Asset Management Plan Development for a Wastewater Treatment Plant

Indiana University - Purdue University IndianapolisThis paper offers insight on the process utilized for developing a basic asset management and maintenance program for a series of assets at a wastewater treatment plant. The wastewater treatment plant where this project was conducted did not have an existing record of its assets nor did it have any type of substantial maintenance plan in place. This ultimately hindered the plant from prolonging the life of its assets and tracking any finances spent on their maintenance and repair. Throughout the duration of this project, asset information was obtained and an asset inventory was created. Operation and maintenance manuals, as well as other supplemental information for each of the assets identified, were obtained in order to develop a substantial maintenance plan for each of the assets. The conclusion of this project resulted in a current asset inventory and a proposed maintenance plan for each of the assets identified. The project provided management at the wastewater treatment plant with a framework for the further development of their asset management plan as well as maintenance plans for any additions to their asset inventory in the future. This project provided a basic framework that allows management to continue to track maintenance and repair costs for the assets in their inventory if they choose to continue to do so. During the course of this project, management of the plant requested that all identifying information is removed. Per management’s request, all identifying information has been removed throughout this paper and all of the other deliverables that were involved in this project. Keywords: asset management, asset maintenance, asset inventory, preventative maintenance, wastewater treatment plant, maintenance plan, reactive maintenance, corrective maintenanceFacilities Management Technolog

The Blackout in Britain and Germany during the Second World War

The impact of air raid precautions in Britain and Germany has received little scholarly attention since the end of the Second World War. Of the protective measures brought about as a result of the invention of the bomber, the blackout was by far the most intrusive and extensive form of civil defence. Yet the historiography of the home front and the bombing war in Britain and Germany has tended to sideline the blackout, or else ignore it entirely. The lack of study given to the blackout is at odds with the scale of its impact across wartime society. This thesis furthers understanding of the blackout and the social history of the British and German home fronts by contextualising the blackout within the development of aviation, and its social and economic effects. It also examines the impact technology could have on the relationship between state and citizens, and addresses the lack of comparative research on Britain and Germany during the Second World War. The thesis draws on extensive research conducted in local and national government archives in Britain and Germany, as well as a wide range of secondary literature on the war and inter-war period. It argues that the blackout was a profound expansion of the state into the lives of each nation’s citizens, and though it was set within two politically very different states, it brought with it similar practical and social problems. The blackout, as the most ‘social’ form of civil defence, is an ideal aspect of the war by which to compare the British and German home fronts. Ultimately, the differences between the two countries were less important than the shared sense of obligation that the blackout principle was intended to foster within the wartime community.Arts and Humanities Research Counci

Bridging the Gap for First Generation Students (BG4FGS): An Occupation-Based Peer Mentoring Program at Dominican University of California

Attending college is a major milestone in the lives of students. The transition to college can be a challenging process for new students, particularly first-generation students, impacting their ability to meet the more rigorous academic demands and to integrate socially into the campus community (Prospero & Vohra-Gupta, 2007; Ramos-Sanchez & Nichols, 2007). To ease the transition to college, peer mentoring programs can assist new college students by offering guidance, one-on-one and group sessions, providing information about campus life and resources, and referring them to support services (Ferrari, 2004; Lennox & Leonard, 2007). The project developers collaborated with Dominican University of California to create a peer mentoring program geared specifically for its first-generation student population called Bridging the Gap for First-Generation Students or BG4FGS. We used an occupational therapy lens to help these students succeed in college by addressing areas including academic performance, social participation, occupational balance, stress management, time management, and college finances. The first outcome of this project was the development of a peer mentor training manual. Mentors received their manuals during the training program in mid-August 2012. The second outcome was the creation of group modules that were implemented during one-hour monthly sessions with the mentors and mentees in September, October, and November 2012. Overall, the mentors reported that the training program and manuals were effective in helping them understand the objectives of BG4FGS and adequately prepare them for their roles. This project has demonstrated that occupational therapy plays a vital role in consultation and training to prepare peer mentors for implementing an effective peer mentoring program, in which first-generation students at Dominican University can benefit from

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus

Background: Multiple laboratory tests are used to diagnose and manage patients with diabetes mellitus. The quality of the scientific evidence supporting the use of these tests varies substantially. Approach: An expert committee compiled evidence-based recommendations for the use of laboratory testing for patients with diabetes. A new system was developed to grade the overall quality of the evidence and the strength of the recommendations. Draft guidelines were posted on the Internet and presented at the 2007 Arnold O. Beckman Conference. The document was modified in response to oral and written comments, and a revised draft was posted in 2010 and again modified in response to written comments. The National Academy of Clinical Biochemistry and the Evidence-Based Laboratory Medicine Committee of the American Association for Clinical Chemistry jointly reviewed the guidelines, which were accepted after revisions by the Professional Practice Committee and subsequently approved by the Executive Committee of the American Diabetes Association. Content: In addition to long-standing criteria based on measurement of plasma glucose, diabetes can be diagnosed by demonstrating increased blood hemoglobin A$_{1c}$ (HbA$_{1c}$) concentrations. Monitoring of glycemic control is performed by self-monitoring of plasma or blood glucose with meters and by laboratory analysis of HbA$_{1c}$. The potential roles of noninvasive glucose monitoring, genetic testing, and measurement of autoantibodies, urine albumin, insulin, proinsulin, C-peptide, and other analytes are addressed. Summary: The guidelines provide specific recommendations that are based on published data or derived from expert consensus. Several analytes have minimal clinical value at present, and their measurement is not recommended

Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial

Background: Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events. Methods: The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627). Findings: Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29–146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0– 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25–1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39–1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65–1·60]; p=0·92). Interpretation: These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention

Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial

Background: Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events. Methods: The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627). Findings: Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29–146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0– 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25–1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39–1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65–1·60]; p=0·92). Interpretation: These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention