Conceptual energy and water recovery system for self-sustained nano membrane toilet

With about 2.4 billion people worldwide without access to improved sanitation facilities, there is a strong incentive for development of novel sanitation systems to improve the quality of life and reduce mortality. The Nano Membrane Toilet is expected to provide a unique household-scale system that would produce electricity and recover water from human excrement and urine. This study was undertaken to evaluate the performance of the conceptual energy and water recovery system for the Nano Membrane Toilet designed for a household of ten people and to assess its self-sustainability. A process model of the entire system, including the thermochemical conversion island, a Stirling engine and a water recovery system was developed in Aspen Plus®. The energy and water recovery system for the Nano Membrane Toilet was characterised with the specific net power output of 23.1 Wh/kgsettledsolids and water recovery rate of 13.4 dm3/day in the nominal operating mode. Additionally, if no supernatant was processed, the specific net power output was increased to 69.2 Wh/kgsettledsolids. Such household-scale system would deliver the net power output (1.9–5.8 W). This was found to be enough to charge mobile phones or power clock radios, or provide light for the household using low-voltage LED bulbs

An experimental investigation of the combustion performance of human faeces

Poor sanitation is one of the major hindrances to the global sustainable development goals. The Reinvent the Toilet Challenge of the Bill and Melinda Gates Foundation is set to develop affordable, next-generation sanitary systems that can ensure safe treatment and wide accessibility without compromise on sustainable use of natural resources and the environment. Energy recovery from human excreta is likely to be a cornerstone of future sustainable sanitary systems. Faeces combustion was investigated using a bench-scale downdraft combustor test rig, alongside with wood biomass and simulant faeces. Parameters such as air flow rate, fuel pellet size, bed height, and fuel ignition mode were varied to establish the combustion operating range of the test rig and the optimum conditions for converting the faecal biomass to energy. The experimental results show that the dry human faeces had a higher energy content (∼25 MJ/kg) than wood biomass. At equivalence ratio between 0.86 and 1.12, the combustion temperature and fuel burn rate ranged from 431 to 558 °C and 1.53 to 2.30 g/min respectively. Preliminary results for the simulant faeces show that a minimum combustion bed temperature of 600 ± 10 °C can handle faeces up to 60 wt.% moisture at optimum air-to-fuel ratio. Further investigation is required to establish the appropriate trade-off limits for drying and energy recovery, considering different stool types, moisture content and drying characteristics. This is important for the design and further development of a self-sustained energy conversion and recovery systems for the NMT and similar sanitary solutions

Design and commissioning of a multi-mode prototype for thermochemical conversion of human faeces

This article describes the design and commissioning of a micro-combustor for energy recovery from human faeces, which can operate both in updraft and downdraft modes. Energy recovery from faecal matter via thermochemical conversion has recently been identified as a feasible solution for sanitation problems in low income countries and locations of high income countries where access to sewage infrastructures is difficult or not possible. This technology can be applied to waterless toilets with the additional outcome of generating heat and power that can be used to pre-treat the faeces before their combustion and to ensure that the entire system is self-sustaining. The work presented here is framed within the Nano Membrane Toilet (NMT) project that is being carried out at Cranfield University, as part of the Reinvent the Toilet Challenge of the Bill and Melinda Gates Foundation. For this study, preliminary trials using simulant faeces pellets were first carried out to find out the optimum values for the main operating variables at the scale required by the process, i.e. a fuel flowrate between 0.4 and 1.2 g/min of dry faeces. Parameters such as ignition temperature, residence time, and maximum temperature reached, were determined and used for the final design of the bench-scale combustor prototype. The prototype was successfully commissioned and the first experimental results, using real human faeces, are discussed in the paper

Unmet supportive care needs of breast, colorectal and testicular cancer survivors in the first 8 months post primary treatment:A prospective longitudinal survey

