Social work in a hospital emergency department

This paper describes how a Hospital Social Work Department's Emergency Team has attempted to provide a crisis and out-of-hours service to its Emergency Department. Through a staffing commitment to extensive evening and weekend cover, the Emergency Team's social worker is able to provide an immediate intervention and assessment service to problems. This has resulted in early detection and treatment of the non-medical aspects of a patient's problem and appropriate referral to other agencies for longer-term follow-up.

Hospital social work in Australia: Emerging trends or more of the same?

Social work in health care has been established for more than 100 years and is one of the largest areas of practice for social workers. Over time, demographic changes and growth in the aging population, increased longevity rates, an explosion in rates of chronic illness together with rapidly increasing cost of health care have created serious challenges for acute hospitals and health social workers. This article reviews the Australian health care system and policies with particular emphasis on the public hospital system. It then examines current hospital social work roles, including the continued role in discharge planning and expanding responsibility for emerging client problems, such as patient complexity, legal, and carer issues. The article concludes with a discussion of evolving issues and challenges facing health social work to ensure that social work remain relevant within this practice context.

Training for reduction of design waste

Construction and demolition (C&D) waste have negative impacts on the environment. As a significant proportion of C&D waste is related to the design stage of a project, there is an opportunity for architects to reduce the waste. However, research suggests that many architects often do not understand the impact of their design on waste generation. Training and education are proposed by current researchers to improve architects’ knowledge; however, this has not been adequately validated as a viable approach to solving waste issues. This research investigates architects’ perceptions towards waste management in the design phase, and determines whether they feel they are adequately skilled in reducing C&D waste. Questionnaire surveys were distributed to architects from 98 architectural firms and 25 completed surveys were returned. The results show that while architects are aware of the relationship between design and waste, ‘extra time’ and ‘lack of knowledge’ are the key barriers to implementing waste reduction strategies. In addition, the majority of respondents acknowledge their lack of skill to reduce waste through design evaluation. Therefore, training programmes can be a viable strategy to enable them to address the pressing issue of C&D waste reduction.

Toxicant distributions and impact models in environmental risk analysis of waste sites

Myrkyllisten aineiden jakaumat ja vaikutusmallit jätealueiden ympäristöriskien analyysissä.

Pain measurement and management in elderly patients : Clinical studies in long term hospital care and after cardiac surgery

The proportion of patients over 75 years of age, receiving all different types of healthcare, is constantly increasing. The elderly undergo surgery and anaesthetic procedures more often than middle-aged patients. Poor pain management in the elderly is still an issue. Although the elderly consumes the greatest proportion of prescribed medicines in Western Europe, most clinical pharmacological studies have been performed in healthy volunteers or middle-aged patients. The aim of this study was to investigate pain measurement and management in cognitively impaired patients in long term hospital care and in cognitively normal elderly patients after cardiac surgery. This thesis incorporated 366 patients, including 86 home-dwelling or hospitalized elderly with chronic pain and 280 patients undergoing cardiac surgery with acute pain. The mean age of patients was 77 (SD ± 8) years and approximately 8400 pain measurements were performed with four pain scales: Verbal Rating Scale (VRS), the Visual Analogue Scale (VAS), the Red Wedge Scale (RWS), and the Facial Pain Scale (FPS). Cognitive function, depression, functional ability in daily life, postoperative sedation and postoperative confusion were assessed with MMSE, GDS, Barthel Index, RASS, and CAM-ICU, respectively. The effects and plasma concentrations of fentanyl and oxycodone were measured in elderly (≥ 75 years) and middle-aged patients (≤ 60 years) and the opioid-sparing effect of pregabalin was studied after cardiac surgery. The VRS pain scores after movement correlated with the Barthel Index. The VRS was most successful in the groups of demented patients (MMSE 17-23, 11-16 and ≤ 10) and in elderly patients on the first day after cardiac surgery. The elderly had a higher plasma concentration of fentanyl at the end of surgery than younger patients. The plasma concentrations of oxycodone were comparable between the groups. Pain intensity on the VRS was lower and the sedation scores were higher in the elderly. Total oxycodone consumption during five postoperative days was reduced by 48% and the CAM-ICU scores were higher on the first postoperative day in the pregabalin group. The incidence of postoperative pain during movement was lower in the pregabalin group three months after surgery. This investigation demonstrates that chronic pain did not seem to impair daily activities in home-dwelling Finnish elderly. The VRS appeared to be applicable for elderly patients with clear cognitive dysfunction (MMSE ≤17) and it was the most feasible pain scale for the early postoperative period after cardiac surgery. After cardiac surgery, plasma concentrations of fentanyl in elderly were elevated, although oxycodone concentrations were at similar level compared to middle-aged patients. The elderly had less pain and were more sedated after doses of oxycodone. Therefore, particular attention must be given to individual dosing of the opioids in elderly surgical patients, who often need a smaller amount for adequate analgesia than middle-aged patients. The administration of pregabalin reduced postoperative oxycodone consumption after cardiac surgery. Pregabalin-treated patients had less confusion, and additionally to less postoperative pain on the first postoperative day and during movement at three months post-surgery. Pregabalin might be a new alternative as analgesic for acute postoperative and chronic pain management in the elderly. Its clinical role and safety remains to be verified in large-scale randomized and controlled studies. In the future, many clinical trials in the older category of patients will be needed to facilitate improvements in health care methods.

