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Sample records for united states refuse

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

    Science.gov (United States)

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

    2005-04-01

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

  2. 25 CFR 135.6 - Refusal of water delivery.

    Science.gov (United States)

    2010-04-01

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

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

    Science.gov (United States)

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

    2017-06-01

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

  4. Legal briefing: conscience clauses and conscientious refusal.

    Science.gov (United States)

    Pope, Thaddeus Mason

    2010-01-01

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

  5. Microbial ecology studies at two coal mine refuse sites in Illinois

    Energy Technology Data Exchange (ETDEWEB)

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

    1978-01-01

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

  6. Caregivers who refuse preventive care for their children: the relationship between immunization and topical fluoride refusal.

    Science.gov (United States)

    Chi, Donald L

    2014-07-01

    The aim of this study was to examine caregivers' refusal of preventive medical and dental care for children. Prevalence rates of topical fluoride refusal based on dental records and caregiver self-reports were estimated for children treated in 3 dental clinics in Washington State. A 60-item survey was administered to 1024 caregivers to evaluate the association between immunization and topical fluoride refusal. Modified Poisson regression models were used to estimate prevalence rate ratios (PRRs). The prevalence of topical fluoride refusal was 4.9% according to dental records and 12.7% according to caregiver self-reports. The rate of immunization refusal was 27.4%. In the regression models, immunization refusal was significantly associated with topical fluoride refusal (dental record PRR = 1.61; 95% confidence interval [CI] = 1.32, 1.96; P refuse both immunizations and topical fluoride (P refusal of immunizations is associated with topical fluoride refusal. Future research should identify the behavioral and social factors related to caregiver refusal of preventive care with the goal of developing multidisciplinary strategies to help caregivers make optimal preventive care decisions for children.

  7. 25 CFR 30.125 - What happens if a State refuses to allow a school access to the State assessment?

    Science.gov (United States)

    2010-04-01

    ... if a State refuses to allow a school access to the State assessment? (a) The Department will work directly with State officials to assist schools in obtaining access to the State's assessment. This can... access to the State's assessment, the Bureau-funded school must submit a waiver for an alternative...

  8. The problematization of urban sprawl in the United States

    OpenAIRE

    Chang, John

    2006-01-01

    This paper examines the controversy over urban sprawl in the United States. Because there is abundant descriptive literature about urban sprawl as well as numerous prescriptive “strategies” and “toolkits” to “tame” and “fight” sprawl, this paper instead examines urban sprawl as a social construction and specifically focuses on its non-problematization, the phenomenon of social groups which do not or refuse to acknowledge sprawl as a legitimate problem.

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

    Science.gov (United States)

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

    2008-07-01

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

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

    Science.gov (United States)

    Al-Momani, Hassan Ali Abdullah

    2017-01-01

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

  11. Greenhouse effect: what are doing the Unites States; Effet de serre: ce que font les Etats-Unis

    Energy Technology Data Exchange (ETDEWEB)

    Quiret, M.

    2004-06-01

    Although they refuse to sign the kyoto protocol, the United States count on the new technologies and the industrialists participation to fight against the greenhouse effect. The author presents the local projects and initiatives (nine states of the north-east decided coordinated actions to fight the CO{sub 2} emissions) facing the increasing non commitment of the federal government. (A.L.B.)

  12. The Caspian energy game: views from the United States and United Kingdom

    International Nuclear Information System (INIS)

    Bird, H.

    2003-01-01

    The importance of the Caspian Sea region to energy production is increasing and the forces influencing it are changing. The attention on this region focuses on its oil and natural gas reserves. A series of interviews with Western experts mainly from the United States and United Kingdom, including those in international organizations, academia, policy institutions, and government and industry officials identified key trends and issues that are important to their future policies and the significance of the Caspian oil and gas to the world energy market. The overriding issues are: The influence of Russia on regional security, stability, and the transportation of oil and gas products in the Caspian region. The outcome of the test between the United States and Iraq and the major effects it could have on commercial interests in the region and on who will be the major actors. Tensions caused by Iran refusal to settle the international demarcation of the Caspian Sea. Turkey position as a player, the affect of its new islamic-dominated government and its energy policies. Europe need to import gas and to diversify its supply. The construction of a pipeline to China. The impact of September 11, 2001 and terrorism on the Caspian region issues. The stability of the former Soviet Republics in the region. (author)

  13. The Caspian energy game: views from the United States and United Kingdom

    Energy Technology Data Exchange (ETDEWEB)

    Bird, H

    2003-07-01

    The importance of the Caspian Sea region to energy production is increasing and the forces influencing it are changing. The attention on this region focuses on its oil and natural gas reserves. A series of interviews with Western experts mainly from the United States and United Kingdom, including those in international organizations, academia, policy institutions, and government and industry officials identified key trends and issues that are important to their future policies and the significance of the Caspian oil and gas to the world energy market. The overriding issues are: The influence of Russia on regional security, stability, and the transportation of oil and gas products in the Caspian region. The outcome of the test between the United States and Iraq and the major effects it could have on commercial interests in the region and on who will be the major actors. Tensions caused by Iran refusal to settle the international demarcation of the Caspian Sea. Turkey position as a player, the affect of its new islamic-dominated government and its energy policies. Europe need to import gas and to diversify its supply. The construction of a pipeline to China. The impact of September 11, 2001 and terrorism on the Caspian region issues. The stability of the former Soviet Republics in the region. (author)

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

    Science.gov (United States)

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

    2012-05-28

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

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

    Directory of Open Access Journals (Sweden)

    Chandran Thoovakkunon

    2012-05-01

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

  16. School Refusal: Clinical Features, Diagnosis and Treatment

    Directory of Open Access Journals (Sweden)

    Kayhan Bahali

    2010-12-01

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

  17. 31 CFR 515.321 - United States; continental United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States; continental United... General Definitions § 515.321 United States; continental United States. The term United States means the United States and all areas under the jurisdiction or authority thereof, including the Trust Territory of...

  18. 31 CFR 500.321 - United States; continental United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States; continental United... General Definitions § 500.321 United States; continental United States. The term United States means the United States and all areas under the jurisdiction or authority thereof, including U.S. trust territories...

  19. 31 CFR 535.321 - United States; continental United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States; continental United... General Definitions § 535.321 United States; continental United States. The term United States means the United States and all areas under the jurisdiction or authority thereof including the Trust Territory of...

  20. Microbial ecology of coal mine refuse

    Energy Technology Data Exchange (ETDEWEB)

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

    1977-01-01

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

  1. Rapanos v. United States & Carabell v. United States

    Science.gov (United States)

    Documents associated with guidance for implementing the definition of waters of the United States under the Clean Water Act following the Rapanos v. United States, and Carabell v. United States Supreme Court decision.

  2. Current status of research on school refusal

    Directory of Open Access Journals (Sweden)

    Cándido J. Inglés

    2015-06-01

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

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

    Science.gov (United States)

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

    2009-11-01

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

  4. Sodium bicarbonate effects on the anaerobic digestion of refuse

    Energy Technology Data Exchange (ETDEWEB)

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

    1989-01-01

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

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

    Science.gov (United States)

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

    2010-01-01

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

  6. Identification and characteristics of vaccine refusers

    OpenAIRE

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

    2009-01-01

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

  7. Situation testing: the case of health care refusal.

    Science.gov (United States)

    Després, C; Couralet, P-E

    2011-04-01

    refusal (CMUc coverage) must be confirmed by a validation procedure (unless clearly stated by the interlocutor). Copyright © 2011 Elsevier Masson SAS. All rights reserved.

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

    Science.gov (United States)

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

    2015-04-01

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

  9. Predictors of Donor Heart Utilization for Transplantation in United States.

    Science.gov (United States)

    Trivedi, Jaimin R; Cheng, Allen; Gallo, Michele; Schumer, Erin M; Massey, H Todd; Slaughter, Mark S

    2017-06-01

    Optimum use of donor organs can increase the reach of the transplantation therapy to more patients on waiting list. The heart transplantation (HTx) has remained stagnant in United States over the past decade at approximately 2,500 HTx annually. With the use of the United Network of Organ Sharing (UNOS) deceased donor database (DCD) we aimed to evaluate donor factors predicting donor heart utilization. UNOS DCD was queried from 2005 to 2014 to identify total number of donors who had at least one of their organs donated. We then generated a multivariate logistic regression model using various demographic and clinical donor factors to predict donor heart use for HTx. Donor hearts not recovered due to consent or family issues or recovered for nontransplantation reasons were excluded from the analysis. During the study period there were 80,782 donors of which 23,606 (29%) were used for HTx, and 38,877 transplants (48%) were not used after obtaining consent because of poor organ function (37%), donor medical history (13%), and organ refused by all programs (5%). Of all, 22,791 donors with complete data were used for logistic regression (13,389 HTx, 9,402 no-HTx) which showed significant predictors of donor heart use for HTx. From this model we assigned probability of donor heart use and identified 3,070 donors with HTx-eligible unused hearts for reasons of poor organ function (28%), organ refused by all programs (15%), and recipient not located (9%). An objective system based on donor factors can predict donor heart use for HTx and may help increase availability of hearts for transplantation from existing donor pool. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  10. Geomorphic reclmation of a coal refuse pile

    Science.gov (United States)

    Hopkinson, L. C.; Quaranta, J.

    2017-12-01

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

  11. 33 CFR 401.89 - Transit refused.

    Science.gov (United States)

    2010-07-01

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

  12. The Legal Ethical Backbone of Conscientious Refusal

    DEFF Research Database (Denmark)

    Munthe, Christian; Nielsen, Morten Ebbe Juul

    2017-01-01

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

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

    International Nuclear Information System (INIS)

    Ripp, B.J.

    1997-01-01

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

  14. Cubicle Refusal in Norwegian Dairy Herds

    Directory of Open Access Journals (Sweden)

    Myren HJ

    2001-03-01

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

  15. A historical context of municipal solid waste management in the United States.

    Science.gov (United States)

    Louis, Garrick E

    2004-08-01

    Municipal solid waste management (MSWM) in the United States is a system comprised of regulatory, administrative, market, technology, and social subcomponents, and can only be understood in the context of its historical evolution. American cities lacked organized public works for street cleaning, refuse collection, water treatment, and human waste removal until the early 1800s. Recurrent epidemics forced efforts to improve public health and the environment. The belief in anticontagionism led to the construction of water treatment and sewerage works during the nineteenth century, by sanitary engineers working for regional public health authorities. This infrastructure was capital intensive and required regional institutions to finance and administer it. By the time attention turned to solid waste management in the 1880s, funding was not available for a regional infrastructure. Thus, solid waste management was established as a local responsibility, centred on nearby municipal dumps. George Waring of New York City organized solid waste management around engineering unit operations; including street sweeping, refuse collection, transportation, resource recovery and disposal. This approach was adopted nationwide, and was managed by City Departments of Sanitation. Innovations such as the introduction of trucks, motorized street sweepers, incineration, and sanitary landfill were developed in the following decades. The Resource Conservation and Recovery Act of 1976 (RCRA), is the defining legislation for MSWM practice in America today. It forced the closure of open dumps nationwide, and required regional planning for MSWM. The closure of municipal dumps caused a 'garbage crisis' in the late 1980s and early 1990s. Private companies assumed an expanded role in MSWM through regional facilities that required the transportation of MSW across state lines. These transboundary movements of MSW created the issue of flow control, in which the US Supreme Court affirmed the protection

  16. 30 CFR 77.215-4 - Refuse piles; abandonment.

    Science.gov (United States)

    2010-07-01

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

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

    Science.gov (United States)

    Mattiasson, A C; Andersson, L

    1994-11-01

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

  18. 30 CFR 816.83 - Coal mine waste: Refuse piles.

    Science.gov (United States)

    2010-07-01

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

  19. 30 CFR 817.83 - Coal mine waste: Refuse piles.

    Science.gov (United States)

    2010-07-01

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

  20. 7 CFR 1220.615 - State and United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false State and United States. 1220.615 Section 1220.615... CONSUMER INFORMATION Procedures To Request a Referendum Definitions § 1220.615 State and United States. State and United States include the 50 States of the United States of America, the District of Columbia...

  1. 7 CFR 1220.129 - State and United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false State and United States. 1220.129 Section 1220.129... CONSUMER INFORMATION Soybean Promotion and Research Order Definitions § 1220.129 State and United States. The terms State and United States include the 50 States of the United States of America, the District...

  2. The Legal Ethical Backbone of Conscientious Refusal.

    Science.gov (United States)

    Munthe, Christian; Nielsen, Morten Ebbe Juul

    2017-01-01

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

  3. 21 CFR 211.50 - Sewage and refuse.

    Science.gov (United States)

    2010-04-01

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

  4. United States Domestic Research Reactor Infrastructure - TRIGA Reactor Fuel Support

    International Nuclear Information System (INIS)

    Morrell, Douglas

    2008-01-01

    The purpose of the United State Domestic Research Reactor Infrastructure Program is to provide fresh nuclear reactor fuel to United States universities at no, or low, cost to the university. The title of the fuel remains with the United States government and when universities are finished with the fuel, the fuel is returned to the United States government. The program is funded by the United States Department of Energy - Nuclear Energy division, managed by Department of Energy - Idaho Field Office, and contracted to the Idaho National Laboratory's Management and Operations Contractor - Battelle Energy Alliance. Program has been at Idaho since 1977 and INL subcontracts with 26 United States domestic reactor facilities (13 TRIGA facilities, 9 plate fuel facilities, 2 AGN facilities, 1 Pulstar fuel facility, 1 Critical facility). University has not shipped fuel since 1968 and as such, we have no present procedures for shipping spent fuel. In addition: floor loading rate is unknown, many interferences must be removed to allow direct access to the reactor tank, floor space in the reactor cell is very limited, pavement ends inside our fence; some of the surface is not finished. The whole approach is narrow, curving and downhill. A truck large enough to transport the cask cannot pull into the lot and then back out (nearly impossible / refused by drivers); a large capacity (100 ton), long boom crane would have to be used due to loading dock obstructions. Access to the entrance door is on a sidewalk. The campus uses it as a road for construction equipment, deliveries and security response. Large trees are on both sides of sidewalk. Spent fuel shipments have never been done, no procedures approved or in place, no approved casks, no accident or safety analysis for spent fuel loading. Any cask assembly used in this facility will have to be removed from one crane, moved on the floor and then attached to another crane to get from the staging area to the reactor room. Reactor

  5. Medication Refusal: Resident Rights, Administration Dilemma.

    Science.gov (United States)

    Haskins, Danielle R; Wick, Jeannette Y

    2017-12-01

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

  6. Public opinion about laws to prohibit weight discrimination in the United States.

    Science.gov (United States)

    Puhl, Rebecca M; Heuer, Chelsea A

    2011-01-01

    Weight discrimination is pervasive in American society and impairs quality of life for obese persons. With approximately two-thirds of Americans now overweight or obese, vast numbers of people are vulnerable to weight prejudice and its consequences. Currently, no laws exist to prohibit weight discrimination. This study conducted an online survey with a national sample of 1,001 adults (representing demographics of the United States) to examine public support for six potential legislative measures to prohibit weight discrimination in the United States. Results indicated substantial support (65% of men, 81% of women) for laws to prohibit weight discrimination in the workplace, especially for legal measures that would prohibit employers from refusing to hire, terminate, or deny promotion based on a person's body weight. Laws that proposed extending the same protections to obese persons as people with physical disabilities received the least support, suggesting that Americans may not be in favor of considering obesity as a disability. Findings also highlight specific predictors of support (related to sex, age, education, income, body weight, and political ideology). These findings can be used to inform policy makers in efforts to develop antidiscrimination laws. Such measures will rectify health disparities for overweight Americans and facilitate public health efforts to address obesity.

  7. 30 CFR 77.214 - Refuse piles; general.

    Science.gov (United States)

    2010-07-01

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

  8. Coal refuse reclamation project

    Energy Technology Data Exchange (ETDEWEB)

    Zellmer, S.D.

    1979-04-06

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

  9. Marketization of refuse collection in Denmark

    DEFF Research Database (Denmark)

    Busck, Ole Gunni

    2006-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  11. 7 CFR 1209.21 - State and United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false State and United States. 1209.21 Section 1209.21... Definitions § 1209.21 State and United States. (a) State means any of the several States, the District of Columbia, and the Commonwealth of Puerto Rico. (b) United States means collectively the several States of...

  12. Refusal to pay electricity bill is illegal

    International Nuclear Information System (INIS)

    Hermann, H.P.

    1979-01-01

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

  13. Personal values and cancer treatment refusal

    NARCIS (Netherlands)

    Evert van Leeuwen; Marli Huijer

    2000-01-01

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

  14. 30 CFR 77.215-1 - Refuse piles; identification.

    Science.gov (United States)

    2010-07-01

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

  15. 30 CFR 77.215-3 - Refuse piles: certification.

    Science.gov (United States)

    2010-07-01

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

  16. 7 CFR 1160.104 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true United States. 1160.104 Section 1160.104 Agriculture... Definitions § 1160.104 United States. United States means the 48 contiguous states in the continental United States and the District of Columbia, except that United States means the 50 states of the United States...

  17. 30 CFR 77.215 - Refuse piles; construction requirements.

    Science.gov (United States)

    2010-07-01

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

  18. 25 CFR 135.23 - Refusal of water delivery.

    Science.gov (United States)

    2010-04-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1990-03-01

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

  20. School Refusal

    Science.gov (United States)

    Wimmer, Mary

    2008-01-01

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

  1. 20 CFR 401.70 - Appeals of refusals to correct records or refusals to allow access to records.

    Science.gov (United States)

    2010-04-01

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

  2. [Refusal of treatments by an adult cancer patient].

    Science.gov (United States)

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

    2018-03-01

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

  3. 31 CFR 800.225 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 800.225 Section 800... TAKEOVERS BY FOREIGN PERSONS Definitions § 800.225 United States. The term United States or U.S. means the United States of America, the States of the United States, the District of Columbia, and any commonwealth...

  4. 7 CFR 1150.106 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true United States. 1150.106 Section 1150.106 Agriculture... Order Definitions § 1150.106 United States. United States means the 48 contiguous States in the continental United States. ...

  5. Malaria Treatment (United States)

    Science.gov (United States)

    ... Providers, Emergency Consultations, and General Public. Contact Us Malaria Treatment (United States) Recommend on Facebook Tweet Share Compartir Treatment of Malaria: Guidelines For Clinicians (United States) Download PDF version ...

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

    Science.gov (United States)

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

    2009-06-01

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

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

    Science.gov (United States)

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

    2011-12-01

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

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

    Science.gov (United States)

    Umotong, Eno

    2016-12-01

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

  9. 30 CFR 77.215-2 - Refuse piles; reporting requirements.

    Science.gov (United States)

    2010-07-01

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

  10. 7 CFR 65.255 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false United States. 65.255 Section 65.255 Agriculture..., PEANUTS, AND GINSENG General Provisions Definitions § 65.255 United States. United States means the 50... United States. ...

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

    NARCIS (Netherlands)

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

    1972-01-01

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

  12. 7 CFR 1250.308 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false United States. 1250.308 Section 1250.308 Agriculture... Research and Promotion Order Definitions § 1250.308 United States. United States means the 48 contiguous States of the United States of America and the District of Columbia. ...

  13. 7 CFR 1205.23 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false United States. 1205.23 Section 1205.23 Agriculture... Procedures for Conduct of Sign-up Period Definitions § 1205.23 United States. The term United States means the 50 states of the United States of America. Procedures ...

  14. Primary care pediatricians' perceptions of vaccine refusal in europe.

    Science.gov (United States)

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

    2011-03-01

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

  15. Persian Speakers' Use of Refusal Strategies across Politeness Systems

    Science.gov (United States)

    Salmani Nodoushan, Mohammad Ali

    2016-01-01

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

  16. 19 CFR 12.114 - Release or refusal of delivery.

    Science.gov (United States)

    2010-04-01

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

  17. 31 CFR 597.318 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 597.318 Section 597... General Definitions § 597.318 United States. The term United States means the United States, its territories, states, commonwealths, districts, and possessions, and all areas under the jurisdiction or...

  18. 7 CFR 1219.26 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false United States. 1219.26 Section 1219.26 Agriculture..., AND INFORMATION Hass Avocado Promotion, Research, and Information Order Definitions § 1219.26 United States. United States means collectively the several 50 States of the United States, the District of...

  19. 7 CFR 1212.31 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false United States. 1212.31 Section 1212.31 Agriculture..., Consumer Education, and Industry Information Order Definitions § 1212.31 United States. “United States... territories and possessions of the United States. ...

  20. 22 CFR 120.13 - United States.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false United States. 120.13 Section 120.13 Foreign... United States. United States, when used in the geographical sense, includes the several states, the Commonwealth of Puerto Rico, the insular possessions of the United States, the District of Columbia, the...

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

    Science.gov (United States)

    Gallagher, Steven B

    2014-12-01

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

  2. Denitrification capacity of bioreactors filled with refuse at different landfill ages

    International Nuclear Information System (INIS)

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

    2009-01-01

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

  3. 31 CFR 592.311 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 592.311 Section 592... § 592.311 United States. The term United States, when used in the geographic sense, means the several States, the District of Columbia, and any commonwealth, territory, or possession of the United States. ...

  4. 36 CFR 1002.14 - Sanitation and refuse.

    Science.gov (United States)

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Sanitation and refuse. 1002.14 Section 1002.14 Parks, Forests, and Public Property PRESIDIO TRUST RESOURCE PROTECTION, PUBLIC USE AND RECREATION § 1002.14 Sanitation and refuse. (a) The following are prohibited: (1) Disposing of...

  5. 7 CFR 1205.313 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false United States. 1205.313 Section 1205.313 Agriculture... Research and Promotion Order Definitions § 1205.313 United States. United States means the 50 States of the United States of America. [31 FR 16758, Dec. 31, 1966. Redesignated at 56 FR 64472, Dec. 10, 1991] ...

  6. Woodrow Wilson's hidden stroke of 1919: the impact of patient-physician confidentiality on United States foreign policy.

    Science.gov (United States)

    Menger, Richard P; Storey, Christopher M; Guthikonda, Bharat; Missios, Symeon; Nanda, Anil; Cooper, John M

    2015-07-01

    World War I catapulted the United States from traditional isolationism to international involvement in a major European conflict. Woodrow Wilson envisaged a permanent American imprint on democracy in world affairs through participation in the League of Nations. Amid these defining events, Wilson suffered a major ischemic stroke on October 2, 1919, which left him incapacitated. What was probably his fourth and most devastating stroke was diagnosed and treated by his friend and personal physician, Admiral Cary Grayson. Grayson, who had tremendous personal and professional loyalty to Wilson, kept the severity of the stroke hidden from Congress, the American people, and even the president himself. During a cabinet briefing, Grayson formally refused to sign a document of disability and was reluctant to address the subject of presidential succession. Wilson was essentially incapacitated and hemiplegic, yet he remained an active president and all messages were relayed directly through his wife, Edith. Patient-physician confidentiality superseded national security amid the backdrop of friendship and political power on the eve of a pivotal juncture in the history of American foreign policy. It was in part because of the absence of Woodrow Wilson's vocal and unwavering support that the United States did not join the League of Nations and distanced itself from the international stage. The League of Nations would later prove powerless without American support and was unable to thwart the rise and advance of Adolf Hitler. Only after World War II did the United States assume its global leadership role and realize Wilson's visionary, yet contentious, groundwork for a Pax Americana. The authors describe Woodrow Wilson's stroke, the historical implications of his health decline, and its impact on United States foreign policy.

  7. Characteristics and Outcomes of Elderly Patients Refused to ICU

    Directory of Open Access Journals (Sweden)

    María-Consuelo Pintado

    2013-01-01

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

  8. 36 CFR 2.14 - Sanitation and refuse.

    Science.gov (United States)

    2010-07-01

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

  9. 31 CFR 542.310 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 542.310 Section 542.310 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF....310 United States. The term United States means the United States, its territories and possessions...

  10. 31 CFR 548.310 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 548.310 Section 548.310 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF....310 United States. The term United States means the United States, its territories and possessions...

  11. 31 CFR 546.310 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 546.310 Section 546.310 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF....310 United States. The term United States means the United States, its territories and possessions...

  12. 31 CFR 586.318 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 586.318 Section 586...) KOSOVO SANCTIONS REGULATIONS General Definitions § 586.318 United States. The term United States means the United States, its territories and possessions, and all areas under the jurisdiction or authority...

  13. 31 CFR 537.318 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 537.318 Section 537.318 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF....318 United States. The term United States means the United States, its territories and possessions...

  14. 31 CFR 585.316 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 585.316 Section 585.316 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... General Definitions § 585.316 United States. The term United States means the United States, its...

  15. 31 CFR 575.319 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 575.319 Section 575.319 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF....319 United States. The term United States means the United States, its territories and possessions...

  16. 31 CFR 539.312 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 539.312 Section 539.312 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... General Definitions § 539.312 United States. The term United States means the United States, its...

  17. 31 CFR 551.309 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 551.309 Section 551.309 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF....309 United States. The term United States means the United States, its territories and possessions...

  18. 31 CFR 587.310 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 587.310 Section 587...) MILOSEVIC SANCTIONS REGULATIONS General Definitions § 587.310 United States. The term United States means the United States, its territories and possessions, and all areas under the jurisdiction or authority...

  19. 31 CFR 547.310 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 547.310 Section 547.310 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... General Definitions § 547.310 United States. The term United States means the United States, its...

  20. 31 CFR 598.317 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 598.317 Section 598.317 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... Definitions § 598.317 United States. The term United States means the United States, its territories and...

  1. 31 CFR 596.312 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 596.312 Section 596.312 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... General Definitions § 596.312 United States. The term United States means the United States, including its...

  2. 31 CFR 538.314 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 538.314 Section 538.314 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... § 538.314 United States. The term United States means the United States, its territories and possessions...

  3. 31 CFR 543.310 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 543.310 Section 543.310 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... Definitions § 543.310 United States. The term United States means the United States, its territories and...

  4. 31 CFR 594.313 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 594.313 Section 594.313 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... Definitions § 594.313 United States. The term United States means the United States, its territories and...

  5. 31 CFR 588.310 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 588.310 Section 588.310 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... Definitions § 588.310 United States. The term United States means the United States, its territories and...

  6. 31 CFR 536.315 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 536.315 Section 536.315 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... Definitions § 536.315 United States. The term United States means the United States, its territories and...

  7. 31 CFR 544.310 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 544.310 Section 544.310 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... REGULATIONS General Definitions § 544.310 United States. The term United States means the United States, its...

  8. 31 CFR 545.313 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 545.313 Section 545.313 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... Definitions § 545.313 United States. The term United States means the United States, its territories and...

  9. 31 CFR 595.314 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 595.314 Section 595.314 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... § 595.314 United States. The term United States means the United States, its territories and possessions...

  10. 31 CFR 560.307 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 560.307 Section 560.307 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... § 560.307 United States. The term United States means the United States, including its territories and...

  11. 31 CFR 593.311 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 593.311 Section 593.311 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... REGULATIONS General Definitions § 593.311 United States. The term United States means the United States, its...

  12. 31 CFR 541.310 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 541.310 Section 541.310 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... § 541.310 United States. The term United States means the United States, its territories and possessions...

  13. 31 CFR 540.313 - United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States. 540.313 Section 540.313 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... REGULATIONS General Definitions § 540.313 United States. The term United States means the United States, its...

  14. Refusal of Curative Radiation Therapy and Surgery Among Patients With Cancer

    International Nuclear Information System (INIS)

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

    2014-01-01

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

  15. Refusal of Curative Radiation Therapy and Surgery Among Patients With Cancer

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-07-15

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

  16. Ethics and Rationing Access to Dialysis in Resource-Limited Settings: The Consequences of Refusing a Renal Transplant in the South African State Sector.

    Science.gov (United States)

    Etheredge, Harriet; Paget, Graham

    2015-12-01

    Resource constraints in developing countries compel policy makers to ration the provision of healthcare services. This article examines one such set of Guidelines: A patient dialysing in the state sector in South Africa may not refuse renal transplantation when a kidney becomes available. Refusal of transplantation can lead to exclusion from the state-funded dialysis programme. This Guideline is legally acceptable as related to Constitutional stipulations which allow for rationing healthcare resources in South Africa. Evaluating the ethical merit of the Guideline, and exploring the ethical dilemma it poses, proves a more complex task. We examine the actions of healthcare professionals as constrained by the Guideline. From a best interests framework, we argue that in these circumstances directing patient decision making (pressurising a patient to undergo renal transplantation) is not necessarily unethical or unacceptably paternalistic. We then scrutinise the guideline itself through several different ethical 'lenses'. Here, we argue that bioethics does not provide a definitive answer as to the moral merit of rationing dialysis under these circumstances, however it can be considered just in this context. We conclude by examining a potential pitfall of the Guideline: Unwilling transplant recipients may not comply with immunosuppressive medication, which raises questions for policies based on resource management and rationing. © 2014 John Wiley & Sons Ltd.

  17. 7 CFR 1206.23 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false United States. 1206.23 Section 1206.23 Agriculture... INFORMATION Mango Promotion, Research, and Information Order Definitions § 1206.23 United States. United... Rico, and the territories and possessions of the United States. ...

  18. 7 CFR 1215.20 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false United States. 1215.20 Section 1215.20 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... United States. United States means all of the States. Popcorn Board ...

  19. 7 CFR 1280.127 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false United States. 1280.127 Section 1280.127 Agriculture... INFORMATION ORDER Lamb Promotion, Research, and Information Order Definitions § 1280.127 United States. United States means collectively the 50 States and the District of Columbia. ...

  20. Factors related to treatment refusal in Taiwanese cancer patients.

    Science.gov (United States)

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

    2015-01-01

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

  1. Pervasive refusal syndrome. Three German cases provide further illustration.

    Science.gov (United States)

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

    2011-09-01

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

  2. Disposable containers as larval habitats for Aedes aegypti in a city with regular refuse collection: a study in Marília, São Paulo State, Brazil.

    Science.gov (United States)

    Mazine, C A; Macoris, M L; Andrighetti, M T; Yasumaro, S; Silva, M E; Nelson, M J; Winch, P J

    1996-09-01

    In Marília, Brazil, refuse is collected at least every other day, yet non-useful, non-returnable containers such as cans, plastic bottles and tires account for almost half of the container habitats found positive for the Aedes aegypti mosquito. A study was therefore conducted to investigate why these containers exist despite regular refuse collection and a high level of awareness of dengue prevention, and how the control program could most effectively respond. Differing community perceptions as to what constitutes refuse were found to lead people to store a variety of containers in their yard. Other dimensions of the problem include the presence of informal refuse collectors in search of saleable materials, and dumping of refuse in vacant lots and along roads. An intervention based on these data will involve the informal refuse collectors in implementation of a community-based recycling project.

  3. Refusal Skill Ability: An Examination of Adolescent Perceptions of Effectiveness

    Science.gov (United States)

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

    2010-01-01

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

  4. 7 CFR 1260.108 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false United States. 1260.108 Section 1260.108 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... Promotion and Research Order Definitions § 1260.108 United States. United States means the 50 States and the...

  5. 7 CFR 1221.32 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false United States. 1221.32 Section 1221.32 Agriculture... INFORMATION ORDER Sorghum Promotion, Research, and Information Order Definitions § 1221.32 United States. United States or U.S. means collectively the 50 States, the District of Columbia, the Commonwealth of...

  6. 7 CFR 1216.30 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false United States. 1216.30 Section 1216.30 Agriculture... INFORMATION ORDER Peanut Promotion, Research, and Information Order Definitions § 1216.30 United States. United States means collectively the 50 states, the District of Columbia, the Commonwealth of Puerto Rico...

  7. 7 CFR 1218.22 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false United States. 1218.22 Section 1218.22 Agriculture... INFORMATION ORDER Blueberry Promotion, Research, and Information Order Definitions § 1218.22 United States. United States means collectively the 50 states, the District of Columbia, the Commonwealth of Puerto Rico...

  8. 47 CFR 73.4005 - Advertising-refusal to sell.

    Science.gov (United States)

    2010-10-01

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

  9. 7 CFR 1210.315 - United States.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false United States. 1210.315 Section 1210.315 Agriculture... PLAN Watermelon Research and Promotion Plan Definitions § 1210.315 United States. United States means each of the several States and the District of Columbia. [60 FR 10797, Feb. 28, 1995] National...

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

    Science.gov (United States)

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

    2014-07-15

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

  11. Elemental composition of suspended particles released in refuse incineration

    International Nuclear Information System (INIS)

    Mamuro, Tetsuo; Mizohata, Akira

    1979-01-01

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

  12. Process for producing a fuel suitable for degassing from refuse

    Energy Technology Data Exchange (ETDEWEB)

    Sulzberger, J

    1975-11-20

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

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

    OpenAIRE

    Wreen, M J

    1991-01-01

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

  14. 14 CFR 121.586 - Authority to refuse transportation.

    Science.gov (United States)

    2010-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Annelize Nienaber

    2016-11-01

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

  16. [Refusal of nursing care, the legal perspective].

    Science.gov (United States)

    Fisman, Jérôme

    2016-10-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-03-01

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

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

    African Journals Online (AJOL)

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

  19. The issue of legal protection of the intensive care unit physician within the context of patient consent to treatment. Part I: conscious patient, refusing treatment.

    Science.gov (United States)

    Siewiera, Jacek; Trnka, Jakub; Kübler, Andrzej

    2014-01-01

    In daily clinical practice, physicians working in intensive care units (ICUs) face situations when their professional duty to protect the patient's life is in conflict with the obligation to respect the will of the patient and to assess his or her chances of treatment. Although the mere fact of conflict between these fundamental values for the ICU physician is a natural and obvious element in the chosen specialisation, many 'non-medical' circumstances make the given conflict not only very difficult but also dangerous for the physician. So far, the ethical and legal aspects of dying have been commented upon by a large group of lawyers and experts involved in the interpretation of the Polish regulations. The authors believe that a detailed analysis of the regulations should be carried out by persons of legal education, possessing a genuine medical experience associated with the specificity of end of life care in ICUs. In this paper, the authors have compared the current regulations of legislative acts of the common law relating to medical activities at anaesthesiology and intensive care units as well as based on the judgements of the common court of law over the past ten years. In the act of dissuading an ICU doctor from a medical procedure, all factors influencing the doctor's responsibility should be taken into account in accordance with the criminal law. In the case of a patient's death due to a refusal of treatment with the patient's full awareness, and given proper notification as to the consequences of refusing treatment, the doctor's responsibility lies under article 150 of the Polish penal code.

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

    Science.gov (United States)

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

  1. School Refusal: Assessment and Intervention within School Settings.

    Science.gov (United States)

    Wimmer, Mary B.

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

  2. Toll Facilities in the United States - Toll Facilities in the United States

    Data.gov (United States)

    Department of Transportation — Biennial report containing selected information on toll facilities in the United States that has been provided to FHWA by the States and/or various toll authorities...

  3. Risk factors associated with treatment refusal in lung cancer.

    Science.gov (United States)

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

    2017-09-01

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

  4. When does food refusal require professional intervention?

    OpenAIRE

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

    2009-01-01

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

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

    Science.gov (United States)

    Ek, Hans; Eriksson, Rikard

    2013-01-01

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

  6. Oil Vulnerabilities and United States Strategy

    Science.gov (United States)

    2007-02-08

    Mazda, Mercedes - Benz , Ford, Mercury, and Nissan offer flexible fuel vehicles in the United States. Ethanol is currently produced in the United States...USAWC STRATEGY RESEARCH PROJECT OIL VULNERABILITIES AND UNITED STATES STRATEGY by Colonel Shawn P. Walsh...Colleges and Schools, 3624 Market Street, Philadelphia, PA 19104, (215) 662-5606. The Commission on Higher Education is an institutional accrediting

  7. [Refusal of application to care in Alzheimer's disease and related diseases: establishment of a mobile unit hospital extra].

    Science.gov (United States)

    Collignon, Julien; Rouch, Isabelle; Gonthier, Régis; Corbin-Seguin, Aude; Combe, Lorraine; Trombert-Paviot, Béatrice; Laurent, Bernard; Girtanner, Chantal

    2013-03-01

    Refusal of care and support in these patients with Alzheimer's disease and related illnesses at home is a cause of accelerated loss of autonomy and increases the risk of a crisis with early institutionalization. Factors contributing to the denial of care are poorly understood and very few epidemiological data exist. we compared age, diagnosis, level of severity of the disease, the type of behavioral, family status of 101 patients living in denial of care and support as seen by a mobile home (group UPEPc) to 136 control patients seen at the memory clinic (group CM). Patients living in denial of care appear to significantly low age [82/80.5, prefusing home care is specific and it is important to educate GPs conditions that favor an obstacle to medicalization. The advantage of a mobile extramural to analyze risk factors for refusal of care and propose alternatives should be further investigated.

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

    Science.gov (United States)

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

    2014-01-01

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

  9. 31 CFR 596.313 - United States person.

    Science.gov (United States)

    2010-07-01

    ... FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY TERRORISM LIST GOVERNMENTS SANCTIONS REGULATIONS General Definitions § 596.313 United States person. The term United States person means any United States...

  10. Nuclear development in the United States

    International Nuclear Information System (INIS)

    Brewer, S.

    1983-01-01

    The history of the nuclear development in the United States has been one of international cooperation relations so far. The United States is to offer the technical information on atomic energy utilization to foreign countries in exchange for the guarantee that they never attempt to have or develop nuclear weapons. Actually, the United States has supplied the technologies on nuclear fuel cycle and other related fields to enable other countries to achieve economical and social progress. The Department of Energy clarified the public promise of the United States regarding the idea of international energy community. The ratio of nuclear power generation to total electric power supply in the United States exceeded 12%, and will exceed 20% by 1990. Since 1978, new nuclear power station has not been ordered, and some of the contracted power stations were canceled. The atomic energy industry in the United States prospered at the beginning of 1970s, but lost the spirit now, mainly due to the institutional problems rather than the technical ones. As the policy of the government to eliminate the obstacles, the improvement of the procedure for the permission and approval, the establishment of waste disposal capability, the verification of fast breeder reactor technology and the promotion of commercial fuel reprocessing were proposed. The re-establishment of the United States as the reliable supplier of atomic energy service is the final aim. (Kako, I.)

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

    Science.gov (United States)

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

    2014-10-08

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

  12. 78 FR 70274 - United States Travel and Tourism Advisory Board: Meeting of the United States Travel and Tourism...

    Science.gov (United States)

    2013-11-25

    ... DEPARTMENT OF COMMERCE International Trade Administration United States Travel and Tourism Advisory Board: Meeting of the United States Travel and Tourism Advisory Board AGENCY: International Trade... the schedule and agenda for an open meeting of the United States Travel and Tourism Advisory Board...

  13. 78 FR 3398 - United States Travel and Tourism Advisory Board: Meeting of the United States Travel and Tourism...

    Science.gov (United States)

    2013-01-16

    ... DEPARTMENT OF COMMERCE International Trade Administration United States Travel and Tourism Advisory Board: Meeting of the United States Travel and Tourism Advisory Board AGENCY: International Trade... the schedule and agenda for an open meeting of the United States Travel and Tourism Advisory Board...

  14. Refusal to medical interventions.

    Science.gov (United States)

    Palacios, G; Herreros, B; Pacho, E

    2014-10-01

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

  15. United States housing, 2012

    Science.gov (United States)

    Delton Alderman

    2013-01-01

    Provides current and historical information on housing market in the United States. Information includes trends for housing permits and starts, housing completions for single and multifamily units, and sales and construction. This report will be updated annually.

  16. Refusing The Choice: Balancing Life and Work

    Science.gov (United States)

    Brooks, J.

    2012-12-01

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

  17. Clean Cities Niche Market Overview: Refuse Haulers (Brochure)

    Energy Technology Data Exchange (ETDEWEB)

    Shea, S.

    2011-09-01

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

  18. Elucidating the consumption and CO_2 emissions of fossil fuels and low-carbon energy in the United States using Lotka–Volterra models

    International Nuclear Information System (INIS)

    Tsai, Bi-Huei; Chang, Chih-Jen; Chang, Chun-Hsien

    2016-01-01

    By using the Lotka–Volterra model, this work examines for the first time the feasibility of using low-carbon energy to reduce fossil fuel consumption in the United States and, ultimately, to decrease CO_2 emissions. The research sample in this work consists of data on energy consumption and CO_2 emissions in the United States. Parameter estimation results reveal that although the consumption of low-carbon energy increases the consumption of fossil fuels, the latter does not affect the former. Low-carbon energy usage, including nuclear energy and solar photovoltaic power, increases fossil fuel consumption because the entire lifetime of a nuclear or solar energy facility, from the construction of electricity plants to decommissioning, consumes tremendous amounts of fossil fuels. This result verifies the infeasibility of low-carbon energy to replace fossil fuels under the current mining technology, electricity generation skills and governmental policy in the United States and explains why the United States refused to become a signatory of the Kyoto Protocol. Equilibrium analysis results indicate that the annual consumption of fossil fuels will ultimately exceed that of low-carbon energy by 461%. Since our proposed Lotka–Volterra model accurately predicts the consumption and CO_2 emission of different energy sources, this work contributes to the energy policies. - Highlights: • Our Lotka–Volterra model accurately predicts consumption of different energy sources. • We find the current infeasibility of using low-carbon energy to reduce fossil fuels. • The set-up of nuclear and solar plants increases fossil fuel usage in the U.S. • The consumption of fossil fuels will exceed that of low-carbon energy by 435%. • United States government prefers economic development over environmental protection.

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

    Science.gov (United States)

    Bhandari, Neeraj; Shi, Yunfeng; Jung, Kyoungrae

    2016-01-01

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

  20. 31 CFR 500.520 - Payments from accounts of United States citizens in employ of United States in foreign countries...

    Science.gov (United States)

    2010-07-01

    ... States citizens in employ of United States in foreign countries and certain other persons. 500.520..., Authorizations and Statements of Licensing Policy § 500.520 Payments from accounts of United States citizens in employ of United States in foreign countries and certain other persons. (a) Banking institutions within...

  1. 31 CFR 515.520 - Payments from accounts of United States citizens in employ of United States in foreign countries...

    Science.gov (United States)

    2010-07-01

    ... States citizens in employ of United States in foreign countries and certain other persons. 515.520..., Authorizations, and Statements of Licensing Policy § 515.520 Payments from accounts of United States citizens in employ of United States in foreign countries and certain other persons. (a) Banking institutions within...

  2. TRAINING OF THE STATE PRESIDENT'S UNIT

    African Journals Online (AJOL)

    The primary function of the State President's Unit is to protect the head of state - not his person as is generally believed, but his authority over the state. Ironically, the ceremonial performances of the State President's Unit lead people to believe that they are only capable of doing drill exer- cises. However, upon investigating.

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

    Science.gov (United States)

    Owiti, J A; Bowers, L

    2011-09-01

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

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

    Science.gov (United States)

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

    2018-01-01

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

  5. Social Justice Feminism and its Counter-Hegemonic Response to Laissez-Faire Industrial Capitalism and Patriarchy in the United States, 1899-1940

    Directory of Open Access Journals (Sweden)

    John Thomas McGuire

    2017-02-01

    Full Text Available This article uses the hegemonic/counter-hegemonic framework of Italian scholar and activist Antonio Gramsci to explain how a movement known as social justice feminism emerged as a counter-hegemonic response to two hegemonic concepts established in and continued, respectively, the post-Civil War United States: laissez-faire industrial capitalism and patriarchal dominance. In four stages from 1899 through 1940, social justice feminists pursued the promotion of an “entering wedge” labor legislation strategy and the increasing participation of women in national politics, particularly in the Democratic Party. While substantially successful in its goals, social justice feminism failed in two important aspects: its inability to work independently of a patriarchal political system, and, most significant, its apparent refusal to include women of color.

  6. [The refusal of nursing care by the families].

    Science.gov (United States)

    Curchod, Claude; Fisher, Marion

    2016-10-01

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

  7. 31 CFR 515.334 - United States national.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States national. 515.334 Section 515.334 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE... of the United States, and which has its principal place of business in the United States. [61 FR...

  8. 7 CFR 1212.32 - United States Customs Service.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false United States Customs Service. 1212.32 Section 1212... § 1212.32 United States Customs Service. “United States Customs Service” or “Customs” means the United States Customs and Border Protection, an agency of the Department of Homeland Security. Honey Packers and...

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

    Science.gov (United States)

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

    2014-03-01

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

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

    Science.gov (United States)

    Wade, Katherine

    2014-01-01

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

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

    Science.gov (United States)

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

    2017-07-01

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

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

    Science.gov (United States)

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

    2015-12-01

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

  13. Nuclear power in the United States

    International Nuclear Information System (INIS)

    Johnston, J.B.

    1985-01-01

    All over the world except in the United States, nuclear energy is a low cost, secure, environmentally acceptable form of energy. In the United States, civilian nuclear power is dead. 112 nuclear power plants have been abandoned or cancelled in the last decade, and there has been no new order for nuclear plants since 1978. It will be fortunate to have 125 operating nuclear plants in the United States in the year 2000. There are almost 90 completed nuclear power plants and about 45 under construction in the United States, but several of those under construction will eventually be abandoned. About 20 % of the electricity in the United States will be generated by nuclear plants in 2000 as compared with 13 % supplied in the last year. Under the present regulatory and institutional arrangement, American electric utilities would not consider to order a new nuclear power plant. Post-TMI nuclear plants became very expensive, and there is also ideological opposition to nuclear power. Coal-firing plants are also in the similar situation. The uncertainty about electric power demand, the cost of money, the inflation of construction cost and regulation caused the situation. (Kako, I.)

  14. Teen Pregnancy in the United States

    Science.gov (United States)

    ... United States: the contribution of abstinence and improved contraceptive use. Am J Public Health. 2007;97(1):150-6. Lindberg LD, Santelli JS, Desai, S. Understanding the Decline in Adolescent Fertility in the United States, 2007–2012. J ...

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

    Science.gov (United States)

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

    2017-10-01

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

  16. Immigration Enforcement Within the United States

    Science.gov (United States)

    2006-04-06

    Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Policy Issues...Remained in the United States, (Washington: Center for Immigration Studies, May 2002). Immigration Enforcement Within the United States Introduction ...interior enforcement lack a border component. For example, fugitive taskforces, investigations of alien slavery and sweatshops , and employer sanctions do

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

    Science.gov (United States)

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

    1999-01-01

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

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

    Science.gov (United States)

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

    2017-11-01

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

  19. Assessment of musculoskeletal load in refuse collectors

    Directory of Open Access Journals (Sweden)

    Zbigniew W. Jóźwiak

    2013-08-01

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

  20. United States advanced technologies

    International Nuclear Information System (INIS)

    Longenecker, J.R.

    1985-01-01

    In the United States, the advanced technologies have been applied to uranium enrichment as a means by which it can be assured that nuclear fuel cost will remain competitive in the future. The United States is strongly committed to the development of advanced enrichment technology, and has brought both advanced gas centrifuge (AGC) and atomic vapor laser isotope separation (AVLIS) programs to a point of significant technical refinement. The ability to deploy advanced technologies is the basis for the confidence in competitive future price. Unfortunately, the development of advanced technologies is capital intensive. The year 1985 is the key year for advanced technology development in the United States, since the decision on the primary enrichment technology for the future, AGC or AVLIS, will be made shortly. The background on the technology selection process, the highlights of AGC and AVLIS programs and the way to proceed after the process selection are described. The key objective is to maximize the sales volume and minimize the operating cost. This will help the utilities in other countries supply low cost energy on a reliable, long term basis. (Kako, I.)

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

    Science.gov (United States)

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

    2018-01-01

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

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

    Science.gov (United States)

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

    2015-06-01

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

  3. The United States and the Arab Gulf Monarchies

    International Nuclear Information System (INIS)

    Kechichian, J.A.

    1999-01-01

    The United States has enduring strategic interests in the Persian Gulf region. To understand these interests and the Usa policy towards the Arab Gulf Monarchies, the french institute of international relations (IFRI) proposes this document. The following chapters are detailed: the United States and the Arab Gulf Monarchies, overview, Chief Unites States Objective: Access to oil, re-evaluating United States Foreign Policy in the Gulf, the second term (Usa strategy). (A.L.B.)

  4. 76 FR 29796 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Refuse...

    Science.gov (United States)

    2011-05-23

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

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

    Directory of Open Access Journals (Sweden)

    Olajide O Adelugba

    2016-01-01

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

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

    Science.gov (United States)

    Wreen, M J

    1991-09-01

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

  7. 78 FR 46686 - Privacy Act of 1974; Treasury/United States Mint .013-United States Mint National Electronic...

