pty Ltd.

  9. 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.

  10. 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.

  11. High-level seismic tests of piping at the HDR [Heissdampfreaktor

    International Nuclear Information System (INIS)

    Kot, C.A.; Srinivasan, M.G.; Hsieh, B.J.; Costello, J.F.

    1989-01-01

    As part of the second-phase testing at the Heissdampfreaktor (HDR) Test Facility in Kahl/Main, Federal Republic of Germany (FRG), high-level seismic experiments, designated SHAM, were performed on an in-plant piping system during the period of 19 April to 27 May 1988. The objectives of the SHAM experiments were to (1) study the response of piping subjected to seismic excitation levels that exceed design levels manifold and which may result in failure/plastification of pipe supports and pipe elements; (2) provide data for the validation of linear and nonlinear pipe response analyses; (3) compare and evaluate, under identical loading conditions, the performance of various dynamic support system, ranging from very flexible to very stiff support configurations; (4) establish seismic margins for piping, dynamic pipe supports, and pipe anchorages; and (5) investigate the response, operability, and fragility of dynamic supports and of a typical US gate valve under extreme levels of seismic excitation. A brief description of the SHAM tests is provided, followed by highlights of the test results that are given primarily in the form of maximum response values. Also presented are very limited comparisons of experimental data and pretest analytical predictions. 6 refs., 8 figs

  12. 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)

  13. 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

  14. Southern routes for high-level radioactive waste: Agencies, contacts, and designations

    International Nuclear Information System (INIS)

    1991-05-01

    The Southern Routes for High-Level Radioactive Waste: Agencies, Contacts and Designations is a compendium of sixteen southern states' routing programs for the transportation of high-level radioactive materials. The report identifies the state-designated routing agencies as defined under 49 Code of Federal Regulations (CFR) Part 171 and provides a reference to the source and scope of the agencies' rulemaking authority. Additionally, the state agency and contact designated by the state's governor to receive advance notification and shipment routing information under 10 CFR Parts 71 and 73 are also listed. This report also examines alternative route designations made by southern states and the lessons that were learned from the designation process

  15. Qualitative description - the poor cousin of health research?

    DEFF Research Database (Denmark)

    Neergaard, Mette Asbjørn; Olesen, Frede; Andersen, Rikke Sand

    2009-01-01

    ', relatives' or professionals' experiences with a particular topic. Another great advantage of the method is that it is suitable if time or resources are limited. SUMMARY: As a consequence of the growth in qualitative research in the health sciences, researchers sometimes feel obliged to designate their work......BACKGROUND: The knowledge and use of qualitative description as a qualitative research approach in health services research is limited.The aim of this article is to discuss the potential benefits of a qualitative descriptive approach, to identify its strengths and weaknesses and to provide examples...... of use. DISCUSSION: Qualitative description is a useful qualitative method in much medical research if you keep the limitations of the approach in mind. It is especially relevant in mixed method research, in questionnaire development and in research projects aiming to gain firsthand knowledge of patients...

  16. A truck cask design for shipping defense high-level waste

    International Nuclear Information System (INIS)

    Madsen, M.M.; Zimmer, A.

    1985-01-01

    The Defense High-Level Waste (DHLW) cask is a Type B packaging currently under development by the U.S. Department of Energy (DOE). This truck cask has been designed to initially transport borosilicate glass waste from the Defense Waste Processing Facility (DWPF) to the Waste Isolation Pilot Plant (WIPP). Specific program activities include designing, testing, certifying, and fabricating a prototype legal-weight truck cask system. The design includes such state-of-the-art features as integral impact limiters and remote handling features. A replaceable shielding liner provides the flexibility for shipping a wide range of waste types and activity levels

  17. Aesthetic Forms of Data Representation in Qualitative Family Therapy Research

    Science.gov (United States)

    Piercy, Fred P.; Benson, Kristen

    2005-01-01

    In this article we provide a rationale for using alternative, aesthetic methods of qualitative representation (e.g., creative writing, art, music, performance, poetry) in qualitative family therapy research. We also provide illustrative examples of methods that bring findings to life, and involve the audience in reflecting on their meaning. One…

  18. 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.

  19. Thermal analysis of Yucca Mountain commercial high-level waste packages

    International Nuclear Information System (INIS)

    Altenhofen, M.K.; Eslinger, P.W.

    1992-10-01

    The thermal performance of commercial high-level waste packages was evaluated on a preliminary basis for the candidate Yucca Mountain repository site. The purpose of this study is to provide an estimate for waste package component temperatures as a function of isolation time in tuff. Several recommendations are made concerning the additional information and modeling needed to evaluate the thermal performance of the Yucca Mountain repository system

  20. 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

  1. 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

  2. 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.

  3. 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

  4. 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

  5. United States regulations for institutional controls at high-level waste repositories

    International Nuclear Information System (INIS)

    Piccone, Josephine

    2015-01-01

    The United States regulations for disposal of spent nuclear fuel and high-level radioactive waste are found at Title 10 of the Code of Federal Regulations (10 CFR) Parts 60 and 63, which cover deep geologic disposal at a generic site and at Yucca Mountain, Nevada, respectively. As an independent regulator, the US Nuclear Regulatory Commission (NRC) is responsible for licensing and oversight of a high-level waste repository in the United States. The licensing approach for disposal has discreet decisions, made by the NRC, that include approval of construction authorisation, approval to receive and possess high-level radioactive waste, and approval for permanent closure. For construction authorisation approval, the applicant must provide a description of the programme to be used to maintain the records. The NRC will have an active oversight role during the construction and operation period, which can be on the order of 100 years for the facility before permanent closure. The oversight activities are part of the active institutional controls, and serve as a means of conveying knowledge for that initial period, given that this will likely involve multiple generations of workers for both the implementer and the regulator. Additionally, the NRC provides requirements for the physical protection of stored spent nuclear fuel and high-level radioactive waste at 10 CFR Chap. 73.51. For permanent closure approval, the applicant must provide a detailed description of the measures to be employed-such as land use controls, construction of monuments, and preservation of records. The NRC's regulatory role in any licensing action is to apply the applicable regulations and guidance, and to review applications for proposed actions to determine if compliance with regulations has been achieved. The burden of proof is on the applicant or licensee to show that the proposed action is safe, to demonstrate that regulations are met, and to ensure continued compliance with the regulations

  6. Language barriers and qualitative nursing research: methodological considerations.

    Science.gov (United States)

    Squires, A

    2008-09-01

    This review of the literature synthesizes methodological recommendations for the use of translators and interpreters in cross-language qualitative research. Cross-language qualitative research involves the use of interpreters and translators to mediate a language barrier between researchers and participants. Qualitative nurse researchers successfully address language barriers between themselves and their participants when they systematically plan for how they will use interpreters and translators throughout the research process. Experienced qualitative researchers recognize that translators can generate qualitative data through translation processes and by participating in data analysis. Failure to address language barriers and the methodological challenges they present threatens the credibility, transferability, dependability and confirmability of cross-language qualitative nursing research. Through a synthesis of the cross-language qualitative methods literature, this article reviews the basics of language competence, translator and interpreter qualifications, and roles for each kind of qualitative research approach. Methodological and ethical considerations are also provided. By systematically addressing the methodological challenges cross-language research presents, nurse researchers can produce better evidence for nursing practice and policy making when working across different language groups. Findings from qualitative studies will also accurately represent the experiences of the participants without concern that the meaning was lost in translation.

  7. Women's motivations for choosing a high risk birth setting against medical advice in the Netherlands: a qualitative analysis

    NARCIS (Netherlands)

    Hollander, Martine; de Miranda, Esteriek; van Dillen, Jeroen; de Graaf, Irene; Vandenbussche, Frank; Holten, Lianne

    2017-01-01

    Background: Home births in high risk pregnancies and unassisted childbirth seem to be increasing in the Netherlands. Until now there were no qualitative data on women's motivations for these choices in the Dutch maternity care system where integrated midwifery care and home birth are regular options

  8. Clinical instructors' perceptions of behaviors that comprise entry-level clinical performance in physical therapist students: a qualitative study.

    Science.gov (United States)

    Jette, Diane U; Bertoni, Alicia; Coots, Renee; Johnson, Heidi; McLaughlin, Catherine; Weisbach, Cody

    2007-07-01

    The purpose of this study was to qualitatively explore clinical instructors' (CIs) perceptions of students' behaviors that comprise entry-level clinical performance, as well as how those perceptions were integrated into their decision making. The participants were 21 physical therapists who were CIs for physical therapist students. Using a grounded theory approach, we conducted interviews, asking the question, "What is it about students' performance that makes you see them as entry-level therapists?" We determined common themes among the interviews and developed a schema to explain the decision-making process. Participants identified 7 attributes that, when demonstrated to a sufficient degree, illustrated to them students' ability to practice at the entry level. Those attributes were knowledge, clinical skills, safety, clinical decision making, self-directed learning, interpersonal communication, and professional demeanor. Participants viewed these attributes in concert to form a subjective "gut feeling" that a student demonstrated entry-level performance. A final theme emerged suggesting a definition of entry-level performance as "mentored independence." Participants reported evaluating students' performance based on attributes similar to those suggested by the American Physical Therapy Association's Physical Therapist Clinical Performance Instrument and previous research. However, subjectivity also was involved in their decision about whether students were able to practice at the entry level. Participants also concluded that entry-level students need not be independent in all clinical situations.

  9. A fuzzy-logic-based approach to qualitative safety modelling for marine systems

    International Nuclear Information System (INIS)

    Sii, H.S.; Ruxton, Tom; Wang Jin

    2001-01-01

    Safety assessment based on conventional tools (e.g. probability risk assessment (PRA)) may not be well suited for dealing with systems having a high level of uncertainty, particularly in the feasibility and concept design stages of a maritime or offshore system. By contrast, a safety model using fuzzy logic approach employing fuzzy IF-THEN rules can model the qualitative aspects of human knowledge and reasoning processes without employing precise quantitative analyses. A fuzzy-logic-based approach may be more appropriately used to carry out risk analysis in the initial design stages. This provides a tool for working directly with the linguistic terms commonly used in carrying out safety assessment. This research focuses on the development and representation of linguistic variables to model risk levels subjectively. These variables are then quantified using fuzzy sets. In this paper, the development of a safety model using fuzzy logic approach for modelling various design variables for maritime and offshore safety based decision making in the concept design stage is presented. An example is used to illustrate the proposed approach

  10. 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 ...