Gypsum treated fly ash as a liner for waste disposal facilities

Fly ash has potential application in the construction of base liners for waste containment facilities. While most of the fly ashes improve in the strength with curing, the ranges of permeabilities they attain may often not meet the basic requirement of a liner material. An attempt has been made in the present context to reduce the hydraulic conductivity by adding lime content up to 10% to two selected samples of class F fly ashes. The use of gypsum, which is known to accelerate the unconfined compressive strength by increasing the lime reactivity, has been investigated in further improving the hydraulic conductivity. Hydraulic conductivities of the compacted specimens have been determined in the laboratory using the falling head method. It has been observed that the addition of gypsum reduces the hydraulic conductivity of the lime treated fly ashes. The reduction in the hydraulic conductivity of the samples containing gypsum is significantly more for samples with high amounts of lime contents (as high as 1000 times) than those fly ashes with lower amounts of lime. However there is a relatively more increase in the strengths of the samples with the inclusion of gypsum to the fly ashes at lower lime contents. This is due to the fact that excess lime added to fly ash is not effectively converted into pozzolanic compounds. Even the presence of gypsum is observed not to activate these reactions with excess lime. On the other hand the higher amount of lime in the presence of sulphate is observed to produce more cementitious compounds which block the pores in the fly ash. The consequent reduction in the hydraulic conductivity of fly ash would be beneficial in reducing the leachability of trace elements present in the fly ash when used as a base liner. (C) 2010 Elsevier Ltd. All rights reserved.

Stress-strain response of plastic waste mixed soil

Recycling plastic waste from water bottles has become one of the major challenges worldwide. The present study provides an approach for the use plastic waste as reinforcement material in soil. The experimental results in the form of stress-strain-pore water pressure response are presented. Based on experimental test results, it is observed that the strength of soil is improved and compressibility reduced significantly with addition of a small percentage of plastic waste to the soil. The use of the improvement in strength and compressibility response due to inclusion of plastic waste can be advantageously used in bearing capacity improvement and settlement reduction in the design of shallow foundations. (C) 2010 Elsevier Ltd. All rights reserved.

Combustion synthesis of oxide materials for nuclear waste immobilization

Oxide materials like perovskite, zirconolite, hollandite, pyrochlore, NASICON and sphene which are used for nuclear waste immobilization have been prepared by a solution combustion process. The process involves the combustion of stoichiometric amount of corresponding metal nitrates and carbohydrazide/tetraformyl trisazine/diformyl hydrazide at 450 degrees C. The combustion products have been characterized using powder X-ray diffraction, infrared spectroscopy, and Si-29 MAS-NMR. The fine particle nature of the combustion derived powders has been studied using density, particle size, BET surface area measurements and scanning electron microscopy. Sintering of combustion derived powder yields 85-95% dense ceramics in the temperature range 1000 degrees-1300 degrees C.

Biosorption of copper and zinc using waste Aspergillus niger biomass

Nonliving waste biomass consisting of Aspergillus niger attached to wheat bran was used as a biosorbent for the removal of copper and zinc from aqueous solutions. Copper and zinc uptake by the biomass obeyed Langmuir isotherms. The binding capacity of the biomass for copper was found to be higher than that for zinc. The metal uptake, expressed in milligrams per gram of biomass, was found to be a function of: the initial metal concentration (with the uptake decreasing with increasing initial concentration), the biomass loading (with the uptake decreasing with increasing biomass loading) and pH (with the uptake increasing with increasing pH in the range of 1.5 and 6.0). The metal uptake was significantly affected in the presence of a co-ion. The uptake of copper by the biomass decreased in the presence of zinc and vice versa. The decrease in metal uptake was dependent on the concentrations of metals in the two-component aqueous solutions. The effect of copper on zinc uptake was more pronounced than the effect of zinc on copper uptake.

Dapsone a new diazotizing reagent for the spectrophotometric determination of nitrite in waste and natural water samples

A new diazotizing reagent for the spectrophotometric determination of nitrite is described. The method is based on diazotization-coupling reaction between dapsone and phloroglucinol in hydrochloric acid medium. The reactions were conducted at room temperature, the molor absorptivity at 425 nm is 4.28 x 10(4) 1 Mol, (1)cm(-1) and was stable for 50 h. Beer's law was obeyed in the nitrite range of 0.008 - 1.0 mug ml(-1). Tolerance limits were tested for 33 species. The method has been found to be applicable for the determination of nitrite in natural and wastewater.

Environmental audit of Municipal Solid Waste Management

The management of municipal solid waste has become an acute problem due to enhanced economic activities and rapid urbanisation. Increased attention has been given by the government in recent years to handle this problem in a safe and hygienic manner. In this regard, Municipal Solid Waste Management (MSWM) environmental audit has been carried out for Bangalore city through the collection of secondary data from government agencies, and interviews with stakeholders and field surveys. Field surveys were carried out in seven wards (representative samples of the city) to understand the practice and identify the lacunae. The MSWM audit that was carried out functional-element-wise in selected wards to understand the efficacy and shortfalls, if any, is discussed in this paper.

Management of Municipal Solid Waste

Solid material thrown away as unused from various sectors such as agricultural, commercial, domestic, industrial and institutional constitutes solid wastes. This places an enormous strain on natural resources and seriously undermines efficient and sustainable development. Management of Municipal Solid Waste discusses the ways to salvage the situation through efficient management of solid wastes from waste generation to final disposal. The various processes such as waste generation, collection, storage, processing, recovery, transport, and disposal, are explained with the support of case studies. The book discusses reduction of waste at the source and to foster implementation of integrated solid waste management systems that are cost-effective and protect human health and the environment.