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Storm water management in an urban catchment: effects of source control and real-time management of sewer systems on receiving water quality.

For the examination of the effects of different storm water management strategies in an urban catchment area on receiving water quality, an integrated simulation of the sewer system, wastewater treatment plant and receiving water is carried out. In the sewer system real-time control measures are implemented. As examples of source control measures the reduction of wastewater and the reduction of the amount of impervious surfaces producing storm water discharges are examined. The surface runoff calculation and the simulation of the sewer system and the WWTP are based on a MATLAB/SIMULINK simulation environment. The impact of the measures on the receiving water is simulated using AQUASIM. It can be shown that the examined storm water management measures, especially the source control measures, can reduce the combined sewer overflow volume and the pollutant discharge load considerably. All examined measures also have positive effects on the receiving water quality. Moreover, the reduction of impervious surfaces avoids combined sewer overflow activities, and in consequence prevents pollutants from discharging into the receiving water after small rainfall events. However, the receiving water quality improvement may not be seen as important enough to avoid acute receiving water effects in general.

Automation↗

Strategic environmental management: time for a new approach.

Attempting to manage the environment as a whole, even from just a scientific standpoint, is not easy. The sheer size and scale can be daunting. It is difficult even to encompass the many facets involved. This short paper therefore attempts to tackle the problem by describing a framework approach which encompasses how one might assess the actual state of the environment at any one time; characterise the ever-changing pressures placed upon it; the manner by which the resultant problems need to be addressed; and thus what sort of responses are required. No system or framework is ever likely to be fully adequate, but some form of framework is essential in order to deliver a more sustainable approach to environmental management than has so far been achieved.

Environment↗

Time management.

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Decision Making↗

[Prehospital thrombolysis with rt-PS. Reperfusion strategy in a time management concept of acute myocardial infarct].

PATIENTS AND METHOD: Prehospital thrombolysis was performed on 93 patients during a time period of 6 years (3/1992 to 9/1998) in an urban area. Thrombolysis with rt-PA (20 mg rt-PA bolus, 30 minute infusion with 30 mg rt-PA) could be started within 2 hours after the onset of symptoms in 67 patients (73.6%). RESULTS: The time gain from prehospital thrombolysis amounted to 38 +/- 14 minutes. Bleeding complications were not observed in the prehospital setting, but 2 patients suffered from intracerebral hemorrhage subsequently and died in the hospital. An aborted infarction (CKmax < 200 U/l and no new Q-waves) was observed in 18 patients (20%) and another 23 patients (25%) had a limitation of infarct size (CKmax < 500 U/l or no new Q-waves) despite obvious signs of myocardial ischemia in the first ECG. CONCLUSION: Our experience demonstrates a considerable time gain for prehospital thrombolysis even for an urban area. Accelerated rt-PA is a safe and comfortable thrombolysis regime.

Adult↗

Nurses' time management in intensive care.

During the 1980s, interest was shown in North America as to how Intensive Care Nurses use their work time, in response to a shortage of trained nurses. These studies were developed to investigate the amount of nursing time that could be saved by computerised recording systems. Similar pressures are now present in the United Kingdom, but there are no published work load studies of Intensive Care Nurses. This study used a five category tool to examine the work load of nurses in a cardiothoracic ICU. The methodology was designed so that comparison could be made with the earlier American studies. The 36 nurses studied spent 41% of their time in direct nursing care, 22% in patient assessment, 19% in clerical duties, 11% in time outside the unit and 7% in non-nursing duties. These findings were compared with the North American studies. Similarities were found which give some support to the reliability and validity of the tool.

Critical Care↗