Towards Base Metal Recovery from Sewage Sludge

With a need for the reuse of sewage sludge as a sustainable phosphate source, removal of contaminant metallic hazards become imperative. Success in leaching metals from sewage sludge leaves open the study of removal and recovery of mobile metals from a slurry. Careful consideration of lixiviants and solution condition controls have been considered for the total removal of specific metals of interest, and the solid phase extraction of target metals has been studied extensively. Copper, iron(II), lead and zinc extraction by C107E, TP214, MTS9100, MTS9501, MTS9301, MTS9570 were screened over the buffering regions of acetic, lactic and citric acid. With acetic acid providing the least hindrance to extraction, isotherm and kinetic characterisation determined MTS9301 as the most effective. Kinetically able to separate iron(II) and other metals (130min vs a maximum of 49min), and extracting >90% of metals without desorption or competition with a surface concentration 2.729mmol/g. Due to the large variation in sewage sludge, a resin-in-pulp was conducted utilising a modified literature surrogate. Leaching was conducted for 24h in pH 1 acetic acid and 9% H2O2, dissolving 33-36, 88-89 and 91-92% of copper, lead and zinc, respectively, before neutralisation and final addition of MTS9301. Elution determined that with 2mL resin 38.9, 37.9 and 53.6% recovery of copper, lead and zinc, respectively, was attained with a simple one stage extraction. As citric acid is not only relevant to this work, but also resource recovery in general, further study was conducted into the performance of MTS9301 within citrate. It was found that optimal extraction was obtained in 0.1mol/L citrate. Total equilibrium and kinetic performance was only slightly effected for copper, lead and zinc, with the resin displaying far lower capacity for iron(II) and a secondary desorption once peak extraction was achieved

Final report of HENRE II 2005-2008

HENRE is a Socrates Erasmus Thematic Network co-financed by the EC and coordinated by the University of Cumbria, UK. The original HENRE Thematic Network (2002-2005) proved to be a valuable vehicle for the commencement of the development of a European dimension in radiography. The rationale for HENRE II has been further involvement in identifying the issues that surround radiography education in the different countries which make up Europe. There are many differences in the type, mode, standards and coverage of educational programmes across individual countries and are in some ways related to the roots from which the profession developed and the traditional approaches to health service provision. Consequently mutual academic and professional recognition is not yet applicable throughout the EU. The development of the Tuning methodology for educational structures in Europe arising in response to the Bologna agreement has provided the opportunity for radiography through the identification and development of a pan European generic and subject specific competencies approach to 1st cycle education. In addition, a focus on a learning outcomes approach to education at both programme and modular level is an area which requires further dissemination. In some European contexts, graduate level radiographers are strongly encouraged to undertake an expanded role in areas conventionally seen as being within the province of a medically qualified practitioner. Continuous Professional Development (CPD) has become a registerable requirement for radiographers in some countries, the CPD survey undertaken within HENRE I has provided the present project with details of the hourages, language, scope and delivery methods acceptable for CPD for radiographers in Europe. Lack of opportunities to progress to 2nd cycle in radiography programmes are developed though the initiation of appropriate European modules including a possible masters programme suitable for entry into Erasmus Mundus. Research and radiography – the extent to which the radiography curriculum is influenced through research undertaken by academics avoidance of isolation of researchers and consideration of researcher mobility. A separate strand looking at radiation protection issues and research and communication with patients on the possible deleterious effects arising from examinations using ionizing radiations. Importance of a high quality service to all in a safe environment with professionals purposefully educated and able to communicate with service users at the appropriate level

Education models used across Europe to train Therapeutic Radiographers/Radiotherapists: a cross-case study

