Pyrolysis of waste plastic fish bags (polyethylene and polypropylene) to useable fuel oil

The objective of this study is to determine the feasibility of pyrolysis of waste plastic fish feed bags to heating oil. Pyrolysis is a thermal treatment without oxygen and produces three products (gas, oil, and solid), the yields depend on the feedstock and operating conditions. The fish feed bags are polyethylene (PE) or polypropylene (PP) and are typically contaminated with a small amount of residual fish feed. This limits the treatment and disposal options. Thermal decomposition of the bags to their original oil base could potentially produce a fuel for use in heating and possibly power for the plant. Unused and used bags were pyrolyzed and compared to determine the impact of the fish feed on the oil and the residual solids and gas evolved during the process. The temperature for the pyrolysis temperature is a function of the feed material. For waste plastic the temperature can range between 400−550°C depending on the type of plastic. In this work a series of pyrolysis experiments were performed where key factors that would impact the oil quality produced, were varied including; temperature of pyrolysis 400−550°C) type of bag (PE, PP, and mixtures of the two), mass of residual fish feed retained in bag (0-40% by mass of feedstock) and gas residence time. Based on these experiments the optimum operating conditions were obtained. A temperature of 500°C produced the maximum wax/oil yields, 69-75wt% of feedstock with a solids (residue) between 6-7wt%, and gas between 23-25wt%, depending on the feedstock. The melting point of wax/oil samples varied between 53-62°C. The melting point of the wax/oil samples decreased slightly with increasing amounts of fish feed. The increase in wax/oil yield is likely a result that the FF pyrolysis products are predominantly lipids, this would both add to the overall oil content and possibly decrease the uncondensable gas content through co-pyrolysis. The heating values of the wax/oil samples varied from 42.8- 45.7 MJ/kg. The pure fish feed heating value was 25.47 MJ/kg. The heating values of all waxes are comparable to standard fuels, 44-46 MJ/kg petrol/gasoline, 43 MJ/kg for diesel, and from 43-44 MJ/kg for fuel oil. Although, the wax/oil samples are solid (wax) at temperatures below 50oC, heating to above 60oC produces a liquid oil with a high heating value. The gas produced in 2 the pyrolysis, largely methane and ethane, could be used as a fuel gas. Based on 100 metric tonnes of waste bags per year this translates to 2.8 MJ/yr from the oil and 1.38 MJ/yr from the gas

Organic Waste in Newfoundland and Labrador: A Review of Available Agriculture, Fishery, Forestry and Municipal Waste Literature

Re-utilisation of organic waste is globally widely employed to maximise both economic and environmental sustainability of human activities. Re-utilisation of organic waste nutrients of biochars produced from such wastes do offer a critical element for enhancing soil fertility and thus supporting sustainable agriculture. Newfoundland and Labrador produces a variety of organic waste streams ranging from municipal to farm, fishery and timber production. We carried out a best estimate of the amount of these waste streams with a goal to understand the potential utility of each as a source of nutrients or biochar for sustaining agricultural activities in the province. Municipal sources, i.e. municipal organic waste streams and wastewaters, and fishery waste were estimated to offer the largest potential for nutrient recovery. Dairy industry is the largest producer of nutrient rich organic waste among agricultural activities. The dairy industry might possibly produce most of the nutrients required to fertilise their own land base; note that the dairies in the province still import a significant portion of their feed and that is reflected in the waste stream. Nutrients currently available in the estimated waste streams are likely sufficient to support most fertilisation needs of the current land-base, or nearly double the current land base in the case of phosphorus. Given the estimated balance of waste nutrients in the province any expansion in agricultural land base would require supplementary imports of fertilizers or, preferably, an integrated livestock and crop agriculture expansion. A secondary estimation was carried out to assess the value of the same organic waste streams for biochar production. This offered an alternative to nutrient reutilisation, an alternative that is also in support of soil fertility. Sawmill waste, that carried little nitrogen and phosphorus value, was also included in biochar estimates. The assessment has shown a significant potential for biochar production mainly for fishery and municipal organic waste. However, pursuing a biochar agenda for these materials would require a trade-off with the nutrients lost during pyrolysis. The assessment presented here confirms that organic wastes are a valuable resource for agricultural production and sustainability. However specific decisions would require a more detailed analysis of the geographic integration of waste streams and agricultural production

