WorldWideScience

Sample records for reported barriers included

  1. Article Including Environmental Barrier Coating System

    Science.gov (United States)

    Lee, Kang N. (Inventor)

    2015-01-01

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

  2. Barriers to medication error reporting among hospital nurses.

    Science.gov (United States)

    Rutledge, Dana N; Retrosi, Tina; Ostrowski, Gary

    2018-03-01

    The study purpose was to report medication error reporting barriers among hospital nurses, and to determine validity and reliability of an existing medication error reporting barriers questionnaire. Hospital medication errors typically occur between ordering of a medication to its receipt by the patient with subsequent staff monitoring. To decrease medication errors, factors surrounding medication errors must be understood; this requires reporting by employees. Under-reporting can compromise patient safety by disabling improvement efforts. This 2017 descriptive study was part of a larger workforce engagement study at a faith-based Magnet ® -accredited community hospital in California (United States). Registered nurses (~1,000) were invited to participate in the online survey via email. Reported here are sample demographics (n = 357) and responses to the 20-item medication error reporting barriers questionnaire. Using factor analysis, four factors that accounted for 67.5% of the variance were extracted. These factors (subscales) were labelled Fear, Cultural Barriers, Lack of Knowledge/Feedback and Practical/Utility Barriers; each demonstrated excellent internal consistency. The medication error reporting barriers questionnaire, originally developed in long-term care, demonstrated good validity and excellent reliability among hospital nurses. Substantial proportions of American hospital nurses (11%-48%) considered specific factors as likely reporting barriers. Average scores on most barrier items were categorised "somewhat unlikely." The highest six included two barriers concerning the time-consuming nature of medication error reporting and four related to nurses' fear of repercussions. Hospitals need to determine the presence of perceived barriers among nurses using questionnaires such as the medication error reporting barriers and work to encourage better reporting. Barriers to medication error reporting make it less likely that nurses will report medication

  3. Electrochemical cell structure including an ionomeric barrier

    Science.gov (United States)

    Lambert, Timothy N.; Hibbs, Michael

    2017-06-20

    An apparatus includes an electrochemical half-cell comprising: an electrolyte, an anode; and an ionomeric barrier positioned between the electrolyte and the anode. The anode may comprise a multi-electron vanadium phosphorous alloy, such as VP.sub.x, wherein x is 1-5. The electrochemical half-cell is configured to oxidize the vanadium and phosphorous alloy to release electrons. A method of mitigating corrosion in an electrochemical cell includes disposing an ionomeric barrier in a path of electrolyte or ion flow to an anode and mitigating anion accumulation on the surface of the anode.

  4. Subsurface barrier verification technologies, informal report

    International Nuclear Information System (INIS)

    Heiser, J.H.

    1994-06-01

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

  5. Hanford prototype-barrier status report FY 1996

    Energy Technology Data Exchange (ETDEWEB)

    Gee, G.W.; Ward, A.L.; Gilmore, B.G.; Link, S.O.; Dennis, G.W.; O`Neil, T.K.

    1996-11-01

    A prototype surface barrier is being evaluated as part of a treatability study at the 200-BP-1 Operable Unit in the 200 East Area of the Hanford Site. Tests include the application of irrigation water to the northern half of the barrier and subsequent measurement of water balance, wind and water erosion, subsidence, plant establishment,a nd plant and animal intrusion. The tests are designed to evaluate both irrigated and nonirrigated sideslope and vegetated surfaces over a period of 3 years. This report documents findings from the second year of testing.

  6. Hanford prototype-barrier status report FY 1996

    International Nuclear Information System (INIS)

    Gee, G.W.; Ward, A.L.; Gilmore, B.G.; Link, S.O.; Dennis, G.W.; O'Neil, T.K.

    1996-11-01

    A prototype surface barrier is being evaluated as part of a treatability study at the 200-BP-1 Operable Unit in the 200 East Area of the Hanford Site. Tests include the application of irrigation water to the northern half of the barrier and subsequent measurement of water balance, wind and water erosion, subsidence, plant establishment,a nd plant and animal intrusion. The tests are designed to evaluate both irrigated and nonirrigated sideslope and vegetated surfaces over a period of 3 years. This report documents findings from the second year of testing

  7. Barriers to Industrial Energy Efficiency - Report to Congress, June 2015

    Energy Technology Data Exchange (ETDEWEB)

    None

    2015-06-01

    This report examines barriers that impede the adoption of energy efficient technologies and practices in the industrial sector, and identifies successful examples and opportunities to overcome these barriers. Three groups of energy efficiency technologies and measures were examined: industrial end-use energy efficiency, industrial demand response, and industrial combined heat and power. This report also includes the estimated economic benefits from hypothetical Federal energy efficiency matching grants, as directed by the Act.

  8. Hanford prototype-barrier status report: FY 1997

    International Nuclear Information System (INIS)

    Ward, A.L.; Gee, G.W.; Link, S.O.

    1997-12-01

    An above-grade surface barrier consisting of a vegetated soil-cover, surrounded by gravel and rock side slopes, is being tested for the US Department of Energy (DOE). It is part of a treatability study at the 200-BP-1 Operable Unit in the 200 East Area of the Hanford Site, near Richland, Washington. The surface barrier, constructed in 1994, covers 2.5 ha (6.9 acre) of land surface and is situated over an inactive liquid-waste disposal crib. A set of under drains, built into the barrier using curbed asphalt, allows precise measurement of drainage from the soil cover and the side slopes. The treatability test includes measurements of water balance, wind and water erosion, subsidence, plant growth, and plant and animal intrusion. The test compares the performance of the barrier under ambient and simulated climate change (elevated precipitation) conditions. This report documents findings from the third year of testing

  9. Barriers to reporting medication errors and near misses among nurses: A systematic review.

    Science.gov (United States)

    Vrbnjak, Dominika; Denieffe, Suzanne; O'Gorman, Claire; Pajnkihar, Majda

    2016-11-01

    To explore barriers to nurses' reporting of medication errors and near misses in hospital settings. Systematic review. Medline, CINAHL, PubMed and Cochrane Library in addition to Google and Google Scholar and reference lists of relevant studies published in English between January 1981 and April 2015 were searched for relevant qualitative, quantitative or mixed methods empirical studies or unpublished PhD theses. Papers with a primary focus on barriers to reporting medication errors and near misses in nursing were included. The titles and abstracts of the search results were assessed for eligibility and relevance by one of the authors. After retrieval of the full texts, two of the authors independently made decisions concerning the final inclusion and these were validated by the third reviewer. Three authors independently assessed methodological quality of studies. Relevant data were extracted and findings were synthesised using thematic synthesis. From 4038 identified records, 38 studies were included in the synthesis. Findings suggest that organizational barriers such as culture, the reporting system and management behaviour in addition to personal and professional barriers such as fear, accountability and characteristics of nurses are barriers to reporting medication errors. To overcome reported barriers it is necessary to develop a non-blaming, non-punitive and non-fearful learning culture at unit and organizational level. Anonymous, effective, uncomplicated and efficient reporting systems and supportive management behaviour that provides open feedback to nurses is needed. Nurses are accountable for patients' safety, so they need to be educated and skilled in error management. Lack of research into barriers to reporting of near misses' and low awareness of reporting suggests the need for further research and development of educational and management approaches to overcome these barriers. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Patient-Reported Barriers to Adherence to Antiretroviral Therapy: A Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Zara Shubber

    2016-11-01

    Full Text Available Maintaining high levels of adherence to antiretroviral therapy (ART is a challenge across settings and populations. Understanding the relative importance of different barriers to adherence will help inform the targeting of different interventions and future research priorities.We searched MEDLINE via PubMed, Embase, Web of Science, and PsychINFO from 01 January 1997 to 31 March 2016 for studies reporting barriers to adherence to ART. We calculated pooled proportions of reported barriers to adherence per age group (adults, adolescents, and children. We included data from 125 studies that provided information about adherence barriers for 17,061 adults, 1,099 children, and 856 adolescents. We assessed differences according to geographical location and level of economic development. The most frequently reported individual barriers included forgetting (adults 41.4%, 95% CI 37.3%-45.4%; adolescents 63.1%, 95% CI 46.3%-80.0%; children/caregivers 29.2%, 95% CI 20.1%-38.4%, being away from home (adults 30.4%, 95% CI 25.5%-35.2%; adolescents 40.7%, 95% CI 25.7%-55.6%; children/caregivers 18.5%, 95% CI 10.3%-26.8%, and a change to daily routine (adults 28.0%, 95% CI 20.9%-35.0%; adolescents 32.4%, 95% CI 0%-75.0%; children/caregivers 26.3%, 95% CI 15.3%-37.4%. Depression was reported as a barrier to adherence by more than 15% of patients across all age categories (adults 15.5%, 95% CI 12.8%-18.3%; adolescents 25.7%, 95% CI 17.7%-33.6%; children 15.1%, 95% CI 3.9%-26.3%, while alcohol/substance misuse was commonly reported by adults (12.9%, 95% CI 9.7%-16.1% and adolescents (28.8%, 95% CI 11.8%-45.8%. Secrecy/stigma was a commonly cited barrier to adherence, reported by more than 10% of adults and children across all regions (adults 13.6%, 95% CI 11.9%-15.3%; children/caregivers 22.3%, 95% CI 10.2%-34.5%. Among adults, feeling sick (15.9%, 95% CI 13.0%-18.8% was a more commonly cited barrier to adherence than feeling well (9.3%, 95% CI 7.2%-11.4%. Health

  11. Attitudes and perceived barriers influencing incident reporting by nurses and their correlation with reported incidents: A systematic review.

    Science.gov (United States)

    Fung, Wing Mei; Koh, Serena Siew Lin; Chow, Yeow Leng

    Clinical incident reporting is an integral feature of risk management system in the healthcare sector. By reporting clinical incidents, nurses allow for learning from errors, identification of error patterns and development of error preventive strategies. The need to understand attitudes to reporting, perceived barriers and incident reporting patterns by nurses are the core highlights of this review. INCLUSION CRITERIA: This review considered descriptive quantitative studies that examined nurses' attitudes or perceived barriers towards incident reporting.The participants in this review were nurses working in acute care settings or step-down care settings. Studies that included non-nursing healthcare personnel were excluded.This review considered studies which examined nurses' attitudes towards incident reporting, perceived barriers and incident reporting practices.The outcomes of interest were the attitudes that nurses have towards incident reporting, perceived barriers and the types of reported incidents in correlation with nurses' attitudes and barriers. A three-step search strategy was utilised in this review. An initial limited search of CINAHL and MEDLINE was undertaken. Search strategies were then developed using identified keywords and index terms. Lastly, the reference lists of all identified articles were examined. All searches were limited to studies published in English, between 1991 and 2010. The studies were independently assessed by two reviewers using the Joanna Briggs Institute Critical Appraisal Checklist for Descriptive/ Case Series studies. The reviewers extracted data independently from included studies using the Joanna Briggs Institute Data Extraction Form for Descriptive/ Case Series studies. Due to the descriptive nature of the study designs, statistical pooling was not possible. Therefore, the findings of this systematic review are presented in a narrative summary. Fifty-five papers were identified from the searches based on their titles and

  12. Patient-Reported Barriers to the Prekidney Transplant Evaluation in an At-Risk Population in the United States.

    Science.gov (United States)

    Lockwood, Mark B; Saunders, Milda R; Nass, Rachel; McGivern, Claire L; Cunningham, Patrick N; Chon, W James; Josephson, Michelle A; Becker, Yolanda T; Lee, Christopher S

    2017-06-01

    Despite our knowledge of barriers to the early stages of the transplant process, we have limited insight into patient-reported barriers to the prekidney transplant medical evaluation in populations largely at-risk for evaluation failure. One-hundred consecutive adults were enrolled at an urban, Midwestern transplant center. Demographic, clinical, and quality of life data were collected prior to patients visit with a transplant surgeon/nephrologist (evaluation begins). Patient-reported barriers to evaluation completion were collected using the Subjective Barriers Questionnaire 90-days after the initial medical evaluation appointment (evaluation ends), our center targeted goal for transplant work-up completion. At 90 days, 40% of participants had not completed the transplant evaluation. Five barrier categories were created from the 85 responses to the Subjective Barriers Questionnaire. Patient-reported barriers included poor communication, physical health, socioeconomics, psychosocial influences, and access to care. In addition, determinants for successful evaluation completion included being of white race, higher income, free of dialysis, a lower comorbid burden, and reporting higher scores on the Kidney Disease Quality of Life subscale role-emotional. Poor communication between patients and providers, and among providers, was the most prominent patient-reported barrier identified. Barriers were more prominent in marginalized groups such as ethnic minorities and people with low income. Understanding the prevalence of patient-reported barriers may aid in the development of patient-centered interventions to improve completion rates.

  13. Self-reported adverse effects as barriers to adherence to ...

    African Journals Online (AJOL)

    Conclusions: In conclusion, self-reported barriers to optimal adherence included the use of non-prescribed drugs, and the presence of side effects such as insomnia, headaches and abdominal pain; while eating well was a facilitator. These findings emphasise the need for better communication between patients and ...

  14. Barriers to Safety Event Reporting in an Academic Radiology Department: Authority Gradients and Other Human Factors.

    Science.gov (United States)

    Siewert, Bettina; Swedeen, Suzanne; Brook, Olga R; Eisenberg, Ronald L; Hochman, Mary

    2018-05-15

    Purpose To investigate barriers to reporting safety concerns in an academic radiology department and to evaluate the role of human factors, including authority gradients, as potential barriers to safety concern reporting. Materials and Methods In this institutional review board-approved, HIPAA-compliant retrospective study, an online questionnaire link was emailed four times to all radiology department staff members (n = 648) at a tertiary care institution. Survey questions included frequency of speaking up about safety concerns, perceived barriers to speaking up, and the annual number of safety concerns that respondents were unsuccessful in reporting. Respondents' sex, role in the department, and length of employment were recorded. Statistical analysis was performed with the Fisher exact test. Results The survey was completed by 363 of the 648 employees (56%). Of those 363 employees, 182 (50%) reported always speaking up about safety concerns, 134 (37%) reported speaking up most of the time, 36 (10%) reported speaking up sometimes, seven (2%) reported rarely speaking up, and four (1%) reported never speaking up. Thus, 50% of employees spoke up about safety concerns less than 100% of the time. The most frequently reported barriers to speaking up included high reporting threshold (69%), reluctance to challenge someone in authority (67%), fear of disrespect (53%), and lack of listening (52%). Conclusion Of employees in a large academic radiology department, 50% do not attain 100% reporting of safety events. The most common human barriers to speaking up are high reporting threshold, reluctance to challenge authority, fear of disrespect, and lack of listening, which suggests that existing authority gradients interfere with full reporting of safety concerns. © RSNA, 2018.

  15. Barriers to Medical Error Reporting for Physicians and Nurses.

    Science.gov (United States)

    Soydemir, Dilek; Seren Intepeler, Seyda; Mert, Hatice

    2017-10-01

    The purpose of the study was to determine what barriers to error reporting exist for physicians and nurses. The study, of descriptive qualitative design, was conducted with physicians and nurses working at a training and research hospital. In-depth interviews were held with eight physicians and 15 nurses, a total of 23 participants. Physicians and nurses do not choose to report medical errors that they experience or witness. When barriers to error reporting were examined, it was seen that there were four main themes involved: fear, the attitude of administration, barriers related to the system, and the employees' perceptions of error. It is important in terms of preventing medical errors to identify the barriers that keep physicians and nurses from reporting errors.

  16. Self-reported barriers to medication adherence among chronically ill adolescents

    DEFF Research Database (Denmark)

    Hanghøj, Signe; Boisen, Kirsten A

    2014-01-01

    's views. Data was analyzed using a thematic synthesis approach. RESULTS: Of 3,655 records 28 articles with both quantitative, qualitative, and q-methodology study designs were included in the review. The synthesis led to the following key themes: Relations, adolescent development, health and illness......, forgetfulness, organization, medicine complexity, and financial costs. Most reported barriers to adherence were not unique to specific diseases. CONCLUSION: Some barriers seem to be specific to adolescence; for example, relations to parents and peers and adolescent development. Knowledge and assessment...

  17. Flexible barrier film, method of forming same, and organic electronic device including same

    Science.gov (United States)

    Blizzard, John; Tonge, James Steven; Weidner, William Kenneth

    2013-03-26

    A flexible barrier film has a thickness of from greater than zero to less than 5,000 nanometers and a water vapor transmission rate of no more than 1.times.10.sup.-2 g/m.sup.2/day at 22.degree. C. and 47% relative humidity. The flexible barrier film is formed from a composition, which comprises a multi-functional acrylate. The composition further comprises the reaction product of an alkoxy-functional organometallic compound and an alkoxy-functional organosilicon compound. A method of forming the flexible barrier film includes the steps of disposing the composition on a substrate and curing the composition to form the flexible barrier film. The flexible barrier film may be utilized in organic electronic devices.

  18. Engineered Barrier System Degradation, Flow, and Transport Process Model Report

    Energy Technology Data Exchange (ETDEWEB)

    E.L. Hardin

    2000-07-17

    The Engineered Barrier System Degradation, Flow, and Transport Process Model Report (EBS PMR) is one of nine PMRs supporting the Total System Performance Assessment (TSPA) being developed by the Yucca Mountain Project for the Site Recommendation Report (SRR). The EBS PMR summarizes the development and abstraction of models for processes that govern the evolution of conditions within the emplacement drifts of a potential high-level nuclear waste repository at Yucca Mountain, Nye County, Nevada. Details of these individual models are documented in 23 supporting Analysis/Model Reports (AMRs). Nineteen of these AMRs are for process models, and the remaining 4 describe the abstraction of results for application in TSPA. The process models themselves cluster around four major topics: ''Water Distribution and Removal Model, Physical and Chemical Environment Model, Radionuclide Transport Model, and Multiscale Thermohydrologic Model''. One AMR (Engineered Barrier System-Features, Events, and Processes/Degradation Modes Analysis) summarizes the formal screening analysis used to select the Features, Events, and Processes (FEPs) included in TSPA and those excluded from further consideration. Performance of a potential Yucca Mountain high-level radioactive waste repository depends on both the natural barrier system (NBS) and the engineered barrier system (EBS) and on their interactions. Although the waste packages are generally considered as components of the EBS, the EBS as defined in the EBS PMR includes all engineered components outside the waste packages. The principal function of the EBS is to complement the geologic system in limiting the amount of water contacting nuclear waste. A number of alternatives were considered by the Project for different EBS designs that could provide better performance than the design analyzed for the Viability Assessment. The design concept selected was Enhanced Design Alternative II (EDA II).

  19. Engineered Barrier System Degradation, Flow, and Transport Process Model Report

    International Nuclear Information System (INIS)

    E.L. Hardin

    2000-01-01

    The Engineered Barrier System Degradation, Flow, and Transport Process Model Report (EBS PMR) is one of nine PMRs supporting the Total System Performance Assessment (TSPA) being developed by the Yucca Mountain Project for the Site Recommendation Report (SRR). The EBS PMR summarizes the development and abstraction of models for processes that govern the evolution of conditions within the emplacement drifts of a potential high-level nuclear waste repository at Yucca Mountain, Nye County, Nevada. Details of these individual models are documented in 23 supporting Analysis/Model Reports (AMRs). Nineteen of these AMRs are for process models, and the remaining 4 describe the abstraction of results for application in TSPA. The process models themselves cluster around four major topics: ''Water Distribution and Removal Model, Physical and Chemical Environment Model, Radionuclide Transport Model, and Multiscale Thermohydrologic Model''. One AMR (Engineered Barrier System-Features, Events, and Processes/Degradation Modes Analysis) summarizes the formal screening analysis used to select the Features, Events, and Processes (FEPs) included in TSPA and those excluded from further consideration. Performance of a potential Yucca Mountain high-level radioactive waste repository depends on both the natural barrier system (NBS) and the engineered barrier system (EBS) and on their interactions. Although the waste packages are generally considered as components of the EBS, the EBS as defined in the EBS PMR includes all engineered components outside the waste packages. The principal function of the EBS is to complement the geologic system in limiting the amount of water contacting nuclear waste. A number of alternatives were considered by the Project for different EBS designs that could provide better performance than the design analyzed for the Viability Assessment. The design concept selected was Enhanced Design Alternative II (EDA II)

  20. Barriers to medical error reporting

    Directory of Open Access Journals (Sweden)

    Jalal Poorolajal

    2015-01-01

    Full Text Available Background: This study was conducted to explore the prevalence of medical error underreporting and associated barriers. Methods: This cross-sectional study was performed from September to December 2012. Five hospitals, affiliated with Hamadan University of Medical Sciences, in Hamedan,Iran were investigated. A self-administered questionnaire was used for data collection. Participants consisted of physicians, nurses, midwives, residents, interns, and staffs of radiology and laboratory departments. Results: Overall, 50.26% of subjects had committed but not reported medical errors. The main reasons mentioned for underreporting were lack of effective medical error reporting system (60.0%, lack of proper reporting form (51.8%, lack of peer supporting a person who has committed an error (56.0%, and lack of personal attention to the importance of medical errors (62.9%. The rate of committing medical errors was higher in men (71.4%, age of 50-40 years (67.6%, less-experienced personnel (58.7%, educational level of MSc (87.5%, and staff of radiology department (88.9%. Conclusions: This study outlined the main barriers to reporting medical errors and associated factors that may be helpful for healthcare organizations in improving medical error reporting as an essential component for patient safety enhancement.

  1. Engineered Barrier Test Facility status report, 1984

    International Nuclear Information System (INIS)

    Phillips, S.J.; Adams, M.R.; Gilbert, T.W.; Meinhardt, C.C.; Mitchell, R.M.; Waugh, W.J.

    1985-02-01

    This report provides a general summary of activities completed to date at the Hanford Engineered Barrier Test Facility. This facility is used to test and compare construction practices and performance of alternative designs of engineered barrier cover systems. These cover systems are being evaluated for potential use for isolation and confinement of buried waste disposal structures

  2. Patients' reports of barriers to expressing concerns during cancer consultations.

    Science.gov (United States)

    Brandes, Kim; Linn, Annemiek J; Smit, Edith G; van Weert, Julia C M

    2015-03-01

    To identify cancer patients' most influential barriers to expressing concerns during cancer consultations in a new manner by examining patients' reports of perceived barriers and perceived occurrence of barriers in consultations. Two online focus groups (N=16) and an online survey (N=236) were conducted among cancer patients and cancer survivors. The online focus groups and survey were used to examine two elements of patients' barriers, i.e., patients' reports of perceived barriers and perceived occurrence of barriers in consultations. Composite scores of these two elements were calculated to determine influential barriers. Results showed that the most influential barriers were related to providers' behavior (e.g., providers do not explicitly invite patients to express concerns) and the environment where the consultation takes place (e.g., perceived lack of time). The results of this study indicate that influential barriers to expressing concerns are barriers that patients cannot overcome themselves (i.e., they are related to providers' behavior or the environment of the consultation). A collaborative approach between researchers, providers and policy makers is needed to overcome these barriers. The results of this study can be used to develop strategies to overcome barriers to patients expressing concerns. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  3. Self-reported financial barriers to care among patients with cardiovascular-related chronic conditions.

    Science.gov (United States)

    Campbell, David J T; King-Shier, Kathryn; Hemmelgarn, Brenda R; Sanmartin, Claudia; Ronksley, Paul E; Weaver, Robert G; Tonelli, Marcello; Hennessy, Deirdre; Manns, Braden J

    2014-05-01

    People with chronic conditions who do not achieve therapeutic targets have a higher risk of adverse health outcomes. Failure to meet these targets may be due to a variety of barriers. This article examines self-reported financial barriers to health care among people with cardiovascular-related chronic conditions. A population-based survey was administered to western Canadians with cardiovascular-related chronic conditions (n = 1,849). Associations between self-reported financial barriers and statin use, the likelihood of stopping use of prescribed medications, and emergency department visits or hospitalizations were assessed. More than 10% respondents reported general financial barriers (12%) and lack of drug insurance (14%); 4% reported financial barriers to accessing medications. Emergency department visits or hospitalizations were 70% more likely among those reporting a general financial barrier. Those reporting a financial barrier to medications were 50% less likely to take statins and three times more likely to stop using prescribed medications. Individuals without drug insurance were nearly 30% less likely to take statins. In this population, self-reported financial barriers were associated with lower medication use and increased likelihood of emergency department visits or hospitalization.

  4. Low-income children's reported motivators of and barriers to healthy eating behaviors: a focus group study.

    Science.gov (United States)

    Kaye, Lillian B; Tucker, Carolyn M; Bragg, Marie A; Estampador, Angela C

    2011-01-01

    Despite national attention to the childhood obesity epidemic, there are few US-based studies that directly ask children--especially children from low-income families and from multiple racial/ethnic groups--why they do or do not engage in healthy eating behaviors. The purpose of this study was to identify motivators of and barriers to healthy eating behaviors, as reported by black, Hispanic, and white children from low-income families. Six gender- and race/ethnicity-concordant focus groups were conducted with 37 children who were aged 9 to 12 years and from families with an annual household income of $40000 or less. Multiple strategies were used to employ a culturally sensitive approach to both data collection and data analysis (eg, a team of culturally diverse researchers utilized inductive qualitative analysis to analyze focus group transcripts). The motivators of and barriers to healthy eating behaviors most commonly reported across the 6 focus groups included social influence, taste, issues of availability, weight concerns, and the desire to be healthy. A variety of less commonly reported motivators and barriers were also discussed. Findings were generally similar across gender and race/ethnicity. Children in this age range can indeed identify a variety of motivators and barriers that influence their engagement in healthy eating behaviors. Interventions targeting obesity and eating behaviors should include an assessment of children's own perceived motivators of and barriers to healthy eating.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2000-12-01

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

  6. Self-reported physical activity in patients on chronic hemodialysis: correlates and barriers.

    Science.gov (United States)

    Bossola, Maurizio; Pellu, Valentina; Di Stasio, Enrico; Tazza, Luigi; Giungi, Stefania; Nebiolo, Pier Eugenio

    2014-01-01

    The knowledge of the barriers that are associated with decreased physical activity (PA) in patients on chronic hemodialysis (PCH) may be of primary importance for the nephrologists. Thus, we aimed to assess the barriers associated with the absent or reduced PA in PCH of a Mediterranean country. Patients were invited to answer the question 'How often do you exercise during your leisure time?'. Also, patients included in the study were asked to answer questions regarding barriers to physical activity lower than desired. We studied 105 patients. Forty (38.1%) patients reported to never exercise, 6 (5.7%) reported to exercise less than once/week, 4 (3.8%) once/week, 23 (21.9%) two to three times/week, 12 (11.4%) four to five times/week and 20 (19%) daily. Overall, 46 (43.8%) patients never exercised or exercised less than once/week ('inactive') and 59 (56.2%) did exercise more often ('active'). At the multivariate analysis, reduced walking ability, fatigue on the non-dialysis days, and shortness of breath were independently and negatively associated with PA. The same results were found when the reduced model of the multivariate logistic backward regression was built introducing in the model also clinical and laboratory variables. In PCH, fatigue on the non-dialysis days, reduced walking ability, and shortness of breath are barriers independently associated to decreased PA. Knowledge about the causes and mechanisms that generate these barriers has to be acquired. © 2014 S. Karger AG, Basel.

  7. 105 K East isolation barrier acceptance analysis report

    International Nuclear Information System (INIS)

    McCracken, K.J.; Irwin, J.J.

    1995-01-01

    The objective of this document is to report and interpret the findings of the isolation barrier acceptance tests performed in 105KE/100K. The tests were performed in accordance with the test plan (McCracken 1995c) and acceptance test procedure (McCracken 1995a). The test report (McCracken 1995b) contains the test data. This document compares the test data (McCracken 1995b) against the criteria (McCracken 1995a, c). A discussion of the leak rate analytical characterization (Irwin 1995) describes how the flow characteristics and the flow rate will be determined using the test data from the test report (McCracken 1995b). The barriers must adequately control the leakage from the main basin to the discharge chute to less than the 1,500 gph (5,680 lph) Safety Analysis Report (SAR 1994) limit

  8. Adherence to HAART: a systematic review of developed and developing nation patient-reported barriers and facilitators.

    Directory of Open Access Journals (Sweden)

    Edward J Mills

    2006-11-01

    Full Text Available Adherence to highly active antiretroviral therapy (HAART medication is the greatest patient-enabled predictor of treatment success and mortality for those who have access to drugs. We systematically reviewed the literature to determine patient-reported barriers and facilitators to adhering to antiretroviral therapy.We examined both developed and developing nations. We searched the following databases: AMED (inception to June 2005, Campbell Collaboration (inception to June 2005, CinAhl (inception to June 2005, Cochrane Library (inception to June 2005, Embase (inception to June 2005, ERIC (inception to June 2005, MedLine (inception to June 2005, and NHS EED (inception to June 2005. We retrieved studies conducted in both developed and developing nation settings that examined barriers and facilitators addressing adherence. Both qualitative and quantitative studies were included. We independently, in duplicate, extracted data reported in qualitative studies addressing adherence. We then examined all quantitative studies addressing barriers and facilitators noted from the qualitative studies. In order to place the findings of the qualitative studies in a generalizable context, we meta-analyzed the surveys to determine a best estimate of the overall prevalence of issues. We included 37 qualitative studies and 47 studies using a quantitative methodology (surveys. Seventy-two studies (35 qualitative were conducted in developed nations, while the remaining 12 (two qualitative were conducted in developing nations. Important barriers reported in both economic settings included fear of disclosure, concomitant substance abuse, forgetfulness, suspicions of treatment, regimens that are too complicated, number of pills required, decreased quality of life, work and family responsibilities, falling asleep, and access to medication. Important facilitators reported by patients in developed nation settings included having a sense of self-worth, seeing positive

  9. Barriers to Innovation--A Seminar Report. Occasional Paper InTER/11/89.

    Science.gov (United States)

    Rhodes, Valerie

    This report is based on discussions and papers circulated at a seminar on barriers to innovation in primary schools. Issues that relate to computers and the teacher are discussed in the first section, including ownership of the technology and models and strategies for inservice teacher education. Focusing on issues pertaining to computers and the…

  10. Knowledge is not power for patients: A systematic review and thematic synthesis of patient-reported barriers and facilitators to shared decision making

    NARCIS (Netherlands)

    Joseph-Williams, N.; Elwyn, G.; Edwards, A.

    2014-01-01

    OBJECTIVE: To systematically review patient-reported barriers and facilitators to shared decision making (SDM) and develop a taxonomy of patient-reported barriers. METHODS: Systematic review and thematic synthesis. Study findings/results for each included paper were extracted verbatim and entered

  11. Systems study on engineered barriers: barrier performance analysis

    International Nuclear Information System (INIS)

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

    1980-09-01

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

  12. Systems study on engineered barriers: barrier performance analysis

    Energy Technology Data Exchange (ETDEWEB)

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

    1980-09-01

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

  13. Barriers to the medication error reporting process within the Irish National Ambulance Service, a focus group study.

    Science.gov (United States)

    Byrne, Eamonn; Bury, Gerard

    2018-02-08

    Incident reporting is vital to identifying pre-hospital medication safety issues because literature suggests that the majority of errors pre-hospital are self-identified. In 2016, the National Ambulance Service (NAS) reported 11 medication errors to the national body with responsibility for risk management and insurance cover. The Health Information and Quality Authority in 2014 stated that reporting of clinical incidents, of which medication errors are a subset, was not felt to be representative of the actual events occurring. Even though reporting systems are in place, the levels appear to be well below what might be expected. Little data is available to explain this apparent discrepancy. To identify, investigate and document the barriers to medication error reporting within the NAS. An independent moderator led four focus groups in March of 2016. A convenience sample of 18 frontline Paramedics and Advanced Paramedics from Cork City and County discussed medication errors and the medication error reporting process. The sessions were recorded and anonymised, and the data was analysed using a process of thematic analysis. Practitioners understood the value of reporting errors. Barriers to reporting included fear of consequences and ridicule, procedural ambiguity, lack of feedback and a perceived lack of both consistency and confidentiality. The perceived consequences for making an error included professional, financial, litigious and psychological. Staff appeared willing to admit errors in a psychologically safe environment. Barriers to reporting are in line with international evidence. Time constraints prevented achievement of thematic saturation. Further study is warranted.

  14. Reducing barriers to energy efficiency in the German higher education sector. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Schleich, J.; Boede, U.

    2000-12-01

    This report describes the empirical research into barriers to energy efficiency in the German higher education (HE) sector. It is one of nine such reports in the BARRIERS project. The report contains description and analysis of six case studies of energy management in German universities. The results are analysed using the theoretical framework developed for the BARRIERS project (Sorrell et al., 2000). The report also provides brief recommendations on how these barriers to the rational use of energy (RUE) may be overcome and how energy efficiency within the sector may be improved. The results of the study for the higher education sector in Germany are summarised in this executive summary under the following headings: - Characterising the higher education sector; - Case studies of energy management in the German higher education sector; - Evidence of barriers in the German higher education sector; - The role of energy service companies in the higher education sector; - Policy implications. (orig.)

  15. Reducing barriers to energy efficiency in the German mechanical engineering sector. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Schleich, J.; Boede, U.

    2000-12-01

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

  16. Hanford Permanent Isolation Barrier Program: Asphalt technology data and status report - FY 1994

    Energy Technology Data Exchange (ETDEWEB)

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

    1994-09-01

    The asphalt layer within the Hanford Permanent Isolation Barrier (HPIB) is an important component of the overall design. This layer provides a RCRA equivalent backup to the overlying earthen layers in the unlikely event that these layers are not able to reduce the infiltration rate to less than 0.05 cm/yr. There is only limited amount of information on using asphalt for a moisture infiltration barrier over the long times required by the HPIB. Therefore, a number of activities are under way, as part of the Barrier Development Program, to obtain data on the performance of asphalt as a moisture barrier in a buried environment over a 1000-year period. These activities include (1) determining RCRA equivalency, (2) measurement of physical properties, (3) measurement of aging characteristics, and (4) relationship to ancient asphalt analogs. During FY 1994 progress was made on all of these activities. Studies were conducted both in the laboratory and on the prototype barrier constructed over the 216-B-57 crib in the 200 East Area on the Hanford Site. This report presents results obtained from the asphalt technology tasks during FY 1994. Also included are updates to planned activities for asphalt analogs and monitoring the asphalt test pad near the prototype barrier. Measurements of hydraulic conductivity on the HMAC portion of the prototype barrier show that the asphalt layers easily meet the RCRA standard of 1 {times} 10{sup -7} cm/s. In-place measurements using a new field falling head technique show an average of 3.66 {times} 10{sup -8} cm/s, while cores taken from the north end of the prototype and measured in a laboratory setup averaged 1.29 {times} 10{sup -9} cm/s. Measurements made on the fluid applied asphalt membrane (polymer-modified asphalt) show an extremely low permeability of less than 1 {times} 10{sup -11} cm/s.

  17. Hanford Permanent Isolation Barrier Program: Asphalt technology data and status report - FY 1994

    International Nuclear Information System (INIS)

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

    1994-09-01

    The asphalt layer within the Hanford Permanent Isolation Barrier (HPIB) is an important component of the overall design. This layer provides a RCRA equivalent backup to the overlying earthen layers in the unlikely event that these layers are not able to reduce the infiltration rate to less than 0.05 cm/yr. There is only limited amount of information on using asphalt for a moisture infiltration barrier over the long times required by the HPIB. Therefore, a number of activities are under way, as part of the Barrier Development Program, to obtain data on the performance of asphalt as a moisture barrier in a buried environment over a 1000-year period. These activities include (1) determining RCRA equivalency, (2) measurement of physical properties, (3) measurement of aging characteristics, and (4) relationship to ancient asphalt analogs. During FY 1994 progress was made on all of these activities. Studies were conducted both in the laboratory and on the prototype barrier constructed over the 216-B-57 crib in the 200 East Area on the Hanford Site. This report presents results obtained from the asphalt technology tasks during FY 1994. Also included are updates to planned activities for asphalt analogs and monitoring the asphalt test pad near the prototype barrier. Measurements of hydraulic conductivity on the HMAC portion of the prototype barrier show that the asphalt layers easily meet the RCRA standard of 1 x 10 -7 cm/s. In-place measurements using a new field falling head technique show an average of 3.66 x 10 -8 cm/s, while cores taken from the north end of the prototype and measured in a laboratory setup averaged 1.29 x 10 -9 cm/s. Measurements made on the fluid applied asphalt membrane (polymer-modified asphalt) show an extremely low permeability of less than 1 x 10 -11 cm/s

  18. Performance Confirmation for the Engineered Barrier System. Report of a Workshop

    International Nuclear Information System (INIS)

    Bennett, David G.

    2004-08-01

    As part of preparations for review of future license applications, the Swedish Nuclear Power Inspectorate (SKI) organised a workshop on the engineered barrier system for the KBS-3 concept, focused on Performance Confirmation (PC). The workshop was held during 12 - 14 May, 2004 at Oskarshamn. The main purpose of the workshop was to identify key issues relating to the demonstration of long-term safety using a system of engineered barriers. The workshop began with introductory presentations on Performance Confirmation, on monitoring, and on long-term experiments in underground research laboratories. Working groups were then convened to discuss these topics and identify questions to put to the Swedish Nuclear Fuel and Waste Management Company (SKB) the following day. On the second day, SKB made several presentations, mainly on long-term experiments conducted at the Aespoe underground research laboratory. These presentations were followed by an informal session during which the questions identified by the working groups on the first day were discussed with SKB and its representatives. This report includes the questions identified by the working groups and a summary of the workshop discussions. Extended abstracts for the introductory presentations are included in an appendix. The conclusions and viewpoints presented in this report are those of one or several workshop participants. They do not necessarily coincide with those of SKI

  19. Improved Barriers to Turbine Engine Fragments: Final Annual Report

    National Research Council Canada - National Science Library

    Shockey, Donald

    2002-01-01

    This final annual technical report describes the progress rnade during year 4 of the SPI International Phase II effort to develop a computational capability for designing lightweight fragment barriers...

  20. Barriers to healthcare for transgender individuals.

    Science.gov (United States)

    Safer, Joshua D; Coleman, Eli; Feldman, Jamie; Garofalo, Robert; Hembree, Wylie; Radix, Asa; Sevelius, Jae

    2016-04-01

    Transgender persons suffer significant health disparities and may require medical intervention as part of their care. The purpose of this manuscript is to briefly review the literature characterizing barriers to healthcare for transgender individuals and to propose research priorities to understand mechanisms of those barriers and interventions to overcome them. Current research emphasizes sexual minorities' self-report of barriers, rather than using direct methods. The biggest barrier to healthcare reported by transgender individuals is lack of access because of lack of providers who are sufficiently knowledgeable on the topic. Other barriers include: financial barriers, discrimination, lack of cultural competence by providers, health systems barriers, and socioeconomic barriers. National research priorities should include rigorous determination of the capacity of the US healthcare system to provide adequate care for transgender individuals. Studies should determine knowledge and biases of the medical workforce across the spectrum of medical training with regard to transgender medical care; adequacy of sufficient providers for the care required, larger social structural barriers, and status of a framework to pay for appropriate care. As well, studies should propose and validate potential solutions to address identified gaps.

  1. CEMENTITIOUS BARRIERS PARTNERSHIP FY13 MID-YEAR REPORT

    Energy Technology Data Exchange (ETDEWEB)

    Burns, H.; Flach, G.; Langton, C.; KOSSON, D.; BROWN, K.; SAMSON, E.; MEEUSSEN, J.; SLOOT, H.; GARBOCZI, E.

    2013-05-01

    In FY2013, the Cementitious Barriers Partnership (CBP) is continuing in its effort to develop and enhance software tools demonstrating tangible progress toward fulfilling the objective of developing a set of tools to improve understanding and prediction of the long-term structural, hydraulic and chemical performance of cementitious barriers used in nuclear applications. In FY2012, the CBP released the initial inhouse “Beta-version” of the CBP Software Toolbox, a suite of software for simulating reactive transport in cementitious materials and important degradation phenomena. The current primary software components are LeachXS/ORCHESTRA, STADIUM, and a GoldSim interface for probabilistic analysis of selected degradation scenarios. THAMES is a planned future CBP Toolbox component (FY13/14) focused on simulation of the microstructure of cementitious materials and calculation of resultant hydraulic and constituent mass transfer parameters needed in modeling. This past November, the CBP Software Toolbox Version 1.0 was released that supports analysis of external sulfate attack (including damage mechanics), carbonation, and primary constituent leaching. The LeachXS component embodies an extensive material property measurements database along with chemical speciation and reactive mass transport simulation cases with emphasis on leaching of major, trace and radionuclide constituents from cementitious materials used in DOE facilities, such as Saltstone (Savannah River) and Cast Stone (Hanford), tank closure grouts, and barrier concretes. STADIUM focuses on the physical and structural service life of materials and components based on chemical speciation and reactive mass transport of major cement constituents and aggressive species (e.g., chloride, sulfate, etc.). The CBP issued numerous reports and other documentation that accompanied the “Version 1.0” release including a CBP Software Toolbox User Guide and Installation Guide. These documents, as well as, the

  2. Thermal damping effect due to a green barrier which includes Arundo donax as bioclimatic element in buildings

    Directory of Open Access Journals (Sweden)

    P. Rodríguez-Salinas

    2017-09-01

    Full Text Available Among the main environmental impacts of the operation of residential buildings are those due to greenhouse gases generation as a result of electric consumption of air conditioning systems. The use of vegetation systems in residential buildings represents an alternative to reduce this energy consumption. Green vegetation systems barriers are often used as protection against winds, but recently they are also being used as acoustic dampers. This work explores their use as thermal insulation systems for buildings. Specifically, we report the behavior of an Arundo donax green barrier as a bioclimatic element. The results are analyzed based on indoor and outdoor temperature measurement in prototype buildings, in function of the green barrier presence. Additionally Arundo donax transpiration under extreme environmental conditions was determined.

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

    Science.gov (United States)

    Russo, Brendan J; Savolainen, Peter T

    2018-08-01

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

  4. Identifying barriers to chronic disease reporting in Chicago Public Schools: a mixed-methods approach.

    Science.gov (United States)

    Rivkina, Victoria; Tapke, David E; Cardenas, Lilliana D; Harvey-Gintoft, Blair; Whyte, Stephanie A; Gupta, Ruchi S

    2014-12-06

    Chronic disease among school-aged children is a public health concern, particularly for asthma and food allergy. In Chicago Public Schools (CPS), rates of asthma and food allergy among students are underreported. The aim of this study was to determine the barriers to chronic disease reporting as experienced by CPS parents and school nurses. A mixed-methods approach included focus groups and key informant interviews with parents and school nurses, and a cross-sectional survey was completed by parents. Qualitative data analysis was performed and survey data were analyzed to determine the significant demographic and knowledge variables associated with successfully completing the reporting process. The three main barriers identified were 1) a lack of parental process knowledge; 2) limited communication from schools; and 3) insufficient availability of school nurses. Parents were significantly more likely to successfully complete the reporting process if they knew about special accommodations for chronic diseases, understood the need for physician verification, and/or knew the school nurse. These findings suggest that increasing parental knowledge of the reporting process will allow schools to better identify and manage their students' chronic conditions. A parent-focused intervention informed by these results has been completed.

  5. Cryogenic Barrier Demonstration Project. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, L.A.; Yarmak, E.; Long, E.L.

    2000-03-01

    A long-term frozen soil barrier was implemented at the HRE (Homogeneous Reactor Experiment) Pond facility at the Oak Ridge National Laboratory in 1997. This was performed to verify the technical feasibility and costs of deploying a frozen barrier at a radiologically contaminated site. Work began in September 1996 and progressed through to December 1999. The frozen barrier has been operational since November 1997. Verification of the barrier integrity was performed independently by the EPA's SITE Program. This project showed frozen barriers offer a proven technology to retain below grade hazardous substances at relatively low costs with minimal effect on the environment.

  6. ENGINEERED BARRIER SYSTEM: PHYSICAL AND CHEMICAL ENVIRONMENT

    International Nuclear Information System (INIS)

    Jarek, R.

    2004-01-01

    The purpose of this report is to describe the evolution of the physical and chemical environmental conditions within the waste emplacement drifts of the repository, including the drip shield and waste package surfaces. The abstraction model is used in the total system performance assessment for the license application (TSPA LA) to assess the performance of the engineered barrier system and the waste form. This report develops and documents a set of these abstraction-level models that describe the engineered barrier system physical and chemical environment. Where possible, these models use information directly from other reports as input, which promotes integration among process models used for TSPA-LA. Specific tasks and activities of modeling the physical and chemical environment are included in ''Technical Work Plan for: Near-Field Environment and Transport In-Drift Geochemistry Model Report Integration'' (BSC 2004 [DIRS 171156], Section 1.2.2). As described in the technical work plan, the development of this report is coordinated with the development of other engineered barrier system reports

  7. ENGINEERED BARRIER SYSTEM: PHYSICAL AND CHEMICAL ENVIRONMENT

    International Nuclear Information System (INIS)

    G.H. Nieder-Westermann

    2005-01-01

    The purpose of this report is to describe the evolution of the physical and chemical environmental conditions within the waste emplacement drifts of the repository, including the drip shield and waste package surfaces. The abstraction model is used in the total system performance assessment for the license application (TSPA LA) to assess the performance of the engineered barrier system and the waste form. This report develops and documents a set of these abstraction-level models that describe the engineered barrier system physical and chemical environment. Where possible, these models use information directly from other reports as input, which promotes integration among process models used for TSPA-LA. Specific tasks and activities of modeling the physical and chemical environment are included in ''Technical Work Plan for: Near-Field Environment and Transport In-Drift Geochemistry Model Report Integration'' (BSC 2004 [DIRS 171156], Section 1.2.2). As described in the technical work plan, the development of this report is coordinated with the development of other engineered barrier system reports

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

    Science.gov (United States)

    Pinson, Paul A.

    1998-01-01

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

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

    International Nuclear Information System (INIS)

    Pinson, P.A.

    1998-01-01

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

  10. Feasibility study of tank leakage mitigation using subsurface barriers

    International Nuclear Information System (INIS)

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

    1994-01-01

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

  11. Reducing barriers to energy efficiency in the German energy service companies sector. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Koewener, D.; Schleich, J.

    2000-12-01

    This report describes the empirical research conducted in the German energy service sector to assess to what extent energy service companies (ESCOs) can help overcome the barriers to energy in the higher education, brewing and mechanical engineering sectors. This report complements the sector for Germany within the BARRIERS project (Sorrell et al., 2000; Schleich/Boede 2000a; Schleich/Boede 2000b; Schleich et al., 2000). The report characterises the German energy service sector, contains a description and analysis of four case studies in the energy service sector, identifies the main barriers and chances for ESCOs in the higher education, brewery and mechanical engineering sectors, and concludes with brief recommendations on how these barriers may be overcome. The results of the study are summarised here under the following headings: Characterising the energy service sector in Germany; - Case studies of energy service companies in Germany; - The role of ESCOs in the case-study sectors; - Policy implications. (orig.)

  12. Hanford protoype surface barrier status report: FY 1994

    International Nuclear Information System (INIS)

    Gee, G.W.; Freeman, H.D.; Walters, W.H. Jr.; Ligotke, M.W.; Campbell, M.D.; Ward, A.L.; Link, S.O.; Smith, S.K.; Gilmore, B.G.; Romine, R.A.

    1994-12-01

    A full-scale prototype surface barrier has been constructed at the 200 BP-1 Operable Unit in the 200 East Area of the Hanford Site. The prototype barrier has been built to evaluate design, construction, and performance features of a surface barrier that may be used for in-place disposal of wastes at the Hanford Site. The design basis and construction of the prototype have been documented. A testing and monitoring plan has been published outlining specific tests planned for the prototype. The current report describes initial testing activities conducted in FY 1994 and outlines activities for testing and monitoring at the prototype barrier in the future. Asphalt permeability was tested during construction of the prototype in April and May 1994. Cores taken from the asphalt concrete layer were tested in the laboratory and found to have hydraulic conductivities below 1E-09 cm/s. Field measurements of hydraulic conductivity taken on the asphalt concrete using a specially-designed falling head permeameter were more than ten times higher than those from core tests. The higher values are attributed to transient flow through the permeameter seal. In spite of this difficulty, the more rapid field measurements (1-day tests in the field compared to 3 months in the laboratory) gave values as low as IE-09 cm/s and averaged about IE-08 cm/s. Samples of fluid-applied asphalt material, used as a sealant on the asphalt concrete layer, were. tested in the laboratory and found to have hydraulic conductivities below IE-10 cm/s. Measurements of hydraulic conductivity taken on an adjacent asphalt test pad using a sealed double-ring infiltrometer (SDRI) were initiated in September 1994 and are expected to be completed in November 1994. Construction of the prototype surface barrier was completed in August 1994

  13. Overcoming barriers to implementing patient-reported outcomes in an electronic health record: a case report.

    Science.gov (United States)

    Harle, Christopher A; Listhaus, Alyson; Covarrubias, Constanza M; Schmidt, Siegfried Of; Mackey, Sean; Carek, Peter J; Fillingim, Roger B; Hurley, Robert W

    2016-01-01

    In this case report, the authors describe the implementation of a system for collecting patient-reported outcomes and integrating results in an electronic health record. The objective was to identify lessons learned in overcoming barriers to collecting and integrating patient-reported outcomes in an electronic health record. The authors analyzed qualitative data in 42 documents collected from system development meetings, written feedback from users, and clinical observations with practice staff, providers, and patients. Guided by the Unified Theory on the Adoption and Use of Information Technology, 5 emergent themes were identified. Two barriers emerged: (i) uncertain clinical benefit and (ii) time, work flow, and effort constraints. Three facilitators emerged: (iii) process automation, (iv) usable system interfaces, and (v) collecting patient-reported outcomes for the right patient at the right time. For electronic health record-integrated patient-reported outcomes to succeed as useful clinical tools, system designers must ensure the clinical relevance of the information being collected while minimizing provider, staff, and patient burden. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  14. Barriers to the success of an electronic pharmacovigilance reporting system in Kenya: an evaluation three years post implementation.

    Science.gov (United States)

    Agoro, Oscar O; Kibira, Sarah W; Freeman, Jenny V; Fraser, Hamish S F

    2018-06-01

    Electronic pharmacovigilance reporting systems are being implemented in many developing countries in an effort to improve reporting rates. This study sought to establish the factors that acted as barriers to the success of an electronic pharmacovigilance reporting system in Kenya 3 years after its implementation. Factors that could act as barriers to using electronic reporting systems were identified in a review of literature and then used to develop a survey questionnaire that was administered to pharmacists working in government hospitals in 6 counties in Kenya. The survey was completed by 103 out of the 115 targeted pharmacists (89.5%) and included free-text comments. The key factors identified as barriers were: unavailable, unreliable, or expensive Internet access; challenges associated with a hybrid system of paper and electronic reporting tools; and system usability issues. Coordination challenges at the national pharmacovigilance center and changes in the structure of health management in the country also had an impact on the success of the electronic reporting system. Different personal, organizational, infrastructural, and reporting system factors affect the success of electronic reporting systems in different ways, depending on the context. Context-specific formative evaluations are useful in establishing the performance of electronic reporting systems to identify problems and ensure that they achieve the desired objectives. While several factors hindered the optimal use of the electronic pharmacovigilance reporting system in Kenya, all were considered modifiable. Effort should be directed toward tackling the identified issues in order to facilitate use and improve pharmacovigilance reporting rates.

  15. Review of potential subsurface permeable barrier emplacement and monitoring technologies

    International Nuclear Information System (INIS)

    Riggsbee, W.H.; Treat, R.L.; Stansfield, H.J.; Schwarz, R.M.; Cantrell, K.J.; Phillips, S.J.

    1994-02-01

    This report focuses on subsurface permeable barrier technologies potentially applicable to existing waste disposal sites. This report describes candidate subsurface permeable barriers, methods for emplacing these barriers, and methods used to monitor the barrier performance. Two types of subsurface barrier systems are described: those that apply to contamination.in the unsaturated zone, and those that apply to groundwater and to mobile contamination near the groundwater table. These barriers may be emplaced either horizontally or vertically depending on waste and site characteristics. Materials for creating permeable subsurface barriers are emplaced using one of three basic methods: injection, in situ mechanical mixing, or excavation-insertion. Injection is the emplacement of dissolved reagents or colloidal suspensions into the soil at elevated pressures. In situ mechanical mixing is the physical blending of the soil and the barrier material underground. Excavation-insertion is the removal of a soil volume and adding barrier materials to the space created. Major vertical barrier emplacement technologies include trenching-backfilling; slurry trenching; and vertical drilling and injection, including boring (earth augering), cable tool drilling, rotary drilling, sonic drilling, jetting methods, injection-mixing in drilled holes, and deep soil mixing. Major horizontal barrier emplacement technologies include horizontal drilling, microtunneling, compaction boring, horizontal emplacement, longwall mining, hydraulic fracturing, and jetting methods

  16. ENGINEERED BARRIER SYSTEM: PHYSICAL AND CHEMICAL ENVIRONMENT

    Energy Technology Data Exchange (ETDEWEB)

    R. Jarek

    2004-11-23

    The purpose of this report is to describe the evolution of the physical and chemical environmental conditions within the waste emplacement drifts of the repository, including the drip shield and waste package surfaces. The abstraction model is used in the total system performance assessment for the license application (TSPA LA) to assess the performance of the engineered barrier system and the waste form. This report develops and documents a set of these abstraction-level models that describe the engineered barrier system physical and chemical environment. Where possible, these models use information directly from other reports as input, which promotes integration among process models used for TSPA-LA. Specific tasks and activities of modeling the physical and chemical environment are included in ''Technical Work Plan for: Near-Field Environment and Transport In-Drift Geochemistry Model Report Integration'' (BSC 2004 [DIRS 171156], Section 1.2.2). As described in the technical work plan, the development of this report is coordinated with the development of other engineered barrier system reports.

  17. ENGINEERED BARRIER SYSTEM: PHYSICAL AND CHEMICAL ENVIRONMENT

    Energy Technology Data Exchange (ETDEWEB)

    G.H. Nieder-Westermann

    2005-04-07

    The purpose of this report is to describe the evolution of the physical and chemical environmental conditions within the waste emplacement drifts of the repository, including the drip shield and waste package surfaces. The abstraction model is used in the total system performance assessment for the license application (TSPA LA) to assess the performance of the engineered barrier system and the waste form. This report develops and documents a set of these abstraction-level models that describe the engineered barrier system physical and chemical environment. Where possible, these models use information directly from other reports as input, which promotes integration among process models used for TSPA-LA. Specific tasks and activities of modeling the physical and chemical environment are included in ''Technical Work Plan for: Near-Field Environment and Transport In-Drift Geochemistry Model Report Integration'' (BSC 2004 [DIRS 171156], Section 1.2.2). As described in the technical work plan, the development of this report is coordinated with the development of other engineered barrier system reports.

  18. The relative importance of patient-reported barriers to colorectal cancer screening.

    Science.gov (United States)

    Jones, Resa M; Woolf, Steven H; Cunningham, Tina D; Johnson, Robert E; Krist, Alex H; Rothemich, Stephen F; Vernon, Sally W

    2010-05-01

    Colorectal cancer (CRC) screening rates are suboptimal. The most important barriers identified by patients are poorly understood. A comprehensive assessment of barriers to all recommended modalities is needed. In 2007, a questionnaire was mailed to 6100 patients, aged 50-75 years, from 12 family medicine practices in the Virginia Ambulatory Care Outcomes Research Network. People aged 65-75 years and African Americans were oversampled. Patients were asked to rate 19-21 barriers to each of four recommended tests. In 2008, responses were coded on a 5-point scale; higher scores reflected stronger barrier endorsement. The response rate was 55% (n=3357). Approximately 40% of respondents were aged >/=65 years, 30% were African-American, and 73% were adherent to screening. A clinician's failure to suggest screening and not knowing testing was necessary received the highest mean scores as barriers. Financial concerns and misconceptions were also cited. Barrier scores differed depending on whether respondents were never screened, overdue for screening, or adherent to guidelines. The top five barriers for each modality included test-specific barriers (e.g., handling stool, bowel preparation), which often outranked generic barriers to screening. Not knowing testing was necessary was a top barrier for all tests but colonoscopy. Although physician advice and awareness of the need for screening are important, barriers to screening are not homogenous across tests, and test-specific barriers warrant consideration in designing strategies to improve screening rates. Barrier scores differ by screening status, highlighting the need to address prior screening experience. Evidence that patients are more familiar with colonoscopy than with other modalities suggests an opportunity to improve screening rates by educating patients about alternative tests. 2010 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  19. Overcoming barriers to ITS : lessons from other technologies : final task E report

    Science.gov (United States)

    1995-12-01

    The Task E report involves an analysis of franchises and license agreements for the provision of public services, which is the fourth in a series in the study. Overcoming Barriers to ITS - Lessons from Other Technologies. This report follows alternat...

  20. Sociodemographic inequalities in barriers to cancer pain management: a report from the American Cancer Society's Study of Cancer Survivors-II (SCS-II).

    Science.gov (United States)

    Stein, Kevin D; Alcaraz, Kassandra I; Kamson, Chelsey; Fallon, Elizabeth A; Smith, Tenbroeck G

    2016-10-01

    Research has increasingly documented sociodemographic inequalities in the assessment and management of cancer-related pain. Most studies have focused on racial/ethnic disparities, while less is known about the impact of other sociodemographic factors, including age and education. We analyzed data from a large, national, population-based study of cancer survivors to examine the influence of sociodemographic factors, and physical and mental health comorbidities on barriers to cancer pain management. The study included data from 4707 cancer survivors in the American Cancer Society's Study of Cancer Survivors-II, who reported experiencing pain from their cancer. A multilevel, socioecological, conceptual framework was used to generate a list of 15 barriers to pain management, representing patient, provider, and system levels. Separate multivariable logistic regressions for each barrier identified sociodemographic and health-related inequalities in cancer pain management, controlling for years since diagnosis, disease stage, and cancer treatment. Two-thirds of survivors reported at least 1 barrier to pain management. While patient-related barriers were most common, the greatest disparities were noted in provider- and system-level barriers. Specifically, inequalities by race/ethnicity, education, age, and physical and mental health comorbidities were observed. Findings indicate survivors who were nonwhite, less educated, older, and/or burdened by comorbidities were most adversely affected. Future efforts in research, clinical practice, and policy should identify and/or implement new strategies to address sociodemographic inequalities in cancer pain management. Copyright © 2016 John Wiley & Sons, Ltd.

  1. Engineered Barrier System - Manufacturing, Testing and Quality Assurance. Report from a Workshop

    International Nuclear Information System (INIS)

    2004-06-01

    As part of preparations for review of future license applications, the Swedish Nuclear Power Inspectorate (SKI) organised a workshop on the engineered barrier system for the KBS-3 concept, with the focus on manufacturing, testing and quality assurance. The main purpose of the workshop was to identify critical issues in the demonstration of how long-term safety requirements could be fulfilled for the engineered barriers. The workshop included presentations related to engineered barrier manufacturing and testing held by external experts, and working group sessions to prepare questions to the Swedish Nuclear Fuel and Waste Management Co. (SKB). SKB presentations were followed by an informal questioning and discussion with SKB representatives. This report includes a presentation of the questions posed by the working groups, SKB's replies to these questions as well as a summary of the working group discussions. The conclusions and viewpoints presented in this report are those of one or several workshop participants. During the workshop many issues regarding manufacturing, testing and quality assurance of the engineered barriers were discussed. The central themes in the questions and discussions are summarised as follows: There is a need to specify how the functional requirements for the buffer and backfill will be achieved in practise. Issues of particular interest are material selection, compaction density, initial water content and manufacturing methods for bentonite blocks. A major problem that must be addressed is the long period required to obtain relevant results from large-scale testing. The uncertainties relating to the wetting and subsequent swelling processes of the bentonite buffer have implications for analysis of the canister. It is necessary to know now non-uniform the bentonite swelling pressure could be in a worst case pressure differential, in order to evaluate the sufficiency of 'as tested' canister performance. Regarding the copper shell of the

  2. Workplace barriers encountered by employed persons with systemic sclerosis.

    Science.gov (United States)

    Poole, Janet L; Anwar, Sahar; Mendelson, Cindy; Allaire, Saralynn

    2016-01-01

    Systemic sclerosis (SSc) is an auto-immune connective tissue disease characterized by fibrosis of skin, blood vessels, and internal organs that results in significant disability. To identify the work barriers faced by people with systemic sclerosis (SSc) in maintaining employment. Thirty-six people with SSc who were working more than 8 hours per week completed the Work Experience Survey, which contains lists of potential work barriers, including the ability to travel to and from work; get around at work; perform essential job functions, including physical, cognitive, and task-related activities; work with others; and manage work conditions. Thirty-three participants completed and returned the questionnaires, most of whom were female, and working full time and in professional careers. Principal disease symptoms included fatigue, Raynaud's phenomenon, esophageal involvement, and leg or hand/wrist pain. All participants reported some barriers with a mean of 18 barriers per participant. At least three quarters of participants cited outside temperature (82%), cold temperatures inside the workplace (76%), and household work (76%), as barriers. The next most common barriers were using both hands (64%), arranging and taking part in social activities (64%), being able to provide self-care (61%) and working 8 hours (58%). Participants reported a wide range of barriers, from cold temperatures, to physical job, fatigue related, and non-workplace demands, in maintaining the worker role. The barriers reflect the disease symptoms they reported. Identifying workplace barriers facilitates the creation of job accommodations or adaptations that will allow people with SSc to continue working.

  3. Animal intrusion studies for protective barriers: Status report for FY 1988

    Energy Technology Data Exchange (ETDEWEB)

    Cadwell, L.L.; Eberhardt, L.E.; Simmons, M.A.

    1989-05-01

    The objective of the Biointrusion Control Task is to provide technical support to Westinghouse Hanford Company's Protective Barrier Development Program for evaluating and predicting potential impacts of animal burrowing on long-term barrier performance. This document reviews the major accomplishments for FY 1988, which is the initial year of the work. The scope of work includes a literature review, field studies, and modeling to assess burrowing impacts as they may contribute to increased infiltration of surface water through barriers, increased quantities of soil available for erosion because of surface soil disturbance, and direct physical transport of contaminants to the surface. 68 refs., 8 figs., 5 tabs.

  4. Report to Congress: Coastal Barrier Resources System with recommendations as required by Section 10 of Public Law 97-348, the Coastal Barrier Resources Act of 1982. Volume 1

    International Nuclear Information System (INIS)

    1988-01-01

    The U.S. shoreline bordering the Atlantic Ocean and Gulf of Mexico contains one of the longest and best defined chains of coastal barriers in the world. In recognition of the fact, the Coastal Barrier Resources Act (CBRA) (16 U.S.C. 3501 et seq.) was enacted in October 1982. The Act established the Coastal Barrier Resources System (CBRS) consisting of 186 coastal barrier units along 670 mi of shoreline on the Atlantic and Gulf of Mexico coasts. The philosophy behind the CBRA is that the risk associated with new development in these areas should be borne by those who choose to live and work along the coast, and not by all American taxpayers. By restricting Federal expenditures and financial assistance on specific undeveloped coastal barriers, the Federal Government can minimize the loss of human life, reduce the wasteful expenditure of Federal revenues, and reduce the damage to fish and wildlife and other natural resources that can accompany development of these fragile areas. Section 10 of the CBRA directs the Department of the Interior to study the CBRS and prepare for Congress a report which includes recommendations for changes in the CBRS based on an evaluation of management alternatives that would foster conservation of the natural resources of the CBRS

  5. 200-BP-1 Prototype Hanford Barrier Annual Monitoring Report for Fiscal Years 2005 Through 2007

    Energy Technology Data Exchange (ETDEWEB)

    Ward, Andy L.; Link, Steven O.; Strickland, Christopher E.; Draper, Kathryn E.; Clayton, Ray E.

    2008-02-01

    A prototype Hanford barrier was deployed over the 216-B-57 Crib at the Hanford Site in 1994 to prevent percolation through the underlying waste and to minimize spreading of buried contaminants. This barrier is being monitored to evaluate physical and hydrologic performance at the field scale. This report summarizes data collected during the period FY 2005 through FY 2007. In FY 2007, monitoring of the prototype Hanford barrier focused on barrier stability, vegetative cover, evidence of plant and animal intrusion, and the main components of the water balance, including precipitation, runoff, storage, drainage, and deep percolation. Owing to a hiatus in funding in FY 2005 through 2006, data collected were limited to automated measurements of the water-balance components. For the reporting period (October 2004 through September 2007) precipitation amount and distribution were close to normal. The cumulative amount of water received from October 1994 through September 2007 was 3043.45 mm on the northern half of the barrier, which is the formerly irrigated treatment, and 2370.58 mm on the southern, non-irrigated treatments. Water storage continued to show a cyclic pattern, increasing in the winter and declining in the spring and summer to a lower limit of around 100 mm in response to evapotranspiration. The 600-mm design storage has never been exceeded. For the reporting period, the total drainage from the soil-covered plots ranged from near zero amounts under the soil-covered plots to almost 20 mm under the side slopes. Over the 13-yr monitoring period, side slope drainage accounted for about 20 percent of total precipitation while the soil-covered plots account for only 0.12 mm total. Above-asphalt and below-asphalt moisture measurements show no evidence of deep percolation of water. Topographic surveys show the barrier and protective side slopes to be stable. Plant surveys show a relatively high coverage of native plants still persists after the initial revegetation

  6. Hanford prototype-barrier status report: FY 1995

    International Nuclear Information System (INIS)

    Gee, G.W.; Ward, A.L.; Gilmore, B.G.; Ligotke, M.W.; Link, S.O.

    1995-11-01

    Surface barriers (or covers) have been proposed for use at the Hanford Site as a means to isolate certain waste sites that, for reasons of cost or worker safety or both, may not be exhumed. Surface barriers are intende to isolated the wastes from the accessible environment and to provide long-term protection to future populations that might use the Hanford Site. Currently, no ''proven'' long-term barrier system is available. For this reason, the Hanford Site Permanent Isolation Surface-Barrier Development Program (BDP) was organized to develop the technology needed to provide long-term surface barrier capability for the Hanford Site for the US Department of Energy (DOE). Designs have been proposed to meet the most stringent needs for long-term waste disposal. The objective of the current barrier design is to use natural materials to develop a protective barrier system that isolates wastes for at least 1000 years by limiting water, plant, animal, and human intrusion; and minimizing erosion. The design criteria for water drainage has been set at 0.5 mm/yr. While other design criteria are more qualitative, it is clear that waste isolation for an extended time is the prime objective of the design. Constructibility and performance. are issues that can be tested and dealt with by evaluating prototype designs prior to extensive construction and deployment of covers for waste sites at Hanford

  7. Interprofessional Education: A Summary of Reports and Barriers to Recommendations.

    Science.gov (United States)

    Meleis, Afaf I

    2016-01-01

    Effective, quality care to achieve the newly developed sustainable development goals requires the development of collaborative teams and is predicated on implementing transformative interprofessional education and on team members who are equally empowered. This is a report on The Lancet commission on transformative education for health professionals and the National Academy of Medicine's dialogues on developing and implementing innovations to enhance collaborations and to facilitate the effectiveness of healthcare teams. Using postcolonial feminist theory for critical analysis and integrations of findings from both reports, as well as for identification of barriers to achieving equity in team functioning. The global Lancet commission and the National Academy of Medicine/Institute of Medicine forum developed frameworks that could be used to educate the next generation of professionals based on identifying the local needs of communities within a global context. Recommendations included breaking down silos that exists between schools and using an equity and justice framework in developing educational programs; utilizing contemporary innovations in teaching that correspond with innovations in healthcare systems; and insuring investments in time, energy, and resources in interprofessional education. However, without addressing the silos created through professional identities and power differentials, goals of interprofessional education and collaborative practice may not be achieved. While a great deal has been written about interprofessional education, it is imperative for faculty in the different professional schools and for members of healthcare teams to engage in dialogues that address the fundamental and most obstinate barriers to forming equitable teams, which is the consistent narrative of medical privilege and centrism. The dialogues about medical privilege and physician centrism in education and health care could drive the development of programmatic approaches

  8. Louisiana Barrier Island Comprehensive Monitoring (BICM) Program Summary Report: Data and Analyses 2006 through 2010

    Science.gov (United States)

    Kindinger, Jack G.; Buster, Noreen A.; Flocks, James G.; Bernier, Julie C.; Kulp, Mark A.

    2013-01-01

    The Barrier Island Comprehensive Monitoring (BICM) program was implemented under the Louisiana Coastal Area Science and Technology (LCA S&T) office as a component of the System Wide Assessment and Monitoring (SWAMP) program. The BICM project was developed by the State of Louisiana (Coastal Protection Restoration Authority [CPRA], formerly Department of Natural Resources [DNR]) to complement other Louisiana coastal monitoring programs such as the Coastwide Reference Monitoring System-Wetlands (CRMS-Wetlands) and was a collaborative research effort by CPRA, University of New Orleans (UNO), and the U.S. Geological Survey (USGS). The goal of the BICM program was to provide long-term data on the barrier islands of Louisiana that could be used to plan, design, evaluate, and maintain current and future barrier-island restoration projects. The BICM program used both historical and newly acquired (2006 to 2010) data to assess and monitor changes in the aerial and subaqueous extent of islands, habitat types, sediment texture and geotechnical properties, environmental processes, and vegetation composition. BICM datasets included aerial still and video photography (multiple time series) for shoreline positions, habitat mapping, and land loss; light detection and ranging (lidar) surveys for topographic elevations; single-beam and swath bathymetry; and sediment grab samples. Products produced using BICM data and analyses included (but were not limited to) storm-impact assessments, rate of shoreline and bathymetric change, shoreline-erosion and accretion maps, high-resolution elevation maps, coastal-shoreline and barrier-island habitat-classification maps, and coastal surficial-sediment characterization maps. Discussions in this report summarize the extensive data-collection efforts and present brief interpretive analyses for four coastal Louisiana geographic regions. In addition, several coastal-wide and topical themes were selected that integrate the data and analyses within a

  9. Theory of Planned Behavior including self-stigma and perceived barriers explain help-seeking behavior for sexual problems in Iranian women suffering from epilepsy.