    Science.gov (United States)

    2013-08-01

    ... available publicly. FOR FURTHER INFORMATION CONTACT: For general questions and privacy issues, please... DEPARTMENT OF THE TREASURY Privacy Act of 1974; Treasury/United States Mint .013--United States... Privacy Act of 1974, as amended, 5 U.S.C. 552a, the Department of the Treasury (``Treasury'') and the...

  8. 39 CFR 221.1 - The United States Postal Service.

    Science.gov (United States)

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false The United States Postal Service. 221.1 Section 221.1 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION GENERAL ORGANIZATION § 221.1 The United States Postal Service. The United States Postal Service was established as an...

  9. UNITED STATES DURING THE COLD WAR 1945-1990

    Directory of Open Access Journals (Sweden)

    Novita Mujiyati

    2016-02-01

    Full Text Available United States and the Soviet Union is a country on the part of allies who emerged as the winner during World War II. However, after reaching the Allied victory in the situation soon changed, man has become an opponent. United States and the Soviet Union are competing to expand the influence and power. To compete the United States strive continuously strengthen itself both in the economic and military by establishing a defense pact and aid agencies in the field of economy. During the Cold War the two are not fighting directly in one of the countries of the former Soviet Union and the United States. However, if understood, teradinya the Korean War and the Vietnam War is a result of tensions between the two countries and is a direct warfare conducted by the United States and the Soviet Union. Cold War ended in conflict with the collapse of the Soviet Union and the United States emerged as the winner of the country.

  10. 78 FR 27857 - United States Standards for Wheat

    Science.gov (United States)

    2013-05-13

    ... RIN 0580-AB12 United States Standards for Wheat AGENCY: Grain Inspection, Packers and Stockyards... (GIPSA) is revising the United States Standards for Wheat under the United States Grain Standards Act (USGSA) to change the definition of Contrasting classes (CCL) in the class Hard White wheat. This change...

  11. 29 CFR 1977.22 - Employee refusal to comply with safety rules.

    Science.gov (United States)

    2010-07-01

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

  12. Tuberculosis along the United States-Mexico border, 1993-2001.

    Science.gov (United States)

    Schneider, Eileen; Laserson, Kayla F; Wells, Charles D; Moore, Marisa

    2004-07-01

    Tuberculosis (TB) is a leading public health problem and a recognized priority for the federal Governments of both Mexico and the United States of America. The objectives of this research, primarily for the four states in the United States that are along the border with Mexico, were to: (1) describe the epidemiological situation of TB, (2) identify TB risk factors, and (3) discuss tuberculosis program strategies. We analyzed tuberculosis case reports collected from 1993 through 2001 by the tuberculosis surveillance system of the United States. We used those data to compare TB cases mainly among three groups: (1) Mexican-born persons in the four United States border states (Arizona, California, New Mexico, and Texas), (2) persons in those four border states who had been born in the United States, and (3) Mexican-born persons in the 46 other states of the United States, which do not border Mexico. For the period from 1993 through 2001, of the 16 223 TB cases reported for Mexican-born persons in the United States, 12 450 of them (76.7%) were reported by Arizona, California, New Mexico, and Texas. In those four border states overall in 2001, tuberculosis case rates for Mexican-born persons were 5.0 times as high as the rates for persons born in the United States; those four states have 23 counties that directly border on Mexico, and the ratio in those counties was 5.8. HIV seropositivity, drug and alcohol use, unemployment, and incarceration were significantly less likely to be reported in Mexican-born TB patients from the four border states and the nonborder states than in patients born in the United States from the four border states (P pulmonary tuberculosis patients who were 18-64 years of age and residing in the four border states, the Mexican-born patients were 3.6 times as likely as the United States-born patients were to have resistance to at least isoniazid and rifampin (i. e., to have multidrug-resistant TB) and twice as likely to have isoniazid resistance

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

    Science.gov (United States)

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

    2011-01-01

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

  14. Global Entrepreneurship and the United States

    Science.gov (United States)

    2010-09-01

    Global Entrepreneurship and the United States by Zoltan J. Acs Laszlo Szerb Ruxton, MD 21204 for under contract number SBAHQ-09...SUBTITLE Global Entrepreneurship and the United States 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT...3 2.1. Assessing Entrepreneurship ..................................................................................4 2.2. Stages of Development

  15. 75 FR 25925 - United States Mint

    Science.gov (United States)

    2010-05-10

    ... Committee May 25, 2010 Public Meeting. SUMMARY: Pursuant to United States Code, Title 31, section 5135(b)(8... scheduled for May 25, 2010. Date: May 25, 2010. Time: 9 a.m. to 12 p.m. Location: 8th Floor Board Room, United States Mint, 801 9th Street, NW., Washington, DC 20220. Subject: Review and discuss obverse and...

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

    NARCIS (Netherlands)

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

    2009-01-01

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

  17. 31 CFR 515.330 - Person within the United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Person within the United States. 515... Definitions § 515.330 Person within the United States. (a) The term person within the United States, includes: (1) Any person, wheresoever located, who is a resident of the United States; (2) Any person actually...

  18. 45 CFR 212.7 - Repayment to the United States.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 2 2010-10-01 2010-10-01 false Repayment to the United States. 212.7 Section 212... UNITED STATES CITIZENS RETURNED FROM FOREIGN COUNTRIES § 212.7 Repayment to the United States. (a) An..., any or all of the cost of such assistance to the United States, except insofar as it is determined...

  19. 20 CFR 416.215 - You leave the United States.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false You leave the United States. 416.215 Section... Eligible § 416.215 You leave the United States. You lose your eligibility for SSI benefits for any month during all of which you are outside of the United States. If you are outside of the United States for 30...

  20. 37 CFR 1.412 - The United States Receiving Office.

    Science.gov (United States)

    2010-07-01

    ... Information § 1.412 The United States Receiving Office. (a) The United States Patent and Trademark Office is a Receiving Office only for applicants who are residents or nationals of the United States of America. (b) The... “United States Receiving Office” or by the abbreviation “RO/US.” (c) The major functions of the Receiving...

  1. Performance Analysis of Cofiring Densified Refuse Derived Fuel in a Military Boiler.

    Science.gov (United States)

    1981-12-01

    Use of Waste Oils to Improve Densified Refuse-Derived Fuel 79 Study of the State of the Art of Dioxin from Corbustion Sour ,-es 81 Numerical...very large hammermills for shredu-,nt ii -et re C strean . Tne suitability of this technique has beer . : , 1:d aeauie of its undesirable proper- ,V.>- ir...oe iut- fraction while reducing the hrsepower requiie:: ,. ht uuty shredders have -c-en used as a pfre -. . :-r,der-s have not beer perfected wnich

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

    African Journals Online (AJOL)

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

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

    Directory of Open Access Journals (Sweden)

    Luana Sorrenti

    2016-08-01

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

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

    Science.gov (United States)

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

    2001-09-01

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

  5. The United States and the Kurds: Case Studies in United States Engagement

    National Research Council Canada - National Science Library

    Lambert, Peter

    1997-01-01

    ..., between 1969- 1975, and 1990-1996. Both eras saw the United States able to influence events relating to the Kurds in support of a larger regional policy, only to find no easy solution to the Kurdish quest for autonomy...

  6. United States rejoin ITER

    International Nuclear Information System (INIS)

    Roberts, M.

    2003-01-01

    Upon pressure from the United States Congress, the US Department of Energy had to withdraw from further American participation in the ITER Engineering Design Activities after the end of its commitment to the EDA in July 1998. In the years since that time, changes have taken place in both the ITER activity and the US fusion community's position on burning plasma physics. Reflecting the interest in the United States in pursuing burning plasma physics, the DOE's Office of Science commissioned three studies as part of its examination of the option of entering the Negotiations on the Agreement on the Establishment of the International Fusion Energy Organization for the Joint Implementation of the ITER Project. These were a National Academy Review Panel Report supporting the burning plasma mission; a Fusion Energy Sciences Advisory Committee (FESAC) report confirming the role of ITER in achieving fusion power production, and The Lehman Review of the ITER project costing and project management processes (for the latter one, see ITER CTA Newsletter, no. 15, December 2002). All three studies have endorsed the US return to the ITER activities. This historical decision was announced by DOE Secretary Abraham during his remarks to employees of the Department's Princeton Plasma Physics Laboratory. The United States will be working with the other Participants in the ITER Negotiations on the Agreement and is preparing to participate in the ITA

  7. United States Stateplane Zones - NAD83

    Data.gov (United States)

    Earth Data Analysis Center, University of New Mexico — U.S. State Plane Zones (NAD 1983) represents the State Plane Coordinate System (SPCS) Zones for the 1983 North American Datum within United States.

  8. United States Stateplane Zones - NAD27

    Data.gov (United States)

    Earth Data Analysis Center, University of New Mexico — U.S. State Plane Zones (NAD 1927) represents the State Plane Coordinate System (SPCS) Zones for the 1927 North American Datum within United States.

  9. Knowledge-based fault diagnosis system for refuse collection vehicle

    International Nuclear Information System (INIS)

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

    2015-01-01

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

  10. Knowledge-based fault diagnosis system for refuse collection vehicle

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-05-15

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

  11. Present state of electric power business in United States and Europe

    International Nuclear Information System (INIS)

    Onishi, Kenichi

    2011-01-01

    This article reported present state of nuclear power and electric power business in United States and Europe after Fukushima Daiichi Accident. As for the trend of demand and supply of electric power and policy, the accident forced Germany possibly to proceed with phase-out of nuclear power, but France and United States to sustain nuclear power with no great change of energy policy at this moment. As for the trend of electric power market, there was not state in United States with liberalized retail market of electric power after rolling blackouts occurred in California State in the early 2000s. In Germany proceeding with renewable energy introduction, renewable electricity fed into the grid was paid for by the network operators at fixed tariffs and the costs passed on to electricity consumers were increasing. Renewable Portfolio Standards (RPS) in United States forced the state to introduction of renewable energy to some ratio, and Feed-in Tariff (FIT) introduced in EU in 1990s lead to introduction of a large amount of renewable electricity targeted in 2020. Huge amount of wind power introduction brought about several problems to solve such that excess electric power above domestic demand had bad effects on grids in neighboring region. Enforcement of power transmission lines was also needed with increase of maximum electric power as well as introduction of a large amount of renewable electricity. (T. Tanaka)

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

    African Journals Online (AJOL)

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

  13. Death in the United States, 2011

    Science.gov (United States)

    ... Order from the National Technical Information Service NCHS Death in the United States, 2011 Recommend on Facebook ... 2011 SOURCE: National Vital Statistics System, Mortality. Do death rates vary by state? States experience different mortality ...

  14. 37 CFR 1.295 - Review of decision finally refusing to publish a statutory invention registration.

    Science.gov (United States)

    2010-07-01

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

  15. Children with pervasive refusal.

    OpenAIRE

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

    1991-01-01

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

  16. Chemical reagent and process for refuse disposal

    International Nuclear Information System (INIS)

    Somerville, R.B.; Fan, L.T.

    1989-01-01

    A process for treating refuse by mixing them with a reactive chemical and a puzzolana-type material. Said chemical includes a retarding agent which modifies the viscosity and an accelerating agent. (author)

  17. 49 CFR 219.213 - Unlawful refusals; consequences.

    Science.gov (United States)

    2010-10-01

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

  18. 31 CFR 103.39 - Person outside the United States.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Person outside the United States. 103... Person outside the United States. For the purposes of this subpart, a remittance or transfer of funds, or... the United States, shall be deemed to be a remittance or transfer to a person outside the United...

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

    Science.gov (United States)

    Kyoso, Masaki

    2015-08-01

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

  20. Energy problems of the United States

    International Nuclear Information System (INIS)

    Pertuzio, A.

    2006-01-01

    The united states are the third world producer of oil which accounts for 440% of world production and 20 million barrels/day of which 60% are imported. That dependence on imports is likely to increase in the next decades. Such supplies and their security are therefore a fundamental factor of the United States foreign policy in combination with their political, economic and strategic objectives in a world both unsure and dangerous

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

    NARCIS (Netherlands)

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

    2007-01-01

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

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

    NARCIS (Netherlands)

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

    2007-01-01

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

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

    NARCIS (Netherlands)

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

    2007-01-01

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

  4. Household pesticide usage in the United States.

    Science.gov (United States)

    Savage, E P; Keefe, T J; Wheeler, H W; Mounce, L; Helwic, L; Applehans, F; Goes, E; Goes, T; Mihlan, G; Rench, J; Taylor, D K

    1981-01-01

    A total of 10,000 U.S. households in 25 standard metropolitan statistical areas and 25 counties were included in the United States. More than 8,200 households granted an interview. Nine of every ten households in the United States used some types of pesticide in their house, garden, or yard. Households in the southeastern United States used the most pesticides. Although more than 500 different pesticide formulations were used by the sampled households, 15 pesticides accounted for 65.5% of all pesticides reported in this study. Thirteen of these 15 pesticides were insecticides, one was a herbicide, and one was a rodenticide.

  5. Responding to the refusal of care in the emergency department.

    Science.gov (United States)

    Nelson, Jennifer; Venkat, Arvind; Davenport, Moira

    2014-01-01

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

  6. 75 FR 13345 - Pricing for Certain United States Mint Products

    Science.gov (United States)

    2010-03-19

    ... DEPARTMENT OF THE TREASURY United States Mint Pricing for Certain United States Mint Products AGENCY: United States Mint, Department of the Treasury. ACTION: Notice. SUMMARY: The United States Mint is announcing the price of First Spouse Bronze Medals and 2010 First Spouse Bronze Medal Series: Four...

  7. 22 CFR 22.3 - Remittances in the United States.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Remittances in the United States. 22.3 Section...-DEPARTMENT OF STATE AND FOREIGN SERVICE § 22.3 Remittances in the United States. (a) Type of remittance. Remittances shall be in the form of: (1) Check or bank draft drawn on a bank in the United States; (2) money...

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

    Science.gov (United States)

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

    2014-01-01

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

  9. Parental refusal of life-saving treatments for adolescents: Chinese familism in medical decision-making re-visited.

    Science.gov (United States)

    Hui, Edwin

    2008-06-01

    This paper reports two cases in Hong Kong involving two native Chinese adolescent cancer patients (APs) who were denied their rights to consent to necessary treatments refused by their parents, resulting in serious harm. We argue that the dynamics of the 'AP-physician-family-relationship' and the dominant role Chinese families play in medical decision-making (MDM) are best understood in terms of the tendency to hierarchy and parental authoritarianism in traditional Confucianism. This ethic has been confirmed and endorsed by various Chinese writers from Mainland China and Hong Kong. Rather than giving an unqualified endorsement to this ethic, based more on cultural sentimentalism than rational moral reasoning, we warn that a strong familism in MDM, which deprives 'weak' family members of rights, represents the less desirable elements of this tradition, against which healthcare professionals working in this cultural milieu need to safeguard. Specifically for APs, we suggest that parental authority and family integrity should be re-interpreted in terms of parental responsibility and the enhancement of children's interests respectively, as done in the West. This implies that when parents refuse to consent to necessary treatment and deny their adolescent children's right to consent, doctors, as the only remaining advocates of the APs' interest, have the duty to inform the state, which can override parental refusal to enable the doctors to fulfill their professional and moral obligations. In so doing the state exercises its 'parens patriae' power to defend the defenseless in society and the integrity of the medical profession.

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

    Science.gov (United States)

    Bock, Gregory L

    2012-11-01

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

  11. Using a Nonaversive Procedure to Decrease Refusals.

    Science.gov (United States)

    Spooner, Fred; And Others

    1990-01-01

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

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

    Science.gov (United States)

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

    2013-09-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Dugan, P.R.

    1987-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Karine Markosyan

    2014-01-01

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

  15. The United Kingdom: Issues for the United States

    National Research Council Canada - National Science Library

    Archick, Kristin

    2007-01-01

    ...; and more recently, from the UK's strong support in countering terrorism and confronting Iraq. The United States and Britain also share a mutually beneficial trade and economic relationship, and are each other's biggest foreign direct investors...

  16. Radiation therapy facilities in the United States

    International Nuclear Information System (INIS)

    Ballas, Leslie K.; Elkin, Elena B.; Schrag, Deborah; Minsky, Bruce D.; Bach, Peter B.

    2006-01-01

    Purpose: About half of all cancer patients in the United States receive radiation therapy as a part of their cancer treatment. Little is known, however, about the facilities that currently deliver external beam radiation. Our goal was to construct a comprehensive database of all radiation therapy facilities in the United States that can be used for future health services research in radiation oncology. Methods and Materials: From each state's health department we obtained a list of all facilities that have a linear accelerator or provide radiation therapy. We merged these state lists with information from the American Hospital Association (AHA), as well as 2 organizations that audit the accuracy of radiation machines: the Radiologic Physics Center (RPC) and Radiation Dosimetry Services (RDS). The comprehensive database included all unique facilities listed in 1 or more of the 4 sources. Results: We identified 2,246 radiation therapy facilities operating in the United States as of 2004-2005. Of these, 448 (20%) facilities were identified through state health department records alone and were not listed in any other data source. Conclusions: Determining the location of the 2,246 radiation facilities in the United States is a first step in providing important information to radiation oncologists and policymakers concerned with access to radiation therapy services, the distribution of health care resources, and the quality of cancer care

  17. 75 FR 13345 - Pricing for Certain 2010 United States Mint Products

    Science.gov (United States)

    2010-03-19

    ... DEPARTMENT OF THE TREASURY United States Mint Pricing for Certain 2010 United States Mint Products AGENCY: United States Mint, Department of the Treasury. ACTION: Notice. SUMMARY: The United States Mint is announcing the price of the 2010 United States Mint Presidential $1 Coin and First Spouse Medal...

  18. Intergenerational educational mobility in Denmark and the United States

    DEFF Research Database (Denmark)

    Andrade, Stefan Bastholm; Thomsen, Jens-Peter

    2018-01-01

    An overall finding in comparative mobility studies is that intergenerational mobility is greater in Scandinavia than in liberal welfare-state countries like the United States and United Kingdom. However, in a recent study, Landersø and Heckman (L & H) (2017) argue that intergenerational educational...... mobility in Denmark and the United States is remarkably similar. L & H’s findings run contrary to widespread beliefs and have been echoed in academia and mass media on both sides of the Atlantic Ocean. In this article, we reanalyze educational mobility in Denmark and the United States using the same data...... sources as L & H. We apply several different methodological approaches from economics and sociology, and we consistently find that educational mobility is higher in Denmark than in the United States....

  19. Toll Facilities in the United States

    Data.gov (United States)

    Department of Transportation — Biennial report containing selected information on toll facilities in the United States that has been provided to FHWA by the States and/or various toll authorities...

  20. State nuclear initiatives in the United States

    International Nuclear Information System (INIS)

    Strauss, P.L.; Stoiber, C.R.

    1977-01-01

    The paper deals with State nuclear initiatives regarding the role of nuclear power in the energy future of the United States. The question of whether and under what circumstances nuclear facilities should be used to generate electricity was put to the popular vote in several States in 1976. Some general principles of Federal-State relations are discussed with specific reference to nuclear regulations. The initiative mechanism itself is described as well as its legal form and background. The parallel developments in the State and Federal legislative consideration of nuclear issues is reviewed and the suggested reasons for the defeat of the proposals in the seven States concerned are discussed. Finally, the author draws some conclusions on the effects of the 1976 initiatives on future decision-making in the US on energy policy in general and nuclear power in particular. (NEA) [fr

  1. 27 CFR 479.89 - Transfers to the United States.

    Science.gov (United States)

    2010-04-01

    ... Transfers to the United States. A firearm may be transferred to the United States or any department... 27 Alcohol, Tobacco Products and Firearms 3 2010-04-01 2010-04-01 false Transfers to the United States. 479.89 Section 479.89 Alcohol, Tobacco Products, and Firearms BUREAU OF ALCOHOL, TOBACCO...

  2. Impact of interventions for patients refusing emergency medical services transport.

    Science.gov (United States)

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

    1995-06-01

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

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

    International Nuclear Information System (INIS)

    Anees, M.; Khan, J.A.

    2014-01-01

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

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

    Science.gov (United States)

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

    2018-01-01

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

  5. Mental health consequences of abortion and refused abortion.

    Science.gov (United States)

    Watter, W W

    1980-02-01

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

  6. 32 CFR 516.54 - Witnesses for the United States.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Witnesses for the United States. 516.54 Section..., Travel, and Expenses of Witnesses § 516.54 Witnesses for the United States. (a) Status of witness. A military member authorized to appear as a witness for the United States, including those authorized to...

  7. 32 CFR 150.21 - Appeals by the United States.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 1 2010-07-01 2010-07-01 false Appeals by the United States. 150.21 Section 150... the United States. (a) Restricted filing. Only a representative of the government designated by the Judge Advocate General of the respective service may file an appeal by the United States under Article...

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

    Science.gov (United States)

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

    2009-01-01

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

  9. United States housing, first quarter 2013

    Science.gov (United States)

    Delton Alderman

    2014-01-01

    Provides current and historical information on housing market in the United States. Information includes trends for housing permits and starts, housing under construction, and housing completions for single and multifamily units, and sales and construction. This report will be updated regularly.

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

    Science.gov (United States)

    Rajtar, Małgorzata

    2013-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Christopher Sarah

    2006-09-01

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

  12. Arsenic in Ground Water of the United States

    Science.gov (United States)

    ... Team More Information Arsenic in groundwater of the United States Arsenic in groundwater is largely the result of ... Gronberg (2011) for updated arsenic map. Featured publications United States Effects of human-induced alteration of groundwater flow ...

  13. Enrichment situation outside the United States

    International Nuclear Information System (INIS)

    Anon.

    1979-01-01

    Different enrichment technologies are briefly characterized which include gaseous diffusion, which is presently the production mainstay of the United States and France; the gaseous centrifuge which is the production plant for Urenco and the technology for future United States enrichment expansion; the aero-dynamic processes which include the jet nozzle (also known as the Becker process) and the fixed-wall centrifuge (also known as the Helikon process); chemical processes; laser isotope separation processes (also referred to in the literature as LIS); and plasma technology

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

    Science.gov (United States)

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

    2015-01-01

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

  15. Leading Causes of Death in Females United States

    Science.gov (United States)

    ... and Health Issues at Work Health Equity Leading Causes of Death in Females, United States Recommend on Facebook Tweet ... to current and previous listings for the leading causes of death in females in the United States. Please note ...

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

    Science.gov (United States)

    Davis, John K

    2008-03-01

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

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

    Science.gov (United States)

    Bouvet, R; Le Gueut, M

    2013-06-01

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

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

    Science.gov (United States)

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

    2017-10-01

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

  19. 33 CFR 2.38 - Waters subject to the jurisdiction of the United States; waters over which the United States has...

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Waters subject to the jurisdiction of the United States; waters over which the United States has jurisdiction. 2.38 Section 2.38 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL JURISDICTION...

  20. Unites States and the oil of the Middle-East

    International Nuclear Information System (INIS)

    Noel, P.

    2005-08-01

    The author discusses different aspects of the United States intervention and behavior in the Middle-East petroleum management. The Iraq and Iran potentials are largely under used. The Saudi Arabia defines its own oil policy, but benefits of the Unites States military help. The United States intervention is in the domain of the security of flux on the world market. (A.L.B.)

  1. 8. European sewage and refuse symposium. Documentation

    International Nuclear Information System (INIS)

    1990-01-01

    The subject of the 8. European Sewage and Refuse Symposium is covered under the following headings: collection and control in sewers, industrial waste water management, pretreatment, combined treatment, special cases, industrial waste water sludges disposal and the European waste business. (orig./BBR)

  2. Food irradiation in the United States

    International Nuclear Information System (INIS)

    Pauli, G.H.

    1991-01-01

    Since 1963, some irradiated foods have been permitted for sale in the United States. Yet, at this time, commercial application has been limited to irradiation of a relatively small fraction of the spices and seasonings used as ingredients in other foods. The current situation regarding irradiated foods in the United States and how it developed is discussed. The author writes from experience gained as a Government regulator concerned primarily with ensuring safety of food and therefore this is stressed together with the crucial role played by consumers and industry. (author)

  3. Vaccine refusal - what we need to know.

    Science.gov (United States)

    Succi, Regina Célia de Menezes

    2018-04-12

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

  4. The State Geologic Map Compilation (SGMC) geodatabase of the conterminous United States

    Science.gov (United States)

    Horton, John D.; San Juan, Carma A.; Stoeser, Douglas B.

