title: Evidence for a seasonal fluctuation of arsenic in New Zealand's longest river and the effect of treatment on concentrations in drinking water

authors: McLaren, Stuart J.

subjects: arsenic

abstract: A year-long survey, with samples collected weekly, was conducted to estimate long-term average concentrations of arsenic in treated and untreated drinking water for the city of Hamilton, New Zealand. The average concentration of arsenic in Waikato River water at Hamilton before processing was found to be (32•1 ± 3•7) μg litre⁻¹, about three times above the new WHO limit of 10 μg litre⁻¹. However, full conventional water treatment effects a five-fold reduction in arsenic concentrations in drinking water to a level which meets the new standards of (6•2 ± 0•8) μg litre⁻¹. The results of both this study and retrospective analysis of archived data suggest that total arsenic concentrations in the Waikato River are likely to follow a regular seasonal variation, being about 10–25 μg litre⁻¹ higher in the summer months. Changes in river flow rates have an almost negligible effect on the summer peak and winter trough; it is proposed that most of the variation in total arsenic concentrations may be due to the seasonal conversion of arsenic in the river sediments to more soluble forms.

text: Evidence for a seasonal fluctuation of arsenic in New Zealand's longest river and the effect of treatment on concentrations in drinking water A year-long survey, with samples collected weekly, was conducted to estimate long-term average concentrations of arsenic in treated and untreated drinking water for the city of Hamilton, New Zealand. The average concentration of arsenic in Waikato River water at Hamilton before processing was found to be (32•1 ± 3•7) μg litre⁻¹, about three times above the new WHO limit of 10 μg litre⁻¹. However, full conventional water treatment effects a five-fold reduction in arsenic concentrations in drinking water to a level which meets the new standards of (6•2 ± 0•8) μg litre⁻¹. The results of both this study and retrospective analysis of archived data suggest that total arsenic concentrations in the Waikato River are likely to follow a regular seasonal variation, being about 10–25 μg litre⁻¹ higher in the summer months. Changes in river flow rates have an almost negligible effect on the summer peak and winter trough; it is proposed that most of the variation in total arsenic concentrations may be due to the seasonal conversion of arsenic in the river sediments to more soluble forms.

year: 1995

title: Exploring discharge delay from an acute surgical unit

authors: Voogt, Jolene Elouise

subjects: Discharge

abstract: Background: Within the hospital system, efficient patient flow is essential. Discharge delay, the period of continued hospital stay after a patient is deemed medically fit to leave hospital, is one of the most significant barriers to optimal patient flow. Discharge delay retains non-acute patients in the acute environment unnecessarily, while preventing acutely presenting patients from accessing services in a timely manner. It results in overcrowded emergency departments with delayed admissions, slowed theatre schedules, and bed blocking in critical care, as well as negatively impacting on patient experience. In the context of a public health system under pressure, reducing discharge delay is critical to improving overall function of the system. This study aims to explore the features in the context of an acute surgical unit that cause discharge delay, the impacts of discharge delay, and the ways discharge delay could be minimised.
Methods: A two phased, mixed methods design was employed in this research. Phase one obtained qualitative data through semi-structured interview with staff members occupying different roles within the health care team within Te Whatu Ora – Waikato. Themes derived from phase one informed the development of an audit form utilised in phase two, which collected quantitative data through its completion by registered nurses working in the acute surgical unit during the two-week audit time period. This audit recorded discharge related times and delaying factors that occurred for all the patients discharged from the ward during the audit period.
Findings: Interviews were undertaken with nine participants (Hospital management n=2, Acute Surgical Unit management n=2, Registered Nurse n=1, Surgical Fellow n=1, Surgical Registrar n=1, Surgical House officer n=1, and multi-disciplinary team member n=1). Thematic analysis of the transcriptions revealed three core themes: (i) It takes a village to discharge a patient; (ii) Preparation, clearance, home; and (iii) Challenges and solutions to discharge delay. The survey was completed by 44 Registered Nurses and on analysis revealed a mean patient delay of 225 minutes, or 3.75 hours. For the audited patients, the most frequently occurring factor was ‘waiting for paperwork’ (55%) followed by ‘waiting for transport’ (40%).
Conclusions: This study found that to reduce discharge delay a coordinated, system-wide approach with discharge focused optimisation across the entire patient journey, and particular focus on reducing the amount of delay caused by discharge paperwork, is required. Introducing a ‘discharge-focused clinician’, would effectively reduce discharge delay by ensuring the prioritisation of discharges, allowing discharge paperwork to be completed promptly. In addition to the introduction of a discharge-focused clinician, the systems and policies surrounding discharge paperwork could also be improved. Additionally, improving the utilisation of transit lounge by routinely sending all appropriate patients to transit lounge to wait for their transport, will also reduce discharge delay.