  11. 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

  12. Partitioning of high level liquid waste: experiences in plant level adoption

    International Nuclear Information System (INIS)

    Manohar, Smitha; Kaushik, C.P.

    2016-01-01

    High Level Radioactive Wastes are presently vitrified in borosilicate matrices in all our back end facilities in our country. This is in accordance with internationally endorsed methodology for the safe management of high level radioactive wastes. Recent advancements in the field of partitioning technology in our group, has presented us with an opportunity to have a fresh perspective on management of high level liquid radioactive wastes streams, that emanate from reprocessing operations. This paper will highlight our experiences with respect to both partitioning studies and vitrification practices, with a focus on waste volume reduction for final disposal. Incorporation of this technique has led to the implementation of the concept of recovering wealth from waste, a marked decrease on the load of disposal in deep geological repositories and serve as a step towards the vision of transmutation of long lived radionuclides

  13. Future health physics prospects in high-level nuclear waste management

    International Nuclear Information System (INIS)

    Waite, D.A.; Mayberry, J.J.

    1986-01-01

    The objective of this presentation is to provide an overview of health physics activities anticipated to be required at a high-level nuclear waste repository and to project the numbers of health physics personnel expected to be required to carry out these activities. Health physics personnel receiving consideration in the projections include the health physics manager, shift supervisors, area supervisors, health physicists, and technologists. Phases of the repository addressed are construction, operation, retrieval, and decommissioning. Specific topics discussed in the process of developing the projections are: (a) the basic features of a geologic repository, (b) the staffing requirements of such a repository, (c) health physics involvement in repository operations, and (d) the anticipated schedule for operation of repositories in the United States. A quantitative assessment of future health physics prospects in high-level nuclear waste management is included

  14. Recent advances on multidimensional liquid chromatography–mass spectrometry for proteomics: From qualitative to quantitative analysis—A review

    International Nuclear Information System (INIS)

    Wu Qi; Yuan Huiming; Zhang Lihua; Zhang Yukui

    2012-01-01

    Highlights: ► We discuss progress of MDLC–MS systems in qualitative and quantitative proteomics. ► Both “Top-down” and “bottom-up” strategies are discussed in detail. ► On-line integrations of stable isotope labeling process are highlighted. ► This review gives insights into further directions for higher level integration. - Abstract: With the acceleration of proteome research, increasing attention has been paid to multidimensional liquid chromatography–mass spectrometry (MDLC–MS) due to its high peak capacity and separation efficiency. Recently, many efforts have been put to improve MDLC-based strategies including “top-down” and “bottom-up” to enable highly sensitive qualitative and quantitative analysis of proteins, as well as accelerate the whole analytical procedure. Integrated platforms with combination of sample pretreatment, multidimensional separations and identification were also developed to achieve high throughput and sensitive detection of proteomes, facilitating highly accurate and reproducible quantification. This review summarized the recent advances of such techniques and their applications in qualitative and quantitative analysis of proteomes.

  15. Special Analysis for Disposal of High-Concentration I-129 Waste in the Intermediate-Level Vaults at the E-Area Low-Level Waste Facility

    Energy Technology Data Exchange (ETDEWEB)

    Collard, L.B.

    2000-09-26

    This revision was prepared to address comments from DOE-SR that arose following publication of revision 0. This Special Analysis (SA) addresses disposal of wastes with high concentrations of I-129 in the Intermediate-Level (IL) Vaults at the operating, low-level radioactive waste disposal facility (the E-Area Low-Level Waste Facility or LLWF) on the Savannah River Site (SRS). This SA provides limits for disposal in the IL Vaults of high-concentration I-129 wastes, including activated carbon beds from the Effluent Treatment Facility (ETF), based on their measured, waste-specific Kds.

  16. Special Analysis for Disposal of High-Concentration I-129 Waste in the Intermediate-Level Vaults at the E-Area Low-Level Waste Facility

    International Nuclear Information System (INIS)

    Collard, L.B.

    2000-01-01

    This revision was prepared to address comments from DOE-SR that arose following publication of revision 0. This Special Analysis (SA) addresses disposal of wastes with high concentrations of I-129 in the Intermediate-Level (IL) Vaults at the operating, low-level radioactive waste disposal facility (the E-Area Low-Level Waste Facility or LLWF) on the Savannah River Site (SRS). This SA provides limits for disposal in the IL Vaults of high-concentration I-129 wastes, including activated carbon beds from the Effluent Treatment Facility (ETF), based on their measured, waste-specific Kds

  17. 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

  18. Ethical issues in the qualitative researcher--participant relationship.

    Science.gov (United States)

    Eide, Phyllis; Kahn, David

    2008-03-01

    Qualitative research poses ethical issues and challenges unique to the study of human beings. In developing the interpersonal relationship that is critical to qualitative research, investigator and participant engage in a dialogic process that often evokes stories and memories that are remembered and reconstituted in ways that otherwise would not occur. Ethical issues are raised when this relationship not only provides qualitative research data, but also leads to some degree of therapeutic interaction for the participant. The purpose of this article is to examine some of the controversies inherent in the researcher's dilemma when this occurs, set within the context of a nursing caring theory (Swanson), and the International Council of Nurses Code of ethics for nurses, which provides guidance on global nursing practice.

  19. Predictors of Placement in Lower Level versus Higher Level High School Mathematics

    Science.gov (United States)

    Archbald, Doug; Farley-Ripple, Elizabeth N.

    2012-01-01

    Educators and researchers have long been interested in determinants of access to honors level and college prep courses in high school. Factors influencing access to upper level mathematics courses are particularly important because of the hierarchical and sequential nature of this subject and because students who finish high school with only lower…

  20. 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

  1. 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…

  2. Motivation and engagement in mathematics: a qualitative framework for teacher-student interactions

    Science.gov (United States)

    Durksen, Tracy L.; Way, Jennifer; Bobis, Janette; Anderson, Judy; Skilling, Karen; Martin, Andrew J.

    2017-02-01

    We started with a classic research question (How do teachers motivate and engage middle year students in mathematics?) that is solidly underpinned and guided by an integration of two theoretical and multidimensional models. In particular, the current study illustrates how theory is important for guiding qualitative analytical approaches to motivation and engagement in mathematics. With little research on how teachers of mathematics are able to maintain high levels of student motivation and engagement, we focused on developing a qualitative framework that highlights the influence of teacher-student interactions. Participants were six teachers (upper primary and secondary) that taught students with higher-than-average levels of motivation and engagement in mathematics. Data sources included one video-recorded lesson and associated transcripts from pre- and post-lesson interviews with each teacher. Overall, effective classroom organisation stood out as a priority when promoting motivation and engagement in mathematics. Results on classroom organisation revealed four key indicators within teacher-student interactions deemed important for motivation and engagement in mathematics—confidence, climate, contact, and connection. Since much of the effect of teachers on student learning relies on interactions, and given the universal trend of declining mathematical performance during the middle years of schooling, future research and intervention studies might be assisted by our qualitative framework.

  3. 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

  4. In their own words: the value of qualitative research to improve the care of children with chronic kidney disease.

    Science.gov (United States)

    Hanson, Camilla S; Craig, Jonathan C; Tong, Allison

    2017-09-01

    Patient- and family-centered care is hailed as a hallmark of high-quality pediatric care. This partnership between patients, families and their healthcare providers is central to caring for children with chronic kidney disease (CKD), given the long-term and profound impact of the disease and its treatment on the development and quality of life of these children. This paradigm hinges on a comprehensive and detailed understanding of the needs, beliefs and values of children with CKD and their families. However, their perspectives may remain undisclosed during time-limited clinical consultations and because of beliefs that if they did disclose their concerns, their care would be jeopardized. Qualitative research provides an avenue for children and families to articulate their perspectives and experiences and thereby to generate relevant, in-depth and often compelling insights to inform care. Yet, qualitative studies remain sparse in biomedical journals. Increasing both our awareness of the role of qualitative research in improving care and outcomes for children and adolescents with CKD and our understanding of the conduct and rigor of qualitative studies is required. This article will outline how qualitative research can generate relevant evidence to inform practice and policy in children with CKD, provide an overview of qualitative methods and introduce a framework to appraise qualitative research. More evidence derived from qualitative research is needed to inform shared decision-making and the development of interventions and policies that address the preferences and priorities of children with CKD and their families. Ultimately, this strategy may help to improve the outcomes that they regard as critical to their care.

  5. 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

  6. 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.

  7. 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

  8. The Qualitative Other: An Autoethnography

    DEFF Research Database (Denmark)

    Jørgensen, Matias Thuen

    2018-01-01

    This autoethnography uses the author’s own experiences and observations as well as selected scholarly sources to reflect on the current state of qualitative research in Asia. It draws on the experiences of doing a qualitative PhD in a primarily quantitative (Asian) environment. The study finds...... that qualitative research in Asia is currently challenged and provides three types of reasons why this is the case: pragmatic and systematic reasons, which show how a strong focus on outcome over process has influenced academic methods in Asia; ontological and epistemological reasons, which show how Asian...... researchers tend to prefer “methodological rule following” over more exploratory approaches; and, finally, reproduction of these ideas is shown to be a reason why significant change to methodological preferences is difficult to achieve. The chapter also reflects on the increasing acceptance and respect...

  9. Qualitative research methods in renal medicine: an introduction.

    Science.gov (United States)

    Bristowe, Katherine; Selman, Lucy; Murtagh, Fliss E M

    2015-09-01

    Qualitative methodologies are becoming increasingly widely used in health research. However, within some specialties, including renal medicine, qualitative approaches remain under-represented in the high-impact factor journals. Qualitative research can be undertaken: (i) as a stand-alone research method, addressing specific research questions; (ii) as part of a mixed methods approach alongside quantitative approaches or (iii) embedded in clinical trials, or during the development of complex interventions. The aim of this paper is to introduce qualitative research, including the rationale for choosing qualitative approaches, and guidance for ensuring quality when undertaking and reporting qualitative research. In addition, we introduce types of qualitative data (observation, interviews and focus groups) as well as some of the most commonly encountered methodological approaches (case studies, ethnography, phenomenology, grounded theory, thematic analysis, framework analysis and content analysis). © The Author 2015. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

  10. A critical review of qualitative interviews in applied linguistics

    OpenAIRE

    Mann, Steve J.

