Application of quality management systems for drinking water quality

Over the past few years the water authorities in Australia have been applying the principles of quality management and risk management in their provision of drinking water of a safe and acceptable quality. These principles have been taken up by the regulatory authorities, and the Australian water industry is ensuring that drinking water guidelines, customer contracts, licences and auditing (both statutory and quality systems auditing), and appropriate quality management systems, are in place for drinking water quality management. A particular focus of this work has been the application of AS/NZS 4360 (Risk Management) and the principles of Hazard Analysis and Critical Control Points developed for the food industry. This paper discusses the important considerations in applying quality management systems to drinking water quality management within water authorities, and the key issues of how best to integrate these risk management systems with the business management systems of the water authority. A generally applicable model for drinking water quality management systems based on ISO 9002 and HACCP is described. The paper also discusses the process of how management systems already in place within a water authority can be assessed and improvements identified. The objective is that the management systems will be consistent with the authority’s existing business management systems, ISO 9001, the principles of HACCP and AS4360, and the expected requirements of the revised Australian Drinking Water Guidelines.</jats:p

Metastatic clear cell renal cell carcinoma demonstrating intense uptake on 68Ga-DOTATATE positron emission tomography: Three case reports and a review of the literature

68Ga-DOTATATE positron emission tomography (PET) is a molecular imaging technology which has shown superiority over 111In-octreotide scanning for the detection and staging of neuroendocrine tumors. We report three patients with pancreatic masses that were ultimately diagnosed as clear cell renal cell carcinoma (ccRCC) metastases on histopathology. During their initial diagnostic assessment, the three patients underwent both 18F-fluorodeoxyglucose (18F-FDG) and 68Ga-DOTATATE PET. While all three patients' lesions showed variable 18F-FDG avidity, uptake on 68Ga-DOTATATE PET was comparatively intense. The small case series illustrates the need to consider ccRCC in the differential diagnosis of 68Ga-DOTATATE avid lesions

<SUP>18</SUP>F-FDG PET/CT features of immune-related adverse events and pitfalls following immunotherapy

18 F-FDG PET/CT scanning is routinely performed to stage and evaluate the treatment response in many malignancies. Immunotherapy is a rapidly growing treatment option for many cancers, and both clinicians and imaging specialists need to be familiar with 18 F-FDG PET/CT imaging characteristics unique to patients on this type of treatment. In particular, many immune-related adverse events (irAEs) can be detected on 18 F-FDG PET/CT and early accurate identification is critical to reduce treatment related morbidity and incorrect interpretation of malignant disease status. This pictorial essay reviews frequently encountered irAEs in clinical practice and their appearances on 18 F-FDG PET/CT along with a brief discussion on pseudoprogression and hyperprogression

Desalination by Continuous Ion Exchange Based on Thermally Regenerable Magnetic Microresins

The removal of small quantities of salt at the 500 to 2000 mg/L level is becoming increasingly necessary to counter one of the most widespread forms of water pollution encountered throughout the world. Ion-exchange resins which can be regenerated with hot water have been used previously in a batch mode for the desalting of both natural waters, and municipal and industrial wastewaters. Continuous operation would offer many advantages, especially for productivity, heat economy and ease of control. Unfortunately existing continuous ion-exchange contactors are intermittent in operation and somewhat complex. This paper describes the unique hydrodynamic and kinetic properties of “Sirotherm” thermally regenerable desalting resins when made in the form of magnetic microbeads, and the development of continuous contacting systems which exploit these properties. A novel multistage contactor has been evaluated on laboratory and pilot-plant scales. A prototype plant, with a throughput of 1 ML/day, is to be installed near Perth, Western Australia, in order to demonstrate the process. It is truly continuous, simple and economic, and does not require preclarification of the raw water.</jats:p

Acoustic radiation force impulse accuracy and the impact of hepatic steatosis on liver fibrosis staging

Introduction The accuracy of Acoustic Radiation Force Impulse (ARFI) imaging has been validated in the setting of hepatitis C, however, the accuracy in the setting of fatty liver disease (FLD) has been less well‐established. The aim of this study was to assess the accuracy of ARFI in the setting of hepatic steatosis. Methods Patients with biopsy proven or sonographically diagnosed liver steatosis were assessed for ARFI trends including: inter‐operator concordance, interquartile range, ARFI failure rate, relationship between ARFI velocity and steatosis severity, and concordance between biopsy and ARFI fibrosis scores. Results Three hundred and forty‐nine patients were assessed (53 ‘biopsy’ cohort and 296 ‘ultrasound’ cohort), with 28 patients having biopsy on the same day as ARFI. Low stages of fibrosis (F0/1) were over‐estimated by ARFI in 62% of cases with biopsy correlation (n = 16, P < 0.001), with ARFI offering increased accuracy in regard to higher‐stage fibrosis (14/15 cases, 93%). In both the biopsy and ultrasound cohorts the failure rate and median inter‐quartile range increased with increasing steatosis, and the inter‐operator concordance remained good across all liver steatosis severities. Conclusion In the setting of steatosis, ARFI is very sensitive in detecting, and accurate in diagnosing, higher stages of fibrosis regardless of steatosis severity. It tends to overestimate the fibrosis category in lower stages of fibrosis. The present study does not show conclusively if the presence of steatosis or its severity independently alters ARFI measurements

Politics and local government

Undergraduate essays and reports submitted as coursework for the Masters of Urban Planning degree. This volume has been digitised from an incomplete copy