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1.
Environ Sci Technol ; 58(19): 8313-8325, 2024 May 14.
Artículo en Inglés | MEDLINE | ID: mdl-38689207

RESUMEN

CO2 is 45 to 50 times more concentrated in soil than in air, resulting in global diffusive fluxes that outpace fossil fuel combustion by an order of magnitude. Despite the scale of soil CO2 emissions, soil-based climate change mitigation strategies are underdeveloped. Existing approaches, such as enhanced weathering and sustainable land management, show promise but continue to face deployment barriers. We introduce an alternative approach: the use of solid adsorbents to directly capture CO2 in soils. Biomass-derived adsorbents could exploit favorable soil CO2 adsorption thermodynamics while also sequestering solid carbon. Despite this potential, previous study of porous carbon CO2 adsorption is mostly limited to single-component measurements and conditions irrelevant to soil. Here, we probe sorption under simplified soil conditions (0.2 to 3% CO2 in balance air at ambient temperature and pressure) and provide physical and chemical characterization data to correlate material properties to sorption performance. We show that minimally engineered pyrogenic carbons exhibit CO2 sorption capacities comparable to or greater than those of advanced sorbent materials. Compared to textural features, sorbent carbon bond morphology substantially influences low-pressure CO2 adsorption. Our findings enhance understanding of gas adsorption on porous carbons and inform the development of effective soil-based climate change mitigation approaches.


Asunto(s)
Dióxido de Carbono , Carbono , Suelo , Dióxido de Carbono/química , Suelo/química , Porosidad , Adsorción , Carbono/química , Carbón Orgánico/química , Cambio Climático
2.
Environ Sci Technol ; 53(19): 11429-11436, 2019 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-31525910

RESUMEN

Lead (Pb) exposure is a major public health problem worldwide. Although high levels of Pb in blood in Bangladesh have been documented, the dominant Pb sources contributing to human exposure in rural Bangladesh have not been determined. Here, we first obtained blood from pregnant women from three rural Bangladeshi districts who were previously assessed by a case-control and sampling study, and we then conducted semistructured in-depth interviews to understand Pb exposure behavior and finally collected samples of the suspected Pb sources. We measured the Pb isotopic composition of both potential Pb sources and 45 blood samples in order to understand which of three sources predominate: (1) food from Pb-soldered cans, (2) turmeric, or (3) geophagous materials (clay, soil, or ash). The Pb isotope ratios of the three sources are distinct (p = 0.0001) and blood isotope ratios are most similar to turmeric. Elevated lead and chromium (Cr) concentrations in turmeric and a yellow pigment used in turmeric processing are consistent with reported consumption behavior that indicated turmeric as a primary contributor to blood Pb. The Pb isotopic composition analyses combined with a case-control and sampling approach provides evidence that turmeric adulterated with the yellow Pb-bearing pigment is the main Pb exposure source in these districts and illustrates the need to assess drivers and practices of turmeric adulteration, as well as the prevalence of adulteration across South Asia.


Asunto(s)
Isótopos , Suelo , Asia , Bangladesh , Monitoreo del Ambiente , Femenino , Humanos , Embarazo , Población Rural
3.
Chemosphere ; 234: 98-107, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31203046

RESUMEN

The reaction kinetics of groundwater contaminants are integral to evaluating the fate and transport of toxic metals in the environment. For redox sensitive contaminants, such as chromium, the kinetics of different reaction pathways can vary by orders of magnitude. Species-specific rate constants for iron-chromium oxidation-reduction reactions are unknown for many systems, especially in the presence of sorbing surfaces. We investigate the role of quartz and amorphous silica (SiO2(am)) surfaces in mediating abiotic reduction of Cr(VI)aq by aqueous and sorbed Fe(II) using batch sorption and redox experiments. Sorption edges indicate outer-sphere (Fe(II)ads,OS) and inner-sphere (Fe(II)ads,IS) complexes are present on both silica surfaces, and their abundance depends on pH, ionic strength, and surface disorder. The rate constants for Cr(VI)aq reduction by Fe(II) species increase in the following order: kaq ≪ kads,OS,quartz < kads,OS,SiO2(am) < kads,IS,quartz < kads,IS,SiO2(am), suggesting that increasing proximity of Fe(II) to the negatively charged silica surface enhances the rate of reduction of Cr(VI)aq. However, we observe that experiments with larger amounts of sorbed Fe(II) reduce less total Cr(VI)aq over time, which we attribute to a portion of the sorbed Fe(II) being sequestered into the Cr(III)-Fe(III)-oxyhydroxide precipitates forming on the silica surface. Therefore, the balance between increases in the rate and decreases in the total amount of Cr(VI)aq reduction by various sorbed Fe(II) species must be considered when devising remediation strategies.


Asunto(s)
Cromo/química , Compuestos Ferrosos/química , Dióxido de Silicio/química , Adsorción , Cinética , Oxidación-Reducción , Sustancias Reductoras/química , Propiedades de Superficie
4.
Environ Sci Technol ; 53(7): 3399-3409, 2019 04 02.
Artículo en Inglés | MEDLINE | ID: mdl-30807121

RESUMEN

Uranium (U) groundwater contamination is a major concern at numerous former mining and milling sites across the Upper Colorado River Basin (UCRB), USA, where U(IV)-bearing solids have accumulated within naturally reduced zones (NRZs). Understanding the processes governing U reduction and oxidation within NRZs is critical for assessing the persistence of U in groundwater. To evaluate the redox cycling of uranium, we measured the U concentrations and isotopic compositions (δ238U) of sediments and pore waters from four study sites across the UCRB that span a gradient in sediment texture and composition. We observe that U accumulation occurs primarily within fine-grained (low-permeability) NRZs that show active redox variations. Low-permeability NRZs display high accumulation and low export of U, with internal redox cycling of U. In contrast, within high-permeability NRZs, U is remobilized under oxidative conditions, possibly without any fractionation, and transported outside the NRZs. The low δ238U of sediments outside of defined NRZs suggests that these reduced zones act as additional U sources. Collectively, our results indicate that fine-grained NRZs have a greater potential to retain uranium, whereas NRZs with higher permeability may constitute a more-persistent but dilute U source.


Asunto(s)
Agua Subterránea , Uranio , Contaminantes Radiactivos del Agua , Colorado , Sedimentos Geológicos , Oxidación-Reducción , Ríos
5.
Environ Sci Technol ; 51(17): 9817-9825, 2017 Sep 05.
Artículo en Inglés | MEDLINE | ID: mdl-28783317

RESUMEN

Hexavalent chromium is a water-soluble pollutant, the mobility of which can be controlled by reduction of Cr(VI) to less soluble, environmentally benign Cr(III). Iron(II/III)-bearing clay minerals are widespread potential reductants of Cr(VI), but the kinetics and pathways of Cr(VI) reduction by such clay minerals are poorly understood. We reacted aqueous Cr(VI) with two abiotically reduced clay minerals: an Fe-poor montmorillonite and an Fe-rich nontronite. The effects of ionic strength, pH, total Fe content, and the fraction of reduced structural Fe(II) [Fe(II)/Fe(total)] were examined. The last variable had the largest effect on Cr(VI) reduction kinetics: for both clay minerals, the rate constant of Cr(VI) reduction varies by more than 3 orders of magnitude with Fe(II)/Fe(total) and is described by a linear free energy relationship. Under all conditions examined, Cr and Fe K-edge X-ray absorption near-edge structure spectra show that the main Cr-bearing product is a Cr(III)-hydroxide and that Fe remains in the clay structure after reacting with Cr(VI). This study helps to quantify our understanding of the kinetics of Cr(VI) reduction by Fe(II/III)-bearing clay minerals and may improve predictions of Cr(VI) behavior in subsurface environments.


