503 resultados para harms


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The production of agricultural and horticultural products requires the use of nitrogenous fertiliser that can cause pollution of surface and ground water and has a large carbon footprint as it is mainly produced from fossil fuels. The overall objective of this research project was to investigate fast pyrolysis and in-situ nitrogenolysis of biomass and biogenic residues as an alternative route to produce a sustainable solid slow release fertiliser mitigating the above stated problems. A variety of biomasses and biogenic residues were characterized by proximate analysis, ultimate analysis, thermogravimetric analysis (TGA) and Pyrolysis – Gas chromatography – Mass Spectroscopy (Py–GC–MS) for their potential use as feedstocks using beech wood as a reference material. Beech wood was virtually nitrogen free and therefore suitable as a reference material as added nitrogen can be identified as such while Dried Distillers Grains with Solubles (DDGS) and rape meal had a nitrogen content between 5.5wt.% and 6.1wt.% qualifying them as high nitrogen feedstocks. Fast pyrolysis and in-situ nitrogenolysis experiments were carried out in a continuously fed 1kg/h bubbling fluidized bed reactor at around 500°C quenching the pyrolysis vapours with isoparaffin. In-situ nitrogenolysis experiments were performed by adding ammonia gas to the fast pyrolysis reactor at nominal nitrogen addition rates between 5wt.%C and 20wt.%C based on the dry feedstock’s carbon content basis. Mass balances were established for the processing experiments. The fast pyrolysis and in-situ nitrogenolysis products were characterized by proximate analysis, ultimate analysis and GC– MS. High liquid yields and good mass balance closures of over 92% were obtained. The most suitable nitrogen addition rate for the in-situ nitrogenolysis experiments was determined to be 12wt.%C on dry feedstock carbon content basis. However, only a few nitrogen compounds that were formed during in-situ nitrogenolysis could be identified by GC–MS. A batch reactor process was developed to thermally solidify the fast pyrolysis and in-situ nitrogenolysis liquids of beech wood and Barley DDGS producing a brittle solid product. This was obtained at 150°C with an addition of 2.5wt% char (as catalyst) after a processing time of 1h. The batch reactor was also used for modifying and solidifying fast pyrolysis liquids derived from beech wood by adding urea or ammonium phosphate as post processing nitrogenolysis. The results showed that this type of combined approach was not suitable to produce a slow release fertiliser, because the solid product contained up to 65wt.% of highly water soluble nitrogen compounds that would be released instantly by rain. To complement the processing experiments a comparative study via Py–GC–MS with inert and reactive gas was performed with cellulose, hemicellulose, lignin and beech wood. This revealed that the presence of ammonia gas during analytical pyrolysis did not appear to have any direct impact on the decomposition products of the tested materials. The chromatograms obtained showed almost no differences between inert and ammonia gas experiments indicating that the reaction between ammonia and pyrolysis vapours does not occur instantly. A comparative study via Fourier Transformed Infrared Spectroscopy of solidified fast pyrolysis and in-situ nitrogenolysis products showed that there were some alterations in the spectra obtained. A shift in frequencies indicating C=O stretches typically related to the presence of carboxylic acids to C=O stretches related to amides was observed and no double or triple bonded nitrogen was detected. This indicates that organic acids reacted with ammonia and that no potentially harmful or non-biodegradable triple bonded nitrogen compounds were formed. The impact of solid slow release fertiliser (SRF) derived from pyrolysis and in-situ nitrogenolysis products from beech wood and Barley DDGS on microbial life in soils and plant growth was tested in cooperation with Rothamsted Research. The microbial incubation tests indicated that microbes can thrive on the SRFs produced, although some microbial species seem to have a reduced activity at very high concentrations of beech wood and Barley DDGS derived SRF. The plant tests (pot trials) showed that the application of SRF derived from beech wood and barley DDGS had no negative impact on germination or plant growth of rye grass. The fertilizing effect was proven by the dry matter yields in three harvests after 47 days, 89 days and 131 days. The findings of this research indicate that in general a slow release fertiliser can be produced from biomass and biogenic residues by in-situ nitrogenolysis. Nevertheless the findings also show that additional research is necessary to identify which compounds are formed during this process.

