Biological monitoring of occupational exposure to polycyclic aromatic hydrocarbons in prebake smelting

In 1984, the International Agency for Research on Cancer determined that working in the primary aluminium production process was associated with exposure to certain polycyclic aromatic hydrocarbons (PAHs) that are probably carcinogenic to humans. Key sources of PAH exposure within the occupational environment of a prebake aluminium smelter are processes associated with use of coal-tar pitch. Despite the potential for exposure via inhalation, ingestion and dermal adsorption, to date occupational exposure limits exist only for airborne contaminants. This study, based at a prebake aluminium smelter in Queensland, Australia, compares exposures of workers who came in contact with PAHs from coal-tar pitch in the smelter’s anode plant (n = 69) and cell-reconstruction area (n = 28), and a non-production control group (n = 17). Literature relevant to PAH exposures in industry and methods of monitoring and assessing occupational hazards associated with these compounds are reviewed, and methods relevant to PAH exposure are discussed in the context of the study site. The study utilises air monitoring of PAHs to quantify exposure via the inhalation route and biological monitoring of 1-hydroxypyrene (1-OHP) in urine of workers to assess total body burden from all routes of entry. Exposures determined for similar exposure groups, sampled over three years, are compared with published occupational PAH exposure limits and/or guidelines. Results of paired personal air monitoring samples and samples collected for 1-OHP in urine monitoring do not correlate. Predictive ability of the benzene-soluble fraction (BSF) in personal air monitoring in relation to the 1-OHP levels in urine is poor (adjusted R2 < 1%) even after adjustment for potential confounders of smoking status and use of personal protective equipment. For static air BSF levels in the anode plant, the median was 0.023 mg/m3 (range 0.002–0.250), almost twice as high as in the cell-reconstruction area (median = 0.013 mg/m3, range 0.003–0.154). In contrast, median BSF personal exposure in the anode plant was 0.036 mg/m3 (range 0.003–0.563), significantly lower than the median measured in the reconstruction area (0.054 mg/m3, range 0.003–0.371) (p = 0.041). The observation that median 1-OHP levels in urine were significantly higher in the anode plant than in the reconstruction area (6.62 µmol/mol creatinine, range 0.09–33.44 and 0.17 µmol/mol creatinine, range 0.001–2.47, respectively) parallels the static air measurements of BSF rather than the personal air monitoring results (p < 0.001). Results of air measurements and biological monitoring show that tasks associated with paste mixing and anode forming in the forming area of the anode plant resulted in higher PAH exposure than tasks in the non-forming areas; median 1-OHP levels in urine from workers in the forming area (14.20 µmol/mol creatinine, range 2.02–33.44) were almost four times higher than those obtained from workers in the non-forming area (4.11 µmol/mol creatinine, range 0.09–26.99; p < 0.001). Results justify use of biological monitoring as an important adjunct to existing measures of PAH exposure in the aluminium industry. Although monitoring of 1-OHP in urine may not be an accurate measure of biological effect on an individual, it is a better indicator of total PAH exposure than BSF in air. In January 2005, interim study results prompted a plant management decision to modify control measures to reduce skin exposure. Comparison of 1-OHP in urine from workers pre- and post-modifications showed substantial downward trends. Exposure via the dermal route was identified as a contributor to overall dose. Reduction in 1-OHP urine concentrations achieved by reducing skin exposure demonstrate the importance of exposure via this alternative pathway. Finally, control measures are recommended to ameliorate risk associated with PAH exposure in the primary aluminium production process, and suggestions for future research include development of methods capable of more specifically monitoring carcinogenic constituents of PAH mixtures, such as benzo[a]pyrene.