    2011-01-01

    This article asks what applied linguistics can learn from related disciplines with regard to the collection, analysis and representation of qualitative interviews. It assesses the contributions of qualitative sociology, anthropology, discursive psychology and outlines four ‘discourse dilemmas’ which might provide the basis for a more critical and reflective dimension to the use of qualitative interviews in applied linguistics. Summarizing important contributions that have already been made in...

  11. 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.

  12. 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

  13. Qualitative and Quantitative Security Analyses for ZigBee Wireless Sensor Networks

    DEFF Research Database (Denmark)

    Yuksel, Ender

    methods and techniques in different areas and brings them together to create an efficient verification system. The overall ambition is to provide a wide range of powerful techniques for analyzing models with quantitative and qualitative security information. We stated a new approach that first verifies...... applications, home automation, and traffic control. The challenges for research in this area are due to the unique features of wireless sensor devices such as low processing power and associated low energy. On top of this, wireless sensor networks need secure communication as they operate in open fields...... low level security protocol s in a qualitative manner and guarantees absolute security, and then takes these verified protocols as actions of scenarios to be verified in a quantitative manner. Working on the emerging ZigBee wireless sensor networks, we used probabilistic verification that can return...

  14. Methodological challenges in qualitative content analysis: A discussion paper.

    Science.gov (United States)

    Graneheim, Ulla H; Lindgren, Britt-Marie; Lundman, Berit

    2017-09-01

    This discussion paper is aimed to map content analysis in the qualitative paradigm and explore common methodological challenges. We discuss phenomenological descriptions of manifest content and hermeneutical interpretations of latent content. We demonstrate inductive, deductive, and abductive approaches to qualitative content analysis, and elaborate on the level of abstraction and degree of interpretation used in constructing categories, descriptive themes, and themes of meaning. With increased abstraction and interpretation comes an increased challenge to demonstrate the credibility and authenticity of the analysis. A key issue is to show the logic in how categories and themes are abstracted, interpreted, and connected to the aim and to each other. Qualitative content analysis is an autonomous method and can be used at varying levels of abstraction and interpretation. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Rigour in qualitative case-study research.

    Science.gov (United States)

    Houghton, Catherine; Casey, Dympna; Shaw, David; Murphy, Kathy

    2013-03-01

    To provide examples of a qualitative multiple case study to illustrate the specific strategies that can be used to ensure the credibility, dependability, confirmability and transferability of a study. There is increasing recognition of the valuable contribution qualitative research can make to nursing knowledge. However, it is important that the research is conducted in a rigorous manner and that this is demonstrated in the final research report. A multiple case study that explored the role of the clinical skills laboratory in preparing students for the real world of practice. Multiple sources of evidence were collected: semi-structured interviews (n=58), non-participant observations at five sites and documentary sources. Strategies to ensure the rigour of this research were prolonged engagement and persistent observation, triangulation, peer debriefing, member checking, audit trail, reflexivity, and thick descriptions. Practical examples of how these strategies can be implemented are provided to guide researchers interested in conducting rigorous case study research. While the flexible nature of qualitative research should be embraced, strategies to ensure rigour must be in place.

  16. The Necessity of Qualitative Materiality in Auditing

    OpenAIRE

    Erdoğan, Nurten

    2006-01-01

    Auditors have to make materiality judgments on every audit. Assessing materiality requires careful consideration of all relevant circumstances, both quantitative and qualitative considerations, as well as interaction of these considerations. This process is difficult because both quantitative and qualitative factors must evaluate.Audit standards on materiality do not provide sufficient formal guidance to quantify materiality. As a result, the auditors have been left to assess materiality base...

  17. Ensuring Quality in qualitative cross-cultural research

    DEFF Research Database (Denmark)

    Demuth, Carolin

    2013-01-01

    Within recent years, there has been an increasing call for qualitative research in cross-cultural psychology. Despite this general openness, there seems to be some confusion about how to evaluate the quality of such research. This has been partly due to the heterogeneity of the field...... and the epistemological underpinnings of qualitative research that do not allow for standard criteria of rigor as in the traditional psychological research. Nevertheless, there is an emerging canon of recognized standards of good practice in qualitative research which the present paper will briefly discuss. The paper...... aims at motivating cross-cultural psychologists to produce high quality qualitative research that will contribute to the further advancement of the field....

  18. 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

  19. A writer's guide to education scholarship: Qualitative education scholarship (part 2).

    Science.gov (United States)

    Chan, Teresa M; Ting, Daniel K; Hall, Andrew Koch; Murnaghan, Aleisha; Thoma, Brent; McEwen, Jill; Yarris, Lalena M

    2018-03-01

    Education scholarship can be conducted using a variety of methods, from quantitative experiments to qualitative studies. Qualitative methods are less commonly used in emergency medicine (EM) education research but are well-suited to explore complex educational problems and generate hypotheses. We aimed to review the literature to provide resources to guide educators who wish to conduct qualitative research in EM education. We conducted a scoping review to outline: 1) a list of journals that regularly publish qualitative educational papers; 2) an aggregate set of quality markers for qualitative educational research and scholarship; and 3) a list of quality checklists for qualitative educational research and scholarship. We found nine journals that have published more than one qualitative educational research paper in EM. From the literature, we identified 39 quality markers that were grouped into 10 themes: Initial Grounding Work (preparation, background); Goals, Problem Statement, or Question; Methods (general considerations); Sampling Techniques; Data Collection Techniques; Data Interpretation and Theory Generation; Measures to Optimize Rigour and Trustworthiness; Relevance to the Field; Evidence of Reflective Practice; Dissemination and Reporting. Lastly, five quality checklists were found for guiding educators in reporting their qualitative work. Many problems that EM educators face are well-suited to exploration using qualitative methods. The results of our scoping review provide publication venues, quality indicators, and checklists that may be useful to EM educators embarking on qualitative projects.

  20. Barriers and facilitators of interventions for improving antiretroviral therapy adherence: a systematic review of global qualitative evidence.

    Science.gov (United States)

    Ma, Qingyan; Tso, Lai Sze; Rich, Zachary C; Hall, Brian J; Beanland, Rachel; Li, Haochu; Lackey, Mellanye; Hu, Fengyu; Cai, Weiping; Doherty, Meg; Tucker, Joseph D

    2016-01-01

    Qualitative research on antiretroviral therapy (ART) adherence interventions can provide a deeper understanding of intervention facilitators and barriers. This systematic review aims to synthesize qualitative evidence of interventions for improving ART adherence and to inform patient-centred policymaking. We searched 19 databases to identify studies presenting primary qualitative data on the experiences, attitudes and acceptability of interventions to improve ART adherence among PLHIV and treatment providers. We used thematic synthesis to synthesize qualitative evidence and the CERQual (Confidence in the Evidence from Reviews of Qualitative Research) approach to assess the confidence of review findings. Of 2982 references identified, a total of 31 studies from 17 countries were included. Twelve studies were conducted in high-income countries, 13 in middle-income countries and six in low-income countries. Study populations focused on adults living with HIV (21 studies, n =1025), children living with HIV (two studies, n =46), adolescents living with HIV (four studies, n =70) and pregnant women living with HIV (one study, n =79). Twenty-three studies examined PLHIV perspectives and 13 studies examined healthcare provider perspectives. We identified six themes related to types of interventions, including task shifting, education, mobile phone text messaging, directly observed therapy, medical professional outreach and complex interventions. We also identified five cross-cutting themes, including strengthening social relationships, ensuring confidentiality, empowerment of PLHIV, compensation and integrating religious beliefs into interventions. Our qualitative evidence suggests that strengthening PLHIV social relationships, PLHIV empowerment and developing culturally appropriate interventions may facilitate adherence interventions. Our study indicates that potential barriers are inadequate training and compensation for lay health workers and inadvertent disclosure of

  1. 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.)

  2. 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.

  3. Privately Provided Accommodation Service Quality and Customer Satisfaction

    Directory of Open Access Journals (Sweden)

    Joshua Mugambwa

    2016-04-01

    Full Text Available Privately provided accommodation is a growing service in Uganda’s higher education sector due to education liberalization and demand for education. This research took a case study of Nsamizi Training Institute of Social Development (NTISD to determine the relationship between privately provided accommodation service quality and customer satisfaction. Specifically, the objectives of the study were (a to find out the relationship between security and NTISD students’ satisfaction with privately provided accommodation, and (b to find out the hierarchical level of importance of NTISD student satisfaction of the three service quality dimensions (reliability, security, and tangibles with privately provided accommodation. Using quantitative and qualitative modes of data analysis and a sample of 300 students from 20 private hostels, this study established a strong positive significant relationship between security and satisfaction regarding privately provided accommodation. This implies that accommodation service providers should increase the quality of security so as to increase the satisfaction of students regarding privately provided accommodation. The study established the hierarchical order of importance from the most important service quality dimension, respectively, as follows: reliability, security, and tangibles. Therefore, private accommodation service managers should pay extra attention to the dimensions in the same order.

  4. 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.

  5. 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

  6. 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

  7. Challenges in conducting qualitative research in health: A conceptual paper

    Science.gov (United States)

    Khankeh, Hamidreza; Ranjbar, Maryam; Khorasani-Zavareh, Davoud; Zargham-Boroujeni, Ali; Johansson, Eva

    2015-01-01

    Background: Qualitative research focuses on social world and provides the tools to study health phenomena from the perspective of those experiencing them. Identifying the problem, forming the question, and selecting an appropriate methodology and design are some of the initial challenges that researchers encounter in the early stages of any research project. These problems are particularly common for novices. Materials and Methods: This article describes the practical challenges of using qualitative inquiry in the field of health and the challenges of performing an interpretive research based on professional experience as a qualitative researcher and on available literature. Results: One of the main topics discussed is the nature of qualitative research, its inherent challenges, and how to overcome them. Some of those highlighted here include: identification of the research problem, formation of the research question/aim, and selecting an appropriate methodology and research design, which are the main concerns of qualitative researchers and need to be handled properly. Insights from real-life experiences in conducting qualitative research in health reveal these issues. Conclusions: The paper provides personal comments on the experiences of a researcher in conducting pure qualitative research in the field of health. It offers insights into the practical difficulties encountered when performing qualitative studies and offers solutions and alternatives applied by these authors, which may be of use to others. PMID:26793245

  8. 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.