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The aim of this study is to characterise and compare fast pyrolysis product yields from straw, high yielding perennial grasses and hardwoods. Feedstocks selected for this study include: wheat straw (Triticum aestivum), switch grass (Panicum virgatum), miscanthus (Miscanthus x giganteus), willow short rotation coppice (Salix viminalis) and beech wood (Fagus sylvatica). The experimental work is divided into two sections: analytical (TGA and Py-GC-MS) and laboratory scale processing using a continuously fed bubbling fluidized bed reactor with a capacity of up to 1 kg/h. Pyrolysis-gas chromatography-mass spectrometry (Py-GC-MS) has been used to quantify pyrolysis products and simulate fast pyrolysis heating rates, in order to study potential key light and medium volatile decomposition products found in these feedstocks. Py-GC-MS quantification results show that the highest yields of furfural (0.57 wt.%), 2-furanmethanol (0.18 wt.%), levoglucosan (0.73 wt.%), 1,2-benzenediol (0.27 wt.%) and 2-methoxy-4-vinylphenol (0.38 wt.%) were found in switch grass, and that willow SRC produced the highest yield of phenol (0.33 wt.%). The bio-oil higher heating value was highest for switch grass (22.3 MJ/kg). Water content within the bio-oil is highest in the straw and perennial grasses and lowest in the hardwood willow SRC. The high bio-oil and char heating value and low water content found in willow SRC, makes this crop an attractive energy feedstock for fast pyrolysis processing, if the associated production costs and harvest yields can be maintained at current reported values. The bio-oil from switch grass has the highest potential for the production of high value chemicals. © 2013 Elsevier Ltd. All rights reserved.

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Methods: It has been estimated that medication error harms 1-2% of patients admitted to general hospitals. There has been no previous systematic review of the incidence, cause or type of medication error in mental healthcare services. Methods: A systematic literature search for studies that examined the incidence or cause of medication error in one or more stage(s) of the medication-management process in the setting of a community or hospital-based mental healthcare service was undertaken. The results in the context of the design of the study and the denominator used were examined. Results: All studies examined medication management processes, as opposed to outcomes. The reported rate of error was highest in studies that retrospectively examined drug charts, intermediate in those that relied on reporting by pharmacists to identify error and lowest in those that relied on organisational incident reporting systems. Only a few of the errors identified by the studies caused actual harm, mostly because they were detected and remedial action was taken before the patient received the drug. The focus of the research was on inpatients and prescriptions dispensed by mental health pharmacists. Conclusion: Research about medication error in mental healthcare is limited. In particular, very little is known about the incidence of error in non-hospital settings or about the harm caused by it. Evidence is available from other sources that a substantial number of adverse drug events are caused by psychotropic drugs. Some of these are preventable and might probably, therefore, be due to medication error. On the basis of this and features of the organisation of mental healthcare that might predispose to medication error, priorities for future research are suggested.

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BACKGROUND: Standardised packaging (SP) of tobacco products is an innovative tobacco control measure opposed by transnational tobacco companies (TTCs) whose responses to the UK government's public consultation on SP argued that evidence was inadequate to support implementing the measure. The government's initial decision, announced 11 months after the consultation closed, was to wait for 'more evidence', but four months later a second 'independent review' was launched. In view of the centrality of evidence to debates over SP and TTCs' history of denying harms and manufacturing uncertainty about scientific evidence, we analysed their submissions to examine how they used evidence to oppose SP. METHODS AND FINDINGS: We purposively selected and analysed two TTC submissions using a verification-oriented cross-documentary method to ascertain how published studies were used and interpretive analysis with a constructivist grounded theory approach to examine the conceptual significance of TTC critiques. The companies' overall argument was that the SP evidence base was seriously flawed and did not warrant the introduction of SP. However, this argument was underpinned by three complementary techniques that misrepresented the evidence base. First, published studies were repeatedly misquoted, distorting the main messages. Second, 'mimicked scientific critique' was used to undermine evidence; this form of critique insisted on methodological perfection, rejected methodological pluralism, adopted a litigation (not scientific) model, and was not rigorous. Third, TTCs engaged in 'evidential landscaping', promoting a parallel evidence base to deflect attention from SP and excluding company-held evidence relevant to SP. The study's sample was limited to sub-sections of two out of four submissions, but leaked industry documents suggest at least one other company used a similar approach. CONCLUSIONS: The TTCs' claim that SP will not lead to public health benefits is largely without foundation. The tools of Better Regulation, particularly stakeholder consultation, provide an opportunity for highly resourced corporations to slow, weaken, or prevent public health policies.