Objectives To explore the supportive care needs of cancer survivors, the characteristics of patients with high levels of unmet need, changes in unmet need after treatment ends and differences in unmet needs of breast, colorectal and testicular survivors. Methods The method used was a prospective longitudinal mailed survey. Unmet needs, measured by 25-item modified Cancer Survivors Unmet Needs survey at baseline (immediately post-treatment) and 8 months later, were analysed descriptively. Results Of 434 breast, 186 colorectal and 75 testicular patients responding at baseline, 56.2%, 65.6% and 50.7%, respectively, had no unmet needs, the top decile having >= 10 (breast) or seven (colorectal and testicular) different needs and seven different unmet needs. The most frequently reported unmet need (all groups) was fear of cancer recurrence. Unmet needs fell significantly at 8 months for breast patients. Some patients reported new needs. Needs were lowest amongst colorectal survivors and differed between the three groups. Higher levels of unmet needs (breast and colorectal) were associated with having had chemotherapy. Conclusion Most survivors reported few unmet needs, but a small proportion have persisting or emerging needs. Routine or regular monitoring of unmet needs is required so that healthcare professionals can deliver personalised care based on individual needs, preferences and circumstances

Quality in cancer care: nurse sensitive indicators for ambulatory chemotherapy

This project, commissioned by the National Cancer Action Team, developed and pilotted a suite of nurse sensitive indicators for ambulatory chemotherapy that contributed to the effective monitoring of these services.<br/

The application of the Diels-Alder reaction in the synthesis of some nitrogen heterocycles

A review of the intramolecular Diels-Alder reaction is given and the intention of investigating the cycloaddition of a number of amido trienes introduced. Six acyclic, secondary amino dienes were synthesised from sorbic acid and from penta-2(E),4-dienoic acid. These dienes were treated with acryloyl chloride to yield trienes which were thermally cyclised to give, in each case, a mixture of cis- and trans-fused lactams. A number of highly functionalised 8-azabicyclo[4.3.0]non-2-en-7-ones were obtained from the intramolecular Diels-Alder reaction of the trienes generated in situ from the amino dienes and dichloromaleic-, bromomaleic- and maleic-anhydride. All the trienes cyclised with a high level of anti selectivity. Aspects of the chemistry of these functionalised lactams were investigated. Dechlorodecarboxylation, dehydrohalogenation, dehalogenation and hydrogenation reactions yielded a number of interesting bicyclic lactams. The dechlorodecarboxylation reaction was studied in some detail. It was found that depending on the substitution of the substrate, conjugated or non-conjugated products were produced. The imino Diels-Alder reaction is reviewed. A model study was made of the Diels-Alder reactions between 4,9-dihydro-3H-pyrido [3,4-b] indole and the dienes methyl-penta-2(E),4-dienoate, 1-cyano-buta-1(E),3-diene and 1-methoxy-3-trimethylsilyloxy-buta-1(E),3-diene. A new method for the synthesis of 1-cyano-buta-1(E),3-diene was developed. An attempt to develop this chemistry, by studying the cycloaddition of the tryptophan derived imine methyl-4,9-dihydro-3H-pyrido[3,4-b]-indole-3-carboxylate with a number of dienes under various conditions was unsuccessful. (D80018)</p

Understanding the urgent and emergency care navigation work undertaken by people with cancer and their informal caregivers: a conceptually framed scoping review