Evaluating the effect of a patient education brochure on patients’ expectations and satisfaction with emergency department service

Introduction: The purpose of this study was to assess the capacity of a written intervention, in this case a patient information brochure, to improve patient satisfaction during an Emergency Department (ED) visit. For the purpose of measuring the effect of the intervention the ED journey was conceptualised as a series of distinct areas of service comprising waiting time, service by the triage nurse, care from doctors and nurses and information giving Background of study: Research into patient satisfaction has become a widespread activity endorsed by both governments and hospital administrations. The literature on ED patient satisfaction has consistently indicated three primary areas of patient dissatisfaction: waiting time, nursing care and communication. Recent developments in the literature on patient satisfaction studies however have highlighted the relationship between patients. expectations of a service encounter and their consequent assessment of the experience as dissatisfying or satisfying. Disconfirmation theory posits that the degree to which expectations are confirmed will affect subsequent levels of satisfaction. The conceptual framework utilised in this study is Coye.s (2004) model of disconfirmation. Coye while reiterating satisfaction is a consequence of the degree expectations are either confirmed or disconfirmed also posits that expectations can be modified by interventions. Coye.s work conceptualises these interventions as intra encounter experiences (cues) which function to adjust expectations. Coye suggests some cues are unintended and may have a negative impact which also reinforces the value of planned cues intended to meet or exceed consumer expectations. Consequently the brochure can be characterized as a potentially positive cue, encouraging the patient to understand processes and to orient them in what can be a confronting environment. Only a limited number of studies have examined the effect of written interventions within an ED. No studies could be located which have tested the effect of ED interventions using a conceptual framework which relates the effect of the degree to which expectations are confirmed or disconfirmed in terms of satisfaction with services. Method: Two studies were conducted. Study One used qualitative methods to explore patients. expectations of the ED from the perspective of both patients and health care professionals. Study One was used in part to direct the development of the intervention (brochure) in Study Two. The brochure was an intervention designed to modify patients. expectations thus increasing their satisfaction with the provision of ED service. As there was no existing tools to measure ED patients. expectations and satisfaction a new tool was also developed based on the findings and the literature of Study One. Study Two used a non-randomised, quasi-experimental approach using a non-equivalent post-test only comparison group design used to investigate the effect of the patient education brochure (Stommel and Wills, 2004). The brochure was disseminated to one of two study groups (the intervention group). The effect of the brochure was assessed by comparing the data obtained from both the intervention and control group. These two groups consisted of 150 participants each. It was expected that any differences in the relevant domains selected for examination would indicate the effect of the brochure both on expectation and potentially satisfaction. Results: Study One revealed several areas of common ground between patients and nurses in terms of relevant content for the written intervention, including the need for information on the triage system and waiting times. Areas of difference were also found with patients emphasizing communication issues, whereas focus group members expressed concern that patients were often unable to assimilate verbal information. The findings suggested the potential utility of written material to reinforce verbal communication particularly in terms of the triage process and other ED protocols. This material was synthesized within the final version of the written intervention. Overall the results of Study Two indicated no significant differences between the two groups. The intervention group did indicate a significant number of participants who viewed the brochure of having changed their expectations. The effect of the brochure may have been obscured by a lack of parity between the two groups as the control group presented with statistically significantly higher levels of acuity and experienced significantly shorter waiting times. In terms of disconfirmation theory this would suggest expectations that had been met or exceeded. The results confirmed the correlation of expectations with satisfaction. Several domains also indicated age as a significant predictor with older patients tending to score higher satisfaction results. Other significant predictors of satisfaction established were waiting time and care from nurses, reinforcing the combination of efficient service and positive interpersonal experiences as being valued by patients. Conclusions: Information presented in written form appears to benefit a significant number of ED users in terms of orientation and explaining systems and procedures. The degree to which these effects may interact with other dimensions of satisfaction however is likely to be limited. Waiting time and interpersonal behaviours from staff also provide influential cues in determining satisfaction. Written material is likely to be one element in a series of coordinated strategies to improve patient satisfaction during periods of peak demand.

