Identification and characteristics of vaccine refusers

OpenAIRE

Wei, Feifei; Mullooly, John P; Goodman, Mike; McCarty, Maribet C; Hanson, Ann M; Crane, Bradley; Nordin, James D

2009-01-01

Abstract Background This study evaluated the utility of immunization registries in identifying vaccine refusals among children. Among refusers, we studied their socioeconomic characteristics and health care utilization patterns. Methods Medical records were reviewed to validate refusal status in the immunization registries of two health plans. Racial, education, and income characteristics of children claiming refusal were collected based on the census tract of each child. Health care utilizat...

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

Energy Technology Data Exchange (ETDEWEB)

NONE

1999-03-10

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

School Refusal: Clinical Features, Diagnosis and Treatment

Directory of Open Access Journals (Sweden)

Kayhan Bahali

2010-12-01

Full Text Available Children regularly and voluntarily go to school in order to fulfill the expectations of society from them to continue their education or schooling. School continuation has been made compulsory by laws. Nonetheless, contrary to popular belief, for some children it is distressing to go to school. These children have difficulty continuing school and/or refuse to go to school. Today school refusal is defined as a child’s inability to continue school for reasons, such as anxiety and depression. The prevalence of school refusal has been reported to be approximately 1% in school-age children and 5% in child psychiatry samples. The prevalence of school refusal is similar among boys and girls. School refusal can occur at any time throughout the child’s academic life and at all socio-economic levels. School refusal is considered a symptom rather than a clinical diagnosis and can manifest itself as a sign of many psychiatric disorders, with anxiety disorders predominant. Separation anxiety disorder, generalized anxiety disorder, social phobia, specific phobia, and adjustment disorder with anxiety symptoms are the most common disorders co-occurring with school refusal. While separation anxiety disorder is associated with school refusal in younger children, other anxiety disorders, especially phobias, are associated with school refusal in adolescents. Children who have parents with psychiatric disorders have a higher incidence of school refusal, and psychiatric disorders are more frequently seen in adult relatives of children with school refusal, which supports a significant role of genetic and environmental factors in th etiology of school refusal. School refusal is a emergency state for child mental health. As it leads to detrimental effects in the short term and the long term, it should be regarded as a serious problem. The long-lasting follow-up studies of school refusing children have revealed that these children have a higher incidence of

33 CFR 401.89 - Transit refused.

Science.gov (United States)

2010-07-01

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

The Legal Ethical Backbone of Conscientious Refusal

DEFF Research Database (Denmark)

Munthe, Christian; Nielsen, Morten Ebbe Juul

2017-01-01

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

Cubicle Refusal in Norwegian Dairy Herds

Directory of Open Access Journals (Sweden)

Myren HJ

2001-03-01

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

30 CFR 77.215-4 - Refuse piles; abandonment.

Science.gov (United States)

2010-07-01

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

30 CFR 816.83 - Coal mine waste: Refuse piles.

Science.gov (United States)

2010-07-01

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

30 CFR 817.83 - Coal mine waste: Refuse piles.

Science.gov (United States)

2010-07-01

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

The Legal Ethical Backbone of Conscientious Refusal.

Science.gov (United States)

Munthe, Christian; Nielsen, Morten Ebbe Juul

2017-01-01

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

21 CFR 211.50 - Sewage and refuse.

Science.gov (United States)

2010-04-01

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

Medication Refusal: Resident Rights, Administration Dilemma.

Science.gov (United States)

Haskins, Danielle R; Wick, Jeannette Y

2017-12-01

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

Legal briefing: conscience clauses and conscientious refusal.

Science.gov (United States)

Pope, Thaddeus Mason

2010-01-01

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

Non-polluting disposal of spent primary batteries. Varta-Spezial-Report

Energy Technology Data Exchange (ETDEWEB)

Hiller, F

1982-01-01

Reflections on non-polluting disposal of spent primary batteries result in the following: Mercury content of battery systems which are either available on or being introduced to the market varies extremely. Coal/zinc cells, i.e. Leclanche cells and lithium cells, contain practically no mercury. A system for collecting and recycling cells with an increased mercury content (HgO/Zn cells) has existed for year. The mercury content of a cell does not mean ony hazard for the user. The following strategy, therefore, appears to be applicable for spent batteries: - collection and recycling of mercury oxide and silver oxide button cells, - disposal of zinc/coal batteries with domestic refuse, - quantitative reduction of alkaline zinc/manganese dioxide cells through substitution.

30 CFR 77.214 - Refuse piles; general.

Science.gov (United States)

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Refuse piles; general. 77.214 Section 77.214... Installations § 77.214 Refuse piles; general. (a) Refuse piles constructed on or after July 1, 1971, shall be..., tipples, or other surface installations and such piles shall not be located over abandoned openings or...

Coal refuse reclamation project

Energy Technology Data Exchange (ETDEWEB)

Zellmer, S.D.

1979-04-06

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

Waste transport and storage: Packaging refused due to failure in fulfilling QC/QA requirements

International Nuclear Information System (INIS)

Bruno, N.C.; Brandao, R.O.; Cavalcante, V.L.

2001-01-01

The Brazilian Nuclear Programme comprises several nuclear and radioactive facilities including Angra I Nuclear Power Plant, in operation since 1981, and Angra II, scheduled to start its operation by the end of 1999. Among the other ones there are uranium mining and milling facilities, four research reactors and one industrial facility of monazite sands processing. The already existing waste generation and near future ones claim to a solution regarding waste disposal. Although site selection criteria for waste repository in Brazil has already been defined, political and psychosocial aspects have strong impact. Trauma generated by Goiania's radiological accident has led to difficulties when decisions about this matter have to be taken. As a consequence, the waste generated by Angra I is still in a provisional facility at the plant's site. Wastes from the medical sources are stored in research institutes while waste generated from monazite sands is kept in a dam system. In order to overpack non-qualified packages containing waste of Angra I NPP, 70 lost concrete shielding packagings had to be provided. Based on successfully designed and tested prototype, packagings and respective lids specifications were written, approved and released for serial production. As part of packaging certification process, Brazilian Competent Authority performed a regulatory inspection and audit. Various findings, such as weaknesses in quality control and quality assurance records, unacceptable test results as well as failure in modify the concrete composition during a testified packaging manufacturing, led Competent Authority to refuse the packagings as containers until complementary tests could be performed. Further tests and evaluations led the Competent Authority to conclude that the manufacturer failed to both comply with requirements established in packaging specification and fulfill quality control/quality assurance requirements. As responsible by federal law for the reception and

Personal values and cancer treatment refusal

NARCIS (Netherlands)

Evert van Leeuwen; Marli Huijer

2000-01-01

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

30 CFR 77.215-1 - Refuse piles; identification.

Science.gov (United States)

2010-07-01

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

30 CFR 77.215-3 - Refuse piles: certification.

Science.gov (United States)

2010-07-01

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

30 CFR 77.215 - Refuse piles; construction requirements.

Science.gov (United States)

2010-07-01

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

25 CFR 135.23 - Refusal of water delivery.

Science.gov (United States)

2010-04-01

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

25 CFR 135.6 - Refusal of water delivery.

Science.gov (United States)

2010-04-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

1990-03-01

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

School Refusal

Science.gov (United States)

Wimmer, Mary

2008-01-01

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

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

Science.gov (United States)

2010-04-01

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

[Refusal of treatments by an adult cancer patient].

Science.gov (United States)

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

2018-03-01

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

Turning refuse plastic into multi-walled carbon nanotube forest

Directory of Open Access Journals (Sweden)

Eugene Oh, Jaegeun Lee, Seung-Ho Jung, Seungho Cho, Hye-Jin Kim, Sung-Hyun Lee, Kun-Hong Lee, Kyong-Hwa Song, Chi-Hoon Choi and Do Suck Han

2012-01-01

Full Text Available A novel and effective method was devised for synthesizing a vertically aligned carbon nanotube (CNT forest on a substrate using waste plastic obtained from commercially available water bottles. The advantages of the proposed method are the speed of processing and the use of waste as a raw material. A mechanism for the CNT growth was also proposed. The growth rate of the CNT forest was ~2.5 μm min−1. Transmission electron microscopy images indicated that the outer diameters of the CNTs were 20–30 nm on average. The intensity ratio of the G and D Raman bands was 1.27 for the vertically aligned CNT forest. The Raman spectrum showed that the wall graphitization of the CNTs, synthesized via the proposed method was slightly higher than that of commercially available multi-walled carbon nanotubes (MWCNTs. We expect that the proposed method can be easily adapted to the disposal of other refuse materials and applied to MWCNT production industries.

Turning refuse plastic into multi-walled carbon nanotube forest

Science.gov (United States)

Oh, Eugene; Lee, Jaegeun; Jung, Seung-Ho; Cho, Seungho; Kim, Hye-Jin; Lee, Sung-Hyun; Lee, Kun-Hong; Song, Kyong-Hwa; Choi, Chi-Hoon; Han, Do Suck

2012-01-01

A novel and effective method was devised for synthesizing a vertically aligned carbon nanotube (CNT) forest on a substrate using waste plastic obtained from commercially available water bottles. The advantages of the proposed method are the speed of processing and the use of waste as a raw material. A mechanism for the CNT growth was also proposed. The growth rate of the CNT forest was ∼2.5 μm min−1. Transmission electron microscopy images indicated that the outer diameters of the CNTs were 20–30 nm on average. The intensity ratio of the G and D Raman bands was 1.27 for the vertically aligned CNT forest. The Raman spectrum showed that the wall graphitization of the CNTs, synthesized via the proposed method was slightly higher than that of commercially available multi-walled carbon nanotubes (MWCNTs). We expect that the proposed method can be easily adapted to the disposal of other refuse materials and applied to MWCNT production industries. PMID:27877482

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

Science.gov (United States)

2010-07-01

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

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

NARCIS (Netherlands)

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

1972-01-01

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

Primary care pediatricians' perceptions of vaccine refusal in europe.

Science.gov (United States)

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

2011-03-01

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

Persian Speakers' Use of Refusal Strategies across Politeness Systems

Science.gov (United States)

Salmani Nodoushan, Mohammad Ali

2016-01-01

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

19 CFR 12.114 - Release or refusal of delivery.

Science.gov (United States)

2010-04-01

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

Disposal of disused sealed sources in France

International Nuclear Information System (INIS)

Certes, C.

2003-01-01

The current status of the disused sealed sources in France is presented and a proposal for future management is given.About 150 000 disused source are registered, most of which are located in the Centre de l'Aube (130 000) and the rest are in about 250 installations. Since 2002 the tracing of the sources are made bu the IRSN/UES. A scheme of sealed sources management is given consisting of collecting, channeling (recycling, reconditioning, interim storage, denaturation) and elimination (surface disposal, long interim or deep disposal). The capacity of the CDA for disposal is 1 mill. m 3 (about 2 mill. tons of waste). It is intended for waste packages containing (basic safety rule I.2) - Low and Intermediate specific activity levels ( ∼ 103 ∼ 106 Bq/g); Short-lived radionuclides (half-life 60 Co). For sources containing one concentrated long-lived radionuclide in case of non-conformity with the basic safety rule I.2 (heterogeneity and long half-life) for example refusal is received for a few sources containing 241 Am). Radiological capacity id base on inventories nad safety evaluation scenarios. Fixed by decree (TBq) are: 60 Co(5.3 y) - 400 000; 3 H(12.3 y) - 4000; 137 Cs(30 y); - 200 000; 90 Sr(29 y) -40 000; Σ alpha (at 300 years) - 750. Waste acceptance criterion is based on the mass activity limit. The importance of the calculation method in this criterion is emphasised. IRSN reflexion basis for disposal is discussed

Denitrification capacity of bioreactors filled with refuse at different landfill ages

International Nuclear Information System (INIS)

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

2009-01-01

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

Toxic and hazardous waste disposal. Volume 1. Processes for stabilization/solidification

International Nuclear Information System (INIS)

Pojasek, R.B.

1979-01-01

Processes for the stabilization and/or solidification of toxic, hazardous, and radioactive wastes are reviewed. The types of wastes classified as hazardous are defined. The following processes for the solidification of hazardous wastes are described: lime-based techniques; thermoplastic techniques; organic polymer techniques; and encapsulation. The following processes for the solidification of high-level radioactive wastes are described: calcination; glassification; and ceramics. The solidification of low-level radioactive wastes with asphalt, cement, and polymeric materials is also discussed. Other topics covered include: the use of an extruder/evaporator to stabilize and solidify hazardous wastes; effect disposal of fine coal refuse and flue gas desulfurization slurries using Calcilox additive stabilization; the Terra-Tite Process; the Petrifix Process; the SFT Terra-Crete Process; Sealosafe Process; Chemfix Process; and options for disposal of sulfur oxide wastes

Characteristics and Outcomes of Elderly Patients Refused to ICU

Directory of Open Access Journals (Sweden)

María-Consuelo Pintado

2013-01-01

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

36 CFR 2.14 - Sanitation and refuse.

Science.gov (United States)

2010-07-01

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

Characterisation of major component leaching and buffering capacity of RDF incineration and gasification bottom ash in relation to reuse or disposal scenarios

NARCIS (Netherlands)

Rocca, S.; Zomeren, van A.; Costa, G.; Dijkstra, J.J.; Comans, R.N.J.; Lombardi, F.

2012-01-01

Thermal treatment of refuse derived fuel (RDF) in waste-to-energy (WtE) plants is considered a promising solution to reduce waste volumes for disposal, while improving material and energy recovery from waste. Incineration is commonly applied for the energetic valorisation of RDF, although RDF

Refusal of Curative Radiation Therapy and Surgery Among Patients With Cancer

International Nuclear Information System (INIS)

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

2014-01-01

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

Refusal of Curative Radiation Therapy and Surgery Among Patients With Cancer

Energy Technology Data Exchange (ETDEWEB)

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

2014-07-15

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

Application for Permit to Operate a Class III Solid Waste Disposal Site at the Nevada Test Site - U10c Disposal Site

Energy Technology Data Exchange (ETDEWEB)

NSTec Environmental Programs

2010-08-05

The NTS is located approximately 105 km (65 mi) northwest of Las Vegas, Nevada. NNSA/NSO is the federal lands management authority for the NTS and NSTec is the Management & Operations contractor. Access on and off the NTS is tightly controlled, restricted, and guarded on a 24-hour basis. The NTS is posted with signs along its entire perimeter. NSTec is the operator of all solid waste disposal sites on the NTS. The U10C Disposal Site is located in the northwest corner of Area 9 at the NTS (Figure 1) and is located in a subsidence crater created by two underground nuclear events, one in October 1962 and another in April 1964. The disposal site opened in 1971 for the disposal of rubbish, refuse, pathological waste, asbestos-containing material, and industrial solid waste. A Notice of Intent form to operate the disposal site as a Class II site was submitted to the state of Nevada on January 26, 1994, and was acknowledged in a letter to the DOE on February 8, 1994. It operated as a state of Nevada Class II Solid Waste Disposal Site (SWDS) until it closed on October 5, 1995, for retrofit as a Class III SWDS. The retrofit consisted of the installation of a minimum four-foot compacted soil layer to segregate the different waste types and function as a liner to inhibit leachate and water flow into the lower waste zone. Five neutron monitoring tubes were installed in this layer to monitor possible leachate production and water activity. Upon acceptance of the installed barrier and approval of an Operating Plan by NDEP/BFF, the site reopened in January 1996 as a Class III SWDS for the disposal of industrial solid waste and other inert waste.

Factors related to treatment refusal in Taiwanese cancer patients.

Science.gov (United States)

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

2015-01-01

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

Pervasive refusal syndrome. Three German cases provide further illustration.

Science.gov (United States)

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

2011-09-01

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

Refusal Skill Ability: An Examination of Adolescent Perceptions of Effectiveness

Science.gov (United States)

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

2010-01-01

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

47 CFR 73.4005 - Advertising-refusal to sell.

Science.gov (United States)

2010-10-01

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

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

Science.gov (United States)

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

2014-07-15

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

Microbial ecology of coal mine refuse

Energy Technology Data Exchange (ETDEWEB)

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

1977-01-01

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

Elemental composition of suspended particles released in refuse incineration

International Nuclear Information System (INIS)

Mamuro, Tetsuo; Mizohata, Akira

1979-01-01

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

Process for producing a fuel suitable for degassing from refuse

Energy Technology Data Exchange (ETDEWEB)

Sulzberger, J

1975-11-20

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

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

OpenAIRE

Wreen, M J

1991-01-01

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

14 CFR 121.586 - Authority to refuse transportation.

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Authority to refuse transportation. 121.586 Section 121.586 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION... transportation. (a) No certificate holder may refuse transportation to a passenger on the basis that, because the...

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

Directory of Open Access Journals (Sweden)

Annelize Nienaber

2016-11-01

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

Situation testing: the case of health care refusal.

Science.gov (United States)

Després, C; Couralet, P-E

2011-04-01

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

[Refusal of nursing care, the legal perspective].

Science.gov (United States)

Fisman, Jérôme

2016-10-01

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

Handbook of solid waste disposal: materials and energy recovery

Energy Technology Data Exchange (ETDEWEB)

Pavoni, J L; Heer, Jr, J E; Hagerty, D J

1975-01-01

Traditional and innovative solid waste disposal techniques and new developments in materials and energy recovery systems are analyzed. Each method is evaluated in terms of system methodology, controlling process parameters, and process requirements, by-products, economics, and case histories. Medium and high temperature incineration; wet pulping; landfill with leachate recirculation; the Hercules, Inc., system; USBM front-end and back-end systems; pyrolysis; waste heat utilization, the Combustion Power Unit-400; use of refuse as a supplementary fuel; and methane production from anaerobic fermentation systems are considered, as well as sanitary landfilling, incineration, and composting. European solid waste management techniques are evaluated for their applicability to the US.

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

Science.gov (United States)

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

School Refusal: Assessment and Intervention within School Settings.

Science.gov (United States)

Wimmer, Mary B.

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

Risk factors associated with treatment refusal in lung cancer.

Science.gov (United States)

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

2017-09-01

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

When does food refusal require professional intervention?

OpenAIRE

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

2009-01-01

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

Steam gasification of tyre waste, poplar, and refuse-derived fuel: A comparative analysis

International Nuclear Information System (INIS)

Galvagno, S.; Casciaro, G.; Casu, S.; Martino, M.; Mingazzini, C.; Russo, A.; Portofino, S.

2009-01-01

In the field of waste management, thermal disposal is a treatment option able to recover resources from 'end of life' products. Pyrolysis and gasification are emerging thermal treatments that work under less drastic conditions in comparison with classic direct combustion, providing for reduced gaseous emissions of heavy metals. Moreover, they allow better recovery efficiency since the process by-products can be used as fuels (gas, oils), for both conventional (classic engines and heaters) and high efficiency apparatus (gas turbines and fuel cells), or alternatively as chemical sources or as raw materials for other processes. This paper presents a comparative study of a steam gasification process applied to three different waste types (refuse-derived fuel, poplar wood and scrap tyres), with the aim of comparing the corresponding yields and product compositions and exploring the most valuable uses of the by-products

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

Science.gov (United States)

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

2014-01-01

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

Current status of research on school refusal

Directory of Open Access Journals (Sweden)

Cándido J. Inglés

2015-06-01

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

Radioactive waste disposal

International Nuclear Information System (INIS)

Petit, J.C.

1998-04-01

A deep gap, reflecting a persisting fear, separates the viewpoints of the experts and that of the public on the issue of the disposal of nuclear WASTES. The history of this field is that of the proliferation with time of spokesmen who pretend to speak in the name of the both humans and non humans involved. Three periods can be distinguished: 1940-1970, an era of contestation and confusion when the experts alone represents the interest of all; 1970-1990, an era of contestation and confusion when spokespersons multiply themselves, generating the controversy and the slowing down of most technological projects; 1990-, an era of negotiation, when viewpoints, both technical and non technical, tend to get closer and, let us be optimistic, leading to the overcome of the crisis. We show that, despite major differences, the options and concepts developed by the different actors are base on two categories of resources, namely Nature and Society, and that the consensus is built up through their 'hydridation'. we show in this part that the perception of nuclear power and, in particular of the underground disposal of nuclear wastes, involves a very deep psychological substrate. Trying to change mentalities in the domain by purely scientific and technical arguments is thus in vain. The practically instinctive fear of radioactivity, far from being due only to lack of information (and education), as often postulated by scientists and engineers, is rooted in archetypical structures. These were, without doubt, reactivated in the 40 s by the traumatizing experience of the atomic bomb. In addition, anthropological-linked considerations allow us to conclude that he underground disposal of wastes is seen as a 'rape' and soiling of Mother Earth. This contributes to explaining, beyond any rationality, the refusal of this technical option by some persons. However, it would naturally be simplistic and counter-productive to limit all controversy in this domain to these psychological aspects

Refusal to medical interventions.

Science.gov (United States)

Palacios, G; Herreros, B; Pacho, E

2014-10-01

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

Refusing The Choice: Balancing Life and Work

Science.gov (United States)

Brooks, J.

2012-12-01

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

Clean Cities Niche Market Overview: Refuse Haulers (Brochure)

Energy Technology Data Exchange (ETDEWEB)

Shea, S.

2011-09-01

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

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

Science.gov (United States)

Bhandari, Neeraj; Shi, Yunfeng; Jung, Kyoungrae

2016-01-01

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

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

Science.gov (United States)

Owiti, J A; Bowers, L

2011-09-01

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

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

Science.gov (United States)

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

2018-01-01

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

[The refusal of nursing care by the families].

Science.gov (United States)

Curchod, Claude; Fisher, Marion

2016-10-01

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

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

Science.gov (United States)

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

2014-03-01

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

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

Science.gov (United States)

Wade, Katherine

2014-01-01

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

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

Science.gov (United States)

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

2017-07-01

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

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

Science.gov (United States)

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

2015-12-01

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

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

Science.gov (United States)

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

2017-10-01

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

Sodium bicarbonate effects on the anaerobic digestion of refuse

Energy Technology Data Exchange (ETDEWEB)

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

1989-01-01

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

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

Science.gov (United States)

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

2009-11-01

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

Attenuation of heavy metal leaching from hazardous wastes by co-disposal of wastes

Energy Technology Data Exchange (ETDEWEB)

Bae, Wookeun; Shin, Eung Bai [Hanyang Univ., Ansan (Korea, Republic of); Lee, Kil Chul; Kim, Jae Hyung [National Institute of Environmental Research, Seoul (Korea, Republic of)] [and others

1996-12-31

The potential hazard of landfill wastes was previously evaluated by examining the extraction procedures for individual waste, although various wastes were co-disposed of in actual landfills. This paper investigates the reduction of extraction-procedure toxicity by co-disposing various combinations of two wastes. When two wastes are mixed homogeneously, the extraction of heavy metals from the waste mixture is critically affected by the extract pH. Thus, co-disposal wastes will have a resultant pH between the pH values of its constituent. The lower the resultant pH, the lower the concentrations of heavy metals in the extract. When these wastes are extracted sequentially, the latter extracted waste has a stronger influence on the final concentration of heavy metals in the extract. Small-scale lysimeter experiments confirm that when heavy-metal-bearing leachates Generated from hazardous-waste lysimeters are passed through a nonhazardous-waste lysimeter filled with compost, briquette ash, or refuse-incineration ashes, the heavy-metal concentration in the final leachates decreases significantly. Thus, the heavy-metal leaching could be attenuated if a less extraction-procedure-toxic waste were placed at the bottom of a landfill. 3 refs., 4 figs., 5 tabs.

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

Science.gov (United States)

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

2010-01-01

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

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

Science.gov (United States)

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

1999-01-01

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

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

Science.gov (United States)

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

2017-11-01

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

Assessment of musculoskeletal load in refuse collectors

Directory of Open Access Journals (Sweden)

Zbigniew W. Jóźwiak

2013-08-01

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

Geomorphic reclmation of a coal refuse pile

Science.gov (United States)

Hopkinson, L. C.; Quaranta, J.

2017-12-01

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

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

Science.gov (United States)

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

2018-01-01

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

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

Science.gov (United States)

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

2015-06-01

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

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

Science.gov (United States)

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

2005-04-01

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

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

Science.gov (United States)

2011-05-23

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

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

Directory of Open Access Journals (Sweden)

Olajide O Adelugba

2016-01-01

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

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

Science.gov (United States)

Wreen, M J

1991-09-01

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

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

Science.gov (United States)

2010-07-01

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

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

Science.gov (United States)

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

2011-01-01

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

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

NARCIS (Netherlands)

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

2009-01-01

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

Application for Permit to Operate a Class II Solid Waste Disposal Site at the Nevada Test Site - U10c Disposal Site

Energy Technology Data Exchange (ETDEWEB)

NSTec Environmental Programs

2010-03-31

The Nevada Test Site (NTS) is located approximately 105 km (65 mi) northwest of Las Vegas, Nevada. National Nuclear Security Administration Nevada Site Office (NNSA/NSO) is the federal lands management authority for the NTS and National Security Technologies LLC (NSTec) is the Management and Operations contractor. Access on and off the NTS is tightly controlled, restricted, and guarded on a 24-hour basis. The NTS is posted with signs along its entire perimeter. NSTec is the operator of all solid waste disposal sites on the NTS. The site will be used for the disposal of refuse, rubbish, garbage, sewage sludge, pathological waste, Asbestos-Containing Material (ACM), industrial solid waste, hydrocarbon-burdened soil, hydrocarbon-burdened demolition and construction waste, and other inert waste (hereafter called permissible waste). Waste containing free liquids or regulated under Subtitle C of the Resource Conservation and Recovery Act (RCRA) will not be accepted for disposal at the site. Waste regulated under the Toxic Substance Control Act (TSCA), excluding Polychlorinated Biphenyl [PCB], Bulk Product Waste (see Section 6.2.5) and ACM (see Section 6.2.2.2) will not be accepted for disposal at the site. The disposal site will be used as the sole depository of permissible waste which is: (1) Generated by entities covered under the U.S. Environmental Protection Agency (EPA) Hazardous Waste Generator Identification Number for the NTS; (2) Generated at sites identified in the Federal Facilities Agreement and Consent Order (FFACO); (3) Sensitive records and media, including documents, vugraphs, computer disks, typewriter ribbons, magnetic tapes, etc., generated by NNSA/NSO or its contractors; (4) ACM generated by NNSA/NSO or its contractors according to Section 6.2.2.2, as necessary; (5) Hydrocarbon-burdened soil and solid waste from areas covered under the EPA Hazardous Waste Generator Identification Number for the NTS; (6) Other waste on a case-by-case concurrence by

Power generation from refuse derived fuel

International Nuclear Information System (INIS)

Surroop, Dinesh; Mohee, Romeela

2010-01-01

Full text: The beginning of the third millennium has been characterized by a progressive increase in the demand for fossil fuels, which has caused a steep rise in oil price. At the same time, several environmental disasters have increased the sensitivity of world-wide public opinion towards the effect that environmental pollution has on human health and climate change. These conditions have fostered a renewed interest in renewable energy like solar energy, wind energy, biomass and solid wastes. In addition, the disposal of municipal solid waste (MSW) has become a critical and costly problem. The traditional landfill method requires large amounts of land and contaminates air, water and soil. The increase in socio-economic condition during the past ten years has also significantly increased the amount of solid waste generated. There are around 1200 tons of municipal solid waste (MSW) generated daily, of which the combustibles namely plastics, paper and textile waste represent 28%, and with the present generation rate, the landfill will be filled by 2012. The study was, therefore, initiated to assess the potential of power generation from refused derived fuels (RDF) from municipal solid waste (MSW) in order to reduce the dependency on fossil fuels. There are 336 tons which is equivalent to 12 tons/ h of RDF that can be generated daily from the MSW and this would generate 19.2 MW power. There will be 312 kg/ h of ash that would be generated and the NO x and SO 2 concentration were found to be 395.5 and 43.3 mg/ Nm 3 respectively. It was also found that the amount of non-biogenic CO 2 produced was 471 g/ kWhe. (author)

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

African Journals Online (AJOL)

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

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

Directory of Open Access Journals (Sweden)

Luana Sorrenti

2016-08-01

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

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

Science.gov (United States)

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

2001-09-01

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

Microbial ecology studies at two coal mine refuse sites in Illinois

Energy Technology Data Exchange (ETDEWEB)

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

1978-01-01

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

Integrated solid waste management in Japan

Energy Technology Data Exchange (ETDEWEB)

1993-10-01

The Japanese, through a combination of public policy, private market conditions, a geographic necessity, practice integrated municipal solid waste (MSW) management. The approach of MSW management in Japan is as follows: The basic concept of refuse treatment consists of recycling discharged refuse into usable resources, reusing such resources as much as possible, and then treating or disposing of the usable portion into a sanitary condition. Considering the difficulty of procuring land or seaside areas for such purpose as a refuse disposal site, it will be necessary to minimize the volume of refuse collected for treatment or disposal.

Knowledge-based fault diagnosis system for refuse collection vehicle

International Nuclear Information System (INIS)

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

2015-01-01

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

Knowledge-based fault diagnosis system for refuse collection vehicle

Energy Technology Data Exchange (ETDEWEB)

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

2015-05-15

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

Production development and utilization of Zimmer Station wet FGD by-products. Final report. Volume 4, A laboratory study conducted in fulfillment of Phase 2, Objective 1 titled. Inhibition of acid production in coal refuse amended with calcium sulfite and calcium sulfate - containing FGD solids

Energy Technology Data Exchange (ETDEWEB)

Hao, Y. L. [Ohio State Univ., Wooster, OH (United States); Dick, W. A. [Ohio State Univ., Wooster, OH (United States); Stehouwer, R. C. [Ohio State Univ., Wooster, OH (United States); Bigham, J. M. [Ohio State Univ., Wooster, OH (United States)

1998-06-30

Control of S0₂ emission from coal combustion requires desulfurization of coal before its combustion to produce coal refuse. Alternatively, gaseous emissions from coal combustion may be scrubbed to yield flue gas desulfurization (FGD) by-products that include calcium sulfite (CaSO₃∙0.5H₂O or simply CaS0₃). Acid production in coal refuse due to pyrite oxidation and disposal of large amounts of FGD can cause environmental degradation. Addition of CaS0₃ and CaS0₃-containing FGD to coal refuse may reduce the amounts of oxygen and ferric ion available to oxidize pyrite because the sulfite moiety in CaS0₃ is a strong reductant and thus may mitigate acid production in coal refuse. In Chapter 1, it was shown that CaS0₃ efficiently scavenged dissolved oxygen and ferric ion in water under the conditions commonly encountered in a coal refuse disposal environment. In the presence ofCaS0₃, the concentration of dissolved oxygen in water exposed to the atmosphere declined to below 0.01 mg L"1 at pH <8.0. In Chapter 2, it was demonstrated that CaS0₃ prevented a pH drop in coal refuse slurry when 0.2 gCaS0₃ was added to a 2% fresh coal refuse slurry every three days. Calcium sulfite also inhibited acid leaching from fresh coal refuse in bench-scale columns under controlled conditions. During the initial 13 weeks of leaching, the total amounts of titratable acidity, soluble H\\ Fe, and Al from CaS0₃-treated refuse (6.4 gin 50 g fresh coal refuse) were only 26%,10%, 32%, and 39% of those of the control columns, respectively. A combination of CaS0₃ with CaC0₃ or fly ash enhanced the inhibitory effect of CaS0₃ on acid leaching. Calcium sulfite-containing FGD which combined CaS0₃, CaC0₃, fly ash, and gypsum showed a much stronger inhibitory effect on acid leaching than CaS0₃ alone. This

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

African Journals Online (AJOL)

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

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

Science.gov (United States)

2010-07-01

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

Children with pervasive refusal.

