Treatment In Rural Areas Research Articles

A novel spatiotemporally anaerobic/semi-aerobic bioreactor for domestic solid waste treatment in rural areas

To meet the requirements of domestic solid waste treatment and technological upgrading of bioreactors, a spatiotemporally anaerobic/semi-aerobic bioreactor (STASAB) was designed. The STASAB took full advantages of anaerobic and semi-aerobic bioreactors by the sequential alternation of anaerobic and semi-aerobic operation and by recirculation of mixed leachate from different-stage bioreactors. Results indicated that after the start-up stage, the pH of leachate in the STASAB always remained higher than 6.88, even in the hydrolysis and acidogenesis stage. The maximum total nitrogen concentration in the STASAB was 1461 mg·L−1, which was merely half that of the sequentially anaerobic/semi-aerobic bioreactor (SASAB) and had no adverse effects on the anaerobic process. Nitrogen removal in the STASAB reached 92.3%–95.5% when operated in the semi-aerobic phase and even reached 49.4% when operated in the anaerobic phase. The peak concentration of chemical oxygen demand was much lower and the anaerobic digestion lag time was much shorter in the STASAB than in the SASAB. The period of rapid biogas production in the STASAB was double that of the SASAB, which resulted in a 70% increase in biogas generation. Moreover, leachate could be exhausted by evaporation in just 3–5 months during the semi-aerobic phase. Therefore, the STASAB can eliminate acidogenic and ammonia inhibition during solid waste treatment, enhance the rate and extent of organic waste decomposition, rapidly initiate methanogenesis, enhance methane generation, and achieve zero leachate discharge (excluding rainfall infiltration). The STASAB is an efficient and feasible technique for treating domestic solid waste in rural areas.

Feasibility of sand filters to wastewater treatment in rural areas in Algeria: experimental study

Feasibility of sand filters to wastewater treatment in rural areas in Algeria: experimental study

Feasibility of sand filters to wastewater treatment in rural areas in Algeria: experimental study

The treatment of domestic wastewater by sand filters is a very interesting alternative technique to collective sewerage in rural areas. In order to assess the accuracy of this technique in Algeria, a feasibility study based on a statistical survey and an experimental study is carried out. The aim of the statistical survey is to determine the potential for the application of this technique by evaluating the rate of connection to collective sewerage networks and the existence of a sewage treatment system in rural areas. The purpose of the experimental study is to assess the suitability of the local sands for this type of process. In this paper the treatment performance over time of two different sands (medium and coarse) are evaluated. The chemical analyses of wastewater and filtered water showed a removal ranges between 57% and 74% for medium sand and between 7% and 49% for coarse sand.

Overcoming Barriers to Prescribing Buprenorphine for the Treatment of Opioid Use Disorder: Recommendations from Rural Physicians.

The United States is in the midst of a severe opioid use disorder epidemic. Buprenorphine is an effective office-based treatment that can be prescribed by physicians, nurse practitioners, and physician assistants with a Drug Enforcement Administration (DEA) waiver. However, many providers report barriers that keep them from either getting a DEA waiver or fully using it. The study team interviewed rural physicians successfully prescribing buprenorphine to identify strategies for overcoming commonly cited barriers for providing this service. Interview candidates were randomly selected from a list of rurally located physicians with a DEA waiver to prescribe buprenorphine who reported treating high numbers of patients on a 2016 survey. Forty-three rural physicians, who were prescribing buprenorphine to a high number of patients, were interviewed about how they overcame prescribing barriers previously identified in that survey. Interviewed physicians reported numerous ways to overcome common barriers to providing buprenorphine treatment in rural areas. Key recommendations included ways to (1) get started and maintain medication-assisted treatment, (2) minimize DEA intrusion and medication diversion, and (3) address the lack of mental health providers and stigma surrounding opioid use disorder (OUD). Overall, physicians found providing this service to be very rewarding. Despite known barriers, rural physicians around the country have been successful in adding buprenorphine treatment to their practices. Nonprescribing providers can learn from the strategies used by successful prescribers to add this service.

Expanding access to buprenorphine treatment in rural areas with the use of telemedicine.

The opioid epidemic in the United States has resulted in a public health emergency. Medication-assisted treatment (MAT) with methadone and buprenorphine are evidence-based treatments for opioid use disorder. However, numerous barriers hinder access to treatment in rural areas. The use of telemedicine to deliver psychiatric services is demonstrated to be safe and effective; however, limited data exist on the novel application of telemedicine in the delivery of MAT. This report describes the results of a retrospective chart review of 177 patients in a rural drug treatment center that were treated with buprenorphine through telemedicine. This study evaluated a program that began providing buprenorphine treatment to patients at a drug treatment center in rural Maryland via telemedicine in August 2015. A chart review was performed of the first 177 patients who were enrolled in the program. Data were extracted to examine retention in treatment and rates of continued opioid use. Retention in treatment was 98% at 1 week, 91% at 1 month, 73% at 2 months, and 57% at 3 months. Of patients still engaged in treatment at 3 months, 86% had opioid-negative urine toxicology. Our findings suggest that treatment with buprenorphine can be effectively delivered by telemedicine to patients with opioid use disorders in a rural drug treatment program. This use of telemedicine is a potential tool to expand medication-assisted treatment to underserved rural populations. (Am J Addict 2018;XX:1-6).

Imbalanced Development and Economic Burden for Urban and Rural Wastewater Treatment in China—Discharge Limit Legislation

Water pollution control is a great challenge for China. Compared with urban regions, the wastewater treatment in rural areas is much undeveloped, which is highly related with the much delayed legislation for rural wastewater. Imbalanced urban-rural development and the economic burden of urban and rural wastewater treatment in China was investigated from the perspective of discharge limit legislation. For now, the national discharge limit for rural wastewater is still vacant, although the national discharge limit for urban wastewater had been released for more than ten years. Recently, local rural wastewater discharge limits from several provinces were released, however, based on quite different principles. Some categories emphasized environmental sensitivity with the discharge limit equal and were more strict than urban standards, while some focused on resource recovery for rural regions with loose discharge limits. This study compared the financial burden between rural and urban regions in 31 provinces under different discharge limit legislation conditions. It was revealed that the resources recovery category discharge principle helped to decrease the financial burden imbalance with a reduced Gini coefficient from 0.37 to 0.17. The reduced economic burden from the implementation of a suitably designed rural discharge limit promoted balancing the rural-urban gap and lowering uncertainties and risk of sustainable rural wastewater treatment. This study also revealed the urgency of rural water legislation and proposed development with a balanced financial burden for urban and rural residents under suitable discharge limits, providing a profound insight for environmental management with a focus on balanced urban-rural development for the policy-makers in developing countries.

Returns to Controlling a Neglected Tropical Disease: Schistosomiasis Control Programme and Education Outcomes in Nigeria

Using the rollout of the schistosomiasis campaign in Nigeria as a quasi-experiment, we examine the impact of the disease control programme on school-age children education outcomes. Schistosomiasis is a parasitic disease caused by infections from a small worm. Its most severe effects hamper growth and cognitive development of children. The mass campaign targeted four states that saw large reduction in the infectious disease afterwards. Using difference-in-differences strategy, we find that the cohort exposed to the treatment in rural areas accumulated an additional 0.6 years of education compared to cohort not exposed to the treatment. Moreover, the impact of the schistosomiasis treatment is mainly on girls residing in rural areas.

A pilot study of hybrid biological activated carbon (BAC) filtration-ultrafiltration process for water supply in rural areas: role of BAC pretreatment in alleviating membrane fouling

For decentralized drinking water treatment in rural areas, a hybrid process of biological activated carbon (BAC) filtration and ultrafiltration (UF) was applied to obtain potable water.

Vitellogenin concentrations in feral Danish brown trout have decreased: An effect of improved sewage treatment in rural areas?

Feminization of male and juvenile fish because of exposure to estrogens or estrogenic chemicals in effluents from central wastewater treatment plants (WWTPs) is a worldwide issue of concern. Intersex and induction of the female yolk protein, vitellogenin, in male and juvenile fish are robust biomarkers for estrogenic exposure, and feminized fish have been observed downstream of WWTP outlets in many countries. Danish central WWTPs reduce effluent estrogenicity effectively by advanced sewage treatment, and feminizations have not been observed downstream of central WWTP outlets. However, between 2000 and 2004, investigations of Danish streams not receiving sewage from central WWTPs revealed a high variation in vitellogenin concentrations of male juvenile brown trout (Salmo trutta); some individuals had high concentrations, probably as a result of estrogenic point sources, and the plasma concentration was >50 ng mL-1 in 79% of the juvenile males. The streams were reinvestigated in 2010 to 2016, and the average male level had decreased to a hitherto unseen baseline level; in 2010 only 0.7% (one individual) of the males had a vitellogenin concentration >50 ng mL-1 , which could indicate that the estrogenicity of the streams decreased after 2004. We examined possible estrogenic sources in streams unaffected by central WWTP effluents, and found that the reduced vitellogenin levels are most likely explained by a national effort to improve on-site wastewater treatment in scattered houses not connected to central WWTPs. Environ Toxicol Chem 2018;37:839-845. © 2017 SETAC.

The patient and the crossing between Primary and Hospital care. Systematic review of trials for the implementation of tools for integration in Spain

Health services are moving towards a complete integration to try and reduce fragmentation, increase efficiencies and improve health outcomes. Estimates the effectiveness in of different tools for integrated care in Spain. We performed a systematic review of articles using MEDLINE (last search July31st, 2017). Randomized clinical trials reporting health outcomes of tools for integrated care used in Spain were included. Studies were appraised for quality using the Cochrane Risk of Bias assessment. Twenty studies met the criteria for the systematic review. Interventions included were hospital-at home (four studies, 455 patients), outpatient clinic by videoconference (three studies, 2438 patients), nurse navigator (four studies, 1051 patients), self-care improvement (four studies, 1291 patients), at-home health monitoring (three, 162), health apps (two, 225) and medical reconciliation (one, 172). Hospital-at-home, nurse navigator or self-care improvement reduced readmission rate in older patients, heart failure (HF) or chronic obstructive pulmonary disease (COPD). Self-care improvement and nurse navigator reduced mortality rate in HF. Hospital-at-home reduced hospital stay in COPD. Self-care improvement reduced outpatient visits in asthma patients. Outpatient video by videoconference reduced time to diagnosis and treatment in rural areas. The quality of the evidence ranged from low to very low for all the outcomes because it was based in double or triple downgraded randomized trials. The implementation of tools for integrated care in Spain improved some outcomes of relevance in patients with chronic conditions, although evidence is low. Self-care improvement stood out due to the improvements made.

Constructing Slow Sand Filters: Engineering Students’ Experiences in San José de Playón, Bolívar, Colombia

Sol Park, Sanyukta Gokhale, and Kaylyn Colinco were members of a Global Design Team (GDT) involved in providing innovative solutions to drinking water treatment in rural areas of developing countries. The immediate goal of the GDT in May 2016 was to deliver large slow sand filters (SSFs) to a rural school in Colombia. The experience placed the students in a small town 80 km (~50 miles) south of Cartagena, Colombia, called San José de Playón. The town pumps water from the Arroyo Reservoir, which is then consumed by the citizens and students at the local school (the only one in town) without any treatment. Students and faculty at the University of Cartagena hosted the GDT to work with the school for a week. The project consisted of building the SSFs and teaching the school staff about disinfection methods. The simple yet smart design of the SSFs was ideal for teachers and children at the school, but collaborative work with NGOs and local community leaders will be necessary to provide clean water for years to come. From speaking rudimentary Spanish with the schoolchildren, to drying the sand and constructing the actual filters, every step of the project was enriching. The experience raised awareness and compassion for all humanity, sharing what can be shared for the benefit of the greater global community, and the notion that all people are one entity regardless of ethnic, cultural, and socioeconomic backgrounds.

Expanding the Mental Health Workforce in China: Narrowing the Mental Health Service Gap.