    2017-06-30

    The State Geologic Map Compilation (SGMC) geodatabase of the conterminous United States (https://doi. org/10.5066/F7WH2N65) represents a seamless, spatial database of 48 State geologic maps that range from 1:50,000 to 1:1,000,000 scale. A national digital geologic map database is essential in interpreting other datasets that support numerous types of national-scale studies and assessments, such as those that provide geochemistry, remote sensing, or geophysical data. The SGMC is a compilation of the individual U.S. Geological Survey releases of the Preliminary Integrated Geologic Map Databases for the United States. The SGMC geodatabase also contains updated data for seven States and seven entirely new State geologic maps that have been added since the preliminary databases were published. Numerous errors have been corrected and enhancements added to the preliminary datasets using thorough quality assurance/quality control procedures. The SGMC is not a truly integrated geologic map database because geologic units have not been reconciled across State boundaries. However, the geologic data contained in each State geologic map have been standardized to allow spatial analyses of lithology, age, and stratigraphy at a national scale.

  5. 24 CFR 3282.354 - Submittal of false information or refusal to submit information.

    Science.gov (United States)

    2010-04-01

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

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

    Science.gov (United States)

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

    2016-10-01

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

  7. Exporting Rambutan to United States: One Reality?

    International Nuclear Information System (INIS)

    Ahmad Zainuri Mohd Dzomir; Zainon Othman; Mohd Sidek Othman

    2011-01-01

    Rambutan is a one of commodity that are passed by United States of America authority to be market in that states. The main condition for the approval is the exporter must use irradiation technology as quarantine treatment to monitor the insects in there. United States of America's Agriculture Department (USDA-APHIS) has make early survey to the facilities involved in exporting process chain to overview Malaysia preparedness for this purpose. This paper work will discussed the possibility of this exporting implemented based on conditions rule by the USDA. (author)

  8. Wheat rusts in the United States in 2016

    Science.gov (United States)

    In 2016, wheat stripe rust caused by Puccinia striiformis f. sp. graminis was widespread throughout the United States. Cool temperatures and abundant rainfall in the southern Great Plains allowed stripe rust to become widely established and spread throughout the Great Plains and eastern United State...

  9. The Prevalence of Sexual Behavior Stigma Affecting Gay Men and Other Men Who Have Sex with Men Across Sub-Saharan Africa and in the United States

    Science.gov (United States)

    Sanchez, Travis Howard; Sullivan, Patrick Sean; Ketende, Sosthenes; Lyons, Carrie; Charurat, Manhattan E; Drame, Fatou Maria; Diouf, Daouda; Ezouatchi, Rebecca; Kouanda, Seni; Anato, Simplice; Mothopeng, Tampose; Mnisi, Zandile; Baral, Stefan David

    2016-01-01

    Background There has been increased attention for the need to reduce stigma related to sexual behaviors among gay men and other men who have sex with men (MSM) as part of comprehensive human immunodeficiency virus (HIV) prevention and treatment programming. However, most studies focused on measuring and mitigating stigma have been in high-income settings, challenging the ability to characterize the transferability of these findings because of lack of consistent metrics across settings. Objective The objective of these analyses is to describe the prevalence of sexual behavior stigma in the United States, and to compare the prevalence of sexual behavior stigma between MSM in Southern and Western Africa and in the United States using consistent metrics. Methods The same 13 sexual behavior stigma items were administered in face-to-face interviews to 4285 MSM recruited in multiple studies from 2013 to 2016 from 7 Sub-Saharan African countries and to 2590 MSM from the 2015 American Men’s Internet Survey (AMIS), an anonymous Web-based behavioral survey. We limited the study sample to men who reported anal sex with a man at least once in the past 12 months and men who were aged 18 years and older. Unadjusted and adjusted prevalence ratios were used to compare the prevalence of stigma between groups. Results Within the United States, prevalence of sexual behavior stigma did not vary substantially by race/ethnicity or geographic region except in a few instances. Feeling afraid to seek health care, avoiding health care, feeling like police refused to protect, being blackmailed, and being raped were more commonly reported in rural versus urban settings in the United States (Psexual behavior stigma among MSM in the United States appears to have a high absolute burden and similar pattern as the same forms of stigma reported by MSM in Sub-Saharan Africa, although results may be influenced by differences in sampling methodology across regions. The disproportionate burden of HIV

  10. United States National Seismographic Network

    International Nuclear Information System (INIS)

    Buland, R.

    1993-09-01

    The concept of a United States National Seismograph Network (USNSN) dates back nearly 30 years. The idea was revived several times over the decades. but never funded. For, example, a national network was proposed and discussed at great length in the so called Bolt Report (U. S. Earthquake Observatories: Recommendations for a New National Network, National Academy Press, Washington, D.C., 1980, 122 pp). From the beginning, a national network was viewed as augmenting and complementing the relatively dense, predominantly short-period vertical coverage of selected areas provided by the Regional Seismograph Networks (RSN's) with a sparse, well-distributed network of three-component, observatory quality, permanent stations. The opportunity finally to begin developing a national network arose in 1986 with discussions between the US Geological Survey (USGS) and the Nuclear Regulatory Commission (NRC). Under the agreement signed in 1987, the NRC has provided $5 M in new funding for capital equipment (over the period 1987-1992) and the USGS has provided personnel and facilities to develop. deploy, and operate the network. Because the NRC funding was earmarked for the eastern United States, new USNSN station deployments are mostly east of 105 degree W longitude while the network in the western United States is mostly made up of cooperating stations (stations meeting USNSN design goals, but deployed and operated by other institutions which provide a logical extension to the USNSN)

  11. 37 CFR 1.413 - The United States International Searching Authority.

    Science.gov (United States)

    2010-07-01

    ... Processing Provisions General Information § 1.413 The United States International Searching Authority. (a... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false The United States International Searching Authority. 1.413 Section 1.413 Patents, Trademarks, and Copyrights UNITED STATES PATENT...

  12. United States Attorney Prosecutions

    Science.gov (United States)

    1993-10-01

    property of CocaCola Bottling Company, Fayetteville, North Carolina, of a value in excess of $100.00, in violation of Title 18 United States Code, Section...another, to-wit: a Cocacola soft drink machine, the amount of damage to said personal property being more than $200.00, in violation of North Carolina

  13. 77 FR 48542 - United States

    Science.gov (United States)

    2012-08-14

    ... litigation.'' United States v. Armour and Co., 402 U.S. 673, 681 (1971). Section 5 of the Clayton Act... relief in consent judgment that contained recitals in which defendants asserted their innocence); Armour...

  14. United States Strategy for Mexico

    National Research Council Canada - National Science Library

    Centner, Robert C

    2005-01-01

    The security and stability of Mexico is of national interest to the United States, and a strong, effective alliance between the two countries is pivotal to our national defense strategy and economic prosperity...

  15. Women's, midwives' and obstetricians' experiences of a structured process to document refusal of recommended maternity care.

    Science.gov (United States)

    Jenkinson, Bec; Kruske, Sue; Stapleton, Helen; Beckmann, Michael; Reynolds, Maree; Kildea, Sue

    2016-12-01

    Ethical and professional guidance for midwives and obstetricians emphasises informed consent and respect for patient autonomy; the right to refuse care is well established. However, the existing literature is largely silent on the appropriate clinical responses when pregnant women refuse recommended care, and accounts of disrespectful interactions and conflict are numerous. Policies and processes to support women and maternity care providers are rare and unstudied. To document the perspectives of women, midwives and obstetricians following the introduction of a structured process (Maternity Care Plan; MCP) to document refusal of recommended maternity care in a large tertiary maternity unit. A qualitative, interpretive study involved thematic analysis of in-depth semi-structured interviews with women (n=9), midwives (n=12) and obstetricians (n=9). Four major themes were identified including: 'Reassuring and supporting clinicians'; 'Keeping the door open'; 'Varied awareness, criteria and use of the MCP process' and 'No guarantees'. Clinicians felt protected and reassured by the structured documentation and communication process and valued keeping women engaged in hospital care. This, in turn, protected women's access to maternity care. However, the process could not guarantee favourable responses from other clinicians subsequently involved in the woman's care. Ongoing discussions of risk, perceived by women and some midwives to be pressure to consent to recommended care, were still evident. These limitations may have been attributable to the absence of agreed criteria for initiating the MCP process and fragmented care. Varying awareness and use of the process also diminished women's access to it. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  16. 9 CFR 93.806 - Animals refused entry.

    Science.gov (United States)

    2010-01-01

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

  17. [Informed consent and parental refusal to medical treatment in childhood. The threshold of medical and social tolerance. Part I].

    Science.gov (United States)

    Guadarrama-Orozco, Jessica H; Garduño Espinosa, Juan; Vargas López, Guillermo; Viesca Treviño, Carlos

    Informed consent is a right of all individuals and no one can force anyone to receive treatment against their wishes. The right to accept or refuse treatment persists in individuals who are incompetent from a legal point of view; this is exercised on their behalf by a third party. Children are considered incompetent to make medical decisions about their own health and their parents or legal guardians are empowered to make those decisions. However, parental authority is not absolute and there are situations where their decisions are not the best, sometimes leading to jeopardizing the well-being and even the lives of their children, forcing the state to intervene on behalf of the best interests of the child. This is the reason why it is necessary to ask the following questions: is it really the child's best interest that moves us to legally intervene when a parent refuses to accept the proposed medical treatment or is the damage done to make this decision? What kind of parental decisions are those that should not be tolerated? After a review of the theme, we conclude that if the decision of the parents regarding a medical decision is considered to be made with maleficence that is harmful to the child, it is justified that the State intervenes. Finally, we exposed four criteria that can be used in making decisions in complex cases where parents refuse treatment for their children. Copyright © 2015. Publicado por Masson Doyma México S.A.

  18. NCHS - Injury Mortality: United States

    Data.gov (United States)

    U.S. Department of Health & Human Services — This dataset describes injury mortality in the United States beginning in 1999. Two concepts are included in the circumstances of an injury death: intent of injury...

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

    Directory of Open Access Journals (Sweden)

    Mustafa Yasin Irmak

    2016-12-01

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

  20. 21 CFR 515.21 - Refusal to approve a medicated feed mill license application.

    Science.gov (United States)

    2010-04-01

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

  1. Both Europe's and the United States' electrification

    International Nuclear Information System (INIS)

    Matly, M.

    2006-01-01

    While the United States quickly had the largest electrical indus in the world, electrification in rural areas ended about thirty years after most European countries. Public intervention is a deciding factor in completing electrification, and the late involvement by the American authorities explains the gap. However it would be wrong to oppose in Europe and in the United States a motivated public sector and little involved private companies. In both continents indeed, major private and public urban distributors were almost not involved in rural electrification processes, where local players prevailed: local communities around Europe, small and medium size business in some European countries such as France, co-operative companies in the United States. Additionally, there is an essential difference between electrification in Europe and in the United States. The former does not provide much more than lighting and its success leaves few traces in popular memories; the latter includes many facilities and services, changes the lives of rural populations and is celebrated a such. Whereas the colonial venture keep European economies away from their domestic markets, while in the United States the urban market growth contents large companies, the American co-operative movement is right to believe in the existence of a large electrical equipment market among farmers then considered poor and behind. It even uses the market to complete a more profitable and less costly electrification. Electricity stories that offer food for the thoughts of Third World decision makers and power companies, when they entrust most rural electrification to their large urban companies and deny the existence of a real equipment market in their own rural world. (author)

  2. Asian Immigration: The View from the United States.

    Science.gov (United States)

    Gardner, Robert W.

    1992-01-01

    Examines contemporary Asian immigration to the United States from a U.S. perspective. Analyzes immigration policies and data on recent immigration from Asia. Discusses impacts concerning the United States and the immigrants themselves and speculates on future immigration. The composition of Asian immigration might change, and the number might…

  3. 26 CFR 1.956-2 - Definition of United States property.

    Science.gov (United States)

    2010-04-01

    ..., which is— (i) Tangible property (real or personal) located in the United States; (ii) Stock of a... year ending June 30, 1964, R Corporation's increase in earnings invested in United States property for... United States property during its taxable year 1965, S Corporation's increase in earnings invested in...

  4. Licensed pertussis vaccines in the United States: History and current state

    OpenAIRE

    Klein, Nicola P

    2014-01-01

    The United States switched from whole cell to acellular pertussis vaccines in the 1990s following global concerns with the safety of the whole cell vaccines. Despite high levels of acellular pertussis vaccine coverage, the United States and other countries are experiencing large pertussis outbreaks. The aim of this article is to describe the historical context which led to acellular pertussis vaccine development, focusing on vaccines currently licensed in the US, and to review evidence that w...

  5. Nations United: The United Nations, the United States, and the Global Campaign Against Terrorism. A Curriculum Unit & Video for Secondary Schools.

    Science.gov (United States)

    Houlihan, Christina; McLeod, Shannon

    This curriculum unit and 1-hour videotape are designed to help students understand the purpose and functions of the United Nations (UN) and explore the relationship between the United Nations and the United States. The UN's role in the global counterterrorism campaign serves as a case study for the unit. The students are asked to develop a basic…

  6. Estimated United States Transportation Energy Use 2005

    Energy Technology Data Exchange (ETDEWEB)

    Smith, C A; Simon, A J; Belles, R D

    2011-11-09

    A flow chart depicting energy flow in the transportation sector of the United States economy in 2005 has been constructed from publicly available data and estimates of national energy use patterns. Approximately 31,000 trillion British Thermal Units (trBTUs) of energy were used throughout the United States in transportation activities. Vehicles used in these activities include automobiles, motorcycles, trucks, buses, airplanes, rail, and ships. The transportation sector is powered primarily by petroleum-derived fuels (gasoline, diesel and jet fuel). Biomass-derived fuels, electricity and natural gas-derived fuels are also used. The flow patterns represent a comprehensive systems view of energy used within the transportation sector.

  7. United States of America National Report

    International Nuclear Information System (INIS)

    1992-01-01

    The United States has produced this report as part of the preparations for the United Nations Conference on Environment and Development (UNCED) to be held in Brazil in June 1992. It summarizes this nation's efforts to protect and enhance the quality of the human environment in concert with its efforts to provide economic well-being during the two decades since the United Nations Conference on the Human Environment was held in Stockholm. The information presented in this report is primarily and deliberately retrospective. It is an attempt to portray the many human, economic and natural resources of the United States, to describe resource use and the principal national laws and programs established to protect these resources, and to analyze key issues on the agenda of UNCED. This analysis is presented in terms of past and present conditions and trends, measures of progress made in responding to the key issues, and a summary of government activities, underway or pending, to address ongoing or newly emerging national environmental and resource management problems

  8. 49 CFR 655.49 - Refusal to submit to a drug or alcohol test.

    Science.gov (United States)

    2010-10-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-10-15

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

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

    International Nuclear Information System (INIS)

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

    2012-01-01

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

  11. African Journals Online: United States Minor Outlying Islands

    African Journals Online (AJOL)

    African Journals Online: United States Minor Outlying Islands. Home > African Journals Online: United States Minor Outlying Islands. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Browse By Category · Browse Alphabetically · Browse By Country · List All Titles ...

  12. The Danish Supreme Court rules on State action defense and refusal to supply under Danish competition law (Copenhagen Airport Terminal A)

    DEFF Research Database (Denmark)

    Bergqvist, Christian; Christensen, Laurits Peder Schmidt

    2015-01-01

    to the application of competition law to the matter at hand. Unhappy, not only with the outcome, but also the process, the access seeking party, Terminal A, lodged a case before the judiciary arguing that air security regulation did not prevent the application of competition law and an order for the granting...... of access. This submission was not accepted by the Danish Supreme Court that moreover held EU Article 106 (2) to be applicable as a defence for Copenhagen Airport’s refusal to lease the land to Terminal A. The case provides guidance on the scope of the state action defence under Danish competition law and...... for the purpose of building a new terminal A. Terminal A would compete with the airport in the supply of services to airlines. Copenhagen airport rejected the request which in turn lead the group of investors to complain to the Danish Competition and Consumer Authority ("DCCA"). In its draft decision the DCCA...

  13. Refugee Status Required for Resettlement in the United States

    Science.gov (United States)

    2017-06-09

    STATES REFUGEE ADMISSIONS PROGRAM FLOWCHART ...the American public’s concerns. 50 APPENDIX A UNITED STATES REFUGEE ADMISSIONS PROGRAM FLOWCHART Source: US Citizenship and Immigration...TITLE AND SUBTITLE Refugee Status Required for Resettlement in the United States 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT

  14. Latin America and the United States: What Do United States History Textbooks Tell Us?

    Science.gov (United States)

    Fleming, Dan B.

    1982-01-01

    Evaluates how U.S.-Latin American relations are presented in high school U.S. history textbooks. An examination of 10 textbooks published between 1977-81 revealed inadequate coverage of Latin American cultural diversity and United States foreign policy from the Latin American perspective. (AM)

  15. Preparation of School Psychologists in the United States

    Science.gov (United States)

    Joyce-Beaulieu, Diana; Rossen, Eric

    2014-01-01

    School psychology in the United States continues to evolve in response to shifts in the country's demographic characteristics, an increasing focus on the importance of child mental health, together with health and education reforms. The landscape of school psychological services in the United States also is shaped through the changing roles and…

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

    Science.gov (United States)

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

    2002-10-01

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

  17. 30 CFR 253.50 - How can MMS refuse or invalidate my OSFR evidence?

    Science.gov (United States)

    2010-07-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  19. Analysis of fouling in refuse waste incinerators

    NARCIS (Netherlands)

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

    2001-01-01

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

  20. Use for refuse of shale carbonization

    Energy Technology Data Exchange (ETDEWEB)

    1917-09-25

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

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

    Directory of Open Access Journals (Sweden)

    Ibrahim Fathi Huwari

    2015-02-01

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

  2. United States position on severe accidents

    International Nuclear Information System (INIS)

    Ross, D.F.

    1988-01-01

    The United States policy on severe accidents was published in 1985 for both new plant applications and for existing plants. Implementation of this policy is in progress. This policy, aided by a related safety goal policy and by analysis capabilities emerging from improved understanding of accident phenomenology, is viewed as a logical development from the pioneering work in the WASH-1400 Reactor Safety Study published by the United States Nuclear Regulatory Commission (NRC) in 1975. This work provided an estimate of the probability and consequences of severe accidents which, prior to that time, had been mostly evaluated by somewhat arbitrary assumptions dating back 30 years. The early history of severe accident evaluation is briefly summarized for the period 1957-1979. Then, the galvanizing action of Three Mile Island Unit 2 (TMI-2) on severe accident analysis, experimentation and regulation is reviewed. Expressions of US policy in the form of rulemaking, severe accident policy, safety research, safety goal policy and court decisions (on adequacy of safety) are discussed. Finally, the NRC policy as of March 1988 is stated, along with a prospective look at the next few years. (author). 19 refs

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

    Directory of Open Access Journals (Sweden)

    S J Thaker

    2015-01-01

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

  4. Understanding human trafficking in the United States.

    Science.gov (United States)

    Logan, T K; Walker, Robert; Hunt, Gretchen

    2009-01-01

    The topic of modern-day slavery or human trafficking has received increased media and national attention. However, to date there has been limited research on the nature and scope of human trafficking in the United States. This article describes and synthesizes nine reports that assess the U.S. service organizations' legal representative knowledge of, and experience with, human trafficking cases, as well as information from actual cases and media reports. This article has five main goals: (a) to define what human trafficking is, and is not; (b) to describe factors identified as contributing to vulnerability to being trafficked and keeping a person entrapped in the situation; (c) to examine how the crime of human trafficking differs from other kinds of crimes in the United States; (d) to explore how human trafficking victims are identified; and, (e) to provide recommendations to better address human trafficking in the United States.

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

    Science.gov (United States)

    Bouaziz, Nora; Titia Rizzi, Alice

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

  6. 42 CFR 410.175 - Alien absent from the United States.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Alien absent from the United States. 410.175... Alien absent from the United States. (a) Medicare does not pay Part B benefits for services furnished to... during the first full calendar month the alien is back in the United States. [53 FR 6634, Mar. 2, 1988] ...

  7. Inventory of power plants in the United States. [By state within standard Federal Regions, using county codes

    Energy Technology Data Exchange (ETDEWEB)

    None

    1977-12-01

    The purpose of this inventory of power plants is to provide a ready reference for planners whose focus is on the state, standard Federal region, and/or national level. Thus the inventory is compiled alphabetically by state within standard Federal regions. The units are listed alphabetically within electric utility systems which in turn are listed alphabetically within states. The locations are identified to county level according to the Federal Information Processing Standards Publication Counties and County Equivalents of the States of the United States. Data compiled include existing and projected electrical generation units, jointly owned units, and projected construction units.

  8. Norovirus in the United States

    Centers for Disease Control (CDC) Podcasts

    2013-09-09

    Dr. Aron Hall, a CDC epidemiologist specializing in norovirus, discusses the impact of norovirus in the United States.  Created: 9/9/2013 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 9/17/2013.

  9. Fragmentation of Continental United States Forests

    Science.gov (United States)

    Kurt H. Riitters; James D. Wickham; Robert V. O' Neill; K. Bruce Jones; Elizabeth R. Smith; John W. Coulston; Timothy G. Wade; Jonathan H. Smith

    2002-01-01

    We report a multiple-scale analysis of forest fragmentation based on 30-m (0.09 ha pixel-1) land- cover maps for the conterminous United States. Each 0.09-ha unit of forest was classified according to fragmentation indexes measured within the surrounding landscape, for five landscape sizes including 2.25, 7.29, 65.61, 590.49, and 5314.41 ha....

  10. Understanding Excessive School Absenteeism as School Refusal Behavior

    Science.gov (United States)

    Dube, Shanta R.; Orpinas, Pamela

    2009-01-01

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

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

    Science.gov (United States)

    Lee, Marcella I.; Miltenberger, Raymond G.

    1996-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  13. Trial by jury in the United States

    Directory of Open Access Journals (Sweden)

    Lochhead Robert

    2015-10-01

    Full Text Available Th e Republic of Moldova is considering the adoption of trial by jury in select criminal cases. Th e following article is intended to contribute to the discussion of that proposal. Th e article will briefl y describe the history of juries under the English common law and as adopted by the United States. It will then outline some of the basic procedures in trials by jury as currently practiced in the United States federal court system.

  14. CEDAW in the Eyes of the United States

    Directory of Open Access Journals (Sweden)

    Al Shraideh Saleh

    2017-12-01

    Full Text Available Despite the large number of reservations registered by Member countries, making it one of the, if not the, most heavily reserved human rights treaties; the Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW has managed to achieve a very high rate of states’ membership [1]. Currently, 187 countries out of the 193 United Nations Members are parties to CEDAW [2]. What is strange to digest, however, is the fact that the United States is one of the seven countries that are yet to ratify the Convention [3]. This article provides an insight into the position of the United States from the ratification of CEDAW. It examines the merits of arguments made for and against the ratification and their rationale to provide a better understanding that explains what is considered by many as a buzzling stand of the United States from the Convention.

  15. Global context for the United States Forest Sector in 2030

    Science.gov (United States)

    James Turner; Joseph Buongiorno; Shushuai Zhu; Jeffrey P. Prestemon

    2005-01-01

    The purpose of this study was to identify markets for, and competitors to, the United States forest industries in the next 30 years. The Global Forest Products Model was used to make predictions of international demand, supply, trade, and prices, conditional on the last RPA Timber Assessment projections for the United States. It was found that the United States, Japan...

  16. A functional intranet for the United States Coast Guard Unit

    OpenAIRE

    Hannah, Robert Todd.

    1998-01-01

    Approved for public release; distribution in unlimited. This thesis describes the complete development process of a friendly functional Intranet for an operational United States Coast Guard (USCG) electronic Support Unit (ESU) in Alameda, California. The final product is suitable for immediate use. It may also be used as a prototype for future Intranet development efforts. The methodology used to develop a finished, working product provides the core subject matter for this thesis. The disc...

  17. Residency training in the United States: What foreign medical ...

    African Journals Online (AJOL)

    FMGs) planning to pursue post-graduate residency training in the United States of America (USA). While the number of residency training positions is shrinking, and the number of United States graduates has steadily declined over the past ...

  18. The state of amphibians in the United States

    Science.gov (United States)

    Muths, E.; Adams, M.J.; Grant, E.H.C.; Miller, D.; Corn, P.S.; Ball, L.C.