OpenAIRE

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

1991-01-01

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

49 CFR 219.213 - Unlawful refusals; consequences.

Science.gov (United States)

2010-10-01

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

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

Science.gov (United States)

Kyoso, Masaki

2015-08-01

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

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

NARCIS (Netherlands)

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

2007-01-01

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

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

NARCIS (Netherlands)

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

2007-01-01

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

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

NARCIS (Netherlands)

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

2007-01-01

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

Responding to the refusal of care in the emergency department.

Science.gov (United States)

Nelson, Jennifer; Venkat, Arvind; Davenport, Moira

2014-01-01

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

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

Science.gov (United States)

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

2014-01-01

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

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

Science.gov (United States)

Bock, Gregory L

2012-11-01

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

Using a Nonaversive Procedure to Decrease Refusals.

Science.gov (United States)

Spooner, Fred; And Others

1990-01-01

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

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

Science.gov (United States)

Pasman, H Roeline W; Willems, Dick L; Onwuteaka-Philipsen, Bregje D

2013-09-01

Obtaining in-depth information from both patient and physician perspectives about what happens after a request for euthanasia or physician-assisted suicide (EAS) is refused. In-depth interviews with nine patients whose EAS request was refused and seven physicians of these patients, and with three relatives of patients who had died after a request was refused and four physicians of these patients. Interviews were conducted at least 6 months after the refusal. A wish to die remained in all patients after refusal, although it sometimes diminished. In most cases patient and physician stopped discussing this wish, and none of the physicians had discussed plans for the future with the patient or evaluated the patient's situation after their refusal. Physicians were aware of patients' continued wish to die. Patients who are refused EAS may subsequently be silent about a wish to die without abandoning it. Open communication about wishes to die is important, even outside the context of EAS, because if people feel unable to talk about them, their quality of life may be further diminished. Follow up appointments after refusal could give patients the opportunity to discuss their feelings and physicians to support them. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

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

Energy Technology Data Exchange (ETDEWEB)

Dugan, P.R.

1987-01-01

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

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

Directory of Open Access Journals (Sweden)

Karine Markosyan

2014-01-01

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

Impact of interventions for patients refusing emergency medical services transport.

Science.gov (United States)

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

1995-06-01

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

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

International Nuclear Information System (INIS)

Anees, M.; Khan, J.A.

2014-01-01

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

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

Science.gov (United States)

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

2018-01-01

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

Mental health consequences of abortion and refused abortion.

Science.gov (United States)

Watter, W W

1980-02-01

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

Knowledge, attitude, and practices on usage, disposal, and effect of plastic bags on sheep and goats.

Science.gov (United States)

Otsyina, H R; Nguhiu-Mwangi, J; Mogoa, E G M; Mbuthia, P G; Ogara, W O

2018-02-08

The objective of this study was to evaluate knowledge, attitudes, and practices of people in the Nairobi and Kajiado Counties, Kenya, on the usage, disposal, and effect of plastic waste on sheep and goats (shoats). A semi-structured questionnaire was used to collect data from 384 respondents in four communities in the two counties. Most of the people irrespective of their age, occupation, and educational status used plastic bags of some type on a daily basis. A high proportion of the respondents (37.0%, 142) used plastic bags because of the low cost. Approximately, 79.1% (304) disposed used plastic bags in open dumps. A total of 147 (38.3%) households kept shoats. Out of these, 38.1% (56) purchased feed and also allowed their animals to roam. Most of them (45.3%, 174) thought that lack of feed for the animals was the main reason why shoats roam and scavenge at refuse dump sites and road sides. A large proportion of the respondents (44.5%, 143) mentioned death of animals as the ultimate consequence of ingestion of waste plastic bags. Though, the respondents were aware that indiscriminate disposal of used plastic bags could result in death of the animals from which they derive their livelihoods, they nevertheless continued with the practice. There is a need for a paradigm shift in the way and manner plastic bags are used and disposed.

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

Science.gov (United States)

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

2009-01-01

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

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

Science.gov (United States)

Rajtar, Małgorzata

2013-12-01

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

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

Directory of Open Access Journals (Sweden)

Christopher Sarah

2006-09-01

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

Solid Waste Management Practices in the Eastern Province of Saudi Arabia

Science.gov (United States)

Khan, Hasin U.; Husain, Tahir; Khan, Suhail M.

1987-11-01

Solid waste management practices in the Eastern Province of Saudi Arabia are reviewed. The officials of various municipalities and agencies responsible for collecting and disposing of municipal waste were interviewed. The refuse generation rate found is in the range of 1.61 2.72 kg per capita per day. The refuse composition data indicate a high percentage of glass, metals, and wood. For storage purposes, 0.2-m3 barrels are used in residential areas and 0.75 to 1.50 m3-capacity containers are used in commerical areas. The present solid-waste collection system is labor-intensive, and a significant part of the budget is spent on collection and haul operations. The unit collection and haul cost is much higher than the unit disposal cost of refuse. The direct haul of refuse is the common practice, and the use of transfer stations has not yet been considered. It is also observed that the disposal methods used at these sites are not in line with modern techniques for refuse disposal. Landfilling and combined burning and landfilling are the common disposal methods at all the sites.

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

Science.gov (United States)

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

2015-01-01

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

Marketization of refuse collection in Denmark

DEFF Research Database (Denmark)

Busck, Ole Gunni

2006-01-01

  Danish municipalities' outsourcing and contracting of refuse collection are framed by a complex set of ideologies and objectives, besides regulation. Both at EU-level and at national level extreme demands for marketization of the public sector are counter-weighed by demands for social and envir......  Danish municipalities' outsourcing and contracting of refuse collection are framed by a complex set of ideologies and objectives, besides regulation. Both at EU-level and at national level extreme demands for marketization of the public sector are counter-weighed by demands for social...... and environmental considerations associated with the superior goal of sustainable development. In the EU regulative complex developments in normative and legal regulation of social and environmental requirements to member-states' performance have co-existed with tough requirements to ensure open competition...... in public authorities contracting. In the latest edition of the procurement directive it has been clarified that public authorities' commitment of private service-providers to social and environmental requirements by contracting is perfectly legitimate. At national level the municipalities when contracting...

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

Science.gov (United States)

Davis, John K

2008-03-01

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

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

Science.gov (United States)

Bouvet, R; Le Gueut, M

2013-06-01

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

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

Science.gov (United States)

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

2017-10-01

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

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

Science.gov (United States)

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

2017-06-01

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

Trends of radioactive waste management policy and disposal of LLW/ILW in the UK

International Nuclear Information System (INIS)

Miyasaka, Yasuhiko

2003-01-01

In 1997, the UK program for the deep disposal of radioactive waste was stopped with the refusal by the Secretary of State for the Environment to allow Nuclear Industry Radioactive Waste Executive, Ltd. (Nirex) to go ahead with its plans for an underground Rock Characterization Facility (RCF) at Sellafield, seen as the precursor of an underground repository for LLW/ILW. Department of Environment, Food and Rural Affairs (DEFRA) and the Developed Administrations published a white paper 'Managing Radioactive Waste Safety' Proposal for developing a policy for managing solid radioactive waste in the UK on 12 September 2001. The paper set out five-stage program of action for reaching decisions until 2007. It suggests their view can be sought via opinion polls, the Internet, workshops, citizens, juries, consensus conferences, stakeholder, local authority and community groups and research panels. With the exception of a disposal facility associated with the operation of the Dounreay site on the north coast of Scotland, essentially all LLW in the UK is disposed of at the Drigg site, near Sellafield. The site has been in operation since 1959. Until 1988, disposals were solely in trenches, cut into the glacial tills underlying the site. In 1988, an engineered concrete vault was brought into operation and is currently in use. Drigg only has a finite capacity in the currently area and may be full by about 2050, hence new arrangements will have to examine. This report describes the trends of radioactive waste management policy and disposal of LLW/ILW in the UK. These include: NDA(Nuclear Decommissioning Authority) organization plan, Feb. 2003; Encapsulation of LLW/ILW and safe store for ILW; Summary of LLW repository at the Drigg site; Nirex concept for underground storage/disposal of LLW/ILW. This information and new approach of the safe management of radioactive waste in the UK will prove helpful to the planning for future management and disposal of LLW in Japan. (author)

Emissions of C&D refuse in landfills: a European case.

Science.gov (United States)

López, Ana; Lobo, Amaya

2014-08-01

A field study was developed in a new landfill for refuse from construction and demolition (C&D) material recovery plants of small size (4 Ha.) in Europe, with the aim of evaluating the liquid and gas emissions in this type of facility at a large scale. It included characterization of the materials, monitoring leachate and gas quantity and composition. Besides thermometers, piezometers and sampling ports were placed in several points within the waste. This paper presents the data obtained for five years of the landfill life. The materials disposed were mainly made up of wood and concrete, similar to other C&D debris sites, but the amount of gypsum drywall (below 3% of the waste) was significantly smaller than other available studies, where percentages above 20% had been reported. Leachate contained typical C&D pollutants, such as different inorganic ions and metals, some of which exceeded other values reported in the literature (conductivity, ammonium, lead and arsenic). The small net precipitation in the area and the leachate recirculation into the landfill surface help explain these higher concentrations, thus highlighting the impact of liquid to solid (L/S) ratio on leachate characteristics. In contrast to previous studies, neither odor nuisances nor significant landfill gas over the surface were detected. However, gas samples taken from the landfill inside revealed sulfate reducing and methanogenic activity. Copyright © 2014 Elsevier Ltd. All rights reserved.

Vaccine refusal - what we need to know.

Science.gov (United States)

Succi, Regina Célia de Menezes

2018-04-12

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

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

Science.gov (United States)

2010-04-01

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

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

Science.gov (United States)

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

2016-10-01

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

9 CFR 93.806 - Animals refused entry.

Science.gov (United States)

2010-01-01

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

Refusal to pay electricity bill is illegal

International Nuclear Information System (INIS)

Hermann, H.P.

1979-01-01

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

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

Directory of Open Access Journals (Sweden)

Mustafa Yasin Irmak

2016-12-01

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

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

Science.gov (United States)

2010-04-01

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

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

Science.gov (United States)

2010-10-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2012-10-15

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

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

International Nuclear Information System (INIS)

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

2012-01-01

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

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

Science.gov (United States)

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

2002-10-01

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

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

Science.gov (United States)

2010-07-01

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

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

Science.gov (United States)

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

2016-01-01

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

Analysis of fouling in refuse waste incinerators

NARCIS (Netherlands)

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

2001-01-01

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

Use for refuse of shale carbonization

Energy Technology Data Exchange (ETDEWEB)

1917-09-25

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

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

Directory of Open Access Journals (Sweden)

Ibrahim Fathi Huwari

2015-02-01

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

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

Directory of Open Access Journals (Sweden)

S J Thaker

2015-01-01

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

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

Science.gov (United States)

Bouaziz, Nora; Titia Rizzi, Alice

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

Understanding Excessive School Absenteeism as School Refusal Behavior

Science.gov (United States)

Dube, Shanta R.; Orpinas, Pamela

2009-01-01

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

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

Science.gov (United States)

Lee, Marcella I.; Miltenberger, Raymond G.

1996-01-01

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

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

Science.gov (United States)

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

2016-01-01

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

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

Science.gov (United States)

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

2009-11-01

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

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

Directory of Open Access Journals (Sweden)

Melissa B Gilkey

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

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

Science.gov (United States)

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

2018-01-01

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

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

Science.gov (United States)

Magrane, Diane; And Others

1994-01-01

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

Consent and assessment of capacity to decide or refuse treatment.

Science.gov (United States)

Simpson, Owena

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

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

Science.gov (United States)

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

2011-12-01

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

NREL Evaluates Performance of Hydraulic Hybrid Refuse Vehicles

Energy Technology Data Exchange (ETDEWEB)

2015-09-01

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

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

Science.gov (United States)

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

2018-05-01

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

Post-disposal safety assessment of toxic and radioactive waste: waste types, disposal practices, disposal criteria, assessment methods and post-disposal impacts

International Nuclear Information System (INIS)

Torres, C.; Simon, I.; Little, R.H.; Charles, D.; Grogan, H.A.; Smith, G.M.; Sumerling, T.J.; Watkins, B.M.

1993-01-01

The need for safety assessments of waste disposal stems not only from the implementation of regulations requiring the assessment of environmental effects, but also from the more general need to justify decisions on protection requirements. As waste-disposal methods have become more technologically based, through the application of more highly engineered design concepts and through more rigorous and specific limitations on the types and quantities of the waste disposed, it follows that assessment procedures also must become more sophisticated. It is the overall aim of this study to improve the predictive modelling capacity for post-disposal safety assessments of land-based disposal facilities through the development and testing of a comprehensive, yet practicable, assessment framework. This report records all the work which has been undertaken during Phase 1 of the study. Waste types, disposal practices, disposal criteria and assessment methods for both toxic and radioactive waste are reviewed with the purpose of identifying those features relevant to assessment methodology development. Difference and similarities in waste types, disposal practices, criteria and assessment methods between countries, and between toxic and radioactive wastes are highlighted and discussed. Finally, an approach to identify post-disposal impacts, how they arise and their effects on humans and the environment is described

Magnetometric Studies of Catalyst Refuses in Nanocarbon Materials

Directory of Open Access Journals (Sweden)

Eklund Peter

2008-01-01

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

[Refusal of personal hygiene care and nursing responsibility].

Science.gov (United States)

Peyé, Anne

2013-03-01

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

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

Science.gov (United States)

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

2016-01-20

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

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

International Nuclear Information System (INIS)

Ripp, B.J.

1997-01-01

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

Refuses and delays in the transportation by ship of radioactive material

International Nuclear Information System (INIS)

Xavier, Clarice; Sobreira, Ana Celia

2011-01-01

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

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

Directory of Open Access Journals (Sweden)

Shohreh Shahpouri Arani

2013-05-01

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

Othermotherwork: "Testimonio" and the Refusal of Historical Trauma

Science.gov (United States)

Vega, Christine

2018-01-01

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

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

Directory of Open Access Journals (Sweden)

Filippello Pina

2018-01-01

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

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

Science.gov (United States)

Shapiro, Michael

2018-06-01

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

[Professionals' training and refusal of nursing care].

Science.gov (United States)

Bay, Corinne

2016-10-01

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

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

Science.gov (United States)

Sobo, Elisa J

2015-09-01

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

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

Directory of Open Access Journals (Sweden)

Mitra Khalili

2016-01-01

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

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

International Nuclear Information System (INIS)

Mafi, S.; Stehouwer, R.C.

1996-01-01

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

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

Science.gov (United States)

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

2013-11-01

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

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

Science.gov (United States)

Blanchard, Karine; Ménard, Rachel; Corvol, Aline

2016-10-01

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

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

Science.gov (United States)

Frescura, Marina

1997-01-01

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

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

Science.gov (United States)

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

2015-04-01

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

Conscientious refusals and reason-giving.

Science.gov (United States)

Marsh, Jason

2014-07-01

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

7 CFR 319.8-26 - Material refused entry.

Science.gov (United States)

2010-01-01

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

Experimental investigation in separating the heavy metal elements of refuse incineration fly ashes by using molten iron

Energy Technology Data Exchange (ETDEWEB)

Yang, J. [Chongqing Univ., Chongqing (China)]|[CPI-Yuanda Environmental-protection Engineering Co. Ltd., Chongqing (China); Liu, Q.; Dong, L. [Chongqing Univ., Chongqing (China); Du, Y. [CPI-Yuanda Environmental-protection Engineering Co. Ltd., Chongqing (China)

2008-07-01

One of the main waste treatment methods in the world for municipal solid waste (MSW) is incineration. It is effective in toxic substance destruction, waste volume reduction, and energy recovery. Some chemical substances are accumulated during incineration, most notably lead, zinc, chromium and cadmium, as well as other heavy metals. Untreated fly ash disposed in landfills can pollute the soil, surface water and groundwater because of the high levels of hazardous heavy metals and high salt concentration that can be leached out. This paper presented an experiment that melt-separated the heavy metal elements from fly ash generated during refuse incineration. Molted iron, was used as resolvent to dissolve the heavy metal elements in it. The paper described the materials and methods as well as the results of the study. It was concluded that using molted iron to separate the heavy metal elements from MSW incineration fly ash was feasible. The removal ratio of the main heavy metal elements was above 80 per cent, and some of it was above 99 per cent. 5 refs., 7 tabs., 1 fig.

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

Science.gov (United States)

2013-01-01

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

10 CFR 61.52 - Land disposal facility operation and disposal site closure.

Science.gov (United States)

2010-01-01

... DISPOSAL OF RADIOACTIVE WASTE Technical Requirements for Land Disposal Facilities § 61.52 Land disposal... wastes by placing in disposal units which are sufficiently separated from disposal units for the other... between any buried waste and the disposal site boundary and beneath the disposed waste. The buffer zone...

Refuse derived fuel incineration: Fuel gas monitoring and analysis

International Nuclear Information System (INIS)

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

1993-11-01

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

Preliminary disposal limits, plume interaction factors, and final disposal limits

Energy Technology Data Exchange (ETDEWEB)

Flach, G. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

2018-01-11

In the 2008 E-Area Performance Assessment (PA), each final disposal limit was constructed as the product of a preliminary disposal limit and a plume interaction factor. The following mathematical development demonstrates that performance objectives are generally expected to be satisfied with high confidence under practical PA scenarios using this method. However, radionuclides that experience significant decay between a disposal unit and the 100-meter boundary, such as H-3 and Sr-90, can challenge performance objectives, depending on the disposed-of waste composition, facility geometry, and the significance of the plume interaction factor. Pros and cons of analyzing single disposal units or multiple disposal units as a group in the preliminary disposal limits analysis are also identified.

Invitation Refusals in Cameroon French and Hexagonal French

Science.gov (United States)

Farenkia, Bernard Mulo

2015-01-01

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

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

Science.gov (United States)

Gurmu, Eshetu; Endale, Senait

2017-03-16

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

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

NARCIS (Netherlands)

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

2013-01-01

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

Deep Borehole Disposal as an Alternative Concept to Deep Geological Disposal

Energy Technology Data Exchange (ETDEWEB)

Lee, Jongyoul; Lee, Minsoo; Choi, Heuijoo; Kim, Kyungsu [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

2016-10-15

In this paper, the general concept and key technologies for deep borehole disposal of spent fuels or HLW, as an alternative method to the mined geological disposal method, were reviewed. After then an analysis on the distance between boreholes for the disposal of HLW was carried out. Based on the results, a disposal area were calculated approximately and compared with that of mined geological disposal. These results will be used as an input for the analyses of applicability for DBD in Korea. The disposal safety of this system has been demonstrated with underground research laboratory and some advanced countries such as Finland and Sweden are implementing their disposal project on commercial stage. However, if the spent fuels or the high-level radioactive wastes can be disposed of in the depth of 3-5 km and more stable rock formation, it has several advantages. Therefore, as an alternative disposal concept to the mined deep geological disposal concept (DGD), very deep borehole disposal (DBD) technology is under consideration in number of countries in terms of its outstanding safety and cost effectiveness. In this paper, the general concept of deep borehole disposal for spent fuels or high level radioactive wastes was reviewed. And the key technologies, such as drilling technology of large diameter borehole, packaging and emplacement technology, sealing technology and performance/safety analyses technologies, and their challenges in development of deep borehole disposal system were analyzed. Also, very preliminary deep borehole disposal concept including disposal canister concept was developed according to the nuclear environment in Korea.

Deep Borehole Disposal as an Alternative Concept to Deep Geological Disposal

International Nuclear Information System (INIS)

Lee, Jongyoul; Lee, Minsoo; Choi, Heuijoo; Kim, Kyungsu

2016-01-01

In this paper, the general concept and key technologies for deep borehole disposal of spent fuels or HLW, as an alternative method to the mined geological disposal method, were reviewed. After then an analysis on the distance between boreholes for the disposal of HLW was carried out. Based on the results, a disposal area were calculated approximately and compared with that of mined geological disposal. These results will be used as an input for the analyses of applicability for DBD in Korea. The disposal safety of this system has been demonstrated with underground research laboratory and some advanced countries such as Finland and Sweden are implementing their disposal project on commercial stage. However, if the spent fuels or the high-level radioactive wastes can be disposed of in the depth of 3-5 km and more stable rock formation, it has several advantages. Therefore, as an alternative disposal concept to the mined deep geological disposal concept (DGD), very deep borehole disposal (DBD) technology is under consideration in number of countries in terms of its outstanding safety and cost effectiveness. In this paper, the general concept of deep borehole disposal for spent fuels or high level radioactive wastes was reviewed. And the key technologies, such as drilling technology of large diameter borehole, packaging and emplacement technology, sealing technology and performance/safety analyses technologies, and their challenges in development of deep borehole disposal system were analyzed. Also, very preliminary deep borehole disposal concept including disposal canister concept was developed according to the nuclear environment in Korea

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

Science.gov (United States)

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

2011-12-29

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

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

International Nuclear Information System (INIS)

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

1999-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

1995-09-01

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

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

Science.gov (United States)

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

2015-01-01

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

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

Science.gov (United States)

2010-01-01

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

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

Science.gov (United States)

2010-01-28

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

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

Science.gov (United States)

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

1992-11-01

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

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

OpenAIRE

Dugan, Patrick R.; Apel, William A.

1983-01-01

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

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

Science.gov (United States)

Azodo, Clement Chinedu; Umoh, Agnes O

2015-09-15

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

Project Startup: Evaluating the Performance of Hydraulic Hybrid Refuse Vehicles

Energy Technology Data Exchange (ETDEWEB)

2015-09-01

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

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

Science.gov (United States)

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

2012-05-28

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

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

Directory of Open Access Journals (Sweden)

Chandran Thoovakkunon

2012-05-01

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

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

Science.gov (United States)

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

2014-01-01

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

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

Science.gov (United States)

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

2008-05-01

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

Execution techniques for high-level radioactive waste disposal. 2. Fundamental concept of geological disposal and implementing approach of disposal project

International Nuclear Information System (INIS)

Kawanishi, Motoi; Komada, Hiroya; Tsuchino, Susumu; Shiozaki, Isao; Kitayama, Kazumi; Akasaka, Hidenari; Inagaki, Yusuke; Kawamura, Hideki

1999-01-01

The making high activity of the high-level radioactive waste disposal business shall be fully started after establishing of the implementing organization which is planned around 2000. Considering each step of disposal business, in this study, the implementation procedure for a series of disposal business such as the selection of the disposal site, the construction and operation of the disposal facility, the closure and decommissioning of the disposal facility and the management after closure, which are carried forward by the implementation body is discussed in detail from the technical viewpoint and an example of the master schedule is proposed. Furthermore, we investigate and propose the concept of the geological disposal which becomes important in carrying forward to making of the business of the disposal, such as the present site selection smoothly, the fundamental idea of the safe securing for disposal, the basic idea to get trust to the disposal technique and the geological environmental condition which is the basic condition of this whole study for the disposal business making. (author)

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

Science.gov (United States)

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

2009-06-01

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

Emissions from co-combustion of wood and household refuse

International Nuclear Information System (INIS)

Zhang, X.J.; Peterson, F.

1996-01-01

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

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

Science.gov (United States)

Dugan, Patrick R.; Apel, William A.

1983-01-01

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

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

Science.gov (United States)

Clarke, Kyra

2016-01-01

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

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

Science.gov (United States)

Manson, Neil C

2015-02-01

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

Lime helps establish crownvetch on coal-breaker refuse

Science.gov (United States)

Miroslaw M. Czapowskyj; Edward A. Sowa

1976-01-01

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

[Refusal of care and respect of the body].

Science.gov (United States)

Bernard, Marie-Fleur

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

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

Science.gov (United States)

Setse, Rosanna W; Maxwell, Celia J

2014-05-01

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

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

Science.gov (United States)

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

2013-01-01

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

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

Science.gov (United States)

Popper-Giveon, Ariela; Keshet, Yael

2018-04-01

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

Constructive and Destructive Aspects of Refusal from Communication

Directory of Open Access Journals (Sweden)

Marianna A. Gulyaeva

2016-12-01

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

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

OpenAIRE

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

2009-01-01

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

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

Science.gov (United States)

Epstein, Jennifer A; Botvin, Gilbert J

2002-07-01

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

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

Science.gov (United States)

Salam, Asma Abdus; Afshan, Gauhar

2016-01-01

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

[Anorexia and refusal to eat in the elderly].

Science.gov (United States)

Hazif-Thomas, Cyril; Thomas, Philippe

2016-01-01

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

Ways to Say No: Refusal Skill Strategies among Urban Adolescents

Science.gov (United States)

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

2006-01-01

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

Disposal safety

International Nuclear Information System (INIS)

Bartlett, J.W.

International consensus does not seem to be necessary or appropriate for many of the issues concerned with the safety of nuclear waste disposal. International interaction on the technical aspects of disposal has been extensive, and this interaction has contributed greatly to development of a consensus technical infrastructure for disposal. This infrastructure provides a common and firm base for regulatory, political, and social actions in each nation

French surface disposal experience. The disposal of large waste

International Nuclear Information System (INIS)

Dutzer, Michel; Lecoq, Pascal; Duret, Franck; Mandoki, Robert

2006-01-01

More than 90 percent of the volume of radioactive waste that are generated in France can be managed in surface disposal facilities. Two facilities are presently operated by ANDRA: the Centre de l'Aube disposal facility that is dedicated to low and intermediate short lived waste and the Morvilliers facility for very low level waste. The Centre de l'Aube facility was designed at the end of the years 1980 to replace the Centre de la Manche facility that ended operation in 1994. In order to achieve as low external exposure as possible for workers it was decided to use remote handling systems as much as possible. Therefore it was necessary to standardize the types of waste containers. But taking into account the fact that these waste were conditioned in existing facilities, it was not possible to change a major part of existing packages. As a consequence, 6 mobile roofs were constructed to handle 12 different types of waste packages in the disposal vaults. The scope of Centre de l'Aube was mainly to dispose operational waste. However some packages, as 5 or 10 m 3 metallic boxes, could be used for larger waste generated by decommissioning activities. The corresponding flow was supposed to be small. After the first years of operations, it appeared interesting to develop special procedures to dispose specific large waste in order to avoid external exposure costly cutting works in the generating facilities. A 40 m 3 box and a large remote handling device were disposed in vaults that were currently used for other types of packages. Such a technique could not be used for the disposal of vessel heads that were replaced in 55 pressurised water power reactors. The duration of disposal and conditioning operation was not compatible with the flow of standard packages that were delivered in the vaults. Therefore a specific type of vault was designed, including handling and conditioning equipment. The first pressure vessel head was delivered on the 29 of July 2004, 6 heads have been

The disposal of Canada's nuclear fuel waste: engineering for a disposal facility

International Nuclear Information System (INIS)

Simmons, G.R.; Baumgartner, P.

1994-01-01

This report presents some general considerations for engineering a nuclear fuel waste disposal facility, alternative disposal-vault concepts and arrangements, and a conceptual design of a used-fuel disposal centre that was used to assess the technical feasibility, costs and potential effects of disposal. The general considerations and alternative disposal-vault arrangements are presented to show that options are available to allow the design to be adapted to actual site conditions. The conceptual design for a used-fuel disposal centre includes descriptions of the two major components of the disposal facility, the Used-Fuel Packaging Plant and the disposal vault; the ancillary facilities and services needed to carry out the operations are also identified. The development of the disposal facility, its operation, its decommissioning, and the reclamation of the site are discussed. The costs, labour requirements and schedules used to assess socioeconomic effects and that may be used to assess the cost burden of waste disposal to the consumer of nuclear energy are estimated. The Canadian Nuclear Fuel Waste Management Program is funded jointly by AECL and Ontario Hydro under the auspices of the CANDU Owners Group. (author)

The geoarchaeology of urban wastes: from refuses to activities and towns organisation (France, 6th c. BC - 10th c. aD)

Science.gov (United States)

Borderie, Q.; Cammas, C.; Petit, C.

2012-04-01

In an urban context, geoarchaeological study of man-environment interaction is often neglected, although recent studies of urbic anthrosols and human induced processes show that it can provide a great amount of data. The sedimentary matrix of the archaeological layers, especially its organic and heavy metal contents (phosphore, organic carbon, lead…) and the pedo-sedimentary processes (such as bioturbation, percolation, decay of organic matter…), are evidence of ancient lifestyle and waste disposal habits. This data are even more useful when archaeological evidence is rare or inefficient, such as in the early medieval Dark Earth. This paper is based on several geoarchaeological studies undertaken since the 1990 in French towns ranging from the Iron Age to the early Middle Ages (Paris, Beauvais, Bayeux, Noyon, Macon, Metz, Lattara…), mainly from rescue excavations. Multi-scale, 3D and fine scale analyses of archaeological stratigraphy are combined with micromorphological studies of undisturbed samples and grain size as well as geochemical analysis of bulk samples (CaCO3, C/N, Fe, Pb, Zn, Cu…). Spatial sampling reveals complex pattern of activities in finely stratified and well defined architectural context like Lattara (Iron Age). Organic refuses were found mainly in specific urban spaces like courtyards or squares and animal housing areas could be delineate. In more undifferentiated stratigraphy (early medieval Dark Earth), bioturbation is one of the main formation process and seems to have obliterated others. Thus, we analysed the 3D pattern of macro-artefacts on field, combined with micromorphology, geochemical and semi quantitative counting of micro-artefacts on thin sections. It allowed us to characterise Dark Earth by the type of activity refuses, in relation with the pedo-sedimentary context and the uses of the areas. It also allowed us to assess the characters induced by in situ activities and those due to the local background. Moreover, in Metz

Alternative Concept to Enhance the Disposal Efficiency for CANDU Spent Fuel Disposal System

International Nuclear Information System (INIS)

Lee, Jong Youl; Cho, Dong Geun; Kook, Dong Hak; Lee, Min Soo; Choi, Heui Joo

2011-01-01

There are two types of nuclear reactors in Korea and they are PWR type and CANDU type. The safe management of the spent fuels from these reactors is very important factor to maintain the sustainable energy supply with nuclear power plant. In Korea, a reference disposal system for the spent fuels has been developed through a study on the direct disposal of the PWR and CANDU spent fuel. Recently, the research on the demonstration and the efficiency analyses of the disposal system has been performed to make the disposal system safer and more economic. PWR spent fuels which include a lot of reusable material can be considered being recycled and a study on the disposal of HLW from this recycling process is being performed. CANDU spent fuels are considered being disposed of directly in deep geological formation, since they have little reusable material. In this study, based on the Korean Reference spent fuel disposal System (KRS) which was to dispose of both PWR type and CANDU type, the more effective CANDU spent fuel disposal systems were developed. To do this, the disposal canister for CANDU spent fuels was modified to hold the storage basket for 60 bundles which is used in nuclear power plant. With these modified disposal canister concepts, the disposal concepts to meet the thermal requirement that the temperature of the buffer materials should not be over 100 .deg. C were developed. These disposal concepts were reviewed and analyzed in terms of disposal effective factors which were thermal effectiveness, U-density, disposal area, excavation volume, material volume etc. and the most effective concept was proposed. The results of this study will be used in the development of various wastes disposal system together with the HLW wastes from the PWR spent fuel recycling process.

