ABORTION PROCUREMENT AND POST-ABORTION CARE SERVICES: EXPERIENCES OF NIGERIAN ADOLESCENTS

ABSTRACT Introduction: The prevention of abortion-related complications and mortality is dependent on the availability, accessibility and usability of emergency post-abortion care (PAC) throughout the health care system. Unfortunately, Nigerian adolescents are often unable to obtain adequate post-abortion care services due to numerous challenges and barriers. This study attempted to explore experiences with abortion and post-abortion care services from the adolescents’ perspective which is the first step in enhancing optimal utilization of adolescents’ PAC services Methods: A qualitative exploratory research design was used. 20 semi-structured interviews were conducted with adolescent patients during hospitalization. The adolescent patients were duly counselled and informed consent obtained prior to the in-depth interview. The semi-structured interview guide was used for data collection and the data were analyzed using content analysis. Results: Findings from the interviews revealed that adolescents found it difficult to discuss issues of pregnancy and abortion with their parents or guardians due to fear, stigmatization or rejection. The adolescents experienced negligence of care, shame and stigma due to failure of health care providers to ensure privacy, as well as delay in treatment due to hospital protocol and non-availability of prescribed drugs which significantly affected the PAC care services they received Conclusion: The adolescents experienced fear, shame, and stigmatization, negligence of care and lack of access to adequate PAC services. These findings highlight the need to review health actions directed towards adolescents with abortion complications and plan interventions aimed at improving provision of adolescents’ friendly PAC services, in order to meet the reproductive health needs of these adolescents

Intimate partner violence amongst undergraduate nursing students

Intimate partner violence (IPV) is reported to be rife among the student population at tertiary institutions and the general population. Yet the abuse is under diagnosed by nurses in health care settings. Research indicates that nurses’ personal experiences of this type of abuse play a role in the management of survivors. Hence, this study investigated the prevalence and factors associated with IPV among the undergraduate nursing student population at a tertiary institution in the Western Cape, South Africa. A self-administered questionnaire was completed by the stratified random sample. The reported lifetime prevalence of IPV included psychological, physical, financial and sexual abuse. IPV was significantly associated with the educational status of the respondent’s mother, financial support and witnessing of abuse during childhood. A support structure is thus needed to prepare the undergraduate student nurses emotionally before commencing with their training in the management of survivors of IPV.Department of HE and Training approved lis

Impact of NOM character on copper adsorption by trace ferric hydroxide from iron corrosion in water supply system

The fate of trace concentrations of cupric sulfate (<0.4 mg/L) dosed into chloraminated distribution systems to inhibit nitrification has been shown in this study to be controlled by at least two crucial factors: the character of natural organic matter (NOM) and iron hydroxide corrosion products present at low concentrations (<2 mg/L). This research quantified the removal of Cu(II) ions added into waters containing trace Fe(OH)3 flocs and the effect of NOM of different character on this removal. The dominant dissolved copper species in NOM-containing waters were found to be Cu(II)–NOM complexes. Both intramolecular chelation and intermolecular complexation can occur, with the latter occurring preferentially and resulting in the aggregation of smaller organic molecules to form larger molecules. The presence of ferric hydroxide flocs when Cu(II) ions were added into NOM-containing waters was shown to result in removal of Cu(II) ions, presumably as Cu(II)–NOM complexes. This removal was through adsorption processes obeying Freundlich isotherms, although the presence of larger NOM molecules and heterogeneous copper species (e.g. Cu(OH)2(s) and CuO(s)) appeared to shield smaller Cu(II)–NOM complexes from adsorption to some extent. For the strategy of inhibition of nitrification in distribution systems by the addition of Cu(II) ions, complexation of Cu(II) ions by NOM and adsorption of Cu(II)–NOM complexes by ferric hydroxide flocs released from pipe walls pose significant operational challenges to maintaining the concentration of Cu(II) ions through the distribution system

Multivariate experimental design provides insights for the optimisation of rechloramination conditions and water age to control disinfectant decay and disinfection by-product formation in treated drinking water