Developing a model of care to improve the health and well-being for Indigenous people receiving renal dialysis treatment

The high levels of end-stage renal disease among Indigenous Australians, particularly in remote areas of the country, are a serious public health concern. The magnitude of the problem is reflected in figures from the Australian and New Zealand Transplant and Dialysis Registry that show that Indigenous Australians experience end-stage renal disease at a rate almost 9–10 times higher than other non-Indigenous Australians. A majority of Indigenous Australians have to relocate to receive appropriate renal dialysis treatment. In some Australian states, renal treatment is based on self-care dialysis which allows those Indigenous Australians to be treated back in their community. Evidence clearly shows that reuniting renal patients with community and family improves overall health and well-being for those Indigenous Australians. With the appropriate resources, training, and support, self-care management of renal dialysis treatment is an effective way for Indigenous people with end-stage renal failure to be treated at home. In this context, the study was used to gain insight and further understanding of the impact that end-stage renal disease and renal dialysis treatment has had on the lives of Indigenous community members. The study findings are from 14 individually interviewed people from South East Queensland. Data from the interviews were analysed using a combination of thematic and content analysis. The study methodology was based on qualitative data principles where the Indigenous community members were able to share their experiences and journeys living with end-stage renal disease. Many of the experiences and understanding closely relate to the renal disease pattern and the treatment with other outside influences, such as social, cultural, and environmental influences, all having an equal impact. Each community member’s experience with end-stage renal disease is unique; some manage with family and medical support, while others try to manage independently. From the study, community members who managed their renal dialysis treatment independently were much more aware of their renal health status. The study provides recommendations towards a model of care to improve the health and well-being is based on self-care and self-determination principles.

Application of K-tree to document clustering

Digital collections are growing exponentially in size as the information age takes a firm grip on all aspects of society. As a result Information Retrieval (IR) has become an increasingly important area of research. It promises to provide new and more effective ways for users to find information relevant to their search intentions. Document clustering is one of the many tools in the IR toolbox and is far from being perfected. It groups documents that share common features. This grouping allows a user to quickly identify relevant information. If these groups are misleading then valuable information can accidentally be ignored. There- fore, the study and analysis of the quality of document clustering is important. With more and more digital information available, the performance of these algorithms is also of interest. An algorithm with a time complexity of O(n2) can quickly become impractical when clustering a corpus containing millions of documents. Therefore, the investigation of algorithms and data structures to perform clustering in an efficient manner is vital to its success as an IR tool. Document classification is another tool frequently used in the IR field. It predicts categories of new documents based on an existing database of (doc- ument, category) pairs. Support Vector Machines (SVM) have been found to be effective when classifying text documents. As the algorithms for classifica- tion are both efficient and of high quality, the largest gains can be made from improvements to representation. Document representations are vital for both clustering and classification. Representations exploit the content and structure of documents. Dimensionality reduction can improve the effectiveness of existing representations in terms of quality and run-time performance. Research into these areas is another way to improve the efficiency and quality of clustering and classification results. Evaluating document clustering is a difficult task. Intrinsic measures of quality such as distortion only indicate how well an algorithm minimised a sim- ilarity function in a particular vector space. Intrinsic comparisons are inherently limited by the given representation and are not comparable between different representations. Extrinsic measures of quality compare a clustering solution to a “ground truth” solution. This allows comparison between different approaches. As the “ground truth” is created by humans it can suffer from the fact that not every human interprets a topic in the same manner. Whether a document belongs to a particular topic or not can be subjective.

Is it necessary to re-fuse a non-union of a hallux metatarsophalangeal joint arthrodesis?