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

Science.gov (United States)

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

2015-04-01

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

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

Science.gov (United States)

Jenkinson, Bec; Kruske, Sue; Kildea, Sue

2018-03-28

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

Low level waste disposal

International Nuclear Information System (INIS)

Barthoux, A.

1985-01-01

Final disposal of low level wastes has been carried out for 15 years on the shallow land disposal of the Manche in the north west of France. Final participant in the nuclear energy cycle, ANDRA has set up a new waste management system from the production center (organization of the waste collection) to the disposal site including the setting up of a transport network, the development of assessment, additional conditioning, interim storage, the management of the disposal center, records of the location and characteristics of the disposed wastes, site selection surveys for future disposals and a public information Department. 80 000 waste packages representing a volume of 20 000 m 3 are thus managed and disposed of each year on the shallow land disposal. The disposal of low level wastes is carried out according to their category and activity level: - in tumuli for very low level wastes, - in monoliths, a concrete structure, of the packaging does not provide enough protection against radioactivity [fr

the development of new generation of solid waste refuse incinerators

African Journals Online (AJOL)

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

9 CFR 351.19 - Refusal of certification for specific lots.

Science.gov (United States)

2010-01-01

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

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

Directory of Open Access Journals (Sweden)

Vincenzo Pacillo

2016-09-01

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

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

African Journals Online (AJOL)

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

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

Science.gov (United States)

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

2007-12-01

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

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

Science.gov (United States)

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

2014-10-08

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

Waste disposal

International Nuclear Information System (INIS)

Neerdael, B.; Marivoet, J.; Put, M.; Verstricht, J.; Van Iseghem, P.; Buyens, M.

1998-01-01

The primary mission of the Waste Disposal programme at the Belgian Nuclear Research Centre SCK/CEN is to propose, develop, and assess solutions for the safe disposal of radioactive waste. In Belgium, deep geological burial in clay is the primary option for the disposal of High-Level Waste and spent nuclear fuel. The main achievements during 1997 in the following domains are described: performance assessment, characterization of the geosphere, characterization of the waste, migration processes, underground infrastructure

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

Science.gov (United States)

Umotong, Eno

2016-12-01

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

Waste disposal

International Nuclear Information System (INIS)

2005-01-01

Radioactive waste, as a unavoidable remnant from the use of radioactive substances and nuclear technology. It is potentially hazardous to health and must therefore be managed to protect humans and the environment. The main bulk of radioactive waste must be permanently disposed in engineered repositories. Appropriate safety standards for repository design and construction are required along with the development and implementation of appropriate technologies for the design, construction, operation and closure of the waste disposal systems. As backend of the fuel cycle, resolving the issue of waste disposal is often considered as a prerequisite to the (further) development of nuclear energy programmes. Waste disposal is therefore an essential part of the waste management strategy that contributes largely to build confidence and helps decision-making when appropriately managed. The International Atomic Energy Agency provides assistance to Member States to enable safe and secure disposal of RW related to the development of national RWM strategies, including planning and long-term project management, the organisation of international peer-reviews for research and demonstration programmes, the improvement of the long-term safety of existing Near Surface Disposal facilities including capacity extension, the selection of potential candidate sites for different waste types and disposal options, the characterisation of potential host formations for waste facilities and the conduct of preliminary safety assessment, the establishment and transfer of suitable technologies for the management of RW, the development of technological solutions for some specific waste, the building of confidence through training courses, scientific visits and fellowships, the provision of training, expertise, software or hardware, and laboratory equipment, and the assessment of waste management costs and the provision of advice on cost minimisation aspects

Vegetation succession and soil infiltration characteristics under different aged refuse dumps at the Heidaigou opencast coal mine

Directory of Open Access Journals (Sweden)

Huang Lei

2015-07-01

Full Text Available Vegetation succession and soil infiltration characteristics under five different restoration models of refuse dumps including different-aged revegetated sites (1995, 1998, 2003 and 2005 in the northern, eastern and western open-pit coal mine dump and a reference site with native vegetation, which had never been damaged by coal mining activities on the Heidaigou Open Cut Coal Mine were studied. Changes in the plant species, soil properties and infiltration rates were evaluated at the different refuse dumps. The results indicated that the number of herbaceous species, plant cover, biomass, fine particles, and total N, P and SOM increased significantly with increasing site age. However, the number of shrub species decreased since revegetation, its cover increased from 17% to 41% initially and subsequently decreased to the present level of 4%. The natural vegetation community and the northern refuse dump had the highest cumulative infiltration rates of 3.96 and 2.89 cm s−1 in contrast to the eastern and western refuse dumps and the abandoned land, where the highest cumulative infiltration rates were 1.26, 1.04 and 0.88 cm s−1, respectively. A multiple linear regression analysis indicated that the infiltration rate was primarily determined by the silt percentage, SOM, plant coverage and the variation in soil bulk density. Our results provide new ideas regarding future soil erosion controls and sustainable development at open-pit coal mine refuse dumps.

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

Science.gov (United States)

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

2015-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

NONE

2000-07-01

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

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

Science.gov (United States)

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

2008-07-01

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

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

OpenAIRE

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

2015-01-01

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

Hybrid disposal systems and nitrogen removal in individual sewage disposal systems

Energy Technology Data Exchange (ETDEWEB)

Franks, A.L.

1993-06-01

The use of individual disposal systems in ground-water basins that have adverse salt balance conditions and/or geologically unsuitable locations, has become a major problem in many areas of the world. There has been much research in design of systems for disposal of domestic sewage. This research includes both hybrid systems for disposal of domestic sewage. This research includes both hybrid systems for disposal of the treated waste in areas with adverse geologic conditions and systems for the removal of nitrogen and phosphorus prior to percolation to the ground water. This paper outlines the history of development and rationale for design and construction of individual sewage disposal systems and describes the designs and limitations of the hybrid and denitrification units. The disposal systems described include Mounds, Evapotranspiration and Evapotranspiration/Infiltration systems. The denitrification units include those using methanol, sulfur and limestone, gray water and secondary treated wastewater for energy sources.

The disposal of orphan wastes using the greater confinement disposal concept

International Nuclear Information System (INIS)

Bonano, E.J.; Chu, M.S.Y.; Price, L.L.; Conrad, S.H.; Dickman, P.T.

1991-01-01

In the United States, radioactive wastes are conventionally classified as high-level wastes, transuranic wastes, or low-level wastes. Each of these types of wastes, by law, has a ''home'' for their final disposal; i.e., high-level wastes are destined for disposal at the proposed repository at Yucca Mountain, transuranic waste for the proposed Waste Isolation Pilot Plant, and low-level waste for shallow-land disposal sites. However, there are some radioactive wastes within the United States Department of Energy (DOE) complex that do not meet the criteria established for disposal of either high-level waste, transuranic waste, or low-level waste. The former are called ''special-case'' or ''orphan'' wastes. This paper describes an ongoing project sponsored by the DOE's Nevada Operations Office for the disposal of orphan wastes at the Radioactive Waste Management Site at Area 5 of the Nevada Test Site using the greater confinement disposal (GCD) concept. The objectives of the GCD project are to evaluate the safety of the site for disposal of orphan wastes by assessing compliance with pertinent regulations through performance assessment, and to examine the feasibility of this disposal concept as a cost-effective, safe alternative for management of orphan wastes within the DOE complex. Decisions on the use of GCD or other alternate disposal concepts for orphan wastes be expected to be addressed in a Programmatic Environmental Impact Statement being prepared by DOE. The ultimate decision to use GCD will require a Record of Decision through the National Environmental Policy Act (NEPA) process. 20 refs., 3 figs., 2 tabs

Radioactive waste disposal; Le stockage des dechets radioactifs (aspects non techniques)

Energy Technology Data Exchange (ETDEWEB)

Petit, J.C

1998-04-01

A deep gap, reflecting a persisting fear, separates the viewpoints of the experts and that of the public on the issue of the disposal of nuclear WASTES. The history of this field is that of the proliferation with time of spokesmen who pretend to speak in the name of the both humans and non humans involved. Three periods can be distinguished: 1940-1970, an era of contestation and confusion when the experts alone represents the interest of all; 1970-1990, an era of contestation and confusion when spokespersons multiply themselves, generating the controversy and the slowing down of most technological projects; 1990-, an era of negotiation, when viewpoints, both technical and non technical, tend to get closer and, let us be optimistic, leading to the overcome of the crisis. We show that, despite major differences, the options and concepts developed by the different actors are base on two categories of resources, namely Nature and Society, and that the consensus is built up through their `hydridation`. we show in this part that the perception of nuclear power and, in particular of the underground disposal of nuclear wastes, involves a very deep psychological substrate. Trying to change mentalities in the domain by purely scientific and technical arguments is thus in vain. The practically instinctive fear of radioactivity, far from being due only to lack of information (and education), as often postulated by scientists and engineers, is rooted in archetypical structures. These were, without doubt, reactivated in the 40 s by the traumatizing experience of the atomic bomb. In addition, anthropological-linked considerations allow us to conclude that he underground disposal of wastes is seen as a `rape` and soiling of Mother Earth. This contributes to explaining, beyond any rationality, the refusal of this technical option by some persons. However, it would naturally be simplistic and counter-productive to limit all controversy in this domain to these psychological aspects

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

Science.gov (United States)

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

2011-02-01

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

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

NARCIS (Netherlands)

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

2006-01-01

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

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

African Journals Online (AJOL)

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

Don't Teach Your Trash to Swim.

Science.gov (United States)

Heide, Kathleen; And Others

1989-01-01

Describes the Newport, Oregon, demonstration marine refuse disposal project and its applicability to other ports and communities. Explains community education and support, refuse collection and recycling, support by fishermen, and the marine pollution international treaty. (RT)

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

Science.gov (United States)

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

2017-05-01

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

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

Science.gov (United States)

Gallagher, Steven B

2014-12-01

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

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

Science.gov (United States)

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

2017-11-24

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

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

Science.gov (United States)

2010-07-01

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

A vermicompostagem do lodo de lagoas de tratamento de efluentes industriais consorciada com composto de lixo urbano The vermicomposting of an industrial sludge combined with a compost of municipal solid refuse

Directory of Open Access Journals (Sweden)

Luciana Rodrigues Valadares Veras

2004-09-01

Full Text Available A destinação dos resíduos sólidos constitui um sério problema ambiental para a humanidade, principalmente em regiões de grande concentração urbana, onde a disponibilidade de áreas para disposição dos rejeitos é quase sempre restrita. Com a intenção de fornecer mais uma alternativa para solução do problema, desenvolveu-se um estudo para avaliar a vermicompostagem de um lodo industrial, resultante do processamento de frutas, consorciado com composto de lixo urbano. Através desse processo, pode-se obter a reciclagem dos resíduos, produzindo-se um composto denominado húmus ou vermicomposto. Dentre os resultados obtidos pode-se destacar bons indicadores do nível de maturidade dos resíduos, representados pela relação carbono/nitrogênio, a influência da minhoca na elevação do pH e sua contribuição para uma estabilização mais acelerada da matéria orgânica.The final disposal of solid wastes is a serious environmental problem, mainly in big towns, where the areas to put the refuses on are not much available. To provide one more alternative to solve this problem, a research was developed to analyse the vermicomposting of industrial sludge combined with a compost of municipal solid refuse. By this process, it was possible to obtain the recycling of the wastes, producing a material called humus or vermicompost. The results showed good maturity levels of the refuses, presented by the carbon/nitrogen relations, the worms influence in the pH elevation and their possible acceleration of the organic material stabilization.

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

Science.gov (United States)

Mattiasson, A C; Andersson, L

1994-11-01

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

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

Directory of Open Access Journals (Sweden)

sj Miller

2016-07-01

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

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

Science.gov (United States)

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

2011-09-01

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

Salt disposal: Paradox Basin, Utah

International Nuclear Information System (INIS)

1983-04-01

This report presents the findings of a study conducted for the National Waste Terminal Storage (NWTS) Program. Permanent disposal options are examined for salt resulting from the excavation of a waste repository in the bedded salt deposits of the Paradox Basin of southeastern Utah. The study is based on a repository salt backfill compaction of 60% of the original density which leaves a total of 8 million tons of 95% pure salt to be disposed of over a 30-year period. The feasibility, impacts, and mitigation methods are examined for five options: commercial disposal, permanent onsite surface disposal, permanent offsite disposal, deepwell injection, and ocean and Great Salt Lake disposal. The study concludes the following: Commercial marketing of all repository salt would require a subsidy for transportation to major salt markets. Permanent onsite surface storage is both economically and technically feasible. Permanent offsite disposal is technically feasible but would incur additional transportation costs. Selection of an offsite location would provide a means of mitigating impacts associated with surface storage at the repository site. Deepwell injection is an attractive disposal method; however, the large water requirement, high cost of development, and poor performance of similar operating brine disposal wells eliminates this option from consideration as the primary means of disposal for the Paradox Basin. Ocean disposal is expensive because of high transportation cost. Also, regulatory approval is unlikely. Ocean disposal should be eliminated from further consideration in the Paradox Basin. Great Salt Lake disposal appears to be technically feasible. Great Salt Lake disposal would require state approval and would incur substantial costs for salt transportation. Permanent onsite disposal is the least expensive method for disposal of all repository salt

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

Science.gov (United States)

2010-10-01

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

Proposal of a SiC disposal canister for very deep borehole disposal

Energy Technology Data Exchange (ETDEWEB)

Choi, Heui-Joo; Lee, Minsoo; Lee, Jong-Youl; Kim, Kyungsu [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

2016-10-15

In this paper authors proposed a silicon carbide, SiC, disposal canister for the DBD concept in Korea. A. Kerber et al. first proposed the SiC canister for a geological disposal of HLW, CANDU or HTR spent nuclear fuels. SiC has some drawbacks in welding or manufacturing a large canister. Thus, we designed a double layered disposal canister consisting of a stainless steel outer layer and a SiC inner layer. KAERI has been interested in developing a very deep borehole disposal (DBD) of HLW generated from pyroprocessing of PWR spent nuclear fuel and supported the relevant R and D with very limited its own budget. KAERI team reviewed the DBD concept proposed by Sandia National Laboratories (SNL) and developed its own concept. The SNL concept was based on the steel disposal canister. The authors developed a new technology called cold spray coating method to manufacture a copper-cast iron disposal canister for a geological disposal of high level waste in Korea. With this method, 8 mm thin copper canister with 400 mm in diameter and 1200 mm in height was made. In general, they do not give any credit on the lifetime of a disposal canister in DBD concept unlike the geological disposal. In such case, the expensive copper canister should be replaced with another one. We designed a disposal canister using SiC for DBD. According to an experience in manufacturing a small size canister, the fabrication of a large-size one is a challenge. Also, welding of SiC canister is not easy. Several pathways are being paved to overcome it.

Research on geological disposal: R and D concept on geological disposal

International Nuclear Information System (INIS)

1993-01-01

The objective on geological disposal of high-level radioactive wastes are to ensure the long term radiological protection of the human and his environment in accordance with current internationally agreed radiation protection principles. The principle of geological disposal is to settle the high-level wastes in deep underground so as to isolate them from the human and his environment considering the existence of groundwater. Japan is currently in the stage of assessing technical feasibility of geological disposal to the extent practicable. In accordance with the AEC (Atomic Energy Commission) policy in 1989, PNC (Power Reactor and Nuclear Fuel Development Corporation) has conducted the research and development on geological disposal in three areas: 1) studies of geological environment, 2) research and development of disposal technology, and 3) performance assessment study. (author)

Cosmic disposal of radioactive waste

Energy Technology Data Exchange (ETDEWEB)

Inoue, Y; Morisawa, S [Kyoto Univ. (Japan). Faculty of Engineering

1975-03-01

The technical and economical possibility and safety of the disposal of highly radioactive waste into cosmos are reviewed. The disposal of highly radioactive waste is serious problem to be solved in the near future, because it is produced in large amounts by the reprocessing of spent fuel. The promising methods proposed are (i) underground disposal, (ii) ocean disposal, (iii) cosmic disposal and (iv) extinguishing disposal. The final disposal method is not yet decided internationally. The radioactive waste contains very long life nuclides, for example transuranic elements and actinide elements. The author thinks the most perfect and safe disposal method for these very long life nuclides is the disposal into cosmos. The space vehicle carrying radioactive waste will be launched safely into outer space with recent space technology. The selection of orbit for vehicles (earth satellite or orbit around planets) or escape from solar system, selection of launching rocket type pretreatment of waste, launching weight, and the cost of cosmic disposal were investigated roughly and quantitatively. Safety problem of cosmic disposal should be examined from the reliable safety study data in the future.

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

Directory of Open Access Journals (Sweden)

J. K. C. Nduka

2008-01-01

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

History of geological disposal concept (3). Implementation phase of geological disposal (2000 upward)

International Nuclear Information System (INIS)

Masuda, Sumio; Sakuma, Hideki; Umeki, Hiroyuki

2015-01-01

Important standards and concept about geological disposal have been arranged as an international common base and are being generalized. The authors overview the concept of geological disposal, and would like this paper to help arouse broad discussions for promoting the implementation plan of geological disposal projects in the future. In recent years, the scientific and technological rationality of geological disposal has been recognized internationally. With the addition of discussions from social viewpoints such as ethics, economy, etc., geological disposal projects are in the stage of starting after establishment of social consensus. As an international common base, the following consolidated and systematized items have been presented as indispensable elements in promoting business projects: (1) step-by-step approach, (2) safety case, (3) reversibility and recovery potential, and (4) trust building and communications. This paper outlines the contents of the following cases, where international common base was reflected on the geological disposal projects in Japan: (1) final disposal method and safety regulations, and (2) impact of the Great East Japan Earthquake and Fukushima Daiichi Nuclear Power Station accident on geological disposal plan. (A.O.)

Utilization of washery dirt and mine refuse

Energy Technology Data Exchange (ETDEWEB)

Leininger, D; Schieder, T

1975-10-02

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

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

Science.gov (United States)

Fanta, Wondimagegn; Worku, Alemayehu

2012-07-26

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

Ocean Disposal Site Monitoring

Science.gov (United States)

EPA is responsible for managing all designated ocean disposal sites. Surveys are conducted to identify appropriate locations for ocean disposal sites and to monitor the impacts of regulated dumping at the disposal sites.

Geological disposal of radioactive wastes

International Nuclear Information System (INIS)

Sato, Tsutomu

2000-01-01

For disposing method of radioactive wastes, various feasibilities are investigated at every nations and international organizations using atomic energy, various methods such as disposal to cosmic space, disposal to ice sheet at the South Pole and so forth, disposal into ocean bed or its sediments, and disposal into ground have been examined. It is, however, impossible institutionally at present, to have large risk on accident in the disposal to cosmic space, to be prohibited by the South Pole Treaty on the disposal to ice sheet at the South Pole, and to be prohibited by the treaty on prevention of oceanic pollution due to the disposal of wastes and so forth on the disposal into oceanic bed or its sediments (London Treaty). Against them, the ground disposal is thought to be the most powerful method internationally from some reasons shown as follows: no burden to the next generation because of no need in long-term management by human beings; safety based on scientific forecasting; disposal in own nation; application of accumulated technologies on present mining industries, civil engineering, and so forth to construction of a disposal facility; and, possibility to take out wastes again, if required. For the ground disposal, wastes must be buried into the ground and evaluated their safety for long terms. It is a big subject to be taken initiative by engineers on geoscience who have quantified some phenomena in the ground and at ultra long term. (G.K.)

Disposal of Radioactive Waste

International Nuclear Information System (INIS)

2011-01-01

This Safety Requirements publication applies to the disposal of radioactive waste of all types by means of emplacement in designed disposal facilities, subject to the necessary limitations and controls being placed on the disposal of the waste and on the development, operation and closure of facilities. The classification of radioactive waste is discussed. This Safety Requirements publication establishes requirements to provide assurance of the radiation safety of the disposal of radioactive waste, in the operation of a disposal facility and especially after its closure. The fundamental safety objective is to protect people and the environment from harmful effects of ionizing radiation. This is achieved by setting requirements on the site selection and evaluation and design of a disposal facility, and on its construction, operation and closure, including organizational and regulatory requirements.

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

NARCIS (Netherlands)

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

2005-01-01

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

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

NARCIS (Netherlands)

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

2010-01-01

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

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

African Journals Online (AJOL)

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

Refusal of implant supported mandibular overdentures by elderly patients.

Science.gov (United States)

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

2011-03-01

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

A preliminary evaluation of a combined tire- and refuse-derived fuel (TDF-RDF)

Energy Technology Data Exchange (ETDEWEB)

Stessel, R.I.; Amari, T.; Themelis, N.J.; Wearnick, I.K.

1999-07-01

In dense urban areas of the US, it is now becoming clear that waste management is far from economically-optimum. Even with the popularity of inexpensive land disposal, hauling and recycling costs are driving up the average waste bill. An historic option has been refuse-derived fuel, or RDF. Difficulties included low energy content and difficulty obtaining uniformity. Today, many resource-recovery technologies used in RDF are finding their way into materials recovery facilities (MRFs), some of which are reviving the automated processing of waste. Any MRF, automated or not, will have residue streams. Currently, one of the most significant problems is waste tires. Local options are difficult to locate in dense urban areas. As fuels, tires typically have energy contents considerably above those for which most solid-fuel combustors are designed, leading to thermal imbalances and various forms of failure. This paper suggests a new fuel that can be either co-fired with coal, or used in its own right in a combustor primarily designed for coal: TDF-RDF. A preliminary examination is undertaken of thermal and emissions characteristics, and possible costs for a few applications of the fuel. Immediately, TDF is already cleaner-burning than many coals, even in sulfur emissions. RDF has been widely-regarded as being similarly cleanly. Posited MRF residue streams should be still cleaner, and more consistent, than RDF. Overall, there is quite a potential for developing a fuel that would allow old coal powerplants in historic urban centers to be better neighbors, while helping with a few problems in municipal waste management.

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

Science.gov (United States)

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

2006-01-01

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

Waste disposal: preliminary studies

International Nuclear Information System (INIS)

Carvalho, J.F. de.

1983-01-01

The problem of high level radioactive waste disposal is analyzed, suggesting an alternative for the final waste disposal from irradiated fuel elements. A methodology for determining the temperature field around an underground disposal facility is presented. (E.G.) [pt

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

Science.gov (United States)

Utt, Sandra H.; Pasternack, Steve

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

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

Energy Technology Data Exchange (ETDEWEB)

NONE

2001-03-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

1977-09-01

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

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

Science.gov (United States)

Cisneros, Nora Alba

2018-01-01

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

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

Science.gov (United States)

2010-01-01

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

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

Science.gov (United States)

2010-01-01

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

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

Science.gov (United States)

2010-01-01

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

Disposal configuration options for future uses of greater confinement disposal at the Nevada Test Site

International Nuclear Information System (INIS)

Price, L.

1994-09-01

The US Department of Energy (DOE) is responsible for disposing of a variety of radioactive and mixed wastes, some of which are considered special-case waste because they do not currently have a clear disposal option. The DOE's Nevada Field Office contracted with Sandia National Laboratories to investigate the possibility of disposing of some of this special-case waste at the Nevada Test Site (NTS). As part of this investigation, a review of a near-surface and subsurface disposal options that was performed to develop alternative disposal configurations for special-case waste disposal at the NTS. The criteria for the review included (1) configurations appropriate for disposal at the NTS; (2) configurations for disposal of waste at least 100 ft below the ground surface; (3) configurations for which equipment and technology currently exist; and (4) configurations that meet the special requirements imposed by the nature of special-case waste. Four options for subsurface disposal of special-case waste are proposed: mined consolidated rock, mined alluvium, deep pits or trenches, and deep boreholes. Six different methods for near-surface disposal are also presented: earth-covered tumuli, above-grade concrete structures, trenches, below-grade concrete structures, shallow boreholes, and hydrofracture. Greater confinement disposal (GCD) in boreholes at least 100 ft deep, similar to that currently practiced at the GCD facility at the Area 5 Radioactive Waste Management Site at the NTS, was retained as the option that met the criteria for the review. Four borehole disposal configurations are proposed with engineered barriers that range from the native alluvium to a combination of gravel and concrete. The configurations identified will be used for system analysis that will be performed to determine the disposal configurations and wastes that may be suitable candidates for disposal of special-case wastes at the NTS

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

Directory of Open Access Journals (Sweden)

Natalia Calanzani

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

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

Science.gov (United States)

Calanzani, Natalia; Higginson, Irene J; Koffman, Jonathan; Gomes, Barbara

2016-01-01

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

Do pharmacists have a right to refuse to fill prescriptions for abortifacient drugs?

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Weinstein, B D

1992-01-01

Some pharmacists opposed to abortion on moral ground are concerned by having to fill prescriptions for abortifacient drugs like mifepristone (RU-486). The issue of the right of pharmacists to refuse to fill such prescriptions depends on the model of the physician-pharmacist-patient relationship. The libertarian model of pharmacy practice holds that physicians, pharmacists, and patients are bound only by the contract that they freely negotiate with one another, thus the pharmacist has no moral obligation to fill a prescription for mifepristone unless he or she has expressly contracted to do so. The American Pharmaceutical Association's 1981 Code of Ethics does not specify what a pharmacist ought to do in particular circumstances. The right to refuse is strongly supported by the principles of nonmaleficence and respect for autonomy. These are principles of the libertarian model of the pharmacist-patient relationship but are also present in the guild or societal models stressing the duty to avoid harming others. Justification for pharmacists right of refusal appeals to their autonomy rights as members of the moral community rather than the profession of pharmacy. Since the professional right to autonomy is not absolute, moral consideration circumscribe it: it is difficult to argue that a pharmacist who believes that homosexuality is immoral has the right to refuse to fill a prescription for AZT. Even if a person who presents such a prescription is homosexual there is no causal relationship between filling a prescription for AZT and participating in a homosexual act. At the opposite end the libertarians reject the notion of even a basic right to health care. A woman in the above situation would not have a right to the abortifacient drug, so a pharmacist has no duty to dispense it. According to the technician model of professionalism, the pharmacist's personal values do not matter, so a pharmacist has a duty to provide the service.

30 CFR 780.25 - Reclamation plan: Siltation structures, impoundments, and refuse piles.

Science.gov (United States)

2010-07-01

... is capable of being done after consideration of cost, logistics, and available technology. The fact... COAL EXPLORATION SYSTEMS UNDER REGULATORY PROGRAMS SURFACE MINING PERMIT APPLICATIONS-MINIMUM..., and refuse piles. (a) General. Each application must include a general plan and a detailed design plan...

30 CFR 784.16 - Reclamation plan: Siltation structures, impoundments, and refuse piles.

Science.gov (United States)

2010-07-01

... of being done after consideration of cost, logistics, and available technology. The fact that one... COAL EXPLORATION SYSTEMS UNDER REGULATORY PROGRAMS UNDERGROUND MINING PERMIT APPLICATIONS-MINIMUM..., and refuse piles. (a) General. Each application must include a general plan and a detailed design plan...

At the Intersection of Faith, Culture, and Family Dynamics: A Complex Case of Refusal of Treatment for Childhood Cancer.

Science.gov (United States)

Brown, Amy E Caruso

2017-01-01

Refusing treatment for potentially curable childhood cancers engenders much discussion and debate. I present a case in which the competent parents of a young Amish child with acute myeloid leukemia deferred authority for decision making to the child's maternal grandfather, who was vocal in his opposition to treatment. I analyze three related concerns that distinguish this case from other accounts of refused treatment. First, I place deference to grandparents as decision makers in the context of surrogate decision making more generally. Second, the maternal grandfather's ardent refusal of treatment and his rationale appeared to be inconsistent with the beliefs expressed by other family members and by members of the same Amish community, leading members of the medical team to question whether refusal of treatment should be treated differently when it appears to be based on the idiosyncratic beliefs of an individual rather than on community-wide values. Third, the medical team perceived tension and dissension between the nonverbal behavior of some family members and the verbal statements made by the maternal grandfather, leading the team to question the parents' true wishes and debate how to weigh nonverbal and indirect forms of communication. Finally, building upon the conclusions of these queries, I explore whether, if the child's prognosis was less favorable or if he were to relapse later, the maternal grandfather should have been permitted to drive a decision to refuse further treatment. Copyright 2017 The Journal of Clinical Ethics. All rights reserved.

Exploring the relationship between postmigratory stressors and mental health for asylum seekers and refused asylum seekers in the UK.