[EN] Interviews with radiotherapy (RT) stakeholders were completed across four European countries to identify the educational models used across Europe and how they affect competencies of Therapeutic Radiographers/Radiotherapists (TR/RTTs). The stakeholders identified the following educational models: Programmes below European Qualifications Framework (EQF) level 6 (EQF4 or EQF5) RT-only BSc programmes (EQF6)Multiple-specialism BSc programmes (EQF6)RT-only apprenticeships (EQF6)Multiple-specialism BSc followed by an MSc (EQF6→EQF7)Integrated masters (EQF7)RT-only pre-registration MSc (EQF7)‘Common trunk’ model (EQF6 or EQF7) Each educational model has its set of advantages and disadvantages, but most  models can be used to achieve the same essential competencies of TR/RTTs. Some models showed weaknesses in their ability to develop adequate RT competencies (low EQF level, low RT-specific content). Regulating the standards of practice at national level ensures that essential competencies are developed across all course programmes, improving the care to RT patients.EACEA (European Education and Culture Executive Agency), University of MaltaCouto, J.; Mcfadden, S.; Mcclure, P.; Bezzina, P.; Hughes, C. (2022). Education models used across Europe to train Therapeutic Radiographers/Radiotherapists: a cross-case study. En 8th International Conference on Higher Education Advances (HEAd'22). Editorial Universitat Politècnica de València. 1125-1133. https://doi.org/10.4995/HEAd22.2022.144051125113

Evaluation of radiotherapy education across the EU and the impact on graduates’ competencies working on the linear accelerator.

Introduction: Regulation and education of the professionals administering radiotherapy treatments in the linear accelerator varies across the EU. However, how different programme characteristics affect the level of competency of these professionals has never been studied before. This study also aimed to assess which are the least and most developed competencies in radiotherapy across the EU. Methods: An online questionnaire was distributed to academic staff teaching radiotherapy across the EU. Staff were asked to identify the characteristics of the course programmes and to classify the level of competency of graduates regarding linear accelerator tasks. Results: Fifty respondents from 19 EU countries answered the questionnaire. The least developed competency theme was pharmacology followed by equipment quality assurance and management and leadership. The most developed competency was positioning and immobilisation, followed by radiotherapy treatment delivery and professional and ethical practice. Some competencies are developed at the same level across EU countries, while others vary considerably between member-states. Longer programmes, with more placements, and larger proportions of radiotherapy in the programme showed significant increase in the development of some competencies. Longer placements in skills labs was correlated with a decrease in competency. Conclusion: There is no harmonisation of radiotherapy eduction across the EU and the differences in programme characteristics are reflected in differences in competency levels of radiotherapy radiographers. This may hinder movement of professionals and create disparities in the level of care offered across the EU. Implications for practice: Longer programmes, with longer clinical practice and adequate proportion of radiotherapy in the course are essential to ensure that these professionals are competent at similar levels across the EU and to ensure patient safety.peer-reviewe

Effect of patient thickness on acute gastrointestinal toxicities following radiotherapy for prostate cancer

BACKGROUND: There is conflicting literature regarding the effect of patient size on radiotherapy toxicities. This study aimed to determine whether there is any association between patient thickness and severity and incidence of acute GI toxicities of prostate cancer patients receiving VMAT radiotherapy. The impact of confounding factors was also examined: rectal dose, age and lymph node irradiation. MATERIALS AND METHODS: This study used a non-experimental, retrospective, descriptive and cross-sectional design. All patients who complied with the inclusion criteria (n = 96) were included. GI toxicity scores (baseline and last week of radiotherapy), rectal dose, lymph nodes irradiation and patient age at diagnosis were collected from the treatment file. Patient separations were measured from the CT-Simulator images. Statistical tests were performed to analyse the influence of these factors on acute GI toxicities. RESULTS: Patient thickness was shown to have no statistically significant effect on the incidence (p = 0.947 for antero-posterior and p = 0.839 for lateral thicknesses), and severity (p = 0.986 and 0.905, respectively) of acute GI toxicities. Severity of GI toxicities increased following radiotherapy: the Expanded Prostate Cancer Index Composite (EPIC) score increased by 2.64 from baseline (p < 0.001). The confounding factors had no statistically significant effect on toxicities (p > 0.05). CONCLUSION: As expected, most patients experienced an increase in GI toxicity following radiotherapy. No relationship was established between patient thickness and the severity or incidence of acute GI toxicities, adding to the existing body of knowledge. Therefore, all patients should receive adequate follow up, irrespective of size. Side-effect recording tools should be implemented systematically for continuous assessment of this relationship

