Bioextractive aquaculture as an alternative nutrient management strategy for water resource recovery facilities.

Advanced nutrient removal in water resource recovery facilities (WRRFs) can reduce coastal eutrophication, but can increase economic costs and indirect environmental impacts associated with energy and materials usage for WRRF construction and operation. A strategy of interest to reduce coastal eutrophication is the cultivation of seaweeds in proximity to WRRF discharge plumes to bioextract nutrients from coastal waters. We report economic and environmental trade-offs of this proposed strategy for a 1,170 m3·d-1 (0.31 mgd) WRRF in Boothbay Harbor, Maine, targeting a Water Environment Research Federation (WERF) level 2 effluent nitrogen goal of 3 mg-N·L-1. The scenarios investigated include WRRF upgrade and year-round nutrient bioextractive aquaculture (Saccharina latissima and Gracilaria tikvahiae cultivation) with end uses of bioenergy feedstock, fertilizer, or food. Based on biomass production characteristics and tissue nitrogen contents in Boothbay Harbor, an aquaculture site of 5.4 hectares would bioextract equivalent nitrogen mass as WRRF upgrade to meet level 2 nitrogen effluent goals. Using a techno-economic analysis, the cost of a WRRF upgrade was estimated to be $0.31 m-3 wastewater treated. The cost of bioextractive seaweed aquaculture depended on beneficial use of seaweed. If dried and sold as sea vegetables (for human consumption), a net revenue of $0.72 m-3 wastewater treated could be generated. If dried and sold as commercial fertilizer, the net cost of nutrient removal would be $0.26 m-3 wastewater treated, less than the WRRF upgrade. However, if anaerobically digested to produce biogas, the net cost of treatment was estimated to be $0.499 m-3 wastewater treated. WRRF upgrade and bioextractive aquaculture significantly reduced marine eutrophication. Bioextractive aquaculture with use as biofuel feedstock had the best performance on human carcinogenic toxicity, global warming, and fossil resource scarcity, marine ecotoxicity, and freshwater ecotoxicity. Use of seaweed product as sea vegetables was favorable considering human non-carcinogenic toxicity, marine eutrophication, freshwater eutrophication, and terrestrial ecotoxicity. The study results imply that nutrient bioextraction by seaweed aquaculture may be attractive as an alternative to advanced nutrient removal technologies in small coastal WRRFs, providing potential economic and environmental benefits for nutrient management.

The effect of organizational and personal variables on the ability to practice compassionately.

BACKGROUND: Nursing governing bodies assert that compassion is essential to nursing practice. Despite the relevance compassion has in nursing, and ample theoretical literature, until now, there has been little empirical work conducted to examine the nature of compassion in nursing and how the expression of compassion in nursing practice may be affected. OBJECTIVES: This study aimed to examine the personal and organizational variables that might affect nurses' ability to practice with compassion. DESIGN: A predictive, non-experimental cross-sectional design was used to explore the relationships amongst the variables of structural and psychological empowerment, inter-professional collaboration, and compassion. PARTICIPANTS: 191 registered nurses of any age, with any length of experience, in any inpatient or outpatient unit, in any hospital (community, long term care, and teaching) with any education level participated in the study. DATA COLLECTION: Data were collected via surveys sent to randomly chosen registrants from the College of Nurses of Ontario (Canada) Registry. RESULTS: Statistically significant correlations were found amongst all the variables. A simple linear regression was calculated to predict the effect of the independent variables of structural empowerment, psychological empowerment, and inter-professional collaboration on the dependent variable compassion. All three had a statistically significant positive relationship to the dependent variable compassion. DISCUSSION AND CONCLUSIONS: Each of structural empowerment, psychological empowerment, and inter-professional collaboration has been discussed in the literature as a possible predictor of compassion. This study shows that that is the case. This is critical information for both organizations and individual nurses to have, as currently there is an inclination to blame nurses for having insufficient compassion rather than considering there may also be environmental and structural reasons for nurses being unable to practice with compassion. With this study as a beginning, future studies could test for models of how these variables interact in order to make more informed decisions about how to enable compassionate nursing practice. These strategies as it turns out, may be both personal and environmental. This study is a step towards the building of nursing compassion literacy.

Prevalence of muscular dystrophies: a systematic literature review.

BACKGROUND: Determining the prevalence of neuromuscular disorders for the general population is important to identify the scope of burden on society and enable comparisons with other health conditions. This systematic review aims to identify and collate the findings of studies published between 1960 and 2013 on the prevalence of all types of muscular dystrophies. SUMMARY: Relevant articles were identified through electronic database searches and manual searches of reference lists. There were 38 articles from across 19 countries that met the inclusion criteria. The total combined prevalence for all muscular dystrophies for studies classified as having a low risk of bias ranged between 19.8 and 25.1 per 100,000 person-years. Myotonic dystrophy (0.5-18.1 per 100,000), Duchenne muscular dystrophy (1.7-4.2) and facioscapulohumeral muscular dystrophy (3.2-4.6 per 100,000) were found to be the most common types of disorder. There was wide variation in study methodology, case ascertainment, and verification procedures and populations studied, all of which may contribute to the wide prevalence range, in addition to the likely variation in prevalence by country. Key Messages: Greater consistency in the conduct and reporting of neuroepidemiological studies is urgently needed to enable comparisons to be made between studies, countries, and over time.

The use of heparin in preparing samples for blood-gas analysis.

Heparin is the only anticoagulant used to prepare samples for blood-gas analysis. There are two ways in which heparin can interfere with results. The first is high heparin concentration in blood, and the second is heparin dilution of blood if liquid rather than dried (lyophilized) heparin is used. Traditional blood-gas analytes (pH, pCO2, and pO2) are less affected than electrolytes (particularly ionized calcium), also measured on modern blood-gas analyzers. The sample requirements as far as heparin is concerned are thus less exacting if only pH, pCO2, and pO2 are to be measured. For these analytes, it is still essential that the heparin (either sodium or lithium) concentration is less than 200 IU/mL blood and that the blood is not diluted more than 5%. The inclusion of electrolytes in the test repertoire excludes the use of sodium heparin in favor of lithium heparin. The inclusion of ionized calcium in the test repertoire demands that the heparin should be lyophilized, and the concentration should not exceed 10 IU/mL blood, unless a specialized heparin that eliminates the effect of calcium binding by heparin is used. Whatever the heparin formulation, it is essential for accurate results that the correct volume of blood is sampled to achieve a correct heparin concentration (and dilution, if liquid heparin is used), and that blood and anticoagulant are well mixed immediately after sampling. One of the most common practical problems associated with blood-gas analysis is inadequate anticoagulation and the formation of small blood clots that can block the sample pathway of blood-gas analyzers and invalidate results. Inadequate mixing of specimen with heparin is usually the problem. Clearly, the lower the heparin concentration the greater is the risk that poor mixing technique will give rise to inadequate anticoagulation and the associated problems.