Science.gov (United States)

Morgan, Gareth; Melluish, Steve; Welham, Alice

2017-01-01

Numerous studies have linked the high rates of traumatic events experienced by refugees to the elevated rate of mental health problems in these populations. A growing body of evidence has also highlighted the importance of considering postmigratory stressors when making sense of displaced person distress. This study explored the relationship between mental health and postmigratory stress for asylum seekers and refused asylum seekers in Britain. The study further examined if those refused asylum experienced elevated distress and postmigratory stress compared to those awaiting the outcome of asylum applications. Results indicated that participants ( N = 97) had endured a range of pre- and postmigratory stressors and had high scores on measures of anxiety, depression, and PTSD. A postmigratory factor comprising items associated with isolation, restrictive policies, and stressors associated with having an insecure immigration status, was significantly associated with PTSD scores. This relationship remained when controlling for the variance accounted for by premigratory trauma predictors. Being refused asylum was the strongest predictor of depression and anxiety. Those refused asylum scored higher on a factor associated with barriers to accessing services. Social materialist theories of distress are drawn upon to contextualise the heightened vulnerability of those refused asylum. The paper concludes by emphasising the problems associated with taking an exclusively trauma-focussed approach when working with asylum seekers and argues for community orientated interventions to support displaced people to cope with the various stressors endured in exile.

Evaluation of Proposed New LLW Disposal Activity: Disposal of Aqueous PUREX Waste Stream in the Saltstone Disposal Facility

International Nuclear Information System (INIS)

Cook, J.R.

2003-01-01

The Aqueous PUREX waste stream from Tanks 33 and 35, which have been blended in Tank 34, has been identified for possible processing through the Saltstone Processing Facility for disposal in the Saltstone Disposal Facility

Clinical practice guidelines of the French Association for Supportive Care in Cancer and the French Society for Psycho-oncology: refusal of treatment by adults afflicted with cancer.

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Faivre, J C; Adam, V; Block, V; Metzger, M; Salleron, J; Dauchy, S

2017-11-01

The study's purpose was to develop practical guidelines for assessment and management of refusal of treatment by adults afflicted with cancer. The French Association for Supportive Care in Cancer and the French Society for Psycho-oncology gathered a task force that applied a consensus methodology to draft guidelines studied predisposing situations, the diagnosis, regulatory aspects, and the management of refusal of treatment by adults afflicted with cancer. We propose five guidelines: (1) be aware of the conditions/profiles of patients most often associated with refusal of treatment so as to adequately underpin the care and support measures; (2) understand the complexity of the process of refusal and knowing how to accurately identify the type and the modalities of the refused treatments; (3) apply a way to systematically analyze refusal, thereby promoting progression from a situation of disaccord toward a consensual decision; (4) devise procedures, according to the legal context, to address refusal of treatment that safeguards the stakeholders in situations of sustained disaccord; and (5) know the indications for ethical collective decision-making. The quality of the relationship between patients and health professionals, and the communication between them are essential components involved in reaching a point of consent or refusal of treatment. A process of systematic analysis of refusal is recommended as the only way to ensure that all of the physiological, psychological, and contextual elements that are potentially involved are taken into account.

[Granted, undecided, withdrawn and refused requests for euthanasia and physician-assisted suicide in the Netherlands; 2000-2002].

Science.gov (United States)

Onwuteaka-Philipsen, B D; Jansen-Van der Weide, M C; Van der Wal, G

2006-02-04

To determine the characteristics of patients who request euthanasia or physician-assisted suicide and whether these characteristics differ among those whose request is granted, those who die before the procedure, those who die before completion of the approval process, those who withdraw their request, and lastly, those whose request is refused by the physician. Questionnaire study. All general practitioners in 18 of the 23 Dutch general practitioner districts received a written questionnaire in which they were asked to describe the most recent request for euthanasia or physician-assisted suicide that they had received (response 60%, n=3614). Of all explicit requests, 44% resulted in euthanasia or physician-assisted suicide. Thirteen percent of patients died before the procedure, 13% died before completion of the approval process, 13% withdrew their request and 12% were refused by the physician. The most prominent symptoms were 'feeling bad', 'tiredness', and 'lack of appetite'. The most frequently mentioned reasons for requesting euthanasia or physician-assisted suicide were 'pointless suffering', 'loss of dignity', and 'general weakness'. The patients' situation met the official requirements for accepted practice best in the group of requests that resulted in euthanasia or physician-assisted suicide and least in the group of refused requests. A lesser degree of competence and less unbearable and hopeless suffering had the strongest associations with the refusal of a request. The complexity of euthanasia or physician-assisted suicide decision-making is reflected in the fact that, besides granting and refusing a request, 3 other situations could be distinguished. The decisions physicians made, the reasons for their decisions and the way they arrived at their decisions appeared to be based on patient evaluations and on the official requirements for accepted practice.

Overcoming healthcare workers vaccine refusal--competition between egoism and altruism.

Science.gov (United States)

Betsch, C

2014-12-04

Vaccination reduces the risk of becoming infected with and transmitting pathogens. The role of healthcare workers (HCWs) in controlling and limiting nosocomial infections has been stressed repeatedly. This has also been recognised at a political level, leading the European Council of Ministers in 2009 to encourage coverage of 75% seasonal influenza vaccine in HCWs. Although there are policies, recommendations and well-tolerated vaccines, still many HCWs refuse to get vaccinated. This article uses literature from psychology and behavioural economics to understand vaccination decisions and the specific situation of HCWs. HCWs are expected to be highly motivated to protect others. However, their individual vaccination decisions follow the same principles (of weighting individual risks) as everyone else’s vaccination decisions. This will lead to decisional conflict in a typical social dilemma situation, in which individual interests are at odds with collective interests. Failure to get vaccinated may be the result. If we understand the motivations and mechanisms of HCWs’ vaccine refusal, interventions and campaigns may be designed more effectively. Strategies to increase HCWs’ vaccine uptake should be directed towards correcting skewed risk perceptions and activating pro-social motivation in HCWs.

Underground disposal of radioactive wastes

Energy Technology Data Exchange (ETDEWEB)

NONE

1979-08-15

Disposal of low- and intermediate-level radioactive wastes by shallow land burial, emplacement in suitable abandoned mines, or by deep well injection and hydraulic fracturing has been practised in various countries for many years. In recent years considerable efforts have been devoted in most countries that have nuclear power programmes to developing and evaluating appropriate disposal systems for high-level and transuranium-bearing waste, and to studying the potential for establishing repositories in geological formations underlaying their territories. The symposium, organized jointly by the IAEA and OECD's Nuclear Energy Agency in cooperation with the Geological Survey of Finland, provided an authoritative account of the status of underground disposal programmes throughout the world in 1979. It was evidence of the experience that has been gained and the comprehensive investigations that have been performed to study various options for the underground disposal of radioactive waste since the last IAEA/NEA symposium on this topic (Disposal of Radioactive Waste into the Ground) was held in 1967 in Vienna. The 10 sessions covered the following topics: National programme and general studies, Disposal of solid waste at shallow depth and in rock caverns, underground disposal of liquid waste by deep well injection and hydraulic fracturing, Disposal in salt formations, Disposal in crystalline rocks and argillaceous sediments, Thermal aspects of disposal in deep geological formations, Radionuclide migration studies, Safety assessment and regulatory aspects.

Conscientious objection and refusal to provide reproductive healthcare: a White Paper examining prevalence, health consequences, and policy responses.

Science.gov (United States)

Chavkin, Wendy; Leitman, Liddy; Polin, Kate

2013-12-01

Global Doctors for Choice-a transnational network of physician advocates for reproductive health and rights-began exploring the phenomenon of conscience-based refusal of reproductive healthcare as a result of increasing reports of harms worldwide. The present White Paper examines the prevalence and impact of such refusal and reviews policy efforts to balance individual conscience, autonomy in reproductive decision making, safeguards for health, and professional medical integrity. The White Paper draws on medical, public health, legal, ethical, and social science literature published between 1998 and 2013 in English, French, German, Italian, Portuguese, and Spanish. Estimates of prevalence are difficult to obtain, as there is no consensus about criteria for refuser status and no standardized definition of the practice, and the studies have sampling and other methodologic limitations. The White Paper reviews these data and offers logical frameworks to represent the possible health and health system consequences of conscience-based refusal to provide abortion; assisted reproductive technologies; contraception; treatment in cases of maternal health risk and inevitable pregnancy loss; and prenatal diagnosis. It concludes by categorizing legal, regulatory, and other policy responses to the practice. Empirical evidence is essential for varied political actors as they respond with policies or regulations to the competing concerns at stake. Further research and training in diverse geopolitical settings are required. With dual commitments toward their own conscience and their obligations to patients' health and rights, providers and professional medical/public health societies must lead attempts to respond to conscience-based refusal and to safeguard reproductive health, medical integrity, and women's lives. Copyright © 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

The role of positive/negative outcome expectancy and refusal self-efficacy of Internet use on Internet addiction among college students in Taiwan.

Science.gov (United States)

Lin, Min-Pei; Ko, Huei-Chen; Wu, Jo Yung-Wei

2008-08-01

Based on Bandura's social cognitive theory, this study was designed to examine positive and negative outcome expectancy and refusal self-efficacy of Internet use and their contribution to Internet addiction among college students by using hierarchical multiple regression analyses in a cross-sectional study design. Schools were first stratified into technical or nontechnical colleges and then into seven majors. A cluster random sampling by department was further applied to randomly choose participants from each major. A representative sample of 4,456 college students participated in this study. The Outcome Expectancy and Refusal Self-Efficacy of Internet Use Questionnaire and the Chen Internet Addiction Scale were used to assess the cognitive factors and the levels of Internet addiction. Results showed that both positive outcome expectancy and negative outcome expectancy were significantly and positively correlated with Internet addiction, and refusal self-efficacy of Internet use was significantly and negatively related to Internet addiction. Further analyses revealed that refusal self-efficacy of Internet use directly and negatively predicted Internet addiction. Moreover, we discovered that positive outcome expectancy positively predicted Internet addiction via refusal self-efficacy of Internet use; however, surprisingly, negative outcome expectancy had both a direct and indirect positive relationship in predicting Internet addiction via the refusal self-efficacy of Internet use. These results give empirical evidence to verify the theoretical effectiveness of the three cognitive factors to Internet addiction and should be incorporated when designing prevention programs and strategies for Internet addicted college students.

Alternative disposal technologies for new low-level radioactive waste disposal/storage facilities at the Savannah River Plant

International Nuclear Information System (INIS)

Cook, J.R.

1987-01-01

A Draft Environmental Impact Statement for Waste Management Activities for groundwater protection has been prepared for the Savannah River Plant. Support documentation for the DEIS included an Environmental Information Document on new radioactive waste disposal and storage facilities in which possible alternative disposal technologies were examined in depth. Six technologies that would meet the needs of the Savannah River Plant that selected for description and analysis include near surface disposal, near surface disposal with exceptions, engineered storage, engineered disposal, vault disposal of untreated waste, and a combination of near surface disposal, engineered disposal, and engineered storage. 2 refs

When a Wife Says "No": Wife Sexual Refusal as a Factor in Husband-Wife Homicides in Ghana.

Science.gov (United States)

Adinkrah, Mensah

2017-11-01

In Ghana, wife sexual refusal is a key factor in uxoricides or husband-to-wife murders. Despite this, there is a dearth of systematic research that examines sexual strife as a precipitant of domestic violence and spousal murder. The present article addresses the current lack of research by systematically examining 25 cases of homicides and attempted homicides where wives were lethally and nonlethally assaulted by their husbands following the former's refusal to engage in husband-initiated sexual intercourse. A content analysis was conducted of all print and electronic media news items where a wife's refusal of sexual intercourse with a husband triggered lethal or aggravated violence. The results showed that the victims were aged 23 to 55 years old and were generally of low socioeconomic status. The assailants were aged 28 to 60 years old. Assailants used machetes, knives, and personal weapons to perpetrate the crimes, and extreme violence was a frequent feature of both lethal and nonlethal acts.

Low-level radioactive mixed waste land disposal facility -- Permanent disposal

International Nuclear Information System (INIS)

Erpenbeck, E.G.; Jasen, W.G.

1993-03-01

Radioactive mixed waste (RMW) disposal at US Department of Energy (DOE) facilities is subject to the Resource Conservation and Recovery Act of 1976 (RCRA) and the Hazardous and Solid Waste Amendments of 1984 (HSWA). Westinghouse Hanford Company, in Richland, Washington, has completed the design of a radioactive mixed waste land disposal facility, which is based on the best available technology compliant with RCRA. When completed, this facility will provide permanent disposal of solid RMW, after treatment, in accordance with the Land Disposal Restrictions. The facility includes a double clay and geosynthetic liner with a leachate collection system to minimize potential leakage of radioactive or hazardous constituents from the landfill. The two clay liners will be capable of achieving a permeability of less than 1 x 10 -7 cm/s. The two clay liners, along with the two high density polyethylene (HDPE) liners and the leachate collection and removal system, provide a more than conservative, physical containment of any potential radioactive and/or hazardous contamination

A Virtual Reality Curriculum for Pediatric Residents Decreases Rates of Influenza Vaccine Refusal.

Science.gov (United States)

Real, Francis J; DeBlasio, Dominick; Beck, Andrew F; Ollberding, Nicholas J; Davis, David; Cruse, Bradley; Samaan, Zeina; McLinden, Daniel; Klein, Melissa D

Influenza vaccine hesitancy is common in the primary care setting. Though physicians can affect caregivers' attitudes toward vaccination, physicians report uneasiness discussing vaccine hesitancy. Few studies have targeted physician-patient communication training as a means to decrease vaccination refusal. An immersive virtual reality (VR) curriculum was created to teach pediatric residents communication skills when discussing influenza vaccine hesitancy. This pilot curriculum consisted of 3 VR simulations during which residents counseled graphical character representatives (avatars) who expressed vaccine hesitancy. Participants were randomized to the intervention (n = 24) or control (n = 21) group. Only residents in the intervention group underwent the VR curriculum. Impact of the curriculum was assessed through difference in influenza vaccine refusal rates between the intervention and control groups in the 3 months after the VR curriculum. Participants included postgraduate level (PL) 2 and PL3 pediatric residents. All eligible residents (n = 45) participated; the survey response rate was 100%. In patients aged 6 to 59 months, residents in the intervention group had a decreased rate of influenza vaccination refusal in the postcurriculum period compared to the control group (27.8% vs 37.1%; P = .03). Immersive VR may be an effective modality to teach communication skills to medical trainees. Next steps include evaluation of the curriculum in a larger, multisite trial. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Uncertainties about the safety of disposal leading to a wish to keep alternatives open. Discussion on the concepts 'storage' ('wait and see') vs. 'disposal' and 'retrievable disposal' vs. 'definitive disposal'

International Nuclear Information System (INIS)

Norrby, S.

2000-01-01

Uncertainties about the safety of final disposal may lead to unwillingness to take decisions about waste management issues that may seem to be non-reversible. This has lead to proposals that we should wait with decisions on final measures and instead store the waste for some period of time. Also the possibility of retrieval may lead to decisions not to go for permanent disposal but instead to retrievable disposal. These aspects and the pros and cons are discussed both from a more general perspective and also with some reflections from the Swedish programme for nuclear waste management and disposal. (author)

CO-COMBUSTION OF REFUSE DERIVED FUEL WITH COAL IN A FLUIDISED BED COMBUSTOR

Directory of Open Access Journals (Sweden)

W. A. WAN AB KARIM GHANI

2009-03-01

Full Text Available Power generation from biomass is an attractive technology which utilizes municipal solid waste-based refused derived fuel. In order to explain the behavior of biomass-fired fluidized bed incinerator, biomass sources from refuse derived fuel was co-fired with coal in a 0.15 m diameter and 2.3 m high fluidized bed combustor. The combustion efficiency and carbon monoxide emissions were studied and compared with those from pure coal combustion. This study proved that the blending effect had increased the carbon combustion efficiency up to 12% as compared to single MSW-based RDF. Carbon monoxide levels fluctuated between 200-1600 ppm were observed when coal is added. It is evident from this research that efficient co-firing of biomass with coal can be achieved with minimum modification of existing coal-fired boilers.

Graduated Exposure and Compliance Training Intervention for Blood Draw Avoidance and Refusal in a Woman with Intellectual Disability and Schizoaffective Disorder

Science.gov (United States)

Cromartie, R. Samuel; Flood, William A.; Luiselli, James K.

2014-01-01

This case report concerns a woman with intellectual disability, schizoaffective disorder, and avoidance and refusal of having her blood drawn. She required but refused blood draws to properly monitor the therapeutic dose of a necessary psychotropic medication. During intervention at a community-based habilitation setting and under simulated…

Unreviewed Disposal Question Evaluation: Waste Disposal In Engineered Trench #3

Energy Technology Data Exchange (ETDEWEB)

Hamm, L. L.; Smith, F. G. III; Flach, G. P.; Hiergesell, R. A.; Butcher, B. T.

2013-07-29

Because Engineered Trench #3 (ET#3) will be placed in the location previously designated for Slit Trench #12 (ST#12), Solid Waste Management (SWM) requested that the Savannah River National Laboratory (SRNL) determine if the ST#12 limits could be employed as surrogate disposal limits for ET#3 operations. SRNL documented in this Unreviewed Disposal Question Evaluation (UDQE) that the use of ST#12 limits as surrogates for the new ET#3 disposal unit will provide reasonable assurance that Department of Energy (DOE) 435.1 performance objectives and measures (USDOE, 1999) will be protected. Therefore new ET#3 inventory limits as determined by a Special Analysis (SA) are not required.

Colloquium on the occasion of the 15th anniversary of the Bavarian State Office for Environmental Protection

International Nuclear Information System (INIS)

1989-01-01

The eleven commemorative contributions give a short survey on the development of environmental parameters, the consequences of the reactor accident in Chernobyl, on radiation protection in nuclear medicine, lake shore analyses in Bavaria, nature protection planning, the application of data processing at the Land Office for Environment Protection (LfU), integrated disposal concepts for domestic refuse, special refuse disposal, implementation of the smog ordinance, environmental effects of shooting ranges and protection of waters against organic and inorganic pollutants as a part of water management outline planning. (DG) [de

Realisation of politically desired projects on the basis of an insufficient development. A consequence of the acceptance discussion on wase incineration; Realisierung politisch erwuenschter Projekte auf Basis unzureichender Entwicklung. Eine Konsequenz der Akzeptanzdiskussion um die Abfallverbrennung

Energy Technology Data Exchange (ETDEWEB)

Thome-Kozmiensky, Karl J. [vivis Consult GmbH, Nietwerder (Germany)

2008-07-01

Despite all efforts toward waste avoidance, re-use and material utilization residual wastes remains. These residual wastes have to be treated before the deposition. This regularly is accomplished thermally after a mechanical or biological pretreatment. In Germany, the present refuse disposal exhibits an optimization potential. The well-known procedures for the refuse disposal exhibit lacks regarding its technical performance and environmental compatibility. A further development of these procedures was required. Under this aspect, the author of the contribution under consideration describes the procedures for the treatment of residual wastes, and evaluates these procedures critically.

Parent Refusal of Topical Fluoride for Their Children: Clinical Strategies and Future Research Priorities to Improve Evidence-Based Pediatric Dental Practice.

Science.gov (United States)

Chi, Donald L

2017-07-01

A growing number of parents are refusing topical fluoride for their children during preventive dental and medical visits. This nascent clinical and public health problem warrants attention from dental professionals and the scientific community. Clinical and community-based strategies are available to improve fluoride-related communications with parents and the public. In terms of future research priorities, there is a need to develop screening tools to identify parents who are likely to refuse topical fluoride and diagnostic instruments to uncover the reasons for topical fluoride refusal. This knowledge will lead to evidence-based strategies that can be widely disseminated into clinical practice. Copyright © 2017 Elsevier Inc. All rights reserved.

The impact of a multiple intelligences teaching approach drug education programme on drug refusal skills of Nigerian pupils.

Science.gov (United States)

Nwagu, Evelyn N; Ezedum, Chuks E; Nwagu, Eric K N

2015-09-01

The rising incidence of drug abuse among youths in Nigeria is a source of concern for health educators. This study was carried out on primary six pupils to determine the effect of a Multiple Intelligences Teaching Approach Drug Education Programme (MITA-DEP) on pupils' acquisition of drug refusal skills. A programme of drug education based on the Multiple Intelligences Teaching Approach (MITA) was developed. An experimental group was taught using this programme while a control group was taught using the same programme but developed based on the Traditional Teaching Approach. Pupils taught with the MITA acquired more drug refusal skills than those taught with the Traditional Teaching Approach. Urban pupils taught with the MITA acquired more skills than rural pupils. There was no statistically significant difference in the mean refusal skills of male and female pupils taught with the MITA. © The Author(s) 2014.

REFUSE DISPOSAL AND ITS ATTENDANT HEALTH HAZARDS: A ...

African Journals Online (AJOL)

Oyem

HAZARDS: A CASE STUDY OF AGBOR, DELTA STATE OF. NIGERIA ... acceptable environmental quality, sound public health, and ... solid waste management and public health, .... by the public relations department of the council to sensitize.

Bioaerosol exposure during refuse collection: results of field studies in the real-life situation.

Science.gov (United States)

Neumann, H D; Balfanz, J; Becker, G; Lohmeyer, M; Mathys, W; Raulf-Heimsoth, M

2002-07-03

To determine the bioaerosol exposure of refuse collectors, field measurements were performed under real working conditions within the framework of a research project. Influencing variables such as different types of refuse, community structure, collection interval and season were taken into account. Overall, 1612 samples were taken in towns of Westfalia, Germany. With workplace levels on a scale of 10(3) to less than 10(4) CFU/m3 for the loader, the results show a surprisingly low total fungi concentration in comparison with earlier studies. Total bacteria concentrations, in contrast, were largely on a scale of 10(4) CFU/m3, with 10(5) CFU/m3 being registered sporadically, especially in apartment-block districts. Endotoxin levels were high especially in the summer months, occasionally reaching values of more than 50 EU/m3, whereas they were normally below 10 EU/m3 in autumn and winter. Inside the cab, the exposure level for the entire spectrum was at least one power of ten lower. The factors believed to account primarily for the low total fungi concentration were workplace hygiene, the prevailing 1-week collection interval, and the low in-process exposure time resulting from the effective deployment of automatic lifting devices. In contrast, the type of refuse was not found to have a significant influence.

Psychosocial Interventions for School Refusal with Primary and Secondary School Students: A Systematic Review

Directory of Open Access Journals (Sweden)

Brandy Maynard

2015-05-01

Full Text Available BACKGROUND School refusal is a psychosocial problem characterized by a student’s difficulty attending school and, in many cases, substantial absence from school (Heyne & Sauter, 2013. It is often distinguished from truancy, in part because of the severe emotional distress associated with having to attend school and the absence of severe antisocial behavior. Truancy, on the other hand, is not typically associated with emotional distress and is commonly associated with severe externalizing behavior. The emotional distress associated with school refusal is often in the form of fear or anxiety, and sometimes in the form of depression. School refusal occurs for about 1-2% of young people, and estimates among clinically referred youth are considerably higher. There is substantial heterogeneity in both the presentation of school refusal and its associated risk factors. Significant adverse consequences may occur in the short- and long-term, including school dropout and problems with social adjustment. Family members and school staff are also affected by school refusal. The most commonly studied interventions for school refusal are behavioral approaches and cognitive-behavioral therapy (CBT. The overarching aim of these interventions is the reduction of the young person’s emotional distress and an increase in school attendance to help the young person follow a normal developmental pathway (Heyne & Sauter, 2013. Behavioral interventions include exposure-based interventions, relaxation training, and/or social skills training with the student, and contingency management procedures with the parents and school staff. CBT manuals additionally focus attention on the identification and modification of maladaptive cognition that may maintain the young person’s emotional distress and absenteeism. In some instances parent cognition is also targeted. Other interventions have been used to treat school refusal (e.g., psychodynamic treatment, family therapy

The use of coal refuse bike substratoun in cultivate techniques without soils; Utilizacion de los Esteriles de Carbon como Sustratos en Cultivos sin Suelo 2 Fase

Energy Technology Data Exchange (ETDEWEB)

NONE

1999-11-01

Coal refuse poses several problems as regards both their storage and environmental impact: landscape alteration, pollution, high costs, an increasing difficulty in finding appropriate places for storage, etc. Therefore, the companies HUMOSA, HORPLASA and the C. S. I. C. Centre for Environmental Sciences carried out a joint study financed by OCICARBON. This study, completing other ones carried out previously, was aimed at determining the use as both a soilless medium for growing other vegetables than tomatoes and a basic component for container gardening. Then, based on previous experiments, two types of coal refuse were selected: coal refuse from dumps and burnt coal refuse. The characterization of the coal refuse was carried out and the investigation-line was established: (I) the adaption of techniques and know-how obtained up to that moment to the production of kidney beans faba de la granja, green beans and pepper; (II) to study the possibilities of coal refuse as basic components of substrates for container gardening of decorative outdoor plants different from the already investigated conifers in order examine thoroughly the cultivation techniques and, in particular, the methods of fertilization by irrigation. Exhaustive controls were carried out with both types of cultivation using as reference other cultivations with conventional substrates. The results obtained proved that coal refuse can be used as soilles growing medium for vegetables and for container gardening of decorative plants.

Toxic and hazardous waste disposal. Volume 4. New and promising ultimate disposal options

International Nuclear Information System (INIS)

Pojasek, R.B.

1980-01-01

Separate abstrats were prepared for four of the eighteen chapters of this book which reviews several disposal options available to the generators of hazardous wastes. The chapters not abstracted deal with land disposal of hazardous wastes, the solidification/fixation processes, waste disposal by incineration and molten salt combustion and the use of stabilized industrial waste for land reclamation and land farming

Mothers' reasons for refusing to give consent to HIV testing and the ...

African Journals Online (AJOL)

under-five mortality rate by more than half since 1990. ... children in sub-Saharan Africa. ... In Limpopo Province, South Africa, the prevention of mother-to-child ... had attended antenatal care, 28 (93%) stated that their HIV results were negative ... (16%) mothers signed refusal of hospital treatment, three (12%) started ARV ...

Disposal of radioactive waste

Energy Technology Data Exchange (ETDEWEB)

NONE

1960-01-15

The problem of disposal can be tackled in two ways: the waste can be diluted and dispersed so that the radiation to which any single individual would be subjected would be negligible, or it can be concentrated and permanently isolated from man and his immediate environment. A variety of methods for the discharge of radioactive waste into the ground were described at the Monaco conference. They range from letting liquid effluent run into pits or wells at appropriately chosen sites to the permanent storage of high activity material at great depth in geologically suitable strata. Another method discussed consists in the incorporation of high level fission products in glass which is either buried or stored in vaults. Waste disposal into rivers, harbours, outer continental shelves and the open sea as well as air disposal are also discussed. Many of the experts at the Monaco conference were of the view that most of the proposed, or actually applied, methods of waste disposal were compatible with safety requirements. Some experts, felt that certain of these methods might not be harmless. This applied to the possible hazards of disposal in the sea. There seemed to be general agreement, however, that much additional research was needed to devise more effective and economical methods of disposal and to gain a better knowledge of the effects of various types of disposal operations, particularly in view of the increasing amounts of waste material that will be produced as the nuclear energy industry expands

Management of hydrocarbon-contaminated soil through bioremediation and landfill disposal at a remote location in northern Canada

Energy Technology Data Exchange (ETDEWEB)

Sanscartier, D.; Reimer, K.; Zeeb, B.; George, K. [Royal Military Coll. of Canada, Kingston, ON (Canada). Environmental Sciences Group; Royal Military Coll. of Canada, Kingston, ON (Canada). Dept. of Chemistry and Chemical Engineering

2010-01-15

This paper described an innovative method of managing diesel-contaminated soil in a remote Labrador community. The soil was treated in an aerated biopile to reduce mobile petroleum hydrocarbons (PHC) concentrations. The soil was then disposed of in a local landfill. An analysis of the soils showed that the method reduced total petroleum hydrocarbon (TPH) concentrations in the soil. Hydrocarbon concentrations were measured using the Canada-Wide standard reference method. TPH in leachate decreased during the 1-year field treatment period. PHC fractions were reduced to below the standard criteria for the protection of aquatic life. Volatilization was the predominant PHC removal mechanism in the field. The treated soils were used as a landfill cover for refuse. The cost of the treatment method compared favorably with other land remediation techniques. The biopile facility will be used to treat other fuel spills in the community and serve as a demonstration project for other communities. 36 refs., 4 tabs., 3 figs.

Características químicas do lixo de formigueiros de Atta sexdens rubropilosa (Hymenoptera: Formicidae mantidos com diferentes substratos Chemical characteristics of nest refuse of Atta sexdens rubropilosa (Hymenoptera: Formicidae reared with different substrates

Directory of Open Access Journals (Sweden)

Marcelo Braga Bueno Guerra

2007-10-01

ecossistema. O lixo pode ser uma das principais razões para o aumento da concentração de nutrientes em solos de formigueiros.Leaf-cutting ants (Atta spp. are widely distributed in South America, and are considered to be important components of the neotropical ecosystems. Several studies have demonstrated the effect of ant-nesting in soil enrichment, thus facilitating vegetation succession. Possibly, this enrichment is due to decomposed organic matter concentration after disposal of nest refuse in the deep soil by the colonies. However, little is known about the chemical composition of refuse material produced by leaf-cutting ants. The present work aimed to compare the macronutrient concentration in nest refuse and leaves of two different harvested plants (Acalypha sp. or Bauhinia sp. in colonies of Atta sexdens rubropilosa Forel (Hymenoptera: Formicidae maintained in laboratory. Eight colonies were divided into two groups (n = 4, and each one was maintained with only one feed type. After 30 days of experiment, samples of leaves and refuse were oven-dried at 70 ºC and subjected to acid digestion for chemical determination of total N, P, K, S, Ca and Mg. Differences in concentrations of macronutrients in both leaves and refuse were compared using ANOVA and T test. Nutrient concentration in the refuse material was consistently higher than in leaves, for both plants. Acalypha sp. leaves showed greater nutrient concentration than those of Bauhinia sp., while the concentration of all refuses were very similar. This indicates an additional enrichment of nutrients in the refuse material by either ant carcasses, fungus cycling or excretions. Results suggest that nests of leaf-cutting ant are important loci of nutrient recycling of the ecosystem. Moreover, the refuse may represent an important factor for chemical enrichment in soils influenced by leaf-cutting ants.

Solid medical waste: a cross sectional study of household disposal practices and reported harm in Southern Ghana.

