Periphyton communities as biological polishing agents in mine waste waters and the precipitation process in tailings : final report.

Work on this project was conducted under the auspices of the Canada Centre for Mineral and Energy Technology, Energy, Mines and Resources Canada. DSS file no.: 028SQ.23440-0-9182; DSS contract no.: 23440-0-9182/01SQ; CANMET project no.: 9182; CANMET scientific authority: Ron McCready.Ecological Engineering as a decommissioning technology for acid-generating waste material from base metal mine sites is being developed on a site in northern Ontario. A zinc/copper concentrator operated 65 km northeast of Ear Falls for 10 years, producing about 760,000 short tons of tailings, covering 20 ha, and containing 41 % pyrite and 4 % pyrrhotite. The tailings are situated above a lake which has acidified during the life of the mine. Since 1986 the site has been investigated intensively. This report represents the last detailed investigation of the hydrology and geochemistry, concentrating on the oxidation and iron precipitation rates which occur in the tailings mass. These rates define the rate at which the contaminants are released. The released contaminants entering the acidified lake are removed in this Ecological Engineered system mainly by different groups of attached algae. A literature review was carried out to provide a technical framework for biological removal processes taking place on the site. Water samples collected from piezometers in 1990 were used to confirm that several precipitation processes could take place in the tailings mass or in the surface water receiving AMD seepage. All piezometer samples show super-saturation with respect to several iron minerals, including ferric hydroxides, aoethite, hematite, letidocrocite, and maanetite, which may be precipitated. Super-saturation with respect to iarosite is shown only by samples from 2 piezometers and Mill Pond. Samples from piezometers M4 and M10 (and from Mill Pond and Boomerang Landing) show super-saturation with respect to several aluminum minerals, including alunite, boehmite, diawore, gibbsite, and several clay minerals. Samples from piezometers M7B, MI 0, M25, M30, M47, M55, Mill Pond, and Dave's Dam show super-saturation with respect to quartz; those from M7B, MI 0, and M47 also show super-saturation with respect to gypsum. Revised sulphide-oxidation rates for the South Bay tailings range from 0.0001 to 0.0427 mol.kg" .yi' (overall average 0.0033 mol.kg-'.yi'). Revised Fe-precipitation rates range from 0.000009 to 0.001 135 mol.kg-'.yr-' (overall average 0.00025 mol.kg-'.yr-'). The literature review on periphytic algae indicated that algal growth rate data in acidic metal rich waters are scarce. However, the tolerance mechanisms of periphytic algal groups which facilitate growth and metal removal from the water were evident. Extracellular carbon in the form of sheaths or jelly is produced in response to metal and acid stress by the algal population. Extracellular carbon production is not only related to metal and acid stress, but also to low nutrients (P and N) in the water or plants. It was concluded that periphytic algae, given their biological polishing characteristics, will indeed prove to be an important contaminant removal process within the Ecological Engineering technology. Research is required to define the conditions which facilitate growth of periphytic algae, and which of the contaminant removal processes (biosieving, uptake, ad/absorption) is the main contaminant removal process. With this information, predictions on the contaminant removal capacity of the system can be made. With the contaminant release rates determined here, the overall effectiveness of biological polishing as a process can be determined

Perceptions of involvement in advance care planning and emotional functioning in patients with advanced cancer

Purpose: Advance Care Planning (ACP) is positively associated with the quality of care, but its impact on emotional functioning is ambiguous. This study investigated the association between perceptions of ACP involvement and emotional functioning in patients with advanced cancer. Methods: This study analyzed baseline data of 1,001 patients of the eQuiPe study, a prospective, longitudinal, multicenter, observational study on quality of care and quality of life in patients with advanced cancer in the Netherlands. Patients with metastatic solid cancer were asked to participate between November 2017 and January 2020. Patients’ perceptions of ACP involvement were measured by three self-administered statements. Emotional functioning was measured by the EORTC-QLQ-C30. A linear multivariable regression analysis was performed while taking gender, age, migrant background, education, marital status, and symptom burden into account. Results: The majority of patients (87%) reported that they were as much involved as they wanted to be in decisions about their future medical treatment and care. Most patients felt that their relatives (81%) and physicians (75%) were familiar with their preferences for future medical treatment and care. A positive association was found between patients’ perceptions of ACP involvement and their emotional functioning (b=0.162, p<0.001, 95%CI[0.095;0.229]) while controlling for relevant confounders. Conclusions: Perceptions of involvement in ACP are positively associated with emotional functioning in patients with advanced cancer. Future studies are needed to further investigate the effect of ACP on emotional functioning. Trial registration number: NTR6584 Date of registration: 30 June 2017 Implications for Cancer Survivors: Patients’ emotional functioning might improve from routine discussions regarding goals of future care. Therefore, integration of ACP into palliative might be promising

