Implementation of occupational therapy within early intervention in psychosis services: Results from a national survey.

AIM: Occupational therapy plays an important role in fostering community participation in areas such as education, employment, leisure, and social relationships, yet its added value within early intervention in psychosis services, especially in the United States, remains poorly understood. The purpose of this research was to conduct a national survey of early intervention in psychosis programs to: (1) understand the role and unique contributions of occupational therapists to early intervention teams, and (2) identify barriers and supports to the implementation of occupational therapy services within these programs. METHODS: Fifty-one senior leaders from U.S.-based early intervention in psychosis programs participated in the national survey. The survey consisted of a series of closed and open-ended questions related to program staffing, the presence of specific services that fall within the occupational therapy scope of practice, and implementation barriers and supports. RESULTS: Despite there being strong interest in employing occupational therapists, a small proportion of programs (31%) reported having them on staff. Occupational therapists supported clients across multiple life areas and were significantly more likely than other team members to promote daily living activities (e.g., cooking) and to address sensory processing needs and challenges. Implementation was influenced by environmental/organizational and staff factors; the primary barrier was funding. CONCLUSIONS: Findings support the role occupational therapists may play in facilitating the community participation of clients of early intervention services, but significant barriers to implementation of occupational therapy services remain. Additional research is needed to further identify the impact of occupational therapy services within the early intervention model.

Odour concentrations prediction based on odorants concentrations from biosolid emissions.

Biosolids storage areas are a significant contributor to wastewater treatment plant (WWTPs) odour emissions which can cause sensorial impact to surrounding communities. Most odour impact regulations are based on odour concentration (COD) measurements determined by dynamic olfactometry. Understanding the relationship between odorants concentrations and COD in the biosolids emission is important to identify how the measurement and monitoring can be conducted using analytical rather than sensorial techniques. Some of the odorants are unknown in biosolid emissions, increasing the uncertainty in predicting COD. In this study, emissions from 56 biosolid samples collected from two WWTPs located in Sydney, Australia, were analysed by analytical and sensorial methods, including olfactory detection port (ODP) and dynamic olfactometry. Concentrations of 25 odorants and two ordinal variables represented odour events detected by ODP assessors were linked to COD values. Bayesian Model Averaging and Variable Selection with Bayesian Adaptive Sampling were applied to model the relation between COD and odorants concentrations. Results indicate the usability of the probabilistic methods and nonlinear transformations in modelling the odour concentrations based on odorants concentrations from biosolids emission and the accuracy of a small dataset.

Measuring volatile emissions from biosolids: A critical review on sampling methods.

As a by-product of wastewater treatment, biosolids are a source of volatile emissions which can lead to community complaints due to odours and other pollution risks. Sampling methods play a significant role in collecting gas emissions from biosolids-related sources (i.e., pure biosolids, landfilling, land application and composting of biosolids). Though a range of different sampling techniques (flux hood, wind tunnel, static chamber, headspace devices) have been explored in many published papers, the management and best practice for sampling emissions from biosolids is unclear. This paper presents a comprehensive review of sampling methods for collecting gaseous emissions from biosolids. To account for the inconsistent terminologies used to describe sampling devices, a standard nomenclature by grouping sampling devices into five categories was proposed. Literature investigating emission sampling from biosolids-related sources was reviewed. Subsequently a critical analysis of sampling methods in terms of design, advantages, and disadvantages were compiled based on literature findings and assumed mechanistic understanding of operation. Key operational factors such as the presence of fans, purge gas flow rates, insertion depth, and incubation conditions were identified and their level of influence on the measurement of emissions were evaluated. From the review, there are still knowledge gaps regarding sampling methods used to collect gases from biosolids-related sources. Therefore, a framework for the management of emission sampling methodologies based on common sampling purposes was proposed. This critical review is expected to improve the understanding of sampling methodologies used in biosolids-related sources, by demonstrating the potential implications and impacts due to different choices in sampling methods.

Occurrence and risk assessment of trace organic contaminants and metals in anaerobically co-digested sludge.