BACKGROUND: The standard treatment for a non-union of the hallux metatarsophalangeal joint fusion has been to revise the fusion. Revision fusion is technically more demanding, often involving bone grafting, more substantial fixation and prolonged period of immobilization postoperatively. We present data to suggest that removal of hardware and debridement alone is an alternative treatment option. ---------- MATERIALS AND METHODS: A case note review identified patients with a symptomatic non-union after hallux metatarsophalangeal joint (MTPJ) fusion. It is our practice to offer these patients revision fusion or removal of hardware and debridement. For the seven patients that chose hardware removal and were left with a pseudarthrosis, a matched control group was selected from patients who had had successful fusions. Three outcome scores were used. Hallux valgus and dorsiflexion angles were recorded.---------- RESULTS: One hundred thirty-nine hallux MTPJ arthrodeses were carried out. Fourteen non-unions were identified. The rate of non-union in males and following previous hallux MTPJ surgery was 19% and 24%, respectively. In females undergoing a primary MTPJ fusion, the rate was 2.4%. Twelve non-union patients were reviewed at 27 months (mean). Eleven patients had elected to undergo removal of hardware and debridement. Four patients with pseudarthrosis were unhappy with the results and proceeded to either revision fusion or MTPJ replacement. Seven non-union patients, who had removal of hardware alone, had outcome scores marginally worse compared to those with successful fusions.---------- CONCLUSION: Removal of hardware alone is a reasonable option to offer as a relatively minor procedure following a failed arthrodesis of the first MTPJ. This must be accepted on the proviso that in this study four out of 11 (36%) patients proceeded to a revision first MTPJ fusion or first MTPJ replacement. We also found that the rate of non-union in primary first MTPJ fusion was significantly higher in males and those patients who had undergone previous surgery.

Ecological and social characterization of key resource areas in Kenyan rangelands

Key resource areas (KRAs), defined as dry season foraging zones for herbivores, were studied relative to the more extensive outlying rangeland areas (non-KRAs) in Kenya. Field surveys with pastoralists, ranchers, scientists and government officials delineated KRAs on the ground. Identified KRAs were mapped based on global positioning and local experts' information on KRAs accessibility and ecological attributes. Using the map of known KRAs and non-KRAs, we examined characteristics of soils, climate, topography, land use/cover attributes at KRAs relative to non-KRAs. How and why do some areas (KRAs) support herbivores during droughts when forage is scarce in other areas of the landscape? We hypothesized that KRAs have fundamental ecological and socially determined attributes that enable them to provide forage during critical times and we sought to characterize some of those attributes in this study. At the landscape level, KRAs took different forms based on forage availability during the dry season but generally occurred in locations of the landscape with aseasonal water availability and/or difficult to access areas during wet season forage abundance. Greenness trends for KRAs versus non-KRAs were evaluated with a 22-year dataset of Normalized Difference Vegetation Index (NDVI). Field surveys of KRAs provided qualitative information on KRAs as dry season foraging zones. At the scale of the study, soil attributes did not significantly differ for KRAs compared to non-KRAs. Slopes of KRA were generally steeper compared to non-KRAs and elevation was higher at KRAs. Field survey respondents indicated that animals and humans generally avoid difficult to access hilly areas using them only when all other easily accessible rangeland is depleted of forage during droughts. Understanding the nature of KRAs will support identification, protection and restoration of critical forage hotspots for herbivores by strengthening rangeland inventory, monitoring, policy formulation, and conservation efforts to improve habitats and human welfare. (c) 2007 Elsevier Ltd. All rights reserved.

The application of neural networks to induction machine control

Neural networks (NNs) are discussed in connection with their possible use in induction machine drives. The mathematical model of the NN as well as a commonly used learning algorithm is presented. Possible applications of NNs to induction machine control are discussed. A simulation of an NN successfully identifying the nonlinear multivariable model of an induction-machine stator transfer function is presented. Previously published applications are discussed, and some possible future applications are proposed.

Dwell-time and run-time control for DC mass rapid transit railways

Dwell times at stations and inter-station run times are the two major operational parameters to maintain train schedule in railway service. Current practices on dwell-time and run-time control are that they are only optimal with respect to certain nominal traffic conditions, but not necessarily the current service demand. The advantages of dwell-time and run-time control on trains are therefore not fully considered. The application of a dynamic programming approach, with the aid of an event-based model, to devise an optimal set of dwell times and run times for trains under given operational constraints over a regional level is presented. Since train operation is interactive and of multi-attributes, dwell-time and run-time coordination among trains is a multi-dimensional problem. The computational demand on devising trains' instructions, a prime concern in real-time applications, is excessively high. To properly reduce the computational demand in the provision of appropriate dwell times and run times for trains, a DC railway line is divided into a number of regions and each region is controlled by a dwell- time and run-time controller. The performance and feasibility of the controller in formulating the dwell-time and run-time solutions for real-time applications are demonstrated through simulations.