Asunto(s)
Silicatos de Aluminio , Cromo/química , Hierro , Contaminantes Químicos del Agua/química , Arcilla , Cinética , Minerales , Oxidación-Reducción
6.
Environ Sci Technol ; 51(1): 141-149, 2017 01 03.
Artículo en Inglés | MEDLINE | ID: mdl-27935688

RESUMEN

Hexavalent chromium (Cr(VI)) is generated in serpentine soils and exported to surface and groundwaters at levels above health-based drinking water standards. Although Cr(VI) concentrations are elevated in serpentine soil pore water, few studies have reported field evidence documenting Cr(VI) production rates and fluxes that govern Cr(VI) transport from soil to water sources. We report Cr speciation (i) in four serpentine soil depth profiles derived from the California Coast Range serpentinite belt and (ii) in local surface waters. Within soils, we detected Cr(VI) in the same horizons where Cr(III)-minerals are colocated with biogenic Mn(III/IV)-oxides, suggesting Cr(VI) generation through oxidation by Mn-oxides. Water-extractable Cr(VI) concentrations increase with depth constituting a 7.8 to 12 kg/km2 reservoir of Cr(VI) in soil. Here, Cr(VI) is produced at a rate of 0.3 to 4.8 kg Cr(VI)/km2/yr and subsequently flushed from soil during water infiltration, exporting 0.01 to 3.9 kg Cr(VI)/km2/yr at concentrations ranging from 25 to 172 µg/L. Although soil-derived Cr(VI) is leached from soil at concentrations exceeding 10 µg/L, due to reduction and dilution during transport to streams, Cr(VI) levels measured in local surface waters largely remain below California's drinking water limit.


Asunto(s)
Contaminantes del Suelo , Suelo , Cromo , Agua Subterránea , Oxidación-Reducción , Óxidos , Contaminantes Químicos del Agua
7.
Environ Sci Technol ; 50(12): 6189-98, 2016 06 21.
Artículo en Inglés | MEDLINE | ID: mdl-27203292

RESUMEN

We use uranium (U) isotope ratios to detect and quantify the extent of natural U reduction in groundwater across a roll front redox gradient. Our study was conducted at the Smith Ranch-Highland in situ recovery (ISR) U mine in eastern Wyoming, USA, where economic U deposits occur in the Paleocene Fort Union formation. To evaluate the fate of aqueous U in and adjacent to the ore body, we investigated the chemical composition and isotope ratios of groundwater samples from the roll-front type ore body and surrounding monitoring wells of a previously mined area. The (238)U/(235)U of groundwater varies by approximately 3‰ and is correlated with U concentrations. Fluid samples down-gradient of the ore zone are the most depleted in (238)U and have the lowest U concentrations. Activity ratios of (234)U/(238)U are ∼5.5 up-gradient of the ore zone, ∼1.0 in the ore zone, and between 2.3 and 3.7 in the down-gradient monitoring wells. High-precision measurements of (234)U/(238)U and (238)U/(235)U allow for development of a conceptual model that evaluates both the migration of U from the ore body and the extent of natural attenuation due to reduction. We find that the premining migration of U down-gradient of the delineated ore body is minimal along eight transects due to reduction in or adjacent to the ore body, whereas two other transects show little or no sign of reduction in the down-gradient region. These results suggest that characterization of U isotopic ratios at the mine planning stage, in conjunction with routine geochemical analyses, can be used to identify where more or less postmining remediation will be necessary.