Science.gov (United States)

Udofia, Emilia Asuquo; Gulis, Gabriel; Fobil, Julius

2017-05-18

Solid medical waste (SMW) in households is perceived to pose minimal risks to the public compared to SMW generated from healthcare facilities. While waste from healthcare facilities is subject to recommended safety measures to minimize risks to human health and the environment, similar waste in households is often untreated and co-mingled with household waste which ends up in landfills and open dumps in many African countries. In Ghana, the management of this potentially hazardous waste stream at household and community level has not been widely reported. The objective of this study was to investigate household disposal practices and harm resulting from SMW generated in households and the community. A cross-sectional questionnaire survey of 600 households was undertaken in Ga South Municipal Assembly in Accra, Ghana from mid-April to June, 2014. Factors investigated included socio-demographic characteristics, medication related practices, the belief that one is at risk of diseases associated with SMW, SMW disposal practices and reported harm associated with SMW at home and in the community. Eighty percent and 89% of respondents discarded unwanted medicines and sharps in household refuse bins respectively. A corresponding 23% and 35% of respondents discarded these items without a container. Harm from SMW in the household and in the community was reported by 5% and 3% of respondents respectively. Persons who believed they were at risk of diseases associated with SMW were nearly three times more likely to report harm in the household (OR 2.75, 95%CI 1.15-6.54). The belief that one can be harmed by diseases associated with SMW influenced reporting rates in the study area. Disposal practices suggest the presence of unwanted medicines and sharps in the household waste stream conferring on it hazardous properties. Given the low rates of harm reported, elimination of preventable harm might justify community intervention.

Report on radioactive waste disposal

International Nuclear Information System (INIS)

1993-01-01

The safe management of radioactive wastes constitutes an essential part of the IAEA programme. A large number of reports and conference proceedings covering various aspects of the subject have been issued. The Technical Review Committee on Underground Disposal (February 1988) recommended that the Secretariat issue a report on the state of the art of underground disposal of radioactive wastes. The Committee recommended the need for a report that provided an overview of the present knowledge in the field. This report covers the basic principles associated with the state of the art of near surface and deep geological radioactive waste disposal, including examples of prudent practice, and basic information on performance assessment methods. It does not include a comprehensive description of the waste management programmes in different countries nor provide a textbook on waste disposal. Such books are available elsewhere. Reviewing all the concepts and practices of safe radioactive waste disposal in a document of reasonable size is not possible; therefore, the scope of this report has been limited to cover essential parts of the subject. Exotic disposal techniques and techniques for disposing of uranium mill tailings are not covered, and only brief coverage is provided for disposal at sea and in the sea-bed. The present report provides a list of references to more specialized reports on disposal published by the IAEA as well as by other bodies, which may be consulted if additional information is sought. 108 refs, 22 figs, 2 tabs

Korean Reference HLW Disposal System

Energy Technology Data Exchange (ETDEWEB)

Choi, Heui Joo; Lee, J. Y.; Kim, S. S. (and others)

2008-03-15

This report outlines the results related to the development of Korean Reference Disposal System for High-level radioactive wastes. The research has been supported around for 10 years through a long-term research plan by MOST. The reference disposal method was selected via the first stage of the research during which the technical guidelines for the geological disposal of HLW were determined too. At the second stage of the research, the conceptual design of the reference disposal system was made. For this purpose the characteristics of the reference spent fuels from PWR and CANDU reactors were specified, and the material and specifications of the canisters were determined in term of structural analysis and manufacturing capability in Korea. Also, the mechanical and chemical characteristics of the domestic Ca-bentonite were analyzed in order to supply the basic design parameters of the buffer. Based on these parameters the thermal and mechanical analysis of the near-field was carried out. Thermal-Hydraulic-Mechanical behavior of the disposal system was analyzed. The reference disposal system was proposed through the second year research. At the final third stage of the research, the Korean Reference disposal System including the engineered barrier, surface facilities, and underground facilities was proposed through the performance analysis of the disposal system.

Disposal options for radioactive waste

International Nuclear Information System (INIS)

Olivier, J.P.

1991-01-01

On the basis of the radionuclide composition and the relative toxicity of radioactive wastes, a range of different options are available for their disposal. Practically all disposal options rely on confinement of radioactive materials and isolation from the biosphere. Dilution and dispersion into the environment are only used for slightly contaminated gaseous and liquid effluents produced during the routine operation of nuclear facilities, such as power plants. For the bulk of solid radioactive waste, whatever the contamination level and decay of radiotoxicity with time are, isolation from the biosphere is the objective of waste disposal policies. The paper describes disposal approaches and the various techniques used in this respect, such as shallow land burial with minimum engineered barriers, engineered facilities built at/near the surface, rock cavities at great depth and finally deep geologic repositories for long-lived waste. The concept of disposing long-lived waste into seabed sediment layers is also discussed, as well as more remote possibilities, such as disposal in outer space or transmutation. For each of these disposal methods, the measures to be adopted at institutional level to reinforce technical isolation concepts are described. To the extent possible, some comments are made with regard to the applicability of such disposal methods to other hazardous wastes. (au)

Underground disposal of radioactive wastes

International Nuclear Information System (INIS)

1981-01-01

This report is an overview document for the series of IAEA reports dealing with underground waste disposal to be prepared in the next few years. It provides an introduction to the general considerations involved in implementing underground disposal of radioactive wastes. It suggests factors to be taken into account for developing and assessing waste disposal concepts, including the conditioned waste form, the geological containment and possible additional engineered barriers. These guidelines are general so as to cover a broad range of conditions. They are generally applicable to all types of underground disposal, but the emphasis is on disposal in deep geological formations. Some information presented here may require slight modifications when applied to shallow ground disposal or other types of underground disposal. Modifications may also be needed to reflect local conditions. In some specific cases it may be that not all the considerations dealt with in this book are necessary; on the other hand, while most major considerations are believed to be included, they are not meant to be all-inclusive. The book primarily concerns only underground disposal of the wastes from nuclear fuel cycle operations and those which arise from the use of isotopes for medical and research activities

Derivation of activity limits for the disposal of radioactive waste in near surface disposal facilities

International Nuclear Information System (INIS)

2003-12-01

Radioactive waste must be managed safely, consistent with internationally agreed safety standards. The disposal method chosen for the waste should be commensurate with the hazard and longevity of the waste. Near surface disposal is an option used by many countries for the disposal of radioactive waste containing mainly short lived radionuclides and low concentrations of long lived radionuclides. The term 'near surface disposal' encompasses a wide range of design options, including disposal in engineered structures at or just below ground level, disposal in simple earthen trenches a few metres deep, disposal in engineered concrete vaults, and disposal in rock caverns several tens of metres below the surface. The use of a near surface disposal option requires design and operational measures to provide for the protection of human health and the environment, both during operation of the disposal facility and following its closure. To ensure the safety of both workers and the public (both in the short term and the long term), the operator is required to design a comprehensive waste management system for the safe operation and closure of a near surface disposal facility. Part of such a system is to establish criteria for accepting waste for disposal at the facility. The purpose of the criteria is to limit the consequences of events which could lead to radiation exposures and in addition, to prevent or limit hazards, which could arise from non-radiological causes. Waste acceptance criteria include limits on radionuclide content concentration in waste materials, and radionuclide amounts in packages and in the repository as a whole. They also include limits on quantity of free liquids, requirements for exclusion of chelating agents and pyrophoric materials, and specifications of the characteristics of the waste containers. Largely as a result of problems encountered at some disposal facilities operated in the past, in 1985 the IAEA published guidance on generic acceptance

ENVIRONMENTALLY SOUND DISPOSAL OF RADIOACTIVE MATERIALS AT A RCRA HAZARDOUS WASTE DISPOSAL FACILITY

International Nuclear Information System (INIS)

Romano, Stephen; Welling, Steven; Bell, Simon

2003-01-01

The use of hazardous waste disposal facilities permitted under the Resource Conservation and Recovery Act (''RCRA'') to dispose of low concentration and exempt radioactive materials is a cost-effective option for government and industry waste generators. The hazardous and PCB waste disposal facility operated by US Ecology Idaho, Inc. near Grand View, Idaho provides environmentally sound disposal services to both government and private industry waste generators. The Idaho facility is a major recipient of U.S. Army Corps of Engineers FUSRAP program waste and received permit approval to receive an expanded range of radioactive materials in 2001. The site has disposed of more than 300,000 tons of radioactive materials from the federal government during the past five years. This paper presents the capabilities of the Grand View, Idaho hazardous waste facility to accept radioactive materials, site-specific acceptance criteria and performance assessment, radiological safety and environmental monitoring program information

Transuranic advanced disposal systems: preliminary 239Pu waste-disposal criteria for Hanford

International Nuclear Information System (INIS)

Kennedy, W.E. Jr.; Napier, B.A.; Soldat, J.K.

1982-08-01

An evaluation of the feasibility and potential application of advanced disposal systems is being conducted for defense transuranic (TRU) wastes at the Hanford Site. The advanced waste disposal options include those developed to provide greater confinement than provided by shallow-land burial. An example systems analysis is discussed with assumed performance objectives and various Hanford-specific disposal conditions, waste forms, site characteristics, and engineered barriers. Preliminary waste disposal criteria for 239 Pu are determined by applying the Allowable Residual Contamination Level (ARCL) method. This method is based on compliance with a radiation dose rate limit through a site-specific analysis of the potential for radiation exposure to individuals. A 10,000 year environmental performance period is assumed, and the dose rate limit for human intrusion is assumed to be 500 mrem/y to any exposed individual. Preliminary waste disposal criteria derived by this method for 239 Pu in soils at the Hanford Site are: 0.5 nCi/g in soils between the surface and a depth of 1 m, 2200 nCi/g of soil at a depth of 5 m, and 10,000 nCi/g of soil at depths 10 m and below. These waste disposal criteria are based on exposure scenarios that reflect the dependence of exposure versus burial depth. 2 figures, 5 tables

The use of town refuse ash in urban agriculture around Jos, Nigeria: health and environmental risks.

Science.gov (United States)

Pasquini, M W

2006-01-15

This paper reports on a study that examines the health and environmental risks of using town refuse ash in urban vegetable production in Jos, Nigeria, in terms of heavy metal accumulation in the food chain. Soil and crop samples, collected from five study farms, and samples of the river water used for irrigation, were analysed for seven heavy metals Fe, Mn, Zn, Cu, Ni, Cd and Pb. On the basis of the field data the paper discusses: (1) the potential soil deficiencies and toxicities; (2) the probable links between soil heavy metal levels and fertilisation practices; (3) the heavy metal concentrations in crop tissue in relation to crop growth and human health. The findings suggest that soil concentrations of the seven metals fall within 'typical' soil levels, and that there should not be any problems of either toxicities or deficiencies for crop growth. There was evidence of slight accumulation of Zn, Cu and Cd on some of the farms with a history of town refuse ash use. However, in all farms lettuce crops contained very large concentrations of Fe, and Pb concentrations that were 20 to 40 times higher than the WHO/FAO maximum recommended level in leafy vegetables for human consumption. The Cd content of carrot tissue was 10 times higher than the WHO/FAO recommended limit. The relatively small number of soil and crop samples precluded any formal attempt at correlating the concentrations of heavy metals found in the vegetable crops with the farm levels. Nevertheless, the data suggested that these were not linked. The paper goes on to consider various potential sources of the metals found in the crops, including irrigation water, town refuse ash and air-borne dust, and discusses additional health and environmental risks pertaining to the use of town refuse ash. Undoubtedly, the heavy Pb and Cd contamination of certain crops indicates the urgent need for future studies to ascertain the precise source of these metals, and although the practice of using town refuse ash does

Nuclear fuel waste disposal

International Nuclear Information System (INIS)

Allan, C.J.

1993-01-01

The Canadian concept for nuclear fuel waste disposal is based on disposing of the waste in a vault excavated 500-1000 m deep in intrusive igneous rock of the Canadian Shield. The author believes that, if the concept is accepted following review by a federal environmental assessment panel (probably in 1995), then it is important that implementation should begin without delay. His reasons are listed under the following headings: Environmental leadership and reducing the burden on future generations; Fostering public confidence in nuclear energy; Forestalling inaction by default; Preserving the knowledge base. Although disposal of reprocessing waste is a possible future alternative option, it will still almost certainly include a requirement for geologic disposal

Abandoned coal mine refuse areas: their reclamation and use

Energy Technology Data Exchange (ETDEWEB)

Zellmer, S. D.; Carter, R. P.

1977-01-01

There are over 4,000 abandoned deep coal mine refuse areas in Illinois ranging in size from a few acres to as large as 160 acres. These sites produce quantities of pollutants which affect the environment, have no real land value, and are a scar on the landscape. The Staunton 1 Site Reclamation Demonstration Project addressess these problems. It also is developing and evaluating new cost-effective methods for reclaiming refuse areas of this type. The program involved determining the final land use for the site, development of detailed engineering plans and specifications for the reclamation effort, a prereclamation environmental inventory, and implementation. Post-construction evaluation is now in process to determine the effectiveness of the reclamation effort. Detailed investigations are being conducted to determine surface water quality improvement, the amount of suitable surface cover and amendments required for revegetation, and field evaluation of candidate vegetation species for revegetation. Other research is examining soil microbial populations, soil fauna reactions, and changes in surface material characteristics at the reclamation site. Surveys are being conducted on groundwater quality, effects on the aquatic ecosystem, and wildlife use of the area. An economic evaluation is underway to determine the cost effectiveness of the total effort and of individual reclamation procedures. Preliminary results from the first year's environmental evaluation of various method tested will be described in detail. An economic assessment, including cost effectiveness, of the first year's work is given.

The stigma of "mental" illness: end stage anorexia and treatment refusal.

Science.gov (United States)

Campbell, Amy T; Aulisio, Mark P

2012-07-01

To answer the questions of whether psychiatric patients should ever be allowed to refuse life-sustaining treatment in favor of comfort care for a condition that is caused by a psychiatric disorder, and if so, under what conditions. Case discussion and normative ethical and legal analysis. We argue that psychiatric patients should sometimes be allowed to refuse life-sustaining treatment in favor of comfort care for a condition that is caused by that psychiatric disorder and articulate the core considerations that should be taken into account when such a case arises. We also suggest that unwillingness among many, especially mental health professionals, to consider seriously both of these questions risks perpetuating stigmatization of persons with psychiatric disorders, i.e., that the "mentally" ill should not be allowed to make significant decisions for themselves-a-a stigmatization that can result in persons with mental disorders both being prevented from exercising autonomous choice even when they are capable of it, and being denied good comfort care at the end of life--care which would be offered to patients with similarly life-threatening conditions that were not deemed to be the result of "mental" illness. Copyright © 2012 Wiley Periodicals, Inc.

Waste-Mixes Study for space disposal

International Nuclear Information System (INIS)

McCallum, R.F.; Blair, H.T.; McKee, R.W.; Silviera, D.J.; Swanson, J.L.

1983-01-01

The Wastes Mixes Study is a component of Cy-1981 and 1982 research activities to determine if space disposal could be a feasible complement to geologic disposal for certain high-level (HLW) and transuranic wastes (TRU). The objectives of the study are: to determine if removal of radionuclides from HLW and TRU significantly reduces the long-term radiological risks of geologic disposal; to determine if chemical partitioning of the waste for space disposal is technically feasible; to identify acceptable waste forms for space disposal; and to compare improvements in geologic disposal system performance to impacts of additional treatment, storage, and transportation necessary for space disposal. To compare radiological effects, five system alternatives are defined: Reference case - All HLW and TRU to a repository. Alternative A - Iodine to space, the balance to a repository. Alternative B - Technetium to space, the balance to a repository. Alternative C - 95% of cesium and strontium to a repository; the balance of HLW aged first, then to space; plutonium separated from TRU for recycle; the balance of the TRU to a repository. Alternative D - HLW aged first, then to space, plutonium separated from TRU for recycle; the balance of the TRU to a repository. The conclusions of this study are: the incentive for space disposal is that it offers a perception of reduced risks rather than significant reduction. Suitable waste forms for space disposal are cermet for HLW, metallic technetium, and lead iodide. Space disposal of HLW appears to offer insignificant safety enhancements when compared to geologic disposal; the disposal of iodine and technetium wastes in space does not offer risk advantages. Increases in short-term doses for the alternatives are minimal; however, incremental costs of treating, storing and transporting wastes for space disposal are substantial

Treated Effluent Disposal Facility

Data.gov (United States)

Federal Laboratory Consortium — Treated non-hazardous and non-radioactive liquid wastes are collected and then disposed of through the systems at the Treated Effluent Disposal Facility (TEDF). More...

Children with food refusal: an assessment of parental eating attitudes and their styles of coping with stress.

Science.gov (United States)

Tan, Seda; Yilmaz, Ayse Esra; Karabel, Musemma; Kara, Semra; Aldemir, Seçil; Karabel, Duran

2012-05-01

In this study, we aimed to assess the eating attitudes and stress coping styles of parents whose children presented to the clinic complaining of food refusal. The parents of 31 children aged ≥3 years, presented to the clinic with the complaint of food refusal. The control group consisted of 30 healthy children with no prior history of food refusal, and their parents. In both groups, birth features, body mass indexes (BMIs), eating attitudes and stress coping styles of the parents were assessed. The parents of both groups were studied, in part utilizing the eating attitudes test (EAT), and the coping styles of stress scale (CSSS). Our study found that body weights and BMI values of the fathers in the study group were significantly lower than fathers in the control group. There was no significant difference in EAT scores between the two groups; however, where the children's body weight and height for age percentile was under 25%, the parents had significantly lower EAT scores. When CSSS scores were assessed, the optimistic approach score of the mother and the self-confident score of the father were found to be significantly high in both groups. The parental perception and definition of eating problems does not necessarily indicate the presence of an eating disorder in a child. In fact, the eating attitudes of the fathers were related to the low percentile weight and height values of the children, and a child's food refusal was not dependent on the stress coping style used by the parent. Copyright © 2012. Published by Elsevier B.V.

Microbial community structure of leaf-cutter ant fungus gardens and refuse dumps.

Science.gov (United States)

Scott, Jarrod J; Budsberg, Kevin J; Suen, Garret; Wixon, Devin L; Balser, Teri C; Currie, Cameron R

2010-03-29

Leaf-cutter ants use fresh plant material to grow a mutualistic fungus that serves as the ants' primary food source. Within fungus gardens, various plant compounds are metabolized and transformed into nutrients suitable for ant consumption. This symbiotic association produces a large amount of refuse consisting primarily of partly degraded plant material. A leaf-cutter ant colony is thus divided into two spatially and chemically distinct environments that together represent a plant biomass degradation gradient. Little is known about the microbial community structure in gardens and dumps or variation between lab and field colonies. Using microbial membrane lipid analysis and a variety of community metrics, we assessed and compared the microbiota of fungus gardens and refuse dumps from both laboratory-maintained and field-collected colonies. We found that gardens contained a diverse and consistent community of microbes, dominated by Gram-negative bacteria, particularly gamma-Proteobacteria and Bacteroidetes. These findings were consistent across lab and field gardens, as well as host ant taxa. In contrast, dumps were enriched for Gram-positive and anaerobic bacteria. Broad-scale clustering analyses revealed that community relatedness between samples reflected system component (gardens/dumps) rather than colony source (lab/field). At finer scales samples clustered according to colony source. Here we report the first comparative analysis of the microbiota from leaf-cutter ant colonies. Our work reveals the presence of two distinct communities: one in the fungus garden and the other in the refuse dump. Though we find some effect of colony source on community structure, our data indicate the presence of consistently associated microbes within gardens and dumps. Substrate composition and system component appear to be the most important factor in structuring the microbial communities. These results thus suggest that resident communities are shaped by the plant degradation

Vermi composting--organic waste management and disposal.

Science.gov (United States)

Kumar, J Sudhir; Subbaiah, K Venkata; Rao, P V V Prasada

2012-01-01

Solid waste is an unwanted byproduct of modern civilization. Landfills are the most common means of solid waste disposal. But the increasing amount of solid waste is rapidly filling existing landfills, and new sites are difficult to establish. Alternatives to landfills include the use of source reduction, recycling, composting and incineration, as well as use of landfills. Incineration is most economical if it includes energy recovery from the waste. Energy can be recovered directly from waste by incineration or the waste can be processed to produce storable refuse derived fuel (RDF). Information on the composition of solid wastes is important in evaluating alternative equipment needs, systems, management programs and plans. Pulverization of municipal solid waste is done and the pulverized solid waste is dressed to form a bed and the bed is fed by earthworms which convert the bed into vermi compost. The obtained vermi compost is sent to Ministry of Environment & Forests (MoEF) recognized lab for estimating the major nutrients, i.e. Potassium (K), Phosphorous (P), Nitrogen (N) and Micro-nutrient values. It is estimated that 59 - 65 tons of wet waste can be collected in a town per day and if this wet waste is converted to quality compost, around 12.30 tons of vermi compost can be generated. If a Municipal Corporation manages this wet waste an income of over (see text symbol) for 0.8 9 crore per anum can be earned which is a considerable amount for providing of better services to public.

Psychological Factors behind Truancy, School Phobia, and School Refusal: A Literature Study

Science.gov (United States)

Ek, Hans; Eriksson, Rikard

2013-01-01

Truancy is a problem that normally leads to treatment interventions within different organizations. Within these organizations different perspectives on the causes and consequences of the above problem can be found. The purpose of this literature study is to map out and describe the current state of research within the fields of school refusal,…

War Memories and the Refusal of Male Dominance in Shakir's "Oh, Lebanon"

Science.gov (United States)

Al-Momani, Hassan Ali Abdullah

2017-01-01

This study investigates the role of the war memories in the construction of the female gender identity in Evelyin Shakir's "Oh, Lebanon," in which the female protagonist refuses to belong to her Arab identity when she lives in the United States because of the brutal war memories she witnesses in Lebanon. Such memories make the…

Unreviewed Disposal Question Evaluation: Waste Disposal in Engineered Trenches 3 and 4

Energy Technology Data Exchange (ETDEWEB)

Butcher, T. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Hamm, L. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Flach, G. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

2017-12-12

Revision 0 of this UDQE addressed the proposal to place Engineered Trench #3 (ET#3) in the footprint designated for Slit Trench #12 (ST#12) and operate using ST#12 disposal limits. Similarly, Revision 1 evaluates whether ET#4 can be located in and operated to Slit Trench #13 (ST#13) disposal limits. Both evaluations conclude that the proposed operations result in an acceptably small risk of exceeding a SOF of 1.0 and approve these actions from a performance assessment (PA) perspective. Because ET#3 will be placed in the location previously designated for ST#12, Solid Waste Management (SWM) requested that the Savannah River National Laboratory (SRNL) determine if the ST#12 limits could be employed as surrogate disposal limits for ET#3 operations. SRNL documented in this Unreviewed Disposal Question Evaluation (UDQE) that the use of ST#12 limits as surrogates for the new ET#3 disposal unit will provide reasonable assurance that Department of Energy (DOE) 435.1 performance objectives and measures (USDOE, 1999) will be protected. Therefore, new ET#3 inventory limits as determined by a Special Analysis (SA) are not required.

Geological disposal of nuclear waste

International Nuclear Information System (INIS)

1979-01-01

Fourteen papers dealing with disposal of high-level radioactive wastes are presented. These cover disposal in salt deposits, geologic deposits and marine disposal. Also included are papers on nuclear waste characterization, transport, waste processing technology, and safety analysis. All of these papers have been abstracted and indexed

The disposal of radioactive waste

International Nuclear Information System (INIS)

Ormai, P.

2006-01-01

The first part shows different ways of 'producing' radioactive wastes, defines the wastes of small, medium and high activity and gives estimation on the quantity of the necessary capacities of waste disposal facilities. The modern radioactive waste disposal that is the integrated processing of the form of waste, the package, the technical facility and the embedding geological environment that guarantee the isolation together. Another factor is the lifetime of radioactive waste which means that any waste containing long lifetime waste in higher concentration than 400-4000 kBq/kg should be disposed geologically. Today the centre of debate disposal of radioactive waste is more social than technical. For this reason not only geological conditions and technical preparations, but social discussions and accepting communities are needed in selecting place of facilities. Now, the focus is on long term temporary disposal of high activity wastes, like burnt out heating elements. The final part of the paper summarizes the current Hungarian situation of disposal of radioactive wastes. (T-R.A.)

Marine disposal of radioactive wastes - the debate

International Nuclear Information System (INIS)

Blair, I.

1985-01-01

The paper defends the case for marine disposal of radioactive wastes. The amount of packaged waste disposed; the site for marine disposal; the method of disposal; the radioactivity arising from the disposal; and safety factors; are all briefly discussed. (U.K.)

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

NARCIS (Netherlands)

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

2005-01-01

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

Innovative Disposal Practices at the Nevada Test Site to Meet Its Low-Level Waste Generators' Future Disposal Needs

International Nuclear Information System (INIS)

Di Sanza, E.F.; Carilli, J.T.

2006-01-01

Low-level radioactive waste (LLW) streams which have a clear, defined pathway to disposal are becoming less common as U.S. Department of Energy accelerated cleanup sites enters their closure phase. These commonly disposed LLW waste streams are rapidly being disposed and the LLW inventory awaiting disposal is dwindling. However, more complex waste streams that have no path for disposal are now requiring attention. The U.S. Department of Energy (DOE) National Nuclear Security Administration Nevada Site Office (NSO) Environmental Management Program is charged with the responsibility of carrying out the disposal of onsite and off-site defense-generated and research-related LLW at the Nevada. Test Site (NTS). The NSO and its generator community are constantly pursuing new LLW disposal techniques while meeting the core mission of safe and cost-effective disposal that protects the worker, the public and the environment. From trenches to present-day super-cells, the NTS disposal techniques must change to meet the LLW generator's disposal needs. One of the many ways the NTS is addressing complex waste streams is by designing waste specific pits and trenches. This ensures unusual waste streams with high-activity or large packaging have a disposal path. Another option the NTS offers is disposal of classified low-level radioactive-contaminated material. In order to perform this function, the NTS has a safety plan in place as well as a secure facility. By doing this, the NTS can accept DOE generated classified low-level radioactive-contaminated material that would be equivalent to U.S. Nuclear Regulatory Commission Class B, C, and Greater than Class C waste. In fiscal year 2006, the NTS will be the only federal disposal facility that will be able to dispose mixed low-level radioactive waste (MLLW) streams. This is an activity that is highly anticipated by waste generators. In order for the NTS to accept MLLW, generators will have to meet the stringent requirements of the NTS

The Right of Psychiatric Patients to Refuse Medication: Where Should Social Workers Stand?

Science.gov (United States)

Bentley, Kia J.

1993-01-01

Addresses differences among competence, commitment, and mental illness; the right to privacy; and the prohibition against cruel and unusual punishment. Reviews professional motivations in relation to both sides of controversy over rights of psychiatric patients to refuse medication. Presents position for social work profession that stands for…

Control and tracking arrangements for solid low-level waste disposals to the UK Drigg disposal site

International Nuclear Information System (INIS)

Elgie, K.G.; Grimwood, P.D.

1993-01-01

The Drigg disposal site has been the principal disposal site for solid low-level radioactive wastes (LLW) in the United Kingdom since 1959. It is situated on the Cumbrian coast, some six kilometers to the south of the Sellafield nuclear reprocessing site. The Drigg site receives LLW from a wide range of sources including nuclear power generation, nuclear fuel cycle activities, defense activities, isotope manufacture, universities, hospitals, general industry and clean-up of contaminated sites. This LLW has been disposed of in a series of trenches cut into the underlying clay layer of the site, and, since 1988, also into concrete lined vault. The total volume of LLW disposed of at Drigg is at present in the order of 800,000m 3 , with disposals currently approximately 25,000m 3 per year. British Nuclear Fuels plc (BNFL) owns and operates the Drigg disposal site. To meet operational and regulatory requirements, BNFL needs to ensure the acceptability of the disposed waste and be able to track it from its arising point to its specific disposal location. This paper describes the system that has been developed to meet these requirements

Augmenting Cognitive Behavior Therapy for School Refusal with Fluoxetine: A Randomized Controlled Trial.

Science.gov (United States)

Melvin, Glenn A; Dudley, Amanda L; Gordon, Michael S; Klimkeit, Ester; Gullone, Eleonora; Taffe, John; Tonge, Bruce J

2017-06-01

This study investigates whether the augmentation of cognitive behavior therapy (CBT) with fluoxetine improves outcomes in anxious school refusing adolescents (11-16.5 years). Sixty-two participants were randomly allocated to CBT alone, CBT + fluoxetine or CBT + placebo. All treatments were well tolerated; with one suicide-attempt in the CBT + placebo group. All groups improved significantly on primary (school attendance) and secondary outcome measures (anxiety, depression, self-efficacy and clinician-rated global functioning); with gains largely maintained at 6-months and 1-year. Few participants were anxiety disorder free after acute treatment. During the follow-up period anxiety and depressive disorders continued to decline whilst school attendance remained stable, at around 54 %. The only significant between-group difference was greater adolescent-reported treatment satisfaction in the CBT + fluoxetine group than the CBT alone group. These results indicate the chronicity of school refusal, and the need for future research into how to best improve school attendance rates.

The rights of the dying: the refusal of medical treatments in Argentine courts

Directory of Open Access Journals (Sweden)

Juan Pedro Alonso

2016-10-01

Full Text Available This paper addresses the judicialization of end of life medical decision-making, as part of the advance of the justice system in the regulation of medical practice and the rise of recognition of patient autonomy. The article analyzes, from a sociological standpoint, legal decisions regarding treatment refusal at the end of life produced by the Argentine courts between 1975 and 2015. Based on a qualitative design, 38 sentences collected from jurisprudential databases using key terms were analyzed. First, judicialized cases during the period are described; these are characterized by a high proportion of claims presented by health institutions, a pro-treatment bias in the legal actions requested, and a high percentage of unnecessary litigation in the absence of conflicts or in situations that do not require court intervention. Second, legal and extralegal factors affecting the justiciability of decisions to refuse or withdraw medical treatments, such as changes in the law and processes of politicization of claims, are analyzed.

Earth-friendly refuse processing. Chikyu kankyo wo kangaeta gomi shori gijutsu

Energy Technology Data Exchange (ETDEWEB)

Nishigaki, M. (Takuma Co. Ltd., Osaka (Japan))

1994-06-15

This paper contains six articles: (1) Earth-friendly Garbage Disposal, (2) Erasable Copy Machine, (3) Making Plastics from Shell of Crustacean, (4) From Garbage into Petroleum, (5) Utilization of Sewage Sludge for a Recycle-type Society, and (6) FRP Boat Disposal Technology. All articles address the latest topics about disposal of wastes and garbage that have been attracting general attention in environmental issues. The article (1) presents the latest waste incineration technology, garbage power generation, and disposal and utilization of incineration residues. The article (2) is about a prototype of the copy paper regeneration device (toner remover) developed and produced by Ricoh Co., Ltd. The article (3) describes biodegradable plastics using chitin and chitosan that can be acquired from shell of crustacean. The article (4) describes how to extract oil or gas from plastic waste through its thermal decomposition. The article (5) presents volume reduction and utilization of sewage sludge. The article (6) presents disassembling and disposing waste plastic boats that have been rapidly increasing. 8 refs., 27 figs.

