Sample records for refuse derived fuel

  1. Binder enhanced refuse derived fuel

    DOEpatents

    Daugherty, Kenneth E.; Venables, Barney J.; Ohlsson, Oscar O.

    1996-01-01

    A refuse derived fuel (RDF) pellet having about 11% or more particulate calcium hydroxide which is utilized in a combustionable mixture. The pellets are used in a particulate fuel bring a mixture of 10% or more, on a heat equivalent basis, of the RDF pellet which contains calcium hydroxide as a binder, with 50% or more, on a heat equivalent basis, of a sulphur containing coal. Combustion of the mixture is effective to produce an effluent gas from the combustion zone having a reduced SO.sub.2 and polycyclic aromatic hydrocarbon content of effluent gas from similar combustion materials not containing the calcium hydroxide.

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

    DTIC Science & Technology

    1981-12-01

    Derived Fuel 70 Design Considerations for Municipal Solid Waste Conveyors 71 Densification of Refuse -Derived Fuels: Preparation Properties and Systems...problems could be realized if the system were expanded and if operating demands were increased. 70 DESIGN CONSIDERATIONS FOR MUNICIPAL SOLID WASTE CONVEYORS ...cleanup might be very useful in order to determine the level at which a conveyor design is monetarily accep~table. A scan of conveying technologies for

  3. Assessment of organic contaminants in emissions from refuse-derived fuel combustion

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Chrostowski, J.; Wait, D.; Kwong, E.

    1985-09-01

    Organic contaminants in emissions from refuse-derived fuel combustion were investigated in a 20-inch-diameter atmospheric fluidized-bed combustor. Combinations of coal/EcoFuel/MSW/toluene were burned inthe combustor with temperatures ranging from 1250 to 1550 degrees F. A Source Assessment Sampling System (SASS) was used to sample the stack gas; Level 1 methodology was used to analyze the organic-contaminant levels. Combustion efficiencies of 93 to 98 percent were achieved in the test burns. Combustion of the EcoFuel generated fewer organic emissions than combustion of coal at similar combustion temperatures. The fine particulate collected by the SASS train filter contained higher concentrations of extractable organics thanmore » the reactor fly ash and the SASS cyclone samples. Combustion of a toluene/EcoFuel mix generated a large number of benzene derivatives not seen in the combustion of pure EcoFuel. Polycyclic aromatic hydrocarbons were the dominant organic compounds contained in the XAD-2 resin extract from coal combustion. A number of different priority pollutants were identified in the samples collected.« less

  4. The RDF/SRF torrefaction: An effect of temperature on characterization of the product - Carbonized Refuse Derived Fuel.

    PubMed

    Białowiec, Andrzej; Pulka, Jakub; Stępień, Paweł; Manczarski, Piotr; Gołaszewski, Janusz

    2017-12-01

    The influence of Refuse Derived Fuel (RDF)/Solid Recovery Fuel (SRF) torrefaction temperature on product characteristic was investigated. RDF/SRF thermal treatment experiment was conducted with 1-h residence time, under given temperatures: 200, 220, 240, 260, 280 and 300°C. Sawdust was used as reference material. The following parameters of torrefaction char from sawdust and Carbonized Refuse Derived Fuel (CRDF) from RDF/SRF were measured: moisture, calorific value, ash content, volatile compounds and sulfur content. Sawdust biochar was confirmed as a good quality solid fuel, due to significant fuel property increase. The study also indicated that RDF torrefaction reduced moisture significantly from 22.9% to 1.4% and therefore increased lower heating value (LHV) from 19.6 to 25.3MJ/kg. Results suggest that RDF torrefaction may be a good method for increasing attractiveness of RDF as an energy source, and it could help unify RDF properties on the market. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Refuse derived fuel potential in DKI Jakarta

    NASA Astrophysics Data System (ADS)

    Widyatmoko, H.

    2018-01-01

    Combustible waste fractions of municipal solid waste (MSW) which can not be easily separated or sorted, reused or recycled, may have a high calorifiv value (CV) that can be used in a fuel for energy recovery. The objective of this study was to explore the Refuse Derived Fuel (RDF) potential of municipal solid waste from DKI Jakarta to produce electricity and to promote it to be socially and politically acceptable. For this purpose, 24 sampels of RDF were taken from Bantargebang, cabonized, molded and pressed to be briquette. All samples were analized for moisture, ash, and calorific value in the physical and chemistry Laboratory of ITB Bandung. The analysis of calorific value (CV) shows the CV difference of 1815.8 cal/g between the briquettes (8051.25 cal/g) and the RDF (9867.12 cal/g. The total waste DKI which can be used as briquettes 5253 ton / day or equivalent with 49154115 kWh / day. If the efficiency of electricity production from RDF was 25%, then Jakarta is able to generate electricity from RDF of 12288529 kWh / day or as much as energy needed by 573,480 middle-class households with energy needs of 642.84 kWh/month.

  6. Investigation of Engineering and Design Considerations in Selecting Conveyors for Densified Refuse-Derived Fuel (dRDF) and dRDF: Coal Mixtures.

    DTIC Science & Technology

    1981-08-01

    or discharge paths of material over the end pulley of a conveyor are important to the proper design and function of discharge chutes , wear plates or...8217 ’iESL-TR-81-58 INVESTIGATION OF ENGINEERING AND DESIGN CONSIDERATIONS IN SELECTING CONVEYORS FOR DENSIFIED REFUSE-DERIVED FUEL (dRDF) AND dRDF: COAL...Engineering and Design Final Report Considerations in Selecting Conveyors for JUN 1980 - SEP 1981 Densified Refuse-Derived Fuel (dRDF) and 6. PERFORMING ORG

  7. Comparison of coal/solid recovered fuel (SRF) with coal/refuse derived fuel (RDF) in a fluidised bed reactor

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Wagland, S.T.; Kilgallon, P.; Coveney, R.

    2011-06-15

    An experimental study was undertaken to compare the differences between municipal solid waste (MSW) derived solid recovered fuel (SRF) (complying with CEN standards) and refuse derived fuel (RDF). Both fuels were co-combusted with coal in a 50 kW fluidised bed combustor and the metal emissions were compared. Synthetic SRF was prepared in the laboratory by grinding major constituents of MSW such as paper, plastic, textile and wood. RDF was obtained from a local mechanical treatment plant. Heavy metal emissions in flue gas and ash samples from the (coal + 10% SRF) fuel mixture were found to be within the acceptablemore » range and were generally lower than that obtained for coal + 10% RDF fuel mixture. The relative distribution of heavy metals in ash components and the flue gas stream shows the presence of a large fraction (up to 98%) of most of the metals in the ash (except Hg and As). Thermo-gravimetric (TG) analysis of SRF constituents was performed to understand the behaviour of fuel mixtures in the absence and presence of air. The results obtained from the experimental study will enhance the confidence of fuel users towards using MSW-derived SRF as an alternative fuel.« less

  8. Jet flames of a refuse derived fuel

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Weber, Roman; Kupka, Tomasz; Zajac, Krzysztof

    This paper is concerned with combustion of a refuse derived fuel in a small-scale flame. The objective is to provide a direct comparison of the RDF flame properties with properties of pulverized coal flames fired under similar boundary conditions. Measurements of temperature, gas composition (O{sub 2}, CO{sub 2}, CO, NO) and burnout have demonstrated fundamental differences between the coal flames and the RDF flames. The pulverized coals ignite in the close vicinity of the burner and most of the combustion is completed within the first 300 ms. Despite the high volatile content of the RDF, its combustion extends far intomore » the furnace and after 1.8 s residence time only a 94% burnout has been achieved. This effect has been attributed not only to the larger particle size of fluffy RDF particles but also to differences in RDF volatiles if compared to coal volatiles. Substantial amounts of oily tars have been observed in the RDF flames even though the flame temperatures exceeded 1300 C. The presence of these tars has enhanced the slagging propensity of RDF flames and rapidly growing deposits of high carbon content have been observed. (author)« less

  9. Steam gasification of tyre waste, poplar, and refuse-derived fuel: a comparative analysis.

    PubMed

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

    2009-02-01

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

  10. Methodology for modeling the devolatilization of refuse-derived fuel from thermogravimetric analysis of municipal solid waste components

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Fritsky, K.J.; Miller, D.L.; Cernansky, N.P.

    1994-09-01

    A methodology was introduced for modeling the devolatilization characteristics of refuse-derived fuel (RFD) in terms of temperature-dependent weight loss. The basic premise of the methodology is that RDF is modeled as a combination of select municipal solid waste (MSW) components. Kinetic parameters are derived for each component from thermogravimetric analyzer (TGA) data measured at a specific set of conditions. These experimentally derived parameters, along with user-derived parameters, are inputted to model equations for the purpose of calculating thermograms for the components. The component thermograms are summed to create a composite thermogram that is an estimate of the devolatilization for themore » as-modeled RFD. The methodology has several attractive features as a thermal analysis tool for waste fuels. 7 refs., 10 figs., 3 tabs.« less

  11. Production, quality and quality assurance of Refuse Derived Fuels (RDFs).

    PubMed

    Sarc, R; Lorber, K E

    2013-09-01

    This contribution describes characterization, classification, production, application and quality assurance of Refuse Derived Fuels (RDFs) that are increasingly used in a wide range of co-incineration plants. It is shown in this paper, that the fuel-parameter, i.e. net calorific value [MJ/kg(OS)], particle size d(90) or d(95) [mm], impurities [w%], chlorine content [w%], sulfur content [w%], fluorine content [w%], ash content [w%], moisture [w%] and heavy metals content [mg/kg(DM)], can be preferentially used for the classification of different types of RDF applied for co-incineration and substitution of fossil-fuel in different industial sectors. Describing the external production of RDF by processing and confectioning of wastes as well as internal processing of waste at the incineration plant, a case study is reported on the application of RDF made out of different household waste fractions in a 120,000t/yr Waste to Energy (WtE) circulating fluidized bed (CFB) incinerator. For that purpose, delivered wastes, as well as incinerator feedstock material (i.e. after internal waste processing) are extensively investigated. Starting with elaboration of sampling plan in accordance with the relevant guidelines and standards, waste from different suppliers was sampled. Moreover, manual sorting analyses and chemical analyses were carried out. Finally, results of investigations are presented and discussed in the paper. Copyright © 2013 Elsevier Ltd. All rights reserved.

  12. Separation of harmful impurities from refuse derived fuels (RDF) by a fluidized bed.

    PubMed

    Krüger, B; Mrotzek, A; Wirtz, S

    2014-02-01

    In firing systems of cement production plants and coal-fired power plants, regular fossil fuels are increasingly substituted by alternative fuels. Rising energy prices and ambitious CO2-reduction goals promote the use of alternative fuels as a significant contribution to efficient energy recovery. One possibility to protect energy resources are refuse-derived fuels (RDF), which are produced during the treatment of municipal solid, commercial and industrial waste. The waste fractions suitable for RDF have a high calorific value and are often not suitable for material recycling. With current treatment processes, RDF still contains components which impede the utilization in firing systems or limit the degree of substitution. The content of these undesired components may amount to 4 wt%. These, in most cases incombustible particles which consist of mineral, ceramic and metallic materials can cause damages in the conveying systems (e. g. rotary feeder) or result in contaminations of the products (e. g. cement, chalk). Up-to-date separation processes (sieve machine, magnet separator or air classifier) have individual weaknesses that could hamper a secure separation of these particles. This article describes a new technology for the separation of impurities from refuse derived fuels based on a rotating fluidized bed. In this concept a rotating motion of the particle bed is obtained by the tangential injection of the fluidization gas in a static geometry. The RDF-particles experience a centrifugal force which fluidized the bed radially. The technical principle allows tearing up of particle clusters to single particles. Radially inwards the vertical velocity is much lower thus particles of every description can fall down there. For the subsequent separation of the particles by form and density an additionally cone shaped plate was installed in the centre. Impurities have a higher density and a compact form compared to combustible particles and can be separated with a high

  13. Sample preparation for thermo-gravimetric determination and thermo-gravimetric characterization of refuse derived fuel.

    PubMed

    Robinson, T; Bronson, B; Gogolek, P; Mehrani, P

    2016-02-01

    Thermo-gravimetric analysis (TGA) is a useful method for characterizing fuels. In the past it has been applied to the study of refuse derived fuel (RDF) and related materials. However, the heterogeneity of RDF makes the preparation of small representative samples very difficult and this difficulty has limited the effectiveness of TGA for characterization of RDF. A TGA method was applied to a variety of materials prepared from a commercially available RDF using a variety of procedures. Applicability of TGA method to the determination of the renewable content of RDF was considered. Cryogenic ball milling was found to be an effective means of preparing RDF samples for TGA. When combined with an effective sample preparation, TGA could be used as an alternative method for assessing the renewable content of RDF. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

  14. Two stages catalytic pyrolysis of refuse derived fuel: production of biofuel via syncrude.

    PubMed

    Miskolczi, N; Buyong, F; Angyal, A; Williams, P T; Bartha, L

    2010-11-01

    Thermo-catalytic pyrolysis of refuse derived fuels with different catalysts had been conducted in a two stages process due to its important potential value as fuel. The first stage was a pure thermal pyrolysis in a horizontal tubular reactor with feed rate of 0.5kg hourly. The second stage was a semi-batch process in the presence of catalysts. Results showed that the tested catalysts significantly have affected the quantity of products. E.g. gas yield could be increased with 350% related to the catalyst free case using ZSM-5, while that of pyrolytic oil was 115% over Y-zeolite. Gases consisted of mainly CO and CO(2) obtained from the tubular reactor, while dominantly hydrocarbons from the second stage. Ni-Mo-catalyst and Co-Mo-catalyst had shown activity in pyrolytic oil upgrading via in-situ hydrogenation-dehydrogenation reactions. Sulphur, nitrogen and chlorine level in pyrolytic oils could be significantly declined by using of catalysts.

  15. Process to convert biomass and refuse derived fuel to ethers and/or alcohols

    DOEpatents

    Diebold, James P.; Scahill, John W.; Chum, Helena L.; Evans, Robert J.; Rejai, Bahman; Bain, Richard L.; Overend, Ralph P.

    1996-01-01

    A process for conversion of a feedstock selected from the group consisting of biomass and refuse derived fuel (RDF) to provide reformulated gasoline components comprising a substantial amount of materials selected from the group consisting of ethers, alcohols, or mixtures thereof, comprising: drying said feedstock; subjecting said dried feedstock to fast pyrolysis using a vortex reactor or other means; catalytically cracking vapors resulting from said pyrolysis using a zeolite catalyst; condensing any aromatic byproduct fraction; catalytically alkylating any benzene present in said vapors after condensation; catalytically oligomerizing any remaining ethylene and propylene to higher olefins; isomerizing said olefins to reactive iso-olefins; and catalytically reacting said iso-olefins with an alcohol to form ethers or with water to form alcohols.

  16. Process to convert biomass and refuse derived fuel to ethers and/or alcohols

    DOEpatents

    Diebold, J.P.; Scahill, J.W.; Chum, H.L.; Evans, R.J.; Rejai, B.; Bain, R.L.; Overend, R.P.

    1996-04-02

    A process is described for conversion of a feedstock selected from the group consisting of biomass and refuse derived fuel (RDF) to provide reformulated gasoline components comprising a substantial amount of materials selected from the group consisting of ethers, alcohols, or mixtures thereof, comprising: drying said feedstock; subjecting said dried feedstock to fast pyrolysis using a vortex reactor or other means; catalytically cracking vapors resulting from said pyrolysis using a zeolite catalyst; condensing any aromatic byproduct fraction; catalytically alkylating any benzene present in said vapors after condensation; catalytically oligomerizing any remaining ethylene and propylene to higher olefins; isomerizing said olefins to reactive iso-olefins; and catalytically reacting said iso-olefins with an alcohol to form ethers or with water to form alcohols. 35 figs.

  17. Systematic Evaluation and Uncertainty Analysis of the Refuse-Derived Fuel Process in Taiwan.

    PubMed

    Chang, Ying-Hsi; Chang, Ni-Bin; Chen, W C

    1998-06-01

    In the last few years, Taiwan has set a bold agenda in solid waste recycling and incineration programs. Not only were the recycling activities and incineration projects promoted by government agencies, but the related laws and regulations were continuously promulgated by the Legislative Yen. The solid waste presorting process that is to be considered prior to the existing incineration facilities has received wide attention. This paper illustrates a thorough evaluation for the first refuse-derived fuel pilot process from both quantitative and qualitative aspects. The process is to be installed and integrated with a large-scale municipal incinerator. This pilot process, developed by an engineering firm in Tainan County, consists of standard unit operations of shredding, magnetic separation, trommel screening, and air classification. A series of sampling and analyses were initialized in order to characterize its potentials in the solid waste management system. The probabilistic modeling for various types o f waste pro perties derived in this analysis may provide a basic understanding of system reliability.

  18. MUNICIPAL WASTE COMBUSTION MULTIPOLLUTANT STUDY EMISSION TEST REPORT, MAINE ENERGY RECOVERY COMPANY, REFUSE DERIVED FUEL FACILITY, BIDDEFORD, MAINE - VOLUME III: APPENDICES G-N

    EPA Science Inventory

    The report gives results of an emission test of a new municipal solid waste combustor, in Biddeford, ME, that burns refuse-derived fuel and is equipped with a lime spray dryer fabric filter (SD/FF) emission control system. Control efficiency of the SD/FF emission control system ...

  19. MUNICIPAL WASTE COMBUSTION MULTIPOLLUTANT STUDY EMISSION TEST REPORT, MAINE ENERGY RECOVERY COMPANY, REFUSE DERIVED FUEL FACILITY, BIDDEFORD, MAINE - VOLUME II: APPENDICES A-F

    EPA Science Inventory

    The report gives results of an emission test of a new municipal solid waste combustor, in Biddeford, ME, that burns refuse-derived fuel and is equipped with a lime spray dryer fabric filter (SD/FF) emission control system. Control efficiency of the SD/FF emission control system ...

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

    Science.gov Websites

    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. Refuse derived fuel (RDF) plasma torch gasification as a feasible route to produce low environmental impact syngas for the cement industry.

    PubMed

    López-Sabirón, Ana M; Fleiger, Kristina; Schäfer, Stefan; Antoñanzas, Javier; Irazustabarrena, Ane; Aranda-Usón, Alfonso; Ferreira, Germán A

    2015-08-01

    Plasma torch gasification (PTG) is currently researched as a technology for solid waste recovery. However, scientific studies based on evaluating its environmental implications considering the life cycle assessment (LCA) methodology are lacking. Therefore, this work is focused on comparing the environmental effect of the emissions of syngas combustion produced by refuse derived fuel (RDF) and PTG as alternative fuels, with that related to fossil fuel combustion in the cement industry. To obtain real data, a semi-industrial scale pilot plant was used to perform experimental trials on RDF-PTG.The results highlight that PTG for waste to energy recovery in the cement industry is environmentally feasible considering its current state of development. A reduction in every impact category was found when a total or partial substitution of alternative fuel for conventional fuel in the calciner firing (60 % of total thermal energy input) was performed. Furthermore, the results revealed that electrical energy consumption in PTG is also an important parameter from the LCA approach. © The Author(s) 2015.

  2. Recovery of plastic wastes from dumpsite as refuse-derived fuel and its utilization in small gasification system.

    PubMed

    Chiemchaisri, Chart; Charnnok, Boonya; Visvanathan, Chettiyappan

    2010-03-01

    An effort to utilize solid wastes at dumpsite as refuse-derived fuel (RDF) was carried out. The produced RDF briquette was then utilized in the gasification system. These wastes were initially examined for their physical composition and chemical characteristics. The wastes contained high plastic content of 24.6-44.8%, majority in polyethylene plastic bag form. The plastic wastes were purified by separating them from other components through manual separation and trommel screen after which their content increased to 82.9-89.7%. Subsequently, they were mixed with binding agent (cassava root) and transformed into RDF briquette. Maximum plastic content in RDF briquette was limit to 55% to maintain physical strength and maximum chlorine content. The RDF briquette was tested in a down-draft gasifier. The produced gas contained average energy content of 1.76 MJ/m(3), yielding cold gas efficiency of 66%. The energy production cost from this RDF process was estimated as USD0.05 perkWh. 2009 Elsevier Ltd. All rights reserved.

  3. Effects of low-temperature pretreatment on enhancing properties of refuse-derived fuel via microwave irradiation.

    PubMed

    Liu, Zhen; Wang, Han-Qing; Zhou, Yue-Yun; Zhang, Xiao-Dong; Liu, Jian-Wen

    2017-07-01

    The present study focuses on pretreatment of enhancing the properties of refuse-derived fuel (RDF) via low-temperature microwave irradiation. These improved properties include lower chlorine content, a more porous surface structure and better combustion characteristics. In this study, low-temperature microwave irradiation was carried out in a modified microwave apparatus and the range of temperature was set to be 220-300℃. We found that the microwave absorbability of RDF was enhanced after being partly carbonized. Moreover, with the increasing of the final temperature, the organochlorine removal ratio was greatly increased to 80% and the content of chlorine was dramatically decreased to an extremely low level. It was also interesting to find that the chlorine of RDF was mainly released as HCl rather than organic chloride volatiles. The finding is just the same as the polyvinyl chloride pyrolysis process. In addition, pores and channels emerged during the modifying operation and the modified RDF has better combustibility and combustion stability than traditional RDF. This work revealed that low-temperature modification of RDF via microwave irradiation is significant for enhancing the quality of RDF and avoiding HCl erosion of equipment substantially.

  4. Production and characterization refuse derived fuel (RDF) from high organic and moisture contents of municipal solid waste (MSW)

    NASA Astrophysics Data System (ADS)

    Dianda, P.; Mahidin; Munawar, E.

    2018-03-01

    Many cities in developing countries is facing a serious problems to dealing with huge municipal solid waste (MSW) generated. The main approach to manage MSW is causes environmental impact associated with the leachate and landfill gas emissions. On the other hand, the energy available also limited by rapid growth of population and economic development due to shortage of the natural resource. In this study, the potential utilized of MSW to produce refuse derived fuel (RDF) was investigate. The RDF was produced with various organic waste content. Then, the RDF was subjected to laboratory analysis to determine its characteristic including the calorific value. The results shows the moisture content was increased by increasing organic waste content, while the calorific value was found 17-36 MJ/kg. The highest calorific value was about 36 MJ/kg obtained at RDF with 40% organic waste content. This results indicated that the RDF can be use to substitute coal in main burning process and calcinations of cement industry.

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

    PubMed

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

    2014-09-01

    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. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. NATIONAL INCINERATOR TESTING AND EVALUATION PROGRAM: THE ENVIRONMENTAL CHARACTERIZATION OF REFUSE-DERIVED FUEL (RDF) COMBUSTION TECHNOLOGY - MID-CONNECTICUT FACILITY,

    EPA Science Inventory

    The report gives results of an environmental characterization of refuse-derived, semi-suspension burning technology at a facility in Hartford, CT, that represents state-of-the-art technology, including a spray dryer/fabric filter flue gas cleaning (FGC) system for each unit. The ...

  7. Alternative Fuels Data Center: CNG Refuse Haulers Do Heavy Lifting in New

    Science.gov Websites

    YorkA> CNG Refuse Haulers Do Heavy Lifting in New York to someone by E-mail Share Alternative combat the rising cost of fuel. For information about this project, contact Greater Long Island Clean Maryland Public Television Related Videos Photo of a car Hydrogen Powers Fuel Cell Vehicles in California

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

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Sortino, Orazio; Dipasquale, Mauro; Montoneri, Enzo, E-mail: enzo.montoneri@unito.it

    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 tomore » 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.« less

  9. Resource recovery of organic sludge as refuse derived fuel by fry-drying process.

    PubMed

    Chang, Fang-Chih; Ko, Chun-Han; Wu, Jun-Yi; Wang, H Paul; Chen, Wei-Sheng

    2013-08-01

    The organic sludge and waste oil were collected from the industries of thin film transistor liquid crystal display and the recycled cooking oil. The mixing ratio of waste cooking oil and organic sludge, fry-drying temperatures, fry-drying time, and the characteristics of the organic sludge pellet grain were investigated. After the fry-drying process, the moisture content of the organic sludge pellet grain was lower than 5% within 25 min and waste cooking oil was absorbed on the dry solid. The fry-drying organic sludge pellet grain was easy to handle and odor free. Additionally, it had a higher calorific value than the derived fuel standards and could be processed into organic sludge derived fuels. Thus, the granulation and fry-drying processes of organic sludge with waste cooking oil not only improves the calorific value of organic sludge and becomes more valuable for energy recovery, but also achieves waste material disposal and cost reduction. Copyright © 2013 Elsevier Ltd. All rights reserved.

  10. Designing the microturbine engine for waste-derived fuels.

    PubMed

    Seljak, Tine; Katrašnik, Tomaž

    2016-01-01

    Presented paper deals with adaptation procedure of a microturbine (MGT) for exploitation of refuse derived fuels (RDF). RDF often possess significantly different properties than conventional fuels and usually require at least some adaptations of internal combustion systems to obtain full functionality. With the methodology, developed in the paper it is possible to evaluate the extent of required adaptations by performing a thorough analysis of fuel combustion properties in a dedicated experimental rig suitable for testing of wide-variety of waste and biomass derived fuels. In the first part key turbine components are analyzed followed by cause and effect analysis of interaction between different fuel properties and design parameters of the components. The data are then used to build a dedicated test system where two fuels with diametric physical and chemical properties are tested - liquefied biomass waste (LW) and waste tire pyrolysis oil (TPO). The analysis suggests that exploitation of LW requires higher complexity of target MGT system as stable combustion can be achieved only with regenerative thermodynamic cycle, high fuel preheat temperatures and optimized fuel injection nozzle. Contrary, TPO requires less complex MGT design and sufficient operational stability is achieved already with simple cycle MGT and conventional fuel system. The presented approach of testing can significantly reduce the extent and cost of required adaptations of commercial system as pre-selection procedure of suitable MGT is done in developed test system. The obtained data can at the same time serve as an input for fine-tuning the processes for RDF production. Copyright © 2015. Published by Elsevier Ltd.

  11. Plasma gasification of refuse derived fuel in a single-stage system using different gasifying agents.

    PubMed

    Agon, N; Hrabovský, M; Chumak, O; Hlína, M; Kopecký, V; Masláni, A; Bosmans, A; Helsen, L; Skoblja, S; Van Oost, G; Vierendeels, J

    2016-01-01

    The renewable evolution in the energy industry and the depletion of natural resources are putting pressure on the waste industry to shift towards flexible treatment technologies with efficient materials and/or energy recovery. In this context, a thermochemical conversion method of recent interest is plasma gasification, which is capable of producing syngas from a wide variety of waste streams. The produced syngas can be valorized for both energetic (heat and/or electricity) and chemical (ammonia, hydrogen or liquid hydrocarbons) end-purposes. This paper evaluates the performance of experiments on a single-stage plasma gasification system for the treatment of refuse-derived fuel (RDF) from excavated waste. A comparative analysis of the syngas characteristics and process yields was done for seven cases with different types of gasifying agents (CO2+O2, H2O, CO2+H2O and O2+H2O). The syngas compositions were compared to the thermodynamic equilibrium compositions and the performance of the single-stage plasma gasification of RDF was compared to that of similar experiments with biomass and to the performance of a two-stage plasma gasification process with RDF. The temperature range of the experiment was from 1400 to 1600 K and for all cases, a medium calorific value syngas was produced with lower heating values up to 10.9 MJ/Nm(3), low levels of tar, high levels of CO and H2 and which composition was in good agreement to the equilibrium composition. The carbon conversion efficiency ranged from 80% to 100% and maximum cold gas efficiency and mechanical gasification efficiency of respectively 56% and 95%, were registered. Overall, the treatment of RDF proved to be less performant than that of biomass in the same system. Compared to a two-stage plasma gasification system, the produced syngas from the single-stage reactor showed more favourable characteristics, while the recovery of the solid residue as a vitrified slag is an advantage of the two-stage set-up. Copyright

  12. Analysis of total copper, cadmium and lead in refuse-derived fuels (RDF): study on analytical errors using synthetic samples.

    PubMed

    Skutan, Stefan; Aschenbrenner, Philipp

    2012-12-01

    Components with extraordinarily high analyte contents, for example copper metal from wires or plastics stabilized with heavy metal compounds, are presumed to be a crucial source of errors in refuse-derived fuel (RDF) analysis. In order to study the error generation of those 'analyte carrier components', synthetic samples spiked with defined amounts of carrier materials were mixed, milled in a high speed rotor mill to particle sizes <1 mm, <0.5 mm and <0.2 mm, respectively, and analyzed repeatedly. Copper (Cu) metal and brass were used as Cu carriers, three kinds of polyvinylchloride (PVC) materials as lead (Pb) and cadmium (Cd) carriers, and paper and polyethylene as bulk components. In most cases, samples <0.2 mm delivered good recovery rates (rec), and low or moderate relative standard deviations (rsd), i.e. metallic Cu 87-91% rec, 14-35% rsd, Cd from flexible PVC yellow 90-92% rec, 8-10% rsd and Pb from rigid PVC 92-96% rec, 3-4% rsd. Cu from brass was overestimated (138-150% rec, 13-42% rsd), Cd from flexible PVC grey underestimated (72-75% rec, 4-7% rsd) in <0.2 mm samples. Samples <0.5 mm and <1 mm spiked with Cu or brass produced errors of up to 220% rsd (<0.5 mm) and 370% rsd (<1 mm). In the case of Pb from rigid PVC, poor recoveries (54-75%) were observed in spite of moderate variations (rsd 11-29%). In conclusion, time-consuming milling to <0.2 mm can reduce variation to acceptable levels, even given the presence of analyte carrier materials. Yet, the sources of systematic errors observed (likely segregation effects) remain uncertain.

  13. Refuse-Derived Fuels in U.S. Air Force Heating and Power Systems.

    DTIC Science & Technology

    1986-01-01

    pellet degradation . Postpellet - cooling may not prevent disintegration into more fines. The Argonne W National Laboratory is sponsoring a research...of fuel,% by using the fuel Orsat (volumetric) analysis and both the carbon and sulfur in the fuel. This is known as a carbon balance. 00 The test... sulfur in the fuel per pound of fuel C ’ = average specific heat of the dry flue gas PG T = flue gas temperature leaving the economizer (or leaving

  14. MUNICIPAL WASTE COMBUSTION MULTIPOLLUTANT STUDY EMISSION TEST REPORT, MAINE ENERGY RECOVERY COMPANY, RE- FUSE DERIVED FUEL FACILITY, BIDDEFORD, MAINE - VOLUME I: SUMMARY OF RESULTS

    EPA Science Inventory

    The report gives results of an emission test of a new municipal solid waste combustor, in Biddeford, ME, that burns refuse-derived fuel and is equipped with a lime spray dryer fabric filter (SD/FF) emission control system. ontrol efficiency of the SD/FF emission control system wa...

  15. MUNICIPAL WASTE COMBUSTION ASSESSMENT: FOSSIL FUEL CO-FIRING

    EPA Science Inventory

    The report identifies refuse derived fuel (RDF) processing operations and various RDF types; describes such fossil fuel co-firing techniques as coal fired spreader stokers, pulverized coal wall fired boilers, pulverized coal tangentially fired boilers, and cyclone fired boilers; ...

  16. Alternative Fuels Data Center: Fleet Application for Refuse Collection

    Science.gov Websites

    CNG - Compressed Natural Gas 1 Electric 1 Hybrid - CNG 1 Hybrid - LNG 1 Hydraulic hybrid 9 LNG - Liquified Natural Gas icon for refuse collection vehicle application Autocar ACMD-Xpert Hybrid - CNG Hybrid - Compressed Natural Gas LNG - Liquified Natural Gas icon for refuse collection vehicle application BYD All

  17. Inhalation health effects of fine particles from the co-combustion of coal and refuse derived fuel.

    PubMed

    Fernandez, Art; Wendt, Jost O L; Wolski, Natacha; Hein, Klaus R G; Wang, Shengjun; Witten, Mark L

    2003-06-01

    This paper is concerned with health effects from the inhalation of particulate matter (PM) emitted from the combustion of coal, and from the co-combustion of refuse derived fuel (RDF) and pulverized coal mixtures, under both normal and low NO(x) conditions. Specific issues focus on whether the addition of RDF to coal has an effect on PM toxicity, and whether the application of staged combustion (for low NO(x)) may also be a factor in this regard. Ash particles were sampled and collected from a pilot scale combustion unit and then re-suspended and diluted to concentrations of approximately 1000 microg/m(3). These particles were inhaled by mice, which were held in a nose-only exposure configuration. Exposure tests were for 1 h per day, and involved three sets (eight mice per set) of mice. These three sets were exposed over 8, 16, and 24 consecutive days, respectively. Pathological lung damage was measured in terms of increases in lung permeability. Results show that the re-suspended coal/RDF ash appeared to cause very different effects on lung permeability than did coal ash alone. In addition, it was also shown that a "snapshot" of lung properties after a fixed number of daily 1-h exposures, can be misleading, since apparent repair mechanisms cause lung properties to change over a period of time. For the coal/RDF, the greatest lung damage (in terms of lung permeability increase) occurred at the short exposure period of 8 days, and thereafter appeared to be gradually repaired. Ash from staged (low NO(x)) combustion of coal/RDF appeared to cause greater lung injury than that from unstaged (high NO(x)) coal/RDF combustion, although the temporal behavior and (apparent) repair processes in each case were similar. In contrast to this, coal ash alone showed a slight decrease of lung permeability after 1 and 3 days, and this disappeared after 12 days. These observations are interpreted in the light of mechanisms proposed in the literature. The results all suggest that the

  18. Method of extracting coal from a coal refuse pile

    DOEpatents

    Yavorsky, Paul M.

    1991-01-01

    A method of extracting coal from a coal refuse pile comprises soaking the coal refuse pile with an aqueous alkali solution and distributing an oxygen-containing gas throughout the coal refuse pile for a time period sufficient to effect oxidation of coal contained in the coal refuse pile. The method further comprises leaching the coal refuse pile with an aqueous alkali solution to solubilize and extract the oxidized coal as alkali salts of humic acids and collecting the resulting solution containing the alkali salts of humic acids. Calcium hydroxide may be added to the solution of alkali salts of humic acid to form precipitated humates useable as a low-ash, low-sulfur solid fuel.

  19. In-use activity, fuel use, and emissions of heavy-duty diesel roll-off refuse trucks.

    PubMed

    Sandhu, Gurdas S; Frey, H Christopher; Bartelt-Hunt, Shannon; Jones, Elizabeth

    2015-03-01

    The objectives of this study were to quantify real-world activity, fuel use, and emissions for heavy duty diesel roll-off refuse trucks; evaluate the contribution of duty cycles and emissions controls to variability in cycle average fuel use and emission rates; quantify the effect of vehicle weight on fuel use and emission rates; and compare empirical cycle average emission rates with the U.S. Environmental Protection Agency's MOVES emission factor model predictions. Measurements were made at 1 Hz on six trucks of model years 2005 to 2012, using onboard systems. The trucks traveled 870 miles, had an average speed of 16 mph, and collected 165 tons of trash. The average fuel economy was 4.4 mpg, which is approximately twice previously reported values for residential trash collection trucks. On average, 50% of time is spent idling and about 58% of emissions occur in urban areas. Newer trucks with selective catalytic reduction and diesel particulate filter had NOx and PM cycle average emission rates that were 80% lower and 95% lower, respectively, compared to older trucks without. On average, the combined can and trash weight was about 55% of chassis weight. The marginal effect of vehicle weight on fuel use and emissions is highest at low loads and decreases as load increases. Among 36 cycle average rates (6 trucks×6 cycles), MOVES-predicted values and estimates based on real-world data have similar relative trends. MOVES-predicted CO2 emissions are similar to those of the real world, while NOx and PM emissions are, on average, 43% lower and 300% higher, respectively. The real-world data presented here can be used to estimate benefits of replacing old trucks with new trucks. Further, the data can be used to improve emission inventories and model predictions. In-use measurements of the real-world activity, fuel use, and emissions of heavy-duty diesel roll-off refuse trucks can be used to improve the accuracy of predictive models, such as MOVES, and emissions

  20. Refuse Derived Fuel (RDF) production and gasification in a pilot plant integrated with an Otto cycle ICE through Aspen plus™ modelling: Thermodynamic and economic viability.

    PubMed

    Násner, Albany Milena Lozano; Lora, Electo Eduardo Silva; Palacio, José Carlos Escobar; Rocha, Mateus Henrique; Restrepo, Julian Camilo; Venturini, Osvaldo José; Ratner, Albert

    2017-11-01

    This work deals with the development of a Refuse Derived Fuel (RDF) gasification pilot plant using air as a gasification agent. A downdraft fixed bed reactor is integrated with an Otto cycle Internal Combustion Engine (ICE). Modelling was carried out using the Aspen Plus™ software to predict the ideal operational conditions for maximum efficiency. Thermodynamics package used in the simulation comprised the Non-Random Two-Liquid (NRTL) model and the Hayden-O'Connell (HOC) equation of state. As expected, the results indicated that the Equivalence Ratio (ER) has a direct influence over the gasification temperature and the composition of the Raw Produced Gas (RPG), and effects of ER over the Lower Heating Value (LHV) and Cold Gasification Efficiency (CGE) of the RPG are also discussed. A maximum CGE efficiency of 57-60% was reached for ER values between 0.25 and 0.3, also an average reactor temperature values in the range of 680-700°C, with a peak LHV of 5.8MJ/Nm 3 . RPG was burned in an ICE, reaching an electrical power of 50kW el . The economic assessment of the pilot plant implementation was also performed, showing the project is feasible, with power above 120kW el with an initial investment of approximately US$ 300,000. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Fiscus, D.E.; Gorman, P.G.; Schrag, M.P.

    1977-09-01

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

  2. RDF (Refuse Derived Fuel) Utilization in a Navy Stoker Coal-Fired Boiler.

    DTIC Science & Technology

    1984-10-01

    the energy production in any coal-fired boiler conversion consideration. The selection of the actual RDF to be used in a converted boiler should be... industrial boilers by gathering information from the Navy Energy and Environmental Support Activity, engineering field divi- sions, and field...activities. Currently the Navy has 27 industrial size boilers firing coal as a primary fuel and 10 firing coal as a secondary fuel. The four principal factors

  3. Waste-to-Fuel: A Case Study of Converting Food Waste to Renewable Natural Gas as a Transportation Fuel

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Mintz, Marianne; Tomich, Matthew

    This case study explores the production and use of renewable compressed natural gas (R-CNG)—derived from the anaerobic digestion (AD) of organic waste—to fuel heavy-duty refuse trucks and other natural gas vehicles in Sacramento, California.

  4. Production and Use of Densified Refuse-Derived Fuel (DRDF) in Military Central Heating and Power Plants.

    DTIC Science & Technology

    1980-03-01

    Table 5 shows the shift in relative position rock. dust , etc.) 20 23 between cardboard and paper as there is process move- ment from raw refuse to RDF...point of the conveyors, including spillage of material .4 As indicated in the process flow diagram in Figure and emission of high volumes of dust . The... process , which is believed to designed to receive up to 500 tons per day of solid reduce the possibility of explosion from dust , which is waste

  5. Characterization of Korean solid recovered fuels (SRFs): an analysis and comparison of SRFs.

    PubMed

    Choi, Yeon-Seok; Han, Soyoung; Choi, Hang-Seok; Kim, Seock-Joon

    2012-04-01

    To date, Korea has used four species of solid recovered fuels (SRFs) which have been certified by the Environmental Ministry of Korea: refuse-derived fuel (RDF), refused plastic fuel (RPF), tyre-derived fuel (TDF), and wood chip fuel (WCF). These fuels have been used in many industrial boilers. In this study, seven regulatory properties associated with each of the four species: particle size, moisture and ash content, lower heating value (LHV), total chlorine, sulfur, and heavy metals content (Pb, As, Cd, Hg, Cr) were analysed. These properties are the main regulation criteria for the usage and transfer of SRFs in Korea. Different properties of each SRF were identified on the basis of data collected over the last 3 years in Korea, and the manufacturing process problem associated with the production of SRFs were considered. It was found that the high moisture content of SRFs (especially WCF) could directly lead to the low LHV of SRFs and that the poor screening and sorting of raw materials could cause defective SRF products with high ash or chlorine contents. The information obtained from this study could contribute to the manufacturing of SRF with good quality.

  6. Progress on coal-derived fuels for aviation systems

    NASA Technical Reports Server (NTRS)

    Witcofski, R. D.

    1978-01-01

    Synthetic aviation kerosene (Syn. Jet-A), liquid methane (LCH4), and liquid hydrogen (LH2) appear to be the most promising coal-derived fuels. Liquid hydrogen aircraft configurations, their fuel systems, and their ground requirements at the airport are identified. These aircraft appear viable, particularly for long haul use, where aircraft fueled with coal derived LH2 would consume 9 percent less coal resources than would aircraft fueled with coal derived Syn. Jet-A. Distribution of hydrogen from the point of manufacture to airports may pose problems. Synthetic JET-A would appear to cause fewer concerns to the air transportation industry. Of the three candidate fuels, LCH4 is the most energy efficient to produce, and an aircraft fueled with coal derived LCH4 may provide both the most efficient utilization of coal resources and the least expensive ticket as well.

  7. Fuel and fuel blending components from biomass derived pyrolysis oil

    DOEpatents

    McCall, Michael J.; Brandvold, Timothy A.; Elliott, Douglas C.

    2012-12-11

    A process for the conversion of biomass derived pyrolysis oil to liquid fuel components is presented. The process includes the production of diesel, aviation, and naphtha boiling point range fuels or fuel blending components by two-stage deoxygenation of the pyrolysis oil and separation of the products.

  8. Alternative Fuels Data Center: Renewable Natural Gas From Landfill Powers

    Science.gov Websites

    Refuse Vehicles Renewable Natural Gas From Landfill Powers Refuse Vehicles to someone by E-mail Share Alternative Fuels Data Center: Renewable Natural Gas From Landfill Powers Refuse Vehicles on Facebook Tweet about Alternative Fuels Data Center: Renewable Natural Gas From Landfill Powers Refuse

  9. Alternative Fuels Data Center: Hydraulic Hybrid Pressed into Service in

    Science.gov Websites

    Refuse Collection Hydraulic Hybrid Pressed into Service in Refuse Collection to someone by E -mail Share Alternative Fuels Data Center: Hydraulic Hybrid Pressed into Service in Refuse Collection on Facebook Tweet about Alternative Fuels Data Center: Hydraulic Hybrid Pressed into Service in Refuse

  10. Soybean-derived biofuels and home heating fuels.

    PubMed

    Mushrush, George W; Wynne, James H; Willauer, Heather D; Lloyd, Christopher L

    2006-01-01

    It is environmentally enticing to consider replacing or blending petroleum derived heating fuels with biofuels for many reasons. Major considerations include the soaring worldwide price of petroleum products, especially home heating oil, the toxicity of the petroleum-derived fuels and the environmental damage that leaking petroleum tanks afford. For these reasons, it has been suggested that domestic renewable energy sources be considered as replacements, or at the least, as blending stocks for home heating fuels. If recycled soy restaurant cooking oils could be employed for this purpose, this would represent an environmental advantage. Renewable plant sources of energy tend to be less toxic than their petroleum counterparts. This is an important consideration when tank leakage occurs. Home fuel oil storage tanks practically always contain some bottom water. This water environment has a pH value that factors into heating fuel stability. Therefore, the question is: would the biofuel help or exacerbate fuel stability and furnace maintenance issues?

  11. Progress on coal-derived fuels for aviation systems

    NASA Technical Reports Server (NTRS)

    Witcofski, R. D.

    1978-01-01

    The results of engineering studies of coal-derived aviation fuels and their potential application to the air transportation system are presented. Synthetic aviation kerosene (SYN. JET-A), liquid methane (LCH4) and liquid hydrogen (LH2) appear to be the most promising coal-derived fuels. Aircraft configurations fueled with LH2, their fuel systems, and their ground requirements at the airport are identified. Energy efficiency, transportation hazards, and costs are among the factors considered. It is indicated that LCH4 is the most energy efficient to produce, and provides the most efficient utilization of coal resources and the least expensive ticket as well.

  12. Alternative fuels for multiple-hearth furnaces

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Bracken, B.D.; Lawson, T.U.

    1980-04-01

    A study of alternative procedures for reducing the consumption of No. 2 fuel oil at the Lower Molonglo Water Quality Control Centre near Canberra, Aust., indicated that in comparison with the present system of incineration with heat supplied by burning fuel oil, the installation of a sludge drying operation, consisting of a rotary dryer heated by furnace exhaust gases with the dried sludge used to fuel the furnace, would become economically desirable by 1985 if afterburning is not required, and would be justified immediately if afterburning is required to meet air pollution control regulations. The substitution of any of fourmore » waste fuels (refuse-derived fuel, waste paper, wood waste, or waste oil) or of coal for the No. 2 fuel oil would not be cost-effective through 1989. The furnace system, including afterburning and fuel oil requirements, the envisioned alternative fuel use systems, sludge processing alternatives, heat balance results, and economics are discussed.« less

  13. 40 CFR 60.53b - Standards for municipal waste combustor operating practices.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Circulating fluidized bed combustor 100 4 Pulverized coal/refuse-derived fuel mixed fuel-fired combustor 150 4 Spreader stoker coal/refuse-derived fuel mixed fuel-fired combustor 150 24 a Measured at the combustor... activated carbon injection rate during dioxin/furan or mercury testing. [60 FR 65419, Dec. 19, 1995, as...

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

    PubMed

    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 < .001; caregiver self-report PRR = 6.20; 95% CI = 3.21, 11.98; P < .001). Caregivers younger than 35 years were significantly more likely than older caregivers to refuse both immunizations and topical fluoride (P < .05). Caregiver 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.

  15. Production of distillate fuels from biomass-derived polyoxygenates

    DOEpatents

    Kania, John; Blommel, Paul; Woods, Elizabeth; Dally, Brice; Lyman, Warren; Cortright, Randy

    2017-03-14

    The present invention provides methods, reactor systems and catalysts for converting biomass and biomass-derived feedstocks to C.sub.8+ hydrocarbons using heterogenous catalysts. The product stream may be separated and further processed for use in chemical applications, or as a neat fuel or a blending component in jet fuel and diesel fuel, or as heavy oils for lubricant and/or fuel oil applications.

  16. Caregivers Who Refuse Preventive Care for Their Children: The Relationship Between Immunization and Topical Fluoride Refusal

    PubMed Central

    2014-01-01

    Objectives. The aim of this study was to examine caregivers’ refusal of preventive medical and dental care for children. Methods. 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). Results. 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 < .001; caregiver self-report PRR = 6.20; 95% CI = 3.21, 11.98; P < .001). Caregivers younger than 35 years were significantly more likely than older caregivers to refuse both immunizations and topical fluoride (P < .05). Conclusions. Caregiver 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. PMID:24832428

  17. Management Impact Assessment of Refuse-Derived Fuel Implementation at Wright-Patterson Air Force Base.

    DTIC Science & Technology

    1982-03-19

    high first and annually recurring costs of flue gas desulfurization . If our future coal systems have the technical flexibility to use these fuels...Democracy Lane Program Element: 64708F Fairfax, Virginia 22030 JON: 20545017 I. CONTROLLING OFFICE NAME AND ADDRESS 12. REPORT DATE Air Force Engineering...plants that supply both heating and process energy to large military installations, the majority of which are natural gas - and/or oil-fired. The goal is

  18. Removal potential of toxic 2378-substituted PCDD/F from incinerator flue gases by waste-derived activated carbons.

    PubMed

    Hajizadeh, Yaghoub; Onwudili, Jude A; Williams, Paul T

    2011-06-01

    The application of activated carbons has become a commonly used emission control protocol for the removal or adsorption of persistent organic pollutants from the flue gas streams of waste incinerators. In this study, the 2378-substituted PCDD/F removal efficiency of three types of activated carbons derived from the pyrolysis of refuse derived fuel, textile waste and scrap tyre was investigated and compared with that of a commercial carbon. Experiments were carried out in a laboratory scale fixed-bed reactor under a simulated flue gas at 275°C with a reaction period of four days. The PCDD/F in the solid matrices and exhaust gas, were analyzed using gas chromatography coupled with a triple quadrupole mass spectrometer. In the absence of activated carbon adsorbent, there was a significant increase in the concentration of toxic PCDD/F produced in the reacted flyash, reaching up to 6.6 times higher than in the raw flyash. In addition, there was a substantial release of PCDD/F into the gas phase, which was found in the flue gas trapping system. By application of the different commercial, refuse derived fuel, textile and tyre activated carbons the total PCDD/F toxic equivalent removal efficiencies in the exhaust gas stream were 58%, 57%, 64% and 52%, respectively. In general, the removal of the PCDDs was much higher with an average of 85% compared to PCDFs at 41%. Analysis of the reacted activated carbons showed that there was some formation of PCDD/F, for instance, a total of 60.6 μg I-TEQ kg(-1) toxic PCDD/F was formed in the refuse derived fuel activated carbon compared to 34 μg I-TEQ kg(-1) in the commercial activated carbon. The activated carbons derived from the pyrolysis of waste, therefore, showed good potential as a control material for PCDD/F emissions in waste incinerator flue gases. Copyright © 2011 Elsevier Ltd. All rights reserved.

  19. Diesel engine performance and emissions with fuels derived from waste tyres.

    PubMed

    Verma, Puneet; Zare, Ali; Jafari, Mohammad; Bodisco, Timothy A; Rainey, Thomas; Ristovski, Zoran D; Brown, Richard J

    2018-02-06

    The disposal of waste rubber and scrap tyres is a significant issue globally; disposal into stockpiles and landfill poses a serious threat to the environment, in addition to creating ecological problems. Fuel production from tyre waste could form part of the solution to this global issue. Therefore, this paper studies the potential of fuels derived from waste tyres as alternatives to diesel. Production methods and the influence of reactor operating parameters (such as reactor temperature and catalyst type) on oil yield are outlined. These have a major effect on the performance and emission characteristics of diesel engines when using tyre derived fuels. In general, tyre derived fuels increase the brake specific fuel consumption and decrease the brake thermal efficiency. The majority of studies indicate that NOx emissions increase with waste tyre derived fuels; however, a few studies have reported the opposite trend. A similar increasing trend has been observed for CO and CO 2 emissions. Although most studies reported an increase in HC emission owing to lower cetane number and higher density, some studies have reported reduced HC emissions. It has been found that the higher aromatic content in such fuels can lead to increased particulate matter emissions.

  20. A novel aerobic sulfate reduction process in landfill mineralized refuse.

    PubMed

    Liu, Weijia; Long, Yuyang; Fang, Yuan; Ying, Luyao; Shen, Dongsheng

    2018-05-08

    It is thought that mineralized refuse could be excavated from almost-full landfill sites to provide space for the increasing burden of municipal solid waste. When excavating, however, the H 2 S emissions from the mineralized waste need to be considered carefully. In an attempt to understand how H 2 S emissions might change during this excavation process, we carried out a series of tests, including exposing anaerobic mineralized refuse to oxygen, isolating and determining possible functional bacteria, and characterizing the electron donors and/or acceptors. The results showed that H 2 S would be released when landfill mineralized refuse was exposed to oxygen (O 2 ), and could reach concentrations of 6 mg m -3 , which was 3 times the concentrations of H 2 S released from anaerobic mineralized refuse. Sulfur-metabolized microorganisms accounted for only 0.5% of the microbial functional bacteria (MFB) derived from the mineralized refuse when exposed to O 2 for 60 days, and SRB were not present. The MFB maintained H 2 S production by aerobic sulfate reduction using SO 4 2- and S 2 O 3 2- as electron acceptors, and sulfate-reducing rates of 16% and 55%, respectively, were achieved. Lactate and S 2 O 3 2- were the preferred electron donor and acceptor, respectively. By enhancing the carbon source and electron transfer, MFB may undergo strong aerobic sulfate reduction even at low abundances of sulfur-metabolized microorganisms. Copyright © 2018 Elsevier B.V. All rights reserved.

  1. Implied consent refusal impact

    DOT National Transportation Integrated Search

    1991-09-01

    This report examines the extent to which persons suspected of DWI refuse to take a chemical test as required by law, describes implied consent laws in 50 States, analyzes the relation of law features to refusal rate, and analyzes the characteristics ...

  2. Comprehensive two-dimensional gas chromatography for the analysis of synthetic and crude-derived jet fuels.

    PubMed

    van der Westhuizen, Rina; Ajam, Mariam; De Coning, Piet; Beens, Jan; de Villiers, André; Sandra, Pat

    2011-07-15

    Fully synthetic jet fuel (FSJF) produced via Fischer-Tropsch (FT) technology was recently approved by the international aviation fuel authorities. To receive approval, comparison of FSJF and crude-derived fuel and blends on their qualitative and quantitative hydrocarbon composition was of utmost importance. This was performed by comprehensive two-dimensional gas chromatography (GC×GC) in the reversed phase mode. The hydrocarbon composition of synthetic and crude-derived jet fuels is very similar and all compounds detected in the synthetic product are also present in crude-derived fuels. Quantitatively, the synthetic fuel consists of a higher degree of aliphatic branching with less than half the aromatic content of the crude-derived fuel. GC×GC analyses also indicated the presence of trace levels of hetero-atomic impurities in the crude-derived product that were absent in the synthetic product. While clay-treatment removed some of the impurities and improved the fuel stability, the crude-derived product still contained traces of cyclic and aromatic S-containing compounds afterwards. Lower level of aromatics and the absence of sulphur are some of the factors that contribute to the better fuel stability and environmental properties of the synthetic fuel. GC×GC was further applied for the analysis of products during Jet Fuel Thermal Oxidation Testing (JFTOT), which measures deposit formation of a fuel under simulated engine conditions. JFTOT showed the synthetic fuel to be much more stable than the crude-derived fuel. Copyright © 2011 Elsevier B.V. All rights reserved.

  3. THERMOCHEMICAL CONVERSION OF FERMENTATION-DERIVED OXYGENATES TO FUELS

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ramasamy, Karthikeyan K.; Wang, Yong

    2013-06-01

    At present ethanol generated from renewable resources through fermentation process is the dominant biofuel. But ethanol suffers from undesirable fuel properties such as low energy density and high water solubility. The production capacity of fermentation derived oxygenates are projected to rise in near future beyond the current needs. The conversion of oxygenates to hydrocarbon compounds that are similar to gasoline, diesel and jet fuel is considered as one of the viable option. In this chapter the thermo catalytic conversion of oxygenates generated through fermentation to fuel range hydrocarbons will be discussed.

  4. Life cycle assessment of the use of alternative fuels in cement kilns: A case study.

    PubMed

    Georgiopoulou, Martha; Lyberatos, Gerasimos

    2018-06-15

    The benefits of using alternative fuels (AFs) in the cement industry include reduction of the use of non-renewable fossil fuels and lower emissions of greenhouse gases, since fossil fuels are replaced with materials that would otherwise be degraded or incinerated with corresponding emissions and final residues. Furthermore, the use of alternative fuels maximizes the recovery of energy. Seven different scenaria were developed for the production of 1 ton of clinker in a rotary cement kiln. Each of these scenaria includes the use of alternative fuels such as RDF (Refuse derived fuel), TDF (Tire derived fuel) and BS (Biological sludge) or a mixture of them, in partial replacement of conventional fuels such as coal and pet coke. The purpose of this study is to evaluate the environmental impacts of the use of alternative fuels in relation to conventional fuels in the kiln operation. The Life Cycle Assessment (LCA) methodology is used to quantify the potential environmental impacts in each scenario. The interpretation of the results provides the conclusion that the most environmentally friendly prospect is the scenario based on RDF while the less preferable scenario is the scenario based on BS. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. School Refuser Child Identities

    ERIC Educational Resources Information Center

    Stroobant, Emma; Jones, Alison

    2006-01-01

    "School refuser" is an always-already negative child identity. The term is used to categorize children or adolescents who appear to dislike and fear school (or aspects of school) and persistently refuse to attend or attend very unwillingly. Given that school attendance is generally considered a necessary social good, regular and anxious…

  6. Refusing to Treat Sexual Dysfunction in Sex Offenders.

    PubMed

    Douglas, Thomas

    2017-01-01

    This article examines one kind of conscientious refusal: the refusal of healthcare professionals to treat sexual dysfunction in individuals with a history of sexual offending. According to what I call the orthodoxy, such refusal is invariably impermissible, whereas at least one other kind of conscientious refusal-refusal to offer abortion services-is not. I seek to put pressure on the orthodoxy by (1) motivating the view that either both kinds of conscientious refusal are permissible or neither is, and (2) critiquing two attempts to buttress it.

  7. 49 CFR 219.505 - Refusals.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Pre-Employment Tests § 219.505 Refusals. An applicant who has refused to submit to pre-employment testing under this section may not be employed in covered service...

  8. 49 CFR 219.505 - Refusals.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Pre-Employment Tests § 219.505 Refusals. An applicant who has refused to submit to pre-employment testing under this section may not be employed in covered service...

  9. 49 CFR 219.505 - Refusals.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Pre-Employment Tests § 219.505 Refusals. An applicant who has refused to submit to pre-employment testing under this section may not be employed in covered service...

  10. 49 CFR 219.505 - Refusals.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Pre-Employment Tests § 219.505 Refusals. An applicant who has refused to submit to pre-employment testing under this section may not be employed in covered service...

  11. 49 CFR 219.505 - Refusals.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Pre-Employment Tests § 219.505 Refusals. An applicant who has refused to submit to pre-employment testing under this section may not be employed in covered service...

  12. School refusal by patients with gender identity disorder.

    PubMed

    Terada, Seishi; Matsumoto, Yosuke; Sato, Toshiki; Okabe, Nobuyuki; Kishimoto, Yuki; Uchitomi, Yosuke

    2012-01-01

    The accumulating evidence suggests that school refusal behavior is associated with severe negative outcomes. However, previous research has not addressed school refusal by patients with gender identity disorder (GID). In this study, we tried to clarify the prevalence of school refusal among GID patients and the relationship of school refusal to demographic characteristics. A total of 579 consecutive Japanese GID patients at the outpatient GID Clinic of Okayama University Hospital between April 1997 and October 2005 were evaluated. The prevalence of school refusal was 29.2% of the total sample. School refusal was more frequent among GID patients with divorced parents than those with intact families. Multiple logistic regression analysis showed that younger age at consultation and divorce of parents were significantly associated with school refusal among the male-to-female GID patients. The rate of school refusal among GID patients is high, and school refusal is closely related with a low level of education and current unemployment. We should pay more attention to GID patients of school age to prevent their school refusal, which results in low educational achievement. Copyright © 2012 Elsevier Inc. All rights reserved.

  13. [Treatment Refusal in Pediatric Oncology].

    PubMed

    Špótová, A; Husáková, K; Hrašková, A; Mikesková, M; Puškáčová, J; Hederová, S; Jamárik, M; Rabenseifertová, E; Jalovecká, Z; Kolenová, A; Šubová, Z

    2017-01-01

    Pediatric oncologists are often faced with situations in which parents or guardians refuse recommended treatment for curable childhood cancer. Deciding how to proceed in such situations is an ethical dilemma. The aim of this article is to consider optimal approaches when parents are strongly against oncological treatment, potentially compromising their childrens rights for health care and to the chance for cure. In this paper, we report two cases of treatment refusal from our department and the impact of such decisions on the children themselves. Case no. 1 describes a child with retinoblastoma whose parents refused standard treatment in order to seek alternative treatment abroad. Case no. 2 describes a patient with a primary lymphoma of bone who received treatment by a court order after parental refusal. When parents refuse a treatment for potentially curable cancer, the medical team often focuses on the certainty of death without treatment. In the background, there is a smaller but still significant risk that - even if the treatment is eventually accepted or compelled - the child will still die from treatment-related complications or refractory disease, possibly with considerable suffering. The reasons for refusing a treatment vary. The entire medical team is tasked with trying to respectfully understand the reasoning behind the parents unwillingness to accept the treatment, in order to address all possible misunderstandings and to propose solutions that could be acceptable for the parents. In some situations however, it is necessary to resolve the dilemma by legal means in order to protect the life of the child.Key words: oncology - ethics - decision making - treatment refusal - legal guardians The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.Submitted: 7. 8. 2017Accepted: 7. 9. 2017.

  14. Influenza vaccine refusal in Israeli young adults.

    PubMed

    Balicer, Ran D; Grotto, Itamar; Huerta, Michael; Levian, Yardena; Davidovitch, Nadav

    2007-10-01

    The purpose of this study was to identify correlates of noncompliance with influenza immunization among young adults and to determine the reasons leading to immunization refusal. Self-administered questionnaires were distributed in 10 military bases during two consecutive annual Israel Defense Force influenza vaccination campaigns. Multivariate logistic regression was performed to identify independent correlates. Of 2,000 questionnaires distributed over two seasons, 942 were completed and returned. Of those, 401 respondents were not vaccinated either because of medical contraindication or for administrative reasons. The remaining 541 respondents who reported either receiving the vaccine or refusing to receive it were analyzed. Risk groups for vaccine refusal included older age (17.9% vs. 3.5% refusal rate) and officer rank (25.9% vs. 13.8% refusal rate). The main reasons for vaccine refusal differed significantly between officers and nonofficers (chi2 = 7.587, p = 0.023). Officers refused mainly (60%) because of fear of possible vaccine adverse effects, whereas nonofficers refused mainly (44.2%) because of disbelief in the vaccine's efficacy in preventing illness. Officers serve as a negative role model in this case, and efforts directed toward dissemination of evidence-based information regarding vaccine-related adverse effects should be introduced to increase vaccination rates in this group.

  15. 49 CFR 219.213 - Unlawful refusals; consequences.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Unlawful refusals; consequences. 219.213 Section 219.213 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD... § 219.213 Unlawful refusals; consequences. (a) Disqualification. An employee who refuses to cooperate in...

  16. The Space Station integrated refuse management system

    NASA Technical Reports Server (NTRS)

    1988-01-01

    The University of Central Florida's design of an Integrated Refuse Management System for the proposed International Space Station is addressed. Four integratable subsystems capable of handling an estimated Orbiter shortfall of nearly 40,000 lbs of refuse produced annually are discussed. The subsystems investigated were: (1) collection and transfer; (2) recycle and reuse; (3) advanced disposal; and (4) propulsion assist in disposal. Emphasis is placed on the recycling or reuse of those materials ultimately providing a source of Space Station refuse. Special consideration is given to various disposal methods capable of completely removing refuse from close proximity of the Space Station. There is evidence that pyrolysis is the optimal solution for disposal of refuse through employment of a Rocket Jettison Vehicle. Additionally, design considerations and specifications of the Refuse Management System are discussed. Optimal and alternate design solutions for each of the four subsystems are summarized. Finally, the system configuration is described and reviewed.

  17. 30 CFR 77.215-4 - Refuse piles; abandonment.

    Code of Federal Regulations, 2010 CFR

    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...

  18. 9 CFR 439.50 - Refusal of accreditation.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... ACCREDITATION OF NON-FEDERAL CHEMISTRY LABORATORIES § 439.50 Refusal of accreditation. Upon a determination by the Administrator, a laboratory will be refused accreditation for the following reasons: (a) A laboratory will be refused accreditation for failure to meet the requirements of § 439.5 or § 439.10 of this...

  19. The space station integrated refuse management system

    NASA Technical Reports Server (NTRS)

    Anderson, Loren A.

    1988-01-01

    The design and development of an Integrated Refuse Management System for the proposed International Space Station was performed. The primary goal was to make use of any existing potential energy or material properties that refuse may possess. The secondary goal was based on the complete removal or disposal of those products that could not, in any way, benefit astronauts' needs aboard the Space Station. The design of a continuous living and experimental habitat in space has spawned the need for a highly efficient and effective refuse management system capable of managing nearly forty-thousand pounds of refuse annually. To satisfy this need, the following four integrable systems were researched and developed: collection and transfer; recycle and reuse; advance disposal; and propulsion assist in disposal. The design of a Space Station subsystem capable of collecting and transporting refuse from its generation site to its disposal and/or recycling site was accomplished. Several methods of recycling or reusing refuse in the space environment were researched. The optimal solution was determined to be the method of pyrolysis. The objective of removing refuse from the Space Station environment, subsequent to recycling, was fulfilled with the design of a jettison vehicle. A number of jettison vehicle launch scenarios were analyzed. Selection of a proper disposal site and the development of a system to propel the vehicle to that site were completed. Reentry into the earth atmosphere for the purpose of refuse incineration was determined to be the most attractive solution.

  20. Performance characteristics of a diesel engine using low- and medium-energy gases as a fuel supplement (fumigation)

    NASA Technical Reports Server (NTRS)

    Monford, L. G.

    1976-01-01

    The use of low- and medium-energy gases derived from solid waste is investigated. Gases that simulate those gases that could be derived from refuse were injected into the air inlet of a 298-kilowatt (400 horsepower) diesel engine as a fuel supplement. This process is called fumigation. Three different gases with thermal-energy contents of 6.11 MJ/cu m (164 Btu/cu ft), 18.1 MJ/cu m (485 Btu/cu ft), and 18.8 MJ/cu m (505 Btu/cu ft, respectively, were used at rates ranging as high as 20 percent of the normal fuel oil energy at four different engine load points. The test results indicated approximately 100 percent gas energy utilization with no observable deleterious effect on the engine.

  1. The Legal Ethical Backbone of Conscientious Refusal.

    PubMed

    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.

  2. 22 CFR 40.6 - Basis for refusal.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Basis for refusal. 40.6 Section 40.6 Foreign Relations DEPARTMENT OF STATE VISAS REGULATIONS PERTAINING TO BOTH NONIMMIGRANTS AND IMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED General Provisions § 40.6 Basis for refusal. A visa can be refused...

  3. 21 CFR 211.50 - Sewage and refuse.

    Code of Federal Regulations, 2010 CFR

    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. Medication Refusal: Resident Rights, Administration Dilemma.

    PubMed

    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.

  5. ACOG Committee Opinion No. 306. Informed refusal.

    PubMed

    2004-12-01

    Informed refusal is a fundamental component of the informed consent process. Informed consent laws have evolved to the "materiality or patient viewpoint" standard. A physician must disclose to the patient the risks, benefits, and alternatives that a reasonable person in the patient's position would want to know to make an informed decision. Throughout this process, the patient's autonomy, level of health literacy, and cultural background should be respected. The subsequent election by the patient to forgo an intervention that has been recommended by the physician constitutes informed refusal. Documentation of the informed refusal process is essential. It should include a notation that the need for the intervention, as well as risks, benefits, and alternatives to the intervention, and possible consequences of refusal, have been explained. The patient's reason for refusal also should be documented.

  6. Legal briefing: conscience clauses and conscientious refusal.

    PubMed

    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

  7. 30 CFR 77.214 - Refuse piles; general.

    Code of Federal Regulations, 2010 CFR

    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. Further studies of fuels from alternate sources - fire extinguishment experiments with JP-5 jet turbine fuel derived from shale. Final report

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hazlett, R.N.; Affens, W.A.; McLaren, G.W.

    1978-05-01

    Fire extinguishment experiments with JP-5 jet fuels derived from shale crude oil and also from petroleum (for comparison) were conducted at NRL's Chesapeake Bay facility. The experiments were conducted in a 40-foot diameter circular pool using Aqueous Film Forming Foam (AFFF) as the fire extinguishing agent. The results with both types of fuel were similar, and it was concluded that the techniques and agents for AFFF application, which have been developed for petroleum fuel fires, can also be used for shale derived jet fuel.

  9. 9 CFR 98.9 - Embryos refused entry.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 1 2012-01-01 2012-01-01 false Embryos refused entry. 98.9 Section 98... EMBRYOS AND ANIMAL SEMEN Ruminant and Swine Embryos from Regions Free of Rinderpest and Foot-and-Mouth Disease; and Embryos of Horses and Asses § 98.9 Embryos refused entry. Any embryo refused entry into the...

  10. 9 CFR 98.9 - Embryos refused entry.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 1 2014-01-01 2014-01-01 false Embryos refused entry. 98.9 Section 98... EMBRYOS AND ANIMAL SEMEN Ruminant and Swine Embryos from Regions Free of Rinderpest and Foot-and-Mouth Disease; and Embryos of Horses and Asses § 98.9 Embryos refused entry. Any embryo refused entry into the...

  11. 9 CFR 98.9 - Embryos refused entry.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 9 Animals and Animal Products 1 2013-01-01 2013-01-01 false Embryos refused entry. 98.9 Section 98... EMBRYOS AND ANIMAL SEMEN Ruminant and Swine Embryos from Regions Free of Rinderpest and Foot-and-Mouth Disease; and Embryos of Horses and Asses § 98.9 Embryos refused entry. Any embryo refused entry into the...

  12. 9 CFR 98.9 - Embryos refused entry.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Embryos refused entry. 98.9 Section 98... EMBRYOS AND ANIMAL SEMEN Ruminant and Swine Embryos from Regions Free of Rinderpest and Foot-and-Mouth Disease; and Embryos of Horses and Asses § 98.9 Embryos refused entry. Any embryo refused entry into the...

  13. 9 CFR 98.9 - Embryos refused entry.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false Embryos refused entry. 98.9 Section 98... EMBRYOS AND ANIMAL SEMEN Ruminant and Swine Embryos from Regions Free of Rinderpest and Foot-and-Mouth Disease; and Embryos of Horses and Asses § 98.9 Embryos refused entry. Any embryo refused entry into the...

  14. Methods for conversion of lignocellulosic-derived products to transportation fuel precursors

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Lilga, Michael A.; Padmaperuma, Asanga B.

    2017-10-03

    Methods are disclosed for converting a biomass-derived product containing levulinic acid and/or gamma-valerolactone to a transportation fuel precursor product containing diesel like hydrocarbons. These methods are expected to produce fuel products at a reduced cost relative to conventional approaches.

  15. The use of modified tyre derived fuel for compression ignition engines.

    PubMed

    Pilusa, T J

    2017-02-01

    This study investigated physical and chemical modification of tyre-derived fuel oil (TDFO) obtained from pyrolysis of waste tyres and rubber products for application as an alternative fuel for compression ignition engines (CIE's). TDFO collected from a local waste tyre treatment facility was refined via a novel "oxidative gas-phase fractional distillation over 13× molecular sieves" to recover the light to medium fractions of the TDFO while oxidising and capturing some sulphur compounds in a gas phase. This was followed by desulphurization and chemical modification to improve cetane number, kinematic viscosity and fuel stability. The resulting fuel was tested in an ADE407T truck engine to compare its performance with petroleum diesel fuel. It was discovered that gas phase oxidative fractional distillation reduces the low boiling point sulphur compounds in TDFO such as mercaptans. Using petroleum diesel fuel as a reference, it was observed that the produced fuel has a lower cetane number, flash point and viscosity. On storage the fuel tends to form fibrous microstructures as a result of auto-oxidation of asphaltenes present in the fuel. Mixtures of alkyl nitrate, vinyl acetate, methacrylic anhydride, methyl-tert butyl ether, n-hexane and n-heptane were used to chemically modify the fuel in accordance with the minimum fuel specifications as per SANS 342. The engine performance tests results did not show any sign of engine ceasing or knocking effect. The power-torque trend was very consistent and compared well with petroleum diesel fuelled engine. The levels of total sulphur are still considerably high compared to other cleaner fuel alternatives derived from zero sulphur sources. Copyright © 2016. Published by Elsevier Ltd.

  16. Recycling of aged refuse from a closed landfill.

    PubMed

    Zhao, Youcai; Song, Liyan; Huang, Renhua; Song, Lijie; Li, Xiong

    2007-04-01

    In this study, refuse excavated from a typical refuse landfill in Shanghai after 8-10 years of placement was characterized in terms of particle size, total nitrogen, total phosphorus, and biodegradable matter. The refuse contained a large and diverse population of micro-organisms with a high capacity for decomposing refractory organic matter present in some wastewaters, including leachate. It was found that the aged refuse was quite stable after about a decade of decomposition in the warm, humid climate of southern China. The fine fractions resembled and had the properties of black soil, a medium that is suitable for green construction, organic fertilizer, or as bioreactor media for biological treatment of organic wastewaters. Excavation of the aged refuse would make about 50% of the space available for fresh refuse. The plastics, glass, textiles, and cans can be readily mechanically separated and recycled after cleaning. It is estimated that at least 200 millions tonnes of such aged refuse are available in China alone, and at least 10 times that much is buried worldwide. Hence, the evaluation of mined landfill waste and consideration of its potential uses is of great significance.

  17. Teaching refusal skills to sexually active adolescents.

    PubMed

    Warzak, W J; Page, T J

    1990-06-01

    Refusal skills training was extended to sexually active handicapped female adolescents who lacked an effective refusal strategy. Role-plays for assessment and training were developed using the who, what, when and where of situations which resulted in unwanted intercourse. Refusal skills were trained following the format of rationale, modeling, rehearsal, feedback, and reinforcement. Baseline rates of most target behaviors were quite low. High frequencies of target behaviors were observed as each behavior became the focus of training. Generalization across staff and time was also observed. The skillfulness and effectiveness of the subjects' refusal skills were judged to be improved as a function of training. One-year follow-up showed decreased sexual activity for each girl.