Ischaemic heart disease risk scores and their applications : a systematic review

Numerous diagnostic strategies can be used on patients suspected of suffering from coronary artery disease (CAD), also referred to as ischaemic heart disease (IHD). Coronary angiography is currently still considered as the gold standard for diagnosing arterial plaques causing obstructive IHD, yet coronary angiography is invasive and costly, and may still not be able to demonstrate non-atheromatous CAD, which, although rare, may still occur in the younger age group. Since the overall risk of IHD is made up of a number of multiple risk factors several risk assessment tools may be used to try and estimate the risk of this pathology within the different age groups.peer-reviewe

Assessing the predictive value of first trimester ultrasound and biochemical markers in miscarriage : a scoping review

Introduction: Vaginal bleeding in the first trimester of pregnancy generates anxiety and uncertainty for expecting parents. The ability to determine pregnancy outcome through a first trimester ultrasound scan remains a challenge in obstetrics. Several first trimester ultrasound markers used individually or in combination, as well as ultrasound markers used in combination with biochemical markers, have been studied to determine their predictive value in pregnancy outcome. This scoping review was performed to determine which markers have already been investigated for this purpose.Methods: An extensive and systematic database search was performed using four different categories of keywords which were combined using Boolean terms. A total of 14 variables were included on the final data charting forms. Data was synthesised collectively for each variable and then separately for the studies analysing only one marker. For the studies which analysed multiple markers, data was synthesised based on the number of markers per study.Results: The search yielded 3608 studies, of which 128 were ultimately used for this review. Data extraction, based on predetermined eligibility criteria, was performed by two authors independently. Seventy-seven (62.6%) studies investigated the predictive value of a single ultrasound marker. The remaining 46 (37.4%) studies explored multiple markers, of which at least one was an ultrasound marker.Conclusion: This review identified several discrepancies among different studies. This highlights the need for better consensus among researchers to allow for the design of a predictive model which enables extrapolation of findings to all pregnant women.Implications for practice: Through the study of ultrasound and biochemical markers in the first trimester of pregnancy, clinicians may provide a more accurate prediction of pregnancy outcome following threatened miscarriage.peer-reviewe

Financial audit report modifications in Malta

This paper analyses the modifications of financial audit reports of Maltese companies between 2005 and 2009. It examines the audit reports of a random sample of 374 limited liability companies registered with the Registry of Companies in Malta. The study shows that the average 2005- 2009 modification rate in Malta stood at 22.4%, this representing an increase over previous periods. Most modified reports were noted in the case of private exempt and international trading non-exempt companies. Generally, private exempt companies had their audit report qualified on the basis of a limitation of scope, whilst most international trading companies had their reports qualified on the basis of disagreement with management. Furthermore, the “small company qualification” (which has been long abolished) was still incorrectly being used in Maltese audit reports till 2009. The results therefore show that there is still room for improvement in audit reporting in Malta. Whilst the Big Four audit firms do not appear to have issues in appropriately adhering to audit reporting standards, Maltese smaller audit firms and sole practitioners were found still to be the main cause for inappropriate audit reporting. Towards improvement, the study provides various recommendations including: a more consistent regulatory framework, stricter enforcement of quality assurance, and the reconsideration of the statutory small audit. Such recommendations may also be applicable to other jurisdictions.peer-reviewe

Education models used across Europe to train therapeutic radiographers/radiotherapists : a cross-case study

Interviews with radiotherapy (RT) stakeholders were completed across four European countries to identify the educational models used across Europe and how they affect competencies of Therapeutic Radiographers/Radiotherapists (TR/RTTs). The stakeholders identified the following educational models: • Programmes below European Qualifications Framework (EQF) level 6 (EQF4 or EQF5) • RT-only BSc programmes (EQF6) • Multiple-specialism BSc programmes (EQF6) • RT-only apprenticeships (EQF6) • Multiple-specialism BSc followed by an MSc (EQF6→EQF7) • Integrated masters (EQF7) • RT-only pre-registration MSc (EQF7) • ‘Common trunk’ model (EQF6 or EQF7) Each educational model has its set of advantages and disadvantages, but most models can be used to achieve the same essential competencies of TR/RTTs. Some models showed weaknesses in their ability to develop adequate RT competencies (low EQF level, low RT-specific content). Regulating the standards of practice at national level ensures that essential competencies are developed across all course programmes, improving the care to RT patients.peer-reviewe