Coast control for mass rapid transit railways with searching methods

With daily commercial and social activity in cities, regulation of train service in mass rapid transit railways is necessary to maintain service and passenger flow. Dwell-time adjustment at stations is one commonly used approach to regulation of train service, but its control space is very limited. Coasting control is a viable means of meeting the specific run-time in an inter-station run. The current practice is to start coasting at a fixed distance from the departed station. Hence, it is only optimal with respect to a nominal operational condition of the train schedule, but not the current service demand. The advantage of coasting can only be fully secured when coasting points are determined in real-time. However, identifying the necessary starting point(s) for coasting under the constraints of current service conditions is no simple task as train movement is governed by a large number of factors. The feasibility and performance of classical and heuristic searching measures in locating coasting point(s) is studied with the aid of a single train simulator, according to specified inter-station run times.

Sodium removal from Maramarua CSG waters using Ngakuru zeolites

Coal seam gas (CSG) waters are a by-product of natural gas extraction from un derground coal seams. The main issue with these waters is their elevated sodium content, which in conjunction with their low calcium and magnesium concentrations can generate soil infiltration problems in the long run , as well as short term toxicity effects in plants due to the sodium ion itself. Zeolites are minerals having a porous structure, crystalline characteristics, and an alumino-silicate configuration resulting in an overall negative charge which is balanced by loosely held cations. In New Zealand, Ngakuru zeolites have been mined for commercial use in wastewater treatment applications, cosmetics, and pet litter. This research focuses on assessing the capacity of Ngakuru zeolites to reduce sodium concentrations of CSG waters from Maramarua. Batch and column test (flow through) experiments revealed that Ngakuru zeolites are capable of sorbing sodium cations from concentrated solutions of sodium. In b atch tests, the sodium adsorption capacity ranged from 5.0 to 34.3meq/100g depending on the solution concentration and on the number of times the zeolite had been regenerated. Regeneration with CaCl2 was foun d to be effective. The calculated sodium adsorption capacity of Ngakuru zeolites under flow-through conditions ranged from 11 to 42meq/100g depending on the strength of the solution being treated and on w hether the zeolites had been previously regenerated. The slow kinetics and low cost of the zeolities, coupled with potentially remote sites for gas extraction, could make semi-batch operational processes without regeneration more favourable than in more industrial ion exchange situations.

Characterisation of Coal Seam Gas Waters in New Zealand

Coal seam gas (CSG) exploration and development requires the abstraction of significant amounts of water. This is so because gas desorbtion in coal seams takes place only after aquifer pressure has been reduced by prolonged pumping of aquifer water. CSG waters have a specific geochemical signature which is a product of their formation process. These waters have high bicarbonate, high sodium, low calcium, low magnesium, and very low sulphate concentrations. Additionally, chloride concentrations may be high depending on the coal depositional environment. This particular signature is not only useful for exploration purposes, but it also highlights potential environmental issues that can arise as a consequence of CSG water disposal. Since 2002 L&M Coal Seam Gas Ltd and CRL Energy Ltd, have been involved in exploration and development of CSG in New Zealand. Anticipating disposal of CSG waters as a key issue in CSG development, they have been assessing CSG water quality along with exploration work. Coal seam gas water samples from an exploration well in Maramarua closely follow the geochemical signature associated with CSG waters. This has helped to identify CSG potential, while at the same time assessing the chemical characteristics and water generation processes in the aquifer. Neutral pH and high alkalinity suggest that these waters could be easily managed once the sodium and chloride concentrations are reduced to acceptable levels.