  18. Pragmatic Transfer in Thai EFL Refusals

    ERIC Educational Resources Information Center

    Wannaruk, Anchalee

    2008-01-01

    Communication breakdowns can occur during cross-cultural communication due to different perceptions and interpretations of appropriateness and politeness. This study investigates similarities and differences between refusals in American English and Thai and incidences of pragmatic transfer by Thai EFL learners when making refusals. The…

  19. 30 CFR 77.215-1 - Refuse piles; identification.

    Code of Federal Regulations, 2010 CFR

    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...

  20. 22 CFR 41.121 - Refusal of individual visas.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Refusal of individual visas. 41.121 Section 41.121 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF NONIMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Refusals and Revocations § 41.121 Refusal of individual visas. (a...

  1. 22 CFR 41.121 - Refusal of individual visas.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Refusal of individual visas. 41.121 Section 41.121 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF NONIMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Refusals and Revocations § 41.121 Refusal of individual visas. (a...

  2. 22 CFR 41.121 - Refusal of individual visas.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Refusal of individual visas. 41.121 Section 41.121 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF NONIMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Refusals and Revocations § 41.121 Refusal of individual visas. (a...

  3. 22 CFR 41.121 - Refusal of individual visas.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Refusal of individual visas. 41.121 Section 41.121 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF NONIMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Refusals and Revocations § 41.121 Refusal of individual visas. (a...

  4. 22 CFR 41.121 - Refusal of individual visas.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Refusal of individual visas. 41.121 Section 41.121 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF NONIMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Refusals and Revocations § 41.121 Refusal of individual visas. (a...

  5. Refusal of treatment in obstetrics - A maternal-fetal conflict.

    PubMed

    Ohel, Iris; Iris, Ohel; Levy, Amalia; Amalia, Levy; Mazor, Moshe; Moshe, Mazor; Wiznitzer, Arnon; Arnon, Wiznitzer; Sheiner, Eyal; Eyal, Sheiner

    2009-07-01

    Clinical studies about the necessity of standard obstetric interventions raise questions, making refusal by pregnant women of treatment a legitimate choice. The present study was aimed at characterising patients refusing medical treatment during pregnancy and delivery, and to examine whether refusal of treatment in obstetrics is associated with adverse perinatal outcome. A population-based study, comparing patients who refused (1898) and did not refuse (164,064) medical intervention during pregnancy and delivery, was conducted. Deliveries occurred between the years 1988 and 2002 in a tertiary medical centre. Patients refusing medical intervention tended to be older (30.5 +/- 5.0 vs. 28.4 +/- 5.9, p < 0.001) and of higher parity (above parity 5: 52.5% vs. 32.4%; parity 1: 10.2% vs. 20.0%; p < 0.001) than the controls. Parturients refusing medical treatment experienced significantly higher rates of adverse perinatal outcome including low Apgar scores (less than 7, in 1 and 5 min: 12.4% vs. 4.4%, p < 0.001 and 1.9% vs. 0.6%, p < 0.001, respectively). Moreover, higher rates of perinatal mortality in general and intra-partum death, in particular, were documented among women refusing medical treatment (3.3% vs. 1.5%, p < 0.001; 0.8% vs. 0.1%, p < 0.001). When using a multiple logistic regression model of risk factors for perinatal mortality, refuse of treatment was an independent risk factor for perinatal mortality (OR = 1.5; 95% CI = 1.1-2.0; p = 0.010). Patients refusing a medically indicated intervention have higher rates of pregnancy- and labour- related complications. Refusal of treatment is an independent risk factor for perinatal mortality.

  6. 9 CFR 93.806 - Animals refused entry.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Elephants, Hippopotami, Rhinoceroses, and Tapirs § 93.806 Animals refused entry. Any elephant, hippopotamus, rhinoceros, or tapir refused entry into the...

  7. 9 CFR 93.806 - Animals refused entry.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Elephants, Hippopotami, Rhinoceroses, and Tapirs § 93.806 Animals refused entry. Any elephant, hippopotamus, rhinoceros, or tapir refused entry into the...

  8. 9 CFR 93.806 - Animals refused entry.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Elephants, Hippopotami, Rhinoceroses, and Tapirs § 93.806 Animals refused entry. Any elephant, hippopotamus, rhinoceros, or tapir refused entry into the...

  9. 9 CFR 93.806 - Animals refused entry.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Elephants, Hippopotami, Rhinoceroses, and Tapirs § 93.806 Animals refused entry. Any elephant, hippopotamus, rhinoceros, or tapir refused entry into the...

  10. 9 CFR 93.806 - Animals refused entry.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Elephants, Hippopotami, Rhinoceroses, and Tapirs § 93.806 Animals refused entry. Any elephant, hippopotamus, rhinoceros, or tapir refused entry into the...

  11. Ways to say no: refusal skill strategies among urban adolescents.

    PubMed

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

    2006-01-01

    To examine associations among adolescents' generated verbal strategies (ie, Simple No, Declarative Statements, Excuse, Alternatives) and underlying nonverbal assertiveness in 2 refusal situations: smoking and shoplifting. Sixth-grade urban minority students (N = 454) participated in videotaped role-play assessments of peer refusal skills. Differences were found by situation with students demonstrating greater use of Simple No in the smoking refusal and Alternatives in the shoplifting refusal. Nonverbal assertiveness was similar across situations and was associated with Declarative Statements, but only in the smoking refusal. Prevention programs should tailor refusal skills practice to cover multiple situations.

  12. 25 CFR 135.23 - Refusal of water delivery.

    Code of Federal Regulations, 2010 CFR

    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...

  13. 25 CFR 135.23 - Refusal of water delivery.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 1 2011-04-01 2011-04-01 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...

  14. 25 CFR 135.23 - Refusal of water delivery.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 25 Indians 1 2012-04-01 2011-04-01 true 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...

  15. 25 CFR 135.23 - Refusal of water delivery.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 1 2013-04-01 2013-04-01 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...

  16. Effective Intervention for School Refusal Behaviour

    ERIC Educational Resources Information Center

    Nuttall, Clare; Woods, Kevin

    2013-01-01

    Evaluation of successful professional intervention for two case studies of female adolescents' school refusal behaviour is presented. Data gathered from the young person, professionals, and parents in each case are synthesised to propose a multi-level, ecologically situated model of intervention for school refusal behaviour. The proposed model…

  17. Children of divorce: the differential diagnosis of contact refusal.

    PubMed

    Freeman, Bradley W

    2011-07-01

    Contact refusal is a common phenomenon that can occur during the course of, or after, divorce, which affects the relationship between a child and the parent. This article defines the concept of contact refusal and discusses the importance of its recognition. The concept is further narrowed to focus on the child as the one refusing contact, not the parent, which can happen as well. Various types of contact refusals are illustrated in the article through clinical vignettes, and an approach to categorizing the various types of contact refusal is presented. Copyright © 2011 Elsevier Inc. All rights reserved.

  18. 25 CFR 135.6 - Refusal of water delivery.

    Code of Federal Regulations, 2010 CFR

    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...

  19. 25 CFR 135.6 - Refusal of water delivery.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 1 2011-04-01 2011-04-01 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...

  20. 25 CFR 135.6 - Refusal of water delivery.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 25 Indians 1 2012-04-01 2011-04-01 true 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...

  1. 25 CFR 135.6 - Refusal of water delivery.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 1 2013-04-01 2013-04-01 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...

  2. The cost of refusing treatment and equality of outcome.

    PubMed Central

    Savulescu, J

    1998-01-01

    Patients have a right to refuse medical treatment. But what should happen after a patient has refused recommended treatment? In many cases, patients receive alternative forms of treatment. These forms of care may be less cost-effective. Does respect for autonomy extend to providing these alternatives? How for does justice constrain autonomy? I begin by providing three arguments that such alternatives should not be offered to those who refuse treatment. I argue that the best argument which refusers can appeal to is based on the egalitarian principle of equality of outcome. However, this principle does not ultimately support a right to less cost-effective alternatives. I focus on Jehovah's Witnesses refusing blood and requesting alternative treatments. However, the point applies to many patients who refuse cost-effective medical care. PMID:9752624

  3. School Refusal

    ERIC Educational Resources Information Center

    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…

  4. ENVIRONMENTAL EFFECTS OF UTILIZING SOLID WASTE AS A SUPPLEMENTARY POWER PLANT FUEL

    EPA Science Inventory

    The results of 3 years of research on the utilization of shredded and magnetically separated municipal refuse to supplement high-sulfur coal as fuel in a stroker-fired boiler are presented. During the first half of the research, a refuse handling and furnace feed system consistin...

  5. The Effect of Fuel Quality on Carbon Dioxide and Nitrogen Oxide Emissions, While Burning Biomass and RDF

    NASA Astrophysics Data System (ADS)

    Kalnacs, J.; Bendere, R.; Murasovs, A.; Arina, D.; Antipovs, A.; Kalnacs, A.; Sprince, L.

    2018-02-01

    The article analyses the variations in carbon dioxide emission factor depending on parameters characterising biomass and RDF (refuse-derived fuel). The influence of moisture, ash content, heat of combustion, carbon and nitrogen content on the amount of emission factors has been reviewed, by determining their average values. The options for the improvement of the fuel to result in reduced emissions of carbon dioxide and nitrogen oxide have been analysed. Systematic measurements of biomass parameters have been performed, by determining their average values, seasonal limits of variations in these parameters and their mutual relations. Typical average values of RDF parameters and limits of variations have been determined.

  6. Highly Selective Upgrading of Biomass-Derived Alcohol Mixtures for Jet/Diesel-Fuel Components.

    PubMed

    Liu, Qiang; Xu, Guoqiang; Wang, Xicheng; Liu, Xiaoran; Mu, Xindong

    2016-12-20

    In light of the increasing concern about the energy and environmental problems caused by the combustion of petroleum-based fuels (e.g., jet and diesel fuels), the development of new procedures for their sustainable production from renewable biomass-derived platform compounds has attracted tremendous attention recently. Long-chain ketones/alcohols are promising fuel components owing to the fuel properties that closely resemble those of traditional fuels. The focus of this report is the production of long-chain ketones/alcohols by direct upgrading of biomass-derived short-chain alcohol mixtures (e.g., isopropanol-butanol-ethanol mixtures) in pure water. An efficient Pd catalyst system was developed for these highly selective transformations. Long-chain ketones/alcohols (C 8 -C 19 ), which can be used as precursors for renewable jet/diesel fuel, were obtained in good-to-high selectivity (>90 %) by using the developed Pd catalyst. © 2016 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  7. Physicians' evaluations of patients' decisions to refuse oncological treatment

    PubMed Central

    van Kleffens, T; van Leeuwen, E

    2005-01-01

    Objective: To gain insight into the standards of rationality that physicians use when evaluating patients' treatment refusals. Design of the study: Qualitative design with indepth interviews. Participants: The study sample included 30 patients with cancer and 16 physicians (oncologists and general practitioners). All patients had refused a recommended oncological treatment. Results: Patients base their treatment refusals mainly on personal values and/or experience. Physicians mainly emphasise the medical perspective when evaluating patients' treatment refusals. From a medical perspective, a patient's treatment refusal based on personal values and experience is generally evaluated as irrational and difficult to accept, especially when it concerns a curative treatment. Physicians have a different attitude towards non-curative treatments and have less difficulty accepting a patient's refusal of these treatments. Thus, an important factor in the physician's evaluation of a treatment refusal is whether the treatment refused is curative or non-curative. Conclusion: Physicians mainly use goal oriented and patients mainly value oriented rationality, but in the case of non-curative treatment refusal, physicians give more emphasis to value oriented rationality. A consensus between the value oriented approaches of patient and physician may then emerge, leading to the patient's decision being understood and accepted by the physician. The physician's acceptance is crucial to his or her attitude towards the patient. It contributes to the patient's feeling free to decide, and being understood and respected, and thus to a better physician–patient relationship. PMID:15738431

  8. Health and environmental effects of refuse derived fuel (RDF) production and RDF/coal co-firing technologies

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    O'Toole, J.J.; Wessels, T.E.; Lynch, J.F.

    1981-10-01

    Six facilities, representing the scope of different co-firing techniques with their associated RDF production systems were reviewed in detail for combustion equipment, firing modes, emission control systems, residue handling/disposal, and effluent wastewater treatment. These facilities encompass all currently operational or soon to be operational co-firing plants and associated RDF production systems. Occupational health and safety risks for these plants were evaluated on the basis of fatal and nonfatal accidents and disease arising from the respective fuel cycles, coal and RDF. Occupational risks include exposure to pathogenic organisms in the workplace. Unusual events that are life threatening in the RDF processingmore » industry (e.g., explosions) are also discussed and remedial and safety measures reviewed. 80 refs., 4 figs., 30 tabs.« less

  9. 20 CFR 401.70 - Appeals of refusals to correct records or refusals to allow access to records.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... explaining the decision on your appeal. The time limit for making our decision after we receive your appeal... 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...

  10. The right not to be treated or to refuse treatment.

    PubMed

    Deutsch, E

    1989-01-01

    The corollary to the right to refuse treatment is the requirement that, in general, informed consent be obtained before treatment. The Declaration of Lisbon recognises this: "The patient has the right to accept or to refuse treatment after receiving adequate information." The information to be given to the patient is of three kinds, but a special problem in relation to the doctrine of informed refusal places a special duty on the doctor to inform the patient about the possible consequences of refusing treatment. Related topics, such as refusal in part, refusal by a parent or guardian, the novus actus interveniens, the living will, and contributory negligence are touched upon.

  11. Factors Associated with School Refusal in Adolescents: Some Preliminary Results.

    ERIC Educational Resources Information Center

    Ficula, Teresa V.; And Others

    School refusal, as differentiated from both school phobia and truancy, is a term used to denote emotionally-based avoidance of school. To identify factors associated with school refusal, 41 junior high and high school students (including special education school refusers, special education non-refusers, and a comparison group from a regular…

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

    PubMed

    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.

  13. Life cycle assessment of camelina oil derived biodiesel and jet fuel in the Canadian Prairies.

    PubMed

    Li, Xue; Mupondwa, Edmund

    2014-05-15

    This study evaluated the environmental impact of biodiesel and hydroprocessed renewable jet fuel derived from camelina oil in terms of global warming potential, human health, ecosystem quality, and energy resource consumption. The life cycle inventory is based on production activities in the Canadian Prairies and encompasses activities ranging from agricultural production to oil extraction and fuel conversion. The system expansion method is used in this study to avoid allocation and to credit input energy to co-products associated with the products displaced in the market during camelina oil extraction and fuel processing. This is the preferred allocation method for LCA analysis in the context of most renewable and sustainable energy programs. The results show that greenhouse gas (GHG) emissions from 1 MJ of camelina derived biodiesel ranged from 7.61 to 24.72 g CO2 equivalent and 3.06 to 31.01 kg CO2/MJ equivalent for camelina HRJ fuel. Non-renewable energy consumption for camelina biodiesel ranged from 0.40 to 0.67 MJ/MJ; HRJ fuel ranged from -0.13 to 0.52 MJ/MJ. Camelina oil as a feedstock for fuel production accounted for the highest contribution to overall environmental performance, demonstrating the importance of reducing environmental burdens during the agricultural production process. Attaining higher seed yield would dramatically lower environmental impacts associated with camelina seed, oil, and fuel production. The lower GHG emissions and energy consumption associated with camelina in comparison with other oilseed derived fuel and petroleum fuel make camelina derived fuel from Canadian Prairies environmentally attractive. Crown Copyright © 2014. Published by Elsevier B.V. All rights reserved.

  14. Natural gas as a future fuel for heavy-duty vehicles

    DOT National Transportation Integrated Search

    2001-06-21

    In addition to their significant environmental impacts, medium-duty and heavy-duty (HD) vehicles are high volume fuel users. Development of such vehicles, which include transit buses, refuse trucks, and HD Class 6-8 trucks, that are fueled with natur...

  15. Alternative Fuels Data Center: Natural Gas Fuels School Buses and Refuse

    Science.gov Websites

    Efficiency March 8, 2014 Renzenberger Inc Saves Money With Propane Vans Feb. 1, 2014 Photo of a school bus Buses Help Kansas City Save Money Nov. 12, 2011 Metropolitan Utilities District Fuels Vehicles With Electric Shuttle Buses Offer Free Rides in Maryland June 18, 2010 Fisher Coachworks Develops Plug-In

  16. Parental Refusal of Childhood Vaccines and Medical Neglect Laws.

    PubMed

    Parasidis, Efthimios; Opel, Douglas J

    2017-01-01

    To examine the relation of vaccine refusal and medical neglect under child welfare laws. We used the Westlaw legal database to search court opinions from 1905 to 2016 and identified cases in which vaccine refusal was the sole or a primary reason in a neglect proceeding. We also delineated if religious or philosophical exemptions from required school immunizations were available at the time of adjudication. Our search yielded 9 cases from 5 states. Most courts (7 of 9) considered vaccine refusal to constitute neglect. In the 4 cases decided in jurisdictions that permitted religious exemptions, courts either found that vaccine refusal did not constitute neglect or considered it neglect only in the absence of a sincere religious objection to vaccination. Some states have a legal precedent for considering parental vaccine refusal as medical neglect, but this is based on a small number of cases. Each state should clarify whether, under its laws, vaccine refusal constitutes medical neglect.

  17. 21 CFR 316.14 - Refusal to provide written recommendations.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 5 2011-04-01 2011-04-01 false Refusal to provide written recommendations. 316.14... (CONTINUED) DRUGS FOR HUMAN USE ORPHAN DRUGS Written Recommendations for Investigations of Orphan Drugs § 316.14 Refusal to provide written recommendations. (a) FDA may refuse to provide written recommendations...

  18. 22 CFR 42.81 - Procedure in refusing individual visas.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Procedure in refusing individual visas. 42.81 Section 42.81 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF IMMIGRANTS UNDER THE... Procedure in refusing individual visas. (a) Issuance or refusal mandatory. When a visa application has been...

  19. 22 CFR 42.81 - Procedure in refusing individual visas.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Procedure in refusing individual visas. 42.81 Section 42.81 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF IMMIGRANTS UNDER THE... Procedure in refusing individual visas. (a) Issuance or refusal mandatory. When a visa application has been...

  20. 22 CFR 42.81 - Procedure in refusing individual visas.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Procedure in refusing individual visas. 42.81 Section 42.81 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF IMMIGRANTS UNDER THE... Procedure in refusing individual visas. (a) Issuance or refusal mandatory. When a visa application has been...

  1. 22 CFR 42.81 - Procedure in refusing individual visas.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Procedure in refusing individual visas. 42.81 Section 42.81 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF IMMIGRANTS UNDER THE... Procedure in refusing individual visas. (a) Issuance or refusal mandatory. When a visa application has been...

  2. 22 CFR 42.81 - Procedure in refusing individual visas.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Procedure in refusing individual visas. 42.81 Section 42.81 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF IMMIGRANTS UNDER THE... Procedure in refusing individual visas. (a) Issuance or refusal mandatory. When a visa application has been...

  3. Breath test refusals

    DOT National Transportation Integrated Search

    2007-11-01

    The National Highway Traffic Safety Administration has found that the percentage of people who refuse to provide breath samples when arrested for Driving While Intoxicated (DWI) varies considerably across States, and this creates a concern in the cri...

  4. Coal-cleaning plant refuse characterization

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Cavalet, J.R.; Torak, E.R.

    1985-06-01

    This report describes a study performed for the Electric Power Research Institute's Coal Cleaning Test Facility in Homer City, Pennsylvania. The purpose of the study was to design a standard methods for chemically and physically classifying refuse generated by physical coal cleaning and to construct a matrix that will accurately predict how a particular refuse will react to particular disposal methods - based solely on raw-coal characteristics and the process used to clean the coal. The value of such a classification system (which has not existed to this point) is the ability to design efficient and economical systems for disposingmore » of specific coal cleaning refuse. The report describes the project's literature search and a four-tier classification system. It also provides designs for test piles, sampling procedures, and guidelines for a series of experiments to test the classfication system and create an accurate, reliable predictive matrix. 38 refs., 39 figs., 35 tabs.« less

  5. Biomass-derived Syngas Utilization for Fuels and Chemicals - Final Report

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Dayton, David C

    2010-03-24

    Executive Summary The growing gap between petroleum production and demand, mounting environmental concerns, and increasing fuel prices have stimulated intense interest in research and development (R&D) of alternative fuels, both synthetic and bio-derived. Currently, the most technically defined thermochemical route for producing alternative fuels from lignocellulosic biomass involves gasification/reforming of biomass to produce syngas (carbon monoxide [CO] + hydrogen [H2]), followed by syngas cleaning, Fischer-Tropsch synthesis (FTS) or mixed alcohol synthesis, and some product upgrading via hydroprocessing or separation. A detailed techno-economic analysis of this type of process has recently been published [1] and it highlights the need for technicalmore » breakthroughs and technology demonstration for gas cleanup and fuel synthesis. The latter two technical barrier areas contribute 40% of the total thermochemical ethanol cost and 70% of the production cost, if feedstock costs are factored out. Developing and validating technologies that reduce the capital and operating costs of these unit operations will greatly reduce the risk for commercializing integrated biomass gasification/fuel synthesis processes for biofuel production. The objective of this project is to develop and demonstrate new catalysts and catalytic processes that can efficiently convert biomass-derived syngas into diesel fuel and C2-C4 alcohols. The goal is to improve the economics of the processes by improving the catalytic activity and product selectivity, which could lead to commercialization. The project was divided into 4 tasks: Task 1: Reactor Systems: Construction of three reactor systems was a project milestone. Construction of a fixed-bed microreactor (FBR), a continuous stirred tank reactor (CSTR), and a slurry bubble column reactor (SBCR) were completed to meet this milestone. Task 2: Iron Fischer-Tropsch (FT) Catalyst: An attrition resistant iron FT catalyst will be developed and

  6. 30 CFR 77.215-2 - Refuse piles; reporting requirements.

    Code of Federal Regulations, 2010 CFR

    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...

  7. Evaluation of Biomass-Derived Distillate Fuel as Renewable Heating Oil

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Mante, Ofei D.; Butcher, Thomas A.; Wei, George

    The utilization of advanced biofuels in stationary applications, such as home heating, is considered as an early entry point for biomass-derived fuels into the distillate fuel market sector. Two renewable fuels produced by a biomass fluidized catalytic cracking (BFCC) process, followed by hydroprocessing and fractionation, were tested. The evaluation was performed on a pure (100%) distillate fraction, 50% blend of the distillate fraction with petroleum-based heating oil, and 20% blend of a heavier gas oil fraction. Combustion experiments were carried out in a transparent quartz chamber and a typical oil-fired residential boiler. The flame stability, size, and shape produced bymore » the fuels were examined. The flue gas was analyzed for O 2, CO, NO x, and smoke. The elastomer compatibility test was performed with nitrile slabs at 43 °C for 1 month. Fuel stability was examined at 80 °C for 1 week. The results from the combustion studies suggest that the distillate fuel blends could be used as alternative fuels to No. 2 heating oil, even up to 100% without any operational issues. The distillate fuels were found to be stable. and the nitrile slab volume swell (~10%) suggests that the fuel could be compatible to legacy elastomers.« less

  8. Evaluation of Biomass-Derived Distillate Fuel as Renewable Heating Oil

    DOE PAGES

    Mante, Ofei D.; Butcher, Thomas A.; Wei, George; ...

    2015-09-18

    The utilization of advanced biofuels in stationary applications, such as home heating, is considered as an early entry point for biomass-derived fuels into the distillate fuel market sector. Two renewable fuels produced by a biomass fluidized catalytic cracking (BFCC) process, followed by hydroprocessing and fractionation, were tested. The evaluation was performed on a pure (100%) distillate fraction, 50% blend of the distillate fraction with petroleum-based heating oil, and 20% blend of a heavier gas oil fraction. Combustion experiments were carried out in a transparent quartz chamber and a typical oil-fired residential boiler. The flame stability, size, and shape produced bymore » the fuels were examined. The flue gas was analyzed for O 2, CO, NO x, and smoke. The elastomer compatibility test was performed with nitrile slabs at 43 °C for 1 month. Fuel stability was examined at 80 °C for 1 week. The results from the combustion studies suggest that the distillate fuel blends could be used as alternative fuels to No. 2 heating oil, even up to 100% without any operational issues. The distillate fuels were found to be stable. and the nitrile slab volume swell (~10%) suggests that the fuel could be compatible to legacy elastomers.« less

  9. 16 CFR 1210.18 - Refusal of importation.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 16 Commercial Practices 2 2011-01-01 2011-01-01 false Refusal of importation. 1210.18 Section 1210.18 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS SAFETY STANDARD FOR CIGARETTE LIGHTERS Certification Requirements § 1210.18 Refusal of importation. (a...

  10. Bio-derived Fuel Blend Dilution of Marine Engine Oil and Imapct on Friction and Wear Behavior

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ajayi, Oyelayo O.; Lorenzo-Martin, Cinta; Fenske, George R.

    To reduce the amount of petroleum-derived fuel used in vehicles and vessels powered by internal combustion engines, the addition of bio-derived fuel extenders is a common practice. Ethanol is perhaps the most common bio-derived fuel used for blending, and butanol is being evaluated as a promising alternative. The present study determined the fuel dilution rate of three lubricating oils (E0, E10, and i-B16) in a marine engine operating in on-water conditions with a start-and-stop cycle protocol. The level of fuel dilution increased with the number of cycles for all three fuels. The most dilution was observed with i-B16 fuel, andmore » the least with E10 fuel. In all cases, fuel dilution substantially reduced the oil viscosity. The impacts of fuel dilution and the consequent viscosity reduction on the lubricating capability of the engine oil in terms of friction, wear, and scuffing prevention were evaluated by four different tests protocols. Although the fuel dilution of the engine oil had minimal effect on friction, because the test conditions were under the boundary lubrication regime, significant effects were observed on wear in many cases. Fuel dilution also was observed to reduce the load-carrying capacity of the engine oils in terms of scuffing load reduction.« less

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

    ERIC Educational Resources Information Center

    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…

  12. Do you feel powerless when a patient refuses medication?

    PubMed

    Carey, N; Jones, S L; O'Toole, A W

    1990-10-01

    1. Because a client legally has the right to refuse medication, the nurse can only recommend, advise, suggest, or urge the patient to comply. Consequently, it is important to understand the nurse's response to patient refusal of medication. 2. Overall, nurses were more apt to identify with indirect indicators than they were to identify words that address the concept directly (control and powerlessness). 3. The most common hazard identified in a medication refusal event was the potential for injury, and the individuals most at risk were the nurse giving the medication and other personnel on the unit. 4. The most prominent nursing response to medication refusal was counseling. Nearly all the nurse subjects believed that the medication refusal event negatively influenced nursing care, the patient/nurse interaction, and patient teaching.

  13. Miami-Dade County Hydraulic Hybrid Refuse Truck Testing | Transportation

    Science.gov Websites

    Research | NREL Miami-Dade County Hydraulic Hybrid Refuse Truck Evaluation Miami-Dade County Hydraulic Hybrid Refuse Truck Evaluation Photo of garbage truck with view of lake and city in background. As hydraulic hybrid refuse vehicles, with 29 more on order. Photo courtesy of Parker Hannifin NREL is

  14. Production of dimethylfuran for liquid fuels from biomass-derived carbohydrates.

    PubMed

    Román-Leshkov, Yuriy; Barrett, Christopher J; Liu, Zhen Y; Dumesic, James A

    2007-06-21

    Diminishing fossil fuel reserves and growing concerns about global warming indicate that sustainable sources of energy are needed in the near future. For fuels to be useful in the transportation sector, they must have specific physical properties that allow for efficient distribution, storage and combustion; these properties are currently fulfilled by non-renewable petroleum-derived liquid fuels. Ethanol, the only renewable liquid fuel currently produced in large quantities, suffers from several limitations, including low energy density, high volatility, and contamination by the absorption of water from the atmosphere. Here we present a catalytic strategy for the production of 2,5-dimethylfuran from fructose (a carbohydrate obtained directly from biomass or by the isomerization of glucose) for use as a liquid transportation fuel. Compared to ethanol, 2,5-dimethylfuran has a higher energy density (by 40 per cent), a higher boiling point (by 20 K), and is not soluble in water. This catalytic strategy creates a route for transforming abundant renewable biomass resources into a liquid fuel suitable for the transportation sector, and may diminish our reliance on petroleum.

  15. Applications study of advanced power generation systems utilizing coal-derived fuels, volume 2

    NASA Technical Reports Server (NTRS)

    Robson, F. L.

    1981-01-01

    Technology readiness and development trends are discussed for three advanced power generation systems: combined cycle gas turbine, fuel cells, and magnetohydrodynamics. Power plants using these technologies are described and their performance either utilizing a medium-Btu coal derived fuel supplied by pipeline from a large central coal gasification facility or integrated with a gasification facility for supplying medium-Btu fuel gas is assessed.

  16. 30 CFR 817.83 - Coal mine waste: Refuse piles.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 3 2013-07-01 2013-07-01 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... removed from the disposal area prior to placement of coal mine waste. Topsoil shall be removed, segregated...

  17. 30 CFR 816.83 - Coal mine waste: Refuse piles.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 3 2014-07-01 2014-07-01 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... removed from the disposal area prior to placement of coal mine waste. Topsoil shall be removed, segregated...

  18. 30 CFR 817.83 - Coal mine waste: Refuse piles.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 3 2014-07-01 2014-07-01 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... removed from the disposal area prior to placement of coal mine waste. Topsoil shall be removed, segregated...

  19. 30 CFR 816.83 - Coal mine waste: Refuse piles.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 3 2013-07-01 2013-07-01 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... removed from the disposal area prior to placement of coal mine waste. Topsoil shall be removed, segregated...

  20. 30 CFR 817.83 - Coal mine waste: Refuse piles.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 3 2012-07-01 2012-07-01 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... removed from the disposal area prior to placement of coal mine waste. Topsoil shall be removed, segregated...

  1. 30 CFR 816.83 - Coal mine waste: Refuse piles.

    Code of Federal Regulations, 2010 CFR

    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... removed from the disposal area prior to placement of coal mine waste. Topsoil shall be removed, segregated...

  2. 30 CFR 816.83 - Coal mine waste: Refuse piles.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 3 2011-07-01 2011-07-01 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... removed from the disposal area prior to placement of coal mine waste. Topsoil shall be removed, segregated...

  3. 30 CFR 816.83 - Coal mine waste: Refuse piles.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 3 2012-07-01 2012-07-01 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... removed from the disposal area prior to placement of coal mine waste. Topsoil shall be removed, segregated...

  4. 30 CFR 817.83 - Coal mine waste: Refuse piles.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 3 2011-07-01 2011-07-01 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... removed from the disposal area prior to placement of coal mine waste. Topsoil shall be removed, segregated...

  5. 30 CFR 817.83 - Coal mine waste: Refuse piles.

    Code of Federal Regulations, 2010 CFR

    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... removed from the disposal area prior to placement of coal mine waste. Topsoil shall be removed, segregated...

  6. Geographic clusters in underimmunization and vaccine refusal.

    PubMed

    Lieu, Tracy A; Ray, G Thomas; Klein, Nicola P; Chung, Cindy; Kulldorff, Martin

    2015-02-01

    Parental refusal and delay of childhood vaccines has increased in recent years and is believed to cluster in some communities. Such clusters could pose public health risks and barriers to achieving immunization quality benchmarks. Our aims were to (1) describe geographic clusters of underimmunization and vaccine refusal, (2) compare clusters of underimmunization with different vaccines, and (3) evaluate whether vaccine refusal clusters may pose barriers to achieving high immunization rates. We analyzed electronic health records among children born between 2000 and 2011 with membership in Kaiser Permanente Northern California. The study population included 154,424 children in 13 counties with continuous membership from birth to 36 months of age. We used spatial scan statistics to identify clusters of underimmunization (having missed 1 or more vaccines by 36 months of age) and vaccine refusal (based on International Classification of Diseases, Ninth Revision, Clinical Modification codes). We identified 5 statistically significant clusters of underimmunization among children who turned 36 months old during 2010-2012. The underimmunization rate within clusters ranged from 18% to 23%, and the rate outside them was 11%. Children in the most statistically significant cluster had 1.58 (P < .001) times the rate of underimmunization as others. Underimmunization with measles, mumps, rubella vaccine and varicella vaccines clustered in similar geographic areas. Vaccine refusal also clustered, with rates of 5.5% to 13.5% within clusters, compared with 2.6% outside them. Underimmunization and vaccine refusal cluster geographically. Spatial scan statistics may be a useful tool to identify locations with challenges to achieving high immunization rates, which deserve focused intervention. Copyright © 2015 by the American Academy of Pediatrics.

  7. The right to refuse treatment: a model act.

    PubMed Central

    1983-01-01

    Although the right to refuse medical treatment is universally recognized as a fundamental principle of liberty, this right is not always honored. A refusal can be thwarted either because a patient is unable to competently communicate or because providers insist on continuing treatment. To help enhance the patient's right to refuse treatment, many states have enacted so-called "living will" or "natural death" statutes. We believe the time has come to move beyond these current legislative models, and we therefore propose a Model Act that clearly enunciates an individual's right to refuse treatment, does not limit its exercise to the terminally ill or to heroic measures, and provides a mechanism by which individuals can set forth their wishes in advance and designate another person to enforce them. PMID:6869647

  8. Processes for converting biomass-derived feedstocks to chemicals and liquid fuels

    DOEpatents

    Held, Andrew; Woods, Elizabeth; Cortright, Randy; Gray, Matthew

    2017-05-23

    The present invention provides processes, methods, and systems for converting biomass-derived feedstocks to liquid fuels and chemicals. The method generally includes the reaction of a hydrolysate from a biomass deconstruction process with hydrogen and a catalyst to produce a reaction product comprising one of more oxygenated compounds. The process also includes reacting the reaction product with a condensation catalyst to produce C.sub.4+ compounds useful as fuels and chemicals.

  9. Processes for converting biomass-derived feedstocks to chemicals and liquid fuels

    DOEpatents

    Held, Andrew; Woods, Elizabeth; Cortright, Randy; Gray, Matthew

    2016-07-05

    The present invention provides processes, methods, and systems for converting biomass-derived feedstocks to liquid fuels and chemicals. The method generally includes the reaction of a hydrolysate from a biomass deconstruction process with hydrogen and a catalyst to produce a reaction product comprising one of more oxygenated compounds. The process also includes reacting the reaction product with a condensation catalyst to produce C.sub.4+ compounds useful as fuels and chemicals.

  10. Processes for converting biomass-derived feedstocks to chemicals and liquid fuels

    DOEpatents

    Held, Andrew; Woods, Elizabeth; Cortright, Randy; Gray, Matthew

    2018-04-17

    The present invention provides processes, methods, and systems for converting biomass-derived feedstocks to liquid fuels and chemicals. The method generally includes the reaction of a hydrolysate from a biomass deconstruction process with hydrogen and a catalyst to produce a reaction product comprising one of more oxygenated compounds. The process also includes reacting the reaction product with a condensation catalyst to produce C.sub.4+ compounds useful as fuels and chemicals.

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

    PubMed

    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 (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). 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-saving care. Copyright © 2014 Elsevier Inc. All rights reserved.

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

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Aizer, Ayal A., E-mail: aaaizer@partners.org; Chen, Ming-Hui; Parekh, Arti

    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.more » 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

  13. PATIENT REFUSAL OF THROMBOLYTIC THERAPY FOR SUSPECTED ACUTE ISCHEMIC STROKE

    PubMed Central

    FS, Vahidy; MH, Rahbar; AP, Lal; JC, Grotta; SI, Savitz

    2012-01-01

    Objective To determine factors associated with patients refusing IV t-PA for suspected acute ischemic stroke (AIS), and to compare the outcomes of patients who refused t-PA (RT) with those treated with t-PA. Methods Patients who were treated with and refused t-PA at our stroke center were identified retrospectively. Demographics, clinical presentation, and outcome measures were collected and compared. Clinical outcome was defined as excellent (mRS: 0–1), good (mRS: 0–2), and poor (mRS: 3–6). Results Over 7.5 years, thirty (4.2%) patients refused t-PA. There were no demographic differences between the treated and RT groups. The rate of RT decreased over time (OR 0.63, 95% CI 0.50 – 0.79). Factors associated with refusal included a later symptom onset to emergency department presentation time (OR 1.02, 95% CI 1.01 – 1.03), lower NIHSS (OR 1.11, 95% CI 1.03 – 1.18), a higher proportion of stroke mimics (OR 17.61, 95% CI 6.20 – 50.02) and shorter hospital stay (OR 1.32, 95% CI 1.09 – 1.61). Among patients who were subsequently diagnosed with ischemic stroke, only length of stay was significantly shorter for refusal patients (OR 1.37, 95% CI 1.06 – 1.78). After controlling for mild strokes and stroke mimics, clinical outcome was not different between the groups (OR 1.61, 95% CI 0.69 – 3.73). Conclusion The incidence of patients refusing t-PA has decreased over time, yet it may be a cause for t-PA under-utilization. Patients with milder symptoms were more likely to refuse t-PA. Refusal patients presented later to the hospital and had shorter hospital stays. One out six refusal patients (16.6%) had a stroke mimic. PMID:23227830

  14. 9 CFR 98.20 - Embryos refused entry.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 9 Animals and Animal Products 1 2013-01-01 2013-01-01 false Embryos refused entry. 98.20 Section... CERTAIN ANIMAL EMBRYOS AND ANIMAL SEMEN Ruminant and Swine Embryos From Regions Where Rinderpest or Foot-and-Mouth Disease Exists § 98.20 Embryos refused entry. If any embryos are determined to be ineligible...

  15. 9 CFR 98.20 - Embryos refused entry.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Embryos refused entry. 98.20 Section... CERTAIN ANIMAL EMBRYOS AND ANIMAL SEMEN Ruminant and Swine Embryos From Regions Where Rinderpest or Foot-and-Mouth Disease Exists § 98.20 Embryos refused entry. If any embryos are determined to be ineligible...

  16. 9 CFR 98.20 - Embryos refused entry.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 1 2012-01-01 2012-01-01 false Embryos refused entry. 98.20 Section... CERTAIN ANIMAL EMBRYOS AND ANIMAL SEMEN Ruminant and Swine Embryos From Regions Where Rinderpest or Foot-and-Mouth Disease Exists § 98.20 Embryos refused entry. If any embryos are determined to be ineligible...

  17. 9 CFR 98.20 - Embryos refused entry.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 1 2014-01-01 2014-01-01 false Embryos refused entry. 98.20 Section... CERTAIN ANIMAL EMBRYOS AND ANIMAL SEMEN Ruminant and Swine Embryos From Regions Where Rinderpest or Foot-and-Mouth Disease Exists § 98.20 Embryos refused entry. If any embryos are determined to be ineligible...

  18. 9 CFR 98.20 - Embryos refused entry.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false Embryos refused entry. 98.20 Section... CERTAIN ANIMAL EMBRYOS AND ANIMAL SEMEN Ruminant and Swine Embryos From Regions Where Rinderpest or Foot-and-Mouth Disease Exists § 98.20 Embryos refused entry. If any embryos are determined to be ineligible...

  19. Combustion Of Poultry-Derived Fuel in a CFBC

    NASA Astrophysics Data System (ADS)

    Jia, Lufei; Anthony, Edward J.

    Poultry farming generates large quantities of waste. Current disposal practice is to spread the poultry wastes onto farmland as fertilizer. However, as the factory farms for poultry grow both in numbers and size, the amount of poultry wastes generated has increased significandy in recent years. In consequence, excessive application of poultry wastes on farmland is resulting in more and more contaminants entering the surface water. One of the options being considered is the use of poultry waste as power plant fuel. Since poultry-derived fuel (PDF) is biomass, its co-firing will have the added advantage of reducing greenhouse gas emissions from power generation. To evaluate the combustion characteristics of co-firing PDF with coal, combustion tests of mixtures of coal and PDF were conducted in CanmetENERGY's pilot-scale CFBC. The goal of the tests was to verify that PDF can be co-fired with coal and, more importantly, that emissions from the combustion process are not adversely affected by the presence of PDF in the fuel feed. The test results were very promising and support the view that co-firing in an existing coal-fired CFBC is an effective method of utilizing this potential fuel, both resolving a potential waste disposal problem and reducing the amount of CO2 released by the boiler.

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

    PubMed

    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 <1%. Of all respondents, 69% prefer a shared decision-making approach to handle refusing parents.

  1. 42 CFR 493.567 - Refusal to cooperate with validation inspection.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 5 2013-10-01 2013-10-01 false Refusal to cooperate with validation inspection... § 493.567 Refusal to cooperate with validation inspection. (a) Laboratory with a certificate of accreditation. (1) A laboratory with a certificate of accreditation that refuses to cooperate with a validation...

  2. 42 CFR 493.567 - Refusal to cooperate with validation inspection.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Refusal to cooperate with validation inspection... § 493.567 Refusal to cooperate with validation inspection. (a) Laboratory with a certificate of accreditation. (1) A laboratory with a certificate of accreditation that refuses to cooperate with a validation...

  3. 42 CFR 493.567 - Refusal to cooperate with validation inspection.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 5 2014-10-01 2014-10-01 false Refusal to cooperate with validation inspection... § 493.567 Refusal to cooperate with validation inspection. (a) Laboratory with a certificate of accreditation. (1) A laboratory with a certificate of accreditation that refuses to cooperate with a validation...

  4. 42 CFR 493.567 - Refusal to cooperate with validation inspection.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Refusal to cooperate with validation inspection... § 493.567 Refusal to cooperate with validation inspection. (a) Laboratory with a certificate of accreditation. (1) A laboratory with a certificate of accreditation that refuses to cooperate with a validation...

  5. 42 CFR 493.567 - Refusal to cooperate with validation inspection.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 5 2012-10-01 2012-10-01 false Refusal to cooperate with validation inspection... § 493.567 Refusal to cooperate with validation inspection. (a) Laboratory with a certificate of accreditation. (1) A laboratory with a certificate of accreditation that refuses to cooperate with a validation...

  6. Prostate Cancer Patients' Refusal of Cancer-Directed Surgery: A Statewide Analysis

    PubMed Central

    Islam, K. M.

    2015-01-01

    Introduction. Prostate cancer is the most common cancer among men in USA. The surgical outcomes of prostate cancer remain inconsistent. Barriers such as socioeconomic factors may play a role in patients' decision of refusing recommended cancer-directed surgery. Methods. The Nebraska Cancer Registry data was used to calculate the proportion of prostate cancer patients recommended the cancer-directed surgery and the surgery refusal rate. Multivariate logistic regression was applied to analyze the socioeconomic indicators that were related to the refusal of surgery. Results. From 1995 to 2012, 14,876 prostate cancer patients were recommended to undergo the cancer-directed surgery in Nebraska, and 576 of them refused the surgery. The overall refusal rate of surgery was 3.9% over the 18 years. Patients with early-stage prostate cancer were more likely to refuse the surgery. Patients who were Black, single, or covered by Medicaid/Medicare had increased odds of refusing the surgery. Conclusion. Socioeconomic factors were related to the refusal of recommended surgical treatment for prostate cancer. Such barriers should be addressed to improve the utilization of surgical treatment and patients' well-being. PMID:25973276

  7. 20 CFR 229.81 - Refusal to accept vocational rehabilitation.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... disabled employee refuses, without good reason, to accept vocational rehabilitation services available... in which the child refuses, without good reason, to accept such vocational rehabilitation services...

  8. Highly selective condensation of biomass-derived methyl ketones as a source of aviation fuel.

    PubMed

    Sacia, Eric R; Balakrishnan, Madhesan; Deaner, Matthew H; Goulas, Konstantinos A; Toste, F Dean; Bell, Alexis T

    2015-05-22

    Aviation fuel (i.e., jet fuel) requires a mixture of C9 -C16 hydrocarbons having both a high energy density and a low freezing point. While jet fuel is currently produced from petroleum, increasing concern with the release of CO2 into the atmosphere from the combustion of petroleum-based fuels has led to policy changes mandating the inclusion of biomass-based fuels into the fuel pool. Here we report a novel way to produce a mixture of branched cyclohexane derivatives in very high yield (>94 %) that match or exceed many required properties of jet fuel. As starting materials, we use a mixture of n-alkyl methyl ketones and their derivatives obtained from biomass. These synthons are condensed into trimers via base-catalyzed aldol condensation and Michael addition. Hydrodeoxygenation of these products yields mixtures of C12 -C21 branched, cyclic alkanes. Using models for predicting the carbon number distribution obtained from a mixture of n-alkyl methyl ketones and for predicting the boiling point distribution of the final mixture of cyclic alkanes, we show that it is possible to define the mixture of synthons that will closely reproduce the distillation curve of traditional jet fuel. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  9. Life cycle assessment of fuel ethanol derived from corn grain via dry milling.

    PubMed

    Kim, Seungdo; Dale, Bruce E

    2008-08-01

    Life cycle analysis enables to investigate environmental performance of fuel ethanol used in an E10 fueled compact passenger vehicle. Ethanol is derived from corn grain via dry milling. This type of analysis is an important component for identifying practices that will help to ensure that a renewable fuel, such as ethanol, may be produced in a sustainable manner. Based on data from eight counties in seven Corn Belt states as corn farming sites, we show ethanol derived from corn grain as E10 fuel would reduce nonrenewable energy and greenhouse gas emissions, but would increase acidification, eutrophication and photochemical smog, compared to using gasoline as liquid fuel. The ethanol fuel systems considered in this study offer economic benefits, namely more money returned to society than the investment for producing ethanol. The environmental performance of ethanol fuel system varies significantly with corn farming sites because of different crop management practices, soil properties, and climatic conditions. The dominant factor determining most environmental impacts considered here (i.e., greenhouse gas emissions, acidification, eutrophication, and photochemical smog formation) is soil related nitrogen losses (e.g., N2O, NOx, and NO3-). The sources of soil nitrogen include nitrogen fertilizer, crop residues, and air deposition. Nitrogen fertilizer is probably the primary source. Simulations using an agro-ecosystem model predict that planting winter cover crops would reduce soil nitrogen losses and increase soil organic carbon levels, thereby greatly improving the environmental performance of the ethanol fuel system.

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

    PubMed

    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.

  11. The right to refuse.

    PubMed

    Baston, Simon

    2007-03-01

    Accepting or refusing clinical treatment is an adult's right, and guidance for healthcare professionals on the issue is set out in the Reference Guide to Consent for Examination or Treatment ( Department of Health 2001 ).

  12. Alternative Bio-Derived JP-8 Class Fuel and JP-8 Fuel: Flame Tube Combustor Test Results Compared using a GE TAPS Injector Configuration

    NASA Technical Reports Server (NTRS)

    Hicks, Yolanda R.; Tedder, Sarah A.; Anderson, Robert C.

    2016-01-01

    This paper presents results from tests in a flame tube facility, where a bio-derived alternate fuel was compared with JP-8 for emissions and general combustion performance. A research version of General Electric Aviation (GE) TAPS injector was used for the tests. Results include combustion efficiency from gaseous emission measurements, 2D planar laser-based imaging as well as basic flow visualization of the flame. Four inlet test conditions were selected that simulate various engine power conditions relevant to NASA Fundamental Aeronautics Supersonics Project and Environmentally Responsible Aviation Program. One inlet condition was a pilot-only test point. The other three inlet conditions incorporated fuel staging via a split between the pilot and main circuits of either 10%/90% or 20%/80%. For each engine power condition, three fuel mixes were used: 100% JP-8; 100% alternative; and a blend of the two, containing 75% alternative. Results for the inlet cases that have fuel split between pilot and main, indicate that fuel from the pilot appears to be evaporated by the time it reaches the dome exit. Main circuit liquid evaporates within a downstream distance equal to annulus height, no matter the fuel. Some fuel fluorescence images for a 10%/90% fuel staging case show a distinct difference between JP-8 and bio-derived fuel. OH PLIF results indicate that OH forms in a region more centrally-located for the JP-8 case downstream of the pilot, in its central recirculation region (CRZ). For the bio-derived Hydrotreated Renewable Jet (HRJ) fuel, however, we do not see much OH in the CRZ. The OH image structure near the dome exit is similar for the two fuels, but farther downstream the OH in the CRZ is much more apparent for the JP-8 than for the alternate fuel. For all conditions, there was no discernable difference between fuel types in combustion efficiency or emissions.

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

    ERIC Educational Resources Information Center

    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…

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

    PubMed

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

    2012-10-01

    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. Copyright © 2012 Elsevier Ltd. All rights reserved.

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

    PubMed

    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 (p<0.001), poor performance(p<0.001), changes in medical condition (p<0.001), timing of case manager contact (p=.026), the methods by which case manager contact patients (p<0.001) and the frequency that case managers contact patients (≥10times) (p=0.016). Cancer patients who refuse 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.

  16. 47 CFR 73.4005 - Advertising-refusal to sell.

    Code of Federal Regulations, 2010 CFR

    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...

  17. 47 CFR 73.4005 - Advertising-refusal to sell.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 4 2011-10-01 2011-10-01 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...

  18. 47 CFR 73.4005 - Advertising-refusal to sell.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 4 2012-10-01 2012-10-01 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...

  19. 47 CFR 73.4005 - Advertising-refusal to sell.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 4 2014-10-01 2014-10-01 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...

  20. 47 CFR 73.4005 - Advertising-refusal to sell.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 4 2013-10-01 2013-10-01 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...

  1. [Novel resources utilization technique for rural domestic refuse].

    PubMed

    Qiu, Cai-Di; He, Ruo; Chen, Song-Mei; Lou, Bin; Shen, Dong-Sheng

    2009-03-15

    In order to speed up rural domestic refuse resources utilization, intermittent aeration and continuous aeration were applied to treat rural domestic refuse after anaerobic fermentation. Three kinds of refuse were selected on base of fermentative age, i.e. three months, five months and seven months. Results showed that aeration could remove water and organic materials of the refuse effectively. Points of view on aeration, continuous aeration was better than intermittent aeration, and on the other side, water removal rate increased with ventilation and decreased with fermentative age in the condition of intermittent aeration. On organic materials removal point, it was affected by fermentative age significantly, i. e. increase of fermentative age could resulted in decrease in the removal efficiency. In conclusion, intermittent aeration of 0.06 m3/(min x m3) was considered to be feasible for treatment. The water removal efficiency of three months, five months and seven months fermentative age refuse could be up to 49.1%, 45.3% and 44.0%, and organic compound removal efficiency was 41.9%, 24.8% and 13.1%, respectively, after intermittent aeration for 21 d. Moreover, concentrated effect was presented on major nutrient ingredients, such as total nitrogen, phosphorus, and potassium during the aeration, which realized for resources utilization.

  2. EVALUATION OF TIRE-DERIVED FUEL FOR USE IN NITROGEN OXIDE REDUCTION BY REBURNING

    EPA Science Inventory

    Tire-derived fuel (TDF) was tested in a small-scale (44 kW or 150,000 Btu/hr) combustor to determine its feasibility as a fuel for use in reburning for control of nitrogen oxide (NO). TDF was gravity-fed into upward flowing combustion gases from a primary natural gas flame doped ...

  3. Electroreduction of carbon monoxide to liquid fuel on oxide-derived nanocrystalline copper.

    PubMed

    Li, Christina W; Ciston, Jim; Kanan, Matthew W

    2014-04-24

    The electrochemical conversion of CO2 and H2O into liquid fuel is ideal for high-density renewable energy storage and could provide an incentive for CO2 capture. However, efficient electrocatalysts for reducing CO2 and its derivatives into a desirable fuel are not available at present. Although many catalysts can reduce CO2 to carbon monoxide (CO), liquid fuel synthesis requires that CO is reduced further, using H2O as a H(+) source. Copper (Cu) is the only known material with an appreciable CO electroreduction activity, but in bulk form its efficiency and selectivity for liquid fuel are far too low for practical use. In particular, H2O reduction to H2 outcompetes CO reduction on Cu electrodes unless extreme overpotentials are applied, at which point gaseous hydrocarbons are the major CO reduction products. Here we show that nanocrystalline Cu prepared from Cu2O ('oxide-derived Cu') produces multi-carbon oxygenates (ethanol, acetate and n-propanol) with up to 57% Faraday efficiency at modest potentials (-0.25 volts to -0.5 volts versus the reversible hydrogen electrode) in CO-saturated alkaline H2O. By comparison, when prepared by traditional vapour condensation, Cu nanoparticles with an average crystallite size similar to that of oxide-derived copper produce nearly exclusive H2 (96% Faraday efficiency) under identical conditions. Our results demonstrate the ability to change the intrinsic catalytic properties of Cu for this notoriously difficult reaction by growing interconnected nanocrystallites from the constrained environment of an oxide lattice. The selectivity for oxygenates, with ethanol as the major product, demonstrates the feasibility of a two-step conversion of CO2 to liquid fuel that could be powered by renewable electricity.

  4. Refusing in a Foreign Language: An Investigation of Problems Encountered by Chinese Learners of English

    ERIC Educational Resources Information Center

    Chang, Yuh-Fang

    2011-01-01

    Whereas the speech act of refusal is universal across language, the politeness value and the types of linguistic forms used to perform it vary across language and culture. The majority of the comparative pragmatic research findings were derived from one single source of data (i.e., either production data or perception data). Few attempts have been…

  5. Veterinary opinions on refusing euthanasia: justifications and philosophical frameworks.

    PubMed

    Yeates, J W; Main, D C J

    2011-03-12

    To obtain information on euthanasia decisions from practising veterinary surgeons, respondents were asked to estimate how often during their time in practice they had refused to euthanase a dog and how often they had wanted to refuse to euthanase a dog but not done so because of other pressures. For each, respondents were then asked to state their most common reasons for refusing/not refusing in free text. The responses of clinicians were considered in the light of established ethical concepts to produce an evidence-based ethical framework for decision making. In total, 58 practitioners responded. Common reasons given for decisions on whether to refuse euthanasia referred to the patient's interests, such as the possibility of treatment or rehoming, and the fear of other unacceptable outcomes for the dog. Other reasons were based on concern for owners' interests. Some respondents reported being pressured into euthanasia by clients and other veterinary surgeons. This gives insight into the ethical principles that explicitly underlie veterinary surgeons' euthanasia decisions and the resultant framework may be useful for discussing and teaching euthanasia.

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

    PubMed

    Després, C; Couralet, P-E

    2011-04-01

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

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

    PubMed

    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.

  8. Hydrodeoxygenation processes: advances on catalytic transformations of biomass-derived platform chemicals into hydrocarbon fuels.

    PubMed

    De, Sudipta; Saha, Basudeb; Luque, Rafael

    2015-02-01

    Lignocellulosic biomass provides an attractive source of renewable carbon that can be sustainably converted into chemicals and fuels. Hydrodeoxygenation (HDO) processes have recently received considerable attention to upgrade biomass-derived feedstocks into liquid transportation fuels. The selection and design of HDO catalysts plays an important role to determine the success of the process. This review has been aimed to emphasize recent developments on HDO catalysts in effective transformations of biomass-derived platform molecules into hydrocarbon fuels with reduced oxygen content and improved H/C ratios. Liquid hydrocarbon fuels can be obtained by combining oxygen removal processes (e.g. dehydration, hydrogenation, hydrogenolysis, decarbonylation etc.) as well as by increasing the molecular weight via C-C coupling reactions (e.g. aldol condensation, ketonization, oligomerization, hydroxyalkylation etc.). Fundamentals and mechanistic aspects of the use of HDO catalysts in deoxygenation reactions will also be discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. 28 CFR 549.65 - Refusal to accept treatment.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Refusal to accept treatment. 549.65 Section 549.65 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT MEDICAL SERVICES Hunger Strikes, Inmate § 549.65 Refusal to accept treatment. (a) When, as a result of...

  10. 16 CFR § 1210.18 - Refusal of importation.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 16 Commercial Practices 2 2013-01-01 2013-01-01 false Refusal of importation. § 1210.18 Section § 1210.18 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS SAFETY STANDARD FOR CIGARETTE LIGHTERS Certification Requirements § 1210.18 Refusal of importation. (a...

  11. Expedited Partner Therapy: Pharmacist Refusal of Legal Prescriptions.

    PubMed

    Borchardt, Lauren N; Pickett, Michelle L; Tan, Kevin T; Visotcky, Alexis M; Drendel, Amy L

    2018-05-01

    Expedited partner therapy (EPT) is an effective strategy for partner management of sexually transmitted infections. Some states, including Wisconsin, allow EPT prescriptions to be filled without a patient name. This study determined the refusal rates of nameless EPT prescriptions in Milwaukee pharmacies. In this cross-sectional study, 3 trained research assistants of different age, sex, and race posed as "patients" and visited 50 pharmacy locations from one pharmacy chain in Milwaukee County, WI, to fill nameless EPT prescriptions. A χ test was used to compare demographics of patients, pharmacists, and pharmacies. Multiple logistic regression was used to identify factors associated with prescription refusal. Twenty-nine (58%) of 50 nameless EPT prescriptions were refused. Univariate analysis showed that prescriptions were more likely to be refused if the pharmacy was in the suburbs (77%) compared with Milwaukee city (43%; P = 0.01), if the pharmacist was older than the patient (82%) compared with being younger (46%) or within the same age group (33%; P = 0.01 for both), and if the patient was white (78%) compared with nonwhite (47%; P = 0.03). Multivariable regression revealed significantly higher refusals for pharmacies located in the suburbs compared with the city (odds ratio, 5.3; 95% confidence interval, 1.4-20.3; P = 0.03) and in patients who were white compared with nonwhite (odds ratio: 4.8; 95% confidence interval, 1.2-19.8; P = 0.01). More than half of nameless EPT prescriptions were refused in Milwaukee county pharmacies, more frequently at suburban pharmacies and for white patients. Increased pharmacist education regarding EPT is essential to help combat the sexually transmitted infection crisis.

  12. A preliminary assessment of the feasibility of deriving liquid and gaseous fuels from grown and waste organics

    NASA Technical Reports Server (NTRS)

    Graham, R. W.; Reynolds, T. W.; Hsu, Y. Y.

    1976-01-01

    The anticipated depletion of our resources of natural gas and petroleum in a few decades has caused a search for renewable sources of fuel. Among the possibilities is the chemical conversion of waste and grown organic matter into gaseous or liquid fuels. The overall feasibility of such a system is considered from the technical, economic, and social viewpoints. Although there are a number of difficult problems to overcome, this preliminary study indicates that this option could provide between 4 and 10 percent of the U.S. energy needs. Estimated costs of fuels derived from grown organic material are appreciably higher than today's market price for fossil fuel. The cost of fuel derived from waste organics is competitive with fossil fuel prices. Economic and social reasons will prohibit the allocation of good food producing land to fuel crop production.

  13. QUANTIFYING HAZARDOUS SPECIES IN PARTICULATE MATTER DERIVED FROM FOSSIL-FUEL COMBUSTION

    EPA Science Inventory

    An analysis protocol that combines X-ray absorption near-edge structure spectroscopy with selective leaching has been developed to examine hazardous species in size- segregated particulate matter (PM) samples derived from the combustion of fossil fuels. The protocol has been used...

  14. Refusal bias in HIV prevalence estimates from nationally representative seroprevalence surveys.

    PubMed

    Reniers, Georges; Eaton, Jeffrey

    2009-03-13

    To assess the relationship between prior knowledge of one's HIV status and the likelihood to refuse HIV testing in populations-based surveys and explore its potential for producing bias in HIV prevalence estimates. Using longitudinal survey data from Malawi, we estimate the relationship between prior knowledge of HIV-positive status and subsequent refusal of an HIV test. We use that parameter to develop a heuristic model of refusal bias that is applied to six Demographic and Health Surveys, in which refusal by HIV status is not observed. The model only adjusts for refusal bias conditional on a completed interview. Ecologically, HIV prevalence, prior testing rates and refusal for HIV testing are highly correlated. Malawian data further suggest that amongst individuals who know their status, HIV-positive individuals are 4.62 (95% confidence interval, 2.60-8.21) times more likely to refuse testing than HIV-negative ones. On the basis of that parameter and other inputs from the Demographic and Health Surveys, our model predicts downward bias in national HIV prevalence estimates ranging from 1.5% (95% confidence interval, 0.7-2.9) for Senegal to 13.3% (95% confidence interval, 7.2-19.6) for Malawi. In absolute terms, bias in HIV prevalence estimates is negligible for Senegal but 1.6 (95% confidence interval, 0.8-2.3) percentage points for Malawi. Downward bias is more severe in urban populations. Because refusal rates are higher in men, seroprevalence surveys also tend to overestimate the female-to-male ratio of infections. Prior knowledge of HIV status informs decisions to participate in seroprevalence surveys. Informed refusals may produce bias in estimates of HIV prevalence and the sex ratio of infections.

  15. A comparison of refuse attenuation in laboratory and field scale lysimeters.

    PubMed

    Youcai, Zhao; Luochun, Wang; Renhua, Hua; Dimin, Xu; Guowei, Gu

    2002-01-01

    For this study, small and middle scale laboratory lysimeters, and a large scale field lysimeter in situ in Shanghai Refuse Landfill, with refuse weights of 187,600 and 10,800,000 kg, respectively, were created. These lysimeters are compared in terms of leachate quality (pH, concentrations of COD, BOD and NH3-N), refuse composition (biodegradable matter and volatile solid) and surface settlement for a monitoring period of 0-300 days. The objectives of this study were to explore both the similarities and disparities between laboratory and field scale lysimeters, and to compare degradation behaviors of refuse at the intensive reaction phase in the different scale lysimeters. Quantitative relationships of leachate quality and refuse composition with placement time show that degradation behaviors of refuse seem to depend heavily on the scales of the lysimeters and the parameters of concern, especially in the starting period of 0-6 months. However, some similarities exist between laboratory and field lysimeters after 4-6 months of placement because COD and BOD concentrations in leachate in the field lysimeter decrease regularly in a parallel pattern with those in the laboratory lysimeters. NH3-N, volatile solid (VS) and biodegradable matter (BDM) also gradually decrease in parallel in this intensive reaction phase for all scale lysimeters as refuse ages. Though the concrete data are different among the different scale lysimeters, it may be considered that laboratory lysimeters with sufficient scale are basically applicable for a rough simulation of a real landfill, especially for illustrating the degradation pattern and mechanism. Settlement of refuse surface is roughly proportional to the initial refuse height.

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

    PubMed

    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.

  17. Lime retention in anthracite coal-breaker refuse

    Treesearch

    Miroslaw M. Czapowskyj; Edward A. Sowa

    1973-01-01

    Hydrated lime was applied to extremely acid anthracite coal-breaker refuse at rates of 2.5 and 5.0 tons per acre. The lime raised the pH to neutral range, and this range was still in evidence 7 years after treatment. The pH readings decreased with the depth of the refuse profile, and below 9 inches they approximated those of the control plots. The 2.5-tons-of-lime-per-...

  18. 38 CFR 17.100 - Refusal of treatment by unnecessarily breaking appointments.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Refusal of treatment by... VETERANS AFFAIRS MEDICAL Breaking Appointments § 17.100 Refusal of treatment by unnecessarily breaking... informed that breaking an additional appointment will be deemed to be a refusal to accept VA treatment. If...

  19. 43 CFR 15.4 - Refuse and polluting substances.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 43 Public Lands: Interior 1 2014-10-01 2014-10-01 false Refuse and polluting substances. 15.4 Section 15.4 Public Lands: Interior Office of the Secretary of the Interior KEY LARGO CORAL REEF PRESERVE § 15.4 Refuse and polluting substances. No person shall dump or deposit in or on the waters of this...

  20. 43 CFR 15.4 - Refuse and polluting substances.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 43 Public Lands: Interior 1 2013-10-01 2013-10-01 false Refuse and polluting substances. 15.4 Section 15.4 Public Lands: Interior Office of the Secretary of the Interior KEY LARGO CORAL REEF PRESERVE § 15.4 Refuse and polluting substances. No person shall dump or deposit in or on the waters of this...

  1. 43 CFR 15.4 - Refuse and polluting substances.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 43 Public Lands: Interior 1 2012-10-01 2011-10-01 true Refuse and polluting substances. 15.4 Section 15.4 Public Lands: Interior Office of the Secretary of the Interior KEY LARGO CORAL REEF PRESERVE § 15.4 Refuse and polluting substances. No person shall dump or deposit in or on the waters of this...

  2. 43 CFR 15.4 - Refuse and polluting substances.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 43 Public Lands: Interior 1 2011-10-01 2011-10-01 false Refuse and polluting substances. 15.4 Section 15.4 Public Lands: Interior Office of the Secretary of the Interior KEY LARGO CORAL REEF PRESERVE § 15.4 Refuse and polluting substances. No person shall dump or deposit in or on the waters of this...

  3. 43 CFR 15.4 - Refuse and polluting substances.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Refuse and polluting substances. 15.4 Section 15.4 Public Lands: Interior Office of the Secretary of the Interior KEY LARGO CORAL REEF PRESERVE § 15.4 Refuse and polluting substances. No person shall dump or deposit in or on the waters of this...

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

    PubMed

    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.

  5. Breath Test Refusals and Their Effect on DWI Prosecution

    DOT National Transportation Integrated Search

    2012-07-01

    This report describes the design and results of a project aimed at estimating the rate that drivers : refuse to submit to a legally-requested breath alcohol concentration test, and the effect of such : refusals on the prosecution of DWI cases. The st...

  6. 37 CFR 211.7 - Reconsideration procedure for refusals to register.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... CONGRESS COPYRIGHT OFFICE AND PROCEDURES MASK WORK PROTECTION § 211.7 Reconsideration procedure for... refusals to register copyright claims are applicable to requests to reconsider refusals to register mask...

  7. Parental Refusal of Vitamin K and Neonatal Preventive Services: A Need for Surveillance

    PubMed Central

    Marcewicz, Lauren H.; Clayton, Joshua; Maenner, Matthew; Odom, Erika; Okoroh, Ekwutosi; Christensen, Deborah; Goodman, Alyson; Warren, Michael D.; Traylor, Julie; Miller, Angela; Jones, Timothy; Dunn, John; Schaffner, William; Grant, Althea

    2017-01-01

    Objectives Vitamin K deficiency bleeding (VKDB) in infants is a coagulopathy preventable with a single dose of injectable vitamin K at birth. The Tennessee Department of Health (TDH) and Centers for Disease Control and Prevention (CDC) investigated vitamin K refusal among parents in 2013 after learning of four cases of VKDB associated with prophylaxis refusal. Methods Chart reviews were conducted at Nashville-area hospitals for 2011–2013 and Tennessee birthing centers for 2013 to identify parents who had refused injectable vitamin K for their infants. Contact information was obtained for parents, and they were surveyed regarding their reasons for refusing. Results At hospitals, 3.0% of infants did not receive injectable vitamin K due to parental refusal in 2013, a frequency higher than in 2011 and 2012. This percentage was much higher at birthing centers, where 31% of infants did not receive injectable vitamin K. The most common responses for refusal were a belief that the injection was unnecessary (53%) and a desire for a natural birthing process (36%). Refusal of other preventive services was common, with 66% of families refusing vitamin K, newborn eye care with erythromycin, and the neonatal dose of hepatitis B vaccine. Conclusions for Practice Refusal of injectable vitamin K was more common among families choosing to give birth at birthing centers than at hospitals, and was related to refusal of other preventive services in our study. Surveillance of vitamin K refusal rates could assist in further understanding this occurrence and tailoring effective strategies for mitigation. PMID:28054156

  8. Parental Refusal of Vitamin K and Neonatal Preventive Services: A Need for Surveillance.

    PubMed

    Marcewicz, Lauren H; Clayton, Joshua; Maenner, Matthew; Odom, Erika; Okoroh, Ekwutosi; Christensen, Deborah; Goodman, Alyson; Warren, Michael D; Traylor, Julie; Miller, Angela; Jones, Timothy; Dunn, John; Schaffner, William; Grant, Althea

    2017-05-01

    Objectives Vitamin K deficiency bleeding (VKDB) in infants is a coagulopathy preventable with a single dose of injectable vitamin K at birth. The Tennessee Department of Health (TDH) and Centers for Disease Control and Prevention (CDC) investigated vitamin K refusal among parents in 2013 after learning of four cases of VKDB associated with prophylaxis refusal. Methods Chart reviews were conducted at Nashville-area hospitals for 2011-2013 and Tennessee birthing centers for 2013 to identify parents who had refused injectable vitamin K for their infants. Contact information was obtained for parents, and they were surveyed regarding their reasons for refusing. Results At hospitals, 3.0% of infants did not receive injectable vitamin K due to parental refusal in 2013, a frequency higher than in 2011 and 2012. This percentage was much higher at birthing centers, where 31% of infants did not receive injectable vitamin K. The most common responses for refusal were a belief that the injection was unnecessary (53%) and a desire for a natural birthing process (36%). Refusal of other preventive services was common, with 66% of families refusing vitamin K, newborn eye care with erythromycin, and the neonatal dose of hepatitis B vaccine. Conclusions for Practice Refusal of injectable vitamin K was more common among families choosing to give birth at birthing centers than at hospitals, and was related to refusal of other preventive services in our study. Surveillance of vitamin K refusal rates could assist in further understanding this occurrence and tailoring effective strategies for mitigation.

  9. Refusal to medical interventions.

    PubMed

    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.

  10. Refusal of Medical and Surgical Interventions by Older Persons with Advanced Chronic Disease

    PubMed Central

    Van Ness, Peter H.; O’Leary, John R.; Fried, Terri R.

    2007-01-01

    BACKGROUND Patients with advanced chronic disease are frequently offered medical and surgical interventions with potentially large trade-offs between benefits and burdens. Little is known about the frequency or outcomes of treatment refusal among these patients. OBJECTIVE To assess the frequency of, reasons for, factors associated with, and outcomes of treatment refusal among older persons with advanced chronic disease. DESIGN Observational cohort study. PARTICIPANTS Two hundred twenty-six community-dwelling persons with advanced cancer, chronic obstructive pulmonary disease, or congestive heart failure, interviewed at least every 4 months for up to 2 years. MEASUREMENTS Participants were asked if they had refused any treatments recommended by their physicians, and why. RESULTS Thirty-six of 226 patients (16%) reported refusing 1 or more medical or surgical treatments recommended by their physician. The most frequently refused interventions were cardiac catheterization and surgery. The most common reason for refusal was fear of side effects (41%). Treatment refusal was more frequent among patients who wanted prognostic information (10% vs 2%, p = .02) or estimated their own longevity at 2 years or less (18% vs 5%, p = .02). There was an increased risk of mortality among refusers compared with non-refusers (HR 1.98, 95% CI 1.02–3.86). CONCLUSIONS Refusal of medical and surgical interventions other than medications is common among persons with advanced chronic disease, and is associated with a greater desire for, and understanding of, prognostic information. PMID:17483977

  11. Consent and refusal in dementia research: conceptual and practical considerations.

    PubMed

    Cohen-Mansfield, J

    2003-01-01

    This article discusses types of consent refusals, rates of refusal, factors that affect consent, and methods to increase rates of consent in elderly research participants and in those with dementia in particular. Refusals can be categorized according to several types: complete refusal, refusal that is time-contingent, partial refusal, and contingent agreement. Rates of consent vary greatly across studies of persons with dementia. This variation can also be affected by different methodologies of calculating rates, in addition to differences in content of studies, populations, and procedures. To warrant consent, a study must first be scientifically sound, with a high likelihood of advancing knowledge, and must provide maximal protection to participants. Consent rates are affected by the following factors: levels of anticipated risks and benefits of the study, relationships among the different caregivers involved in the care of the potential subject, the ability of the researcher to properly identify and locate the person who needs to provide consent, characteristics and attitudes of the person providing consent, and the method of obtaining consent, including timing, location, method of presentation, and type of consent requested. An understanding of these issues can assist the researcher in tailoring research procedures so as to maximize rates of consent. It also raises ethical issues that warrant further discussion concerning the process of obtaining consent from and for persons with dementia.

  12. Technology Evaluation for Densified Refuse-Derived Fuel Specifications and Acquisition.

    DTIC Science & Technology

    1983-12-01

    1983 Port Hueneme, CA 93043 13 "U"Safm OF VAS34 14 ONITORING AGENCYv NAME 6 ADDRESS"’I d’"""e..s f.. e.Ifgs.o"".) WI SECURITY CLASS, (-# ch ~l e...21180 7845 17.88 23.26 23.50 4.43 7122180 9345 18.27 22.18 12.22 15.1t) 7/23/80 7922 15.88 8.92 19.84 13.95 7/24/80 8177 21.28 18.71 21.20 lb.5, 7/25

  13. Size exclusion chromatographic analysis of refuse-derived fuel for mycotoxins

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Bicking, M.K.; Kniseley, R.N.

    1980-11-01

    A Styragel packing material is characterized in several solvent systems by using a series of test solutes and mycotoxins. Differences in interpretation with other work are discussed. Three different separation modes are generated on one stationary phase. An improved separation of mycotoxins from a compilcated matrix results by simultaneously using size exclusion and liquid-liquid partitioning. 4 figures, 3 tables.

  14. Refusing The Choice: Balancing Life and Work

    NASA Astrophysics Data System (ADS)

    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.

  15. 49 CFR 219.209 - Reports of tests and refusals.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 4 2012-10-01 2012-10-01 false Reports of tests and refusals. 219.209 Section 219.209 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Post-Accident Toxicological Testing § 219.209 Reports of tests and refusals. (...