Comparison of pharmacist managed anticoagulation with usual medical care in a family medicine clinic

Background The beneficial outcomes of oral anticoagulation therapy are dependent upon achieving and maintaining an optimal INR therapeutic range. There is growing evidence that better outcomes are achieved when anticoagulation is managed by a pharmacist with expertise in anticoagulation management rather than usual care by family physicians. This study compared a pharmacist managed anticoagulation program (PC) to usual physician care (UC) in a family medicine clinic. Methods A retrospective cohort study was carried out in a family medicine clinic which included a clinical pharmacist. In 2006, the pharmacist assumed anticoagulation management. For a 17-month period, the PC group (n = 112) of patients on warfarin were compared to the UC patients (n = 81) for a similar period prior to 2006. The primary outcome was the percentage of time patients' INR was in the therapeutic range (TTR). Secondary outcomes were the percentage of time in therapeutic range within ± 0.3 units of the recommended range (expanded TTR) and percentage of time the INR was >5.0 or <1.5. Results The baseline characteristics were similar between the groups. Fifty-five percent of the PC group was male with a mean age of 67 years; 51% of the UC group was male with a mean age of 71 years. The most common indications for warfarin in both groups were atrial fibrillation, mechanical heart valves and deep vein thrombosis. The TTR was 73% for PC and 65% for UC (p 5 were 0.3% for PC patients and 0.1% for UC (p < 0.0001). Conclusion The pharmacist-managed anticoagulation program within a family practice clinic compared to usual care by the physicians achieved significantly better INR control as measured by the percentage of time patients' INR values were kept in both the therapeutic and expanded range. Based on the results of this study, a collaborative family practice clinic using pharmacists and physicians may be an effective model for anticoagulation management with these results verified in future prospective randomized studies

Survey of Canadian Pharmacists’ Responses to Warnings of Potential Interactions Between Ceftriaxone and Calcium in IV Solutions