Asunto(s)
Uranio , Contaminantes Radiactivos del Agua , Agua Subterránea/química , Minerales , Minería
8.
Proc Natl Acad Sci U S A ; 113(9): 2360-5, 2016 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-26884155

RESUMEN

Delayed Earth system recovery following the end-Permian mass extinction is often attributed to severe ocean anoxia. However, the extent and duration of Early Triassic anoxia remains poorly constrained. Here we use paired records of uranium concentrations ([U]) and (238)U/(235)U isotopic compositions (δ(238)U) of Upper Permian-Upper Triassic marine limestones from China and Turkey to quantify variations in global seafloor redox conditions. We observe abrupt decreases in [U] and δ(238)U across the end-Permian extinction horizon, from ∼3 ppm and -0.15‰ to ∼0.3 ppm and -0.77‰, followed by a gradual return to preextinction values over the subsequent 5 million years. These trends imply a factor of 100 increase in the extent of seafloor anoxia and suggest the presence of a shallow oxygen minimum zone (OMZ) that inhibited the recovery of benthic animal diversity and marine ecosystem function. We hypothesize that in the Early Triassic oceans-characterized by prolonged shallow anoxia that may have impinged onto continental shelves-global biogeochemical cycles and marine ecosystem structure became more sensitive to variation in the position of the OMZ. Under this hypothesis, the Middle Triassic decline in bottom water anoxia, stabilization of biogeochemical cycles, and diversification of marine animals together reflect the development of a deeper and less extensive OMZ, which regulated Earth system recovery following the end-Permian catastrophe.


Asunto(s)
Planeta Tierra , Extinción Biológica , Oxígeno/análisis , Agua de Mar , Ecosistema
9.
Environ Sci Technol ; 50(1): 46-53, 2016 Jan 05.
Artículo en Inglés | MEDLINE | ID: mdl-26651843

RESUMEN

The Rifle alluvial aquifer along the Colorado River in west central Colorado contains fine-grained, diffusion-limited sediment lenses that are substantially enriched in organic carbon and sulfides, as well as uranium, from previous milling operations. These naturally reduced zones (NRZs) coincide spatially with a persistent uranium groundwater plume. There is concern that uranium release from NRZs is contributing to plume persistence or will do so in the future. To better define the physical extent, heterogeneity and biogeochemistry of these NRZs, we investigated sediment cores from five neighboring wells. The main NRZ body exhibited uranium concentrations up to 100 mg/kg U as U(IV) and contains ca. 286 g of U in total. Uranium accumulated only in areas where organic carbon and reduced sulfur (as iron sulfides) were present, emphasizing the importance of sulfate-reducing conditions to uranium retention and the essential role of organic matter. NRZs further exhibited centimeter-scale variations in both redox status and particle size. Mackinawite, greigite, pyrite and sulfate coexist in the sediments, indicating that dynamic redox cycling occurs within NRZs and that their internal portions can be seasonally oxidized. We show that oxidative U(VI) release to the aquifer has the potential to sustain a groundwater contaminant plume for centuries. NRZs, known to exist in other uranium-contaminated aquifers, may be regionally important to uranium persistence.


Asunto(s)
Sedimentos Geológicos/química , Agua Subterránea/química , Compuestos Orgánicos/análisis , Uranio/química , Contaminantes Radiactivos del Agua/análisis , Carbono/análisis , Color , Colorado , Oxidación-Reducción , Tamaño de la Partícula , Azufre/análisis , Uranio/análisis , Espectroscopía de Absorción de Rayos X
10.
Environ Sci Technol ; 49(10): 5939-47, 2015 May 19.
Artículo en Inglés | MEDLINE | ID: mdl-25909757

RESUMEN

In situ recovery (ISR) uranium (U) mining mobilizes U in its oxidized hexavalent form (U(VI)) by oxidative dissolution of U from the roll-front U deposits. Postmining natural attenuation of residual U(VI) at ISR mines is a potential remediation strategy. Detection and monitoring of naturally occurring reducing subsurface environments are important for successful implementation of this remediation scheme. We used the isotopic tracers (238)U/(235)U (δ(238)U), (234)U/(238)U activity ratio, and (34)S/(32)S (δ(34)S), and geochemical measurements of U ore and groundwater collected from 32 wells located within, upgradient, and downgradient of a roll-front U deposit to detect U(VI) reduction and U mobility at an ISR mining site at Rosita, TX, USA. The δ(238)U in Rosita groundwater varies from +0.61‰ to -2.49‰, with a trend toward lower δ(238)U in downgradient wells. The concurrent decrease in U(VI) concentration and δ(238)U with an ε of 0.48‰ ± 0.08‰ is indicative of naturally occurring reducing environments conducive to U(VI) reduction. Additionally, characteristic (234)U/(238)U activity ratio and δ(34)S values may also be used to trace the mobility of the ore zone groundwater after mining has ended. These results support the use of U isotope-based detection of natural attenuation of U(VI) at Rosita and other similar ISR mining sites.


