Withdrawal Process Research Articles

Demonetization and its effects on Indian economy

Indian government has taken a bold decision on note ban on 08/11/2016. Central government was a judicious, well-thought out and well-implemented step, and whether it would really eradicate all the existing black money. Here I have utilized the opinions of great expert on economics, financial economist and intellectual politicians. This study will help us to know about the positive and negative impact of note ban decision taken by Indian government. This study is purely based on secondary data, which is collected from news papers, magazines, websites from internet, some useful books related to topic etc. This paper entails the problems related to pre and post demonetization period and thereby to find out solutions and to provide suggestions in order to overcome the problem. Demonetization is the process of withdrawal of a particular form of currency from circulation. The purpose of the study is to compare and analyse the impact of demonetization on Indian economy during pre and post period. The older denominations must be replaced with the new ones. The findings of the study reveal that India will achieve a significant growth by adopting the demonetization strategy and will create a huge positive impact on the entire economy in a long run. This paper also shows that it was quick step taken by the government of India without any measures which people had to face a lot of consequences in standing in the long queues to exchange their older denominations.

What is helpful and unhelpful when people try to withdraw from antipsychotics: An international survey.

Antipsychotics remain the first-line treatment for people diagnosed with psychotic disorders despite adverse effects which lead many people to stop their medication. Many stop without the support of the prescriber, who may fear relapse. The objective of this study is to better understand the process of withdrawal from antipsychotics, from the perspective of people taking antipsychotics. Online survey. An international online survey elicited quantitative responses about pre-withdrawal planning (560) and qualitative responses about what was helpful and unhelpful when withdrawing from antipsychotics (443). Responses came from users of antipsychotics in 29 countries. Forty-seven per cent did not consult their psychiatrist before discontinuing. Only 40% made preparations, most commonly making a plan, gathering information and informing family. The most frequently reported helpful factors were focussing on the benefits of getting off the drugs (including ending adverse effects and feeling more alive), information about withdrawal symptoms and how to withdraw safely, withdrawing slowly, and support from psychologists, counsellors and psychotherapists. The most common unhelpful factor was the psychiatrist/doctor, largely because of their lack of knowledge, refusal to support the patient's wishes and the threat or use of coercion. Evidence-based, respectful, collaborative responses to patients' concerns about adverse effects and desires to withdraw would probably reduce relapse rates and improve long-term outcomes. It would definitely help end pervasive breaching of the principle of informed consent and human rights legislation.

A qualitative exploratory study into medical, nursing and allied health professional experiences of elective withdrawal of non-invasive ventilation in a motor neurone disease cohort.

With absence of a cure, the mainstay of management for patients with motor neurone disease (MND) is holistic supportive care and symptom control. Non-invasive ventilation (NIV) can provide relief from distressing dyspnoea which often accompanies progressive respiratory muscle weakness. Some patients using NIV will become dependent on it, with a small proportion of these patients going on to request withdrawal. Despite being legal in the UK, elective withdrawal of NIV can be emotionally and ethically challenging for the staff involved. To guide the process of symptom-controlled withdrawal, in 2015 the Association for Palliative Medicine (APM) released clinical guidance. The aim of this study is to explore the experiences of the multi-disciplinary team (MDT) involved in elective withdrawal of NIV in an MND cohort following the publication of this guidance. A qualitative, semi-structured interview study of eight NHS qualified staff members (three Doctors, four Nurses, one Allied Health Professional). Clinicians were asked questions relating to their experiences of the withdrawals. After full transcription, data was analysed thematically. Four main themes were identified, offering insight into how the withdrawals affected staff's well-being and summarised via an 'enablers and barriers' model. The setting was important, as was the depth and longevity of the clinician's investment in the patient. Positive influences on staff's well-being arose from the sense of fulfilling the patient's wishes, good teamwork, presence of an experienced clinician and awareness of the APM (2015) Guidance. Conversely, barriers to well-being were expressed through the unpredictability of each scenario, moral and ethical uncertainties, external pressures on time, mismatched expectations, poor communication and the emotional intensity of the act. Elective withdrawal is highly emotive, simultaneously positively and negatively influencing staff well-being. By addressing the potential mitigating factors, the overall impact on staff's mental health and well-being maybe improved and thus, subsequently, patient care.

National review of end-of-life care withdrawal guidelines for non-invasive advanced respiratory support using document analysis

ObjectivesThis study aims to understand the breadth of practice around end-of-life withdrawal of non-invasive advanced respiratory support (encompassing both continuous positive airway pressure and non-invasive ventilation) by analysing NHS-published guidelines...

