By D. Bufford. State University of New York College of Agriculture and Technology, Cobleskill.
In the case of each possible cause cheap antabuse 500 mg line, it sets out what the likely symptoms of malfunction and the remedial action to be taken together with possible preventative operational practices or maintenance to be taken Water Treatment Manual: Disinfection Malfunction: Possible Cause Fault Analysis Possible prevention Corrective action What is ozone residual after contactor? Regular maintenance and re- Increase the ozone dose manually Low Ozone Dose controller not calibration of ozone sensor and dose or dose supply with chlorine residual in operating properly or Is the air drier operating properly? Is the water vapour content of air above equipment operation antabuse 500 mg low cost, monitoring and Maintain air drier to ensure dry air manufacturer’s instructions? Obtain proof that the contactor as Process redesign to assess the Low Ozone Inadequate designed has been effective in most cost effective way to increase residual in equipment design Is the ozonator and contactor suitably sized operation in similar water quality the required design Ct – usually by contactor to maintain the required log inactivation of applications cheap 250mg antabuse amex. Is ozone residual after contactor only low A properly designed and optimised Turn up ozone dose manually Low Ozone High Ozone demand during periods of poor water quality? Process redesign to assess the demand most cost effective way to reduce If very high - is the ozone generator able to Dose control strategy with feedback ozone demand e order 250mg antabuse with visa. Establish bromide ion content of water to Ozonation of water at low pH to Optimise upstream pre- treatment High level of High level of be ozonated minimise bromate formation. As ClO2 cannot be compressed or stored commercially as a gas because it is explosive under pressure, chlorine dioxide requires to be generated on site using a variety of generation methods, which are set out in Section 6. ClO2 generates a residual which is used for the calculation of Ct as a measure of disinfection performance. Chapter 6 of this Manual details the use and efficacy of chlorine dioxide as either as an oxidant or a primary disinfectant which is often followed by chlorine as a residual generating secondary disinfection. As a disinfectant, ClO2 can inactivate most waterborne microorganisms over a wide pH range between 5 and 10. The Ct values for the inactivation of protozoa are generally much higher than ozone. However due to the formation of chemically stable chlorate by-product in water dosed with ClO2, dose rates are limited by regulation internationally. Further information on chlorite and chlorate by-product formation and on the possibility of halogenated by-product formation consequent to downstream secondary chlorine disinfection are detailed in section 6. In the case of each possible cause, it sets out what the likely symptoms of malfunction and the remedial action to be taken together with possible preventative operational practices or maintenance to be taken Water Treatment Manual:Disinfection Malfunction: Possible Cause Fault Analysis Possible prevention Corrective action What is ClO2 residual? Regular maintenance and re- Increase the ClO2 dose manually Low ClO2 Dose controller not calibration of ClO2 sensor and dose or dose supply with chlorine residual operating properly or Check maintenance record for the most control calibration pending rectification. ClO2 sensor or controller as Is the water vapour content of air above appropriate. Monitoring of ClO2 residuals particularly following water quality Train staff in the correct method for Check preventative maintenance log variability dose calculations Check records of dose calculation – are Checking of dose calculation by Recalculate dose rates and alter frequent errors recorded? Obtain proof from suppliers that the Use alternative or larger ClO2 Low ClO2 Inadequate system as designed has been generator to increase the required residual equipment design Is the ClO2 system suitably sized to effective in operation in similar water design Ct maintain the required log inactivation of quality applications especially for targeted waterborne pathogens especially sources with high risk of protozoa and Cryptosporidium in Cryptosporidium. Can the required disinfection inactivation be achieved given the internationally recommended maximum dose rates? Can the generator deliver the maximum recommended dose rate at the highest ClO2 demand? Low level set point alarms on Dose supply with chlorine pending Low ClO2 No ClO2 from constituent generation chemicals rectification. A log of chemical deliveries and Install low set point alarms on expected replacement dates. Adequate spare chemical deliveries Water Treatment Manual:Disinfection Malfunction: Possible Cause Fault Analysis Possible prevention Corrective action Check deliver record for ClO2 generation Comprehensive commissioning tests Train staff in the correct chemical Low ClO2 ClO2 generation chemical concentrations i. Adhere to planned preventative maintenance and keep record Check ClO2 residual levels Adhere to planned preventative Increase the ClO2 generation Low ClO2 Insufficient ClO2 maintenance of pump and keep chemical feed rates or manually residual solution being dosed Is pump capacity sufficient to meet record dose water supply with chlorine maximum ClO2 demand pending rectification Is malfunction due to scaling in dosing lines Replace pump if deficient or injectors? If scaling of dosing lines or injectors is a problem consider softening of sodium chlorite make- up water Is ClO2 residual in disinfected water only A properly designed and optimised Turn up ClO2 dose manually Low ClO2 High ClO2 demand low during periods of poor water quality? Process redesign to assess the demand of variability in water most cost effective way to reduce If very high - is the ClO2 generator able to quality Dose control strategy with feedback ClO2 demand e. Lower ClO dose pending pump residual malfunction due to delivery curve and checking of pump 2 incorrect calibration Incomplete pump maintenance record?