    Science.gov (United States)

    Lin, Chung-Ying; Oveisi, Sonia; Burri, Andrea; Pakpour, Amir H

    2017-03-01

    To apply the Theory of Planned Behavior (TPB) and the two additional concepts self-stigma and perceived barriers to the help-seeking behavior for sexual problems in women with epilepsy. In this 18-month follow-up study, TPB elements, including attitude, subjective norm, perceived behavioral control, and behavioral intention along with self-stigma and perceived barriers in seeking help for sexual problems were assessed in n=818 women with epilepsy (94.0% aged ≤40years). The basic TPB model (model 1) and the TPB model additionally including self-stigma and perceived barriers (Model 2) were analyzed using structural equation modeling (SEM). Both SEM models showed satisfactory model fits. According to model, attitude, subjective norms, perceived behavioral control, and intention explained 63.1% of the variance in help-seeking behavior. Variance was slightly higher (64.5%) when including self-stigma and perceived barriers (model 2). In addition, the fit indices of the models were better highlighting the importance of self-stigma and perceived barriers in help-seeking behavior for sexual problems. Theory of Planned Behavior is useful in explaining help-seeking behavior for sexual problems in women with epilepsy. Self-stigma and perceived barriers are additional factors that should be considered in future interventions aiming to adopt TPB to improve help-seeking behavior for sexual problems. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Market and policy barriers to energy storage deployment :

    Energy Technology Data Exchange (ETDEWEB)

    Bhatnagar, Dhruv; Currier, Aileen B.; Hernandez, Jacquelynne; Ma, Ookie; Kirby, Brendan

    2013-09-01

    Electric energy storage technologies have recently been in the spotlight, discussed as essential grid assets that can provide services to increase the reliability and resiliency of the grid, including furthering the integration of variable renewable energy resources. Though they can provide numerous grid services, there are a number of factors that restrict their current deployment. The most significant barrier to deployment is high capital costs, though several recent deployments indicate that capital costs are decreasing and energy storage may be the preferred economic alternative in certain situations. However, a number of other market and regulatory barriers persist, limiting further deployment. These barriers can be categorized into regulatory barriers, market (economic) barriers, utility and developer business model barriers, crosscutting barriers and technology barriers. This report, through interviews with stakeholders and review of regulatory filings in four regions roughly representative of the United States, identifies the key barriers restricting further energy storage development in the country. The report also includes a discussion of possible solutions to address these barriers and a review of initiatives around the country at the federal, regional and state levels that are addressing some of these issues. Energy storage could have a key role to play in the future grid, but market and regulatory issues have to be addressed to allow storage resources open market access and compensation for the services they are capable of providing. Progress has been made in this effort, but much remains to be done and will require continued engagement from regulators, policy makers, market operators, utilities, developers and manufacturers.

  11. Laboratory evaluation of performance and durability of polymer grouts for subsurface hydraulic/diffusion barriers. Informal report, October 1993--May 1994

    International Nuclear Information System (INIS)

    Heiser, J.H.; Milian, L.W.

    1994-05-01

    Contaminated soils, buried waste and leaking underground storage tanks pose a threat to the environment through contaminant transport. One of the options for control of contaminant migration from buried waste sites is the construction of a subsurface barrier. Subsurface barriers increase the performance of waste disposal sites by providing a low permeability layer that can reduce percolation water migration into the waste site, minimize surface transport of contaminants, and reduce migration of volatile species. Also, a barrier can be constructed to envelop the site or plume completely, there by containing the contaminants and the potential leakage. Portland cement grout curtains have been used for barriers around waste sites. However, large castings of hydraulic cements result invariably in cracking due to shrinkage, thermal stresses induced by the hydration reactions, and wet-dry cycling prevalent at and sites. Therefore, improved, low permeability, high integrity materials are under investigation by the Department of Energy's (DOE) Office of Technology Development, Integrated Demonstrations and Programs. The binders chosen for characterization include: an acrylic, a vinylester styrene, bitumen, a polyester styrene, furfuryl alcohol, and sulfur polymer cement. These materials cover broad ranges of chemical and physical durability, performance, viscosity, and cost. This report details the results of laboratory formulation, testing, and characterization of several innovative polymer grouts. An appendix containing a database of the barrier materials is at the end of this report

  12. Making connections: Case studies of interconnection barriers and their impact on distributed power projects

    Energy Technology Data Exchange (ETDEWEB)

    Alderfer, B.; Eldridge, M.; Starrs, T.

    2000-07-25

    Distributed power is modular electric generation or storage located close to the point of use. Based on interviews of distributed generation project proponents, this report reviews the barriers that distributed generators of electricity are encountering when attempting to interconnect to the electrical grid. Descriptions of 26 of 65 case studies are included in the report. The survey found and the report describes a wide range of technical, business-practice, and regulatory barriers to interconnection. An action plan for reducing the impact of these barriers is also included.

  13. Cementitious Barriers Partnership FY2013 End-Year Report

    Energy Technology Data Exchange (ETDEWEB)

    Flach, G. P. [Savannah River Site (SRS), Aiken, SC (United States); Langton, C. A. [Savannah River Site (SRS), Aiken, SC (United States); Burns, H. H. [Savannah River Site (SRS), Aiken, SC (United States); Smith, F. G. [Savannah River Site (SRS), Aiken, SC (United States); Kosson, D. S. [Vanderbilt University, School of Engineering, Nashville, TN (United States); Brown, K. G. [Vanderbilt University, School of Engineering, Nashville, TN (United States); Samson, E. [SIMCO Technologies, Inc., Quebec (Canada); Meeussen, J. C.L. [Nuclear Research and Consultancy Group (NRG), Petten (The Netherlands); van der Sloot, H. A. [Hans van der Sloot Consultancy, Langedijk (The Netherlands); Garboczi, E. J. [Materials & Construction Research Division, National Institute of Standards and Technology, Gaithersburg, MD (United States)

    2013-11-01

    In FY2013, the Cementitious Barriers Partnership (CBP) demonstrated continued tangible progress toward fulfilling the objective of developing a set of software tools to improve understanding and prediction of the long-term structural, hydraulic and chemical performance of cementitious barriers used in nuclear applications. In November 2012, the CBP released “Version 1.0” of the CBP Software Toolbox, a suite of software for simulating reactive transport in cementitious materials and important degradation phenomena. In addition, the CBP completed development of new software for the “Version 2.0” Toolbox to be released in early FY2014 and demonstrated use of the Version 1.0 Toolbox on DOE applications. The current primary software components in both Versions 1.0 and 2.0 are LeachXS/ORCHESTRA, STADIUM, and a GoldSim interface for probabilistic analysis of selected degradation scenarios. The CBP Software Toolbox Version 1.0 supports analysis of external sulfate attack (including damage mechanics), carbonation, and primary constituent leaching. Version 2.0 includes the additional analysis of chloride attack and dual regime flow and contaminant migration in fractured and non-fractured cementitious material. The LeachXS component embodies an extensive material property measurements database along with chemical speciation and reactive mass transport simulation cases with emphasis on leaching of major, trace and radionuclide constituents from cementitious materials used in DOE facilities, such as Saltstone (Savannah River) and Cast Stone (Hanford), tank closure grouts, and barrier concretes. STADIUM focuses on the physical and structural service life of materials and components based on chemical speciation and reactive mass transport of major cement constituents and aggressive species (e.g., chloride, sulfate, etc.). THAMES is a planned future CBP Toolbox component focused on simulation of the microstructure of cementitious materials and calculation of resultant

  14. Barriers to disaster preparedness among medical special needs populations

    Directory of Open Access Journals (Sweden)

    Leslie eMeyer

    2015-09-01

    Full Text Available A medical special needs (MSN assessment was conducted among 3088 respondents in a hurricane prone area. The sample was female (51.7%, Hispanic (92.9%, aged > 45 years (51%, not insured for health (59.2%, and with an MSN (33.2%. Barriers to preparedness were characterized for all households, including those with inhabitants reporting MSN ranging from level 0 (mild to level 4 (most severe. Multivariable logistic regression tested associations between hurricane preparedness and barriers to evacuation by level of MSN. A significant interaction effect between number of evacuation barriers and MSN was found. Among households that reported individuals with level 0 MSN, the odds of being unprepared increased 18% for each additional evacuation barrier [OR=1.18, 95% CI (1.08, 1.30]. Among households that reported individuals with level 1 MSN, the odds of being unprepared increased 29% for each additional evacuation barrier [OR=1.29, 95% CI (1.11, 1.51]. Among households that reported individuals with level 3 MSN, the odds of being unprepared increased 68% for each additional evacuation barrier [OR=1.68, 95% CI (1.21, 1.32]. MSN alone did not explain the probability of unpreparedness, but rather MSN in the presence of barriers helped explain unpreparedness.

  15. A systematic review of perceived barriers and motivators to physical activity after stroke.

    Science.gov (United States)

    Nicholson, Sarah; Sniehotta, Falko F; van Wijck, Frederike; Greig, Carolyn A; Johnston, Marie; McMurdo, Marion E T; Dennis, Martin; Mead, Gillian E

    2013-07-01

    Physical fitness is impaired after stroke, may contribute to disability, yet is amenable to improvement through regular physical activity. To facilitate uptake and maintenance of physical activity, it is essential to understand stroke survivors' perceived barriers and motivators. Therefore, we undertook a systematic review of perceived barriers and motivators to physical activity after stroke. Electronic searches of EMBASE, Medline, CINAHL, and PsychInfo were performed. We included peer-reviewed journal articles, in English, between 1 January 1966 and 30 August 2010 reporting stroke survivors' perceived barriers and motivators to physical activity. Searches identified 73,807 citations of which 57 full articles were retrieved. Six articles were included, providing data on 174 stroke survivors (range 10 to 83 per article). Two reported barriers and motivators, two reported only motivators, and two reported only barriers. Five were qualitative articles and one was quantitative. The most commonly reported barriers were lack of motivation, environmental factors (e.g. transport), health concerns, and stroke impairments. The most commonly reported motivators were social support and the need to be able to perform daily tasks. This review has furthered our understanding of the perceived barriers and motivators to physical activity after a stroke. This review will enable the development of tailored interventions to target barriers, while building upon perceived motivators to increase and maintain stroke survivors' physical activity. © 2012 The Authors. International Journal of Stroke © 2012 World Stroke Organization.

  16. Barriers to blood glucose monitoring in a multiethnic community.

    Science.gov (United States)

    Zgibor, Janice C; Simmons, David

    2002-10-01

    We studied a multiethnic community to determine factors associated with blood glucose monitoring (BGM) and to determine the independent association between barriers to diabetes care and BGM. A total of 323 participants (35.6% European, 32.2% Maori, and 32.2% Pacific Islander) from the South Auckland Diabetes Project (free of major complications by self-report) completed a qualitative survey to determine barriers to diabetes care. Five barriers to diabetes care categories were generated including internal psychological (self efficacy/health beliefs), external psychological (psychosocial environment), internal physical (comorbidities/side effects of treatment), external physical (finance/access to care), and educational (knowledge of diabetes/services) barriers. Characteristics associated with BGM greater than or equal to twice weekly were female sex, HbA(1c) >8%, higher diabetes knowledge scores, and insulin use. Multivariate analyses demonstrated that those reporting external physical barriers (OR 0.47, 95% CI 0.26-0.84), external psychological barriers (0.55, 0.30-1.0), and internal psychological barriers (0.56, 0.32-1.0) were less likely to perform BGM independent of ethnicity, insulin use, age, sex, diabetes knowledge, and glycemic control. Further multivariate analyses demonstrated that those reporting external physical barriers, particularly related to personal finance, were less likely to perform BGM. These data demonstrate that patient-reported barriers to diabetes care are associated with BGM, particularly in relation to financial, psychosocial, and self-efficacy issues. Understanding these barriers and overcoming them within the context of the patient's ethnic environment may lead to increased participation in self-care.

  17. Implementing patient-reported outcome measures in palliative care clinical practice: a systematic review of facilitators and barriers.

    Science.gov (United States)

    Antunes, Bárbara; Harding, Richard; Higginson, Irene J

    2014-02-01

    Many patient-reported outcome measures have been developed in the past two decades, playing an increasingly important role in palliative care. However, their routine use in practice has been slow and difficult to implement. To systematically identify facilitators and barriers to the implementation of patient-reported outcome measures in different palliative care settings for routine practice, and to generate evidence-based recommendations, to inform the implementation process in clinical practice. Systematic literature review and narrative synthesis. Medline, PsycInfo, Cumulative Index to Nursing and Allied Health Literature, Embase and British Nursing Index were systematically searched from 1985. Hand searching of reference lists for all included articles and relevant review articles was performed. A total of 3863 articles were screened. Of these, 31 articles met the inclusion criteria. First, data were integrated in the main themes: facilitators, barriers and lessons learned. Second, each main theme was grouped into either five or six categories. Finally, recommendations for implementation on outcome measures at management, health-care professional and patient levels were generated for three different points in time: preparation, implementation and assessment/improvement. Successful implementation of patient-reported outcome measures should be tailored by identifying and addressing potential barriers according to setting. Having a coordinator throughout the implementation process seems to be key. Ongoing cognitive and emotional processes of each individual should be taken into consideration during changes. The educational component prior to the implementation is crucial. This could promote ownership and correct use of the measure by clinicians, potentially improving practice and the quality of care provided through patient-reported outcome measure data use in clinical decision-making.

  18. Effects of barrier composition and electroplating chemistry on adhesion and voiding in copper/dielectric diffusion barrier films

    Energy Technology Data Exchange (ETDEWEB)

    Birringer, Ryan P.; Dauskardt, Reinhold H. [Department of Materials Science and Engineering, Stanford University, Durand Building, Stanford, California 94305-4034 (United States); Shaviv, Roey [Novellus Systems Inc., 4000 North First Street, San Jose, California 95134 (United States); Geiss, Roy H.; Read, David T. [National Institute of Standards and Technology, 325 Broadway, Boulder, Colorado 80305 (United States)

    2011-08-15

    The effects of electroplating chemistry and dielectric diffusion barrier composition on copper voiding and barrier adhesion are reported. Adhesion was quantified using the four-point bend thin film adhesion technique, and voiding in the Cu films was quantified using scanning electron microscopy. A total of 12 different film stacks were investigated, including three different Cu electroplating chemistries and four different barrier materials (SiN, N-doped SiC, O-doped SiC, and dual-layer SiC). Both plating chemistry and barrier composition have a large effect on interface adhesion and voiding in the Cu film. X-ray photoelectron spectroscopy was used to investigate the segregation of Cu electroplating impurities, such as S and Cl, to the Cu/barrier interface. Secondary ion mass spectrometry was used to quantify oxygen content at the Cu/barrier interface in a subset of samples. This interface oxygen content is correlated with measured adhesion values.

  19. Barriers to treatment for older adults seeking psychological therapy.

    Science.gov (United States)

    Wuthrich, Viviana M; Frei, Jacqueline

    2015-07-01

    Older adults with mental health disorders underutilize mental health services more than other adults. While there are well known general barriers to help seeking across the population, specific barriers for older adults include difficulties with transportation, beliefs that it is normal to be anxious and depressed in old age, and beliefs by referrers that psychological therapy is less likely to be effective. This study examined barriers related to identifying the need for help, seeking help and participating in therapy in a clinical population of older adults. Sixty older adults (aged 60-79 years) with comorbid anxiety and unipolar mood disorders completed barriers to treatment questionnaires before and after psychological group treatment, as well as measures of cognitive ability, anxiety, depression, and quality of life at baseline. The greatest barriers to help seeking related to difficulties identifying the need for help, with 50% of the sample reporting their belief that their symptoms were normal as a major barrier. Other major barriers identified were related to: self-reliance, cost of treatment, and fear of medication replicating previous findings. The main barriers reported for difficulties in continuing therapy included not finding therapy helpful, cost of treatment, and thinking that the therapist did not understand their issues. The main barriers identified related to issues with identifying the need to seek help. More attention is needed to educate older adults and professionals about the need for, and effectiveness of, psychological therapies for older adults with anxiety and depression to reduce this barrier to help seeking.

  20. Perceived barriers to physical activity among Nigerian stroke survivors.

    Science.gov (United States)

    Idowu, Opeyemi Ayodiipo; Adeniyi, Ade Fatai; Ogwumike, Omoyemi Olubunmi; Fawole, Henrietta Oluwafunmilola; Akinrolie, Olayinka

    2015-01-01

    Benefits of physical activity in the prevention and management of stroke are well documented in the literature. There is increasing evidence that stroke survivors in South-West Nigeria are physically inactive. Data on barriers to the achievement of the recommended physical activity levels including its differences along socio-demographic characteristics among stroke survivors in South-West Nigeria are needed. The Exercise Benefits and Barrier Scale and the International Physical Activity Questionnaire were administered on 121 stroke survivors to determine their perceived barriers to physical activity and physical activity levels respectively. Information on socio-demographic data and clinical variables were also collected. The sample included 70.2% males, with majority of the participants reporting low physical activity levels (80.2%) and high perceived barriers (Mean = 48.13, SD = 7.88). The four most reported common barriers among stroke survivors were access to exercise facilities (95.0%), being embarrassed to exercise (94.2%), economic cost demands of exercise (94.2%) and notion that people in exercise clothes look funny (94.2%) respectively. There were no significant differences found in barriers to physical activity between gender (U = 1471.00, P = 0.74) and across each of: occupational status (H = 4.37, P = 0.22), age group (H = 0.82, P = 0.84) and educational levels (H = 4.56, P = 0.33). Significant difference however existed in perceived barriers across marital status categories (H = 12.87, P = 0.05). Stroke survivors indicated high perceived barriers to physical activity and these barriers were associated with marital status.

  1. Frozen soil barrier technology. Innovative technology summary report

    International Nuclear Information System (INIS)

    1995-04-01

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

  2. 78 FR 63271 - Request for Public Comments to Compile the Report on Technical Barriers to Trade

    Science.gov (United States)

    2013-10-23

    ... 2014 a Report on Technical Barriers to Trade (TBT Report) identifying and analyzing significant...: Questions regarding the TBT Report or substantive questions or comments concerning standards-related..., USTR (202-395-4498). SUPPLEMENTARY INFORMATION: The TBT Report sets out an inventory of standards...

  3. Cementitious Barriers Partnership - FY2015 End-Year Report

    International Nuclear Information System (INIS)

    Burns, H. H.; Flach, G. P.; Langton, C. A.; Smith, F. G.; Kosson, D. S.; Meeussen, J. C. L.; Seignette, Paul; Van der Sloot, H. A.

    2015-01-01

    The DOE-EM Office of Tank Waste Management Cementitious Barriers Partnership (CBP) is chartered with providing the technical basis for implementing cement-based waste forms and radioactive waste containment structures for long-term disposal. Therefore, the CBP ultimate purpose is to support progress in final treatment and disposal of legacy waste and closure of High-Level Waste (HLW) tanks in the DOE complex. This status report highlights the CBP 2015 Software and Experimental Program efforts and accomplishments that support DOE needs in environmental cleanup and waste disposal. DOE needs in this area include: Long-term performance predictions to provide credibility (i.e., a defensible technical basis) for regulator and DOE review and approvals, Facility flow sheet development/enhancements, and Conceptual designs for new disposal facilities. In 2015, the CBP developed a beta release of the CBP Software Toolbox - ''Version 3.0'', which includes new STADIUM carbonation and damage models, a new SRNL module for estimating hydraulic properties and flow in fractured and intact cementitious materials, and a new LeachXS/ORCHESTRA (LXO) oxidation module. In addition, the STADIUM sulfate attack and chloride models have been improved as well as the LXO modules for sulfate attack, carbonation, constituent leaching, and percolation with radial diffusion (for leaching and transport in cracked cementitious materials). These STADIUM and LXO models are applicable to and can be used by both DOE and the Nuclear Regulatory Commission (NRC) end-users for service life prediction and long-term leaching evaluations of radioactive waste containment structures across the DOE complex.

  4. Cementitious Barriers Partnership - FY2015 End-Year Report

    Energy Technology Data Exchange (ETDEWEB)

    Burns, H. H. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Flach, G. P. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Langton, C. A. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Smith, F. G. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Kosson, D. S. [Vanderbilt Univ., Nashville, TN (United States). School of Engineering; Brown, K. G. [Vanderbilt Univ., Nashville, TN (United States). School of Engineering; Samson, E. [SIMCO Technologies, Inc., QC (Canada); Meeussen, J. C. L. [Nuclear Research and Consultancy Group (NRG); Seignette, Paul [Energy Research Center of the Netherlands; van der Sloot, H. A. [Hans van der Sloot Consultancy

    2015-09-17

    The DOE-EM Office of Tank Waste Management Cementitious Barriers Partnership (CBP) is chartered with providing the technical basis for implementing cement-based waste forms and radioactive waste containment structures for long-term disposal. Therefore, the CBP ultimate purpose is to support progress in final treatment and disposal of legacy waste and closure of High-Level Waste (HLW) tanks in the DOE complex. This status report highlights the CBP 2015 Software and Experimental Program efforts and accomplishments that support DOE needs in environmental cleanup and waste disposal. DOE needs in this area include: Long-term performance predictions to provide credibility (i.e., a defensible technical basis) for regulator and DOE review and approvals, Facility flow sheet development/enhancements, and Conceptual designs for new disposal facilities. In 2015, the CBP developed a beta release of the CBP Software Toolbox – “Version 3.0”, which includes new STADIUM carbonation and damage models, a new SRNL module for estimating hydraulic properties and flow in fractured and intact cementitious materials, and a new LeachXS/ORCHESTRA (LXO) oxidation module. In addition, the STADIUM sulfate attack and chloride models have been improved as well as the LXO modules for sulfate attack, carbonation, constituent leaching, and percolation with radial diffusion (for leaching and transport in cracked cementitious materials). These STADIUM and LXO models are applicable to and can be used by both DOE and the Nuclear Regulatory Commission (NRC) end-users for service life prediction and long-term leaching evaluations of radioactive waste containment structures across the DOE complex.

  5. CMHC research project: Testing of air barrier construction details, II: Report

    Energy Technology Data Exchange (ETDEWEB)

    1993-01-01

    Air leakage control through the building envelope of wood framed houses is more important than ever. The leakage of air is controlled by the air barrier system. There are several new technologies to construct an air barrier system for the building envelope. These are the Poly Approach, the Air Drywall Approach and the EASE system. The development of these systems was undertaken primarily by the building community without significant research and development. The purpose of this study was to determine the actual performance of several different types of construction details for each of the different approaches. Each of these details was designed and constructed using one of the air barrier methods and tested in the laboratory. The test details included the sill plate, the partition wall, the stair stringer, the electrical outlets, the bathtub detail, the plumbing stack detail, the metal chimney detail, the bathroom fan detail and the EASE wall system.

  6. Barriers to participation in mental health research: are there specific gender, ethnicity and age related barriers?

    Directory of Open Access Journals (Sweden)

    Howard Louise

    2010-12-01

    Full Text Available Abstract Background It is well established that the incidence, prevalence and presentation of mental disorders differ by gender, ethnicity and age, and there is evidence that there is also differential representation in mental health research by these characteristics. The aim of this paper is to a review the current literature on the nature of barriers to participation in mental health research, with particular reference to gender, age and ethnicity; b review the evidence on the effectiveness of strategies used to overcome these barriers. Method Studies published up to December 2008 were identified using MEDLINE, PsycINFO and EMBASE using relevant mesh headings and keywords. Results Forty-nine papers were identified. There was evidence of a wide range of barriers including transportation difficulties, distrust and suspicion of researchers, and the stigma attached to mental illness. Strategies to overcome these barriers included the use of bilingual staff, assistance with travel, avoiding the use of stigmatising language in marketing material and a focus on education about the disorder under investigation. There were very few evaluations of such strategies, but there was evidence that ethnically matching recruiters to potential participants did not improve recruitment rates. Educational strategies were helpful and increased recruitment. Conclusion Mental health researchers should consider including caregivers in recruitment procedures where possible, provide clear descriptions of study aims and describe the representativeness of their sample when reporting study results. Studies that systematically investigate strategies to overcome barriers to recruitment are needed.

  7. Self-reported hand hygiene perceptions and barriers among companion animal veterinary clinic personnel in Ontario, Canada

    Science.gov (United States)

    Anderson, Maureen E.C.; Weese, J. Scott

    2016-01-01

    The objective of this study was to describe the perceived importance of and barriers to hand hygiene among companion animal clinic staff. An anonymous, voluntary written questionnaire was completed by 356 of approximately 578 individuals (62%) from 49/51 clinics. On a scale of 1 (not important) to 7 (very important), the percentage of respondents who rated hand hygiene as a 5 or higher was at least 82% in all clinical scenarios queried. The most frequently reported reason for not performing hand hygiene was forgetting to do so (40%, 141/353). Specific discussion of hand hygiene practices at work was recalled by 32% (114/354) of respondents. Although veterinary staff seem to recognize the importance of hand hygiene, it should be emphasized more during staff training. Other barriers including time constraints and skin irritation should also be addressed, possibly through increased access to and use of alcohol-based hand sanitizers. PMID:26933265

  8. ENGINEERED BARRIER SYSTEM: PHYSICAL AND CHEMICAL ENVIRONMENT

    International Nuclear Information System (INIS)

    R. Jarek

    2005-01-01

    The purpose of this model report is to describe the evolution of the physical and chemical environmental conditions within the waste emplacement drifts of the repository, including the drip shield and waste package surfaces. The resulting seepage evaporation and gas abstraction models are used in the total system performance assessment for the license application (TSPA-LA) to assess the performance of the engineered barrier system and the waste form. This report develops and documents a set of abstraction-level models that describe the engineered barrier system physical and chemical environment. Where possible, these models use information directly from other reports as input, which promotes integration among process models used for TSPA-LA. Specific tasks and activities of modeling the physical and chemical environment are included in ''Technical Work Plan for: Near-Field Environment and Transport In-Drift Geochemistry Model Report Integration'' (BSC 2005 [DIRS 173782], Section 1.2.2). As described in the technical work plan, the development of this report is coordinated with the development of other engineered barrier system reports. To be consistent with other project documents that address features, events, and processes (FEPs), Table 6.14.1 of the current report includes updates to FEP numbers and FEP subjects for two FEPs identified in the technical work plan (TWP) governing this report (BSC 2005 [DIRS 173782]). FEP 2.1.09.06.0A (Reduction-oxidation potential in EBS), as listed in Table 2 of the TWP (BSC 2005 [DIRS 173782]), has been updated in the current report to FEP 2.1.09.06.0B (Reduction-oxidation potential in Drifts; see Table 6.14-1). FEP 2.1.09.07.0A (Reaction kinetics in EBS), as listed in Table 2 of the TWP (BSC 2005 [DIRS 173782]), has been updated in the current report to FEP 2.1.09.07.0B (Reaction kinetics in Drifts; see Table 6.14-1). These deviations from the TWP are justified because they improve integration with FEPs documents. The updates

  9. Barriers to mental health treatment for military wives.

    Science.gov (United States)

    Lewy, Colleen S; Oliver, Celina M; McFarland, Bentson H

    2014-09-01

    An Internet-based survey sought information about barriers to mental health services for military wives. On the basis of qualitative work, an Internet-based program was created to identify military wives who may have major depressive disorder. Women (N=569, ages 18 to 56) were recruited from 45 states and eight foreign countries. Most participants (78%) reported mild to severe depression. Many (44%) reported unaddressed mental health needs. Barriers included inability to attend daytime appointments (38%), inability to find a counselor who understands the needs of military spouses (35%), inability to find a counselor the participant could trust (29%), concerns about confidentiality (26%), and lack of knowledge about where to get services (25%). The barriers reported differed markedly from those described by distressed women in the general population. Military wives are an underserved population. Knowledge of military culture is essential for civilian mental health providers working with military wives.

  10. No Easy Talk: A Mixed Methods Study of Doctor Reported Barriers to Conducting Effective End-of-Life Conversations with Diverse Patients.

    Directory of Open Access Journals (Sweden)

    Vyjeyanthi S Periyakoil

    Full Text Available Though most patients wish to discuss end-of-life (EOL issues, doctors are reluctant to conduct end-of-life conversations. Little is known about the barriers doctors face in conducting effective EOL conversations with diverse patients. This mixed methods study was undertaken to empirically identify barriers faced by doctors (if any in conducting effective EOL conversations with diverse patients and to determine if the doctors' age, gender, ethnicity and medical sub-specialty influenced the barriers reported.Mixed-methods study of multi-specialty doctors caring for diverse, seriously ill patients in two large academic medical centers at the end of the training; data were collected from 2010 to 2012.Doctor-reported barriers to EOL conversations with diverse patients.1040 of 1234 potential subjects (84.3% participated. 29 participants were designated as the development cohort for coding and grounded theory analyses to identify primary barriers. The codes were validated by analyses of responses from 50 randomly drawn subjects from the validation cohort (n= 996 doctors. Qualitative responses from the validation cohort were coded and analyzed using quantitative methods. Only 0.01% doctors reported no barriers to conducting EOL conversations with patients. 99.99% doctors reported barriers with 85.7% finding it very challenging to conduct EOL conversations with all patients and especially so with patients whose ethnicity was different than their own. Asian-American doctors reported the most struggles (91.3%, followed by African Americans (85.3%, Caucasians (83.5% and Hispanic Americans (79.3% in conducting EOL conversations with their patients. The biggest doctor-reported barriers to effective EOL conversations are (i language and medical interpretation issues, (ii patient/family religio-spiritual beliefs about death and dying, (iii doctors' ignorance of patients' cultural beliefs, values and practices, (iv patient/family's cultural differences in truth

  11. Development of self-report measures of social attitudes that act as environmental barriers and facilitators for people with disabilities.

    Science.gov (United States)

    Garcia, Sofia F; Hahn, Elizabeth A; Magasi, Susan; Lai, Jin-Shei; Semik, Patrick; Hammel, Joy; Heinemann, Allen W

    2015-04-01

    To describe the development of new self-report measures of social attitudes that act as environmental facilitators or barriers to the participation of people with disabilities in society. A mixed-methods approach included a literature review; item classification, selection, and writing; cognitive interviews and field testing of participants with spinal cord injury (SCI), traumatic brain injury (TBI), or stroke; and rating scale analysis to evaluate initial psychometric properties. General community. Individuals with SCI, TBI, or stroke participated in cognitive interviews (n=9); community residents with those same conditions participated in field testing (n=305). None. Self-report item pool of social attitudes that act as facilitators or barriers to people with disabilities participating in society. An interdisciplinary team of experts classified 710 existing social environment items into content areas and wrote 32 new items. Additional qualitative item review included item refinement and winnowing of the pool prior to cognitive interviews and field testing of 82 items. Field test data indicated that the pool satisfies a 1-parameter item response theory measurement model and would be appropriate for development into a calibrated item bank. Our qualitative item review process supported a social environment conceptual framework that includes both social support and social attitudes. We developed a new social attitudes self-report item pool. Calibration testing of that pool is underway with a larger sample to develop a social attitudes item bank for persons with disabilities. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  12. Socio-demographic and behavioral variation in barriers to leisure-time physical activity.

    Science.gov (United States)

    Borodulin, Katja; Sipilä, Noora; Rahkonen, Ossi; Leino-Arjas, Päivi; Kestilä, Laura; Jousilahti, Pekka; Prättälä, Ritva

    2016-02-01

    We examined the socio-demographic and behavioral determinants of perceived barriers to leisure-time physical activity (LTPA) in a population-based sample of working-aged adults. Data comprised the National FINRISK 2002 Study, a population-based health examination study. Analyses were restricted to those aged 25-64 years and who perceived that their amount of LTPA did not reach sufficient levels. They reported barriers to LTPA, defined as a lack of time, motivation and lack of companionship to be active with, as well as high expenses. Age, education, household income, employment status, family type, physical activity, smoking and body mass index (BMI) were included as explanatory variables. Lack of time was the most frequent barrier. Each barrier was explained by a different set of factors that also varied between genders. The strongest and most systematic associations with the barriers were found for age, employment status and family type. Lack of time was less often reported as a barrier among the unemployed, singles without children and older people. Lacking motivation as a barrier was most common among singles without children. High expenses as a barrier was more often reported by the unemployed, and less often reported in the highest income group. When considering actions to promote LTPA, there is not one single solution, because the perceived barriers vary by population subgroups. © 2015 the Nordic Societies of Public Health.

  13. Model for safety reports including descriptive examples

    International Nuclear Information System (INIS)

    1995-12-01

    Several safety reports will be produced in the process of planning and constructing the system for disposal of high-level radioactive waste in Sweden. The present report gives a model, with detailed examples, of how these reports should be organized and what steps they should include. In the near future safety reports will deal with the encapsulation plant and the repository. Later reports will treat operation of the handling systems and the repository

  14. Understanding the barriers to physician error reporting and disclosure: a systemic approach to a systemic problem.

    Science.gov (United States)

    Perez, Bianca; Knych, Stephen A; Weaver, Sallie J; Liberman, Aaron; Abel, Eileen M; Oetjen, Dawn; Wan, Thomas T H

    2014-03-01

    The issues of medical errors and medical malpractice have stimulated significant interest in establishing transparency in health care, in other words, ensuring that medical professionals formally report medical errors and disclose related outcomes to patients and families. However, research has amply shown that transparency is not a universal practice among physicians. A review of the literature was carried out using the search terms "transparency," "patient safety," "disclosure," "medical error," "error reporting," "medical malpractice," "doctor-patient relationship," and "physician" to find articles describing physician barriers to transparency. The current literature underscores that a complex Web of factors influence physician reluctance to engage in transparency. Specifically, 4 domains of barriers emerged from this analysis: intrapersonal, interpersonal, institutional, and societal. Transparency initiatives will require vigorous, interdisciplinary efforts to address the systemic and pervasive nature of the problem. Several ethical and social-psychological barriers suggest that medical schools and hospitals should collaborate to establish continuity in education and ensure that knowledge acquired in early education is transferred into long-term learning. At the institutional level, practical and cultural barriers suggest the creation of supportive learning environments and private discussion forums where physicians can seek moral support in the aftermath of an error. To overcome resistance to culture transformation, incremental change should be considered, for example, replacing arcane transparency policies and complex reporting mechanisms with clear, user-friendly guidelines.

  15. Engineered Barrier System: Physical and Chemical Environment

    International Nuclear Information System (INIS)

    Dixon, P.

    2004-01-01

    The conceptual and predictive models documented in this Engineered Barrier System: Physical and Chemical Environment Model report describe the evolution of the physical and chemical conditions within the waste emplacement drifts of the repository. The modeling approaches and model output data will be used in the total system performance assessment (TSPA-LA) to assess the performance of the engineered barrier system and the waste form. These models evaluate the range of potential water compositions within the emplacement drifts, resulting from the interaction of introduced materials and minerals in dust with water seeping into the drifts and with aqueous solutions forming by deliquescence of dust (as influenced by atmospheric conditions), and from thermal-hydrological-chemical (THC) processes in the drift. These models also consider the uncertainty and variability in water chemistry inside the drift and the compositions of introduced materials within the drift. This report develops and documents a set of process- and abstraction-level models that constitute the engineered barrier system: physical and chemical environment model. Where possible, these models use information directly from other process model reports as input, which promotes integration among process models used for total system performance assessment. Specific tasks and activities of modeling the physical and chemical environment are included in the technical work plan ''Technical Work Plan for: In-Drift Geochemistry Modeling'' (BSC 2004 [DIRS 166519]). As described in the technical work plan, the development of this report is coordinated with the development of other engineered barrier system analysis model reports

  16. Evaluation of the potential of PV noise barrier technology for electricity production and market share. Final report

    International Nuclear Information System (INIS)

    Goetzberger, A.; Kleiss, G.; Castello, S.; Hille, G.; Reise, C.; Wiemken, E.; Betcke, J.W.H.; Van Dijk, V.A.P.; Pearsall, N.; Hynes, K.; Gaidddon, B.; Nordmann, T.; Froelich, A.

    1999-06-01

    The analysis of existing and planned noise barriers along rails and roads has been carried out by the national partners together with national authorities, which are experts and responsible for the required data. The methodical approach of this study includes the set-up of a grid along longitude and latitudes with 1 by 1 degrees for Germany, Italy, France, United Kingdom and 0.5 by 0.5 degrees for the Netherlands and Switzerland. For each degree the length and orientation of rails and roads, the existing and planned noise barriers are registered and grouped according to their orientations. The solar radiation is based on data of a METEONORM data set. This includes the solar radiation on horizontal orientation as well as various inclination angles for all possible orientations. Moreover, possible shading has been considered. The technical specifications of noise barriers (PVNB) are based on the comprehensive knowledge of TNC GmbH and TNC AG with various plants realised. Technologies have been considered for both state-of-the-art and innovative concepts such as bifacial PVNB. In bifacial PVNB the PV-module is mounted vertically on both sides and is used at the same time as noise reflecting material. Installed PV power and produced electricity have been calculated for: 1. theoretical potential 2. technical potential 3. short-term resp. European extrapolated potential 4. anticipated potential 5. EU-member assessment The result of this study confirms the current activities to implement PV on noise barriers as an important share in the PV market.The report is subdivided into two volumes: Volume 1 contains the main topics and results, and Volume 2 contains additional information on the solar radiation, typical concepts as an excerpt of the various potentials and all country maps with the required explanations. 95 refs

  17. 78 FR 50481 - Request for Public Comments Regarding the National Trade Estimate Report on Foreign Trade Barriers

    Science.gov (United States)

    2013-08-19

    ... barriers to U.S. exports of goods, services, and U.S. foreign direct investment for inclusion in the NTE... affecting U.S. exports of goods and services, U.S. foreign direct investment, and protection of intellectual... National Trade Estimate Report on Foreign Trade Barriers AGENCY: Office of the United States Trade...

  18. Estimating the Economic Effects of Reducing Non-Tariff Barriers in the EEU

    OpenAIRE

    Vinokurov, Evgeny; Demidenko, Mikhail; Pelipas, Igor; Tochitskaya, Irina; Shymanovich, Gleb; Lipin, Andrey; Movchan, Veronika

    2015-01-01

    The report provides the first comprehensive assessment of the effects of non-tariff barriers on mutual trade in the EEU and gives recommendations as to how to remove them. It is based on a poll of 530 Russian, Kazakh and Belarusian exporters. In the research non-tariff barriers are divided into two groups. The first group includes non-tariff barriers such as sanitary and phytosanitary measures, technical barriers to trade, quotas, prohibitions, and quantitative controls. The second group comp...

  19. Barriers to Use of Family Planning Methods Among Heterosexual Mexican Couples.

    Science.gov (United States)

    Arias, María Luisa Flores; Champion, Jane Dimmitt; Soto, Norma Elva Sáenz; Tovar, Marlene; Dávila, Sandra Paloma Esparza

    2017-05-01

    Family planning has become increasingly important as a fundamental component of sexual health and as such is offered via public health systems worldwide. Identification of barriers to use of family planning methods among heterosexual couples living in Mexico is indicated to facilitate access to family planning methods. Barriers to family planning methods were assessed among Mexican heterosexual, sexually active males and females of reproductive age, using a modified Spanish version of the Barriers to the Use of Family Planning Methods scale (Cronbach's alpha = .89, subscales ranging from .53 to .87). Participants were recruited via convenience sampling in ambulatory care clinics within a metropolitan area in Central Mexico. Participants included 52 heterosexual couples aged 18-35 years (N = 104). Sociodemographic comparisons by gender identified older age and higher education, income, and numbers of sexual partners among men than women. More men (50%) than women (25%) were currently using family planning methods; however, 80% overall indicated intentions for its use. Overall, male condoms were used and intended for use most often by men than women. Significant gender-specific differences were found, with men (71.15%) reporting no family planning barriers, whereas women (55.66%) reported barriers including low socioeconomic status, medical concerns, and stigma. The modified Spanish translation demonstrated usefulness for measuring barriers to family planning methods use in Mexico among heterosexual males and females of reproductive age. Barriers identified by Mexican women in this study may be addressed to reduce potential barriers to family planning among Mexican populations.

  20. Sexual Harassment in Medical Schools: The Challenge of Covert Retaliation as a Barrier to Reporting.

    Science.gov (United States)

    Binder, Renee; Garcia, Paul; Johnson, Bonnie; Fuentes-Afflick, Elena

    2018-05-22

    Although Title IX, the federal law prohibiting sexual harassment in educational institutions, was enacted in 1972, sexual harassment continues to be distressingly common in medical training. In addition, many women who experience sexual harassment do not report their experiences to authorities within the medical school.In this article, the authors review the literature on the prevalence of sexual harassment in medical schools since Title IX was enacted and on the cultural and legal changes that have occurred during that period that have affected behaviors. These changes include decreased tolerance for harassing behavior, increased legal responsibility assigned to institutions, and a significant increase in the number of female medical students, residents, and faculty. The authors then discuss persisting barriers to reporting sexual harassment, including fears of reprisals and retaliation, especially covert retaliation. They define covert retaliation as vindictive comments made by a person accused of sexual harassment about his or her accuser in a confidential setting, such as a grant review, award selection, or search committee.The authors concluding by highlighting institutional and organizational approaches to decreasing sexual harassment and overt retaliation, and they propose other approaches to decreasing covert retaliation. These initiatives include encouraging senior faculty members to intervene and file bystander complaints when they witness inappropriate comments or behaviors as well as group reporting when multiple women are harassed by the same person.

  1. Barriers to Implementing a Reporting and Learning Patient Safety System: Pediatric Chiropractic Perspective.

    Science.gov (United States)

    Pohlman, Katherine A; Carroll, Linda; Hartling, Lisa; Tsuyuki, Ross T; Vohra, Sunita

    2016-04-01

    A reporting and learning system is a method of monitoring the occurrence of incidents that affect patient safety. This cross-sectional survey asked pediatric chiropractors about factors that may limit their participation in such a system. The list of potential barriers for participation was developed using a systematic approach. All members of the 2 pediatric councils associated with US national chiropractic organizations were invited to complete the survey (N = 400). The cross-sectional survey was created using an online survey tool (REDCap) and sent directly to member emails addressed by the respective executive committees. Of the 400 potential respondents, 81 responded (20.3%). The most common limitations to participating were identified as time pressure (96%) and patient concerns (81%). Reporting and learning systems have been utilized to increase safety awareness in many high-risk industries. To be successful, future patient safety studies with pediatric chiropractors need to ensure these barriers are understood and addressed. © The Author(s) 2015.

  2. Language barriers and patient safety risks in hospital care. A mixed methods study.

    Science.gov (United States)

    van Rosse, Floor; de Bruijne, Martine; Suurmond, Jeanine; Essink-Bot, Marie-Louise; Wagner, Cordula

    2016-02-01

    A language barrier has been shown to be a threat for quality of hospital care. International studies highlighted a lack of adequate noticing, reporting, and bridging of a language barrier. However, studies on the link between language proficiency and patient safety are scarce, especially in Europe. The present study investigates patient safety risks due to language barriers during hospitalization, and the way language barriers are detected, reported, and bridged in Dutch hospital care. We combined quantitative and qualitative methods in a sample of 576 ethnic minority patients who were hospitalized on 30 wards within four urban hospitals. The nursing and medical records of 17 hospital admissions of patients with language barriers were qualitatively analyzed, and complemented by 12 in-depth interviews with care providers and patients and/or their relatives to identify patient safety risks during hospitalization. The medical records of all 576 patients were screened for language barrier reports. The results were compared to patients' self-reported Dutch language proficiency. The policies of wards regarding bridging language barriers were compared with the reported use of interpreters in the medical records. Situations in hospital care where a language barrier threatened patient safety included daily nursing tasks (i.e. medication administration, pain management, fluid balance management) and patient-physician interaction concerning diagnosis, risk communication and acute situations. In 30% of the patients that reported a low Dutch proficiency, no language barrier was documented in the patient record. Relatives of patients often functioned as interpreter for them and professional interpreters were hardly used. The present study showed a wide variety of risky situations in hospital care for patients with language barriers. These risks can be reduced by adequately bridging the language barrier, which, in the first place, demands adequate detecting and reporting of a

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

    Science.gov (United States)

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

    2011-08-01

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

  4. Engineered Barrier System Thermal-Hydraulic-Chemical Column Test Report

    International Nuclear Information System (INIS)

    W.E. Lowry

    2001-01-01

    The Engineered Barrier System (EBS) Thermal-Hydraulic-Chemical (THC) Column Tests provide data needed for model validation. The EBS Degradation, Flow, and Transport Process Modeling Report (PMR) will be based on supporting models for in-drift THC coupled processes, and the in-drift physical and chemical environment. These models describe the complex chemical interaction of EBS materials, including granular materials, with the thermal and hydrologic conditions that will be present in the repository emplacement drifts. Of particular interest are the coupled processes that result in mineral and salt dissolution/precipitation in the EBS environment. Test data are needed for thermal, hydrologic, and geochemical model validation and to support selection of introduced materials (CRWMS M and O 1999c). These column tests evaluated granular crushed tuff as potential invert ballast or backfill material, under accelerated thermal and hydrologic environments. The objectives of the THC column testing are to: (1) Characterize THC coupled processes that could affect performance of EBS components, particularly the magnitude of permeability reduction (increases or decreases), the nature of minerals produced, and chemical fractionation (i.e., concentrative separation of salts and minerals due to boiling-point elevation). (2) Generate data for validating THC predictive models that will support the EBS Degradation, Flow, and Transport PMR, Rev. 01

  5. Engineered Barrier System: Physical and Chemical Environment

    Energy Technology Data Exchange (ETDEWEB)

    P. Dixon

    2004-04-26

    The conceptual and predictive models documented in this Engineered Barrier System: Physical and Chemical Environment Model report describe the evolution of the physical and chemical conditions within the waste emplacement drifts of the repository. The modeling approaches and model output data will be used in the total system performance assessment (TSPA-LA) to assess the performance of the engineered barrier system and the waste form. These models evaluate the range of potential water compositions within the emplacement drifts, resulting from the interaction of introduced materials and minerals in dust with water seeping into the drifts and with aqueous solutions forming by deliquescence of dust (as influenced by atmospheric conditions), and from thermal-hydrological-chemical (THC) processes in the drift. These models also consider the uncertainty and variability in water chemistry inside the drift and the compositions of introduced materials within the drift. This report develops and documents a set of process- and abstraction-level models that constitute the engineered barrier system: physical and chemical environment model. Where possible, these models use information directly from other process model reports as input, which promotes integration among process models used for total system performance assessment. Specific tasks and activities of modeling the physical and chemical environment are included in the technical work plan ''Technical Work Plan for: In-Drift Geochemistry Modeling'' (BSC 2004 [DIRS 166519]). As described in the technical work plan, the development of this report is coordinated with the development of other engineered barrier system analysis model reports.

  6. Devices for overcoming biological barriers: the use of physical forces to disrupt the barriers.

    Science.gov (United States)

    Mitragotri, Samir

    2013-01-01

    Overcoming biological barriers including skin, mucosal membranes, blood brain barrier as well as cell and nuclear membrane constitutes a key hurdle in the field of drug delivery. While these barriers serve the natural protective function in the body, they limit delivery of drugs into the body. A variety of methods have been developed to overcome these barriers including formulations, targeting peptides and device-based technologies. This review focuses on the use of physical methods including acoustic devices, electric devices, high-pressure devices, microneedles and optical devices for disrupting various barriers in the body including skin and other membranes. A summary of the working principles of these devices and their ability to enhance drug delivery is presented. Copyright © 2012. Published by Elsevier B.V.

  7. A home monitoring program including real-time wireless home spirometry in idiopathic pulmonary fibrosis: a pilot study on experiences and barriers.

    Science.gov (United States)

    Moor, C C; Wapenaar, M; Miedema, J R; Geelhoed, J J M; Chandoesing, P P; Wijsenbeek, M S

    2018-05-29

    In idiopathic pulmonary fibrosis (IPF), home monitoring experiences are limited, not yet real-time available nor implemented in daily care. We evaluated feasibility and potential barriers of a new home monitoring program with real-time wireless home spirometry in IPF. Ten patients with IPF were asked to test this home monitoring program, including daily home spirometry, for four weeks. Measurements of home and hospital spirometry showed good agreement. All patients considered real-time wireless spirometry useful and highly feasible. Both patients and researchers suggested relatively easy solutions for the identified potential barriers regarding real-time home monitoring in IPF.

  8. Multimethod Assessment of Medication Nonadherence and Barriers in Adolescents and Young Adults With Solid Organ Transplants.

    Science.gov (United States)

    Eaton, Cyd K; Gutierrez-Colina, Ana M; Quast, Lauren F; Liverman, Rochelle; Lee, Jennifer L; Mee, Laura L; Reed-Knight, Bonney; Cushman, Grace; Chiang, Gloria; Romero, Rene; Mao, Chad; Garro, Rouba; Blount, Ronald L

    2018-03-17

    To (a) examine levels of medication nonadherence in adolescent and young adult (AYA) solid organ transplant recipients based on AYA- and caregiver proxy-reported nonadherence to different medication types and the medication-level variability index (MLVI) for tacrolimus, and (b) examine associations of adherence barriers and AYA and caregiver emotional distress symptoms with reported nonadherence and the MLVI. The sample included 47 AYAs (M age = 16.67 years, SD = 1.74; transplant types: 25% kidney, 47% liver, 28% heart) and their caregivers (94 total participants). AYAs and caregivers reported on AYAs' adherence barriers and their own emotional functioning. Nonadherence was measured with AYA self- and caregiver proxy-report and the MLVI for tacrolimus. The majority of AYAs and caregivers denied nonadherence, with lower rates of nonadherence reported for antirejection medications. In contrast, 40% of AYAs' MLVI values indicated nonadherence to tacrolimus. AYAs and caregivers who verbally acknowledged nonadherence had more AYA barriers and greater caregiver emotional distress symptoms compared with those who denied nonadherence. AYAs with MLVIs indicating nonadherence had more barriers than AYAs with MLVIs indicating adherence. Multimethod nonadherence evaluations for AYA transplant recipients should assess objective nonadherence using the MLVI, particularly in light of low reported nonadherence rates for antirejection medications. Assessments should include adherence barriers measures, given associations with the MLVI, and potentially prioritize assessing barriers over gauging nonadherence via self- or proxy-reports. Caregiver emotional distress symptoms may also be considered to provide insight into family or environmental barriers to adherence.

  9. ENGINEERED BARRIER SYSTEM: PHYSICAL AND CHEMICAL ENVIRONMENT

    Energy Technology Data Exchange (ETDEWEB)

    R. Jarek

    2005-08-29

    The purpose of this model report is to describe the evolution of the physical and chemical environmental conditions within the waste emplacement drifts of the repository, including the drip shield and waste package surfaces. The resulting seepage evaporation and gas abstraction models are used in the total system performance assessment for the license application (TSPA-LA) to assess the performance of the engineered barrier system and the waste form. This report develops and documents a set of abstraction-level models that describe the engineered barrier system physical and chemical environment. Where possible, these models use information directly from other reports as input, which promotes integration among process models used for TSPA-LA. Specific tasks and activities of modeling the physical and chemical environment are included in ''Technical Work Plan for: Near-Field Environment and Transport In-Drift Geochemistry Model Report Integration'' (BSC 2005 [DIRS 173782], Section 1.2.2). As described in the technical work plan, the development of this report is coordinated with the development of other engineered barrier system reports. To be consistent with other project documents that address features, events, and processes (FEPs), Table 6.14.1 of the current report includes updates to FEP numbers and FEP subjects for two FEPs identified in the technical work plan (TWP) governing this report (BSC 2005 [DIRS 173782]). FEP 2.1.09.06.0A (Reduction-oxidation potential in EBS), as listed in Table 2 of the TWP (BSC 2005 [DIRS 173782]), has been updated in the current report to FEP 2.1.09.06.0B (Reduction-oxidation potential in Drifts; see Table 6.14-1). FEP 2.1.09.07.0A (Reaction kinetics in EBS), as listed in Table 2 of the TWP (BSC 2005 [DIRS 173782]), has been updated in the current report to FEP 2.1.09.07.0B (Reaction kinetics in Drifts; see Table 6.14-1). These deviations from the TWP are justified because they improve integration with FEPs

  10. Improved Barriers to Turbine Engine Fragments: Final Annual Report

    National Research Council Canada - National Science Library

    Shockey, Donald

    2002-01-01

    .... Previous large-scale fragment impact testing of comer peg-mounted fabric barriers indicated that the failure of the fabric around the pegged hole was a significant factor in the barrier's effectiveness...

  11. Nationwide survey on barriers for dental research in India

    Directory of Open Access Journals (Sweden)

    Kundendu Arya Bishen

    2015-01-01

    Full Text Available Objective: Research in the dental field is progressing at mightier speed worldwide, but an unfortunately representation of India at this platform is negligible. The present study was undertaken to unearth the barriers for dental research among dental professionals in Indian scenario. Materials and Methods: A cross-sectional questionnaire study was conducted on 1514 participant′s (Master of Dental Surgery and Bachelor of Dental Surgery staff and postgraduates in 40 dental colleges of India selected by multistage random sampling. The response rate was 75.7%. The survey was undertaken from July 2013 to December 2013. The survey instrument was 24-item, investigator developed, self-structured, close-ended, and self-administered questionnaire grouped into four categories that are, institutional/departmental support related barriers, financial/training support related barriers, time-related barriers, and general barriers. Results: Among all respondents 47.23% informed that they are administrative and educational work rather than research work as (P < 0.001. Overall 57.53% of study participants reported lack of administrative and technical support for research work as (P < 0.001. Overall 64.9% reported meager college funding was the barrier (P < 0.001. Overall 61.5% respondents reported lack of time to do research work due to clinical and teaching responsibilities (P < 0.001 was the barrier for research. Largely 80.25% agreed that, the lack of documentation and record maintenance are an obvious barrier for research (P < 0.001. Conclusions: Present study unearths certain barriers for research in an Indian scenario, which includes administrative overburden, lack of funds, and lack of documentation of the dental data. Governing authorities of dentistry in India have to make major interventions to make research non-intensive environment to research-friendly environment.

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

    International Nuclear Information System (INIS)

    Heiser, J.H.

    1997-09-01

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

  13. Engineered Barrier System: Physical and Chemical Environment Model

    International Nuclear Information System (INIS)

    Jolley, D. M.; Jarek, R.; Mariner, P.

    2004-01-01

    The conceptual and predictive models documented in this Engineered Barrier System: Physical and Chemical Environment Model report describe the evolution of the physical and chemical conditions within the waste emplacement drifts of the repository. The modeling approaches and model output data will be used in the total system performance assessment (TSPA-LA) to assess the performance of the engineered barrier system and the waste form. These models evaluate the range of potential water compositions within the emplacement drifts, resulting from the interaction of introduced materials and minerals in dust with water seeping into the drifts and with aqueous solutions forming by deliquescence of dust (as influenced by atmospheric conditions), and from thermal-hydrological-chemical (THC) processes in the drift. These models also consider the uncertainty and variability in water chemistry inside the drift and the compositions of introduced materials within the drift. This report develops and documents a set of process- and abstraction-level models that constitute the engineered barrier system: physical and chemical environment model. Where possible, these models use information directly from other process model reports as input, which promotes integration among process models used for total system performance assessment. Specific tasks and activities of modeling the physical and chemical environment are included in the technical work plan ''Technical Work Plan for: In-Drift Geochemistry Modeling'' (BSC 2004 [DIRS 166519]). As described in the technical work plan, the development of this report is coordinated with the development of other engineered barrier system analysis model reports

  14. Safety-barrier diagrams

    DEFF Research Database (Denmark)

    Duijm, Nijs Jan

    2007-01-01

    Safety-barrier diagrams and the related so-called "bow-tie" diagrams have become popular methods in risk analysis. This paper describes the syntax and principles for constructing consistent and valid safety-barrier diagrams. The relation with other methods such as fault trees and Bayesian networks...... are discussed. A simple method for quantification of safety-barrier diagrams is proposed, including situations where safety barriers depend on shared common elements. It is concluded that safety-barrier diagrams provide a useful framework for an electronic data structure that integrates information from risk...... analysis with operational safety management....

  15. Barriers and enablers to physical activity participation in patients with COPD: a systematic review.

    Science.gov (United States)

    Thorpe, Olivia; Johnston, Kylie; Kumar, Saravana

    2012-01-01

    Physical activity (PA) has been shown to improve symptoms in people with chronic obstructive pulmonary disease (COPD). Despite the high health and financial costs, the uptake of management strategies, particularly participation in PA and pulmonary rehabilitation (PR), are low. The review objective here was to identify potential barriers and enablers, which people with COPD report being associated with their participation in PA programs, including PR. A systematic search was undertaken to identify studies (published Jan 2000 to Aug 2011) reporting any barriers and enablers experienced by people with COPD regarding participation in PA and PR. Methodological quality of the studies was appraised using McMaster critical appraisal tools. A narrative summary of findings was undertaken reporting on individual study characteristics, country of origin, participants, and potential barriers and enablers. Eleven studies (8 qualitative and 3 quantitative) met the inclusion criteria for this systematic review. Several methodological issues (small sampling, poor description of data collection and analysis, issues with generalizability of the research findings) were common among included studies. Barriers identified included changing health status, personal issues, lack of support, external factors, ongoing smoking, and program-specific barriers. Enablers identified included social support, professional support, personal drivers, personal benefit, control of condition, specific goals, and program-specific enablers. The findings from this review may assist health professionals, patients, care givers and the wider community to develop effective strategies to promote participation in PA and PR among people with COPD.

  16. Barriers to the collaborative care of patients with orofacial injury.

    Science.gov (United States)

    Wong, Eunice C; Marshall, Grant N

    2010-05-01

    Collaborative care interventions show significant promise in facilitating integrative care, which addresses the physical and mental health needs of patients with orofacial trauma. Ensuring the successful implementation of collaborative care interventions depends on having an adequate understanding of the potential barriers to the provision and receipt of mental health services within specific clinical settings. This article reviews recent findings on the patients' and providers' perceptions of barriers to psychosocial aftercare services in oral and maxillofacial trauma care settings. These findings indicate that although patients and providers recognize the need for psychosocial aftercare, they report substantial barriers to these services. Structural barriers, such as not knowing where to obtain services and financial cost, are the major obstacles among patients. Among providers, structural barriers also serve as significant impediments to the provision of psychosocial services. Some of the most common structural barriers reported by providers include a shortage of financial resources, trained clinical staff, and space. Although collaborative care interventions may be well suited to capitalize on patients' and providers' interests in psychosocial aftercare programs, further research is needed to determine the viability of this promising aftercare model within oral and maxillofacial trauma care settings.

  17. 200-BP-1 Prototype Hanford Barrier Annual Monitoring Report for Fiscal Year 2004

    Energy Technology Data Exchange (ETDEWEB)

    Ward, Andy L.; Linville, Jenifer K.; Keller, Jason M.; Seedahmed, Gamal H.

    2005-01-03

    In FY 2004, monitoring of the prototype Hanford barrier focused on barrier stability, vegetative cover, evidence of plant and animal intrusion, and the main components of the water balance. Monitored water-balance components included precipitation, runoff, storage, drainage, and deep percolation. Precipitation in FY 2004 was 26 percent less than in FY 2003 but was still higher than normal. The seasonal distribution in precipitation was also different from the previous year with a 43 percent reduction in spring precipitation and a 46 percent increase in summer precipitation. The cumulative amount of water received from October 1994, through September 2004, was 2,559.58 mm on the northern half of the barrier, which is the formerly irrigated treatment, and 1,886.71 mm on the southern non-irrigated treatments. Water storage continued to show a cyclic pattern, increasing in the winter and declining in the spring and summer to a lower limit of about 100 mm in response to evapotranspiration. The 600-mm design storage has never been exceeded. Total drainage from the soil-covered plots range from 2.9E-4 mm to 0.22 mm or 0.003 6 0.004 percent of precipitation. Side-slope drainage was much higher at 20.9 6 2.3 percent of precipitation from the gravel and 18.6 6 5.1 percent from the riprap. There was no runoff from the barrier, but runoff from the BY tank farm following a thunderstorm in May eroded a 45-inch-deep channel into the structural fill at the toe of the riprap slope. Above-asphalt and below-asphalt moisture measurements show no evidence of deep percolation of water. Topographic surveys were conducted on the barrier surface, including the two settlement gauges and 12 creep gauges on the riprap slope using aerial photogrammetry (AP) and a global positioning system (GPS). Comparing the aerial photogrammetry (AP) and global positioning system (GPS) surveys with the traditional survey shows the barrier and side slopes to be stable. Both AP and GPS show potential for

  18. Perception of Key Barriers in Using and Publishing Open Data

    Directory of Open Access Journals (Sweden)

    Martin Beno

    2017-12-01

    Full Text Available TThere is a growing body of literature recognizing the benefits of Open Data. However, many potential data providers are unwilling to publish their data and at the same time, data users are often faced with difficulties when attempting to use Open Data in practice. Despite various barriers in using and publishing Open Data still being present, studies which systematically collect and assess these barriers are rare. Based on this observation we present a review on prior literature on barriers and the results of an empirical study aimed at assessing both the users’ and publishers’ views on obstacles regarding Open Data adoption. We collected data with an online survey in Austria and internationally. Using a sample of 183 participants, we draw conclusions about the relative importance of the barriers reported in the literature. In comparison to a previous conference paper presented at the conference for E-Democracy and Open Government, this article includes new additional data from participants outside Austria, reports new analyses, and substantially extends the discussion of results and of possible strategies for the mitigation of Open Data barriers.

  19. Smart parking barrier

    KAUST Repository

    Alharbi, Abdulrazaq M.

    2016-05-06

    Various methods and systems are provided for smart parking barriers. In one example, among others, a smart parking barrier system includes a movable parking barrier located at one end of a parking space, a barrier drive configured to control positioning of the movable parking barrier, and a parking controller configured to initiate movement of the parking barrier, via the barrier drive. The movable parking barrier can be positioned between a first position that restricts access to the parking space and a second position that allows access to the parking space. The parking controller can initiate movement of the movable parking barrier in response to a positive identification of an individual allowed to use the parking space. The parking controller can identify the individual through, e.g., a RFID tag, a mobile device (e.g., a remote control, smartphone, tablet, etc.), an access card, biometric information, or other appropriate identifier.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2002-07-01

    barriers. Therefore, it is important to address primary barriers. Measures to remove the identified barriers were suggested by the stake holders in all the three countries. Final national workshops were held in June in Egypt and Ghana, and in August 2000 in Zimbabwe to discuss the study findings. The workshops were attended by a spectrum of stake holders and generated a lot of interest and discussions on the findings of the studies in all the three countries. The feedback from the stake holders has been included in the reports finalised during 2001. The lessons learnt from the studies included in this summary report point to the key concerns of the stake holders on the RETs and their suggestions to promote these technologies. (au)

  1. Barrier mechanisms in the Drosophila blood-brain barrier

    Directory of Open Access Journals (Sweden)

    Samantha Jane Hindle

    2014-12-01

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

  2. Diabetes and diet : managing dietary barriers

    NARCIS (Netherlands)

    Friele, R.D.

    1989-01-01

    This thesis reports on the barriers diabetic patients experience with their diet, and the ways they cope with these barriers. A dietary barrier is a hinderance to a person's well-being, induced by being advised a diet. First inventories were made of possible dietary barriers and ways of

  3. Physician variation in perceived barriers to personal health

    Directory of Open Access Journals (Sweden)

    Rubenfire M

    2012-01-01

    Full Text Available Adam RB Kosteva1, Brian M Salata1, Sangeetha Mahadevan Krishnan2, Michael Howe3, Alissa Weber3, Melvyn Rubenfire2,3, Elizabeth A Jackson2,31Michigan Cardiovascular Research and Reporting Program, 2Division of Cardiovascular Medicine, 3Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USAObjective: Physicians’ personal health habits are associated with their counseling habits regarding physical activity. We sought to examine physicians’ own barriers to a healthy lifestyle by level of training and gender.Methods: Physicians at a major teaching hospital were surveyed regarding their lifestyle habits and barriers to healthy habits. The frequency of reported barriers was examined by years in practice (trainees vs staff physicians and gender.Results: 183 total responses were received. Over 20% of respondents were overweight. Work schedule was cited as the greatest barrier to regular exercise in 70.5% of respondents. Trainees were more likely to cite time constraints or cost as a barrier to a healthy diet compared to staff physicians. Staff physicians were more likely to report the time to prepare healthy foods as a barrier. For both trainees and staff physicians, time was a barrier to regular exercise. For trainees work schedule was a barrier, while both work schedule and family commitments were top barriers cited by staff physicians. Women were more likely to report family commitments as a barrier than men. Respondents suggested healthier options in vending machines and the hospital cafeteria, healthy recipes, and time and/or facilities for exercise at work as options to help overcome these barriers.Conclusion: Work schedules and family commitments are frequently reported by providers as barriers to healthy lifestyle. Efforts to reduce such barriers may lead to improved health habits among providers.Keywords: diet, exercise, counseling, prevention, gender, barriers, health

  4. Engineered barrier construction in salt rock. Final report of project phase 2. Period covered: 1 July 1989 - 31 December 1992

    International Nuclear Information System (INIS)

    Stockmann, N.; Beinlich, A.; Droste, J.; Flach, D.; Glaess, F.; Jockwer, N.; Krogmann, P.; Miehe, R.; Moeller, J.; Schwaegermann, F.; Wallmueller, R.; Walter, F.; Yaramanci, U.

    1994-01-01

    The project report presents and explains data obtained by a specific measuring programme, giving evidence of the sealing efficiency of an engineered barrier comprising abutment, long-term barrier, and hydraulic short-term barrier, the sealing performance having been verified for shorter and longer periods of time ( up to approx. 500 years). Specific computer codes have been applied for computing and verifying the long-term efficiency of the complex engineered barrier system (artificial structures and surrounding rock). The technical feasibility and the performance of an engineered barrier for reliable sealing of a radwaste repository is thus demonstrated at a scale of 1:1 at the site of the Asse mine [de

  5. Engineered Barrier System: Physical and Chemical Environment Model

    Energy Technology Data Exchange (ETDEWEB)

    D. M. Jolley; R. Jarek; P. Mariner

    2004-02-09

    The conceptual and predictive models documented in this Engineered Barrier System: Physical and Chemical Environment Model report describe the evolution of the physical and chemical conditions within the waste emplacement drifts of the repository. The modeling approaches and model output data will be used in the total system performance assessment (TSPA-LA) to assess the performance of the engineered barrier system and the waste form. These models evaluate the range of potential water compositions within the emplacement drifts, resulting from the interaction of introduced materials and minerals in dust with water seeping into the drifts and with aqueous solutions forming by deliquescence of dust (as influenced by atmospheric conditions), and from thermal-hydrological-chemical (THC) processes in the drift. These models also consider the uncertainty and variability in water chemistry inside the drift and the compositions of introduced materials within the drift. This report develops and documents a set of process- and abstraction-level models that constitute the engineered barrier system: physical and chemical environment model. Where possible, these models use information directly from other process model reports as input, which promotes integration among process models used for total system performance assessment. Specific tasks and activities of modeling the physical and chemical environment are included in the technical work plan ''Technical Work Plan for: In-Drift Geochemistry Modeling'' (BSC 2004 [DIRS 166519]). As described in the technical work plan, the development of this report is coordinated with the development of other engineered barrier system analysis model reports.

  6. Municipal officials' perceived barriers to consideration of physical activity in community design decision making.

    Science.gov (United States)

    Goins, Karin Valentine; Schneider, Kristin L; Brownson, Ross; Carnoske, Cheryl; Evenson, Kelly R; Eyler, Amy; Heinrich, Katie; Litt, Jill; Lyn, Rodney; Maddock, Jay; Reed, Hannah; Tompkins, Nancy Oʼhara; Lemon, Stephenie C

    2013-01-01

    Built environment-focused interventions and policies are recommended as sustainable approaches for promoting physical activity. Physical activity has not traditionally been considered in land use and transportation decision making. Effective collaboration with non-public health partners requires knowledge of their perceived barriers to such consideration. This analysis sought to (a) establish prevalence estimates of selected barriers to the consideration of physical activity in community design and layout decisions and (b) describe how barrier reporting by public health officials differs from other municipal officials among a wide range of job functions and departments in a geographically diverse sample. A Web-based survey was conducted among municipal officials in 94 cities and towns with populations of at least 50 000 residents in 8 states. A total of 453 municipal officials from public health, planning, transportation/public works, community and economic development, parks and recreation, city management, and municipal legislatures in 83 cities and towns responded to the survey. Five barriers to consideration of physical activity in community design and layout were assessed. The most common barriers included lack of political will (23.5%), limited staff (20.4%), and lack of collaboration across municipal departments (16.2%). Fewer participants reported opposition from the business community or residents as barriers. Public health department personnel were more likely to report the barriers of limited staff and lack of collaboration across municipal departments than other professionals. They were also more likely to report lack of political will than city managers or mayors and municipal legislators. Barriers to increasing consideration of physical activity in decision making about community design and layout are encouragingly low. Implications for public health practice include the need to strategically increase political will despite public health staffing

  7. Healthcare Communication Barriers and Self-Rated Health in Older Chinese American Immigrants.

    Science.gov (United States)

    Tsoh, Janice Y; Sentell, Tetine; Gildengorin, Ginny; Le, Gem M; Chan, Elaine; Fung, Lei-Chun; Pasick, Rena J; Stewart, Susan; Wong, Ching; Woo, Kent; Burke, Adam; Wang, Jun; McPhee, Stephen J; Nguyen, Tung T

    2016-08-01

    Older Chinese immigrants are a growing population in the United States who experience multiple healthcare communication barriers such as limited English proficiency and low health literacy. Each of these obstacles has been associated with poor health outcomes but less is known about their effects in combination. This study examined the association between healthcare communication barriers and self-rated health among older Chinese immigrants. Cross-sectional survey data were obtained from 705 Chinese American immigrants ages 50-75 living in San Francisco, California. Communication barriers examined included spoken English proficiency, medical interpreter needs, and health literacy in written health information. The study sample (81 % females, mean age = 62) included 67 % who spoke English poorly or not at all, 34 % who reported needing a medical interpreter, and 37 % who reported "often" or "always" needing assistance to read health information. Two-thirds reported poor self-rated health; many reported having access to racial-concordant (74 %) and language-concordant (86 %) healthcare services. Both poor spoken English proficiency and low health literacy were associated with poor self-rated health, independent of other significant correlates (unemployment, chronic health conditions, and having a primary doctor who was ethnic Chinese). Results revealed that spoken English proficiency and print health literacy are independent communication barriers that are directly associated with health status among elderly Chinese American immigrants. Access to racial- or language-concordant health care services did not appear to resolve these barriers. These findings underscore the importance of addressing both spoken and written healthcare communication needs among older Chinese American immigrants.

