Search

Onsite reuse of blackwater requires removal of considerable amounts of suspended solids and organic material in addition to inactivation of pathogens. Previously, we showed that electrochemical treatment could be used for effective pathogen inactivation in blackwater, but was inadequate to remove solids and organics to emerging industry standards. Further, we found that as solids and organics accumulate with repeated recycling, electrochemical treatment becomes less energetically sustainable. Here, we describe a pilot study in which concentrated blackwater is pretreated with ultrafiltration and granular activated carbon prior to electrochemical disinfection, and show that this combination of treatments removes 75-99% of chemical oxygen demand, 92-100% of total suspended solids, and improves the energy efficiency of electrochemical blackwater treatment by an order of magnitude., Competing Interests: No competing interests were disclosed.

Over 1/3 of the global population lacks access to improved sanitation, leading to disease, death, and impaired economic development. Our group is working to develop rapidly deployable, cost-effective, and sustainable solutions to this global problem that do not require significant investments in infrastructure. Previously, we demonstrated the feasibility of a toilet system that recycles blackwater for onsite reuse as flush water, in which the blackwater is electrochemically treated to remove pathogens due to fecal contamination. However, this process requires considerable energy (48-93 kJ/L) to achieve complete disinfection of the process liquid, and the disinfected liquid retains color and chemical oxygen demand (COD) in excess of local discharge standards, negatively impacting user acceptability. Granular activated carbon (GAC) efficiently reduces COD in concentrated wastewaters. We hypothesized that reduction of COD with GAC prior to electrochemical treatment would both improve disinfection energy efficiency and user acceptability of the treated liquid. Here we describe the development and testing of a hybrid system that combines these technologies and demonstrate its ability to achieve full disinfection with improved energy efficiency and liquid quality more suitable for onsite reuse and/or discharge., (Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Onsite reuse of blackwater requires removal of considerable amounts of suspended solids and organic material in addition to inactivation of pathogens. Previously, we showed that electrochemical treatment could be used for effective pathogen inactivation in blackwater, but was inadequate to remove solids and organics to emerging industry standards. Further, we found that as solids and organics accumulate with repeated recycling, electrochemical treatment becomes less energetically sustainable. Here, we describe a pilot study in which concentrated blackwater is pretreated with ultrafiltration and granular activated carbon prior to electrochemical disinfection, and show that this combination of treatments removes 75-99% of chemical oxygen demand, 92-100% of total suspended solids, and improves the energy efficiency of electrochemical blackwater treatment by an order of magnitude., Competing Interests: No competing interests were disclosed.

1. While falls on medical-surgical units are the focus of extensive research, falls on inpatient psychiatric units are an understudied critical event. 2. The purposes of this study were to identify the variables associated with psychiatric patient falls and to use that information to assess risk and, therefore, prevent falls in this population. 3. The psychiatric patient at risk for falling is described as a woman with a prior history of falls; less than 65 years of age; experiencing anxiety and agitation; and receiving a sedative, a tranquilizer, and a laxative. Additionally, this patient is more likely to fall in a community area.

Quasi-experimental and descriptive methods were used to investigate thrombosis incidence in 294 tunneled central venous catheters inserted in adult clients with cancer. Thrombosis incidence was measured in relation to heparin flush regimen, internal catheter tip location, and chemotherapy infusate volume. Data were collected for two cohorts: 1) 145 tunneled catheters using 5 ml daily of 10 U/ml heparin flush, and 2) 51 catheters using 10 cc daily of 100 U/ml heparin flush. Data were also collected for an additional 98 catheters (transitional) utilizing a combination of flush #1 and #2 from adjacent time periods. Chi square analysis of the cohorts revealed no difference in thrombosis incidence by flush regimen or chemotherapy infusate volume. Suboptimal internal catheter tip location and catheters placed on the left side were related to higher thrombosis incidence. Practice implications include: the need for staff and patient education regarding signs and symptoms of catheter-related thrombosis, additional systematic data collection and evaluation, and support for empirical research to establish optimal vascular access device care.

Team-building efforts of the nurse executive will raise nursing's status and strengthen nursing's image as a reliable, self-managed department able to make valuable contributions to health care delivery. Nurse administrators who assume the responsibility of building and maintaining productive interdisciplinary teams at the executive level will be rewarded with increased visibility, recognition, and power. Such opportunities for leadership should not be ignored or left to the purview of hospital administrators, physicians, or any other discipline.