  9. Qualitative risk assessment: a conceptual context and three diverse applications

    International Nuclear Information System (INIS)

    Elsea, K.J.; Conger, D.S.

    1992-01-01

    Risk is defined as the probability of an occurrence multiplied by the consequences of that occurrence. Such a definition implies a quantitative or at least a mathematical operation. However, qualitative uses of risk have proved useful tools in incident investigation and management decision making. This paper provides a conceptual context for qualitative risk assessment and discusses three efforts at subject organizations [an aerospace firm, a US Department of Energy weapons-related facility, and a commercial nuclear reactor] that have applied qualitative risk techniques for different uses and with different results. A lessons-learned section summarizes and provides future direction

  10. CIGeO geological disposal for high-level radioactive waste in France

    International Nuclear Information System (INIS)

    Ouzounian, Gerald; Bolia, Jelana

    2014-01-01

    Andra is the sole French organization responsible for the radioactive waste management in the country. Its work relies extensively on the legal basis provided by several major laws (Waste Act of 1991 and the Planning Act of 2006), which shaped the main principles of the waste management strategy and determined the corresponding implementation tools. Andra's industrial activities are essentially based around three of its national disposal facilities. Two of these operational facilities, by their design and comprehensive monitoring system, are considered worldwide as solid and proven reference solutions for the concerned types of radioactive waste. Andra is also charged with designing a future deep geological repository for intermediate-level long-lived and high-level waste and researching potential management and disposal solutions for the graphite and radium-bearing waste. The purpose of this article is to update the information to the readers about the Cigeo geological disposal project for high-level radioactive waste in France (authors)

  11. Perceptions of the characteristics of the Alberta Nutrition Guidelines for Children and Youth by child care providers may influence early adoption of nutrition guidelines in child care centres.

    Science.gov (United States)

    Nikolopoulos, Hara; Farmer, Anna; Berry, Tanya R; McCargar, Linda J; Mager, Diana R

    2015-04-01

    In 2008, the Alberta government released the Alberta Nutrition Guidelines for Children and Youth (ANGCY) as a resource for child care facilities to translate nutrition recommendations into practical food choices. Using a multiple case study method, early adoption of the guidelines was examined in two child care centres in Alberta, Canada. Key constructs from the Diffusion of Innovations framework were used to develop an interview protocol based on the perceived characteristics of the guidelines (relative advantage, compatibility, complexity, trialability and observability) by child care providers. Analysis of the ANGCY was conducted by a trained qualitative researcher and validated by an external qualitative researcher. This entailed reviewing guideline content, layout, organisation, presentation, format, comprehensiveness and dissemination to understand whether characteristics of the guidelines affect the adoption process. Data were collected through direct observation, key informant interviews and documentation of field notes. Qualitative data were analysed using content analysis. Overall, the guidelines were perceived positively by child care providers. Child care providers found the guidelines to have a high relative advantage, be compatible with current practice, have a low level of complexity, easy to try and easy to observe changes. It is valuable to understand how child care providers perceive characteristics of guidelines as this is the first step in identifying the needs of child care providers with respect to early adoption and identifying potential educational strategies important for dissemination. © 2012 Blackwell Publishing Ltd.

  12. 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...

  13. Exploring how substance use impedes engagement along the HIV care continuum: A qualitative exploration

    Directory of Open Access Journals (Sweden)

    Marya eGwadz

    2016-04-01

    Full Text Available Drug use is associated with low uptake of HIV antiretroviral therapy (ART, an under-studied step in the HIV care continuum, and insufficient engagement in HIV primary care. However, the specific underlying mechanisms by which drug use impedes these HIV health outcomes are poorly understood. The present qualitative study addresses this gap in the literature, focusing on African American/Black and Hispanic persons living with HIV (PLWH who had delayed, declined, or discontinued ART and who also were generally poorly engaged in health care. Participants (N=37 were purposively sampled from a larger study for maximum variation on HIV indices. They engaged in 1-2 hour audio-recorded in-depth semi-structured interviews on HIV histories guided by a multi-level social cognitive theory. Transcripts were analyzed using a systematic content analysis approach. Consistent with the existing literature, heavy substance use, but not casual or social use, impeded ART uptake, mainly by undermining confidence in medication management abilities and triggering depression. The confluence of African American/Black or Latino race/ethnicity, poverty, and drug use was associated with high levels of perceived stigma and inferior treatment in health care settings compared to their peers. Further, providers were described as frequently assuming participants were selling their medications to buy drugs, which strained provider-patient relationships. High levels of medical distrust, common in this population, created fears of ART and of negative interactions between street drugs and ART, but participants could not easily discuss this concern with health care providers. Barriers to ART initiation and HIV care were embedded in other structural- and social-level challenges, which disproportionately affect low-income African American/Black and Hispanic PLWH (e.g. homelessness, violence. Yet, HIV management was cyclical. In collaboration with trusted providers and ancillary staff

  14. Phylogeographic reconstruction of a bacterial species with high levels of lateral gene transfer

    Science.gov (United States)

    Pearson, T.; Giffard, P.; Beckstrom-Sternberg, S.; Auerbach, R.; Hornstra, H.; Tuanyok, A.; Price, E.P.; Glass, M.B.; Leadem, B.; Beckstrom-Sternberg, J. S.; Allan, G.J.; Foster, J.T.; Wagner, D.M.; Okinaka, R.T.; Sim, S.H.; Pearson, O.; Wu, Z.; Chang, J.; Kaul, R.; Hoffmaster, A.R.; Brettin, T.S.; Robison, R.A.; Mayo, M.; Gee, J.E.; Tan, P.; Currie, B.J.; Keim, P.

    2009-01-01

    Background: Phylogeographic reconstruction of some bacterial populations is hindered by low diversity coupled with high levels of lateral gene transfer. A comparison of recombination levels and diversity at seven housekeeping genes for eleven bacterial species, most of which are commonly cited as having high levels of lateral gene transfer shows that the relative contributions of homologous recombination versus mutation for Burkholderia pseudomallei is over two times higher than for Streptococcus pneumoniae and is thus the highest value yet reported in bacteria. Despite the potential for homologous recombination to increase diversity, B. pseudomallei exhibits a relative lack of diversity at these loci. In these situations, whole genome genotyping of orthologous shared single nucleotide polymorphism loci, discovered using next generation sequencing technologies, can provide very large data sets capable of estimating core phylogenetic relationships. We compared and searched 43 whole genome sequences of B. pseudomallei and its closest relatives for single nucleotide polymorphisms in orthologous shared regions to use in phylogenetic reconstruction. Results: Bayesian phylogenetic analyses of >14,000 single nucleotide polymorphisms yielded completely resolved trees for these 43 strains with high levels of statistical support. These results enable a better understanding of a separate analysis of population differentiation among >1,700 B. pseudomallei isolates as defined by sequence data from seven housekeeping genes. We analyzed this larger data set for population structure and allele sharing that can be attributed to lateral gene transfer. Our results suggest that despite an almost panmictic population, we can detect two distinct populations of B. pseudomallei that conform to biogeographic patterns found in many plant and animal species. That is, separation along Wallace's Line, a biogeographic boundary between Southeast Asia and Australia. Conclusion: We describe an

  15. Phylogeographic reconstruction of a bacterial species with high levels of lateral gene transfer

    Directory of Open Access Journals (Sweden)

    Kaul Rajinder

    2009-11-01

    Full Text Available Abstract Background Phylogeographic reconstruction of some bacterial populations is hindered by low diversity coupled with high levels of lateral gene transfer. A comparison of recombination levels and diversity at seven housekeeping genes for eleven bacterial species, most of which are commonly cited as having high levels of lateral gene transfer shows that the relative contributions of homologous recombination versus mutation for Burkholderia pseudomallei is over two times higher than for Streptococcus pneumoniae and is thus the highest value yet reported in bacteria. Despite the potential for homologous recombination to increase diversity, B. pseudomallei exhibits a relative lack of diversity at these loci. In these situations, whole genome genotyping of orthologous shared single nucleotide polymorphism loci, discovered using next generation sequencing technologies, can provide very large data sets capable of estimating core phylogenetic relationships. We compared and searched 43 whole genome sequences of B. pseudomallei and its closest relatives for single nucleotide polymorphisms in orthologous shared regions to use in phylogenetic reconstruction. Results Bayesian phylogenetic analyses of >14,000 single nucleotide polymorphisms yielded completely resolved trees for these 43 strains with high levels of statistical support. These results enable a better understanding of a separate analysis of population differentiation among >1,700 B. pseudomallei isolates as defined by sequence data from seven housekeeping genes. We analyzed this larger data set for population structure and allele sharing that can be attributed to lateral gene transfer. Our results suggest that despite an almost panmictic population, we can detect two distinct populations of B. pseudomallei that conform to biogeographic patterns found in many plant and animal species. That is, separation along Wallace's Line, a biogeographic boundary between Southeast Asia and Australia

  16. Quantitative and qualitative coronary arteriography. 1

    International Nuclear Information System (INIS)

    Brown, B.G.; Simpson, Paul; Dodge, J.T. Jr; Bolson, E.L.; Dodge, H.T.

    1991-01-01

    The clinical objectives of arteriography are to obtain information that contributes to an understanding of the mechanisms of the clinical syndrome, provides prognostic information, facilitates therapeutic decisions, and guides invasive therapy. Quantitative and improved qualitative assessments of arterial disease provide us with a common descriptive language which has the potential to accomplish these objectives more effectively and thus to improve clinical outcome. In certain situations, this potential has been demonstrated. Clinical investigation using quantitative techniques has definitely contributed to our understanding of disease mechanisms and of atherosclerosis progression/regression. Routine quantitation of clinical images should permit more accurate and repeatable estimates of disease severity and promises to provide useful estimates of coronary flow reserve. But routine clinical QCA awaits more cost- and time-efficient methods and clear proof of a clinical advantage. Careful inspection of highly magnified, high-resolution arteriographic images reveals morphologic features related to the pathophysiology of the clinical syndrome and to the likelihood of future progression or regression of obstruction. Features that have been found useful include thrombus in its various forms, ulceration and irregularity, eccentricity, flexing and dissection. The description of such high-resolution features should be included among, rather than excluded from, the goals of image processing, since they contribute substantially to the understanding and treatment of the clinical syndrome. (author). 81 refs.; 8 figs.; 1 tab

  17. 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

  18. Effect of hybrid iterative reconstruction technique on quantitative and qualitative image analysis at 256-slice prospective gating cardiac CT

    International Nuclear Information System (INIS)

    Utsunomiya, Daisuke; Weigold, W. Guy; Weissman, Gaby; Taylor, Allen J.

    2012-01-01

    To evaluate the effect of hybrid iterative reconstruction on qualitative and quantitative parameters at 256-slice cardiac CT. Prospective cardiac CT images from 20 patients were analysed. Paired image sets were created using 3 reconstructions, i.e. filtered back projection (FBP) and moderate- and high-level iterative reconstructions. Quantitative parameters including CT-attenuation, noise, and contrast-to-noise ratio (CNR) were determined in both proximal- and distal coronary segments. Image quality was graded on a 4-point scale. Coronary CT attenuation values were similar for FBP, moderate- and high-level iterative reconstruction at 293 ± 74-, 290 ± 75-, and 283 ± 78 Hounsfield units (HU), respectively. CNR was significantly higher with moderate- and high-level iterative reconstructions (10.9 ± 3.5 and 18.4 ± 6.2, respectively) than FBP (8.2 ± 2.5) as was the visual grading of proximal vessels. Visualisation of distal vessels was better with high-level iterative reconstruction than FBP. The mean number of assessable segments among 289 segments was 245, 260, and 267 for FBP, moderate- and high-level iterative reconstruction, respectively; the difference between FBP and high-level iterative reconstruction was significant. Interobserver agreement was significantly higher for moderate- and high-level iterative reconstruction than FBP. Cardiac CT using hybrid iterative reconstruction yields higher CNR and better image quality than FBP. circle Cardiac CT helps clinicians to assess patients with coronary artery disease circle Hybrid iterative reconstruction provides improved cardiac CT image quality circle Hybrid iterative reconstruction improves the number of assessable coronary segments circle Hybrid iterative reconstruction improves interobserver agreement on cardiac CT. (orig.)

  19. Space-Based Space Surveillance Logistics Case Study: A Qualitative Product Support Element Analysis

    Science.gov (United States)

    2017-12-01

    REPORT TYPE AND DATES COVERED Joint applied project 4. TITLE AND SUBTITLE SPACE-BASED SPACE SURVEILLANCE LOGISTICS CASE STUDY: A QUALITATIVE ...INTENTIONALLY LEFT BLANK v ABSTRACT This research provides a qualitative analysis of the logistics impacts, effects, and sustainment challenges...provides a qualitative product support element-by-element review for both research questions. Chapters IV and V present the findings, results

  20. 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

  1. Establishing the credibility of qualitative research findings: the plot thickens.

    Science.gov (United States)

    Cutcliffe, J R; McKenna, H P

    1999-08-01

    Qualitative research is increasingly recognized and valued and its unique place in nursing research is highlighted by many. Despite this, some nurse researchers continue to raise epistemological issues about the problems of objectivity and the validity of qualitative research findings. This paper explores the issues relating to the representativeness or credibility of qualitative research findings. It therefore critiques the existing distinct philosophical and methodological positions concerning the trustworthiness of qualitative research findings, which are described as follows: quantitative studies should be judged using the same criteria and terminology as quantitative studies; it is impossible, in a meaningful way, for any criteria to be used to judge qualitative studies; qualitative studies should be judged using criteria that are developed for and fit the qualitative paradigm; and the credibility of qualitative research findings could be established by testing out the emerging theory by means of conducting a deductive quantitative study. The authors conclude by providing some guidelines for establishing the credibility of qualitative research findings.

  2. High-Level Waste Tank Lay-Up Assessment - Year-End Progress Report

    International Nuclear Information System (INIS)

    Elmore, Monte R.; Henderson, Colin

    2002-01-01

    This report documents the preliminary needs assessment of high-level waste (HLW) tank lay-up requirements and considerations for the Hanford Site, Idaho National Engineering and Environmental Lab (INEEL), Savannah River Site (SRS) and Oak Ridge Reservation (ORR). This assessment includes the development of a high-level requirements and considerations list that evolved from work done for the West Valley Demonstration Project (WVDP) earlier in fiscal year (FY) 2001, and is based on individual site conditions and tank retrieval/tank closure schedules. Because schedules are continually subject to change, this assessment is considered preliminary and needs review and validation by the individual sites. The lay-up decision methodology developed for WVDP was based on standard systems engineering principles, and provided a structured framework for producing an effective, technically-defensible lay-up strategy

  3. Impact of transporting defense high-level waste to a geologic repository

    International Nuclear Information System (INIS)

    Joy, D.S.; Shappert, L.B.; Boyle, J.W.

    1984-12-01

    The Nuclear Waste Policy Act of 1982 (Public Law 97-425) provides for the development of repositories for the disposal of high-level radioactive waste and spent nuclear fuel and requires the Secretary of Energy to evaluate five potential repository sites. One factor that is to be examined is transportation of radioactive materials to such a repository and whether transportation might be affected by shipments to a defense-only repository, or to one that accepts both defense and commercial waste. In response to this requirement, The Department of Energy has undertaken an evaluation of the cost and risk associated with the potential shipments. Two waste-flow scenarios are considered which are related to the total quantity of defense high-level waste which will be placed in a repository. The low-flow case is based on a total of 6700 canisters being transported from one site, while the high-flow case assumes that a total of 20,000 canisters will be transported from three sites. For the scenarios considered, the estimated shipping costs range from $105 million to $257 million depending upon the mode of transport and the repository location. The total risks associated with shipping defense high-level waste to a repository are estimated to be significantly smaller than predicted for other transportation activities. In addition, the cost of shipping defense high-level waste to a repository does not depend on whether the site is a defense-only or a commercial repository. Therefore, the transportation considerations are not a basis for the selection of one of the two disposal options

  4. 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.).

  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. Standards for reporting qualitative research: a synthesis of recommendations.

    Science.gov (United States)

    O'Brien, Bridget C; Harris, Ilene B; Beckman, Thomas J; Reed, Darcy A; Cook, David A

    2014-09-01

    Standards for reporting exist for many types of quantitative research, but currently none exist for the broad spectrum of qualitative research. The purpose of the present study was to formulate and define standards for reporting qualitative research while preserving the requisite flexibility to accommodate various paradigms, approaches, and methods. The authors identified guidelines, reporting standards, and critical appraisal criteria for qualitative research by searching PubMed, Web of Science, and Google through July 2013; reviewing the reference lists of retrieved sources; and contacting experts. Specifically, two authors reviewed a sample of sources to generate an initial set of items that were potentially important in reporting qualitative research. Through an iterative process of reviewing sources, modifying the set of items, and coding all sources for items, the authors prepared a near-final list of items and descriptions and sent this list to five external reviewers for feedback. The final items and descriptions included in the reporting standards reflect this feedback. The Standards for Reporting Qualitative Research (SRQR) consists of 21 items. The authors define and explain key elements of each item and provide examples from recently published articles to illustrate ways in which the standards can be met. The SRQR aims to improve the transparency of all aspects of qualitative research by providing clear standards for reporting qualitative research. These standards will assist authors during manuscript preparation, editors and reviewers in evaluating a manuscript for potential publication, and readers when critically appraising, applying, and synthesizing study findings.

  8. Qualitative description – the poor cousin of health research?

    Science.gov (United States)

    2009-01-01

    Background The knowledge and use of qualitative description as a qualitative research approach in health services research is limited. The aim of this article is to discuss the potential benefits of a qualitative descriptive approach, to identify its strengths and weaknesses and to provide examples of use. Discussion Qualitative description is a useful qualitative method in much medical research if you keep the limitations of the approach in mind. It is especially relevant in mixed method research, in questionnaire development and in research projects aiming to gain firsthand knowledge of patients', relatives' or professionals' experiences with a particular topic. Another great advantage of the method is that it is suitable if time or resources are limited. Summary As a consequence of the growth in qualitative research in the health sciences, researchers sometimes feel obliged to designate their work as phenomenology, grounded theory, ethnography or a narrative study when in fact it is not. Qualitative description might be a useful alternative approach to consider. PMID:19607668

  9. 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

  10. Computer-assisted qualitative data analysis software.

    Science.gov (United States)

    Cope, Diane G

    2014-05-01

    Advances in technology have provided new approaches for data collection methods and analysis for researchers. Data collection is no longer limited to paper-and-pencil format, and numerous methods are now available through Internet and electronic resources. With these techniques, researchers are not burdened with entering data manually and data analysis is facilitated by software programs. Quantitative research is supported by the use of computer software and provides ease in the management of large data sets and rapid analysis of numeric statistical methods. New technologies are emerging to support qualitative research with the availability of computer-assisted qualitative data analysis software (CAQDAS).CAQDAS will be presented with a discussion of advantages, limitations, controversial issues, and recommendations for this type of software use.

  11. [A call for qualitative research in Orthodontics].

    Science.gov (United States)

    Yitschaky, O; Hofnung, T; Zini, A

    2015-01-01

    Qualitative research is an umbrella term for an array of attitudes and strategies for conducting inquiries that are aimed at discerning how human beings understand, experience, and interpret the social world. It is employed in many different academic disciplines most particularly in the social sciences and humanities, however recently more and more qualitative research is being conducted under the medical sciences including dentistry and orthodontics. This is due to its nature of in-depth investigation, which can provide answers to questions that cannot be satisfactorily answered using quantitative methods alone. The aims of this article are to discuss the characteristics of qualitative research, to review the orthodontic English literature, and to highlight the advantages of qualitative research in orthodontics. The literature review yielded several important conclusions regarding qualitative research in orthodontics: 1. most of the qualitative research done in orthodontics chose to use semi structured in-depth interviews for data collection; 2. qualitative research highlights aspects that are very important, and sometimes crucial to everyday practice and long term treatment; 3. there is a lack of qualitative studies in the field of orthodontics. Taking into account the nature of the orthodontic treatment, which is a prolonged one, demanding of a good orthodontist-patient rapport, and a wide perspective on behalf of the clinician, filling the gap in the discipline through conducting more qualitative studies aimed at understanding the point of view of the patient, as well as that of the clinician, may be beneficial for the improvement of the treatment.