  8. BSN completion barriers, challenges, incentives, and strategies.

    Science.gov (United States)

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

    2014-04-01

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

  9. Barriers to Participation in Tourism in the Disabled

    Directory of Open Access Journals (Sweden)

    Kaganek Krzysztof

    2017-06-01

    Full Text Available Introduction. Physical activity is critical to effective rehabilitation in people with disabilities and, consequently, is of high importance in their lives. However, participation of the disabled in physical activity, including tourism, is a much more complex issue than in the case in able-bodied individuals. Material and methods. This paper aims to fill the gap and familiarise the reader with barriers faced by the disabled who engage in tourism. The study group consisted of randomly selected 460 participants with certificates specifying the degree of their disability. The group included 55 (12% individuals with visual impairments, 203 (44.1% individuals with hearing impairments, and 202 (43.9% individuals with locomotor system disabilities. Results. The data derived from interviews made with people with physical dysfunctions, designed with a view to achieving the aims of the study, were used to develop logistic regression models. Conclusions. On average, the greatest and smallest numbers of barriers were reported by individuals with severe disabilities and those who had large families, respectively. Younger disabled people most often complained about the equipment barriers to participation in tourism. Older respondents were mostly challenged with social barriers. Of all the determinants analysed in the study, the perception of barriers to participation in tourism most often depended on the subjects’ degree of disability.

  10. Allergists' self-reported adherence to anaphylaxis practice parameters and perceived barriers to care: an American College of Allergy, Asthma, and Immunology member survey.

    Science.gov (United States)

    Fineman, Stanley; Dowling, Paul; O'Rourke, Dianne

    2013-12-01

    Anaphylaxis is life-threatening and requires rapid medical intervention. Knowledge of treatment guidelines and addressing barriers to care are essential for appropriate management. To investigate allergists' self-reported practices in managing patients at risk for anaphylaxis, specifically in following practice parameters for diagnosis, treatment, and appropriate use of epinephrine, and to identify perceived barriers to care. Online questionnaires were distributed to members of the American College of Allergy, Asthma, and Immunology. The US physicians who self-identified as "allergist/immunologist" were eligible to participate. The first 500 completed questionnaires were analyzed. Nearly all (≥95%) reported adherence to practice parameters in prescribing an epinephrine auto-injector and instructing patients on its use, taking a detailed allergy history, counseling patients on avoidance measures, and educating patients on the signs and symptoms of anaphylaxis. More than 90% stated they determined the best diagnostic procedures to identify triggers and coordinated laboratory and allergy testing. Adherence to practice parameters was less robust for providing patients with written action plans and in-office anaphylaxis preparedness. Perceived barriers to care included a significant proportion of patients who were uncomfortable using epinephrine auto-injectors and inadequate knowledge of anaphylaxis among referral physicians. Allergists overwhelmingly adhere to practice parameter recommendations for the treatment and management of anaphylaxis, including appropriate use of epinephrine as first-line treatment, educating patients, and testing to diagnose anaphylaxis and identify its triggers. Opportunities for improvement include preparing staff and patients for anaphylactic events, providing written action plans, and improving knowledge of referring physicians. Copyright © 2013 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights

  11. Richards Barrier LA Reference Design Feature Evaluation

    International Nuclear Information System (INIS)

    N.E. Kramer

    1999-01-01

    The Richards Barrier is one of the design features of the repository to be considered for the License Application (LA), Richards was a soil scientist who first described the diversion of moisture between two materials with different hydrologic properties. In this report, a Richards Barrier is a special type of backfill with a fine-grained material (such as sand) overlaying a coarse-grained material (such as gravel). Water that enters an emplacement drift will first encounter the fine-grained material and be transported around the coarse-grained material covering the waste package, thus protecting the waste package from contact with most of the groundwater. The objective of this report is to discuss the benefits and liabilities to the repository by the inclusion of a Richards Barrier type backfill in emplacement drifts. The Richards Barrier can act as a barrier to water flow, can reduce the waste package material dissolution rate, limit mobilization of the radionuclides, and can provide structural protection for the waste package. The scope of this report is to: (1) Analyze the behavior of barrier materials following the intrusion of groundwater for influxes of 1 to 300 mm per year. The report will demonstrate diversion of groundwater intrusions into the barrier over an extended time period when seismic activity and consolidation may cause the potential for liquefaction and settlement of the Richards Barrier. (2) Review the thermal effects of the Richards Barrier on material behavior. (3) Analyze the effect of rockfall on the performance of the Richards Barrier and the depth of the barrier required to protect waste packages under the barrier. (4) Review radiological and heating conditions on placement of multiple layers of the barrier. Subsurface Nuclear Safety personnel will perform calculations to determine the radiation reduction-time relationship and shielding capacity of the barrier. (5) Evaluate the effects of ventilation on cooling of emplacement drifts and

  12. Barriers to providing the sexuality education that teachers believe students need.

    Science.gov (United States)

    Eisenberg, Marla E; Madsen, Nikki; Oliphant, Jennifer A; Sieving, Renee E

    2013-05-01

    Sexuality education teachers' perspectives are important to gain a full understanding of the issues surrounding teaching this subject. This study uses a statewide sample of public school teachers to examine what sexuality education content is taught, what barriers teachers face, and which barriers are associated with teaching specific topics. Participants included 368 middle and high school teachers with sexuality education assignments in Minnesota. Survey data included topics they teach, what they think they should teach, and barriers they face. Logistic regression was used to examine associations between barriers and teaching each of 9 sexual health topics, among those who believed the topic should be taught. Almost two thirds of participants faced structural barriers; 45% were concerned about parent, student, or administrator response; and one quarter reported restrictive policies. Structural barriers were inversely associated with teaching about communication (OR = 0.20), teen parenting (OR = 0.34), and abortion (OR = 0.32); concerns about responses were associated only with teaching about sexual violence (OR = 0.42); and restrictive policies were inversely associated with teaching about abortion (OR = 0.23) and sexual orientation (OR = 0.47). Addressing teachers' barriers requires a multipronged approach, including curriculum development and evaluation, training, and reframing the policy debate to support a wider range of sexuality education topics. © 2013, American School Health Association.

  13. CMHC research project: Testing of air barriers construction details: Report

    Energy Technology Data Exchange (ETDEWEB)

    1991-01-01

    This project was conducted to quantify the air leakage characteristics of the header joist, the electric outlets, and the window openings in wood-frame walls. The study evaluated the sealed internal membrane method, where polyethylene sheet and sealant provide the air barrier; the external air barrier method, which uses a continuous vapour permeable membrane (spun-bonded olefin film), sandwiched between two layers of external wall sheathing; and the airtight drywall method, where the interior gypsum board finish, together with framing materials and gaskets, are used as the air barrier. In addition, the traditional approach to wood-frame wall construction, where no special attention is given to achieving a continuous air barrier, was evaluated for comparison.

  14. Patient-reported financial barriers to adherence to treatment in neurology

    Directory of Open Access Journals (Sweden)

    Moura LMVR

    2016-11-01

    Full Text Available Lidia MVR Moura,1 Eli L Schwamm,1 Valdery Moura Junior,1 Michael P Seitz,1 Daniel B Hoch,1 John Hsu,2,3 Lee H Schwamm1 1Department of Neurology, 2Mongan Institute for Health Policy, Massachusetts General Hospital, 3Department of Medicine and Department of Health Care Policy, Harvard Medical School, Boston, MA, USA Objective: Many effective medical therapies are available for treating neurological diseases, but these therapies tend to be expensive and adherence is critical to their effectiveness. We used patient-reported data to examine the frequency and determinants of financial barriers to medication adherence among individuals treated for neurological disorders. Patients and methods: Patients completed cross-sectional surveys on iPads as part of routine outpatient care in a neurology clinic. Survey responses from a 3-month period were collected and merged with administrative sources of demographic and clinical information (eg, insurance type. We explored the association between patient characteristics and patient-reported failure to refill prescription medication due to cost in the previous 12 months, termed here as “nonadherence”. Results: The population studied comprised 6075 adults who were presented between July and September 2015 for outpatient neurology appointments. The mean age of participants was 56 (standard deviation: 18 years, and 1613 (54% were females. The patients who participated in the surveys (2992, 49% were comparable to nonparticipants with respect to gender and ethnicity but more often identified English as their preferred language (94% vs 6%, p<0.01. Among respondents, 9.8% (n=265 reported nonadherence that varied by condition. These patients were more frequently Hispanic (16.7% vs 9.8% white, p=0.01, living alone (13.9% vs 8.9% cohabitating, p<0.01, and preferred a language other than English (15.3% vs 9.4%, p=0.02. Conclusion: Overall, the magnitude of financial barriers to medication adherence appears to vary

  15. Barriers and Delays in Tuberculosis Diagnosis and Treatment Services: Does Gender Matter?

    Directory of Open Access Journals (Sweden)

    Wei-Teng Yang

    2014-01-01

    Full Text Available Background. Tuberculosis (TB remains a global public health problem with known gender-related disparities. We reviewed the quantitative evidence for gender-related differences in accessing TB services from symptom onset to treatment initiation. Methods. Following a systematic review process, we: searched 12 electronic databases; included quantitative studies assessing gender differences in accessing TB diagnostic and treatment services; abstracted data; and assessed study validity. We defined barriers and delays at the individual and provider/system levels using a conceptual framework of the TB care continuum and examined gender-related differences. Results. Among 13,448 articles, 137 were included: many assessed individual-level barriers (52% and delays (42%, 76% surveyed persons presenting for care with diagnosed or suspected TB, 24% surveyed community members, and two-thirds were from African and Asian regions. Many studies reported no gender differences. Among studies reporting disparities, women faced greater barriers (financial: 64% versus 36%; physical: 100% versus 0%; stigma: 85% versus 15%; health literacy: 67% versus 33%; and provider-/system-level: 100% versus 0% and longer delays (presentation to diagnosis: 45% versus 0% than men. Conclusions. Many studies found no quantitative gender-related differences in barriers and delays limiting access to TB services. When differences were identified, women experienced greater barriers and longer delays than men.

  16. Barriers and delays in tuberculosis diagnosis and treatment services: does gender matter?

    Science.gov (United States)

    Yang, Wei-Teng; Gounder, Celine R; Akande, Tokunbo; De Neve, Jan-Walter; McIntire, Katherine N; Chandrasekhar, Aditya; de Lima Pereira, Alan; Gummadi, Naveen; Samanta, Santanu; Gupta, Amita

    2014-01-01

    Background. Tuberculosis (TB) remains a global public health problem with known gender-related disparities. We reviewed the quantitative evidence for gender-related differences in accessing TB services from symptom onset to treatment initiation. Methods. Following a systematic review process, we: searched 12 electronic databases; included quantitative studies assessing gender differences in accessing TB diagnostic and treatment services; abstracted data; and assessed study validity. We defined barriers and delays at the individual and provider/system levels using a conceptual framework of the TB care continuum and examined gender-related differences. Results. Among 13,448 articles, 137 were included: many assessed individual-level barriers (52%) and delays (42%), 76% surveyed persons presenting for care with diagnosed or suspected TB, 24% surveyed community members, and two-thirds were from African and Asian regions. Many studies reported no gender differences. Among studies reporting disparities, women faced greater barriers (financial: 64% versus 36%; physical: 100% versus 0%; stigma: 85% versus 15%; health literacy: 67% versus 33%; and provider-/system-level: 100% versus 0%) and longer delays (presentation to diagnosis: 45% versus 0%) than men. Conclusions. Many studies found no quantitative gender-related differences in barriers and delays limiting access to TB services. When differences were identified, women experienced greater barriers and longer delays than men.

  17. Physical activity barriers and facilitators among working mothers and fathers.

    Science.gov (United States)

    Mailey, Emily L; Huberty, Jennifer; Dinkel, Danae; McAuley, Edward

    2014-06-27

    The transition to parenthood is consistently associated with declines in physical activity. In particular, working parents are at risk for inactivity, but research exploring physical activity barriers and facilitators in this population has been scarce. The purpose of this study was to qualitatively examine perceptions of physical activity among working parents. Working mothers (n = 13) and fathers (n = 12) were recruited to participate in one of four focus group sessions and discuss physical activity barriers and facilitators. Data were analyzed using immersion/crystallization in NVivo 10. Major themes for barriers included family responsibilities, guilt, lack of support, scheduling constraints, and work. Major themes for facilitators included being active with children or during children's activities, being a role model for children, making time/prioritizing, benefits to health and family, and having support available. Several gender differences emerged within each theme, but overall both mothers and fathers reported their priorities had shifted to focus on family after becoming parents, and those who were fitting in physical activity had developed strategies that allowed them to balance their household and occupational responsibilities. The results of this study suggest working mothers and fathers report similar physical activity barriers and facilitators and would benefit from interventions that teach strategies for overcoming barriers and prioritizing physical activity amidst the demands of parenthood. Future interventions might consider targeting mothers and fathers in tandem to create an optimally supportive environment in the home.

  18. Facilitators and Barriers for Successful Breastfeeding Among Migrant Chuukese Mothers on Guam

    Directory of Open Access Journals (Sweden)

    Kathryn M. Wood PhD, RNC-OB

    2017-01-01

    Full Text Available The aim of this study was to identify factors that serve as facilitators and barriers for breastfeeding among Chuukese immigrant women living in Guam. Traditionally, Chuukese women exclusively breastfeed their babies; however, it is reported that breastfeeding decreases among these women when they migrate to Guam. Little is known about why this happens. A qualitative approach that included key informant interviews and focus groups of Chuukese women ( N  = 24 who had migrated to Guam and delivered a baby on Guam within the past 5 years was completed. The project interview or discussion guides were guided by the Theory of Reasoned Action and explored facilitators and barriers for successful breastfeeding among these Chuukese immigrant women. Among this population, key facilitators for breastfeeding included high levels of self-confidence, family support, knowledge about breastfeeding, and the existence of strong traditional Chuukese cultural values. Key barriers included experiences of cultural conflict or social change, lack of support from their local community, family and health-care staff, as well as limited self-knowledge about how to manage common breastfeeding problems. Where more facilitators were reported, breastfeeding was more often practiced, and where more barriers were reported, formula feeding was more likely. Social factors, health system policies, and proactive nursing support are important influencing factors for breastfeeding among the Chuukese immigrant population on Guam. Nursing can play key roles in policy, professional leadership and practice, and social advocacy to support breastfeeding promotion and maintenance on Guam.

  19. Vehicle barriers: emphasis on natural features

    International Nuclear Information System (INIS)

    Adams, K.G.; Roscoe, B.J.

    1985-07-01

    The recent increase in the use of car and truck bombs by terrorist organizations has led NRC to evaluate the adequacy of licensee security against such threats. As part of this evaluation, one of the factors is the effectiveness of terrain and vegetation in providing barriers against the vehicle entry. The effectiveness of natural features is presented in two contexts. First, certain natural features are presented. Second, the effectiveness of combinations of features is presented. In addition to the discussion of natural features, this report provides a discussion of methods to slow vehicles. Also included is an overview of man-made barrier systems, with particular attention to ditches. 17 refs., 49 figs

  20. Qualitative Comparison of Barriers to Antiretroviral Medication Adherence Among Perinatally and Behaviorally HIV-Infected Youth.

    Science.gov (United States)

    Fields, Errol L; Bogart, Laura M; Thurston, Idia B; Hu, Caroline H; Skeer, Margie R; Safren, Steven A; Mimiaga, Matthew J

    2017-07-01

    Medication adherence among youth living with HIV (28%-69%) is often insufficient for viral suppression. The psychosocial context of adherence barriers is complex. We sought to qualitatively understand adherence barriers among behaviorally infected and perinatally infected youth and develop an intervention specific to their needs. We conducted in-depth interviews with 30 youth living with HIV (aged 14-24 years) and analyzed transcripts using the constant comparative method. Barriers were influenced by clinical and psychosocial factors. Perinatally infected youth barriers included reactance, complicated regimens, HIV fatigue, and difficulty transitioning to autonomous care. Behaviorally infected youth barriers included HIV-related shame and difficulty initiating medication. Both groups reported low risk perception, medication as a reminder of HIV, and nondisclosure, but described different contexts to these common barriers. Common and unique barriers emerged for behaviorally infected and perinatally infected youth reflecting varying HIV experiences and psychosocial contexts. We developed a customizable intervention addressing identified barriers and their psychosocial antecedents.

  1. Irish psychiatric nurses' self-reported barriers, facilitators and skills for developing evidence-based practice.

    LENUS (Irish Health Repository)

    Yadav, B L

    2012-03-01

    Evidence-based practice places an emphasis on integration of clinical expertise with available best evidence, patient\\'s clinical information and preferences, and with local health resources. This paper reports the findings of a study that investigated the barriers, facilitators and skills in developing evidence-based practice among psychiatric nurses in Ireland. A postal survey was conducted among a random sample of Irish psychiatric nurses and survey data were collected using the Development of Evidence-Based Practice Questionnaire. Respondents reported that insufficient time to find and read research reports and insufficient resources to change practice were the greatest barriers to the development of evidence-based practice. Practice development coordinators were perceived as the most supportive resource for changing practice. Using the Internet to search for information was the highest-rated skill and using research evidence to change practice was the lowest-rated skill for developing evidence-based practice. Nurses\\' precursor skills for developing evidence-based practice, such as database searching and information retrieval, may be insufficient in themselves for promoting evidence-based practice if they cannot find evidence relating to their particular field of practice or if they do not have the time, resources and supports to develop their practice in response to evidence.

  2. Facilitators and Barriers to Preparedness Partnerships: A Veterans Affairs Medical Center Perspective.

    Science.gov (United States)

    Schmitz, Susan; Wyte-Lake, Tamar; Dobalian, Aram

    2017-09-13

    This study sought to understand facilitators and barriers faced by local US Department of Veterans Affairs Medical Center (VAMC) emergency managers (EMs) when collaborating with non-VA entities. Twelve EMs participated in semi-structured interviews lasting 60 to 90 minutes discussing their collaboration with non-VAMC organizations. Sections of the interview transcripts concerning facilitators and barriers to collaboration were coded and analyzed. Common themes were organized into 2 categories: (1) internal (ie, factors affecting collaboration from within VAMCs or by VA policy) and (2) external (ie, interagency or interpersonal factors). Respondents reported a range of facilitators and barriers to collaboration with community-based agencies. Internal factors facilitating collaboration included items such as leadership support. An internal barrier example included lack of clarity surrounding the VAMC's role in community disaster response. External factors noted as facilitators included a shared goal across organizations while a noted barrier was a perception that potential partners viewed a VAMC partnership with skepticism. Federal institutions are important partners for the success of community disaster preparedness and response. Understanding the barriers that VAMCs confront, as well as potential facilitators to collaboration, should enhance the development of VAMC-community partnerships and improve community health resilience. (Disaster Med Public Health Preparedness. 2017; page 1 of 6).

  3. Claudins, dietary milk proteins, and intestinal barrier regulation.

    Science.gov (United States)

    Kotler, Belinda M; Kerstetter, Jane E; Insogna, Karl L

    2013-01-01

    The family of claudin proteins plays an important role in regulating the intestinal barrier by modulating the permeability of tight junctions. The impact of dietary protein on claudin biology has not been studied extensively. Whey proteins have been reported to improve intestinal barrier function, but their mechanism of action is not clear. Recent studies, however, have demonstrated increased intestinal claudin expression in response to milk protein components. Reviewed here are new findings suggesting that whey-protein-derived transforming growth factor β transcriptionally upregulates claudin-4 expression via a Smad-4-dependent pathway. These and other data, including limited clinical studies, are summarized below and, in the aggregate, suggest a therapeutic role for whey protein in diseases of intestinal barrier dysfunction, perhaps, in part, by regulating claudin expression. © 2013 International Life Sciences Institute.

  4. Municipal Officials’ Perceived Barriers to Consideration of Physical Activity in Community Design Decision Making

    Science.gov (United States)

    Goins, Karin Valentine; Schneider, Kristin L.; Brownson, Ross; Carnoske, Cheryl; Evenson, Kelly; Eyler, Amy; Heinrich, Katie; Litt, Jill; Lyn, Rodney; Maddock, Jay; Reed, Hannah; Tompkins, Nancy O’Hara; Lemon, Stephenie C.

    2016-01-01

    Context Built environment-focused interventions and policies are recommended as sustainable approaches for promoting physical activity. Physical activity has not traditionally been considered in land use and transportation decision making. Effective collaboration with non-public health partners requires knowledge of their perceived barriers to consideration of physical activity in decision making. Objective This study aimed to 1) identify barriers to the consideration of physical activity in community design and planning decisions among municipal decision makers and 2) explore differences in these barriers among a wide range of job functions and departments in a geographically diverse sample. Design A web-based survey was conducted among municipal officials in 94 cities and towns with populations of at least 50,000 residents in eight states. Participants 453 municipal officials from public health, planning, transportation/public works, community and economic development, parks and recreation, city management, and municipal legislatures responded to the survey. Main Outcome Measures Five barriers to consideration of physical activity in community design and layout were assessed. Results The most common barriers included lack of political will (23.5%), limited staff (20.4%) and lack of collaboration across municipal departments (16.2%). Fewer participants reported opposition from the business community or residents as barriers. Compared to other professionals, public health department personnel were more likely to report the barriers of limited staff and lack of collaboration across municipal departments. They were also more likely to report lack of political will compared to city managers or mayors and municipal legislators. Conclusions Barriers to increasing consideration of physical activity in decision making about community design and layout are encouragingly low. Implications for public health practice include the need to strategically increase political will

  5. Disability and physical and communication-related barriers to health care related services among Florida residents: A brief report.

    Science.gov (United States)

    Bauer, Sarah E; Schumacher, Jessica R; Hall, Allyson; Marlow, Nicole M; Friedel, Claudia; Scheer, Danielle; Redmon, Susan

    2016-07-01

    Research has not fully characterized barriers to health care faced by persons with disabilities (PWD) which constitutes a critical gap given the increased risk of chronic illness faced by PWD. To understand the current barriers to seeking health care-related services for PWD in Florida. The study was based on a random-digit-dial telephone interview survey of respondents aged 18 and over (n = 1429). Multivariable logistic regression assessed the relationship between disability and physical and communication barriers. One thousand four hundred and twenty-nine Florida residents participated in the survey. Thirty-three percent of respondents (n = 471) reported having a disability. PWD were significantly older (mean age 68 vs. 61) and had lower levels of income and education than persons without disabilities (PWOD) (p barrier (Odds Ratio [OR] = 16.6 95% CI: 7.9, 34.9), a clinical experience barrier (OR = 13.9 95% CI: 6.9, 27.9) a communication and knowledge barrier (OR = 6.7 95% CI: 4.0, 11.3) and a barrier coordinating care (OR = 5.7 95% CI: 3.4, 9.6) compared to persons without disabilities (PWOD). PWD disproportionately face health care access difficulties that can impede the receipt of high quality care within and between provider visits. Efforts to reduce physical barriers and improve communication between providers and PWD may improve functional status and quality of life for these patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Multilayer moisture barrier

    Science.gov (United States)

    Pankow, Joel W; Jorgensen, Gary J; Terwilliger, Kent M; Glick, Stephen H; Isomaki, Nora; Harkonen, Kari; Turkulainen, Tommy

    2015-04-21

    A moisture barrier, device or product having a moisture barrier or a method of fabricating a moisture barrier having at least a polymer layer, and interfacial layer, and a barrier layer. The polymer layer may be fabricated from any suitable polymer including, but not limited to, fluoropolymers such as polyethylene terephthalate (PET) or polyethylene naphthalate (PEN), or ethylene-tetrafluoroethylene (ETFE). The interfacial layer may be formed by atomic layer deposition (ALD). In embodiments featuring an ALD interfacial layer, the deposited interfacial substance may be, but is not limited to, Al.sub.2O.sub.3, AlSiO.sub.x, TiO.sub.2, and an Al.sub.2O.sub.3/TiO.sub.2 laminate. The barrier layer associated with the interfacial layer may be deposited by plasma enhanced chemical vapor deposition (PECVD). The barrier layer may be a SiO.sub.xN.sub.y film.

  7. Reducing Barriers to Care in the Office-Based Health Care Setting for Children With Autism.

    Science.gov (United States)

    Bultas, Margaret W; McMillin, Stephen Edward; Zand, Debra H

    2016-01-01

    The purpose of this survey-design research study was to evaluate the usefulness of a researcher-developed tool designed to improve office-based health care services and to assess the barriers and resources affecting office-based health care services for children with autism spectrum disorder. Fifty-four health care providers (HCPs) and 59 parents participated in the study. HCPs reported child behaviors, communication, and fears as barriers to providing care, whereas parents reported child behavior, sensory issues, and feelings of a disconnect with the HCP as barriers. HCPs identified the parent as a key resource. Parent-identified resources included provider adaptations to the patient, including slowing down the delivery of care and environmental adaptations to the office. In addition, both HCPs and parents indicated that the researcher-developed tool would be useful in reducing barriers during the HCE. Reducing barriers and improving health care interactions during delivery of care for children with autism spectrum disorder has the potential to improve health outcomes. Copyright © 2016 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

  8. Barriers to Physical Activity in Individuals with Spinal Cord Injury

    DEFF Research Database (Denmark)

    Roberton, Terri; Bucks, Romola S.; Skinner, Timothy C.

    2011-01-01

    This study examined barriers to physical activity reported individuals with spinal cord injury (SCI) and the degree to which these barriers differed across varying degrees of independence. Participants were 65 individuals recruited from the Western Australian Spinal Cord Injury database. Data...... on physical activity participation and perceived barriers to physical activity participation were collected using a cross-sectional survey and analysed using independent samples t-tests. We found that, regardless of level of ambulation or ability to transfer, few participants reported being physically active....... While there were no significant differences in the amount of barriers reported by individuals with different levels of independence, the type of barriers reported varied across groups....

  9. Barrier Data Base user's guide

    International Nuclear Information System (INIS)

    Worrell, R.B.; Gould, D.J.; Wall, D.W.

    1977-06-01

    A special purpose data base for physical security barriers has been developed. In addition to barriers, the entities accommodated by the Barrier Data Base (BDB) include threats and references. A threat is established as a configuration of people and equipment which has been employed to penetrate (or attempt to penetrate) a barrier. References are used to cite publications pertinent to the barriers and threats in the data base. Utilization and maintenance of the Barrier Data Base is achieved with LIST, QUERY, ENTER, DELETE, and CHANGE commands which are used to manipulate the data base entities

  10. Performing a local barrier operation

    Science.gov (United States)

    Archer, Charles J; Blocksome, Michael A; Ratterman, Joseph D; Smith, Brian E

    2014-03-04

    Performing a local barrier operation with parallel tasks executing on a compute node including, for each task: retrieving a present value of a counter; calculating, in dependence upon the present value of the counter and a total number of tasks performing the local barrier operation, a base value, the base value representing the counter's value prior to any task joining the local barrier; calculating, in dependence upon the base value and the total number of tasks performing the local barrier operation, a target value of the counter, the target value representing the counter's value when all tasks have joined the local barrier; joining the local barrier, including atomically incrementing the value of the counter; and repetitively, until the present value of the counter is no less than the target value of the counter: retrieving the present value of the counter and determining whether the present value equals the target value.

  11. Barriers and Facilitators for Type-2 Diabetes Management in South Asians: A Systematic Review.

    Directory of Open Access Journals (Sweden)

    Tanveer Sohal

    Full Text Available Although South Asian populations have among the highest burden of type 2 diabetes in the world, their diabetes management remains poor. We systematically reviewed studies on South Asian patient's perspectives on the barriers and facilitators to diabetes management.We conducted a literature search using OVID, CINHAL and EMBASE (January, 1990 -February, 2014 evaluating the core components of diabetes management: interactions with health care providers, diet, exercise, and medication adherence. South Asian patients were self-reported as Indian, Pakistani, Malaysian-Indian or Bangladeshi origin. From 208 abstracts reviewed, 20 studies were included (19 qualitative including mixed methods studies, 1 questionnaire. Barriers and facilitators were extracted and combined using qualitative synthesis.All studies included barriers and few facilitators were identified. Language and communication discordance with the healthcare provider was a significant barrier to receiving and understanding diabetes education. There was inconsistent willingness to partake in self-management with preference for following their physician's guidance. Barriers to adopting a diabetic diet were lack of specific details on South Asian tailored diabetic diet; social responsibilities to continue with a traditional diet, and misconceptions on the components of the diabetic diet. For exercise, South Asian patients were concerned with lack of gender specific exercise facilities and fear of injury or worsening health with exercise. Patients reported a lack of understanding about diabetes medication management, preference for folk and phytotherapy, and concerns about the long-term safety of diabetes medications. Facilitators included trust in care providers, use of culturally appropriate exercise and dietary advice and increasing family involvement. Overall themes for the barriers included lack of knowledge and misperceptions as well as lack of cultural adaptation to diabetes management

  12. Barriers and Facilitators for Type-2 Diabetes Management in South Asians: A Systematic Review.

    Science.gov (United States)

    Sohal, Tanveer; Sohal, Parmjit; King-Shier, Kathryn M; Khan, Nadia A

    2015-01-01

    Although South Asian populations have among the highest burden of type 2 diabetes in the world, their diabetes management remains poor. We systematically reviewed studies on South Asian patient's perspectives on the barriers and facilitators to diabetes management. We conducted a literature search using OVID, CINHAL and EMBASE (January, 1990 -February, 2014) evaluating the core components of diabetes management: interactions with health care providers, diet, exercise, and medication adherence. South Asian patients were self-reported as Indian, Pakistani, Malaysian-Indian or Bangladeshi origin. From 208 abstracts reviewed, 20 studies were included (19 qualitative including mixed methods studies, 1 questionnaire). Barriers and facilitators were extracted and combined using qualitative synthesis. All studies included barriers and few facilitators were identified. Language and communication discordance with the healthcare provider was a significant barrier to receiving and understanding diabetes education. There was inconsistent willingness to partake in self-management with preference for following their physician's guidance. Barriers to adopting a diabetic diet were lack of specific details on South Asian tailored diabetic diet; social responsibilities to continue with a traditional diet, and misconceptions on the components of the diabetic diet. For exercise, South Asian patients were concerned with lack of gender specific exercise facilities and fear of injury or worsening health with exercise. Patients reported a lack of understanding about diabetes medication management, preference for folk and phytotherapy, and concerns about the long-term safety of diabetes medications. Facilitators included trust in care providers, use of culturally appropriate exercise and dietary advice and increasing family involvement. Overall themes for the barriers included lack of knowledge and misperceptions as well as lack of cultural adaptation to diabetes management. Diabetes

  13. Barriers in education of indigenous nursing students: a literature review.

    Science.gov (United States)

    Foxall, Donna

    2013-11-01

    The poor health status of indigenous people has been identified internationally as a critical issue. It is now commonly accepted that the ability to address this concern is hindered, in part, by the disproportionately low number of indigenous health professionals, including nurses. This paper reports the findings of a review of literature that aimed to identify key barriers in the education of the indigenous undergraduate nursing students in the tertiary sector, to identify strategies to overcome these, and discuss these elements within the New Zealand context. A number of health-related databases were searched and a total of 16 peer-reviewed articles from Canada, U.S.A., Australia and New Zealand were reviewed. Key barriers to recruitment and retention and strategies to overcome these are presented. Barriers to recruitment included: academic unpreparedness; poor understanding of cultural needs; and conflicting obligations, and financial constraints. Barriers to retention included lack of cultural and academic support, family obligations and financial hardship. Strategies to address recruitment barriers included: addressing pre-entry education requirements; targeted promotion of nursing programmes; indigenous role models in the recruitment process; and streamlining enrolment processes to make programmes attractive and attainable for indigenous students. Strategies to address retention barriers included: cultural relevance within the curriculum; identifying and supporting cultural needs of indigenous students with active participation of indigenous staff; engaging communities and funding support. The crucial development of partnerships between academic institutes and indigenous communities to ensure the provision of a culturally safe, supportive environment for the students was stressed. In New Zealand, while government-level policy exists to promote the success of MBori nursing students, the translation of what is known about the recruitment and retention of

  14. Barriers for Nonparticipation and Dropout of Women in Cardiac Rehabilitation Programs: A Systematic Review.

    Science.gov (United States)

    Resurrección, Davinia M; Motrico, Emma; Rigabert, Alina; Rubio-Valera, Maria; Conejo-Cerón, Sonia; Pastor, Luis; Moreno-Peral, Patricia

    2017-08-01

    Cardiovascular disease (CVD) is a major health problem worldwide. Cardiac rehabilitation (CR) programs are effective in reducing mortality and improving the quality of life of patients with CVD. Women are under-represented in CR and have a higher dropout rate than men. We aimed to systematically review the literature on barriers perceived by women with CVD affecting their nonparticipation in and/or dropping out from CR programs. Systematic review was done using MEDLINE, Embase, Scopus, Open Grey, and Cochrane Database from inception to September 2016. Search terms included (1) heart disease and other cardiac conditions, (2) CR and secondary prevention, and (3) nonparticipation in and/or dropout. Databases were searched following the "participants, interventions, comparisons, outcomes, and study design" method. A total of 24 studies (17 descriptive, 6 qualitative, and 1 randomized controlled trial) reporting several barriers were grouped into five broad categories: intrapersonal barriers (self-reported health, health beliefs, lack of time, motivation, and religious reasons); interpersonal barriers (lack of family/social support and work conflicts); logistical barriers (transport, distance, and availability of personal/community resources); CR program barriers (services offered, group format, exercise component, and CR sessions); and health system barriers (lack of referral, cost, negative experiences with the health system, and language). We found differences between the barriers related to nonparticipation in and dropout from CR programs. Women reported multilevel barriers for nonparticipation in and dropout from CR programs. Future clinical guidelines should evaluate and eliminate these barriers to improve adherence to CR programs in women. In addition, understanding the barriers for nonparticipation and dropout may be beneficial for future intervention trials.

  15. Perceived barriers to quitting smoking among alcohol dependent patients in treatment.

    Science.gov (United States)

    Asher, Marilyn K; Martin, Rosemarie A; Rohsenow, Damaris J; MacKinnon, Selene Varney; Traficante, Regina; Monti, Peter M

    2003-03-01

    Little is known about the perceived barriers to quitting smoking among alcohol abusers. In addition to the usual barriers perceived by smokers, alcohol dependent smokers may have a few barriers unique to their addictive lifestyle. The Barriers to Quitting Smoking in Substance Abuse Treatment (BQS-SAT) was administered to 96 alcohol dependent smokers in residential substance abuse treatment. The BQS-SAT is designed to assess perceived barriers to quitting smoking among alcohol abusers using eleven true-false items. One open-ended item was included to gather information about potential additional barriers. The majority of respondents reported withdrawal-related barriers such as expecting to feel irritable, anxious, restless, and about half expected intolerable urges to smoke if they were to quit smoking, as most smokers do. However, concerns about effects on sobriety and needing cigarettes to cope with feeling down were also endorsed by almost half of the patients. Total number of perceived barriers was significantly related to smoking history, expected effects from smoking, and smoking temptation but was not associated with severity of alcohol use or dependence on admission. Providing corrective feedback about these barriers could be useful when addressing smoking with patients who have alcohol abuse or dependence.

  16. Barriers to accessing urethroplasty.

    Science.gov (United States)

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

    2016-01-01

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

  17. Are barriers to physical activity similar for adults with and without abnormal glucose metabolism?

    Science.gov (United States)

    Hume, Clare; Dunstan, David; Salmon, Jo; Healy, Genevieve; Andrianopoulos, Nick; Owen, Neville

    2010-01-01

    The purpose of this study was to examine perceived barriers to physical activity among adults with and without abnormal glucose metabolism (AGM), and whether barriers varied according to physical activity status. The 1999 to 2000 Australian Diabetes, Obesity, and Lifestyle Study (AusDiab) was a population-based cross-sectional study among adults aged > or =25 years. AGM was identified through an oral glucose tolerance test. The previous week's physical activity and individual, social, and environmental barriers to physical activity were self-reported. Logistic regression analyses examined differences in barriers to physical activity between those with and without AGM, and for those with and without AGM who did and did not meet the minimum recommendation of 150 minutes/week of moderate-to-vigorous intensity physical activity. Of the 7088 participants (47.5 +/- 12.7 years; 46% male), 18.5% had AGM. Approximately 47.5% of those with AGM met the physical activity recommendation, compared to 54.7% of those without AGM (P barriers to physical activity included lack of time, other priorities, and being tired. Following adjustment for sociodemographic and behavioral factors, there were few differences in barriers to physical activity between those with and without AGM, even after stratifying according to physical activity. Adults with AGM report similar barriers to physical activity, as do those without AGM. Programs for those with AGM can therefore focus on the known generic adult-reported barriers to physical activity.

  18. Skin barrier function

    DEFF Research Database (Denmark)

    2016-01-01

    Renowned experts present the latest knowledge Although a very fragile structure, the skin barrier is probably one of the most important organs of the body. Inward/out it is responsible for body integrity and outward/in for keeping microbes, chemicals, and allergens from penetrating the skin. Since...... the role of barrier integrity in atopic dermatitis and the relationship to filaggrin mutations was discovered a decade ago, research focus has been on the skin barrier, and numerous new publications have become available. This book is an interdisciplinary update offering a wide range of information...... on the subject. It covers new basic research on skin markers, including results on filaggrin and on methods for the assessment of the barrier function. Biological variation and aspects of skin barrier function restoration are discussed as well. Further sections are dedicated to clinical implications of skin...

  19. Transportation Energy Futures Series. Non-Cost Barriers to Consumer Adoption of New Light-Duty Vehicle Technologies

    Energy Technology Data Exchange (ETDEWEB)

    Stephens, Thomas [Argonne National Lab. (ANL), Argonne, IL (United States)

    2013-03-01

    Consumer preferences are key to the adoption of new vehicle technologies. Barriers to consumer adoption include price and other obstacles, such as limited driving range and charging infrastructure; unfamiliarity with the technology and uncertainty about direct benefits; limited makes and models with the technology; reputation or perception of the technology; standardization issues; and regulations. For each of these non-cost barriers, this report estimates an effective cost and summarizes underlying influences on consumer preferences, approximate magnitude and relative severity, and assesses potential actions, based on a comprehensive literature review. While the report concludes that non-cost barriers are significant, effective cost and potential market share are very uncertain. Policies and programs including opportunities for drivers to test drive advanced vehicles, general public outreach and information programs, incentives for providing charging and fueling infrastructure, and development of technology standards were examined for their ability to address barriers, but little quantitative data exists on the effectiveness of these measures. This is one in a series of reports produced as a result of the Transportation Energy Futures project, a Department of Energy-sponsored multi-agency effort to pinpoint underexplored strategies for reducing GHGs and petroleum dependence related to transportation. View all reports on the TEF Web page, http://www.eere.energy.gov/analysis/transportationenergyfutures/index.html.

  20. Engineered barriers: current status

    International Nuclear Information System (INIS)

    Atkinson, A.; Marsh, G.P.

    1988-01-01

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

  1. Studying Executive Barriers on Rationalizing the Size of Iranian Government

    Directory of Open Access Journals (Sweden)

    Mohammad Hussein Rahmati

    2012-01-01

    Full Text Available To rationalize the size of government, Act on adjusting a part of government‟s financial rules is approved and the government is obliged to assign a part of its activities through (1 services by nonpublic sector, (2 partnership with nonpublic sector, and (3 assigning the management to nonpublic sector. There are many barriers in executing this law. The present study derived from a field study tries to provide a report on the performance of various organs in Qom province on executing this law and identifies the executive barriers and provides practical proposals to remove them.Overall, seventeen organs in Qom are subjected to this law of which five organs are selected as our sample. In this respect, different documents were studied, ten interviews were conducted and one hundred and four executive barriers and forty seven operational proposals including twenty three barriers and eleven proposals in organization and structure area, sixteen barriers and five proposals in administrative technology and working processes area, thirty two barriers and twelve proposals in human resources area, twenty one barriers and eight proposals in laws and regulations area and twelve barriers and eleven proposals in management area have been analyzed and summarized regarding their contents.

  2. Transportation Energy Futures Series: Non-Cost Barriers to Consumer Adoption of New Light-Duty Vehicle Technologies

    Energy Technology Data Exchange (ETDEWEB)

    Stephens, T.

    2013-03-01

    Consumer preferences are key to the adoption of new vehicle technologies. Barriers to consumer adoption include price and other obstacles, such as limited driving range and charging infrastructure; unfamiliarity with the technology and uncertainty about direct benefits; limited makes and models with the technology; reputation or perception of the technology; standardization issues; and regulations. For each of these non-cost barriers, this report estimates an effective cost and summarizes underlying influences on consumer preferences, approximate magnitude and relative severity, and assesses potential actions, based on a comprehensive literature review. While the report concludes that non-cost barriers are significant, effective cost and potential market share are very uncertain. Policies and programs including opportunities for drivers to test drive advanced vehicles, general public outreach and information programs, incentives for providing charging and fueling infrastructure, and development of technology standards were examined for their ability to address barriers, but little quantitative data exists on the effectiveness of these measures. This is one in a series of reports produced as a result of the Transportation Energy Futures project, a Department of Energy-sponsored multi-agency effort to pinpoint underexplored strategies for reducing GHGs and petroleum dependence related to transportation.

  3. K-Basin isolation barrier seal

    International Nuclear Information System (INIS)

    Ruff, E.S.

    1994-10-01

    This report documents various aspects of the design, analysis, procurement, and fabrication of the hydraulic seal on the isolation barriers to be installed in the 100-K Area spent nuclear fuel basin. The isolation barrier is used to keep water in the basin in the event of an earthquake

  4. Vehicle barrier with access delay

    Science.gov (United States)

    Swahlan, David J; Wilke, Jason

    2013-09-03

    An access delay vehicle barrier for stopping unauthorized entry into secure areas by a vehicle ramming attack includes access delay features for preventing and/or delaying an adversary from defeating or compromising the barrier. A horizontally deployed barrier member can include an exterior steel casing, an interior steel reinforcing member and access delay members disposed within the casing and between the casing and the interior reinforcing member. Access delay members can include wooden structural lumber, concrete and/or polymeric members that in combination with the exterior casing and interior reinforcing member act cooperatively to impair an adversarial attach by thermal, mechanical and/or explosive tools.

  5. Barriers to Maori sole mothers’ primary health care access

    Directory of Open Access Journals (Sweden)

    Lee R

    2013-12-01

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

  6. Planning and Implementing Immunization Billing Programs at State and Local Health Departments: Barriers and Possible Solutions.

    Science.gov (United States)

    Corriero, Rosemary; Redmon, Ginger

    Before participating in a project funded by the Centers for Disease Control and Prevention, most state and local health departments (LHDs) were not seeking reimbursement or being fully reimbursed by insurance plans for the cost of immunization services (including vaccine costs and administration fees) they provided to insured patients. Centers for Disease Control and Prevention's Billables Project was designed to enable state and LHDs to bill public and private insurance plans for immunization services provided to insured patients. Identify and describe key barriers state and LHDs may encounter while planning and implementing a billing program, as well as possible solutions for overcoming those barriers. This study used reports from Billables Project participants to explore barriers they encountered when planning and implementing a billing program and steps taken to address those barriers. Thirty-eight state immunization programs. Based on project participants' reports, barriers were noted in 7 categories: (1) funding and costs, (2) staff, (3) health department characteristics, (4) third-party payers and insurance plans, (5) software, (6) patient insurance status, and (7) other barriers. Possible solutions for overcoming those barriers included hiring or seeking external help, creating billing guides and training modules, streamlining workflows, and modifying existing software systems. Overcoming barriers during planning and implementation of a billing program can be challenging for state and LHDs, but the experiences and suggestions of past Billables Project participants can help guide future billing program efforts.

  7. Common Perceived Barriers and Facilitators for Reducing Sedentary Behaviour among Office Workers.

    Science.gov (United States)

    Nooijen, Carla F J; Kallings, Lena V; Blom, Victoria; Ekblom, Örjan; Forsell, Yvonne; Ekblom, Maria M

    2018-04-18

    Qualitative studies identified barriers and facilitators associated with work-related sedentary behaviour. The objective of this study was to determine common perceived barriers and facilitators among office workers, assess subgroup differences, and describe sedentary behaviour. From two Swedish companies, 547 office workers (41 years (IQR = 35–48), 65% women, 66% highly educated) completed questionnaires on perceived barriers and facilitators, for which subgroup differences in age, gender, education, and workplace sedentary behaviour were assessed. Sedentary behaviour was measured using inclinometers ( n = 311). The most frequently reported barrier was sitting is a habit (67%), which was reported more among women than men (Χ² = 5.14, p = 0.03) and more among highly sedentary office workers (Χ² = 9.26, p < 0.01). The two other most reported barriers were that standing is uncomfortable (29%) and standing is tiring (24%). Facilitators with the most support were the introduction of either standing- or walking-meetings (respectively 33% and 29%) and more possibilities or reminders for breaks (31%). The proportion spent sedentary was 64% at the workplace, 61% on working days, and 57% on non-working days. This study provides a detailed understanding of office workers’ ideas about sitting and means to reduce sitting. We advise to include the supported facilitators and individualized support in interventions to work towards more effective strategies to reduce sedentary behaviour.

  8. Enershield : energy saving air barriers

    Energy Technology Data Exchange (ETDEWEB)

    Hallihan, D. [Enershield Industries Ltd., Edmonton, AB (Canada)

    2008-07-01

    Enershield Industries is a leader in air barrier technology and provides solution for the Canadian climate. This presentation described the advantages of air barriers and the impact of rising energy costs. An air barrier is used to separate areas of differing environments and makes existing building systems more efficient. This presentation discussed how an air barrier works. It also identified how Enershield Industries calculates energy savings. It described air barrier applications and those who use barrier technology. These include the commercial and industrial sector as well as the personnel and retail sector. Barrier technology can be used for cold storage; vehicle and equipment washes; food processing; and environmental separation. Features and benefits such as the ability to create seal, acoustic insulation, and long term durability were also discussed. Last, the presentation addressed model selection and design criteria issues. Design criteria that were presented included a discussion of acoustic installation, articulating nozzles, scroll cased fans, and structural frame. Other design criteria presented were galvanized frames, telescopic sliders, and off the shelf parts. It was concluded that the ability to reduce energy consumption and enhance employee/client comfort is beneficial to the employer as well as to the employee. figs.

  9. Deployment Efficiency and Barrier Effectiveness Testing of a Temporary Anti-Personnel (TAP) Barrier System.

    Energy Technology Data Exchange (ETDEWEB)

    Allen, David James [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Hedrick, Charles D. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Martinez, Ruben [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2017-02-01

    This report documents tests conducted by Sandia National Laboratories (SNL) on behalf of the U.S. Department of State to evaluate a temporary anti-personnel (TAP) barrier system developed by Mitigation Technologies. For this, the SNL Denial and Structural Assessment department developed a test protocol for the evaluation of the TAP barrier system on the basis of deployment efficiency and barrier effectiveness against a riotous/mob attack threat. The test protocol was then executed by SNL personnel and the results of the testing are documented.

  10. Identifying and overcoming barriers to technology implementation

    International Nuclear Information System (INIS)

    Bailey, M.; Warren, S.; McCune, M.

    1996-01-01

    In a recent General Accounting Office report, the Department of Energy's (DOE) Office of Environmental Management was found to be ineffective in integrating their environmental technology development efforts with the cleanup actions. As a result of these findings, a study of remediation documents was performed by the Technology Applications Team within DOE's Office of Environmental Restoration (EM-40) to validate this finding and to understand why it was occurring. A second initiative built on the foundation of the remediation document study and evaluated solutions to the ineffective implementation of improved technologies. The Technology Applications Team examined over 50 remediation documents (17 projects) which included nearly 600 proposed remediation technologies. It was determined that very few technologies are reaching the Records of Decision documents. In fact, most are eliminated in the early stages of consideration. These observations stem from regulators' and stakeholders' uncertainties in cost and performance of the technology and the inability of the technology to meet site specific conditions. The Technology Applications Team also set out to identify and evaluate solutions to barriers to implementing innovative technology into the DOE's environmental management activities. Through the combined efforts of DOE and the Hazardous Waste Action Coalition (HWAC), a full day workshop was conducted at the annual HWAC meeting in June 1995 to solve barriers to innovative technology implementation. Three barriers were identified as widespread throughout the DOE complex and industry. Identified barriers included a lack of verified or certified cost and performance data for innovative technologies; risk of failure to reach cleanup goals using innovative technologies; and communication barriers that are present at virtually every stage of the characterization/remediation process from development through implementation

  11. An examination of how women and underrepresented racial/ethnic minorities experience barriers in biomedical research and medical programs

    Science.gov (United States)

    Chakraverty, Devasmita

    Women in medicine and biomedical research often face challenges to their retention, promotion, and advancement to leadership positions (McPhillips et al., 2007); they take longer to advance their careers, tend to serve at less research-intensive institutions and have shorter tenures compared to their male colleagues (White, McDade, Yamagata, & Morahan, 2012). Additionally, Blacks and Hispanics are the two largest minority groups that are vastly underrepresented in medicine and biomedical research in the United States (AAMC, 2012; NSF, 2011). The purpose of this study is to examine specific barriers reported by students and post-degree professionals in the field through the following questions: 1. How do women who are either currently enrolled or graduated from biomedical research or medical programs define and make meaning of gender-roles as academic barriers? 2. How do underrepresented groups in medical schools and biomedical research institutions define and make meaning of the academic barriers they face and the challenges these barriers pose to their success as individuals in the program? These questions were qualitatively analyzed using 146 interviews from Project TrEMUR applying grounded theory. Reported gender-role barriers were explained using the "Condition-Process-Outcome" theoretical framework. About one-third of the females (across all three programs; majority White or Black between 25-35 years of age) reported gender-role barriers, mostly due to poor mentoring, time constraints, set expectations and institutional barriers. Certain barriers act as conditions, causing gender-role issues, and gender-role issues influence certain barriers that act as outcomes. Strategies to overcome barriers included interventions mostly at the institutional level (mentor support, proper specialty selection, selecting academia over medicine). Barrier analysis for the two largest URM groups indicated that, while Blacks most frequently reported racism, gender barriers

  12. KBS Annual Report 1983. Including summaries of technical reports issued during 1983

    International Nuclear Information System (INIS)

    1984-06-01

    The purpose of the KBS Annual Report is to inform interested organizations and individuals of the research and development work performed by the division KBS within the Swedish Nuclear Fuel Supply Co (SKBF) on the handling, treatment and final storage of nuclear wastes in Sweden. The Annual Report normally contains a presentation of the legal and organizational situation followed by an account of the progress within different areas of the R and D-work. This account also includes indications of the activities planned for the future. At the end of the report the summaries of 76 technical reports and other publications issued during the year are listed in special appendices. (K.A.E.)

  13. Recommendations for a barrier island breach management plan for Fire Island National Seashore, including the Otis Pike High Dune Wilderness Area, Long Island, New York

    Science.gov (United States)

    Williams, S. Jeffress; Foley, Mary K.

    2007-01-01

    The U.S Army Corps of Engineers, New York District is developing engineering plans, including economic costs and benefits, for storm damage reduction along an 83 mile stretch of the coastal barrier islands and beaches on the south shore of Long Island, NY from Fire Island Inlet east to the Montauk Point headland. The plan, expected to include various alternatives for storm protection and erosion mitigation, is referred to as the Fire Island to Montauk Point Reformulation Plan (FIMP). These plans are expected to follow the Corps of Engineers’ Environmental Operating Principles striving for long term environmental sustainability and balance between environmental protection and protection of human health and property. Fire Island National Seashore (FIIS), a 19,579 acre unit of the National Park System includes a 32 mile long coastal barrier island located within the FIMP project area. A seven-mile section of the park, Otis Pike Fire Island High Dune Wilderness Area, is also a designated Federal Wilderness Area. The FIIS includes not only the barrier island and sand dunes, but also several islands, sand flats and wetlands landward of the barrier, submerged parts of Great South Bay shoreface, extending approximately 4,000 feet into the bay with the inner shelf region extending approximately 1,000 feet seaward of the Fire Island shoreline. The Fire Island barrier islands, a sand-starved system dominated by highly dynamic processes, are struggling to maintain their integrity in the face of sea-level rise and storms. Adding to the dilemma is that development on the barriers and the mainland has increased greatly during the past 50 years. As such, managers and decision makers in federal agencies, state agencies and local governments are challenged to balance tradeoffs between protection of lives and property, public access and long term conservation of natural habitats and processes and the plants and animals that depend on these habitats. National Park Service (NPS

  14. Factors predicting barriers to exercise in midlife Australian women.

    Science.gov (United States)

    McGuire, Amanda; Seib, Charrlotte; Anderson, Debra

    2016-05-01

    Chronic diseases are the leading cause of death and disability worldwide. They are, though, largely attributable to modifiable lifestyle risk factors, including lack of exercise. This study aims to investigate what factors predict perceptions of barriers to exercise in midlife women. This cross-sectional descriptive study collected data from midlife Australian women by online questionnaire. Volunteers aged between 40 and 65 years were recruited following media publicity about the study. The primary outcome measure was perceived exercise barriers (EBBS Barriers sub-scale). Other self-report data included: exercise, smoking, alcohol, fruit and vegetable consumption, body mass index, physical and mental health and well-being (MOS SF-12v2) and exercise self-efficacy. On average, the 225 participants were aged 50.9 years (SD=5.9). The significant predictors of perceived barriers to exercise were perceived benefits of exercise, exercise self-efficacy, physical well-being and mental well-being. These variables explained 41% of the variance in the final model (F (8219)=20.1, pexercise correlate with beliefs about the health benefits of exercise, exercise self-efficacy, physical and mental well-being. These findings have application to health promotion interventions targeting exercise behaviour change in midlife women. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  15. Model assessment of protective barrier designs: Part 2

    International Nuclear Information System (INIS)

    Fayer, M.J.

    1987-11-01

    Protective barriers are being considered for use at the Hanford Site to enhance the isolation of radioactive wastes from water, plant, and animal intrusion. This study assesses the effectiveness of protective barriers for isolation of wastes from water. In this report, barrier designs are reviewed and several barrier modeling assumptions are tested. 20 refs., 16 figs., 6 tabs

  16. A new approach to performance assessment of barriers in a repository. Executive summary, draft, technical appendices. Final report

    International Nuclear Information System (INIS)

    Mueller-Hoeppe, N.; Krone, J.; Niehues, N.; Poehler, M.; Raitz von Frentz, R.; Gauglitz, R.

    1999-06-01

    Multi-barrier systems are accepted as the basic approach for long term environmental safe isolation of radioactive waste in geological repositories. Assessing the performance of natural and engineered barriers is one of the major difficulties in producing evidence of environmental safety for any radioactive waste disposal facility, due to the enormous complexity of scenarios and uncertainties to be considered. This report outlines a new methodological approach originally developed basically for a repository in salt, but that can be transferred with minor modifications to any other host rock formation. The approach is based on the integration of following elements: (1) Implementation of a simple method and efficient criteria to assess and prove the tightness of geological and engineered barriers; (2) Using the method of Partial Safety Factors in order to assess barrier performance at certain reasonable level of confidence; (3) Integration of a diverse geochemical barrier in the near field of waste emplacement limiting systematically the radiological consequences from any radionuclide release in safety investigations and (4) Risk based approach for the assessment of radionuclide releases. Indicative calculations performed with extremely conservative assumptions allow to exclude any radiological health consequences from a HLW repository in salt to a reference person with a safety level of 99,9999% per year. (orig.)

  17. Barriers to Physical Activity in East Harlem, New York

    Directory of Open Access Journals (Sweden)

    Ashley M. Fox

    2012-01-01

    Full Text Available Background. East Harlem is an epicenter of the intertwining epidemics of obesity and diabetes in New York. Physical activity is thought to prevent and control a number of chronic illnesses, including diabetes, both independently and through weight control. Using data from a survey collected on adult (age 18+ residents of East Harlem, this study evaluated whether perceptions of safety and community-identified barriers were associated with lower levels of physical activity in a diverse sample. Methods. We surveyed 300 adults in a 2-census tract area of East Harlem and took measurements of height and weight. Physical activity was measured in two ways: respondents were classified as having met the weekly recommended target of 2.5 hours of moderate physical activity (walking per week (or not and reporting having engaged in at least one recreational physical activity (or not. Perceived barriers were assessed through five items developed by a community advisory board and perceptions of neighborhood safety were measured through an adapted 7-item scale. Two multivariate logistic regression models with perceived barriers and concerns about neighborhood safety were modeled separately as predictors of engaging in recommended levels of exercise and recreational physical activity, controlling for respondent weight and sociodemographic characteristics. Results. The most commonly reported perceived barriers to physical activity identified by nearly half of the sample were being too tired or having little energy followed by pain with exertion and lack of time. Multivariate regression found that individuals who endorsed a greater number of perceived barriers were less likely to report having met their weekly recommended levels of physical activity and less likely to engage in recreational physical activity controlling for covariates. Concerns about neighborhood safety, though prevalent, were not associated with physical activity levels. Conclusions. Although

  18. Effectiveness of air vapor barriers combined with ventilated crawlspaces in decreasing residential exposure to radon daughters to radon daughters: preliminary report

    International Nuclear Information System (INIS)

    Sterling, T.D.; Arundel, A.; McIntyre, D.; Sterling, E.; Sterling, T.D.

    1986-01-01

    Radon gas is present in many homes. Concentrations may be increased in airtight, energy-efficient structures. This is especially true in cold climates where energy conservation is an important factor leading to the widespread application of sealing and tightening techniques both in older renovated homes and new construction. To reduce radon concentrations, it may be effective to ventilate crawlspaces and prevent infiltration of radon gas into the house by means of an air/vapor barrier. The authors report first results of comparing radon levels in homes with and without ventilated crawlspaces and air/vapor barriers. Radon emissions were measured in a tightly sealed home with ventilated crawlspaces and an air/vapor barrier and in two homes without such vapor barriers and ventilated crawlspaces, but differing in ventilation. Preliminary results suggest that use of ventilated crawlspaces and bottomside vapor barriers may reduce indoor radon levels by approximately 60%. 15 references, 1 table

  19. Influenza Vaccine Uptake, Hand Hygiene Practices, and Perceived Barriers in Decision Making.

    Science.gov (United States)

    Stedman-Smith, Maggie; Kingsbury, Diana M; Dubois, Cathy L Z; Grey, Scott F

    2017-01-01

    The annual costs of influenza are in the billions of dollars, with employers bearing substantial burdens. Yet, influenza vaccine uptake is sub-optimal. A random survey was administered to employees at a Midwestern public university using mixed quantitative and qualitative methods to identify the rate, characteristics, and barriers of self-reported flu vaccine uptake during March-April of 2012. The lowest uptake was among adults, ages 18 to 49 (29.8%), even though they are included in universal recommendations. Multiple regression analysis adjusted for demographic confounders showed an increase in self-identified protective hand hygiene behavior among those who reported influenza vaccine uptake compared with those who did not. Qualitative thematic analysis revealed contextual accounts of why vaccine uptake was declined including structural, perceptual, and knowledge barriers. Implementation and evaluation of novel multicomponent worksite vaccine interventions tailored to reach young and middle-aged employees including utilization of risk communication is needed to facilitate increased uptake.

  20. Assessing barriers to adherence in routine clinical care for pediatric kidney transplant patients.

    Science.gov (United States)

    Varnell, Charles D; Rich, Kristin L; Nichols, Melissa; Dahale, Devesh; Goebel, Jens W; Pai, Ahna L H; Hooper, David K; Modi, Avani C

    2017-11-01

    Patient-identified barriers to immunosuppressive medications are associated with poor adherence and negative clinical outcomes in transplant patients. Assessment of adherence barriers is not part of routine post-transplant care, and studies regarding implementing such a process in a reliable way are lacking. Using the Model for Improvement and PDSA cycles, we implemented a system to identify adherence barriers, including patient-centered design of a barriers assessment tool, identification of eligible patients, clear roles for clinic staff, and creating a culture of non-judgmental discussion around adherence. We performed time-series analysis of our process measure. Secondary analyses examined the endorsement and concordance of adherence barriers between patient-caregiver dyads. After three methods of testing, the most reliable delivery system was an EHR-integrated tablet that alerted staff of patient eligibility for assessment. Barriers were endorsed by 35% of caregivers (n=85) and 43% of patients (n=60). The most frequently patient-endorsed barriers were forgetting, poor taste, and side effects. Caregivers endorsed forgetting and side effects. Concordance between patient-caregiver dyads was fair (k=0.299). Standardized adherence barriers assessment is feasible in the clinical care of pediatric kidney transplant patients. Features necessary for success included automation, redundant systems with designated staff to identify and mitigate failures, aligned reporting structures, and reliable measurement approaches. Future studies will examine whether barriers predict clinical outcomes (eg, organ rejection, graft loss). © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. Purposeful exposure of a polylactic acid barrier to achieve socket preservation for placement of dental implants: case series report.

    Science.gov (United States)

    Rosen, Paul S; Rosen, Adam D

    2013-01-01

    This retrospective case series reports on the use of a polylactic acid barrier that was left exposed in the process of socket preparation for the placement of dental implants. A retrospective chart review found 43 patients with 48 extraction sockets that were treated in this manner. Teeth were removed and the sockets were thoroughly debrided, with 40 of them receiving a bone replacement graft covered by the polylactic acid barrier and the additional 8 receiving the membrane alone. Suturing left the barrier exposed, and the sites were re-entered on average at 23 weeks for the placement of a dental implant. All sites were able to receive a dental implant, demonstrating the ability to leave a polylactic acid barrier exposed and achieve successful guided bone regeneration (GBR) results. This ultimately helped avoid some of the negative sequelae of trying to achieve primary closure of the flaps at the time of tooth extraction.

  2. Market barriers to welfare product innovations

    NARCIS (Netherlands)

    Binnekamp, M.H.A.; Ingenbleek, P.T.M.

    2006-01-01

    New products that are based on higher animal welfare standards encounter several barriers on the road to market acceptance. The authors focus on the Dutch poultry sector and distinguish between retailer and consumer barriers. Retailer barriers include the powerful position of retailers, the price

  3. Barriers to lifestyle changes for prevention of cardiovascular disease - a survey among 40-60-year old Danes.

    Science.gov (United States)

    Nielsen, Jesper Bo; Leppin, Anja; Gyrd-Hansen, Dort E; Jarbøl, Dorte Ejg; Søndergaard, Jens; Larsen, Pia Veldt

    2017-09-12

    Elimination of modifiable risk factors including unhealthy lifestyle has the potential for prevention of 80% of cardiovascular disease cases. The present study focuses on disclosing barriers for maintaining specific lifestyle changes by exploring associations between perceiving these barriers and various sociodemographic and health-related characteristics. Data were collected through a web-based questionnaire survey and included 962 respondents who initially accepted treatment for a hypothetical cardiovascular risk, and who subsequently stated that they preferred lifestyle changes to medication. Logistic regression was used to analyse associations between barriers to lifestyle changes and relevant covariates. A total of 45% of respondents were identified with at least one barrier to introducing 30 min extra exercise daily, 30% of respondents reported at least one barrier to dietary change, and among smokers at least one barrier to smoking cessation was reported by 62% of the respondents. The perception of specific barriers to lifestyle change depended on sociodemographic and health-related characteristics. We observed a considerable heterogeneity between different social groups in the population regarding a number of barriers to lifestyle change. Our study demonstrates that social inequality exists in the ability to take appropriate preventive measures through lifestyle changes to stay healthy. This finding underlines the challenge of social inequality even in populations with equal and cost-free access to health care. Our study suggests supplementing traditional public campaigns to counter cardiovascular disease by using individualized and targeted initiatives.

  4. A cross sectional observational study of research activity of allied health teams: is there a link with self-reported success, motivators and barriers to undertaking research?

    Science.gov (United States)

    Wenke, Rachel J; Mickan, Sharon; Bisset, Leanne

    2017-02-06

    Team-based approaches to research capacity building (RCB) may be an efficient means to promote allied health research participation and activity. In order to tailor such interventions, a clearer understanding of current patterns of research participation within allied health teams is needed. Different self-report measures exist which evaluate a team's research capacity and participation, as well as associated barriers and motivators. However, it remains unclear how such measures are associated with a team's actual research activity (e.g., journal publications, funding received). In response, this observational study aimed to identify the research activity, self-reported success, and motivations and barriers to undertaking research of eight allied health professional (AHP) teams and to explore whether any relationships exist between the self-reported measures and actual research activity within each team. A total of 95 AHPs from eight teams completed the research capacity and culture survey to evaluate team success, barriers and motivators to undertaking research, and an audit of research activity from January 2013 to August 2014 was undertaken within each team. Kendell's correlation coefficients were used to determine the association between research activity (i.e., number of journal publications, ethically approved projects and funding received) and the self-reported measures. Seven out of eight teams rated their teams as having average success in research and demonstrated some form of research activity including at least two ethically approved projects. Research activity varied between teams, with funding received ranging from $0 to over $100,000, and half the teams not producing any journal publications. Team motivators demonstrated a stronger association with research activity compared to barriers, with the motivator "enhancing team credibility" being significantly associated with funding received. No significant association between self-reported research

  5. Evaluation of barriers and resilience to improve organizational performance in nuclear power plants

    Energy Technology Data Exchange (ETDEWEB)

    Nelson, P. F.; Martin del Campo, C., E-mail: pnelson_007@yahoo.com [UNAM, Facultad de Ingenieria, Departamento de Sistemas Energeticos, Paseo Cuauhnahuac 8532, Jiutepec 62550, Morelos (Mexico)

    2014-10-15

    In this study, several models are built from the information contained in the Condition Reports from the Corrective Action Program ar a nuclear power plant. Condition Reports are seen as indications of organizational stress levels with consequential Condition Reports being further evidence of organizational resilience being exceeded. Also contained in this paper is an examination of methods used to assess organizational resilience thresholds to preclude consequential events, based on examination of the number and severity of the Condition Reports. In combination with PSA risk insights, it is possible to identify risk significant procedures and their corresponding risk significant steps. Leading indicators can be used to identify the need for installing a barrier or defense to reduce human errors in a nuclear power plant. These indicators are developed from the Corrective Action Program data by detecting increases in events. Organizational barriers can then be identified to improve performance. The resulting identified barriers are evaluated to rank the value of each possible barrier, and determine the best barrier(s) to implement. The tool described in this paper is designed to provide a systematic approach to identify areas where improvements in organizational effectiveness best reduce the likelihood of consequential events. Due to the uncertainty of many of the factors that influence the performance of humans in nuclear power plant activities, we propose using Bayesian networks to identify sources of organizational errors leading to consequential events. This study, using actual nuclear power plant data, includes a method for data processing and highlights some potential uses of Bayesian networks for improving organizational effectiveness in the nuclear power industry. (Author)

  6. Evaluation of barriers and resilience to improve organizational performance in nuclear power plants

    International Nuclear Information System (INIS)

    Nelson, P. F.; Martin del Campo, C.

    2014-10-01

    In this study, several models are built from the information contained in the Condition Reports from the Corrective Action Program ar a nuclear power plant. Condition Reports are seen as indications of organizational stress levels with consequential Condition Reports being further evidence of organizational resilience being exceeded. Also contained in this paper is an examination of methods used to assess organizational resilience thresholds to preclude consequential events, based on examination of the number and severity of the Condition Reports. In combination with PSA risk insights, it is possible to identify risk significant procedures and their corresponding risk significant steps. Leading indicators can be used to identify the need for installing a barrier or defense to reduce human errors in a nuclear power plant. These indicators are developed from the Corrective Action Program data by detecting increases in events. Organizational barriers can then be identified to improve performance. The resulting identified barriers are evaluated to rank the value of each possible barrier, and determine the best barrier(s) to implement. The tool described in this paper is designed to provide a systematic approach to identify areas where improvements in organizational effectiveness best reduce the likelihood of consequential events. Due to the uncertainty of many of the factors that influence the performance of humans in nuclear power plant activities, we propose using Bayesian networks to identify sources of organizational errors leading to consequential events. This study, using actual nuclear power plant data, includes a method for data processing and highlights some potential uses of Bayesian networks for improving organizational effectiveness in the nuclear power industry. (Author)

  7. Do stigma and other perceived barriers to mental health care differ across Armed Forces?

    Science.gov (United States)

    Gould, Matthew; Adler, Amy; Zamorski, Mark; Castro, Carl; Hanily, Natalie; Steele, Nicole; Kearney, Steve; Greenberg, Neil

    2010-01-01

    Summary Objectives Military organizations are keen to address barriers to mental health care yet stigma and barriers to care remain little understood, especially potential cultural differences between Armed Forces. The aim of this study was to compare data collected by the US, UK, Australian, New Zealand and Canadian militaries using Hoge et al.'s perceived stigma and barriers to care measure (Combat duty in Iraq and Afghanistan, mental health problems and barriers to care. New Engl J Med 2004;351:13–22). Design Each member country identified data sources that had enquired about Hoge et al.'s perceived stigma and perceived barriers to care items in the re-deployment or immediate post-deployment period. Five relevant statements were included in the study. Setting US, UK Australian, New Zealand and Canadian Armed Forces. Results Concerns about stigma and barriers to care tended to be more prominent among personnel who met criteria for a mental health problem. The pattern of reported stigma and barriers to care was similar across the Armed Forces of all five nations. Conclusions Barriers to care continue to be a major issue for service personnel within Western military forces. Although there are policy, procedural and cultural differences between Armed Forces, the nations studied appear to share some similarities in terms of perceived stigma and barriers to psychological care. Further research to understand patterns of reporting and subgroup differences is required. PMID:20382906

  8. Modelling of safety barriers including human and organisational factors to improve process safety

    DEFF Research Database (Denmark)

    Markert, Frank; Duijm, Nijs Jan; Thommesen, Jacob

    2013-01-01

    It is believed that traditional safety management needs to be improved on the aspect of preparedness for coping with expected and unexpected deviations, avoiding an overly optimistic reliance on safety systems. Remembering recent major accidents, such as the Deep Water Horizon, the Texas City....... A valuable approach is the inclusion of human and organisational factors into the simulation of the reliability of the technical system using event trees and fault trees and the concept of safety barriers. This has been demonstrated e.g. in the former European research project ARAMIS (Accidental Risk...

  9. Barriers to antiretroviral therapy adherence in developed countries: a qualitative synthesis to develop a conceptual framework for a new patient-reported outcome measure.