Wetting Preference of Silica Surfaces in the Context of Underground Hydrogen Storage: A Molecular Dynamics Perspective.

The growing interest in large-scale underground hydrogen (H2) storage (UHS) emphasizes the need for a comprehensive understanding of the fundamental characteristics of subsurface environments. The wetting preference of subsurface rock is a crucial parameter influencing the H2 flow behavior during storage and withdrawal processes. In this study, we utilized molecular dynamics simulation to evaluate the wetting preference of the silica surface in subsurface hydrogen systems, with the aim of addressing disparities observed in experimental results. We conducted an initial comprehensive assessment of potential models, comparing the wettability of five common silica surfaces with different surface morphologies and hydroxyl densities in CO2-H2/water/silica systems against experimental data. After introducing the INTERFACE force field as the most accurate potential model for the silica surface, we evaluated the wetting behavior of the α-quartz (101) surface with a hydroxyl density of 5.9 number/nm2 under the impact of actual geological storage conditions (333-413 K and 10-30 MPa), the coexistence of cushion gases (i.e., CO2, CH4, and N2) at various mole fractions, and pH levels ranging from 2 to 11 characterized through considering the negative charges of 0 to -0.12 C/m2 via deprotonation of silanol on the silica surface. Our results indicate that neither pressure nor temperature has a significant impact on the wetness of the silica in the case of pure H2 (single component UHS operations). However, when CO2 coexists with H2, especially at higher mole fractions, an increase in pressure and a decrease in temperature lead to higher contact angles. Moreover, when the mole fraction of cushion gas ranges from 0 to 1, the contact angle increases 20, 9.5, and 4.5° for CO2, CH4, and N2, respectively, on the neutral silica substrate. Interestingly, at higher pH conditions where the silica surface carries a negative charge, the contact angle considerably reduces where surface charges of -0.03 and -0.06 C/m2 result in an average reduction of 20 and 80% in the contact angle, respectively. More importantly, at a pH of ∼11 (-0.12 C/m2), a 0° contact angle is observed for the silica surface under all temperatures, pressures, types of cushion gases, and varying mole fractions.

The Impact of Turkey's Withdrawal From the Istanbul Convention on Suspicious Female Deaths and Femicides.

In recent years, suspicious deaths, often portrayed as "falls from a height," have been increasingly associated with femicides in Turkey. This phenomenon coincided with the official withdrawal process from the "Council of Europe Convention on Preventing and Combating Violence against Women and Domestic Violence" (Istanbul Convention). Our study aims to reveal the impact of Turkey's withdrawal from the Istanbul Convention on femicides and the yet officially unrecognized "suspicious female deaths." This research, conducted in a descriptive, cross-sectional epidemiological style, draws its population from records of suspicious female deaths and femicides that occurred in Turkey between January 1, 2020, and June 1, 2023. There has been a notable increase in the rate of suspicious female deaths. Additionally, a significant rise has been observed in the proportion of women who were employed, had children, and sought legal protection in these deaths. The study suggests a return to the Istanbul Convention.

Realization Mechanism of Farmers’ Rights and Interests Protection in the Paid Withdrawal of Rural Homesteads in China—Empirical Analysis Based on Judicial Verdicts

In recent years, the paid withdrawal of rural homesteads has become a widely discussed topic within the academic community. However, from the perspective of protecting farmers’ rights and interests, literature exploring the impact of this policy’s implementation remains scarce. As the reform of the separation of the three rights of the homestead deepens, disputes related to paid withdrawal of homesteads have escalated rapidly. This study aims to highlight the importance of protecting farmers’ rights and interests, seeking to enhance their property rights and revitalize unused rural resources. Employing a case study methodology, this study systematically examines the issue of farmers’ rights and interests protection during homestead withdrawal. This analysis is based on the survey, collection, and evaluation of 324 judicial cases. The findings reveal the following: (1) Disputes involving paid withdrawal of homesteads encompass the entire withdrawal process, with the majority of conflicts arising during the withdrawal stage. (2) Prior to withdrawal, farmers express heightened concern regarding their political rights, particularly the right to be informed and to participate in withdrawal decisions. (3) During the withdrawal process, farmers prioritize resettlement and compensation rights. Additionally, novel issues such as the allocation of withdrawal compensation surface after farmers receive resettlement and compensation benefits. (4) After withdrawal, farmers anticipate more suitable “alternative” social rights and remedies. Based on these findings, this study presents policy recommendations for realizing farmers’ rights and interests in the context of paid withdrawal of rural homesteads. These suggestions include consistently respecting farmers’ autonomy and preserving their political rights throughout the withdrawal procedure. During the withdrawal stage, emphasis should be placed on the comprehensive value of resettlement compensation, encompassing both the residential and social security aspects of rural homesteads. Post-withdrawal, farmers’ social rights and the development rights of their homesteads ought to be fully guaranteed, ensuring a harmonious balance between farmers’ immediate and long-term interests. Furthermore, optimizing the dispute resolution mechanism stands as a pivotal aspect of safeguarding farmers’ rights and interests through legal recourse.