  12. The patient experience of high technology medical imaging: A systematic review of the qualitative evidence

    International Nuclear Information System (INIS)

    Munn, Zachary; Jordan, Zoe

    2011-01-01

    Background: When presenting to an imaging department, the person who is to be imaged is often in a vulnerable state, and can experience the scan in a number of ways. It is the role of the radiographer to produce a high quality image and facilitate patient care throughout the imaging process. A qualitative systematic review was performed to synthesise the existent evidence on the patient experience of high technology medical imaging. Only papers relating to Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) were identified. Inclusion criteria: Studies that were of a qualitative design that explored the phenomenon of interest, the patient experience of high technology medical imaging. Participants included anyone who had undergone one of these procedures. Methods: A systematic search of medical and allied health databases was conducted. Articles identified during the search process that met the inclusion criteria were then critically appraised for methodological quality independently by two reviewers. Results: During the search and inclusion process, 15 studies were found that were deemed of suitable quality to be included in the review. From the 15 studies, 127 findings were extracted from the included studies. These were analysed in more detail to observe common themes, and then grouped into 33 categories. From these 33 categories, 11 synthesised findings were produced. The 11 synthesised findings highlight the diverse, unique and challenging ways in which people experience imaging with MRI and CT scanners. Conclusion: The results of the review demonstrate the diverse ways in which people experience medical imaging. All health professionals involved in imaging need to be aware of the different ways each patient may experience imaging.

  13. Teaching Qualitative Market Research: Multi-Perspectival Evaluation of a Curriculum Innovation

    Directory of Open Access Journals (Sweden)

    Bettina König

    2011-03-01

    Full Text Available The principal goal of teaching qualitative market research in a business degree programme at a university of applied sciences is to provide students with methodological skills that prove applicable in practice and are, at the same time, compliant with prevailing standards of academic research. Creating an appropriate curriculum that includes the methods of conducting expert interviews and carrying out focus groups poses challenges to instructors and students, both full-time and part-time. Designed as a "research workshop," the course we designed turned out to be most effective for teaching future graduates of business administration how to use relevant and practical qualitative market research methods. Students had to implement independently both research techniques 1. within their group and 2. in teams. They were thereby enabled to draw on synergies with respect to the recruitment of interview partners, implementation of analysis methods, and the visualization of results. At the same time, they gathered experiences in the triangulation of methods and data. Concurrently, a critical examination of quality criteria in the field of qualitative market research—as opposed to commonly used quantitative approaches—was ensured. Referring to the organization and communication efforts required by instructors and students, the integration of blended learning in this project-oriented course design made the implementation of this programme highly complex. The experiences reported here provide a solid basis for future programs that intend to teach qualitative market research techniques to prospective graduates of business administration in a blended learning framework. URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs110240

  14. Series: Practical guidance to qualitative research. Part 3: Sampling, data collection and analysis.

    Science.gov (United States)

    Moser, Albine; Korstjens, Irene

    2018-12-01

    In the course of our supervisory work over the years, we have noticed that qualitative research tends to evoke a lot of questions and worries, so-called frequently asked questions (FAQs). This series of four articles intends to provide novice researchers with practical guidance for conducting high-quality qualitative research in primary care. By 'novice' we mean Master's students and junior researchers, as well as experienced quantitative researchers who are engaging in qualitative research for the first time. This series addresses their questions and provides researchers, readers, reviewers and editors with references to criteria and tools for judging the quality of qualitative research papers. The second article focused on context, research questions and designs, and referred to publications for further reading. This third article addresses FAQs about sampling, data collection and analysis. The data collection plan needs to be broadly defined and open at first, and become flexible during data collection. Sampling strategies should be chosen in such a way that they yield rich information and are consistent with the methodological approach used. Data saturation determines sample size and will be different for each study. The most commonly used data collection methods are participant observation, face-to-face in-depth interviews and focus group discussions. Analyses in ethnographic, phenomenological, grounded theory, and content analysis studies yield different narrative findings: a detailed description of a culture, the essence of the lived experience, a theory, and a descriptive summary, respectively. The fourth and final article will focus on trustworthiness and publishing qualitative research.

  15. Series: Practical guidance to qualitative research. Part 3: Sampling, data collection and analysis

    Science.gov (United States)

    Moser, Albine; Korstjens, Irene

    2018-01-01

    Abstract In the course of our supervisory work over the years, we have noticed that qualitative research tends to evoke a lot of questions and worries, so-called frequently asked questions (FAQs). This series of four articles intends to provide novice researchers with practical guidance for conducting high-quality qualitative research in primary care. By ‘novice’ we mean Master’s students and junior researchers, as well as experienced quantitative researchers who are engaging in qualitative research for the first time. This series addresses their questions and provides researchers, readers, reviewers and editors with references to criteria and tools for judging the quality of qualitative research papers. The second article focused on context, research questions and designs, and referred to publications for further reading. This third article addresses FAQs about sampling, data collection and analysis. The data collection plan needs to be broadly defined and open at first, and become flexible during data collection. Sampling strategies should be chosen in such a way that they yield rich information and are consistent with the methodological approach used. Data saturation determines sample size and will be different for each study. The most commonly used data collection methods are participant observation, face-to-face in-depth interviews and focus group discussions. Analyses in ethnographic, phenomenological, grounded theory, and content analysis studies yield different narrative findings: a detailed description of a culture, the essence of the lived experience, a theory, and a descriptive summary, respectively. The fourth and final article will focus on trustworthiness and publishing qualitative research. PMID:29199486

  16. A Critical Review of Qualitative Interviews in Applied Linguistics

    Science.gov (United States)

    Mann, Steve

    2011-01-01

    This article asks what applied linguistics can learn from related disciplines with regard to the collection, analysis and representation of qualitative interviews. It assesses the contributions of qualitative sociology, anthropology, discursive psychology and outlines four "discourse dilemmas" which might provide the basis for a more critical and…

  17. Water security at local government level in South Africa: a qualitative interview-based analysis

    CSIR Research Space (South Africa)

    Meissner, Richard

    2018-05-01

    Full Text Available understanding of water security exists. The aim of this study was to research, using qualitative social scientific methods, how people in two South African localities understand water security....

  18. On the design of high-rise buildings with a specified level of reliability

    Science.gov (United States)

    Dolganov, Andrey; Kagan, Pavel

    2018-03-01

    High-rise buildings have a specificity, which significantly distinguishes them from traditional buildings of high-rise and multi-storey buildings. Steel structures in high-rise buildings are advisable to be used in earthquake-proof regions, since steel, due to its plasticity, provides damping of the kinetic energy of seismic impacts. These aspects should be taken into account when choosing a structural scheme of a high-rise building and designing load-bearing structures. Currently, modern regulatory documents do not quantify the reliability of structures. Although the problem of assigning an optimal level of reliability has existed for a long time. The article shows the possibility of designing metal structures of high-rise buildings with specified reliability. Currently, modern regulatory documents do not quantify the reliability of high-rise buildings. Although the problem of assigning an optimal level of reliability has existed for a long time. It is proposed to establish the value of reliability 0.99865 (3σ) for constructions of buildings and structures of a normal level of responsibility in calculations for the first group of limiting states. For increased (construction of high-rise buildings) and reduced levels of responsibility for the provision of load-bearing capacity, it is proposed to assign respectively 0.99997 (4σ) and 0.97725 (2σ). The coefficients of the use of the cross section of a metal beam for different levels of security are given.

  19. Fuel reprocessing plant: No qualitative differences as compared to other sensitive process plants

    International Nuclear Information System (INIS)

    Schweinoch, J.

    1986-01-01

    Nuclear power plants like the fuel reprocessing plant belong to the highly sensitive installations in respect of safety, but involve the same risks qualitatively as liquid-gas plants or chemical plants. Therefore no consequences for basic rights are discernible. The police can take adequate preventive measures. The regulations governing police action provide proper and sufficient warrants. (DG) [de

  20. Comparison of Qualitative and Quantitative Risk Results for Shutdown Operation

    International Nuclear Information System (INIS)

    Oh, Hae Cheol; Kim, Myung Ki; Chung, Bag Soon; Seo, Mi Ro; Hong, Sung Yull

    2006-01-01

    The Defense-In-Depth philosophy is a fundamental concept of nuclear safety. The objective of Defense-In- Depth (DID) evaluation is to assess the level of Defense- In-Depth maintained during the various plant maintenance activities. Especially for shutdown and outage operations, the Defense-In-Depth might be challenged due to the reduction in redundancy and diversity resulting from the maintenance. The qualitative defense-in-depth evaluation using deterministic trees such as SFAT (Safety Function Assessment Tree), can provide 'Safety' related information on the levels of defense-in-depth according to the plant configuration including the levels of redundancy and diversity. For the more reasonable color decision of SFAT, it is necessary to identify the risk impact of degradation of redundancy and diversity of mitigation systems. The probabilistic safety analysis for the shutdown status can provide risk information related on the degradation of redundancy and diversity level for the safety functions during outage. Insights from the both methods for the plant status can be the same or different. The results of DID approach and PSA for the shutdown state are compared in this paper

  1. Top Ten Musings about Publishing Qualitative Manuscripts: Managing the Devil in the Details

    Science.gov (United States)

    Palladino, John M.