Asunto(s)
Restauración y Remediación Ambiental , Minería , Uranio/análisis , Contaminantes Radiactivos del Agua/análisis , Geografía , Agua Subterránea/química , Oxidación-Reducción , Isótopos de Azufre , Texas
11.
Am J Hosp Palliat Care ; 32(5): 484-9, 2015 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-24803586

RESUMEN

PURPOSE: The purpose of this qualitative analysis was to examine the experiences of family caregivers supporting a dying person in the home setting. In particular, it explores caregivers' perceptions of receiving palliative care at home when supplied with an emergency medication kit (EMK). RESULTS: Most family caregivers described preexisting medication management strategies that were unable to provide timely intervention in symptoms. The EMK was largely viewed as an effective strategy in providing timely symptom control and preventing readmission to inpatient care. Caregivers reported varying levels of confidence in the administration of medication. CONCLUSION: The provision of an EMK is an effective strategy for improving symptom control and preventing inpatient admissions of home-dwelling palliative care patients.


Asunto(s)
Cuidadores/psicología , Familia/psicología , Servicios de Atención de Salud a Domicilio/organización & administración , Cuidados Paliativos/organización & administración , Medicamentos bajo Prescripción/administración & dosificación , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Comodidad del Paciente , Investigación Cualitativa
12.
Am J Hosp Palliat Care ; 32(6): 581-7, 2015 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-24871345

RESUMEN

Improving symptom management for palliative care patients has obvious benefits for patients and advantages for the clinicians, as workload demands and work-related stress can be reduced when the emergent symptoms of patients are managed in a timely manner. The use of emergency medication kits (EMKs) can provide such timely symptom relief. The purpose of this study was to conduct a survey of a local service to examine views on medication management before and after the implementation of an EMK and to conduct a nationwide prevalence survey examining the use of EMKs in Australia. Most respondents from community palliative care services indicated that EMKs were not being supplied to palliative care patients but believed such an intervention could improve patient care.


Asunto(s)
Analgésicos Opioides/administración & dosificación , Antieméticos/administración & dosificación , Quimioterapia/métodos , Servicios de Atención de Salud a Domicilio , Hipnóticos y Sedantes/administración & dosificación , Cuidados Paliativos/métodos , Australia , Humanos , Encuestas y Cuestionarios
13.
Environ Sci Technol ; 48(15): 8636-44, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24984107

RESUMEN

High concentrations of uranium are commonly observed in naturally occurring amorphous silica (including opal) deposits, suggesting that incorporation of U into amorphous silica may represent a natural attenuation mechanism and promising strategy for U remediation. However, the stability of uranium in opaline silicates, determined in part by the binding mechanism for U, is an important factor in its long-term fate. U may bind directly to the opaline silicate matrix, or to materials such as iron (hydr)oxides that are subsequently occluded within the opal. Here, we examine the coordination environment of U within opaline silica to elucidate incorporation mechanisms. Precipitates (with and without ferrihydrite inclusions) were synthesized from U-bearing sodium metasilicate solutions, buffered at pH ∼ 5.6. Natural and synthetic solids were analyzed with X-ray absorption spectroscopy and a suite of other techniques. In synthetic amorphous silica, U was coordinated by silicate in a double corner-sharing coordination geometry (Si at ∼ 3.8-3.9 Å) and a small amount of uranyl and silicate in a bidentate, mononuclear (edge-sharing) coordination (Si at ∼ 3.1-3.2 Å, U at ∼ 3.8-3.9 Å). In iron-bearing synthetic solids, U was adsorbed to iron (hydr)oxide, but the coordination environment also contained silicate in both edge-sharing and corner-sharing coordination. Uranium local coordination in synthetic solids is similar to that of natural U-bearing opals that retain U for millions of years. The stability and extent of U incorporation into opaline and amorphous silica represents a long-term repository for U that may provide an alternative strategy for remediation of U contamination.