Construction, application and validation of selection evaluation model (SEM) for intelligent HVAC control system

Design teams are confronted with the quandary of choosing apposite building control systems to suit the needs of particular intelligent building projects, due to the availability of innumerable ‘intelligent’ building products and a dearth of inclusive evaluation tools. This paper is organised to develop a model for facilitating the selection evaluation for intelligent HVAC control systems for commercial intelligent buildings. To achieve these objectives, systematic research activities have been conducted to first develop, test and refine the general conceptual model using consecutive surveys; then, to convert the developed conceptual framework into a practical model; and, finally, to evaluate the effectiveness of the model by means of expert validation. The results of the surveys are that ‘total energy use’ is perceived as the top selection criterion, followed by the‘system reliability and stability’, ‘operating and maintenance costs’, and ‘control of indoor humidity and temperature’. This research not only presents a systematic and structured approach to evaluate candidate intelligent HVAC control system against the critical selection criteria (CSC), but it also suggests a benchmark for the selection of one control system candidate against another.

Modeling crash outcome probabilities at rural intersections: Application of hierarchical binomial logistic models

It is important to examine the nature of the relationships between roadway, environmental, and traffic factors and motor vehicle crashes, with the aim to improve the collective understanding of causal mechanisms involved in crashes and to better predict their occurrence. Statistical models of motor vehicle crashes are one path of inquiry often used to gain these initial insights. Recent efforts have focused on the estimation of negative binomial and Poisson regression models (and related deviants) due to their relatively good fit to crash data. Of course analysts constantly seek methods that offer greater consistency with the data generating mechanism (motor vehicle crashes in this case), provide better statistical fit, and provide insight into data structure that was previously unavailable. One such opportunity exists with some types of crash data, in particular crash-level data that are collected across roadway segments, intersections, etc. It is argued in this paper that some crash data possess hierarchical structure that has not routinely been exploited. This paper describes the application of binomial multilevel models of crash types using 548 motor vehicle crashes collected from 91 two-lane rural intersections in the state of Georgia. Crash prediction models are estimated for angle, rear-end, and sideswipe (both same direction and opposite direction) crashes. The contributions of the paper are the realization of hierarchical data structure and the application of a theoretically appealing and suitable analysis approach for multilevel data, yielding insights into intersection-related crashes by crash type.

Effects of transportation accessibility on residential property values: Application of spatial hedonic price model in Seoul, South Korea, metropolitan area

A number of studies have focused on estimating the effects of accessibility on housing values by using the hedonic price model. In the majority of studies, estimation results have revealed that housing values increase as accessibility improves, although the magnitude of estimates has varied across studies. Adequately estimating the relationship between transportation accessibility and housing values is challenging for at least two reasons. First, the monocentric city assumption applied in location theory is no longer valid for many large or growing cities. Second, rather than being randomly distributed in space, housing values are clustered in space—often exhibiting spatial dependence. Recognizing these challenges, a study was undertaken to develop a spatial lag hedonic price model in the Seoul, South Korea, metropolitan region, which includes a measure of local accessibility as well as systemwide accessibility, in addition to other model covariates. Although the accessibility measures can be improved, the modeling results suggest that the spatial interactions of apartment sales prices occur across and within traffic analysis zones, and the sales prices for apartment communities are devalued as accessibility deteriorates. Consistent with findings in other cities, this study revealed that the distance to the central business district is still a significant determinant of sales price.

Further notes on the application of zero-inflated models in highway safety

The intent of this note is to succinctly articulate additional points that were not provided in the original paper (Lord et al., 2005) and to help clarify a collective reluctance to adopt zero-inflated (ZI) models for modeling highway safety data. A dialogue on this important issue, just one of many important safety modeling issues, is healthy discourse on the path towards improved safety modeling. This note first provides a summary of prior findings and conclusions of the original paper. It then presents two critical and relevant issues: the maximizing statistical fit fallacy and logic problems with the ZI model in highway safety modeling. Finally, we provide brief conclusions.