Associate Specialist Research Articles

Best Practice Guide on the Control of Iron and Manganese in Water Supply

This Best Practice Guide on the Control of Iron and Manganese in Water Supply is one of a series produced by the International Water Association's Specialist Group on Metals and Related Substances in Drinking Water. Iron and manganese are often found in soft upland water sources associated with natural organic matter and are also commonly found in the groundwaters abstracted from confined and unconfined aquifers. The presence of iron and manganese in water is one of the most frequent reasons for customers' complaint due to aesthetic issues (yellow, brown and black or stains on laundry and plumbing fixtures). These two metals can be removed fairly readily by physico-chemical treatment. The municipal treatment systems deployed derive benefit from their larger scale, particularly in relation to control, but the processes used are less suitable for the numerous small supplies that are the most common water supplies throughout Europe especially in rural areas. One important source of iron in drinking water is from old corroded cast-iron water mains, historically the material used most commonly in supply networks. Replacement and refurbishment is very expensive and the major challenge is how best to prioritize available expenditure. The purpose for this Best Practice Guide on the Control of Iron and Manganese in Water Supply is to give readers the broad view of a problem based on state-of-the-art compilation of the range of scientific, engineering, regulatory and operational issues concerned with the control of iron and manganese in drinking water. The Guide will be of interest to water utility practitioners, health agencies and policy makers, as well as students on civil engineering and environmental engineering courses. This title belongs to Best Practice Guides on Metals and Related Substances in Drinking Water. . ISBN: 9781780400747 (eBook) ISBN: 9781780400044 (Print)

Best Practice Guide on Metals Removal from Drinking Water by Treatment

The EU Drinking Water Directive sets a range of standards for metals and related substances in drinking water, many of which are concerned with health protection. A number of these standards are very stringent and require compliance to be assessed at the point of use. Because of the difficulties associated with monitoring, historic practices in many countries have concentrated on the quality of water within the distribution network. As a result, the magnitude of problems with some metals and related substances in drinking water is not fully appreciated in all European countries, and the extent and nature of corrective actions differ widely. This Best Practice Guide on Metals Removal From Drinking Water By Treatment describes drinking water standards and regulations, and explains the impact of a range of water treatment processes on metal levels in drinking water. Its objectives are to provide a basis for assessing the extent of problems and to identify appropriate water treatment options. The Guide provides a reasoned guide to selection of key water treatment processes. Each chapter focuses on a specific water treatment process and has been written by experts in that particular process. Best Practice Guide on Metals Removal From Drinking Water By Treatment provides practice-based knowledge for water engineers and scientists in large and small water utilities, regulatory agencies, health agencies and local municipalities (from cities through to small rural communities). It also supports university level teaching in degree schemes that relate to water management. This title belongs to Best Practice Guides on Metals and Related Substances in Drinking Water . This Guide is one of a series produced by the International Water Association's Specialist Group on Metals and Related Substances in Drinking Water. The series is an up-to-date compilation of a range of scientific, engineering, regulatory and operational issues concerned with the control and removal of metals from drinking water ISBN: 9781843393849 (Print) ISBN: 9781780400686 (eBook)

Do trainee surgeons really take that much longer when operating in day-case surgery?

s / International Journal of Surgery 10 (2012) S53–S109 S76 ABSTRACTS 0610: DO TRAINEE SURGEONS REALLY TAKE THAT MUCH LONGER WHEN OPERATING IN DAY-CASE SURGERY? Ahmed M. El-Sharkawy, Elena Theophilidou, John W. Quarmby. Royal Derby Hospital, Derby, UK Aim: Theatre time pressures may prevent trainees from taking the lead when operating and this can impact on their training. We aim to assess the operating time taken by trainee surgeons in the Day-Case Surgical Unit (DSU). Method: Operative Room Management Information System records for DSU were reviewed between December 2007-2008 and 2010-2011 at the Royal Derby Hospital. Data was collected on operating times for general surgical cases and compared between consultants, associate specialists (AS) and trainees. Results: The total number of open hernia procedures performed was 772 by consultants, 398 by AS and 97 by trainees. The mean time for all open hernia surgery in minutes was 38.8 for consultants, 34.2 for AS and 41.2 for trainees. Sub-group analysis demonstrated similar trends. Furthermore, operative time in minutes for excision of benign lesions was 18.5 for consultants, 13.5 for AS and 21.5 for trainees. Similar results were demonstrated when comparing other day-case procedures including laparoscopic cholecystectomy. Conclusions: The results show that there are little differences in operating times, particularly when trainees perform appropriately selected cases. DSU provides the perfect setting for trainees to perform appropriately selected procedures on relatively uncomplicated patients in order to develop and practice their operative skills. 0616: THE IMPORTANCE OF CONSULTANT-LED SUPERVISION AND TRAINING IN EMERGENCY COLOSTOMY FORMATION Pritesh Morar, Riaz Agha, John Meyrick-Thomas. West Hertfordshire NHS Trust, Vicarage Road, Watford, Hertfordshire, UK Aim: We performed an audit systematically analysing the early incidence of problematic stomas at our district general hospital. The aim of the audit was to quantify our incidence of problematic stomas, attribute causative factors, highlight awareness and implement change. Method: The standard* showed 66% of stomas were healthy and 34% were problematic nationwide. A problematic stoma was defined by complications within 3 weeks of surgery, requiring one or more accessories. Retrospective evaluation of 41 patients’ notes over a six month period yielded the following data: the type of operation; elective or emergency; consultant or trainee performed; and stoma-related outcome. Results: Of the 16 end colostomies produced: 25% were healthy and 75% were problematic. Retraction compromised 75% of problematic end colostomies; problematic stomas were noted in trainee (79%) verses consultant (30%) constructions, emergency (65%) verses elective (29%) constructions, with Hartmann's procedures (50%) in the presence of diverticular disease (80%). Conclusion: In conclusion, a higher incidence of end colostomy retraction following Hartmann's procedures performed by unsupervised trainees in the emergency setting exists. Consultant supervision in such settings is vital, providing additional experience in tension-free stoma formations. *Standard from National Audit of Stoma Complications within 3 weeks of Surgery, (Cottam and Richards 2006) 0619: ARE MEDICAL TRAINEES FOLLOWING BEST PRACTICE GUIDELINES WHEN PERFORMING ARTERIAL BLOOD GAS SAMPLING ON ACUTE SURGICAL PATIENTS? MATHURI SAKTHITHASAN, MICHAEL MAGRO , AKLAK CHOUDHURY, ROBERT FOWLERQUEEN'S HOSPITAL. BARKING, HAVERING AND REDBRIDGE UNIVERSITY HOSPITALS NHS TRUST, ROMFORD, UNITED KINGDOM Mathuri Sakthithasan, Michael Magro, Aklak Choudhury. Queens Hospital,