ABSTRACT Background: In 2007, because of a potential interaction between ceftriaxone and calcium-containing IV solutions, Roche Laboratories (manufacturer of Rocephin [ceftriaxone] in the United States) issued letters to health care professionals advising them of changes to the product monograph. Subsequently, warning letters were also issued by the US Food and Drug Administration (FDA) and Health Canada. The Health Canada recommendations and their implications for clinical practice generated debate in the Canadian hospital pharmacy community.Objective: To evaluate the response to the warnings among hospital pharmacists and their respective institutions.Methods: An anonymous, voluntary 10-question survey was distributed to members of the Pharmacy Specialty Networks of the Canadian Society of Hospital Pharmacists. Requests to participate were solicited via 2 e-mail messages. Responses were analyzed descriptively.Results: A total of 152 pharmacists participated in the survey. Fortythree respondents (28.3%) reported being very concerned and 86 (56.6%) reported being somewhat concerned about the Health Canada Notice to Hospitals. About half (77/152 [50.7%]) of the respondents felt that the Health Canada notice did not need to be strictly heeded. Two-thirds (98/145 [67.6%]) reported that their institutions had addressed the risk of an interaction through a change in policy regarding the administration of ceftriaxone. Eighty-eight (61.5%) of 143 participants indicated that their institution’s official position on the notice was that it represented a “relative contraindication” (i.e., the benefit may outweigh the risk).Conclusions: Warning letters issued by the manufacturer, the FDA, and Health Canada generated concern within the Canadian hospital pharmacy community. However, a large proportion of hospital pharmacy practitioners did not agree with strict adherence to the Health Canada notice.RÉSUMÉ Contexte : En 2007, à cause d’une interaction potentielle entre la ceftriaxone et les solutions intraveineuses contenant du calcium, Roche Laboratories (fabricant de Rocephin [ceftriaxone] aux États-Unis) ont émis une mise en garde aux professionnels de la santé les informant d’une modification à la monographie du produit. Par la suite, des mises en garde ont également été émises par la Food and Drug Administration (FDA) des États-Unis et par Santé Canada. Les recommandations de Santé Canada et leurs conséquences sur la pratique clinique ont soulevé un débat au sein de la communauté de la pharmacie hospitalière.Objectif : Évaluer la réponse à la mise en garde parmi les pharmaciens d’hôpitaux et leurs établissements respectifs.Méthodes : Un sondage anonyme à participation volontaire comportant 10 questions a été remis aux membres des Réseaux de spécialistes en pharmacie de la Société canadienne des pharmaciens d’hôpitaux. Les invitations à participer au sondage ont été communiquées au moyen de deux courriels. Les réponses ont été analysées de façon descriptive.Résultats : Au total, 152 pharmaciens ont participé au sondage. Quarante-trois répondants (28,3%) ont déclaré être très préoccupés et 86 (56,6%) ont déclaré être quelque peu préoccupés par l’Avis aux hôpitaux de Santé Canada. Environ la moitié (77/152 [50,7%]) des répondants estimaient qu’il n’était pas nécessaire de suivre à la lettre l’avis de Santé Canada. Les deux-tiers (98/145 [67,6%]) ont déclaré que leur établissement avait pris des mesures contre le risque d’interaction en modifiant leur politique d’administration de la ceftriaxone. Par ailleurs, 88 (61,5%) de 143 répondants ont indiqué que la position officielle de leur établissement relativement à cet avis était que celui-ci représentait une « contre-indication relative » (c.-à-d. que les bienfaits pouvaient l’emporter sur le risque).Conclusions : Les mises en garde émises par les fabricants, par la FDA et par Santé Canada ont soulevé des inquiétudes au sein de la communauté des pharmaciens d’hôpitaux du Canada. En revanche, une forte proportion des praticiens de la pharmacie hospitalière n’étaient pas d’accord pour observer à l’avis de Santé Canada

Use of Evidence-Based Therapy at Discharge for Patients with Acute Myocardial Infarction: Retrospective Audit of Medical Records