Cigarette smoking, disease severity and autoantibody expression in African Americans with recent-onset rheumatoid arthritis

To examine the association of smoking with clinical and serologic features in African Americans with recent-onset rheumatoid arthritis (RA) and to explore whether this association is dependent on the presence of the HLA-DRB1 shared epitope (SE)

Pattern and quality of care of cancer pain management. Results from the Cancer Pain Outcome Research Study Group

Most patients with advanced or metastatic cancer experience pain and despite several guidelines, undertreatment is well documented. A multicenter, open-label, prospective, non-randomised study was launched in Italy in 2006 to evaluate the epidemiology, patterns and quality of pain care of cancer patients. To assess the adequacy of analgesic care, we used a standardised measure, the pain management index (PMI), that compares the most potent analgesic prescribed for a patient with the reported level of the worst pain of that patient together with a selected list of clinical indicators. A total of 110 centres recruited 1801 valid cases. 61% of cases were received a WHO-level III opioid; 25.3% were classified as potentially undertreated, with wide variation (9.8–55.3%) according to the variables describing patients, centres and pattern of care. After adjustment with a multivariable logistic regression model, type of recruiting centre, receiving adjuvant therapy or not and type of patient recruited (new or already on follow-up) had a significant association with undertreatment. Non-compliance with the predefined set of clinical indicators was generally high, ranging from 41 to 76%. Despite intrinsic limitations of the PMI that may be considered as an indicator of the poor quality of cancer pain care, results suggest that the recourse to WHO third-level drugs still seems delayed in a substantial percentage of patients. This delay is probably related to several factors affecting practice in participating centres and suggests that the quality of cancer pain management in Italy deserves specific attention and interventions aimed at improving patients' outcomes

Cancer specialist nurses’ perspectives of physical activity promotion and the potential role of physical activity apps in cancer care

Purpose: The purpose of this study was to understand breast, prostate and colorectal cancer Clinical Nurse Specialists’ (CNSs) perspectives on physical activity (PA) promotion and the role of smartphone apps to support PA promotion in cancer care. Methods: CNSs working in breast, prostate or colorectal cancer were recruited via advertisements distributed by professional organisations. In-depth semi-structured telephone interviews were conducted and analysed using thematic analysis. Results: 19 CNSs participated. The analysis resulted in 4 themes regarding CNSs’ perspectives of PA promotion within cancer care: i) policy changes in survivorship care have influenced CNSs’ promotion of PA; ii) CNSs recognise their role in supporting PA but sit within a wider system necessary for effective PA promotion; iii) CNSs use several techniques to promote PA within their consultations; iv) remaining challenges in PA promotion. The analysis resulted in 3 themes regarding CNSs’ perspectives on the use of apps to promote PA within cancer care: i) the influence of apps on access to PA support; ii) the role of apps in self-directed PA; iii) implementing apps in cancer care. Conclusions: The results of this study provide valuable insight into the CNS role and provide a number of important considerations for the development and implementation of PA interventions within cancer care, with a specific focus on smartphone-based interventions. Implications for cancer survivors: CNSs play an important role in PA promotion in cancer care and this research can inform the development of PA interventions delivered via smartphone app for people affected by cancer

Access to pain treatment as a human right

<p>Abstract</p> <p>Background</p> <p>Almost five decades ago, governments around the world adopted the 1961 Single Convention on Narcotic Drugs which, in addition to addressing the control of illicit narcotics, obligated countries to work towards universal access to the narcotic drugs necessary to alleviate pain and suffering. Yet, despite the existence of inexpensive and effective pain relief medicines, tens of millions of people around the world continue to suffer from moderate to severe pain each year without treatment.</p> <p>Discussion</p> <p>Significant barriers to effective pain treatment include: the failure of many governments to put in place functioning drug supply systems; the failure to enact policies on pain treatment and palliative care; poor training of healthcare workers; the existence of unnecessarily restrictive drug control regulations and practices; fear among healthcare workers of legal sanctions for legitimate medical practice; and the inflated cost of pain treatment. These barriers can be understood not only as a failure to provide essential medicines and relieve suffering but also as human rights abuses.</p> <p>Summary</p> <p>According to international human rights law, countries have to provide pain treatment medications as part of their core obligations under the right to health; failure to take reasonable steps to ensure that people who suffer pain have access to adequate pain treatment may result in the violation of the obligation to protect against cruel, inhuman and degrading treatment.</p

Assessment of seepage characteristics waste rock pile and holding pond : Hope Brook Gold Mines Ltd.

In fulfillment of Purchase Order No. 03549Report examines the acid mine drainage from the Hope Brook waste-rock pile and seepage into creeks from the pile and a holding pond