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

    PubMed

    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.

  17. 40 CFR 49.123 - General provisions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Liquid Hydrocarbon Fuels by Bomb Calorimeter, IBR approved for § 49.123(a). (iv) ASTM D1826-94(Reapproved... Test Method for Gross Calorific Value of Refuse-Derived Fuel by the Bomb Calorimeter, IBR approved for...

  18. [The parents' experience of school refusal in adolescence].

    PubMed

    Bussard, Dewi; Harf, Aurélie; Sibeoni, Jordan; Radjack, Rahmeth; Benoit, Jean Pierre; Moro, Marie Rose

    2015-01-01

    While today's society places considerable importance on schooling and performances, school absenteeism is currently very high. One of the causes is anxiety-based school refusal. This phenomenon affects the adolescent but also has an impact on their family. Exploring the experience of the parents of teenagers presenting anxiety-based school refusal enables these families to be given better support. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  19. Intensive (Daily) Behavior Therapy for School Refusal: A Multiple Baseline Case Series

    ERIC Educational Resources Information Center

    Tolin, David F.; Whiting, Sara; Maltby, Nicholas; Diefenbach, Gretchen J.; Lothstein, Mary Anne; Hardcastle, Surrey; Catalano, Amy; Gray, Krista

    2009-01-01

    The following multiple baseline case series examines school refusal behavior in 4 male adolescents. School refusal symptom presentation was ascertained utilizing a functional analysis from the School Refusal Assessment Scale (Kearney, 2002). For the majority of cases, treatment was conducted within a 15-session intensive format over a 3-week…

  20. 49 CFR 219.209 - Reports of tests and refusals.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Reports of tests and refusals. 219.209 Section 219... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Post-Accident Toxicological Testing § 219.209 Reports of tests and refusals. (a)(1) A railroad that has experienced one or more events for...

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

    PubMed

    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.

  2. Alternative Fuels Data Center: Kentucky Charges Forward with All-Electric

    Science.gov Websites

    Partnership. Download QuickTime Video QuickTime (.mov) Download Windows Media Video Windows Media (.wmv) Video Fuel Cell Vehicles in California Nov. 18, 2017 Photo of a car Smart Car Shopping Nov. 4, 2017 Image of Photo of a truck Natural Gas Fuels School Buses and Refuse Trucks in Tulsa, Oklahoma Feb. 18, 2017 Photo

  3. Refusal of postoperative radiotherapy and its association with survival in head and neck cancer.

    PubMed

    Schwam, Zachary G; Husain, Zain; Judson, Benjamin L

    2015-11-01

    Administering postoperative radiotherapy (PORT) is associated with improved survival and slower disease progression in select head and neck cancer patients. Predictive factors for PORT refusal have not been described in this population. Retrospective analysis of 6127 head and neck cancer patients who received or refused PORT in the National Cancer Database (2003-2006) was performed. Statistical analysis included Chi-square, multivariable logistic regression, Kaplan-Meier, and Cox proportional hazards analysis. In total, 247 patients (4.0%) refused PORT. Three-year overall survival was 62.8% versus 53.4% for those who received and refused PORT, respectively. PORT refusers were more likely to have negative nodes than those who underwent PORT (37.4% versus 20.1%, p<.001). In multivariate analysis, predictive factors for refusing PORT included living far from the treatment facility (OR 1.92), having negative nodes (OR 2.14), and Charlson score of ⩾ 2 (OR 2.14) (all p ⩽.001). PORT refusal was associated with increased mortality (hazard ratio 1.20, p=.044). A significant proportion of head and neck cancer patients refused PORT; this was associated with compromised overall survival. Predictive factors for PORT refusal included socioeconomic, demographic, and pathologic variables. Elucidating root causes of refusal may lead to interventions that improve long-term outcomes. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  4. 40 CFR 260.11 - References.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Hydrocarbon Fuels by Bomb Calorimeter (High-Precision Method),” IBR approved for §§ 264.1033, 265.1033. (5... Methods for Preparing Refuse-Derived Fuel (RDF) Samples for Analyses of Metals,” Test Method C—Bomb, Acid...

  5. Production and Optimization of Direct Coal Liquefaction derived Low Carbon-Footprint Transportation Fuels

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Steven Markovich

    This report summarizes works conducted under DOE Contract No. DE-FC26-05NT42448. The work scope was divided into two categories - (a) experimental program to pretreat and refine a coal derived syncrude sample to meet transportation fuels requirements; (b) system analysis of a commercial scale direct coal liquefaction facility. The coal syncrude was derived from a bituminous coal by Headwaters CTL, while the refining study was carried out under a subcontract to Axens North America. The system analysis included H{sub 2} production cost via six different options, conceptual process design, utilities requirements, CO{sub 2} emission and overall plant economy. As part ofmore » the system analysis, impact of various H{sub 2} production options was evaluated. For consistence the comparison was carried out using the DOE H2A model. However, assumptions in the model were updated using Headwaters database. Results of Tier 2 jet fuel specifications evaluation by the Fuels & Energy Branch, US Air Force Research Laboratory (AFRL/RZPF) located at Wright Patterson Air Force Base (Ohio) are also discussed in this report.« less

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

    ERIC Educational Resources Information Center

    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…

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

    PubMed

    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.

  8. Sampling, characterisation and processing of solid recovered fuel production from municipal solid waste: An Italian plant case study.

    PubMed

    Ranieri, Ezio; Ionescu, Gabriela; Fedele, Arcangela; Palmieri, Eleonora; Ranieri, Ada Cristina; Campanaro, Vincenzo

    2017-08-01

    This article presents the classification of solid recovered fuel from the Massafra municipal solid waste treatment plant in Southern Italy in compliancy with the EN 15359 standard. In order to ensure the reproducibility of this study, the characterisation methods of waste input and output flow, the mechanical biological treatment line scheme and its main parameters for each stage of the processing chain are presented in details, together with the research results in terms of mass balance and derived fuel properties. Under this study, only 31% of refused municipal solid waste input stream from mechanical biological line was recovered as solid recovered fuel with a net heating value (NC=HV) average of 15.77 MJ kg -1 ; chlorine content average of 0.06% on a dry basis; median of mercury <0.0064 mg MJ -1 and 80th percentile <0.0068 mg MJ -1 . The solid recovered fuel produced meets the European Union standard requirements and can be classified with the class code: Net heating value (3); chlorine (1); mercury (1).

  9. Refusal skill ability: an examination of adolescent perceptions of effectiveness.

    PubMed

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

    2010-06-01

    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 second by a group of high school interns. Consistency with programming criteria was found for interns' ratings of several indicators of verbal and non-verbal assertiveness. However, a strategy previously defined by the program as effective was perceived as ineffective by adolescents while another deemed ineffective and problematic by intervention developers was viewed as effective. Interns endorsed presenting detailed and reasonable arguments as an effective refusal strategy while short, simple statements were deemed ineffective. This study suggests the importance of including adolescent perspectives in the design, delivery, and evaluation of drug prevention strategies.

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

    PubMed

    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.

  11. Development of OTM Syngas Process and Testing of Syngas Derived Ultra-clean Fuels in Diesel Engines and Fuel Cells

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    E.T. Robinson; John Sirman; Prasad Apte

    2005-05-01

    This final report summarizes work accomplished in the Program from January 1, 2001 through December 31, 2004. Most of the key technical objectives for this program were achieved. A breakthrough material system has lead to the development of an OTM (oxygen transport membrane) compact planar reactor design capable of producing either syngas or hydrogen. The planar reactor shows significant advantages in thermal efficiency and a step change reduction in costs compared to either autothermal reforming or steam methane reforming with CO{sub 2} recovery. Syngas derived ultra-clean transportation fuels were tested in the Nuvera fuel cell modular pressurized reactor and inmore » International Truck and Engine single cylinder test engines. The studies compared emission and engine performance of conventional base fuels to various formulations of ultra-clean gasoline or diesel fuels. A proprietary BP oxygenate showed significant advantage in both applications for reducing emissions with minimal impact on performance. In addition, a study to evaluate new fuel formulations for an HCCI engine was completed.« less

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

    PubMed

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

    PubMed

    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 <10% residents having less than ninth grade 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.

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

    PubMed

    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.

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

    PubMed

    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.

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

    PubMed

    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.

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

    ERIC Educational Resources Information Center

    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. 9 CFR 590.160 - Refusal, suspension, or withdrawal of service.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... INSPECTION ACT) Denial of Service § 590.160 Refusal, suspension, or withdrawal of service. (a) The... service. 590.160 Section 590.160 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE...) may refuse to provide or may withdraw inspection service under this part with respect to any plant if...

  19. 9 CFR 590.160 - Refusal, suspension, or withdrawal of service.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... INSPECTION ACT) Denial of Service § 590.160 Refusal, suspension, or withdrawal of service. (a) The... service. 590.160 Section 590.160 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE...) may refuse to provide or may withdraw inspection service under this part with respect to any plant if...

  20. Thermal stability of some aircraft turbine fuels derived from oil shale and coal

    NASA Technical Reports Server (NTRS)

    Reynolds, T. W.

    1977-01-01

    Thermal stability breakpoint temperatures are shown for 32 jet fuels prepared from oil shale and coal syncrudes by various degrees of hydrogenation. Low severity hydrotreated shale oils, with nitrogen contents of 0.1 to 0.24 weight percent, had breakpoint temperatures in the 477 to 505 K (400 to 450 F) range. Higher severity treatment, lowering nitrogen levels to 0.008 to 0.017 weight percent, resulted in breakpoint temperatures in the 505 to 533 K (450 to 500 F) range. Coal derived fuels showed generally increasing breakpoint temperatures with increasing weight percent hydrogen, fuels below 13 weight percent hydrogen having breakpoints below 533 K (500 F). Comparisons are shown with similar literature data.

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

    PubMed

    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.

  2. 22 CFR 92.9 - Refusals of requests for notarial services.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Refusals of requests for notarial services. 92.9 Section 92.9 Foreign Relations DEPARTMENT OF STATE LEGAL AND RELATED SERVICES NOTARIAL AND RELATED... services should be refused only after the most careful deliberation. [22 FR 10858, Dec. 27, 1957, as...

  3. [Analysis of the refusal of the flu vaccination (REGRIVI study)].

    PubMed

    Méijome-Blanco, S; González-Cristobo, G; Regueiro-Martínez, A Á

    2018-02-10

    The objective of this study is to determine the reasons for refusing the flu vaccination in the Primary Care Health Centre of Vilanova de Arousa, Spain, as well as to evaluate the flu vaccination coverage after an educational intervention. A quasi-experimental before and after study was conducted after an educational intervention on a total of 73 people that included those Primary Care Health Centre patients from Vilanova de Arousa who had refused the flu vaccination in 2014, and who did not meet the exclusion criteria (death during 2014 and 2015 campaigns, non-acceptance of participation, vaccine registration mistakes, contraindication or no indication for the vaccine, inability to contact). After a brief educational intervention, vaccination data from those patients in the 2015 and 2016 campaigns were checked. A descriptive analysis of the variables under study was then carried out. Of the 73 patients initially included, 72 completed the study. The main reasons for refusing a vaccination were the concerns about the adverse effects and patient perception of good health. Vaccination coverage was 50.7% in 2015, and 48.6% in 2016. The reasons for refusing vaccination are approachable with a brief intervention since the refusal decreases by half in the long-term. Copyright © 2018 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  4. Geomorphic reclmation of a coal refuse pile

    NASA Astrophysics Data System (ADS)

    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.

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

    PubMed

    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.

  6. Physician switching after drug request refusal.

    PubMed

    Lee, Doohee; Begley, Charles E

    2011-10-01

    Physician switching is a barometer of the quality of the relationship between a patient and a physician. Understanding the factors associated with physician switching in the context of direct-to-consumer advertising (DTCA) of prescription drugs has been largely unexamined. A total of 818 of 2,988 participants in a national telephone survey (27.4%) who had received DTCA reported asking their physician for a prescription drug, and 196 (24.0%) reported that their physician refused to prescribe the drug. Of those whose physicians refused, 13.9% (n = 27 of 194 with data) switched doctors. We found that individuals with regular medical-seeking behavior, full prescription drug coverage, with certain chronic conditions, and of African American origin were significantly more likely to switch physicians in this context.

  7. 21 CFR 514.110 - Reasons for refusing to file applications.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... of the applicant and to receive communications on all matters pertaining to the application. (7) The... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Reasons for refusing to file applications. 514.110... Applications § 514.110 Reasons for refusing to file applications. (a) The date of receipt of an application for...

  8. Blood Transfusion in Children: The Refusal of Jehovah's Witness Parents'.

    PubMed

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

    2018-01-01

    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. 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. 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. 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. When the patient is a minor, the child's best interest always come first.

  9. 76 FR 29796 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Refuse...

    Federal Register 2010, 2011, 2012, 2013, 2014

    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...

  10. Risk factors associated with treatment refusal in lung cancer

    PubMed Central

    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

    2017-01-01

    Background 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. Methods 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. Results 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 < 0.05). In logistic regression analysis, age (odds ratio [OR] 1.10, 95% confidence interval [CI] 1.07–1.13), educational status lower than high school (OR 1.95, 95% CI 1.2–3.2), no history of surgery (OR 2.29, 95% CI 1.4–3.7), body mass index < 18.5 (OR 2.49, 95% CI 1.3–4.7), and a high Eastern Cooperative Oncology Group score of 3 or 4 (OR 5.02, 95% CI 2.3–10.8) were significant factors for refusal of cancer treatment. Conclusion 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. PMID:28627788

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

    PubMed

    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.

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

    PubMed Central

    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 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. PMID:1941952

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

    PubMed

    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 < 0.001 in all cases). Median survival for patients 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.

  14. Using a Preventive Social Work Program for Reducing School Refusal

    ERIC Educational Resources Information Center

    Elsherbiny, Mohamed Mohamed

    2017-01-01

    This article describes a study aimed at solving the problem of school refusal by implementing a preventive program and raising the awareness of parents, social workers, and school personnel. The school children involved in this study were reported by their parents and school social workers to refuse to go to school, and according to the children's…

  15. Immunofluorescence Approach to the Study of the Ecology of Thermoplasma acidophilum In Coal Refuse Material

    PubMed Central

    Bohlool, B. B.; Brock, T. D.

    1974-01-01

    Specific immunofluorescence staining was applied to the study of the localization, distribution, and growth of Thermoplasma acidophilum in its natural habitat, the coal refuse pile. Different antigenic groups of T. acidophilum could be isolated from the same refuse pile, and the same antigenic groups were isolated from piles from different geographical areas. No correlation could be established between the antigenic groups and the pH or temperature of the habitats. Brightly fluorescing cells of T. acidophilum were detected on microscope slides buried in contact with the coal refuse material or immersed in the water in the stream draining a refuse pile. T. acidophilum grew when inoculated into either coal refuse material and/or an aqueous extract of coal refuse when incubated at its optimal temperature of 55 C, but not when incubated at room temperature or 37 C. The coal refuse pile appears to be a primary habitat for T. acidophilum. PMID:4602306

  16. Metagenomic analysis of antibiotic resistance genes (ARGs) during refuse decomposition.

    PubMed

    Liu, Xi; Yang, Shu; Wang, Yangqing; Zhao, He-Ping; Song, Liyan

    2018-04-12

    Landfill is important reservoirs of residual antibiotics and antibiotic resistance genes (ARGs), but the mechanism of landfill application influence on antibiotic resistance remains unclear. Although refuse decomposition plays a crucial role in landfill stabilization, its impact on the antibiotic resistance has not been well characterized. To better understand the impact, we studied the dynamics of ARGs and the bacterial community composition during refuse decomposition in a bench-scale bioreactor after long term operation (265d) based on metagenomics analysis. The total abundances of ARGs increased from 431.0ppm in the initial aerobic phase (AP) to 643.9ppm in the later methanogenic phase (MP) during refuse decomposition, suggesting that application of landfill for municipal solid waste (MSW) treatment may elevate the level of ARGs. A shift from drug-specific (bacitracin, tetracycline and sulfonamide) resistance to multidrug resistance was observed during the refuse decomposition and was driven by a shift of potential bacteria hosts. The elevated abundance of Pseudomonas mainly contributed to the increasing abundance of multidrug ARGs (mexF and mexW). Accordingly, the percentage of ARGs encoding an efflux pump increased during refuse decomposition, suggesting that potential bacteria hosts developed this mechanism to adapt to the carbon and energy shortage when biodegradable substances were depleted. Overall, our findings indicate that the use of landfill for MSW treatment increased antibiotic resistance, and demonstrate the need for a comprehensive investigation of antibiotic resistance in landfill. Copyright © 2018. Published by Elsevier B.V.

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

    PubMed

    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.

  18. Conscientious refusal in healthcare: the Swedish solution.

    PubMed

    Munthe, Christian

    2017-04-01

    The Swedish solution to the legal handling of professional conscientious refusal in healthcare is described. No legal right to conscientious refusal for any profession or class of professional tasks exists in Sweden, regardless of the religious or moral background of the objection. The background of this can be found in strong convictions about the importance of public service provision and related civic duties, and ideals about rule of law, equality and non-discrimination. Employee's requests to change work tasks are handled on a case-by-case basis within the frames of labour law, ensuring full voluntariness, and also employer's privilege regarding the organisation and direction of work, and duties of public institutions to provide services. Two complicating aspects of this solution related to the inclusion of 'alternative medical' service providers in a national health service, and professional insistence on conscientious refusal rights to accept legalised assisted dying are discussed. The latter is found to undermine the pragmatic reasons behind recent attempts by prolife groups to challenge the Swedish solution related to legal abortion in courts. 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/.

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

    PubMed

    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 < 0.05). In logistic regression analysis, age (odds ratio [OR] 1.10, 95% confidence interval [CI] 1.07-1.13), educational status lower than high school (OR 1.95, 95% CI 1.2-3.2), no history of surgery (OR 2.29, 95% CI 1.4-3.7), body mass index < 18.5 (OR 2.49, 95% CI 1.3-4.7), and a high Eastern Cooperative Oncology Group score of 3 or 4 (OR 5.02, 95% CI 2.3-10.8) were significant factors for 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.

  20. Reasons for family refusal of ocular tissue donation.

    PubMed

    Hermann, K C; Pagnussato, F; Franke, C A; de Oliveira, M L B

    2014-01-01

    Corneal donations do not fill the transplant demand. The waiting list had 5512 individuals in Brazil and 143 in Rio Grande do Sul in December 2012. The aim of this study was to identify the reasons for family refusal of ocular tissues donation. This retrospective study analyzed interview records for ocular tissue procurement performed in a general, public university hospital located in Southern Brazil between January 2008 and December 2012. It identified the reasons of family refusal for ocular tissue donation. A total of 1010 interviews for ocular tissues procurement were performed. From these, 513 (50.79%) refused donation with the following reasons: 60 (11.69%) family members were unaware of the desire of the potential donor, 153 (29.82%) of potential donors spoke against donation in life, 113 (22.02%) family members were undecided about the donation, 156 (30.40%) family members were against donation, 3 (0.58%) family members were unhappy with the service, 11 (2.14%) family members were afraid of body release delay, 6 (1.16%) families expressed religious convictions against donation, and 11 (2.14%) family members wanted to keep the body intact. There are many reasons for ocular tissues donation refusal, and the knowledge provides better strategies for family interviews. In this study, most of the reasons, around 90%, can be related to lack of information or communication about the subject. Greater awareness of the population about the subject can be a good way to increase ocular tissue procurement indexes. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. School Refusal Behavior Associated with Separation Anxiety Disorder: A Cognitive-Behavioral Approach to Treatment

    ERIC Educational Resources Information Center

    Doobay, Alissa F.

    2008-01-01

    School refusal behavior can lead to disruptions in both educational attainment and social development. One of the common causes of school refusal behavior is separation anxiety disorder (SAD). Research suggests that children with SAD and school refusal behavior show an increased rate of psychiatric consultation and a decreased likelihood of…

  2. Synthesis of high density aviation fuel with cyclopentanol derived from lignocellulose

    PubMed Central

    Sheng, Xueru; Li, Ning; Li, Guangyi; Wang, Wentao; Yang, Jinfan; Cong, Yu; Wang, Aiqin; Wang, Xiaodong; Zhang, Tao

    2015-01-01

    For the first time, renewable high density aviation fuels were synthesized at high overall yield (95.6%) by the Guerbet reaction of cyclopentanol which can be derived from lignocellulose, followed by the hydrodeoxygenation (HDO). The solvent-free Guerbet reaction of cyclopentanol was carried out under the co-catalysis of solid bases and Raney metals. Among the investigated catalyst systems, the combinations of magnesium-aluminium hydrotalcite (MgAl-HT) and Raney Ni (or Raney Co) exhibited the best performances. Over them, high carbon yield (96.7%) of C10 and C15 oxygenates was achieved. The Guerbet reaction products were further hydrodeoxygenated to bi(cyclopentane) and tri(cyclopentane) over a series of Ni catalysts. These alkanes have high densities (0.86 g mL−1 and 0.91 g mL−1) and can be used as high density aviation fuels or additives to bio-jet fuel. Among the investigated HDO catalysts, the 35 wt.% Ni-SiO2-DP prepared by deposition-precipitation method exhibited the highest activity. PMID:25826744

  3. Synthesis of high density aviation fuel with cyclopentanol derived from lignocellulose

    NASA Astrophysics Data System (ADS)

    Sheng, Xueru; Li, Ning; Li, Guangyi; Wang, Wentao; Yang, Jinfan; Cong, Yu; Wang, Aiqin; Wang, Xiaodong; Zhang, Tao

    2015-03-01

    For the first time, renewable high density aviation fuels were synthesized at high overall yield (95.6%) by the Guerbet reaction of cyclopentanol which can be derived from lignocellulose, followed by the hydrodeoxygenation (HDO). The solvent-free Guerbet reaction of cyclopentanol was carried out under the co-catalysis of solid bases and Raney metals. Among the investigated catalyst systems, the combinations of magnesium-aluminium hydrotalcite (MgAl-HT) and Raney Ni (or Raney Co) exhibited the best performances. Over them, high carbon yield (96.7%) of C10 and C15 oxygenates was achieved. The Guerbet reaction products were further hydrodeoxygenated to bi(cyclopentane) and tri(cyclopentane) over a series of Ni catalysts. These alkanes have high densities (0.86 g mL-1 and 0.91 g mL-1) and can be used as high density aviation fuels or additives to bio-jet fuel. Among the investigated HDO catalysts, the 35 wt.% Ni-SiO2-DP prepared by deposition-precipitation method exhibited the highest activity.

  4. Synthesis of high density aviation fuel with cyclopentanol derived from lignocellulose.

    PubMed

    Sheng, Xueru; Li, Ning; Li, Guangyi; Wang, Wentao; Yang, Jinfan; Cong, Yu; Wang, Aiqin; Wang, Xiaodong; Zhang, Tao

    2015-03-31

    For the first time, renewable high density aviation fuels were synthesized at high overall yield (95.6%) by the Guerbet reaction of cyclopentanol which can be derived from lignocellulose, followed by the hydrodeoxygenation (HDO). The solvent-free Guerbet reaction of cyclopentanol was carried out under the co-catalysis of solid bases and Raney metals. Among the investigated catalyst systems, the combinations of magnesium-aluminium hydrotalcite (MgAl-HT) and Raney Ni (or Raney Co) exhibited the best performances. Over them, high carbon yield (96.7%) of C10 and C15 oxygenates was achieved. The Guerbet reaction products were further hydrodeoxygenated to bi(cyclopentane) and tri(cyclopentane) over a series of Ni catalysts. These alkanes have high densities (0.86 g mL(-1) and 0.91 g mL(-1)) and can be used as high density aviation fuels or additives to bio-jet fuel. Among the investigated HDO catalysts, the 35 wt.% Ni-SiO2-DP prepared by deposition-precipitation method exhibited the highest activity.

  5. Family Influences on Treatment Refusal in School-Linked Mental Health Services

    ERIC Educational Resources Information Center

    Keeley, Mary L.; Wiens, Brenda A.

    2008-01-01

    This study analyzed family influences on treatment refusal in school-linked mental health services (SLMHS). Specifically, it assessed whether levels of family cohesion, conflict, and organization were related to whether a family refused to initiate recommended treatment. Children (N = 133) referred for emotional and behavioral problems and their…

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

    PubMed

    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.

  7. State Right to Refuse Medication Laws and Procedures: Impact on Homicide and Suicide.

    PubMed

    Edwards, Griffin

    2016-09-01

    As part of the expansive overhaul of the mental health system that occurred in the latter half of the 20th Century, many states passed laws that allow, under certain conditions, voluntary and involuntarily committed patients to refuse medication. While some predicted the consequences of these laws would be dire, the effect on violent behavior remains untested. The aim is to decipher any differences state right to refuse medication laws may have on violence. Using the homicide rate of every US state between 1972 and 2001 (N = 1,479), and the suicide rate between 1981 and 2001 (N = 1,071). The study compares the difference in homicide/suicide rates before and after a law change to that same difference in a set of control states to estimate the effect of laws aimed at extending the right to refuse medication to both voluntary and involuntarily committed mental health patients. Laws designed to allow voluntarily committed patients to refuse medication are associated with a 0.8 increase in homicides per 100,000 of the state population while laws dictating an involuntarily committed patient's right to request refusal of medication are negative but statistically insignificant using standard t test. Laws designed to allow voluntarily committed patients to refuse medication have no statistically significant effect on suicides while laws dictating an involuntarily committed patient's right to request refusal of medication, specifically when the request is reviewed by independent mental health professionals, are associated with a statistically significant reduction in suicides. Allowing voluntarily committed patients to refuse medication may entice some to enter in-patient facilities, but the brief and optional exposure to medication and their side effects may actually discourage treatment and increase violence.

  8. EFFECTS OF COMBUSTION PARAMETERS ON POLYCHLORINATED DIBENZODIOXIN AND DIBENZOFURAN HOMOLOGUE PROFILES FROM MUNICIPAL WASTE AND COAL CO-COMBUSTION

    EPA Science Inventory

    Variation in polychlorinated dibenzo-p-dioxin and polychlorinated dibenzofuran (PCDD and PCDF) homologue profiles from a pilot scale (0.6 MWt, 2x106 Btu/hr), co-fired-fuel [densified refuse derived fuel (dRDF) and high-sulfur Illinois coal] combustion system was used to provide i...

  9. [Refusal of initiation of dialysis by elderly patients with chronic renal failure].

    PubMed

    Fujimaki, Hiroshi; Kasuya, Yutaka; Kawaguchi, Sachiko; Hara, Shino; Koga, Shiro; Takahashi, Tadao; Mizuno, Shoichi

    2005-07-01

    Refusal of dialysis is not uncommon in elderly patients with chronic renal failure. In this study, we retrospectively inspected our dealings with patients who refused our offer to initiate dialysis. In addition, we discussed how to grasp the meaning of this phenomenon. We treated 152 patients with advanced chronic renal failure aged 60 years and over at Tokyo Metropolitan Geriatric Hospital. The patients fulfilling the following two criteria were considered to be refusal cases. The first criterion was that an acceptance of the initiation of dialysis could not be obtained in spite of repeated counseling. The second criterion was that a definite outcome was precipitated by the development of severe uremic symptoms. In every refusal case, clinical characteristics and household members were surveyed. Verbal expressions of the reasons for refusal were retrieved from medical charts. The outcome was also studied. The two criteria were fulfilled in 7 cases. The male/female ratio was 5:2. The age was 78 +/- 7 years (mean +/- standard deviation). All but one cases were ambulatory, and all cases had normal cognitive function. Four cases were married, and the other cases had lost their partners. The number of household members was 3.9 +/- 1.8. We speculated that every case could maintain a good quality of life even after the initiation of dialysis. Representative expressions of the reasons for refusal were "I have already lived fully" and "I would prefer to accept death rather than dialysis". The outcome was urgent initiation of dialysis (five cases) and death (two cases). The time between initial counseling and the outcome was 115 +/- 37 days. Accepting or refusing dialysis therapy is a selection related to life or death. We must make an effort to obtain consent to initiating dialysis if patients are assessed as suitable for dialysis.

  10. Radiocarbon-based assessment of fossil fuel-derived contaminant associations in sediments.

    PubMed

    White, Helen K; Reddy, Christopher M; Eglinton, Timothy I

    2008-08-01

    Hydrophobic organic contaminants (HOCs) are associated with natural organic matter (OM) in the environment via mechanisms such as sorption or chemical binding. The latter interactions are difficult to quantitatively constrain, as HOCs can reside in different OM pools outside of conventional analytical windows. Here, we exploited natural abundance variations in radiocarbon (14C) to trace various fossil fuel-derived HOCs (14C-free) within chemically defined fractions of contemporary OM (modern 14C content) in 13 samples including marine and freshwater sediments and one dust and one soil sample. Samples were sequentially treated by solvent extraction followed by saponification. Radiocarbon analysis of the bulk sample and resulting residues was then performed. Fossil fuel-derived HOCs released by these treatments were quantified from an isotope mass balance approach as well as by gas chromatography-mass spectrometry. For the majority of samples (n = 13), 98-100% of the total HOC pool was solvent extractable. Nonextracted HOCs are only significant (29% of total HOC pool)in one sample containing p,p-2,2-bis(chlorophenyl)-1,1,1-trichloroethane and its metabolites. The infrequency of significant incorporation of HOCs into nonextracted OM residues suggests that most HOCs are mobile and bioavailable in the environment and, as such, have a greater potential to exert adverse effects.

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

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Tan, CheeFai; Juffrizal, K.; Khalil, S. N.

    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 knowledgemore » 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.« less

  12. Refusals in Chinese: How Do L1 and L2 Differ?

    ERIC Educational Resources Information Center

    Hong, Wei

    2011-01-01

    This article reports on an empirical study of refusal strategies in Chinese by native speakers (NS) and nonnative Chinese learners (NNS). Sixty subjects (perceived as "students") were to refuse an invitation by "the professor" to a Chinese New Year's party. The study found that the NS group produced 10 strategies, whereas the…

  13. 37 CFR 1.295 - Review of decision finally refusing to publish a statutory invention registration.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... refusing to publish a statutory invention registration. 1.295 Section 1.295 Patents, Trademarks, and... decision finally refusing to publish a statutory invention registration. (a) Any requester who is dissatisfied with the final refusal to publish a statutory invention registration for reasons other than...

  14. Patient refusal of glaucoma surgery and associated factors in Lagos, Nigeria.

    PubMed

    Adekoya, Bola Josephine; Akinsola, Feyisayo B; Balogun, Bola Grace; Balogun, Modupe Medinat; Ibidapo, Olajumoke O

    2013-01-01

    To determine the prevalence of patient refusal of glaucoma surgery (GSR) and the associated factors in Lagos, Nigeria. A multicenter cross-sectional survey was conducted in Lagos state, Nigeria. Twelve centres were invited to participate, but data collection was completed in 10. Newly diagnosed glaucoma patients were recruited and interviewed from these sites over a four week period on prior awareness of glaucoma, surgery refusal, and reason(s) for the refusal. Presenting visual acuity was recorded from the patient files. The odds ratio and 95% confidence intervals (CI) were calculated. A total of 208 newly diagnosed glaucoma patients were recruited. Sixty-five (31.2%) patients refused surgery. Fear of surgery (31 (47.7%) patients), and fear of going blind (19 (29.2%) patients) were the most common reasons. The odds ratio of surgery refusal were marital status - not married versus married (2.0; 95% CI, 1.02-3.94), use of traditional medication - users versus non users (2.4; 95% CI, 1.1-5.2), perception of glaucoma causing blindness - no versus yes (3.7; 95% CI, 1.3-10.5), type of institution - government versus private (5.7; 95% CI, 1.3-25.1), and visual acuity in the better eye - normal vision versus visual impairment (2.3; 95% CI, 1.1-4.9). Age, gender, level of education, family history of glaucoma, and prior awareness of the diagnosis of glaucoma, were not significantly associated with surgery refusal. Perception of patients concerning glaucoma blindness was the strongest factor on multivariate analysis. GSR was relatively low in this study. Unmarried status, use of traditional medications, perception that glaucoma cannot cause blindness, government hospital patients, and good vision in the better eye were associated with GSR. These factors might help in the clinical setting in identifying appropriate individuals for targeted counseling, as well as the need for increased public awareness about glaucoma.

  15. New Report Compares Performance of Compressed Natural Gas Refuse Haulers to

    Science.gov Websites

    Diesel-Powered Trucks Report Compares Performance of Compressed Natural Gas Refuse Haulers to Diesel-Powered Trucks For more information contact: e:mail: Public Affairs A new report that compares the performance of compressed natural gas (CNG) refuse haulers in New York City to similar diesel-powered trucks

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

    DOE Office of Scientific and Technical Information (OSTI.GOV)

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

    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 andmore » biotic ecosystem components associated with reclamation of the refuse piles.« less

  17. Techno-Economic Analysis of Camelina-Derived Hydroprocessed Renewable Jet Fuel and its Implications on the Aviation Industry

    NASA Astrophysics Data System (ADS)

    Shila, Jacob Joshua Howard

    Although the aviation industry contributes toward global economic growth via transportation of passengers and cargo, the increasing demand for air transportation causes concern due to the corresponding increase in aircraft engine exhaust emissions. Use of alternative fuels is one pathway that has been explored for reducing emissions in the aviation industry. Hydroprocessed renewable jet (HRJ) (also known as Hydroprocessed Esters and Fatty Acids - HEFA) fuels have been approved for blending with traditional jet fuel up to 50% by volume to be used as drop-in fuels. However, limited information exists on the economic viability of these fuels. While techno-economic studies have been conducted on the HRJ production process using soybean oil, different vegetable oils possess different hydrocarbon structures that affect the yield of HRJ fuels. This study involves the techno-economic analysis of producing Camelina-derived HRJ fuel using the option of hydro-deoxygenation (HDO). The hydrodeoxygenation option requires extra hydrogen and hence affects the overall cost of HRJ fuel production. Similar studies have been conducted on the production of Camelina-derived HRJ fuels using the same path of hydrodeoxygenation with minor contributions from both decarbonylation and decarboxylation reactions. This study, however, employs the UOP Honeywell procedure using the hydrodeoxygenation chemical reaction to estimate the breakeven price of Camelina-derived HRJ fuel. In addition, the study treats the cultivation of Camelina oilseeds, extraction of oilseeds, and the conversion of HRJ fuel as separate entities. The production of Camelina oilseed, Camelina oil, and finally Camelina-derived HRJ fuel is modeled in order to estimate the breakeven price of the fuel. In addition, the information obtained from the techno-economic analysis is used to assess the breakeven carbon price. All costs are analyzed based on 2016 US dollars. The breakeven price of Camelina oilseeds is found to be 228

  18. Outsourcing in the public refuse collection sector: exploiting old certainties or exploring new possibilities?

    PubMed

    Gustafsson, Ove; Saksvik, Per Øystein

    2005-01-01

    An outsourcing process in a medium-size city, by Norwegian standards, provided the background for our study. In 1996, the city council decided to contract out the refuse collection in half of its total area (the western part of the city), and to let the public refuse collection enterprise continue to collect in the other half of the area. The public enterprise also participated in the competitive tender, without success, however. The bid submitted by the public refuse collection enterprise was used as the basis for a benchmarking process performed by the chief administrative officer of the city in May 1999. The process resulted in the requirement that the public enterprise downsize its number of refuse collectors by 27 per cent. The city thus acquired a more cost-effective refuse collection system both in the western part, now run by a private company, and in the rest of the city, where the collection remained the responsibility of the public enterprise, in its newly pared-down and reorganized version. Detectable changes in the refuse collectors' health status in the three-year period immediately following the outsourcing constitute our main focus in this study. We found that the downsizing and reorganization of the public enterprise had a negative impact on the refuse collectors' health status. One year after the downsizing, six of the 27 refuse collectors remaining in the public enterprise had been diagnosed with heart problems or musculoskeletal pains that were sufficiently serious to form the basis of their individual approaches to secure a disability pension, which all six were in the process of acquiring. The registered sick leave among the refuse collectors showed a dramatic increase during the same period. We found clear indications that the refuse collectors remaining in the employment of the public enterprise had no alternatives in the labour market. Although not the focus of this study, we found that the totality of costs and benefits, not only for the

  19. Vaccine refusal and the endgame: walking the last mile first.

    PubMed

    Saint-Victor, Diane S; Omer, Saad B

    2013-08-05

    As multiple papers within this special issue illustrate, the dynamics of disease eradication are different from disease control. When it comes to disease eradication, 'the last mile is longest'. For social and ecological reasons such as vaccine refusal, further ending incidence of a disease when it has reached low levels is frequently complex. Issues of non-compliance within a target population often influence the outcome of disease eradication efforts. Past eradication efforts confronted such obstacles towards the tail end of the campaign, when disease incidence was lowest. This article provides a comparison of non-compliance within polio, measles and smallpox campaigns, demonstrating the tendency of vaccine refusal to rise as disease incidence falls. In order to overcome one of the most intractable challenges to eradication, future disease eradication efforts must prioritize vaccine refusal from the start, i.e. 'walk the last mile first'.

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

    PubMed

    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.

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

    PubMed

    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.

  2. Refusal of care: the physician-patient relationship and decisionmaking capacity.

    PubMed

    Simon, Jeremy R

    2007-10-01

    Problems of refusal of care, among the most common ethical dilemmas in the emergency department, are also often the most difficult to resolve, pitting 2 conflicting duties, that of helping patients and that of respecting their autonomy, against each other. Using a case presentation as a backdrop, this article offers a practical approach to patients who refuse treatment, including assessment of decisionmaking capacity but emphasizing the role of trust, communication, and compromise in these cases.

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

    PubMed

    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.

  4. Dialysis patients refusing kidney transplantation: data from the Slovenian Renal Replacement Therapy Registry.

    PubMed

    Buturović-Ponikvar, Jadranka; Gubenšek, Jakob; Arnol, Miha; Bren, Andrej; Kandus, Aljoša; Ponikvar, Rafael

    2011-06-01

    Kidney transplantation is considered the best renal replacement therapy (RRT) for patients with end-stage renal disease; nevertheless, some dialysis patients refuse to be transplanted. The aim of our registry-based, cross-sectional study was to compare kidney transplant candidates to dialysis patients refusing transplantation. Data were collected from the Slovenian Renal Replacement Therapy Registry database, as of 31 December 2008. Demographic and some RRT data were compared between the groups. There were 1448 dialysis patients, of whom 1343 were treated by hemodialysis and 105 by peritoneal dialysis (PD); 132 (9%) were on the waiting list for transplantation, 208 (14%) were preparing for enrollment (altogether 340 [23%] dialysis patients were kidney transplant candidates); 200 (13.7%) patients were reported to refuse transplantation, all ≤ 65 years of age; 345 (24%) were not enrolled due to medical contraindications, 482 (33%) due to age, and 82 (6%) due to other or unknown reasons. No significant difference was found in age, gender, or presence of diabetes between kidney transplant candidates vs. patients refusing transplantation (mean age 50.5 ± 13.9 vs. 51.3 ± 9.6 years, males 61% vs. 63%, diabetics 18% vs. 17%). The proportion of patients ≤ 65 years old who were refusing transplantation was 28% (187/661) for hemodialysis and 17% (13/79) for PD patients (P = 0.03). There is a considerable group of dialysis patients in Slovenia refusing kidney transplantation. Compared to the kidney transplant candidates, they are similar in age, gender and prevalence of diabetes. Patients treated by peritoneal dialysis refuse kidney transplantation less often than hemodialysis patients. © 2011 The Authors. Therapeutic Apheresis and Dialysis © 2011 International Society for Apheresis.

  5. Direct Coal -to-Liquids (CTL) for Jet Fuel Using Biomass-Derived Solvents

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Chauhan, Satya P.; Garbark, Daniel B.; Taha, Rachid

    Battelle has demonstrated a novel and potentially breakthrough technology for a direct coal-to-liquids (CTL) process for producing jet fuel using biomass-derived coal solvents (bio-solvents). The Battelle process offers a significant reduction in capital and operating costs and a substantial reduction in greenhouse gas (GHG) emissions, without requiring carbon capture and storage (CCS). The results of the project are the advancement of three steps of the hybrid coal/biomass-to-jet fuel process to the technology readiness level (TRL) of 5. The project objectives were achieved over two phases. In Phase 1, all three major process steps were explored and refined at bench-scale, including:more » (1) biomass conversion to high hydrogen-donor bio-solvent; (2) coal dissolution in biomass-derived bio-solvent, without requiring molecular H 2, to produce a synthetic crude (syncrude); and (3) two-stage catalytic hydrotreating/hydrogenation of syncrude to jet fuel and other distillates. In Phase 2, all three subsystems of the CTL process were scaled up to a pre-pilot scale, and an economic analysis was carried out. A total of over 40 bio-solvents were identified and prepared. The most unique attribute of Battelle’s bio-solvents is their ability to provide much-needed hydrogen to liquefy coal and thus increase its hydrogen content so much that the resulting syncrude is liquid at room temperature. Based on the laboratory-scale testing with bituminous coals from Ohio and West Virginia, a total of 12 novel bio-solvent met the goal of greater than 80% coal solubility, with 8 bio-solvents being as good as or better than a well-known but expensive hydrogen-donor solvent, tetralin. The Battelle CTL process was then scaled up to 1 ton/day (1TPD) at a pre-pilot facility operated in Morgantown, WV. These tests were conducted, in part, to produce enough material for syncrude-upgrading testing. To convert the Battelle-CTL syncrude into a form suitable as a blending stock for jet turbine

  6. Using a Nonaversive Procedure to Decrease Refusals.

    ERIC Educational Resources Information Center

    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)

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

    PubMed

    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.

  8. 21 CFR 1316.12 - Refusal to allow inspection with an administrative warrant.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Refusal to allow inspection with an administrative warrant. 1316.12 Section 1316.12 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE ADMINISTRATIVE FUNCTIONS, PRACTICES, AND PROCEDURES Administrative Inspections § 1316.12 Refusal to allow...

  9. Refusal to participate in heart failure studies: do age and gender matter?

    PubMed Central

    Harrison, Jordan M; Jung, Miyeon; Lennie, Terry A; Moser, Debra K; Smith, Dean G; Dunbar, Sandra B; Ronis, David L; Koelling, Todd M; Giordani, Bruno; Riley, Penny L; Pressler, Susan J

    2018-01-01

    Aims and objectives The objective of this retrospective study was to evaluate reasons heart failure patients decline study participation, to inform interventions to improve enrollment. Background Failure to enrol older heart failure patients (age > 65) and women in studies may lead to sampling bias, threatening study validity. Design This study was a retrospective analysis of refusal data from four heart failure studies that enrolled 788 patients in four states. Methods Chi-Square and a pooled t-test were computed to analyse refusal data (n = 300) obtained from heart failure patients who were invited to participate in one of the four studies but declined. Results Refusal reasons from 300 patients (66% men, mean age 65 33) included: not interested (n = 163), too busy (n = 64), travel burden (n = 50), too sick (n = 38), family problems (n = 14), too much commitment (n = 13) and privacy concerns (n = 4). Chi-Square analyses showed no differences in frequency of reasons (p > 0 05) between men and women. Patients who refused were older, on average, than study participants. Conclusions Some reasons were patient-dependent; others were study-dependent. With ‘not interested’ as the most common reason, cited by over 50% of patients who declined, recruitment measures should be targeted at stimulating patients’ interest. Additional efforts may be needed to recruit older participants. However, reasons for refusal were consistent regardless of gender. Relevance to clinical practice Heart failure researchers should proactively approach a greater proportion of women and patients over age 65. With no gender differences in type of reasons for refusal, similar recruitment strategies can be used for men and women. However, enrolment of a representative proportion of women in heart failure studies has proven elusive and may require significant effort from researchers. Employing strategies to stimulate interest in studies is essential for recruiting heart failure patients, who

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

    PubMed

    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 < .0001) and metastatic cancer (OR, 5.82; 95% CI, 2.22-15.28). Other risk factors were organizational, namely, full unit (OR, 3.16; 95% CI, 1.88-5.31), center (OR, 3.81; 95% CI, 2.27-6.39), phone admission (OR, 0.23; 95% CI, 0.14-0.40), and daytime admission (OR, 0.52; 95% CI, 0.32-0.84). The Standardized Mortality Ratio was 1.41 (95% CI, 1.19-1.69) for immediately admitted patients, 1.75 (95% CI, 1.60-1.84) for 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.

  11. 10 CFR 709.13 - Implications of refusal to take a polygraph examination.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Implications of refusal to take a polygraph examination. 709.13 Section 709.13 Energy DEPARTMENT OF ENERGY COUNTERINTELLIGENCE EVALUATION PROGRAM CI Evaluation Protocols and Protection of National Security § 709.13 Implications of refusal to take a polygraph...

  12. Vaccine refusal and the endgame: walking the last mile first

    PubMed Central

    Saint-Victor, Diane S.; Omer, Saad B.

    2013-01-01

    As multiple papers within this special issue illustrate, the dynamics of disease eradication are different from disease control. When it comes to disease eradication, ‘the last mile is longest’. For social and ecological reasons such as vaccine refusal, further ending incidence of a disease when it has reached low levels is frequently complex. Issues of non-compliance within a target population often influence the outcome of disease eradication efforts. Past eradication efforts confronted such obstacles towards the tail end of the campaign, when disease incidence was lowest. This article provides a comparison of non-compliance within polio, measles and smallpox campaigns, demonstrating the tendency of vaccine refusal to rise as disease incidence falls. In order to overcome one of the most intractable challenges to eradication, future disease eradication efforts must prioritize vaccine refusal from the start, i.e. ‘walk the last mile first’. PMID:23798696

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

    PubMed

    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.

  14. Mental health consequences of abortion and refused abortion.

    PubMed

    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.

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

    ERIC Educational Resources Information Center

    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…

  16. The impact of municipal refuse utilization on energy and our environment

    NASA Technical Reports Server (NTRS)

    1978-01-01

    The incinerator/boiler configuration is stressed as the most reliable method of waste utilization. It is also pointed out that the high cost of refuse disposal and the ever increasing cost of energy, have made this method attractive. A plan is outlined for operating a waste utilization plant. Community participation is encouraged in investigating the feasibility of refuse to energy facilities in their area.

  17. Emissions of toxic pollutants from co-combustion of demolition and construction wood and household waste fuel blends.

    PubMed

    Edo, Mar; Ortuño, Núria; Persson, Per-Erik; Conesa, Juan A; Jansson, Stina

    2018-07-01

    Four different types of fuel blends containing demolition and construction wood and household waste were combusted in a small-scale experimental set-up to study the effect of fuel composition on the emissions of polychlorinated dibenzo-p-dioxins (PCDDs), dibenzofurans (PCDFs), biphenyls (PCBs), chlorobenzenes (PCBzs), chlorophenols (PCPhs) and polycyclic aromatic hydrocarbons (PAHs). Two woody materials, commercial stemwood (ST) and demolition and construction wood (DC) were selected because of the differences in their persistent organic pollutants (POPs), ash and metals content. For household waste, we used a municipal solid waste (MSW) and a refuse-derived fuel (RDF) from MSW with 5-20 wt% and up to 5 wt% food waste content respectively. No clear effect on the formation of pollutants was observed with different food waste content in the fuel blends tested. Combustion of ST-based fuels was very inefficient which led to high PAH emissions (32 ± 3.8 mg/kg fuel ). The use of DC clearly increased the total PCDD and PCDF emissions (71 ± 26 μg/kg fuel ) and had a clear effect on the formation of toxic congeners (210 ± 87 ng WHO 2005 -TEQ/kg fuel ). The high PCDD and PCDF emissions from DC-based fuels can be attributed to the presence of material contaminants such as small pieces of metals or plastics as well as timber treated with chromated copper arsenate preservatives and pentachlorophenol in the DC source. Copyright © 2018 Elsevier Ltd. All rights reserved.

  18. Assessment and analysis of aged refuse as ammonium-removal media for the treatment of landfill leachate.

    PubMed

    He, Yan; Li, Dan; Zhao, Youcai; Huang, Minsheng; Zhou, Gongming

    2017-11-01

    This is the first attempt to explore the sustainability of aged refuse as ammonium-removal media. Batch experiments combined with the aged-refuse-based reactor were performed to examine how the adsorption and desorption processes are involved in the ammonia removal via aged refuse media in this research. The results showed that the adsorption of ammonium by aged refuse occurred instantly and the adsorbed ammonium was stable and less exchangeable. The adsorption data fit the Freundlich isotherms well and the n value of 0.1-0.5 indicated that the adsorption of ammonium occurred easily. The maximum adsorbed ammonium occupied less than 10% of the cation exchange capacity in aged-refuse-based reactors owing to the high solid/liquid ratios (50:1-120:1). The synergistic transformations of ammonium within the aged-refuse-based reactor indicated that the cation exchange sites only provide temporary storage of ammonium, and the subsequent nitrification process can be considered the predominant restoration pathway of ammonium adsorption capacity of the reactor. It seems reasonable to assume that there is no expiry for the aged-refuse-based reactor in terms of ammonium removal owing to its bioregeneration via nitrification.

  19. Children and refusal of medical treatment: in urgent need of reform.

    PubMed

    Lennings, Nicholas

    2013-09-01

    The ability of children to refuse medical treatment is far from certain. The New South Wales Law Reform Commission report on this topic, released in 2008, addressed a number of key concerns. As yet, no action on that report has been taken. Neither the present statutory nor common law regime provides sufficient guidance on this issue. The case of Gillick v West Norfolk and Wisbech Area Health Authority [1986] AC 112, while important, is not as far-reaching as it first appeared and has been subject to substantial limitations regarding refusals of treatment. Specifically, the position in relation to the assessment of competency, and the weight of a competent decision, remains outstanding. The ability of children to refuse medical treatment is in urgent need of attention and rectification.

  20. 9 CFR 156.8 - Refusal of service; denial or withdrawal of service.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 1 2014-01-01 2014-01-01 false Refusal of service; denial or withdrawal of service. 156.8 Section 156.8 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE VOLUNTARY INSPECTION AND CERTIFICATION SERVICE VOLUNTARY INSPECTION AND CERTIFICATION SERVICE § 156.8 Refusal of...

  1. 9 CFR 156.8 - Refusal of service; denial or withdrawal of service.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 9 Animals and Animal Products 1 2013-01-01 2013-01-01 false Refusal of service; denial or withdrawal of service. 156.8 Section 156.8 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE VOLUNTARY INSPECTION AND CERTIFICATION SERVICE VOLUNTARY INSPECTION AND CERTIFICATION SERVICE § 156.8 Refusal of...

  2. 9 CFR 156.8 - Refusal of service; denial or withdrawal of service.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 1 2012-01-01 2012-01-01 false Refusal of service; denial or withdrawal of service. 156.8 Section 156.8 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE VOLUNTARY INSPECTION AND CERTIFICATION SERVICE VOLUNTARY INSPECTION AND CERTIFICATION SERVICE § 156.8 Refusal of...

  3. 9 CFR 156.8 - Refusal of service; denial or withdrawal of service.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false Refusal of service; denial or withdrawal of service. 156.8 Section 156.8 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE VOLUNTARY INSPECTION AND CERTIFICATION SERVICE VOLUNTARY INSPECTION AND CERTIFICATION SERVICE § 156.8 Refusal of...

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

    PubMed Central

    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

  5. Fuel Supply Defaults for Regional Fuels and Fuel Wizard Tool in MOVES201X

    EPA Science Inventory

    The fuel supply report documents the data and methodology used to derive the default gasoline, diesel and fuel-blend fuel properties, and their respective fuel market share in MOVES. The default market share of the individual fuels varies by calendar year, seasons, and several do...

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

    PubMed

    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.

  7. Examining the ethico-legal aspects of the right to refuse treatment in Turkey.

    PubMed

    Sert, Gurkan; Guven, Tolga

    2013-10-01

    This paper examines the ethico-legal problems regarding the right to refuse treatment in Turkey's healthcare system. We discuss these problems in the light of a recent case that was directly reported to us. We first summarise the experience of a chronically dependent patient (as recounted by her daughter) and her family during their efforts to refuse treatment and receive palliative care only. This is followed by a summary of the legal framework governing the limits of the right to refuse treatment in Turkey. With the help of this background information on the legal framework, we re-examine the ethico-legal aspects of the case and explain the underlying reasons for the problems the family and the patient experienced. Finally, we conclude that Turkey's legal framework relating to the right to refuse treatment needs to be clarified and amended in accordance with international conventions and fundamental human rights.

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

    PubMed

    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.

  9. 16 CFR 1210.18 - Refusal of importation.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ....18 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS SAFETY STANDARD FOR CIGARETTE LIGHTERS Certification Requirements § 1210.18 Refusal of importation. (a... in this part is violated. (b) For noncompliance with this standard and for lack of a certification...

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

    PubMed

    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 < .01). Religiosity (AOR = 1.12, p < .05) and the use of alternative medicine (AOR = 2.85, p < .001) increased the odds of vaccine refusal. However, individual characteristics seem to be relatively poor predictors of CVRH intentions in Croatia. Following the social contagion model, future research should move beyond individual-level approach and take into account social interaction and social network effects.

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

    PubMed

    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.

  12. High performance liquid chromatographic hydrocarbon group-type analyses of mid-distillates employing fuel-derived fractions as standards

    NASA Technical Reports Server (NTRS)

    Seng, G. T.; Otterson, D. A.

    1983-01-01

    Two high performance liquid chromatographic (HPLC) methods have been developed for the determination of saturates, olefins and aromatics in petroleum and shale derived mid-distillate fuels. In one method the fuel to be analyzed is reacted with sulfuric acid, to remove a substantial portion of the aromatics, which provides a reacted fuel fraction for use in group type quantitation. The second involves the removal of a substantial portion of the saturates fraction from the HPLC system to permit the determination of olefin concentrations as low as 0.3 volume percent, and to improve the accuracy and precision of olefins determinations. Each method was evaluated using model compound mixtures and real fuel samples.

  13. Alternative Fuel Trucks Case Studies: Running Refuse Haulers on Compressed Natural Gas

    DOT National Transportation Integrated Search

    1996-01-01

    Since 1992 the CNG trash trucks have accumulated more than 60,000 miles in : regular service in the New York City fleet. Overall, their performance has been : excellent. The Alternative Fuels Data Center (AFDC) at the Department of : Energy's Nationa...

  14. Vaccine refusal - what we need to know.

    PubMed

    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.

  15. Pd/activated carbon sorbents for mid-temperature capture of mercury from coal-derived fuel gas.

    PubMed

    Li, Dekui; Han, Jieru; Han, Lina; Wang, Jiancheng; Chang, Liping

    2014-07-01

    Higher concentrations of Hg can be emitted from coal pyrolysis or gasification than from coal combustion, especially elemental Hg. Highly efficient Hg removal technology from coal-derived fuel gas is thus of great importance. Based on the very excellent Hg removal ability of Pd and the high adsorption abilities of activated carbon (AC) for H₂S and Hg, a series of Pd/AC sorbents was prepared by using pore volume impregnation, and their performance in capturing Hg and H₂S from coal-derived fuel gas was investigated using a laboratory-scale fixed-bed reactor. The effects of loading amount, reaction temperature and reaction atmosphere on Hg removal from coal-derived fuel gas were studied. The sorbents were characterized by N₂ adsorption, X-ray diffraction (XRD) and X-ray photoelectron spectroscopy (XPS). The results indicated that the efficiency of Hg removal increased with the increasing of Pd loading amount, but the effective utilization rate of the active component Pd decreased significantly at the same time. High temperature had a negative influence on the Hg removal. The efficiency of Hg removal in the N₂-H₂S-H₂-CO-Hg atmosphere (simulated coal gas) was higher than that in N₂-H₂S-Hg and N₂-Hg atmospheres, which showed that H₂ and CO, with their reducing capacity, could benefit promote the removal of Hg. The XPS results suggested that there were two different ways of capturing Hg over sorbents in N₂-H₂S-Hg and N₂-Hg atmospheres. Copyright © 2014. Published by Elsevier B.V.

  16. Parents who refuse or delay HPV vaccine: Differences in vaccination behavior, beliefs, and clinical communication preferences

    PubMed Central

    Gilkey, Melissa B.; Calo, William A.; Marciniak, Macary W.

    2017-01-01

    ABSTRACT Background: We sought to estimate the national prevalence of HPV vaccine refusal and delay in a nationally-representative sample of parents of adolescents. We also compared parents who refused versus delayed HPV vaccine in terms of their vaccination beliefs and clinical communication preferences. Methods: In 2014 to 2015, we conducted an online survey of 1,484 US parents who reported on an 11- to 17-year-old child in their household. We used weighted multinomial logistic regression to assess correlates of HPV vaccine refusal and delay. Results: Overall, 28% of parents reported that they had ever “refused or decided not to get” HPV vaccine for their child, and an additional 8% of parents reported that they had “delayed or put off getting” HPV vaccine. Compared to no refusal/delay, refusal was associated with lower confidence in adolescent vaccination (relative risk ratio [RRR] = 0.66, 95% confidence interval [CI], 0.48–0.91), lower perceived HPV vaccine effectiveness (RRR = 0.68, 95% CI, 0.50–0.91), and higher perceived harms (RRR = 3.49, 95% CI, 2.65–4.60). In contrast, delay was associated with needing more information (RRR = 1.76, 95% CI, 1.08–2.85). Most parents rated physicians and information sheets as helpful for making decisions about HPV vaccination, although parents who reported refusal endorsed these resources less often. Conclusions: Our findings suggest that HPV vaccine refusal is common among parents of adolescents and may have increased relative to previous estimates. Because the vaccination beliefs and communication preferences of parents who refuse appear to differ from those who delay, targeted communication strategies may be needed to effectively address HPV vaccine hesitancy. PMID:27763818

  17. 24 CFR 3282.354 - Submittal of false information or refusal to submit information.

    Code of Federal Regulations, 2010 CFR

    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...

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

    PubMed

    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.

  19. Production of liquid fuels out of plant biomass and refuse: Methods, cost, potential (in MIXED)

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Woick, B.; Friedrich, R.

    1981-09-01

    Different ways of producing biomass and its conversion into high grade fuel for vehicles are reviewed with particular reference to physical and geographical factors, pertaining in the Federal Republic of Germany (FRG). Even with the potentially small amount of biomass in the FRG, the fueling of diesel engines with rape oil or modified ethanol, which can be obtained from any cellulosic feedstock, seems to pose the fewest difficulties and promises greatest efficiency. However, the amount of fuel produced from biomass can probably only meet a very small percentage of the total amount required.

  20. Acquisition of cup drinking using previously refused foods as positive and negative reinforcement.

    PubMed

    Kelley, Michael E; Piazza, Cathleen C; Fisher, Wayne W; Oberdorff, Amanda J

    2003-01-01

    We used previously refused foods as positive and negative reinforcement in the acquisition of cup drinking. Cup drinking increased with positive and negative reinforcement, both alone and in combination (without escape extinction), indicating that treatment of food refusal can establish some foods as appetitive stimuli whereas others remain aversive.

  1. Pollution concentrations in runoff water from refuse piles

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Guin, J.A.

    1977-03-01

    In the processes of removal, refinement and disposal of raw materials, large quantities of waste products become exposed to weathering forces. Subsequent percolation, flushing, and oxidation results in the pollution of waterways, low-lying farmlands and underground aquifers with acidity, alkalinity, hardness, heavy metals, and undesirable organic materials such as tannin and lignin. The need for methodology for estimating the chemical nature and quantity of these leachates becomes more compelling as the extraction of natural materials accelerates. In this work a mass transfer model is formulated which describes the leaching of such pollutants from refuse piles. The model is applied tomore » an actual refuse pile under natural precipitation and weathering conditions and found to adequately represent the pollutant concentrations in the rainfall runoff.« less

  2. Drink refusal training as part of a combined behavioral intervention: Effectiveness and mechanisms of change

    PubMed Central

    Witkiewitz, Katie; Donovan, Dennis M.; Hartzler, Bryan

    2012-01-01

    Objective Many trials have demonstrated the effectiveness of cognitive behavioral interventions for alcohol dependence, yet few studies have examined why particular treatments are effective. This study was designed to evaluate whether drink refusal training was an effective component of a combined behavioral intervention (CBI) and whether change in self-efficacy was a mechanism of change following drink refusal training for individuals with alcohol dependence. Method The current study is a secondary analysis of data from the COMBINE study, a randomized clinical trial that combined pharmacotherapy with behavioral intervention in the treatment of alcohol dependence. The goal of the current study was to examine whether a drink refusal skills training module, administered as part of a 16-week CBI (n=776; 31% female, 23% non-White, average age=44) predicted changes in drinking frequency and self-efficacy during and following the CBI, and whether changes in self-efficacy following drink refusal training predicted changes in drinking frequency up to one year following treatment. Results Participants (n=302) who received drink refusal skills training had significantly fewer drinking days during treatment (d=0.50) and up to one year following treatment (d=0.23). In addition the effect of the drink refusal skills training module on drinking outcomes following treatment was significantly mediated by changes in self-efficacy, even after controlling for changes in drinking outcomes during treatment (proportion mediated = 0.47). Conclusions Drink refusal training is an effective component of CBI and some of the effectiveness may be attributed to changes in client self-efficacy. PMID:22289131

  3. 27 CFR 46.273 - Refusing entry or examination.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... PRODUCTS AND CIGARETTE PAPERS AND TUBES Floor Stocks Tax on Certain Tobacco Products, Cigarette Papers, and Cigarette Tubes Held for Sale on April 1, 2009 Ttb Authorities § 46.273 Refusing entry or examination. If...

  4. 27 CFR 46.273 - Refusing entry or examination.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... PRODUCTS AND CIGARETTE PAPERS AND TUBES Floor Stocks Tax on Certain Tobacco Products, Cigarette Papers, and Cigarette Tubes Held for Sale on April 1, 2009 Ttb Authorities § 46.273 Refusing entry or examination. If...

  5. 27 CFR 46.273 - Refusing entry or examination.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... PRODUCTS AND CIGARETTE PAPERS AND TUBES Floor Stocks Tax on Certain Tobacco Products, Cigarette Papers, and Cigarette Tubes Held for Sale on April 1, 2009 Ttb Authorities § 46.273 Refusing entry or examination. If...

  6. 27 CFR 46.273 - Refusing entry or examination.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... PRODUCTS AND CIGARETTE PAPERS AND TUBES Floor Stocks Tax on Certain Tobacco Products, Cigarette Papers, and Cigarette Tubes Held for Sale on April 1, 2009 Ttb Authorities § 46.273 Refusing entry or examination. If...

  7. Alternative Fuels Data Center

    Science.gov Websites

    with gasoline; natural gas and liquid fuels domestically produced from natural gas; propane; coal -derived liquid fuels; hydrogen; electricity; pure biodiesel (B100); fuels, other than alcohol, derived

  8. 21 CFR 515.21 - Refusal to approve a medicated feed mill license application.

    Code of Federal Regulations, 2010 CFR

    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...

  9. The use of solid wastes as a fuel in the cement industry in the UK

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Haley, C.A.C.; Chatterton, M.H.

    1985-01-01

    Blue Circle has installed a commercial plant for processing and firing MSW as a fuel in cement kilns. The plant, a world first, has operated successfully since 1979 at Wiltshire, UK. By the end of January 1984, 173,000 tonnes of refuse had been processed.

  10. EEOC claims employer refused reasonable accommodation. Equal Employment Opportunity Commission.

    PubMed

    1995-06-30

    The Equal Employment Opportunity Commission (EEOC) has sued Spectacor, one of the largest stadium-management companies, on behalf of employee [name removed]. [Name removed], who claimed his employer refused to grant him flexible work hours to accommodate his AIDS diagnosis. [Name removed] had submitted a note from one of his doctors stating that [name removed] had AIDS and was taking an experimental medicine. The doctors requested some added flexibility in working hours to enable [name removed] to prepare special meals and take showers to reduce the discomfort of the experimental medicines he was taking. Spectacor, instead of granting the request, informed [name removed] that his job was in jeopardy and that he would be discharged because of absenteeism and declining productivity. The suit alleges Spectacor violated the Americans with Disabilities Act (ADA) by refusing to grant [name removed] a reasonable accommodation for his disability and that the employer had breached its obligation to keep confidential his medical information. Spectacor denied that its refusal to accommodate [name removed]'s scheduling requests constituted a violation of the ADA.

  11. 36 CFR 1002.14 - Sanitation and refuse.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 36 Parks, Forests, and Public Property 3 2014-07-01 2014-07-01 false Sanitation and refuse. 1002.14 Section 1002.14 Parks, Forests, and Public Property PRESIDIO TRUST RESOURCE PROTECTION, PUBLIC USE... vehicle, except in facilities provided for such purpose. (5) Bathing, or washing food, clothing, dishes...

  12. 36 CFR 1002.14 - Sanitation and refuse.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 36 Parks, Forests, and Public Property 3 2012-07-01 2012-07-01 false Sanitation and refuse. 1002.14 Section 1002.14 Parks, Forests, and Public Property PRESIDIO TRUST RESOURCE PROTECTION, PUBLIC USE... vehicle, except in facilities provided for such purpose. (5) Bathing, or washing food, clothing, dishes...

  13. Medication Refusal in Schizophrenia: Preventive and Reactive Ethical Considerations.

    PubMed

    Sabin, James

    2016-06-01

    Clinicians treating patients with recurrent psychosis should encourage contingency planning with patients and families for how to respond to potential recurrences. Whether or not patients create a formal psychiatric advance directive, patients, families, and clinicians will be better prepared to deal with emergencies if they include "scenario planning" as part of ongoing clinical care. In the case under discussion this was not done, resulting in an ethical conundrum as to whether it was ethically justifiable to override the proxy decision maker's refusal of medication. Law on this question is unsettled, but the author argues that from the perspective of ethics, overriding medication refusal is sometimes ethically permissible. © 2016 American Medical Association. All Rights Reserved. ISSN 2376-6980.

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

    PubMed

    Gilkey, Melissa B; McRee, Annie-Laurie; Magnus, Brooke E; Reiter, Paul L; Dempsey, Amanda F; Brewer, Noel T

    2016-01-01

    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.

  15. Response of crownvetch planted on anthracite breaker refuse

    Treesearch

    Miroslaw M. Czapowskyj; John P. Mikulecky; Edward A. Sowa

    1968-01-01

    Lime applications were essential to establishment of crownvetch (Coronilla vuria L.) on coal breaker refuse in the Pennsylvania Anthracite Region, and mulch treatments were highly beneficial. Fertilizer applications had only slight effect on either establishment or growth.

  16. Refusal of oral polio vaccine in northwestern Pakistan: a qualitative and quantitative study.

    PubMed

    Murakami, Hitoshi; Kobayashi, Makoto; Hachiya, Masahiko; Khan, Zahir S; Hassan, Syed Q; Sakurada, Shinsaku

    2014-03-10

    Refusal of the oral polio vaccine (OPV) is a difficulty faced by the Polio Eradication Initiative (PEI) in multiple endemic areas, including the Khyber Pakhtunkhwa Province (KPP), Pakistan. In 2007, we investigated community perceptions of the OPV and estimated the prevalence of OPV refusal in three districts in Swat Valley, KPP, a polio-endemic area. Qualitative data concerning community perceptions were collected by focus group discussions among lady health workers (LHWs) and mothers with children <1 year old and by key informant interviews with local health managers and officials. Quantitative data collection followed using a questionnaire survey of 200 LHWs and a cluster sampling survey of 210 mothers (per district) with children <1 year old. The qualitative assessments identified the grounded theory of OPV refusal involving facts known by the residents that are related to the OPV (too frequent OPV campaigns, an OPV boycott in northern Nigeria in 2003 and that birth control is viewed as is against Islam), the local interpretations of these facts (perceptions that OPV contained birth control or pork, that OPV was a foreign/central plot against Muslims, and that the vaccination was against the Hadith and the fate determined by God) and different manifestations of OPV refusal. Among the three districts studied, the proportion of LHWs who encountered OPV refusal ranged from 0 to 33%, whereas among the districts, the proportions of mothers unwilling to give OPV to their children ranged from 0.5 to 5.7%. Refusal of other injectable vaccines was almost equally prevalent for reasons that were very similar. The PEI needs to reflect local value system in the path to polio eradication in the studied districts in the Swat Valley. The religious and cultural values as well as the interpretation of the international political situation are of particular importance. Copyright © 2014 Elsevier Ltd. All rights reserved.

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

    PubMed

    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.

  18. 21 CFR 211.50 - Sewage and refuse.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 4 2011-04-01 2011-04-01 false Sewage and refuse. 211.50 Section 211.50 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR FINISHED PHARMACEUTICALS Buildings and Facilities § 211.50 Sewage...

  19. 21 CFR 211.50 - Sewage and refuse.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 4 2012-04-01 2012-04-01 false Sewage and refuse. 211.50 Section 211.50 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR FINISHED PHARMACEUTICALS Buildings and Facilities § 211.50 Sewage...

  20. 21 CFR 211.50 - Sewage and refuse.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 4 2013-04-01 2013-04-01 false Sewage and refuse. 211.50 Section 211.50 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR FINISHED PHARMACEUTICALS Buildings and Facilities § 211.50 Sewage...

  1. 21 CFR 211.50 - Sewage and refuse.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 4 2014-04-01 2014-04-01 false Sewage and refuse. 211.50 Section 211.50 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR FINISHED PHARMACEUTICALS Buildings and Facilities § 211.50 Sewage...

  2. 36 CFR 2.14 - Sanitation and refuse.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 36 Parks, Forests, and Public Property 1 2012-07-01 2012-07-01 false Sanitation and refuse. 2.14 Section 2.14 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR... washing food, clothing, dishes, or other property at public water outlets, fixtures or pools, except at...

  3. 36 CFR 2.14 - Sanitation and refuse.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 36 Parks, Forests, and Public Property 1 2013-07-01 2013-07-01 false Sanitation and refuse. 2.14 Section 2.14 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR... washing food, clothing, dishes, or other property at public water outlets, fixtures or pools, except at...

  4. 36 CFR 2.14 - Sanitation and refuse.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 36 Parks, Forests, and Public Property 1 2014-07-01 2014-07-01 false Sanitation and refuse. 2.14 Section 2.14 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR... washing food, clothing, dishes, or other property at public water outlets, fixtures or pools, except at...

  5. CRITERIA FOR SELECTION OF PCDD/F INDICATORS

    EPA Science Inventory

    Emission samples from a simulated hazardous waste-fired North American Package Boiler (NAPB) and a refuse-derived fuel incineration facility (RDFF) were analyzed separately and combined in order to identify single polychlorinated dibenzo-p-dioxin and polychlorinated dibenzofuran ...

  6. Refusal of Recommended Chemotherapy for Ovarian Cancer: Risk Factors and Outcomes; a National Cancer Data Base Study.

    PubMed

    Wallace, Sumer K; Lin, Jeff F; Cliby, William A; Leiserowitz, Gary S; Tergas, Ana I; Bristow, Robert E

    2016-05-01

    To identify risk factors associated with refusal of recommended chemotherapy and its impact on patients with epithelial ovarian cancer (EOC). We identified patients in the National Cancer Data Base diagnosed with EOC from January 1998 to December 2011. Patients who refused chemotherapy were identified and compared with those who received recommended, multiagent chemotherapy. Univariate and multivariable analyses were performed using chi-square test with Bonferroni correction, binary logistic regression, log-rank test, and Cox proportional hazards modeling. The threshold for statistical significance was set at a P value of less than 0.05. From a cohort of 147,713 eligible patients, 2,707 refused chemotherapy. These patients were compared with 92,212 patients who received recommended multiagent chemotherapy. Older age, more medical comorbidities, not having insurance, and later year of diagnosis were directly and significantly associated with chemotherapy refusal when analyzed using multivariable logistic regression. In addition, lower-than-expected facility adherence to NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Ovarian Cancer, treatment at low-volume center, lower grade, and higher stage were all significantly and independently associated with chemotherapy refusal. Median overall survival of patients who received multiagent chemotherapy was significantly longer than that of those who refused chemotherapy (43 vs 4.8 months; P<.0005). After controlling for known patient, facility, and disease prognostic factors, chemotherapy refusal is significantly associated with increased risk of death. Refusal of recommended chemotherapy carries significant risk of early death from ovarian cancer. Our data demonstrate that the decision to refuse chemotherapy is multifactorial and, in addition to unalterable factors (eg, stage/grade, age), involves factors that can be changed, including facility type and payor. Efforts at addressing these discrepancies in

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

    PubMed

    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.

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

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... IN TRANSIT OPERATIONS Types of Testing § 655.49 Refusal to submit to a drug or alcohol test. (a) Each employer shall require a covered employee to submit to a post-accident drug and alcohol test required under... 49 Transportation 7 2013-10-01 2013-10-01 false Refusal to submit to a drug or alcohol test. 655...

  9. 49 CFR 655.49 - Refusal to submit to a drug or alcohol test.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... IN TRANSIT OPERATIONS Types of Testing § 655.49 Refusal to submit to a drug or alcohol test. (a) Each employer shall require a covered employee to submit to a post-accident drug and alcohol test required under... 49 Transportation 7 2011-10-01 2011-10-01 false Refusal to submit to a drug or alcohol test. 655...