Anatomy of an FDA Drug Recall: The 17α-Hydroxyprogesterone Accelerated Approval and Withdrawal Processes

Anatomy of an FDA Drug Recall: The 17α-Hydroxyprogesterone Accelerated Approval and Withdrawal Processes

Barriers and facilitators of early postpartum modern contraceptive method uptake in Dessie and Kombolcha City zones, northeast Ethiopia: Conventional content analysis qualitative study.

Despite progress in access to family planning services in many sub-Saharan African countries in recent decades, advances in effective early postpartum contraceptive adoption remain low, and the unmet need for early postpartum contraceptives is high. In Ethiopia, early postpartum modern contraceptive method uptake is still unacceptably low. The barriers/challenges have not yet been sufficiently explored. A deep and detailed understanding of the contextualized barriers and challenges in the adoption of early postpartum contraceptive methods is crucial in developing future locally-appropriate interventions. This study aimed to explore barriers/challenges to the uptake of early postpartum modern contraceptive methods after childbirth in Dessie and Kombolcha zones, in northeast Ethiopia. Aconventional content analysis qualitative study was deployed in Dessie and Kombolcha town zones, northeast Ethiopia using a theoretical purposive sampling technique. A total of 57 study subjects were participated. The sample size was determined using the rule of information saturation through 7 key informant interviews, 6 in-depth interviews, and 5 focused-group discussions with 8-10 participants each. Data were collected using an unstructured interview guide and recorded using a digital audio recorder and field notes. The trustworthiness of the study was assured using different techniques. The collected data were transcribed and translated from native language to English. Atlas-ti version7 software was used to facilitate conventional content qualitative data analysis approach. Open coding, categories, subthemes, and overreaching themes were developed, and a conceptual model of barriers was organized through network analysis. Barriers to uptake of early postpartum modern contraception quoted by study participants and themed were related knowledge, attitude, family-community, health facility, contraceptive method, cultural, religious, fertility desire, gender issues, and misconceptions. The sub-themes of knowledge-related barriers that emerged were lack of awareness of the time to take birth control methods, not knowing the time pregnancy is likely after childbirth, and not being committed to taking contraceptives early enough after childbirth. Moreover, beliefs that modern contraceptives cause breast milk to dry up and perceived low fecundability after childbirth were indicated as attitude barriers. Health facility barriers were lack of reminders and follow-up mechanisms, sporadic service delivery and opening time, long waiting time, and card withdrawal process and providers' approach. Social stigma, child sex preference, and religious restrictions against contraceptive use were community barriers. Generally individual, facility-based, method-related, misconceptions, societal, and cultural barriers were identified as hindrances to the uptake of early postpartum modern contraceptive methods. There is a need for health-seeking behavioral interventions, innovative contraceptive methods, and facility-level interventions to overcome each identified barrier.

John Boorman’s “Excalibur” as a Quasi-Jungian and Eclectic Story of Arthurian Psyche

Abstract For four decades John Boorman’s “Excalibur” has been either partially analyzed by scholars in Jungian categories or just described as a Jungian-inspired film in more general terms by film critics. The six-stage model of King Arthur’s personal and archetypal development in “Excalibur” was first published by Jungian analyst Al Collins in 1981, but remained unknown in mainstream scholarship. This article describes this significant absence and argues for a shift to significant presence, merging many Jungian approaches to “Excalibur” with Piotr Toczyski’s own depth-psychological vision of Boormanian quasi-Jungian Arthurianism. The scholars globally may get further inspiration to relaunch new interpretations of this classic Arthurian retelling in terms of dynamics of conscious and unconscious, meeting the shadow, coping with anger, underlying projections, withdrawal of projections as the moment of lysis similar to psychotherapy, and the self-awareness of archetypes. The process of projection withdrawal is the hero’s journey on its own, bringing some similarities with well-known Joseph Campbell’s post-Jungian model.