Near-surface land disposal

International Nuclear Information System (INIS)

Kittel, J.H.

1989-01-01

The Radioactive Waste Management Handbook provides a comprehensive, systematic treatment of nuclear waste management. Near-Surface Land Disposal, the first volume, is a primary and secondary reference for the technical community. To those unfamiliar with the field, it provides a bridge to a wealth of technical information, presenting the technology associated with the near-surface disposal of low or intermediate level wastes. Coverage ranges from incipient planning to site closure and subsequent monitoring. The book discusses the importance of a systems approach during the design of new disposal facilities so that performance objectives can be achieved; gives an overview of the radioactive wastes cosigned to near-surface disposal; addresses procedures for screening and selecting sites; and emphasizes the importance of characterizing sites and obtaining reliable geologic and hydrologic data. The planning essential to the development of particular sites (land acquisition, access, layout, surface water management, capital costs, etc.) is considered, and site operations (waste receiving, inspection, emplacement, closure, stabilization, etc.) are reviewed. In addition, the book presents concepts for improved confinement of waste, important aspects of establishing a monitoring program at the disposal facility, and corrective actions available after closure to minimize release. Two analytical techniques for evaluating alternative technologies are presented. Nontechnical issues surrounding disposal, including the difficulties of public acceptance are discussed. A glossary of technical terms is included

Disposal options for disused radioactive sources

International Nuclear Information System (INIS)

2005-01-01

This report presents a review of relevant information on the various technical factors and issues, as well as approaches and relevant technologies, leading to the identification of potential disposal options for disused radioactive sources. The report attempts to provide a logical 'road map' for the disposal of disused radioactive sources, taking into consideration the high degree of variability in the radiological properties of such types of radioactive waste. The use of borehole or shaft type repositories is highlighted as a potential disposal option, particularly for those countries that have limited resources and are looking for a simple, safe and cost effective solution for the disposal of their radioactive source inventories. It offers information about usage and characteristics of radioactive sources, disposal considerations, identification and screening of disposal options as well as waste packaging and acceptance criteria for disposal. The information provided in the report could be adapted or adopted to identify and develop specific disposal options suitable for the type and inventory of radioactive sources kept in storage in a given Member State

Disposal of tritium-exposed metal hydrides

International Nuclear Information System (INIS)

Nobile, A.; Motyka, T.

1991-01-01

A plan has been established for disposal of tritium-exposed metal hydrides used in Savannah River Site (SRS) tritium production or Materials Test Facility (MTF) R ampersand D operations. The recommended plan assumes that the first tritium-exposed metal hydrides will be disposed of after startup of the Solid Waste Disposal Facility (SWDF) Expansion Project in 1992, and thus the plan is consistent with the new disposal requiremkents that will be in effect for the SWDF Expansion Project. Process beds containing tritium-exposed metal hydride powder will be disposed of without removal of the powder from the bed; however, disposal of tritium-exposed metal hydride powder that has been removed from its process vessel is also addressed

Disposal of Iodine-129

International Nuclear Information System (INIS)

Morgan, M.T.; Moore, J.G.; Devaney, H.E.; Rogers, G.C.; Williams, C.; Newman, E.

1978-01-01

One of the problems to be solved in the nuclear waste management field is the disposal of radioactive iodine-129, which is one of the more volatile and long-lived fission products. Studies have shown that fission products can be fixed in concrete for permanent disposal. Current studies have demonstrated that practical cementitious grouts may contain up to 18% iodine as barium iodate. The waste disposal criterion is based on the fact that harmful effects to present or future generations can be avoided by isolation and/or dilution. Long-term isolation is effective in deep, dry repositories; however, since penetration by water is possible, although unlikely, release was calculated based on leach rates into water. Further considerations have indicated that sea disposal on or in the ocean floor may be a more acceptable alternative

Effects from different types of construction refuse in the soil on electrodialytic remediation

DEFF Research Database (Denmark)

Ottosen, Lisbeth M.; Eriksson, Thomas; Hansen, Henrik K.

2002-01-01

At abandoned industrial sites some of the previous buildings are often left behind. If the soil at such site is polluted with heavy metals and is to be remediated by an electrochemical method, the construction refuse within the soil matrix will influence the remediation action. The influence of d...

Sub-seabed disposal of radioactive wastes

International Nuclear Information System (INIS)

Sivintsaev, Yu.V.

1990-01-01

The first stage of investigations of possibility of sub-seabed disposal of long-living intermediate-level radioactive wastes carried out by NIREX (UK) is described. Advantages and disadvantages of sub-seabed disposal of radioactive wastes are considered; regions suitable for disposal, transport means for marine disposal are described. Three types of sub-seabed burials are characterized

PATIENT’S CONSCIOUS REFUSAL OF TREATMENT AND REQUEST FOR ACTIVETREATMENT WHEN RECOVERY IS NOT POSSIBLE

Directory of Open Access Journals (Sweden)

Peter Černoga

2008-01-01

General practitioner and a specialist doctor are faced with difficult dilemma when there isa case of a competent but unwilling to consent patient refusing the timely treatment inspite of the predicted fatal consequences

Developmentally sensitive cognitive behavioral therapy for adolescent school refusal: rationale and case illustration.

Science.gov (United States)

Heyne, David; Sauter, Floor M; Ollendick, Thomas H; Van Widenfelt, Brigit M; Westenberg, P Michiel

2014-06-01

School refusal can be difficult to treat and the poorest treatment response is observed among older school refusers. This poor response may be explained, in part, by the impact of developmental transitions and tasks upon the young person, their family, and the treatment process. This paper describes and illustrates the @school program, a cognitive behavioral therapy (CBT) designed to promote developmental sensitivity when planning and delivering treatment for adolescent school refusal. Treatment is modularized and it incorporates progress reviews, fostering a planned yet flexible approach to CBT. The treatment is illustrated in the case of Allison, a 16-year-old female presenting with major depressive disorder and generalized anxiety disorder. A case formulation guided the selection, sequencing, and pacing of modules targeting predisposing, precipitating, perpetuating, and protective factors. Treatment comprised 16 sessions with Allison (interventions addressing depression, anxiety, and school attendance) and 15 concurrent sessions with her mother (strategies to facilitate an adolescent's school attendance), including two sessions with Allison and mother together (family communication and problem solving to reduce parent-adolescent conflict). Two treatment-related consultations were also conducted with Allison's homeroom teacher. Allison's school attendance improved during the course of treatment. By post-treatment, there was a decrease in internalizing behavior, an increase in self-efficacy, and remission of depressive disorder and anxiety disorder. Clinically significant treatment gains were maintained at 2-month follow-up. Factors influencing outcome may include those inherent to the @school program together with less specific factors. Special consideration is given to parents' use of both authoritative and autonomy-granting approaches when helping an adolescent to attend school.

Financing of radioactive waste disposal

International Nuclear Information System (INIS)

Reich, J.

1989-01-01

Waste disposal is modelled as a financial calculus. In this connection the particularity is not primarily the dimension to be expected of financial requirement but above all the uncertainty of financial requirement as well as the ecological, socio-economic and especially also the temporal dimension of the Nuclear Waste Disposal project (disposal of spent fuel elements from light-water reactors with and without reprocessing, decommissioning = safe containment and disposal of nuclear power plants, permanent isolation of radioactive waste from the biosphere, intermediate storage). Based on the above mentioned factors the author analyses alternative approaches of financing or financial planning. He points out the decisive significance of the perception of risks or the evaluation of risks by involved or affected persons - i.e. the social acceptance of planned and designed waste disposal concepts - for the achievement and assessment of alternative solutions. With the help of an acceptance-specific risk measure developed on the basis of a mathematical chaos theory he illustrates, in a model, the social influence on the financing of nuclear waste disposal. (orig./HP) [de

Social dimensions of nuclear waste disposal

Energy Technology Data Exchange (ETDEWEB)

Grunwald, Armin [Karlsruhe Institute of Technology, Karlsruhe (Germany). Inst. for Technology Assessment and Systems Analysis

2015-07-01

Nuclear waste disposal is a two-faceted challenge: a scientific and technological endeavour, on the one hand, and confronted with social dimensions, on the other. In this paper I will sketch the respective social dimensions and will give a plea for interdisciplinary research approaches. Relevant social dimensions of nuclear waste disposal are concerning safety standards, the disposal 'philosophy', the process of determining the disposal site, and the operation of a waste disposal facility. Overall, cross-cutting issues of justice, responsibility, and fairness are of major importance in all of these fields.

Phytoextraction crop disposal--an unsolved problem

International Nuclear Information System (INIS)

Sas-Nowosielska, A.; Kucharski, R.; Malkowski, E.; Pogrzeba, M.; Kuperberg, J.M.; Krynski, K.

2004-01-01

Several methods of contaminated crop disposal after phytoextraction process (composting, compaction, incineration, ashing, pyrolysis, direct disposal, liquid extraction) have been described. Advantages and disadvantages of methods are presented and discussed. Composting, compaction and pyrolysis are the pretreatment steps, since significant amount of contaminated biomass will still exist after each of the process. Four methods of final disposal were distinguished: incineration, direct disposal, ashing and liquid extraction. Among them, incineration (smelting) is proposed as the most feasible, economically acceptable and environmentally sound. - Methods of contaminated crop disposal are described and evaluated

Social dimensions of nuclear waste disposal

International Nuclear Information System (INIS)

Grunwald, Armin

2015-01-01

Nuclear waste disposal is a two-faceted challenge: a scientific and technological endeavour, on the one hand, and confronted with social dimensions, on the other. In this paper I will sketch the respective social dimensions and will give a plea for interdisciplinary research approaches. Relevant social dimensions of nuclear waste disposal are concerning safety standards, the disposal 'philosophy', the process of determining the disposal site, and the operation of a waste disposal facility. Overall, cross-cutting issues of justice, responsibility, and fairness are of major importance in all of these fields.

Psychosocial factors influencing parental decision to allow or refuse potentially lifesaving enucleation in children with retinoblastoma

Directory of Open Access Journals (Sweden)

Rolando Enrique D. Domingo

2017-01-01

Full Text Available Objective: Retinoblastoma is the most common malignancy of the eye and ocular adnexa in the Philippines. It is curable when treated early, but delay in enucleation is common due to the parental refusal of surgery for varied reasons. The aim of this study is to identify the psychosocial barriers and facilitating factors for accepting versus refusing enucleation as treatment for retinoblastoma. Methods: This is a cross-sectional descriptive study utilizing structured interviews and a questionnaire. It was conducted at the Retinoblastoma Clinic of the Philippine General Hospital. A questionnaire using the Likert scale was constructed after performing key informant interviews and focus group discussions. It was pretested and revised before parents of patients with retinoblastoma were invited to participate in the study. Descriptive statistics, quantitative item analyses using inter-item correlations and item-total correlations was performed. Results: Factors that correlate with refusal to enucleate are the beliefs that cancer is a fatal illness, the fear of unacceptable esthetic outcome of the surgery, and the cost of treatment. Favorable factors include value of life, high regard for the opinion of medical practitioners, and appreciation of the efficacy of treatment. Conclusions: There are several favorable factors and barriers that health practitioners must consider in facilitating parental decision-making toward enucleation for retinoblastoma.

Land disposal alternatives for low-level waste

International Nuclear Information System (INIS)

Alexander, P.; Lindeman, R.; Saulnier, G.; Adam, J.; Sutherland, A.; Gruhlke, J.; Hung, C.

1982-01-01

The objective of this project is to develop data regarding the effectiveness and costs of the following options for disposing of specific low-level nuclear waste streams; sanitary landfill; improved shallow land burial; intermediate depth disposal; deep well injection; conventional shallow land burial; engineered surface storage; deep geological disposal; and hydrofracturing. This will be accomplished through the following steps: (1) characterize the properties of the commercial low-level wastes requiring disposal; (2) evaluate the various options for disposing of this waste, characterize selected representative waste disposal sites and design storage facilities suitable for use at those sites; (3) calculate the effects of various waste disposal options on population health risks; (4) estimate the costs of various waste disposal options for specific sites; and (5) perform trade-off analyses of the benefits of various waste disposal options against the costs of implementing these options. These steps are described. 2 figures, 2 tables

Unreviewed Disposal Question: A Discipline Process to Manage Change in LLW Disposal

International Nuclear Information System (INIS)

Goldston, W.T.

2000-01-01

The Department of Energy's waste management Order, DOE O 435.1, requires that low--level waste disposal facilities develop and maintain a radiological performance assessment to ensure that disposal operations are within a performance envelope defined by performance objectives for long-term protection of the public and the environment. The Order also requires that a radiological composite analysis be developed and maintained to ensure that the disposal facility, in combination with other sources of radioactive material that may remain when all DOE activities have ceased, will not compromise future radiological protection of the public and the environment. The Order further requires that a Disposal Authorization Statement (DAS) be obtained from DOE Headquarters and that the disposal facility be operated within the performance assessment, composite analysis, and DAS. Maintenance of the performance assessment and composite analysis includes conducting test, research, and monitoring activities to increase confidence in the results of the analyses. It also includes updating the analyses as changes are proposed in the disposal operations, or other information requiring an update, becomes available. Personnel at the Savannah River Site have developed and implemented an innovative process for reviewing proposed or discovered changes in low-level radioactive waste disposal operations. The process is a graded approach to determine, in a disciplined manner, whether changes are within the existing performance envelope, as defined by the performance assessment, composite analysis, and DAS, or whether additional analysis is required to authorize the change. This process is called the Unreviewed Disposal Question (UDQ) process. It has been developed to be analogous to the Unreviewed Safety Question (UDQ) process that has been in use within DOE for many years. This is the first formalized system implemented in the DOE complex to examine low-level waste disposal changes the way the

Subseabed disposal safety analysis

International Nuclear Information System (INIS)

Koplick, C.M.; Kabele, T.J.

1982-01-01

This report summarizes the status of work performed by Analytic Sciences Corporation (TASC) in FY'81 on subseabed disposal safety analysis. Safety analysis for subseabed disposal is divided into two phases: pre-emplacement which includes all transportation, handling, and emplacement activities; and long-term (post-emplacement), which is concerned with the potential hazard after waste is safely emplaced. Details of TASC work in these two areas are provided in two technical reports. The work to date, while preliminary, supports the technical and environmental feasibility of subseabed disposal of HLW

Disposal of radioactive wastes

International Nuclear Information System (INIS)

Dlouhy, Z.

1982-01-01

This book provides information on the origin, characteristics and methods of processing of radioactive wastes, as well as the philosophy and practice of their storage and disposal. Chapters are devoted to the following topics: radioactive wastes, characteristics of radioactive wastes, processing liquid and solid radioactive wastes, processing wastes from spent fuel reprocessing, processing gaseous radioactive wastes, fixation of radioactive concentrates, solidification of high-level radioactive wastes, use of radioactive wastes as raw material, radioactive waste disposal, transport of radioactive wastes and economic problems of radioactive wastes disposal. (C.F.)

Overview of nuclear waste disposal in space

International Nuclear Information System (INIS)

Rice, E.E.; Priest, C.C.

1981-01-01

One option receiving consideration by the Department of Energy (DOE) is the space disposal of certain high-level nuclear wastes. The National Aeronautics and Space Administration is assessing the space disposal option in support of DOE studies on alternatives for nuclear waste management. The space disposal option is viewed as a complement, since total disposal of fuel rods from commercial power plants is not considered to be economically practical with Space Shuttle technology. The space disposal of certain high-level wastes may, however, provide reduced calculated and perceived risks. The space disposal option in conjunction with terrestrial disposal may offer a more flexible and lower risk overall waste management system. For the space disposal option to be viable, it must be demonstrated that the overall long-term risks associated with this activity, as a complement to the mined geologic repository, would be significantly less than the long-term risk associated with disposing of all the high-level waste. The long-term risk benefit must be achieved within an acceptable short-term and overall program cost. This paper briefly describes space disposal alternatives, the space disposal destination, possible waste mixes and forms, systems and typical operations, and the energy and cost analysis

Drinking Refusal Self-Efficacy and Intended Alcohol Consumption During a Mass-Attended Youth Event.

Science.gov (United States)

Jongenelis, Michelle I; Pettigrew, Simone; Biagioni, Nicole

2018-04-16

Mass-attended youth events represent a substantial public health challenge due to high levels of alcohol consumption and corresponding high rates of alcohol-related harm. Although previous research has documented the protective effect of high drinking refusal self-efficacy (DRSE) on alcohol consumption in general, there is a lack of research examining the role of DRSE in reducing consumption during mass-attended youth events and the factors associated with DRSE in these contexts. This study aimed to identify potentially modifiable factors that influence DRSE and drinking intentions to inform interventions designed to reduce alcohol-related harm during mass-attended events. Australian secondary school students (n = 586; 70% female) in their final two years of high school completed an online survey assessing their alcohol consumption intentions for Schoolies, their perceived degree of DRSE, and other individual and environmental factors. Path analysis was used to assess a mediational model examining factors associated with DRSE and alcohol consumption intentions. DRSE was found to be significantly associated with intended alcohol consumption during Schoolies. Specifically, leavers who believed they would not be able to refuse others' offers of alcoholic drinks reported significantly greater alcohol consumption intentions. Results also revealed that DRSE was enhanced in those respondents who believed there would be a variety of non-drinking activities and non-alcoholic beverages available to them during Schoolies. Results suggest the need to increase leavers' confidence in their ability to refuse unwanted alcoholic beverages and highlight the importance of providing celebration options that do not involve alcohol consumption.

[Behavioural psychotherapy for encopresis shown on a girl with chronic "toilet-refusal-syndrome"].

Science.gov (United States)

Hansen, Berit; Lehmkuhl, Ulrike

2007-01-01

Encopresis is one of the areas of the psychiatric diseases in childhood and adolescence that has been less researched. There is not much literature on the treatment of encopresis. The article describes a standard behavioural therapy including a case report on a 7, 9 year old girl with chronic "toilet-refusal-syndrome".

HLW disposal dilemma

International Nuclear Information System (INIS)

Andrei, V.; Glodeanu, F.

2003-01-01

The radioactive waste is an inevitable residue from the use of radioactive materials in industry, research and medicine, and from the operation of generating electricity nuclear power stations. The management and disposal of such waste is therefore an issue relevant to almost all countries. Undoubtedly the biggest issue concerning radioactive waste management is that of high level waste. The long-lived nature of some types of radioactive wastes and the associated safety implications of disposal plans have raised concern amongst those who may be affected by such facilities. For these reasons the subject of radioactive waste management has taken on a high profile in many countries. Not one Member State in the European Union can say that their high level waste will be disposed of at a specific site. Nobody can say 'that is where it is going to go'. Now, there is a very broad consensus on the concept of geological disposal. The experts have little, if any doubt that we could safely dispose of the high level wastes. Large sectors of the public continue to oppose to most proposals concerning the siting of repositories. Given this, it is increasingly difficult to get political support, or even political decisions, on such sites. The failure to advance to the next step in the waste management process reinforces the public's initial suspicion and resistance. In turn, this makes the political decisions even harder. In turn, this makes the political decisions even harder. The management of spent fuel from nuclear power plant became a crucial issue, as the cooling pond of the Romanian NPP is reaching saturation. During the autumn of 2000, the plant owner proceeded with an international tendering process for the supply of a dry storage system to be implemented at the Cernavoda station to store the spent fuel from Unit 1 and eventually from Unit 2 for a minimum period of 50 years. The facility is now in operation. As concern the disposal of the spent fuel, the 'wait and see

Engineering geology of waste disposal

International Nuclear Information System (INIS)

Bentley, S.P.

1996-01-01

This volume covers a wide spectrum of activities in the field of waste disposal. These activities range from design of new landfills and containment properties of natural clays to investigation, hazard assessment and remediation of existing landfills. Consideration is given to design criteria for hard rock quarries when used for waste disposal. In addition, an entire section concerns the geotechnics of underground repositories. This covers such topics as deep drilling, in situ stress measurement, rock mass characterization, groundwater flows and barrier design. Engineering Geology of Waste Disposal examines, in detail, the active role of engineering geologists in the design of waste disposal facilities on UK and international projects. The book provides an authoritative mix of overviews and detailed case histories. The extensive spectrum of papers will be of practical value to those geologists, engineers and environmental scientists who are directly involved with waste disposal. (UK)

Waste Water Disposal Design And Management I

International Nuclear Information System (INIS)

Yang, Sang Hyeon; Lee, Jung Su

2004-04-01

This book gives descriptions of waste water disposal, design and management, which includes design of waterworks and sewerage facility such as preparatory work and building plan, used waste water disposal facilities, waste water disposal plant and industrial waste water disposal facilities, water use of waste water disposal plant and design of pump and pump facilities such as type and characteristic, selection and plan, screening and grit.

Costs for off-site disposal of nonhazardous oil field wastes: Salt caverns versus other disposal methods

Energy Technology Data Exchange (ETDEWEB)

Veil, J.A.

1997-09-01

According to an American Petroleum Institute production waste survey reported on by P.G. Wakim in 1987 and 1988, the exploration and production segment of the US oil and gas industry generated more than 360 million barrels (bbl) of drilling wastes, more than 20 billion bbl of produced water, and nearly 12 million bbl of associated wastes in 1985. Current exploration and production activities are believed to be generating comparable quantities of these oil field wastes. Wakim estimates that 28% of drilling wastes, less than 2% of produced water, and 52% of associated wastes are disposed of in off-site commercial facilities. In recent years, interest in disposing of oil field wastes in solution-mined salt caverns has been growing. This report provides information on the availability of commercial disposal companies in oil-and gas-producing states, the treatment and disposal methods they employ, and the amounts they charge. It also compares cavern disposal costs with the costs of other forms of waste disposal.

Efficiency analyses of the CANDU spent fuel repository using modified disposal canisters for a deep geological disposal system design

International Nuclear Information System (INIS)

Lee, J.Y.; Cho, D.K.; Lee, M.S.; Kook, D.H.; Choi, H.J.; Choi, J.W.; Wang, L.M.

2012-01-01

Highlights: ► A reference disposal concept for spent nuclear fuels in Korea has been reviewed. ► To enhance the disposal efficiency, alternative disposal concepts were developed. ► Thermal analyses for alternative disposal concepts were performed. ► From the result of the analyses, the disposal efficiency of the concepts was reviewed. ► The most effective concept was suggested. - Abstract: Deep geological disposal concept is considered to be the most preferable for isolating high-level radioactive waste (HLW), including nuclear spent fuels, from the biosphere in a safe manner. The purpose of deep geological disposal of HLW is to isolate radioactive waste and to inhibit its release of for a long time, so that its toxicity does not affect the human beings and the biosphere. One of the most important requirements of HLW repository design for a deep geological disposal system is to keep the buffer temperature below 100 °C in order to maintain the integrity of the engineered barrier system. In this study, a reference disposal concept for spent nuclear fuels in Korea has been reviewed, and based on this concept, efficient alternative concepts that consider modified CANDU spent fuels disposal canister, were developed. To meet the thermal requirement of the disposal system, the spacing of the disposal tunnels and that of the disposal pits for each alternative concept, were drawn following heat transfer analyses. From the result of the thermal analyses, the disposal efficiency of the alternative concepts was reviewed and the most effective concept suggested. The results of these analyses can be used for a deep geological repository design and detailed analyses, based on exact site characteristics data, will reduce the uncertainty of the results.

Program for responsible and safe disposal of spent fuel elements and radioactive wastes (National disposal program)

International Nuclear Information System (INIS)

2015-01-01

The contribution covers the following topics: fundamentals of the disposal policy; amount of radioactive wastes and prognosis; disposal of radioactive wastes - spent fuel elements and wastes from waste processing, radioactive wastes with low heat production; legal framework of the nuclear waste disposal in Germany; public participation, cost and financing.

Update on the Federal Facilities Compliance Act disposal workgroup disposal site evaluation - what has worked and what has not

International Nuclear Information System (INIS)

Case, J.T.; Waters, R.D.

1995-01-01

The Department of Energy (DOE) has been developing a planning process for mixed low-level waste (MLLW) disposal in conjunction with the affected states for over two years and has screened the potential disposal sites from 49 to 15. A radiological performance evaluation was conducted on these fifteen sites to further identify their strengths and weaknesses for disposal of MLLW. Technical analyses are on-going. The disposal evaluation process has sufficiently satisfied the affected states' concerns to the point that disposal has not been a major issue in the consent order process for site treatment plans. Additionally, a large amount of technical and institutional information on several DOE sites has been summarized. The relative technical capabilities of the remaining fifteen sites have been demonstrated, and the benefits of waste form and disposal facility performance have been quantified. However, the final disposal configuration has not yet been determined. Additionally, the MLLW disposal planning efforts will need to integrate more closely with the low-level waste disposal activities before a final MLLW disposal configuration can be determined. Recent Environmental Protection Agency efforts related to the definition of hazardous wastes may also affect the process

Toilet refusal syndrome in preschool children: do different subtypes exist?

Science.gov (United States)

Niemczyk, Justine; Equit, Monika; El Khatib, Diana; von Gontard, Alexander

2014-03-01

Toilet refusal syndrome (TRS) is a common, benign disorder in toddlers defined by the use of diapers and refusal of toilet for defaecation, but has not been described systematically in preschool children yet. The aim of the study was to analyse and identify possible subgroups of TRS. Retrospective analysis of all of the consecutive children with TRS presented as outpatients in a clinic for elimination disorders. Patients had received a detailed paediatric and child psychiatric assessment, including the Child Behavior Checklist questionnaire. Three typical case vignettes are presented of TRS with constipation, oppositional defiant disorder, and sibling rivalry. Twenty-five children (10 boys) with a mean age of 5.2 (3.4-7.3) years were included-representing 2.5% of all of the children (n = 1001) presented. They had high rates of constipation (60%) and elimination disorders (24%-44%). Child psychiatric International Classification of Diseases-10th Edition disorders were common (40%) and heterogeneous, with significantly more boys affected, but no differences between children with and without constipation. This study shows that TRS occurs also in older preschool (and even school) children. At this later age, it is associated with constipation and behavioural disorders. The case vignettes show differences in therapy and may represent different subgroups of TRS. TRS is associated with constipation, elimination disorders, and psychiatric disorders. Owing to this variety of comorbid disorders, different therapeutic approaches are needed. A general screening for behavioural symptoms is recommended.

Rationality, religion and refusal of treatment in an ambulance revisited.

Science.gov (United States)

McMahon-Parkes, Kate

2013-09-01

In their recent article, Erbay et al considered whether a seriously injured patient should be able to refuse treatment if the refusal was based on a (mis)interpretation of religious doctrine. They argued that in such a case 'what is important…is whether the teaching or philosophy used as a reference point has been in fact correctly perceived' (p 653). If it has not been, they asserted that this eroded the patient's capacity to make an autonomous decision and that therefore, in such cases, it is the role of the healthcare professional (HCP) to 'assist patients to think more clearly and rationally' (p 653). There are, however, a number of problems with the reasons why Erbay et al suggest we should help patients to rationalise their decisions and how HCPs should go about this. In this article, the author explores some of their main arguments regarding consent and rationality (particularly in relation to religious beliefs), as well as Erbay et al's normative claim that HCPs have an obligation to promote autonomy by helping patients to come to a 'rational' decision. Ultimately, the author agrees that the (temporary) solution to the dilemma presented in this scenario (which was to insert an intravenous cannula into the patient in order to allow an infusion of fluids in the event that he changed his mind) seemed both pragmatic and ethically permissible. However, it is suggested that the arguments which underpin this conclusion in Erbay et al's article are largely unsound.

Generalized economic model for evaluating disposal costs at a low-level waste disposal facility

International Nuclear Information System (INIS)

Baird, R.D.; Rogers, V.C.

1985-01-01

An economic model is developed which can be used to evaluate cash flows associated with the development, operations, closure, and long-term maintenance of a proposed Low-Level Radioactive Waste disposal facility and to determine the unit disposal charges and unit surcharges which might result. The model includes the effects of nominal interest rate (rate of return on investment, or cost of capital), inflation rate, waste volume growth rate, site capacity, duration of various phases of the facility history, and the cash flows associated with each phase. The model uses standard discounted cash flow techniques on an after-tax basis to determine that unit disposal charge which is necessary to cover all costs and expenses and to generate an adequate rate of return on investment. It separately considers cash flows associated with post-operational activities to determine the required unit surcharge. The model is applied to three reference facilities to determine the respective unit disposal charges and unit surcharges, with various values of parameters. The sensitivity of the model results are evaluated for the unit disposal charge

Bonus Point System for Refuse Classification and Sustainable Development: A Study in China

Directory of Open Access Journals (Sweden)

Shijie Guo

2017-09-01

Full Text Available The rapid growth of household waste not only endangers the environment and people’s health, but also limits social and economic development. The effective sorting and recycling of garbage can control this problem. Adopting a semi-quantitative case study method, our researchers investigated the effect of a bonus point system for refuse classification that improves the accuracy of refuse classification and the residents’ environment awareness. In the system, residents will receive some gifts after sorting the garbage correctly. We also investigated the attitudes of residents and companies towards this novel system. Our researchers employed various methods to analyze garbage-sorting data, questionnaires completed by residents, and interview records. The results show that use of a bonus point system affects the management of domestic waste by improving the accuracy and enhancing the awareness of garbage sorting. Overall, residents support the system and benefit from it, which increases participation and consciousness of environmental protection. However, continuous publicity and coordination of various policies are required to promote the wide-range implementation and sustainable development of this system.

radioactive waste disposal standards abroad

International Nuclear Information System (INIS)

Lu Yan; Xin Pingping; Wu Jian; Zhang Xue

2012-01-01

With the world focus on human health and environmental protection, the problem of radioactive waste disposal has gradually become a global issue, and the focus of attention of public. The safety of radioactive waste disposal, is not only related to human health and environmental safety, but also an important factor of affecting the sustainable development of nuclear energy. In recent years the formulation of the radioactive waste disposal standards has been generally paid attention to at home and abroad, and it has made great progress. In China, radioactive waste management standards are being improved, and there are many new standards need to be developed. The revised task of implement standards is very arduous, and there are many areas for improvement about methods and procedures of the preparation of standards. This paper studies the current situation of radioactive waste disposal standards of the International Atomic Energy Agency, USA, France, Britain, Russia, Japan, and give some corresponding recommendations of our radioactive waste disposal standards. (authors)

Disposal of radioactive waste material

International Nuclear Information System (INIS)

Cairns, W.J.; Burton, W.R.