Best Practice Guide on the Control of Lead in Drinking Water

The Best Practice Guide on the Control of Lead in Drinking Water brings together, for the first time, all of the regulatory, health, monitoring, risk assessment, operational and technological issues relevant to the control of lead in drinking water. Its focus is Europe and North America and the Guide benefits from the input of an international research network involving 28 countries. A large range of illustrative examples and case studies are provided. The Guide will be of interest to scientists, engineers, regulators and health specialists who are involved in the provision of safe drinking water.The reader will gain a comprehensive understanding of how to assess lead in drinking water problems, both in the water supply systems that serve a City, Town or rural area and at individual properties, dependent on their knowledge of pipe-work circumstances and water quality. Options for corrective action are outlined and their strengths and weaknesses explained, with information on costs and environmental impact. The reader should then be able to develop a strategy for controlling lead in drinking water in their area, establish an appropriate monitoring programme, select the right combination of corrective measures, and define the level of risk reduction that will likely be achieved.The Best Practice Guide provides a succinct compilation of the wide range of issues that relate to lead in drinking water, at a time when the regulations are under review in both Europe and North America. It will also be very relevant to all those implementing the Protocol on Water and Health, as lead in drinking water has recently been adopted as one of the key issues requiring assessment, improvement planning and reporting.The key features are:For the first time, all the complex inter-related aspects of lead in drinking water have been brought together.The detailed explanations given on sampling and monitoring should avoid mistakes being repeated.The information on optimising corrective treatment measures is the most comprehensive to date.The Best Practice Guide will facilitate the protection of water consumers from lead contamination and reduce associated health risks.This Guide is one of a series produced by the International Water Association's Specialist Group on Metals and Related Substances in Drinking Water. It is a state-of-the-art compilation of the range of scientific, engineering, regulatory and operational issues concerned with the control of lead in drinking water.This title belongs to Best Practice Guides on Metals and Related Substances in Drinking Water.ISBN: 9781843393696 (Print)ISBN: 9781780401546 (eBook)

British Accounting Association's Special Interest Group On Accounting Education Annual Prize 2007

The British Accounting Association's Special Interest Group (BAA-SIG) on Accounting Education offers an annual prize for the best paper published in each volume of Accounting Education: an internat...

Vitreous haemorrhage without obvious cause: national survey of management practices.

We undertook a national survey to establish the management of dense vitreous haemorrhage without obvious cause. Cross-sectional anonymous self-reporting survey of ophthalmic practitioners within three target groups: vitreoretinal specialists (VRS), nonvitreoretinal specialists (NVRS), and associate specialists (AS). Presentation of the hypothetical scenario of a patient presenting with recent onset (fresh) vitreous haemorrhage with no retinal view and no apparent cause on history taken at presentation. The relative importance assigned by respondents to eight examination techniques at presentation. The proportion of respondents stating that they would review patients and perform B-scan examination at or prior to 2 weeks after presentation. The stated time to surgical intervention by VRS, and the time to referral by NVRS and AS. VRS ranked B-scan examination higher than AS (P<0.001). A total of 98.1% of VRS indicated that they would next review patients within 2 weeks of presentation, this figure fell to 86.5% for NVRS and 47% for AS (P<0.001). A 98.1% of VRS indicated that they would next perform B-scan ultrasound within 2 weeks of presentation, this figure fell to 88.9% for NVRS and 70.6% for AS (P<0.001). The mean time to surgical intervention by VRS was 9.5 weeks without retinal tear demonstrated on B-scan, 1.7 weeks with retinal tear demonstrated on B-scan and 1 week with retinal detachment demonstrated on B-scan. The mean time to referral by NVRS was 6.7 weeks and by AS was 11.9 weeks. Vitreoretinal specialists considered B-scan the most important examination tool, and typically perform B-scan early and frequently after presentation. Non-VR ophthalmologists (particularly associate specialists) review patients and perform B-scan ultrasound later and less often than vitreoretinal specialists. We recommend early referral to VR specialists, as reported referral even in uncomplicated cases would often be outside the timeframe within which VR specialists would typically choose to operate.

Report on the Inaugural Meeting of the Laboratory Animal Science Association's Specialist Section on Transgenic Animals, The Wellcome Institute -- 27th September 1996

Report on the Inaugural Meeting of the Laboratory Animal Science Association's Specialist Section on Transgenic Animals, The Wellcome Institute -- 27th September 1996

AUSTRALIAN MEDICAL ASSOCIATION SPECIAL MEETING OF FEDERAL COUNCIL

AUSTRALIAN MEDICAL ASSOCIATION SPECIAL MEETING OF FEDERAL COUNCIL