Anaerobic co-digestion of sludge increases biogas production and maintains anaerobic digestion stability. However, it is unclear whether the addition of co-substrates may increase the concentration of trace organic contaminants (TrOCs) and metals, limiting potential resource recovery opportunities when applied to agricultural land. This study explored the occurrence of 20 TrOCs and 18 metals in wastewater sludge anaerobically co-digested with beverage rejects (cola, beer and juice) and food wastes. TrOCs results showed that cola reject caused an accumulation of caffeine in final digestate. Bisphenol A also significantly increased in food waste co-digestion when compared with the mono-digestion (control). No significant difference in TrOCs was observed in the juice reject co-digestion. Analysis of the metal composition revealed a significant increase in Cr and Al in juice reject co-digested sludge. While restaurant food waste increased concentrations of K and Ca, both of which may be beneficial when applied to land. All metals in this study were below the maximum permissible concentrations specified for agricultural land use in Australia. Environmental risk assessment of sludge when used as soil fertiliser, showed that caffeine, diuron, triclocarban, triclosan, Cu and Zn exhibited high risks, with the largest risk quotient (RQ) posed by caffeine. Estrone and naproxen implied medium risks, and ibuprofen implied a high risk except for the co-digestion using cola reject (RQ = 0.9, medium risk). The results emphasise the importance for wastewater utility operators to understand the impact of co-substrate selection on the quality of sludge to minimise environmental risk from the use of biosolids on agricultural land.

Identification of volatile sulfur odorants emitted from ageing wastewater biosolids.

Volatile sulfur compounds (VSCs) are important sources of unpleasant odours in biosolid emissions. However, the study of VSCs may be limited by complications in their gas phase measurements due to reactivity, transformations and varying reported odour detection thresholds. A range of methods were used to quantitatively analyse VSCs in wastewater biosolid emissions. VSCs were identified in aged biosolid emissions by gas chromatography (GC) with a sulfur chemiluminescence detector (SCD) and mass spectrometry coupled with olfactory detection port (MS/O). In total, 10 VSC's were identified with two volatile organic sulfur compounds (VOSCs), allyl methyl sulfide and methyl propyl sulfide being reported for the first time in biosolid emissions. The emission patterns of different VSCs varied as the biosolids aged. Initially, the median concentrations of H2S, dimethyl sulfide (DMS), dimethyl trisulfide (DMTS), methanethiol (MeSH) and ethanethiol (EtSH) were orders of magnitude greater than their reported odour detection threshold, suggesting they would contribute to the odorous impact of the biosolids. The maximum H2S value was equal to 59.9 × 103 µg/m3 and was at least one magnitude higher compared to VOSCs, such as dimethyl disulfide (DMDS) (3.8×103 µg/m3), DMS (4.53 × 103 µg/m3), EtSH (2.83 × 103 µg/m3) and MeSH (3.25 × 103 µg/m3). Among the identified VSCs, H2S was the prominent odorant in terms of the magnitude and the frequency of detection, both initially as well as throughout storage. However, DMTS should be considered as a high priority or key odorant due to its odour activity value (OAV) and frequency of detection (sensorially detected in more than 75% of samples, with an OAVs higher than 1).

Improved Outcomes Associated with the use of Shock Protocols: Updates from the National Cardiogenic Shock Initiative.

BACKGROUND: The National Cardiogenic Shock Initiative is a single-arm, prospective, multicenter study to assess outcomes associated with early mechanical circulatory support (MCS) in patients presenting with acute myocardial infarction and cardiogenic shock (AMICS) treated with percutaneous coronary intervention (PCI). METHODS: Between July 2016 and February 2019, 35 sites participated and enrolled into the study. All centers agreed to treat patients with AMICS using a standard protocol emphasizing invasive hemodynamic monitoring and rapid initiation of MCS. Inclusion and exclusion criteria mimicked those of the "SHOCK" trial with an additional exclusion criteria of intra-aortic balloon pump counter-pulsation prior to MCS. RESULTS: A total of 171 consecutive patients were enrolled. Patients had an average age of 63 years, 77% were male, and 68% were admitted with AMICS. About 83% of patients were on vasopressors or inotropes, 20% had a witnessed out of hospital cardiac arrest, 29% had in-hospital cardiac arrest, and 10% were under active cardiopulmonary resuscitation during MCS implantation. In accordance with the protocol, 74% of patients had MCS implanted prior to PCI. Right heart catheterization was performed in 92%. About 78% of patients presented with ST-elevation myocardial infarction with average door to support times of 85 ± 63 min and door to balloon times of 87 ± 58 min. Survival to discharge was 72%. Creatinine ≥2, lactate >4, cardiac power output (CPO) <0.6 W, and age ≥ 70 years were predictors of mortality. Lactate and CPO measurements at 12-24 hr reliably predicted overall mortality postindex procedure. CONCLUSION: In contemporary practice, use of a shock protocol emphasizing best practices is associated with improved outcomes.

Investigation of non-community stakeholders regarding community engagement and environmental malodour.

Research into industry-community relationships have focused almost exclusively on the ways in which communities responds to actions from industries. This has led to a paucity of understanding with regards to how community engagement and malodour amelioration practices have been adopted by industry personnel, as well as the attitudes and beliefs of non-community stakeholders in general. In this study, a survey to water industry personnel was distributed to three Australian water utilities in South-Eastern Australia and a semi-structured interview process was carried out with plant managers at six wastewater treatment plants. It was observed that best practice has not yet been established with regards to community engagement and odour amelioration, and that water industry personnel in general had a poor understanding of these concepts. Recommendations for how this situation could be improved, and how non-community stakeholders investigated, are discussed.

Quantification of VOCs and the development of odour wheels for rubber processing.

The impacts of rubber variations (clonal, seasonal, and pre-treatment) were investigated to assess changes in the composition of volatile organic compounds (VOCs) emitted during rubber processing. VOC emissions from 14 different rubber types were evaluated by headspace micro-chamber (µ-TEC) extraction coupled with gas chromatography-mass spectrometry (GC-MS). Headspace extracted at 120 °C, which is equivalent to the drying temperature during rubber processing, revealed a significant number of odorants in terms of concentrations as well as odorant type. Volatile fatty acids (VFAs) such as acetic, propanoic, butanoic, pentanoic and hexanoic acids, were frequently detected at concentrations greater than their odour detection thresholds. Other odorous compounds including trimethylamine, p-cresol, butanone, indole, and phenol, were also detected. Emissions collected at ambient conditions represent odorants released during material storage (or maturation) and were dominated by benzene derivatives followed by ketones, aldehydes, esters, and acids. Emission composition during storage appeared to be governed by specific rubber properties such as protein and rubber moisture content. Seasonal variations revealed greater impacts on the concentration of VOCs for all studied clones, compared to pre-treatment variations, suggesting that the VOCs composition was seasonally dependent and may represents the 'potential' emissions from rubber as they are processed. A combination of sensorial and analytical measurements were used to produce odour wheels which may be used as tool to identify key malodours in onsite rubber processing. The linking of odours and odorants can facilitate communication between receptors (the public) and plant operators inorder to minimise odour impact and develop effective abatement and on-site management practices.

Identification of odorant characters using GC-MS/O in biosolids emissions from aerobic and anaerobic stabilisation.

Malodorous emissions from biosolids limit potential re-use opportunities. Emissions from anaerobically stabilised biosolids have been widely studied. In contrast, emissions from aerobically stabilised biosolids have not been well documented. Individual odorants in complex emissions can be detected using sensorial analysis methods, such as gas chromatography mass spectroscopy coupled with an odour detection port (GC-MS/O) where assessors sniff the GC effluent to identify odorants present. In this study, GC-MS/O was used to study and compare emissions from biosolids produced from aerobically and anaerobically stabilised biosolids from different wastewater treatment plants (WWTPs). The WWTPs varied in size, catchments and dewatering technology. Three GC-MS/O assessors were used for the sensorial analysis. The identified odorants varied significantly between the two sites using aerobic stabilisation, in number of odour characters detected, as well as their intensity. Different odour characters were noted from biosolids generated at the aerobic digestion sites compared to characters from biosolids generated at the anaerobic digestion site. Biosolids from the aerobic digestion sites had medicinal, acrid or putrid type odours not noted from the anaerobic site. However, descriptors of biosolids emissions were commonly noted as: rotten vegetables, seaweed, garbage, garlic, or bad-breath. Many of the descriptors were associated with the presence of sulfur-type compounds. The importance of assessor variability was also highlighted in the paper where certain characters were not detected or were described differently by assessors.

Sewer catchment effects on wastewater and biosolids odour management.

The composition of wastewater in sewer catchments is known to affect the performance of wastewater treatment plants (WWTPs). However, there is limited knowledge as to how catchment characteristics, such as types of catchment industries, impact odour emissions from downstream sludge processing and biosolids management. Odorous emissions from biosolids processing at WWTPs can represent a significant community impact when the local population is exposed to odours. The main odorants emitted from biosolids are volatile sulfur compounds (VSCs), however, volatile organic compounds (VOCs) in emissions may also be perceptable after the removal of VSCs in odour abatement systems. Types of compounds present in emissions throughout biosolids processing at five WWTPs of varying sizes and levels of treatment (primary only and primary and secondary) were analysed. The ratio of total VSCs to VOCs in emissions, and the sensorial importance of each class varied between the sites. As a number of the VOCs in emissions were of industrial origin, this variation is likely dependent on industrial flows into the upstream sewer catchment. The impact of different emission compositions on both activated carbon and biologically based odour abatement systems were discussed.