    2011-01-01

    The purpose of this presentation was to engage in dialogue with editors of other qualitative journals and conference participants about the common roadblocks that hinder the publication possibilities for qualitative research studies. All audience participants were conference presenters and/or qualitative researchers, novice level and above. The…

  2. An international qualitative study of ability and disability in ADHD using the WHO-ICF framework.

    Science.gov (United States)

    Mahdi, Soheil; Viljoen, Marisa; Massuti, Rafael; Selb, Melissa; Almodayfer, Omar; Karande, Sunil; de Vries, Petrus J; Rohde, Luis; Bölte, Sven

    2017-10-01

    This is the third in a series of four cross-cultural empirical studies designed to develop International Classification of Functioning, Disability and Health (ICF, and Children and Youth version, ICF(-CY) Core Sets for Attention-Deficit Hyperactivity Disorder (ADHD). To explore the perspectives of individuals diagnosed with ADHD, self-advocates, immediate family members and professional caregivers on relevant areas of impairment and functional abilities typical for ADHD across the lifespan as operationalized by the ICF(-CY). A qualitative study using focus group discussions or semi-structured interviews of 76 participants, divided into 16 stakeholder groups. Participants from five countries (Brazil, India, Saudi Arabia, South Africa and Sweden) were included. A deductive qualitative content analysis was conducted to extract meaningful functioning and disability concepts from verbatim material. Extracted concepts were then linked to ICF(-CY) categories by independent researchers using a standardized linking procedure. In total, 82 ICF(-CY) categories were identified, of which 32 were related to activities and participation, 25 to environmental factors, 23 to body functions and 2 to body structures. Participants also provided opinions on experienced positive sides to ADHD. A high level of energy and drive, creativity, hyper-focus, agreeableness, empathy, and willingness to assist others were the most consistently reported strengths associated with ADHD. Stakeholder perspectives highlighted the need to appraise ADHD in a broader context, extending beyond diagnostic criteria into many areas of ability and disability as well as environmental facilitators and barriers. This qualitative study, along with three other studies (comprehensive scoping review, expert survey and clinical study), will provide the scientific basis to define ICF(-CY) Core Sets for ADHD, from which assessment tools can be derived for use in clinical and research setting, as well as in health care

  3. Cochrane Qualitative and Implementation Methods Group guidance series-paper 6: reporting guidelines for qualitative, implementation, and process evaluation evidence syntheses.

    Science.gov (United States)

    Flemming, Kate; Booth, Andrew; Hannes, Karin; Cargo, Margaret; Noyes, Jane

    2018-05-01

    To outline contemporary and novel developments for the presentation and reporting of syntheses of qualitative, implementation, and process evaluation evidence and provide recommendations for the use of reporting guidelines. An overview of reporting guidelines for qualitative, implementation, and process evaluation evidence syntheses drawing on current international literature and the collective expert knowledge of the Cochrane Qualitative and Implementation Methods Group. Several reporting guidelines exist that can be used or adapted to report syntheses of qualitative, implementation, and process evaluation evidence. Methods to develop individual guidance varied. The use of a relevant reporting guideline can enhance the transparency, consistency, and quality of reporting. Guidelines that exist are generic, method specific, and for particular aspects of the reviewing process, searching. Caution is expressed over the potential for reporting guidelines to produce a mechanistic approach moving the focus away from the content and toward the procedural aspects of the review. The use of a reporting guideline is recommended and a five-step decision flowchart to guide the choice of reporting guideline is provided. Gaps remain in method-specific reporting guidelines such as mixed-study, implementation, and process evaluation evidence syntheses. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Time to standardise levels of care amongst Out-of-Hospital Emergency Care providers in Africa

    OpenAIRE

    Mould-Millman, N.K.; Stein, C.; Wallis, L.A.

    2016-01-01

    The African Federation for Emergency Medicine’s Out-of-Hospital Emergency Care (OHEC) Committee convened 15 experts from various OHEC systems in Africa to participate in a consensus process to define levels of care within which providers in African OHEC systems should safely and effectively function. The expert panel concluded that four provider levels were relevant for African OHEC systems: (i) first aid, (ii) basic life support, (iii) intermediate life support, and (iv) advanced life suppor...

  5. Investigation of Inquiry-based Science Pedagogy among Middle Level Science Teachers: A Qualitative Study

    Science.gov (United States)

    Weiland, Sunny Minelli

    This study implemented a qualitative approach to examine the phenomenon of "inquiry-based science pedagogy or inquiry instruction" as it has been experienced by individuals. Data was collected through online open-ended surveys, focus groups, and teacher reported self-reflections to answer the research questions: 1) How do middle level science teachers conceptualize "inquiry-based instruction?" 2) What are preferred instructional strategies for implementation in middle level science classrooms? And 3) How do middle level science teachers perceive the connection between science instruction and student learning? The participants within this research study represent 33 percent of teachers in grades 5 through 9 within six school districts in northeastern Pennsylvania. Of the 12 consent forms originally obtained, 10 teachers completed all three phases of the data collection, including the online survey, participation in focus groups, and teacher self-reflection. 60 percent of the participants taught only science, and 40 percent taught all content areas. Of the ten participants, 50 percent were certified teachers of science and 50 percent were certified as teachers of elementary education. 70 percent of the research participants reflected having obtained a master's, with 60 percent of these degrees being received in areas of education, and 10 percent in the area of science. The research participants have a total of 85 collective years of experience as professional educators, with the average years of experience being 8.5 years. Analysis of data revealed three themes related to research question #1) How do middle-level science teachers conceptualize inquiry-based instruction? and sub-question #1) How do middle-level science teachers characterize effective instruction? The themes that capture the essence of teachers' formulation of inquiry-based instruction that emerged in this study were student centered, problem solving, and hands-on . Analysis of data revealed one theme

  6. Beyond the clinic walls: empowering young people through Youth Peer Provider programmes in Ecuador and Nicaragua.

    Science.gov (United States)

    Tebbets, Claire; Redwine, Dee

    2013-05-01

    Youth in Latin America experience high rates of teen pregnancy and sexually transmitted infections, but traditional health services are not meeting their health care needs. Youth require access to tailored health care and information to make informed, healthy decisions. To break down barriers to these vital sexual and reproductive health services, Planned Parenthood Global, a division of Planned Parenthood Federation of America, developed a Youth Peer Provider model which has been implemented in Latin America since the early 1990s. The model goes beyond peer education to train Youth Peer Providers under age 20 to provide condoms, oral contraceptive pills, emergency contraception, injectable contraceptives, and sexual and reproductive health information to their peers. Peers with needs beyond Youth Peer Providers' capacity are referred to health professionals offering youth-friendly services. Survey results reveal high levels of contraceptive use among those served by the Youth Peer Providers: 98% of sexually active survey respondents wishing to avoid pregnancy report contraceptive use at least five years after joining the programme. Results of qualitative programme evaluations highlight higher self-esteem, stronger communication and decision-making skills, close relationships with friends and family, more interest in school, understanding of responsibility in relationships, and other positive outcomes among programme participants. Copyright © 2013 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  7. Benefits and challenges of qualitative methodologies in cross-cultural psychology studies

    NARCIS (Netherlands)

    de Quadros Rigoni, R.

    2016-01-01

    Qualitative research has been considered increasingly valuable for cross-cultural psychology studies, but its contributions and challenges to the field remain under discussed. This chapter does that by analysing a qualitative study which compares interpretive beliefs and behaviour of street-level

  8. The provider perspective: investigating the effect of the Electronic Patient-Reported Outcome (ePRO) mobile application and portal on primary care provider workflow.

    Science.gov (United States)

    Hans, Parminder K; Gray, Carolyn Steele; Gill, Ashlinder; Tiessen, James

    2018-03-01

    Aim This qualitative study investigates how the Electronic Patient-Reported Outcome (ePRO) mobile application and portal system, designed to capture patient-reported measures to support self-management, affected primary care provider workflows. The Canadian health system is facing an ageing population that is living with chronic disease. Disruptive innovations like mobile health technologies can help to support health system transformation needed to better meet the multifaceted needs of the complex care patient. However, there are challenges with implementing these technologies in primary care settings, in particular the effect on primary care provider workflows. Over a six-week period interdisciplinary primary care providers (n=6) and their complex care patients (n=12), used the ePRO mobile application and portal to collaboratively goal-set, manage care plans, and support self-management using patient-reported measures. Secondary thematic analysis of focus groups, training sessions, and issue tracker reports captured user experiences at a Toronto area Family Health Team from October 2014 to January 2015. Findings Key issues raised by providers included: liability concerns associated with remote monitoring, increased documentation activities due to a lack of interoperability between the app and the electronic patient record, increased provider anxiety with regard to the potential for the app to disrupt and infringe upon appointment time, and increased demands for patient engagement. Primary care providers reported the app helped to focus care plans and to begin a collaborative conversation on goal-setting. However, throughout our investigation we found a high level of provider resistance evidenced by consistent attempts to shift the app towards fitting with existing workflows rather than adapting much of their behaviour. As health systems seek innovative and disruptive models to better serve this complex patient population, provider change resistance will need to

  9. 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.

  10. Perception of risk and communication among conventional and complementary health care providers involving cancer patients' use of complementary therapies: a literature review.

    Science.gov (United States)

    Stub, Trine; Quandt, Sara A; Arcury, Thomas A; Sandberg, Joanne C; Kristoffersen, Agnete E; Musial, Frauke; Salamonsen, Anita

    2016-09-08

    Communication between different health care providers (conventional and complementary) and cancer patients about their use of complementary therapies affects the health and safety of the patients. The aim of this study was to examine the qualitative research literature on the perception of and communication about the risk of complementary therapies between different health care providers and cancer patients. Systematic searches in six medical databases covering literature from 2000 to 2015 were performed. The studies were accessed according to the level of evidence and summarized into different risk situations. Qualitative content analysis was used to analyze the text data, and the codes were defined before and during the data analysis. Twenty-nine papers were included in the primary analysis and five main themes were identified and discussed. The main risk situations identified were 1. Differences in treatment concepts and philosophical values among complementary and conventional health care providers. 2. Adverse effects from complementary products and herbs due to their contamination/toxicity and interactions with conventional cancer treatment. 3. Health care physicians and oncologists find it difficult to recommend many complementary modalities due to the lack of scientific evidence for their effect. 4. Lack of knowledge and information about complementary and conventional cancer treatments among different health care providers. The risk of consuming herbs and products containing high level of toxins is a considerable threat to patient safety (direct risk). At the same time, the lack of scientific evidence of effect for many complementary therapies and differences in treatment philosophy among complementary and conventional health care providers potentially hinder effective communication about these threats with mutual patients (indirect risk). As such, indirect risk may pose an additional risk to patients who want to combine complementary therapies with

  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. Two Strategies for Qualitative Content Analysis: An Intramethod Approach to Triangulation.