The stability of drinking water disinfectant residuals is known to be influenced by multiple variables. To evaluate the effects of various influencing variables on disinfectant stability, a multivariate analysis of chloramine decay and associated disinfection by-products (DBPs) formation was investigated in a series of bench-scale experiments. Of nine water quality variables previously identified, monochloramine dose, pH, and bromide concentration were selected as key water quality variables based on previous investigations and modelling. Co-effects of these key variables on monochloramine decay and formation of 33 halogenated and nitrogen-containing DBPs were investigated using response surface experimental design. Rechloramination conditions, including monochloramine dose, pH and bromide concentration, were optimised via a 3-factorial multivariate analysis of monochloramine stability in post-treatment drinking water. Effects of influencing variables on disinfectant decay and DBP formation were assessed and graphically presented as response surfaces with minimal experiments using Doehlert matrix experimental design compared to other multivariate experimental designs. Concentrations of trihalomethanes (THMs), haloacetic acids (HAAs), and N-nitrosamines were found to increase with water age, whereas opposite phenomenon was observed in the net production of haloacetonitriles (HANs). Increasing pH was found to stabilise monochloramine but it could cause DBP speciation to shift. Furthermore, increasing bromide concentration elevated Br-DBP formation. In bromide-containing water, pH = 7.8–8.0 should be considered as higher pH increases Br-THMs formations and lower pH increases formations of Br-HAAs and Br-HANs. However, water age or pH has insignificant impacts on DBP formation after significant monochloramine decay or at low initial monochloramine dose. These findings indicate that effective combined control measures to maintain monochloramine stability should include the application of high monochloramine dose (>1.5 mg-Cl2.L−1) under conditions of moderate to high pH (pH = 7.8–8.0) and minimal bromide concentration. This study provides relevant insights to water utilities aiming to design effective disinfectant residual management strategies for controlling monochloramine decay and DBP formation

A multivariate Bayesian network analysis of water quality factors influencing trihalomethanes formation in drinking water distribution systems

Controlling disinfection by-products formation while ensuring effective drinking water disinfection is important for protecting public health. However, understanding and predicting disinfection by-product formation under a variety of conditions in drinking water distribution systems remains challenging as disinfection by-product formation is a multifactorial phenomenon. This study aimed to assess the application of Bayesian Network models to predict the concentration of trihalomethanes, the dominant halogenated disinfection by-product class, using various water quality parameters. Naïve Bayesian and semi-naïve Bayesian models were constructed from Sydney and South East Queensland datasets across 15 drinking water distribution systems in Australia. The targeted variable, total trihalomethanes concentration, was discretised into 3 bins (&lt;0.1 mg L−1, 0.1 – 0.2 mg L−1 and &gt;0.2 mg L−1). The Bayesian network structures were built using water quality parameters including concentrations of individual and total trihalomethanes, disinfectant species (free chlorine, monochloramine, dichloramine, total chlorine), nitrogen species (free ammonia, total ammonia, nitrate, nitrite), and other physical/chemical parameters (temperature, pH, dissolved organic carbon, total dissolved solids, conductivity and turbidity). Seven performance parameters, including predictive accuracy and the rates of true and false positive and negative results, were used to assess the accuracy and precision of the Bayesian network models. After evaluating the model performance, the optimum models were selected to be Bayesian network augmented naïve models. These were observed to have the highest predictive accuracies for Sydney (78%) and South East Queensland (94%). Although disinfectant residuals are among the key variables that lead to trihalomethanes formation, potential concentrations of trihalomethanes in distribution systems can be more confidently predicted, in terms of probability associated with a wider range of water quality variables, using Bayesian networks. The modelling procedure developed in this work can now be applied to develop system-specific Bayesian network models for trihalomethanes prediction in other drinking water distribution systems

Effect of organic loading rate on organic matter and foulant characteristics in membrane bio-reactor