    Science.gov (United States)

    Engler, Kim; Lènàrt, Andras; Lessard, David; Toupin, Isabelle; Lebouché, Bertrand

    2018-05-02

    Suboptimal adherence to antiretroviral therapy (ART) remains common. Patient-centered tools are needed to comprehensively assess adherence barriers in HIV clinical practice. Thus, we conducted a research synthesis to produce a conceptual framework for a new patient-reported outcome measure (PRO) for use in routine HIV care in Canada and France. A PRO's conceptual framework graphically represents the concepts to be measured and the potential relationships between them. Towards ensuring the framework's relevance to the target populations' concerns, qualitative studies with HIV-positive adults on barriers to ART adherence in developed countries were synthesized with thematic analysis, attending to the cross-study prevalence and interrelationships of barrier themes. In March 2016, searches within Medline, PsychINFO, and Embase produced 5,284 records. Two reviewers determined the final sample (n = 41). Analysis generated three levels of ART adherence barrier themes. Twenty Level 2 themes and their component subthemes (Level 3) were organized into 6 higher-order themes (Level 1): Cognitive and emotional aspects (100% of studies contributing content -prevalence), Lifestyle factors (95%), Social and material context (95%), Characteristics of ART (90%), Health experience and state (73%), and Healthcare services and system (66%). As to interrelationships, study authors articulated relationships between all higher-order themes (Level 3). Linkages between Level 2 barrier themes showed great variability, from 21% to 95%. Overall, this synthesis contributes an exceptionally detailed conceptual framework and report of ART adherence barriers, applicable to a wide range of PLHIV. It suggests that a key to understanding many barriers is through their interconnections. It also identifies gaps in barrier research. Concerning the new PRO's development, comprehensiveness will need to be weighed against other concerns (e.g., respondent burden) and the provision of barrier

  10. 40 CFR 60.1885 - What must I include in my annual report?

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 6 2010-07-01 2010-07-01 false What must I include in my annual report...-Reporting § 60.1885 What must I include in my annual report? Summarize data collected for all pollutants and... controlling dioxins/furans or mercury emissions, include four records: (1) The average carbon feed rates...

  11. Containment wells to form hydraulic barriers along site boundaries

    International Nuclear Information System (INIS)

    Vo, D.; Ramamurthy, A.S.; Qu, J.; Zhao, X.P.

    2008-01-01

    In the field, aquifer remediation methods include pump and treat procedures based on hydraulic control systems. They are used to reduce the level of residual contamination present in the soil and soil pores of aquifers. Often, physical barriers are erected along the boundaries of the target (aquifer) site to reduce the leakage of the released soil contaminant to the surrounding regions. Physical barriers are expensive to build and dismantle. Alternatively, based on simple hydraulic principles, containment wells or image wells injecting clear water can be designed and built to provide hydraulic barriers along the contaminated site boundaries. For brevity, only one pattern of containment well system that is very effective is presented in detail. The study briefly reports about the method of erecting a hydraulic barrier around a contaminated region based on the simple hydraulic principle of images. During the clean-up period, hydraulic barriers can considerably reduce the leakage of the released contaminant from the target site to surrounding pristine regions. Containment wells facilitate the formation of hydraulic barriers. Hence, they control the movement of contaminants away from the site that is being remedied. However, these wells come into play, only when the pumping operation for cleaning up the site is active. After operation, they can be filled with soil to permit the natural ground water movement. They can also be used as monitoring wells

  12. Electrical characteristics of schottky barriers on 4H-SiC: The effects of barrier height nonuniformity

    Science.gov (United States)

    Skromme, B. J.; Luckowski, E.; Moore, K.; Bhatnagar, M.; Weitzel, C. E.; Gehoski, T.; Ganser, D.

    2000-03-01

    Electrical properties, including current-voltage (I-V) and capacitance-voltage (C-V) characteristics, have been measured on a large number of Ti, Ni, and Pt-based Schottky barrier diodes on 4H-SiC epilayers. Various nonideal behaviors are frequently observed, including ideality factors greater than one, anomalously low I-V barrier heights, and excess leakage currents at low forward bias and in reverse bias. The nonidealities are highly nonuniform across individual wafers and from wafer to wafer. We find a pronounced linear correlation between I-V barrier height and ideality factor for each metal, while C-V barrier heights remain constant. Electron beam induced current (EBIC) imaging strongly suggests that the nonidealities result from localized low barrier height patches. These patches are related to discrete crystal defects, which become visible as recombination centers in the EBIC images. Alternative explanations involving generation-recombination current, uniform interfacial layers, and effects related to the periphery are ruled out.

  13. Explanation of the barrier heights of graphene Schottky contacts by the MIGS-and-electronegativity concept

    Science.gov (United States)

    Mönch, Winfried

    2016-09-01

    Graphene-semiconductor contacts exhibit rectifying properties and, in this respect, they behave in exactly the same way as a "conventional" metal-semiconductor or Schottky contacts. It will be demonstrated that, as often assumed, the Schottky-Mott rule does not describe the reported barrier heights of graphene-semiconductor contacts. With "conventional" Schottky contacts, the same conclusion was reached already in 1940. The physical reason is that the Schottky-Mott rule considers no interaction between the metal and the semiconductor. The barrier heights of "conventional" Schottky contacts were explained by the continuum of metal-induced gap states (MIGSs), where the differences of the metal and semiconductor electronegativities describe the size and the sign of the intrinsic electric-dipoles at the interfaces. It is demonstrated that the MIGS-and-electronegativity concept unambiguously also explains the experimentally observed barrier heights of graphene Schottky contacts. This conclusion includes also the barrier heights reported for MoS2 Schottky contacts with "conventional" metals as well as with graphene.

  14. Barriers to promote cardiovascular health in community pharmacies: a systematic review.

    Science.gov (United States)

    Alonso-Perales, María Del Mar; Lasheras, Berta; Beitia, Guadalupe; Beltrán, Idoia; Marcos, Beatriz; Núñez-Córdoba, Jorge M

    2017-06-01

    Community pharmacists play an important role in the provision of health promotion services, and community pharmacies are considered as a potentially ideal site for cardiovascular health promotion. Information based on a systematic review of barriers to promoting cardiovascular health in community pharmacy is currently lacking. We have sought to identify the most important barriers to cardiovascular health promotion in the community pharmacy. We have systematically searched PubMed and International Pharmaceutical Abstracts for a period of 15 years from 1 April 1998 to 1 April 2013, contacted subject experts and hand-searched bibliographies. We have included peer-reviewed articles, with English abstracts in the analysis, if they reported community pharmacists' perceptions of the barriers to cardiovascular health promotion activities in a community pharmacy setting. Two reviewers have independently extracted study characteristics and data. We identified 24 studies that satisfy the eligibility criteria. The main barriers to cardiovascular health promotion in the community pharmacy included pharmacist-related factors; practice site factors; financial factors; legal factors; and patient-related factors. This review will help to provide reliable evidence for health promotion practitioners of the barriers to promoting cardiovascular health in the community pharmacy setting. This knowledge is valuable for the improvement of cardiovascular health promotion in this setting and guiding future research. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  15. Improved Barriers to Turbine Engine Fragments: Interim Report II

    National Research Council Canada - National Science Library

    Shockey, Donald

    1999-01-01

    ... the effects of uncontained engine bursts. SRI International is evaluating the ballistic effectiveness of fabric structures made from advanced polymers and developing a computational ability to design fragment barriers...

  16. Barrier rf systems in synchrotrons

    International Nuclear Information System (INIS)

    Bhat, Chandra M.

    2004-01-01

    Recently, many interesting applications of the barrier RF system in hadron synchrotrons have been realized. A remarkable example of this is the development of longitudinal momentum mining and implementation at the Fermilab Recycler for extraction of low emittance pbars for the Tevatron shots. At Fermilab, we have barrier RF systems in four different rings. In the case of Recycler Ring, all of the rf manipulations are carried out using a barrier RF system. Here, the author reviews various uses of barrier rf systems in particle accelerators including some new schemes for producing intense proton beam and possible new applications

  17. Development of the SEAtrace{trademark} barrier verification and validation technology. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Dunn, S.D.; Lowry, W.; Walsh, R.; Rao, D.V. [Science and Engineering Associates, Santa Fe, NM (United States); Williams, C. [Sandia National Labs., Albuquerque, NM (United States). Underground Storage Technology Dept.

    1998-08-01

    In-situ barrier emplacement techniques and materials for the containment of high-risk contaminants in soils are currently being developed by the Department of Energy (DOE). Because of their relatively high cost, the barriers are intended to be used in cases where the risk is too great to remove the contaminants, the contaminants are too difficult to remove with current technologies, or the potential movement of the contaminants to the water table is so high that immediate action needs to be taken to reduce health risks. Assessing the integrity of the barrier once it is emplaced, and during its anticipated life, is a very difficult but necessary requirement. Science and Engineering Associates, Inc., (SEA) and Sandia National Laboratories (SNL) have developed a quantitative subsurface barrier assessment system using gaseous tracers in support of the Subsurface Contaminants Focus Area barrier technology program. Called SEAtrace{trademark}, this system integrates an autonomous, multi-point soil vapor sampling and analysis system with a global optimization modeling methodology to locate and size barrier breaches in real time. The methodology for the global optimization code was completed and a prototype code written using simplifying assumptions. Preliminary modeling work to validate the code assumptions were performed using the T2VOC numerical code. A multi-point field sampling system was built to take soil gas samples and analyze for tracer gas concentration. The tracer concentration histories were used in the global optimization code to locate and size barrier breaches. SEAtrace{trademark} was consistently able to detect and locate leaks, even under very adverse conditions. The system was able to locate the leak to within 0.75 m of the actual value, and was able to determine the size of the leak to within 0.15 m.

  18. Development of the SEAtrace trademark barrier verification and validation technology. Final report

    International Nuclear Information System (INIS)

    Dunn, S.D.; Lowry, W.; Walsh, R.; Rao, D.V.; Williams, C.

    1998-08-01

    In-situ barrier emplacement techniques and materials for the containment of high-risk contaminants in soils are currently being developed by the Department of Energy (DOE). Because of their relatively high cost, the barriers are intended to be used in cases where the risk is too great to remove the contaminants, the contaminants are too difficult to remove with current technologies, or the potential movement of the contaminants to the water table is so high that immediate action needs to be taken to reduce health risks. Assessing the integrity of the barrier once it is emplaced, and during its anticipated life, is a very difficult but necessary requirement. Science and Engineering Associates, Inc., (SEA) and Sandia National Laboratories (SNL) have developed a quantitative subsurface barrier assessment system using gaseous tracers in support of the Subsurface Contaminants Focus Area barrier technology program. Called SEAtrace trademark, this system integrates an autonomous, multi-point soil vapor sampling and analysis system with a global optimization modeling methodology to locate and size barrier breaches in real time. The methodology for the global optimization code was completed and a prototype code written using simplifying assumptions. Preliminary modeling work to validate the code assumptions were performed using the T2VOC numerical code. A multi-point field sampling system was built to take soil gas samples and analyze for tracer gas concentration. The tracer concentration histories were used in the global optimization code to locate and size barrier breaches. SEAtrace trademark was consistently able to detect and locate leaks, even under very adverse conditions. The system was able to locate the leak to within 0.75 m of the actual value, and was able to determine the size of the leak to within 0.15 m

  19. Barriers and Solutions to Fieldwork Education in Hand Therapy.

    Science.gov (United States)

    Short, Nathan; Sample, Shelby; Murphy, Malachi; Austin, Brittany; Glass, Jillian

    2017-08-09

    Survey. Fieldwork education is a vital component of training the next generation of CHTs. Barriers and solutions to fieldwork rotations in hand therapy are examined, as well as proposed solutions, including recommendations for student preparation. This descriptive study examined barriers for certified hand therapist clinicians to accept students for clinical rotations and clinicians' preferences for student preparation before a rotation in a hand setting. A survey was developed, peer reviewed, and distributed using the electronic mailing list of the Hand Therapy Certification Commission via SurveyMonkey. Aggregate responses were analyzed to identify trends including barriers to student clinical rotations and recommendations for students to prepare for hand rotations. A total of 2080 participants responded to the survey, representing a 37% response rate. Common logistical barriers were identified for accepting students such as limited clinical time and space. Many clinicians (32% agree and 8% strongly agree) also felt that the students lack the clinical knowledge to be successful. Areas of knowledge, skill set, and experience were surveyed for development before a clinical rotation in a hand setting. Most respondents (74%) reported increased likelihood of accepting a student with the recommended preparation. Novel qualitative responses to improve clinical experiences are presented as well. Student preparation before a clinical rotation in a hand setting appears to be a significant barrier based on the survey results. Areas of recommended knowledge, skill set, and experience may serve to guide both formal and informal methods of student preparation before a hand-specific clinical rotation to facilitate knowledge translation from experienced certified hand therapists to the next generation. Although logistical barriers may be difficult to overcome, hand-specific preparation based on clinician' recommendations may facilitate student acceptance and success in hand

  20. Physical activities and barriers reported by adolescents attending a health service. DOI: 10.5007/1980-0037.2011v13n3p163

    Directory of Open Access Journals (Sweden)

    Leandro Garcia

    2011-04-01

    Full Text Available This study characterized the physical activity and barriers reported by adolescents attending the Physical Education service of the Adolescent Care and Support Center, São Paulo, Brazil. An exploratory study was conducted using anamnesis data from118 adolescents aged 10 to 19 years seen between April 2005 and June 2008. The following aspects were analyzed according to gender and age group: participation in leisure-time physical activities and physical education classes, physical activity preferences, and barriers to preferred physical activity. Data are reported as frequencies and were compared by Fisher’s exact test. Enjoying physical activities was reported by 93.2% of the adolescents, whereas 50.8% did not perform any physical activity during their leisure time. The lack of participation in school physical education classes predominated among older adolescents of both genders. Games and team games were the preferred activities, irrespective of gender or age. The lack of company or friends and the lack of places were the most frequently reported barriers to preferred physical activity. The results highlight the importance of a health service program for adolescents that promotes, guides, and supports a more active lifestyle.

  1. Associations between barriers to self-care and diabetes complications among patients with type 2 diabetes.

    Science.gov (United States)

    Sina, Maryam; Graffy, Jonathan; Simmons, David

    2018-07-01

    To determine which barriers to care are associated with type 2 diabetes complications in an area in rural East England. 3649 individuals with type 2 diabetes from 62 general practices were contacted via postal invitation which included a 33 item Barriers-to-Diabetes-Care Survey. Barriers were grouped into five priori major categories: educational, physical, psychological, psychosocial, and systems. The associations of reported barriers, both individually and as a group, with self-reported complications were assessed using logistic regression. 39.5% of participants had self-reported diabetes complications. Physical health barriers (OR = 3.3; 95%CI: 2.7, 4.0), systems barriers (OR = 1.6; 95%CI: 1.3, 2.0) and psychological barriers (OR = 1.3 (95%CI: 1.1, 1.5) were associated with diabetes complications. In subcategories, presence of comorbidities (OR = 4.8; 95%CI: 3.9, 5.9), financial difficulties (OR = 1.7; 95%CI: 1.3, 2.1), absence of services (OR = 2.0; 95%CI: 1.4, 3.0), feeling others should bear more financial responsibility for their care (OR = 1.6 (95%CI: 1.1, 2.1), no access to diabetes service (OR = 1.3; 95%CI: 1.1, 1.5), feeling worried about their diabetes (OR = 1.5; 95%CI: 1.2, 2.0) and lack of readiness to exercise (OR = 1.4; 95%CI: 1.2, 1.7) were associated with diabetes complications. Barriers to self-care are significantly more common among those with, than those without, diabetes complications. Systematic identification and management of different barriers to self-care could help personalise care for those with diabetes related complications. Copyright © 2018 Elsevier B.V. All rights reserved.

  2. Engineered barriers: current status 1989

    International Nuclear Information System (INIS)

    Atkinson, A.; Marsh, G.B.

    1989-06-01

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

  3. 40 CFR 60.2958 - What must I include in the deviation report?

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 6 2010-07-01 2010-07-01 false What must I include in the deviation... PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Operator Training and Qualification Recordkeeping and Reporting § 60.2958 What must I include in the deviation report? In each report...

  4. Barriers to Care and 1-Year Mortality Among Newly Diagnosed HIV-Infected People in Durban, South Africa.

    Science.gov (United States)

    Bassett, Ingrid V; Coleman, Sharon M; Giddy, Janet; Bogart, Laura M; Chaisson, Christine E; Ross, Douglas; Flash, Moses J E; Govender, Tessa; Walensky, Rochelle P; Freedberg, Kenneth A; Losina, Elena

    2017-04-01

    Prompt entry into HIV care is often hindered by personal and structural barriers. Our objective was to evaluate the impact of self-perceived barriers to health care on 1-year mortality among newly diagnosed HIV-infected individuals in Durban, South Africa. Before HIV testing at 4 outpatient sites, adults (≥18 years) were surveyed regarding perceived barriers to care including (1) service delivery, (2) financial, (3) personal health perception, (4) logistical, and (5) structural. We assessed deaths via phone calls and the South African National Population Register. We used multivariable Cox proportional hazards models to determine the association between number of perceived barriers and death within 1 year. One thousand eight hundred ninety-nine HIV-infected participants enrolled. Median age was 33 years (interquartile range: 27-41 years), 49% were females, and median CD4 count was 192/μL (interquartile range: 72-346/μL). One thousand fifty-seven participants (56%) reported no, 370 (20%) reported 1-3, and 460 (24%) reported >3 barriers to care. By 1 year, 250 [13%, 95% confidence interval (CI): 12% to 15%] participants died. Adjusting for age, sex, education, baseline CD4 count, distance to clinic, and tuberculosis status, participants with 1-3 barriers (adjusted hazard ratio: 1.49, 95% CI: 1.06 to 2.08) and >3 barriers (adjusted hazard ratio: 1.81, 95% CI: 1.35 to 2.43) had higher 1-year mortality risk compared with those without barriers. HIV-infected individuals in South Africa who reported perceived barriers to medical care at diagnosis were more likely to die within 1 year. Targeted structural interventions, such as extended clinic hours, travel vouchers, and streamlined clinic operations, may improve linkage to care and antiretroviral therapy initiation for these people.

  5. Barriers for realisation of energy savings in buildings; Barrierer for realisering af energibesparelser i bygninger

    Energy Technology Data Exchange (ETDEWEB)

    Jensen, O.M.

    2004-07-01

    Many years' efforts within the energy labelling area have shown large saving potentials in heating and use of electricity in buildings. At the same time it has been proved that these saving potentials, even when economically advantageous, only are cashed to a limited extent. The reason to this is ascribed to barriers that meet the individual building owner who wants to start saving energy. Most barriers are known and a lot of these have been sought overcome for some time. The questions are how many barriers still exist, have new barriers arisen and the character of these barriers. On this background the objective of this survey has been to concretize and study the barriers, which are blocking reasonable energy savings. Focus has especially been on barriers for realisation of heating savings, but through a general evaluation of energy savings of barriers other forms of energy saving methods have been taken into consideration. Special interest has been directed towards houses, typically one family houses, which are affected by the Energy Labelling Scheme. The concept barriers include all kinds of barriers, also barriers that not are acknowledged as barriers by the individual house owner, or that on closer inspection turn out to be something else than actual barriers. This note suggests an alternative inertia model, in order to create an idea of the inertness characteristic of the many house owners who understand the message but fail to act on it. (BA)

  6. The influence of nurse home visits, including provision of 3 months of contraceptives and contraceptive counseling, on perceived barriers to contraceptive use and contraceptive use self-efficacy.

    Science.gov (United States)

    Melnick, Alan L; Rdesinski, Rebecca E; Creach, E Dawn; Choi, Dongseok; Harvey, S Marie

    2008-01-01

    To identify the influence of a community health nurse (CHN) home visit on perceived barriers to contraceptive access and contraceptive use self-efficacy. We enrolled 103 women into two groups in a randomized trial evaluating the influence of contraceptive dispensing and family planning counseling during home visits on perceived barriers to accessing contraceptives and contraceptive use self-efficacy. Both groups received counseling by a CHN about sexually transmitted disease and pregnancy prevention, and a resource card listing phone numbers of family planning clinics. After randomization, the CHN dispensed three months of hormonal contraception to the intensive intervention group and advised the minimal intervention group to schedule an appointment at a family planning clinic. Data collection at baseline and 12 months included demographic, reproductive and other health-related information as well as quantitative assessments of information on perceived barriers to contraceptive access and contraceptive use self-efficacy. The mean age of participants was 24.7 years. Three-fourths had household incomes under $25,000. We found significant reductions in three perceived barriers to contraceptive access for both groups, as well as significant increases in two measures of contraceptive use self-efficacy at twelve months compared to baseline. Nurse home visits involving family planning counseling might be effective in reducing perceived barriers to contraceptive access and increasing contraceptive use self-efficacy.

  7. Engineered Barrier System performance requirements systems study report. Revision 02

    International Nuclear Information System (INIS)

    Balady, M.A.

    1997-01-01

    This study evaluates the current design concept for the Engineered Barrier System (EBS), in concert with the current understanding of the geologic setting to assess whether enhancements to the required performance of the EBS are necessary. The performance assessment calculations are performed by coupling the EBS with the geologic setting based on the models (some of which were updated for this study) and assumptions used for the 1995 Total System Performance Assessment (TSPA). The need for enhancements is determined by comparing the performance assessment results against the EBS related performance requirements. Subsystem quantitative performance requirements related to the EBS include the requirement to allow no more than 1% of the waste packages (WPs) to fail before 1,000 years after permanent closure of the repository, as well as a requirement to control the release rate of radionuclides from the EBS. The EBS performance enhancements considered included additional engineered components as well as evaluating additional performance available from existing design features but for which no performance credit is currently being taken

  8. Engineered Barrier System performance requirements systems study report. Revision 02

    Energy Technology Data Exchange (ETDEWEB)

    Balady, M.A.

    1997-01-14

    This study evaluates the current design concept for the Engineered Barrier System (EBS), in concert with the current understanding of the geologic setting to assess whether enhancements to the required performance of the EBS are necessary. The performance assessment calculations are performed by coupling the EBS with the geologic setting based on the models (some of which were updated for this study) and assumptions used for the 1995 Total System Performance Assessment (TSPA). The need for enhancements is determined by comparing the performance assessment results against the EBS related performance requirements. Subsystem quantitative performance requirements related to the EBS include the requirement to allow no more than 1% of the waste packages (WPs) to fail before 1,000 years after permanent closure of the repository, as well as a requirement to control the release rate of radionuclides from the EBS. The EBS performance enhancements considered included additional engineered components as well as evaluating additional performance available from existing design features but for which no performance credit is currently being taken.

  9. Double barrier system for an in situ conversion process

    Science.gov (United States)

    McKinzie, Billy John [Houston, TX; Vinegar, Harold J [Bellaire, TX; Cowan, Kenneth Michael [Sugar land, TX; Deeg, Wolfgang Friedrich Johann [Houston, TX; Wong, Sau-Wai [Rijswijk, NL

    2009-05-05

    A barrier system for a subsurface treatment area is described. The barrier system includes a first barrier formed around at least a portion of the subsurface treatment area. The first barrier is configured to inhibit fluid from exiting or entering the subsurface treatment area. A second barrier is formed around at least a portion of the first barrier. A separation space exists between the first barrier and the second barrier.

  10. 40 CFR 60.2220 - What must I include in the deviation report?

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 6 2010-07-01 2010-07-01 false What must I include in the deviation... PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Standards of Performance for... Recordkeeping and Reporting § 60.2220 What must I include in the deviation report? In each report required under...

  11. SOLPLAN Report: An Assessment of Barriers and Incentives to Conservation and Alternative-Energy Use in the Residential Sector in Wisconsin

    Energy Technology Data Exchange (ETDEWEB)

    Fulenwider, Claire K.; Weiss, Lonnie S.; Pfefferkorn, Carol; Wiener, Don E.; Feldman, Stephen L.

    1981-03-01

    The Alternative Energy Policy Project of the Wisconsin Center for Public Policy focused upon two principle objectives: (1) gathering and analyzing new and previously unavailable data on barriers and incentives to greater energy conservation and alternative energy commercialization in the state of Wisconsin; and (2) building consensus around alternative energy policy to develop guidelines for alternative energy policy for the state. Particular attention was paid to public involvement in the policy process and to assessing barriers and incentives from as many key sectors of the energy field as possible. Thus, data were gathered from the general public, alternative energy users, the heating industry generally, the alternative-energy industry specifically, and key decision makers. The report is divided into four principal sections. The first looks at findings and analyses dealing with barriers to greater conservation and alternative energy use. Incentives for accelerating the extent of residential conservation and alternative energy use are discussed in the second section. The decision-making process itself in energy policy has been little analyzed and seldom documented. The role of consensus-building in the alternative-energy field and analysis of the decision-making process are discussed in Section III. Appendices in Section IV provide survey instruments and descriptions, a compendium of energy-related legislation developed within the project, and various reports. The total report reflects the interactive decision-making model as it was applied in SOLPLAN. (MCW)

  12. Comparison of Edge and Internal Transport Barriers in Drift Wave Predictive Simulations

    DEFF Research Database (Denmark)

    Weiland, J.; Crombe, K.; Mantica, P.

    2011-01-01

    We have simulated the formation of an internal transport barrier on JET including a self-consistent treatment of ion and electron temperatures and poloidal and toroidal momentum. Similar simulations of edge transport barriers, including the L-H transition have also been made. However, here only p...... for the internal barrier. For the edge barrier the edge density was varied and it turned out that a lower edge density gave a stronger barrier. Electromagnetic and nonlocal effects were important for both types of barriers. [ABSTRACT FROM AUTHOR]......We have simulated the formation of an internal transport barrier on JET including a self-consistent treatment of ion and electron temperatures and poloidal and toroidal momentum. Similar simulations of edge transport barriers, including the L-H transition have also been made. However, here only...... polodal momentum and the temperatures were simulated. The internal barrier included an anomalous spinup of poloidal momentum similar to that in the experiment. Also the edge barrier was accompanied by a spinup of poloidal momentum. The experimental density (with no barrier) was used and kept fixed...

  13. EVALUATION OF AMENDMENTS FOR MENDING THE INSITU REDOX MANIPULATION (ISRM) BARRIER

    Energy Technology Data Exchange (ETDEWEB)

    PETERSEN, S.W.

    2006-02-07

    In May of 2004, the U.S. Department of Energy (DOE) Richland and Fluor Hanford requested technical assistance from DOE Headquarters EM-23 to provide a team of technical experts to evaluate likely chemical/biological amendments for mending the In Situ Redox Manipulation (ISRM) Barrier in the 100-D Area of the Hanford Site. This request was a follow-on to an earlier request for assistance regarding the cause of chromium (Cr) breakthrough and recommendations for mending the barrier (March 2004 workshop). This report provides written documentation of the team's findings and recommendations. In 1995, a plume of dissolved hexavalent chromium [Cr(VI)] was discovered along the Columbia River shoreline and in the 100-D Area. Between 1999 and 2003, a reactive barrier using the ISRM technology, was installed at a distance of 680 meters along the river to reduce the Cr(VI) in the groundwater. The ISRM technology creates a treatment zone within the aquifer by injection of sodium dithionite, a strong reducing agent that scavenges dissolved oxygen (DO) from the aquifer and reduces ferric iron [Fe(III)], related metals, and oxy-ions. Bench-scale and field-scale treatability tests were conducted to demonstrate proof-of principle and to estimate barrier longevity, calculated to be in excess of twenty years. However, several years after initial and secondary treatment, groundwater in approximately 17 wells has been found to contain elevated Cr concentrations. The March 2004 technical assistance team (TAT) identified potential causes of Cr breakthrough as likely related to physical and chemical heterogeneity within the aquifer (including loss of reductive capacity within preferential flow paths) and the presence of other oxidants (DO and nitrate) significantly affecting the reductive capacity of the treated aquifer. These aquifer characteristics may limit the ability of alternative amendments to extend the reducing capacity of the barrier. A 2001 Bechtel Hanford report and

  14. Qualitative risk assessment of subsurface barriers in applications supporting retrieval of SST waste

    International Nuclear Information System (INIS)

    Treat, R.L.

    1994-04-01

    This report provides a brief, qualitative assessment of risks associated with the potential use of impermeable surface barriers installed around and beneath Hanford Site single-shell tanks (SSTs) to support the retrieval of wastes from those tanks. These risks are compared to qualitative assessment of costs and risks associated with a case in which barriers are not used. A quantitative assessment of costs and risks associated with these two cases will be prepared and documented in a companion report. The companion report will compare quantitatively the costs and risks of several retrieval options with varying parameters, such as effectiveness of retrieval, effectiveness of subsurface barriers, and the use of surface barriers. For ease of comparison of qualitative risks, a case in which impermeable subsurface barriers are used in conjunction with another technology to remove tank waste is referred, to in this report as the Barrier Case. A case in which waste removal technologies are used without employing a subsurface barrier is referred to as the No Barrier Case. The technologies associated with each case are described in the following sections

  15. Herbal medicines that benefit epidermal permeability barrier function

    Directory of Open Access Journals (Sweden)

    Lizhi Hu

    2015-06-01

    Full Text Available Epidermal permeability barrier function plays a critical role in regulating cutaneous functions. Hence, researchers have been searching for effective and affordable regimens to enhance epidermal permeability barrier function. In addition to topical stratum corneum lipids, peroxisome proliferator-activated receptor, and liver X receptor ligands, herbal medicines have been proven to benefit epidermal permeability barrier function in both normal and diseased skin, including atopic dermatitis, glucocorticoid-induced skin damage, and UVB-damaged skin. The potential mechanisms by which herbal medicines improve the permeability barrier include stimulation of epidermal differentiation, lipid production, antimicrobial peptide expression, and antioxidation. Therefore, utilization of herbal medicines could be a valuable alternative approach to enhance epidermal permeability barrier function in order to prevent and/or treat skin disorders associated with permeability barrier abnormalities.

  16. 40 CFR 62.15340 - What must I include in the annual report?

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 8 2010-07-01 2010-07-01 false What must I include in the annual... August 30, 1999 Reporting § 62.15340 What must I include in the annual report? Summarize data collected... combustion units that use activated carbon for controlling dioxins/furans or mercury emissions, include four...

  17. Barriers to hydroxyurea adherence and health-related quality of life in adolescents and young adults with sickle cell disease.

    Science.gov (United States)

    Badawy, Sherif M; Thompson, Alexis A; Penedo, Frank J; Lai, Jin-Shei; Rychlik, Karen; Liem, Robert I

    2017-06-01

    To identify barriers to hydroxyurea adherence (negative beliefs, access, and/or recall barriers), and their relationship to adherence rates and health-related quality of life (HRQOL) among adolescents and young adults (AYA) with sickle cell disease (SCD). A cross-sectional survey was administered to 34 AYAs (12-22 years old) in SCD clinics from January to December 2015. Study measures included Brief Medication Questionnaire, Modified Morisky Adherence Scale 8-items, visual analog scale, and Patient Reported Outcomes Measurement Information System. Participants (59% male; 91% Black) had a median age of 13.5 years (IQR 12-18). Participants reported negative beliefs (32%), recall barriers (44%), and access barriers (32%). Participants with recall barriers reported worse pain (P=.02), fatigue (P=.05), and depression (P=.05). The number of adherence barriers inversely correlated with adherence level using ©MMAS-8 (r s =-.38, P=.02) and VAS dose (r s =-.25, P=.14) as well as MCV (r s =-.45, P=.01) and HbF% (r s =-.36, P=.05), suggesting higher hydroxyurea adherence in patients with fewer barriers. Patients with fewer barriers to hydroxyurea adherence were more likely to have higher adherence rates and better HRQOL scores. Routine assessment of hydroxyurea adherence and its related barriers could provide actionable information to improve adherence rates, HRQOL, and other clinical outcomes. © 2017 The Authors. European Journal of Haematology Published by John Wiley & Sons Ltd.

  18. Countermeasures and barriers

    International Nuclear Information System (INIS)

    Petersen, Johannes

    2005-10-01

    In 1973 Haddon proposed ten strategies for reducing and avoiding damages based on a model of potential harmful energy transfer (Haddon, 1973). The strategies apply to a large variety of unwanted phenomena. Haddon's pioneering work on countermeasures has had a major influence on later thinking about safety. Considering its impact it is remarkable that the literature offers almost no discussions related to the theoretical foundations of Haddon's countermeasure strategies. The present report addresses a number of theoretical issues related to Haddon's countermeasure strategies, which are: 1) A reformulation and formalization of Haddon's countermeasure strategies. 2) An identification and description of some of the problems associated with the term 'barrier'. 3) Suggestions for a more precise terminology based on the causal structure of countermeasures. 4) Extending the scope of countermeasures to include sign-based countermeasures. (au)

  19. Barriers to and facilitators of ultra-processed food consumption: perceptions of Brazilian adults.

    Science.gov (United States)

    Almeida, Luara Bellinghausen; Scagliusi, Fernanda Baeza; Duran, Ana Clara; Jaime, Patricia Constante

    2018-01-01

    To explore how individuals perceive the availability of ultra-processed foods in their neighbourhoods and the barriers to and facilitators of consumption of such foods. A qualitative design was chosen. In-depth, face-to-face semi-structured interviews were conducted and a content analysis was performed. São Paulo, Brazil. A purposeful sample of adults (n 48), stratified by sex and age group (20-39 years and 40-59 years). All participants perceived their neighbourhoods as favourable regarding the availability of ultra-processed foods. Three barriers were identified: health concerns, not appreciating the taste of these foods and not being used to eating them. Five facilitators, however, were identified: appreciating the taste of these foods, their children's preference, convenience, addiction and cost. Participants perceived their neighbourhoods as favourable to the consumption of ultra-processed foods and reported more facilitators than barriers to their consumption. Reported barriers point to the need to include measures promoting a healthy food system and traditional eating practices. The facilitators reinforce the idea that these foods are habit-forming and that regulatory measures to offset the exposure to ultra-processed foods are necessary.

  20. Perceived Barriers to Healthy Eating and Physical Activity among Adolescents in Seven Arab Countries: A Cross-Cultural Study

    Directory of Open Access Journals (Sweden)

    Abdulrahman O. Musaiger

    2013-01-01

    Full Text Available Objective. To highlight the perceived personal, social, and environmental barriers to healthy eating and physical activity among Arab adolescents. Method. A multistage stratified sampling method was used to select 4698 students aged 15–18 years (2240 males and 2458 females from public schools. Seven Arab counties were included in the study, namely, Algeria, Jordan, Kuwait, Libya, Palestine, Syria, and the United Arab Emirates. Self-reported questionnaire was used to list the barriers to healthy eating and physical activity facing these adolescents. Results. It was found that lack of information on healthy eating, lack of motivation to eat a healthy diet, and not having time to prepare or eat healthy food were the main barriers to healthy eating among both genders. For physical activity, the main barriers selected were lack of motivation to do physical activity, less support from teachers, and lack of time to do physical activity. In general, females faced more barriers to physical activity than males in all countries included. There were significant differences between males and females within each country and among countries for most barriers. Conclusion. Intervention programmes to combat obesity and other chronic noncommunicable diseases in the Arab world should include solutions to overcome the barriers to weight maintenance, particularly the sociocultural barriers to practising physical activity.

  1. Barriers to Optimal Pain Management in Aged Care Facilities: An Australian Qualitative Study.

    Science.gov (United States)

    Veal, Felicity; Williams, Mackenzie; Bereznicki, Luke; Cummings, Elizabeth; Thompson, Angus; Peterson, Gregory; Winzenberg, Tania

    2018-04-01

    Up to 80% of residents in aged care facilities (ACFs) experience pain, which is often suboptimally managed. The purpose of this study was to characterize pain management in ACFs and identify the barriers to optimal pain management. This exploratory descriptive qualitative study used semistructured interviews in five Southern Tasmania, Australian ACFs. Interviewees included 23 staff members (18 nurses and 5 facility managers) and were conducted from September to November 2015. Interviews included questions about how pain was measured or assessed, what happened if pain was identified, barriers to pain management, and potential ways to overcome these barriers. Interviewees noted that there were no formal requirements regarding pain assessment at the ACFs reviewed; however, pain was often informally assessed. Staff noted the importance of adequate pain management for the residents' quality of life and employed both nonpharmacologic and pharmacologic techniques to reduce pain when identified. The barriers to optimal pain management included difficulty identifying and assessing pain, residents' resistance to reporting pain and/or taking medications, and communication barriers between the nursing staff and GPs. Staff interviewed were dedicated to managing residents' pain effectively; however, actions in a number of areas could improve resident outcomes. These include a more consistent approach to documenting pain in residents' progress notes and improving nurse-GP communications to ensure that new or escalating pain is identified and expedient changes can be made to the resident's management. Additionally, resident, family, nurse, and carer education, conducted within the facilities on a regular basis, could help improve the pain management of residents. Copyright © 2017. Published by Elsevier Inc.

  2. Perceived barriers to leisure-time physical activity during pregnancy: A literature review of quantitative and qualitative evidence.

    Science.gov (United States)

    Coll, Carolina V N; Domingues, Marlos R; Gonçalves, Helen; Bertoldi, Andréa D

    2017-01-01

    Identify perceived barriers to leisure-time physical activity during pregnancy to inform future interventions aimed at improving physical activity levels in pregnancy. PubMed/Medline and Web of Science databases were systematically searched using a reference period between 1986 and January/2016. A comprehensive search strategy was developed combining the following keywords: (barriers OR constraints OR perceptions OR attitudes) AND (physical activity OR exercise OR motor activity) AND (pregnancy OR pregnant women OR antenatal OR prenatal). Thematic synthesis was conducted to analyze the data. A socioecological model was used to categorize the reported barriers. Twelve quantitative studies and 14 qualitative studies were included. Barriers belonging to the intrapersonal level of the socioecological model were the most reported in the studies and were categorized in five themes as follows: (1) Pregnancy-related symptoms and limitations; (2) Time constraints; (3) Perceptions of already being active, (4) Lack of motivation and (5) Mother-child safety concerns. At the interpersonal level, barriers were coded into two descriptive themes: (1) Lack of advice and information and (2) Lack of social support. Two other themes were used to summarize Environmental, Organizational and Policy barriers: (1) Adverse weather and (2) Lack of resources. A range of relevant barriers to leisure-time physical-activity engagement during pregnancy were identified in this literature review. Pregnancy-related symptoms and limitations barriers were the most reported in studies, regardless of study design. Mother-child safety concerns, lack of advice/information and lack of social support were also important emphasized pregnancy-related barriers to be targeted in future interventions. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  3. Barriers and facilitators to exchanging health information: a systematic review.

    Science.gov (United States)

    Eden, Karen B; Totten, Annette M; Kassakian, Steven Z; Gorman, Paul N; McDonagh, Marian S; Devine, Beth; Pappas, Miranda; Daeges, Monica; Woods, Susan; Hersh, William R

    2016-04-01

    We conducted a systematic review of studies assessing facilitators and barriers to use of health information exchange (HIE). We searched MEDLINE, PsycINFO, CINAHL, and the Cochrane Library databases between January 1990 and February 2015 using terms related to HIE. English-language studies that identified barriers and facilitators of actual HIE were included. Data on study design, risk of bias, setting, geographic location, characteristics of the HIE, perceived barriers and facilitators to use were extracted and confirmed. Ten cross-sectional, seven multiple-site case studies, and two before-after studies that included data from several sources (surveys, interviews, focus groups, and observations of users) evaluated perceived barriers and facilitators to HIE use. The most commonly cited barriers to HIE use were incomplete information, inefficient workflow, and reports that the exchanged information that did not meet the needs of users. The review identified several facilitators to use. Incomplete patient information was consistently mentioned in the studies conducted in the US but not mentioned in the few studies conducted outside of the US that take a collective approach toward healthcare. Individual patients and practices in the US may exercise the right to participate (or not) in HIE which effects the completeness of patient information available to be exchanged. Workflow structure and user roles are key but understudied. We identified several facilitators in the studies that showed promise in promoting electronic health data exchange: obtaining more complete patient information; thoughtful workflow that folds in HIE; and inclusion of users early in implementation. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  4. A cross sectional survey of the barriers for implementing rapid HIV testing among French general practitioners.

    Science.gov (United States)

    Fraisse, Thibaut; Fourcade, Camille; Brazes-Sanz, Julie; Koumar, Yatrika; Lavigne, Jean Philippe; Sotto, Albert; Laureillard, Didier

    2016-10-01

    In France, almost 30,000 people are unaware of their HIV-positive status. Innovative screening strategies are essential to reach this population. The aim of this study was to describe the acceptability of rapid HIV testing (RHT) among French general practitioners (GPs) working in the south of France and barriers for implementing this strategy. We analysed an anonymous questionnaire sent by mail to GPs about demographic data, routine practice, knowledge of RHT and barriers to its use. Between 1 April and 30 September 2013, out of the 165 GPs contacted, 78 returned the questionnaires. The GPs' mean age was 52 years; 49 were men. Fifty-one GPs reported that their registered patients included at least one HIV-infected person and 70 GPs reported taking care of high-risk patients. Sixty-three percent of GPs reported being interested in using RHT in their daily practice. The main reasons reported by uninterested GPs were: greater confidence in standard HIV testing, difficulties including RHT during the routine consultation, difficulties to screen for other sexually transmitted infections simultaneously, and difficulties to deliver a positive result. French National Authorities for Health propose to screen the population at least once in their lifetime and high-risk people at least once a year. In order to achieve this aim, RHT should be included in the GPs' arsenal for HIV testing. We showed a high acceptability of RHT by GPs. If specific and adapted training is developed, and if solutions to barriers reported by GPs are found, RHT could be implemented in to their routine activity. © The Author(s) 2016.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2000-12-01

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

  6. Understanding barriers to implementation of an adaptive land management program

    Science.gov (United States)

    Jacobson, S.K.; Morris, J.K.; Sanders, J.S.; Wiley, E.N.; Brooks, M.; Bennetts, R.E.; Percival, H.F.; Marynowski, S.

    2006-01-01

    The Florida Fish and Wildlife Conservation Commission manages over 650,000 ha, including 26 wildlife management and environmental areas. To improve management, they developed an objective-based vegetation management (OBVM) process that focuses on desired conditions of plant communities through an adaptive management framework. Our goals were to understand potential barriers to implementing OBVM and to recommend strategies to overcome barriers. A literature review identified 47 potential barriers in six categories to implementation of adaptive and ecosystem management: logistical, communication, attitudinal, institutional, conceptual, and educational. We explored these barriers through a bureau-wide survey of 90 staff involved in OBVM and personal interviews with area managers, scientists, and administrators. The survey incorporated an organizational culture assessment instrument to gauge how institutional factors might influence OBVM implementation. The survey response rate was 69%. Logistics and communications were the greatest barriers to implementing OBVM. Respondents perceived that the agency had inadequate resources for implementing OBVM and provided inadequate information. About one-third of the respondents believed OBVM would decrease their job flexibility and perceived greater institutional barriers to the approach. The 43% of respondents who believed they would have more responsibility under OBVM also had greater attitudinal barriers. A similar percentage of respondents reported OBVM would not give enough priority to wildlife. Staff believed that current agency culture was hierarchical but preferred a culture that would provide more flexibility for adaptive management and would foster learning from land management activities. In light of the barriers to OBVM, we recommend the following: (1) mitigation of logistical barriers by addressing real and perceived constraints of staff, funds, and other resources in a participatory manner; (2) mitigation of

  7. Patient-related barriers to hypertension control in a Nigerian population

    Science.gov (United States)

    Okwuonu, Chimezie Godswill; Ojimadu, Nnamdi Ezekiel; Okaka, Enajite Ibiene; Akemokwe, Fatai Momodu

    2014-01-01

    Background Hypertension control is a challenge globally. Barriers to optimal control exist at the patient, physician, and health system levels. Patient-related barriers in our environment are not clear. The aim of this study was to identify patient-related barriers to control of hypertension among adults with hypertension in a semiurban community in South-East Nigeria. Methods This was a cross-sectional descriptive study of patients with a diagnosis of hypertension and on antihypertensive medication. Results A total of 252 participants were included in the survey, and comprised 143 males (56.7%) and 109 females (43.3%). The mean age of the participants was 56.6±12.7 years, with a diagnosis of hypertension for a mean duration of 6.1±3.3 years. Among these patients, 32.9% had controlled blood pressure, while 39.3% and 27.8%, respectively, had stage 1 and stage 2 hypertension according to the Seventh Report of the Joint National Committee on Prevention, Detection and Evaluation of High Blood Pressure. Only 23.4% knew the consequences of poor blood pressure control and 64% were expecting a cure from treatment even when the cause of hypertension was not known. Furthermore, 68.7% showed low adherence to medication, the reported reasons for which included forgetfulness (61.2%), financial constraints (56.6%), high pill burden (22.5%), side effects of medication (17.3%), and low measured blood pressure (12.1%). Finally, knowledge and practice of the lifestyle modifications necessary for blood pressure control was inadequate among the participants. Conclusion Poor knowledge regarding hypertension, unrealistic expectations of treatment, poor adherence with medication, unawareness of lifestyle modification, and failure to apply these were identified as patient-related barriers to blood pressure control in this study. PMID:25061335

  8. Barrier mechanisms in the Drosophila blood-brain barrier.

    Science.gov (United States)

    Hindle, Samantha J; Bainton, Roland J

    2014-01-01

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

  9. Physiotherapy postgraduate studies in South Africa: Facilitators and barriers

    Directory of Open Access Journals (Sweden)

    Saul Cobbing

    2017-02-01

    Full Text Available Aim: To investigate the facilitators and barriers to attaining a postgraduate physiotherapy degree in South Africa. Methods: A quantitative, cross-sectional design using an internet-based survey was employed. The population of the study included all qualified physiotherapists who had completed community service and who were on the South African Society of Physiotherapy e-mailing list at the time of the study. Results: In all, 425 valid responses were received. The study participants were predominantly white women with a mean age of 36.9 and the majority were working in private practice. A total of 20.5% of respondents had completed a master’s or doctoral degree in physiotherapy, while a further 13% of respondents were registered for a postgraduate degree in physiotherapy at the time of the study. Study participants who had obtained a postgraduate degree identified the same main barriers (namely cost/lack of financial support, family commitments and lack of time and the same main facilitators (namely gaining of expertise, fulfilment of a personal goal and improvement of patient care as participants who had not obtained a postgraduate degree. Participants who had not obtained a postgraduate degree were significantly more likely (p < 0.05 to report concerns regarding their own ability and a lack of motivation as barriers to further study. Conclusion: South African physiotherapists with and without a postgraduate degree reported common facilitators and barriers to pursuing postgraduate studies. In order to ensure that a greater number and diversity of physiotherapists see postgraduate studies as a worthwhile career option, stakeholders in health and education in both the South African public and private sectors need to be engaged to limit the barriers to postgraduate study and seek novel methods of making postgraduate study a more attractive option from a personal development and career perspective.

  10. Retrofitting the Low Impact Development Practices into Developed Urban areas Including Barriers and Potential Solution

    Science.gov (United States)

    Shafique, Muhammad; Kim, Reeho

    2017-06-01

    Low impact development (LID)/green infrastructure (GI) practices have been identified as the sustainable practices of managing the stormwater in urban areas. Due to the increasing population, most of the cities are more developing which results in the change of natural area into impervious areas (roads, buildings etc.). Moreover, urbanization and climate change are causing many water-related problems and making over cities unsafe and insecure. Under these circumstances, there is a need to introduce new stormwater management practices into developed cities to reduce the adverse impacts of urbanization. For this purpose, retrofitting low impact development practices demands more attention to reduce these water-related problems and trying to make our cities sustainable. In developed areas, there is a little space is available for the retrofitting of LID practices for the stormwater management. Therefore, the selection of an appropriate place to retrofitting LID practices needs more concern. This paper describes the successfully applied retrofitting LID practices around the globe. It also includes the process of applying retrofitting LID practices at the suitable place with the suitable combination. Optimal places for the retrofitting of different LID practices are also mentioned. This paper also highlights the barriers and potential solutions of retrofitting LID practices in urban areas.

  11. Retrofitting the Low Impact Development Practices into Developed Urban areas Including Barriers and Potential Solution

    Directory of Open Access Journals (Sweden)

    Shafique Muhammad

    2017-06-01

    Full Text Available Low impact development (LID/green infrastructure (GI practices have been identified as the sustainable practices of managing the stormwater in urban areas. Due to the increasing population, most of the cities are more developing which results in the change of natural area into impervious areas (roads, buildings etc.. Moreover, urbanization and climate change are causing many water-related problems and making over cities unsafe and insecure. Under these circumstances, there is a need to introduce new stormwater management practices into developed cities to reduce the adverse impacts of urbanization. For this purpose, retrofitting low impact development practices demands more attention to reduce these water-related problems and trying to make our cities sustainable. In developed areas, there is a little space is available for the retrofitting of LID practices for the stormwater management. Therefore, the selection of an appropriate place to retrofitting LID practices needs more concern. This paper describes the successfully applied retrofitting LID practices around the globe. It also includes the process of applying retrofitting LID practices at the suitable place with the suitable combination. Optimal places for the retrofitting of different LID practices are also mentioned. This paper also highlights the barriers and potential solutions of retrofitting LID practices in urban areas.

  12. AAEC report titles-cumulation 1956-1975 including author and KWIC indexes

    International Nuclear Information System (INIS)

    1976-03-01

    This publication lists all unclassified technical reports issued by the AAEC Research Establishment since 1956. It supersedes the List of Report Publications dated April 1974 and is the final cumulation of reports published between 1956 and December 1975. Future editions will list reports published from January 1976. An alphabetical author index and a KWIC index to the titles are included. (author)

  13. Barriers to Liposomal Gene Delivery: from Application Site to the Target.

    Science.gov (United States)

    Saffari, Mostafa; Moghimi, Hamid Reza; Dass, Crispin R

    2016-01-01

    Gene therapy is a therapeutic approach to deliver genetic material into cells to alter their function in entire organism. One promising form of gene delivery system (DDS) is liposomes. The success of liposome-mediated gene delivery is a multifactorial issue and well-designed liposomal systems might lead to optimized gene transfection particularly in vivo. Liposomal gene delivery systems face different barriers from their site of application to their target, which is inside the cells. These barriers include presystemic obstacles (epithelial barriers), systemic barriers in blood circulation and cellular barriers. Epithelial barriers differ depending on the route of administration. Systemic barriers include enzymatic degradation, binding and opsonisation. Both of these barriers can act as limiting hurdles that genetic material and their vector should overcome before reaching the cells. Finally liposomes should overcome cellular barriers that include cell entrance, endosomal escape and nuclear uptake. These barriers and their impact on liposomal gene delivery will be discussed in this review.

  14. Identifying barriers to emergency care services.

    Science.gov (United States)

    Cannoodt, Luk; Mock, Charles; Bucagu, Maurice

    2012-01-01

    This paper aims to present a review of published evidence of barriers to emergency care, with attention towards both financial and other barriers. With the keywords (financial) accessibility, barriers and emergency care services, citations in PubMed were searched and further selected in the context of the objective of this article. Forty articles, published over a period of 15 years, showed evidence of significant barriers to emergency care. These barriers often tend to persist, despite the fact that the evidence was published many years ago. Several publications stressed the importance of the financial barriers in foregoing or delaying potentially life-saving emergency services, both in poor and rich countries. Other publications report non-financial barriers that prevent patients in need of emergency care (pre-hospital and in-patient care) from seeking care, from arriving in the proper emergency department without undue delay or from receiving proper treatment when they do arrive in these departments. It is clear that timely access to life-saving and disability-preventing emergency care is problematic in many settings. Yet, low-cost measures can likely be taken to significantly reduce these barriers. It is time to make an inventory of these measures and to implement the most cost-effective ones worldwide. Copyright © 2011 John Wiley & Sons, Ltd.

  15. Barriers to diabetes awareness and self-help are influenced by people's demographics: perspectives of South Asians with type 2 diabetes.

    Science.gov (United States)

    Pardhan, Shahina; Nakafero, Georgina; Raman, Rajiv; Sapkota, Raju

    2018-03-26

    To determine whether barriers to diabetes awareness and self-help differ in South Asian participants of different demographic characteristics (age, gender, and literacy) with type 2 diabetes living in the United Kingdom. Six focus group discussions (FGDs) were carried out in patients who were categorized according to age (30-60 years, ≥60 years), gender (male, female) and literacy status (literate, illiterate). Data were analysed following the iterative process of thematic analysis techniques. Barriers were demographic-specific. The illiterate groups reported language as the major barrier to improved diabetes awareness and self-help. The literate groups reported that information provided by healthcare providers was general, and not specific to their diet/culture. Major barriers to adherence to the recommended diet for diabetes included: insufficient knowledge/awareness about nutritional content of food (all groups); lack of self-will to resist eating sweets, especially during weddings/festivals (literate older groups/literate younger females/illiterate older males); difficulty cooking separate meals for diabetic and non-diabetic family members (illiterate/literate older females). Other barriers to seeking advice/help ranged from not wanting to disclose their diabetes as it may affect employment/work (literate groups) to fear of being singled out at social gatherings (illiterate groups). General lack of motivation to exercise was reported by all groups. Time constraints and not knowing what/how to exercise was reported by literate younger groups whilst the illiterate older groups reported to not having suitable exercising facilities at local communities. Different barriers were also reported when accessing healthcare; language barriers (illiterate groups), restricted access to doctors' appointments/difficulty attending specific appointment slots offered by General Practitioners (literate females). Different barriers exist to improved awareness about diabetes and

  16. Nagra technical report 14-02, Geological basics - Dossier VI - Barrier properties of proposed host rock sediments and neighbouring rock

    International Nuclear Information System (INIS)

    Gautschi, A.; Deplazes, G.; Traber, D.; Marschall, P.; Mazurek, M.; Gimmi, T.; Maeder, U.

    2014-01-01

    This dossier is the sixth of a series of eight reports concerning the safety and technical aspects of locations for the disposal of radioactive wastes in Switzerland. It discusses the barrier properties of the proposed host rock sediments and neighbouring rock layers. The mineralogical composition of the host rocks are discussed as are their pore densities and hydrological properties. Diffusion aspects are discussed. The aquifer systems in the proposed depository areas and their classification are looked at. The barrier properties of the host rocks and those of neighbouring sediments are discussed. Finally, modelling concepts and parameters for the transport of radionuclides in the rocks are discussed

  17. Mental health care for irregular migrants in Europe: Barriers and how they are overcome

    Directory of Open Access Journals (Sweden)

    Straßmayr Christa

    2012-05-01

    Full Text Available Abstract Background Irregular migrants (IMs are exposed to a wide range of risk factors for developing mental health problems. However, little is known about whether and how they receive mental health care across European countries. The aims of this study were (1 to identify barriers to mental health care for IMs, and (2 to explore ways by which these barriers are overcome in practice. Methods Data from semi-structured interviews with 25 experts in the field of mental health care for IMs in the capital cities of 14 European countries were analysed using thematic analysis. Results Experts reported a range of barriers to mental health care for IMs. These include the absence of legal entitlements to health care in some countries or a lack of awareness of such entitlements, administrative obstacles, a shortage of culturally sensitive care, the complexity of the social needs of IMs, and their fear of being reported and deported. These barriers can be partly overcome by networks of committed professionals and supportive services. NGOs have become important initial points of contact for IMs, providing mental health care themselves or referring IMs to other suitable services. However, these services are often confronted with the ethical dilemma of either acting according to the legislation and institutional rules or providing care for humanitarian reasons, which involves the risk of acting illegally and providing care without authorisation. Conclusions Even in countries where access to health care is legally possible for IMs, various other barriers remain. Some of these are common to all migrants, whilst others are specific for IMs. Attempts at improving mental health care for IMs should consider barriers beyond legal entitlement, including communicating information about entitlement to mental health care professionals and patients, providing culturally sensitive care and ensuring sufficient resources.

  18. Barriers against psychosocial communication: oncologists' perceptions.

    Science.gov (United States)

    Fagerlind, Hanna; Kettis, Åsa; Glimelius, Bengt; Ring, Lena

    2013-10-20

    To explore oncologists' psychosocial attitudes and beliefs and their perceptions regarding barriers against psychosocial communication. A questionnaire was distributed to oncologists in Sweden (n = 537). Questions covered demography, the Physician Psychosocial Beliefs Scale (PPBS), and barriers against psychosocial communication. Stepwise multiple regression was used to determine what factors contribute the most to the PPBS score and the total number of barriers and barriers affecting clinical practice, respectively. Spearman rank-order correlation was used to determine correlation between PPBS score and number of barriers. Questionnaire response rate was 64%. Mean PPBS value was 85.5 (range, 49 to 123; SD, 13.0). Most oncologists (93%) perceived one or more barriers in communicating psychosocial aspects with patients. On average, five different communication barriers were perceived, of which most were perceived to affect clinical practice. These barriers included insufficient consultation time, lack of resources for taking care of problems discovered, and lack of methods to evaluate patients' psychosocial health in clinical practice. There was a positive correlation (rs = 0.490; P barriers (ie, less psychosocially oriented oncologists perceived more barriers). Oncologists with supplementary education with a psychosocial focus perceived fewer barriers/barriers affecting clinical practice (P barriers affecting psychosocial communication in clinical practice. Interventions aiming to improve psychosocial communication must therefore be multifaceted and individualized to clinics and individual oncologists. It is important to minimize barriers to facilitate optimal care and treatment of patients with cancer.

  19. Combination HIV Prevention Strategy Implementation in El Salvador: Perceived Barriers and Adaptations Reported by Outreach Peer Educators and Supervisors

    Directory of Open Access Journals (Sweden)

    Meredith Buck

    2017-04-01

    Full Text Available El Salvador was one of three countries to receive funding from the Global Fund to Fight AIDS, Tuberculosis and Malaria to conduct a combination HIV prevention intervention among transwomen (TW, men who have sex with men (MSM, and commercial sex workers (CSW. Program evaluation revealed that prevention activities reached only 50% of the target population. The purpose of this study is to examine the barriers that Salvadoran educators faced in implementing the peer education as designed and adaptations made as a result. Between March and June 2015, 18 in-depth interviews with educators were conducted. Violence was reported as the biggest barrier to intervention implementation. Other barriers differed by subpopulation. The level of violence and discrimination calls into question the feasibility and appropriateness of peer-led interventions in the Salvadoran context and demonstrates the importance of implementation research when translating HIV prevention interventions developed in high-income countries to low- and middle-income countries.

  20. Penetration through the Skin Barrier

    DEFF Research Database (Denmark)

    Nielsen, Jesper Bo; Benfeldt, Eva; Holmgaard, Rikke

    2016-01-01

    The skin is a strong and flexible organ with barrier properties essential for maintaining homeostasis and thereby human life. Characterizing this barrier is the ability to prevent some chemicals from crossing the barrier while allowing others, including medicinal products, to pass at varying rates......-through diffusion cells) as well as in vivo methods (microdialysis and microperfusion). Then follows a discussion with examples of how different characteristics of the skin (age, site and integrity) and of the penetrants (size, solubility, ionization, logPow and vehicles) affect the kinetics of percutaneous...

  1. The blood-tendon barrier: identification and characterisation of a novel tissue barrier in tendon blood vessels

    Directory of Open Access Journals (Sweden)

    C Lehner

    2016-05-01

    Full Text Available Tissue barriers function as “gate keepers” between different compartments (usually blood and tissue and are formed by specialised membrane-associated proteins, localising to the apicolateral plasma membrane domain of epithelial and endothelial cells. By sealing the paracellular space, the free diffusion of solutes and molecules across epithelia and endothelia is impeded. Thereby, tissue barriers contribute to the establishment and maintenance of a distinct internal and external environment, which is crucial during organ development and allows maintenance of an organ-specific homeostatic milieu. So far, various epithelial and endothelial tissue barriers have been described, including the blood-brain barrier, the blood-retina barrier, the blood-testis barrier, the blood-placenta barrier, and the cerebrospinal fluid (CSF-brain barrier, which are vital for physiological function and any disturbance of these barriers can result in severe organ damage or even death. Here, we describe the identification of a novel barrier, located in the vascular bed of tendons, which we term the blood-tendon barrier (BTB. By using immunohistochemistry, transmission electron microscopy, and tracer studies we demonstrate the presence of a functional endothelial barrier within tendons restricting the passage of large blood-borne molecules into the surrounding tendon tissue. We further provide in vitro evidence that the BTB potentially contributes to the creation of a distinct internal tissue environment impacting upon the proliferation and differentiation of tendon-resident cells, effects which might be fundamental for the onset of tendon pathologies.

  2. Field study plan for alternate barriers

    International Nuclear Information System (INIS)

    Freeman, H.D.; Gee, G.W.; Relyea, J.F.

    1989-05-01

    Pacific Northwest Laboratory (PNL) is providing technical assistance in selecting, designing, evaluating, and demonstrating protective barriers. As part of this technical assistance effort, asphalt, clay, and chemical grout will be evaluated for use as alternate barriers. The purpose of the subsurface layer is to reduce the likelihood that extreme events (i.e., 100-year maximum storms, etc.) will cause significant drainage through the barrier. The tests on alternate barriers will include laboratory and field analysis of the subsurface layer performance. This field test plan outlines the activities required to test and design subsurface moisture barriers. The test plan covers activities completed in FY 1988 and planned through FY 1992 and includes a field-scale test of one or more of the alternate barriers to demonstrate full-scale application techniques and to provide performance data on a larger scale. Tests on asphalt, clay, and chemical grout were initiated in FY 1988 in small (30.5 cm diameter) tube-layer lysimeters. The parameters used for testing the materials were different for each one. The tests had to take into account the differences in material characteristics and response to change in conditions, as well as information provided by previous studies. 33 refs., 8 figs., 1 tab

  3. Music therapists' research activity and utilization barriers: a survey of the membership.

    Science.gov (United States)

    Waldon, Eric G

    2015-01-01

    Music therapists have access to a rapidly expanding body of research supporting the use of music-based interventions. What is not known is the extent to which music therapists access these resources and what factors may prevent them from incorporating research findings into clinical work. After constructing the Music Therapists' Research Activity and Utilization Barrier (MTRAUB) database, the purposes of this study involved: assessing the extent to which American Music Therapy Association (AMTA) members engage in certain research-related activities; and identifying respondents' perceived barriers to integrating research into clinical practice. This study employed a quantitative, non-experimental approach using an online survey. Respondents included professional, associate, student/graduate student, retired, inactive, and honorary life members of AMTA. Instrumentation involved a researcher-designed Background Questionnaire as well as the Barriers to Research Utilization Scale (BARRIERS; Funk, Champagne, Wiese, & Tornquist, 1991), a tool designed to assess perceived barriers to incorporating research into practice. Of the 3,194 survey invitations distributed, 974 AMTA members replied (a response rate of 30%). Regarding research-related activities, descriptive findings indicate that journal reading is the most frequently reported research-related activity while conducting research is the least frequently reported activity. Results from the BARRIERS Scale indicated that Organizational and Communication factors are perceived as interfering most prominently with the ability to utilize research in clinical practice. Findings suggest that research-related activity and perceived barriers vary as a function of educational attainment, work setting, and occupational role. The author discusses these differential findings in detail, suggests supportive mechanisms to encourage increased research activity and utilization, and offers recommendations for further analysis of the

  4. Barriers to initiating tuberculosis treatment in sub-Saharan Africa: a systematic review focused on children and youth.

    Science.gov (United States)

    Sullivan, Brittney J; Esmaili, B Emily; Cunningham, Coleen K

    2017-01-01

    Tuberculosis (TB) is the deadliest infectious disease globally, with 10.4 million people infected and more than 1.8 million deaths in 2015. TB is a preventable, treatable, and curable disease, yet there are numerous barriers to initiating treatment. These barriers to treatment are exacerbated in low-resource settings and may be compounded by factors related to childhood. Timely initiation of tuberculosis (TB) treatment is critical to reducing disease transmission and improving patient outcomes. The aim of this paper is to describe patient- and system-level barriers to TB treatment initiation specifically for children and youth in sub-Saharan Africa through systematic review of the literature. This review was conducted in October 2015 in accordance with preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Six databases were searched to identify studies where primary or secondary objectives were related to barriers to TB treatment initiation and which included children or youth 0-24 years of age. A total of 1490 manuscripts met screening criteria; 152 met criteria for full-text review and 47 for analysis. Patient-level barriers included limited knowledge, attitudes and beliefs regarding TB, and economic burdens. System-level barriers included centralization of services, health system delays, and geographical access to healthcare. Of the 47 studies included, 7 evaluated cost, 19 health-seeking behaviors, and 29 health system infrastructure. Only 4 studies primarily assessed pediatric cohorts yet all 47 studies were inclusive of children. Recognizing and removing barriers to treatment initiation for pediatric TB in sub-Saharan Africa are critical. Both patient- and system-level barriers must be better researched in order to improve patient outcomes.

  5. Power supply instrumentation for pulsed dielectric barrier discharges

    International Nuclear Information System (INIS)

    Quiroz Velázquez, V E; López Callejas, R; De la Piedad Beneitez, A; Rodríguez Méndez, B G; Peña Eguiluz, R; Muñoz Castro, A E; Barocio, S R; Mercado Cabrera, A; Valencia Alvarado, R

    2012-01-01

    The design and implementation of a pulsed high voltage supply intended to the production and control of pulsed dielectric barrier discharges are reported. The instrumentation includes three independently built DC sources coupled to Flyback-like converters using three 1:50 high voltage transformers. The system is capable of supplying voltages up to 70 kV at a 100-2000 Hz repetition rate, delivering 1-500 μs wide pulses. The system has been applied to the development of pulsed dielectric barrier discharges in a stainless steel coaxial reactor 30 cm long and with a 2.54 cm diameter. The inner nickel electrode diameter is 0.005 cm and is embedded in alumina. The discharges have been carried out in room pressure air. Discharges have been implemented. The discharge is made is a water environment for purposes of bacterial elimination.

  6. Perceived exercise benefits and barriers of non-exercising female university students in the United Kingdom.

    Science.gov (United States)

    Lovell, Geoff P; El Ansari, Walid; Parker, John K

    2010-03-01

    Many individuals do not engage in sufficient physical activity due to low perceived benefits and high perceived barriers to exercise. Given the increasing incidence of obesity and obesity related health disorders, this topic requires further exploration. We used the Exercise Benefits/Barriers Scale to assess perceived benefit and barrier intensities to exercise in 200 non-exercising female university students (mean age 19.3 years, SD = 1.06) in the UK. Although our participants were selected because they self reported themselves to be non-exercising, however they reported significantly higher perceived benefits from exercise than perceived barriers to exercise [t(199) = 6.18, p exercise was physical performance followed by the benefits of psychological outlook, preventive health, life enhancement, and then social interaction. Physical performance was rated significantly higher than all other benefits. Psychological outlook and preventive health were not rated significantly different, although both were significantly higher than life enhancement and social interaction. Life enhancement was also rated significantly higher than social interaction. The greatest perceived barrier to exercise was physical exertion, which was rated significantly higher than time expenditure, exercise milieu, and family discouragement barriers. Implications from this investigation for the design of physical activity programmes include the importance, for females, of a perception of high benefit/barrier ratio that could be conducive to participation in exercise. Applied interventions need to assist female students to 'disengage' from or overcome any perceived 'unpleasantness' of physical exertion during physical activity (decrease their perceived barriers), and to further highlight the multiple health and other benefits of regular exercising (increase their perceived benefits).

  7. Global Account of Barriers and Facilitators of Physical Activity Among Patients with Diabetes Mellitus: A Narrative Review of the Literature.

    Science.gov (United States)

    Adeniyi, Ade F; Anjana, Ranjit M; Weber, Mary B

    2016-01-01

    With diabetes rates escalating globally, there is the need for a better integration of all aspects of diabetes care for improved population outcomes. An understanding, not only of regional but global literature on physical activity barriers and its facilitators is important if healthcare providers and policy makers are to create programs tailored to their populations. Herein, we report the results of a narrative review of the global barriers and facilitators of physical activity for patients with diabetes mellitus. An in-depth literature search was conducted to identify English-language studies that examined physical activity barriers and associated facilitators among patients with diabetes mellitus. Major electronic literature databases that were searched included Google Scholar, PubMed, Hub-Med, and Highwire. Studies were available from Africa, Asia, Australia, Europe, and, predominantly North America. A total of 34 predominantly internal barriers emerged globally. The most commonly reported were time constrains, fear of provoking additional disorders, exercise venue and weather related barriers. Facilitators of physical activity were reported for most of the internal barriers (e.g. time constraints, lack of knowledge etc) while the external barriers (e.g. weather, environmental pollution etc) received only a minimal attention. Globally, patients with diabetes are confronted with an enormous number of physical activity barriers. Unlike the robust solutions proffered for the internal barriers, the literature is largely silent about solutions to the external barriers, which though fewer, may be highly influential. Additional data is needed to better understand physical activity behaviors in populations outside of North America.

  8. Technical considerations for the implementation of subsurface microbial barriers for restoration of groundwater at UMTRA sites

    Energy Technology Data Exchange (ETDEWEB)

    Tucker, M.D.

    1996-01-01

    The Uranium Mill Tailings Remediation Action (UMTRA) Program is responsible for the assessment and remedial action at the 24 former uranium mill tailings sites located in the United States. The surface remediation phase, which has primarily focused on containment and stabilization of the abandoned uranium mill tailings piles, is nearing completion. Attention has now turned to the groundwater restoration phase. One alternative under consideration for groundwater restoration at UMTRA sites is the use of in-situ permeable reactive subsurface barriers. In this type of a system, contaminated groundwater will be allowed to flow naturally through a barrier filled with material which will remove hazardous constituents from the water by physical, chemical or microbial processes while allowing passage of the pore water. The subject of this report is a reactive barrier which would remove uranium and other contaminants of concern from groundwater by microbial action (i.e., a microbial barrier). The purpose of this report is to assess the current state of this technology and to determine issues that must be addressed in order to use this technology at UMTRA sites. The report focuses on six contaminants of concern at UMTRA sites including uranium, arsenic, selenium, molybdenum, cadmium and chromium. In the first section of this report, the fundamental chemical and biological processes that must occur in a microbial barrier to control the migration of contaminants are described. The second section contains a literature review of research which has been conducted on the use of microorganisms to immobilize heavy metals. The third section addresses areas which need further development before a microbial barrier can be implemented at an UMTRA site.

  9. Technical considerations for the implementation of subsurface microbial barriers for restoration of groundwater at UMTRA sites

    International Nuclear Information System (INIS)

    Tucker, M.D.