text: Exploring discharge delay from an acute surgical unit Background: Within the hospital system, efficient patient flow is essential. Discharge delay, the period of continued hospital stay after a patient is deemed medically fit to leave hospital, is one of the most significant barriers to optimal patient flow. Discharge delay retains non-acute patients in the acute environment unnecessarily, while preventing acutely presenting patients from accessing services in a timely manner. It results in overcrowded emergency departments with delayed admissions, slowed theatre schedules, and bed blocking in critical care, as well as negatively impacting on patient experience. In the context of a public health system under pressure, reducing discharge delay is critical to improving overall function of the system. This study aims to explore the features in the context of an acute surgical unit that cause discharge delay, the impacts of discharge delay, and the ways discharge delay could be minimised.
Methods: A two phased, mixed methods design was employed in this research. Phase one obtained qualitative data through semi-structured interview with staff members occupying different roles within the health care team within Te Whatu Ora – Waikato. Themes derived from phase one informed the development of an audit form utilised in phase two, which collected quantitative data through its completion by registered nurses working in the acute surgical unit during the two-week audit time period. This audit recorded discharge related times and delaying factors that occurred for all the patients discharged from the ward during the audit period.
Findings: Interviews were undertaken with nine participants (Hospital management n=2, Acute Surgical Unit management n=2, Registered Nurse n=1, Surgical Fellow n=1, Surgical Registrar n=1, Surgical House officer n=1, and multi-disciplinary team member n=1). Thematic analysis of the transcriptions revealed three core themes: (i) It takes a village to discharge a patient; (ii) Preparation, clearance, home; and (iii) Challenges and solutions to discharge delay. The survey was completed by 44 Registered Nurses and on analysis revealed a mean patient delay of 225 minutes, or 3.75 hours. For the audited patients, the most frequently occurring factor was ‘waiting for paperwork’ (55%) followed by ‘waiting for transport’ (40%).
Conclusions: This study found that to reduce discharge delay a coordinated, system-wide approach with discharge focused optimisation across the entire patient journey, and particular focus on reducing the amount of delay caused by discharge paperwork, is required. Introducing a ‘discharge-focused clinician’, would effectively reduce discharge delay by ensuring the prioritisation of discharges, allowing discharge paperwork to be completed promptly. In addition to the introduction of a discharge-focused clinician, the systems and policies surrounding discharge paperwork could also be improved. Additionally, improving the utilisation of transit lounge by routinely sending all appropriate patients to transit lounge to wait for their transport, will also reduce discharge delay.

year: 2022

title: Māori Goddesses in Literature Part 1: pre 1880 - 1900

authors: Yates-Smith, Aroha

subjects: Atua wāhine

abstract: Many contemporary Māori are familiar with atua wāhine, Māori goddesses, through accounts that have been passed on to them by word of mouth. Few, however, have had an opportunity to consult accounts of atua wāhine that date from the early period of Māori-Pākehā contact. Those who wish to do so may have considerable difficulty in sifting through all of the written materials for the information they seek. For this reason, this paper provides a review of the literature pertaining to atua wāhine from pre-1880 to 1900, together with a commentary on the sources to which reference is made. A review of literature on atua wāhine which appeared after 1900 will appear in the second volume of this journal.

text: Māori Goddesses in Literature Part 1: pre 1880 - 1900 Many contemporary Māori are familiar with atua wāhine, Māori goddesses, through accounts that have been passed on to them by word of mouth. Few, however, have had an opportunity to consult accounts of atua wāhine that date from the early period of Māori-Pākehā contact. Those who wish to do so may have considerable difficulty in sifting through all of the written materials for the information they seek. For this reason, this paper provides a review of the literature pertaining to atua wāhine from pre-1880 to 1900, together with a commentary on the sources to which reference is made. A review of literature on atua wāhine which appeared after 1900 will appear in the second volume of this journal.

year: 2000-10