Asunto(s)
Dióxido de Silicio/química , Uranio/química , Adsorción , Compuestos Férricos , Hierro/química , Óxidos/química , Silicatos , Espectroscopía de Absorción de Rayos X
14.
Appl Nurs Res ; 27(1): 78-83, 2014 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-24332958

RESUMEN

There are many challenges in developing research projects in research-naïve clinical settings, especially palliative care where resistance to participate in research has been identified. These challenges to the implementation of research are common in nursing practice and are associated with attitudes towards research participation, and some lack of understanding of research as a process to improve clinical practice. This is despite the professional nursing requirement to conduct research into issues that influence palliative care practice. The purpose of this paper is to describe the process of implementing a clinical research project in collaboration with the clinicians of a palliative care community team and to reflect on the strategies implemented to overcome the challenges involved. The challenges presented here demonstrate the importance of proactively implementing engagement strategies from the inception of a research project in a clinical setting.


Asunto(s)
Investigación en Enfermería , Cuidados Paliativos , Ética en Investigación , Humanos , Encuestas y Cuestionarios
16.
Inorg Chem ; 52(7): 3510-32, 2013 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-23137032

RESUMEN

Although minor in abundance in Earth's crust (U, 2-4 ppm; Th, 10-15 ppm) and in seawater (U, 0.003 ppm; Th, 0.0007 ppm), light actinides (Th, Pa, U, Np, Pu, Am, and Cm) are important environmental contaminants associated with anthropogenic activities such as the mining and milling of uranium ores, generation of nuclear energy, and storage of legacy waste resulting from the manufacturing and testing of nuclear weapons. In this review, we discuss the abundance, production, and environmental sources of naturally occurring and some man-made light actinides. As is the case with other environmental contaminants, the solubility, transport properties, bioavailability, and toxicity of actinides are dependent on their speciation (composition, oxidation state, molecular-level structure, and nature of the phase in which the contaminant element or molecule occurs). We review the aqueous speciation of U, Np, and Pu as a function of pH and Eh, their interaction with common inorganic and organic ligands in natural waters, and some of the common U-containing minerals. We also discuss the interaction of U, Np, Pu, and Am solution complexes with common Earth materials, including minerals, colloids, gels, natural organic matter (NOM), and microbial organisms, based on simplified model system studies. These surface interactions can inhibit (e.g., sorption to mineral surfaces, formation of insoluble biominerals) or enhance (e.g., colloid-facilitated transport) the dispersal of light actinides in the biosphere and in some cases (e.g., interaction with dissimilatory metal-reducing bacteria, NOM, or Mn- and Fe-containing minerals) can modify the oxidation states and, consequently, the behavior of redox-sensitive light actinides (U, Np, and Pu). Finally, we review the speciation of U and Pu, their chemical transformations, and cleanup histories at several U.S. Department of Energy field sites that have been used to mill U ores, produce fissile materials for reactors and weapons, and store high-level nuclear waste from both civilian and defense operations, including Hanford, WA; Rifle, CO; Oak Ridge, TN; Fernald, OH; Fry Canyon, UT; and Rocky Flats, CO.