    Science.gov (United States)

    Renz, Susan M; Carrington, Jane M; Badger, Terry A

    2018-04-01

    The overarching aim of qualitative research is to gain an understanding of certain social phenomena. Qualitative research involves the studied use and collection of empirical materials, all to describe moments and meanings in individuals' lives. Data derived from these various materials require a form of analysis of the content, focusing on written or spoken language as communication, to provide context and understanding of the message. Qualitative research often involves the collection of data through extensive interviews, note taking, and tape recording. These methods are time- and labor-intensive. With the advances in computerized text analysis software, the practice of combining methods to analyze qualitative data can assist the researcher in making large data sets more manageable and enhance the trustworthiness of the results. This article will describe a novel process of combining two methods of qualitative data analysis, or Intramethod triangulation, as a means to provide a deeper analysis of text.

  13. Researching collaboratively: implications for qualitative research and researchers.

    Science.gov (United States)

    Cheek, Julianne

    2008-11-01

    Often discussions about collaborative research, and collaboration generally, begin at the point of how to collaborate, who to collaborate with, and what to collaborate about. Rarely do they include equally important questions of why we are having discussions about collaboration, where such an impetus and emphasis is coming from, and how it connects to the contemporary political research context. In a recent editorial in Qualitative Health Research, Janice Morse highlighted the need for reflection about collaboration. This article responds to that call, providing reflections on collaboration, the imperative to collaborate, and what this all might mean for both qualitative research and qualitative researchers. I hope to stimulate new points of departure for thinking and action shaping collaborative research endeavors without-and just as crucially, within-qualitative research.

  14. A qualitative study on acceptable levels of risk for pregnant women in clinical research.

    Science.gov (United States)

    van der Zande, Indira S E; van der Graaf, Rieke; Oudijk, Martijn A; van Delden, Johannes J M

    2017-05-15

    There is ambiguity with regard to what counts as an acceptable level of risk in clinical research in pregnant women and there is no input from stakeholders relative to such research risks. The aim of our paper was to explore what stakeholders who are actively involved in the conduct of clinical research in pregnant women deem an acceptable level of risk for pregnant women in clinical research. Accordingly, we used the APOSTEL VI study, a low-risk obstetrical randomised controlled trial, as a case-study. We conducted a prospective qualitative study using 35 in-depth semi-structured interviews and one focus group. We interviewed healthcare professionals, Research Ethics Committee members (RECs) and regulators who are actively involved in the conduct of clinical research in pregnant women, in addition to pregnant women recruited for the APOSTEL VI case-study in the Netherlands. Three themes characterise the way stakeholders view risks in clinical research in pregnant women in general. Additionally, one theme characterises the way healthcare professionals and pregnant women view risks with respect to the case-study specifically. First, ideas on what constitutes an acceptable level of risk in general ranged from a preference for zero risk for the foetus up to minimal risk. Second, the desirability of clinical research in pregnant women in general was questioned altogether. Third, stakeholders proposed to establish an upper limit of risk in potentially beneficial clinical research in pregnant women in order to protect the foetus and the pregnant woman from harm. Fourth and finally, the case-study illustrates that healthcare professionals' individual perception of risk may influence recruitment. Healthcare professionals, RECs, regulators and pregnant women are all risk adverse in practice, possibly explaining the continuing underrepresentation of pregnant women in clinical research. Determining the acceptable levels of risk on a universal level alone is insufficient

  15. Problem solving, loneliness, depression levels and associated factors in high school adolescents.

    Science.gov (United States)

    Sahin, Ummugulsum; Adana, Filiz

    2016-01-01

    To determine problem solving, loneliness, depression levels and associated factors in high school adolescents. This cross-sectional study was conducted in a city west of Turkey (Bursa) in a public high school and the population was 774 and the sampling was 394 students. Students to be included in the study were selected using the multiple sampling method. A personal Information Form with 23 questions, Problem Solving Inventory (PSI), Loneliness Scale (UCLA), Beck Depression Inventory (BDI) were used as data collection tools in the study. Basic statistical analyses, t-test, Kruskall Wallis-H, One Way Anova and Pearson Correlation test were used to evaluate the data. Necessary permissions were obtained from the relevant institution, students, parents and the ethical committee. The study found significant differences between "problem solving level" and family type, health assessment, life quality and mothers', fathers' siblings' closeness level; between "loneliness level" and gender, family income, health assessment, life quality and mothers', fathers', siblings' closeness level; between "depression level" and life quality, family income, fathers' closeness level. Unfavorable socio-economic and cultural conditions can have an effect on the problem solving, loneliness and depression levels of adolescents. Providing structured education to adolescents at risk under school mental health nursing practices is recommended.

  16. 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.

  17. What factors determine academic achievement in high achieving undergraduate medical students? A qualitative study.

    Science.gov (United States)

    Abdulghani, Hamza M; Al-Drees, Abdulmajeed A; Khalil, Mahmood S; Ahmad, Farah; Ponnamperuma, Gominda G; Amin, Zubair

    2014-04-01

    Medical students' academic achievement is affected by many factors such as motivational beliefs and emotions. Although students with high intellectual capacity are selected to study medicine, their academic performance varies widely. The aim of this study is to explore the high achieving students' perceptions of factors contributing to academic achievement. Focus group discussions (FGD) were carried out with 10 male and 9 female high achieving (scores more than 85% in all tests) students, from the second, third, fourth and fifth academic years. During the FGDs, the students were encouraged to reflect on their learning strategies and activities. The discussion was audio-recorded, transcribed and analysed qualitatively. Factors influencing high academic achievement include: attendance to lectures, early revision, prioritization of learning needs, deep learning, learning in small groups, mind mapping, learning in skills lab, learning with patients, learning from mistakes, time management, and family support. Internal motivation and expected examination results are important drivers of high academic performance. Management of non-academic issues like sleep deprivation, homesickness, language barriers, and stress is also important for academic success. Addressing these factors, which might be unique for a given student community, in a systematic manner would be helpful to improve students' performance.

  18. Evaluation of Dermatology Practice Online Reviews: Lessons From Qualitative Analysis.

    Science.gov (United States)

    Smith, Robert J; Lipoff, Jules B

    2016-02-01

    Patient satisfaction is an increasingly important component of health care quality measures. Online reviews of physicians represent a promising platform for capturing patient perspectives of care. To identify qualitative themes associated with patient reviews of dermatologic care on consumer reporting websites. A qualitative analysis was conducted of patient-generated reviews of dermatology practices on 2 consumer review platforms. Yelp is an online consumer portal for users to review their experience with local businesses; ZocDoc is an online patient-scheduling portal that provides opportunity for patients to write reviews of physician practices. A total of 518 reviews from 45 dermatology practices on Yelp and 4921 reviews from 45 dermatology providers on ZocDoc were collected from 3 geographically diverse cities: Philadelphia, Pennsylvania; Houston, Texas; and Seattle, Washington. The study was conducted from January 15 to July 15, 2015. Reviews were separated into high-scoring and low-scoring groups. An inductive qualitative method was used to code and identify key themes associated with positive and negative patient experiences. Analysis was completed upon reaching thematic saturation. Reported as mean (95% CI), the overall Yelp score for the 45 selected practices was 3.46 of 5 stars (3.17-3.75) and overall ZocDoc score for the 45 selected practices was 4.72 of 5 stars (4.47-4.80). The proportion of individual reviews giving a score of 5.0 was significantly higher on ZocDoc (3986 [81.0%]) than on Yelp (229 [44.2%]) (P dermatology providers. Online consumer review websites are designed to facilitate instantaneous and public communication among patients. These platforms provide elaborate and timely data for dermatologists to garner insight into their patients' experiences. The themes identified in this study are consistent with past satisfaction studies and may aid dermatologists in optimizing the patient care experience.

  19. Lay health workers perceptions of an anemia control intervention in Karnataka, India: a qualitative study.

    Science.gov (United States)

    Shet, Arun S; Rao, Abha; Jebaraj, Paul; Mascarenhas, Maya; Zwarenstein, Merrick; Galanti, Maria Rosaria; Atkins, Salla

    2017-09-18

    Lay health workers (LHWs) are increasingly used to complement health services internationally. Their perceptions of the interventions they implement and their experiences in delivering community based interventions in India have been infrequently studied. We developed a novel LHW led intervention to improve anemia cure rates in rural community dwelling children attending village day care centers in South India. Since the intervention is delivered by the village day care center LHW, we sought to understand participating LHWs' acceptance of and perspectives regarding the intervention, particularly in relation to factors affecting daily implementation. We conducted a qualitative study alongside a cluster randomized controlled trial evaluating a complex community intervention for childhood anemia control in Karnataka, South India. Focus group discussions (FGDs) were conducted with trained LHWs assigned to deliver the educational intervention. These were complemented by non-participant observations of LHWs delivering the intervention. Transcripts of the FGDs were translated and analyzed using the framework analysis method. Several factors made the intervention acceptable to the LHWs and facilitated its implementation including pre-implementation training modules, intervention simplicity, and ability to incorporate the intervention into the routine work schedule. LHWs felt that the intervention impacted negatively on their preexisting workload. Fluctuating relationships with mothers weakened the LHWs position as providers of the intervention and hampered efficient implementation, despite the LHWs' highly valued position in the community. Modifiable barriers to the successful implementation of this intervention were seen at two levels. At a broader contextual level, hindering factors included the LHW being overburdened, inadequately reimbursed, and receiving insufficient employer support. At the health system level, lack of streamlining of LHW duties, inability of LHWs to

  20. Using Qualitative Metasummary to Synthesize Qualitative and Quantitative Descriptive Findings

    OpenAIRE

    Sandelowski, Margarete; Barroso, Julie; Voils, Corrine I.

    2007-01-01

    The new imperative in the health disciplines to be more methodologically inclusive has generated a growing interest in mixed research synthesis, or the integration of qualitative and quantitative research findings. Qualitative metasummary is a quantitatively oriented aggregation of qualitative findings originally developed to accommodate the distinctive features of qualitative surveys. Yet these findings are similar in form and mode of production to the descriptive findings researchers often ...