In this study, the influence of organic loading rate (OLR) on the performance of a membrane bio-reactor (MBR) was investigated. The MBR was operated with 6 different OLRs between 0.5 and 3.0kgCOD/m 3d. The hydrodynamic parameters of the MBR were kept constant. The hydraulic retention time and sludge retention time were kept at 8h and 40d respectively. From the experimental investigation, it was found that the removal efficiency of DOC, COD and NH 4-N decreased when OLRs were increased from 0.5 to 3.0kgCOD/m 3d. Higher OLRs of 2.75-3.0kgCOD/m 3d resulted in a higher transmembrane pressure development. The fractionation of organic matters showed more hydrophilic substances with higher OLRs. A detailed organic matter characterization of membrane foulant, soluble microbial product and extracellular polymeric substances showed that bio-polymers type substances together with humic acid and lower molecular neutral and acids were responsible for membrane fouling. © 2011 Elsevier Ltd

Experimental investigation and modeling of dissolved organic carbon removal by coagulation from seawater

Coagulation removes colloidal matters and dissolved organic carbon (DOC) which can cause irreversible membrane fouling. However, how DOC is removed by coagulant is not well-known. Jar test was used to study the removal of hydrophobic and hydrophilic DOC fractions at various doses (0.5-8.0mg-Fe+3L-1) of ferric chloride (FeCl3) and pH (5.0-9.0). Natural organic matter (NOM) in seawater and treated seawater were fractionated by liquid chromatography-organic carbon detector (LC-OCD). Compared to surface water, the removal of DOC in seawater by coagulation was remarkably different. Majority of DOC could be easily removed with very low coagulant dose (<5.0mg-Fe+3L-1) and the removal efficiency did not vary with pH, but the DOC composition in treated water had significantly changed. Hydrophobic fraction (HB) was better removed at high pH while hydrophilic fraction (HF) was better removed at low pH. A modified model of Kastl et al. (2004) which assumed that the removal occurred by adsorption of un-dissociated compounds onto ferric hydroxide was formulated and successfully validated against the jar test data. © 2013 Elsevier Ltd

Disinfectant residual stability leading to disinfectant decay and by-product formation in drinking water distribution systems : a systematic review

Secondary disinfectants, such as chlorine and chloramine, have been widely applied to minimise microbial risks in drinking water during distribution. Key challenges have included the maintenance of stable concentrations of disinfectant residuals and the control of disinfection by-products that may form as a consequence of residual decay processes. Many factors may influence disinfectant residual stability and the consequential formation of by-products. Thus predictions of disinfectant stability and by-product formation are multifactorial problems, complete with numerous complications of parameter co-dependence and feedback amplification of some key parameters. The aim of this review was to derive an understanding of how disinfectant residual stability in drinking water distribution systems is impacted by various influencing factors such as water quality and operational parameters. Factors known to influence disinfectant stability and by-product formation were critically reviewed. A systematic review method was applied to identify 1809 journal articles published in the two decades from January 1998 to December 2017. From the initial screening, 161 papers were selected for detailed assessment. Important factors were identified to include temperature, water age, piping material, corrosion products, pH, hydraulic condition, disinfectant residual type and dosage and microbial activity. Microbial activity is a particularly complex parameter on which to base predictions since many factors are known to influence the degree and nature of such activity. These include temperature, water age, piping material, corrosion products, nutrients, natural organic matter, hydraulic condition and disinfectant residual type and dosage. Disinfectant types and dosages were found to be among the most important factors. Many knowledge gaps and research needs still remain, including the need for a more complete understanding of the factors that influence the production of nitrogenous disinfection by-products

Effect of imposed flux on fouling behavior in high rate membrane bioreactor

The influence of imposed flux and aeration rates on membrane fouling in a submerged membrane bioreactor was studied. The experiments were conducted at four imposed fluxes and three aeration rates. The effect of flux on the reduction of membrane fouling was much higher than that caused by aeration rate. A lower flux of 20L/m2h produced 75 times more water than a higher flux of 40L/m2h with an aeration rate of 2 L/min. Low flux showed slightly higher removal of NH4-N and 93-96% removal of dissolved organic matter and chemical oxygen demand. Imposed flux also had a significant effect on the composition of organics present in the soluble microbial product (SMP) and extracellular polymeric substances (EPS). At a higher flux, both SMP and EPS had organics of high molecular weight (MW) of around 48kDa as well as lower MW organics below 200Da. © 2012