17.
J Neurosci ; 31(9): 3197-206, 2011 Mar 02.
Artículo en Inglés | MEDLINE | ID: mdl-21368031

RESUMEN

Disrupted-in-Schizophrenia 1 (DISC1) is a strong candidate gene for schizophrenia and other mental disorders. DISC1 regulates neurodevelopmental processes including neurogenesis, neuronal migration, neurite outgrowth, and neurotransmitter signaling. Abnormal neuronal morphology and cortical architecture are seen in human postmortem brain from patients with schizophrenia. However, the etiology and development of these histological abnormalities remain unclear. We analyzed the histology of two Disc1 mutant mice with point mutations (Q31L and L100P) and found a relative reduction in neuron number, decreased neurogenesis, and altered neuron distribution compared to wild-type littermates. Frontal cortical neurons have shorter dendrites and decreased surface area and spine density. Overall, the histology of Disc1 mutant mouse cortex is reminiscent of the findings in schizophrenia. These results provide further evidence that Disc1 participates in cortical development, including neurogenesis and neuron migration.


Asunto(s)
Corteza Cerebral/embriología , Corteza Cerebral/patología , Proteínas del Tejido Nervioso/genética , Mutación Puntual/genética , Sustitución de Aminoácidos/genética , Animales , Corteza Cerebral/ultraestructura , Femenino , Inhibidores de Crecimiento/genética , Inhibidores de Crecimiento/fisiología , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Ratones Transgénicos , Proteínas del Tejido Nervioso/fisiología , Neurogénesis/genética , Neuronas/metabolismo , Neuronas/patología , Polimorfismo de Nucleótido Simple/genética , Embarazo
18.
Int J Palliat Nurs ; 17(12): 607-10, 2011 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-22240743

RESUMEN

As the global population grows and ages, an increasing number of patients are being referred to specialist palliative care services with multiple comorbidities. A parallel increase in interventional cardiology technology, techniques, and availability means that an increasing minority of these patients are having an implantable cardioverter defibrillator device (ICD) in place. It is essential that issues relating to these devices are discussed early in patients' planning for end-of-life care, as the discharging of a device in a patient who has chosen not to be resuscitated will be contrary to their wishes. These issues are explored here by presenting two case studies with vastly different outcomes that were experienced at a hospice in Australia. Examination of these case studies by the hospice staff culminated in the development of a policy for the home-based palliative care team and the hospice inpatient unit for deactivation of ICDs according to patients' and caregivers' wishes at a variety of stages of their palliative care journey. Elements of this policy are also presented here as guidance for others looking to implement similar processes.


Asunto(s)
Desfibriladores Implantables , Política de Salud , Cuidados Paliativos/organización & administración , Australia , Humanos
19.
Environ Sci Technol ; 38(12): 3330-7, 2004 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-15260332

RESUMEN

In the mid-1990s, a groundwater plume of uranium (U) was detected in monitoring wells in the B-BX-BY Waste Management Area at the Hanford Site in Washington. This area has been used since the late 1940s to store high-level radioactive waste and other products of U fuel-rod processing. Using multiple-collector ICP source magnetic sector mass spectrometry, high-precision uranium isotopic analyses were conducted of samples of vadose zone contamination and of groundwater. The isotope ratios 236U/238U, 234U/238U, and 238U/235U are used to distinguish contaminant sources. On the basis of the isotopic data, the source of the groundwater contamination appears to be related to a 1951 overflow event at tank BX-102 that spilled high-level U waste into the vadose zone. The U isotopic variation of the groundwater plume is a result of mixing between contaminant U from this spill and natural background U. Vadose zone U contamination at tank B-110 likely predates the recorded tank leak and can be ruled out as a significant source of groundwater contamination, based on the U isotopic composition. The locus of vadose zone contamination is displaced from the initial locus of groundwater contamination, indicating that lateral migration in the vadose zone was at least 8 times greater than vertical migration. The time evolution of the groundwater plume suggests an average U migration rate of approximately 0.7-0.8 m/day showing slight retardation relative to a groundwater flow of approximately 1 m/day.


Asunto(s)
Residuos Radiactivos , Contaminantes Radiactivos del Suelo/análisis , Uranio/análisis , Contaminantes Radiactivos del Agua/análisis , Monitoreo del Ambiente , Washingtón , Movimientos del Agua
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