ABSTRACTBackground: Various guidelines are available outlining optimal therapy for patients with acute myocardial infarction. Canadian institutions providing care for such patients have been encouraged to evaluate their care processes using specific indicators.Objective: To determine the proportion of patients with acute myocardial infarction discharged from a single health authority for whom acetylsalicylic acid (ASA), adrenergic &szlig;-receptor antagonists (&szlig;-blockers), angiotensin-converting enzyme (ACE) inhibitors, or 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins) had been prescribed.Methods: Patients treated over a 12-month period (April 1, 2004, to March 31, 2005) for whom the most responsible diagnosis was acute myocardial infarction were eligible for inclusion in this review. Retrieved data included diagnosis, demographic information, comorbidities, and medications at the time of admission and discharge. Rates of discharge prescribing for the 4 drug classes were calculated for all patients and for &ldquo;ideal&rdquo; patients (those without documented contraindications). Rates were compared with published benchmark values.Results: Medical records for a total of 346 eligible patients were reviewed. Mean age was 65.3 years (standard deviation 13.4 years), and 226 (65.3%) of the patients were male. The coded diagnosis was ST-elevation myocardial infarction for 91 patients (26.3%), non-STelevation myocardial infarction for 164 (47.4%), and myocardial infarction not specified for 91 (26.3%). For &ldquo;ideal&rdquo; patients, the prescribing rates were 99.0% (308 of 311 patients) for ASA, 96.3% (310 of 322 patients) for &szlig;-blockers, 90.4% (264 of 292 patients) for ACE inhibitors, and 88.8% (278 of 313 patients) for statins.Conclusions: Rates of prescribing of ASA, &szlig;-blockers, ACE inhibitors, and statins for &ldquo;ideal&rdquo; patients discharged after treatment for acute myocardial infarction exceeded the published Canadian benchmark rates (&ge; 90% for ASA, &ge; 85% for &szlig;-blockers and ACE inhibitors, &ge; 70% for statins).R&Eacute;SUM&Eacute;Contexte : Il existe diverses lignes directrices d&eacute;crivant le traitement optimal pour les patients ayant subi un infarctus aigu du myocarde. Les &eacute;tablissements de sant&eacute; canadiens qui soignent de tels patients ont &eacute;t&eacute; encourag&eacute;s &agrave; &eacute;valuer leurs processus de soins en utilisant des indicateurs pr&eacute;cis.Objectif : D&eacute;terminer la proportion de patients ayant subi un infarctus aigu du myocarde et ayant re&ccedil;u leur cong&eacute; d&rsquo;une seule r&eacute;gie de la sant&eacute; avec une prescription d&rsquo;acide ac&eacute;tylsalicylique (AAS), d&rsquo;antagoniste des r&eacute;cepteurs &beta;-adr&eacute;nergiques (&beta;-bloquant), d&rsquo;inhibiteur de l&rsquo;enzyme de conversion de l&rsquo;angiotensine (ECA) ou d&rsquo;inhibiteur de la 3-hydroxy- 3-m&eacute;thylglutaryl-coenzyme A (HMG-CoA) r&eacute;ductase (statine).M&eacute;thodes : Les patients trait&eacute;s sur une p&eacute;riode de 12 mois (entre le 1er avril 2004 et le 31 mars 2005) et dont le diagnostic le plus responsable &eacute;tait celui d&rsquo;infarctus aigu du myocarde &eacute;taient admissibles &agrave; l&rsquo;analyse. Les donn&eacute;es recueillies incluaient le diagnostic, les renseignements d&eacute;mographiques, les comorbidit&eacute;s et les m&eacute;dicaments au moment de l&rsquo;admission et du cong&eacute;. Un taux de prescription au cong&eacute; pour les quatre classes de m&eacute;dicaments a &eacute;t&eacute; calcul&eacute; pour tous les patients et pour les patients &laquo; id&eacute;aux &raquo; (ceux sans contre-indications document&eacute;es). Ces taux ont &eacute;t&eacute; compar&eacute;s aux r&eacute;f&eacute;rences optimales publi&eacute;es.R&eacute;sultats : Les dossiers m&eacute;dicaux d&rsquo;un total de 346 patients admissibles ont &eacute;t&eacute; analys&eacute;s. L&rsquo;&acirc;ge moyen des patients &eacute;tait de 65,3 ans (&eacute;cart-type de 13,4 ans) et 226 (65,3 %) des patients &eacute;taient des hommes. Le diagnostic cod&eacute; &eacute;tait un infarctus du myocarde avec &eacute;l&eacute;vation du segment ST (91 patients ou 26,3 %), un infarctus du myocarde sans &eacute;l&eacute;vation du segment ST (164 ou 47,4 %) et infarctus du myocarde non pr&eacute;cis&eacute; (91 ou 26,3 %). Pour les patients &laquo; id&eacute;aux &raquo;, les taux de prescription &eacute;taient de 99,0 % (308 des 311 patients) pour l&rsquo;AAS, de 96,3 % (310 des 322 patients) pour les &beta;-bloquants, de 90,4 % (264 des 292 patients) pour les inhibiteurs de l&rsquo;ECA et de 88,8 % (278 des 313 patients) pour les statines.Conclusions : Les taux de prescription d&rsquo;AAS, de &beta;-bloquants, d&rsquo;inhibiteurs de l&rsquo;ECA et de statines pour les patients &laquo; id&eacute;aux &raquo; ayant re&ccedil;u leur cong&eacute; apr&egrave;s le traitement de l&rsquo;infarctus du myocarde d&eacute;passaient les taux de r&eacute;f&eacute;rence canadiens publi&eacute;s (&ge; 90% pour l&rsquo;AAS, &ge; 85% pour les &szlig;-bloquants et les inhibiteurs de l&rsquo;ECA, &ge; 70% pour les statines)