Summary Existing work in this area has gone a long way toward improving our understanding of price indexes and the kinds of questions that they can and cannot address antabuse 250mg mastercard. First effective antabuse 500mg, much has been learned about the relative merits of different aggregation schemes purchase antabuse 250mg visa. Indexes that more-closely track the composition of products sold in the market are better than those that do not: chained indexes are better than unchained ones and the Fisher formula is better than the Laspeyres 500 mg antabuse sale. Second, different ways of dealing with the entry of generic drugs can yield very different price indexes. Third, perhaps the most daunting problem is that existing methods do not provide an adequate way to deal with improvements provided by new drugs. At the end of the day, many believe that the complicated features of medical care markets do not allow the interpretation of prices as a gauge of patients’ valuations of drugs and, hence, question the ability of methods like price indexes and hedonics to adequately capture the quality of goods. What we’re left with is an interpretation of these indexes as upper bounds to true price change: Assuming that the quality of drugs is improving over time, price indexes 23 that do not adequately account for these better outcomes are overstating the price per quality unit to patients. More work is needed to find alternative methods that allow one to infer the benefit to patients of new drugs. Merging what is known about price indexes with cost effectiveness methods would seem to be a promising avenue of research. Namely, there are difficulties in tying these indexes to consumer welfare or , more specifically, to the improved outcomes from medications. Structural demand estimation that allows one to estimate utilities—like Lucarelli and Nicholson (2009)—is a promising line of research that could fill this gap. Beyond the Market: Designing Nonmarket Accounts for the United States: The National Academies Press, 2005. Conceptualizing and Measuring Cost-of-Living and Price Indexes, Panel on Conceptual, Measurement, and Other Statistical Issues in Developing Cost of Living Indexes. Handbook on Hedonic Indexes and Quality Adjustments in Price Indexes: Special Application to Information Technology Products. Charitable Trust, the Glass House Trust or other Transform funders Transform Drug Policy Foundation is a registered Charity # 1100518 and Limited Company # 4862177 Design and production by Tim Barnes, chicken www. I came to the conclusion that legalisation and regulation of all drugs was the only way to reduce the harmful effects of this unstoppable activity. Charitable Trust, and the Glass House Trust for supporting the production of this publication Thanks to Transform’s current and past funders including: the Esmée Fairbairn Foundation, the Allen Lane Foundation, the Linnet Trust, Atlantic Philanthropies, Ken Aylmer, Henry Hoare and individual donors ix Foreword Heroin, cocaine, ecstasy, cannabis, prescription and over-the-counter medicines, alcohol, tobacco, coffee, tea - we are all people who use drugs. Our refusal to acknowledge this comes from a deep-seated fear that ‘we’ might become, or be seen as, one of ‘them’. What we really need to focus on is the difference between drug use and drug addiction or dependency. Global prohibitionist drug policy continues to focus efforts primarily on the substances alone. But most of the harms are due to the way that a particular drug is acquired (for example, in a dark alley versus from a pharmacy), the way in which it is used (as a pill, for example, versus smoking, snorting or injecting), and, even more importantly, the way in which society treats people who use drugs. These call for a strict prohibitionist stance on the production, distribution and use of non- medical drugs. It doesn’t take a rocket scientist to show that criminalising drugs and drug use has directly and indirectly led to a dramatic increase in drug- related harms, and that controlling and regulating the production and distribution of all drugs would go a long way towards reducing those harms. So long as we continue to defne the drug user as ‘other’ and defne the drug itself as the problem, we will be trapped in our misguided and harm-inducing programmes and policies. A number of Latin American governments, including Argentina, Brazil, Ecuador, Bolivia and Mexico have moved, or are moving, towards decriminalisation of drug possession and are shifting to a public health model to prevent and treat misuse of drugs. They are no longer able to tolerate the damage xii done to their societies by the War on Drugs. This is not a radical book, nor does it posit radical approaches to global drug policy.
Class I antiarrhythmics are sodium-channel blockers cheap antabuse 500mg amex, and include procainamide and mexilitine cheap antabuse 250 mg line. Most antiarrhythmics help control the heart rate purchase antabuse 500 mg mastercard, and may be prescribed to patients with rapid heart rates (tachycardia) discount antabuse 250mg on-line. In general, these drugs are very well tolerated with low risk for side effects, which may include gastrointestinal upset and neurologic dysfunction in rare cases. Reducing the heart rate and strength of heart muscle contraction can be beneficial for cats with the condition called hypertrophic cardiomyopathy, especially when the heart contracts so vigorously it obstructs the path of blood. Carvedilol also has alpha-blocking activity, which helps to cause relaxation of the arteries, helping to reduce high blood pressure. Beta-blockers may cause some animals to become weak due to a slow heart rate or low blood pressure. If your pet collapses while receiving a beta-blocker, contact a veterinarian immediately. The goal is to block the ability to generate a heart rate greater than 160 bpm even under stressful conditions. Sotalol may cause some animals to become weak due to a slow heart rate or lower blood pressure. It can depress heart muscle function and heart rate to the point of reducing cardiac output. If your pet collapses while receiving sotalol, contact a veterinarian immediately. There is a risk for changing the electrical conduction in a manner that is less stable than the current abnormality. The primary use of diltiazem is for treatment (and sometimes prevention) of cardiac arrhythmias, including atrial fibrillation, atrial flutter and supraventricular tachycardia. Diltiazem may relax blood vessels or depress the heart contraction or rate to such a degree that some animals become weak due to low blood pressure. These drugs typically contain an opiod, and as such, they are often controlled substances. Some over-the-counter formulations are available, and typically include the drug dextromethorphan. These include tracheobronchitis (kennel cough), chronic bronchitis, tracheal collapse and bronchial compression. In many instances, the only effective therapy for these major airway irritations is a cough suppressant or antitussive drug. These drugs suppress the cough reflex within the brain and also can cause sedation. They should not be used in the setting of an active bacterial infection of the lungs since a cough is an essential reflex to rid the lung of infection. Cough suppressants should be avoided in animals with significant heart or lung disease, unless supervised by a veterinarian. Certain nutritional deficiencies have been associated with heart disease, and supplementation may improve cardiovascular function in certain situations. The following substances are not classified as drugs (pharmaceuticals) and may be known as neutraceuticals. Fortunately, despite the lack of documented efficacy of many nutritional supplements, side effects are generally minimal. The possibility of a drug interaction also increases with the number of drugs a patient is taking, and most dogs and cats are placed on multiple drugs for the treatment of congestive heart failure. Congestive heart failure can be associated with a number of electrolyte (blood salt) imbalances, and many common veterinary medications may worsen the symptoms of heart failure. Vitamin E supplementation may increase the risk of congestive heart failure, and vitamin C supplementation may worsen muscle function in humans suffering from congestive heart failure. Congestive heart failure is a very serious and potentially life-threatening condition. The following supplements are therefore not intended to be used in place of, but rather in addition to conventional drug therapy. Taurine: Taurine (2-aminoethanesulfonic acid) is an amino acid normally found in high concentrations in tissues including the heart and retina, and is used in the liver for detoxification and excretion through the bile. Though taurine is not an essential amino acid in the dog, severe dietary restriction in certain situations may predispose dogs to deficiency.