Generation of cutting heat and simulation of core tube wall temperature during coring in primary structure coal seam

When the drilling core method is used to determine the coalbed gas content, the cutting heat generated by the core bit cutting coal will increase the core tube temperature, and the excessively high core tube temperature will have an heating effect on the coal core, which will accelerate the coal core gas desorption rate and increase the gas loss amount. The generation of cutting heat of core bit and the measurement of core tube temperature are the basis for grasping the gas desorption law of coal core and projecting the amount of gas loss. Firstly, the self-developed core tube temperature measurement device was used to conduct on-site core temperature measurement experiments at different cutting speeds. Then, the cutting temperature of core bit was solved by establishing thermodynamic model for cutting coal and heat transfer model of cutting edge. Finally, based on the thermal conductivity characteristics of the core tube, the core tube temperature at different cutting speeds was simulated, and the simulated temperature was compared with the on-site measured temperature to verify the reliability of the model. The results show that when coring in primary structural coal, the temperature change trend of core tube wall temperature measurement point at different cutting speeds is basically consistent, the temperature measurement point at the front end of the core tube mainly goes through a relatively stable period in the drilling process, a sharp rising period in the cutting process, a slow rise and cooling period in the withdrawal process. However, the temperature measurement point at the back end of the core tube wall mainly goes through a relatively stable phase and a slowly increasing phase. The temperature rise of the core bit and the core tube wall are significantly positively correlated with the cutting speed. When coring in hard coal seam and the core depth is not large, the cutting heat generated by the core bit and the coal body is the dominant factor for the temperature rise of the core tube. The core tube wall temperature calculated using the model matches well with the field measured temperature, and the error is small, which fully shows that the coring thermodynamic model is feasible. This study provides a basis for further research on the dynamic distribution characteristic of coal core temperature during coring, which is of profound significance to calculate the gas loss and coalbed gas content.

Technical note: Removing dynamic sea-level influences from groundwater-level measurements

Abstract. The sustainability of limited freshwater resources in coastal settings requires an understanding of the processes that affect them. This is especially relevant for freshwater lenses of oceanic islands. Yet, these processes are often obscured by dynamic oceanic water levels that change over a range of timescales. We use regression deconvolution to estimate an oceanic response function (ORF) that accounts for how sea-level fluctuations affect measured groundwater levels, thus providing a clearer understanding of recharge and withdrawal processes. The method is demonstrated using sea-level and groundwater-level measurements on the island of Norderney in the North Sea (northwestern Germany). We expect that the method is suitable for any coastal groundwater system where it is important to understand processes that affect freshwater lenses or other coastal freshwater resources.

Multiple nonlinearities in the process of embedding and pulling out of nails: A numerical approach

This paper presents a numerical approach to analyze the embedding and withdrawal process of nails. Multiple nonlinearities are considered: law of orthotropic large strain elasto-plastic materials and contact with friction. The Uzawa algorithm based on the bi-potential method is used to describe the nonlinearity of boundary conditions. A return mapping algorithm is applied to deal with the elasto-plastic constitutive laws. On the basis of the Updated Lagrangian formulation, we adopt a Rotationally Neutralized Objective hypothesis to describe the geometrically nonlinear behavior. The Newton–Raphson iterative method is employed to solve the nonlinear equation. The simulation results show the deformation and the stress distribution of wood in the process of the nail embedding and withdrawal. The effectiveness and accuracy of the numerical scheme are proved by comparing with the existing engineering experiments. The influence of friction coefficients on the nail embedding and withdrawal strength is also explored.

Venous Anatomy of the Superior and Inferior Sagittal Sinuses

The superior sagittal sinus(SSS)is contained within the dura, which consists of the dura propria and osteal dura at the junction of the falx cerebri, in addition to the attachment of the falx to the cranial vault. The SSS extends anteriorly from the foramen cecum and posteriorly to the torcular Herophili. The superior cerebral veins flow into the SSS, coursing under the lateral venous lacunae via bridging veins. Most of the bridging veins reach the dura and empty directly into the SSS. However, some are attached to the dural or existed in it for some distance before their sinus entrance. The venous structures of the junctional zone between the bridging vein and the SSS existed in the dura are referred to as dural venous channels. The SSS communicates with the lateral venous lacunae connecting the meningeal and diploic veins, as well as the emissary veins. These anatomical variations of the SSS are defined by the embryological processes of fusion and withdrawal of the sagittal plexus and marginal sinus.