ARTICLE Survey of Canadian Pharmacists ’ Responses to Warnings of Potential Interactions Between Ceftriaxone and Calcium in IV Solutions

Background: In 2007, because of a potential interaction between ceftriaxone and calcium-containing IV solutions, Roche Laboratories (manufacturer of Rocephin [ceftriaxone] in the United States) issued letters to health care professionals advising them of changes to the product monograph. Subsequently, warning letters were also issued by the US Food and Drug Administration (FDA) and Health Canada. The Health Canada recommendations and their implications for clinical practice generated debate in the Canadian hospital pharmacy community. Objective: To evaluate the response to the warnings among hospital pharmacists and their respective institutions. Methods: An anonymous, voluntary 10-question survey was distributed to members of the Pharmacy Specialty Networks of the Canadian Society of Hospital Pharmacists. Requests to participate were solicited via 2 e-mail messages. Responses were analyzed descriptively. Results: A total of 152 pharmacists participated in the survey. Fortythree respondents (28.3%) reported being very concerned and 86 (56.6%) reported being somewhat concerned about the Health Canada Notice to Hospitals. About half (77/152 [50.7%]) of the respondents felt that the Health Canada notice did not need to be strictly heeded. Two-thirds (98/145 [67.6%]) reported that their institutions had addressed the risk of an interaction through a change in policy regarding the administration of ceftriaxone. Eighty-eight (61.5%) of 143 participants indicated that their institution’s official position on the notice was that it represented a “relative contraindication ” (i.e., the benefit may outweigh the risk). Conclusions: Warning letters issued by the manufacturer, the FDA, and Health Canada generated concern within the Canadian hospital pharmacy community. However, a large proportion of hospital pharmacy practitioners did not agree with strict adherence to the Health Canada notice

ARTICLE Use of Evidence-Based Therapy at Discharge for Patients with Acute Myocardial Infarction: Retrospective Audit of Medical Records

Background: Various guidelines are available outlining optimal therapy for patients with acute myocardial infarction. Canadian institutions providing care for such patients have been encouraged to evaluate their care processes using specific indicators. Objective: To determine the proportion of patients with acute myocardial infarction discharged from a single health authority for whom acetylsalicylic acid (ASA), adrenergic ß-receptor antagonists (ß-blockers), angiotensin-converting enzyme (ACE) inhibitors, or 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins) had been prescribed. Methods: Patients treated over a 12-month period (April 1, 2004, to March 31, 2005) for whom the most responsible diagnosis was acute myocardial infarction were eligible for inclusion in this review. Retrieved data included diagnosis, demographic information, comorbidities, and medications at the time of admission and discharge. Rates of discharge prescribing for the 4 drug classes were calculated for all patients and for “ideal ” patients (those without documented contraindications). Rates were compared with published benchmark values. Results: Medical records for a total of 346 eligible patients were reviewed. Mean age was 65.3 years (standard deviation 13.4 years), and 226 (65.3%) of the patients were male. The coded diagnosis was ST-elevation myocardial infarction for 91 patients (26.3%), non-STelevation myocardial infarction for 164 (47.4%), and myocardial infarction not specified for 91 (26.3%). For “ideal ” patients, the prescribing rates were 99.0 % (308 of 311 patients) for ASA, 96.3 % (310 of 322 patients) for ß-blockers, 90.4 % (264 of 292 patients) for ACE inhibitors, and 88.8 % (278 of 313 patients) for statins. Conclusions: Rates of prescribing of ASA, ß-blockers, ACE inhibitors, and statins for “ideal ” patients discharged after treatment for acute myocardial infarction exceeded the published Canadian benchmark rates ( ≥ 90 % for ASA, ≥ 85 % for ß-blockers and ACE inhibitors, ≥ 70 % for statins)