  10. 49 CFR 655.49 - Refusal to submit to a drug or alcohol test.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... IN TRANSIT OPERATIONS Types of Testing § 655.49 Refusal to submit to a drug or alcohol test. (a) Each employer shall require a covered employee to submit to a post-accident drug and alcohol test required under... 49 Transportation 7 2014-10-01 2014-10-01 false Refusal to submit to a drug or alcohol test. 655...

  11. 49 CFR 655.49 - Refusal to submit to a drug or alcohol test.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... IN TRANSIT OPERATIONS Types of Testing § 655.49 Refusal to submit to a drug or alcohol test. (a) Each employer shall require a covered employee to submit to a post-accident drug and alcohol test required under... 49 Transportation 7 2012-10-01 2012-10-01 false Refusal to submit to a drug or alcohol test. 655...

  12. 49 CFR 655.49 - Refusal to submit to a drug or alcohol test.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... IN TRANSIT OPERATIONS Types of Testing § 655.49 Refusal to submit to a drug or alcohol test. (a) Each employer shall require a covered employee to submit to a post-accident drug and alcohol test required under... 49 Transportation 7 2010-10-01 2010-10-01 false Refusal to submit to a drug or alcohol test. 655...

  13. Realization of Speech Acts of Refusals and Pragmatic Competence by Turkish EFL Learners

    ERIC Educational Resources Information Center

    Han, Turgay; Burgucu-Tazegül, Assiye

    2016-01-01

    The purpose of the present study is to examine a) how lower-intermediate and upper-intermediate level Turkish learners of English-as-a-foreign language (EFL) realize refusals in English, b) the differences between native and non-native speakers of English in the use of refusals, and c) if L2 proficiency affects possible pragmatic transfer or not.…

  14. Alternative Fuels Data Center: Glacier-Waterton Park Powers Buses With

    Science.gov Websites

    Photo of a truck Natural Gas Fuels School Buses and Refuse Trucks in Tulsa, Oklahoma Feb. 18, 2017 Photo of buses Baton Rouge School District Adds Propane Buses to Its Fleet Dec. 23, 2016 photo of a truck Buses to Its Fleet Nov. 11, 2016 photo of a propane school bus Propane Powers School Buses in Tuscaloosa

  15. Alternative Fuels

    EPA Pesticide Factsheets

    Alternative fuels include gaseous fuels such as hydrogen, natural gas, and propane; alcohols such as ethanol, methanol, and butanol; vegetable and waste-derived oils; and electricity. Overview of alternative fuels is here.

  16. Long-term monitoring and prediction for settlement and composition of refuse in Shanghai Laogang Municipal Landfill.

    PubMed

    Jiangying, Liu; Dimin, Xu; Youcai, Zhao; Shaowei, Chen; Guojian, Li; Qi, Zhou

    2004-09-01

    Parameters about composition of refuse such as mass percentage of biodegradable matter, volatile solid, organic carbon, cellulose, total sugar, and settlement were monitored and analyzed in a large-scale experimental unit. The empirical formulas between composition and refuse age were established in terms of the data obtained from the experimental unit and verified by comparing with the corresponding parameters of refuse in the closed landfill units from 1991 until 1994 in the Shanghai Laogang Municipal Landfill. Furthermore, the long-term prediction for the composition of refuse was made, and it was predicted that the half-life is 7 to 11 years for biodegradable matter, 9 to 12 years for organic carbon or volatile solid, 7 to 16 years for cellulose, and 4 to 6 years for total sugar. In addition, a mathematical model, based on the mechanism of refuse biodegradation in the landfill, was developed to simulate the relationship between the settlement and the refuse age and manifests the secondary settlement potential. The mathematical model was proved not only to be reliable but also should be accurate for predicting the settlement of the landfill. The secondary settlement, which mainly results from the slow and gradual biodegradation of refuse, is linear with respect to the exponent of refuse age. Finally, according to the settlement model and empirical biodegradation formulas, it may be predicted that, 79.4% of biodegradable matter, 92.9% of total sugar, 72.7% of volatile solid and organic carbon, and 73.1% of cellulose will be biodegraded and that 79% of the maximum secondary settlement potential will occur before the Shanghai Laogang Municipal Landfill is in a high stabilization situation, i.e., approximately 21 years after final closure.

  17. Refusal of Vitamin K by Parents of Newborns: A Survey of the Better Outcomes Through Research for Newborns Network

    PubMed Central

    Loyal, Jaspreet; Taylor, James A.; Phillipi, Carrie A.; Goyal, Neera K.; Dhepyasuwan, Niramol; Shapiro, Eugene D.; Colson, Eve

    2018-01-01

    Objective To survey newborn clinicians in the United States regarding the frequency of intramuscular (IM) vitamin K refusal by a parent, reasons for refusal, and approaches of clinicians to refusals. Methods An electronic survey was administered to the clinician site representative (nursery director or designee knowledgeable about site-specific nursery policies) at all newborn nurseries in the Better Outcomes through Research for Newborns (BORN) network of newborn nurseries. Results Of 92 BORN sites, 85 (92%) respondents completed the survey. Frequency of IM vitamin K refusal during the past 5 years was reported as increased by 52% of respondents, unchanged by 42%, and 6% did not know. Reported frequencies of refusal of IM vitamin K was weekly (9%), a few times a month (31%), once a month (13%), once every 3 to 4 months (20%), once or twice a year (26%), or never (1%). The overall distribution of the reported frequencies of refusal differed among regions in the United States (higher in the West and the South; P < .05). Reported reasons for refusal by parents included perceptions of parents that the injection was unnecessary, lack of knowledge about vitamin K deficiency bleeding, and concern about preservatives. Approaches to refusal included attempts to educate parents, enlisting support from community clinicians, a state mandate, and prescription of oral vitamin K. Conclusions Respondents from a national sample of newborn nursery clinicians reported an increase in refusal of IM vitamin K in the past 5 years with regional variation. Approaches to refusals need further investigation to determine effectiveness. PMID:28277269

  18. Understanding Excessive School Absenteeism as School Refusal Behavior

    ERIC Educational Resources Information Center

    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…

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

    ERIC Educational Resources Information Center

    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…

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

    PubMed Central

    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

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

    PubMed

    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.

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

    PubMed Central

    Gilkey, Melissa B.; McRee, Annie-Laurie; Magnus, Brooke E.; Reiter, Paul L.; Dempsey, Amanda F.; Brewer, Noel T.

    2016-01-01

    Objective 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. Methods 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. Results 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). Conclusions 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. PMID:27391098

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

    ERIC Educational Resources Information Center

    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…

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

    ERIC Educational Resources Information Center

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

    PubMed

    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.

  6. 14 CFR 121.586 - Authority to refuse transportation.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Authority to refuse transportation. 121.586 Section 121.586 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIR CARRIERS AND OPERATORS FOR COMPENSATION OR HIRE: CERTIFICATION AND OPERATIONS OPERATING...

  7. 14 CFR 121.586 - Authority to refuse transportation.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Authority to refuse transportation. 121.586 Section 121.586 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIR CARRIERS AND OPERATORS FOR COMPENSATION OR HIRE: CERTIFICATION AND OPERATIONS OPERATING...

  8. 14 CFR 121.586 - Authority to refuse transportation.

    Code of Federal Regulations, 2010 CFR

    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 (CONTINUED) AIR CARRIERS AND OPERATORS FOR COMPENSATION OR HIRE: CERTIFICATION AND OPERATIONS OPERATING...

  9. 14 CFR 121.586 - Authority to refuse transportation.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Authority to refuse transportation. 121.586 Section 121.586 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIR CARRIERS AND OPERATORS FOR COMPENSATION OR HIRE: CERTIFICATION AND OPERATIONS OPERATING...

  10. 14 CFR 121.586 - Authority to refuse transportation.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Authority to refuse transportation. 121.586 Section 121.586 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIR CARRIERS AND OPERATORS FOR COMPENSATION OR HIRE: CERTIFICATION AND OPERATIONS OPERATING...

  11. 49 CFR 219.107 - Consequences of unlawful refusal.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Consequences of unlawful refusal. 219.107 Section 219.107 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Prohibitions § 219.107 Consequences...

  12. Effects of furan derivatives and phenolic compounds on electricity generation in microbial fuel cells

    NASA Astrophysics Data System (ADS)

    Catal, Tunc; Fan, Yanzhen; Li, Kaichang; Bermek, Hakan; Liu, Hong

    Lignocellulosic biomass is an attractive fuel source for MFCs due to its renewable nature and ready availability. Furan derivatives and phenolic compounds could be potentially formed during the pre-treatment process of lignocellulosic biomass. In this study, voltage generation from these compounds and the effects of these compounds on voltage generation from glucose in air-cathode microbial fuel cells (MFCs) were examined. Except for 5-hydroxymethyl furfural (5-HMF), all the other compounds tested were unable to be utilized directly for electricity production in MFCs in the absence of other electron donors. One furan derivate, 5-HMF and two phenolic compounds, trans-cinnamic acid and 3,5-dimethoxy-4-hydroxy-cinnamic acid did not affect electricity generation from glucose at a concentration up to 10 mM. Four phenolic compounds, including syringaldeyhde, vanillin, trans-4-hydroxy-3-methoxy, and 4-hydroxy cinnamic acids inhibited electricity generation at concentrations above 5 mM. Other compounds, including 2-furaldehyde, benzyl alcohol and acetophenone, inhibited the electricity generation even at concentrations less than 0.2 mM. This study suggests that effective electricity generation from the hydrolysates of lignocellulosic biomass in MFCs may require the employment of the hydrolysis methods with low furan derivatives and phenolic compounds production, or the removal of some strong inhibitors prior to the MFC operation, or the improvement of bacterial tolerance against these compounds through the enrichment of new bacterial cultures or genetic modification of the bacterial strains.

  13. Understanding Partnerships: A Rural College's Role in Recycling Refuse.

    ERIC Educational Resources Information Center

    Adams, Frank G.

    2000-01-01

    Describes the partnership that was formed by a county government, three city governments, Weyerhaeuser Company, and Cossatot Technical College in Arkansas to solve the refuse problem when the local landfill closed. (JOW)

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

    PubMed

    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.

  15. 7 CFR 322.10 - Inspection; refusal of entry.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... SERVICE, DEPARTMENT OF AGRICULTURE BEES, BEEKEEPING BYPRODUCTS, AND BEEKEEPING EQUIPMENT Importation of Adult Honeybees, Honeybee Germ Plasm, and Bees Other Than Honeybees From Approved Regions § 322.10 Inspection; refusal of entry. (a) Shipments of honeybees, honeybee germ plasm, and bees other than honeybees...

  16. 7 CFR 322.19 - Inspection; refusal of entry.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 5 2010-01-01 2010-01-01 false Inspection; refusal of entry. 322.19 Section 322.19 Agriculture Regulations of the Department of Agriculture (Continued) ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE BEES, BEEKEEPING BYPRODUCTS, AND BEEKEEPING EQUIPMENT Importation of...

  17. 7 CFR 322.34 - Inspection; refusal of entry.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 5 2010-01-01 2010-01-01 false Inspection; refusal of entry. 322.34 Section 322.34 Agriculture Regulations of the Department of Agriculture (Continued) ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE BEES, BEEKEEPING BYPRODUCTS, AND BEEKEEPING EQUIPMENT Importation and...

  18. 7 CFR 322.10 - Inspection; refusal of entry.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... SERVICE, DEPARTMENT OF AGRICULTURE BEES, BEEKEEPING BYPRODUCTS, AND BEEKEEPING EQUIPMENT Importation of Adult Honeybees, Honeybee Germ Plasm, and Bees Other Than Honeybees From Approved Regions § 322.10 Inspection; refusal of entry. (a) Shipments of honeybees, honeybee germ plasm, and bees other than honeybees...

  19. 7 CFR 322.10 - Inspection; refusal of entry.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... SERVICE, DEPARTMENT OF AGRICULTURE BEES, BEEKEEPING BYPRODUCTS, AND BEEKEEPING EQUIPMENT Importation of Adult Honeybees, Honeybee Germ Plasm, and Bees Other Than Honeybees From Approved Regions § 322.10 Inspection; refusal of entry. (a) Shipments of honeybees, honeybee germ plasm, and bees other than honeybees...

  20. 7 CFR 322.34 - Inspection; refusal of entry.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 5 2014-01-01 2014-01-01 false Inspection; refusal of entry. 322.34 Section 322.34 Agriculture Regulations of the Department of Agriculture (Continued) ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE BEES, BEEKEEPING BYPRODUCTS, AND BEEKEEPING EQUIPMENT Importation and...

  1. 7 CFR 322.19 - Inspection; refusal of entry.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 5 2011-01-01 2011-01-01 false Inspection; refusal of entry. 322.19 Section 322.19 Agriculture Regulations of the Department of Agriculture (Continued) ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE BEES, BEEKEEPING BYPRODUCTS, AND BEEKEEPING EQUIPMENT Importation of...

  2. 7 CFR 322.19 - Inspection; refusal of entry.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 5 2013-01-01 2013-01-01 false Inspection; refusal of entry. 322.19 Section 322.19 Agriculture Regulations of the Department of Agriculture (Continued) ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE BEES, BEEKEEPING BYPRODUCTS, AND BEEKEEPING EQUIPMENT Importation of...

  3. 7 CFR 322.19 - Inspection; refusal of entry.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 5 2012-01-01 2012-01-01 false Inspection; refusal of entry. 322.19 Section 322.19 Agriculture Regulations of the Department of Agriculture (Continued) ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE BEES, BEEKEEPING BYPRODUCTS, AND BEEKEEPING EQUIPMENT Importation of...

  4. 7 CFR 322.19 - Inspection; refusal of entry.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 5 2014-01-01 2014-01-01 false Inspection; refusal of entry. 322.19 Section 322.19 Agriculture Regulations of the Department of Agriculture (Continued) ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE BEES, BEEKEEPING BYPRODUCTS, AND BEEKEEPING EQUIPMENT Importation of...

  5. 7 CFR 322.10 - Inspection; refusal of entry.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... SERVICE, DEPARTMENT OF AGRICULTURE BEES, BEEKEEPING BYPRODUCTS, AND BEEKEEPING EQUIPMENT Importation of Adult Honeybees, Honeybee Germ Plasm, and Bees Other Than Honeybees From Approved Regions § 322.10 Inspection; refusal of entry. (a) Shipments of honeybees, honeybee germ plasm, and bees other than honeybees...

  6. 7 CFR 322.34 - Inspection; refusal of entry.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 5 2013-01-01 2013-01-01 false Inspection; refusal of entry. 322.34 Section 322.34 Agriculture Regulations of the Department of Agriculture (Continued) ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE BEES, BEEKEEPING BYPRODUCTS, AND BEEKEEPING EQUIPMENT Importation and...

  7. 7 CFR 322.10 - Inspection; refusal of entry.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... SERVICE, DEPARTMENT OF AGRICULTURE BEES, BEEKEEPING BYPRODUCTS, AND BEEKEEPING EQUIPMENT Importation of Adult Honeybees, Honeybee Germ Plasm, and Bees Other Than Honeybees From Approved Regions § 322.10 Inspection; refusal of entry. (a) Shipments of honeybees, honeybee germ plasm, and bees other than honeybees...

  8. 7 CFR 322.34 - Inspection; refusal of entry.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 5 2011-01-01 2011-01-01 false Inspection; refusal of entry. 322.34 Section 322.34 Agriculture Regulations of the Department of Agriculture (Continued) ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE BEES, BEEKEEPING BYPRODUCTS, AND BEEKEEPING EQUIPMENT Importation and...

  9. 7 CFR 322.34 - Inspection; refusal of entry.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 5 2012-01-01 2012-01-01 false Inspection; refusal of entry. 322.34 Section 322.34 Agriculture Regulations of the Department of Agriculture (Continued) ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE BEES, BEEKEEPING BYPRODUCTS, AND BEEKEEPING EQUIPMENT Importation and...

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

    PubMed

    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.

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

    PubMed

    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/

  12. Alternative Fuels Data Center

    Science.gov Websites

    alternative fuels as propane, natural gas, liquefied hydrogen, liquid fuel derived from coal through the Fischer-Tropsch process, liquid hydrocarbons derived from biomass, and P-Series fuels. Biodiesel, ethanol ;hydrocarbons" includes liquids that contain oxygen, hydrogen, and carbon and as such "liquid

  13. 7 CFR 91.34 - When an appeal of a laboratory service may be refused.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...) COMMODITY LABORATORY TESTING PROGRAMS SERVICES AND GENERAL INFORMATION Appeal of Laboratory Services § 91.34 When an appeal of a laboratory service may be refused. An application for an appeal of a laboratory... 7 Agriculture 3 2010-01-01 2010-01-01 false When an appeal of a laboratory service may be refused...

  14. Are patients' decisions to refuse treatment binding on health care professionals?

    PubMed

    Murphy, Peter

    2005-06-01

    When patients refuse to receive medical treatment, the consequences of honouring their decisions can be tragic. This is no less true of patients who autonomously decide to refuse treatment. I distinguish three possible implications of these autonomous decisions. According to the Permissibility Claim, such a decision implies that it is permissible for the patient who has made the autonomous decision to forego medical treatment. According to the Anti-Paternalism Claim, it follows that health-care professionals are not morally permitted to treat that patient. According to the Binding Claim it follows that these decisions are binding on health-care professionals. My focus is the last claim. After arguing that it is importantly different from each of the first two claims, I give two arguments to show that it is false. One argument against the Binding Claim draws a comparison with cases in which patients autonomously choose perilous positive treatments. The other argument appeals to considered judgments about cases in which disincentives are used to deter patients from refusing sound treatments.

  15. Obstetrician-gynaecologists' opinions about conscientious refusal of a request for abortion: results from a national vignette experiment.

    PubMed

    Rasinski, Kenneth A; Yoon, John D; Kalad, Youssef G; Curlin, Farr A

    2011-12-01

    Conscientious refusal of abortion has been discussed widely by medical ethicists but little information on practitioners' opinions exists. The American College of Obstetricians and Gynecologists (ACOG) issued recommendations about conscientious refusal. We used a vignette experiment to examine obstetrician-gynecologists' (OB/GYN) support for the recommendations. A national survey of OB/GYN physicians contained a vignette experiment in which an OB/GYN doctor refused a requested elective abortion. The vignette varied two issues recently addressed by the ACOG ethics committee--whether the doctor referred and whether the doctor disclosed their objection to the abortion. 1800 OB/GYN randomly selected physicians were asked to complete a mail survey containing the vignette. The response rate was 66% (n=1154) after excluding 40 ineligible cases. Physicians indicated their approval for the vignette doctor's decision. Overall, 43% of OB/GYN physicians responded that the conscientious refusal exercised by the vignette physician was appropriate. 70% rated the vignette doctor as acting appropriately when a referral was made. This dropped to 51% when the doctor disclosed objections to the patient, and to 12% when the doctor disclosed objections and refused to make a referral. Consistent with previous research, males were more likely to support disclosure and refusal to refer. Highly religious physicians supported non-referral but not disclosure. OB/GYN physicians are less likely to support conscientious refusal of abortion if physicians disclose their objections to patients. This is at odds with ACOG recommendations and with some models of the doctor-patient relationship.

  16. 25 CFR 171.420 - Can I dispose of sewage, trash, or other refuse on a BIA irrigation project?

    Code of Federal Regulations, 2010 CFR

    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...

  17. Characteristics of H2S emission from aged refuse after excavation exposure.

    PubMed

    Shen, Dong-Sheng; Du, Yao; Fang, Yuan; Hu, Li-Fang; Fang, Cheng-Ran; Long, Yu-Yang

    2015-05-01

    Hydrogen sulfide (H2S(g)) emission from landfills is a widespread problem, especially when aged refuse is excavated. H2S(g) emission from aged refuse exposed to air was investigated and the results showed that large amounts of H2S(g) can be released, especially in the first few hours after excavation, when H2S(g) concentrations in air near refuse could reach 2.00 mg m(-3). Initial exposure to air did not inhibit the emission of H2S(g), as is generally assumed, but actually promoted it. The amounts of H2S(g) emitted in the first 2 d after excavation can be very dangerous, and the risks associated with the emission of H2S(g) could decrease significantly with time. Unlike a large number of sulfide existed under anaerobic conditions, the sulfide in aged municipal solid waste can be oxidized chemically to elemental sulfur (but not sulfate) under aerobic conditions, and its conversion rate was higher than 80%. Only microorganisms can oxidize the reduced sulfur species to sulfate, and the conversion rate could reach about 50%. Using appropriate techniques to enhance these chemical and biological transformations could allow the potential health risks caused by H2S(g) after refuse excavation to be largely avoided. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

    PubMed

    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 < 0.001) between insulin recipient patients (mean = 2.02, SD = 0.31) and insulin 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 < 0.001). 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.

  19. A novel silica alumina-based backfill material composed of coal refuse and fly ash.

    PubMed

    Yao, Yuan; Sun, Henghu

    2012-04-30

    In this paper, a systematic study was conducted to investigate a novel silica alumina-based backfill material composed of coal refuse and fly ash. The coal refuse and fly ash had different properties under various thermal activation temperatures (20 °C, 150 °C, 350 °C, 550 °C, 750 °C and 950 °C). It is known that a thermal activation temperature ranging from 20 °C to 950 °C significantly increases the flowability and pozzolanic properties of the coal refuse; however, the flowability of fly ash decreases when the activation temperature is higher than 550 °C because of a severe agglomeration phenomenon on its surface. An optimal design for this backfill material was determined to include an activated portion composed of 5% coal refuse at 750 °C and 15% fly ash at 20 °C. This combination yields the best performance with excellent flowability, a high compressive strength and a low bleeding rate. The microanalysis results corresponded well with the performance tests at different activation conditions. In the coal refuse, kaolinite peaks began to decrease because of their transformation into metakaolin at 550 °C. Chlorite peaks disappeared at 750 °C. Muscovite peaks decreased at 750 °C and disappeared at 950 °C. During this process, muscovite 2M(1) gradually dehydroxylated to muscovite HT. Furthermore, this paper examined the environmental acceptance and economic feasibility of this technology and found that this silica alumina-based backfill material composed of coal refuse and fly ash not only meets EPA requirements but also has several advantages in industry feasibility when compared with hydraulic backfill, rock backfill and paste backfill. Published by Elsevier B.V.

  20. Refusal of recommended travel-related vaccines among U.S. international travellers in Global TravEpiNet

    PubMed Central

    Lammert, Sara M.; Rao, Sowmya R.; Jentes, Emily S.; Fairley, Jessica K.; Erskine, Stefanie; Walker, Allison T.; Hagmann, Stefan H.; Sotir, Mark J.; Ryan, Edward T.

    2017-01-01

    Background: International travellers are at risk of travel-related, vaccine-preventable diseases. More data are needed on the proportion of travellers who refuse vaccines during a pre-travel health consultation and their reasons for refusing vaccines. Methods: We analyzed data on travellers seen for a pre-travel health consultation from July 2012 through June 2014 in the Global TravEpiNet (GTEN) consortium. Providers were required to indicate one of three reasons for a traveller refusing a recommended vaccine: (1) cost concerns, (2) safety concerns or (3) not concerned with the illness. We calculated refusal rates among travellers eligible for each vaccine based on CDC recommendations current at the time of travel. We used multivariable logistic regression models to examine the effect of individual variables on the likelihood of accepting all recommended vaccines. Results: Of 24 478 travellers, 23 768 (97%) were eligible for at least one vaccine. Travellers were most frequently eligible for typhoid (N = 20 092), hepatitis A (N = 12 990) and influenza vaccines (N = 10 539). Of 23 768 eligible travellers, 6573 (25%) refused one or more recommended vaccine(s). Of those eligible, more than one-third refused the following vaccines: meningococcal: 2232 (44%) of 5029; rabies: 1155 (44%) of 2650; Japanese encephalitis: 761 (41%) of 1846; and influenza: 3527 (33%) of 10 539. The most common reason for declining vaccines was that the traveller was not concerned about the illness. In multivariable analysis, travellers visiting friends and relatives (VFR) in low or medium human development countries were less likely to accept all recommended vaccines, compared with non-VFR travellers (OR = 0.74 (0.59–0.95)). Conclusions: Travellers who sought pre-travel health care refused recommended vaccines at varying rates. A lack of concern about the associated illness was the most commonly cited reason for all refused vaccines. Our data suggest more effective

  1. Refusal of recommended travel-related vaccines among U.S. international travellers in Global TravEpiNet.

    PubMed

    Lammert, Sara M; Rao, Sowmya R; Jentes, Emily S; Fairley, Jessica K; Erskine, Stefanie; Walker, Allison T; Hagmann, Stefan H; Sotir, Mark J; Ryan, Edward T; LaRocque, Regina C

    2016-07-01

    International travellers are at risk of travel-related, vaccine-preventable diseases. More data are needed on the proportion of travellers who refuse vaccines during a pre-travel health consultation and their reasons for refusing vaccines. We analyzed data on travellers seen for a pre-travel health consultation from July 2012 through June 2014 in the Global TravEpiNet (GTEN) consortium. Providers were required to indicate one of three reasons for a traveller refusing a recommended vaccine: (1) cost concerns, (2) safety concerns or (3) not concerned with the illness. We calculated refusal rates among travellers eligible for each vaccine based on CDC recommendations current at the time of travel. We used multivariable logistic regression models to examine the effect of individual variables on the likelihood of accepting all recommended vaccines. Of 24 478 travellers, 23 768 (97%) were eligible for at least one vaccine. Travellers were most frequently eligible for typhoid (N = 20 092), hepatitis A (N = 12 990) and influenza vaccines (N = 10 539). Of 23 768 eligible travellers, 6573 (25%) refused one or more recommended vaccine(s). Of those eligible, more than one-third refused the following vaccines: meningococcal: 2232 (44%) of 5029; rabies: 1155 (44%) of 2650; Japanese encephalitis: 761 (41%) of 1846; and influenza: 3527 (33%) of 10 539. The most common reason for declining vaccines was that the traveller was not concerned about the illness. In multivariable analysis, travellers visiting friends and relatives (VFR) in low or medium human development countries were less likely to accept all recommended vaccines, compared with non-VFR travellers (OR = 0.74 (0.59-0.95)). Travellers who sought pre-travel health care refused recommended vaccines at varying rates. A lack of concern about the associated illness was the most commonly cited reason for all refused vaccines. Our data suggest more effective education about disease risk is needed for

  2. A comparison of food refusal related to characteristics of food in children with autism spectrum disorder and typically developing children.

    PubMed

    Hubbard, Kristie L; Anderson, Sarah E; Curtin, Carol; Must, Aviva; Bandini, Linda G

    2014-12-01

    Parents of children with autism spectrum disorder (ASD) frequently report child food refusal based on characteristics of food. Our study sought to determine whether parent report of food refusal based on the characteristics of food was greater in children with ASD than in typically developing children, associated with a greater percentage of foods refused of those offered, and associated with fruit and vegetable intake. A modified food frequency questionnaire was used to determine overall food refusal as well as fruit and vegetable intake. Parent-reported food refusal related to characteristics of food (eg, texture/consistency, temperature, brand, color, shape, taste/smell, foods mixed together, or foods touching other foods) was compared between 53 children with ASD and 58 typically developing children aged 3 to 11 years in the Children's Activity and Meal Patterns Study (2007-2008). Children with ASD were significantly more likely to refuse foods based on texture/consistency (77.4% vs 36.2%), taste/smell (49.1% vs 5.2%), mixtures (45.3% vs 25.9%), brand (15.1% vs 1.7%), and shape (11.3% vs 1.7%). No differences between groups were found for food refusal based on temperature, foods touching other foods, or color. Irrespective of ASD status, the percentage of foods refused of those offered was associated with parent reports of food refusal based on all characteristics examined, except temperature. Food refusal based on color was inversely associated with vegetable consumption in both groups. Routine screening for food refusal among children with ASD is warranted to prevent dietary inadequacies that may be associated with selective eating habits. Future research is needed to develop effective and practical feeding approaches for children with ASD. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  3. Is bariatric surgery safe in patients who refuse blood transfusion?

    PubMed

    Kitahama, Seiichi; Smith, Mark D; Rosencrantz, David R; Patterson, Emma J

    2013-01-01

    A small, but significant, number of patients undergoing bariatric surgery refuse blood transfusion for religious or other personal reasons. Jehovah's Witnesses number more than 1 million members in the United States alone. The reported rates of hemorrhage vary from .5% to 4% after bariatric surgery, with transfusion required in one half of these cases. Pharmacologic prophylaxis against venous thromboembolism could further increase the perioperative bleeding risk. Our objective was to report the perioperative outcomes of bariatric surgery who refuse blood transfusion at a bariatric center of excellence, private practice in the United States. A retrospective review of all patients who refused blood transfusion when undergoing bariatric surgery during a 10-year period was conducted. Patients were identified from a prospectively maintained database by the bloodless surgery program at Legacy Good Samaritan Hospital. Data were collected on demographics, co-morbidities, laboratory values, medication use, blood loss, and 30-day complications. Thirty-five bloodless surgery patients underwent bariatric surgery from 2000 to 2009. Of these 35 patients, 21 underwent laparoscopic adjustable gastric banding and 14 Roux-en-Y gastric bypass. Before 2006, only pneumatic compression devices were applied for venous thromboembolism prophylaxis (n = 6). Subsequently, combination venous thromboembolism prophylaxis was performed with fondaparinux sodium 2.5 mg for RYGB or enoxaparin 40 mg for LAGB (n = 29). One RYGB patient developed postoperative hemorrhage requiring reoperation. No venous thromboembolisms or deaths occurred. Bariatric surgery can be performed in patients who refuse blood transfusion with acceptable postoperative morbidity. Larger studies are necessary to confirm the safety of this approach and to examine the effect of pharmacologic thromboprophylaxis in this patient group. Copyright © 2013 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc

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

    ERIC Educational Resources Information Center

    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…

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

    PubMed

    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.

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

    PubMed

    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.

  7. 49 CFR 382.211 - Refusal to submit to a required alcohol or controlled substances test.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ....211 Refusal to submit to a required alcohol or controlled substances test. No driver shall refuse to submit to a post-accident alcohol or controlled substances test required under § 382.303, a random... controlled substances test. 382.211 Section 382.211 Transportation Other Regulations Relating to...

  8. 49 CFR 382.211 - Refusal to submit to a required alcohol or controlled substances test.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ....211 Refusal to submit to a required alcohol or controlled substances test. No driver shall refuse to submit to a post-accident alcohol or controlled substances test required under § 382.303, a random... controlled substances test. 382.211 Section 382.211 Transportation Other Regulations Relating to...

  9. Forms and Functions of School Refusal Behavior in Youth: An Empirical Analysis of Absenteeism Severity

    ERIC Educational Resources Information Center

    Kearney, Christopher A.

    2007-01-01

    Background: School refusal behavior is a particularly nettlesome problem for mental health and education professionals because of its symptom severity and heterogeneity as well as lack of consensus regarding inclusive classification strategies. Alternatively, a functional model of school refusal behavior may provide a particularly useful way of…

  10. 33 CFR 95.040 - Refusal to submit to testing.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... OPERATING REGULATIONS OPERATING A VESSEL WHILE UNDER THE INFLUENCE OF ALCOHOL OR A DANGEROUS DRUG § 95.040... be presumed to be under the influence of alcohol or a dangerous drug. (b) If an individual refuses to...

  11. Descriptive Analyses of Pediatric Food Refusal and Acceptance

    ERIC Educational Resources Information Center

    Borrero, Carrie S. W.; Woods, Julia N.; Borrero, John C.; Masler, Elizabeth A.; Lesser, Aaron D.

    2010-01-01

    Functional analyses of inappropriate mealtime behavior typically include conditions to determine if the contingent delivery of attention, tangible items, or escape reinforce food refusal. In the current investigation, descriptive analyses were conducted for 25 children who had been admitted to a program for the assessment and treatment of food…

  12. Renewable liquid fuels from catalytic reforming of biomass-derived oxygenated hydrocarbons

    NASA Astrophysics Data System (ADS)

    Barrett, Christopher J.

    Diminishing fossil fuel reserves and growing concerns about global warming require the development of sustainable sources of energy. Fuels for use in the transportation sector must have specific physical properties that allow for efficient distribution, storage, and combustion; these requirements are currently fulfilled by petroleum-derived liquid fuels. The focus of this work has been the development of two new biofuels that have the potential to become widely used transportation fuels from carbohydrate intermediates. Our first biofuel has cetane numbers ranging from 63 to 97 and is comprised of C7 to C15 straight chain alkanes. These alkanes can be blended with diesel like fuels or with P-series biofuel. Production involves a solid base catalyzed aldol condensation with mixed Mg-Al-oxide between furfural or 5-hydroxymethylfurfural (HMF) and acetone, followed by hydrogenation over Pd/Al2O3, and finally hydrogenation/dehydration over Pt/SiO2-Al2O3. Water was the solvent for all process steps, except for the hydrogenation/dehydration stage where hexadecane was co-fed to spontaneously separate out all alkane products and eliminate the need for energy intensive distillation. A later optimization identified Pd/MgO-ZrO2 as a hydrothermally stable bifunctional catalyst to replace Pd/Al2O3 and the hydrothermally unstable Mg-Al-oxide catalysts along with optimizing process parameters, such as temperature and molar ratios of reactants to maximize yields to heavier alkanes. Our second biofuel involved creating an improved process to produce HMF through the acid-catalyzed dehydration of fructose in a biphasic reactor. Additionally, we developed a technique to further convert HMF into 2,5-dimethylfuran (DMF) by hydrogenolysis of C-O bonds over a copper-ruthenium catalyst. DMF has many properties that make it a superior blending agent to ethanol: it has a high research octane number at 119, a 40% higher energy density than ethanol, 20 K higher boiling point, and is insoluble in

  13. Alternative Fuels Data Center

    Science.gov Websites

    mixture containing at least 85% methanol, denatured ethanol, or other alcohols; natural gas, propane , hydrogen, or coal derived liquid fuels; or fuels derived from biological materials. PEVs are defined as

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

    PubMed

    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.

  15. Missed opportunities: refusal to confirm reactive rapid HIV tests in the emergency department.

    PubMed

    Ganguli, Ishani; Collins, Jamie E; Reichmann, William M; Losina, Elena; Katz, Jeffrey N; Arbelaez, Christian; Donnell-Fink, Laurel A; Walensky, Rochelle P

    2013-01-01

    HIV infection remains a major US public health concern. While HIV-infected individuals now benefit from earlier diagnosis and improved treatment options, progress is tempered by large numbers of newly diagnosed patients who are lost to follow-up prior to disease confirmation and linkage to care. In the randomized, controlled USHER trial, we offered rapid HIV tests to patients presenting to a Boston, MA emergency department. Separate written informed consent was required for confirmatory testing. In a secondary analysis, we compared participants with reactive results who did and did not complete confirmatory testing to identify factors associated with refusal to complete the confirmation protocol. Thirteen of 62 (21.0%, 95% CI (11.7%, 33.2%)) participants with reactive rapid HIV tests refused confirmation; women, younger participants, African Americans, and those with fewer HIV risks, with lower income, and without primary care doctors were more likely to refuse. We projected that up to four true HIV cases were lost at the confirmation stage. These findings underscore the need to better understand the factors associated with refusal to confirm reactive HIV testing and to identify interventions that will facilitate confirmatory testing and linkage to care among these populations. ClinicalTrials.gov NCT00502944; NCT01258582.

  16. Sensitive Topics, Missing Data, and Refusal in Social Network Studies: An Ethical Examination.

    PubMed

    Ellison, Erin Rose; Langhout, Regina Day

    2017-12-01

    We describe our ethics-driven process of addressing missing data within a social network study about accountability for racism, classism, sexism, heterosexism, cis-sexism, ableism, and other forms of oppression among social justice union organizers. During data collection, some would-be participants did not return emails and others explicitly refused to engage in the research. All refusals came from women of color. We faced an ethical dilemma: Should we continue to seek participation from those who had not yet responded, with the hopes of recruiting more women of color from within the network so their perspectives would not be tokenized? Or, should we stop asking those who had been contacted multiple times, which would compromise the social network data and analysis? We delineate ways in which current discussions of the ethics of social network studies fell short, given our framework and our community psychology (CP) values. We outline literature that was helpful in thinking through this challenge; we looked outside of CP to the decolonization literature on refusal. Lessons learned include listening for the possible meanings of refusals and considering the level of engagement and the labor required of participants when designing research studies. © Society for Community Research and Action 2017.

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

    PubMed

    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.

  18. 49 CFR 382.211 - Refusal to submit to a required alcohol or controlled substances test.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ....211 Refusal to submit to a required alcohol or controlled substances test. No driver shall refuse to submit to a pre-employment controlled substance test required under § 382.301, a post-accident alcohol or... controlled substances test. 382.211 Section 382.211 Transportation Other Regulations Relating to...