Person, People, Planet: Eco-Systematic Analysis of Older Adults’ Experiences of Engagement with Nature and Discourse About Nature

ABSTRACT This study combined ecological, environmental, nature-based, and epistemic interpretations of older adulthood to gain a previously unresearched look at how older adults feel that their relations with nature are treated by others. Sixty older adults were interviewed in-depth, and data was analyzed using the Eco-Appreciation framework and Thematic Content Analysis. The results indicate the concurrence of processes of withdrawal of older adults from spaces of nature and discourse about nature. These processes obstruct older adults’ wellbeing; entail the infliction of existential epistemic injustices and “eco-ageism” toward them; and emphasize the crucial role social work can play in responding thereto.

Temporal evolution of demarcations between the unsteady and steady regions and between the film and meniscus during dip coating with vertical withdrawal of Newtonian fluids

Thus far studies on dip coating focus on the asymptotic layer thickness which is reached only in the lower part of the layer when the withdrawal time is sufficiently long. This work attempts to offer a complete description of the evolution of layer thickness profile with withdrawal time for vertical withdrawal of Newtonian fluids using simulation and the Buckingham π theorem. The results show that over time, the withdrawal process successively undergoes two regimes: (I) an unsteady film region and an unsteady meniscus region and (II) an unsteady film region connected to a steady meniscus region through an unsteady meniscus region. The controlling factors for the two regimes are identified at different values of capillary number and Reynolds number. Models are proposed to predict the heights of the demarcations between different regions. The models agree well with experimental results when the controlling forces are viscous force and gravity.

Development and Application of Concentric Lock Platform Under Digital Cultural Tourism Product Innovation

With the global spread of the COVID-19 epidemic, the traditional tourism industry has suffered an unprecedented impact, pushing the tourism industry towards digital transformation. As an important direction of this transformation, digital cultural tourism (digital Literature & Tourism) utilizes the latest digital technologies such as 3D simulation, Virtual Reality (VR), Augmented Reality (AR), etc., to provide a brand-new form of cultural and tourism experience. Taking the concentric lock platform as an example, this study explores the development and application under the innovation of digital cultural and tourism products, analyzes its contribution to the recovery of tourism, cultural inheritance and innovation, and puts forward the outlook for future development. Designed with the concepts of emotional interaction, cultural inheritance and technological innovation, the concentric lock platform provides a space where users can padlock their locks in a virtual environment to express their emotions and share their stories. The platform not only redefines the emotional connection between couples, but also provides a new profit model and cultural inheritance for tourist attractions. In terms of technical realization, the platform adopts cloud computing to support high concurrent access, and utilizes technologies such as WebGL and Three.js to render complex 3D graphics in web browsers to create realistic virtual attraction models for users, while focusing on data security and privacy protection. The platform's functional modules include the padlocking and viewing of virtual concentric locks, the withdrawal process of breaking up locks, as well as a rich cloud tourism experience and cultural heritage content, which meets the diversified needs of users. By cooperating with tourist attractions, the concentric lock platform developed the virtual concentric lock function with attractions as the background, promoting cultural heritage and tourism recovery. Especially during the epidemic, the platform provided global users with the possibility of cloud tourism and virtual emotional interaction, effectively mitigating the impact of the tourism industry affected by the epidemic. In the Discussion and Outlook section, this study points out that the concentric lock platform and similar digital cultural and tourism products face challenges and opportunities in terms of technological development, market demand, cultural heritage and social impact. In the future, with the application of new technologies such as 5G and artificial intelligence, more personalized and interactive cultural tourism experiences are expected to be developed. At the same time, how to effectively integrate online experiences with on-the-ground tourism activities, protect user privacy and ensure data security will be the key issues to be solved for digital cultural tourism products such as the concentric lock platform. To summarize, the concentric lock platform, as a typical case of digital cultural tourism, not only shows the potential of digital technology application in the field of cultural tourism, but also provides an effective strategy and practice case for the digital transformation of the tourism industry. With the continuous progress of technology and increasing consumer demand, the future development of the digital cultural tourism field will be broader, providing people with richer and deeper cultural tourism experience.

Efficient prediction of hydrogen storage performance in depleted gas reservoirs using machine learning

Underground hydrogen (H2) storage (UHS) has emerged as a promising technology to facilitate the widespread adoption of fluctuating renewable energy sources. However, the current UHS experience primarily focuses on salt caverns, with no working examples of storing pure H2 in porous reservoirs. A key challenge in UHS within porous rocks is the uncertainty in evaluating storage performance due to complicated geological and operational conditions. While physics-based reservoir simulations are commonly used to quantify H2 injection and withdrawal processes during storage cycles, they are computationally demanding and unsuitable for providing rapid support to UHS operations. In this study, we develop efficient reduced-order models (ROMs) for UHS in depleted natural gas reservoirs using deep neural networks (DNNs) based on comprehensive reservoir simulation data sets. The ROMs can accurately forecast UHS performance metrics (H2 withdrawal efficiency, produced H2 purity, produced gas-water ratio) across various geological and operational conditions and are over 22000 times faster than physics-based simulations. Then, we employ the ROMs for sensitivity analysis to assess the impact of geological and operational parameters on UHS performance and conduct uncertainty quantification to characterize potential performance and associated probabilities. Lastly, we present a field case study from the Dakota formation of the Basin field in the Intermountain-West (I-WEST) region, USA. Based on the ROMs’ predictions, Dakota formation is favorable for UHS due to its high H2 withdrawal efficiency and purity, and low water production risk. By optimizing operational parameters, we can further improve the storage performance in Dakota formation and reduce the uncertainty in UHS performance prediction. This study introduces an efficient ROM-based approach to assess and optimize UHS performance, supporting the development of effective UHS projects in depleted gas reservoirs.

Knowing when to step in: linking teachers’ behavioural responses to workplace dissatisfaction with intent to leave

ABSTRACT Increasing attention worldwide has been paid to strategies for improving teacher retention as shortages reach critical levels. While a large body of research has focused on the conditions that lead to teacher turnover, little attention has been paid to the warning signs of teacher exits. In response, this paper aims to demonstrate how teachers behave in response to specific sources of workplace dissatisfaction, so that leaders may recognise highly dissatisfied teachers and intervene before it is too late. Through a representative survey of 550 U.S. teachers in the U.S. high shortage state of Alabama, we use Hirschman’s Exit-Voice-Loyalty-Neglect framework to look for dissatisfaction behaviours along the process of teacher withdrawal. We ask (1) what workplace behaviours are expressed when feeling dissatisfied with teaching, and (2) which behaviours are most closely aligned with intent to leave? Results demonstrate that (1) teachers mainly respond to dissatisfaction by focusing on core instruction and limiting communication; (2) they do this most often when they feel they are stuck with conflicting expectations of their job; and (3) more than half actively consider leaving when dissatisfied. This paper offers recommendations on how school leaders can recognise pre-exit behaviours and redirect teacher dissatisfaction towards positive retention techniques.

Process of Withdrawal of Mechanical Ventilation at End of Life in the ICU: Clinician Perceptions

BackgroundNearly a quarter of all Americans die in the intensive care unit (ICU). Many of their deaths are anticipated and occur after withdrawal of mechanical ventilation (WMV). Yet, there are few data on which to base best practices for interdisciplinary ICU teams to conduct WMV. Research QuestionTo investigate the perceptions of current WMV practices among ICU clinicians, and gain their opinions of processes that might improve the practice of WMV at end of life in the ICU. Study Design and MethodsWe conducted a prospective two-center observational study in Boston, MA of the withdrawal of mechanical ventilation (OBSERVE-WMV) designed to better understand the perspectives of clinicians and experience of patients undergoing WMV. This report focuses on analyses of qualitative data obtained from in-person surveys administered to the ICU clinicians (nurses, respiratory therapists, physicians) caring for these patients. Surveys assessed a broad range of clinician perspectives on planning, and key processes required for WMV. This analysis utilized independent open, inductive coding of responses to open-ended questions. Initial codes were reconciled iteratively, and then organized and interpreted using a thematic analysis approach. We assessed opinions on how WMV could be improved for individual patients and the ICU as a whole. ResultsAmong 456 eligible clinicians, 312 in-person surveys were completed by clinicians caring for 152 patients who underwent WMV. Qualitative analyses identified two main themes characterizing high quality WMV processes: good communication (e.g. mutual understanding of family preferences) between the ICU team and family, and medical management (e.g. planning, availability of ICU team) that minimizes patient distress. Team member support was identified as an essential process component in both themes. InterpretationClinician perceptions of the appropriateness or success of WMV prioritize the quality of team and family communication and patient symptom management. Both are modifiable targets of interventions aimed at optimizing overall WMV.