Current Status of Home Medical Care Waste Collection by Nurses in Japan

A questionnaire survey was conducted to determine the current status of home medical care (HMC) waste collection by nurses for individual items and whether the collection rate differs with city size. The questionnaire was mailed to 1,022 nursing offices, of which 645 offices provided valid responses. Offices were classified into three groups according to the local population size. Responses indicated that used syringes and needles, except for pen-type self-injection needles, were collected by >50% of HMC nurses. On the other hand, enteral nutrients, nutritional adjustment diet vessels, feeding tubes, portable injectors, ventilator masks, endotracheal suction catheters, tracheal cannulas, continuous ambulatory peritoneal dialysis (CAPD) bags, and urinary catheters and bags had a low collection rate in comparison with syringes or needles. The collection percentage of used syringes, needles, and infusion needles (p < 0.05) and that for infusion bags, tubes, and catheters (p < 0.001) differed among the three population groups. Although municipalities are responsible for collect all HMC waste, sharp or infectious items should be collected by HMC doctors or nurses. On the contrary, nonhazardous HMC waste should be collected by municipalities.

Implications: This paper illustrates the status of waste collection of individual home medical care (HMC) items by HMC nurses. Infectious waste, such as needles and syringes, is collected by nurses. The collection rate of infectious waste by nurses in large cities was low compared with that in small cities. Although municipalities are responsible for collecting all HMC waste, sharp or infectious items should be collected by HMC doctors or nurses, whereas nonhazardous HMC waste should be collected by the municipalities.     

Removal of Linear and Branched p-Alkylphenols from Aqueous Solution by Combined Use of melB Tyrosinase and Chitosan Beads

In this study, melB tyrosinase was applied for enzymatic removal of linear and branched p-alkylphenols from aqueous solutions. First, systematic studies were carried out to estimate the effects of the process parameters such as the temperature, pH value, and enzyme dose on quinone conversion of p-cresol as a model phenol compound. A variety of p-alkylphenols were removed from aqueous solutions through the tyrosinase-catalyzed quinone conversion and subsequent nonenzymatic adsorption of quinone derivatives on chitosan beads at pH 6.0 and 30 °C under the optimum conditions determined for p-cresol. The % removal values of 98–100 were obtained for p-n-alkylphenols. Branched p-alkylphenols with a weak estrogenic activity containing 4-tert-butylphenol and 4-tert-pentylphenol, which underwent no quinone conversion by commercially available mushroom tyrosinase in the absence of H₂O₂, were also effectively removed by further increasing either the melB tyrosinase concentration or the amount of added chitosan beads. The present technique is much effective in the fact that a series of reactions rapidly progress under mild conditions and the chitosan beads can be readily separated from the reaction medium after the enzymatic treatment.     

Effect of seasonal variation in seawater dissolved mercury concentrations on mercury accumulation in the muscle of red sea bream (Pagrus major) held in Minamata Bay, Japan

Japanese stingfish (Sebastiscus marmoratus) and Bambooleaf wrasse (Pseudolabrus japonicas) are monitored annually for mercury pollution in Minamata Bay, Japan. The average total mercury concentration in the muscle of these two species in Minamata Bay was 0.36 mg?kg^?1 wet weight and 0.20 kg^?1 wet weigh, respectively, between 2008 and 2010. This is higher than levels elsewhere in Japan (0.125 mg?kg^?1 wet weight and 0.038 mg?kg^?1 wet weight, respectively). The FDA (2001) and EPA (2004) suggested that a proportion of mercury accumulated in fish is derived from seawater. We reared young red sea bream (Pagrus major) over a 2-year period in Minamata Bay and Nagashima (control) to evaluate the uptake of mercury from seawater and dietary sources. Fish were fed a synthesized diet that did not contain mercury. There was no difference in mercury accumulation in the muscle of red sea bream between Minamata Bay and Nagashima. Thus, our results suggest that the majority of mercury accumulated in fish muscle is not from seawater.     