There is a significant gap between mental health service coverage and the need for these services in China. In particular, workforce shortages impair several aspects of China's national mental health service system, including access to timely diagnosis and treatment in rural areas, expansion of general hospital psychiatric consultation-liaison services, and leadership in establishing a collaborative stepped-care system. This column focuses on China's ongoing efforts to develop its mental health workforce to ensure a sustainable supply of psychiatrists and allied mental health professionals.

Arsenic(V) Removal from Drinking Water by Polyaluminum Chloride in a Sand Filter Medium

AbstractArsenic-containing groundwater is used normally as drinking water after treatment in rural areas of some developing countries. This study describes removing arsenate [As(V)] by contact filt...

Study on a stepped eco-filter for treating greywater from single farm household

A stepped eco-filter based greywater treating facility was built on-site in a typical farm house of China. This study was aimed to investigate the hydraulic loading rate (HLR) for the optimal removal efficiency and to analyze the processing performance throughout an entire year. The results showed that, the average value of TP from the influent was much lower while the linear alkylbenzene sulfonate was a little higher compared with other related studies. The removal rates of the indexes were all showed a distinct decline and dropped to a low level while the HLR was raised from 0.2 m3/(m2 day) to 0.4 m3/(m2 day). Therefore, the optimal HLR of the process ought to be in the range of 0.2–0.4 m3/(m2 day). The average system removal rates in summer were all higher than that in winter, but the facility still performed well in winter. Clogging has never occurred in the facility during the operation over an entire year. Together with the good performance, advantaged of lower cost and easier maintenance, this process has shown good applicability for greywater treatment in rural area.

Mental health treatment seeking patterns and preferences of Appalachian women with depression.

This qualitative study explored social-cultural factors that shape treatment seeking behaviors among depressed rural, low-income women in Appalachia-a region with high rates of depression and a shortage of mental health services. Recent research shows that increasingly rural women are receiving some form of treatment and identifying their symptoms as depression. Using purposive sampling, investigators recruited 28 depressed low-income women living in Appalachian Kentucky and conducted semistructured interviews on participants' perceptions of depression and treatment seeking. Even in this sample of women with diverse treatment behaviors (half reported current treatment), participants expressed ambivalence about treatment and its potential to promote recovery. Participants stressed that poor treatment quality-not merely access-limited their engagement in treatment and at times reinforced their depression. While women acknowledged the stigma of depression, they indicated that their resistance to seek help for their depression was influenced by the expectation of women's self-reliance in the rural setting and the gendered taboo against negative thinking. Ambivalence and stigma led women to try to cope independently, resulting in further isolation. This study's findings reiterate the need for improved quality and increased availability of depression treatment in rural areas. In addition, culturally appropriate depression interventions must acknowledge rural cultural values of self-reliance and barriers to obtaining social support that lead many women to endure depression in isolation. (PsycINFO Database Record

Wastewater Treatment in Chinese Rural Areas

In the last 10 years, the extent of wastewater treated in China has increased by 57%, the great amounts of sewage have threatened people's health as well the natural environment. In the last 10 years, the sewage treatment rate has improved, in December 2013, 99.1% of Chinese cities and 82.6% counties have sewage treatment plants. This review paper describes the current situation and has suggestion of how to overcome future sewage problems especially water pollution in China from domestic, agriculture and industrial sectors. It also discusses the urban/ rural wastewater for treatment including sewerage systems, treatment plants and water quality standards in China. The paper highlights the challenges of effective wastewater treatment in rural areas as a particular issue due to lack of monitoring and law support. This has led to ineffective management of treatment plants, financial difficulties; inappropriate sewerage, treatment facilities and standards; as well as poor awareness.