    2012-01-01

    More than 25 years ago, scientists began to identify unexplained declines in amphibian populations around the world. Much has been learned since then, but amphibian declines have not abated and the interactions among the various threats to amphibians are not clear. Amphibian decline is a problem of local, national, and international scope that can affect ecosystem function, biodiversity, and commerce. This fact sheet provides a snapshot of the state of the amphibians and introduces examples to illustrate the range of issues in the United States.

  19. Inventory of power plants in the United States, 1993

    International Nuclear Information System (INIS)

    1994-12-01

    The Inventory of Power Plants in the United States is prepared annually by the Survey Management Division, Office of Coal, Nuclear, Electric and Alternate Fuels, Energy Information Administration (EIA), U.S. Department of Energy (DOE). The purpose of this publication is to provide year-end statistics about electric generating units operated by electric utilities in the United States (the 50 States and the District of Columbia). The publication also provides a 10-year outlook of future generating unit additions. Data summarized in this report are useful to a wide audience including Congress, Federal and State agencies, the electric utility industry, and the general public. Data presented in this report were assembled and published by the EIA to fulfill its data collection and dissemination responsibilities as specified in the Federal Energy Administration Act of 1974 (Public Law 93-275) as amended

  20. Inventory of power plants in the United States, 1993

    Energy Technology Data Exchange (ETDEWEB)

    1994-12-01

    The Inventory of Power Plants in the United States is prepared annually by the Survey Management Division, Office of Coal, Nuclear, Electric and Alternate Fuels, Energy Information Administration (EIA), U.S. Department of Energy (DOE). The purpose of this publication is to provide year-end statistics about electric generating units operated by electric utilities in the United States (the 50 States and the District of Columbia). The publication also provides a 10-year outlook of future generating unit additions. Data summarized in this report are useful to a wide audience including Congress, Federal and State agencies, the electric utility industry, and the general public. Data presented in this report were assembled and published by the EIA to fulfill its data collection and dissemination responsibilities as specified in the Federal Energy Administration Act of 1974 (Public Law 93-275) as amended.

  1. Use of Internet Search Data to Monitor Rotavirus Vaccine Impact in the United States, United Kingdom, and Mexico.

    Science.gov (United States)

    Shah, Minesh P; Lopman, Benjamin A; Tate, Jacqueline E; Harris, John; Esparza-Aguilar, Marcelino; Sanchez-Uribe, Edgar; Richardson, Vesta; Steiner, Claudia A; Parashar, Umesh D

    2018-02-19

    Previous studies have found a strong correlation between internet search and public health surveillance data. Less is known about how search data respond to public health interventions, such as vaccination, and the consistency of responses in different countries. In this study, we aimed to study the correlation between internet searches for "rotavirus" and rotavirus disease activity in the United States, United Kingdom, and Mexico before and after introduction of rotavirus vaccine. We compared time series of internet searches for "rotavirus" from Google Trends with rotavirus laboratory reports from the United States and United Kingdom and with hospitalizations for acute gastroenteritis in the United States and Mexico. Using time and location parameters, Google quantifies an internet query share (IQS) to measure the relative search volume for specific terms. We analyzed the correlation between IQS and laboratory and hospitalization data before and after national vaccine introductions. There was a strong positive correlation between the rotavirus IQS and laboratory reports in the United States (R2 = 0.79) and United Kingdom (R2 = 0.60) and between the rotavirus IQS and acute gastroenteritis hospitalizations in the United States (R2 = 0.87) and Mexico (R2 = 0.69) (P United States and by 70% (95% CI, 55%-86%) in Mexico. In the United Kingdom, there was a loss of seasonal variation after vaccine introduction. Rotavirus internet search data trends mirrored national rotavirus laboratory trends in the United States and United Kingdom and gastroenteritis-hospitalization data in the United States and Mexico; lower correlations were found after rotavirus vaccine introduction. Published by Oxford University Press on behalf of The Journal of the Pediatric Infectious Diseases Society 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

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

    Science.gov (United States)

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

    2009-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Melissa B Gilkey

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

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

    Science.gov (United States)

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

    2018-01-01

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

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

    Science.gov (United States)

    Magrane, Diane; And Others

    1994-01-01

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

  6. Consent and assessment of capacity to decide or refuse treatment.

    Science.gov (United States)

    Simpson, Owena

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

  7. Licensed pertussis vaccines in the United States. History and current state.

    Science.gov (United States)

    Klein, Nicola P

    2014-01-01

    The United States switched from whole cell to acellular pertussis vaccines in the 1990s following global concerns with the safety of the whole cell vaccines. Despite high levels of acellular pertussis vaccine coverage, the United States and other countries are experiencing large pertussis outbreaks. The aim of this article is to describe the historical context which led to acellular pertussis vaccine development, focusing on vaccines currently licensed in the US, and to review evidence that waning protection following licensed acellular pertussis vaccines have been significant factors in the widespread reappearance of pertussis.

  8. The United States initiative for international radioactive source management (ISRM)

    International Nuclear Information System (INIS)

    Naraine, N.; Karhnak, J.

    1999-01-01

    The United States takes seriously the potential problems from uncontrolled radioactive sources. To address these problems, the United States Department of State is leading the development of an initiative for International Radioactive Source Management (ISRM). The Department of State, through a number of Federal and state agencies, regulatory bodies and private industry, will endeavor to provide coordinated support to the international community, particularly through IAEA, to assist in the development and implementation of risk-based clearance levels to support import/export of radioactive contaminated metals and the tracking, management, identification, remediation, and disposition of 'lost sources' entering nation states and targeted industries. The United States believes that the international control of radioactive sources is critical in avoiding wide-spread contamination of the world metal supply. Thus the initiative has four objectives: (1) Protect sources from becoming lost (Tracking management); (2) Identify primary locations where sources have been lost (Stop future losses); (3) Locate lost sources (monitor and retrieve); and (4) Educate and train (deploy knowledge and technology). A number of efforts already underway in the United States support the overall initiative. The EPA has provided a grant to the Conference of Radiation Program Control Directors (CRCPD) to develop a nation-wide program for the disposition of orphaned radioactive sources. This program now has internet visibility and a toll-free telephone number to call for assistance in the disposal of sources. The Nuclear Regulatory Commission (NRC), the Department of Energy (DOE), and other government agencies as well as private companies are assisting CRCPD in this program. The NRC has begun a program to improve control of radioactive sources in the United States, and also intends to promulgate a regulation defining conditions for the release of materials from licensed facilities. The DOE is

  9. Antiabortion violence in the United States.

    Science.gov (United States)

    Russo, Jennefer A; Schumacher, Kristin L; Creinin, Mitchell D

    2012-11-01

    This study was conducted to determine if an association exists between the amount of harassment and violence directed against abortion providers and the restrictiveness of state laws relating to family planning. We used responses from a July 2010 survey of 357 abortion providers in 50 states to determine their experience of antiabortion harassment and violence. Their responses were grouped and analyzed in relation to a published grading of state laws in the United States (A, B, C, D and F) as they relate to restrictions on family planning services. Group by group comparison of respondents illustrates that the difference in the number of reported incidents of minor vandalism by group is statistically significant (A vs. C, p=.07; A vs. D, p=.017; A vs. F, p=.0002). Incidents of harassment follow a similar pattern. There were no differences noted overall for violence or major vandalism. Major violence, including eight murders, is a new occurrence in the last two decades. Harassment of abortion providers in the United States has an association with the restrictiveness of state abortion laws. In the last two decades, murder of abortion providers has become an unfortunate part of the violence. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. Masturbation in the United States.

    Science.gov (United States)

    Das, Aniruddha

    2007-01-01

    Using data from the nationally representative National Health and Social Life Survey, this study queried the correlates of masturbation in the United States in 1992. Among those aged 18-60, 38% (CI, 35-41) of women and 61% (CI, 57-65) of men reported any masturbation over the preceding year. The system of factors underlying masturbation was similar for both genders, consistent with a convergence in gender patterns of sexual expression in the United States. Among both women and men, masturbation responded to a stable sexualized personality pattern, catalyzed by early-life factors and manifested in current sexual traits. Strikingly, the masturbation-partnered sex linkage, often conceptualized either as compensating for unsatisfying sex or complementing a satisfactory sex life, appeared to be bimodal for both genders. For some, masturbation complemented an active and pleasurable sex life, while among others, it compensated for a lack of partnered sex or satisfaction in sex.

  11. Research on Anoplophora glabripennis in the United States

    Science.gov (United States)

    Robert A. Haack

    2003-01-01

    In the mid-1990s it was estimated that more than 400 exotic (non-native) forest insects had already become established in the United States (HAACK and BYLER, 1993; MATTSON et al., 1994; NIEMELA and MATTSON, 1996). This number has continued to grow with new exotics discovered annually in the United States (HAACK, 2002; HAACK and POLAND, 2001; HAACK et al., 2002). One...

  12. Leading Causes of Death in Males United States, 2010

    Science.gov (United States)

    ... What’s this? Submit What’s this? Submit Button Leading Causes of Death in Males and Females, United States Recommend on ... to current and previous listings for the leading causes of death for males and females in the United States. ...

  13. 76 FR 18198 - European Union-United States Atlantis Program

    Science.gov (United States)

    2011-04-01

    ... DEPARTMENT OF EDUCATION European Union-United States Atlantis Program AGENCY: Office of...)--Special Focus Competition: European Union-(EU) United States (U.S.) Atlantis Program Notice inviting... and Culture, European Commission for funding under a separate but parallel EU competition. Within this...

  14. Development of Water Quality Modeling in the United States

    Science.gov (United States)

    This presentation describes historical trends in water quality model development in the United States, reviews current efforts, and projects promising future directions. Water quality modeling has a relatively long history in the United States. While its origins lie in the work...

  15. Solar energy in the United States

    International Nuclear Information System (INIS)

    Ochoa, D.; Slaoui, A.; Soler, R.; Bermudez, V.

    2009-01-01

    Written by a group of five French experts who visited several research centres, innovating companies and solar power stations in the United States, this report first proposes an overview of solar energy in the United States, indicating and commenting the respective shares of different renewable energies in the production, focusing on the photovoltaic energy production and its RD sector. The second part presents industrial and research activities in the solar sector, and more specifically photovoltaic technologies (silicon and thin layer technology) and solar concentrators (thermal solar concentrators, photovoltaic concentrators). The last chapter presents the academic research activities in different universities (California Tech Beckman Institute, Stanford, National Renewable Energy Laboratory, Colorado School of Mines)

  16. 75 FR 22551 - United States Standards for Grades of Frozen Blueberries

    Science.gov (United States)

    2010-04-29

    ...] United States Standards for Grades of Frozen Blueberries AGENCY: Agricultural Marketing Service, USDA... United States Standards for Grades of Frozen Blueberries. After considering the comments received... . The United States Standards for Grades of Frozen Blueberries are available by accessing the AMS Web...

  17. NREL Evaluates Performance of Hydraulic Hybrid Refuse Vehicles

    Energy Technology Data Exchange (ETDEWEB)

    2015-09-01

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

  18. 77 FR 64031 - United States-Peru Trade Promotion Agreement

    Science.gov (United States)

    2012-10-18

    ... Trade Promotion Agreement AGENCIES: U.S. Customs and Border Protection, Department of Homeland Security... tariff treatment and other customs-related provisions of the United States-Peru Trade Promotion Agreement... other customs-related provisions of the United States-Peru Trade Promotion Agreement (PTPA). Please...

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

    Science.gov (United States)

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

    2018-05-01

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

  20. Inching toward incrementalism: federalism, devolution, and health policy in the United States and the United Kingdom.

    Science.gov (United States)

    Sparer, Michael S; France, George; Clinton, Chelsea

    2011-02-01

    In the United States, the recently enacted Patient Protection and Affordable Care Act of 2010 envisions a significant increase in federal oversight over the nation's health care system. At the same time, however, the legislation requires the states to play key roles in every aspect of the reform agenda (such as expanding Medicaid programs, creating insurance exchanges, and working with providers on delivery system reforms). The complicated intergovernmental partnerships that govern the nation's fragmented and decentralized system are likely to continue, albeit with greater federal oversight and control. But what about intergovernmental relations in the United Kingdom? What impact did the formal devolution of power in 1999 to Scotland, Wales, and Northern Ireland have on health policy in those nations, and in the United Kingdom more generally? Has devolution begun a political process in which health policy in the United Kingdom will, over time, become increasingly decentralized and fragmented, or will this "state of unions" retain its long-standing reputation as perhaps the most centralized of the European nations? In this article, we explore the federalist and intergovernmental implications of recent reforms in the United States and the United Kingdom, and we put forward the argument that political fragmentation (long-standing in the United States and just emerging in the United Kingdom) produces new intergovernmental partnerships that, in turn, produce incremental growth in overall government involvement in the health care arena. This is the impact of what can be called catalytic federalism.

  1. 15 CFR 760.2 - Prohibitions.

    Science.gov (United States)

    2010-01-01

    ... refusal to do business under this section for a United States person to provide management, procurement... race, religion, sex, or national origin of any U.S. person. (d) Furnishing information about business... OR BOYCOTTS § 760.2 Prohibitions. (a) Refusals to do business. Prohibition Against Refusals To Do...

  2. Magnetometric Studies of Catalyst Refuses in Nanocarbon Materials

    Directory of Open Access Journals (Sweden)

    Eklund Peter

    2008-01-01

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

  3. [Refusal of personal hygiene care and nursing responsibility].

    Science.gov (United States)

    Peyé, Anne

    2013-03-01

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

  4. THE UNITED STATES EDUCATIONAL SYSTEM

    OpenAIRE

    David Suriñach Fernández

    2017-01-01

    The United States educational system is very complex. Due to the fact a big number of agents take play of its regulation, the differences between the education from one State compared to the education from another, or even between school districts, might be considerable. The last two largest federal education initiatives, No Child Left Behind and Race to the Top, have had a huge impact on the American education system. The escalation of the standardized test throughout the whole country as a ...

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

    Science.gov (United States)

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

    2016-01-20

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

  6. Inventory of Power Plants in the United States, October 1992

    Energy Technology Data Exchange (ETDEWEB)

    1993-10-27

    The Inventory of Power Plants in the United States is prepared annually by the Survey Management Division, Office of Coal, Nuclear, Electric and Alternate Fuels, Energy Information Administration (EIA), US Department of Energy (DOE). The purpose of this publication is to provide year-end statistics about electric generating units operated by electric utilities in the United States (the 50 States and the District of Columbia). The publication also provides a 10-year outlook of future generating unit additions. Data summarized in this report are useful to a wide audience including Congress, Federal and State agencies, the electric utility industry, and the general public. Data presented in this report were assembled and published by the EIA to fulfill its data collection and dissemination responsibilities as specified in the Federal Energy Administration Act of 1974 (Public Law 93-275) as amended. The report is organized into the following chapters: Year in Review, Operable Electric Generating Units, and Projected Electric Generating Unit Additions. Statistics presented in these chapters reflect the status of electric generating units as of December 31, 1992.

  7. 78 FR 63052 - United States-Panama Trade Promotion Agreement

    Science.gov (United States)

    2013-10-23

    ...-Panama Trade Promotion Agreement AGENCY: U.S. Customs and Border Protection, Department of Homeland... Trade Promotion Agreement entered into by the United States and the Republic of Panama. DATES: Interim... and the Republic of Panama (the ``Parties'') signed the United States-Panama Trade Promotion Agreement...

  8. United States Military in Central Asia: Beyond Operation Enduring Freedom

    Science.gov (United States)

    2009-10-23

    Malinowski , advocacy director for Human Rights Watch, stated, “the United States is most effective in promoting liberty around the world when people...26 U.S. President, The National Security Strategy of the United States of America, page? 27 Thomas Malinowski , “Testimony

  9. 31 CFR Appendix D to Subpart A of... - United States Secret Service

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false United States Secret Service D...—United States Secret Service 1. In general. This appendix applies to the United States Secret Service. 2. Public reading room. The United States Secret Service will provide a room on an ad hoc basis when...

  10. 76 FR 68271 - To Modify the Harmonized Tariff Schedule of the United States

    Science.gov (United States)

    2011-11-03

    ... the Convention and do not run counter to the national economic interest of the United States. I have... United States obligations under the Convention and do not run counter to the national economic interest of the United States. 7. On June 6, 2003, the United States and Chile entered into the United States...

  11. Geographic and Individual Differences in Healthcare Access for U.S. Transgender Adults: A Multilevel Analysis.

    Science.gov (United States)

    White Hughto, Jaclyn M; Murchison, Gabriel R; Clark, Kirsty; Pachankis, John E; Reisner, Sari L

    2016-12-01

    To identify geographic and individual-level factors associated with healthcare access among transgender people in the United States. Multilevel analyses were conducted to investigate lifetime healthcare refusal using national data from 5831 U.S. transgender adults. Hierarchical generalized linear models examined associations between individual (age, gender, race, income, insurance, and healthcare avoidance) and state-level factors (percent voting Republican, percent same-sex couple households, income inequality, and transgender protective laws) and lifetime refusal of care. Results show that individual-level factors (being older; trans feminine; Native American, multiracial, or other racial/ethnic minority; having low income; and avoiding care due to discrimination) are positively associated with care refusal (all P-values transgender residents at increased odds of experiencing care refusal, relative to other regions of the United States. When adjusting for state-level factors, the percentage of the state population voting Republican was positively associated with care refusal among the transgender adults sampled (P Transgender adults surveyed reported differential access to healthcare by geographic region. Identifying geographic and individual-level factors associated with healthcare barriers allows for the development of targeted educational and policy interventions to improve healthcare access for transgender people most in need of services.

  12. Refuses and delays in the transportation by ship of radioactive material

    International Nuclear Information System (INIS)

    Xavier, Clarice; Sobreira, Ana Celia

    2011-01-01

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

  13. Human prion diseases in the United States.

    Directory of Open Access Journals (Sweden)

    Robert C Holman

    Full Text Available BACKGROUND: Prion diseases are a family of rare, progressive, neurodegenerative disorders that affect humans and animals. The most common form of human prion disease, Creutzfeldt-Jakob disease (CJD, occurs worldwide. Variant CJD (vCJD, a recently emerged human prion disease, is a zoonotic foodborne disorder that occurs almost exclusively in countries with outbreaks of bovine spongiform encephalopathy. This study describes the occurrence and epidemiology of CJD and vCJD in the United States. METHODOLOGY/PRINCIPAL FINDINGS: Analysis of CJD and vCJD deaths using death certificates of US residents for 1979-2006, and those identified through other surveillance mechanisms during 1996-2008. Since CJD is invariably fatal and illness duration is usually less than one year, the CJD incidence is estimated as the death rate. During 1979 through 2006, an estimated 6,917 deaths with CJD as a cause of death were reported in the United States, an annual average of approximately 247 deaths (range 172-304 deaths. The average annual age-adjusted incidence for CJD was 0.97 per 1,000,000 persons. Most (61.8% of the CJD deaths occurred among persons >or=65 years of age for an average annual incidence of 4.8 per 1,000,000 persons in this population. Most deaths were among whites (94.6%; the age-adjusted incidence for whites was 2.7 times higher than that for blacks (1.04 and 0.40, respectively. Three patients who died since 2004 were reported with vCJD; epidemiologic evidence indicated that their infection was acquired outside of the United States. CONCLUSION/SIGNIFICANCE: Surveillance continues to show an annual CJD incidence rate of about 1 case per 1,000,000 persons and marked differences in CJD rates by age and race in the United States. Ongoing surveillance remains important for monitoring the stability of the CJD incidence rates, and detecting occurrences of vCJD and possibly other novel prion diseases in the United States.

  14. 25 CFR 171.420 - Can I dispose of sewage, trash, or other refuse on a BIA irrigation project?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Can I dispose of sewage, trash, or other refuse on a BIA... AND WATER IRRIGATION OPERATION AND MAINTENANCE Irrigation Facilities § 171.420 Can I dispose of sewage, trash, or other refuse on a BIA irrigation project? No. Sewage, trash, or other refuse are considered...

  15. Competitive Electricity Market Regulation in the United States: A Primer

    Energy Technology Data Exchange (ETDEWEB)

    Flores-Espino, Francisco [National Renewable Energy Lab. (NREL), Golden, CO (United States); Tian, Tian [National Renewable Energy Lab. (NREL), Golden, CO (United States); Chernyakhovskiy, Ilya [National Renewable Energy Lab. (NREL), Golden, CO (United States); Chernyakhovskiy, Ilya [National Renewable Energy Lab. (NREL), Golden, CO (United States); Miller, Mackay [National Grid, Warwick (United Kingdom)

    2016-12-01

    The electricity system in the United States is a complex mechanism where different technologies, jurisdictions and regulatory designs interact. Today, two major models for electricity commercialization operate in the United States. One is the regulated monopoly model, in which vertically integrated electricity providers are regulated by state commissions. The other is the competitive model, in which power producers can openly access transmission infrastructure and participate in wholesale electricity markets. This paper describes the origins, evolution, and current status of the regulations that enable competitive markets in the United States.

  16. Health, United States, 2012: Men's Health

    Science.gov (United States)

    ... Mailing List Previous Reports Suggested Citation Related Sites Purchase Health, United States Behavioral Health Report Children’s ... with Internet Explorer may experience difficulties in directly accessing links to Excel files ...

  17. Dengue Fever in the United States

    Centers for Disease Control (CDC) Podcasts

    Dr. Amesh Adalja, an associate at the Center for Biosecurity and clinical assistant professor at the University of Pittsburgh School, of Medicine, discusses dengue fever outbreaks in the United States.

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

    Directory of Open Access Journals (Sweden)

    Shohreh Shahpouri Arani

    2013-05-01

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

  19. 15 CFR 971.209 - Processing outside the United States.

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 3 2010-01-01 2010-01-01 false Processing outside the United States... THE ENVIRONMENTAL DATA SERVICE DEEP SEABED MINING REGULATIONS FOR COMMERCIAL RECOVERY PERMITS Applications Contents § 971.209 Processing outside the United States. (a) Except as provided in this section...

  20. Othermotherwork: "Testimonio" and the Refusal of Historical Trauma

    Science.gov (United States)

    Vega, Christine

    2018-01-01

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

  1. Obesity: A United States Strategic Imperative

    Science.gov (United States)

    2013-04-01

    States Department of Veterans Affairs 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING AGENCY NAME(S) AND ADDRESS(ES) Dr. Thomas ...Army Ms. Karen Malebranche United States Department of Veterans Affairs Project Adviser Dr. Thomas Williams U.S. Army War...per American has increased by 57 pounds per year ( poultry representing 46 pounds).86 Surprisingly however, the percentage of calories from meat

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

    Directory of Open Access Journals (Sweden)

    Filippello Pina

    2018-01-01

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

  3. Cholera in the United States

    Centers for Disease Control (CDC) Podcasts

    2011-11-08

    Anna Newton, Surveillance Epidemiologist at CDC, discusses cholera that was brought to the United States during an outbreak in Haiti and the Dominican Republic (Hispaniola).  Created: 11/8/2011 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 11/8/2011.

  4. The Prevalence of Sexual Behavior Stigma Affecting Gay Men and Other Men Who Have Sex with Men Across Sub-Saharan Africa and in the United States.

    Science.gov (United States)

    Stahlman, Shauna; Sanchez, Travis Howard; Sullivan, Patrick Sean; Ketende, Sosthenes; Lyons, Carrie; Charurat, Manhattan E; Drame, Fatou Maria; Diouf, Daouda; Ezouatchi, Rebecca; Kouanda, Seni; Anato, Simplice; Mothopeng, Tampose; Mnisi, Zandile; Baral, Stefan David

    2016-07-26

    There has been increased attention for the need to reduce stigma related to sexual behaviors among gay men and other men who have sex with men (MSM) as part of comprehensive human immunodeficiency virus (HIV) prevention and treatment programming. However, most studies focused on measuring and mitigating stigma have been in high-income settings, challenging the ability to characterize the transferability of these findings because of lack of consistent metrics across settings. The objective of these analyses is to describe the prevalence of sexual behavior stigma in the United States, and to compare the prevalence of sexual behavior stigma between MSM in Southern and Western Africa and in the United States using consistent metrics. The same 13 sexual behavior stigma items were administered in face-to-face interviews to 4285 MSM recruited in multiple studies from 2013 to 2016 from 7 Sub-Saharan African countries and to 2590 MSM from the 2015 American Men's Internet Survey (AMIS), an anonymous Web-based behavioral survey. We limited the study sample to men who reported anal sex with a man at least once in the past 12 months and men who were aged 18 years and older. Unadjusted and adjusted prevalence ratios were used to compare the prevalence of stigma between groups. Within the United States, prevalence of sexual behavior stigma did not vary substantially by race/ethnicity or geographic region except in a few instances. Feeling afraid to seek health care, avoiding health care, feeling like police refused to protect, being blackmailed, and being raped were more commonly reported in rural versus urban settings in the United States (Pharassment as the most common form of stigma. Disclosure of same-sex practices to family members increased prevalence of reported stigma from family members within all geographic settings (Psexual behavior stigma among MSM in the United States appears to have a high absolute burden and similar pattern as the same forms of stigma reported by

  5. The United States

    International Nuclear Information System (INIS)

    Art, R.J.