1984-01-01

A method of disposal of radioactive waste consists in disposing the waste in trenches dredged in the sea bed beneath shallow coastal waters. Advantageously selection of the sites for the trenches is governed by the ability of the trenches naturally to fill with silt after disposal. Furthermore, this natural filling can be supplemented by physical filling of the trenches with a blend of absorber for radionuclides and natural boulders. (author)

Refusal of Treatment by Mentally Competent Patient: The Choice of Doctor-Patient Relationship Models

Directory of Open Access Journals (Sweden)

Andrei M. Beliaev

2010-01-01

Full Text Available Introduction: In modern medicine professional relationship between the clinician and the patient is patient-centered. Patients become actively involved in the treatment decision making process and are encouraged to express their health-related preferences. Some patients may, however, refuse a favorable risk/benefit ratio treatment. This manuscript presents three cases of refusal of treatment by mentally competent surgical patients and discusses differences in their management. Conclusion: To achieve the best medical outcome for patients who possess the Actual Understanding test of mental competence clinicians use the deliberate model of medical professional relationship. For patients demonstrating the Understanding test of mental competence and wishing to utilize their health-related preferences physicians are obliged to deploy the interpretive model of doctor-patient relationship. In mentally competent patients with an illness-induced acute psychological regression the interpretive model of doctor-patient relationship as an initial strategy and cognitive behavior therapy can be useful in modifying treatment rejecting behavior and improving medical outcome.

48 CFR 2845.603 - Disposal methods.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Disposal methods. 2845.603 Section 2845.603 Federal Acquisition Regulations System DEPARTMENT OF JUSTICE Contract Management GOVERNMENT PROPERTY Reporting, Redistribution, and Disposal of Contractor Inventory 2845.603 Disposal methods...

48 CFR 945.603 - Disposal methods.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Disposal methods. 945.603 Section 945.603 Federal Acquisition Regulations System DEPARTMENT OF ENERGY CONTRACT MANAGEMENT GOVERNMENT PROPERTY Reporting, Redistribution, and Disposal of Contractor Inventory 945.603 Disposal methods. ...

Safety of direct disposal of spent fuel and of disposal of reprocessing waste

Energy Technology Data Exchange (ETDEWEB)

Besnus, F. [Institut de Radioprotection et de Surete Nucleaire (IRSN), 92 - Fontenay-aux-Roses (France)

2006-07-01

In 2005, the French Agency for Radioactive waste management (ANDRA) established a report on the feasibility of the geological disposal of high level and intermediate level long lived radioactive waste, in a clay formation. The hypothesis of spent fuel direct disposal was also considered. By the end of 2005, IRSN performed a complete technical review of ANDRA's report, aiming at highlighting the salient safety issues that were to be addressed within a process that may possibly lead to the creation of a disposal facility for these wastes. The following publication presents the main conclusions of this technical review. (author)

Safety of direct disposal of spent fuel and of disposal of reprocessing waste

International Nuclear Information System (INIS)

Besnus, F.

2006-01-01

In 2005, the French Agency for Radioactive waste management (ANDRA) established a report on the feasibility of the geological disposal of high level and intermediate level long lived radioactive waste, in a clay formation. The hypothesis of spent fuel direct disposal was also considered. By the end of 2005, IRSN performed a complete technical review of ANDRA's report, aiming at highlighting the salient safety issues that were to be addressed within a process that may possibly lead to the creation of a disposal facility for these wastes. The following publication presents the main conclusions of this technical review. (author)

Waste disposal

CERN Multimedia

2006-01-01

We should like to remind you that you can have all commonplace, conventional waste (combustible, inert, wood, etc.) disposed of by the TS-FM Group. Requests for the removal of such waste should be made by contacting FM Support on tel. 77777 or by e-mail (Fm.Support@cern.ch). For requests to be acted upon, the following information must be communicated to FM Support: budget code to be debited for the provision and removal of the skip / container. type of skip required (1m3, 4 m3, 7 m3, 15 m3, 20 m3, 30 m3). nature of the waste to be disposed of (bulky objects, cardboard boxes, etc.). building concerned. details of requestor (name, phone number, department, group, etc.). We should also like to inform you that the TS-FM Group can arrange for waste to be removed from work-sites for firms under contract to CERN, provided that the prior authorisation of the CERN Staff Member in charge of the contract is obtained and the relevant disposal/handling charges are paid. You are reminded that the selective sorting o...

Waste disposal

CERN Multimedia

2006-01-01

We should like to remind you that you can have all commonplace, conventional waste (combustible, inert, wood, etc.) disposed of by the TS-FM Group. Requests for the removal of such waste should be made by contacting FM Support on tel. 77777 or by e-mail (Fm.Support@cern.ch). For requests to be acted upon, the following information must be communicated to FM Support: budget code to be debited for the provision and removal of the skip / container; type of skip required (1m3, 4 m3, 7 m3, 15 m3, 20 m3, 30 m3); nature of the waste to be disposed of (bulky objects, cardboard boxes, etc.); building concerned; details of requestor (name, phone number, department, group, etc.). We should also like to inform you that the TS-FM Group can arrange for waste to be removed from work-sites for firms under contract to CERN, provided that the prior authorisation of the CERN Staff Member in charge of the contract is obtained and the relevant disposal/handling charges are paid. You are reminded that the selective sorting...

No nuclear power. No disposal facility?

Energy Technology Data Exchange (ETDEWEB)

Feinhals, J. [DMT GmbH und Co.KG, Hamburg (Germany)

2016-07-01

Countries with a nuclear power programme are making strong efforts to guarantee the safe disposal of radioactive waste. The solutions in those countries are large disposal facilities near surface or in deep geological layers depending on the activity and half-life of the nuclides in the waste. But what will happen with the radioactive waste in countries that do not have NPPs but have only low amounts of radioactive waste from medical, industrial and research facilities as well as from research reactors? Countries producing only low amounts of radioactive waste need convincing solutions for the safe and affordable disposal of their radioactive waste. As they do not have a fund by an operator of nuclear power plants, those countries need an appropriate and commensurate solution for the disposal of their waste. In a first overview five solutions seem to be appropriate: (i) the development of multinational disposal facilities by using the existing international knowhow; (ii) common disposal with hazardous waste; (iii) permanent storage; (iv) use of an existing mine or tunnel; (v) extension of the borehole disposal concept for all the categories of radioactive wastes.

Geological aspects of radioactive waste disposal

International Nuclear Information System (INIS)

Kobera, P.

1985-01-01

Geological formations suitable for burying various types of radioactive wastes are characterized applying criteria for the evaluation and selection of geological formations for building disposal sites for radioactive wastes issued in IAEA technical recommendations. They are surface disposal sites, disposal sites in medium depths and deep disposal sites. Attention is focused on geological formations usable for injecting self-hardening mixtures into cracks prepared by hydraulic decomposition and for injecting liquid radioactive wastes into permeable rocks. Briefly outlined are current trends of the disposal of radioactive wastes in Czechoslovakia and the possibilities are assessed from the geological point of view of building disposal sites for radioactive wastes on the sites of Czechoslovak nuclear power plants at Jaslovske Bohunice, Mochovce, Dukovany, Temelin, Holice (eastern Bohemia), Blahoutovice (northern Moravia) and Zehna (eastern Slovakia). It is stated that in order to design an optimal method of the burial of radioactive waste it will be necessary to improve knowledge of geological conditions in the potential disposal sites at the said nuclear plants. There is usually no detailed knowledge of geological and hydrological conditions at greater depths than 100 m. (Z.M.)

Comparison of the waste management aspects of spent fuel disposal and reprocessing: post-disposal radiological impact

International Nuclear Information System (INIS)

Mobbs, S.F.; Harvey, M.P.; Martin, J.S.; Mayall, A.; Jones, M.E.

1991-01-01

A joint project involving contractors from France, Germany and the UK was set up by the Commission of the European Communities to assess the implications of two waste management options: the direct disposal of spent fuel and reprocessing of that fuel. This report describes the calculation of the radiological impact on the public of the management and disposal of the wastes associated with these two options. Six waste streams were considered: discharge of liquid reprocessing effluents, discharge of gaseous reprocessing effluents, disposal of low-level solid wastes arising from reprocessing, disposal of intermediate-level solid wastes arising from reprocessing, disposal of vitrified high-level reprocessing wastes, and direct disposal of spent fuel. The results of the calculations are in the form of maximum annual doses and risks to individual members of the public, and collective doses to four population groups, integrated over six time periods. These results were designed for input into a computer model developed by another contractor, Yard Ltd, which combines costs and impacts in a multi-attribute hierarchy to give an overall measure of the impact of a given option

Hydrogeology and simulation of groundwater flow at the Green Valley reclaimed coal refuse site near Terre Haute, Indiana

Science.gov (United States)

Bayless, E. Randall; Arihood, Leslie D.; Fowler, Kathleen K.

2011-01-01

The Green Valley reclaimed coal refuse site, near Terre Haute, Ind., was mined for coal from 1948 to 1963. Subsurface coal was cleaned and sorted at land surface, and waste material was deposited over the native glacial till. Approximately 2.7 million cubic yards of waste was deposited over 159 acres (92.3 hectares) in tailings ponds and gob piles. During 1993, the Indiana Department of Natural Resources, Division of Reclamation, improved the site by grading gob piles, filling tailings ponds, and covering the refuse with a layer of glacial drift. During 2008, the Division of Reclamation and U.S. Geological Survey initiated a cooperative investigation to characterize the hydrogeology of the site and construct a calibrated groundwater flow model that could be used to simulate the results of future remedial actions. In support of the modeling, a data-collection network was installed at the Green Valley site to measure weather components, geophysical properties, groundwater levels, and stream and seep flow. Results of the investigation indicate that (1) there is negligible overland flow from the site, (2) the prevailing groundwater-flow direction is from northeast to southwest, with a much smaller drainage to the northeast, (3) there is not a direct hydraulic connection between the refuse and West Little Sugar Creek, (4) about 24 percent of the groundwater recharge emerges through seeps, and water from the seeps evaporates or eventually flows to West Little Sugar Creek and the Green Valley Mine Pond, and (5) about 72 percent of groundwater recharge moves vertically downward from the coal refuse into the till and follows long, slow flow paths to eventual dischage points.

37 CFR 204.8 - Appeal of refusal to correct or amend an individual's record.

Science.gov (United States)

2010-07-01

... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Appeal of refusal to correct or amend an individual's record. 204.8 Section 204.8 Patents, Trademarks, and Copyrights COPYRIGHT OFFICE, LIBRARY OF CONGRESS COPYRIGHT OFFICE AND PROCEDURES PRIVACY ACT: POLICIES AND PROCEDURES § 204.8...

36 CFR 228.57 - Types of disposal.

Science.gov (United States)

2010-07-01

... 36 Parks, Forests, and Public Property 2 2010-07-01 2010-07-01 false Types of disposal. 228.57... Disposal of Mineral Materials Types and Methods of Disposal § 228.57 Types of disposal. Except as provided... qualified bidder after formal advertising and other appropriate public notice; (b) Sale by negotiated...

Vaccination refusal: ethics, individual rights, and the common good.

Science.gov (United States)

Schwartz, Jason L; Caplan, Arthur L

2011-12-01

Among the obstacles to the success of vaccination programs is the apparent recent increase in hesitancy and outright resistance to the recommended vaccination schedule by some parents and patients. This article reviews the spectrum of patient or parental attitudes that may be described as vaccine refusal, explores related ethical considerations in the context of the doctor-patient relationship and public health, and evaluates the possible responses of physicians when encountering resistance to vaccination recommendations. Health care providers should view individuals hesitant about or opposed to vaccines not as frustrations or threats to public health, but as opportunities to educate and inform. Copyright © 2011 Elsevier Inc. All rights reserved.

Stop on construction of fast breeder at Kalkar refused

International Nuclear Information System (INIS)

Anon.

1978-01-01

The application of a plaintiff was refused by the verdict of the High Court for North Rhine-Westphalia of 16.6.1978, which would have restored the delaying effect of his application against the defendant Minister of the Land (his opponent) on the first part licence of the Kalkar nuclear power station. The plaintiff had to bear the costs of the proceedings, including extra legal costs of the co-defendant nuclear power company. The value of the object of the case was set at DM 10,000. This means that construction can continue. The most important reasons for turning down the application are given. (orig./HP) [de

7 CFR 2902.21 - Disposable containers.

Science.gov (United States)

2010-01-01

... 7 Agriculture 15 2010-01-01 2010-01-01 false Disposable containers. 2902.21 Section 2902.21... Items § 2902.21 Disposable containers. (a) Definition. Products designed to be used for temporary... paragraph (d): Disposable containers can include boxes and packaging made from paper. Under the Resource...

Solid waste disposal into salt mines

International Nuclear Information System (INIS)

Repke, W.

1981-01-01

The subject is discussed as follows: general introduction to disposal of radioactive waste; handling of solid nuclear waste; technology of final disposal, with specific reference to salt domes; conditioning of radioactive waste; safety barriers for radioactive waste; practice of final disposal in other countries. (U.K.)

Consent, Refusal, and Waivers in Patient-Centered Dysphagia Care: Using Law, Ethics, and Evidence to Guide Clinical Practice.

Science.gov (United States)

Horner, Jennifer; Modayil, Maria; Chapman, Laura Roche; Dinh, An

2016-11-01

When patients refuse medical or rehabilitation procedures, waivers of liability have been used to bar future lawsuits. The purpose of this tutorial is to review the myriad issues surrounding consent, refusal, and waivers. The larger goal is to invigorate clinical practice by providing clinicians with knowledge of ethics and law. This tutorial is for educational purposes only and does not constitute legal advice. The authors use a hypothetical case of a "noncompliant" individual under the care of an interdisciplinary neurorehabilitation team to illuminate the ethical and legal features of the patient-practitioner relationship; the elements of clinical decision-making capacity; the duty of disclosure and the right of informed consent or informed refusal; and the relationship among noncompliance, defensive practices, and iatrogenic harm. We explore the legal question of whether waivers of liability in the medical context are enforceable or unenforceable as a matter of public policy. Speech-language pathologists, among other health care providers, have fiduciary and other ethical and legal obligations to patients. Because waivers try to shift liability for substandard care from health care providers to patients, courts usually find waivers of liability in the medical context unenforceable as a matter of public policy.

Shallow ground disposal of radioactive wastes

International Nuclear Information System (INIS)

1981-01-01

This guidebook outlines the factors to be considered in site selection, design, operation, shut-down and surveillance as well as the regulatory requirements of repositories for safe disposal of radioactive waste in shallow ground. No attempt is made to summarize the existing voluminous literature on the many facets of radioactive waste disposal. In the context of this guidebook, shallow ground disposal refers to the emplacement of radioactive waste, with or without engineered barriers, above or below the ground surface, where the final protective covering is of the order of a few metres thick. Deep geological disposal and other underground disposal methods, management of mill tailings and disposal into the sea have been or will be considered in other IAEA publications. These guidelines have been made sufficiently general to cover a broad variety of climatic, hydrogeological and biological conditions. They may need to be interpreted or modified to reflect local conditions and national regulations

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

Classification and disposal of radioactive wastes

International Nuclear Information System (INIS)

Kocher, D.C.

1990-01-01

This paper reviews the historical development in the U.S. of definitions and requirements for permanent disposal of different classes of radioactive waste. We first consider the descriptions of different waste classes that were developed prior to definitions in laws and regulations. These descriptions usually were not based on requirements for permanent disposal but, rather, on the source of the waste and requirements for safe handling and storage. We then discuss existing laws and regulations for disposal of different waste classes. Current definitions of waste classes are largely qualitative, and thus somewhat ambiguous, and are based primarily on the source of the waste rather than the properties of its radioactive constituents. Furthermore, even though permanent disposal is clearly recognized as the ultimate goal of radioactive water management, current laws and regulations do not associated the definitions of different waste classes with requirement for particular disposal systems. Thus, requirements for waste disposal essentially are unaffected by ambiguities in the present waste classification system

Disposal of radioactive wastes

International Nuclear Information System (INIS)

Blomeke, J.O.

1979-01-01

Radioactive waste management and disposal requirements options available are discussed. The possibility of beneficial utilization of radioactive wastes is covered. Methods of interim storage of transuranium wastes are listed. Methods of shipment of low-level and high-level radioactive wastes are presented. Various methods of radioactive waste disposal are discussed

A right to choose how to live: the Australian common law position on refusals of care.

Science.gov (United States)

Curnow, Katherine

2014-12-01

There has been limited examination of the Australian common law position regarding contemporaneous refusals of care or medical treatment by competent adults since the first two Australian cases to adjudicate on refusals of this type: H Ltd v J and Brightwater Care Group (Inc) v Rossiter. This article maps the legal position in Australia in light of the two cases with particular emphasis on the finding in H Ltd v J that self-starvation is not suicide at common law. Finally, this article highlights the broader relevance of this area of the law and its capacity to inform debates as disparate as whether to legalise voluntary euthanasia and the possible implications for the autonomy of pregnant women of proposed laws giving legal status to fetuses (particularly Zoe's Law).

Radioactive waste disposal in W.A

International Nuclear Information System (INIS)

Hartley, B.M.

1983-01-01

Radioactive waste in Western Australia arises primarily from medical diagnosis and treatment and from scientific research mainly with a medical orientation. Waste is classified before disposal depending on its level and type of radioactivity and then disposed of either to municipal land fill sites, to the sewerage system or by incineration. The amounts of radioactive materials which may be disposed of to the sewers and air are set by the Radiation Safety Act (1975) Regulations, and the land fill operations are controlled to ensure isolation of the material. Other waste such as unwanted sources used in industrial applications are stored for future disposal. Discussions are being held between officers of the State and Australian Governments aimed at providing suitable disposal methods for sources of this kind

36 CFR 13.1118 - Solid waste disposal.

Science.gov (United States)

2010-07-01

... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Solid waste disposal. 13.1118... Provisions § 13.1118 Solid waste disposal. (a) A solid waste disposal site may accept non-National Park Service solid waste generated within the boundaries of the park area. (b) A solid waste disposal site may...

36 CFR 13.1008 - Solid waste disposal.

Science.gov (United States)

2010-07-01

... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Solid waste disposal. 13.1008... § 13.1008 Solid waste disposal. (a) A solid waste disposal site may accept non-National Park Service solid waste generated within the boundaries of the park area. (b) A solid waste disposal site may be...

36 CFR 13.1912 - Solid waste disposal.

Science.gov (United States)

2010-07-01

... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Solid waste disposal. 13.1912....1912 Solid waste disposal. (a) A solid waste disposal site may accept non-National Park Service solid waste generated within the boundaries of the park area. (b) A solid waste disposal site may be located...

36 CFR 13.1604 - Solid waste disposal.

Science.gov (United States)

2010-07-01

... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Solid waste disposal. 13.1604... Solid waste disposal. (a) A solid waste disposal site may accept non-National Park Service solid waste generated within the boundaries of the park area. (b) A solid waste disposal site may be located within one...

Minors' rights to refuse medical treatment requested by their parents: remaining issues.

Science.gov (United States)

Griswold, D P; Griswold, D B

2000-08-01

Nurse practitioners are regularly faced with ethical and legal dilemmas when providing care to minors. Laws may not provide clear direction; there may even be conflicting precedents regarding the status of minors, particularly with regard to the juvenile justice system. This article reviews the status of minors' rights with regard to refusing or consenting to medical tests or treatments. Three cases from one author's (DPG) practice illustrate the issues involved.

[THE INDIVIDUAL AND SOCIAL FACTORS EFFECTING REFUSAL FROM VACCINATION OF CHILDREN IN THE TOWN OF SEMEII OF THE REPUBLIC OF KAZAKHSTAN].

Science.gov (United States)

Baibusinova, A J; Musakhanova, A K; Shalgumbaeva, G M; Dauletiarova, M A; Tokanova, Sh E; Nurtasina, S K

2015-01-01

The number of cases of refusal from vaccination increases all over the world. In the Republic of Kazakhstan many studies are devoted to epidemiology of propagation of vaccine-controllable infections, medical aspects ofimmunization, analysis of immunological status and complications of immunization. The issues of awareness of population of the Republic of Kazakhstan about vaccination and refusal of it are investigated insufficiently. This occurrence became a cause of studying the given problem. The study was carried out to investigate attitude ofpopulation to vaccination and main factors of risk of refusal from vaccination of children residing in the city of Semeii and rural districts of the Eastern Kazakhstan oblast. The single-stage longitudinal study was carried out in the Centers of primary medical social care ofpopulation ofcity of Semeii and in polyclinic of the Abaiiskii district of the Eastern Kazakhstan oblast. The period of study continued from April 7 2015 to May 31 2015. The criteria of inclusion were conditionally healthy children. The questionnaire survey included 1184 respondents (mothers) with average age of 27.2 years. The sampling predominantly consisted ofKazakhs (805), Russians (307), representatives ofother nationalities (72). Among mothers, most of them had specialized secondary education (43.7%), the higher education had 30.5%, undergraduate higher education - 1.4%, secondary education - 21.6% and basic school education --2.8%. The results of study demonstrated that families refused from vaccination have negative attitude to vaccination in general though they are satisfied with functioning of vaccination room. The refusal of vaccination is more characterized to urban full families with satisfied income and having girls as children. The respondents consider that information about vaccination received by themfrom medical personnel contains surplus data concerning complications. They are not enouzh for activities in case of deterioration of

Analysis of scenarios for the direct disposal of spent nuclear fuel disposal conditions as expected in Germany

International Nuclear Information System (INIS)

Ashton, P.; Mehling, O.; Mohn, R.; Wingender, H.J.

1990-01-01

This report contains an investigation of aspects of the waste management of spent light water reactor fuel by direct disposal in a deep geological formation on land. The areas covered are: interim dry storage of spent fuel with three options of pre-conditioning; conditioning of spent fuel for final disposal in a salt dome repository; disposal of spent fuel (heat-generating waste) in a salt dome repository; disposal of medium and low-level radioactive wastes in the Konrad mine. Dose commitments, effluent discharges and potential incidents were not found to vary significantly for the various conditioning options/salt dome repository types. Due to uncertainty in the cost estimates, in particular the disposal cost estimates, the variation between the three conditioning options examined is not considered as being significant. The specific total costs for the direct disposal strategy are estimated to lie in the range ECU 600 to 700 per kg hm (basis 1988)

Retrievable disposal - opposing views on ethics

International Nuclear Information System (INIS)

Selling, H.A.

2000-01-01

In the previous decades many research programmes on the disposal of radioactive waste have been completed in the Netherlands. The experts involved have reconfirmed their view that deep underground disposal in suitable geological formations would ensure a safe and prolonged isolation of the waste from the biosphere. Both rock salt and clay formations are considered to qualify as a suitable host rock. In 1993 the government in a position paper stated that such a repository should be designed in a way that the waste can be retrieved from it, should the need arise. In an attempt to involve stakeholders in the decision-making process, a research contract was awarded to an environmental group to study the ethical aspects related to retrievable disposal of radioactive waste. In their report which was published in its final form in January 2000 the authors concluded that retrievable disposal is acceptable from an ethical point of view. However, this conclusion was reached in the understanding that this situation of retrievability would be permanent. From the concept of equity between generations, each successive generation should be offered equal opportunities to decide for itself how to dispose of the radioactive waste. Consequently, the preferred disposal option is retrievable disposal (or long term storage) in a surface facility. Although this view is not in conformity with the ''official'' position on radioactive waste disposal, there is a benefit of having established a dialogue between interested parties in a broad sense. (author)

Delays and Refusal in Treatment for Breast Cancer Among Native American and Hispanic Women with Breast Cancer

National Research Council Canada - National Science Library

Saavedra, Elba

2000-01-01

..., attitudinal, spiritual and demographic variables associated with delays and refusals in breast cancer treatment The focus of the semi-structured interview is to encourage the women in story-telling...

41 CFR 102-75.415 - What happens after the disposal agency receives the FAA's recommendation for disposal of the...

Science.gov (United States)

2010-07-01

... disposal agency receives the FAA's recommendation for disposal of the property for a public airport? 102-75... receives the FAA's recommendation for disposal of the property for a public airport? The head of the disposal agency, or his or her designee, may convey property approved by the FAA for use as a public...

The Hazardous Waste/Mixed Waste Disposal Facility

International Nuclear Information System (INIS)

Bailey, L.L.

1991-01-01

The Hazardous Waste/Mixed Waste Disposal Facility (HW/MWDF) will provide permanent Resource Conservation and Recovery Act (RCRA) permitted storage, treatment, and disposal for hazardous and mixed waste generated at the Department of Energy's (DOE) Savannah River Site (SRS) that cannot be disposed of in existing or planned SRS facilities. Final design is complete for Phase I of the project, the Disposal Vaults. The Vaults will provide RCRA permitted, above-grade disposal capacity for treated hazardous and mixed waste generated at the SRS. The RCRA Part B Permit application was submitted upon approval of the Permit application, the first Disposal Vault is scheduled to be operational in mid 1994. The technical baseline has been established for Phase II, the Treatment Building, and preliminary design work has been performed. The Treatment Building will provide RCRA permitted treatment processes to handle a variety of hazardous and mixed waste generated at SRS in preparation for disposal. The processes will treat wastes for disposal in accordance with the Environmental Protection Agency's (EPA's) Land Disposal Restrictions (LDR). A RCRA Part B Permit application has not yet been submitted to SCDHEC for this phase of the project. The Treatment Building is currently scheduled to be operational in late 1996

Acceptance of HIV testing among women attending antenatal care in south-western Uganda: risk factors and reasons for test refusal.

Science.gov (United States)

Dahl, V; Mellhammar, L; Bajunirwe, F; Björkman, P

2008-07-01

A problem commonly encountered in programs for prevention of mother-to-child-transmission (PMTCT) of HIV in sub-Saharan Africa is low rates of HIV test acceptance among pregnant women. In this study, we examined risk factors and reasons for HIV test refusal among 432 women attending three antenatal care clinics offering PMTCT in urban and semi-urban parts of the Mbarara district, Uganda. Structured interviews were performed following pre-test counselling. Three-hundred-eighty women were included in the study, 323 (85%) of whom accepted HIV testing. In multivariate analysis, testing site (Site A: OR = 1.0; Site B: OR = 3.08; 95%CI: 1.12-8.46; Site C: OR = 5.93; 95%CI: 2.94-11.98), age between 30 and 34 years (refusal. Testing sites operating for longer durations had higher rates of acceptance. The most common reasons claimed for test refusal were: lack of access to antiretroviral therapy (ART) for HIV-infected women (88%; n=57), a need to discuss with partner before decision (82%; n=57) and fear of partner's reaction (54%; n=57). Comparison with previous periods showed that the acceptance rate increased with the duration of the program. Our study identified risk factors for HIV test refusal among pregnant women in Uganda and common reasons for not accepting testing. These findings may suggest modifications and improvements in the performance of HIV testing in this and similar populations.

Refusal to provide health care to people with HIV in France.

OpenAIRE

Douay , Caroline; Toullier , Adeline; Benayoun , Sarah; Castro , Daniela Rojas; Chauvin , Pierre

2016-01-01

International audience; Refusals to provide care to people with HIV have been reported in the USA, the UK and elsewhere in Europe but their frequency remains poorly documented. In 2015, the French parliament examined a law that includes an article on non-discrimination in access to health care and the possibility of doing tests to determine the extent and nature of the discrimination. During the legislative debates, AIDES did a situation testing survey4 to ascertain the frequency and nature o...

High-level nuclear waste disposal

International Nuclear Information System (INIS)

Burkholder, H.C.

1985-01-01

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

Spent nuclear fuel disposal liability insurance

International Nuclear Information System (INIS)

Martin, D.W.

1984-01-01

This thesis examines the social efficiency of nuclear power when the risks of accidental releases of spent fuel radionuclides from a spent fuel disposal facility are considered. The analysis consists of two major parts. First, a theoretical economic model of the use of nuclear power including the risks associated with releases of radionuclides from a disposal facility is developed. Second, the costs of nuclear power, including the risks associated with a radionuclide release, are empirically compared to the costs of fossil fuel-fired generation of electricity. Under the provisions of the Nuclear Waste Policy Act of 1982, the federally owned and operated spent nuclear fuel disposal facility is not required to maintain a reserve fund to cover damages from an accidental radionuclide release. Thus, the risks of a harmful radionuclide release are not included in the spent nuclear fuel disposal fee charged to the electric utilities. Since the electric utilities do not pay the full, social costs of spent fuel disposal, they use nuclear fuel in excess of the social optimum. An insurance mechanism is proposed to internalize the risks associated with spent fueled disposal. Under this proposal, the Federal government is required to insure the disposal facility against any liabilities arising from accidental releases of spent fuel radionuclides

Solid medical waste: a cross sectional study of household disposal practices and reported harm in Southern Ghana

Directory of Open Access Journals (Sweden)

Emilia Asuquo Udofia

2017-05-01

Full Text Available Abstract Background Solid medical waste (SMW in households is perceived to pose minimal risks to the public compared to SMW generated from healthcare facilities. While waste from healthcare facilities is subject to recommended safety measures to minimize risks to human health and the environment, similar waste in households is often untreated and co-mingled with household waste which ends up in landfills and open dumps in many African countries. In Ghana, the management of this potentially hazardous waste stream at household and community level has not been widely reported. The objective of this study was to investigate household disposal practices and harm resulting from SMW generated in households and the community. Methods A cross-sectional questionnaire survey of 600 households was undertaken in Ga South Municipal Assembly in Accra, Ghana from mid-April to June, 2014. Factors investigated included socio-demographic characteristics, medication related practices, the belief that one is at risk of diseases associated with SMW, SMW disposal practices and reported harm associated with SMW at home and in the community. Results Eighty percent and 89% of respondents discarded unwanted medicines and sharps in household refuse bins respectively. A corresponding 23% and 35% of respondents discarded these items without a container. Harm from SMW in the household and in the community was reported by 5% and 3% of respondents respectively. Persons who believed they were at risk of diseases associated with SMW were nearly three times more likely to report harm in the household (OR 2.75, 95%CI 1.15–6.54. Conclusion The belief that one can be harmed by diseases associated with SMW influenced reporting rates in the study area. Disposal practices suggest the presence of unwanted medicines and sharps in the household waste stream conferring on it hazardous properties. Given the low rates of harm reported, elimination of preventable harm might justify community

Design of the disposal facility 2012

International Nuclear Information System (INIS)

Saanio, T.; Ikonen, A.; Keto, P.; Kirkkomaeki, T.; Kukkola, T.; Nieminen, J.; Raiko, H.

