Gaseous emissions from herding agent-mediated in-situ burning for Arctic oil spills

Thesis (M.S.) University of Alaska Fairbanks, 2017If a crude oil spill were to occur in partially ice-covered waters, many of the response tactics typically utilized in either open water or completely ice-covered conditions would become inefficient. In such situations, in-situ burning (ISB) can prove to be an efficient response tool; herding agent application is one available approach to thicken an oil slick. This study assessed the impacts on air quality following ISB tests on crude oil, in combination with herding agents, in partially ice-infested waters. The research focused on measuring downwind concentrations of respirable particulate matter (PM₂.₅) and seven different combustion gasses (CO, CO₂, NO, NO₂, NOx, SO₂, and VOCs) during five ISB events, with sampling instruments placed in-plume and 6-12 m away from the source area. The study also investigated if the utilized herding agent was detectable in the airborne plume. Findings include: 1) Concentrations of particulate matter (<2.5μm in diameter), SO₂, and CO were found to significantly (P <0.01) exceed various exposure limits and air quality standards, while the remaining compounds measured were significantly (P <0.01) below established exposure limits. Also, downwind, in the smoke plume, measured concentrations of SO₂, NOx, and total VOCs were higher than found in previous studies. It should be noted that instrument and methods not specifically approved by the U.S. Environmental Protection Agency, Occupational Safety and Health Administration, and the National Institute for Occupational Safety and Health were utilized during this study; 2) GC/MS analysis of aerosol samples collected utilizing a flow meter and carbon sorbent tubes in the smoke plume; the Siltech OP-40 silicone based functional group of the applied herding agent was not detected in the collected samples analyzed using GC/MS. Future research should include additional scalability studies where the concentrations of particulate matter and various combustion gasses are compared to modeled concentrations using computer software. Additional research is also needed to find a cost-effective method to decrease the amount of particulate matter during an in-situ burn. It is also recommended that guidance specific for conducting in-situ burns of crude oil or refined petroleum products in the Arctic is written and published by regulatory agencies, so the industry can rapidly make plans and propose such tactics if an incident did occur where mechanical or other non-mechanical response tactics are not feasible

Screening for Distress in Ambulatory Oncology Patients: the Cope Project

The purpose of this Doctorate of Nursing Practice (DNP) Capstone Project was to identify, assess, and refer patients who are experiencing an elevated level of distress as measured by the NCCN Distress Thermometer. The goal of this project was to decrease the psychosocial distress level in patients receiving chemotherapy. The primary objective of this evidence-based practice project was to decrease distress in oncology patients. The secondary objective was to formally adopt the NCCN clinical practice guidelines for distress management in ambulatory oncology patients. The NCCN Distress Thermometer (DT) was utilized to measure the distress level of ambulatory oncology patients currently receiving chemotherapy in an outpatient infusion center. The capstone project received Institutional Review Board approval from Regis University as well as the New England Institutional Review Board and met exempt status. A total of 21 ambulatory oncology patients participated in this project. The majority of patients (57%) presented with clinical evidence of moderate to severe distress as evidenced by a distress score of \u3e4. Data analysis revealed an overall decrease in distress scores. However, there was not a statistically significant difference in individual distress scores. The NCCN Distress Thermometer facilitated the identification, assessment, and treatment of distress in ambulatory oncology patients. As a result of this project, the NCCN Distress Management clinical practice guidelines have been formally integrated into routine nursing assessments

Long-term renal outcome in children with OCRL mutations: retrospective analysis of a large international cohort

BACKGROUND: Lowe syndrome (LS) and Dent-2 disease (DD2) are disorders associated with mutations in the OCRL gene and characterized by progressive chronic kidney disease (CKD). Here, we aimed to investigate the long-term renal outcome and identify potential determinants of CKD and its progression in children with these tubulopathies. METHODS: Retrospective analyses were conducted of clinical and genetic data in a cohort of 106 boys (LS: 88 and DD2: 18). For genotype-phenotype analysis, we grouped mutations according to their type and localization. To investigate progression of CKD we used survival analysis by Kaplan-Meier method using stage 3 CKD as the end-point. RESULTS: Median estimated glomerular filtration rate (eGFR) was lower in the LS group compared with DD2 (58.8 versus 87.4 mL/min/1.73 m(2), P < 0.01). CKD stage II-V was found in 82% of patients, of these 58% and 28% had moderate-to-severe CKD in LS and DD2, respectively. Three patients (3%), all with LS, developed stage 5 of CKD. Survival analysis showed that LS was also associated with a faster CKD progression than DD2 (P < 0.01). On multivariate analysis, eGFR was dependent only on age (b = -0.46, P < 0.001). Localization, but not type of mutations, tended to correlate with eGFR. There was also no significant association between presence of nephrocalcinosis, hypercalciuria, proteinuria and number of adverse clinical events and CKD. CONCLUSIONS: CKD is commonly found in children with OCRL mutations. CKD progression was strongly related to the underlying diagnosis but did not associate with clinical parameters, such as nephrocalcinosis or proteinuria