    1996-01-01

    The Uranium Mill Tailings Remediation Action (UMTRA) Program is responsible for the assessment and remedial action at the 24 former uranium mill tailings sites located in the United States. The surface remediation phase, which has primarily focused on containment and stabilization of the abandoned uranium mill tailings piles, is nearing completion. Attention has now turned to the groundwater restoration phase. One alternative under consideration for groundwater restoration at UMTRA sites is the use of in-situ permeable reactive subsurface barriers. In this type of a system, contaminated groundwater will be allowed to flow naturally through a barrier filled with material which will remove hazardous constituents from the water by physical, chemical or microbial processes while allowing passage of the pore water. The subject of this report is a reactive barrier which would remove uranium and other contaminants of concern from groundwater by microbial action (i.e., a microbial barrier). The purpose of this report is to assess the current state of this technology and to determine issues that must be addressed in order to use this technology at UMTRA sites. The report focuses on six contaminants of concern at UMTRA sites including uranium, arsenic, selenium, molybdenum, cadmium and chromium. In the first section of this report, the fundamental chemical and biological processes that must occur in a microbial barrier to control the migration of contaminants are described. The second section contains a literature review of research which has been conducted on the use of microorganisms to immobilize heavy metals. The third section addresses areas which need further development before a microbial barrier can be implemented at an UMTRA site

  10. Sexual orientation, treatment utilization, and barriers for alcohol related problems: Findings from a nationally representative sample.

    Science.gov (United States)

    Allen, Junior Lloyd; Mowbray, Orion

    2016-04-01

    Gay, lesbian, and bisexual (GLB) individuals appear to have an increased likelihood of alcohol use disorders and treatment utilization for alcohol related problems compared to heterosexual individuals. Despite this increase, treatment utilization rates among GLB individuals remain low. In an effort to address this, our paper examined whether or not GLB individuals encounter unique barriers when pursuing treatment for alcohol related problems. Using data from the National Epidemiologic Survey on Alcohol Related Conditions (NESARC), we examined service sector specific factors, some of which included (a) utilization rates, (b) self-reported treatment barriers, and (c) whether or not there were emergent differences among GLB individuals, after controlling for socio-demographic and clinical characteristics. Findings indicated that GLB individuals reported higher severity rates for alcohol use disorders when compared to heterosexual individuals, and were significantly more likely to utilize treatment services for alcohol related problems, however, not across all treatment sectors. While similar patterns were observed when examining barriers to treatment, bisexual individuals reported significantly more barriers than heterosexual and gay/lesbian individuals. These findings underscored the importance of identifying and developing interventions that addresses treatment barriers associated with alcohol use service utilization among GLB populations, and creating improved outreach and education programs to better address stigmas associated with substance use and sexuality. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  11. Corrosion-Mitigating, Bondable, Fluorinated Barrier Coating for Anodized Magnesium

    Science.gov (United States)

    2016-05-01

    ARL-TR-7669 ● MAY 2016 US Army Research Laboratory Corrosion -Mitigating, Bondable, Fluorinated Barrier Coating for Anodized...ARL-TR-7669 ● MAY 2016 US Army Research Laboratory Corrosion -Mitigating, Bondable, Fluorinated Barrier Coating for Anodized...TO THE ABOVE ADDRESS. 1. REPORT DATE (DD-MM-YYYY) May 2016 2. REPORT TYPE Final 3. DATES COVERED (From - To) January–December 2015 4. TITLE

  12. Barriers to voluntary participation in sport for children: a systematic review.

    Science.gov (United States)

    Somerset, Sarah; Hoare, Derek J

    2018-02-09

    Numerous studies have detailed the physical health benefits of children's participation in sport and a growing body of research also highlights the benefits for mental health. Children who participate in sport have also been shown to be advantaged academically. However, despite the benefits there is evidence that children are leading increasingly sedentary lifestyles and are at greater risk of chronic disease than those with active lifestyles. Sport provides an important means for children to achieve their recommended amount of daily physical activity. This systematic review asks 'what are those barriers to children's participation in sport?' Literature searches were carried out in June 2015 using; EMBASE, Medline, CINAHL and SportDiscus using the search terms barrier*, stop*, prevent*, participat*, taking part, Sports/, sport*, "physical education", PE, child*, young person*, adolescen*. These were supplemented with hand searches. A total of 3434 records were identified of which 22 were suitable for inclusion in the review, two additional studies were identified from Google Scholar in November 2016. Both qualitative and quantitative studies were included. Study's included in the review assessed children up to 18 years of age. Study quality was assessed using Critical Appraisal Skills Programme (CASP) tools. Studies took place in the school environment (n = 14), sports club (n = 1), community setting (n = 8) and adolescent care setting (n = 1). Frequently reported barriers across quantitative studies were 'time' (n = 4), 'cost' (n = 3), 'opportunity/accessibility' (n = 3) and 'friends' (n = 2). Frequently reported barriers across qualitative studies were 'time' (n = 6), 'cost' (n = 5), 'not being good at sport' (n = 6) and 'fear of being judged/embarrassed' (n = 6). Policy makers, parents and teachers should all be aware that 'cost' and 'time' are key barriers to participation in sport. More local sports opportunities are needed where costs are reduced. Schools

  13. 40 CFR 60.3053 - What must I include in the deviation report?

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 6 2010-07-01 2010-07-01 false What must I include in the deviation... PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emission Guidelines and Compliance... Model Rule-Recordkeeping and Reporting § 60.3053 What must I include in the deviation report? In each...

  14. Key barriers to gout care: a systematic review and thematic synthesis of qualitative studies.

    Science.gov (United States)

    Rai, Sharan K; Choi, Hyon K; Choi, Sally H J; Townsend, Anne F; Shojania, Kam; De Vera, Mary A

    2018-04-17

    Gout care remains highly suboptimal, contributing to an increased global disease burden. To understand barriers to gout care, our aim was to provide a systematic review and thematic synthesis of qualitative studies worldwide reporting provider and patient perspectives and experiences with management. We conducted a mapped search of MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature, and Social Sciences Citation Index databases and selected qualitative studies of provider and patient perspectives on gout management. We used thematic synthesis to combine the included studies and identify key themes across studies. We included 20 studies that reported the experiences and perspectives of 480 gout patients and 120 providers spanning five different countries across three continents. We identified three predominant provider themes: knowledge gaps and management approaches; perceptions and beliefs about gout patients; and system barriers to optimal gout care (e.g. time constraints and a lack of incentives). We also identified four predominant themes among gout patients: limited gout knowledge; interactions with health-care providers; attitudes towards and experiences with taking medication; and practical barriers to long-term medication use. Our systematic review of worldwide literature consistently identified gaps in gout knowledge among providers, which is likely to contribute to patients' lack of appropriate education about the fundamental causes of and essential treatment approaches for gout. Furthermore, system barriers among providers and day-to-day challenges of taking long-term medications among patients are considerable. These factors provide key targets to improve the widespread suboptimal gout care.

  15. Spiritual beliefs and barriers among managed care practitioners.

    Science.gov (United States)

    McCauley, Jeanne; Jenckes, Mollie W; Tarpley, Margaret J; Koenig, Harold G; Yanek, Lisa R; Becker, Diane M

    2005-01-01

    Ninety percent of American adults believe in God and 82% pray weekly. A majority wants their physicians to address spirituality during their health care visit. However, clinicians incorporate spiritual discussion in less than 20% of visits. Our objectives were to measure clinician beliefs and identify perceived barriers to integrating spirituality into patient care in a statewide, primary care, managed care group. Practitioners completed a 30-item survey including demographics and religious involvement (DUREL), spirituality in patient care (SPC), and barriers (BAR). We analyzed data using frequencies, means, standard deviations, and ANOVA. Clinicians had a range of religious denominations (67% Christian, 14% Jewish, 11% Muslim, Hindu or Buddhist, 8% agnostic), were 57% female and 24% had training in spirituality. Sixty-six percent reported experiencing the divine. Ninety-five percent felt that a patient's spiritual outlook was important to handling health difficulties and 68% percent agreed that addressing spirituality was part of the physician's role. Ninety-five percent of our managed care group noted 'lack of time' as an important barrier, 'lack of training' was indicated by 69%, and 21% cited 'fear of response from administration'. Managed care practitioners in a time constrained setting were spiritual themselves and believed this to be important to patients. Respondents indicated barriers of time and training to implementing these beliefs. Comparing responses from our group to those in other published surveys on clinician spirituality, we find similar concerns. Clinician education may overcome these barriers and improve ability to more fully meet their patients' expressed needs regarding spirituality and beliefs.

  16. 40 CFR 60.1410 - What must I include in my annual report?

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 6 2010-07-01 2010-07-01 false What must I include in my annual report... Modification or Reconstruction is Commenced After June 6, 2001 Reporting § 60.1410 What must I include in my...) For municipal waste combustion units that use activated carbon for controlling dioxins/furans or...

  17. Overcoming Barriers in Working with Families

    Science.gov (United States)

    Heru, Alison M.; Drury, Laura

    2006-01-01

    Objective: The Accreditation Council for Graduate Medical Education and the Residency Review Committee for psychiatry outline the expected competencies for residents. These competencies include working with families. This article describes barriers that residents face when working with families, and offers ways to overcome these barriers. Method:…

  18. 200-BP-1 Prototype Hanford Barrier -- 15 Years of Performance Monitoring

    Energy Technology Data Exchange (ETDEWEB)

    Ward, Anderson L.; Draper, Kathryn E.; Link, Steven O.; Clayton, Ray E.

    2011-09-30

    Monitoring is an essential component of engineered barrier system design and operation. A composite capacitive cover, including a capillary break and an evapotranspiration (ET) barrier at the Hanford Site, is generating data that can be used to help resolve these issues. The prototype Hanford barrier was constructed over the 216-B-57 Crib in 1994 to evaluate surface-barrier constructability, construction costs, and physical and hydrologic performance at the field scale. The barrier has been routinely monitored between November 1994 and September 1998 as part of a Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA) treatability test of barrier performance for the 200 BP 1 Operable Unit. Since FY 1998, monitoring has focused on a more limited set of key water balance, stability, and biotic parameters. In FY 2009, data collection was focused on: (1) water-balance monitoring, consisting of precipitation, runoff, soil moisture storage, and drainage measurements with evapotranspiration calculated by difference; (2) stability monitoring, consisting of asphalt-layer-settlement, basalt-side-slope-stability, and surface-elevation measurements; (3) vegetation dynamics; and (4) animal use. September 2009 marked 15 years since the start of monitoring and the collection of performance data. This report describes the results of monitoring activities during the period October 1, 2008, through September 30, 2009, and summarizes the 15 years of performance data collected from September 1994 through September 2009.

  19. Designed to deter. Community barriers to physical activity for people with visual or motor impairments.

    Science.gov (United States)

    Kirchner, Corinne E; Gerber, Elaine G; Smith, Brooke C

    2008-04-01

    People with disabilities are more likely to be obese, in poor health, and get less physical activity than the general population. However, research on community factors for physical activity has generally either excluded most people with disabilities, or overlooked relevant factors of community accessibility. This exploratory study investigated environmental factors affecting people with motor impairments and people with visual impairments in urban neighborhoods. Quantitative and qualitative methods were used with a nonrandom sample (n=134) of users of four types of assistive mobility technologies: guide dogs, long canes, and motorized and manual wheelchairs. From July 2005 to August 2006, the sample participated in two telephone surveys. Between the surveys, a stratified random subsample (n =32) engaged in an ethnographic phase of observation and interviews. Most participants in all groups using assistive mobility technologies rated their neighborhoods as accessible, although they also reported many specific barriers. Users of assistive mobility technologies differed in the amount of reported physical activity and on specific barriers. Problems with sidewalk pavement and puddles/poor drainage were the most frequently mentioned environmental barriers, by 90% and 80%, respectively. Users of assistive mobility technologies were more similar on main strategies for dealing with barriers. All groups reported having to plan routes for outings, to alter planned routes, to go more slowly than planned, or to wait for a different time. Despite legislative requirements for accommodation, people with disabilities face barriers to physical activity, both in the built and social environments. Determined people with disabilities were able to overcome barriers, but required additional expenditure of resources to do so. Community design that can include people with disabilities requires detailed understanding of barriers specific both to types of impairments and to different types

  20. Simulating barrier penetration during combat. Technical report

    International Nuclear Information System (INIS)

    De Laquil, P. III.

    1980-04-01

    A computer program, BARS, simulates combat between an adversary group attempting to hijack special nuclear material and escort personnel attempting to protect it. BARS is designed to investigate how various combat strategies and levels of performance affect the time required to penetrate barriers (armor, deterrent systems, etc.) against forcible entry. A Monte Carlo code, BARS uses a game theoretic approach to allocate the attacking and defending forces. Combat suppression is simulated using a stochastic state-transition model for the behavior of individuals under combat stress. The BARS program was developed as part of the overall combat modelling effort of the transportation safeguards program

  1. 105K West Isolation Barrier Acceptance Test results

    International Nuclear Information System (INIS)

    McCracken, K.J.; Irwin, J.J.

    1995-01-01

    The objective of this document is to report and interpret the findings of the isolation barrier acceptance tests performed in 105KW/100K. The tests were performed in accordance with the test plan and acceptance test procedure. The test report contains the test data. This document compares the test data against the criteria. A discussion of the leak rate analytical characterization describes how the flow characteristics flow rate will be determined using the test data from the test report. Two modes of water loss were considered; basin and/or discharge chute leakage, and evaporation. An initial test established baseline leakage data and instrumentation performance. Test 2 evaluated the sealing performance of the isolation barrier by inducing an 11 in. (27.9 cm) level differential across the barrier. The leak rate at this 11 in. (27.9 cm) level is extrapolated to the 16 ft. (4.9 m) level differential postulated in the DBE post seismic event. If the leak rate, adjusted for evaporation and basin leakage (determined from Test 1), is less than the SAR limit of 1,500 gph (5,680 lph) at a 16 ft (4.9 m) level differential, the barriers pass the acceptance test

  2. Motivators and barriers to a healthy postpartum lifestyle in women at increased cardiovascular and metabolic risk: a focus-group study.

    Science.gov (United States)

    Hoedjes, Meeke; Berks, Durk; Vogel, Ineke; Franx, Arie; Duvekot, Johannes J; Oenema, Anke; Steegers, Eric A P; Raat, Hein

    2012-01-01

    To describe the motivators and barriers to the adoption of a healthy postpartum lifestyle after a pregnancy complicated by preeclampsia, intrauterine growth restriction, and/or gestational diabetes. Thirty-six women with complicated pregnancies participated in six focus-group interviews that aimed to explore the perceptions of modifiable determinants of postpartum lifestyle. Although women expressed that they intended to live a healthy postpartum lifestyle, it was generally not achieved. The motivators included improving their own current health condition as well as modeling a healthy lifestyle for their children. Important barriers were reported to be lack of knowledge, poor recovery, and lack of professional support after delivery. The reported motivators and barriers can be used to develop a postpartum lifestyle intervention.

  3. In situ construction of horizontal soil containment barrier at Fernald

    International Nuclear Information System (INIS)

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

    1995-01-01

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

  4. Contaminant fluxes through site containment barriers: Performance assessment and illustrative results

    International Nuclear Information System (INIS)

    Vita, C.L.

    1994-01-01

    Contaminant mass flux by advective and diffusive transport is predicted for five containment barriers that use one or more clay liners, flexible membrane liners (FMLs), or liquid collection and removal systems (LCRS)s. Barriers are engineered systems intended to contain and isolate site contaminants from the environment. Barriers include liners, caps, and cutoff walls. Barriers may be used in contaminated-site cleanups (including CERCLA and RCRA), RCRA landfills, or other RCRA TSDFs. Concepts are provided for barrier performance assessment, including analysis and optimization, for meeting performance requirements and controlling risk at minimum cost. Concepts and results can help in planning, designing, or evaluating and communicating, the use or effectiveness of proposed or existing barriers for site cleanups or waste containment. 15 refs., 6 figs., 5 tabs

  5. Barriers to Cleft Lip and Palate Repair Around the World.

    Science.gov (United States)

    Massenburg, Benjamin B; Jenny, Hillary E; Saluja, Saurabh; Meara, John G; Shrime, Mark G; Alonso, Nivaldo

    2016-10-01

    Cleft lip and/or palate (CLP) is estimated to occur in 1 out of every 700 births, but for many people residing in low- and middle-income countries this deformity may be repaired late in life or not at all. This study aims to analyze worldwide provider-perceived barriers to the surgical repair of CLP in low- and middle-income countries. From 2011 to 2014, Smile Train distributed a multiple-choice, voluntary survey to healthcare providers to identify areas of need in CLP care worldwide. Data on provider-reported barriers to care were aggregated by year, country, and larger world regions. A total of 1997 surveys were completed by surgeons and healthcare providers (60.7% response rate). The most commonly reported barriers were "patient travel costs" (60.7%), "lack of patient awareness" (54.1%), and "lack of financial support" (52.8%). "Patient travel costs" was the most commonly reported barrier in sub-Saharan Africa, the Middle East and North Africa, and South and Southeast Asia. "Lack of financial support" was the most commonly reported barrier in the Americas, Eastern Europe, and East Asia. This is the largest intercontinental study on healthcare provider-identified barriers to care, representing the limitations experienced by healthcare professionals in providing corrective surgery for CLP around the world. Financial risk protection from hidden costs, such as patient travel costs, is essential. Community health workers and nurses are critical for communication and linking CLP care to the rest of the community. Recognition of these barriers can inform future policy decisions, targeted by region, for surgical systems delivering care for patients with CLP worldwide.

  6. Modeling approaches for concrete barriers used in low-level waste disposal

    International Nuclear Information System (INIS)

    Seitz, R.R.; Walton, J.C.

    1993-11-01

    A series of three NUREGs and several papers addressing different aspects of modeling performance of concrete barriers for low-level radioactive waste disposal have been prepared previously for the Concrete Barriers Research Project. This document integrates the information from the previous documents into a general summary of models and approaches that can be used in performance assessments of concrete barriers. Models for concrete degradation, flow, and transport through cracked concrete barriers are discussed. The models for flow and transport assume that cracks have occurred and thus should only be used for later times in simulations after fully penetrating cracks are formed. Most of the models have been implemented in a computer code. CEMENT, that was developed concurrently with this document. User documentation for CEMENT is provided separate from this report. To avoid duplication, the reader is referred to the three previous NUREGs for detailed discussions of each of the mathematical models. Some additional information that was not presented in the previous documents is also included. Sections discussing lessons learned from applications to actual performance assessments of low-level waste disposal facilities are provided. Sensitive design parameters are emphasized to identify critical areas of performance for concrete barriers, and potential problems in performance assessments are also identified and discussed

  7. Barriers to effective communication between veterans with chronic kidney disease and their healthcare providers.

    Science.gov (United States)

    Lederer, Swati; Fischer, Michael J; Gordon, Howard S; Wadhwa, Anuradha; Popli, Subhash; Gordon, Elisa J

    2015-12-01

    Many patients with chronic kidney disease (CKD) have insufficient knowledge about CKD, which is associated with poorer health outcomes. Effective patient-provider communication can improve CKD patients' knowledge, thereby augmenting their participation in self-care practices. However, barriers to addressing CKD patients' information needs have not been previously characterized. Adults with an estimated glomerular filtration rate (eGFR) of communication dynamics. Thirty-two patients participated. The mean age of participants was 63 years; most were male (94%) and non-Hispanic white (53%). CKD severity groups represented included CKD-3 (eGFR 30-59 mL/min/1.73 m(2); 34%), CKD-4 (eGFR 15-29 mL/min/1.73 m(2); 25%), CKD-5 (eGFR barriers to patient-provider communication based on patients' reported care at both VA and non-VA facilities, including patients perceived their role as a 'listener', reported limited CKD knowledge, did not understand physicians' explanations and were dissatisfied with the patient-provider relationship. Several barriers to patient-provider communication prevent patients from meeting their information needs and perpetuate patient passivity. Future research should evaluate whether interventions that empower CKD patients to actively participate in their care increase knowledge and improve health outcomes.

  8. Reported barriers to evaluation in chronic care: experiences in six European countries.

    Science.gov (United States)

    Knai, Cécile; Nolte, Ellen; Brunn, Matthias; Elissen, Arianne; Conklin, Annalijn; Pedersen, Janice Pedersen; Brereton, Laura; Erler, Antje; Frølich, Anne; Flamm, Maria; Fullerton, Birgitte; Jacobsen, Ramune; Krohn, Robert; Saz-Parkinson, Zuleika; Vrijhoef, Bert; Chevreul, Karine; Durand-Zaleski, Isabelle; Farsi, Fadila; Sarría-Santamera, Antonio; Soennichsen, Andreas

    2013-05-01

    The growing movement of innovative approaches to chronic disease management in Europe has not been matched by a corresponding effort to evaluate them. This paper discusses challenges to evaluation of chronic disease management as reported by experts in six European countries. We conducted 42 semi-structured interviews with key informants from Austria, Denmark, France, Germany, The Netherlands and Spain involved in decision-making and implementation of chronic disease management approaches. Interviews were complemented by a survey on approaches to chronic disease management in each country. Finally two project teams (France and the Netherlands) conducted in-depth case studies on various aspects of chronic care evaluation. We identified three common challenges to evaluation of chronic disease management approaches: (1) a lack of evaluation culture and related shortage of capacity; (2) reluctance of payers or providers to engage in evaluation and (3) practical challenges around data and the heterogeity of IT infrastructure. The ability to evaluate chronic disease management interventions is influenced by contextual and cultural factors. This study contributes to our understanding of some of the most common underlying barriers to chronic care evaluation by highlighting the views and experiences of stakeholders and experts in six European countries. Overcoming the cultural, political and structural barriers to evaluation should be driven by payers and providers, for example by building in incentives such as feedback on performance, aligning financial incentives with programme objectives, collectively participating in designing an appropriate framework for evaluation, and making data use and accessibility consistent with data protection policies. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

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

    International Nuclear Information System (INIS)

    Moline, G.R.

    1998-03-01

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

  10. IRSN annual report 2012 - including Financial report 2012

    International Nuclear Information System (INIS)

    Schuler, Matthieu; Marchal, Valerie; Albert, Marc-Gerard; Baudry, Michel; Bigot, Marie-Pierre; Charron, Sylvie; Clavelle, Stephanie; Cousinou, Patrick; Deschamps, Patrice; Delattre, Aleth; Demeillers, Didier; Dumas, Agnes; Franquard, Dominique; Goudal, Bernard; Jalouneix, Jean; Laloi, Patrick; Monti, Pascale; Richer, Gerard; Rollinger, Francois; Rouyer, Veronique; Rutschkovsky, Nathalie; Scott De Martinville, Edouard; Tharaud, Christine; Verpeaux, Jean-luc; Jaunet, Camille; Hedouin, Jean-Christophe

    2013-01-01

    This annual report for the French nuclear safety and radiation protection Institute (IRSN) addresses its organizational aspects (highlights, figures illustrating the activity, organizational chart, councils and committees), proposes a summary of activities and presentation of the strategy (transparency and communication policy, promotion of a safety and radiation protection culture). The main part addresses the activities regarding safety, nuclear security and non-proliferation, radiation protection of the environment and in terms of human health, and emergency and post-accidental situations. The last part addresses issues of efficiency (property, health, safety, environmental protection and quality, and human resources). A financial report is also proposed and contains a management report, financial statements, and an appendix to annual accounts

  11. Reporting Mental Health Symptoms: Breaking Down Barriers to Care with Virtual Human Interviewers

    Directory of Open Access Journals (Sweden)

    Gale M. Lucas

    2017-10-01

    Full Text Available A common barrier to healthcare for psychiatric conditions is the stigma associated with these disorders. Perceived stigma prevents many from reporting their symptoms. Stigma is a particularly pervasive problem among military service members, preventing them from reporting symptoms of combat-related conditions like posttraumatic stress disorder (PTSD. However, research shows (increased reporting by service members when anonymous assessments are used. For example, service members report more symptoms of PTSD when they anonymously answer the Post-Deployment Health Assessment (PDHA symptom checklist compared to the official PDHA, which is identifiable and linked to their military records. To investigate the factors that influence reporting of psychological symptoms by service members, we used a transformative technology: automated virtual humans that interview people about their symptoms. Such virtual human interviewers allow simultaneous use of two techniques for eliciting disclosure that would otherwise be incompatible; they afford anonymity while also building rapport. We examined whether virtual human interviewers could increase disclosure of mental health symptoms among active-duty service members that just returned from a year-long deployment in Afghanistan. Service members reported more symptoms during a conversation with a virtual human interviewer than on the official PDHA. They also reported more to a virtual human interviewer than on an anonymized PDHA. A second, larger sample of active-duty and former service members found a similar effect that approached statistical significance. Because respondents in both studies shared more with virtual human interviewers than an anonymized PDHA—even though both conditions control for stigma and ramifications for service members’ military records—virtual human interviewers that build rapport may provide a superior option to encourage reporting.

  12. Preventing Sexual Violence Through Bystander Intervention: Attitudes, Behaviors, Missed Opportunities, and Barriers to Intervention Among Australian University Students.

    Science.gov (United States)

    Kania, Rachel; Cale, Jesse

    2018-03-01

    The concept of bystander intervention is gaining popularity in universities as a mechanism to prevent sexual violence. Prior research has focused on correlates of bystanders' intentions to intervene and intervention behaviors in situations where there is a risk of sexual violence. The current study builds on this literature by exploring the nature of missed opportunities, including perceived barriers to intervention. In all, 380 Australian undergraduate university students completed an online survey. Measures included a rape myth acceptance scale, bystander intentions to intervene, actual intervention behaviors, missed opportunities for intervention, and perceived barriers for missed opportunities. Promisingly, students reported high levels of intentions to intervene in situations where there was a risk of sexual violence and reported relatively few missed opportunities to do so when these situations did occur. Intervention behaviors varied by important demographic characteristics such as gender, age, attitudes toward sexual violence, and the nature of the situation. Younger female students, with lower levels of rape myth acceptance, who had previously engaged in bystander intervention behaviors were more likely to report intentions to intervene in future risky situations, and female international students reported fewer missed opportunities for intervention. The most common barrier to intervention for identified missed opportunities was a failure to recognize situations as having a potential risk for sexual violence, and students were most likely to intervene in situations when the opportunity to help a friend in distress arose. This study provides some preliminary empirical evidence about bystander intervention against sexual violence among Australian university students, and identifies unique contexts for intervention and what current barriers to intervention may be.

  13. Method and device for detecting impact events on a security barrier which includes a hollow rebar allowing insertion and removal of an optical fiber

    Science.gov (United States)

    Pies, Ross E.

    2016-03-29

    A method and device for the detection of impact events on a security barrier. A hollow rebar is farmed within a security barrier, whereby the hollow rebar is completely surrounded by the security barrier. An optical fiber passes through the interior of the hollow rebar. An optical transmitter and an optical receiver are both optically connected to the optical fiber and connected to optical electronics. The optical electronics are configured to provide notification upon the detection of an impact event at the security barrier based on the detection of disturbances within the optical fiber.

  14. Information barriers for the protection of sensitive information

    International Nuclear Information System (INIS)

    Dougan, A.D.; Dunn, J.; Seager, K.; Smith, M.; Beach, D.; Clinton, J.; Vanier, P.

    2013-01-01

    An Information Barrier is a combination of technology and procedures that prevent the release of a host country's sensitive information to a monitoring party during an inspection of a sensitive item, while enabling assurance of an accurate assessment of host country declarations regarding the item. Information barriers, as a concept, arose from the need to balance two competing requirements - specifically, certification of information protection by a host country and authentication of measurement and information accuracy by a monitoring party. The U.S. Department of Energy's National Nuclear Security Administration, in conjunction with several U.S. National Laboratories, has explored information barrier development in detail, and has continued the evolution of essential work done by the U.S. Information Barrier Working Group beginning in the late 1990's, and other international efforts, including the U.S.-Russia-IAEA Trilateral Initiative. This paper explains the rationale for information barriers, and explores the development and application of information barrier concepts for potential future arms control initiatives, including recent work and advances in capabilities. It also considers applications of information barrier concepts applied in other fields.The paper is followed by the slides of the presentation. (authors)

  15. Perceived Exercise Benefits and Barriers of Non-Exercising Female University Students in the United Kingdom

    Directory of Open Access Journals (Sweden)

    John K. Parker

    2010-03-01

    Full Text Available Many individuals do not engage in sufficient physical activity due to low perceived benefits and high perceived barriers to exercise. Given the increasing incidence of obesity and obesity related health disorders, this topic requires further exploration. We used the Exercise Benefits/Barriers Scale to assess perceived benefit and barrier intensities to exercise in 200 non-exercising female university students (mean age 19.3 years, SD = 1.06 in the UK. Although our participants were selected because they self reported themselves to be non-exercising, however they reported significantly higher perceived benefits from exercise than perceived barriers to exercise [t(199 = 6.18, p < 0.001], and their perceived benefit/barrier ratio was 1.33. The greatest perceived benefit from exercise was physical performance followed by the benefits of psychological outlook, preventive health, life enhancement, and then social interaction. Physical performance was rated significantly higher than all other benefits. Psychological outlook and preventive health were not rated significantly different, although both were significantly higher than life enhancement and social interaction. Life enhancement was also rated significantly higher than social interaction. The greatest perceived barrier to exercise was physical exertion, which was rated significantly higher than time expenditure, exercise milieu, and family discouragement barriers. Implications from this investigation for the design of physical activity programmes include the importance, for females, of a perception of high benefit/barrier ratio that could be conducive to participation in exercise. Applied interventions need to assist female students to ‘disengage’ from or overcome any perceived ‘unpleasantness’ of physical exertion during physical activity (decrease their perceived barriers, and to further highlight the multiple health and other benefits of regular exercising (increase their perceived

  16. Disparities in Barriers to Follow-up Care between African American and White Breast Cancer Survivors

    Science.gov (United States)

    Palmer, Nynikka R. A.; Weaver, Kathryn E.; Hauser, Sally P.; Lawrence, Julia A.; Talton, Jennifer; Case, L. Douglas; Geiger, Ann M.

    2015-01-01

    Purpose Despite recommendations for breast cancer survivorship care, African American women are less likely to receive appropriate follow-up care, which is concerning due to their higher mortality rates. This study describes differences in barriers to follow-up care between African American and White breast cancer survivors. Methods We conducted a mailed survey of women treated for non-metastatic breast cancer in 2009–2011, 6–24 months post-treatment (N=203). Survivors were asked about 14 potential barriers to follow-up care. We used logistic regression to explore associations between barriers and race, adjusting for covariates. Results Our participants included 31 African American and 160 White survivors. At least one barrier to follow-up care was reported by 62%. Compared to White survivors, African Americans were more likely to identify barriers related to out-of-pocket costs (28% vs. 51.6%, p=0.01), other healthcare costs (21.3% vs. 45.2%, p=0.01), anxiety/worry (29.4% vs. 51.6%, p=0.02), and transportation (4.4% vs. 16.1%, p=0.03). After adjustment for covariates, African Americans were three times as likely to report at least one barrier to care (OR=3.3, 95%CI=1.1–10.1). Conclusions Barriers to care are common among breast cancer survivors, especially African American women. Financial barriers to care may prevent minority and underserved survivors from accessing follow-up care. Enhancing insurance coverage or addressing out-of-pocket costs may help address financial barriers to follow-up care among breast cancer survivors. Psychosocial care aimed at reducing fear of recurrence may also be important to improve access among African American breast cancer survivors. PMID:25821145

  17. Barriers to physical activity between adults with stroke and their care partners.

    Science.gov (United States)

    Zalewski, Kathryn R; Dvorak, Leah

    2011-10-01

    Healthy living includes meeting daily physical activity guidelines. This study compares daily physical activity rates and barriers to physical activity for people with stroke and their partners (spouse or significant other). Physical abilities, energy expenditure, daily steps, and barriers to physical activity are evaluated in people who have completed stroke rehabilitation and their partners. Twenty pairs of adults (mean age 69.7 years) participated. Participants with stroke were classified as sedentary, averaging 2,990 (± 2,488) steps per day. Their partners are classified as low active, averaging 6,378 (± 2,149) steps per day. For stroke survivors, physical abilities were positively correlated to daily activity rates. The number of steps walked per day was moderately correlated to 6-minute walk tests (r = 0.550, P physical abilities were not correlated to daily physical activity. People with stroke report lack of skill as a primary barrier; their partners report lack of time. The relationship between physical ability and physical activity is reinforced with this study. The impact of stroke on the family, particularly on time demands of the primary caregiver, suggests the needs of the care partner may not be adequately addressed in the rehabilitation process.

  18. Barriers to the use of hydrotherapy in labor.

    Science.gov (United States)

    Stark, Mary Ann; Miller, Michael G

    2009-01-01

    To determine nurses' perceived barriers to the use of hydrotherapy in labor. While effective in relieving pain, reducing anxiety, encouraging relaxation, and promoting a sense of control, hydrotherapy is rarely used during labor. Comparative descriptive survey design. A national convention and perinatal listserves. Intrapartum nurses (N=401) attending a national convention (Association of Women's Health, Obstetric, and Neonatal Nurses, 2007; n=225) and members of perinatal listserves (n=176) were recruited. A questionnaire was designed for this study (Nurses' Perception of the Use of Hydrotherapy in Labor). The questionnaire was available in paper format and online. Institutional but not individual characteristics (age, education, and role) were associated with Nurses' Perception of the Use of Hydrotherapy in Labor. Nurses who reported higher epidural rates (r=.45, p=.000) and Cesarean section rates (r=.30, p=.000) reported more barriers. There was no difference in perception of barriers for nurses at hospitals providing different levels of care; there were significant differences when primary care providers were considered. Intrapartum nurses in facilities where certified nurse-midwives do most deliveries reported significantly fewer barriers than nurses who worked in facilities where physicians attended most deliveries (F=6.84, df=2, p=.000). The culture of the birthing unit in which nurses provide care influences perception of barriers to the use of hydrotherapy in labor. Providing hydrotherapy requires a supportive environment, adequate nursing policies and staffing, and collaborative relationships among the health care team.

  19. Kangaroo mother care: a systematic review of barriers and enablers.

    Science.gov (United States)

    Chan, Grace J; Labar, Amy S; Wall, Stephen; Atun, Rifat

    2016-02-01

    To investigate factors influencing the adoption of kangaroo mother care in different contexts. We searched PubMed, Embase, Scopus, Web of Science and the World Health Organization's regional databases, for studies on "kangaroo mother care" or "kangaroo care" or "skin-to-skin care" from 1 January 1960 to 19 August 2015, without language restrictions. We included programmatic reports and hand-searched references of published reviews and articles. Two independent reviewers screened articles and extracted data on carers, health system characteristics and contextual factors. We developed a conceptual model to analyse the integration of kangaroo mother care in health systems. We screened 2875 studies and included 112 studies that contained qualitative data on implementation. Kangaroo mother care was applied in different ways in different contexts. The studies show that there are several barriers to implementing kangaroo mother care, including the need for time, social support, medical care and family acceptance. Barriers within health systems included organization, financing and service delivery. In the broad context, cultural norms influenced perceptions and the success of adoption. Kangaroo mother care is a complex intervention that is behaviour driven and includes multiple elements. Success of implementation requires high user engagement and stakeholder involvement. Future research includes designing and testing models of specific interventions to improve uptake.

  20. Sprache als Barriere (Language as a Barrier)

    Science.gov (United States)

    Mattheier, Klaus

    1974-01-01

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

  1. Fingolimod promotes blood-nerve barrier properties in vitro.

    Science.gov (United States)

    Nishihara, Hideaki; Maeda, Toshihiko; Sano, Yasuteru; Ueno, Maho; Okamoto, Nana; Takeshita, Yukio; Shimizu, Fumitaka; Koga, Michiaki; Kanda, Takashi

    2018-04-01

    The main effect of fingolimod is thought to be functional antagonism of lymphocytic S1P1 receptors and the prevention of lymphocyte egress from lymphoid tissues, thereby reducing lymphocyte infiltration into the nervous system. However, a growing number of reports suggest that fingolimod also has a direct effect on several cell types in the nervous system. Although we previously reported that fingolimod enhances blood-brain barrier (BBB) functions, there have been no investigations regarding the blood-nerve barrier (BNB). In this study, we examine how fingolimod affects the BNB. An immortalized human peripheral nerve microvascular endothelial cell line (HPnMEC) was used to evaluate BNB barrier properties. We examined tight junction proteins and barrier functions of HPnMECs in conditioned medium with or without fingolimod-phosphate and blood sera from patients with typical chronic inflammatory demyelinating polyneuropathy (CIDP). Incubation with fingolimod-phosphate increased levels of claudin-5 mRNA and protein as well as TEER values in HPnMECs. Conversely, typical CIDP sera decreased claudin-5 mRNA/protein levels and TEER values in HPnMECs; however, pretreatment with fingolimod-phosphate inhibited the effects of the typical CIDP sera. Fingolimod-phosphate directly modifies the BNB and enhances barrier properties. This mechanism may be a viable therapeutic target for CIDP, and fingolimod may be useful in patients with typical CIDP who have severe barrier disruption.

  2. Work-related pain and injury and barriers to workers' compensation among Las Vegas hotel room cleaners.

    Science.gov (United States)

    Scherzer, Teresa; Rugulies, Reiner; Krause, Niklas

    2005-03-01

    We examined the prevalence of work-related pain and injury and explored barriers to and experiences of reporting among workers. We surveyed 941 unionized hotel room cleaners about work-related pain, injury, disability, and reporting. During the past 12 months, 75% of workers in our study experienced work-related pain, and 31% reported it to management; 20% filed claims for workers' compensation as a result of work-related injury, and 35% of their claims were denied. Barriers to reporting injury included "It would be too much trouble" (43%), "I was afraid" (26%), and "I didn't know how" (18%). An estimated 69% of medical costs were shifted from employers to workers. The reasons for underreporting and the extent of claim denial warrant further investigation. Implications for worker health and the precise quantification of shifting costs to workers also should be addressed.

  3. Barriers to pediatric cochlear implantation: A parental survey.

    Science.gov (United States)

    Yang, Charles Q; Reilly, Brian K; Preciado, Diego A

    2018-01-01

    This study aims to (1) determine barriers in the pediatric cochlear implantation process specific to publicly insured patients, wherein delayed implantation has been reported, and (2) compare the perceived barriers between publicly and privately insured patients. Tertiary care cochlear implantation center at academic pediatric hospital. Cross-sectional survey, retrospective chart review. The validated, 39 item Barriers to Care Questionnaire was administered to the parents of 80 recipients of cochlear implantation by two surgeons between 2013 and 2016. Survey results and diagnosis to implant interval were compared based on public or private insurance status. Two-tailed Mann-Whitney and Fisher's exact test was used for statistical analysis. Of 110 cochlear implants, 27 of 80 (34%) English-speaking parents completed the survey. 15 were privately insured and 12 were publicly insured. 23 of 27 respondents received cochlear implantation for pre-lingual sensorineural hearing loss. Publicly insured patients had significantly longer median time from diagnosis to implant than privately insured (19 vs. 8 mo, p = 0.01). The three worst scoring barrier categories for privately insured families in order were Pragmatics, Expectations, and Marginalization, whereas for publicly insured families it was Pragmatics, Skills, and Expectations. The worst scoring question for privately insured patients was "Having to take time off work". For the publicly insured, it was "Lack of communication." Privately insured patients reported more barriers on the Barriers to Care Questionnaire than publicly insured patients did. Although pragmatics was the worst-scoring barrier category for both groups, difficulties found on the survey ranked differently for each group. This information can help providers address disparities and access barriers for vulnerable patients. Published by Elsevier B.V.

  4. Countermeasures and barriers

    Energy Technology Data Exchange (ETDEWEB)

    Petersen, Johannes [Oersted - DTU, Automation, Kgs. Lyngby (Denmark)

    2005-10-01

    In 1973 Haddon proposed ten strategies for reducing and avoiding damages based on a model of potential harmful energy transfer (Haddon, 1973). The strategies apply to a large variety of unwanted phenomena. Haddon's pioneering work on countermeasures has had a major influence on later thinking about safety. Considering its impact it is remarkable that the literature offers almost no discussions related to the theoretical foundations of Haddon's countermeasure strategies. The present report addresses a number of theoretical issues related to Haddon's countermeasure strategies, which are: 1) A reformulation and formalization of Haddon's countermeasure strategies. 2) An identification and description of some of the problems associated with the term 'barrier'. 3) Suggestions for a more precise terminology based on the causal structure of countermeasures. 4) Extending the scope of countermeasures to include sign-based countermeasures. (au)

  5. Barriers to Homeless Persons Acquiring Health Insurance Through the Affordable Care Act.

    Science.gov (United States)

    Fryling, Lauren R; Mazanec, Peter; Rodriguez, Robert M

    2015-11-01

    Medicaid expansion under the Affordable Care Act (ACA) is intended to provide a framework for increasing health care access for vulnerable populations, including the 1.2 million who experience homelessness each year in the United States. We sought to characterize homeless persons' knowledge of the ACA, identify barriers to their ACA enrollment, and determine access to various forms of communication that could be used to facilitate enrollment. At an urban county Level I trauma center, we interviewed all noncritically ill adults who presented to the emergency department (ED) during daytime hours and were able to provide consent. We assessed access to communication, awareness of the ACA, insurance status, and barriers preventing subjects from enrolling in health insurance and compared homeless persons' responses with concomitantly enrolled housed individuals. Of the 650 enrolled subjects, 134 (20.2%) were homeless. Homeless subjects were more likely to have never heard of the ACA (26% vs. 10%). "Not being aware if they qualify for Medicaid" was the most common (70%) and most significant (30%) barrier to enrollment reported by uninsured homeless persons. Of homeless subjects who were unsure if they qualified for Medicaid, 91% reported an income homeless subjects reported access. Homeless persons report having less knowledge of the ACA than their housed counterparts, poor understanding of ACA qualification criteria, and limited access to phone and internet. ED-based outreach and education regarding ACA eligibility may increase their enrollment. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Health Barriers to Learning

    Directory of Open Access Journals (Sweden)

    Delaney Gracy

    2014-01-01

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

  7. NRC Information No. 88-04: Inadequate qualification and documentation of fire barrier penetration seals

    International Nuclear Information System (INIS)

    Rossi, C.E.

    1992-01-01

    The current NRC review was prompted by reports, inspection findings, allegations, and other information that indicated the possibility that NRC requirements for fire barrier penetration seals were not being met in all aspects. The review included: evaluations of fire barrier penetration seal specifications and procedures developed by licensees, licensee agents, and licensee contractors; evaluations of various fire barrier penetration seal tests and test data; and inspections of various fire barrier penetrations seal designs and installations. The types of concerns identified to date and mentioned below are related to weaknesses in the implementation of NRC requirements and guidelines as related to fire barrier penetration seal design qualification. The NRC review also has identified a current practice that can affect the qualification status of installed seals. Plant modifications are being made that require running new cable and conduits through existing penetration seals. These modifications are generally being made without an associated technical review to ensure that the resulting penetration seal design configuration or design parameters are consistent with those validated by initial qualification tests. Over a period of time, numerous minor modifications to the same area could cumulatively result in a degraded fire barrier rating

  8. Delays in nuclear power plant construction. Volume II. Final report

    International Nuclear Information System (INIS)

    Mason, G.E.; Larew, R.E.; Borcherding, J.D.; Okes, S.R. Jr.; Rad, P.F.

    1977-01-01

    The report identifies barriers to shortening nuclear power plant construction schedules and recommends research efforts which should minimize or eliminate the identified barriers. The identified barriers include (1) Design and Construction Interfacing Problems; (2) Problems Relating to the Selection and Use of Permanent Materials and Construction Methods; (3) Construction Coordination and Communication Problems; and (4) Problems Associated with Manpower Availability and Productivity

  9. Delays in nuclear power plant construction. Volume I. Final report

    International Nuclear Information System (INIS)

    1977-01-01

    The report identifies barriers to shortening nuclear power plant construction schedules and recommends research efforts which should minimize or eliminate the identified barriers. The identified barriers include: (1) Design and Construction Interfacing Problems; (2) Problems Relating to the Selection and Use of Permanent Materials and Construction Methods; (3) Construction Coordination and Communication Problems; and (4) Problems Associated with Manpower Availability and Productivity

  10. Advanced house air-barrier systems

    Energy Technology Data Exchange (ETDEWEB)

    Lee, R.K. [Natural Resources Canada, Ottawa, ON (Canada)

    1996-08-01

    Air barrier systems used in modern Canadian airtight homes were discussed. The Advanced Houses Program sets its airtightness requirements at 1.5 air changes per hour at 50 Pascals pressure difference (ACH{sub 5}0). In recent tests of 10 houses, it was suggested that a better airtightness level was attainable with average airtightness of about 1.0 ACH{sub 5}0. Six of the homes tested did not use the traditional polyethylene approach. Two of the houses used the airtight drywall approach, one used a foam system, and three used exterior air barriers. The advantages and disadvantages of each system was described, including cost effectiveness, cost reduction, performance and installation advantages. The confusion between an air barrier and a vapour diffusion retarder was explained. Exterior air barriers showed the greatest potential for meeting airtightness requirements at reasonable cost. 5 refs., 3 tabs.

  11. Motivators and barriers for physical activity in the oldest old: a systematic review.

    Science.gov (United States)

    Baert, Veerle; Gorus, Ellen; Mets, Tony; Geerts, Christel; Bautmans, Ivan

    2011-09-01

    Worldwide, people engage insufficiently in physical activity, particularly subjects aged 80 years and over. For optimal life-style campaigns, knowledge of motivators and barriers for physical activity is mandatory. Given their specific needs, it is conceivable that these would be different for the oldest old compared to younger subjects. Pubmed, Web of Science and Psychinfo were systematically screened for articles reporting motivators and barriers for physical activity. Papers were excluded if data regarding elderly aged >79 years were absent. Forty-four relevant articles were included, involving a total of 28,583 subjects. Sixty one motivators and 59 barriers for physical activity in the elderly were identified, including those who are relevant for persons aged 80 years and over. Based on the results of our literature review, we recommend that when promoting physical activity in the oldest old, special attention is paid to the health benefits of physical activity, to the subject's fears, individual preferences and social support, and to constraints related to the physical environment. However, no studies were found exclusively describing people aged 80 years and over, and future research is necessary to differentiate the barriers or motivators that are specific for the oldest old from those of younger elderly. Copyright © 2011 Elsevier B.V. All rights reserved.

  12. Identifying barriers and facilitators to participation in pressure ulcer prevention in allied healthcare professionals: a mixed methods evaluation.

    Science.gov (United States)

    Worsley, Peter R; Clarkson, Paul; Bader, Dan L; Schoonhoven, Lisette

    2017-09-01

    To evaluate the barriers and facilitators for allied health professional's participation in pressure ulcer prevention. Mixed method cohort study. Single centre study in an acute university hospital trust. Five physiotherapists and four occupational therapists were recruited from the hospital trust. Therapists had been working in the National Health Service (NHS) for a minimum of one year. Therapist views and experiences were collated using an audio recorded focus group. This recording was analysed using constant comparison analysis. Secondary outcomes included assessment of attitudes and knowledge of pressure ulcer prevention using questionnaires. Key themes surrounding barriers to participation in pressure ulcer prevention included resources (staffing and equipment), education and professional boundaries. Fewer facilitators were described, with new training opportunities and communication being highlighted. Results from the questionnaires showed the therapists had a positive attitude towards pressure ulcer prevention with a median score of 81% (range 50 to 83%). However, there were gaps in knowledge with a median score of 69% (range 50 to 77%). The therapist reported several barriers to pressure ulcer prevention and few facilitators. The primary barriers were resources, equipment and education. Attitudes and knowledge in AHPs were comparable to data previously reported from experienced nursing staff. Copyright © 2016 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  13. Pancreatic cancer survivors' preferences, barriers, and facilitators related to physical activity and diet interventions.

    Science.gov (United States)

    Arthur, Anna E; Delk, Ashley; Demark-Wahnefried, Wendy; Christein, John D; Contreras, Carlo; Posey, James A; Vickers, Selwyn; Oster, Robert; Rogers, Laura Q

    2016-12-01

    To conduct a telephone survey establishing pancreatic cancer survivors' level of interest in, preferences for, and perceived barriers and facilitators to participating in exercise and diet intervention programming. These data will inform the development of such interventions for newly-diagnosed patients. Seventy-one survivors treated for resectable pancreatic adenocarcinoma from October 2011 to August 2014 were identified through an institutional cancer registry and contacted via telephone. A telephone survey was conducted to query survivors' level of interest in, preferences for, and perceived barriers and facilitators to participating in an exercise and dietary intervention program shortly after disease diagnosis. Acceptability of a technology-based visual communication (e.g., Skype™, FaceTime®) intervention was also assessed. Fifty participants completed the survey (response rate 71.8 %). Over two-thirds of participants reported interest in exercise and diet intervention programming. Over half reported comfort with a technology-delivered visual communication intervention. Barriers to participation included older age and physical, personal, and emotional problems. The most common facilitator was program awareness. Outcomes for future research important to participants were supportive care and quality of life. Most pancreatic cancer patients are interested in exercise and diet interventions shortly after diagnosis; however, some barriers to program participation exist. Future research and intervention planning for pancreatic cancer survivors should focus on developing messaging and strategies that provide support for survivorship outcomes, increase survivor awareness, address lack of familiarity with technology, reduce fears about potential barriers, and help survivors overcome these barriers. In so doing, survivorship needs can be better met and quality of life improved in this understudied population.

  14. Reducing barriers to energy efficiency in the German mechanical engineering sector. Executive summary

    Energy Technology Data Exchange (ETDEWEB)

    Schleich, J.; Boede, U.

    2000-12-01

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

  15. Reducing barriers to energy efficiency in the German higher education sector. Executive summary

    Energy Technology Data Exchange (ETDEWEB)

    Schleich, J.; Boede, U.

    2000-12-01

    This report describes the empirical research into barriers to energy efficiency in the German higher education (HE) sector. It is one of nine such reports in the BARRIERS project. The report contains description and analysis of six case studies of energy management in German universities. The results are analysed using the theoretical framework developed for the BARRIERS project (Sorrell et al., 2000). The report also provides brief recommendations on how these barriers to the rational use of energy (RUE) may be overcome and how energy efficiency within the sector may be improved. The results of the study for the higher education sector in Germany are summarised in this executive summary under the following headings: - Characterising the higher education sector; - Case studies of energy management in the German higher education sector; - Evidence of barriers in the German higher education sector; - The role of energy service companies in the higher education sector; - Policy implications. (orig.)

  16. Psychological and behavioral barriers to ART adherence among PLWH in China: role of self-efficacy.

    Science.gov (United States)

    Zhou, Guangyu; Li, Xiaoming; Qiao, Shan; Zhou, Yuejiao; Shen, Zhiyong

    2017-12-01

    Globally, optimal adherence to antiretroviral therapy (ART) is insufficient despite it is critical for maximum clinical benefits and treatment success among people living with HIV (PLWH). Many factors have been evidenced to influence medication adherence, including perceived barriers and self-efficacy. However, limited data are available regarding to psychological and behavioral barriers to ART adherence in China. Moreover, few studies have examined the mechanism of these two factors underlying HIV medication adherence. The aim of the current study is to examine the mediating role of adherence self-efficacy between perceived barriers and ART adherence among PLWH. Cross-sectional data were obtained from 2095 PLWH in Guangxi China who provided data on ART adherence. Participants reported their medication adherence, self-efficacy, barriers to ART adherence, as well as background characteristics. Results indicated a significant indirect effect from perceived barriers to medication adherence through adherence self-efficacy. Higher perceived psychological and behavioral barriers to ART adherence were related to lower adherence self-efficacy, which in turn was related to lower ART adherence. Self-efficacy could buffer the negative effects of perceived barriers on ART adherence. Future interventions to promote HIV medication adherence are recommended to focus on eliminating psychological and behavioral barriers, as well as increasing adherence self-efficacy.

  17. Attitudinal Barriers to Analgesic Use among Patients with Substance Use Disorders

    Directory of Open Access Journals (Sweden)

    Leah Zallman

    2012-01-01

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

  18. Influence of horizontally curved roadway section characteristics on motorcycle-to-barrier crash frequency.

    Science.gov (United States)

    Gabauer, Douglas J; Li, Xiaolong

    2015-04-01

    The purpose of this study was to investigate motorcycle-to-barrier crash frequency on horizontally curved roadway sections in Washington State using police-reported crash data linked with roadway data and augmented with barrier presence information. Data included 4915 horizontal curved roadway sections with 252 of these sections experiencing 329 motorcycle-to-barrier crashes between 2002 and 2011. Negative binomial regression was used to predict motorcycle-to-barrier crash frequency using horizontal curvature and other roadway characteristics. Based on the model results, the strongest predictor of crash frequency was found to be curve radius. This supports a motorcycle-to-barrier crash countermeasure placement criterion based, at the very least, on horizontal curve radius. With respect to the existing horizontal curve criterion of 820 feet or less, curves meeting this criterion were found to increase motorcycle-to-barrier crash frequency rate by a factor of 10 compared to curves not meeting this criterion. Other statistically significant predictors were curve length, traffic volume and the location of adjacent curves. Assuming curves of identical radius, the model results suggest that longer curves, those with higher traffic volume, and those that have no adjacent curved sections within 300 feet of either curve end would likely be better candidates for a motorcycle-to-barrier crash countermeasure. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Dos Hermanas Chicanas: Overcoming Barriers to Professional Advancement

    Science.gov (United States)

    Prospero, Moises

    2007-01-01

    Women and ethnic minorities face steep barriers to professional advancement, and those who rise to the executive level typically use a variety of strategies to overcome obstacles in their way. This study first reviewed the literature on barriers to professional advancement for women and ethnic minorities and the strategies that they report using…

  20. Impact of support schemes and barriers in Europe on the evolution of cogeneration

    International Nuclear Information System (INIS)

    Moya, José Antonio

    2013-01-01

    This paper analyses the effectiveness of different support measures to promote cogeneration in the European Union. The analysis looks into the average progress of cogeneration between two different periods. The economic effect of the support measures in each country is quantified with the help of a cost–benefit analysis carried out by the Cogeneration Observatory and Dissemination Europe (CODE) project. The scope of this study is necessarily affected by the need to limit the number of projects and support measures. However, there is no evidence of a relationship between the economic advantage offered by support measures and the deployment of cogeneration in the Member States. The study considers the effect of different barriers (reported by the Member States) on the promotion of cogeneration. The individual analyses of the barriers differ widely in quality and depth. When some barriers are reported, there is an increase of the variability of the penetration of cogeneration. This counter-intuitive fact leads us to conclude that there is a lack of consistency in the barriers reported, and a clear need for consistent reporting on barriers. The possible effect of competition between measures supporting combined heat and power and renewable energy sources is also analysed. - Highlights: • Support measures to promote cogeneration are analysed. • The growth of cogeneration in European countries is not aligned with the measures in place. • None of the reported barriers for cogeneration can be considered a clear show-stopper. • The variation in the development of cogeneration when some barriers are reported raises questions about the reporting. • Countries with a high share of cogeneration are sensitive to the continuity or discontinuity of support

  1. PATTERNS OF PHYSICAL ACTIVITY AMONG AMERICAN INDIAN CHILDREN: AN ASSESSMENT OF BARRIERS AND SUPPORT

    Science.gov (United States)

    Thompson, Janice L.; Davis, Sally M.; Gittelsohn, Joel; Going, Scott; Becenti, Alberta; Metcalfe, Lauve; Stone, Elaine; Harnack, Lisa; Ring, Kim

    2016-01-01

    Estimates indicate that 10% to 50% of American Indian and non-Indian children in the U.S. are obese, defined as a body mass index ≥ 95th percentile of the NHANES II reference data. Pathways is a two-phase, multi-site study to develop and test a school-based obesity prevention program in American Indian schoolchildren in grades three through five. During Phase I feasibility prior to initiation of the Pathways trial, data were collected related to physical activity patterns, and the supports of, and barriers to, physical activity. Nine schools from communities representing six different tribal groups participated in this study. Multiple measures were used for data collection including direct observation, paired child interviews, and in-depth interviews and focus groups with adults. Students completed the self-administered Knowledge, Attitudes, and Behaviors (KAB) survey, and a Physical Activity Questionnaire (PAQ). Barriers to physical activity at schools included a lack of facilities, equipment, and trained staff persons for PE. Adults were not consistently active with their children, but they were highly supportive of their children’s activity level. Children reported a strong enjoyment of physical activity and strong peer support to be physically active. Weather conditions, safety concerns, and homework/chores were common barriers to physical activity reported by children and adult caregivers. The information was used to design culturally and age-appropriate, practical interventions including the five physical activity programs for schoolchildren in the Pathways study. PMID:11759094

  2. Preliminary engineering specifications for a test demonstration multilayer protective barrier cover system

    International Nuclear Information System (INIS)

    Phillips, S.J.; Gilbert, T.W.; Adams, M.R.

    1985-03-01

    This report presents preliminary engineering specifications for a test protective barrier cover system and support radiohydrology facility to be constructed at the Hanford Protective Barrier Test Facility (PBTF). Construction of this test barrier and related radiohydrology facility is part of a continuing effort to provide construction experience and performance evaluation of alternative barrier designs used for long-term isolation of disposed radioactive waste materials. Design specifications given in this report are tentative, based on interim engineering and computer simulation design efforts. Final definitive design specifications and engineering prints will be produced in FY 1986. 6 refs., 10 figs., 1 tab

  3. Patient-related barriers to pain management: the Barriers Questionnaire II (BQ-II).

    Science.gov (United States)

    Gunnarsdottir, Sigridur; Donovan, Heidi S; Serlin, Ronald C; Voge, Catherine; Ward, Sandra

    2002-10-01

    Patients' beliefs can act as barriers to optimal management of cancer pain. The Barriers Questionnaire (BQ) is a tool used to evaluate such barriers. Here, the BQ has been revised to reflect changes in pain management practices, resulting in the Barriers Questionnaire-II (BQ-II), a 27-item, self report instrument. This paper presents the results from two studies where the psychometric properties of the BQ-II were evaluated. In the first study, the responses of 27 nurses trained in pain management were compared to responses of a convenience sample of 12 patients with cancer. The results indicated that patients with cancer had higher mean scores on the BQ-II than did nurses trained in pain management. In the second study, a convenience sample of 172 patients with cancer responded to the BQ-II and a set of pain and quality of life (QOL) measures. A factor analysis supported four factors. Factor one, physiological effects, consists of 12 items addressing the beliefs that side effects of analgesics are inevitable and unmanageable, concerns about tolerance, and concerns about not being able to monitor changes in one's body when taking strong pain medications. Factor two, Fatalism, consists of three items addressing fatalistic beliefs about cancer pain and its management. Factor three, Communication, consists of six items addressing the concern that reports of pain distract the physician from treating the underlying disease, and the belief that 'good' patients do not complain of pain. The fourth and final factor, harmful effects, consists of six items addressing fear of becoming addicted to pain medication and the belief that pain medications harm the immune system. The BQ-II total had an internal consistency of 0.89, and alpha for the subscales ranged from 0.75 to 0.85. Mean (SD) scores on the total scale was 1.52 (0.73). BQ-II scores were related to measures of pain intensity and duration, mood, and QOL. Patients who used adequate analgesics for their levels of pain had

  4. Life Prediction Issues in Thermal/Environmental Barrier Coatings in Ceramic Matrix Composites

    Science.gov (United States)

    Shah, Ashwin R.; Brewer, David N.; Murthy, Pappu L. N.

    2001-01-01

    Issues and design requirements for the environmental barrier coating (EBC)/thermal barrier coating (TBC) life that are general and those specific to the NASA Ultra-Efficient Engine Technology (UEET) development program have been described. The current state and trend of the research, methods in vogue related to the failure analysis, and long-term behavior and life prediction of EBCITBC systems are reported. Also, the perceived failure mechanisms, variables, and related uncertainties governing the EBCITBC system life are summarized. A combined heat transfer and structural analysis approach based on the oxidation kinetics using the Arrhenius theory is proposed to develop a life prediction model for the EBC/TBC systems. Stochastic process-based reliability approach that includes the physical variables such as gas pressure, temperature, velocity, moisture content, crack density, oxygen content, etc., is suggested. Benefits of the reliability-based approach are also discussed in the report.

  5. Barriers related to physical activity practice in adolescents. A focus-group study

    Directory of Open Access Journals (Sweden)

    Ciro Romélio Rodriguez Añez

    2010-04-01

    Full Text Available The aim of study was to identify barriers to physical activity in adolescents. Focus group interviews were conducted with subjects aged 15 to 18 years (n=59, 50.8% girls and divided according to gender. Content analysis was used to classify the reports into specific dimensions. Descriptive statistics employing relative and absolute frequencies of similar reports was performed using the SPSS 11.0 software. The most frequent barriers among adolescents were those associated with “psychological, cognitive and emotional” and “cultural and social” dimensions. For boys, the most frequently reported barriers were “feeling lazy”, “lack of company” and “lack of time”. For girls, “feeling lazy”, “lack of com-pany” and “occupation” were the most common barriers. In conclusion, the perception of barriers by adolescents varies according to gender, a fact requiring specific actions for the promotion of physical activity in this group.

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

    Science.gov (United States)

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

    2016-08-01

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

  7. Barriers and solutions to online learning in medical education - an integrative review.

    Science.gov (United States)

    O'Doherty, Diane; Dromey, Marie; Lougheed, Justan; Hannigan, Ailish; Last, Jason; McGrath, Deirdre

    2018-06-07

    The aim of this study is to review the literature on known barriers and solutions that face educators when developing and implementing online learning programs for medical students and postgraduate trainees. An integrative review was conducted over a three-month period by an inter-institutional research team. The search included ScienceDirect, Scopus, BioMedical, PubMed, Medline (EBSCO & Ovid), ERIC, LISA, EBSCO, Google Scholar, ProQuest A&I, ProQuest UK & Ireland, UL Institutional Repository (IR), UCDIR and the All Aboard Report. Search terms included online learning, medical educators, development, barriers, solutions and digital literacy. The search was carried out by two reviewers. Titles and abstracts were screened independently and reviewed with inclusion/exclusion criteria. A consensus was drawn on which articles were included. Data appraisal was performed using the Critical Appraisal Skills Programme (CASP) Qualitative Research Checklist and NHMRC Appraisal Evidence Matrix. Data extraction was completed using the Cochrane Data Extraction Form and a modified extraction tool. Of the 3101 abstracts identified from the search, ten full-text papers met the inclusion criteria. Data extraction was completed on seven papers of high methodological quality and on three lower quality papers. Findings suggest that the key barriers which affect the development and implementation of online learning in medical education include time constraints, poor technical skills, inadequate infrastructure, absence of institutional strategies and support and negative attitudes of all involved. Solutions to these include improved educator skills, incentives and reward for the time involved with development and delivery of online content, improved institutional strategies and support and positive attitude amongst all those involved in the development and delivery of online content. This review has identified barriers and solutions amongst medical educators to the implementation of

  8. [Healthy eating according to teenagers: perceptions, barriers, and expected characteristics of teaching materials].

    Science.gov (United States)

    Toral, Natacha; Conti, Maria Aparecida; Slater, Betzabeth

    2009-11-01

    The aim of this study was to evaluate perceptions, barriers, and characteristics of teaching materials to promote healthy eating, as described by teenagers. Four focus groups were conducted with 25 adolescents, including questions on: perceptions regarding diet and motivations to change; concepts of (and barriers to) healthy eating; and characteristics needed for teaching materials to promote healthy eating. The teens were often undecided when attempting to classify a diet as healthy. They generally reported feeling insecure about making dietary changes, but showed adequate notions of healthy eating. The main barriers involved personal and social characteristics: temptation, food flavors, parental influence, and lack of time and options for healthy snacks at school. According to these teenagers, educational materials for promotion of healthy eating should emphasize the immediate benefits and emphasize high-impact messages on the health risks of unhealthy diet.

  9. Drivers and barriers for implementation of the biorefinery

    International Nuclear Information System (INIS)

    Janssen, M.; Stuart, P.

    2010-01-01

    This paper discussed the barriers and drivers for the implementation of biorefinery technology in the forestry industry. A multi-criteria decision making (MCDM) methodology was used by a panel of industry experts. The objective, drivers and barriers, and the decision structure and weighting procedure were established during a pre-panel phase. An analytic hierarchy process (AHP) was then applied to compare qualitative criteria. Pair-wise criteria were used to determine the importance of each driver and barrier. Drivers for the implementation of biorefineries included the opportunity to ensure short-term profitability; the provision of raw materials at competitive prices; potential financial incentives; and the opportunity to transform the forestry business model and increase its market value. Barriers included uncertainty in relation to government policies for biorefineries; high technology risks; the need for partnerships; and the fact that many industry members favour short-term decision-making. Results of the study showed that the most significant barrier was related to risk. 5 refs., 3 tabs., 3 figs.

  10. Transport barrier fluctuations governed by SOL turbulence spreading

    International Nuclear Information System (INIS)

    Ghendrih, Ph.; Sarazin, Y.; Ciraolo, G.; Darmet, G.; Garbet, X.; Grangirard, V.; Tamain, P.; Benkadda, S.; Beyer, P.

    2007-01-01

    Turbulence spreading, namely turbulent transport extending into a stable region is reported both for the flat density profiles in the far SOL and into a modeled H-mode barrier. It is shown that due to turbulence penetration, the pedestal width fluctuates and that its effective width is a factor 2 smaller than the linear predicted width. Turbulence overshooting throughout the pedestal leads to a non-vanishing turbulent transport within the barrier and provides a coupling of core and SOL turbulence despite the transport barrier

  11. An observational study of emergency department utilization among enrollees of Minnesota Health Care Programs: financial and non-financial barriers have different associations.

    Science.gov (United States)

    Shippee, Nathan D; Shippee, Tetyana P; Hess, Erik P; Beebe, Timothy J

    2014-02-08

    Emergency department (ED) use is costly, and especially frequent among publicly insured populations in the US, who also disproportionately encounter financial (cost/coverage-related) and non-financial/practical barriers to care. The present study examines the distinct associations financial and non-financial barriers to care have with patterns of ED use among a publicly insured population. This observational study uses linked administrative-survey data for enrollees of Minnesota Health Care Programs to examine patterns in ED use-specifically, enrollee self-report of the ED as usual source of care, and past-year count of 0, 1, or 2+ ED visits from administrative data. Main independent variables included a count of seven enrollee-reported financial concerns about healthcare costs and coverage, and a count of seven enrollee-reported non-financial, practical barriers to access (e.g., limited office hours, problems with childcare). Covariates included health, health care, and demographic measures. In multivariate regression models, only financial concerns were positively associated with reporting ED as usual source of care, but only non-financial barriers were significantly associated with greater ED visits. Regression-adjusted values indicated notable differences in ED visits by number of non-financial barriers: zero non-financial barriers meant an adjusted 78% chance of having zero ED visits (95% C.I.: 70.5%-85.5%), 15.9% chance of 1(95% C.I.: 10.4%-21.3%), and 6.2% chance (95% C.I.: 3.5%-8.8%) of 2+ visits, whereas having all seven non-financial barriers meant a 48.2% adjusted chance of zero visits (95% C.I.: 30.9%-65.6%), 31.8% chance of 1 visit (95% C.I.: 24.2%-39.5%), and 20% chance (95% C.I.: 8.4%-31.6%) of 2+ visits. Financial barriers were associated with identifying the ED as one's usual source of care but non-financial barriers were associated with actual ED visits. Outreach/literacy efforts may help reduce reliance on/perception of ED as usual source of care

  12. Motivational readiness for active commuting by university students: incentives and barriers.

    Science.gov (United States)

    Cole, Rachel; Leslie, Eva; Donald, Maria; Cerin, Ester; Neller, Anne; Owen, Neville

    2008-12-01

    Walking for transport can contribute significantly to health-enhancing physical activity. We examined the associations of stages of motivational readiness for active transport with perceived barriers and incentives to walking to and from university among students. Mail-back surveys were completed by 781 students in a regional university in south-east Queensland. They identified one of eight options on motivational readiness for active commuting, which were then classified as: pre-contemplation; contemplation-preparation; or, action-maintenance. Open-ended questions were used to identify relevant barriers and incentives. Logistic regressions were used to examine the barriers and incentives that distinguished between those at different stages of motivational readiness. Barriers most frequently reported were long travel distances, inconvenience and time constraints. Incentives most frequently reported were shorter travel distance, having more time, supportive infrastructure and better security. Those not considering active commuting (pre-contemplation) were significantly more likely to report shorter travel distance as an incentive compared to those in contemplation-preparation. Those in contemplation-preparation were significantly more likely to report lack of motivation, inadequate infrastructure, shorter travel distance and inconvenience as barriers; and, having more time, supportive infrastructure, social support and incentive programs as encouragement. Different barriers and incentives to walking to or from university exist for students in the different stages of motivational readiness for active commuting. Interventions targeted specifically to stage of motivational readiness may be potentially helpful in increasing activity levels, through active transport.

  13. Facilitators and barriers of medication adherence in pediatric liver and kidney transplant recipients: a mixed-methods study.

    Science.gov (United States)

    Claes, Anouck; Decorte, Anneloes; Levtchenko, Elena; Knops, Noel; Dobbels, Fabienne

    2014-12-01

    Many young transplant patients (≤11 years old) struggle to take their immunosuppressive and co-medications correctly, yet it remains unclear which factors positively or negatively affect medication adherence. Research studies on determinants in this age group are scarce, have methodological flaws, and focus exclusively on immunosuppressants or on barriers rather than on facilitators. This study used a consecutive mixed-methods (qualitative + quantitative) design. Semistructured interviews with parents of 10 pediatric liver or kidney transplant recipients 2 to 11 years old on adherence facilitators and barriers were conducted, complemented by quantification of adherence to the immunosuppressants and co-medications, and completion of the "immunosuppressive medication adherence barriers" self-report instrument. A median of 19 (range, 10-29) barriers was reported: the most commonly encountered were forgetfulness (70%), vomiting (70%), bad taste (60%), and interruptions in routine (60%). Parents reported a median of 15 facilitators (range, 6-26), including using practical aids (100%), having medication with you at all times (100%), having to take fewer medications (80%), and experiencing fewer regimen changes over time (80%). No clear distinction between immunosuppressants or co-medications was made. This study provides several new insights based on peer experience to support future patients and their parents in medication adherence.