Enhanced long-term organics and nitrogen removal and associated microbial community in intermittently aerated subsurface flow constructed wetlands

The long-term enhanced removal efficiency of organics and nitrogen in subsurface flow constructed wetlands (SSF CWs) with and without intermittent aeration for decentralized domestic wastewater was evaluated, and the function of intermittent aeration on microbial community was also investigated in this study. The high and long-term 95.6% COD, 96.1% NH4+-N and 85.8% TN removal efficiencies were achieved in experimental intermittently aerated SSF CW compared with non-aerated SSF CW. Aerated SSF CWs also exhibited the excellent removal performance when comparatively comparing with other strategies and techniques applied in CWs. In addition, fluorescence in situ hybridization (FISH) analysis revealed that associated microbial abundance significantly increased owing to intermittent aeration. These results indicated intermittent aeration CWs might be an effective and sustainable strategy for wastewater treatment in rural areas, but require further full-scale investigation in future.

Impacts of different media on constructed wetlands for rural household sewage treatment

Constructed wetland systems have been used for treating a variety of household and industrial wastewater; they are a wastewater treatment technology that has high economic efficiency and environmental effectiveness, especially for sewage treatment in rural areas. Medium filler plays an important role in wetland sewage treatment processes. By carrying out a problem analysis of the ineffective operation and treatment of traditional wetlands, this paper designs different constructed wetland fillers to treat rural household sewage. Using the same plants, this paper chooses four different fillers, namely maifanite, steel slag, bamboo charcoal and limestone as substrates to build constructed wetland systems, and studies rural household sewage treatment in order to examine their effects on the degradation of pollutants. The results show the removal efficiencies obtain good effect. The theoretical maximum adsorption capacities of all these media are ordered as: maifanite > steel slag > bamboo charcoal > limestone. The effluent water quality meets the first class A standard of the “Discharge standard of pollutants for municipal wastewater treatment plant” (GB18918-2002). The selection of medium has an important significance for the operating results of constructed wetland sewage treatment systems.

Outcome of treatment seeking rural gamblers attending a nurse-led cognitive-behaviour therapy service: A pilot study

ObjectivesLittle is known about the differences between urban and rural gamblers in Australia, in terms of comorbidity and treatment outcome. Health disparities exist between urban and rural areas in terms of accessibility, availability, and acceptability of treatment programs for problem gamblers. However, evidence supporting cognitive-behaviour therapy as the main treatment for problem gamblers is strong. This pilot study aimed to assess the outcome of a Cognitive-Behavioural Therapy (CBT) treatment program offered to urban and rural treatment-seeking gamblers. MethodsPeople who presented for treatment at a nurse-led Cognitive-Behavioural Therapy (CBT) gambling treatment service were invited to take part in this study. A standardised clinical assessment and treatment service was provided to all participants. A series of validated questionnaires were given to all participants at (a) assessment, (b) discharge, (c) at a one-month, and (d) at a 3-month follow-up visit. ResultsDifferences emerged between urban and rural treatment-seeking gamblers. While overall treatment outcomes were much the same at three months after treatment, rural gamblers appeared to respond more rapidly and to have sustained improvements over time. ConclusionThis study suggests that rural problem gamblers experience different levels of co-morbid anxiety and depression from their urban counterparts, but once in treatment appear to respond quicker. ACBT approach was found to be effective in treating rural gamblers and outcomes were maintained. Ensuring better availability and access to such treatment in rural areas is important. Nurses are in a position as the majority health professional in rural areas to provide such help.

Vinegar-amended anaerobic biosand filter for the removal of arsenic and nitrate from groundwater

The performance of a vinegar-amended anaerobic biosand filter was evaluated for future application as point-of-use water treatment in rural areas for the removal of arsenic and nitrate from groundwater containing common ions. Due to the importance of sulfate and iron in arsenic removal and their variable concentrations in groundwater, influent sulfate and iron concentrations were varied. Complete removal of influent nitrate (50 mg/L) and over 50% removal of influent arsenic (200 μg/L) occurred. Of all conditions tested, the lowest median effluent arsenic concentration was 88 μg/L. Iron removal occurred completely when 4 mg/L was added, and sulfate concentrations were lowered to a median concentration <2 mg/L from influent concentrations of 22 and 50 mg/L. Despite iron and sulfate removal and the establishment of reducing conditions, arsenic concentrations remained above the World Health Organization's arsenic drinking water standard. Further research is necessary to determine if anaerobic biosand filters can be improved to meet the arsenic drinking water standard and to evaluate practical implementation challenges.