Background: people with cancer frequently use urgent and emergency care. Reviews of research have focussed on the incidence and predictors of service use in this population, rather than how people make decisions about which service to access. Understanding what factors influence these choices will inform ways in which we might enable people with cancer to effectively access services.Aims: (1) Describe research undertaken about choices made by people with cancer about routes to access urgent and emergency care; (2) characterise decisions made by patients and informal caregivers to use certain services, with specific reference to work involved in navigating access; and (3) identify research priorities.Methods: scoping review of qualitative and mixed methods studies. Electronic database searches (AMED, CINAHL, Embase, MEDLINE, PsycInfo) and ‘berrypicking’ identified 18 papers. Study, participant, and service characteristics were mapped, and Turnbull et al.’s Model of Urgent Care Help-seeking informed a directed qualitative content analysis.Results: studies have involved people with advanced cancer to the relative exclusion of people with curable disease, receiving anticancer treatment, and who are multi-morbid. Six subcategories of navigation work were identified: (1) making decisions with, and seeking help from, specialists, (2) seeking safety, (3) positioning to access desired treatment, (4) negotiating tortuous pathways to help, (5) making decisions in collaboration with caregivers, and (6) managing isolation from services and social networks.Conclusion: there are significant knowledge gaps and a need for more research, particularly studies of how different patient groups prepare for potential deterioration and make sense of systems of urgent and emergency care

Rebuilding self-confidence after cancer: a feasibility study of life-coaching

BackgroundCancer survivors often experience decreased self-confidence which impacts negatively on their ability to self-manage the practical, social and emotional problems frequently faced as they emerge from end of treatment. This was a feasibility study of a life-coaching intervention, designed to rebuild confidence of survivors and support transition to life after cancer treatment.MethodsA one group pre-test, post-test design was used, recruiting participants from community organisations. Eligibility criteria are as follows: &lt;1 year of completion of primary cancer treatment, aged &gt;18, no metastases, and no mental health problems. Participants received one individualised face-to-face and five telephone coaching sessions over 3 months. Outcome measures are as follows: New General Self-Efficacy Scale, Hope Scale, Personal Well-being Index, Assessment of Survivorship Concerns, Quality of Life in Adult Cancer Survivors, Hospital Anxiety and Depression Scale, Social Difficulties Index, and a goal attainment score. Interviews explored feasibility, acceptability and impact of life-coaching and research design.ResultsNine women and two men were recruited, representing varying cancer diagnoses. All outcome measures were sensitive to change and indicated positive trends post-intervention. Participant interviews indicated the intervention was well received and had a positive impact. Lessons were learnt about study design, recruitment and intervention delivery.ConclusionsLife-coaching has a potential to enable cancer survivors to manage the transition to life beyond cancer and effect change on a range of outcomes. The intervention was feasible to deliver and acceptable to survivors at a time when many struggle to make sense of life. It merits further evaluation through a randomised controlled trial.<br/

Development and Testing of the Patient-Reported Chemotherapy Indicators of Symptoms and Experience

Background: Outcome indicators are increasingly advocated to demonstrate the impact of high-quality care; however, generic measures do not encompass outcomes relevant to specialist areas. Objective: The aim of this study was to develop an outcome measure (Patient-Reported Chemotherapy Indicators of Symptoms and Experience [PR-CISE]) for use in ambulatory chemotherapy settings and assess its feasibility, acceptability, and preliminary efficacy in clinical practice. Methods: Three areas were covered by PR-CISE—symptom management, safe medication administration, and experience of supportive care. Outcome selection was guided by review of evidence and reference groups of users, clinicians, and experts. Over 12 weeks, PR-CISE was distributed to patients receiving ambulatory chemotherapy at 10 cancer centers. Data were analyzed descriptively and with case mix adjustment using regression-based models. Results: There were 2466 responses. There was variability across centers in terms of symptom experience and support provided. Across the whole sample, 25% reported moderate or severe nausea; however, rates varied between centers (25%–75%). Similar results emerged for other symptoms. When asked about support for symptom management, 80% reported that chemotherapy nurses asked about and were aware of symptom severity and provided useful information/advice. Once again, there was substantial variability between centers. Unexplained variation remained after case mix adjustment, suggesting that differences may be “real” rather than caused by population differences. Stakeholders planned to make changes to care delivery based on data on their performance. Conclusions: We successfully developed and tested indicators assessing the quality of care provided in ambulatory chemotherapy services. Implications: Results show that monitoring outcomes demonstrate potential differences in care quality and provide a stimulus to improve the experience and health of patients.</p