Modeling Jar Test Results Using Gene Expression to Determine the Optimal Alum Dose in Drinking Water Treatment Plants

يعد التخثير من أهم العمليات في محطات تنقية مياه الشرب، ان استخدام مخثر الشبة يؤدي الى زيادة تركيز الألمنيوم المتبقي في المياه، والذي تم ربطه في العديد من الدراسات بمرض الزهايمر. لذلك فإنه من المهم استخدامه في الجرع الأمثل. في هذه الدراسة، تم إجراء أربع مراحل من التجارب لتحديد تأثير مواصفات المياه الخام، مثل: العكارة، pH، القلوية والحرارة على الجرعة الأمثل من مخثر الشبة  [   .14 O] للحصول على علاقة رياضية تمكن من الاستغناء عن الحاجة لتجارب الجرة. تم إجراء التجارب بظروف مختلفة وعلى مدى فصول السنة، وتم تحديد الجرعة الأمثل لكل دورة من التجارب لتشكيل نموذج يعتمد على التعابير الجينية.تم بناء النموذج عن طريق بيانات مواصفات المياه: العكارة، pH، الحرارة والقلوية للتنبؤ بقيمة جرعة الشبة الأمثل اللازمة، النموذج الذي تم الحصول عليه أعطى نتائج جيدة بمعامل ارتباط 0.91   ومربع جذر الأخطاء 1.8.  تمت مقارنة النتائج مع نموذج انحدار خطي والذي لم يكن كافيا لإعطاء نتائج جيدة نظرا لطبيعة العلاقة الغير خطية المعقدة.  سلاسل أخرى من التجارب تم القيام بها لتحديد الجرعة الأمثل اللازمة أثناء حدوث الفيضانات والتي تصل فيها قيم عكارة الى قيم عالية مع دراسة استخدام النشاء كمادة مساعدة للتخثير، تم الحصول على نموذج جيد للتنبؤ، بقيمة معامل 0.92 وجذر مربعات أخطاء   5.1.Coagulation is the most important process in drinking water treatment. Alum coagulant increases the aluminum residuals, which have been linked in many studies to Alzheimer's disease. Therefore, it is very important to use it with the very optimal dose. In this paper, four sets of experiments were done to determine the relationship between raw water characteristics: turbidity, pH, alkalinity, temperature, and optimum doses of alum [   .14 O] to form a mathematical equation that could replace the need for jar test experiments. The experiments were performed under different conditions and under different seasonal circumstances. The optimal dose in every set was determined, and used to build a gene expression model (GEP). The models were constructed using data of the jar test experiments: turbidity, pH, alkalinity, and temperature, to predict the coagulant dose. The best GEP model gave very good results with a correlation coefficient (0.91) and a root mean square error of 1.8. Multi linear regression was used to be compared with the GEP results; it could not give good results due to the complex nonlinear relation of the process. Another round of experiments was done with high initial turbidity like the values that comes to the plant during floods and heavy rain. To give an equation for these extreme values, with studying the use of starch as a coagulant aid, the best GEP gave good results with a correlation coefficient of 0.92 and RMSE 5.

Challenges to optimal medicines use in people living with dementia and their caregivers: A literature review

Dementia is fast becoming a global concern due to a demographic shift towards an older population. Many studies have shown that caring for a family member or friend has a profound and negative impact on the physical, emotional and psychosocial aspects of the caregivers’ life. One significant activity that a family caregiver undertakes is assistance with the management of medicines. This review was undertaken to ascertain what the issues are that affect optimal medicines use from the perspectives of people living with dementia and their caregivers, both in the community and care home settings. A literature search was conducted using electronic databases, employing a combination of search terms. A total of 16 studies met the inclusion criteria. Six broad themes were identified, together with some recommendations to improve medicines use in people with dementia. Challenges to medicines use centred on medicines management and administration, the impact on the caregiver and care recipient, their partnership and interface with formal care. Future research should focus on developing targeted interventions that can overcome these challenges to achieve optimal medicines use

Using public engagement and consultation to inform the development of ageing-and dementia-friendly pharmacies – Innovative practice

This study explored public perceptions about the importance of, and how to create, ageing- and dementia-friendly pharmacists and pharmacies. In September 2016, four focus groups (45 minutes each) were conducted with 16 participants who represented organisations, groups or forums working with and/or for older people and people with dementia in Greater London. Discussions were recorded via handwritten notes and thematically analysed. Participants confirmed the importance of pharmacists and pharmacies being ageing- and dementia-friendly and described variability in whether this is currently the case. Suggested strategies for improvement included targeting communication, pharmacist leadership and shop layout

Older people's priorities in health and social care research and practice: a public engagement workshop

As the world’s population ages, there is an increasing need for research that addresses the priorities of older people. A public engagement workshop focusing on the priorities of older people for research and practice in health and social care was attended by seventy-five people aged 70 years and above in London, United Kingdom (UK). The workshop aimed to identify and prioritise issues important to older people that would benefit from further research and act as a platform to promote sharing of ideas and problems related to these important issues. Key priorities emerged including loneliness and isolation, support and training for professional and family carers, post-surgical care, negative perceptions of older people and inequalities related to public services and healthcare. Participants further suggested older people should be actively involved in all stages of the research process

What works for whom in the management of diabetes in people living with dementia: a realist review

Background Dementia and diabetes mellitus are common long-term conditions and co-exist in a large number of older people. People living with dementia (PLWD) may be less able to manage their diabetes, putting them at increased risk of complications such as hypoglycaemia. The aim of this review was to identify key mechanisms within different interventions that are likely to improve diabetes outcomes in PLWD. Methods This is a realist review involving scoping of the literature and stakeholder interviews to develop theoretical explanations of how interventions might work, systematic searches of the evidence to test and develop the theories and their validation with a purposive sample of stakeholders. Twenty-six stakeholders — user/patient representatives, dementia care providers, clinicians specialising in diabetes or dementia and researchers — took part in interviews, and 24 participated in a consensus conference. Results We included 89 papers. Ten focused on PLWD and diabetes, and the remainder related to people with either dementia, diabetes or other long-term conditions. We identified six context-mechanism-outcome configurations which provide an explanatory account of how interventions might work to improve the management of diabetes in PLWD. This includes embedding positive attitudes towards PLWD, person-centred approaches to care planning, developing skills to provide tailored and flexible care, regular contact, family engagement and usability of assistive devices. An overarching contingency emerged concerning the synergy between an intervention strategy, the dementia trajectory and social and environmental factors, especially family involvement. Conclusions Evidence highlighted the need for personalised care, continuity and family-centred approaches, although there was limited evidence that this happens routinely. This review suggests there is a need for a flexible service model that prioritises quality of life, independence and patient and carer priorities. Future research on the management of diabetes in older people with complex health needs, including those with dementia, needs to look at how organisational structures and workforce development can be better aligned to their needs. Trial registration PROSPERO, CRD42015020625. Registered on 18 May 2015