Eculizumab treatment for rescue of renal function in IgA nephropathy.

Immunoglobulin A (IgA) nephropathy is a chronic glomerulonephritis with excessive glomerular deposition of IgA1, C3 and C5b-9, which may lead to renal failure

Strategy for instant neutralisation and metal immobilisation in ARD

Abstract For ARD filters, reactive barriers are often the methods of choice. Some problems are recognised though; iron precipitation cause hydraulic changes and inhibition of neutralising phases. Instead of filter/barrier installation alkalinity is suggested to be added in an aqueous phase (leach beds). Addition of a highly alkaline solution to different ARD results in a rapid, almost instant neutralisation, precipitation of metals (Fe, Al) as well as almost quantitative coprecipitation and sorption of trace metals at near neutral pH. Generation of alkalinity on-site, added to ARD as an aqueous phase, would be a fast and simple ARD treatment method

Eculizumab discontinuation in atypical haemolytic uraemic syndrome : TMA recurrence risk and renal outcomes

Eculizumab modifies the course of disease in patients with atypical haemolytic uraemic syndrome (aHUS), but data evaluating whether eculizumab discontinuation is safe are limited. Patients enrolled in the Global aHUS Registry who received ≥1 month of eculizumab before discontinuing, demonstrated haematologic or renal response prior to discontinuation and had ≥6 months of follow-up were analysed. The primary endpoint was the proportion of patients suffering from thrombotic microangiopathy (TMA) recurrence after eculizumab discontinuation. Additional endpoints included: estimated glomerular filtration rate changes following eculizumab discontinuation to last available follow-up; number of TMA recurrences; time to TMA recurrence; proportion of patients restarting eculizumab; and changes in renal function. We analysed 151 patients with clinically diagnosed aHUS who had evidence of haematologic or renal response to eculizumab, before discontinuing. Thirty-three (22%) experienced a TMA recurrence. Univariate analysis revealed that patients with an increased risk of TMA recurrence after discontinuing eculizumab were those with a history of extrarenal manifestations prior to initiating eculizumab, pathogenic variants or a family history of aHUS. Multivariate analysis showed an increased risk of TMA recurrence in patients with pathogenic variants and a family history of aHUS. Twelve (8%) patients progressed to end-stage renal disease after eculizumab discontinuation; seven (5%) patients eventually received a kidney transplant. Forty (27%) patients experienced an extrarenal manifestation of aHUS after eculizumab discontinuation. Eculizumab discontinuation in patients with aHUS is not without risk, potentially leading to TMA recurrence and renal failure. A thorough assessment of risk factors prior to the decision to discontinue eculizumab is essentia

Supporting health education policies: translation, cross-cultural adaptation and validation of a health literacy instrument, in French

Background: Oral health is a fundamental human right and is inseparable and indivisible from overall health and well-being. Oral Health Literacy (OHL) has been proved to be fundamental to promoting oral health and reducing oral health inequalities. To our knowledge, no OHL instrument to evaluate OHL level is currently validated in French language despite the fact it is the fifth most widely spoken languages on the planet. The Oral health literacy Instrument (OHLI) appears to be the most interesting OHL instrument to adapt into French because it is already available in English, Spanish, Russian, Malaysian, and it contains both reading comprehension and numeracy sections. Its psychometric properties have been rated as adequate. Objective: The aim of this study was to translate and adapt cross-culturally the OHLI into French, to evaluate its psychometric properties and to compare its results to oral health knowledge. Method: This study followed and applied well-established processes of translation, cross-cultural adaptation and validation, based on the recommendations of the World Health Organization guidelines and on the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) study design checklist for patient-reported outcomes. Two psychometric assessments were planned, the comparison of OHLI-F scores according to education level and frequency of dental visits, and the test-retest reliability of the OHLI-F. Results: A total of 284 participants answered the OHLI-F. The OHLI-F scores were significantly different between participants with different levels of education and frequency of dental visits (p < 0.001). Participants with an education level lower than the baccalaureate, and those who never visit the dentist or only in case of pain, had significantly lower OHLI-F scores. Internal consistency was excellent (Cronbach's alpha = 0.881-0.914). Test-retest reliability was very high (intraclass correlation = 0.985 to 0.996). Conclusion: The OHLI-F has demonstrated adequate psychometric properties and can therefore be used to measure oral health literacy in French-speaking populations