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Understanding the pharmacological principles and safe use of drugs is just as important in surgical practice as in any other medical specialty. With an ageing population with often multiple comorbidities and medications, as well as an expanding list of new pharmacological treatments, it is important that surgeons understand the implications of therapeutic drugs on their daily practice. The increasing emphasis on high quality and safe patient care demands that doctors are aware of preventable adverse drug reactions (ADRs) and interactions, try to minimize the potential for medication errors, and consider the benefits and harms of medicines in their patients. This chapter examines these aspects from the view of surgical practice and expands on the implications of some of the most common medical conditions and drug classes in the perioperative period. The therapeutic care of surgical patients is obvious in many circumstances – for example, antibacterial prophylaxis, thromboprophylaxis, and postoperative analgesia. However, the careful examination of other drug therapies is often critical not only to the sustained treatment of the associated medical conditions but to the perioperative outcomes of patients undergoing surgery. The benefit–harm balance of many therapies may be fundamentally altered by the stress of an operation in one direction or the other; this is not a decision that should wait until the anaesthetist arrives for a preoperative assessment or one that should be left to junior medical or nursing staff on the ward.

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The objective was to identify evidence to support use of specific harms for the development of a children and young people's safety thermometer (CYPST). We searched PubMed, Web of Knowledge, and Cochrane Library post-1999 for studies in pediatric settings about pain, skin integrity, extravasation injury, and use of pediatric early warning scores (PEWS). Following screening, nine relevant articles were included. Convergent synthesis methods were used drawing on thematic analysis to combine findings from studies using a range of methods (qualitative, quantitative, and mixed methods). A review of PEWS was identified so other studies on this issue were excluded. No relevant studies about extravasation injury were identified. The synthesized results therefore focused on pain and skin integrity. Measurement and perception of pain were complex and not always carried out according to best practice. Skin abrasions were common and mostly associated with device related injuries. The findings demonstrate a need for further work on perceptions of pain and effective communication of concerns about pain between parents and nursing staff. Strategies for reducing device-related injuries warrant further research focusing on prevention. Together with the review of PEWS, these synthesized findings support the inclusion of pain, skin integrity, and PEWS in the CYPST.

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Monahan and Walker (1988) delineated three uses of social science evidence within the courts: social authority, social fact, and social framework. Social authority evidence is social science evidence used in making policy or law. Social fact evidence is social science evidence that describes research undertaken expressly for the case at hand. Social framework evidence involves providing conclusions from previously conducted social science research to assist jurors in evaluating the other evidence in the case. Although this type of evidence has traditionally been presented via expert testimony, Monahan and Walker (1988) have suggested that, because the social science research involved comes from the extant literature and is not the province of any particular expert, it would be more economical to have the judge present this information as part of the judicial instructions to the jury. This study tested the implicit assumption that the presentation of the social framework evidence by the judge will have the same impact on juror verdicts as presentation of this evidence by an expert. ^ Two hundred mock jurors watched a videotaped hostile work environment sexual harassment trial. The social framework evidence consisted of the discussion of factors that have been found to increase the likelihood of sex stereotyping of women by men. The trial included either no social framework evidence, social framework evidence presented by the expert, or social framework evidence presented in judicial instructions. ^ Results indicated that men who heard the social framework evidence from the judge were more likely to vote for the defendant than men who heard no social framework evidence. Men who heard the judicial instruction with the social framework evidence also rated the plaintiff as less credible than the other men and women in the study. Thus, it appears that, for men, social framework evidence presented by the judge harms the plaintiff's case by reducing ratings of her credibility, but the same evidence presented by an expert does not affect men's verdicts. For women, however, social framework evidence, irrespective of who presents it, enhances the plaintiff's case. ^

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Since Plato's Republic and Aristotle's Politics established the basis for Western political thought almost 2500 years ago, the discipline of international relations has evolved substantially. However, most of the literature revolves around state interaction within the system, and there is little discussion of countries that opt out of the international states system and become isolationist. Given the interdependent nature of the modern international system, this study elaborates on domestic and foreign isolationism by expounding upon the reasons and consequences of states opting out of the international system. The empirical case studies utilized to explore isolationism are Albania, North Korea, and Burma. By empirically verifying the components, motivations, and consequences of isolationism in an interdependent world, this study provides insight into why and how states resist engagement with the global socioeconomic and political state system. ^ Using historical, comparative, and inductive analysis, this study explains why states choose to isolate themselves both domestically and internationally. Specifically, comparative historical analysis highlights isolationism as a concept and practice. This study maintains that extreme forms of self-imposed isolation in an interdependent international system, while perhaps serving the immediate interests of a ruling regime, harms the long-term national interests of the state and the populace. Although the leadership in an isolationist state gains a significant amount of power and control over the people within its borders, the state as a whole experiences profound negative effects. In the long term, a state loses power, stability, prestige, and suffers a decline in overall economic prosperity. ^ States that withdraw from the international system, therefore, provide insight into an unexplored area of international relations when considering notions of rationality, self-interest, power politics, cooperation, and alliances. In short, isolationism in an interdependent state system goes against the logic of the modern society/system of states, resulting in deleterious consequences to the wellbeing of the state. ^

