Methodological developments and practice in characterisation of unconventional and legacy waste

Radioactive waste management requires planned and systematic actions to provide confidence that the entire system, processes and final products will satisfy given requirements for quality. The characterisation process is dependent on setting clear characterisation objectives and gathering the right information to underpin the decisions that need to be taken to manage the waste safely. This paper reviews experience of characterisation of waste generated from past nuclear activities that were not conducted in compliance consistent with current criteria, or from unexpected situations that were not planned for. This experience shows that the development of a reliable and efficient characterisation and categorisation methodology is a common challenge for such wastes, referred to here as unconventional and legacy (UL) waste. Through the activites of the Nuclear Energy Agency Expert Group on the Characterisation of Unconventional and Legacy Waste (EGCUL), consideration has been given to widely used waste stream characterisation procedures and methods that were originally developed primarily for application in conventional decommissioning work. Although they provide a substantial basis for characterisation, there are various additional factors that commonly need to be taken into account in the case of UL waste. By analysing the challenges and lessons learned from a variety of case studies and other international experience, it has been possible to identify opportunities for adaptations and enhancements to these characterisation methologies, and these are set out and explained. The need for integration of waste characterisation with other aspects of strategic planning for UL waste management is discussed, including characterisation to address any non-radiological hazards.The analysed case studies have also highlighted the importance of developing a robust legislative and regulatory framework in parallel with an appropriate waste infrastructure to treat, store and dispose of UL waste. Finally, the basic features of a UL waste characterisation roadmap are presented, including the interactions within a wider UL waste management programme and key areas for further consideration and possible development. It is anticipated such work can be supported by continued international cooperation.

Challenges experienced by community health workers and their motivation to attend a self-management programme

Background: Community health workers (CHWs) are change agents expected to assist in decreasing the global burden of disease in the communities they serve. However, they themselves have health risk behaviours, which predispose them to non-communicable diseases and thus need to be empowered to make better health choices. There is a gap in literature detailing the challenges faced by CHWs in addressing their own health risk behaviours.Aim: This study aimed to explore the challenges experienced by CHWs in carrying out their daily duties and the motivating factors to join a self-management programme.Setting: The study was conducted in a low socio-economic urban area of the Western Cape, South Africa.Methods: This study used a qualitative exploratory design using in-depth interviews to obtain rich data about the personal and professional challenges that CHWs experience on a daily basis.Results: Five themes emerged with regard to professional challenges (social conditions, mental health of patients, work environment, patient adherence and communication). This cadre identified ineffective self-management as a personal challenge and two themes emerged as motivation for participating in a self-management programme: empowerment and widening perspective.Conclusion: The challenges raised by the CHWs have a direct impact on their role in communities. This study therefore highlights an urgent need for policymakers and leaders who plan training programmes to take intentional strategic action to address their health challenges and to consider utilising a self-management intervention model to improve their overall health status.

JUDICIAL ENFORCEMENT BY SOCIAL ASPECTS

Nowadays, mortality loses its importance. Moral behaviour, and religion have become an alternative. In the public consciousness, religion and morality play second fiddle to law, which is contrary to the use of public discourse. In every rule of law, however, law and its enforcement not a matter of choice. Law is mandatory for all people without exception – as The Fundamental Law of Hungary also sets it out. The main objective of my study is to combine the judicial enforcement with the social network in Hungary, as a system, based on solidarity, given that no particular attention has been paid to this so far. Apart from some measures (debt management programme, National Asset Management Programme), the involvement of the social network in the enforcement procedure has not taken place, although it could be extremely important in particular when judgment debtors are on the verge of eviction.

Certificates and certification programmes for clinical excellence: A guide to international pharmacists

Pharmacy practice continues to evolve, and knowledge update is necessary to facilitate better and safer patient care. This article provides information about certificates and certification programmes hosted for international pharmacists to support their scope in advanced pharmacy practices. A pilot online survey to 59 pharmacists revealed preferences towards Board of Pharmacy Specialties (BPS), American Society of Health-system Pharmacists (ASHP) certificate, Society of Infectious Diseases Pharmacy (SIDP) Antimicrobial stewardship certificate programmes, University of Florida pharmacy certificate programmes, and Medication therapy management programme (MTM) for their certification programme. Grey literature and authentic websites of each programme were collected to provide information on each programme. This article serves as a guide for international pharmacists to know further information about certificates and certification programmes available to support them in advancing their practice.

Patients’ experiences of occupational therapy within a multidisciplinary pain management programme: A qualitative study

Background Occupational problems are common for adults experiencing chronic pain, but occupational therapists are not always accessed as part of the multidisciplinary team. Despite evidence of benefit for work-focused interventions, there is limited evidence for broader benefit from occupational therapy interventions within the context of multidisciplinary pain management. The aim of this study was to explore the experiences of programme attendees who received structured intervention from an occupational therapist as part of a multidisciplinary pain management programme, and gain an understanding as to how they felt it influenced changes they made to occupational participation. Method A qualitative approach was undertaken with 9 individual patients recruited from a group pain management programme for adults with chronic low back pain. Semi-structured interviews were carried out, recorded and transcribed. Thematic analysis was used to identify themes in the data. Results Three key themes were identified: 1) the helpfulness of activity pacing techniques 2) the value of participating in a therapeutic activity-based session and 3) an increased understanding of the importance of leisure and creative activities in the context of their lives. Conclusion Participants perceived the specific occupational therapy content of the programme to be helpful in a number of different ways. The findings suggest that occupational therapy can be important in facilitating patients to apply theoretical techniques in the real world, thereby increasing the likelihood of long term benefit.