Int J Environ Res Public Health

Alcohol, a psychoactive substance with addictive potential, has major consequences on the population and public health. In France, alcohol use disorder affects approximately 3.5 million people, and 41,000 persons died in 2015. Alcohol consumption is significantly correlated to the workplace. Thus, the workplace is an area of opportunity to change risky behaviors and must play a key role in the prevention of alcohol misuse. To do this, it is essential to understand the consumption framework and to identify specific environmental risk factors. This qualitative study aims to describe the framework of alcohol consumption in the French public service. A focus group will be organized in France from November to January 2023. The participants will be: (i) representatives of the Local Health Insurance; (ii) over 18 years old; (iii) active or retired civil servants; (iv) mutualist activists; and (v) representatives of the Union of Health Prevention for the Obligatory System of the Public Service. The exclusion criteria for the study will be: (i) lack of consent form; (ii) inability to participate in the focus group, and (iii) early departure during the focus group. The focus groups will be supervised by two researchers following an interview guide. The data will be analyzed using the methodological framework, which consists in carrying out a thematic analysis. This will allow for an understanding of the sources of usage behaviors, and the identification of the most appropriate intervention functions for suitable prevention actions in order to reduce the risk of a transition to alcohol use disorder

Work context and drinking behavior in the French public service: a qualitative study

IntroductionAlcohol use disorders (AUD) are a major public health problem. Among the working population, alcohol is the most frequently used psychoactive substance, as well as the most inappropriately used. Alcohol consumption reduces the worker’s psychophysical integrity, leads to an increase in inappropriate behavior, accidents and injuries, and affects the safety and health of other workers. Thus, the workplace must play an essential role in prevention. Particularly in France, in the civil service, a specific professional sector made up of many professionals exposed to stress, the prevention of AUD must play an essential role. The objective of this study was to describe the framework of alcohol consumption in the French public service in order to understand the sources of alcohol consumption behaviors and to identify the prevention measures to be implemented, in order to reduce the risk of transition to an alcohol use disorder.MethodsThis descriptive qualitative study was based on focus groups. Sampling was purposive and data saturation was verified. Coding was “in vivo,” descriptive and pattern-oriented. Analysis was inductive thematic, and the COREQ guidelines were followed.ResultsFirstly, the presence of alcohol in the workplace has been characterized by a before-and-after a prohibition law, and by the revelation of mechanisms for avoiding the ban. Then, the three main determinants for alcohol use disorders were: society, work and personal factors. Lastly, the prevention initiatives identified must be based on both collective and individual approaches. They must be encouraged by the hierarchy, include screening, accompaniment to care, and take into account both work in the workplace and work at home. The fight against work-related alcohol use disorders must be part of the corporate culture.DiscussionPreventing alcohol-related disorders among civil servants will help fight the burden of non-communicable diseases

Learning About the History of Landscape Use for the Future: Consequences for Ecological and Social Systems in Swedish Bergslagen

Barriers and bridges to implement policies about sustainable development and sustainability commonly depend on the past development of social–ecological systems. Production of metals required integration of use of ore, streams for energy, and wood for bioenergy and construction, as well as of multiple societal actors. Focusing on the Swedish Bergslagen region as a case study we (1) describe the phases of natural resource use triggered by metallurgy, (2) the location and spatial extent of 22 definitions of Bergslagen divided into four zones as a proxy of cumulative pressure on landscapes, and (3) analyze the consequences for natural capital and society. We found clear gradients in industrial activity, stream alteration, and amount of natural forest from the core to the periphery of Bergslagen. Additionally, the legacy of top-down governance is linked to today’s poorly diversified business sector and thus municipal vulnerability. Comparing the Bergslagen case study with other similar regions in Russia and Germany, we discuss the usefulness of multiple case studies. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s13280-012-0369-z) contains supplementary material, which is available to authorized users