2013-11-01

The spent nuclear fuel accumulated from the nuclear power plants in Olkiluoto in Eurajoki and in Haestholmen in Loviisa will be disposed of in Olkiluoto. A facility complex will be constructed at Olkiluoto, and it will include two nuclear waste facilities according to Government Degree 736/2008. The nuclear waste facilities are an encapsulation plant, constructed to encapsulate spent nuclear fuel and a disposal facility consisting of an underground repository and other underground rooms and above ground service spaces. The repository is planned to be excavated to a depth of 400 - 450 meters. Access routes to the disposal facility are an inclined access tunnel and vertical shafts. The encapsulated fuel is transferred to the disposal facility in the canister lift. The canisters are transferred from the technical rooms to the disposal area via central tunnel and deposited in the deposition holes which are bored in the floors of the deposition tunnels and are lined beforehand with compacted bentonite blocks. Two parallel central tunnels connect all the deposition tunnels and these central tunnels are inter-connected at regular intervals. The solution improves the fire safety of the underground rooms and allows flexible backfilling and closing of the deposition tunnels in stages during the operational phase of the repository. An underground rock characterization facility, ONKALO, is excavated at the disposal level. ONKALO is designed and constructed so that it can later serve as part of the repository. The goal is that the first part of the disposal facility will be constructed under the building permit phase in the 2010's and operations will start in the 2020's. The fuel from 4 operating reactors as well the fuel from the fifth nuclear power plant under construction, has been taken into account in designing the disposal facility. According to the information from TVO and Fortum, the amount of the spent nuclear fuel is 5,440 tU. The disposal facility is being excavated

Disposal phase experimental program plan

International Nuclear Information System (INIS)

1997-01-01

The Waste Isolation Pilot Plant (WIPP) facility comprises surface and subsurface facilities, including a repository mined in a bedded salt formation at a depth of 2,150 feet. It has been developed to safely and permanently isolate transuranic (TRU) radioactive wastes in a deep geological disposal site. On April 12, 1996, the DOE submitted a revised Resource Conservation and Recovery Act (RCRA) Part B permit application to the New Mexico Environment Department (NMED). The DOE anticipates receiving an operating permit from the NMED; this permit is required prior to the start of disposal operations. On October 29, 1996, the DOE submitted a Compliance Certification Application (CCA) to the US Environmental Protection Agency (EPA) in accordance with the WIPP land Withdrawal Act (LWA) of 1992 (Public Law 102-579) as amended, and the requirements of Title 40 of the Code of Federal Regulations (40 CFR) Parts 191 and 194. The DOE plans to begin disposal operations at the WIPP in November 1997 following receipt of certification by the EPA. The disposal phase is expected to last for 35 years, and will include recertification activities no less than once every five years. This Disposal Phase Experimental Program (DPEP) Plan outlines the experimental program to be conducted during the first 5-year recertification period. It also forms the basis for longer-term activities to be carried out throughout the 35-year disposal phase. Once the WIPP has been shown to be in compliance with regulatory requirements, the disposal phase gives an opportunity to affirm the compliance status of the WIPP, enhance the operations of the WIPP and the national TRU system, and contribute to the resolution of national and international nuclear waste management technical needs. The WIPP is the first facility of its kind in the world. As such, it provides a unique opportunity to advance the technical state of the art for permanent disposal of long-lived radioactive wastes

40 CFR 160.43 - Test system care facilities.

Science.gov (United States)

2010-07-01

... testing facility shall have a number of animal rooms or other test system areas separate from those... housed, facilities shall exist for the collection and disposal of all animal waste and refuse or for safe sanitary storage of waste before removal from the testing facility. Disposal facilities shall be so...

Sexual revictimization during women's first year of college: self-blame and sexual refusal assertiveness as possible mechanisms.

Science.gov (United States)

Katz, Jennifer; May, Pamela; Sörensen, Silvia; DelTosta, Jill

2010-11-01

Although sexual victimization during adolescence increases risk for later revictimization, mechanisms for increased risk among new college students have not been identified. Female undergraduates (N = 87) were assessed at the start and end of their first academic year. Those who reported initial sexual victimization at Time 1 were more likely than other women to report later college victimization at Time 2. Path analyses showed that self-blame and decreased sexual refusal assertiveness (SRA) explained this effect. Specifically, initial victimization was associated with increased self-blame; in turn, self-blame indirectly predicted later college victimization via decreased sexual refusal assertiveness. Prevention efforts focused on self-blame and other barriers to SRA may reduce risk for revictimization during women's transition to college.

Situation of Environmental Health of Rural Communities in Palpa District of Nepal

Directory of Open Access Journals (Sweden)

Moushami Ghimire

2013-12-01

Full Text Available Background: Sanitation  refers to create and  maintain  hygienic conditions, through services such as garbage collection and its proper disposal, wastewater disposal, consumption of safe drinking water, housing condition and its surrounding, an act or process of making sanitary,  the promotion of hygiene and prevention of disease. Human being is a social animal and being a part of society, factors affecting the society also affect human and his surroundings. The study is concerned to demographic variables and environmental practices in rural communities. Objectives: To find out environmental situation and observe an impact of demographic variables on environmental factors. Materials and methods: A cross-sectional study was followed to conduct the study in palpa district of Nepal at 2012. Three hundred thirty nine households were selected through simple random procedure. Semi-structure interview schedule was used to collect information. Data were analyzed using software SPSS for windows version 16.0.  Results: Most of the families were faithful to ethnic group. Practices of refuse and excreta disposable had unsatisfactory where percentages of throwing refuse and open field defecation was 39.2 and 9.1 respectively. 77.6% households were consumed tap water. Most of the households (53.4% did not have proper drainage system around their houses. Conclusion: Family type and caste of households were strongly associated with practice related to excreta disposal, drainage system and refuse disposable. Improper sanitation could be main threat to public health promotion and disease prevention in study areas.

Greater-confinement disposal

International Nuclear Information System (INIS)

Trevorrow, L.E.; Schubert, J.P.

1989-01-01

Greater-confinement disposal (GCD) is a general term for low-level waste (LLW) disposal technologies that employ natural and/or engineered barriers and provide a degree of confinement greater than that of shallow-land burial (SLB) but possibly less than that of a geologic repository. Thus GCD is associated with lower risk/hazard ratios than SLB. Although any number of disposal technologies might satisfy the definition of GCD, eight have been selected for consideration in this discussion. These technologies include: (1) earth-covered tumuli, (2) concrete structures, both above and below grade, (3) deep trenches, (4) augered shafts, (5) rock cavities, (6) abandoned mines, (7) high-integrity containers, and (8) hydrofracture. Each of these technologies employ several operations that are mature,however, some are at more advanced stages of development and demonstration than others. Each is defined and further described by information on design, advantages and disadvantages, special equipment requirements, and characteristic operations such as construction, waste emplacement, and closure

Waste disposal options report. Volume 1

International Nuclear Information System (INIS)

Russell, N.E.; McDonald, T.G.; Banaee, J.; Barnes, C.M.; Fish, L.W.; Losinski, S.J.; Peterson, H.K.; Sterbentz, J.W.; Wenzel, D.R.

1998-02-01

This report summarizes the potential options for the processing and disposal of mixed waste generated by reprocessing spent nuclear fuel at the Idaho Chemical Processing Plant. It compares the proposed waste-immobilization processes, quantifies and characterizes the resulting waste forms, identifies potential disposal sites and their primary acceptance criteria, and addresses disposal issues for hazardous waste

Disposal of radioactive wastes. Chapter 11

International Nuclear Information System (INIS)

Skitt, J.

1979-01-01

An account is given of the history and present position of legislation in the United Kingdom on the disposal of radioactive wastes. The sections are headed: introduction and definitions; history; the Radioactive Substances Act 1960; disposal of solid radioactive wastes through Local Authority services; function of Local Authorities; exemptions; national radioactive waste disposal service; incidents involving radioactivity. (U.K.)

Oil statistics 1976: supply and disposal

Energy Technology Data Exchange (ETDEWEB)

1976-01-01

Summary tables are included for the period 1960 to 1976. The detailed tables for 1976 cover production, supply and disposal; supply and disposal by product; imports by sources; imports from member countries; exports by destination; exports to member countries; consumption by end-use sectors; and supply and disposal of finished products by country (1975 and 1976). (DLC)

Recycling And Disposal Of Waste

Energy Technology Data Exchange (ETDEWEB)

Choi, Ui So

1987-01-15

This book introduces sewage disposal sludge including properties of sludge and production amount, stabilization of sludge by anaerobic digestion stabilization of sludge by aerobic digestion, stabilization of sludge by chemical method, and dewatering, water process sludge, human waste and waste fluid of septic tank such as disposal of waste fluid and injection into the land, urban waste like definition of urban waste, collection of urban waste, recycling, properties and generation amount, and disposal method and possibility of injection of industrial waste into the ground.

Influence of liming and topsoil thickness on vegetative growth and leachate quality on acidic coal refuse

International Nuclear Information System (INIS)

Li, R.S.; Daniels, W.L.

1998-01-01

Coal waste materials inhibit direct vegetation establishment due to adverse physical and chemical properties, particularly low water retention and high potential acidity. The Moss No. 1 coal refuse pile is located in Dickenson County, Virginia, and was idled in the late 1980's with little topsoil resource available for final closure. The refuse was acidic (Total-S = 0.38%; pH = 3.6), black, high (70%) in coarse fragments, and had a low water holding capacity (4.5% in 6.0 over a two-year period, which resulted in greater vegetative cover and biomass than the control plots. All topsoil treatments resulted in greater vegetative cover and biomass than plots treated with lime only due to improved surface soil physical and chemical properties. A topsoil treatment of 60 cm gave the thickest vegetative cover and biomass yield. Such a treatment, however, would be cost-prohibitive at this location. Application of 27 Mg/ha of lime to the refuse surface along with 15 cm of topsoil produced acceptable two-year vegetative cover and biomass, and appeared to be the optimal treatment for this particular situation. Both liming and topsoil had no affect on leachate pH and the electrical conductivity in leachates collected below the plots. This suggests that surface revegetation will have little effect on the quality of water draining through the pile, so long term water treatment requirements may not be reduced by successfully revegetating the pile surface

Geohydrology of industrial waste disposal site

International Nuclear Information System (INIS)

Gaynor, R.K.

1984-01-01

An existing desert site for hazardous chemical and low-level radioactive waste disposal is evaluated for suitability. This site is characterized using geologic, geohydrologic, geochemical, and other considerations. Design and operation of the disposal facility is considered. Site characteristics are also evaluated with respect to new and proposed regulatory requirements under the Resource Conservation and Recovery Act (1976) regulations, 40 CFR Part 264, and the ''Licensing Requirements for Landfill Disposal of Radioactive Waste,'' 10 CRF Part 61. The advantages and disadvantages of siting new disposal facilities in similar desert areas are reviewed and contrasted to siting in humid locations

ICRP guidance on radioactive waste disposal

International Nuclear Information System (INIS)

Cooper, J.R.

2002-01-01

The International Commission on Radiological Protection (ICRP) issued recommendations for a system of radiological protection in 1991 as the 1990 Recommendations. Guidance on the application of these recommendations in the general area of waste disposal was issued in 1997 as Publication 77 and guidance specific to disposal of solid long-lived radioactive waste was issued as Publication 81. This paper summarises ICRP guidance in radiological protection requirements for waste disposal concentrating on the ones of relevance to the geological disposal of solid radioactive waste. Suggestions are made for areas where further work is required to apply the ICRP guidance. (author)

User's guide to the 'DISPOSALS' model

International Nuclear Information System (INIS)

Groom, M.S.; James, A.R.; Laundy, R.S.

1984-03-01

This report provides a User's Guide to the 'DISPOSALS' computer model and includes instructions on how to set up and run a specific problem together with details of the scope, theoretical basis, data requirements and capabilities of the model. The function of the 'DISPOSALS' model is to make assignments of nuclear waste material in an optimum manner to a number of disposal sites each subject to a number of constraints such as limits on the volume and activity. The user is able to vary the number of disposal sites, the range and limits of the constraints to be applied to each disposal site and the objective function for optimisation. The model is based on the Linear Programming technique and uses CAP Scientific's LAMPS and MAGIC packages. Currently the model has been implemented on CAP Scientific's VAX 11/750 minicomputer. (author)

Disposal of Radioactive Waste. Specific Safety Requirements

International Nuclear Information System (INIS)

2011-01-01

This publication establishes requirements applicable to all types of radioactive waste disposal facility. It is linked to the fundamental safety principles for each disposal option and establishes a set of strategic requirements that must be in place before facilities are developed. Consideration is also given to the safety of existing facilities developed prior to the establishment of present day standards. The requirements will be complemented by Safety Guides that will provide guidance on good practice for meeting the requirements for different types of waste disposal facility. Contents: 1. Introduction; 2. Protection of people and the environment; 3. Safety requirements for planning for the disposal of radioactive waste; 4. Requirements for the development, operation and closure of a disposal facility; 5. Assurance of safety; 6. Existing disposal facilities; Appendices.

[Recommendations for making decisions when parents refuse to vaccinate their children: ethical analysis].

Science.gov (United States)

Riaño Galán, I; Martínez González, C; Sánchez Jacob, M

2013-07-01

Vaccinating children is the most effective primary prevention activity and many lives have been saved due to vaccines. Anti-vaccine movements have spread doubts about the safety and effectiveness of childhood vaccines, leading to some parents refusing to vaccinate their children. This refusal raises a conflict of values between the right of parents to the upbringing of their children according to their beliefs and justice, putting the immunity of the group at risk. In Spain, the law protects this ability for parents to decide not to comply with the official vaccine program. Pediatricians play an essential role in a parent's decision, and must provide accurate information about vaccination. It is necessary to explore The values of the parents, their concerns need to be empathetically examined, in order to reach an agreement. Respect for freedom does not exempt us from using discussion and persuasion to achieve attitudes and healthy choices for children. Our commitment to responsability promotion is essential for maintaining high vaccination levels that protect the health of children. Copyright © 2012 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

Aggression Profiles in the Spanish Child Population: Differences in Perfectionism, School Refusal and Affect

Directory of Open Access Journals (Sweden)

María Vicent

2018-01-01

Full Text Available The aim of this study was to identify the existence of combinations of aggression components (Anger, Hostility, Physical Aggression and Verbal Aggression that result in different profiles of aggressive behavior in children, as well as to test the differences between these profiles in scores of perfectionism, school refusal and affect. It is interesting to analyze these variables given: (a their clinical relevance due to their close relationship with the overall psychopathology; and (b the need for further evidence regarding how they are associated with aggressive behavior. The sample consisted of 1202 Spanish primary education students between the ages of 8 and 12. Three aggressive behavior profiles for children were identified using Latent Class Analysis (LCA: High Aggression (Z scores between 0.69 and 0.7, Moderate Aggression (Z scores between −0.39 and −0.47 and Low Aggression (Z scores between −1.36 and −1.58. These profiles were found for 49.08%, 38.46% and 12.48% of the sample, respectively. High Aggression scored significantly higher than Moderate Aggression and Low Aggression on Socially Prescribed Perfectionism (SPP, Self-Oriented Perfectionism (SOP, the first three factors of school refusal (i.e., FI. Negative Affective, FII. Social Aversion and/or Evaluation, FIII. To Pursue Attention, and Negative Affect (NA. In addition, Moderate Aggression also reported significantly higher scores than Low Aggression for the three first factors of school refusal and NA. Conversely, Low Aggression had significantly higher mean scores than High Aggression and Moderate Aggression on Positive Affect (PA. Results demonstrate that High Aggression was the most maladaptive profile having a high risk of psychological vulnerability. Aggression prevention programs should be sure to include strategies to overcome psychological problems that characterize children manifesting high levels of aggressive behavior.

A case of pervasive refusal syndrome: a diagnostic conundrum.

LENUS (Irish Health Repository)

McNicholas, Fiona

2013-01-01

A case is presented of an 11-year-old girl with pervasive refusal syndrome (PRS) who ultimately recovered acutely and completely after an 18-month paediatric hospitalisation. There was an apparent absence of previously proposed important aetiological factors in PRS, such as family pathology and markedly traumatic or abusive experiences, and her recovery was sudden and complete. The authors consider the differential diagnoses of PRS paying particular attention to the possibility of a conversion disorder or catatonia, given the absence of PRS in the North American literature. Consideration of catatonia is important as it has a diagnostic test and responds rapidly to appropriate treatment, in contrast to conventional treatment for PRS and conversion disorder.

Disposal Site Information Management System

International Nuclear Information System (INIS)

Larson, R.A.; Jouse, C.A.; Esparza, V.

1986-01-01

An information management system for low-level waste shipped for disposal has been developed for the Nuclear Regulatory Commission (NRC). The Disposal Site Information Management System (DSIMS) was developed to provide a user friendly computerized system, accessible through NRC on a nationwide network, for persons needing information to facilitate management decisions. This system has been developed on NOMAD VP/CSS, and the data obtained from the operators of commercial disposal sites are transferred to DSIMS semiannually. Capabilities are provided in DSIMS to allow the user to select and sort data for use in analysis and reporting low-level waste. The system also provides means for describing sources and quantities of low-level waste exceeding the limits of NRC 10 CFR Part 61 Class C. Information contained in DSIMS is intended to aid in future waste projections and economic analysis for new disposal sites

Refuses and delays in the transportation by ship of radioactive material; Recusas e demoras no transporte maritimo de material radioativo

Energy Technology Data Exchange (ETDEWEB)

Xavier, Clarice; Sobreira, Ana Celia [REM Industria e Comercio Ltda., Sao Paulo, SP (Brazil)

2011-10-26

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

Adsorption of phenolic compound by aged-refuse

Energy Technology Data Exchange (ETDEWEB)

Chai Xiaoli [State Key Laboratory of Pollution Control and Resource Reuse, School of Enviromental Science and Engineering, Tongji University, Siping Road 1239, Shanghai 200092 (China)]. E-mail: xlchai@mail.tongji.edu.cn; Zhao Youcai [State Key Laboratory of Pollution Control and Resource Reuse, School of Enviromental Science and Engineering, Tongji University, Siping Road 1239, Shanghai 200092 (China)

2006-09-01

The adsorption of phenol, 2-chlorophenol, 4-chlorophenol and 2,4-dichlorophenol by aged-refuse has been studied. Adsorption isotherms have been determined for phenol, 2-chlorophenol, 4-chlorophenol and 2,4-dichlorophenol and the data fits well to the Freundlich equation. The chlorinated phenols are absorbed more strongly than the phenol and the adsorption capacity has an oblivious relationship with the numbers and the position of chlorine subsistent. The experiment data suggests that both the partition function and the chemical adsorption involve in the adsorption process. Pseudo-first-order and pseudo-second-order model were applied to investigate the kinetics of the adsorption and the results show that it fit the pseudo-second-order model. More than one step involves in the adsorption process and the overall rate of the adsorption process appears to be controlled by the chemical reaction. The thermodynamic analysis indicates that the adsorption is spontaneous and endothermic.

Adsorption of phenolic compound by aged-refuse

International Nuclear Information System (INIS)

Chai Xiaoli; Zhao Youcai

2006-01-01

The adsorption of phenol, 2-chlorophenol, 4-chlorophenol and 2,4-dichlorophenol by aged-refuse has been studied. Adsorption isotherms have been determined for phenol, 2-chlorophenol, 4-chlorophenol and 2,4-dichlorophenol and the data fits well to the Freundlich equation. The chlorinated phenols are absorbed more strongly than the phenol and the adsorption capacity has an oblivious relationship with the numbers and the position of chlorine subsistent. The experiment data suggests that both the partition function and the chemical adsorption involve in the adsorption process. Pseudo-first-order and pseudo-second-order model were applied to investigate the kinetics of the adsorption and the results show that it fit the pseudo-second-order model. More than one step involves in the adsorption process and the overall rate of the adsorption process appears to be controlled by the chemical reaction. The thermodynamic analysis indicates that the adsorption is spontaneous and endothermic

Nuclear waste disposal in space

Science.gov (United States)

Burns, R. E.; Causey, W. E.; Galloway, W. E.; Nelson, R. W.

1978-01-01

Work on nuclear waste disposal in space conducted by the George C. Marshall Space Flight Center, National Aeronautics and Space Administration, and contractors are reported. From the aggregate studies, it is concluded that space disposal of nuclear waste is technically feasible.

Tritium waste disposal technology in the US

International Nuclear Information System (INIS)

Albenesius, E.L.; Towler, O.A.

1983-01-01

Tritium waste disposal methods in the US range from disposal of low specific activity waste along with other low-level waste in shallow land burial facilities, to disposal of kilocurie amounts in specially designed triple containers in 65' deep augered holes located in an aird region of the US. Total estimated curies disposed of are 500,000 in commercial burial sites and 10 million curies in defense related sites. At three disposal sites in humid areas, tritium has migrated into the ground water, and at one arid site tritium vapor has been detected emerging from the soil above the disposal area. Leaching tests on tritium containing waste show that tritium in the form of HTO leaches readily from most waste forms, but that leaching rates of tritiated water into polymer impregnated concrete are reduced by as much as a factor of ten. Tests on improved tritium containment are ongoing. Disposal costs for tritium waste are 7 to 10 dollars per cubic foot for shallow land burial of low specific activity tritium waste, and 10 to 20 dollars per cubic foot for disposal of high specific activity waste. The cost of packaging the high specific activity waste is 150 to 300 dollars per cubic foot. 18 references

Radioactive waste (disposal)

International Nuclear Information System (INIS)

Jenkin, P.

1985-01-01

The disposal of low- and intermediate-level radioactive wastes was discussed. The following aspects were covered: public consultation on the principles for assessing disposal facilities; procedures for dealing with the possible sites which the Nuclear Industry Radioactive Waste Executive (NIREX) had originally identified; geological investigations to be carried out by NIREX to search for alternative sites; announcement that proposal for a site at Billingham is not to proceed further; NIREX membership; storage of radioactive wastes; public inquiries; social and environmental aspects; safety aspects; interest groups; public relations; government policies. (U.K.)

Geological disposal of radioactive waste. Safety requirements

International Nuclear Information System (INIS)

2006-01-01

This Safety Requirements publication is concerned with providing protection to people and the environment from the hazards associated with waste management activities related to disposal, i.e. hazards that could arise during the operating period and following closure. It sets out the protection objectives and criteria for geological disposal and establishes the requirements that must be met to ensure the safety of this disposal option, consistent with the established principles of safety for radioactive waste management. It is intended for use by those involved in radioactive waste management and in making decisions in relation to the development, operation and closure of geological disposal facilities, especially those concerned with the related regulatory aspects. This publication contains 1. Introduction; 2. Protection of human health and the environment; 3. The safety requirements for geological disposal; 4. Requirements for the development, operation and closure of geological disposal facilities; Appendix: Assurance of compliance with the safety objective and criteria; Annex I: Geological disposal and the principles of radioactive waste management; Annex II: Principles of radioactive waste management

Alternatives for definse waste-salt disposal

International Nuclear Information System (INIS)

Benjamin, R.W.; McDonell, W.R.

1983-01-01

Alternatives for disposal of decontaminated high-level waste salt at Savannah River were reviewed to estimate costs and potential environmental impact for several processes. In this review, the reference process utilizing intermediate-depth burial of salt-concrete (saltcrete) monoliths was compared with alternatives including land application of the decontaminated salt as fertilizer for SRP pine stands, ocean disposal with and without containment, and terminal storage as saltcake in existing SRP waste tanks. Discounted total costs for the reference process and its modifications were in the same range as those for most of the alternative processes; uncontained ocean disposal with truck transport to Savannah River barges and storage as saltcake in SRP tanks had lower costs, but presented other difficulties. Environmental impacts could generally be maintained within acceptable limits for all processes except retention of saltcake in waste tanks, which could result in chemical contamination of surrounding areas on tank collapse. Land application would require additional salt decontamination to meet radioactive waste disposal standards, and ocean disposal without containment is not permitted in existing US practice. The reference process was judged to be the only salt disposal option studied which would meet all current requirements at an acceptable cost

Geological disposal concept hearings

International Nuclear Information System (INIS)

1996-01-01

The article outlines the progress to date on AECL spent-nuclear fuel geological disposal concept. Hearings for discussion, organised by the federal Environmental Assessment Review Panel, of issues related to this type of disposal method occur in three phases, phase I focuses on broad societal issues related to long term management of nuclear fuel waste; phase II will focus on the technical aspects of this method of disposal; and phase III will consist of community visits in New Brunswick, Quebec, Ontario, Manitoba and Saskatchewan. This article provides the events surrounding the first two weeks of phase I hearings (extracted from UNECAN NEWS). In the first week of hearings, where submissions on general societal issues was the focus, there were 50 presentations including those by Natural Resources Canada, Energy Probe, Ontario Hydro, AECL, Canadian Nuclear Society, Aboriginal groups, environmental activist organizations (Northwatch, Saskatchewan Environmental Society, the Inter-Church Uranium Committee, and the Canadian Coalition for Nuclear responsibility). In the second week of hearings there was 33 presentations in which issues related to siting and implementation of a disposal facility was the focus. Phase II hearings dates are June 10-14, 17-21 and 27-28 in Toronto

Waste management, final waste disposal, fuel cycle

International Nuclear Information System (INIS)

Rengeling, H.W.

1991-01-01

Out of the legal poblems that are currently at issue, individual questions from four areas are dealt with: privatization of ultimate waste disposal; distribution of responsibilities for tasks in the field of waste disposal; harmonization and systematization of regulations; waste disposal - principles for making provisions for waste disposal - proof of having made provisions for waste disposal; financing and fees. A distinction has to be made between that which is legally and in particular constitutionally imperative or, as the case may be, permissible, and issues where there is room for political decision-making. Ultimately, the deliberations on the amendment are completely confined to the sphere of politics. (orig./HSCH) [de

Assessing the Risk of Prehospital Administration of Naloxone with Subsequent Refusal of Care.

Science.gov (United States)

Levine, Michael; Sanko, Stephen; Eckstein, Marc

2016-01-01

EMS providers frequently encounter opioid-toxic patients who receive naloxone and then refuse further medical care. Older studies revealed this practice to be safe. In light of the evolving patterns of opioid abuse, this study attempted to determine the safety of this practice. This is a retrospective review of all patient encounters by the Los Angeles Fire Department (LAFD) between July 1, 2011-December 31, 2013. All LAFD patient encounters are stored electronically. These electronic records were reviewed for subjects who received naloxone had a documented respiratory rate (RR) less than 12, and subsequently refused transport. Data abstracted included name, social security number (SSN), date of birth (DOB), date of EMS encounter, age, and treatment rendered. The names, SSN, and DOB, as available, were supplied to the coroner's office. The Coroner's records were reviewed to determine if a patient with the same or similar name (e.g., Jon vs. Jonathan) had died within 24 hours, 30 days, or 6 months of the initial EMS encounter. The abstractor was blinded to the study hypothesis. 205 subjects were identified; the median (IQR) age was 41 (29-53) years. 27 (13%) were female. One subject (0.49%) died within 24 hours of the initial EMS encounter. The cause of death (COD) was coronary artery disease and heroin use. Two additional subjects (1. %) died within 30 days. One of these subjects died 6 days later; the COD is unknown. The other subject died 20 days after the EMS encounter; the COD was cardiovascular disease and liver cirrhosis. No additional subjects were identified at the 6 month follow up. A third subject died of a heroin overdose 16 months after the initial EMS encounter, but was beyond the pre-defined follow up period. The practice of receiving pre-hospital naloxone by paramedics and subsequently refusing care is associated with an extremely low short- and intermediate-term mortality. Despite an evolving pattern of opioid abuse, the results of this study

Disposable products in the hospital waste stream.

OpenAIRE

Gilden, D. J.; Scissors, K. N.; Reuler, J. B.

1992-01-01

Use of disposable products in hospitals continues to increase despite limited landfill space and dwindling natural resources. We analyzed the use and disposal patterns of disposable hospital products to identify means of reducing noninfectious, nonhazardous hospital waste. In a 385-bed private teaching hospital, the 20 disposable products of which the greatest amounts (by weight) were purchased, were identified, and total hospital waste was tabulated. Samples of trash from three areas were so...

Shallow land disposal of radioactive waste

International Nuclear Information System (INIS)

1987-01-01

The application of basic radiation protection concepts and objectives to the disposal of radioactive wastes requires the development of specific reference levels or criteria for the radiological acceptance of each type of waste in each disposal option. This report suggests a methodology for the establishment of acceptance criteria for the disposal of low-level radioactive waste containing long-lived radionuclides in shallow land burial facilities

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

Chemical Waste Management and Disposal.

Science.gov (United States)

Armour, Margaret-Ann

1988-01-01

Describes simple, efficient techniques for treating hazardous chemicals so that nontoxic and nonhazardous residues are formed. Discusses general rules for management of waste chemicals from school laboratories and general techniques for the disposal of waste or surplus chemicals. Lists specific disposal reactions. (CW)

50 CFR 12.33 - Disposal.

Science.gov (United States)

2010-10-01

... other equipment), except wildlife or plants, in accordance with current Federal Property Management..., TRANSPORTATION, SALE, PURCHASE, BARTER, EXPORTATION, AND IMPORTATION OF WILDLIFE AND PLANTS SEIZURE AND FORFEITURE PROCEDURES Disposal of Forfeited or Abandoned Property § 12.33 Disposal. (a) The Director shall...

Attitudes of prehospital emergency care professionals toward refusal of treatment: A regional survey in Turkey.

Science.gov (United States)

Erbay, Hasan; Alan, Sultan; Kadioglu, Selim

2014-08-01

Prehospital emergency medicine is a specific field of emergency medicine. The basic approach of prehospital emergency medicine is to provide patients with medical intervention at the scene of the incident. This special environment causes health professionals to encounter various problems. One of the most important problems in this field is ethics, in particular questions involving refusal of treatment and the processes associated with it. The objective of this study is to identify emergency health professionals' views regarding refusal of treatment. This study was conducted with 356 health professionals who were on active duty in prehospital emergency health services. The data were collected through a form which included 10 statements. The participants were asked to indicate their level of agreement with the statements given by rating them between 0 and 10. Before conducting the research, permission was received from the local ethics committee. Participants were given written information about the purpose of the study. Participants were assured that their participation was voluntary. The healthcare professionals with fewer years of experience in the profession and female participants adopted an attitude of giving priority to providing care. Young participants, in general, respected patient autonomy. However, paradoxically, when it comes to emergency medical cases, they expressed an opinion closer to paternalism. This study has found that prehospital emergency health professionals generally respect the patient's right to refuse treatment; however, they do not prioritize this right when there is a life-threatening situation or when the person does not have decision-making capacity. In these cases, prehospital emergency health professionals tended to adopt a more paternalistic approach. © The Author(s) 2013.

Development of technical information database for high level waste disposal

International Nuclear Information System (INIS)

Kudo, Koji; Takada, Susumu; Kawanishi, Motoi

2005-01-01

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