    1991-01-01

    This paper reports that at least in the national security arena, the outcomes of bureaucratic infighting and domestic political struggles are not determined wholly by what goes on with the state. Rather struggles among contending groups are greatly affected by what is perceived to be happening outside the nation. Because external conditions give greater potency to some domestic forces over other, the external environment is never neutral in its domestic impact. The decisions of the period 1950-53 discussed above illustrate the point. But so too do the decisions of 1947, 1960-61 and 1969-72. In the 1947 case, Soviet intransigence provoked US nuclear rearmament. In the 1960-61 case, extended deterrent considerations pushed the United States to preserve its again newly discovered nuclear superiority. In the 1969-72 case, a Soviet determination to remain equal forced US acceptance of nuclear equality. And perhaps the best evidence of all, the perpetuation of parity ended the US inclination to resort to nuclear brinkmanship. In each instance, concerns about relative position heavily affected nuclear choice. Finally, the events of the past three years testify to the effects of international events on domestic choice. Under the terms of the 1987 INF Treaty, the two superpowers decided to dismantle and destroy an entire class of missiles of intermediate range (500-3000 kilometers) that both had deployed in Europe in the 1970s and 1980s, and in their June 1990 joint statement on strategic nuclear weapons, President Gorbachev and Brush agreed to cut the number of Soviet and US long range nuclear forces by 30 per cent. This agreement marks a watershed in US-Soviet strategic arm negotiations because for the first time the United States and the Soviet Union agreed in principals to reduce the number of weapons aimed at one another. Between 1985 and 1990 the cold war was brought to a close

  6. Malaria Surveillance - United States, 2015.

    Science.gov (United States)

    Mace, Kimberly E; Arguin, Paul M; Tan, Kathrine R

    2018-05-04

    Malaria in humans is caused by intraerythrocytic protozoa of the genus Plasmodium. These parasites are transmitted by the bite of an infective female Anopheles species mosquito. The majority of malaria infections in the United States occur among persons who have traveled to regions with ongoing malaria transmission. However, malaria is occasionally acquired by persons who have not traveled out of the country through exposure to infected blood products, congenital transmission, laboratory exposure, or local mosquitoborne transmission. Malaria surveillance in the United States is conducted to provide information on its occurrence (e.g., temporal, geographic, and demographic), guide prevention and treatment recommendations for travelers and patients, and facilitate transmission control measures if locally acquired cases are identified. This report summarizes confirmed malaria cases in persons with onset of illness in 2015 and summarizes trends in previous years. Malaria cases diagnosed by blood film microscopy, polymerase chain reaction, or rapid diagnostic tests are reported to local and state health departments by health care providers or laboratory staff members. Case investigations are conducted by local and state health departments, and reports are transmitted to CDC through the National Malaria Surveillance System (NMSS), the National Notifiable Diseases Surveillance System (NNDSS), or direct CDC consultations. CDC reference laboratories provide diagnostic assistance and conduct antimalarial drug resistance marker testing on blood samples submitted by health care providers or local or state health departments. This report summarizes data from the integration of all NMSS and NNDSS cases, CDC reference laboratory reports, and CDC clinical consultations. CDC received reports of 1,517 confirmed malaria cases, including one congenital case, with an onset of symptoms in 2015 among persons who received their diagnoses in the United States. Although the number of

  7. Malaria Surveillance - United States, 2014.

    Science.gov (United States)

    Mace, Kimberly E; Arguin, Paul M

    2017-05-26

    Malaria in humans is caused by intraerythrocytic protozoa of the genus Plasmodium. These parasites are transmitted by the bite of an infective female Anopheles mosquito. The majority of malaria infections in the United States occur among persons who have traveled to regions with ongoing malaria transmission. However, malaria is occasionally acquired by persons who have not traveled out of the country through exposure to infected blood products, congenital transmission, laboratory exposure, or local mosquitoborne transmission. Malaria surveillance in the United States is conducted to identify episodes of local transmission and to guide prevention recommendations for travelers. This report summarizes cases in persons with onset of illness in 2014 and trends during previous years. Malaria cases diagnosed by blood film, polymerase chain reaction, or rapid diagnostic tests are reported to local and state health departments by health care providers or laboratory staff. Case investigations are conducted by local and state health departments, and reports are transmitted to CDC through the National Malaria Surveillance System, National Notifiable Diseases Surveillance System, or direct CDC consultations. CDC conducts antimalarial drug resistance marker testing on blood samples submitted by health care providers or local or state health departments. Data from these reporting systems serve as the basis for this report. CDC received reports of 1,724 confirmed malaria cases, including one congenital case and two cryptic cases, with onset of symptoms in 2014 among persons in the United States. The number of confirmed cases in 2014 is consistent with the number of confirmed cases reported in 2013 (n = 1,741; this number has been updated from a previous publication to account for delayed reporting for persons with symptom onset occurring in late 2013). Plasmodium falciparum, P. vivax, P. ovale, and P. malariae were identified in 66.1%, 13.3%, 5.2%, and 2.7% of cases, respectively

  8. 26 CFR 1.993-7 - Definition of United States.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 10 2010-04-01 2010-04-01 false Definition of United States. 1.993-7 Section 1.993-7 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Domestic International Sales Corporations § 1.993-7 Definition of United States...

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

    Science.gov (United States)

    Shapiro, Michael

    2018-06-01

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

  10. [Professionals' training and refusal of nursing care].

    Science.gov (United States)

    Bay, Corinne

    2016-10-01

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

  11. 26 CFR 49.4261-5 - Payments made outside the United States.

    Science.gov (United States)

    2010-04-01

    ... travel under section 4262(b), the tax imposed by section 4261(b), shall not apply unless the... made outside the United States for one-way or round-trip transportation between a point within the United States and a point outside the United States. (b) Transportation between two or more points in the...

  12. 42 CFR 455.21 - Cooperation with State Medicaid fraud control units.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Cooperation with State Medicaid fraud control units... Detection and Investigation Program § 455.21 Cooperation with State Medicaid fraud control units. In a State with a Medicaid fraud control unit established and certified under subpart C of this part, (a) The...

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

    Science.gov (United States)

    Sobo, Elisa J

    2015-09-01

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

  14. Low birth weight in the United States.

    Science.gov (United States)

    Goldenberg, Robert L; Culhane, Jennifer F

    2007-02-01

    Pregnancy outcomes in the United States and other developed countries are considerably better than those in many developing countries. However, adverse pregnancy outcomes are generally more common in the United States than in other developed countries. Low-birth-weight infants, born after a preterm birth or secondary to intrauterine growth restriction, account for much of the increased morbidity, mortality, and cost. Wide disparities exist in both preterm birth and growth restriction among different population groups. Poor and black women, for example, have twice the preterm birth rate and higher rates of growth restriction than do most other women. Low birth weight in general is thought to place the infant at greater risk of later adult chronic medical conditions, such as diabetes, hypertension, and heart disease. Of interest, maternal thinness is a strong predictor of both preterm birth and fetal growth restriction. However, in the United States, several nutritional interventions, including high-protein diets, caloric supplementation, calcium and iron supplementation, and various other vitamin and mineral supplementations, have not generally reduced preterm birth or growth restriction. Bacterial intrauterine infections play an important role in the etiology of the earliest preterm births, but, at least to date, antibiotic treatment either before labor for risk factors such as bacterial vaginosis or during preterm labor have not consistently reduced the preterm birth rate. Most interventions have failed to reduce preterm birth or growth restriction. The substantial improvement in newborn survival in the United States over the past several decades is mostly due to better access to improved neonatal care for low-birth-weight infants.

  15. 31 CFR 594.315 - United States person; U.S. person.

    Science.gov (United States)

    2010-07-01

    ... (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY GLOBAL TERRORISM SANCTIONS REGULATIONS General Definitions § 594.315 United States person; U.S. person. The term United States person or...

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

    Directory of Open Access Journals (Sweden)

    Mitra Khalili

    2016-01-01

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

  17. Stigma and abortion complications in the United States.

    Science.gov (United States)

    Harris, Lisa H

    2012-12-01

    Abortion is highly stigmatized in the United States and elsewhere. As a result, many women who seek or undergo abortion keep their decision a secret. In many regions of the world, stigma is a recognized contributor to maternal morbidity and mortality from unsafe abortion, even when abortion is legal. Women may self-induce abortion in ways that are dangerous, or seek unsafe clandestine abortion from inadequately trained health care providers out of fear that their sexual activity, pregnancy, or abortion will be exposed if they present to a safe, licensed facility. However, unsafe abortion rarely occurs in the United States, and accordingly, stigma as a cause of unsafe abortion in the United States context has not been described. I consider the relationship of stigma to two serious abortion complications experienced by U.S. patients. Both patients wished to keep their abortion decision a secret from family and friends, and in both cases, their inability to disclose their abortion contributed to life-threatening complications. The experiences of these patients suggest that availability of legal abortion services in the United States may not be enough to keep all women safe. The cases also challenge the rhetoric that "abortion hurts women," suggesting instead that abortion stigma hurts women.

  18. Vanadium recycling in the United States in 2004

    Science.gov (United States)

    Goonan, Thomas G.

    2011-01-01

    As one of a series of reports that describe the recycling of metal commodities in the United States, this report discusses the flow of vanadium in the U.S. economy in 2004. This report includes a description of vanadium supply and demand in the United States and illustrates the extent of vanadium recycling and recycling trends. In 2004, apparent vanadium consumption, by end use, in the United States was 3,820 metric tons (t) in steelmaking and 232 t in manufacturing, of which 17 t was for the production of superalloys and 215 t was for the production of other alloys, cast iron, catalysts, and chemicals. Vanadium use in steel is almost entirely dissipative because recovery of vanadium from steel scrap is chemically impeded under the oxidizing conditions in steelmaking furnaces. The greatest amount of vanadium recycling is in the superalloy, other-alloy, and catalyst sectors of the vanadium market. Vanadium-bearing catalysts are associated with hydrocarbon recovery and refining in the oil industry. In 2004, 2,850 t of vanadium contained in alloy scrap and spent catalysts was recycled, which amounted to about 44 percent of U.S. domestic production. About 94 percent of vanadium use in the United States was dissipative (3,820 t in steel/4,050 t in steel+fabricated products).

  19. The voluntary safeguards offer of the United States

    International Nuclear Information System (INIS)

    Houck, F.S.

    1985-01-01

    During negotiations of the Treaty on the Non-Proliferation of Nuclear Weapons (NPT) concerns were expressed by non-nuclear-weapon States that their acceptance of Agency safeguards would put them at a disadvantage vis-a-vis the nuclear-weapon States. To allay these concerns, the United States and the United Kingdom in December 1967 made voluntary offers to accept Agency safeguards on their peaceful nuclear activities. Subsequently, France made a voluntary offer, the safeguards agreement for which was approved by the IAEA Board of Governors in February 1978, with a view to encouraging acceptance of Agency safeguards by additional States. More recently, in February 1985 the Board approved the safeguards agreement for the voluntary offer of the USSR, made inter alia to encourage further acceptance of Agency safeguards. These safeguards agreements with nuclear-weapon-States have two important features in common: Namely, they result from voluntary offers to accept safeguards rather than from multilateral or bilateral undertakings, and they give the Agency the right but generally not an obligation to apply its safeguards. The agreements differ in certain respects, the most noteworthy of which is the scope of the nuclear activities covered by each offer. The agreements of the United States and United Kingdom are the broadest, covering all peaceful nuclear activities in each country. The safeguards agreement for the US voluntary offer has been in force since December 1980. Now is an appropriate time to review the experience with the agreement's implementation during its first four years, as well as its history and salient features

  20. Studies of the combustion of coal/refuse derived fuels using thermogravimetric-Fourier transform infrared-mass spectrometry

    International Nuclear Information System (INIS)

    Lu, Huagang; Li, Jigui; Lloyd, W.G.

    1995-01-01

    According to a report of the Environmental Protection Agency (EPA), 'Characterization of Municipal Solid Waste (MSW) in the United States', the total MSW produced in the U.S. increased from 179 million tons in 1988 to 195 million tons in 1990. The EPA predicted that the country would produce about 216 million tons of garbage in the year 2000. The amount of waste generated and the rapidly declining availability of sanitary landfills has forced most municipalities to evaluate alternative waste management technologies for reducing the volume of waste sent to landfills. The fraction of MSW that is processed by such technologies as separation and recycling, composting, and waste-to-energy was forecast to increase from a few percent today to 30-40% by the year 2000. Waste-to-energy conversion of MSW can appear to be attractive because of the energy recovered, the economic value of recycled materials, and the cost savings derived from reduced landfill usage. However, extra care needs to be taken in burning MSW or refuse-derived fuel (RDF) to optimize the operating conditions of a combustor so that the combustion takes place in an environmentally acceptable manner. For instance, polychlorinated dibenzodioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs) have been found in the precipitator fly ash and flue gas of some incinerator facilities in the United States and Europe. The amount of PCDDs and PCDFs occurs only in the parts-per-billion to parts-per-trillion range, but these chlorinated organics exhibit very high toxicity (LD 50 < 10 μg/Kg). The compound 2,3,7,8-tetrachlorodibenzodioxin has been found to be acnegenic, carcinogenic, and teratogenic. This has slowed or even stopped the construction and operation of waste-to-energy plants

  1. Studies of the combustion of coal/refuse derived fuels using thermogravimetric-Fourier transform infrared-mass spectrometry

    Energy Technology Data Exchange (ETDEWEB)

    Lu, Huagang; Li, Jigui; Lloyd, W.G.

    1995-11-01

    According to a report of the Environmental Protection Agency (EPA), `Characterization of Municipal Solid Waste (MSW) in the United States`, the total MSW produced in the U.S. increased from 179 million tons in 1988 to 195 million tons in 1990. The EPA predicted that the country would produce about 216 million tons of garbage in the year 2000. The amount of waste generated and the rapidly declining availability of sanitary landfills has forced most municipalities to evaluate alternative waste management technologies for reducing the volume of waste sent to landfills. The fraction of MSW that is processed by such technologies as separation and recycling, composting, and waste-to-energy was forecast to increase from a few percent today to 30-40% by the year 2000. Waste-to-energy conversion of MSW can appear to be attractive because of the energy recovered, the economic value of recycled materials, and the cost savings derived from reduced landfill usage. However, extra care needs to be taken in burning MSW or refuse-derived fuel (RDF) to optimize the operating conditions of a combustor so that the combustion takes place in an environmentally acceptable manner. For instance, polychlorinated dibenzodioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs) have been found in the precipitator fly ash and flue gas of some incinerator facilities in the United States and Europe. The amount of PCDDs and PCDFs occurs only in the parts-per-billion to parts-per-trillion range, but these chlorinated organics exhibit very high toxicity (LD{sub 50} < 10 {mu}g/Kg). The compound 2,3,7,8-tetrachlorodibenzodioxin has been found to be acnegenic, carcinogenic, and teratogenic. This has slowed or even stopped the construction and operation of waste-to-energy plants.

  2. United States Navy DL Perspective

    Science.gov (United States)

    2010-08-10

    United States Navy DL Perspective CAPT Hank Reeves Navy eLearning Project Director 10 August 2010 Report Documentation Page Form ApprovedOMB No...Marine Corps (USMC) Navy eLearning Ongoing Shared with USMC, Coast Guard 9 NeL Help Site https://ile-help.nko.navy.mil/ile/ https://s-ile

  3. 26 CFR 1.953-2 - Actual United States risks.

    Science.gov (United States)

    2010-04-01

    ... being the promotion of such sales to United States retail outlets by advertising in trade publications... 26 Internal Revenue 10 2010-04-01 2010-04-01 false Actual United States risks. 1.953-2 Section 1.953-2 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX...

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

    International Nuclear Information System (INIS)

    Mafi, S.; Stehouwer, R.C.

    1996-01-01

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

  5. 31 CFR 595.315 - United States person; U.S. person.

    Science.gov (United States)

    2010-07-01

    ... (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY TERRORISM SANCTIONS REGULATIONS General Definitions § 595.315 United States person; U.S. person. The term United States person or U.S...

  6. United States Interagency Elevation Inventory (USIEI)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The U.S. Interagency Elevation Inventory displays high-accuracy topographic and bathymetric data for the United States and its territories. The project is a...

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

    Science.gov (United States)

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

    2013-11-01

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

  8. An investigation on the fuel savings potential of hybrid hydraulic refuse collection vehicles

    Energy Technology Data Exchange (ETDEWEB)

    Bender, Frank A., E-mail: bender@isys.uni-stuttgart.de; Bosse, Thomas; Sawodny, Oliver

    2014-09-15

    Highlights: • Driving cycle acquisition in a refuse collection vehicle. • Vehicle modeling and validation for numerical simulations based on the measured driving cycle. • Fuel consumption analysis for a conventional diesel vehicle and a hybrid hydraulic vehicle. - Abstract: Refuse trucks play an important role in the waste collection process. Due to their typical driving cycle, these vehicles are characterized by large fuel consumption, which strongly affects the overall waste disposal costs. Hybrid hydraulic refuse vehicles offer an interesting alternative to conventional diesel trucks, because they are able to recuperate, store and reuse braking energy. However, the expected fuel savings can vary strongly depending on the driving cycle and the operational mode. Therefore, in order to assess the possible fuel savings, a typical driving cycle was measured in a conventional vehicle run by the waste authority of the City of Stuttgart, and a dynamical model of the considered vehicle was built up. Based on the measured driving cycle and the vehicle model including the hybrid powertrain components, simulations for both the conventional and the hybrid vehicle were performed. Fuel consumption results that indicate savings of about 20% are presented and analyzed in order to evaluate the benefit of hybrid hydraulic vehicles used for refuse collection.

  9. An investigation on the fuel savings potential of hybrid hydraulic refuse collection vehicles

    International Nuclear Information System (INIS)

    Bender, Frank A.; Bosse, Thomas; Sawodny, Oliver

    2014-01-01

    Highlights: • Driving cycle acquisition in a refuse collection vehicle. • Vehicle modeling and validation for numerical simulations based on the measured driving cycle. • Fuel consumption analysis for a conventional diesel vehicle and a hybrid hydraulic vehicle. - Abstract: Refuse trucks play an important role in the waste collection process. Due to their typical driving cycle, these vehicles are characterized by large fuel consumption, which strongly affects the overall waste disposal costs. Hybrid hydraulic refuse vehicles offer an interesting alternative to conventional diesel trucks, because they are able to recuperate, store and reuse braking energy. However, the expected fuel savings can vary strongly depending on the driving cycle and the operational mode. Therefore, in order to assess the possible fuel savings, a typical driving cycle was measured in a conventional vehicle run by the waste authority of the City of Stuttgart, and a dynamical model of the considered vehicle was built up. Based on the measured driving cycle and the vehicle model including the hybrid powertrain components, simulations for both the conventional and the hybrid vehicle were performed. Fuel consumption results that indicate savings of about 20% are presented and analyzed in order to evaluate the benefit of hybrid hydraulic vehicles used for refuse collection

  10. China's international trade and air pollution in the United States.

    Science.gov (United States)

    Lin, Jintai; Pan, Da; Davis, Steven J; Zhang, Qiang; He, Kebin; Wang, Can; Streets, David G; Wuebbles, Donald J; Guan, Dabo

    2014-02-04

    China is the world's largest emitter of anthropogenic air pollutants, and measurable amounts of Chinese pollution are transported via the atmosphere to other countries, including the United States. However, a large fraction of Chinese emissions is due to manufacture of goods for foreign consumption. Here, we analyze the impacts of trade-related Chinese air pollutant emissions on the global atmospheric environment, linking an economic-emission analysis and atmospheric chemical transport modeling. We find that in 2006, 36% of anthropogenic sulfur dioxide, 27% of nitrogen oxides, 22% of carbon monoxide, and 17% of black carbon emitted in China were associated with production of goods for export. For each of these pollutants, about 21% of export-related Chinese emissions were attributed to China-to-US export. Atmospheric modeling shows that transport of the export-related Chinese pollution contributed 3-10% of annual mean surface sulfate concentrations and 0.5-1.5% of ozone over the western United States in 2006. This Chinese pollution also resulted in one extra day or more of noncompliance with the US ozone standard in 2006 over the Los Angeles area and many regions in the eastern United States. On a daily basis, the export-related Chinese pollution contributed, at a maximum, 12-24% of sulfate concentrations over the western United States. As the United States outsourced manufacturing to China, sulfate pollution in 2006 increased in the western United States but decreased in the eastern United States, reflecting the competing effect between enhanced transport of Chinese pollution and reduced US emissions. Our findings are relevant to international efforts to reduce transboundary air pollution.

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

    Science.gov (United States)

    Blanchard, Karine; Ménard, Rachel; Corvol, Aline

    2016-10-01

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

  12. Comparison of Plastic Surgery Residency Training in United States and China.

    Science.gov (United States)

    Zheng, Jianmin; Zhang, Boheng; Yin, Yiqing; Fang, Taolin; Wei, Ning; Lineaweaver, William C; Zhang, Feng

    2015-12-01

    Residency training is internationally recognized as the only way for the physicians to be qualified to practice independently. China has instituted a new residency training program for the specialty of plastic surgery. Meanwhile, plastic surgery residency training programs in the United States are presently in a transition because of restricted work hours. The purpose of this study is to compare the current characteristics of plastic surgery residency training in 2 countries. Flow path, structure, curriculum, operative experience, research, and evaluation of training in 2 countries were measured. The number of required cases was compared quantitatively whereas other aspects were compared qualitatively. Plastic surgery residency training programs in 2 countries differ regarding specific characteristics. Requirements to become a plastic surgery resident in the United States are more rigorous. Ownership structure of the regulatory agency for residency training in 2 countries is diverse. Training duration in the United States is more flexible. Clinical and research training is more practical and the method of evaluation of residency training is more reasonable in the United States. The job opportunities after residency differ substantially between 2 countries. Not every resident has a chance to be an independent surgeon and would require much more training time in China than it does in the United States. Plastic surgery residency training programs in the United States and China have their unique characteristics. The training programs in the United States are more standardized. Both the United States and China may complement each other to create training programs that will ultimately provide high-quality care for all people.

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

    Science.gov (United States)

    Frescura, Marina

    1997-01-01

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

  14. 19 CFR 10.46 - Articles for the United States.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Articles for the United States. 10.46 Section 10... THE TREASURY ARTICLES CONDITIONALLY FREE, SUBJECT TO A REDUCED RATE, ETC. General Provisions Articles for Institutions § 10.46 Articles for the United States. Pursuant to subheadings 9808.00.10 and 9808...

  15. 26 CFR 1.864-2 - Trade or business within the United States.

    Science.gov (United States)

    2010-04-01

    ... States, as his agent to effect transactions in the United States in stocks and securities for the account... A ordinarily effects transactions in the United States in stocks or securities. Under the agency..., effects transactions in the United States in stocks or securities for the partnership's own account or...

  16. Conscientious refusals and reason-giving.

    Science.gov (United States)

    Marsh, Jason

    2014-07-01

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

  17. 7 CFR 319.8-26 - Material refused entry.