  14. Perceived unmet need and barriers to care amongst street-involved people who use illicit drugs.

    Science.gov (United States)

    Hyshka, Elaine; Anderson, Jalene Tayler; Wild, T Cameron

    2017-05-01

    Research on perceived unmet need for care for mental health and substance use problems focuses on general populations to the detriment of hidden populations. This study describes prevalence and correlates of perceived unmet need for care in a community-based sample of street-involved people who use illicit drugs and identifies barriers to care. A sample of 320 street-involved people who use drugs participated in a structured, interviewer-assisted survey in Edmonton, Canada. The survey included the Perceived Need for Care Questionnaire, which assessed unmet need for care for mental health and substance use problems across seven service types. Logistic regression examined the associations between perceived unmet need, extent of socioeconomic marginalisation and problem severity. Barriers underlying unmet service needs were also examined. Most (82%) participants reported unmet need for one or more services during the past year. Odds of reporting one or more unmet needs were elevated amongst participants reporting substantial housing instability (adjusted odds ratio = 2.37; 95% confidence interval 1.19-4.28) and amongst participants meeting criteria for drug dependence (adjusted odds ratio = 1.22; 95% confidence interval 1.03-1.50), even after adjustment for sociodemographic covariates. Structural, rather than motivational barriers were the most commonly reported reasons underlying unmet service needs. Street-involved people who use drugs experience very high rates of perceived unmet need for care for mental health and substance use problems. General population studies on perceived unmet need are insufficient for understanding needs and barriers to care in hidden populations.[Hyshka E, Anderson JT, Wild TC. Perceived unmet need and barriers to care amongst street-involved people who use illicit drugs. Drug Alcohol Rev 2017;36:295-304]. © 2016 Australasian Professional Society on Alcohol and other Drugs.

  15. External and Internal Barriers to Studying Can Affect Student Success and Retention in a Diverse Classroom

    Directory of Open Access Journals (Sweden)

    Laurence Clement

    2016-12-01

    Full Text Available Although a majority of under-represented minority (URM students begin their postsecondary education at community colleges, little is known about barriers to success and retention for transfer-bound science students. This study focuses on some of the barriers that affect these students’ ability to study adequately for a community college “gateway” course. It tests whether instructors’ expectations of study time were realistic for community college students and whether students reported facing external barriers, such as job and family responsibilities, or internal barriers to studying, such as lack of motivational, cognitive, and metacognitive abilities, all of which have been shown to impact academic success and retention. It also tests whether students who faced such barriers were less likely to succeed in and complete the course, as well as whether time spent studying was related to course success. The findings reported here show that community college students do not have enough available time to study and that external and internal barriers are both prevalent among these students. In addition, students who faced such barriers are more likely to fail or drop the class. Results also show that study time is positively correlated with retention, but not performance, as well as with some motivational, cognitive, and metacognitive dimensions of self-regulated learning. These findings lead to new questions, including whether student success in a community college class is associated with the use of cognitive and metacognitive learning strategies for students with no prior degrees, and whether increased course structure may improve success for college students with lower self-regulated abilities.

  16. Recent results from TMX-U thermal barrier experiments

    International Nuclear Information System (INIS)

    Molvik, A.W.; Allen, S.; Barter, J.

    1984-01-01

    The Tandem Mirror Experiment-Upgrade (TMX-U) device was designed to study plasma confinement in a tandem mirror with thermal barriers. Previously the author reported improved axial confinement with high end-plug potentials, consistent with thermal barrier operation. Now, the existence of thermal barriers in TMX-U confirmed by measuring the axial potential profile. Specifically, measured the change in energy of a 5-keV deuterium neutral beam that is injected nearly parallel to the axis and is ionized between the barrier and the central cell. The authors found that the barrier potential is lower than the central cell potential, as required for a thermal barrier. The peak potential is at least 2.4 keV, as determined from the minimum energy of end loss ions. In addition, radial transport is reduced by the use of floating and electrodes that map to concentric cylinders in the central cell. Sloshing ions continue to be microstable

  17. Physical activity in hypertrophic cardiomyopathy: prevalence of inactivity and perceived barriers

    Science.gov (United States)

    Sweeting, Joanna; Ingles, Jodie; Timperio, Anna; Patterson, Jillian; Ball, Kylie; Semsarian, Christopher

    2016-01-01

    Objectives This study aimed to determine the prevalence of physical inactivity and perceived barriers to physical activity among individuals with hypertrophic cardiomyopathy (HCM), and to determine potential demographic, clinical and health-related factors influencing likelihood of meeting physical activity guidelines. Methods This was a cross-sectional study of consecutive patients (n=198) with HCM attending a specialist HCM centre from July 2014 to November 2015. The primary outcome measure was physical activity (minutes per day), as measured by self-report (International Physical Activity Questionnaire (IPAQ)) and objective means (ActiGraph accelerometer). For both, participants were classified as meeting guidelines if they did at least 150 min per week of physical activity. Quality of life (Short Form-36 V.2, SF-36v2), barriers to exercise and clinical–demographic data were also collected. Results In total, 54.8% of participants did not meet physical activity recommendations based on IPAQ, and 12.7% did not meet guidelines based on accelerometer data. The most commonly identified barriers to exercise were ‘pain interferes with my exercise’ (33%) and ‘I have an injury/disability that stops me’ (29%). Independent factors associated with meeting guidelines included older age (OR 0.66, 95% CI 0.51 to 0.85, p=0.002), higher education level (OR 2.31, 95% CI 1.08 to 4.93, p=0.03), better physical quality of life (OR 1.05, 95% CI 1.0 to 1.09, p=0.05) and more reported barriers (OR 0.71, 95% CI 0.56 to 0.91, p=0.01). Conclusions More than half of the patients with HCM did not meet minimum physical activity recommendations. Several barriers to exercise among individuals with HCM exist, and provide the basis for targeted interventions to promote physical activity and improve overall health in patients with HCM. PMID:27547438

  18. Economic evaluation of closure cap barrier materials study

    Energy Technology Data Exchange (ETDEWEB)

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

    1993-09-01

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

  19. Motivators and Barriers to Exercise in Parkinson's Disease.

    Science.gov (United States)

    Afshari, Mitra; Yang, Amy; Bega, Danny

    2017-01-01

    Despite evidence for the benefits of exercise in Parkinson's disease (PD), many patients remain sedentary for undefined reasons. To compare exercise habits, perceptions about exercise, and barriers to exercise in 'low' (motivating factors. Both groups benefited from having a significant other or a personal trainer motivate them, and both were more likely to exercise if their neurologist encouraged them. Low-exercisers reported twice as many barriers as high-exercisers (p = 0.001). Barriers that were significantly more common in low-exercisers were: lacking someone to motivate them (33.3% versus 10.5%, p motivators and barriers. These findings should be considered when tailoring recommendations for PD patients to encourage exercise, and in designing future interventions.

  20. Economic evaluation of closure cap barrier materials study

    International Nuclear Information System (INIS)

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

    1993-09-01

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

  1. Work-Related Pain and Injury and Barriers to Workers’ Compensation Among Las Vegas Hotel Room Cleaners

    Science.gov (United States)

    Scherzer, Teresa; Rugulies, Reiner; Krause, Niklas

    2005-01-01

    Objectives. We examined the prevalence of work-related pain and injury and explored barriers to and experiences of reporting among workers. Methods. We surveyed 941 unionized hotel room cleaners about work-related pain, injury, disability, and reporting. Results. During the past 12 months, 75% of workers in our study experienced work-related pain, and 31% reported it to management; 20% filed claims for workers’ compensation as a result of work-related injury, and 35% of their claims were denied. Barriers to reporting injury included “It would be too much trouble” (43%), “I was afraid” (26%), and “I didn’t know how” (18%). An estimated 69% of medical costs were shifted from employers to workers. Conclusions. The reasons for underreporting and the extent of claim denial warrant further investigation. Implications for worker health and the precise quantification of shifting costs to workers also should be addressed. PMID:15727981

  2. Engineered Barrier System - Mechanical Integrity of KBS-3 Spent Fuel Canisters. Report from a Workshop. Synthesis and extended abstracts

    Energy Technology Data Exchange (ETDEWEB)

    2007-09-15

    SKI is preparing to review the license applications being developed by the Swedish Nuclear Fuel and Waste Management Company (SKB) for a final repository for the geological disposal of spent nuclear fuel in the year 2009. As part of its preparation, SKI is conducting a series of technical workshops on key aspects of the Engineered Barrier System (EBS). The workshop reported here mainly dealt with the mechanical integrity of KBS-3 spent fuel canisters. This included assessment and review of various loading conditions, structural integrity models and mechanical properties of the copper shell and the cast iron insert. Degradation mechanisms such as stress corrosion cracking and brittle creep fracture were also briefly addressed. Previous workshops have addressed the overall concept for long-term integrity of the EBS, the manufacturing, testing and QA of the EBS, the performance confirmation for the EBS, long-term stability of the buffer and the backfill, corrosion properties of copper canisters and the spent fuel dissolution and source term modelling. The goal of ongoing review work in connection of the workshop series is to achieve a comprehensive overview of all aspects of SKB's EBS and spent fuel work prior to the handling of the forthcoming license application. This report aims to summarise the issues discussed at the workshop and to extract the essential viewpoints that have been expressed. The report is not a comprehensive record of all the discussions at the workshop, and individual statements made by workshop participants should be regarded as personal opinions rather than SKI viewpoints. Results from the EBS workshops series will be used as one important basis in future review work. This reports includes in addition to the workshop synthesis, questions to SKB identified prior to the workshop, and extended abstracts for introductory presentations

  3. Intestinal barrier integrity and inflammatory bowel disease

    DEFF Research Database (Denmark)

    Holmberg, Fredrik Eric Olof; Pedersen, Jannie; Jørgensen, Peter

    2018-01-01

    Disruption of normal barrier function is a fundamental factor in the pathogenesis of inflammatory bowel disease, which includes increased epithelial cell death, modified mucus configuration, altered expression and distribution of tight junction-proteins, along with a decreased expression of antim......Disruption of normal barrier function is a fundamental factor in the pathogenesis of inflammatory bowel disease, which includes increased epithelial cell death, modified mucus configuration, altered expression and distribution of tight junction-proteins, along with a decreased expression...... of antimicrobial peptides. Inflammatory bowel disease is associated with life-long morbidity for affected patients, and both the incidence and prevalence is increasing globally, resulting in substantial economic strain for society. Mucosal healing and re-establishment of barrier integrity is associated......, novel treatment strategies to accomplish mucosal healing and to re-establish normal barrier integrity in inflammatory bowel disease are warranted, and luminal stem cell-based approaches might have an intriguing potential. Transplantation of in vitro expanded intestinal epithelial stem cells derived...

  4. Barrier-island and estuarine-wetland physical-change assessment after Hurricane Sandy

    Science.gov (United States)

    Plant, Nathaniel G.; Smith, Kathryn E.L.; Passeri, Davina L.; Smith, Christopher G.; Bernier, Julie C.

    2018-04-03

    IntroductionThe Nation’s eastern coast is fringed by beaches, dunes, barrier islands, wetlands, and bluffs. These natural coastal barriers provide critical benefits and services, and can mitigate the impact of storms, erosion, and sea-level rise on our coastal communities. Waves and storm surge resulting from Hurricane Sandy, which made landfall along the New Jersey coast on October 29, 2012, impacted the U.S. coastline from North Carolina to Massachusetts, including Assateague Island, Maryland and Virginia, and the Delmarva coastal system. The storm impacts included changes in topography, coastal morphology, geology, hydrology, environmental quality, and ecosystems.In the immediate aftermath of the storm, light detection and ranging (lidar) surveys from North Carolina to New York documented storm impacts to coastal barriers, providing a baseline to assess vulnerability of the reconfigured coast. The focus of much of the existing coastal change assessment is along the ocean-facing coastline; however, much of the coastline affected by Hurricane Sandy includes the estuarine-facing coastlines of barrier-island systems. Specifically, the wetland and back-barrier shorelines experienced substantial change as a result of wave action and storm surge that occurred during Hurricane Sandy (see also USGS photograph, http://coastal.er.usgs.gov/hurricanes/sandy/photo-comparisons/virginia.php). Assessing physical shoreline and wetland change (land loss as well as land gains) can help to determine the resiliency of wetland systems that protect adjacent habitat, shorelines, and communities.To address storm impacts to wetlands, a vulnerability assessment should describe both long-term (for example, several decades) and short-term (for example, Sandy’s landfall) extent and character of the interior wetlands and the back-barrier-shoreline changes. The objective of this report is to describe several new wetland vulnerability assessments based on the detailed physical changes

  5. Barrier experiment: Shock initiation under complex loading

    Energy Technology Data Exchange (ETDEWEB)

    Menikoff, Ralph [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-01-12

    The barrier experiments are a variant of the gap test; a detonation wave in a donor HE impacts a barrier and drives a shock wave into an acceptor HE. The question we ask is: What is the trade-off between the barrier material and threshold barrier thickness to prevent the acceptor from detonating. This can be viewed from the perspective of shock initiation of the acceptor subject to a complex pressure drive condition. Here we consider key factors which affect whether or not the acceptor undergoes a shock-to-detonation transition. These include the following: shock impedance matches for the donor detonation wave into the barrier and then the barrier shock into the acceptor, the pressure gradient behind the donor detonation wave, and the curvature of detonation front in the donor. Numerical simulations are used to illustrate how these factors affect the reaction in the acceptor.

  6. [Prevalence of barriers for physical activity in adolescents].

    Science.gov (United States)

    Santos, Mariana Silva; Hino, Adriano Akira Ferreira; Reis, Rodrigo Siqueira; Rodriguez-Añez, Ciro Romélio

    2010-03-01

    The aim of this study was to analyze the prevalence and association of barriers to physical activity among adolescents. This cross-sectional study evaluated a representative sample of public high school students in Curitiba-PR, Brazil. A total of 1,609 school adolescents (59.7% male) between 14 and 18 years of age answered a questionnaire on physical activity status and barriers to physical activity. Logistic regressions were conducted for each barrier investigated to verify the association between the prevalence of barriers and physical activity, adjusting for confounding variables (age and socioeconomic status). Analyses were done separately for boys and girls. Only 22% of boys and 9% of girls achieved the current physical activity recommendation. Among the 12 barriers investigated, only "there is nobody to take" did not differ between boys and girls. The perception of barriers was higher for girls than boys (p barriers. "Lack of friends company" and "feel lazy" were the barriers most often reported by boys (30.4%) and girls (51.8%) respectively; however, the barrier most strongly associated with prevalence of physical inactivity was "prefer to do other things" for both boys (OR = 5.02 (2.69 - 9.37); p barriers for the practice of physical activity were more prevalent in girls and differed as to the extent of importance between genders.

  7. Services for people with communication disability in Fiji: barriers and drivers of change.

    Science.gov (United States)

    Hopf, Suzanne C; McLeod, Sharynne

    2015-01-01

    The World Health Organization's World report on disability calls upon all nations to 'remove the barriers which prevent [people with disabilities] from participating in their communities; getting a quality education, finding decent work, and having their voices heard' (p. 5). People with communication disability (PWCD), as a consequence of their atypical communication, may be more likely to be excluded from society, and denied their basic human rights, than other people with disability. Fiji, a multicultural and multilingual nation in the south-western Pacific Ocean, has limited services for PWCD. Service providers in Fiji include disability care workers, special education teachers, traditional healers, and a small number of visiting volunteer speech-language pathologists. This paper outlines the historical and current barriers to, and drivers of change for, service development for PWCD in Fiji. Five barriers to service development for PWCD in Fiji were identified. (1) A major structural barrier is the small population size to develop appropriate infrastructure including professional education programs. (2) Geographical barriers include the dispersed geography across 300 islands, low population density, the rural-urban divide, and risk of disaster from cyclones and flooding. (3) Linguistic diversity, while culturally important, can present a barrier to the provision of quality services that are available in the languages spoken by PWCD. (4) Cultural barriers include historical political instability, although Fiji has become more stable due to the recent democratic elections. The social climate affects development of services that are appropriate for different dominant cultural groups. (5) Financial barriers include low gross domestic product, low financial security and low human development index; however, the financial outlook for Fiji is steadily improving due to the change in political stability. Three levels of drivers of change were identified. Macro

  8. Performance of engineered barriers for low-level waste

    International Nuclear Information System (INIS)

    Taplin, D.; Claridge, F.B.

    1987-09-01

    Geotechnical Resources Ltd., in association with Komex Consultants Ltd., was retained to collect, synthesize and evaluate the available information on the long term performance of engineered barriers for low-level radioactive wastes disposed in Canada. Literature was researched from Canadian, United States and European sources. A variety of barrier materials were assessed in the study and included natural clays, concrete and cement, metals, bentonite-sand admixes, bitumen and bituminous admixes, soil cement and polymeric membranes. The generalized geological and geotechnical conditions encountered within the soil and rock host media currently under consideration for disposal sites in southern Ontario were also summarized. Both internal barriers, or buffers, to immobilize the waste material and reduce radionuclide mobility, as well as external barriers to limit the migration of contaminants were examined. Microbial activities within the waste forms were analyzed, including cellulose degradation, methanogenesis and bicarbonate and organic reactions. Microbial interactions with the various engineered barrier materials under consideration were also assessed. Finally, the anticipated long term performances of the respective barrier materials under consideration were evaluated, along with the general suitability of the geological host media being proposed for disposal sites

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

    Directory of Open Access Journals (Sweden)

    Rasha Khatib

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

  10. Ethnic differences in cancer symptom awareness and barriers to seeking medical help in England.

    Science.gov (United States)

    Niksic, Maja; Rachet, Bernard; Warburton, Fiona G; Forbes, Lindsay J L

    2016-06-28

    Ethnic differences in cancer symptom awareness and barriers to seeking medical help in the English population are not fully understood. We aimed to quantify these differences, to help develop more effective health campaigns, tailored to the needs of different ethnic groups. Using a large national data set (n=38 492) of cross-sectional surveys that used the Cancer Research UK Cancer Awareness Measure, we examined how cancer symptom awareness and barriers varied by ethnicity, controlling for socio-economic position, age and gender. Data were analysed using multivariable logistic regression. Awareness of cancer symptoms was lower in minority ethnic groups than White participants, with the lowest awareness observed among Bangladeshis and Black Africans. Ethnic minorities were more likely than White British to report barriers to help-seeking. South Asians reported the highest emotional barriers, such as lack of confidence to talk to the doctor, and practical barriers, such as worry about many other things. The Irish were more likely than the White British to report practical barriers, such as being too busy to visit a doctor. White British participants were more likely than any other ethnic group to report that they would feel worried about wasting the doctor's time. Overall, Black Africans had the lowest barriers. All differences were statistically significant (Pcancer symptoms among ethnic minorities. Campaigns should tackle the specific barriers prevalent in each ethnic group.

  11. Property Evaluation and Damage Evolution of Environmental Barrier Coatings and Environmental Barrier Coated SiC/SiC Ceramic Matrix Composite Sub-Elements

    Science.gov (United States)

    Zhu, Dongming; Halbig, Michael; Jaskowiak, Martha; Hurst, Janet; Bhatt, Ram; Fox, Dennis S.

    2014-01-01

    This paper describes recent development of environmental barrier coatings on SiC/SiC ceramic matrix composites. The creep and fatigue behavior at aggressive long-term high temperature conditions have been evaluated and highlighted. Thermal conductivity and high thermal gradient cyclic durability of environmental barrier coatings have been evaluated. The damage accumulation and complex stress-strain behavior environmental barrier coatings on SiCSiC ceramic matrix composite turbine airfoil subelements during the thermal cyclic and fatigue testing of have been also reported.

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

    NARCIS (Netherlands)

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

    2009-01-01

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

  13. Nationally Certified School Psychologists' use and reported barriers to using evidence-based interventions in schools: the influence of graduate program training and education.

    Science.gov (United States)

    Hicks, Taylor B; Shahidullah, Jeffrey D; Carlson, John S; Palejwala, Mohammed H

    2014-12-01

    The purpose of this study was to empirically investigate Nationally Certified School Psychologists' (NCSP) training in and use of evidence-based interventions (EBIs) for child behavior concerns as well as their reported implementation barriers. A modified Tailored Design Method (TDM; Dillman, Smyth, & Christian, 2009) using up to four mail-based participant contacts was used to obtain survey data (72% usable response rate; n = 392) from a randomly selected national sample of 548 currently practicing NCSPs. Lack of time was rated as the most serious barrier to behavioral EBI implementation, followed by a lack of necessary resources, and financial constraints. Nearly three-quarters (71%) of respondents reported a perceived inadequacy of graduate program training in behavioral EBIs, with a statistically significant difference found between respondents who attended American Psychological Association (APA)-accredited/National Association of School Psychologists (NASP)-approved programs and those who did not. These findings highlight the significant barriers school psychologists encounter when attempting to implement behavioral EBIs within applied practice, as well as the importance of graduate program training in implementation science. Implications for training, practice, and research are discussed. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  14. Aging and Phase Stability of Waste Package Outer Barrier

    Energy Technology Data Exchange (ETDEWEB)

    Tammy S. Edgecumble Summers

    2001-08-23

    This Analysis Model Report (AMR) was prepared in accordance with the Work Direction and Planning Document, ''Aging and Phase Stability of Waste Package Outer Barrier'' (CRWMS M&O 1999a). ICN 01 of this AMR was developed following guidelines provided in TWP-MGR-MD-000004 REV 01, ''Technical Work Plan for: Integrated Management of Technical Product Input Department'' (BSC 2001, Addendum B). It takes into consideration the Enhanced Design Alternative II (EDA II), which has been selected as the preferred design for the Engineered Barrier System (EBS) by the License Application Design Selection (LADS) program team (CRWMS M&O 1999b). The salient features of the EDA II design for this model are a waste package (WP) consisting of an outer barrier of Alloy 22 and an inner barrier of Type 316L stainless steel. This report provides information on the phase stability of Alloy 22l, the current waste-package-outer-barrier (WPOB) material. These phase stability studies are currently divided into three general areas: (1) Long-range order reactions; (2) Intermetallic and carbide precipitation in the base metal; and (3) Intermetallic and carbide precipitation in welded samples.

  15. STI Services for Adolescents and Youth in Low and Middle Income Countries: Perceived and Experienced Barriers to Accessing Care

    Science.gov (United States)

    Newton-Levinson, Anna; Leichliter, Jami S.; Chandra-Mouli, Venkatraman

    2017-01-01

    Access to sexual and reproductive health services (SRH) is vital for sexually active adolescents; yet, their SRH care needs are often unmet. We conducted a qualitative systematic review of mixed methods studies to assess adolescent and provider views of barriers to seeking appropriate medical care for sexually transmitted infection (STI) services for adolescents. We searched peer-reviewed literature for studies published between 2001–2014 with a study population of youth (aged 10–24 years) and/or health service providers. Nineteen studies were identified for inclusion from fifteen countries. Thematic analyses identified key themes across the studies. Findings suggest that youth lacked knowledge about STIs and services. Additionally, youth experienced barriers related to service availability and a lack of integration of services. The most reported barriers were related to acceptability of services. Youth reported avoiding services or having confidentiality concerns based on provider demographics and some behaviors. Finally, experiences of shame and stigma were common barriers to seeking care. Adolescents in low and middle income countries experience significant barriers in obtaining STI and SRH services. Improving uptake may require efforts to address clinic systems and provider attitudes, including confidentiality issues. Moreover, addressing barriers to STI services may require addressing cultural norms related to adolescent sexuality. PMID:27338664

  16. Facilitators and barriers to discussing HIV prevention with adolescents: perspectives of HIV-infected parents.

    Science.gov (United States)

    Edwards, Laura L; Reis, Janet S; Weber, Kathleen M

    2013-08-01

    We examined HIV-infected parents' conversations about HIV prevention with their uninfected children, including what facilitated or hindered communication. Parents with HIV/AIDS (n = 90) who had children aged 10 to 18 years were recruited for a mixed method study from 2009 to 2010. Interviews assessed facilitators and barriers to discussing HIV prevention. A questionnaire identified the frequency and content of conversations, parental confidence level, and perceived importance of discussing preventive topics. Eighty-one percent of parents reported "sometimes" or "often" communicating about HIV prevention. A subset of parents found these conversations difficult; 44% indicated their desire for support. Facilitators to communication included utilizing support, focusing on the benefits of talking, and having a previous relationship with one's child. Barriers to discussions included fear of negative consequences, living in denial, and lacking a parental role model who discussed safer sex. Parents varied as to how they believed their HIV status affected communication. Those who did not disclose their HIV status to their children reported less frequent communication; self-efficacy partially mediated this relationship. Findings highlighted the need for communication skills training that support HIV-infected parents in their efforts to discuss HIV-related information with adolescents.

  17. Barriers and facilitators of evidence-based practice in pediatric behavioral sleep care: qualitative analysis of the perspectives of health professionals.

    Science.gov (United States)

    Boerner, Katelynn E; Coulombe, J Aimée; Corkum, Penny

    2015-01-01

    Behavioral sleep problems are highly prevalent among young and school-aged children. Despite strong evidence for effective interventions, few children receive evidence-based care. In this study, 124 Canadian health professionals answered open-ended questions regarding barriers and facilitators of their provision of evidence-based behavioral sleep-related care, and responses were analyzed for content. Responses represented issues at an individual practice level, as well as broader systemic issues. The most frequently reported barrier and facilitator related to knowledge, training, and education. Other barriers included lack of time and institutional support, and facilitators included supportive sleep attitudes and beliefs. This study may inform the design of education programs for health professionals, and provides support for broader systems-level initiatives targeted at increasing evidence-based practice.

  18. Barriers to adherence in adolescents and young adults with cystic fibrosis

    DEFF Research Database (Denmark)

    Bregnballe, Vibeke; Schiøtz, Peter Oluf; Boisen, Kirsten A

    2011-01-01

    Treatment adherence is crucial in patients with cystic fibrosis, but poor adherence is a problem, especially during adolescence. Identification of barriers to treatment adherence and a better understanding of how context shapes barriers is of great importance in the disease. Adolescent reports of...... of barriers to adherence have been studied, but studies of their parents' experience of such barriers have not yet been carried out. The aim of the present study was to explore barriers to treatment adherence identified by young patients with cystic fibrosis and by their parents....

  19. Electron transmission through a periodically driven graphene magnetic barrier

    Energy Technology Data Exchange (ETDEWEB)

    Biswas, R., E-mail: rbiswas.pkc@gmail.com [Department of Physics, P. K. College, Contai, Purba Medinipur, West Bengal – 721401 (India); Maiti, S. [Ajodhya Hills G.S.A.T High School, Ajodhya, Purulia, West Bengal – 723152 (India); Mukhopadhyay, S. [Purulia Zilla School, Dulmi Nadiha, Purulia, West Bengal – 723102 (India); Sinha, C. [Department of Physics, P. K. College, Contai, Purba Medinipur, West Bengal – 721401 (India); Department of Theoretical Physics, Indian Association for the Cultivation of Science, Jadavpur – 700032 (India)

    2017-05-10

    Electronic transport through graphene magnetic barriers is studied theoretically in presence of an external time harmonic scalar potential in the framework of non-perturbative Landau–Floquet Formalism. The oscillating field mostly suppresses the transmission for rectangular magnetic barrier structure and exhibits the Fano resonance for multiphoton processes due to the presence of bound state inside the barrier. While, for a pair of delta function barriers of larger separation, the oscillating potential suppresses the usual Fabry–Perot oscillations in the transmission and a new type of asymmetric Fano resonance is noted for smaller separation, occurring due to extended states between the barriers. - Highlights: • Tunnelling of the Dirac Fermions through oscillating pure magnetic barriers is reported for the first time. • The high energy transmission through a graphene magnetic barrier is suppressed by the application of time periodic modulation. • Suppression of the Fabry Perot transmission is noted due to the application of an external time harmonic potential. • Two kinds of the Fano resonances are noted in transmission through a pair of modulated δ-function magnetic barriers.

  20. Modeling Safety Barriers and Defense in Depth with Mulitlevel Flow Modeling

    DEFF Research Database (Denmark)

    Lind, Morten

    2012-01-01

    in MFM is a barrier function. It is shown that other barrier types can be represented andthat their combination into barrier chains may be used to analyze and design levels of safety in automated processes.Suggestion for further research on barrier modeling with MFM are included....

  1. Barriers to the Identification and Management of Psychosocial Problems: Changes from 2004 to 2013

    Science.gov (United States)

    Horwitz, Sarah McCue; Storfer-Isser, Amy; Kerker, Bonnie D.; Szilagyi, Moira; Garner, Andrew; O’Connor, Karen G.; Hoagwood, Kimberly E.; Stein, Ruth E.K.

    2015-01-01

    Objective Pediatricians report many barriers to caring for children with mental health (MH) problems. The American Academy of Pediatrics (AAP) has focused attention on MH problems but the impact on perceived barriers is unknown. We examined whether perceived barriers and their correlates changed from 2004 to 2013. Methods In 2004, 832/1600 (52%) and in 2013, 594/1617 (36.7%) of randomly selected AAP members surveyed responded to Periodic Surveys, answering questions about socio-demographics, practice characteristics, and 7 barriers to identifying, treating/managing and referring child/adolescent MH problems. To reduce non-response bias, weighted descriptive and logistic regression analyses were conducted. Results Lack of training in treatment of child MH problems (~65%) and lack of confidence treating children with counseling (~60%) did not differ across surveys. Five barriers (lack of training in identifying MH problems, lack of confidence diagnosing, lack of confidence treating with medications, inadequate reimbursement and lack of time) were less frequently endorsed in 2013 (all p<.01), although lack of time was still endorsed by 70% in 2013. In 2004, 34% of pediatricians endorsed 6 or 7 barriers compared to 26% in 2013 (p<.005). Practicing general pediatrics exclusively was associated with endorsing 6 or 7 barriers in both years (p <.001). Conclusion Although fewer barriers were endorsed in 2013, most pediatricians believe that they have inadequate training in treating child MH problems, a lack of confidence to counsel children, and limited time for these problems. These findings suggest significant barriers still exist, highlighting the need for improved developmental and behavioral pediatrics training. What’s New This study compares reported barriers from the 2004 and 2013 Periodic Surveys. Although pediatricians report fewer barriers in 2013, 66% continue to report lack of training in counseling or medication of children with MH problems, suggesting

  2. Perceived barriers to physical activity among Nigerian stroke survivors

    African Journals Online (AJOL)

    The four most reported common barriers among stroke survivors were access to exercise facilities (95.0 %), being embarrassed to exercise (94.2%), economic cost demands of exercise (94.2 %) and notion that people in exercise clothes look funny (94.2%) respectively. There were no significant differences found in barriers ...

  3. Barriers to human papillomavirus vaccination among US adolescents: a systematic review of the literature.

    Science.gov (United States)

    Holman, Dawn M; Benard, Vicki; Roland, Katherine B; Watson, Meg; Liddon, Nicole; Stokley, Shannon

    2014-01-01

    Since licensure of the human papillomavirus (HPV) vaccine in 2006, HPV vaccine coverage among US adolescents has increased but remains low compared with other recommended vaccines. To systematically review the literature on barriers to HPV vaccination among US adolescents to inform future efforts to increase HPV vaccine coverage. We searched PubMed and previous review articles to identify original research articles describing barriers to HPV vaccine initiation and completion among US adolescents. Only articles reporting data collected in 2009 or later were included. Findings from 55 relevant articles were summarized by target populations: health care professionals, parents, underserved and disadvantaged populations, and males. Health care professionals cited financial concerns and parental attitudes and concerns as barriers to providing the HPV vaccine to patients. Parents often reported needing more information before vaccinating their children. Concerns about the vaccine's effect on sexual behavior, low perceived risk of HPV infection, social influences, irregular preventive care, and vaccine cost were also identified as potential barriers among parents. Some parents of sons reported not vaccinating their sons because of the perceived lack of direct benefit. Parents consistently cited health care professional recommendations as one of the most important factors in their decision to vaccinate their children. Continued efforts are needed to ensure that health care professionals and parents understand the importance of vaccinating adolescents before they become sexually active. Health care professionals may benefit from guidance on communicating HPV recommendations to patients and parents. Further efforts are also needed to reduce missed opportunities for HPV vaccination when adolescents interface with the health care system. Efforts to increase uptake should take into account the specific needs of subgroups within the population. Efforts that address system

  4. Efficacy and flexibility impact perceived adherence barriers in pediatric kidney post-transplantation.

    Science.gov (United States)

    Guilfoyle, Shanna M; Goebel, Jens W; Pai, Ahna L H

    2011-03-01

    The alarming rates of medication nonadherence and its detrimental effect on long-term graft survival in pediatric kidney transplantation has called attention to identifying modifiable factors that promote better adherence and subsequent transplant outcomes. In a sample of 45 adolescent kidney transplant recipients (14.7 ± 3.3 years, 77.8% Caucasian, 39.5% female) and their primary caregivers, study aims included: 1) identifying sociodemographic and medical correlates of both caregiver- and patient-reported general family functioning (i.e., efficacy, flexibility, and communication) and 2) determining the unique contributions of these family functioning indices to perceived posttransplant adherence barriers. During a routine clinic visit, caregivers completed a sociodemographic form and questionnaire on general family functioning. Both caregivers and the adolescents completed a measure on perceived medication adherence barriers. Data identified household income and family structure as persistent correlates of family functioning. Familial efficacy and flexibility contributed significant variance to perceived adherence barriers. Family-based interventions enhancing modifiable family factors, such as flexibility and efficacy, in overcoming medication adherence barriers would likely promote more optimal health outcomes in the pediatric kidney transplant population. (c) 2011 APA, all rights reserved

  5. Overview Of The U.S. Department Of Energy And Nuclear Regulatory Commission Performance Assessment Approaches: Cementitious Barriers Partnership

    International Nuclear Information System (INIS)

    Langton, C.; Burns, H.

    2009-01-01

    Engineered barriers including cementitious barriers are used at sites disposing or contaminated with low-level radioactive waste to enhance performance of the natural environment with respect to controlling the potential spread of contaminants. Drivers for using cementitious barriers include: high radionuclide inventory, radionuclide characteristics (e.g., long half-live, high mobility due to chemical form/speciation, waste matrix properties, shallow water table, and humid climate that provides water for leaching the waste). This document comprises the first in a series of reports being prepared for the Cementitious Barriers Partnership. The document is divided into two parts which provide a summary of: (1) existing experience in the assessment of performance of cementitious materials used for radioactive waste management and disposal and (2) sensitivity and uncertainty analysis approaches that have been applied for assessments. Each chapter is organized into five parts: Introduction, Regulatory Considerations, Specific Examples, Summary of Modeling Approaches and Conclusions and Needs. The objective of the report is to provide perspective on the state of the practice for conducting assessments for facilities involving cementitious barriers and to identify opportunities for improvements to the existing approaches. Examples are provided in two contexts: (1) performance assessments conducted for waste disposal facilities and (2) performance assessment-like analyses (e.g., risk assessments) conducted under other regulatory regimes. The introductory sections of each section provide a perspective on the purpose of performance assessments and different roles of cementitious materials for radioactive waste management. Significant experience with assessments of cementitious materials associated with radioactive waste disposal concepts exists in the US Department of Energy Complex and the commercial nuclear sector. Recently, the desire to close legacy facilities has created

  6. OVERVIEW OF THE U.S. DEPARTMENT OF ENERGY AND NUCLEAR REGULATORY COMMISSION PERFORMANCE ASSESSMENT APPROACHES: CEMENTITIOUS BARRIERS PARTNERSHIP

    Energy Technology Data Exchange (ETDEWEB)

    Langton, C.; Burns, H.

    2009-05-29

    Engineered barriers including cementitious barriers are used at sites disposing or contaminated with low-level radioactive waste to enhance performance of the natural environment with respect to controlling the potential spread of contaminants. Drivers for using cementitious barriers include: high radionuclide inventory, radionuclide characteristics (e.g., long half-live, high mobility due to chemical form/speciation, waste matrix properties, shallow water table, and humid climate that provides water for leaching the waste). This document comprises the first in a series of reports being prepared for the Cementitious Barriers Partnership. The document is divided into two parts which provide a summary of: (1) existing experience in the assessment of performance of cementitious materials used for radioactive waste management and disposal and (2) sensitivity and uncertainty analysis approaches that have been applied for assessments. Each chapter is organized into five parts: Introduction, Regulatory Considerations, Specific Examples, Summary of Modeling Approaches and Conclusions and Needs. The objective of the report is to provide perspective on the state of the practice for conducting assessments for facilities involving cementitious barriers and to identify opportunities for improvements to the existing approaches. Examples are provided in two contexts: (1) performance assessments conducted for waste disposal facilities and (2) performance assessment-like analyses (e.g., risk assessments) conducted under other regulatory regimes. The introductory sections of each section provide a perspective on the purpose of performance assessments and different roles of cementitious materials for radioactive waste management. Significant experience with assessments of cementitious materials associated with radioactive waste disposal concepts exists in the US Department of Energy Complex and the commercial nuclear sector. Recently, the desire to close legacy facilities has created

  7. Learning from social media: utilizing advanced data extraction techniques to understand barriers to breast cancer treatment.

    Science.gov (United States)

    Freedman, Rachel A; Viswanath, Kasisomayajula; Vaz-Luis, Ines; Keating, Nancy L

    2016-07-01

    Past examinations of breast cancer treatment barriers have typically included registry, claims-based, and smaller survey studies. We examined treatment barriers using a novel, comprehensive, social media analysis of online, candid discussions about breast cancer. Using an innovative toolset to search postings on social networks, message boards, patient communities, and topical sites, we performed a large-scale qualitative analysis. We examined the sentiments and barriers expressed about breast cancer treatments by Internet users during 1 year (2/1/14-1/31/15). We categorized posts based on thematic patterns and examined trends in discussions by race/ethnicity (white/black/Hispanic) when this information was available. We identified 1,024,041 unique posts related to breast cancer treatment. Overall, 57 % of posts expressed negative sentiments. Using machine learning software, we assigned treatment barriers for 387,238 posts (38 %). Barriers included emotional (23 % of posts), preferences and spiritual/religious beliefs (21 %), physical (18 %), resource (15 %), healthcare perceptions (9 %), treatment processes/duration (7 %), and relationships (7 %). Black and Hispanic (vs. white) users more frequently reported barriers related to healthcare perceptions, beliefs, and pre-diagnosis/diagnosis organizational challenges and fewer emotional barriers. Using a novel analysis of diverse social media users, we observed numerous breast cancer treatment barriers that differed by race/ethnicity. Social media is a powerful tool, allowing use of real-world data for qualitative research, capitalizing on the rich discussions occurring spontaneously online. Future research should focus on how to further employ and learn from this type of social intelligence research across all medical disciplines.

  8. Identification of Barriers to Stroke Awareness and Risk Factor Management Unique to Hispanics

    Directory of Open Access Journals (Sweden)

    Marina Martinez

    2015-12-01

    Full Text Available Barriers to risk factor control may differ by race/ethnicity. The goal of this study was to identify barriers to stroke awareness and risk factor management unique to Hispanics as compared to non-Hispanic whites (NHWs. We performed a prospective study of stroke patients from an academic Stroke Center in Arizona and surveyed members of the general community. Questionnaires included: the Duke Social Support Index (DSSI, the Multidimensional Health Locus of Control (MHLC Scale, a stroke barriers questionnaire, and a Stroke Awareness Test. Of 145 stroke patients surveyed (72 Hispanic; 73 NHW, Hispanics scored lower on the Stroke Awareness Test compared to NHWs (72.5% vs. 79.1%, p = 0.029. Hispanic stroke patients also reported greater barriers related to medical knowledge, medication adherence, and healthcare access (p < 0.05 for all. Hispanics scored higher on the “powerful others” sub-scale (11.3 vs. 10, p < 0.05 of the MHLC. Of 177 members of the general public surveyed, Hispanics had lower stroke awareness compared to NHWs and tended to have lower awareness than Hispanic stroke patients. These results suggest that Hispanic stroke patients perceive less control over their health, experience more healthcare barriers, and demonstrate lower rates of stroke literacy. Interventions for stroke prevention and education in Hispanics should address these racial/ethnic differences in stroke awareness and barriers to risk factor control.

  9. Barriers to access and minority ethnic carers' satisfaction with social care services in the community: a systematic review of qualitative and quantitative literature

    Science.gov (United States)

    Greenwood, Nan; Habibi, Ruth; Smith, Raymond; Manthorpe, Jill

    2015-01-01

    As populations age, the numbers of carers overall and numbers of carers from minority ethnic groups in particular are rising. Evidence suggests that carers from all sections of the community and particularly carers from minority groups often fail to access care services. This may relate to barriers in accessing services and service dissatisfaction. The aim of this systematic review was to identify and summarise minority ethnic carers' perceptions of barriers to accessing community social care services and their satisfaction with these services if accessed. The following databases were searched from their start until July 2013: Social Care Online, Social Policy and Research, Scopus, PsychINFO, HMIC, ASSIA, MEDLINE, Embase, CINAHL Plus and AMED. Thirteen studies met the inclusion criteria. Most investigated either barriers to access or satisfaction levels, although three explored both. Only 4 studies investigated minority ethnic carers' satisfaction with social care, although 12 studies reported perceived barriers to accessing services. Few studies compared minority ethnic carers' perceptions with majority ethnic groups, making it difficult to identify issues specific to minority groups. Most barriers described were potentially relevant to all carers, irrespective of ethnic group. They included attitudinal barriers such as not wanting to involve outsiders or not seeing the need for services and practical barriers such as low awareness of services and service availability. Issues specific to minority ethnic groups included language barriers and concerns about services' cultural or religious appropriateness. Studies investigating satisfaction with services reported a mixture of satisfaction and dissatisfaction. Barriers common to all groups should not be underestimated and a better understanding of the relationship between perceived barriers to accessing services and dissatisfaction with services is needed before the experiences of all carers can be improved. PMID

  10. Roll-to-roll vacuum deposition of barrier coatings

    CERN Document Server

    Bishop, Charles A

    2015-01-01

    It is intended that the book will be a practical guide to provide any reader with the basic information to help them understand what is necessary in order to produce a good barrier coated web or to improve the quality of any existing barrier product. After providing an introduction, where the terminology is outlined and some of the science is given (keeping the mathematics to a minimum), including barrier testing methods, the vacuum deposition process will be described. In theory a thin layer of metal or glass-like material should be enough to convert any polymer film into a perfect barrier material. The reality is that all barrier coatings have their performance limited by the defects in the coating. This book looks at the whole process from the source materials through to the post deposition handling of the coated material. This holistic view of the vacuum coating process provides a description of the common sources of defects and includes the possible methods of limiting the defects. This enables readers...

  11. Measuring Perceived Barriers to Physical Activity in Adolescents.

    Science.gov (United States)

    Gunnell, Katie E; Brunet, Jennifer; Wing, Erin K; Bélanger, Mathieu

    2015-05-01

    Perceived barriers to moderate-to-vigorous physical activity (PA) may contribute to the low rates of moderate-to-vigorous PA in adolescents. We examined the psychometric properties of scores from the perceived barriers to moderate-to-vigorous PA scale (PB-MVPA) by examining composite reliability and validity evidence based on the internal structure of the PB-MVPA and relations with other variables. This study was a cross-sectional analysis of data collected in 2013 from adolescents (N = 507; Mage = 12.40, SD = .62) via self-report scales. Using exploratory and confirmatory factor analyses, we found that perceived barriers were best represented as two factors representing internal (e.g., "I am not interested in physical activity") and external (e.g., "I need equipment I don't have") dimensions. Composite reliability was over .80. Using multiple regression to examine the relationship between perceived barriers and moderate-to-vigorous PA, we found that perceived internal barriers were inversely related to moderate-to-vigorous PA (β = -.32, p barriers (p > .26). The PB-MVPA scale demonstrated evidence of score reliability and validity. To improve the understanding of the impact of perceived barriers on moderate-to- vigorous PA in adolescents, researchers should examine internal and external barriers separately.

  12. What are the barriers to initiating end-of-life conversations with patients in the last year of life?

    Science.gov (United States)

    Travers, Alice; Taylor, Vanessa

    2016-09-02

    Improving end of life care is a national imperative. Unsatisfactory care persists particularly in acute hospitals, with shortcomings, variability in communication and advance care planning identified as fundamental issues. This review explored the literature to identify what is known about the barriers to initiating end-of-life conversations with patients from the perspective of doctors and nurses in the acute hospital setting. Six electronic databases were searched for potentially relevant records published between 2008 and 2015. Studies were included if the authors reported on barriers to discussing end of life with families or patients as described by doctors or nurses in hospital settings, excluding critical care. Of 1267 potentially relevant records, 12 were included in the review. Although there is limited high-quality evidence available, several barriers were identified. Recurrent themes within the literature related to a lack of education and training, difficulty in prognostication, cultural differences and perceived reluctance of the patient or family. This study illustrated that, in addressing barriers to communication, consideration needs to be extended to include how to embed good communication practice between patients and health professionals into the culture of this setting. Board level commitment is required to raise awareness of, and familiarity with, policies and protocols concerning communication and end-of-life care. Communication training should include practical skills and tools, opportunities to explore the personal beliefs of practitioners and managing their emotions, opportunities to analyse the local organisational (physical and social environment) and team barriers.

  13. Schottky barrier MOSFET systems and fabrication thereof

    Science.gov (United States)

    Welch, J.D.

    1997-09-02

    (MOS) device systems-utilizing Schottky barrier source and drain to channel region junctions are disclosed. Experimentally derived results which demonstrate operation of fabricated N-channel and P-channel Schottky barrier (MOSFET) devices, and of fabricated single devices with operational characteristics similar to (CMOS) and to a non-latching (SRC) are reported. Use of essentially non-rectifying Schottky barriers in (MOS) structures involving highly doped and the like and intrinsic semiconductor to allow non-rectifying interconnection of, and electrical accessing of device regions is also disclosed. Insulator effected low leakage current device geometries and fabrication procedures therefore are taught. Selective electrical interconnection of drain to drain, source to drain, or source to source, of N-channel and/or P-channel Schottky barrier (MOSFET) devices formed on P-type, N-type and Intrinsic semiconductor allows realization of Schottky Barrier (CMOS), (MOSFET) with (MOSFET) load, balanced differential (MOSFET) device systems and inverting and non-inverting single devices with operating characteristics similar to (CMOS), which devices can be utilized in modulation, as well as in voltage controlled switching and effecting a direction of rectification. 89 figs.

  14. Mucus as a Barrier to Drug Delivery

    DEFF Research Database (Denmark)

    Bøgh, Marie; Nielsen, Hanne Mørck

    2015-01-01

    Viscoelastic mucus lines all mucosal surfaces of the body and forms a potential barrier to mucosal drug delivery. Mucus is mainly composed of water and mucins; high-molecular weight glycoproteins forming an entangled network. Consequently, mucus forms a steric barrier and due to its negative charge...... barrier to drug delivery. Current knowledge of mucus characteristics and barrier properties, as achieved by state-of-the-art methodologies, is the topic of this MiniReview emphasizing the gastrointestinal mucus and an overall focus on oral drug delivery. Cell culture-based in vitro models are well......, studies of peptide and protein drug diffusion in and through mucus and studies of mucus-penetrating nanoparticles are included to illustrate the mucus as a potentially important barrier to obtain sufficient bioavailability of orally administered drugs, and thus an important parameter to address...

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

    OpenAIRE

    Sklet, Snorre; Hauge, Stein

    2004-01-01

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

  16. Technical Barriers, Gaps, and Opportunities Related to Home Energy Upgrade Market Delivery

    Energy Technology Data Exchange (ETDEWEB)

    Bianchi, M. V. A.

    2011-11-01

    This report outlines the technical barriers, gaps, and opportunities that arise in executing home energy upgrade market delivery approaches, as identified through research conducted by the U.S. Department of Energy's Building America program. The objective of this report is to outline the technical1 barriers, gaps, and opportunities that arise in executing home energy upgrade market delivery approaches, as identified through research conducted by the U.S. Department of Energy's (DOE) Building America program. This information will be used to provide guidance for new research necessary to enable the success of the approaches. Investigation for this report was conducted via publications related to home energy upgrade market delivery approaches, and a series of interviews with subject matter experts (contractors, consultants, program managers, manufacturers, trade organization representatives, and real estate agents). These experts specified technical barriers and gaps, and offered suggestions for how the technical community might address them. The potential benefits of home energy upgrades are many and varied: reduced energy use and costs; improved comfort, durability, and safety; increased property value; and job creation. Nevertheless, home energy upgrades do not comprise a large part of the overall home improvement market. Residential energy efficiency is the most complex climate intervention option to deliver because the market failures are many and transaction costs are high (Climate Change Capital 2009). The key reasons that energy efficiency investment is not being delivered are: (1) The opportunity is highly fragmented; and (2) The energy efficiency assets are nonstatus, low-visibility investments that are not properly valued. There are significant barriers to mobilizing the investment in home energy upgrades, including the 'hassle factor' (the time and effort required to identify and secure improvement works), access to financing, and the

  17. Motivators and Barriers to Reducing Sedentary Behavior Among Overweight and Obese Older Adults.

    Science.gov (United States)

    Greenwood-Hickman, Mikael Anne; Renz, Anne; Rosenberg, Dori E

    2016-08-01

    To explore individual, social, environmental, and program-related motivators, barriers, and impacts of sedentary behavior (SB) reduction among a group of overweight and obese older adults aged 60 and older. Semistructured interviews were conducted with 24 participants following a SB reduction intervention. Transcripts from these interviews were iteratively coded by a team, and key themes were defined and refined guided by the social-ecological framework. Motivators included the desire to improve health, newly acquired awareness of SB, the ease of incorporating SB reduction into current lifestyle, an adaptable environment, and the use of reminders. Barriers included existing health conditions, enjoyment of sedentary activities, unadaptable environments, fatigue, and difficulty understanding SB reduction as distinct from physical activity (PA). Participants reported impacts on physical and mental health and changes in awareness, exercise, and daily activity. Although in many ways motivators and barriers to reducing SB are similar to those of PA, SB interventions have special considerations and may ultimately be easier for some individuals to incorporate into their lifestyle. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  18. Design of barrier coatings on kink-resistant peripheral nerve conduits

    Directory of Open Access Journals (Sweden)

    Basak Acan Clements

    2016-02-01

    Full Text Available Here, we report on the design of braided peripheral nerve conduits with barrier coatings. Braiding of extruded polymer fibers generates nerve conduits with excellent mechanical properties, high flexibility, and significant kink-resistance. However, braiding also results in variable levels of porosity in the conduit wall, which can lead to the infiltration of fibrous tissue into the interior of the conduit. This problem can be controlled by the application of secondary barrier coatings. Using a critical size defect in a rat sciatic nerve model, the importance of controlling the porosity of the nerve conduit walls was explored. Braided conduits without barrier coatings allowed cellular infiltration that limited nerve recovery. Several types of secondary barrier coatings were tested in animal studies, including (1 electrospinning a layer of polymer fibers onto the surface of the conduit and (2 coating the conduit with a cross-linked hyaluronic acid-based hydrogel. Sixteen weeks after implantation, hyaluronic acid-coated conduits had higher axonal density, displayed higher muscle weight, and better electrophysiological signal recovery than uncoated conduits or conduits having an electrospun layer of polymer fibers. This study indicates that braiding is a promising method of fabrication to improve the mechanical properties of peripheral nerve conduits and demonstrates the need to control the porosity of the conduit wall to optimize functional nerve recovery.

  19. Biointrusion test plan for the Permanent Isolation Surface Barrier Prototype

    International Nuclear Information System (INIS)

    Link, S.O.; Cadwell, L.L.; Brandt, C.A.; Downs, J.L.; Rossi, R.E.; Gee, G.W.

    1994-04-01

    This document provides a testing and monitoring plan for the biological component of the prototype barrier slated for construction at the Hanford Site. The prototype barrier is an aboveground structure engineered to demonstrate the basic features of an earthen cover system. It is designed to permanently isolate waste from the biosphere. The features of the barrier include multiple layers of soil and rock materials and a low-permeability asphalt sublayer. The surface of the barrier consists of silt loam soil, covered with plants. The barrier sides are reinforced with rock or coarse earthen-fill to protect against wind and water erosion. The sublayers inhibit plant and animal intrusion and percolation of water. A series of tests will be conducted on the prototype barrier over the next several years to evaluate barrier performance under extreme climatic conditions. Plants and animals will play a significant role in the hydrologic and water and wind erosion characteristics of the prototype barrier. Studies on the biological component of the prototype barrier will include work on the initial revegetation of the surface, continued monitoring of the developing plant community, rooting depth and dispersion in the context of biointrusion potential, the role of plants in the hydrology of the surface and toe regions of the barrier, the role of plants in stabilizing the surface against water and wind erosion, and the role of burrowing animals in the hydrology and water and wind erosion of the barrier

  20. InGaP Heterojunction Barrier Solar Cells

    Science.gov (United States)

    Welser, Roger E. (Inventor)

    2014-01-01

    A new solar cell structure called a heterojunction barrier solar cell is described. As with previously reported quantum-well and quantum-dot solar cell structures, a layer of narrow band-gap material, such as GaAs or indium-rich InGaP, is inserted into the depletion region of a wide band-gap PN junction. Rather than being thin, however, the layer of narrow band-gap material is about 400-430 nm wide and forms a single, ultrawide well in the depletion region. Thin (e.g., 20-50 nm), wide band-gap InGaP barrier layers in the depletion region reduce the diode dark current. Engineering the electric field and barrier profile of the absorber layer, barrier layer, and p-type layer of the PN junction maximizes photogenerated carrier escape. This new twist on nanostructured solar cell design allows the separate optimization of current and voltage to maximize conversion efficiency.

  1. "Left to my own devices, I don't know": using theory and patient-reported barriers to move from physical activity recommendations to practice.

    Science.gov (United States)

    Ziebart, C; McArthur, C; Lee, L; Papaioannou, A; Laprade, J; Cheung, A M; Jain, R; Giangregorio, L

    2018-05-01

    Knowledge exchange with community-dwelling individuals across Ontario revealed barriers to implementation of physical activity recommendations that reflected capability, opportunity, and motivation; barriers unique to individuals with osteoporosis include fear of fracturing, trust in providers, and knowledge of exercise terminology. Using the Behaviour Change Wheel, we identified interventions (training, education, modeling) and policy categories (communication/marketing, guidelines, service provision). Physical activity recommendations exist for individuals with osteoporosis; however, to change behavior, we must address barriers and facilitators to their implementation. The purposes of this project are (1) to identify barriers to and facilitators of uptake of disease-specific physical activity recommendations (2) to use the findings to identify behavior change strategies using the Behaviour Change Wheel (BCW). Focus groups and semi-structured interviews were conducted with community-dwelling individuals attending osteoporosis-related programs or education sessions in Ontario. They were stratified by geographic area, urban/rural, and gender, and transcribed verbatim. Two researchers coded data and identified emerging themes. Using the Behaviour Change Wheel framework, themes were categorized into capability, opportunity, and motivation, and interventions were identified. Two hundred forty community-dwelling individuals across Ontario participated (mean ± SD age = 72 ± 8.28). Barriers were as follows: capability: disease-related symptoms hinder exercise and physical activity participation, lack of exercise-related knowledge, low exercise self-efficacy; opportunity: access to exercise programs that meet needs and preferences, limited resources and time, physical activity norms and preferences; motivation: incentives to exercise, fear of fracturing, trust in exercise providers. Interventions selected were training, education, and modeling. Policy categories

  2. Apparent Barrier Height in Scanning Tunneling Microscopy Revisited

    DEFF Research Database (Denmark)

    Olesen, L.; Brandbyge, Mads; Sørensen, Mads Reinholdt

    1996-01-01

    The apparent barrier height phi(ap), that is, the rate of change of the logarithm of the conductance with tip-sample separation in a scanning tunneling microscope (STM), has been measured for Ni, Pt, and Au single crystal surfaces. The results show that phi(ap) is constant until point contact...... is reached rather than decreasing at small tunneling gap distances, as previously reported. The findings for phi(ap) can be accounted for theoretically by including the relaxations of the tip-surface junction in an STM due to the strong adhesive forces at close proximity. These relaxation effects are shown...

  3. 40 CFR 60.2780 - What must I include in the deviation report?

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 6 2010-07-01 2010-07-01 false What must I include in the deviation... PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions Guidelines and... the deviation report? In each report required under § 60.2775, for any pollutant or parameter that...

  4. Perceived barriers to physical activity among Polish adolescents.

    Science.gov (United States)

    Jodkowska, Maria; Mazur, Joanna; Oblacińska, Anna

    2015-01-01

    To identify barriers to physical activity (PA) for adolescents according to the gender and age and examine the association between these barriers and youths' physical activity. 3346 students aged 10-16 years (1759 girls) took part in the cross-sectional, nationally representative study. For this paper the dataset was created from adolescents who reported perceived barriers to PA, N = 2300, (1259 girls), range 13-16 years. Barriers and physical activity (MVPA) were analysed for all participants, as well as by gender, age group and place of residence. Multiple regression analysis was used to examine the relationships between perceived barriers and physical inactivity for all and than separately for boys and girls. Lack of energy, lack of time and lack of support were three of the five barriers reported by more than 40% of adolescents, statistically more likely by girls than boys and older youth than younger. For boys - lack of time (OR = 2.56; CI = 1.66-3.96), lack of skills (OR = 2.35; CI = 1.94-3.95), lack of willpower (OR = 1.71, CI = 1.05-2.80) and lack of support (OR = 1.64, CI = 1.11-2.41) were the predictors contributing to low level of PA. For girls lack of skills (OR = 3.16, CI = 1.62-6.18), lack of energy (OR = 1.84, CI = 1.14-2.96), lack of support (OR = 1.64, CI = 1.07-2.54) and lack of time (OR = 1.61,CI = 1.00-2.60) were positively and statistically significant associated with physical inactivity. 1. Perceived barriers to physical activity among adolescents have strong negative impact on recommended PA level. For girls lack of skills is the strongest predictor of low PA, for boys - lack of time. 2. Identification more precisely barriers to physical activity among adolescents will enable to developed more effective interventions in high-risk populations.

  5. Evaluation studies of EMA implementation’s barriers in business practice

    Directory of Open Access Journals (Sweden)

    Petra Mísařová

    2010-01-01

    Full Text Available Environmental Management Accounting (EMA is a system, which collects, records, evaluates and disseminates information about environmentally induced financial impacts and environmental impacts of the system itself. EMA is an important source of information for decision-making processes such as management of an organization, for EMS or environmental reporting. Identified barriers were included in the study which was conducted in three phases – in organizations espousing to Responsible Care, in selected companies with ISO 14000 and in companies with environmental management systems, validated by European EMAS. In early 2010 research was completed in the field of environmental management accounting and barriers defending the implemention of EMA to organization’s information system and the subsequent use of EMA. Primary data obtained from this study were subjected to cluster analysis and the results are presented in this scientific thesis. In practise there are many obstacles to full-fledged EMA implementation process into practice organization and its functioning. Findings of the study give answers to the question: „What barriers act as obstacles to the implementation of EMA into the practise of the organization and its functioning?“

  6. Nurse-patient communication barriers in Iranian nursing.

    Science.gov (United States)

    Anoosheh, M; Zarkhah, S; Faghihzadeh, S; Vaismoradi, M

    2009-06-01

    Providing effective communication with patients is an essential aspect of nursing care. Understanding the barriers that inhibit nurse-patient communication can provide an opportunity to eliminate them. To investigate nurse-patient and environment-related communication barriers perceived by patients and nurses in Iranian nursing. A descriptive survey was carried out in three randomly selected educational hospitals in a large urban city in Iran. Data were collected by questionnaire; the study sample consisted of 61 patients and 75 nurses. Participants were asked to rate the importance of each communication barriers item. Finally, data were analysed using descriptive statistics, and to compare the perceived importance of communication barriers between patients and nurses, item means were calculated and the t-test for independent samples was applied. Similarities and differences between the two groups were identified. According to nurses' views, 'heavy nursing workload', 'hard nursing tasks' and 'lack of welfare facilities for nurses' were the main communication barriers. From patients' views, 'unfamiliarity of nurses with dialect', 'having contagious diseases' and 'sex differences between nurses and patients' were determined as the main communication barriers. The shared communication barriers were 'age difference', 'social class difference' and 'having contagious diseases'. It can be concluded that nursing managers and healthcare system planners should focus on eliminating or modifying the barriers stated by the two groups, particularly the shared ones. It is suggested that understanding the cultural aspects of nurse-patient communication barriers in various contexts can help nurses. The study relied on self-report by a limited sample of nurses and patients. The responses should now be tested by a larger sample and then by empirical research into actual practice in order to test whether the nurses' and patients' perceived ideas of communication barriers are

  7. Barriers and limitations during implementation of the surgical safety checklist of the World Health Organization

    Directory of Open Access Journals (Sweden)

    Rosa Amalia Arboleda

    2014-04-01

    Full Text Available Introduction: The surgical safety checklist of the World Health Organization (WHO is a tool that checks and evaluates each procedure in the operating room. Despite its demonstrated effectiveness, it has many limitations and barriers to its implementation. The aim of this article was to present the current evidence regarding limitations and barriers to achieve a successful implementation of the surgical safety WHO checklist. Methods: A narrative review was designed. We performed a systematic literature search in PubMed/MEDLINE. Articles that describe or present as primary or secondary endpoints barriers or limitations during the implementation of the checklist WHO were selected. Observational or experimental articles were included from the date of the official launch of the WHO list. To describe the data a summary table was designed. Detailed results were organized qualitatively extracting the most prevalent limitations. Results: 17 studies were included in the final review process. The main findings were: 1 a large number of constraints reported in the literature that hinder the implementation process, 2 limitations were grouped into 9 categories according to their similarities and 3 the most frequently reported category was “knowledge”. Discussion: There are several factors that limit the proper implementation of the surgical safety checklist WHO. Among these, cultural factors, knowledge, indifference and / or relevance, communication, filling completeness, among others. Effective implementation strategies would reach its successful implementation.

  8. Analysis of barriers and levers to the implementation of strategies of adaptation to climate changes - 2014-2015. The case of urban communities. Final report

    International Nuclear Information System (INIS)

    Simonet, Guillaume; Leseur, Alexia

    2015-12-01

    This is the final report of a research project (ABSTRACT-colurba) which aimed at exploring decision mechanisms and organisational dynamics underlying the elaboration of strategies of adaptation to climate changes by using results of a field study among ten previously selected French local communities. The objectives were to determine priority local social and economic challenges associated with expected impacts of climate changes, to identify economic, organisational and cognitive barriers and levers (at the State, representative or collectivity level) to an optimal implementation of measures of reduction of local vulnerabilities to climate changes, to identify possible or already used diagnosis tools for the assessment of costs and of priority investments, and to make comparisons with other referenced cases and to assess possibilities to bypass barriers thanks to a dialogue with stakeholders. After a presentation of the project (objectives, institutional context, guides and methodologies, scientific approach for data acquisition and analysis), the report presents and discusses the obtained results regarding the place given to adaptation in local policies (PCET, the French local climate-energy plans), representations of adaptation, the inclusion of adaptation in the agenda of public climatic action, tools to make adaptation operational, barriers and levers to action implementation

  9. Barriers to accessing substance abuse treatment in Mexico: national comparative analysis by migration status

    Science.gov (United States)

    2014-01-01

    Background We examined Mexican migrants’ perceived barriers to entering substance abuse treatment and potential differences by gender. Methods This study analyzed a subset of household data collected in Mexico in 2011 via the Encuesta Nacional de Adicciones (National Survey of Addictions). A sample of 1,143 individuals who reported using illicit drugs was analyzed using multivariate negative binomial models to determine direct and moderated relationships of gender, migrant status, and drug dependence with perceived barriers to accessing treatment. Results Significant findings included disparities in drug dependence by migrant status. Compared with non-migrant men, women who have traveled to the United States was associated with fewer (1.3) barriers to access treatment. Fewer barriers to access care were associated with individuals residing in other regions of the country, compared to those living in Mexico City. Conclusions Drug dependence, gender, migration status and regional location are factors associated with access to needed treatment. Implications for health care policy to develop treatment services infrastructure and for future research are discussed in the context of ongoing drug policy reform in Mexico. PMID:25074067

  10. The Blood-Brain Barrier: An Engineering Perspective

    Directory of Open Access Journals (Sweden)

    Andrew eWong

    2013-08-01

    Full Text Available It has been more than 100 years since Paul Ehrlich reported that various water-soluble dyes injected into the circulation did not enter the brain. Since Ehrlich’s first experiments, only a small number of molecules, such as alcohol and caffeine have been found to cross the blood-brain barrier, and it remains the major roadblock to treatment of many central nervous system diseases. At the same time, many central nervous system diseases are associated with disruption of the blood-brain barrier that can lead to changes in permeability, modulation of immune cell transport, and trafficking of pathogens into the brain. Therefore advances in our understanding of the structure and function of the blood-brain barrier are key to advances in treatment of a wide range of central nervous system diseases. Over the past 10 years it has become recognized that the blood-brain barrier is a complex dynamic system that involves biomechanical and biochemical signaling between the vascular system and the brain. Here we reconstruct the structure, function, and transport properties of the blood-brain barrier from an engineering perspective. New insight into the physics of the blood-brain barrier could ultimately lead to clinical advances in the treatment of central nervous system diseases.

  11. Ground-Source Heat Pumps. Overview of Market Status, Barriers to Adoption, and Options for Overcoming Barriers

    Energy Technology Data Exchange (ETDEWEB)

    Goetzler, William [Navigant Consulting, Inc., Chicago, IL (United States); Zogg, Robert [Navigant Consulting, Inc., Chicago, IL (United States); Lisle, Heather [Navigant Consulting, Inc., Chicago, IL (United States); Burgos, Javier [Navigant Consulting, Inc., Chicago, IL (United States)

    2009-02-03

    February 2009 final report submitted to DOE by Navigant Consulting, Inc. This report summarizes the status of ground-source heat pump (GSHP) technology and market penetration globally, estimates the energy saving potential of GSHPs in the U.S., identifies key market barriers that are inhibiting wider market adoption of GSHPs, and recommends initiatives that can be implemented or facilitated by the DOE to accelerate market adoption.

  12. Barriers to investment in emerging power markets

    Energy Technology Data Exchange (ETDEWEB)

    Beardsworth, Jr, J J [Hunton and Williams, Richmond, VA (United States)

    1994-12-31

    Investing in private power projects in developing countries is a very different issue from investment in the US or the UK. There are many investment barriers not present in developed nations. Firstly investment barriers need to be identified. Trouble may be encountered with legal authorization; the regulatory framework; government guarantees; fuel supply security; lender protection; labour laws and local commercial restrictions such as profits repatriation, currency convertibility, and taxes. Political barriers may also be encountered in the form of: government commitments and support; funding sources; political unrest; religion; and relationships with other countries. Investment barriers may be minimised by persuading the government to remove any legal barriers; the contract has then to be agreed. Factors in a successful contract include: power purchase agreements; fuel agreements; and implementation agreements. It is vital to have a source of information on local rules and customs, by working with local companies and employing local attorneys.

  13. Air barrier systems: Construction applications

    Energy Technology Data Exchange (ETDEWEB)

    Perrault, J.C

    1989-01-01

    An examination is presented of how ordinary building materials can be used in an innovative manner to design, detail, and construct effective air barrier systems for common types of walls. For residential construction, the air drywall approach uses the interior gypsum board as the main component of the wall air barrier system. Joints between the gypsum board and adjacent materials or assemblies are sealed by gaskets. In commercial construction, two different techniques are employed for using gypsum board as air barrier material: the accessible drywall and non-accessible drywall approaches. The former is similar to the air drywall approach except that high performance sealants are used instead of gaskets. In the latter approach, exterior drywall sheathing is the main component of the air barrier system; joints between boards are taped and joints between boards and other components are sealed using elastomeric membrane strips. For various types of commercial and institutional buildings, metal air barrier systems are widely used and include pre-engineered curtain walls or sheet metal walls. Masonry wall systems are regarded as still the most durable, fireproof, and soundproof wall type available but an effective air barrier system has typically been difficult to implement. Factory-made elastomeric membranes offer the potential to provide airtightness to masonry walls. These membranes are applied on the entire masonry wall surface and are used to make airtight connections with other building components. Two types of product are available: thermofusible and peel-and-stick membranes. 5 figs.

  14. Chaotic correlations in barrier billiards with arbitrary barriers

    International Nuclear Information System (INIS)

    Osbaldestin, A H; Adamson, L N C

    2013-01-01

    We study autocorrelation functions in symmetric barrier billiards for golden mean trajectories with arbitrary barriers. Renormalization analysis reveals the presence of a chaotic invariant set and thus that, for a typical barrier, there are chaotic correlations. The chaotic renormalization set is the analogue of the so-called orchid that arises in a generalized Harper equation. (paper)

  15. Identifying barriers to recovery from work related upper extremity disorders: use of a collaborative problem solving technique.

    Science.gov (United States)

    Shaw, William S; Feuerstein, Michael; Miller, Virginia I; Wood, Patricia M

    2003-08-01

    Improving health and work outcomes for individuals with work related upper extremity disorders (WRUEDs) may require a broad assessment of potential return to work barriers by engaging workers in collaborative problem solving. In this study, half of all nurse case managers from a large workers' compensation system were randomly selected and invited to participate in a randomized, controlled trial of an integrated case management (ICM) approach for WRUEDs. The focus of ICM was problem solving skills training and workplace accommodation. Volunteer nurses attended a 2 day ICM training workshop including instruction in a 6 step process to engage clients in problem solving to overcome barriers to recovery. A chart review of WRUED case management reports (n = 70) during the following 2 years was conducted to extract case managers' reports of barriers to recovery and return to work. Case managers documented from 0 to 21 barriers per case (M = 6.24, SD = 4.02) within 5 domains: signs and symptoms (36%), work environment (27%), medical care (13%), functional limitations (12%), and coping (12%). Compared with case managers who did not receive the training (n = 67), workshop participants identified more barriers related to signs and symptoms, work environment, functional limitations, and coping (p Problem solving skills training may help focus case management services on the most salient recovery factors affecting return to work.