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The prevalence of waterpipe smoking exceeds that of cigarettes among adolescents in the Middle East where waterpipe is believed as less harmful, less addictive and can be a safer alternative to cigarettes. This dissertation tested the gateway hypothesis that waterpipe can provide a bridge to initiate cigarette smoking, identified the predictors of cigarette smoking progression, and identified predictors of waterpipe smoking progression among a school-based sample of Jordanian adolescents (mean age ± SD) (12.7 ±0.61) years at baseline. Data for this research have been drawn from Irbid Longitudinal Study of smoking behavior, Jordan (2008-2011). The grouped-time survival analysis showed that waterpipe smoking was associated with a higher risk of cigarette smoking initiation compared to never smokers (P < 0.001) and this association was dose dependent (P < 0.001). Predictors of cigarette smoking progression were peer smoking and attending public schools for boys, siblings’ smoking for girls, and the urge to smoke for both genders. Predictors of waterpipe smoking progression were enrollment in public schools, frequent physical activity, and low refusal self-efficacy for boys, ever smoking cigarettes, friends’ and siblings’ waterpipe smoking for girls. Awareness of harms of waterpipe among boys and seeing warning labels on the tobacco packs by girls were protective against waterpipe smoking progression. In Conclusion, waterpipe can serve as a gateway to cigarette smoking initiation among adolescents. Waterpipe and cigarette smoking progressions among initiators were solely family-related among girls, and mainly peer-related among boys. The unique gender differences for both cigarette and waterpipe smoking among Jordanian adolescents in Irbid call for cultural and gender-specific smoking prevention interventions to prevent the progression of smoking among initiators.

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The exponential growth of studies on the biological response to ocean acidification over the last few decades has generated a large amount of data. To facilitate data comparison, a data compilation hosted at the data publisher PANGAEA was initiated in 2008 and is updated on a regular basis (doi:10.1594/PANGAEA.149999). By January 2015, a total of 581 data sets (over 4 000 000 data points) from 539 papers had been archived. Here we present the developments of this data compilation five years since its first description by Nisumaa et al. (2010). Most of study sites from which data archived are still in the Northern Hemisphere and the number of archived data from studies from the Southern Hemisphere and polar oceans are still relatively low. Data from 60 studies that investigated the response of a mix of organisms or natural communities were all added after 2010, indicating a welcomed shift from the study of individual organisms to communities and ecosystems. The initial imbalance of considerably more data archived on calcification and primary production than on other processes has improved. There is also a clear tendency towards more data archived from multifactorial studies after 2010. For easier and more effective access to ocean acidification data, the ocean acidification community is strongly encouraged to contribute to the data archiving effort, and help develop standard vocabularies describing the variables and define best practices for archiving ocean acidification data.

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The recognition of the food as determinant and health-disease process etching requires new explanations and interventions of the food and nutrition policy action and demand health care model based on the completeness of the actions and focused on health promotion. This study, characterized as research-action of interventionist character, sought to develop strategies to support the transverse insertion of healthy eating promotion in professionals practices a core of support for the health of the family and a family health strategy Unit in the city of Natal, capital of Rio Grande do Norte, from the analysis of perceptions and work processes of these teams. Several methodological strategies were adopted: Dialectical Hermeneutical Circle, direct observation, reflective and Thematic Meetings Workshop "Rethinking the educational practices for promoting healthy eating". For data logging, search diaries - SD were used and moments. The analysis of procedural form occurred in conjunction with research participants, in constant movement of reflection-action-reflection, based on hermeneutics-dialectic. About the results, in relation to the promotion of health, showed the following insights: health promotion and disease prevention-related harms; health promotion related to quality of life and well-being, in its various dimensions; health promotion as a responsibility of the State; health promotion related to the actions of health education; health promotion as an expression of efficaciousness and accessibility to health services. Regarding healthy nutrition, predominated the perceptions relating to nutritional aspects. With regard to food and nutritional education - FNE, it was observed a predominance of perception of FNE as information, guidance and knowledge transfer for changes of dietary practices. As regards the working process, it was observed that among the actions for health promotion, educational activities predominate, such as lectures, conversations, groups that mostly occur in fragmentary form, without joint planning teams, varying according to the professionals and the moment of work in which they are carried out. The results pointed to the need for reorganization of the work processes, in the context of intra-and intersectoral coordination and the construction of new technologies, such as: Health project of the territory – HPT, Unique Therapeutic Project- UPT, Expanded Clinic and educational practices, Shared with active teaching and learning methodologies. From the results we believe that it is necessary to "thought reform", from changes in vocational training and strengthening of the permanent education spaces, whereas the complexity that involves feeding, food and nutrition education and health promotion. The reformation of thought must be articulate and closely tied to the production of knowledge and practices that encourage intersectoral approach, the transversality, dialogue and democratic and supportive attitude, based on the collective construction of know-how. We hope that this study can contribute with reflections and initiatives that encourage building practices that promote healthy eating in primary health care, in terms of completeness of the care and the attainment of food security and nutrition.