    Science.gov (United States)

    2010-01-01

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

  18. Taxation of United States general aviation

    Science.gov (United States)

    Sobieralski, Joseph Bernard

    General aviation in the United States has been an important part of the economy and American life. General aviation is defined as all flying excluding military and scheduled airline operations, and is utilized in many areas of our society. The majority of aircraft operations and airports in the United States are categorized as general aviation, and general aviation contributes more than one percent to the United States gross domestic product each year. Despite the many benefits of general aviation, the lead emissions from aviation gasoline consumption are of great concern. General aviation emits over half the lead emissions in the United States or over 630 tons in 2005. The other significant negative externality attributed to general aviation usage is aircraft accidents. General aviation accidents have caused over 8000 fatalities over the period 1994-2006. A recent Federal Aviation Administration proposed increase in the aviation gasoline tax from 19.4 to 70.1 cents per gallon has renewed interest in better understanding the implications of such a tax increase as well as the possible optimal rate of taxation. Few studies have examined aviation fuel elasticities and all have failed to study general aviation fuel elasticities. Chapter one fills that gap and examines the elasticity of aviation gasoline consumption in United States general aviation. Utilizing aggregate time series and dynamic panel data, the price and income elasticities of demand are estimated. The price elasticity of demand for aviation gasoline is estimated to range from -0.093 to -0.185 in the short-run and from -0.132 to -0.303 in the long-run. These results prove to be similar in magnitude to automobile gasoline elasticities and therefore tax policies could more closely mirror those of automobile tax policies. The second chapter examines the costs associated with general aviation accidents. Given the large number of general aviation operations as well as the large number of fatalities and

  19. Analysis of United States' Broadband Policy

    National Research Council Canada - National Science Library

    Uzarski, Joel S

    2007-01-01

    .... With every month that passes, the United States fails to close the gap in the digital divide both inside its borders as well as among the other countries that lead the world in broadband penetration...

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

    Science.gov (United States)

    2013-01-01

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

  1. Refuse derived fuel incineration: Fuel gas monitoring and analysis

    International Nuclear Information System (INIS)

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

    1993-11-01

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

  2. Anti-Terrorism Authority Under the Laws of the United Kingdom and the United States

    National Research Council Canada - National Science Library

    Feikert, Clare; Doyle, Charles

    2006-01-01

    This is a comparison of the laws of the United Kingdom and of the United States that govern criminal and intelligence investigations of terrorist activities Both systems rely upon a series of statutory authorizations...

  3. 76 FR 38700 - United States, et al.

    Science.gov (United States)

    2011-07-01

    ... prices in advertisements, in-store displays, and online. Consumer World believes these rules should be... has ruled on that motion. I. Procedural History The United States and seven Plaintiff States filed the... Restraints result in higher merchant costs, and merchants generally pass costs on to consumers, retail prices...

  4. Invitation Refusals in Cameroon French and Hexagonal French

    Science.gov (United States)

    Farenkia, Bernard Mulo

    2015-01-01

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

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

    Science.gov (United States)

    Gurmu, Eshetu; Endale, Senait

    2017-03-16

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

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

    NARCIS (Netherlands)

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

    2013-01-01

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

  7. 75 FR 10561 - Pricing for 2010 United States Mint America the Beautiful QuartersTM

    Science.gov (United States)

    2010-03-08

    ... DEPARTMENT OF THE TREASURY United States Mint Pricing for 2010 United States Mint America the Beautiful Quarters\\TM\\ Two-Roll Set, etc. AGENCY: United States Mint, Department of the Treasury. ACTION: Notice. SUMMARY: The United States Mint is announcing the price of the 2010 United States Mint America...

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

    Science.gov (United States)

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

    2011-12-29

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

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

    International Nuclear Information System (INIS)

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

    1999-01-01

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

  10. 78 FR 77103 - United States Travel and Tourism Advisory Board

    Science.gov (United States)

    2013-12-20

    ... DEPARTMENT OF COMMERCE International Trade Administration United States Travel and Tourism... extended deadline for application for membership on the United States Travel and Tourism Advisory Board... Travel and Tourism Advisory Board (Board). The November 25, 2013 notice provided that all applications...

  11. State of pine decline in the southeastern United States

    Science.gov (United States)

    Lori Eckhardt; Mary Anne Sword Sayer; Don Imm

    2010-01-01

    Pine decline is an emerging forest health issue in the southeastern United States. Observations suggest pine decline is caused by environmental stress arising from competition, weather, insects and fungi, anthropogenic disturbances, and previous management. The problem is most severe for loblolly pine on sites that historically supported longleaf pine, are highly...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1995-09-01

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

  13. 78 FR 53426 - United States Travel and Tourism Advisory Board Charter Renewal

    Science.gov (United States)

    2013-08-29

    ... DEPARTMENT OF COMMERCE International Trade Administration United States Travel and Tourism... for the United States Travel and Tourism Advisory Board on August 19, 2013. DATES: The Charter for the United States Travel and Tourism Advisory Board was renewed on August 19, 2013. FOR FURTHER INFORMATION...

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

    Science.gov (United States)

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

    2015-01-01

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

  15. 13 CFR 115.18 - Refusal to issue further guarantees; suspension and termination of PSB status.

    Science.gov (United States)

    2010-01-01

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

  16. 75 FR 4565 - Federal Acquisition Regulation; Submission for OMB Review; Right of First Refusal of Employment

    Science.gov (United States)

    2010-01-28

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

  17. Summary of Notifiable Diseases, United States. Volume 45, Number 53.

    Science.gov (United States)

    1997-10-31

    Trichinosis Tuberculosis Typhoid fever Yellow fever NOTE: Although varicella is not a nationally notifiable disease, the Council of State and...plague among humans, two of which were fatal, were re- ported in the United States (two cases in Arizona, one in Colorado, and two in New Mexico ). Both...13 cases per year) were reported in the United States. Of these cases, 80% occurred in the southwestern states of New Mexico , Arizona, and

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

    Science.gov (United States)

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

    1992-11-01

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

  19. Forest carbon management in the United States: 1600-2100

    Science.gov (United States)

    Richard A. Birdsey; Kurt Pregitzer; Alan Lucier

    2006-01-01

    This paper reviews the effects of past forest management on carbon stocks in the United States, and the challenges for managing forest carbon resources in the 21st century. Forests in the United States were in approximate carbon balance with the atmosphere from 1600-1800. Utilization and land clearing caused a large pulse of forest carbon emissions during the 19th...

  20. Review of the potential for utilizing washery refuse in N. S. W. and Queensland

    Energy Technology Data Exchange (ETDEWEB)

    Sullivan, K M

    1977-06-01

    The growing importance attached to the environment, coupled with the increasing quantities of coal refuse resulting from expanded coal production has highlighted the problem of coal refuse disposal and provided the necessary impetus to find uses for the by-product, which will eventually be regarded as a fuel and engineering material rather than a waste. Potential areas of use will be as a fuel; as a potential fuel replacement and raw material additive for brick manufacture; as a raw material for lightweight aggregate manufacture; as a construction material; for agricultural purposes, or a number of other areas of special use. The successful marketing of coal refuse will depend on an in-depth technical market analysis being carried out, followed by practical research and a comprehensive product examination and identification program being undertaken.

  1. Fundamental aspects of municipal refuse generated in Beirut and Tripoli: field studies 1994-1996

    International Nuclear Information System (INIS)

    Ayoub, G.M.; Acra, A.; Abdallah, R.; Merhebi, F.

    1996-01-01

    This study presents socio-economic survey on collection and analysis of data pertaining to the municipal refuse generated in Beirut and Tripoli, Two big cities of Lebanon.Although the collection process applied in Beirut has progressed immensely in the past two years, the unsatisfactory methods of disposal that have been employed until now has an impact on the environment:marine environment as well as the air pollution becoming problems in the city of Beirut. In this respect, solid wastes characterization and generation rates in both cities of Beirut and Tripoli are presented. Mapping of refuse collection and disposal services in the two cities is described. Sources of refuse like hospitals, industries, household,...are enumerated. Recycling potentials of plastics, paper and cardboard, glass wastes, metallic wastes, textile wastes are described

  2. NCHS - Births and General Fertility Rates: United States

    Data.gov (United States)

    U.S. Department of Health & Human Services — This dataset includes crude birth rates and general fertility rates in the United States since 1909. The number of states in the reporting area differ historically....

  3. Green electricity policies in the United States: case study

    International Nuclear Information System (INIS)

    Menz, Fredric C.

    2005-01-01

    While there has been interest in promoting the use of renewable energy in electricity production for a number of years in the United States, the market share of non-hydro renewable energy sources in electricity production has remained at about 2 percent over the past decade. The paper reviews the principal energy resources used for electricity production, considers the changing regulatory environment for the electricity industry, and describes government policies that have been used to promote green electricity in the United States, with an emphasis on measures adopted by state governments. Factors influencing the development of green power markets are also discussed, including underlying economic issues, public policy measures, the regulatory environment, external costs, and subsidies. Without significant increases in fossil fuel prices, much more stringent environmental regulations, or significant changes in electricity customer preferences, green electricity markets are likely to develop slowly in the United States

  4. 78 FR 70275 - United States Travel and Tourism Advisory Board

    Science.gov (United States)

    2013-11-25

    ... DEPARTMENT OF COMMERCE International Trade Administration United States Travel and Tourism... an opportunity to apply for membership on the United States Travel and Tourism Advisory Board... Travel and Tourism Advisory Board (Board). The purpose of the Board is to advise the Secretary of...

  5. Veterinary Fusarioses within the United States

    Science.gov (United States)

    Multilocus DNA sequence data was used to retrospectively assess the genetic diversity and evolutionary relationships of 67 Fusarium strains from veterinary sources, most of which were from the United States. Molecular phylogenetic analyses revealed that the strains comprised 23 phylogenetically dist...

  6. Geographic and Individual Differences in Healthcare Access for U.S. Transgender Adults: A Multilevel Analysis

    Science.gov (United States)

    Murchison, Gabriel R.; Clark, Kirsty; Pachankis, John E.; Reisner, Sari L.

    2016-01-01

    Abstract Purpose: To identify geographic and individual-level factors associated with healthcare access among transgender people in the United States. Methods: Multilevel analyses were conducted to investigate lifetime healthcare refusal using national data from 5831 U.S. transgender adults. Hierarchical generalized linear models examined associations between individual (age, gender, race, income, insurance, and healthcare avoidance) and state-level factors (percent voting Republican, percent same-sex couple households, income inequality, and transgender protective laws) and lifetime refusal of care. Results: Results show that individual-level factors (being older; trans feminine; Native American, multiracial, or other racial/ethnic minority; having low income; and avoiding care due to discrimination) are positively associated with care refusal (all P-values care refusal, relative to other regions of the United States. When adjusting for state-level factors, the percentage of the state population voting Republican was positively associated with care refusal among the transgender adults sampled (P < 0.01). Conclusion: Transgender adults surveyed reported differential access to healthcare by geographic region. Identifying geographic and individual-level factors associated with healthcare barriers allows for the development of targeted educational and policy interventions to improve healthcare access for transgender people most in need of services. PMID:27636030

  7. Low-level radioactive waste disposal technologies used outside the United States

    International Nuclear Information System (INIS)

    Templeton, K.J.; Mitchell, S.J.; Molton, P.M.; Leigh, I.W.

    1994-01-01

    Low-level radioactive waste (LLW) disposal technologies are an integral part of the waste management process. In the United States, commercial LLW disposal is the responsibility of the State or groups of States (compact regions). The United States defines LLW as all radioactive waste that is not classified as spent nuclear fuel, high- level radioactive waste, transuranic waste, or by-product material as defined in Section II(e)(2) of the Atomic Energy Act. LLW may contain some long-lived components in very low concentrations. Countries outside the United States, however, may define LLW differently and may use different disposal technologies. This paper outlines the LLW disposal technologies that are planned or being used in Canada, China, Finland, France, Germany, Japan, Sweden, Taiwan, and the United Kingdom (UK)

  8. Pakistan: Can the United States Secure an Insecure State?

    Science.gov (United States)

    2010-01-01

    do not have female staff; the male-to-female staff ratio in the health field is 7 to 1.130 More nurses and female staff are needed, especially to...exercise was rescheduled for 2009. 9 Interview with Ninth Air Force personnel, September 12, 2008. 200 Pakistan: Can the United States Secure an Insecure

  9. The hydroelectric power market in the United States

    International Nuclear Information System (INIS)

    2002-01-01

    The second-largest producer of hydroelectric power in the world is the United States, right after Canada. In the United States, 7.1 per cent of net electricity generation was attributed to hydroelectric power in 2000, which totalled 269 terawatt hours (TWh). Aging facilities, outdated technology in some facilities, a cumbersome licensing process, and increasing environmental demands from interest groups for the preservation of river systems and surrounding wildlife challenge the industry. Pacific Coast states, especially California, were faced with electric power shortages during the summer of 2001, due to low market prices, high power usage among consumers and drought. The problems with the deregulation of the electricity market were brought to light by these shortages. Legislation to restructure the electric power industry in 25 states had not been enacted as of January 2002. The purchase of more power from both Canada and the Mexico is being considered by the government of the United States, as is the creation of a national power grid to allow for power transmission throughout the country. The Canada-United States energy trade might be affected by such a move, and result in project construction opportunities for Canadian companies. Renewable energy sources must be responsible for the generation of 10 per cent of power generation levels by 2020, on a gradual basis as mandated by law. By 2005, New York City must purchase 10 per cent of its power from renewable energy sources, reaching 20 per cent by 2010. The repair and replacement of aging dam equipment, the development of advanced turbine technology to protect fish stocks and water quality, dam removal, the construction of power lines are all opportunities open to Canadian companies. 60 refs., 5 tabs

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

    OpenAIRE

    Dugan, Patrick R.; Apel, William A.

    1983-01-01

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

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

    Science.gov (United States)

    Azodo, Clement Chinedu; Umoh, Agnes O

    2015-09-15

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

  12. Research and photovoltaic industry at the United States

    International Nuclear Information System (INIS)

    Lerouge, Ch.; Herino, R.; Delville, R.; Allegre, R.

    2006-06-01

    For a big country as the United States, the solar energy can be a solution for the air quality improvement, the greenhouse gases fight and the reduction of the dependence to the imported petroleum and also for the economic growth by the increase of the employment in the solar industry sector. This document takes stock on the photovoltaic in the United States in the industrial and research domains. The american photovoltaic industry is the third behind the Japan and the Germany. (A.L.B.)

  13. Determinants of refusal of A/H1N1 pandemic vaccination in a high risk population: a qualitative approach.

    Directory of Open Access Journals (Sweden)

    Eugenie d'Alessandro

    Full Text Available BACKGROUND: Our study analyses the main determinants of refusal or acceptance of the 2009 A/H1N1 vaccine in patients with cystic fibrosis, a high-risk population for severe flu infection, usually very compliant for seasonal flu vaccine. METHODOLOGY/PRINCIPAL FINDINGS: We conducted a qualitative study based on semi-structured interviews in 3 cystic fibrosis referral centres in Paris, France. The study included 42 patients with cystic fibrosis: 24 who refused the vaccine and 18 who were vaccinated. The two groups differed quite substantially in their perceptions of vaccine- and disease-related risks. Those who refused the vaccine were motivated mainly by the fears it aroused and did not explicitly consider the 2009 A/H1N1 flu a potentially severe disease. People who were vaccinated explained their choice, first and foremost, as intended to prevent the flu's potential consequences on respiratory cystic fibrosis disease. Moreover, they considered vaccination to be an indirect collective prevention tool. Patients who refused the vaccine mentioned multiple, contradictory information sources and did not appear to consider the recommendation of their local health care provider as predominant. On the contrary, those who were vaccinated stated that they had based their decision solely on the clear and unequivocal advice of their health care provider. CONCLUSIONS/SIGNIFICANCE: These results of our survey led us to formulate three main recommendations for improving adhesion to new pandemic vaccines. (1 it appears necessary to reinforce patient education about the disease and its specific risks, but also general population information about community immunity. (2 it is essential to disseminate a clear and effective message about the safety of novel vaccines. (3 this message should be conveyed by local health care providers, who should be involved in implementing immunization.

  14. State cigarette minimum price laws - United States, 2009.

    Science.gov (United States)

    2010-04-09

    Cigarette price increases reduce the demand for cigarettes and thereby reduce smoking prevalence, cigarette consumption, and youth initiation of smoking. Excise tax increases are the most effective government intervention to increase the price of cigarettes, but cigarette manufacturers use trade discounts, coupons, and other promotions to counteract the effects of these tax increases and appeal to price-sensitive smokers. State cigarette minimum price laws, initiated by states in the 1940s and 1950s to protect tobacco retailers from predatory business practices, typically require a minimum percentage markup to be added to the wholesale and/or retail price. If a statute prohibits trade discounts from the minimum price calculation, these laws have the potential to counteract discounting by cigarette manufacturers. To assess the status of cigarette minimum price laws in the United States, CDC surveyed state statutes and identified those states with minimum price laws in effect as of December 31, 2009. This report summarizes the results of that survey, which determined that 25 states had minimum price laws for cigarettes (median wholesale markup: 4.00%; median retail markup: 8.00%), and seven of those states also expressly prohibited the use of trade discounts in the minimum retail price calculation. Minimum price laws can help prevent trade discounting from eroding the positive effects of state excise tax increases and higher cigarette prices on public health.

  15. 75 FR 78338 - Meeting of the United States-Oman Joint Forum on Environmental Cooperation Pursuant to the United...

    Science.gov (United States)

    2010-12-15

    ... DEPARTMENT OF STATE [Public Notice 7261] Meeting of the United States-Oman Joint Forum on Environmental Cooperation Pursuant to the United States-Oman Memorandum of Understanding on Environmental Cooperation ACTION: Notice of the meeting of the U.S.-Oman Joint Forum on Environmental Cooperation and...

  16. 77 FR 27669 - Modifications to Definition of United States Property

    Science.gov (United States)

    2012-05-11

    ... contracts. The temporary regulations provide that certain obligations of United States persons arising from upfront payments made by controlled foreign corporations pursuant to contracts that are cleared by a... the meaning of section 956(c)) for obligations of United States persons arising from certain upfront...

  17. Contemporary United States Foreign Policy Towards Indonesia

    National Research Council Canada - National Science Library

    McAslan, Hugh

    2004-01-01

    United States national interests in Indonesia have traditionally being based on strategic security requirements given Indonesia's geographic location between the Indian and Pacific Oceans, and strong...

  18. Project Startup: Evaluating the Performance of Hydraulic Hybrid Refuse Vehicles

    Energy Technology Data Exchange (ETDEWEB)

    2015-09-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

  20. Employers mexican migrants in the United States

    Directory of Open Access Journals (Sweden)

    Eduardo Fernández Guzmán

    2013-09-01

    Full Text Available You might think that by definition the migrant labor plays in less profitable niches and meager social mobility. However, a large group of migrants in different economically developed countries have successfully launched businesses of diverse nature and volume. This is why entrepreneurship of migrants is an issue that has received increasing attention in recent years. Compared to other immigrant groups in the United States, Mexicans show low levels of entrepreneurial activity. The aim of this paper is to, through a general literature review of official statistical data, a preliminary analysis of mexican migrant entrepreneurship in the United States, that is to say in recent years has been growing in importance.

  1. Motorcycle trends in the United States

    Science.gov (United States)

    2009-05-01

    During the last decade there has been a significant increase in the number of motorcycle sales and registrations in the United States. At the same time there has been a shift in the demographics of motorcycle users and increased focus on motorcycle s...

  2. THE UNITED STATES AND NIGERIAN RELATIONS:

    African Journals Online (AJOL)

    Mrs. I.D

    2009-12-25

    Dec 25, 2009 ... response from the Nigerian government. ... domestic crises that negatively impacts state stability, the US government ... Harrison C. Ajebon, Department of Political Science, University of Calabar, ..... Sweden. United Kingdom. Switzerland. Asia & far East. Japan ..... case Study of Nigeria, in Ikonnechidi and.

  3. 37 CFR 1.416 - The United States International Preliminary Examining Authority.

    Science.gov (United States)

    2010-07-01

    ... STATES PATENT AND TRADEMARK OFFICE, DEPARTMENT OF COMMERCE GENERAL RULES OF PRACTICE IN PATENT CASES International Processing Provisions General Information § 1.416 The United States International Preliminary... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false The United States...

  4. 31 CFR Appendix C to Subpart C of... - United States Customs Service

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false United States Customs Service C... Customs Service 1. In general. This appendix applies to the United States Customs Service. It sets forth... records and accounting of disclosures. (a) For records which are maintained at the United States Customs...

  5. The State of Homeless Children in the United States

    Science.gov (United States)

    Kabler, Brenda; Weinstein, Elana

    2009-01-01

    Across America, the numbers of homeless children and families are growing as a result of many factors including the recent economic crisis, home foreclosures, and natural disasters. Because of an increase in the number of homeless children throughout the United States, this population has unmet needs that can be targeted in school settings under…

  6. 78 FR 53478 - Proposed Information Collection; United States Park Police Personal History Statement

    Science.gov (United States)

    2013-08-29

    ...] Proposed Information Collection; United States Park Police Personal History Statement AGENCY: National Park... about this IC, contact Major Scott Fear, United States Park Police, 1100 Ohio Drive SW., Washington, DC... INFORMATION: I. Abstract The United States Park Police (USPP) is a unit of the National Park Service...

  7. 44 CFR 351.26 - The United States Department of Agriculture.

    Science.gov (United States)

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false The United States Department of Agriculture. 351.26 Section 351.26 Emergency Management and Assistance FEDERAL EMERGENCY... PREPAREDNESS Interagency Assignments § 351.26 The United States Department of Agriculture. (a) Assist FEMA in...

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

    Science.gov (United States)

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

    2008-05-01

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

  9. Fragmented patterns of flood change across the United States

    Science.gov (United States)

    Archfield, Stacey A.; Hirsch, Robert M.; Viglione, A.; Blöschl, G.

    2016-01-01

    Trends in the peak magnitude, frequency, duration, and volume of frequent floods (floods occurring at an average of two events per year relative to a base period) across the United States show large changes; however, few trends are found to be statistically significant. The multidimensional behavior of flood change across the United States can be described by four distinct groups, with streamgages experiencing (1) minimal change, (2) increasing frequency, (3) decreasing frequency, or (4) increases in all flood properties. Yet group membership shows only weak geographic cohesion. Lack of geographic cohesion is further demonstrated by weak correlations between the temporal patterns of flood change and large-scale climate indices. These findings reveal a complex, fragmented pattern of flood change that, therefore, clouds the ability to make meaningful generalizations about flood change across the United States.

  10. Media Education in the United States: A Check under the "Gestalt" Hood.

    Science.gov (United States)

    Phillips, Melissa

    1998-01-01

    Examines four commonalities of media education in the United States. Outlines the four ideological perspectives that in fact guide media education in the United States: celebration, protectionism, cultural criticism, and educated consumerism. Suggests what all of this means for the future of media education in the United States and what will be…

  11. Right to refuse treatment in Turkey: a diagnosis and a slightly less than modest proposal for reform.

    Science.gov (United States)

    Irmak, Nurbay

    2016-07-01

    This paper examines the current state of right to refuse medical treatment in Turkey. Even though there are only a few studies carried out with Turkish physicians on their attitude towards the right to refuse treatment, I argue that recent studies on physicians' views on informed consent and honest disclosure show that Turkish physicians do not tend to recognise their patients' right to decline treatment. This is because the refusal of treatment crucially requires that patients be properly informed and asked for their consent before the treatment. Turkish physicians and healthcare providers' tendency to ignore the right to decline medical treatment cannot be separated from their paternalistic approach to patients and their rights. I argue that part of the problem is the legal framework, which, in essence, is still paternalistic. More specifically, the frequent appearance of the phrase 'medical necessity' in the relevant legislation is conveniently used to justify medical intervention against a patient's will. I conclude the paper by proposing reforms in the legal documents defining and regulating patient rights, including the Constitution of the Turkish Republic, and I will argue that these reforms will help enhance patient rights in Turkey. Turkey has been discussing a new Constitution for the past several years, so my proposal should best be understood as contributing to public discussion of the new Constitution by initiating debate about medical paternalism and patient autonomy in Turkish medicine. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  12. Emissions from co-combustion of wood and household refuse

    International Nuclear Information System (INIS)

    Zhang, X.J.; Peterson, F.

    1996-01-01

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

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

    Science.gov (United States)

    Dugan, Patrick R.; Apel, William A.

    1983-01-01

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

  14. 7 CFR 58.2825 - United States Standard for ice cream.

    Science.gov (United States)

    2010-01-01

    ... AND STANDARDS UNDER THE AGRICULTURAL MARKETING ACT OF 1946 AND THE EGG PRODUCTS INSPECTION ACT... DAIRY PRODUCTS 1 United States Department of Agriculture Standard for Ice Cream § 58.2825 United States... from the use of bulky optional ingredients, chocolate and cocoa solids used shall be considered the...