  16. The Uphill Battle of Performing Education Scholarship: Barriers Educators and Education Researchers Face.

    Science.gov (United States)

    Jordan, Jaime; Coates, Wendy C; Clarke, Samuel; Runde, Daniel; Fowlkes, Emilie; Kurth, Jaqueline; Yarris, Lalena

    2018-05-01

    Educators and education researchers report that their scholarship is limited by lack of time, funding, mentorship, expertise, and reward. This study aims to evaluate these groups' perceptions regarding barriers to scholarship and potential strategies for success. Core emergency medicine (EM) educators and education researchers completed an online survey consisting of multiple-choice, 10-point Likert scale, and free-response items in 2015. Descriptive statistics were reported. We used qualitative analysis applying a thematic approach to free-response items. A total of 204 educators and 42 education researchers participated. Education researchers were highly productive: 19/42 reported more than 20 peer-reviewed education scholarship publications on their curricula vitae. In contrast, 68/197 educators reported no education publications within five years. Only a minority, 61/197 had formal research training compared to 25/42 education researchers. Barriers to performing research for both groups were lack of time, competing demands, lack of support, lack of funding, and challenges achieving scientifically rigorous methods and publication. The most common motivators identified were dissemination of knowledge, support of evidence-based practices, and promotion. Respondents advised those who seek greater education research involvement to pursue mentorship, formal research training, collaboration, and rigorous methodological standards. The most commonly cited barriers were lack of time and competing demands. Stakeholders were motivated by the desire to disseminate knowledge, support evidence-based practices, and achieve promotion. Suggested strategies for success included formal training, mentorship, and collaboration. This information may inform interventions to support educators in their scholarly pursuits and improve the overall quality of education research in EM.

  17. Patient-related barriers to hypertension control in a Nigerian population

    Directory of Open Access Journals (Sweden)

    Okwuonu CG

    2014-07-01

    Full Text Available Chimezie Godswill Okwuonu,1 Nnamdi Ezekiel Ojimadu,2 Enajite Ibiene Okaka,3 Fatai Momodu Akemokwe41Nephrology Unit, Department of Internal Medicine, 2Department of Family Medicine, Federal Medical Center Umuahia, Abia State, 3Renal Unit, 4Neurology Unit, Department of Internal Medicine University of Benin Teaching Hospital, Benin City, NigeriaBackground: Hypertension control is a challenge globally. Barriers to optimal control exist at the patient, physician, and health system levels. Patient-related barriers in our environment are not clear. The aim of this study was to identify patient-related barriers to control of hypertension among adults with hypertension in a semiurban community in South-East Nigeria.Methods: This was a cross-sectional descriptive study of patients with a diagnosis of hypertension and on antihypertensive medication.Results: A total of 252 participants were included in the survey, and comprised 143 males (56.7% and 109 females (43.3%. The mean age of the participants was 56.6±12.7 years, with a diagnosis of hypertension for a mean duration of 6.1±3.3 years. Among these patients, 32.9% had controlled blood pressure, while 39.3% and 27.8%, respectively, had stage 1 and stage 2 hypertension according to the Seventh Report of the Joint National Committee on Prevention, Detection and Evaluation of High Blood Pressure. Only 23.4% knew the consequences of poor blood pressure control and 64% were expecting a cure from treatment even when the cause of hypertension was not known. Furthermore, 68.7% showed low adherence to medication, the reported reasons for which included forgetfulness (61.2%, financial constraints (56.6%, high pill burden (22.5%, side effects of medication (17.3%, and low measured blood pressure (12.1%. Finally, knowledge and practice of the lifestyle modifications necessary for blood pressure control was inadequate among the participants.Conclusion: Poor knowledge regarding hypertension, unrealistic

  18. Medication assisted treatment in US drug courts: results from a nationwide survey of availability, barriers and attitudes.

    Science.gov (United States)

    Matusow, Harlan; Dickman, Samuel L; Rich, Josiah D; Fong, Chunki; Dumont, Dora M; Hardin, Carolyn; Marlowe, Douglas; Rosenblum, Andrew

    2013-01-01

    Drug treatment courts are an increasingly important tool in reducing the census of those incarcerated for non-violent drug offenses; medication assisted treatment (MAT) is proven to be an effective treatment for opioid addiction. However, little is known about the availability of and barriers to MAT provision for opioid-addicted people under drug court jurisdiction. Using an online survey, we assessed availability, barriers, and need for MAT (especially agonist medication) for opioid addiction in drug courts. Ninety-eight percent reported opioid-addicted participants, and 47% offered agonist medication (56% for all MAT including naltrexone). Barriers included cost and court policy. Responses revealed significant uncertainty, especially among non-MAT providing courts. Political, judicial and administrative opposition appear to affect MAT's inconsistent use and availability in drug court settings. These data suggest that a substantial, targeted educational initiative is needed to increase awareness of the treatment and criminal justice benefits of MAT in the drug courts. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. Model for safety reports including descriptive examples; Mall foer saekerhetsrapporter med beskrivande exempel

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-12-01

    Several safety reports will be produced in the process of planning and constructing the system for disposal of high-level radioactive waste in Sweden. The present report gives a model, with detailed examples, of how these reports should be organized and what steps they should include. In the near future safety reports will deal with the encapsulation plant and the repository. Later reports will treat operation of the handling systems and the repository.

  20. A systematic review of the implementation of recommended psychological interventions for schizophrenia: Rates, barriers, and improvement strategies.

    Science.gov (United States)

    Ince, Paul; Haddock, Gillian; Tai, Sara

    2016-09-01

    A systematic review of the literature exploring if the UK recommendations for psychological interventions for schizophrenia were being met was carried out. Rates of implementation for cognitive behavioural therapy (CBT) and family intervention (FI) were compared. The barriers against implementation and described strategies aimed at improving implementation were reviewed. A literature search of electronic bibliography databases (Psychinfo, Medline, Pubmed, AMED, CINHAL, and EMBASE), reference and citation lists, the Evaluation and Review of NICE Implementation (ERNIE) database, a manual search of Clinical Psychology Forum, governmental reports, charity, and service user group reports was conducted. Twenty-six articles met the inclusion criteria, 11 provided data on implementation rates, 13 explored the barriers to implementation, and 10 gave information about improvement strategies. Rates of implementation varied from 4% to 100% for CBT and 0% to 53% for FI, and studies varied in the methodology used and quality of the articles. Previously reported barriers to implementation were found, with organisational barriers being most commonly followed by barriers met by staff members and service users. Implementation strategies discovered included training packages for CBT, FI, and psychosocial interventions as well as empirical evidence suggesting methods for engagement with service users. Rates of implementation for CBT and FI are still below recommended levels with wide variation of rates found. This suggests inequalities in the provision of psychological interventions for schizophrenia are still present. Previously identified barriers to implementation were confirmed. Attempted implementation strategies have been met with modest success. Inequalities in the provision of psychological therapies for schizophrenia persist. Good quality cognitive behavioural therapy and FI training do not ensure implementation. Collaboration at all levels of healthcare is needed for

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

    Science.gov (United States)

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

    2016-01-01

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

  2. MENDING THE IN SITU MANIPULATION BARRIER

    Energy Technology Data Exchange (ETDEWEB)

    PETERSEN, S.W.

    2006-02-06

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

  3. Overcoming regulatory barriers: DOE environmental technology development program

    International Nuclear Information System (INIS)

    Kurtyka, B.M.; Clodfelter-Schumack, K.; Evans, T.T.

    1995-01-01

    The potential to improve environmental conditions via compliance or restoration is directly related to the ability to produce and apply innovative technological solutions. However, numerous organizations, including the US General Accounting Office (GAO), the EPA National Advisory Council for Environmental Policy and Technology (NACEPT), the DOE Environmental Management Advisory Board (EMAB), and the National Science and Technology Council (NSTC) have determined that significant regulatory barriers exist that inhibit the development and application of these technologies. They have noted the need for improved efforts in identifying and rectifying these barriers for the purpose of improving the technology development process, providing innovative alternatives, and enhancing the likelihood of technology acceptance by all. These barriers include, among others, regulator and user bias against ''unknown/unproven'' technologies; multi-level/multi-media permit disincentives; potential liability of developers and users for failed implementation; wrongly defined or inadequate data quality objectives: and lack of customer understanding and input. The ultimate goal of technology development is the utilization of technologies. This paper will present information on a number of regulatory barriers hindering DOE's environmental technology development program and describe DOE efforts to address these barriers

  4. A prospective, randomized, multicenter, controlled study of the safety of Seprafilm adhesion barrier in abdominopelvic surgery of the intestine.

    NARCIS (Netherlands)

    Beck, D.E.; Cohen, Z.; Fleshman, J.W.; Kaufman, H.S.; Goor, H. van; Wolff, B.G.

    2003-01-01

    INTRODUCTION: Seprafilm adhesion barrier (Seprafilm) has been proven to prevent adhesion formation after abdominal and pelvic surgery. This article reports safety results, including the postoperative incidence of abdominal and pelvic abscess and pulmonary embolism, from a large, multicenter trial

  5. Barriers to Leisure-Time Physical Activities in Individuals with Spinal Cord Injury.

    Science.gov (United States)

    Hwang, Eric J; Groves, Mary D; Sanchez, Jacqueline N; Hudson, Cassandra E; Jao, Rachel G; Kroll, Meghan E

    2016-07-01

    This study investigated the personal, environmental, and activity barriers to leisure-time physical activities (LTPAs) among individuals with spinal cord injury (SCI). A survey instrument was administered to 85 participants with SCI. Personal barriers to LTPAs included issues involving motivation, pain, scheduling, and financial resources. Environmental barriers marked the issues regarding availability and accessibility to specialized programs, activities, and professional services. Activity barriers included limitations in equipment, training, and personal skills required by the selected activities. Significant negative correlations were found between these barriers and the levels of physical activity and satisfaction with physical activity. While working with clients with SCI, occupational therapists should identify those LTPA barriers and possible solutions in order to establish individualized action plans for enhancing participation in LTPAs.

  6. Electron grafted barrier coatings for packaging film modification

    International Nuclear Information System (INIS)

    Rangwalla, I.J.; Nablo, S.V.

    1993-01-01

    The O 2 barrier performance of organosilane films, coated, dried and electron beam grafted to polyolefin film has been studied. Excellent anti-scalping properties based upon limonene (dipentene) transmission measurements have also been observed. Results are also reported on O 2 permeability reduction when the process is applied to common barrier polymers such as EVOH and acrylonitrile. Experience with its in-line application on LDPE is discussed. (author)

  7. Physical Activity Pattern of Malaysian Preschoolers: Environment, Barriers, and Motivators for Active Play.

    Science.gov (United States)

    Lee, Shoo Thien; Wong, Jyh Eiin; Ong, Wei Wen; Ismail, Mohd Noor; Deurenberg, Paul; Poh, Bee Koon

    2016-07-01

    Children's physical activity has been correlated with child characteristics and social or physical environment. This study aimed to compare preschoolers' physical activity among various sociodemographic characteristics and to determine barriers, motivators, and environmental factors for active play. A total of 835 preschoolers were included in this analysis. Time spent on active play, quiet play, and screen time was reported by parents. Boys spent significantly more time on active play and screen time than girls. Time spent on quiet play was highest in East Coast Peninsular Malaysia and lowest in Sarawak. Some 40% of children achieved active play recommendation while 27% exceeded daily screen time recommendation. Most parents reported that their child played actively in the house area; and that the main barrier and motivator to active play were safety and child's enjoyment, respectively. These findings demonstrate that sociodemographic characteristics and environment should be considered in designing physical activity intervention programs. © 2016 APJPH.

  8. Barriers to cancer screening in Hmong Americans: the influence of health care accessibility, culture, and cancer literacy.

    Science.gov (United States)

    Lee, Hee Yun; Vang, Suzanne

    2010-06-01

    Hmong Americans face high cancer mortality rates even in comparison to their Asian American counterparts, and report low utilization of cancer screenings. To date, no study has been conducted on the cultural barriers this population faces in undergoing cancer screenings. A systematic review of the literature was conducted to examine the existing knowledge regarding the barriers to cancer screening for Hmong Americans. Potential barriers were identified from this examination to include: health access factors (type of health insurance, ethnicity of provider, low English proficiency, and years spent in the U.S.); cultural factors (belief in the spiritual etiology of diseases, patriarchal values, modesty, and mistrust of the western medical system); and cancer literacy factors (cancer and prevention illiteracy). Based on this review, potential cultural and ethnic group-specific prevention strategies and cancer health policies are discussed to address these barriers and enhance screening behavior among the Hmong.

  9. Recruitment barriers in a randomized controlled trial from the physicians' perspective – A postal survey

    Directory of Open Access Journals (Sweden)

    Karrer Werner

    2009-03-01

    Full Text Available Abstract Background The feasibility of randomized trials often depends on successful patient recruitment. Although numerous recruitment barriers have been identified it is unclear which of them complicate recruitment most. Also, most surveys have focused on the patients' perspective of recruitment barriers whereas the perspective of recruiting physicians has received less attention. Therefore, our aim was to conduct a postal survey among recruiting physicians of a multi-center trial to weigh barriers according to their impact on recruitment. Methods We identified any potential recruitment barriers from the literature and from our own experience with a multi-center trial of respiratory rehabilitation in patients with chronic obstructive pulmonary disease. We developed and pilot-tested a self-administered questionnaire where recruiting physicians were asked to express their agreement with statements about recruitment barriers on a Likert-type scale from 1 (full agreement with statement = very substantial recruitment barrier to 7 (no agreement with statement = no recruitment barrier. Results 38 of 55 recruiting physicians returned questionnaires (69% response rate, of which 35 could be analyzed (64% useable response rate. Recruiting physicians reported that "time constraints" (median agreement of 3, interquartile range 2–5 had the most negative impact on recruitment followed by "difficulties including identified eligible patients" (median agreement of 5, IQR 3–6. Other barriers such as "trial design barriers", "lack of access to treatment", "individual barriers of recruiting physicians" or "insufficient training of recruiting physicians" were perceived to have little or no impact on patient recruitment. Conclusion Physicians perceived time constraints as the most relevant recruitment barrier in a randomized trial. To overcome recruitment barriers interventions, that are affordable for both industry- and investigator-driven trials, need to be

  10. A prospective examination of exercise and barrier self-efficacy to engage in leisure-time physical activity during pregnancy.

    Science.gov (United States)

    Cramp, Anita G; Bray, Steven R

    2009-06-01

    Pregnant women without medical contraindications should accumulate 30 min of moderate exercise on most days of the week, yet many pregnant women do not exercise at recommended levels. The purpose the study was to examine barriers to leisure-time physical activity (LTPA) and investigate barrier and exercise self-efficacy as predictors of self-reported LTPA during pregnancy. Pregnant women (n = 160) completed questionnaires eliciting barriers to LTPA, measures of exercise and barrier self-efficacy, and 6-week LTPA recall at gestational weeks 18, 24, 30, and 36. A total of 1,168 barriers were content-analyzed, yielding nine major themes including fatigue, time constraints, and physical limitations. Exercise self-efficacy predicted LTPA from gestational weeks 18 to 24 (beta = 0.32, R(2) = 0.26) and weeks 30 to 36 (beta = 0.41, R(2) = 0.37), while barrier self-efficacy predicted LTPA from weeks 24 to 30 (beta = 0.40, R(2) = 0.32). Pregnant women face numerous barriers to LTPA during pregnancy, the nature of which may change substantially over the course of pregnancy. Higher levels of self-efficacy to exercise and to overcome exercise barriers are associated with greater LTPA during pregnancy. Research and interventions to understand and promote LTPA during pregnancy should explore the dynamic nature of exercise barriers and foster women's confidence to overcome physical activity barriers.

  11. Study of Quasielastic scattering for 7Li+159Tb at around- barrier energies

    Directory of Open Access Journals (Sweden)

    Mukherjee A.

    2017-01-01

    Full Text Available Quasielastic scattering cross sections for the reaction 7Li+159Tb have been measured at large backangles, at energies around the Coulomb barrier. The quasielastic barrier distribution has been extracted from the measured quasielastic scattering excitation function, including and excluding α particle contribution. The peak of the quasielastic barrier distribution including α particle contribution shows a shift towards higher energy compared to the peak of the distribution without α particles. The quasielastic barrier distribution when compared to the calculated fusion barrier distribution, appears to show reasonable agreement for the system.

  12. Systematic Review of Voluntary Participation in Simulation-Based Laparoscopic Skills Training: Motivators and Barriers for Surgical Trainee Attendance.

    Science.gov (United States)

    Gostlow, Hannah; Marlow, Nicholas; Babidge, Wendy; Maddern, Guy

    To examine and report on evidence relating to surgical trainees' voluntary participation in simulation-based laparoscopic skills training. Specifically, the underlying motivators, enablers, and barriers faced by surgical trainees with regard to attending training sessions on a regular basis. A systematic search of the literature (PubMed; CINAHL; EMBASE; Cochrane Collaboration) was conducted between May and July 2015. Studies were included on whether they reported on surgical trainee attendance at voluntary, simulation-based laparoscopic skills training sessions, in addition to qualitative data regarding participant's perceived barriers and motivators influencing their decision to attend such training. Factors affecting a trainee's motivation were categorized as either intrinsic (internal) or extrinsic (external). Two randomised control trials and 7 case series' met our inclusion criteria. Included studies were small and generally poor quality. Overall, voluntary simulation-based laparoscopic skills training was not well attended. Intrinsic motivators included clearly defined personal performance goals and relevance to clinical practice. Extrinsic motivators included clinical responsibilities and available free time, simulator location close to clinical training, and setting obligatory assessments or mandated training sessions. The effect of each of these factors was variable, and largely dependent on the individual trainee. The greatest reported barrier to attending voluntary training was the lack of available free time. Although data quality is limited, it can be seen that providing unrestricted access to simulator equipment is not effective in motivating surgical trainees to voluntarily participate in simulation-based laparoscopic skills training. To successfully encourage participation, consideration needs to be given to the factors influencing motivation to attend training. Further research, including better designed randomised control trials and large

  13. Smart parking barrier

    KAUST Repository

    Alharbi, Abdulrazaq M.

    2016-01-01

    positioning of the movable parking barrier, and a parking controller configured to initiate movement of the parking barrier, via the barrier drive. The movable parking barrier can be positioned between a first position that restricts access to the parking

  14. Questionnaires used to assess barriers of clinical guideline use among physicians are not comprehensive, reliable, or valid: a scoping review.

    Science.gov (United States)

    Willson, Melina L; Vernooij, Robin W M; Gagliardi, Anna R

    2017-06-01

    This study described the number and characteristics of questionnaires used to assess barriers of guideline use among physicians. A scoping review was conducted. MEDLINE and EMBASE were searched from 2005 to June 2016. English-language studies that administered a questionnaire to assess barriers of guideline use among practicing physicians were eligible. Summary statistics were used to report study and questionnaire characteristics. Questionnaire content was assessed with a checklist of 57 known barriers. Each of the 178 included studies administered a unique questionnaire. The number of questionnaires increased yearly from 2005 to 2015. Few were pilot-tested (50, 28.1%) or tested for psychometric properties (3, 1.7%). Two were based on theory. None probed for the full range of known barriers. Ten included a free-text option. The majority assessed professional barriers (177, 99.4%) but few of the 14 factors within this domain. Questionnaire characteristics did not change over time. Organizations administered questionnaires that were not reliable or valid and did not comprehensively assess barriers and may have selected interventions unlikely to promote guideline use. Research is needed to construct a questionnaire that is practical, adaptable, and robust and leads to the selection of interventions that support guideline use. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  15. Is the perception of time pressure a barrier to healthy eating and physical activity among women?

    Science.gov (United States)

    Welch, Nicky; McNaughton, Sarah A; Hunter, Wendy; Hume, Clare; Crawford, David

    2009-07-01

    To describe the proportion of women reporting time is a barrier to healthy eating and physical activity, the characteristics of these women and the perceived causes of time pressure, and to examine associations between perceptions of time as a barrier and consumption of fruit, vegetables and fast food, and physical activity. A cross-sectional survey of food intake, physical activity and perceived causes of time pressure. A randomly selected community sample. A sample of 1580 women self-reported their food intake and their perceptions of the causes of time pressure in relation to healthy eating. An additional 1521 women self-reported their leisure-time physical activity and their perceptions of the causes of time pressure in relation to physical activity. Time pressure was reported as a barrier to healthy eating by 41% of the women and as a barrier to physical activity by 73%. Those who reported time pressure as a barrier to healthy eating were significantly less likely to meet fruit, vegetable and physical activity recommendations, and more likely to eat fast food more frequently. Women reporting time pressure as a barrier to healthy eating and physical activity are less likely to meet recommendations than are women who do not see time pressure as a barrier. Further research is required to understand the perception of time pressure issues among women and devise strategies to improve women's food and physical activity behaviours.

  16. Facilitators and Barriers to Discussing HIV Prevention With Adolescents: Perspectives of HIV-Infected Parents

    Science.gov (United States)

    Reis, Janet S.; Weber, Kathleen M.

    2013-01-01

    Objectives. We examined HIV-infected parents’ conversations about HIV prevention with their uninfected children, including what facilitated or hindered communication. Methods. Parents with HIV/AIDS (n = 90) who had children aged 10 to 18 years were recruited for a mixed method study from 2009 to 2010. Interviews assessed facilitators and barriers to discussing HIV prevention. A questionnaire identified the frequency and content of conversations, parental confidence level, and perceived importance of discussing preventive topics. Results. Eighty-one percent of parents reported “sometimes” or “often” communicating about HIV prevention. A subset of parents found these conversations difficult; 44% indicated their desire for support. Facilitators to communication included utilizing support, focusing on the benefits of talking, and having a previous relationship with one’s child. Barriers to discussions included fear of negative consequences, living in denial, and lacking a parental role model who discussed safer sex. Parents varied as to how they believed their HIV status affected communication. Those who did not disclose their HIV status to their children reported less frequent communication; self-efficacy partially mediated this relationship. Conclusions. Findings highlighted the need for communication skills training that support HIV-infected parents in their efforts to discuss HIV-related information with adolescents. PMID:23763390

  17. Oncology care provider perspectives on exercise promotion in people with cancer: an examination of knowledge, practices, barriers, and facilitators.

    Science.gov (United States)

    Nadler, Michelle; Bainbridge, Daryl; Tomasone, Jennifer; Cheifetz, Oren; Juergens, Rosalyn A; Sussman, Jonathan

    2017-07-01

    Despite the reported benefits of physical activity in alleviating the impact of cancer and its treatments, oncology care providers (OCPs) are not routinely discussing exercise with their patients, suggesting a knowledge to action gap. We sought to determine OCP's knowledge, beliefs, barriers, and facilitators to exercise discussion. A survey was administered to OCPs at the cancer center in Hamilton, Ontario. Questions comprised of demographics, knowledge and beliefs regarding exercise guidelines, and barriers and facilitators to exercise discussion. Analysis of survey responses was descriptive. Pearson's chi-squared test was used to examine select associations. There were 120 respondents (61% response rate) representing a diversity of professions. Approximately, 80% of OCPs were not aware of any exercise guidelines in cancer and self-reported poor knowledge on when, how, and which patients to refer to exercise programs. OCPs who reported meeting Canada's Physical Activity guidelines were significantly more likely to identify correct guidelines (p = 0.023) and to report good knowledge on how to provide exercise counseling (p = 0.014). Across OCP groups, barriers to exercise discussion included poor knowledge, lack of time, and safety concerns. Most felt that educational sessions and having an exercise specialist on the clinical team would be beneficial. OCPs have low knowledge regarding exercise counseling, but believe that discussing exercise is a multidisciplinary task and expressed a desire for further training. Interventions will require a multi-pronged approach including education for OCPs and guidance on assessment for exercise safety.

  18. Tandem mirror reactor with thermal barriers

    International Nuclear Information System (INIS)

    Carlson, G.A.; Arfin, B.; Barr, W.L.; Boghosian, B.M.; Erickson, J.L.; Fink, J.H.; Hamilton, G.W.; Logan, B.G.; Myall, J.O.; Neef, W.S. Jr.

    1979-01-01

    This report gives detailed information in the form of the following chapters: (1) overview, (2) plasma physics, (3) magnets, (4) end-plug neutral beams, (5) barrier pump neutral beams, (6) ecr heating, (7) plasma direct converter, and (8) central cell

  19. Biological and Sociocultural Differences in Perceived Barriers to Physical Activity Among Fifth- to Seventh-Grade Urban Girls.

    Science.gov (United States)

    Vermeesch, Amber L; Ling, Jiying; Voskuil, Vicki R; Bakhoya, Marion; Wesolek, Stacey M; Bourne, Kelly A; Pfeiffer, Karin A; Robbins, Lorraine B

    2015-01-01

    Inadequate physical activity (PA) contributes to the high prevalence of overweight and obesity among U.S. adolescent girls. Barriers preventing adolescent girls from meeting PA guidelines have not been thoroughly examined. The threefold purpose of this study was to (a) determine pubertal stage, racial/ethnic, and socioeconomic status (SES) differences in ratings of interference of barriers to PA; (b) examine relationships between perceived barriers and age, body mass index, recreational screen time, sedentary activity, and PA; and (c) identify girls' top-rated perceived barriers to PA. Girls (N = 509) from eight Midwestern U.S. schools participated. Demographic, pubertal stage, perceived barriers, and recreational screen time data were collected via surveys. Height and weight were measured. Accelerometers measured sedentary activity, moderate-to-vigorous PA (MVPA), and light plus MVPA. Girls of low SES reported greater interference of perceived barriers to PA than those who were not of low SES (1.16 vs. 0.97, p = .01). Girls in early/middle puberty had lower perceived barriers than those in late puberty (1.03 vs. 1.24, p barriers were negatively related to MVPA (r = -.10, p = .03) and light plus MVPA (r = -.11, p = .02). Girls' top five perceived barriers included lack of skills, hating to sweat, difficulty finding programs, being tired, and having pain. Innovative interventions, particularly focusing on skill development, are needed to assist girls in overcoming their perceived barriers to PA.

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

    Science.gov (United States)

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

    2016-03-15

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

  1. Medication errors among nurses in teaching hospitals in the west of Iran: what we need to know about prevalence, types, and barriers to reporting

    Directory of Open Access Journals (Sweden)

    Afshin Fathi

    2017-05-01

    Full Text Available OBJECTIVES This study aimed to examine the prevalence and types of medication errors (MEs, as well as barriers to reporting MEs, among nurses working in 7 teaching hospitals affiliated with Kermanshah University of Medical Sciences in 2016. METHODS A convenience sampling method was used to select the study participants (n=500 nurses. A self-constructed questionnaire was employed to collect information on participants’ socio-demographic characteristics (10 items, their perceptions about the main causes of MEs (31 items, and barriers to reporting MEs to nurse managers (11 items. Data were collected from September 1 to November 30, 2016. Negative binomial regression was used to identify the main predictors of the frequency of MEs among nurses. RESULTS The prevalence of MEs was 17.0% (95% confidence interval, 13.7 to 20.3%. The most common types of MEs were administering medications at the wrong time (24.0%, dosage errors (16.8%, and administering medications to the wrong patient (13.8%. A heavy workload and the type of shift work were considered to be the main causes of MEs by nursing staff. Our findings showed that 45.0% of nurses did not report MEs. A heavy workload due to a high number of patients was the most important reason for not reporting MEs (mean score, 3.57±1.03 among nurses. Being male, having a second unrelated job, and fixed shift work significantly increased MEs among nurses (p=0.001. CONCLUSIONS Our study documented a high prevalence of MEs among nurses in the west of Iran. A heavy workload was considered to be the most important barrier to reporting MEs among nurses. Thus, appropriate strategies (e.g., reducing the nursing staff workload should be developed to address MEs and improve patient safety in hospital settings in Iran.

  2. Thermal model of attic systems with radiant barriers

    Energy Technology Data Exchange (ETDEWEB)

    Wilkes, K.E.

    1991-07-01

    This report summarizes the first phase of a project to model the thermal performance of radiant barriers. The objective of this phase of the project was to develop a refined model for the thermal performance of residential house attics, with and without radiant barriers, and to verify the model by comparing its predictions against selected existing experimental thermal performance data. Models for the thermal performance of attics with and without radiant barriers have been developed and implemented on an IBM PC/AT computer. The validity of the models has been tested by comparing their predictions with ceiling heat fluxes measured in a number of laboratory and field experiments on attics with and without radiant barriers. Cumulative heat flows predicted by the models were usually within about 5 to 10 percent of measured values. In future phases of the project, the models for attic/radiant barrier performance will be coupled with a whole-house model and further comparisons with experimental data will be made. Following this, the models will be utilized to provide an initial assessment of the energy savings potential of radiant barriers in various configurations and under various climatic conditions. 38 refs., 14 figs., 22 tabs.

  3. Barriers to HIV testing in Cote d'Ivoire: the role of individual characteristics and testing modalities.

    Directory of Open Access Journals (Sweden)

    Kévin Jean

    Full Text Available BACKGROUND: Expanding HIV testing requires a better understanding of barriers to its uptake. We investigated barriers to HIV testing in Côte d'Ivoire, taking into account test circumstances (client vs. provider-initiated. METHODS: We used data from the 2005 nationally representative Demographic and Health Survey conducted in Côte d'Ivoire. Socio-demographic characteristics, sexual behaviour and knowledge and attitudes toward HIV/AIDS associated with recent (<2 years HIV testing were identified using gender-specific univariate and multivariate logistic regressions. Among women, differential effects of barriers to testing according to test circumstance (whether they have been offered for a prenatal test or not were assessed through interaction tests. RESULTS: Recent HIV testing was reported by 6.1% of men and 9.5% of women (including 4.6% as part of antenatal care. Among men, having a low socioeconomic status, having a low HIV-related knowledge level and being employed [compared to those inactive: adjusted Odds Ratio (aOR 0.46; 95% confidence interval (CI 0.25-0.87] were associated with lower proportions of recent HIV testing. Among women without a prenatal HIV testing offer, living outside the capital (aOR 0.38; CI 0.19-0.77 and reporting a unique lifetime sexual partner constituted additional barriers to HIV testing. By contrast, among women recently offered to be tested in prenatal care, none of these variables was found to be associated with recent HIV testing. CONCLUSIONS: Various dimensions of individuals' characteristics constituted significant barriers to HIV testing in Côte d'Ivoire in 2005, with gender specificities. Such barriers are substantially reduced when testing was proposed in the framework of antenatal care. This suggests that provider-initiated testing strategies may help overcome individual barriers to HIV testing.

  4. A Qualitative Study of Barriers to Accessing Water, Sanitation and Hygiene for Disabled People in Malawi.

    Science.gov (United States)

    White, Sian; Kuper, Hannah; Itimu-Phiri, Ambumulire; Holm, Rochelle; Biran, Adam

    2016-01-01

    Globally, millions of people lack access to improved water, sanitation and hygiene (WASH). Disabled people, disadvantaged both physically and socially, are likely to be among those facing the greatest inequities in WASH access. This study explores the WASH priorities of disabled people and uses the social model of disability and the World Health Organization's International Classification of Functioning, Disability and Health (ICF) framework to look at the relationships between impairments, contextual factors and barriers to WASH access. 36 disabled people and 15 carers from urban and rural Malawi were purposively selected through key informants. The study employed a range of qualitative methods including interviews, emotion mapping, free-listing of priorities, ranking, photo voice, observation and WASH demonstrations. A thematic analysis was conducted using nVivo 10. WASH access affected all participants and comprised almost a third of the challenges of daily living identified by disabled people. Participants reported 50 barriers which related to water and sanitation access, personal and hand hygiene, social attitudes and participation in WASH programs. No two individuals reported facing the same set of barriers. This study found that being female, being from an urban area and having limited wealth and education were likely to increase the number and intensity of the barriers faced by an individual. The social model proved useful for classifying the majority of barriers. However, this model was weaker when applied to individuals who were more seriously disabled by their body function. This study found that body function limitations such as incontinence, pain and an inability to communicate WASH needs are in and of themselves significant barriers to adequate WASH access. Understanding these access barriers is important for the WASH sector at a time when there is a global push for equitable access.

  5. Model assessment of protective barrier designs

    International Nuclear Information System (INIS)

    Fayer, M.J.; Conbere, W.; Heller, P.R.; Gee, G.W.

    1985-11-01

    A protective barrier is being considered for use at the Hanford site to enhance the isolation of previously disposed radioactive wastes from infiltrating water, and plant and animal intrusion. This study is part of a research and development effort to design barriers and evaluate their performance in preventing drainage. A fine-textured soil (the Composite) was located on the Hanford site in sufficient quantity for use as the top layer of the protective barrier. A number of simulations were performed by Pacific Northwest Laboratory to analyze different designs of the barrier using the Composite soil as well as the finer-textured Ritzville silt loam and a slightly coarser soil (Coarse). Design variations included two rainfall rates (16.0 and 30.1 cm/y), the presence of plants, gravel mixed into the surface of the topsoil, an impermeable boundary under the topsoil, and moving the waste form from 10 to 20 m from the barrier edge. The final decision to use barriers for enhanced isolation of previously disposed wastes will be subject to decisions resulting from the completion of the Hanford Defense Waste Environmental Impact Statement, which addresses disposal of Hanford defense high-level and transuranic wastes. The one-dimensional simulation results indicate that each of the three soils, when used as the top layer of the protective barrier, can prevent drainage provided plants are present. Gravel amendments to the upper 30 cm of soil (without plants) reduced evaporation and allowed more water to drain

  6. Doping enhanced barrier lowering in graphene-silicon junctions

    Science.gov (United States)

    Zhang, Xintong; Zhang, Lining; Chan, Mansun

    2016-06-01

    Rectifying properties of graphene-semiconductor junctions depend on the Schottky barrier height. We report an enhanced barrier lowering in graphene-Si junction and its essential doping dependence in this paper. The electric field due to ionized charge in n-type Si induces the same type doping in graphene and contributes another Schottky barrier lowering factor on top of the image-force-induced lowering (IFIL). We confirm this graphene-doping-induced lowering (GDIL) based on well reproductions of the measured reverse current of our fabricated graphene-Si junctions by the thermionic emission theory. Excellent matching between the theoretical predictions and the junction data of the doping-concentration dependent barrier lowering serves as another evidence of the GDIL. While both GDIL and IFIL are enhanced with the Si doping, GDIL exceeds IFIL with a threshold doping depending on the as-prepared graphene itself.

  7. Barriers to Business Model Innovation in Swedish Agriculture

    Directory of Open Access Journals (Sweden)

    Olof Sivertsson

    2015-02-01

    Full Text Available Swedish agricultural companies, especially small farms, are struggling to be profitable in difficult economic times. It is a challenge for Swedish farmers to compete with imported products on prices. The agricultural industry, however, supports the view that through business model innovation, farms can increase their competitive advantage. This paper identifies and describes some of the barriers Swedish small farms encounter when they consider business model innovation. A qualitative approach is used in the study. Agriculture business consultants were interviewed. In a focus group led by the researchers, farmers discussed business model innovation, including the exogenous and endogenous barriers to such innovation. The paper concludes many barriers exist when farmers consider innovation of agricultural business models. Some barriers are caused by human factors, such as individuals’ attitudes, histories, and traditions. Other barriers are more contextual in nature and relate to a particular industry or company setting. Still other barriers, such as government regulations, value chain position, and weather, are more abstract. All barriers, however, merit attention when Swedish agricultural companies develop new business models.

  8. Probabilistic modelling of the damage of geological barriers of the nuclear waste deep storage - ENDOSTON project, final report

    International Nuclear Information System (INIS)

    2010-01-01

    As the corrosion of metallic casings of radioactive waste storage packages releases hydrogen under pressure, and as the overpressure disturbs the stress fields, the authors report the development of methodologies and numerical simulation tools aimed at a better understanding of the mechanisms of development and propagation of crack networks in the geological barrier due to this overpressure. They present a probabilistic model of the formation of crack networks in rocks, with the probabilistic post-processing of a finite element calculation. They describe the modelling of crack propagation and damage in quasi-brittle materials. They present the ENDO-HETEROGENE model for the formation and propagation of cracks in heterogeneous media, describe the integration of the model into the Aster code, and report the model validation (calculation of the stress intensity factor, grid dependence). They finally report a test case of the ENDO-HETEROGENE model

  9. Differential Rollover Risk in Vehicle-to-Traffic Barrier Collisions

    Science.gov (United States)

    Gabauer, Douglas J.; Gabler, Hampton C.

    2009-01-01

    In the roadside safety community, there has been debate over the influence of vehicle and barrier type on rollover rates in traffic barrier crashes. This study investigated rollover rates between sport utility vehicles (SUVs), pickup trucks, and cars in vehicle-traffic barrier crashes and has examined the effect of barrier type on rollover risk for concrete barrier and metal barrier impacts. The analysis included 955 barrier impact cases that were selected from 11-years of in-depth crash data available through the National Automotive Sampling System (NASS) / Crashworthiness Data System (CDS). In real world tow-away level longitudinal barrier collisions, the most important predictors of vehicle rollover were found to be vehicle type and whether the vehicle was tracking prior to barrier impact. Based on binary logistic regression, SUVs were found to have 8 times the risk of rollover as cars in barrier impacts. Although pickups were found to have an increased risk of rollover compared to cars, the risk was not as pronounced as that found for SUVs. This finding has direct implications for the full scale crash testing of longitudinal barriers as the testing procedures have been predicated on the assumption that the pickup truck provides a critical or worst case impact scenario. In towaway crashes, our study does not support the notion that concrete barriers have a higher risk of vehicle rollover than metal beam barriers. PMID:20184839

  10. Water erosion field tests for Hanford protective barriers: FY 1992 status report

    International Nuclear Information System (INIS)

    Gilmore, B.G.; Walters, W.H.

    1993-11-01

    Pacific Northwest Laboratory (PNL) conducted this study for the Office of Technology Development and the Office of Environmental Restoration of the US Department of Energy. The purpose of the study was to investigate the erosion potential of barrier soil covers from high-intensity rainfall events and to propose erosion mitigation criteria for the soil cover. Two sets of field plots were used in the testing program. Small plots (1 m 2 ) were used initially for scoping studies and larger plots (32.5 m 2 ) were used for a more comprehensive study of soil cover erosion. The study investigated the use of pea gravel admix and naturally established vegetation to reduce erosion of barrier soil covers

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

    Science.gov (United States)

    Wood, Emily; Ohlsen, Sally; Ricketts, Thomas

    2017-05-01

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

  12. Oncologists' strategies and barriers to effective communication about the end of life.

    Science.gov (United States)

    Granek, Leeat; Krzyzanowska, Monika K; Tozer, Richard; Mazzotta, Paolo

    2013-07-01

    Communicating about the end of life with patients has been reported as one of the most difficult and stressful part of the work of oncologists. Despite this fact, oncologists receive little training in this area, and many do not communicate effectively with patients. The purpose of this analysis, part of a larger study examining oncologists' experiences of patient loss, was to explore oncologists' communication strategies and communication barriers when discussing end-of-life issues with patients. Twenty oncologists were interviewed at three hospitals about their communication strategies on end-of-life issues with patients. The data were analyzed using the grounded theory method. The findings revealed the strategies to effective communication about the end of life included: being open and honest; having ongoing, early conversations; communicating about modifying treatment goals; and balancing hope and reality. Barriers to implementing these strategies fell broadly into three domains, including physician factors, patient factors, and institutional factors. Physician factors included difficulty with treatment and palliation, personal discomfort with death and dying, diffusion of responsibility among colleagues, using the "death-defying mode," lack of experience, and lack of mentorship. Patient factors included, patients and/or families being reluctant to talk about the end of life, language barriers, and younger age. Institutional factors included stigma around palliative care, lack of protocol about end-of-life issues; and lack of training for oncologists on how to talk with patients about end-of-life issues. We conclude by drawing implications from our study and suggest that further research and intervention are necessary to aid oncologists in achieving effective communication about end-of-life issues.

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

    Science.gov (United States)

    Williams, Brett; Brown, Ted; Costello, Shane

    2015-10-24

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

  14. A systematic review of barriers to and facilitators of the use of evidence by policymakers.

    Science.gov (United States)

    Oliver, Kathryn; Innvar, Simon; Lorenc, Theo; Woodman, Jenny; Thomas, James

    2014-01-03

    The gap between research and practice or policy is often described as a problem. To identify new barriers of and facilitators to the use of evidence by policymakers, and assess the state of research in this area, we updated a systematic review. Systematic review. We searched online databases including Medline, Embase, SocSci Abstracts, CDS, DARE, Psychlit, Cochrane Library, NHSEED, HTA, PAIS, IBSS (Search dates: July 2000 - September 2012). Studies were included if they were primary research or systematic reviews about factors affecting the use of evidence in policy. Studies were coded to extract data on methods, topic, focus, results and population. 145 new studies were identified, of which over half were published after 2010. Thirteen systematic reviews were included. Compared with the original review, a much wider range of policy topics was found. Although still primarily in the health field, studies were also drawn from criminal justice, traffic policy, drug policy, and partnership working. The most frequently reported barriers to evidence uptake were poor access to good quality relevant research, and lack of timely research output. The most frequently reported facilitators were collaboration between researchers and policymakers, and improved relationships and skills. There is an increasing amount of research into new models of knowledge transfer, and evaluations of interventions such as knowledge brokerage. Timely access to good quality and relevant research evidence, collaborations with policymakers and relationship- and skills-building with policymakers are reported to be the most important factors in influencing the use of evidence. Although investigations into the use of evidence have spread beyond the health field and into more countries, the main barriers and facilitators remained the same as in the earlier review. Few studies provide clear definitions of policy, evidence or policymaker. Nor are empirical data about policy processes or implementation of

  15. Perceived gender-based barriers to careers in academic surgery.

    Science.gov (United States)

    Cochran, Amalia; Hauschild, Tricia; Elder, William B; Neumayer, Leigh A; Brasel, Karen J; Crandall, Marie L

    2013-08-01

    Women represent roughly 50% of US medical students and one third of US surgery residents. Within academic surgery departments, however, women are disproportionately underrepresented, particularly at senior levels. The aim of this study was to test the hypothesis that female surgeons perceive different barriers to academic careers relative to their male colleagues. A modified version of the Career Barriers Inventory-Revised was administered to senior surgical residents and early-career surgical faculty members at 8 academic medical centers using an online survey tool. Likert-type scales were used to measure respondents' agreement with each survey item. Fisher's exact test was used to identify significant differences on the basis of gender. Respondents included 70 women (44 residents, 26 faculty members) and 84 men (41 residents, 43 faculty members). Women anticipated or perceived active discrimination in the form of being treated differently and experiencing negative comments about their sex, findings that differed notably from those for male counterparts. Sex-based negative attitudes inhibited the career aspirations of female surgeons. The presence of overt and implicit bias resulted in a sense that sex is a barrier to female surgeons' career development in academic surgery. No differences were observed between male and female respondents with regard to career preparation or structural barriers. Female academic surgeons experience challenges that are perceived to differ from their male counterparts. Women who participated in this study reported feeling excluded from the dominant culture in departments of surgery. This study may help guide transformative initiatives within academic surgery departments. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. Healthcare Barriers and Utilization Among Adolescents and Young Adults Accessing Services for Homeless and Runaway Youth.

    Science.gov (United States)

    Chelvakumar, Gayathri; Ford, Nancy; Kapa, Hillary M; Lange, Hannah L H; McRee, Annie-Laurie; Bonny, Andrea E

    2017-06-01

    Homeless and runaway youth are at disproportionate risk for adverse health outcomes. Many barriers to accessing healthcare have been documented; however, the relative impact of discrete barriers on homeless youth healthcare utilization behavior is not firmly established. We administered a survey examining reported barriers and healthcare utilization among adolescents and young adults accessing services at three community centers for homeless and runaway youth. Of 180 respondents, 57 % were male, 80 % non-White, and 21 % identified as a sexual minority. Stepwise logistic regression models, controlling for age and study site, explored associations between barriers and 3 healthcare utilization outcomes (doctor visit in past 12 months; regular care provider; frequent emergency department (ED) visits). The most commonly reported barriers were "don't have a ride" (27.2 %), "no insurance" (23.3 %), and "costs too much" (22.8 %). All fear-based barriers (e.g., "I don't trust the doctors") were reported by runaway youth as the impact of discrete barriers varies depending on outcome of focus.

  17. Barriers and Facilitators to Healthy Lifestyle Changes in Minority Ethnic Populations in the UK: a Narrative Review.

    Science.gov (United States)

    Patel, Naina; Ferrer, Harriet Batista; Tyrer, Freya; Wray, Paula; Farooqi, Azhar; Davies, Melanie J; Khunti, Kamlesh

    2017-12-01

    Minority ethnic populations experience a disproportionate burden of health inequalities compared with the rest of the population, including an increased risk of type 2 diabetes (T2DM). The purpose of this narrative review was to explore knowledge and attitudes around diabetes, physical activity and diet and identify barriers and facilitators to healthy lifestyle changes in minority ethnic populations in the UK. The narrative review focused on three key research topics in relation to barriers and facilitators to healthy lifestyle changes in minority adult ethnic populations: (i) knowledge and attitudes about diabetes risk; (ii) current behaviours and knowledge about physical activity and diet; and (iii) barriers and facilitators to living a healthier lifestyle. Nearly all of the studies that we identified reported on South Asian minority ethnic populations; we found very few studies on other minority ethnic populations. Among South Asian communities, there was generally a good understanding of diabetes and its associated risk factors. However, knowledge about the levels of physical activity required to gain health benefits was relatively poor and eating patterns varied. Barriers to healthy lifestyle changes identified included language barriers, prioritising work over physical activity to provide for the family, cultural barriers with regard to serving and eating traditional food, different perceptions of a healthy body weight and fear of racial harassment or abuse when exercising. Additional barriers for South Asian women included expectations to remain in the home, fear for personal safety, lack of same gender venues and concerns over the acceptability of wearing 'western' exercise clothing. Facilitators included concern that weight gain might compromise family/carer responsibilities, desire to be healthy, T2DM diagnosis and exercise classes held in 'safe' environments such as places of worship. Our findings suggest that South Asian communities are less likely to

  18. Barriers and Facilitators of Partner Treatment of Chlamydia: A Qualitative Investigation with Prescribers and Community Pharmacists

    Directory of Open Access Journals (Sweden)

    Helen Wood

    2018-02-01

    Full Text Available Chlamydia trachomatis is the most frequently-notified sexually transmitted infection in Australia. Effective and timely partner treatment of chlamydia is essential to reduce overall prevalence and the burden of infection. Currently in most of Australia, the only avenue for partner treatment of chlamydia (“standard partner therapy” is a tedious, and often inconvenient, process. The barriers and facilitators of standard partner therapy, and newer models of accelerated partner therapy (APT, need to be identified in the Australian setting. Additionally, the potential role of community pharmacists need to be explored. Semi-structured interview guides for two key stakeholder groups (prescribers and pharmacists were developed and piloted. Eleven prescribers (general practitioners, sexual health clinicians and nurse practitioners and twelve pharmacists practicing in the Perth metropolitan region were interviewed. Key reported barriers to standard partner therapy were lack of or delayed chlamydia testing. Key facilitators included ability to test and educate sexual partner. Key barriers for APT included prescribers’ legal responsibility and potential for medication-related adverse effects. Healthcare provider consultation and chlamydia testing were seen as potential facilitators of APT. Pharmacists were receptive to the idea of expanding their role in chlamydia treatment, however, barriers to privacy must be overcome in order to be acceptable to prescribers and pharmacists.

  19. Delays in nuclear power plant construction. Progress report, September 15, 1976--September 14, 1977

    International Nuclear Information System (INIS)

    Mason, G.E.; Larew, R.E.

    1977-01-01

    This report identifies barriers to shortening nuclear power plant construction schedules and recommends research efforts that should minimize or eliminate the identified barriers. The identified barriers include: (1) design and construction interfacing problems; (2) problems relating to the selection and use of permanent materials and construction methods; (3) construction coordination and communication problems; and (4) problems associated with manpower availability and productivity;

  20. Recommendations for Constructing Roadside Vegetation Barriers to Improve Near-Road Air Quality

    Science.gov (United States)

    The EPA report, Recommendations for Constructing Roadside Vegetation Barriers to Improve Near-Road Air Quality, summarizes the research findings on the best practices for building roadside vegetative barriers to improve air quality. This fact sheet describ

  1. Barriers to performing stretching exercises among Korean-Chinese female migrant workers in Korea.

    Science.gov (United States)

    Lee, Hyeonkyeong; Wilbur, JoEllen; Chae, Duckhee; Lee, Kyongeun; Lee, Meenhye

    2015-01-01

    The purpose of this study was to investigate the barriers to performing stretching exercise experienced by Korean-Chinese female migrant workers during a community-based 12-week stretching exercise intervention trial. Qualitative secondary data analysis was conducted using telephone counseling interview transcripts from 27 middle-aged, Korean-Chinese migrant women workers. A semistructured interview question asking barriers to performing stretching exercise was given to women who did not adhere to recommended stretching exercise. During the 12-week home-based stretching exercise intervention trial, six telephone calls were made to participants biweekly to elicit barriers to performing stretching exercise. Directed content analysis approach was utilized using three barrier categories: intrapersonal, interpersonal, and work-related environmental factors based on the ecological model. Participants experienced an average of 2.5 barriers during the study period. Intrapersonal barriers included lack of time and lack of motivation, and interpersonal barriers included no family to provide support and also a feeling resistance from coworkers. Work-related environmental barriers included frequent job changes, long working hours, lack of rest time, and unpredictable job demands. The findings highlight that migrant workers in Korea face unique work-related difficulties which present barriers to exercise. © 2014 Wiley Periodicals, Inc.

  2. The cost-of-living index with trade barriers

    OpenAIRE

    Thomas von Brasch

    2013-01-01

    The standard cost-of-living index hinges on the assumption that there is free trade. Applying it to situations where trade barriers are present yields biased results with respect to a true cost-of-living index. Import price indices are particularly vulnerable to this bias since many of the goods included in these indices are characterised by either explicit or implicit trade barriers. In this article I generalise the cost-of-living index to also allow for barriers to trade in the form of quan...

  3. Stability of barrier buckets with zero RF-barrier separations

    Energy Technology Data Exchange (ETDEWEB)

    Ng, K.Y.; /Fermilab

    2005-03-01

    A barrier bucket with very small separation between the rf barriers (relative to the barrier widths) or even zero separation has its synchrotron tune decreasing rather slowly from a large value towards the boundary of the bucket. As a result, large area at the bucket edges can become unstable under the modulation of rf voltage and/or rf phase. In addition, chaotic regions may form near the bucket center and extend outward under increasing modulation. Application is made to those barrier buckets used in the process of momentum mining at the Fermilab Recycler Ring.

  4. An evaluation of the fire barrier system thermo-lag 330-1

    International Nuclear Information System (INIS)

    Nowlen, S.P.

    1994-09-01

    This report presents the results of three fire endurance tests and one ampacity derating test set of the fire barrier system Thermo-Lag 330-1 Subliming Coating. Each test was performed using cable tray specimens protected by a nominal three-hour fire barrier envelope comprised of two layers of nominal 1/2 inch thick material. The fire barrier systems for two of the three fire endurance test articles and for the ampacity derating test article were installed in accordance with the manufacturer's installations procedures. The barrier system for the third fire endurance test article was a full reproduction of one of the original manufacturer's qualification test articles. This final test article included certain installation enhancements not considered typical of current nuclear power plant installations. The primary criteria for fire endurance performance evaluation was based on cable circuit integrity testing. Secondary consideration was also given to the temperature rise limits set forth in the ASTM E119 standard fire barrier test procedure. All three of the fire endurance specimens failed prematurely. Circuit integrity failures for the two fire endurance test articles with procedures-based installations were recorded at approximately 76 and 59 minutes into the exposures for a 6 inch wide and 12 inch wide cable tray respectively. Temperature excursion failures (single point) for these two test articles were noted at approximately 65 and 56 minutes respectively. The first circuit integrity failure for the full reproduction test article was recorded approximately 119 minutes into the exposure, and the first temperature excursion failure for this test article was recorded approximately 110 minutes into the exposure

  5. Three integrated photovoltaic/sound barrier power plants. Construction and operational experience

    International Nuclear Information System (INIS)

    Nordmann, T.; Froelich, A.; Clavadetscher, L.

    2002-01-01

    After an international ideas competition by TNC Switzerland and Germany in 1996, six companies where given the opportunity to construct a prototype of their newly developed integrated PV-sound barrier concepts. The main goal was to develop highly integrated concepts, allowing the reduction of PV sound barrier systems costs, as well as the demonstration of specific concepts for different noise situations. This project is strongly correlated with a German project. Three of the concepts of the competition are demonstrated along a highway near Munich, constructed in 1997. The three Swiss installations had to be constructed at different locations, reflecting three typical situations for sound barriers. The first Swiss installation was the world first Bi-facial PV-sound barrier. It was built on a highway bridge at Wallisellen-Aubrugg in 1997. The operational experience of the installation is positive. But due to the different efficiencies of the two cell sides, its specific yield lies somewhat behind a conventional PV installation. The second Swiss plant was finished in autumn 1998. The 'zig-zag' construction is situated along the railway line at Wallisellen in a densely inhabited area with some local shadowing. Its performance and its specific yield is comparatively low due to a combination of several reasons (geometry of the concept, inverter, high module temperature, local shadows). The third installation was constructed along the motor way A1 at Bruettisellen in 1999. Its vertical panels are equipped with amorphous modules. The report show, that the performance of the system is reasonable, but the mechanical construction has to be improved. A small trial field with cells directly laminated onto the steel panel, also installed at Bruettisellen, could be the key development for this concept. This final report includes the evaluation and comparison of the monitored data in the past 24 months of operation. (author)

  6. Barriers to student success in engineering education

    Science.gov (United States)

    Boles, Wageeh; Whelan, Karen

    2017-07-01

    In the UK, the USA and Australia, there have been calls for an increase in the number of engineering graduates to meet the needs of current global challenges. Universities around the world have been grappling with how to both attract more engineering students and to then retain them. Attrition from engineering programmes is disturbingly high. This paper reports on an element of research undertaken through an Australian Learning and Teaching Council-funded Fellowship that investigated the factors leading to student attrition in engineering programmes, by identifying barriers to student success. Here, we contrast a review of the literature related to student barriers and success with student perceptions, gathered through a series of focus groups and interviews at three Australian universities. We also present recommendations for action to try to remove barriers to student success.

  7. Effect of contact barrier on electron transport in graphene.

    Science.gov (United States)

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

    2010-01-14

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

  8. TMX tandem-mirror experiments and thermal-barrier theoretical studies

    International Nuclear Information System (INIS)

    Simonen, T.C.; Baldwin, D.E.; Allen, S.L.

    1982-01-01

    This paper describes recent analysis of energy confinement in the Tandem Mirror Experiment (TMX). TMX data also indicates that warm plasma limits the amplitude of the anisotropy driven Alfven ion cyclotron (AIC) mode. Theoretical calculations show strong AIC stabilization with off-normal beam injection as planned in TMX-U and MFTF-B. This paper reports results of theoretical analysis of hot electrons in thermal barriers including electron heating calculations by Monte Carlo and Fokker-Planck codes and analysis of hot electron MHD and microinstability. Initial results from the TMX-U experiment are presented which show the presence of sloshing ions

  9. Self-efficacy and barriers to disaster evacuation in Hong Kong.

    Science.gov (United States)

    Newnham, Elizabeth A; Balsari, Satchit; Lam, Rex Pui Kin; Kashyap, Shraddha; Pham, Phuong; Chan, Emily Y Y; Patrick, Kaylie; Leaning, Jennifer

    2017-12-01

    To investigate specific challenges to Hong Kong's capacity for effective disaster response, we assessed perceived barriers to evacuation and citizens' self-efficacy. Global positioning system software was used to determine random sampling locations across Hong Kong, weighted by population density. The resulting sample of 1023 participants (46.5% female, mean age 40.74 years) were invited to complete questionnaires on emergency preparedness, barriers to evacuation and self-efficacy. Latent profile analysis and multinomial logistic regression were used to identify self-efficacy profiles and predictors of profile membership. Only 11% of the sample reported feeling prepared to respond to a disaster. If asked to evacuate in an emergency, 41.9% of the sample cited significant issues that would preclude them from doing so. Self-efficacy was negatively associated with barriers to disaster response so that participants reporting higher levels of self-efficacy cited fewer perceived barriers to evacuation. Hong Kong has established effective strategies for emergency response, but concerns regarding evacuation and mobilisation remain. The findings indicate that improving self-efficacy for disaster response has potential to increase evacuation readiness.

  10. Light Barrier for Non-Foil Packaging

    Science.gov (United States)

    2010-12-16

    foil and all-plastic materials were retorted and a second set of all-plastic packaged entrees were Microwave Sterilized on the Washington State...Copolymers for Retort Applications; SPE Polyolefins and Flexible Packaging Conference: Society of Plastics Engineers. Newtown. CT, 43pp. Thellen C...Final Scientific Report Light Barrier for Non-Foil Packaging Contract No. W911QY-08-C-0132 Final Scientific Report Contract No. W911QY-08-C-0132

  11. A DESIGN STUDY OF AN INNOVATIVE BARRIER SYSTEM FOR PERSONAL PARKING LOTS

    OpenAIRE

    BÖRKLÜ, Hüseyin; KALYON, Sadık

    2018-01-01

    The increase in the number of cars made it necessary to protectthe parking areas. This research includes a literature review aboutcommercially available barriers, which are arm barriers, rising bollards, chainbarriers, automatic and manual private barriers from the point of common andside-by-side parking lots. Their advantages and disadvantages are evaluated.After the literature review work, a design requirements list for a car parkprotector, which includes important and strong properties of ...

  12. Perceived benefits and barriers to exercise for recently treated patients with multiple myeloma: a qualitative study.

    Science.gov (United States)

    Craike, Melinda J; Hose, Kaye; Courneya, Kerry S; Harrison, Simon J; Livingston, Patricia M

    2013-07-01

    Understanding the physical activity experiences of patients with multiple myeloma (MM) is essential to inform the development of evidence-based interventions and to quantify the benefits of physical activity. The aim of this study was to gain an in-depth understanding of the physical activity experiences and perceived benefits and barriers to physical activity for patients with MM. This was a qualitative study that used a grounded theory approach. Semi-structured interviews were conducted in Victoria, Australia by telephone from December 2011-February 2012 with patients who had been treated for MM within the preceding 2-12 months. Interviews were transcribed and analysed using the constant comparison coding method to reduce the data to themes. Gender differences and differences between treatment groups were explored. Twenty-four interviews were completed. The sample comprised 13 females (54%), with a mean age of 62 years (SD = 8.8). Sixteen (67%) participants had received an autologous stem cell transplant (ASCT). All participants currently engaged in a range of light to moderate intensity physical activity; walking and gardening were the most common activities. Recovery from the symptoms of MM and side effects of therapy, psychological benefits, social factors and enjoyment were important benefits of physical activity. Barriers to physical activity predominately related to the symptoms of MM and side effects of therapy, including pain, fatigue, and fear of infection. Low self- motivation was also a barrier. Women participated in a more diverse range of physical activities than men and there were gender differences in preferred type of physical activity. Women were more likely to report psychological and social benefits; whereas men reported physical activity as a way to keep busy and self-motivation was a barrier. Patients treated with an ASCT more often reported affective benefits of participation in physical activity and fatigue as a barrier. Patients

  13. Overcoming Barriers to Skills Training in Borderline Personality Disorder: A Qualitative Interview Study.

    Science.gov (United States)

    Barnicot, Kirsten; Couldrey, Laura; Sandhu, Sima; Priebe, Stefan

    2015-01-01

    Despite evidence suggesting that skills training is an important mechanism of change in dialectical behaviour therapy, little research exploring facilitators and barriers to this process has been conducted. The study aimed to explore clients' experiences of barriers to dialectical behaviour therapy skills training and how they felt they overcame these barriers, and to compare experiences between treatment completers and dropouts. In-depth qualitative interviews were conducted with 40 clients with borderline personality disorder who had attended a dialectical behaviour therapy programme. A thematic analysis of participants' reported experiences found that key barriers to learning the skills were anxiety during the skills groups and difficulty understanding the material. Key barriers to using the skills were overwhelming emotions which left participants feeling unable or unwilling to use them. Key ways in which participants reported overcoming barriers to skills training were by sustaining their commitment to attending therapy and practising the skills, personalising the way they used them, and practising them so often that they became an integral part of their behavioural repertoire. Participants also highlighted a number of key ways in which they were supported with their skills training by other skills group members, the group therapists, their individual therapist, friends and family. Treatment dropouts were more likely than completers to describe anxiety during the skills groups as a barrier to learning, and were less likely to report overcoming barriers to skills training via the key processes outlined above. The findings of this qualitative study require replication, but could be used to generate hypotheses for testing in further research on barriers to skills training, how these relate to dropout, and how they can be overcome. The paper outlines several such suggestions for further research.

  14. Overcoming Barriers to Skills Training in Borderline Personality Disorder: A Qualitative Interview Study.

    Directory of Open Access Journals (Sweden)

    Kirsten Barnicot

    Full Text Available Despite evidence suggesting that skills training is an important mechanism of change in dialectical behaviour therapy, little research exploring facilitators and barriers to this process has been conducted. The study aimed to explore clients' experiences of barriers to dialectical behaviour therapy skills training and how they felt they overcame these barriers, and to compare experiences between treatment completers and dropouts. In-depth qualitative interviews were conducted with 40 clients with borderline personality disorder who had attended a dialectical behaviour therapy programme. A thematic analysis of participants' reported experiences found that key barriers to learning the skills were anxiety during the skills groups and difficulty understanding the material. Key barriers to using the skills were overwhelming emotions which left participants feeling unable or unwilling to use them. Key ways in which participants reported overcoming barriers to skills training were by sustaining their commitment to attending therapy and practising the skills, personalising the way they used them, and practising them so often that they became an integral part of their behavioural repertoire. Participants also highlighted a number of key ways in which they were supported with their skills training by other skills group members, the group therapists, their individual therapist, friends and family. Treatment dropouts were more likely than completers to describe anxiety during the skills groups as a barrier to learning, and were less likely to report overcoming barriers to skills training via the key processes outlined above. The findings of this qualitative study require replication, but could be used to generate hypotheses for testing in further research on barriers to skills training, how these relate to dropout, and how they can be overcome. The paper outlines several such suggestions for further research.

  15. Barriers and facilitators of disclosures of domestic violence by mental health service users: qualitative study.

    Science.gov (United States)

    Rose, Diana; Trevillion, Kylee; Woodall, Anna; Morgan, Craig; Feder, Gene; Howard, Louise

    2011-03-01

    Mental health service users are at high risk of domestic violence but this is often not detected by mental health services. To explore the facilitators and barriers to disclosure of domestic violence from a service user and professional perspective. A qualitative study in a socioeconomically deprived south London borough, UK, with 18 mental health service users and 20 mental health professionals. Purposive sampling of community mental health service users and mental healthcare professionals was used to recruit participants for individual interviews. Thematic analysis was used to determine dominant and subthemes. These were transformed into conceptual maps with accompanying illustrative quotations. Service users described barriers to disclosure of domestic violence to professionals including: fear of the consequences, including fear of Social Services involvement and consequent child protection proceedings, fear that disclosure would not be believed, and fear that disclosure would lead to further violence; the hidden nature of the violence; actions of the perpetrator; and feelings of shame. The main themes for professionals concerned role boundaries, competency and confidence. Service users and professionals reported that the medical diagnostic and treatment model with its emphasis on symptoms could act as a barrier to enquiry and disclosure. Both groups reported that enquiry and disclosure were facilitated by a supportive and trusting relationship between the individual and professional. Mental health services are not currently conducive to the disclosure of domestic violence. Training of professionals in how to address domestic violence to increase their confidence and expertise is recommended.

  16. Injectable barriers for waste isolation

    International Nuclear Information System (INIS)

    Persoff, P.; Finsterle, S.; Moridis, G.J.; Apps, J.; Pruess, K.; Muller, S.J.

    1995-03-01

    In this paper the authors report laboratory work and numerical simulation done in support of development and demonstration of injectable barriers formed from either of two fluids: colloidal silica or polysiloxane. Two principal problems addressed here are control of gel time and control of plume emplacement in the vadose zone. Gel time must be controlled so that the viscosity of the barrier fluid remains low long enough to inject the barrier, but increases soon enough to gel the barrier in place. During injection, the viscosity must be low enough to avoid high injection pressures which could uplift or fracture the formation. To test the grout gel time in the soil, the injection pressure was monitored as grouts were injected into sandpacks. When grout is injected into the vadose zone, it slumps under the influence of gravity, and redistributes due to capillary forces as it gels. The authors have developed a new module for the reservoir simulator TOUGH2 to model grout injection into the vadose zone, taking into account the increase of liquid viscosity as a function of gel concentration and time. They have also developed a model to calculate soil properties after complete solidification of the grout. The numerical model has been used to design and analyze laboratory experiments and field pilot tests. The authors present the results of computer simulations of grout injection, redistribution, and solidification

  17. Implementation of a Non-Metallic Barrier in an Electric Motor

    Science.gov (United States)

    M'Sadoques, George A. (Inventor); Carra, Michael R. (Inventor); Beringer, Durwood M. (Inventor)

    2013-01-01

    A motor for use in a volatile environment includes a rotor exposed to the volatile environment, electronics for rotating the rotor, an impervious ceramic barrier separating the electronics and the rotor, and a flexible seal for preventing the volatile environment from contacting the electronics and for minimizing vibratory and twisting loads upon the barrier to minimize damage to the barrier.

  18. The Uphill Battle of Performing Education Scholarship: Barriers Educators and Education Researchers Face

    Directory of Open Access Journals (Sweden)

    Wendy C. Coates

    2018-03-01

    Full Text Available Introduction: Educators and education researchers report that their scholarship is limited by lack of time, funding, mentorship, expertise, and reward. This study aims to evaluate these groups’ perceptions regarding barriers to scholarship and potential strategies for success. Methods: Core emergency medicine (EM educators and education researchers completed an online survey consisting of multiple-choice, 10-point Likert scale, and free-response items in 2015. Descriptive statistics were reported. We used qualitative analysis applying a thematic approach to free-response items. Results: A total of 204 educators and 42 education researchers participated. Education researchers were highly productive: 19/42 reported more than 20 peer-reviewed education scholarship publications on their curricula vitae. In contrast, 68/197 educators reported no education publications within five years. Only a minority, 61/197 had formal research training compared to 25/42 education researchers. Barriers to performing research for both groups were lack of time, competing demands, lack of support, lack of funding, and challenges achieving scientifically rigorous methods and publication. The most common motivators identified were dissemination of knowledge, support of evidence-based practices, and promotion. Respondents advised those who seek greater education research involvement to pursue mentorship, formal research training, collaboration, and rigorous methodological standards. Conclusion: The most commonly cited barriers were lack of time and competing demands. Stakeholders were motivated by the desire to disseminate knowledge, support evidence-based practices, and achieve promotion. Suggested strategies for success included formal training, mentorship, and collaboration. This information may inform interventions to support educators in their scholarly pursuits and improve the overall quality of education research in EM.

  19. Biological and Sociocultural Differences in Perceived Barriers to Physical Activity among 5th–7th Grade Urban Girls

    Science.gov (United States)

    Vermeesch, Amber L.; Ling, Jiying; Voskuil, Vicki R.; Bakhoya, Marion; Wesolek, Stacey M.; Bourne, Kelly A.; Pfeiffer, Karin A.; Robbins, Lorraine B.

    2015-01-01

    Background Inadequate physical activity (PA) contributes to the high prevalence of overweight and obesity among U.S. adolescent girls. Barriers preventing adolescent girls from meeting PA guidelines have not been thoroughly examined. Objectives The threefold purpose of this study was to: (a) determine pubertal stage, racial/ethnic, and socioeconomic status (SES) differences in ratings of interference of barriers to PA; (b) examine relationships between perceived barriers and age, body mass index (BMI), recreational screen time, sedentary activity, and PA; and (c) identify girls’ top-rated perceived barriers to PA. Methods Girls (N = 509) from eight Midwestern U.S. schools participated. Demographic, pubertal stage, perceived barriers, and recreational screen time data were collected via surveys. Height and weight were measured. Accelerometers measured sedentary activity, moderate-to-vigorous physical activity (MVPA), and light plus MVPA. Results Girls of low SES reported greater interference of perceived barriers to PA than those who were not of low SES (1.16 vs. 0.97, p = .01). Girls in early/middle puberty had lower perceived barriers than those in late puberty (1.03 vs. 1.24, p barriers were negatively related to MVPA (r = −.10, p = .03) and light plus MVPA (r = −.11, p = .02). Girls’ top five perceived barriers included lack of skills, hating to sweat, difficulty finding programs, being tired, and having pain. Discussion Innovative interventions, particularly focusing on skill development, are needed to assist girls in overcoming their perceived barriers to PA. PMID:26325276

  20. Oncology nurse communication barriers to patient-centered care.

    Science.gov (United States)

    Wittenberg-Lyles, Elaine; Goldsmith, Joy; Ferrell, Betty

    2013-04-01

    Although quality communication has been identified as a necessary component to cancer care, communication skills training programs have yet to focus on the unique role of nurses. This study explored communication barriers as reported by seven nurse managers to better identify communication skills needed for oncology nurses to practice patient-centered care. Thematic analysis of transcripts was used to identify barriers to patient and family communication and desirable patient-centered nursing communication skills. Overall, the nurse managers reported that nurses experience patient and family communication difficulties as a result of inconsistent messages to patients and family from other healthcare staff. Physician assumptions about nursing left nurses feeling uncomfortable asking for clarification, creating a barrier to team communication processes. Patient-centered communication and care cannot be actualized for nurses unless team roles are clarified and nurses receive training in how to communicate with physicians, patients, and family. Therefore, the authors of this article created the COMFORT communication training protocol, and key concepts and resources for nurse communication training through COMFORT are detailed in this article.

  1. Students' benefits and barriers to mental health help-seeking

    Science.gov (United States)

    Vidourek, Rebecca A.; King, Keith A.; Nabors, Laura A.; Merianos, Ashley L.

    2014-01-01

    Stigma is recognized as a potential barrier to seeking help for a mental health disorder. The present study assessed college students' perceived benefits and barriers to obtaining mental health treatment and stigma-related attitudes via a four-page survey. A total of 682 students at one Midwestern university participated in the study. Findings indicated that females perceived a greater number of benefits to having participated in mental health services and held significantly lower stigma-related attitudes than did males. Students who had ever received mental health services reported significantly more barriers to treatment than did students who had never received services. Health professionals should target students with educational programs about positive outcomes related to receiving mental health services and work with treatment centers to reduce barriers for receiving services. PMID:25750831

  2. Evaluation of Subsurface Engineered Barriers at Waste Sites Volumes 1 and 2

    Science.gov (United States)

    This report provides the U.S. Environmental Protection Agency’s (EPA) waste programs with a national retrospective analysis of barrier field performance, as well as information that useful in developing guidance on the use and evaluation of barrier systems

  3. Modifiable barriers to leisure-time physical activity during pregnancy: a qualitative study investigating first time mother's views and experiences.