NEAR‐STREAM LANDUSE EFFECTS ON STREAMWATER NUTRIENT DISTRIBUTION IN AN URBANIZING WATERSHED1

ABSTRACT: We investigated spatial and temporal relationships among surface and subsurface watershed attributes and stream nutrient concentrations in urbanizing Johnson Creek watershed in northern Oregon. We sampled stream water at eight urban and five nonurban locations from March 1998 through December 1999. We sampled eight wells distributed over the two primary aquifers in the watershed. Using a Geographic Information System (GIS), percentages of landuse attributes within a radius of 30, 91, and 152 m from each sample site were quantified. We analyzed relationships between (1) nutrient concentrations and percentage cover of different landuse attributes, and (2) nutrient concentrations and underlying hydrologic units. We did not find a significant relationship between ground water chemistry and stream water chemistry. We found elevated levels of phosphorus (P) concentrations correlated with urban landuse, while higher nitrogen (N) concentrations were correlated with nonurban (primarily agricultural) landuse. We concluded that elevated levels of N in nonurban areas of Johnson Creek watershed were associated with agricultural practices. We further concluded that urban development factors such as increases in storm drains, dry wells, and impermeable surfaces may be responsible for higher input of P to the stream in urbanizing areas of the Johnson Creek watershed.     

Vegetation monitoring using different scale of remote sensing data

This work sets out to simulate landscape model of Mu Us Desert in Inner Mongolia Autonomous Region of China at different spatial resolution using remote sensing images and distinguished landscape heterogeneity among different spatial resolutions. Landscape models were created from classification image of SPOT satellite data with 20m resolution and NOAA data with 1 km resolution. This study created landscape models of different scales by resampling the SPOT classified image using majority rule. The pixel resolution was increased from the finest scale of 20m by 20m up to 1000m by 1000m that was the coarsest spatial resolution. The Shannon diversity index was used to compare landscape models between different scales. At the finer scale the verify small patches such as deciduous forest, shrub and reedswamp with high vegetation coverage set on matrices with low vegetation cover (moving sand dune and sparse grassland) were verified. Broadening of scale resulted to the loss of small patches and at 1000m resolution, matrix classes were dominant. At 1km resolution of NOAA data, the matrix classes which greatly related to the topography of Mu Us Desert were detected. Diversity index decreased during scale broadening and the difference between SPOT 1km scale model and AVHRR data was not significant. The results showed that SPOT 20m model is good for the use of ecotone oriented revegetation planning, and NOAA 1km model is good for the seasonal and annual monitoring of each landscape unit, and revegetation planning at the regional level.     

Evaluation of light-duty vehicle mobile source regulations on ozone concentration trends in 2018 and 2030 in the western and eastern United States

To improve U.S. air quality, there are many regulations on-the-way (OTW) and on-the-books (OTB), including mobile source California Low Emission Vehicle third generation (LEV III) and federal Tier 3 standards. This study explores the effects of those regulations by using the U.S. Environmental Protection Agency's (EPA) Community Multiscale Air Quality (CMAQ) model for 8-hr ozone concentrations in the western and eastern United States in the years 2018 and 2030 during a month with typical high ozone concentrations, July. Alterations in pollutant emissions can be due to technological improvements, regulatory amendments, and changes in growth. In order to project emission rates for future years, the impacts of all of these factors were estimated. This study emphasizes the potential light-duty vehicle emission changes by year to predict ozone levels. The results of this study show that most areas have decreases in 8-hr ozone concentrations in the year 2030, although there are some areas with increased concentrations. Additionally, there are areas with 8-hr ozone concentrations greater than the current U.S. National Ambient Air Quality Standard level, which is 75 ppb.

Implications:

To improve U.S. air quality, many regulations are on the way and on the books, including mobile source California LEV III and federal Tier 3 standards. This study explores the effects of those regulations for 8-hr ozone concentrations in the western and eastern United States in the years 2018 and 2030. The results of this study show that most areas have decreases in 8-hr ozone concentrations in 2030, although there are some areas with increased concentrations. Additionally, there are areas with 8-hr ozone concentrations greater than the current U.S. National Ambient Air Quality Standard level.     

Importance of patient education on home medical care waste disposal in Japan

To determine current practices in the disposal and handling of home medical care (HMC) waste, a questionnaire was mailed to 1965 offices nationwide. Of the office that responded, 1283 offices were analyzed. Offices were classified by management configuration: those attached to hospitals were classified as ”attached offices” and others as “independent offices”. More nurses from attached offices recovered medical waste from patients’ homes than those from independent offices. Most nurses educated their patients on how to store HMC waste in their homes (79.3% of total) and on how to separate HMC waste (76.5% of total). On the other hand, only around half of nurses (47.3% from attached offices and 53.2% from independent offices) educated their patients on where to dispose of their HMC waste. 66.0% of offices replied that patients had separated their waste appropriately. The need for patient education has emerged in recent years, with education for nurses under the diverse conditions of HMC being a key factor in patient education.     