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Tourism remains one of the most fast growing and important industries in the world. It is hard to underestimate the importance and the spectrum of the benefits that tourism provides. On the other hand, nowadays, the increasing growth of tourism poses a range of challenges and problems that need to be solved. These challenges resonate in the emergence of the so called 'alternative' or sustainable forms of tourism, which deem to be an antidote against the harms the traditional forms of tourism cause to the environment and local communities. These new forms of tourism, among which is creative tourism, are reinforced by the new breed of tourists, who are no longer satisfied with the static offer of tourism but rather prefer the dynamic one. The present research shows on the case of Óbidos the potential of creative tourism to meet these new needs of modern tourists while also solving number of problems that many destinations face, namely seasonality in tourism, as well as how creative tourism contributes to the sustainable development of tourism.

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Universal screening for prostate cancer (Pca) using prostate-specific antigen-based testing is not recommended, as the potential harms of screening (overdiagnosis and overtreatment) outweigh potential benefits. The case for Pca screening requires a paradigm shift, which emphasizes the risks of screening over the risks of undetected cancer. Physicians are encouraged to use shared decision making with patients who express an interest in Pca screening, taking into account both the patient's screening preferences and individual risk profile. New models of care informed by the Patient Protection and Affordable Care Act are intended to assist clinicians in providing recommended preventive services. © 2014 Elsevier Inc.

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Aim: Alcohol consumption is a leading cause of global suffering. The harms caused by alcohol to the individual, their peers and the society in which they live provokes public health concern. Elevated levels of consumption and consequences have been noted in those aged 18-29 years. University students represent a unique subsection of society within this age group. University authorities have attempted to tackle this issue throughout the past decade. However, the issue persists. Thus, the aim of this study is to contribute to the evidence base for policy and practice in relation to alcohol harm reduction among third-level students in Ireland. Methods: A mixed methods approach was employed. A systematic review of the prevalence of hazardous alcohol consumption among university students in Ireland and the United Kingdom from 2002 to 2014 was conducted. In addition, a narrative synthesis of studies of drinking types evidenced among youths in western societies was undertaken. A cross-sectional study focused on university students’ health and lifestyle behaviours with particular reference to alcohol consumption was undertaken using previously validated instruments. Undergraduate students registered to one university in Ireland were recruited using two separate modes; classroom and online. Studies investigated the impact of mode of data collection, the prevalence of hazardous alcohol consumption and resultant adverse consequences for mental health and wellbeing. In addition a study using a Q-methodology approach was undertaken to gain a deeper understanding of the cultural factors influencing current patterns of alcohol consumption. Data were analysed using IBM SPPS statistics 20, Stata 12, MPLUS and PQ Method. Results: The literature review focusing on students’ alcohol consumption found that there has been both an increase in hazardous alcohol consumption among university students and a convergence of male and female drinking patterns throughout the past decade. Updating this research, the thesis found that two-thirds of university students consume alcohol at a hazardous level, detailing the range of adverse consequences reported by university students in Ireland. Finally, the heterogeneous nature of this drinking was described in a narrative synthesis exposing six types of consumption. The succeeding chapters develop this review further by describing three typologies of consumption, two quantitative and one quali-quantilogical. The quantitative typology describes three types of drinking for men (realistic hedonist, responsible conformer and guarded drinker) and four types for women (realistic hedonist, peer-influenced, responsible conformer and guarded drinker). The quali-quantilogical approach describes four types of consumption. These are defined as the ‘guarded drinker’, the ‘calculated hedonist’, the ‘peer-influenced drinker’ and the ‘inevitable binger’. Discussion: The findings of this thesis highlight the scale of the issue and provide up-to-date estimates of alcohol consumption among university students in Ireland. Hazardous alcohol consumption is associated with a range of harms to self and harms to others in proximity to the alcohol consumer. The classification of drinkers into types signal the necessity for university management, health promotion practitioners and public health policy makers to tackle this issue using a multi-faceted approach.