    Science.gov (United States)

    Connelly, Megan; Brown, Helen; van der Pligt, Paige; Teychenne, Megan

    2015-04-22

    Evidence suggests physical activity often declines during pregnancy, however explanations for the decline are not well understood. The aim of this study was to identify modifiable barriers to leisure-time physical activity among women who did not meet physical activity guidelines during pregnancy. Analyses were based on data from 133 mothers (~3-months postpartum) who were recruited from the Melbourne InFANT Extend study (2012/2013). Women completed a self-report survey at baseline in which they reported their leisure-time physical activity levels during pregnancy as well provided an open-ended written response regarding the key barriers that they perceived prevented them from meeting the physical activity guidelines during their pregnancy. Thematic analyses were conducted to identify key themes. The qualitative data revealed six themes relating to the barriers of leisure-time physical activity during pregnancy. These included work-related factors (most commonly reported), tiredness, pregnancy-related symptoms, being active but not meeting the guidelines, lack of motivation, and a lack of knowledge of recommendations. Considering work-related barriers were suggested to be key factors to preventing women from meeting the physical activity guidelines during pregnancy, workplace interventions aimed at providing time management skills along with supporting physical activity programs for pregnant workers should be considered. Such interventions should also incorporate knowledge and education components, providing advice for undertaking leisure-time physical activity during pregnancy.

  4. Safety- barrier diagrams

    DEFF Research Database (Denmark)

    Duijm, Nijs Jan

    2008-01-01

    Safety-barrier diagrams and the related so-called 'bow-tie' diagrams have become popular methods in risk analysis. This paper describes the syntax and principles for constructing consistent and valid safety-barrier diagrams. The relation of safety-barrier diagrams to other methods such as fault...... trees and Bayesian networks is discussed. A simple method for quantification of safety-barrier diagrams is proposed. It is concluded that safety-barrier diagrams provide a useful framework for an electronic data structure that integrates information from risk analysis with operational safety management....

  5. Barriers, motivators and facilitators related to prenatal care utilization among inner-city women in Winnipeg, Canada: a case-control study.

    Science.gov (United States)

    Heaman, Maureen I; Moffatt, Michael; Elliott, Lawrence; Sword, Wendy; Helewa, Michael E; Morris, Heather; Gregory, Patricia; Tjaden, Lynda; Cook, Catherine

    2014-07-15

    The reasons why women do not obtain prenatal care even when it is available and accessible are complex. Despite Canada's universally funded health care system, use of prenatal care varies widely across neighborhoods in Winnipeg, Manitoba, with the highest rates of inadequate prenatal care found in eight inner-city neighborhoods. The purpose of this study was to identify barriers, motivators and facilitators related to use of prenatal care among women living in these inner-city neighborhoods. We conducted a case-control study with 202 cases (inadequate prenatal care) and 406 controls (adequate prenatal care), frequency matched 1:2 by neighborhood. Women were recruited during their postpartum hospital stay, and were interviewed using a structured questionnaire. Stratified analyses of barriers and motivators associated with inadequate prenatal care were conducted, and the Mantel-Haenszel common odds ratio (OR) was reported when the results were homogeneous across neighborhoods. Chi square analysis was used to test for differences in proportions of cases and controls reporting facilitators that would have helped them get more prenatal care. Of the 39 barriers assessed, 35 significantly increased the odds of inadequate prenatal care for inner-city women. Psychosocial issues that increased the likelihood of inadequate prenatal care included being under stress, having family problems, feeling depressed, "not thinking straight", and being worried that the baby would be apprehended by the child welfare agency. Structural barriers included not knowing where to get prenatal care, having a long wait to get an appointment, and having problems with child care or transportation. Attitudinal barriers included not planning or knowing about the pregnancy, thinking of having an abortion, and believing they did not need prenatal care. Of the 10 motivators assessed, four had a protective effect, such as the desire to learn how to protect one's health. Receiving incentives and getting

  6. Barriers to implementing evidence-based practices in addiction treatment programs: comparing staff reports on Motivational Interviewing, Adolescent Community Reinforcement Approach, Assertive Community Treatment, and Cognitive-behavioral Therapy.

    Science.gov (United States)

    Amodeo, M; Lundgren, L; Cohen, A; Rose, D; Chassler, D; Beltrame, C; D'Ippolito, M

    2011-11-01

    This qualitative study explored barriers to implementing evidence-based practices (EBPs) in community-based addiction treatment organizations (CBOs) by comparing staff descriptions of barriers for four EBPs: Motivational Interviewing (MI), Adolescent Community Reinforcement Approach (A-CRA), Assertive Community Treatment (ACT), and Cognitive-behavioral Therapy (CBT). The CBOs received CSAT/SAMHSA funding from 2003 to 2008 to deliver services using EBPs. Phone interview responses from 172 CBO staff directly involved in EBP implementation were analyzed using content analysis, a method for making inferences and developing themes from the systematic review of participant narratives (Berelson, 1952). Staff described different types of barriers to implementing each EBP. For MI, the majority of barriers involved staff resistance or organizational setting. For A-CRA, the majority of barriers involved specific characteristics of the EBP or client resistance. For CBT, the majority of barriers were associated with client resistance, and for ACT, the majority of barriers were associated with resources. EBP designers, policy makers who support EBP dissemination and funders should include explicit strategies to address such barriers. Addiction programs proposing to use specific EBPs must consider whether their programs have the organizational capacity and community capacity to meet the demands of the EBP selected. Copyright © 2011 Elsevier Ltd. All rights reserved.

  7. Evolution of mid-Atlantic coastal and back-barrier estuary environments in response to a hurricane: Implications for barrier-estuary connectivity

    Science.gov (United States)

    Miselis, Jennifer L.; Andrews, Brian D.; Nicholson, Robert S.; Defne, Zafer; Ganju, Neil K.; Navoy, Anthony S.

    2016-01-01

    Assessments of coupled barrier island-estuary storm response are rare. Hurricane Sandy made landfall during an investigation in Barnegat Bay-Little Egg Harbor estuary that included water quality monitoring, geomorphologic characterization, and numerical modeling; this provided an opportunity to characterize the storm response of the barrier island-estuary system. Barrier island morphologic response was characterized by significant changes in shoreline position, dune elevation, and beach volume; morphologic changes within the estuary were less dramatic with a net gain of only 200,000 m3 of sediment. When observed, estuarine deposition was adjacent to the back-barrier shoreline or collocated with maximum estuary depths. Estuarine sedimentologic changes correlated well with bed shear stresses derived from numerically simulated storm conditions, suggesting that change is linked to winnowing from elevated storm-related wave-current interactions rather than deposition. Rapid storm-related changes in estuarine water level, turbidity, and salinity were coincident with minima in island and estuarine widths, which may have influenced the location of two barrier island breaches. Barrier-estuary connectivity, or the transport of sediment from barrier island to estuary, was influenced by barrier island land use and width. Coupled assessments like this one provide critical information about storm-related coastal and estuarine sediment transport that may not be evident from investigations that consider only one component of the coastal system.

  8. Health Care Experiences and Perceived Barriers to Health Care Access: A Qualitative Study Among African Migrants in Guangzhou, Guangdong Province, China.

    Science.gov (United States)

    Lin, Lavinia; Brown, Katherine B; Yu, Fan; Yang, Jingqi; Wang, Jason; Schrock, Joshua M; Bodomo, Adams B; Yang, Ligang; Yang, Bin; Nehl, Eric J; Tucker, Joseph D; Wong, Frank Y

    2015-10-01

    Guangzhou, one of China's largest cities and a main trading port in South China, has attracted many African businessmen and traders migrating to the city for financial gains. Previous research has explored the cultural and economic roles of this newly emerging population; however, little is known about their health care experiences while in China. Semi-structured interviews and focus groups were used to assess health care experiences and perceived barriers to health care access among African migrants in Guangzhou, China. Overall, African migrants experienced various barriers to accessing health care and were dissatisfied with local health services. The principal barriers to care reported included affordability, legal issues, language barriers, and cultural differences. Facing multiple barriers, African migrants have limited access to care in Guangzhou. Local health settings are not accustomed to the African migrant population, suggesting that providing linguistically and culturally appropriate services may improve access to care for the migrants.

  9. Barriers and Effective Educational Strategies to Develop Extension Agents' Professional Competencies

    Science.gov (United States)

    Lakai, Dona; Jayaratne, K. S. U.; Moore, Gary E.; Kistler, Mark J.

    2012-01-01

    The study reported here determined the barriers and effective educational strategies to develop Extension agents' professional competencies. This was a descriptive survey research conducted with a random sample of Extension agents. Increased workload and lack of time and funding were identified as the most constraining barriers of Extension agents…

  10. Large-scale fabrication of BN tunnel barriers for graphene spintronics

    International Nuclear Information System (INIS)

    Fu, Wangyang; Makk, Péter; Maurand, Romain; Bräuninger, Matthias; Schönenberger, Christian

    2014-01-01

    We have fabricated graphene spin-valve devices utilizing scalable materials made from chemical vapor deposition (CVD). Both the spin-transporting graphene and the tunnel barrier material are CVD-grown. The tunnel barrier is realized by Hexagonal boron nitride, used either as a monolayer or bilayer and placed over the graphene. Spin transport experiments were performed using ferromagnetic contacts deposited onto the barrier. We find that spin injection is still greatly suppressed in devices with a monolayer tunneling barrier due to resistance mismatch. This is, however, not the case for devices with bilayer barriers. For those devices, a spin relaxation time of ∼260 ps intrinsic to the CVD graphene material is deduced. This time scale is comparable to those reported for exfoliated graphene, suggesting that this CVD approach is promising for spintronic applications which require scalable materials

  11. Mucosal Barrier Injury Laboratory-Confirmed Bloodstream Infections (MBI-LCBI): Descriptive Analysis of Data Reported to National Healthcare Safety Network (NHSN), 2013.

    Science.gov (United States)

    Epstein, Lauren; See, Isaac; Edwards, Jonathan R; Magill, Shelley S; Thompson, Nicola D

    2016-01-01

    OBJECTIVES To determine the impact of mucosal barrier injury laboratory-confirmed bloodstream infections (MBI-LCBIs) on central-line-associated bloodstream infection (CLABSI) rates during the first year of MBI-LCBI reporting to the National Healthcare Safety Network (NHSN) DESIGN Descriptive analysis of 2013 NHSN data SETTING Selected inpatient locations in acute care hospitals METHODS A descriptive analysis of MBI-LCBI cases was performed. CLABSI rates per 1,000 central-line days were calculated with and without the inclusion of MBI-LCBIs in the subset of locations reporting ≥1 MBI-LCBI, and in all locations (regardless of MBI-LCBI reporting) to determine rate differences overall and by location type. RESULTS From 418 locations in 252 acute care hospitals reporting ≥1 MBI-LCBIs, 3,162 CLABSIs were reported; 1,415 (44.7%) met the MBI-LCBI definition. Among these locations, removing MBI-LCBI from the CLABSI rate determination produced the greatest CLABSI rate decreases in oncology (49%) and ward locations (45%). Among all locations reporting CLABSI data, including those reporting no MBI-LCBIs, removing MBI-LCBI reduced rates by 8%. Here, the greatest decrease was in oncology locations (38% decrease); decreases in other locations ranged from 1.2% to 4.2%. CONCLUSIONS An understanding of the potential impact of removing MBI-LCBIs from CLABSI data is needed to accurately interpret CLABSI trends over time and to inform changes to state and federal reporting programs. Whereas the MBI-LCBI definition may have a large impact on CLABSI rates in locations where patients with certain clinical conditions are cared for, the impact of MBI-LCBIs on overall CLABSI rates across inpatient locations appears to be more modest. Infect. Control Hosp. Epidemiol. 2015;37(1):2-7.

  12. Sexually Transmitted Infection Services for Adolescents and Youth in Low- and Middle-Income Countries: Perceived and Experienced Barriers to Accessing Care.

    Science.gov (United States)

    Newton-Levinson, Anna; Leichliter, Jami S; Chandra-Mouli, Venkatraman

    2016-07-01

    Access to sexual and reproductive health (SRH) services is vital for sexually active adolescents; yet, their SRH care needs are often unmet. We conducted a qualitative systematic review of mixed methods studies to assess adolescent and provider views of barriers to seeking appropriate medical care for sexually transmitted infection (STI) services for adolescents. We searched peer-reviewed literature for studies published between 2001 and 2014 with a study population of youth (aged 10-24 years) and/or health service providers. Nineteen studies were identified for inclusion from 15 countries. Thematic analyses identified key themes across the studies. Findings suggest that youth lacked knowledge about STIs and services. In addition, youth experienced barriers related to service availability and a lack of integration of services. The most reported barriers were related to acceptability of services. Youth reported avoiding services or having confidentiality concerns based on provider demographics and some behaviors. Finally, experiences of shame and stigma were common barriers to seeking care. Adolescents in low- and middle-income countries experience significant barriers in obtaining STI and SRH services. Improving uptake may require efforts to address clinic systems and provider attitudes, including confidentiality issues. Moreover, addressing barriers to STI services may require addressing cultural norms related to adolescent sexuality. Copyright © 2016 Society for Adolescent Health and Medicine. All rights reserved.

  13. Measuring Health-related Transportation Barriers in Urban Settings.

    Science.gov (United States)

    Locatelli, Sara M; Sharp, Lisa K; Syed, Saming T; Bhansari, Shikhi; Gerber, Ben S

    Access to reliable transportation is important for people with chronic diseases considering the need for frequent medical visits and for medications from the pharmacy. Understanding of the extent to which transportation barriers, including lack of transportation, contribute to poor health outcomes has been hindered by a lack of consistency in measuring or operationally defining "transportation barriers." The current study uses the Rasch measurement model to examine the psychometric properties of a new measure designed to capture types of transportation and associated barriers within an urban context. Two hundred forty-four adults with type 2 diabetes were recruited from within an academic medical center in Chicago and completed the newly developed transportation questions as part of a larger National Institutes of Health funded study (ClinicalTrials.gov identifier: NCT01498159). Results suggested a two subscale structure that reflected 1) general transportation barriers and 2) public transportation barriers.

  14. Vehicle barrier systems

    International Nuclear Information System (INIS)

    Sena, P.A.

    1986-01-01

    The ground vehicle is one of the most effective tools available to an adversary force. Vehicles can be used to penetrate many types of perimeter barriers, transport equipment and personnel rapidly over long distances, and deliver large amounts of explosives directly to facilities in suicide missions. The function of a vehicle barrier system is to detain or disable a defined threat vehicle at a selected distance from a protected facility. Numerous facilities are installing, or planning to install, vehicle barrier systems and many of these facilities are requesting guidance to do so adequately. Therefore, vehicle barriers are being evaluated to determine their stopping capabilities so that systems can be designed that are both balanced and capable of providing a desired degree of protection. Equally important, many of the considerations that should be taken into account when establishing a vehicle barrier system have been identified. These considerations which pertain to site preparation, barrier selection, system integration and operation, and vehicle/barrier interaction, are discussed in this paper

  15. Barriers and facilitators influencing ethical evaluation in health technology assessment.

    Science.gov (United States)

    Assasi, Nazila; Schwartz, Lisa; Tarride, Jean-Eric; O'Reilly, Daria; Goeree, Ron

    2015-01-01

    The objective of this study was to explore barriers and facilitators influencing the integration of ethical considerations in health technology assessment (HTA). The study consisted of two complementary approaches: (a) a systematic review of the literature; and (b) an eighteen-item online survey that was distributed to fifty-six HTA agencies affiliated with the International Network of Agencies for Health Technology Assessment. The review identified twenty-six relevant articles. The most often cited barriers in the literature were: scarcity, heterogeneity and complexity of ethical analysis methods; challenges in translating ethical analysis results into knowledge that is useful for decision makers; and lack of organizational support in terms of required expertise, time and financial resources. The most frequently cited facilitators included: usage of value-based appraisal methods, stakeholder and public engagement, enhancement of practice guidelines, ethical expertise, and educational interventions. Representatives of twenty-six (46.5 percent) agencies from nineteen countries completed the survey. A median of 10 percent (interquartile range, 5 percent to 50 percent) of the HTA products produced by the agencies was reported to include an assessment of ethical aspects. The most commonly perceived barriers were: limited ethical knowledge and expertise, insufficient time and resources, and difficulties in finding ethical evidence or using ethical guidelines. Educational interventions, demand by policy makers, and involvement of ethicists in HTA were the most commonly perceived facilitators. Our results emphasize the importance of simplification of ethics methodology and development of good practice guidelines in HTA, as well as capacity building for engaging HTA practitioners in ethical analyses.

  16. Implementation of renewable energy technologies - Opportunities and barriers. Ghana country study

    Energy Technology Data Exchange (ETDEWEB)

    Edjekumhene, I.; Atakora, S.B.; Atta-Konadu, R.; Brew-Hammond, A. [Kumasi Inst. og Technology and Environment (Ghana)

    2001-07-01

    This report presents the experience of Ghana in the development, utilisation and promotion of Renewable Energy Technologies (RETs). The report gives a general overview of the state of RETs, describes past/existing institutional, regulatory and policy framework, identifies key barriers to and opportunities for RETs, and recommends directional changes needed to remove barriers and promote wide-scale adoption of RETs in Ghana. A total of eight RETs - biomass-fired dryers, sawdust stoves, sawdust briquette, biogas, solar crop dryer, solar water heater, solar water pump and small hydro power - are covered in the report. Analyses of barriers to the eight RETs are carried out using a framework approach that categorises barriers into socio-technical, economic and crosscutting barriers. Financial analyses, as opposed to economic analyses, have been carried out for all the selected RETs. The report also incorporates stake holders' perspectives and views on barriers and how they can be removed. Ghana is endowed with several renewable energy resources like solar radiation, small hydro, biomass, and wind. Exploitation of Ghana's renewable energy resources has been carried out under two main policy regimes - PND Law 62 (1983) and the Energy Sector Development Programme (ESDP). Several measures and instruments have been employed in the implementation of renewable energy policies. The main measures used are research and development, information and eduction, and some normative measures (like the passing of PNDC Law 62 and the Energy Commission Law). Some economic instruments, such as subsidies, taxes, pricing, financing and duty waiver/reduction, have been used as well but only to a limited extent. The effective development, implementation and dissemination of all the RETs studied are hampered by several barriers, which can be grouped into three main categories - Socio-technical barriers, economic barriers and crosscutting barriers. Socio-technical barriers refer to

  17. Implementation of renewable energy technologies - Opportunities and barriers. Ghana country study

    Energy Technology Data Exchange (ETDEWEB)

    Edjekumhene, I; Atakora, S B; Atta-Konadu, R; Brew-Hammond, A [Kumasi Inst. og Technology and Environment (Ghana)

    2001-07-01

    This report presents the experience of Ghana in the development, utilisation and promotion of Renewable Energy Technologies (RETs). The report gives a general overview of the state of RETs, describes past/existing institutional, regulatory and policy framework, identifies key barriers to and opportunities for RETs, and recommends directional changes needed to remove barriers and promote wide-scale adoption of RETs in Ghana. A total of eight RETs - biomass-fired dryers, sawdust stoves, sawdust briquette, biogas, solar crop dryer, solar water heater, solar water pump and small hydro power - are covered in the report. Analyses of barriers to the eight RETs are carried out using a framework approach that categorises barriers into socio-technical, economic and crosscutting barriers. Financial analyses, as opposed to economic analyses, have been carried out for all the selected RETs. The report also incorporates stake holders' perspectives and views on barriers and how they can be removed. Ghana is endowed with several renewable energy resources like solar radiation, small hydro, biomass, and wind. Exploitation of Ghana's renewable energy resources has been carried out under two main policy regimes - PND Law 62 (1983) and the Energy Sector Development Programme (ESDP). Several measures and instruments have been employed in the implementation of renewable energy policies. The main measures used are research and development, information and eduction, and some normative measures (like the passing of PNDC Law 62 and the Energy Commission Law). Some economic instruments, such as subsidies, taxes, pricing, financing and duty waiver/reduction, have been used as well but only to a limited extent. The effective development, implementation and dissemination of all the RETs studied are hampered by several barriers, which can be grouped into three main categories - Socio-technical barriers, economic barriers and crosscutting barriers. Socio-technical barriers refer to resource

  18. Integration of depression and primary care: barriers to adoption.

    Science.gov (United States)

    Grazier, Kyle L; Smith, Judith E; Song, Jean; Smiley, Mary L

    2014-01-01

    Despite the prevailing consensus as to its value, the adoption of integrated care models is not widespread. Thus, the objective of this article it to examine the barriers to the adoption of depression and primary care models in the United States. A literature search focused on peer-reviewed journal literature in Medline and PsycInfo. The search strategy focused on barriers to integrated mental health care services in primary care, and was based on previously existing searches. The search included: MeSH terms combined with targeted keywords; iterative citation searches in Scopus; searches for grey literature (literature not traditionally indexed by commercial publishers) in Google and organization websites, examination of reference lists, and discussions with researchers. Integration of depression care and primary care faces multiple barriers. Patients and families face numerous barriers, linked inextricably to create challenges not easily remedied by any one party, including the following: vulnerable populations with special needs, patient and family factors, medical and mental health comorbidities, provider supply and culture, financing and costs, and organizational issues. An analysis of barriers impeding integration of depression and primary care presents information for future implementation of services.

  19. Collective phenomena in volume and surface barrier discharges

    Science.gov (United States)

    Kogelschatz, U.

    2010-11-01

    Barrier discharges are increasingly used as a cost-effective configuration to produce non-equilibrium plasmas at atmospheric pressure. This way, copious amounts of electrons, ions, free radicals and excited species can be generated without significant heating of the background gas. In most applications the barrier is made of dielectric material. Major applications utilizing mainly dielectric barriers include ozone generation, surface cleaning and modification, polymer and textile treatment, sterilization, pollution control, CO2 lasers, excimer lamps, plasma display panels (flat TV screens). More recent research efforts are devoted to biomedical applications and to plasma actuators for flow control. Sinusoidal feeding voltages at various frequencies as well as pulsed excitation schemes are used. Volume as well as surface barrier discharges can exist in the form of filamentary, regularly patterned or diffuse, laterally homogeneous discharges. The physical effects leading to collective phenomena in volume and surface barrier discharges are discussed in detail. Special attention is paid to self-organization of current filaments and pattern formation. Major similarities of the two types of barrier discharges are elaborated.

  20. A qualitative meta-summary using Sandelowski and Barroso's method for integrating qualitative research to explore barriers and facilitators to self-care in heart failure patients.

    Science.gov (United States)

    Herber, Oliver Rudolf; Bücker, Bettina; Metzendorf, Maria-Inti; Barroso, Julie

    2017-12-01

    Individual qualitative studies provide varied reasons for why heart failure patients do not engage in self-care, yet articles that aggregated primary studies on the subject have methodological weaknesses that justified the execution of a qualitative meta-summary. The aim of this study is to integrate the findings of qualitative studies pertaining to barriers and facilitators to self-care using meta-summary techniques. Qualitative meta-summary techniques by Sandelowski and Barroso were used to combine the findings of qualitative studies. Meta-summary techniques include: (1) extraction of relevant statements of findings from each report; (2) reduction of these statements into abstracted findings and (3) calculation of effect sizes. Databases were searched systematically for qualitative studies published between January 2010 and July 2015. Out of 2264 papers identified, 31 reports based on the accounts of 814 patients were included in the meta-summary. A total of 37 statements of findings provided a comprehensive inventory of findings across all reports. Out of these statements of findings, 21 were classified as barriers, 13 as facilitators and three were classed as both barriers and facilitators. The main themes relating to barriers and facilitators to self-care were: beliefs, benefits of self-care, comorbidities, financial constraints, symptom recognition, ethnic background, inconsistent self-care, insufficient information, positive and negative emotions, organizational context, past experiences, physical environment, self-initiative, self-care adverse effects, social context and personal preferences. Based on the meta-findings identified in this study, future intervention development could address these barriers and facilitators in order to further enhance self-care abilities in heart failure patients.

  1. Enablers and barriers for women with gestational diabetes mellitus to achieve optimal glycaemic control - a qualitative study using the theoretical domains framework.

    Science.gov (United States)

    Martis, Ruth; Brown, Julie; McAra-Couper, Judith; Crowther, Caroline A

    2018-04-11

    Glycaemic target recommendations vary widely between international professional organisations for women with gestational diabetes mellitus (GDM). Some studies have reported women's experiences of having GDM, but little is known how this relates to their glycaemic targets. The aim of this study was to identify enablers and barriers for women with GDM to achieve optimal glycaemic control. Women with GDM were recruited from two large, geographically different, hospitals in New Zealand to participate in a semi-structured interview to explore their views and experiences focusing on enablers and barriers to achieving optimal glycaemic control. Final thematic analysis was performed using the Theoretical Domains Framework. Sixty women participated in the study. Women reported a shift from their initial negative response to accepting their diagnosis but disliked the constant focus on numbers. Enablers and barriers were categorised into ten domains across the three study questions. Enablers included: the ability to attend group teaching sessions with family and hear from women who have had GDM; easy access to a diabetes dietitian with diet recommendations tailored to a woman's context including ethnic food and financial considerations; free capillary blood glucose (CBG) monitoring equipment, health shuttles to take women to appointments; child care when attending clinic appointments; and being taught CBG testing by a community pharmacist. Barriers included: lack of health information, teaching sessions, consultations, and food diaries in a woman's first language; long waiting times at clinic appointments; seeing a different health professional every clinic visit; inconsistent advice; no tailored physical activities assessments; not knowing where to access appropriate information on the internet; unsupportive partners, families, and workplaces; and unavailability of social media or support groups for women with GDM. Perceived judgement by others led some women only to share

  2. Barriers and facilitators of antiretroviral therapy adherence in rural Eastern province, Zambia: the role of household economic status.

    Science.gov (United States)

    Masa, Rainier; Chowa, Gina; Nyirenda, Victor

    2017-07-01

    In Zambia, more people living with HIV now have access to lifesaving antiretroviral therapy than ever before. However, progress in HIV treatment and care has not always resulted in lower mortality. Adherence remains a critical barrier to treatment success. The objective of this study was to examine the barriers and facilitators of antiretroviral therapy adherence, particularly the role of household economic status. The study included a cross-sectional sample of 101 people living with HIV (PLHIV) in two rural communities in eastern Zambia. Adherence was measured using patient self-assessment and pharmacy information. Household economic status included components such as occupation, income, assets, food security, and debt. Multivariable logistic regression was conducted to examine the associations between household economic factors and adherence. Our findings suggest that the role of economic status on adherence appears to be a function of the economic component. Debt and non-farming-related occupation were consistently associated with non-adherence. The association between assets and adherence depends on the type of asset. Owning more transportation-related assets was consistently associated with non-adherence, whereas owning more livestock was associated with self-reported adherence. Additionally, living in a community with fewer economic opportunities was associated with non-adherence. The associations between place of residence and pharmacy refill adherence and between transportation assets and self-reported adherence were statistically significant. Improving adherence requires a multifaceted strategy that addresses the role of economic status as a potential barrier and facilitator. Programmes that provide economic opportunities and life-skills training may help PLHIV to overcome economic, social, and psychological barriers.

  3. A qualitative study of recruitment barriers, motivators, and community-based strategies for increasing clinical trials participation among rural and urban populations.

    Science.gov (United States)

    Friedman, Daniela B; Foster, Caroline; Bergeron, Caroline D; Tanner, Andrea; Kim, Sei-Hill

    2015-01-01

    Participation in clinical trials (CTs) is low among rural communities. Investigators report difficulty recruiting rural individuals for CTs. The study purpose was to identify recruitment barriers, motivators, and strategies to help increase access to and participation in CTs in rural and urban communities. Qualitative focus groups/interviews. Rural and urban counties in one southeastern state. Two hundred twelve African-American and white men and women ages 21+. Nineteen focus groups and nine interviews were conducted. Audio files were transcribed and organized into NVivo10. Recurring themes were examined by geographic location. Although similar barriers, motivators, and strategies were reported by urban and rural groups, perceptions regarding their importance varied. Recruitment barriers mentioned in both rural and urban groups included fear, side effects, limited understanding, limited time, and mistrust. Rural groups were more mindful of time commitment involved. Both rural and urban participants reported financial incentives as the top motivator to CT participation, followed by personal illness (urban groups) and benefits to family (rural groups). Recruitment strategies suggested by rural participants involved working with schools/churches and using word of mouth, whereas partnering with schools, word of mouth, and media were recommended most by urban groups. Perceived recruitment barriers, motivators, and strategies did not differ considerably between rural and urban groups. Major barriers identified by participants should be addressed in future CT recruitment and education efforts. Findings can inform recruitment and communication strategies for reaching both urban and rural communities.

  4. Standard practice for prediction of the long-term behavior of materials, including waste forms, used in engineered barrier systems (EBS) for geological disposal of high-level radioactive waste

    CERN Document Server

    American Society for Testing and Materials. Philadelphia

    2007-01-01

    1.1 This practice describes test methods and data analyses used to develop models for the prediction of the long-term behavior of materials, such as engineered barrier system (EBS) materials and waste forms, used in the geologic disposal of spent nuclear fuel (SNF) and other high-level nuclear waste in a geologic repository. The alteration behavior of waste form and EBS materials is important because it affects the retention of radionuclides by the disposal system. The waste form and EBS materials provide a barrier to release either directly (as in the case of waste forms in which the radionuclides are initially immobilized), or indirectly (as in the case of containment materials that restrict the ingress of groundwater or the egress of radionuclides that are released as the waste forms and EBS materials degrade). 1.1.1 Steps involved in making such predictions include problem definition, testing, modeling, and model confirmation. 1.1.2 The predictions are based on models derived from theoretical considerat...

  5. SMEs and Barriers to Skill Development: A Scottish Perspective.

    Science.gov (United States)

    Lange, Thomas; Ottens, Melanie; Taylor, Andrea

    2000-01-01

    Analysis of Scottish small and medium-sized enterprises reveals that small business culture is a significant barrier to skill development. Other barriers include awareness, finance, and access to training. A welter of recent policy initiatives has added to a state of confusion about the role of training. (SK)

  6. Surface barrier research at the Hanford Site

    International Nuclear Information System (INIS)

    Gee, G.W.; Ward, A.L.; Fayer, M.J.

    1997-01-01

    At the DOE Hanford Site, a field-scale prototype surface barrier was constructed in 1994 over an existing waste site as a part of a CERCLA treatability test. The above-grade barrier consists of a fine-soil layer overlying coarse layers of sands, gravels, basalt rock (riprap), and a low permeability asphalt layer. Two sideslope configurations, clean-fill gravel on a 10:1 slope and basalt riprap on a 2:1 slope, were built and are being tested. Design considerations included: constructability; drainage and water balance monitoring, wind and water erosion control and monitoring; surface revegetation and biotic intrusion; subsidence and sideslope stability, and durability of the asphalt layer. The barrier is currently in the final year of a three-year test designed to answer specific questions related to stability and long-term performance. One half of the barrier is irrigated such that the total water applied, including precipitation, is 480 mm/yr (three times the long-term annual average). Each year for the past two years, an extreme precipitation event (71 mm in 8 hr) representing a 1,000-yr return storm was applied in late March, when soil water storage was at a maximum. While the protective sideslopes have drained significant amounts of water, the soil cover (2-m of silt-loam soil overlying coarse sand and rock) has never drained. During the past year there was no measurable surface runoff or wind erosion. This is attributed to extensive revegetation of the surface. In addition, the barrier elevation has shown a small increase of 2 to 3 cm that is attributed to a combination of root proliferation and freeze/thaw activity. Testing will continue through September 1997. Performance data from the prototype barrier will be used by DOE in site-closure decisions at Hanford

  7. Motivators and barriers to participating in health promotion behaviors in Black men.

    Science.gov (United States)

    Calvert, Wilma J; Isaac-Savage, E Paulette

    2013-08-01

    There is limited research examining the health promotion behaviors (HPBs) of low-income Black men. This study examined the relationship between HPBs, and motivators and barriers to participating in these behaviors in Black men (N = 107), aged 21 to 56. Using descriptive statistics, more than 96% of the participants reported they were motivated because of the desire to be healthy. Canonical correlation analysis and conditional random forest were used to determine the importance of individual motivators and barriers. Canonical correlation analysis yielded one interpretable canonical variate that explained 39.5% of the variance in sets of motivators and barriers, and health promotion lifestyle variables. Men with fewer motivators and more barriers took less responsibility for their health, participated in less physical activity, and reported less spiritual growth. Having too many things to do and not knowing what to do best predicted participation in HPBs.

  8. Filamentary and diffuse barrier discharges

    International Nuclear Information System (INIS)

    Kogelschatz, U.

    2001-01-01

    Barrier discharges, sometimes also referred to as dielectric-barrier discharges or silent discharges, are characterized by the presence of at least one insulating layer in contact with the discharge between two planar or cylindrical electrodes connected to an ac power supply. The main advantage of this type of electrical discharge is, that non-equilibrium plasma conditions in atmospheric-pressure gases can be established in an economic and reliable way. This has led to a number of important applications including industrial ozone generation, surface modification of polymers, plasma chemical vapor deposition, excitation of CO 2 lasers, excimer lamps and, most recently, large-area flat plasma display panels. Depending on the application, the width of the discharge gap can range from less than 0.1 mm to about 100 mm and the applied frequency from below line frequency to several gigahertz. Typical materials used for the insulating layer (dielectric barrier) are glass, quartz, ceramics but also thin enamel or polymer layers

  9. Trends and barriers to lateral gene transfer in prokaryotes.

    Science.gov (United States)

    Popa, Ovidiu; Dagan, Tal

    2011-10-01

    Gene acquisition by lateral gene transfer (LGT) is an important mechanism for natural variation among prokaryotes. Laboratory experiments show that protein-coding genes can be laterally transferred extremely fast among microbial cells, inherited to most of their descendants, and adapt to a new regulatory regime within a short time. Recent advance in the phylogenetic analysis of microbial genomes using networks approach reveals a substantial impact of LGT during microbial genome evolution. Phylogenomic networks of LGT among prokaryotes reconstructed from completely sequenced genomes uncover barriers to LGT in multiple levels. Here we discuss the kinds of barriers to gene acquisition in nature including physical barriers for gene transfer between cells, genomic barriers for the integration of acquired DNA, and functional barriers for the acquisition of new genes. Copyright © 2011 Elsevier Ltd. All rights reserved.

  10. The facilitators and barriers of physical activity among Aboriginal and Torres Strait Islander regional sport participants.

    Science.gov (United States)

    Péloquin, Claudie; Doering, Thomas; Alley, Stephanie; Rebar, Amanda

    2017-10-01

    Disparities in health perspectives between Indigenous and non-Indigenous populations are major concerns in many of the world's well-developed nations. Indigenous populations are largely less healthy, more prone to chronic diseases, and have an earlier overall mortality than non-Indigenous populations. Low levels of physical activity (PA) contribute to the high levels of disease in Indigenous Australians. Qualitative analysis of structured one-on-one interviews discussing PA in a regional setting. Participants were 12 Indigenous Australian adults, and 12 non-Indigenous Australian adults matched on age, sex, and basketball division. Most participants reported engaging in regular exercise; however, the Indigenous group reported more barriers to PA. These factors included cost, time management and environmental constraints. The physical facilitators identified by our Indigenous sample included social support, intrinsic motivation and role modelling. Findings describe individual and external factors that promote or constraint PA as reported by Indigenous Australian adults. Results indicate that Indigenous people face specific barriers to PA when compared to a non-Indigenous sample. Implications for public health: This study is the first to compare the perspective of Indigenous Australians to a matched group of non-Indigenous Australians and provides useful knowledge to develop public health programs based on culturally sensitive data. © 2017 The Authors.

  11. 28 CFR 36.304 - Removal of barriers.

    Science.gov (United States)

    2010-07-01

    ..., vending machines, display racks, and other furniture; (5) Repositioning telephones; (6) Adding raised.... These measures include, for example, removal of obstructing furniture or vending machines, widening of...) General. A public accommodation shall remove architectural barriers in existing facilities, including...

  12. A high rotational barrier for physisorbed hydrogen in an fcu-metal-organic framework

    KAUST Repository

    Pham, Tony T.; Forrest, Katherine A.; Georgiev, Peter A L; Lohstroh, Wiebke; Xue, Dongxu; Hogan, Adam; Eddaoudi, Mohamed; Space, Brian; Eckert, Juergen

    2014-01-01

    A combined inelastic neutron scattering (INS) and theoretical study of H2 sorption in Y-FTZB, a recently reported metal-organic framework (MOF) with fcu topology, reveals that the strongest binding site in the MOF causes a high barrier to rotation on the sorbed H2. This rotational barrier for H2 is the highest yet of reported MOF materials based on physisorption. This journal is

  13. Placing barrier-island transgression in a blue-carbon context

    Science.gov (United States)

    Theuerkauf, Ethan J.; Rodriguez, Antonio B.

    2017-07-01

    Backbarrier saltmarshes are considered carbon sinks; however, barrier island transgression and the associated processes of erosion and overwash are typically not included in coastal carbon budgets. Here, we present a carbon-budget model for transgressive barrier islands that includes a dynamic carbon-storage term, driven by backbarrier-marsh width, and a carbon-export term, driven by ocean and backbarrier shoreline erosion. To examine the impacts of storms, human disturbances and the backbarrier setting of a transgressive barrier island on carbon budgets and reservoirs, the model was applied to sites at Core Banks and Onslow Beach, NC, USA. Results show that shoreline erosion and burial of backbarrier marsh from washover deposition and dredge-spoil disposal temporarily transitioned each site into a net exporter (source) of carbon. The magnitude of the carbon reservoir was linked to the backbarrier setting of an island. Carbon reservoirs of study sites separated from the mainland by only backbarrier marsh (no lagoon) decreased for over a decade because carbon storage could not keep pace with erosion. With progressive narrowing of the backbarrier marsh, these barriers will begin to function more persistently as carbon sources until the reservoir is depleted at the point where the barrier welds with the mainland. Undeveloped barrier islands with wide lagoons are carbon sources briefly during erosive periods; however, at century time scales are net carbon importers (sinks) because new marsh habitat can form during barrier rollover. Human development on backbarrier saltmarsh serves to reduce the carbon storage capacity and can hasten the transition of an island from a sink to a source.

  14. Structure information from fusion barriers

    Indian Academy of Sciences (India)

    Pb, using the coupled reaction channel (CRC) method and correct structure information, have been analysed. The barrier distributions derived from these excitation functions including many of the significant channels are featureless, although these channels have considerable effects on the fusion excitation function.

  15. Barriers to fusion

    International Nuclear Information System (INIS)

    Berriman, A.C.; Butt, R.D.; Dasgupta, M.; Hinde, D.J.; Morton, C.R.; Newton, J.O.

    1999-01-01

    The fusion barrier is formed by the combination of the repulsive Coulomb and attractive nuclear forces. Recent research at the Australian National University has shown that when heavy nuclei collide, instead of a single fusion barrier, there is a set of fusion barriers. These arise due to intrinsic properties of the interacting nuclei such deformation, rotations and vibrations. Thus the range of barrier energies depends on the properties of both nuclei. The transfer of matter between nuclei, forming a neck, can also affect the fusion process. High precision data have been used to determine fusion barrier distributions for many nuclear reactions, leading to new insights into the fusion process

  16. Extremal surface barriers

    International Nuclear Information System (INIS)

    Engelhardt, Netta; Wall, Aron C.

    2014-01-01

    We present a generic condition for Lorentzian manifolds to have a barrier that limits the reach of boundary-anchored extremal surfaces of arbitrary dimension. We show that any surface with nonpositive extrinsic curvature is a barrier, in the sense that extremal surfaces cannot be continuously deformed past it. Furthermore, the outermost barrier surface has nonnegative extrinsic curvature. Under certain conditions, we show that the existence of trapped surfaces implies a barrier, and conversely. In the context of AdS/CFT, these barriers imply that it is impossible to reconstruct the entire bulk using extremal surfaces. We comment on the implications for the firewall controversy

  17. Factors for Consideration in an Open-Flame Test for Assessing Fire Blocking Performance of Barrier Fabrics

    Directory of Open Access Journals (Sweden)

    Shonali Nazaré

    2016-09-01

    Full Text Available The main objective of the work reported here is to assess factors that could affect the outcome of a proposed open flame test for barrier fabrics (BF-open flame test. The BF-open flame test characterizes barrier effectiveness by monitoring the ignition of a flexible polyurethane foam (FPUF layer placed in contact with the upper side of the barrier fabric, exposed to a burner flame from below. Particular attention is given to the factors that influence the ignitibility of the FPUF, including thermal resistance, permeability, and structural integrity of the barrier fabrics (BFs. A number of barrier fabrics, displaying a wide range of the properties, are tested with the BF-open flame test. Visual observations of the FPUF burning behavior and BF char patterns, in addition to heat flux measurements on the unexposed side of the barrier fabrics, are used to assess the protective performance of the BF specimen under the open flame test conditions. The temperature and heat transfer measurements on the unexposed side of the BF and subsequent ranking of BFs for their thermal protective performance suggest that the BF-open flame test does not differentiate barrier fabrics based on their heat transfer properties. A similar conclusion is reached with regard to BF permeability characterized at room temperature. However, the outcome of this BF-open flame test is found to be heavily influenced by the structural integrity of thermally degraded BF. The BF-open flame test, in its current form, only ignited FPUF when structural failure of the barrier was observed.

  18. Subsurface barrier feasibility evaluation: External review meeting report

    International Nuclear Information System (INIS)

    Lindberg, S.L.; Rouse, J.K.

    1994-12-01

    The Westinghouse Hanford Company -- Tank Waste Remediation System Division (TWRS) Program is evaluating subsurface barrier technologies for potential use in supporting remediation of the Hanford Tank Farms for the US Department of Energy, Richland Operations Office (DOE-RL). An External Review Team (ERT) was assembled to perform an independent technical review of the work performed to-date supporting the evaluation process. A set of draft documents was forwarded to the ERT for their review, and a meeting was held August 10 through 12, 1994, to facilitate comments and resolutions. This document summarizes the meeting, the comments provided by the ERT, and the ongoing work to resolve the comments and support a pending decision by The US Department of Energy, Richland Operations Office; the Washington State Department of Ecology; and the US Environmental Protection Agency

  19. Parkinson's disease in Jordan: Barriers and motivators to exercise.

    Science.gov (United States)

    Khalil, Hanan; Nazzal, Mohammad; Al-Sheyab, Nihaya

    2016-10-01

    Perceived barriers to engaging in exercise in people with Parkinson's disease (PD) are becoming more defined in countries such as the UK and the US. This, however, may vary by culture and environment. This study aimed to explore the perceptions of exercise and barriers that may affect participation in people with PD from Jordan. Two focus groups and seven individual interviews were conducted with people with PD. Additionally, individual interviews were conducted with two neurologists. Conversations were digitally recorded and transcribed. Transcripts were analyzed using thematic analysis and validated via researcher triangulation and peer checking. Most of the PD participants lacked previous participation in any disease-specific exercises. Several barriers were perceived by PD participants for such lack of participation. Barriers included difficulty of diagnosis, lack of informational support provided by neurologists, lack of referral to physiotherapy services, disease-specific issues, and setting-related issues. Neurologists indicated a number of barriers in counseling their PD patients on exercise including lack of time and lack of health system resources. Motivators to participate in future exercise included outcome expectations and family support. Findings of the study shed light into large areas of unmet needs of supporting exercise and physiotherapy for people with PD in developing countries as per Jordan. For better patient outcomes, findings of the study suggest that it is crucial to raise awareness among all PD-related stakeholders on the benefits of early referrals to physiotherapy and early engagement in exercise programs.

  20. Barriers to quality health care for the transgender population.

    Science.gov (United States)

    Roberts, Tiffany K; Fantz, Corinne R

    2014-07-01

    The transgender community is arguably the most marginalized and underserved population in medicine. A special issue focusing on men's health would be incomplete without mention of this vulnerable population, which includes those transitioning to and from the male gender. Transgender patients face many barriers in their access to healthcare including historical stigmatization, both structural and financial barriers, and even a lack of healthcare provider experience in treating this unique population. Historical stigmatization fosters a reluctance to disclose gender identity, which can have dire consequences for long-term outcomes due to a lack of appropriate medical history including transition-related care. Even if a patient is willing to disclose their gender identity and transition history, structural barriers in current healthcare settings lack the mechanisms necessary to collect and track this information. Moreover, healthcare providers acknowledge that information is lacking regarding the unique needs and long-term outcomes for transgender patients, which contributes to the inability to provide appropriate care. All of these barriers must be recognized and addressed in order to elevate the quality of healthcare delivered to the transgender community to a level commensurate with the general population. Overcoming these barriers will require redefinition of our current system such that the care a patient receives is not exclusively linked to their sex but also considers gender identity. Copyright © 2014 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  1. Barriers to Surgical Care and Health Outcomes: A Prospective Study on the Relation Between Wealth, Sex, and Postoperative Complications in the Republic of Congo.

    Science.gov (United States)

    Lin, Brian M; White, Michelle; Glover, Ana; Wamah, Greta Peterson; Trotti, Davi L; Randall, Kirstie; Alkire, Blake C; Cheney, Mack L; Parker, Gary; Shrime, Mark G

    2017-01-01

    Approximately thirty percent of the global burden of disease is comprised of surgical conditions. However, five billion people lack access to surgery, with complex factors acting as barriers. We examined whether patient demographics predict barriers to care, and the relation between these factors and postoperative complications in a prospective cohort. Participants included people presenting to a global charity in Republic of Congo with a surgical condition between August 2013 and May 2014. The outcomes were self-reported barrier to care and postoperative complications documented by medical record. Logistic regression was used to adjust for covariates. Of 1237 patients in our study, 1190 (96.2 %) experienced a barrier to care and 126 (10.2 %) experienced a postoperative complication. The most frequently reported barrier was cost (73 %), followed by lack of provider (8.2 %). Greater wealth was associated with decreased odds of cost as a barrier (OR 0.72 [0.57, 0.90]). Greater wealth (OR 1.52 [1.03, 2.25]) and rural home location (OR 3.35 [1.16, 9.62]) were associated with increased odds of no surgeon being available. Cost as a barrier (OR 2.82 [1.02, 7.77]), female sex (OR 3.45 [1.62, 7.33]), and lack of surgeon (OR 5.62 [1.68, 18.77]) were associated with increased odds of postoperative complication. Patient wealth was not associated with odds of postoperative complication. Barriers to surgery were common in Republic of Congo. Patient wealth and home location may predict barriers to surgery. Addressing gender disparities, access to providers, and patient perception of barriers in addition to removal of barriers may help maximize patient health benefits.

  2. Trait Positive Affect Buffers the Effects of Acute Stress on Skin Barrier Recovery

    Science.gov (United States)

    Robles, Theodore F.; Brooks, Kathryn P.; Pressman, Sarah D.

    2010-01-01

    Objective This study examines the role of self-reported trait positive affect (PA) on skin barrier recovery after skin disruption, and whether the role of trait PA in wound healing is consistent with the direct effects model or the stress-buffering model of PA and health. Design Sixty healthy participants (mean age 22.7 ± 3.9 years) completed a self-report measure of trait positive and negative affect, underwent a “tape-stripping” procedure that disrupts normal skin barrier function, and were randomly assigned to a Stress (Trier Social Stress Test) or No Stress (reading task) condition. Main Outcome Measures Skin barrier recovery was assessed by measuring transepidermal water loss up to 2 hr after skin disruption. Results Multilevel modeling indicated that greater trait PA was related to faster skin barrier recovery (p < .05). The effects of PA on skin barrier recovery were independent of levels of trait NA. Conclusion These findings suggest that trait PA may influence skin barrier recovery following a brief stressor. In addition, these results provide additional evidence that trait PA can positively impact objective health outcomes. PMID:19450044

  3. Barriers to pediatric pain management: a nursing perspective.

    Science.gov (United States)

    Czarnecki, Michelle L; Simon, Katherine; Thompson, Jamie J; Armus, Cheryl L; Hanson, Tom C; Berg, Kristin A; Petrie, Jodie L; Xiang, Qun; Malin, Shelly

    2011-09-01

    This study describes strategies used by the Joint Clinical Practice Council of Children's Hospital of Wisconsin to identify barriers perceived as interfering with nurses' (RNs) ability to provide optimal pain management. A survey was used to ascertain how nurses described optimal pain management and how much nurses perceived potential barriers as interfering with their ability to provide that level of care. The survey, "Barriers to Optimal Pain management" (adapted from Van Hulle Vincent & Denyes, 2004), was distributed to all RNs working in all patient care settings. Two hundred seventy-two surveys were returned. The five most significant barriers identified were insufficient physician (MD) orders, insufficient MD orders before procedures, insufficient time to premedicate patients before procedures, the perception of a low priority given to pain management by medical staff, and parents' reluctance to have patients receive pain medication. Additional barriers were identified through narrative comments. Information regarding the impact of the Acute Pain Service on patient care, RNs' ability to overcome barriers, and RNs' perception of current pain management practices is included, as are several specific interventions aimed at improving or ultimately eliminating identified barriers. Copyright © 2011 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  4. Communication barriers among Spanish-speaking women with pelvic floor disorders: lost in translation?

    Science.gov (United States)

    Khan, Aqsa A; Sevilla, Claudia; Wieslander, Cecilia K; Moran, Meghan B; Rashid, Rezoana; Mittal, Brita; Maliski, Sally L; Rogers, Rebecca G; Anger, Jennifer T

    2013-01-01

    The purpose of our study was to evaluate barriers in communication and disease understanding among office staff and interpreters when communicating with Spanish-speaking women with pelvic floor disorders. We conducted a qualitative study to evaluate barriers to communication with Spanish-speaking women with pelvic floor disorders among office staff and interpreters. Sixteen office staff and interpreters were interviewed; interview questions focused on experiences with Spanish-speaking patients with pelvic floor disorders in the clinic setting. Interview transcripts were analyzed qualitatively using grounded theory methodology. Analysis of the interview transcripts revealed several barriers in communication as identified by office staff and interpreters. Three major classes were predominant: patient, interpreter, and system-related barriers. Patient-related barriers included a lack of understanding of anatomy and medical terminology and inhibited discussions due to embarrassment. Provider-related barriers included poor interpreter knowledge of pelvic floor vocabulary and the use of office staff without interpreting credentials. System-related barriers included poor access to information. From these preliminary themes, an emergent concept was revealed: it is highly likely that Spanish-speaking women with pelvic floor disorders have poor understanding of their condition owing to multiple obstacles in communication. There are many levels of barriers to communications with Latin women treated for pelvic floor disorders, arising from the patient, interpreter, and the system itself. These barriers contribute to a low level of understanding of their diagnosis, treatment options, and administered therapies.

  5. Sex Differences in Financial Barriers and the Relationship to Recovery After Acute Myocardial Infarction

    OpenAIRE

    Beckman, Adam L.; Bucholz, Emily M.; Zhang, Weiwei; Xu, Xiao; Dreyer, Rachel P.; Strait, Kelly M.; Spertus, John A.; Krumholz, Harlan M.; Spatz, Erica S.

    2016-01-01

    Background Financial barriers to health care are associated with worse outcomes following acute myocardial infarction (AMI). Yet, it is unknown whether the prevalence of financial barriers and their relationship with post?AMI outcomes vary by sex among young adults. Methods and Results We assessed sex differences in patient?reported financial barriers among adults aged

  6. Fission Meter Information Barrier Attribute Measurement System: Task 1 Report: Document existing Fission Meter neutron IB system

    Energy Technology Data Exchange (ETDEWEB)

    Kerr, P. L. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2017-02-28

    An SNM attribute Information Barrier (IB) system was developed for a 2011 US/UK Exercise. The system was modified and extensively tested in a 2013-2014 US-UK Measurement Campaign. This work demonstrated rapid deployment of an IB system for potential treaty use. The system utilizes an Ortec Fission Meter neutron multiplicity counter and custom computer code. The system demonstrates a proof-of-principle automated Pu-240 mass determination with an information barrier. After a software start command is issued, the system automatically acquires and downloads data, performs an analysis, and displays the results. This system conveys the results of a Pu mass threshold measurements in a way the does not reveal sensitive information. In full IB mode, only red/green ‘lights’ are displayed in the software. In test mode, more detailed information is displayed. The code can also read in, analyze, and display results from previously acquired or simulated data. Because the equipment is commercial-off-the-shelf (COTS), the system demonstrates a low-cost short-lead-time technology for treaty SNM attribute measurements. A deployed system will likely require integration of additional authentication and tamper-indicating technologies. This will be discussed for the project in this and future progress reports.

  7. Technical Work Plan for: Near Field Environment: Engineered Barrier System: Radionuclide Transport Abstraction Model Report

    International Nuclear Information System (INIS)

    J.D. Schreiber

    2006-01-01

    This technical work plan (TWP) describes work activities to be performed by the Near-Field Environment Team. The objective of the work scope covered by this TWP is to generate Revision 03 of EBS Radionuclide Transport Abstraction, referred to herein as the radionuclide transport abstraction (RTA) report. The RTA report is being revised primarily to address condition reports (CRs), to address issues identified by the Independent Validation Review Team (IVRT), to address the potential impact of transport, aging, and disposal (TAD) canister design on transport models, and to ensure integration with other models that are closely associated with the RTA report and being developed or revised in other analysis/model reports in response to IVRT comments. The RTA report will be developed in accordance with the most current version of LP-SIII.10Q-BSC and will reflect current administrative procedures (LP-3.15Q-BSC, ''Managing Technical Product Inputs''; LP-SIII.2Q-BSC, ''Qualification of Unqualified Data''; etc.), and will develop related Document Input Reference System (DIRS) reports and data qualifications as applicable in accordance with prevailing procedures. The RTA report consists of three models: the engineered barrier system (EBS) flow model, the EBS transport model, and the EBS-unsaturated zone (UZ) interface model. The flux-splitting submodel in the EBS flow model will change, so the EBS flow model will be validated again. The EBS transport model and validation of the model will be substantially revised in Revision 03 of the RTA report, which is the main subject of this TWP. The EBS-UZ interface model may be changed in Revision 03 of the RTA report due to changes in the conceptualization of the UZ transport abstraction model (a particle tracker transport model based on the discrete fracture transfer function will be used instead of the dual-continuum transport model previously used). Validation of the EBS-UZ interface model will be revised to be consistent with

  8. Simulation Tool for Dielectric Barrier Discharge Plasma Actuators at Atmospheric and Sub-Atmospheric Pressures: SBIR Phase I Final Report

    Science.gov (United States)

    Likhanskii, Alexandre

    2012-01-01

    This report is the final report of a SBIR Phase I project. It is identical to the final report submitted, after some proprietary information of administrative nature has been removed. The development of a numerical simulation tool for dielectric barrier discharge (DBD) plasma actuator is reported. The objectives of the project were to analyze and predict DBD operation at wide range of ambient gas pressures. It overcomes the limitations of traditional DBD codes which are limited to low-speed applications and have weak prediction capabilities. The software tool allows DBD actuator analysis and prediction for subsonic to hypersonic flow regime. The simulation tool is based on the VORPAL code developed by Tech-X Corporation. VORPAL's capability of modeling DBD plasma actuator at low pressures (0.1 to 10 torr) using kinetic plasma modeling approach, and at moderate to atmospheric pressures (1 to 10 atm) using hydrodynamic plasma modeling approach, were demonstrated. In addition, results of experiments with pulsed+bias DBD configuration that were performed for validation purposes are reported.

  9. Identifying common barriers and facilitators to linkage and retention in chronic disease care in western Kenya

    Directory of Open Access Journals (Sweden)

    Beth Rachlis

    2016-08-01

    Full Text Available Abstract Background Sub-Saharan Africa is increasingly being challenged in providing care and treatment for chronic diseases, both communicable and non-communicable. In order to address the challenges of linkage to and retention in chronic disease management, there is the need to understand the factors that can influence engagement in care. We conducted a qualitative study to identify barriers and facilitators to linkage and retention in chronic care for HIV, tuberculosis (TB and Hypertension (HTN as part of the Academic Model Providing Access to Healthcare (AMPATH program in western Kenya. Methods In-depth interviews and focus group discussions were conducted July 2012-August 2013. Study participants were purposively sampled from three AMPATH clinics and included patients within the AMPATH program receiving HIV, TB, and HTN care, as well as caregivers of children with HIV, community leaders, and healthcare providers. A set of interview guides were developed to explore perceived barriers and facilitators to chronic disease management, particularly related to linkage to and retention in HIV, TB and HTN care. Data were coded and various themes were identified. We organized the concepts and themes generated using the Andersen-Newman Framework of Health Services Utilization. Results A total of 235 participants including 110 individuals living with HIV (n = 50, TB (n = 39, or HTN (n = 21; 24 caregivers; 10 community leaders; and 62 healthcare providers participated. Barriers and facilitators were categorized as predisposing characteristics, enabling resources and need factors. Many of the facilitators and barriers reported in this study were consistently reported across disease categories including personal drive, patient-provider relationships and the need for social and peer support. Conclusions Our findings provide insight into the individual as well as broader structural factors that can deter or encourage linkage and retention that

  10. “I don’t have the heart”: a qualitative study of barriers to and facilitators of physical activity for people with coronary heart disease and depressive symptoms

    Directory of Open Access Journals (Sweden)

    Rogerson Michelle C

    2012-11-01

    Full Text Available Abstract Background Physical activity has been shown to reduce depression in people with coronary heart disease (CHD, however many people with CHD do not engage in sufficient levels of physical activity to reap its positive effects. People with depression and CHD are at particular risk of non-adherence to physical activity. Little is known about the barriers to and facilitators of physical activity for people with CHD and depressive symptoms. Using qualitative interviews, the aim of this study was to explore the barriers to and facilitators of physical activity for cardiac patients with depressive symptoms. Methods Fifteen participants with CHD and depressive symptoms (assessed using the Cardiac Depression Scale participated in in-depth semi-structured interviews. The interviews were focussed on investigating participants’ experiences of physical activity since their cardiac event. Interviews were content analysed to determine major themes. Results Participants identified a number of barriers to and facilitators of physical activity. Barriers included having negative perceptions towards health and life changes as a result of the cardiac event, having low mood and low motivation to exercise, feeling physically restricted towards or fearful of exercise, lacking knowledge regarding exercise and perceiving external barriers. Facilitators included having a reason for exercising, being able to identify the psychological benefits of exercise, having positive social support and using psychological strategies. ‘Inactive’ participants reported more barriers and fewer facilitators than did ‘active’ participants. Conclusions The barriers reported in this study were highly salient for a number of participants. Health professionals and researchers can use this information to assist people with CHD and depressive symptoms to identify and possibly overcome barriers to physical activity. Relevant barriers and facilitators could be taken into account to

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

    Science.gov (United States)

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

    2007-01-01

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

  12. Ion-barrier for memristors/ReRAM and methods thereof

    Science.gov (United States)

    Haase, Gad S.

    2017-11-28

    The present invention relates to memristive devices including a resistance-switching element and a barrier element. In particular examples, the barrier element is a monolayer of a transition metal chalcogenide that sufficiently inhibits diffusion of oxygen atoms or ions out of the switching element. As the location of these atoms and ions determine the state of the device, inhibiting diffusion would provide enhanced state retention and device reliability. Other types of barrier elements, as well as methods for forming such elements, are described herein.

  13. Barriers to care for women with breast cancer symptoms in rural Bangladesh.

    Science.gov (United States)

    Steiness, Heather Story; Villegas-Gold, Michelle; Parveen, Homaira; Ferdousy, Tahmina; Ginsburg, Ophira

    2018-05-01

    Breast cancer survival rates in lower-income countries like Bangladesh are approximately 50%, versus over 80% in high income countries. Anecdotal reports suggest that, beyond economic and health system barriers, sociocultural factors may influence a woman's care-seeking behavior and resultant early stage diagnoses. To understand these barriers, we conducted 63 interviews (43 women with breast cancer symptoms and 20 men) in Khulna, Bangladesh. We identified socio-cultural barriers like neglect and indifference toward women, women's lack of power to use resources, and reduced support from family due to stigma. Interventions must address these barriers and improve the status of women in Bangladesh.

  14. Barriers to health care for undocumented immigrants: a literature review

    Science.gov (United States)

    Hacker, Karen; Anies, Maria; Folb, Barbara L; Zallman, Leah

    2015-01-01

    With the unprecedented international migration seen in recent years, policies that limit health care access have become prevalent. Barriers to health care for undocumented immigrants go beyond policy and range from financial limitations, to discrimination and fear of deportation. This paper is aimed at reviewing the literature on barriers to health care for undocumented immigrants and identifying strategies that have or could be used to address these barriers. To address study questions, we conducted a literature review of published articles from the last 10 years in PubMed using three main concepts: immigrants, undocumented, and access to health care. The search yielded 341 articles of which 66 met study criteria. With regard to barriers, we identified barriers in the policy arena focused on issues related to law and policy including limitations to access and type of health care. These varied widely across countries but ultimately impacted the type and amount of health care any undocumented immigrant could receive. Within the health system, barriers included bureaucratic obstacles including paperwork and registration systems. The alternative care available (safety net) was generally limited and overwhelmed. Finally, there was evidence of widespread discriminatory practices within the health care system itself. The individual level focused on the immigrant’s fear of deportation, stigma, and lack of capital (both social and financial) to obtain services. Recommendations identified in the papers reviewed included advocating for policy change to increase access to health care for undocumented immigrants, providing novel insurance options, expanding safety net services, training providers to better care for immigrant populations, and educating undocumented immigrants on navigating the system. There are numerous barriers to health care for undocumented immigrants. These vary by country and frequently change. Despite concerns that access to health care attracts

  15. T Tank Farm Interim Surface Barrier Demonstration -- Vadose Zone Monitoring FY07 Report

    International Nuclear Information System (INIS)

    Zhang, Z. F.; Strickland, Christopher E.; Keller, Jason M.; Wittreich, Curtis D.; Sydnor, Harold A.

    2008-01-01

    CH2M HILL Hanford Group, Inc. is currently in the process of constructing a temporary surface barrier over a portion of the T Tank Farm as part of the T farm Interim Surface Barrier Demonstration Project. The surface barrier is designed to prevent the infiltration of precipitation into the contaminated soil zone created by the Tank T-106 leak and minimize movement of the contamination. As part of the demonstration effort, vadose zone moisture monitoring is being performed to assess the effectiveness of the barrier at reducing soil moisture. A solar-powered and remotely-controlled system was installed to continuously monitor soil water conditions in four instrument nests (i.e., A, B, C, and D) and the site meteorological condition. Each instrument nest was composed of a capacitance probe with multiple sensors, multiple heat-dissipation units, a neutron probe access tube and a datalogger. Nests A and B also contained a drain gauge each. The principle variables monitored for this purpose are soil-water content, soil-water pressure, and soil-water flux. In addition to these, soil temperature, precipitation, and air temperature are measured. Data from each of the dataloggers were transmitted remotely to the receiving computer. The neutron probe access tube was used to perform quarterly manual measurements of soil-water content using a neutron probe. This monitoring system was used to assess the soil water conditions in the soil outside and within the footprint of the surface barrier to be emplaced in the Hanford T Tank Farm. Data to date is baseline under the condition without the interim surface barrier in place. All the instruments except the two drain gauges were functional in FY07. The capacitance-probe measurements showed that the soil-moisture content at relatively shallow depths (e.g., 0.6 and 0.9 m) was increasing since October 2006 and reached the highest in early January 2007 followed by a slight decrease. Soil-moisture contents at the depths of 1.3 m and

  16. A qualitative theory guided analysis of stroke survivors' perceived barriers and facilitators to physical activity.

    Science.gov (United States)

    Nicholson, Sarah L; Donaghy, Marie; Johnston, Marie; Sniehotta, Falko F; van Wijck, Frederike; Johnston, Derek; Greig, Carolyn; McMurdo, Marion E T; Mead, Gillian

    2014-01-01

    After stroke, physical activity and physical fitness levels are low, impacting on health, activity and participation. It is unclear how best to support stroke survivors to increase physical activity. Little is known about the barriers and facilitators to physical activity after stroke. Thus, our aim was to explore stroke survivors' perceived barriers and facilitators to physical activity. Semi-structured interviews with 13 ambulatory stroke survivors exploring perceived barriers and facilitators to physical activity post stroke were conducted in participants' homes, audio-recorded and transcribed verbatim. The Theoretical Domains Framework (TDF) informed content analysis of the interview transcripts. Data saturation was reached after interviews with 13 participants (median age of 76 years (inter-quartile range (IQR) = 69-83 years). The median time since stroke was 345 d (IQR = 316-366 d). The most commonly reported TDF domains were "beliefs about capabilities", "environmental context and resources" and "social influence". The most commonly reported perceived motivators were: social interaction, beliefs of benefits of exercise, high self-efficacy and the necessity of routine behaviours. The most commonly reported perceived barriers were: lack of professional support on discharge from hospital and follow-up, transport issues to structured classes/interventions, lack of control and negative affect. Stroke survivors perceive several different barriers and facilitators to physical activity. Stroke services need to address barriers to physical activity and to build on facilitators to promote physical activity after stroke. Physical activity post stroke can improve physical fitness and function, yet physical activity remains low among stroke survivors. Understanding stroke survivors' perceived barriers and facilitators to physical activity is essential to develop targeted interventions to increase physical activity. Beliefs about capabilities, environmental

  17. The Use of information technology tools to reduce barriers of distance learning

    OpenAIRE

    Targamadzė, Aleksandras; Petrauskienė, Rūta

    2012-01-01

    Distance learning takes place when learning conditions do not allow using traditional learning. Remoteness is the main feature of distance learning; however, it can be various. Remoteness is frequently described as barriers and includes traditional barriers such as distance and time as well as technological, organizational, social, cultural, psychological and other barriers that have not been examined so widely. Barriers can be eliminated or reduced when using information technologies (ITs). ...

  18. Transparent, Ultrahigh-Gas-Barrier Films with a Brick-Mortar-Sand Structure.

    Science.gov (United States)

    Dou, Yibo; Pan, Ting; Xu, Simin; Yan, Hong; Han, Jingbin; Wei, Min; Evans, David G; Duan, Xue

    2015-08-10

    Transparent and flexible gas-barrier materials have shown broad applications in electronics, food, and pharmaceutical preservation. Herein, we report ultrahigh-gas-barrier films with a brick-mortar-sand structure fabricated by layer-by-layer (LBL) assembly of XAl-layered double hydroxide (LDH, X=Mg, Ni, Zn, Co) nanoplatelets and polyacrylic acid (PAA) followed by CO2 infilling, denoted as (XAl-LDH/PAA)n-CO2. The near-perfectly parallel orientation of the LDH "brick" creates a long diffusion length to hinder the transmission of gas molecules in the PAA "mortar". Most significantly, both the experimental studies and theoretical simulations reveal that the chemically adsorbed CO2 acts like "sand" to fill the free volume at the organic-inorganic interface, which further depresses the diffusion of permeating gas. The strategy presented here provides a new insight into the perception of barrier mechanism, and the (XAl-LDH/PAA)n-CO2 film is among the best gas barrier films ever reported. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  19. Barriers and Facilitators for Health Behavior Change among Adults from Multi-Problem Households: A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Gera E. Nagelhout

    2017-10-01

    Full Text Available Multi-problem households are households with problems on more than one of the following core problem areas: socio-economic problems, psycho-social problems, and problems related to child care. The aim of this study was to examine barriers and facilitators for health behavior change among adults from multi-problem households, as well as to identify ideas for a health promotion program. A qualitative study involving 25 semi-structured interviews was conducted among Dutch adults who received intensive family home care for multi-problem households. Results were discussed with eight social workers in a focus group interview. Data were analyzed using the Framework Method. The results revealed that the main reason for not engaging in sports were the costs. Physical activity was facilitated by physically active (transport to work and by dog ownership. Respondents who received a food bank package reported this as a barrier for healthy eating. Those with medical conditions such as diabetes indicated that this motivated them to eat healthily. Smokers and former smokers reported that stress was a major barrier for quitting smoking but that medical conditions could motivate them to quit smoking. A reported reason for not using alcohol was having difficult past experiences such as violence and abuse by alcoholics. Mentioned intervention ideas were: something social, an outdoor sports event, cooking classes, a walking group, and children’s activities in nature. Free or cheap activities that include social interaction and reduce stress are in line with the identified barriers and facilitators. Besides these activities, it may be important to influence the target group’s environment by educating social workers and ensuring healthier food bank packages.

  20. Barriers to diabetes education in urban patients: perceptions, patterns, and associated factors.

    Science.gov (United States)

    Rhee, Mary K; Cook, Curtiss B; El-Kebbi, Imad; Lyles, Robert H; Dunbar, Virginia G; Panayioto, Rita M; Berkowitz, Kathy J; Boyd, Barbara; Broussard, Sandra; George, Christopher D

    2005-01-01

    This study explored patients' perceptions of barriers to diabetes education among a mostly African American population of adults with diabetes. A survey was conducted among 605 new patients attending an urban outpatient diabetes clinic. The questionnaire gathered information on issues patients believed would adversely affect their ability to learn about diabetes. The type and frequency of education barriers were evaluated, and variables associated with reporting an obstacle were analyzed. Average patient age was 50 years, diabetes duration was 5.6 years, body mass index was 32 kg/m2, and hemoglobin A1C was 9.1%. The majority (56%) were women, 89% were African American, and 95% had type 2 diabetes. Most respondents (96%) had received some prior instruction in diabetes care; however, 53% anticipated future difficulties learning about diabetes. The most commonly cited concerns were poor vision (74%) and reading problems (29%). Patients with a perceived barrier to diabetes education were older (P barrier, and they differed in both employment and educational status (both P education or less were associated with a significantly increased likelihood of having a barrier to diabetes education, whereas having a college education decreased the odds. Higher hemoglobin A1C levels also tended to be associated with a greater chance of reporting an education barrier (P = .05). A substantial number of persons anticipated a barrier to diabetes education. Interventions at multiple levels that address the demographic and socioeconomic obstacles to diabetes education are needed to ensure successful self-management training.