  15. 22 CFR 61.8 - Coordination with United States Customs Service.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Coordination with United States Customs Service... FREE FLOW OF AUDIO-VISUAL MATERIALS § 61.8 Coordination with United States Customs Service. (a) Nothing in this part shall preclude examination of imported materials pursuant to the Customs laws and...

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

    Science.gov (United States)

    Clarke, Kyra

    2016-01-01

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

  17. 49 CFR 24.208 - Aliens not lawfully present in the United States.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Aliens not lawfully present in the United States... Requirements § 24.208 Aliens not lawfully present in the United States. (a) Each person seeking relocation... of an individual, that he or she is either a citizen or national of the United States, or an alien...

  18. Environmental performance reviews: United States

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2006-01-15

    This book presents OECD assessments and recommendations regarding the United States' effort to manage its environment including air, water nature, and biodiversity to do this in a sustainable manner; and to do this in co-operation with its global neighbours. In particular, it assesses progress made since 1996, when OECD's previous review on the US was done. 40 figs., 21 tabs.

  19. Consumer bankruptcy law for Ethiopia: Lessons from United States ...

    African Journals Online (AJOL)

    After deregulation of consumer credit and resultant availability, ... Germany, United States, United Kingdom and France are some of the countries ... social insurance, development policy and rehabilitative function of discharge and fresh start.

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

    Science.gov (United States)

    Manson, Neil C

    2015-02-01

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

  1. United States - Japanese nuclear relations: implications for the pacific region

    International Nuclear Information System (INIS)

    Suttmeier, R.P.

    1980-01-01

    The initiation of a new approach to non-proliferation policy by the United States in 1977 was the most upsetting development in the history of US-Japanese nuclear relations. The policy has seemingly altered Japanese views of its own nuclear future very little, yet it has altered the tone of the nuclear relationship with the United States. Recent Japanese nuclear power developments, both technical and administrative, are outlined and the prospects for the future of the United States-Japanese nuclear relationship and for Pacific regional cooperation assessed. Issues of importance in the relationship include reprocessing - enrichment, plutonium management, spent fuel and waste management and uranium supplies

  2. 46 CFR 153.12 - IMO Certificates for United States Ships.

    Science.gov (United States)

    2010-10-01

    ... 8, or the Officer in Charge, Marine Inspection, issues a United States ship an IMO Certificate... 46 Shipping 5 2010-10-01 2010-10-01 false IMO Certificates for United States Ships. 153.12 Section... CARGOES SHIPS CARRYING BULK LIQUID, LIQUEFIED GAS, OR COMPRESSED GAS HAZARDOUS MATERIALS General § 153.12...

  3. Costs and outcomes after cardiac surgery in patients refusing transfusion compared with those who do not: a case-matched study.

    Science.gov (United States)

    Guinn, Nicole R; Roberson, Russell S; White, William; Cowper, Patricia A; Broomer, Bob; Milano, Carmelo; Chiricolo, Antonio; Hill, Steven

    2015-12-01

    Although numerous studies have demonstrated the feasibility of cardiac surgery for blood refusal patients, few studies match to controls, and fewer examine cost. This historical cohort study aims to compare costs and outcomes after cardiac surgery in Jehovah's Witness patients who refuse blood transfusion with a group of matched patients accepting transfusion. A retrospective database review was performed to find all patients having cardiac surgery who refused blood products from January 2005 to July 2012 at Duke University Medical Center. These 45 patients were closely matched 1:2 with controls who accepted transfusion based on characteristics likely to influence transfusion. Cost from day of surgery to hospital discharge and other outcome data (length of stay [LOS], discharge hemoglobin [Hb], acute kidney injury) were analyzed retrospectively. Forty-five Witnesses having cardiac surgery were temporally matched to two controls having the same surgery. Median euroSCORE was the same in both groups (6.0, p = 0.9981). In the matched-pairs comparison of cost, there was no significant difference in total cost for Witnesses and controls. There was no difference in intensive care unit LOS (median, 1 day, both groups) or total LOS (median, 9 days for Witnesses vs. 7 days for controls). Mean Hb at discharge was higher in Witnesses than in controls (11.7 g/dL vs. 9.8 g/dL, p conservation measures, cardiac surgery may be performed with similar outcomes and cost from day of surgery to discharge compared to controls in select patients without blood transfusion. © 2015 AABB.

  4. China’s international trade and air pollution in the United States

    Science.gov (United States)

    Lin, Jintai; Pan, Da; Davis, Steven J.; Zhang, Qiang; He, Kebin; Wang, Can; Streets, David G.; Wuebbles, Donald J.; Guan, Dabo

    2014-01-01

    China is the world’s largest emitter of anthropogenic air pollutants, and measurable amounts of Chinese pollution are transported via the atmosphere to other countries, including the United States. However, a large fraction of Chinese emissions is due to manufacture of goods for foreign consumption. Here, we analyze the impacts of trade-related Chinese air pollutant emissions on the global atmospheric environment, linking an economic-emission analysis and atmospheric chemical transport modeling. We find that in 2006, 36% of anthropogenic sulfur dioxide, 27% of nitrogen oxides, 22% of carbon monoxide, and 17% of black carbon emitted in China were associated with production of goods for export. For each of these pollutants, about 21% of export-related Chinese emissions were attributed to China-to-US export. Atmospheric modeling shows that transport of the export-related Chinese pollution contributed 3–10% of annual mean surface sulfate concentrations and 0.5–1.5% of ozone over the western United States in 2006. This Chinese pollution also resulted in one extra day or more of noncompliance with the US ozone standard in 2006 over the Los Angeles area and many regions in the eastern United States. On a daily basis, the export-related Chinese pollution contributed, at a maximum, 12–24% of sulfate concentrations over the western United States. As the United States outsourced manufacturing to China, sulfate pollution in 2006 increased in the western United States but decreased in the eastern United States, reflecting the competing effect between enhanced transport of Chinese pollution and reduced US emissions. Our findings are relevant to international efforts to reduce transboundary air pollution. PMID:24449863

  5. Lime helps establish crownvetch on coal-breaker refuse

    Science.gov (United States)

    Miroslaw M. Czapowskyj; Edward A. Sowa

    1976-01-01

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

  6. [Refusal of care and respect of the body].

    Science.gov (United States)

    Bernard, Marie-Fleur

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

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

    Science.gov (United States)

    Setse, Rosanna W; Maxwell, Celia J

    2014-05-01

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

  8. The United States and world energy markets

    International Nuclear Information System (INIS)

    Ramsay, W.C.

    1992-01-01

    The United States, dominating the world's energy markets as a producer and consumer, is sensitive to changes in this market and intends to influence the development of global energy policy. Supply will be increased by nations such as Venezuela, Indonesia and perhaps in the future a United Yemen and the Commonwealth of Independent States, moving to freer market economies which will allow investment opportunities previously inaccessible to foreign companies. Although world energy demand will grow, little of this will be in the US where, under the National Energy Strategy, comprehensive measures are being introduced to improve energy efficiency. The US energy security will be further improved by such measures as diversification of supply, larger domestic production and increasing interdependence between suppliers, traders and consumers. (author)

  9. 45 CFR 261.15 - Can a family be penalized if a parent refuses to work because he or she cannot find child care?

    Science.gov (United States)

    2010-10-01

    ... work because he or she cannot find child care? 261.15 Section 261.15 Public Welfare Regulations... work because he or she cannot find child care? (a) No, the State may not reduce or terminate assistance based on an individual's refusal to engage in required work if the individual is a single custodial...

  10. The financial burden of out-of-pocket expenses in the United States and Canada: How different is the United States?

    Directory of Open Access Journals (Sweden)

    Katherine E Baird

    2016-01-01

    Full Text Available Background: This article compares the burden that medical cost-sharing requirements place on households in the United States and Canada. It estimates the probability that individuals with similar demographic features in the two countries have large medical expenses relative to income. Method: The study uses 2010 nationally representative household survey data harmonized for cross-national comparisons to identify individuals with high medical expenses relative to income. Using logistic regression, it estimates the probability of high expenses occurring among 10 different demographic groups in the two countries. Results: The results show the risk of large medical expenses in the United States is 1.5–4 times higher than it is in Canada, depending on the demographic group and spending threshold used. The United States compares least favorably when evaluating poorer citizens and when using a higher spending threshold. Conclusion: Recent health care reforms can be expected to reduce Americans’ catastrophic health expenses, but it will take very large reductions in out-of-pocket expenditures—larger than can be expected—if poorer and middle-class families are to have the financial protection from high health care costs that their counterparts in Canada have.

  11. GEOPOLITICS AND TRANSPORTATION. UNITED STATES AND PANAMA CANAL

    Directory of Open Access Journals (Sweden)

    Benea Ciprian Beniamin

    2009-05-01

    Full Text Available This article presents the great connection which exists between the realization of Panama Canal and the rising power on United States; and how this state, after the construction of this canal, could promote efficiently at global level its interests.

  12. Improving the United States' Strategic Communication Strategy

    National Research Council Canada - National Science Library

    Risberg, Robert H

    2008-01-01

    ...? Much of the answer to this question is the failure of the United States Government to effectively use strategic communication to inform and influence populations to recognize the value of American...

  13. Nickel recycling in the United States in 2004

    Science.gov (United States)

    Goonan, Thomas G.

    2009-01-01

    As one of a series of reports that describe the recycling of metal commodities in the United States, this report discusses the flow of nickel from production through distribution and use, with particular emphasis on the recycling of industrial scrap (new scrap) and used products (old scrap) in 2004. This materials flow study includes a description of nickel supply and demand for the United States to illustrate the extent of nickel recycling and to identify recycling trends. Understanding how materials flow from a source through disposition can aid in improving the management of natural resource delivery systems. In 2004, the old scrap recycling efficiency for nickel was estimated to be 56.2 percent. In 2004, nickel scrap consumption in the United States was as follows: new scrap containing 13,000 metric tons (t) of nickel (produced during the manufacture of products), 12 percent; and old scrap containing 95,000 t of nickel (articles discarded after serving a useful purpose), 88 percent. The recycling rate for nickel in 2004 was 40.9 percent, and the percentage of nickel in products attributed to nickel recovered from nickel-containing scrap was 51.6 percent. Furthermore, U.S. nickel scrap theoretically generated in 2004 had the following distribution: scrap to landfills, 24 percent; recovered and used scrap, 50 percent; and unaccounted for scrap, 26 percent. Of the 50 percent of old scrap generated in the United States that was recovered and then used in 2004, about one-third was exported and two-thirds was consumed in the domestic production of nickel-containing products.

  14. School Autonomy: A Comparison between China and the United States

    Science.gov (United States)

    Xia, Jiangang; Gao, Xingyuan; Shen, Jianping

    2017-01-01

    This study examined and compared school autonomy in China and the United States. Based on the international PISA 2012 school data, the authors examined three aspects of school autonomy. We found that in comparison with the United States, (1) principals from China were less likely to have responsibility over eleven school decisions (hiring…

  15. 6 CFR 13.45 - Deposit in Treasury of United States.

    Science.gov (United States)

    2010-01-01

    ... 6 Domestic Security 1 2010-01-01 2010-01-01 false Deposit in Treasury of United States. 13.45 Section 13.45 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY PROGRAM FRAUD CIVIL REMEDIES § 13.45 Deposit in Treasury of United States. All amounts collected pursuant to this part...

  16. 14 CFR 47.7 - United States citizens and resident aliens.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false United States citizens and resident aliens... AIRCRAFT AIRCRAFT REGISTRATION General § 47.7 United States citizens and resident aliens. (a) U.S. citizens... the application. (b) Resident aliens. An applicant for aircraft registration under 49 U.S.C. 44102 who...

  17. Promoting "Academic Entrepreneurship" in Europe and the United States

    DEFF Research Database (Denmark)

    Tvarnø, Christina D.; Bagley, Constance E.

    2016-01-01

    and business thereby contributing to the development of the knowledge based economy.” As the European Commission has recognized, the European Union (“EU”) needs to take action to “unlock the potential of IPRs [intellectual property rights] that lie dormant in universities, research institutes and companies...... States (“U.S.”). Our comparative analysis of the EU and U.S. approaches to translational medicine shows that there are lessons to be shared. The EU can apply the experiences from the U.S. Bayh-Dole Act and PPPPs in the United States, and the United States can emulate certain of the open innovation...

  18. The Energy Puzzle Between the United States and China

    Science.gov (United States)

    2013-03-01

    securing China’s status as a great power.2 As of 2011, China is the second largest consumer of natural resources (oil, liquefied petroleum gas ( LPG ...pursuit of natural resources, (oil, natural gas , coal or renewable energy sources) is reshaping the world’s energy security. The United States is...pursuit of natural resources, (oil, natural gas , coal or renewable energy sources) is reshaping the world’s energy security. The United States is

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

    Science.gov (United States)

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

    2013-01-01

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

  20. 40 CFR 62.15265 - How do I monitor the load of my municipal waste combustion unit?

    Science.gov (United States)

    2010-07-01

    ... continuously estimate load level (for example, the feed rate of municipal solid waste or refuse-derived fuel... municipal waste combustion unit? 62.15265 Section 62.15265 Protection of Environment ENVIRONMENTAL... DESIGNATED FACILITIES AND POLLUTANTS Federal Plan Requirements for Small Municipal Waste Combustion Units...

  1. Assisted Reproductive Technology Surveillance - United States, 2015.

    Science.gov (United States)

    Sunderam, Saswati; Kissin, Dmitry M; Crawford, Sara B; Folger, Suzanne G; Boulet, Sheree L; Warner, Lee; Barfield, Wanda D

    2018-02-16

    Since the first U.S. infant conceived with assisted reproductive technology (ART) was born in 1981, both the use of ART and the number of fertility clinics providing ART services have increased steadily in the United States. ART includes fertility treatments in which eggs or embryos are handled in the laboratory (i.e., in vitro fertilization [IVF] and related procedures). Although the majority of infants conceived through ART are singletons, women who undergo ART procedures are more likely than women who conceive naturally to deliver multiple-birth infants. Multiple births pose substantial risks for both mothers and infants, including obstetric complications, preterm delivery (state-specific information for the United States (including the District of Columbia and Puerto Rico) on ART procedures performed in 2015 and compares birth outcomes that occurred in 2015 (resulting from ART procedures performed in 2014 and 2015) with outcomes for all infants born in the United States in 2015. 2015. In 1995, CDC began collecting data on ART procedures performed in fertility clinics in the United States as mandated by the Fertility Clinic Success Rate and Certification Act of 1992 (FCSRCA) (Public Law 102-493 [October 24, 1992]). Data are collected through the National ART Surveillance System, a web-based data collection system developed by CDC. This report includes data from 52 reporting areas (the 50 states, the District of Columbia, and Puerto Rico). In 2015, a total of 182,111 ART procedures (range: 135 in Alaska to 23,198 in California) with the intent to transfer at least one embryo were performed in 464 U.S. fertility clinics and reported to CDC. These procedures resulted in 59,334 live-birth deliveries (range: 55 in Wyoming to 7,802 in California) and 71,152 infants born (range: 68 in Wyoming to 9,176 in California). Nationally, the number of ART procedures performed per 1 million women of reproductive age (15-44 years), a proxy measure of the ART utilization rate, was

  2. Chapter 16. Conservation status of great gray owls in the United States

    Science.gov (United States)

    Gregory D. Hayward

    1994-01-01

    Previous chapters outlined the biology and ecology of great gray owls as well as the ecology of this species in the western United States. That technical review provides the basis to assess the current conservation status of great gray owls in the United States. Are populations of great gray owls in the United States currently threatened? Are current land management...

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

    Science.gov (United States)

    Popper-Giveon, Ariela; Keshet, Yael

    2018-04-01

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

  4. Regulations for radiochemical facilities in the United States

    International Nuclear Information System (INIS)

    Emeigh, Ch; Smith, B.; Williams, T

    1999-01-01

    Material control and accounting is implemented to provide assurance that physical protection measures have been effective, and in case they fail, to provide delayed detection of the loss. Regulations in the United States have been developed that include both performance and compliance requirements to provide a defence in depth approach addressing the unique characteristics of each facility. Regulations address administrative controls, material control and material accounting. Nuclear materials control and accounting plans are negotiated between regulatory agencies and facilities to develop a site-specific approach. An overview of the regulations and their implementation in the United State is provided [ru

  5. Platinum recycling in the United States in 1998

    Science.gov (United States)

    Hilliard, Henry E.

    2001-01-01

    In the United States, catalytic converters are the major source of secondary platinum for recycling. Other sources of platinum scrap include reforming and chemical process catalysts. The glass industry is a small but significant source of platinum scrap. In North America, it has been estimated that in 1998 more than 20,000 kilograms per year of platinum-group metals from automobile catalysts were available for recycling. In 1998, an estimated 7,690 kilograms of platinum were recycled in the United States. U.S. recycling efficiency was calculated to have been 76 percent in 1998; the recycling rate was estimated at 16 percent.

  6. The independent nuclear state. The United States, Britain and the military atom

    International Nuclear Information System (INIS)

    Simpson, J.

    1983-01-01

    A chronological account and overview are presented of the 40-year history of British military research, development and production work in atomic energy. The United Kingdom's efforts in this field have always had close links with equivalent activities in the United States, and have often been conducted on a mutually co-operative basis. This book contains descriptions of the technical evolution of British nuclear weapon designs and production models, estimates of annual output figures for fissile material and weapon types, and indications of the nature of the weapon-testing programme. Decision-points are charted. The impact of the agreements with the United States, both upon weapon development and production programmes and upon stockpiling, is analysed, as well as their effects upon the nuclear submarine programme. The impact of later events upon Anglo-American relations is identified, together with the recent British attempts to move to a closer political association with Europe. The study concludes by evaluating the essential nature of four decades of United Kingdom military nuclear development, and identifying the practical limits imposed by past policies upon any attempt by a British government to implement a policy of unilateral nuclear disarmament. (author)

  7. Income Distribution Policy in the United States [and] Discussion Paper.

    Science.gov (United States)

    Okner, Benjamin A.; Rivlin, Alice M.

    The focus of this paper is inequality - primarily, income - inequality - in the United States and the historical-political context in which policies that affect inequality are being discussed. The first section gives a brief description of recent trends in the distribution of income in the United States, a picture whose most remarkable feature is…

  8. Constructive and Destructive Aspects of Refusal from Communication

    Directory of Open Access Journals (Sweden)

    Marianna A. Gulyaeva

    2016-12-01

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

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

    OpenAIRE

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

    2009-01-01

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

  10. IAEA Completes Nuclear Security Review Mission in United States

    International Nuclear Information System (INIS)

    2013-01-01

    Full text: A team of nuclear security experts led by the International Atomic Energy Agency (IAEA) today completed a mission to review nuclear security practices of civil nuclear facilities licensed by the United States Nuclear Regulatory Commission (NRC). Conducted at the U.S. Government's request, the two-week International Physical Protection Advisory Service (IPPAS) mission reviewed the United States' nuclear security-related legislative and regulatory framework. As part of this work, the IPPAS team, led by John O'Dacre of Canada and comprising nine experts from eight IAEA Member States, met with NRC officials and reviewed the physical protection systems at the Center for Neutron Research (NCNR) at the National Institute of Standards and Technology. The IPPAS team concluded that nuclear security within the U.S. civil nuclear sector is robust and sustainable and has been significantly enhanced in recent years. The team identified a number of good practices in the nation's nuclear security regime and at the NCNR. The IPPAS team also made a recommendation and some suggestions for the continuing improvement of nuclear security overall. The mission in the United States was the 60th IPPAS mission organized by the IAEA. 'Independent international peer reviews such as IAEA IPPAS missions are increasingly being recognized for their value as a key component for exchanges of views and advice on nuclear security measures', said Khammar Mrabit, Director of the IAEA Office of Nuclear Security. 'The good practices identified during this mission will contribute to the continuous improvements of nuclear security in other Member States'. The IPPAS team provided a draft report to the NRC and will submit a final report soon. Because it contains security-related information about a specific nuclear site, IPPAS reports are not made public. 'The IPPAS programme gives us a chance to learn from the experience and perspective of our international partners', said NRC Chairman Allison M

  11. 2009 United States Automatic Identification System Database

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The 2009 United States Automatic Identification System Database contains vessel traffic data for planning purposes within the U.S. coastal waters. The database is...

  12. 2014 United States Automatic Identification System Database

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The 2014 United States Automatic Identification System Database contains vessel traffic data for planning purposes within the U.S. coastal waters. The database is...

  13. 2012 United States Automatic Identification System Database

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The 2012 United States Automatic Identification System Database contains vessel traffic data for planning purposes within the U.S. coastal waters. The database is...

  14. 2010 United States Automatic Identification System Database

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The 2010 United States Automatic Identification System Database contains vessel traffic data for planning purposes within the U.S. coastal waters. The database is...

  15. 2011 United States Automatic Identification System Database

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The 2011 United States Automatic Identification System Database contains vessel traffic data for planning purposes within the U.S. coastal waters. The database is...

  16. United Kingdom and United States Tourism Demand for Malaysia:A Cointegration Analysis

    OpenAIRE

    Habibi, Fateh; Abdul Rahim, Khalid; Chin, Lee

    2008-01-01

    Tourism industry has been an important contributor to the Malaysia economy. In this paper we inspect variations in the long run demand for tourism from United Kingdom and United States to Malaysia. The demand for tourism has been explained by macroeconomic variables, including income in origin countries, tourism prices in Malaysia, and travel cost between the two countries. Annual data from 1972 to 2006 are used for the analysis. Augmented Dickey-Fuller and Johansen’s maximum likelihood tests...

  17. Status of nuclear engineering education in the United States

    International Nuclear Information System (INIS)

    Brown, G.J.

    2000-01-01

    Nuclear engineering education in the United States is reflective of the perceived health of the nuclear electric power industry within the country. Just as new commercial reactor orders have vanished and some power plants have shut down, so too have university enrollments shrunk and research reactors closed. This decline in nuclear trained specialists and the disappearance of the nuclear infrastructure is a trend that must be arrested and reversed if the United States is to have a workforce capable of caring for a nuclear power industry to not only meet future electric demand but to ensure that the over 100 existing plants, their supporting facilities and their legacy in the form of high level waste and facility clean-up are addressed. Additionally, the United States has an obligation to support and maintain its nuclear navy and other defence needs. And, lastly, if the United States is to have a meaningful role in the international use of nuclear power with regard to safety, non-proliferation and the environment, then it is imperative that the country continues to produce world-class nuclear engineers and scientists by supporting nuclear engineering education at its universities. The continued support of the federal government. and industry for university nuclear engineering and nuclear energy research and development is essential to sustain the nuclear infrastructure in the United States. Even with this support, and the continued excellent operation of the existing fleet of nuclear electric power plants, it is conceivable that nuclear engineering as an academic discipline may fall victim to poor communications and a tarnished public image. What is needed is a combination of federal and industrial support along with the creativity of the universities to expand their offerings to include more than power production. The objective is a positive message on careers in nuclear related fields, and recognition of the important role of nuclear energy in meeting the country

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

    Science.gov (United States)

    Epstein, Jennifer A; Botvin, Gilbert J

    2002-07-01

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

  19. Aerosol container-related eye injuries in the United States: 1997-2009.

    Science.gov (United States)

    Seidman, Carly J; Linakis, James G; Mello, Michael J; Greenberg, Paul B

    2011-06-01

    To quantify and characterize eye injuries related to aerosol container consumer products treated in United States hospital emergency departments (EDs) from 1997 through 2009. Retrospective study. Descriptive analysis of aerosol container-related eye injury data derived from the National Electronic Injury Surveillance System, a stratified probability sample of hospital-affiliated United States EDs. Data collected included demographic variables (gender and age), locale, diagnoses, and hospital disposition associated with aerosol container-related eye injuries treated in United States EDs from 1997 through 2009. Products associated with injury and mechanisms of injury also were extracted and analyzed. There were an estimated 10 765 (95% confidence interval [CI], 9842 to 11 688) visits to United States EDs for aerosol container-related eye injuries during the study period; 6756 (95% CI, 5771 to 7742; 63%) patients were male; 5927 (95% CI, 4956 to 6897; 55%) injuries occurred in children (age container-related eye injuries in the United States occur in men and children and that self-inflicted spray to the eye is the most common mechanism of injury. Further research is needed to devise effective prevention strategies for these types of injuries. Published by Elsevier Inc.

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

    Science.gov (United States)

    Salam, Asma Abdus; Afshan, Gauhar

    2016-01-01

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

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