  19. 49 CFR 382.211 - Refusal to submit to a required alcohol or controlled substances test.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ....211 Refusal to submit to a required alcohol or controlled substances test. No driver shall refuse to submit to a pre-employment controlled substance test required under § 382.301, a post-accident alcohol or... controlled substances test. 382.211 Section 382.211 Transportation Other Regulations Relating to...

  20. 49 CFR 382.211 - Refusal to submit to a required alcohol or controlled substances test.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ....211 Refusal to submit to a required alcohol or controlled substances test. No driver shall refuse to submit to a pre-employment controlled substance test required under § 382.301, a post-accident alcohol or... controlled substances test. 382.211 Section 382.211 Transportation Other Regulations Relating to...

  1. Small-Scale Waste-to-Energy Technology for Contingency Bases

    DTIC Science & Technology

    2012-05-24

    Expedient, No Waste Sorting Technology Readiness Level High Fuel Demand Water Required Steam Infrastructure Required Air Emissions Gasification ...Full gasification system • Costs $26K • GM Industrial Engine (GM 4 Cylinder, 3.00 L) • MeccAlte Generator Head • Imbert type downdraft reactor...Solid waste volume reduction − Response to waste streams  biomass , refuse-derived fuel, shredded waste − Operation and maintenance requirements

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

    PubMed

    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.

  3. Conscientious refusals and reason-giving.

    PubMed

    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.

  4. 36 CFR § 1002.14 - Sanitation and refuse.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 36 Parks, Forests, and Public Property 3 2013-07-01 2012-07-01 true Sanitation and refuse. § 1002.14 Section § 1002.14 Parks, Forests, and Public Property PRESIDIO TRUST RESOURCE PROTECTION, PUBLIC... vehicle, except in facilities provided for such purpose. (5) Bathing, or washing food, clothing, dishes...

  5. 7 CFR 319.8-26 - Material refused entry.

    Code of Federal Regulations, 2010 CFR

    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...

  6. Effect of fuel properties on performance of a single aircraft turbojet combustor. [from coal and oil-shale derived syncrudes

    NASA Technical Reports Server (NTRS)

    Butze, H. F.; Ehlers, R. C.

    1975-01-01

    The performance of a single-can JT8D combustor was investigated with a number of fuels exhibiting wide variations in chemical composition and volatility. Performance parameters investigated were combustion efficiency, emissions of CO, unburned hydrocarbons and NOx, as well as liner temperatures and smoke. At the simulated idle condition no significant differences in performance were observed. At cruise, liner temperatures and smoke increased sharply with decreasing hydrogen content of the fuel. No significant differences were observed in the performance of an oil-shale derived JP-5 and a petroleum-based Jet A fuel except for emissions of NOx which were higher with the oil-shale JP-5. The difference is attributed to the higher concentration of fuel-bound nitrogen in the oil-shale JP-5.

  7. 49 CFR 199.103 - Use of persons who fail or refuse a drug test.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... SAFETY DRUG AND ALCOHOL TESTING Drug Testing § 199.103 Use of persons who fail or refuse a drug test. (a) An operator may not knowingly use as an employee any person who— (1) Fails a drug test required by... 49 Transportation 3 2013-10-01 2013-10-01 false Use of persons who fail or refuse a drug test. 199...

  8. 49 CFR 199.103 - Use of persons who fail or refuse a drug test.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... SAFETY DRUG AND ALCOHOL TESTING Drug Testing § 199.103 Use of persons who fail or refuse a drug test. (a) An operator may not knowingly use as an employee any person who— (1) Fails a drug test required by... 49 Transportation 3 2014-10-01 2014-10-01 false Use of persons who fail or refuse a drug test. 199...

  9. 49 CFR 199.103 - Use of persons who fail or refuse a drug test.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... SAFETY DRUG AND ALCOHOL TESTING Drug Testing § 199.103 Use of persons who fail or refuse a drug test. (a) An operator may not knowingly use as an employee any person who— (1) Fails a drug test required by... 49 Transportation 3 2011-10-01 2011-10-01 false Use of persons who fail or refuse a drug test. 199...

  10. 49 CFR 199.103 - Use of persons who fail or refuse a drug test.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... SAFETY DRUG AND ALCOHOL TESTING Drug Testing § 199.103 Use of persons who fail or refuse a drug test. (a) An operator may not knowingly use as an employee any person who— (1) Fails a drug test required by... 49 Transportation 3 2012-10-01 2012-10-01 false Use of persons who fail or refuse a drug test. 199...

  11. 49 CFR 199.103 - Use of persons who fail or refuse a drug test.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... SAFETY DRUG AND ALCOHOL TESTING Drug Testing § 199.103 Use of persons who fail or refuse a drug test. (a) An operator may not knowingly use as an employee any person who— (1) Fails a drug test required by... 49 Transportation 3 2010-10-01 2010-10-01 false Use of persons who fail or refuse a drug test. 199...

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

    PubMed Central

    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

  13. A FIELD TEST USING COAL:DRDF BLENDS IN SPREADER STOKER-FIRED BOILERS

    EPA Science Inventory

    This program was conducted to characterize and demonstrate the technical, economic, and environmental feasibility of combustion densified forms of refuse derived fuel (dRDF) blended with coal in spreader stoker-fired boilers. A total of 258.5 Mg (285 tons) of pelletized 1/2-inch-...

  14. Use of warrants for breath test refusal : case studies

    DOT National Transportation Integrated Search

    2007-10-01

    This study investigated the use of warrants to obtain blood samples from drivers arrested for alcohol-impaired driving and who refuse to provide breath samples when requested to do so by law enforcement officers. Case studies were conducted in four S...

  15. Partial replacement of fossil fuel in a cement plant: risk assessment for the population living in the neighborhood.

    PubMed

    Rovira, Joaquim; Mari, Montse; Nadal, Martí; Schuhmacher, Marta; Domingo, José L

    2010-10-15

    In cement plants, the substitution of traditional fossil fuels not only allows a reduction of CO(2), but it also means to check-out residual materials, such as sewage sludge or municipal solid wastes (MSW), which should otherwise be disposed somehow/somewhere. In recent months, a cement plant placed in Alcanar (Catalonia, Spain) has been conducting tests to replace fossil fuel by refuse-derived fuel (RDF) from MSW. In July 2009, an operational test was progressively initiated by reaching a maximum of partial substitution of 20% of the required energy. In order to study the influence of the new process, environmental monitoring surveys were performed before and after the RDF implementation. Metals and polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) were analyzed in soil, herbage, and air samples collected around the facility. In soils, significant decreases of PCDD/F levels, as well as in some metal concentrations were found, while no significant increases in the concentrations of these pollutants were observed. In turn, PM(10) levels remained constant, with a value of 16μgm(-3). In both surveys, the carcinogenic and non-carcinogenic risks derived from exposure to metals and PCDD/Fs for the population living in the vicinity of the facility were within the ranges considered as acceptable according to national and international standards. This means that RDF may be a successful choice in front of classical fossil fuels, being in accordance with the new EU environmental policies, which entail the reduction of CO(2) emissions and the energetic valorization of MSW. However, further long-term environmental studies are necessary to corroborate the harmlessness of RDF, in terms of human health risks. Copyright © 2010 Elsevier B.V. All rights reserved.

  16. Invitation Refusals in Cameroon French and Hexagonal French

    ERIC Educational Resources Information Center

    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…

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

    PubMed

    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

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

    PubMed

    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.

  19. Understanding the Antecedents of Korean High School Students’ Drinking Refusal Self-Efficacy: Parental Influence, Peer Influence, and Behavior

    PubMed Central

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

    2012-01-01

    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. PMID:22980099

  20. Performance and economics of advanced energy conversion systems for coal and coal-derived fuels

    NASA Technical Reports Server (NTRS)

    Corman, J. C.; Fox, G. R.

    1978-01-01

    The desire to establish an efficient Energy Conversion System to utilize the fossil fuel of the future - coal - has produced many candidate systems. A comparative technical/economic evaluation was performed on the seven most attractive advanced energy conversion systems. The evaluation maintains a cycle-to-cycle consistency in both performance and economic projections. The technical information base can be employed to make program decisions regarding the most attractive concept. A reference steam power plant was analyzed to the same detail and, under the same ground rules, was used as a comparison base. The power plants were all designed to utilize coal or coal-derived fuels and were targeted to meet an environmental standard. The systems evaluated were two advanced steam systems, a potassium topping cycle, a closed cycle helium system, two open cycle gas turbine combined cycles, and an open cycle MHD system.

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

    ERIC Educational Resources Information Center

    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…

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

    PubMed

    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.

  3. Performance and bacterial compositions of aged refuse reactors treating mature landfill leachate.

    PubMed

    Xie, Bing; Xiong, Shunzi; Liang, Shaobo; Hu, Chong; Zhang, Xiaojun; Lu, Jun

    2012-01-01

    Aged landfill leachates become more refractory over time and difficulty to treat. Recently, aged refuse bioreactors show great promise in treating leachates. In this study, aged refuse bioreactors were constructed to simulate landfill leachate degradation process. The characteristics of leachate were: CODcr, ∼2200 mg/L; BOD5, ∼280 mg/L; total nitrogen, ∼2030 mg/L; and ammonia, ∼1900 mg/L. Results showed that bioreactor could remove leachate pollutants effectively at hydraulic loading of 20 L/m3 d. The removal rate reduced when hydraulic loading doubled or temperature lowered. Effluent recirculation could alleviate the temperature effect. Combining aged refuse and slag biofilters could treat leachate more efficiently. Pyrosequencing analysis indicated that bacteria from Pseudomonas, Lysobacter, Bacillus and δ-proteobacter, Flexibacteraceae were more abundant in the samples. The Shannon index decreased at lower temperature, while evenness and equitability increased with recirculation. We suggest that filter medium and temperature may be the main factors for shaping bacterial community structure. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

  4. Refinery Integration of By-Products from Coal-Derived Jet Fuels

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Caroline Clifford; Andre Boehman; Chunshan Song

    2008-03-31

    The final report summarizes the accomplishments toward project goals during length of the project. The goal of this project was to integrate coal into a refinery in order to produce coal-based jet fuel, with the major goal to examine the products other than jet fuel. These products are in the gasoline, diesel and fuel oil range and result from coal-based jet fuel production from an Air Force funded program. The main goal of Task 1 was the production of coal-based jet fuel and other products that would need to be utilized in other fuels or for non-fuel sources, using knownmore » refining technology. The gasoline, diesel fuel, and fuel oil were tested in other aspects of the project. Light cycle oil (LCO) and refined chemical oil (RCO) were blended, hydrotreated to removed sulfur, and hydrogenated, then fractionated in the original production of jet fuel. Two main approaches, taken during the project period, varied where the fractionation took place, in order to preserve the life of catalysts used, which includes (1) fractionation of the hydrotreated blend to remove sulfur and nitrogen, followed by a hydrogenation step of the lighter fraction, and (2) fractionation of the LCO and RCO before any hydrotreatment. Task 2 involved assessment of the impact of refinery integration of JP-900 production on gasoline and diesel fuel. Fuel properties, ignition characteristics and engine combustion of model fuels and fuel samples from pilot-scale production runs were characterized. The model fuels used to represent the coal-based fuel streams were blended into full-boiling range fuels to simulate the mixing of fuel streams within the refinery to create potential 'finished' fuels. The representative compounds of the coal-based gasoline were cyclohexane and methyl cyclohexane, and for the coal-base diesel fuel they were fluorine and phenanthrene. Both the octane number (ON) of the coal-based gasoline and the cetane number (CN) of the coal-based diesel were low, relative to

  5. THE EFFECT OF COFIRING HIGH-SULFUR COAL WITH MUNICIPAL WASTE ON FORMATION OF POLYCHLORINATED DIBENZODIOXIN AND POLYCHLORINATED DIBENZOFURAN

    EPA Science Inventory

    The effect of co-firing minor amounts (5-10 wt%) of high sulfur coal with municipal refuse-derived fuel (RDF) on emissions of polychlorinated dibenzo-p-dioxin (PCDD) and polychlorinated dibenzofuran (PCDF) was studied under a range of operating conditions. Through use of 2x facto...

  6. 40 CFR Table 1 to Subpart Cb of... - Nitrogen Oxides Guidelines for Designated Facilities

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions... (parts per million by volume) a Mass burn waterwall 205 205. Mass burn rotary waterwall 250 210. Refuse-derived fuel combustor 250 250. Fluidized bed combustor 180 180. Mass burn refractory combustors No limit...

  7. 40 CFR Table 1 to Subpart Cb of... - Nitrogen Oxides Guidelines for Designated Facilities

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions... (parts per million by volume) a Mass burn waterwall 205 205. Mass burn rotary waterwall 250 210. Refuse-derived fuel combustor 250 250. Fluidized bed combustor 180 180. Mass burn refractory combustors No limit...

  8. 40 CFR Table 1 to Subpart Cb of... - Nitrogen Oxides Guidelines for Designated Facilities

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Emissions... (parts per million by volume) a Mass burn waterwall 205 205. Mass burn rotary waterwall 250 210. Refuse-derived fuel combustor 250 250. Fluidized bed combustor 180 180. Mass burn refractory combustors No limit...

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

    PubMed

    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

  10. 30 CFR 77.215 - Refuse piles; construction requirements.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... on a pile shall be spread in layers and compacted in such a manner so as to minimize the flow of air... constructed in compacted layers not exceeding 2 feet in thickness and shall not have any slope exceeding 2... refuse pile in compacted layers exceeding 2 feet in thickness and with slopes exceeding 27° where...

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

    PubMed Central

    2012-01-01

    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 for condom-use and

  12. Reasons for Chemotherapy Refusal or Acceptance in Older Adults With Cancer.

    PubMed

    Gopal, Naveen; Kozikowski, Andrzej; Barginear, Myra F; Fishbein, Joanna; Pekmezaris, Renee; Wolf-Klein, Gisele

    2017-01-01

    The majority of Americans diagnosed as having cancer are older than 65 years. They are, however, less likely than younger patients to receive chemotherapy. Our study aimed to better understand the specific reasons for acceptance or refusal of chemotherapy in older adults with cancer. An anonymous cross-sectional survey was distributed during a 6-month study period in a cancer center and an outpatient geriatric medicine faculty practice to patients at least 50 years old with cancer or to their family members. Data collected included reasons for refusal or acceptance, stage/type of cancer, and demographics. The association between chemotherapy refusal or initiation and these factors was assessed using the Fisher exact test. Among the 37 respondents meeting the inclusion criteria, 78.4% were patients and 21.6% were family members. The following factors were significantly associated with chemotherapy decision: perceived chemotherapy benefit ( P < 0.001), trust in the doctor's recommendation ( P = 0.013), social support ( P = 0.018), marital status ( P < 0.001), sex ( P = 0.037), race/ethnicity ( P = 0.021), and whether respondents had a family member or friend who had previously received chemotherapy ( P = 0.040). In contrast, none of the clinical variables, such as stage of cancer, previous receipt of chemotherapy, or interest in complementary/alternative medicine showed significant association with a patient's decision to accept or refuse chemotherapy treatment. Chemotherapy decisions made by older adults appear to be associated with demographic and social factors rather than with medical information. Recognizing the influence of these factors for older patients with cancer may help hematologists and oncologists to proactively address specific barriers and explore concerns regarding chemotherapy in older patients whose quality of life and longevity may be affected by treatment.

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

    PubMed

    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.

  14. Emissions During Co-Firing of RDF-5 with Coal in a 22 t/h Steam Bubbling Fluidized Bed Boiler

    NASA Astrophysics Data System (ADS)

    Wan, Hou-Peng; Chen, Jia-Yuan; Juch, Ching-I.; Chang, Ying-Hsi; Lee, Hom-Ti

    The co-firing of biomass and fossil fuel in the same power plant is one of the most important issues when promoting the utilization of renewable energy in the world. Recently, the co-firing of coal together with biomass fuel, such as "densified refuse derived fuel" (d-RDF or RDF-5) or RPF (refuse paper & plastic fuel) from waste, has been considered as an environmentally sound and economical approach to both waste remediation and energy production in the world. Because of itscomplex characteristics when compared to fossil fuel, potential problems, such as combustion system stability, the corrosion of heat transfer tubes, the qualities of the ash, and the emissionof pollutants, are major concerns when co-firing the biomass fuel with fossil fuel in a traditional boiler. In this study, co-firing of coal with RDF-5 was conducted in a 22t/h bubbling fluidized bed (BFB) steam boiler to investigate the feasibility of utilizing RDF-5 as a sustainable fuels in a commercial coal-fired steam BFB boiler. The properties of the fly ash, bottom ash, and the emission of pollutants are analyzed and discussed in this study.

  15. Ground-Water Quality in the Vicinity of Coal-Refuse Areas Reclaimed with Biosolids in Fulton County, Illinois

    USGS Publications Warehouse

    Morrow, William S.

    2007-01-01

    The Metropolitan Water Reclamation District of Greater Chicago has applied biosolids, followed by revegetation, to reclaim three coal-refuse areas. Most of the reclamation at the three sites was done from 1989 through 1992, and included the application of lime, clay, and various loads of biosolids up to 1,000 dry tons per acre. Water samples collected from 12 monitoring wells installed in the vicinity of the three reclaimed coal-refuse areas were analyzed to better understand the hydrogeology and water-quality effects. Ground water probably flows along preferential paths in the disturbed coal-refuse areas, and is impeded by undisturbed glacial till. Most of the samples contained elevated concentrations of sulfate, iron, and manganese, constituents associated with ground water in coal-mined areas. Concentrations of aluminum, cadmium, nickel, or zinc were somewhat elevated in samples from four wells, and greatest in water samples with pH less than 5. The smaller nutrient concentrations indicate that the applied biosolids are not identifiably affecting nutrients or metal concentrations in shallow ground water near the refuse piles. The coal refuse likely is the primary influence on the chemical characterization of ground-water in the area.

  16. Clinical Characteristics of the Suicide Attempters Who Refused to Participate in a Suicide Prevention Case Management Program.

    PubMed

    Park, Soyoung; Choi, Kyoung Ho; Oh, Youngmin; Lee, Hae-Kook; Kweon, Yong-Sil; Lee, Chung Tai; Lee, Kyoung-Uk

    2015-10-01

    Case management interventions for suicide attempters aimed at helping adjust their social life to prevent reattempts have high nonparticipation and dropout rates. We analyzed the clinical characteristics of the group who refused to participate in the suicide prevention program in Korea. A total of 489 patients with a suicide attempt who visited Uijeongbu St. Mary's Hospital, the Catholic University of Korea, from December 2009 to December 2013 were analyzed. All patients were divided into the participation group (n = 262) and the refusal group (n = 227) according to their participation in the case management program. Demographic and clinical characteristics of each group were examined. Results showed that the refusal group had low risks for suicide in terms of risk factors related with psychopathologies and presenting suicide behavior. That is, the refusal group had less patients with co-morbid medical illnesses and more patients with mild severity of depression compared to the participation group. However, the refusal group had more interpersonal conflict, more isolation of social integrity, and more impaired insight about suicide attempt. The results suggest that nonparticipation in the case management program may depend upon the patient's impaired insight about the riskiness of suicide and lack of social support.

  17. 41 CFR 51-9.404 - Refusal of request to amend.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Public Contracts COMMITTEE FOR PURCHASE FROM PEOPLE WHO ARE BLIND OR SEVERELY DISABLED 9-PRIVACY ACT..., or any official acting for him, shall have the authority to issue an initial refusal of a request to...

  18. Parental Delay or Refusal of Vaccine Doses, Childhood Vaccination Coverage at 24 Months of Age, and the Health Belief Model

    PubMed Central

    Smith, Philip J.; Humiston, Sharon G.; Marcuse, Edgar K.; Zhao, Zhen; Dorell, Christina G.; Howes, Cynthia; Hibbs, Beth

    2011-01-01

    Objective We evaluated the association between parents' beliefs about vaccines, their decision to delay or refuse vaccines for their children, and vaccination coverage of children at aged 24 months. Methods We used data from 11,206 parents of children aged 24–35 months at the time of the 2009 National Immunization Survey interview and determined their vaccination status at aged 24 months. Data included parents' reports of delay and/or refusal of vaccine doses, psychosocial factors suggested by the Health Belief Model, and provider-reported up-to-date vaccination status. Results In 2009, approximately 60.2% of parents with children aged 24–35 months neither delayed nor refused vaccines, 25.8% only delayed, 8.2% only refused, and 5.8% both delayed and refused vaccines. Compared with parents who neither delayed nor refused vaccines, parents who delayed and refused vaccines were significantly less likely to believe that vaccines are necessary to protect the health of children (70.1% vs. 96.2%), that their child might get a disease if they aren't vaccinated (71.0% vs. 90.0%), and that vaccines are safe (50.4% vs. 84.9%). Children of parents who delayed and refused also had significantly lower vaccination coverage for nine of the 10 recommended childhood vaccines including diphtheria-tetanus-acellular pertussis (65.3% vs. 85.2%), polio (76.9% vs. 93.8%), and measles-mumps-rubella (68.4% vs. 92.5%). After adjusting for sociodemographic differences, we found that parents who were less likely to agree that vaccines are necessary to protect the health of children, to believe that their child might get a disease if they aren't vaccinated, or to believe that vaccines are safe had significantly lower coverage for all 10 childhood vaccines. Conclusions Parents who delayed and refused vaccine doses were more likely to have vaccine safety concerns and perceive fewer benefits associated with vaccines. Guidelines published by the American Academy of Pediatrics may assist

  19. Utilization of alternative fuels in diesel engines

    NASA Technical Reports Server (NTRS)

    Lestz, S. A.

    1984-01-01

    Performance and emission data are collected for various candidate alternate fuels and compare these data to that for a certified petroleum based number two Diesel fuel oil. Results for methanol, ethanol, four vegetable oils, two shale derived oils, and two coal derived oils are reported. Alcohol fumigation does not appear to be a practical method for utilizing low combustion quality fuels in a Diesel engine. Alcohol fumigation enhances the bioactivity of the emitted exhaust particles. While it is possible to inject many synthetic fuels using the engine stock injection system, wholly acceptable performance is only obtained from a fuel whose specifications closely approach those of a finished petroleum based Diesel oil. This is illustrated by the contrast between the poor performance of the unupgraded coal derived fuel blends and the very good performance of the fully refined shale derived fuel.

  20. Potential bias in the bank: what distinguishes refusers, nonresponders and participants in a clinic-based biobank?

    PubMed

    Ridgeway, J L; Han, L C; Olson, J E; Lackore, K A; Koenig, B A; Beebe, T J; Ziegenfuss, J Y

    2013-01-01

    Biobanks are an important resource for genetic and epidemiologic research, but bias may be introduced if those who accept the recruitment invitation differ systematically from those who do not in terms of attributes important to health-related investigations. To understand potential bias in a clinic-based biobank of biological samples, including genetic data linked to electronic health record information, we compared patient characteristics and self-reported information among participants, nonresponders and refusers. We also compared reasons for nonparticipation between refusers and nonresponders to elucidate potential pathways to reduce nonparticipation and any uncovered bias. We mailed recruitment packets to 1,600 adult patients with upcoming appointments at Mayo Clinic (Rochester, Minn., USA) and recorded their participation status. Administrative data were used to compare characteristics across groups. We used phone interviews with 26 nonresponders and 26 refusers to collect self-reported information, including reasons for nonparticipation. Participants were asked to complete a mailed questionnaire. We achieved 26.2% participation (n=419) with 12.1% refusing (n=193) and 61.8% nonresponse (n=988). In multivariate analyses, sex, age, region of residence, and race/ethnicity were significantly associated with participation. The groups differed in information-seeking behaviors and research experience. Refusers more often cited privacy concerns, while nonresponders more often identified time constraints as the reason for nonparticipation. For genomic medicine to advance, large, representative biobanks are required. Significant associations between patient characteristics and nonresponse, as well as systematic differences between refusers and nonresponders, could introduce bias. Oversampling or recruitment changes, including heightened attention to privacy protection and participation burden, may be necessary to increase participation among less-represented groups

  1. Delta13C values of grasses as a novel indicator of pollution by fossil-fuel-derived greenhouse gas CO2 in urban areas.

    PubMed

    Lichtfouse, Eric; Lichtfouse, Michel; Jaffrézic, Anne

    2003-01-01

    A novel fossil fuel pollution indicator based on the 13C/12C isotopic composition of plants has been designed. This bioindicator is a promising tool for future mapping of the sequestration of fossil fuel CO2 into urban vegetation. Theoretically, plants growing in fossil-fuel-CO2-contaminated areas, such as major cities, industrial centers, and highway borders, should assimilate a mixture of global atmospheric CO2 of delta13C value of -8.02 per thousand and of fossil fuel CO2 of average delta13C value of -27.28 per thousand. This isotopic difference should, thus, be recorded in plant carbon. Indeed, this study reveals that grasses growing near a major highway in Paris, France, have strikingly depleted delta13C values, averaging at -35.08 per thousand, versus rural grasses that show an average delta13C value of -30.59 per thousand. A simple mixing model was used to calculate the contributions of fossil-fuel-derived CO2 to the plant tissue. Calculation based on contaminated and noncontaminated isotopic end members shows that urban grasses assimilate up to 29.1% of fossil-fuel-CO2-derived carbon in their tissues. The 13C isotopic composition of grasses thus represents a promising new tool for the study of the impact of fossil fuel CO2 in major cities.

  2. 50 CFR 14.53 - Detention and refusal of clearance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 50 Wildlife and Fisheries 1 2010-10-01 2010-10-01 false Detention and refusal of clearance. 14.53 Section 14.53 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR TAKING, POSSESSION, TRANSPORTATION, SALE, PURCHASE, BARTER, EXPORTATION, AND IMPORTATION OF WILDLIFE AND...

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

    PubMed Central

    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

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

    ERIC Educational Resources Information Center

    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…

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

    PubMed

    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.

  6. Validation of the Vaccination Confidence Scale: A brief measure to identify parents at risk for refusing adolescent vaccines

    PubMed Central

    Reiter, Paul L.; Magnus, Brooke E.; McRee, Annie-Laurie; Dempsey, Amanda F.; Brewer, Noel T.

    2015-01-01

    Objective To support efforts to address vaccine hesitancy, we sought to validate a brief measure of vaccination confidence using a large, nationally representative sample of parents. Methods We analyzed weighted data from 9,018 parents who completed the 2010 National Immunization Survey-Teen, an annual, population-based telephone survey. Parents reported on the immunization history of a 13- to 17-year-old child in their households for vaccines including tetanus, diphtheria, and acellular pertussis (Tdap), meningococcal, and human papillomavirus (HPV) vaccines. For each vaccine, separate logistic regression models assessed associations between parents’ mean scores on the 8-item Vaccination Confidence Scale and vaccine refusal, vaccine delay, and vaccination status. We repeated analyses for the scale’s 4-item short form. Results One quarter of parents (24%) reported refusal of any vaccine, with refusal of specific vaccines ranging from 21% for HPV to 2% for Tdap. Using the full 8-item scale, vaccination confidence was negatively associated with measures of vaccine refusal and positively associated with measures of vaccination status. For example, refusal of any vaccine was more common among parents whose scale scores were medium (odds ratio [OR] = 2.08, 95% confidence interval [CI], 1.75–2.47) or low (OR = 4.61, 95% CI, 3.51–6.05) versus high. For the 4-item short form, scores were also consistently associated with vaccine refusal and vaccination status. Vaccination confidence was inconsistently associated with vaccine delay. Conclusions The Vaccination Confidence Scale shows promise as a tool for identifying parents at risk for refusing adolescent vaccines. The scale’s short form appears to offer comparable performance. PMID:26300368

  7. A proposed framework of food waste collection and recycling for renewable biogas fuel production in Hong Kong.

    PubMed

    Woon, Kok Sin; Lo, Irene M C

    2016-01-01

    Hong Kong is experiencing a pressing need for food waste management. Currently, approximately 3600 tonnes of food waste are disposed of at landfills in Hong Kong daily. The landfills in Hong Kong are expected to be exhausted by 2020. In the long run, unavoidable food waste should be sorted out from the other municipal solid waste (MSW) and then valorized into valuable resources. A simple sorting process involving less behavioural change of residents is, therefore, of paramount importance in order to encourage residents to sort the food waste from other MSW. In this paper, a sustainable framework of food waste collection and recycling for renewable biogas fuel production is proposed. For an efficient separation and collection system, an optic bag (i.e. green bag) can be used to pack the food waste, while the residual MSW can be packed in a common plastic bag. All the wastes are then sent to the refuse transfer stations in the conventional way (i.e. refuse collection vehicles). At the refuse transfer stations, the food waste is separated from the residual MSW using optic sensors which recognize the colours of the bags. The food waste in the optic bags is then delivered to the proposed Organic Waste Treatment Facilities, in which biogas is generated following the anaerobic digestion technology. The biogas can be further upgraded via gas upgrading units to a quality suitable for use as a vehicle biogas fuel. The use of biogas fuel from food waste has been widely practiced by some countries such as Sweden, France, and Norway. Hopefully, the proposed framework can provide the epitome of the waste-to-wealth concept for the sustainable collection and recycling of food waste in Hong Kong. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Treatment of Severe Feeding Refusal in Infants and Toddlers.

    ERIC Educational Resources Information Center

    Foy, Thomas; And Others

    1997-01-01

    This retrospective study examined the effectiveness of an inpatient multidisciplinary program for treatment of severe feeding refusal. Nineteen infants and toddlers recovering from medical and surgical disorders which had required non-oral feeding were studied. A modified method of rapid introduction of oral feedings resulted in conversion to…

  9. 7 CFR 75.46 - When appeal refused or withdrawn.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 3 2013-01-01 2013-01-01 false When appeal refused or withdrawn. 75.46 Section 75.46 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETING ACT O...

  10. An assessment of the reasons for oral poliovirus vaccine refusals in northern Nigeria.

    PubMed

    Michael, Charles A; Ogbuanu, Ikechukwu U; Storms, Aaron D; Ohuabunwo, Chima J; Corkum, Melissa; Ashenafi, Samra; Achari, Panchanan; Biya, Oladayo; Nguku, Patrick; Mahoney, Frank

    2014-11-01

    Accumulation of susceptible children whose caregivers refuse to accept oral poliovirus vaccine (OPV) contributes to the spread of poliovirus in Nigeria. During and immediately following the OPV campaign in October 2012, polio eradication partners conducted a study among households in which the vaccine was refused, using semistructured questionnaires. The selected study districts had a history of persistent OPV refusals in previous campaigns. Polio risk perception was low among study participants. The majority (59%) of participants believed that vaccination was either not necessary or would not be helpful, and 30% thought it might be harmful. Religious beliefs were an important driver in the way people understood disease. Fifty-two percent of 48 respondents reported that illnesses were due to God's will and/or destiny and that only God could protect them against illnesses. Only a minority (14%) of respondents indicated that polio was a significant problem in their community. Caregivers refuse OPV largely because of poor polio risk perception and religious beliefs. Communication strategies should, therefore, aim to increase awareness of polio as a real health threat and educate communities about the safety of the vaccine. In addition, polio eradication partners should collaborate with other agencies and ministries to improve total primary healthcare packages to address identified unmet health and social needs. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  11. Lime helps establish crownvetch on coal-breaker refuse

    Treesearch

    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...

  12. [Refusal of care and respect of the body].

    PubMed

    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.

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

    PubMed

    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.

  14. Environmental economics of lignin derived transport fuels.

    PubMed

    Obydenkova, Svetlana V; Kouris, Panos D; Hensen, Emiel J M; Heeres, Hero J; Boot, Michael D

    2017-11-01

    This paper explores the environmental and economic aspects of fast pyrolytic conversion of lignin, obtained from 2G ethanol plants, to transport fuels for both the marine and automotive markets. Various scenarios are explored, pertaining to aggregation of lignin from several sites, alternative energy carries to replace lignin, transport modalities, and allocation methodology. The results highlight two critical factors that ultimately determine the economic and/or environmental fuel viability. The first factor, the logistics scheme, exhibited the disadvantage of the centralized approach, owing to prohibitively expensive transportation costs of the low energy-dense lignin. Life cycle analysis (LCA) displayed the second critical factor related to alternative energy carrier selection. Natural gas (NG) chosen over additional biomass boosts well-to-wheel greenhouse gas emissions (WTW GHG) to a level incompatible with the reduction targets set by the U.S. renewable fuel standard (RFS). Adversely, the process' economics revealed higher profits vs. fossil energy carrier. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  15. Characteristics and combustion of future hydrocarbon fuels. [aircraft fuels

    NASA Technical Reports Server (NTRS)

    Rudey, R. A.; Grobman, J. S.

    1978-01-01

    As the world supply of petroleum crude oil is being depleted, the supply of high-quality crude oil is also dwindling. This dwindling supply is beginning to manifest itself in the form of crude oils containing higher percentages of aromatic compounds, sulphur, nitrogen, and trace constituents. The result of this trend is described and the change in important crude oil characteristics, as related to aircraft fuels, is discussed. As available petroleum is further depleted, the use of synthetic crude oils (those derived from coal and oil shale) may be required. The principal properties of these syncrudes and the fuels that can be derived from them are described. In addition to the changes in the supply of crude oil, increasing competition for middle-distillate fuels may require that specifications be broadened in future fuels. The impact that the resultant potential changes in fuel properties may have on combustion and thermal stability characteristics is illustrated and discussed in terms of ignition, soot formation, carbon deposition flame radiation, and emissions.

  16. Social context factors, refusal self-efficacy, and alcohol use among female sex workers in China.

    PubMed

    Su, Shaobing; Li, Xiaoming; Lin, Danhua; Zhang, Chen; Qiao, Shan; Zhou, Yeujiao

    2015-01-01

    Excessive alcohol use is considered as a health-risk behavior that may produce negative health outcomes. Examining predictors of alcohol use in social and individual contexts can advance understanding of why people indulge in alcohol use. Our research on female sex workers (FSWs) examined associations among several social context factors (alcohol use by family members, alcohol use by peers, and client-perpetrated pressure or violence), refusal self-efficacy, and alcohol use. Seven hundred FSWs were recruited from two cities in southern China. Structural equation modeling (SEM) was used to analyze the direct effects of alcohol use by family members, alcohol use by peers, and client-perpetrated pressure or violence on FSWs' alcohol use. In addition, the mediation effects of refusal self-efficacy were also examined in the SEM model. Results showed that alcohol use by family members and alcohol use by peers significantly predicted FSWs' alcohol use; the prediction effect of alcohol use by peers on FSWs' alcohol use was stronger than that of alcohol use by family members; client-perpetrated pressure or violence directly predicted FSWs' alcohol use and indirectly influenced FSWs' alcohol use through refusal self-efficacy; refusal self-efficacy directly predicted FSWs' alcohol use. Administrators of effective intervention programs focused on alcohol use in China should adopt a multilevel approach to reduce negative social influences, particularly the influence from peer and sex work establishments on FSWs' alcohol use. Meanwhile, training to improve refusal self-efficacy should also be included in the intervention programs to reduce FSWs' alcohol use.

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

    PubMed

    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.

  18. 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.

    PubMed

    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.

  19. Environmental, Economic, and Scalability Considerations and Trends of Selected Fuel Economy-Enhancing Biomass-Derived Blendstocks

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Dunn, Jennifer B.; Biddy, Mary; Jones, Susanne

    24 biomass-derived compounds and mixtures, identified based on their physical properties, that could be blended into fuels to improve spark ignition engine fuel economy were assessed for their economic, technology readiness, and environmental viability. These bio-blendstocks were modeled to be produced biochemically, thermochemically, or through hybrid processes. To carry out the assessment, 17 metrics were developed for which each bio-blendstock was determined to be favorable, neutral, or unfavorable. Cellulosic ethanol was included as a reference case. Overall, bio-blendstock yields in biochemical processes were lower than in thermochemical processes, in which all biomass, including lignin, is converted to a product. Bio-blendstockmore » yields were a key determinant in overall viability. Key knowledge gaps included the degree of purity needed for use as a bio-blendstock as compared to a chemical. Less stringent purification requirements for fuels could cut processing costs and environmental impacts. Additionally, more information is needed on the blendability of many of these bio-blendstocks with gasoline to support the technology readiness evaluation. Overall, the technology to produce many of these blendstocks from biomass is emerging and as it matures, these assessments must be revisited. Importantly, considering economic, environmental, and technology readiness factors in addition to physical properties of blendstocks that could be used to boost fuel economy can help spotlight those most likely to be viable in the near term.« less

  20. 14 CFR 61.16 - Refusal to submit to an alcohol test or to furnish test results.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Refusal to submit to an alcohol test or to furnish test results. 61.16 Section 61.16 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRMEN CERTIFICATION: PILOTS, FLIGHT INSTRUCTORS, AND GROUND INSTRUCTORS General § 61.16 Refusal to submit to a...