Framework for the use of odour wheels to manage odours throughout wastewater biosolids processing.

Odorous emissions from wastewater biosolids processing can cause nuisance impacts to the surrounding community. Odour Wheels are an effective tool for environmental odour management, but have yet to be provided for wastewater biosolids processing. Emissions throughout the biosolids processing from eight wastewater treatment plants, each with different unit operation configurations, were surveyed to identify odorants present and their olfactory properties. Chemical and olfactory methods identified a range of odorants and odours emitted throughout biosolids processing. Within the biosolids processing locations studied Sulfur type odours, described as rotten eggs or cabbage, were typically encountered. However, there was also a varying presence of Rancid/putrid and Faecal/manure type odours. Odour Wheels were generated to communicate both the olfactory and chemical components of emissions which were measured throughout biosolids processing. Examples based on the operation of the eight wastewater treatment plants were used to demonstrate how the Odour Wheels can be used as an onsite odour management aid. The paper demonstrates how Odour Wheels can be prepared using chemical and olfactory measurements and then used to communicate olfactory properties, as well as identify the causes of nuisance emissions throughout biosolids processing at wastewater treatment plants. The linking of odours and odorants to process conditions throughout biosolids processing facilitates effective abatement and management practices.

Variations of odorous VOCs detected by different assessors via gas chromatography coupled with mass spectrometry and olfactory detection port (ODP) system.

Odorous volatile organic compounds (VOCs) were analysed via a thermal desorption gas chromatograph coupled with a mass spectrometer and olfactory detection port (TD-GC-MS/ODP) to characterize odour emissions from a wastewater treatment plant (WWTP). Three trained ODP assessors, screened according to the European dynamic olfactometry standard (EN: 13725), were used for the olfactory analysis. Their sensitivity to n-butanol varied within the acceptable limits. VOC samples from the WWTP were collected onto Tenax TA sorbent tubes in triplicate and each assessor analysed one tube in the same sample desorbing and analysing conditions. Intensities of odours detected from ODP were scaled from 1 to 4. The ODP assessors used their own odour descriptors based on their own experience as well as referenced descriptors on published compost and wastewater odour wheels. The ODP assessors detected a total of 32 different odorous VOCs; however, the intensities assigned by each assessor to particular VOCs varied. Moreover, some odorous VOCs were not detected by all assessors. For example, geosmin was detected by only two assessors. The use of a TD-GC-MS/ODP system for the analysis of odorous VOCs is valuable when analysed by different assessors, allowing a range of responses to specific odorants in a populations to be investigated.

The Influence of Receiver Status on Donor Prosociality in 6- to 11-Year-Old Children.

The aim of this study was to explore the interplay between donor prosociality and receiver status using a fixed-choice resource distribution paradigm. Sixty children aged 6-11 years allocated resources to two high-status adults and two lower status adults under three different payoff structures. The donor could choose between an egalitarian option and an option that either resulted in an allocation that favored either the donor (Prosocial) or the receiver (Envy), or one in which the donor sacrificed resources to maintain parity (Costly Sharing). The results showed that the interplay between receiver status, donor age, and the payoff structure was complex, with children displaying selective generosity in which the status of the receiver played a key role.

Fingermark recovery from riot debris: Bricks and stones.

During the UK riots in August 2011, large volumes of bricks and stones were used as weapons or projectiles in acts of violence or to gain illegal entry to properties. As a result, it has been emphasised that it is necessary to determine suitable chemical treatment(s) that will enable the development of fingermarks on such items in order to identify those involved. This study has undertaken the task of attempting to develop latent fingermarks on common house bricks, limestone and sandstone using current techniques including ninhydrin and fluorescence. Results produced have shown that, with fluorescent fingerprint powder, silver nitrate and superglue providing the best results, it is now possible to enhance fingermarks that were previously left undeveloped. In addition, Isomark T-1 Rapid Grey High Resolution Forensic Impression Material has proved extremely effective as an alternative method of recovering fingermarks developed with fluorescent fingerprint powder.