Drought impact assessment from monitoring the seasonality of vegetation condition using long-term time-series satellite images: a case study of Mt. Kenya region

Drought-induced anomalies in vegetation condition over wide areas can be observed by using time-series satellite remote sensing data. Previous methods to assess the anomalies may include limitations in considering (1) the seasonality in terms of each vegetation-cover type, (2) cumulative damage during the drought event, and (3) the application to various types of land cover. This study proposed an improved methodology to assess drought impact from the annual vegetation responses, and discussed the result in terms of diverse landscape mosaics in the Mt. Kenya region (0.4° N 35.8° E?~?1.6° S 38.4° E). From the 30-year annual rainfall records at the six meteorological stations in the study area, we identified 2000 as the drought year and 2001, 2004, and 2007 as the normal precipitation years. The time-series profiles of vegetation condition in the drought and normal precipitation years were obtained from the values of Enhanced Vegetation Index (EVI; Huete et al. 2002), which were acquired from Terra MODIS remote sensing dataset (MOD13Q1) taken every 16 days at the scale of 250-m spatial resolution. The drought impact was determined by integrating the annual differences in EVI profiles between drought and normal conditions, per pixel based on nearly same day of year. As a result, we successfully described the distribution of landscape vulnerability to drought, considering the seasonality of each vegetation-cover type at every MODIS pixel. This result will contribute to the large-scale landscape management of Mt. Kenya region. Future study should improve this method by considering land-use change occurred during the long-term monitoring period.     

Effects of ocean acidification on the early developmental stages of the horned turban,Turbo cornutus

To estimate the impact of CO₂-driven ocean acidification on the early life stages of gastropods, the effects of increased partial pressure of seawater carbon dioxide (pCO₂) (800–2,000 μatm) on the early developmental stages and larval shell length of the commercially important gastropod, the horned turban snail, Turbo cornutus were investigated. Increase in experimental seawater pCO₂ had an increasingly negative impact on the early developmental rate; the proportion of embryos or larvae displaying retarded development increased at higher pCO₂. The proportion of embryos that developed to the 4-cell stage at 2 h after fertilization decreased linearly with increasing pCO₂. At ~1,000 μatm pCO₂, retarded development was observed in ~50 % of larvae. No embryos developed to the 4-cell stage at 2,000 μatm pCO₂ within 2 h of fertilization. A similar trend continued until 24–26 h after fertilization; the proportion of larvae attaining veliger stage by 24–26 h also decreased with increasing pCO₂. The shell length of T. cornutus veligers decreased gradually as seawater pCO₂ increased, but markedly decreased in seawater under nearly unsaturated and unsaturated conditions (≤1.04) of the aragonite saturation state (Ω _aragonite). The results indicate that increased pCO₂ seawater has a progressive and acute effect on embryonic and larval T. cornutus, and imply that the extended early developmental period and/or the downsized larval shell produced by ocean acidification will have a negative impact on survival, settlement and recruitment well into the future.     

Current status of waste management at home-visit nursing stations and during home visits in Japan

A questionnaire survey was conducted with the aim of examining the problems involved in the disposal of infectious waste at home-visit nursing stations and in its handling during home visits by nurses. From among the home-visit nursing stations registered with the National Association for Home-Visit Nursing Care, 1,965 offices were selected at random and questionnaires were sent to the selected offices. Nurses at 1,314 offices (66.9?%) responded to the survey and responses from 1,283 offices were identified as suitable for analysis after excluding 26 offices that closed and five offices whose main field of care was psychiatry. Offices were classified by management configuration. Offices attached to hospitals were classified as “attached office” and all others were classified as “independent office”. More attached office nurses recovered medical waste from patients’ homes than did independent office nurses. They were also more likely to transport waste with them during the course of a day’s visits. There was a significant difference between attached and independent offices in the burden of expense for waste disposal. Both offices have strong concern about waste treatment containers and handling in improvement in home medical care (HMC) waste disposal. Thus, in order to alleviate these concerns, it is necessary to provide nurses with containers for medical waste suited to home-visit nursing care and tools for preventing injuries. Japanese government should address HMC waste disposal more comprehensively through necessary legislation, subsidization and standardization.