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Abstract: The COVID-19 pandemic has increased the use of disposable plastics, including medical masks, which have become a necessity in our daily lives. As these are often improperly disposed of, they represent an important potential source of microplastics in the environment. We prepared microplastics from polypropylene medical masks and characterised their size, shape, organic chemical leaching, and acute toxicity to the planktonic crustacean Daphnia magna. The three layers of the masks were separately milled and characterised. Each of the inner frontal, middle filtering, and outer layers yielded different types of microplastics: fibres were obtained from the inner and outer layer, but irregular fragments from the middle layer. The shape of the obtained microplastics differed from the initial fibrous structure of the intact medical mask layers, which indicates that the material is deformed during cryo-milling. The chemical compositions of plastics-associated chemicals also varied between the different layers. Typically, the inner layer contained more chemicals related to antimicrobial function and flavouring. The other two layers also contained antioxidants and their degradation products, plasticisers, cross-linking agents, antistatic agents, lubricants, and non-ionic surfactants. An acute study with D. magna showed that these microplastics do not cause immobility but do physically interact with the daphnids. Further long-term studies with these microplastics are needed using a suite of test organisms. Indeed, studies with other polypropylene microplastics have shown numerous adverse effects on other organisms at concentrations that have already been reported in the environment. Further efforts should be made to investigate the environmental hazards of polypropylene microplastics from medical masks and how to handle this new source of environmental burden.
Keywords: COVID-19 pandemic, plastics-associated chemicals, Daphnia magna, fibres, fragments, nanofibres, polypropylene microplastics, single-use plastic
Published in DiRROS: 05.05.2023; Views: 343; Downloads: 214
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Abstract: Magnetic extraction offers a rapid and low-cost solution to microplastic (MP) separation, in which we magnetize the hydrophobic surface of MPs to separate them from complex environmental matrices using magnets. We synthesized a hydrophobic Fe-silane based nanocomposite (Fe@SiO2/MDOS) to separate MPs from freshwater. Pristine and weathered, polyethylene (PE) and tire wear particles (TWP) of different sizes were used in the study. The weathering of MPs was performed in an accelerated weathering chamber according to ISO 4892-2:2013 standards that mimic natural weathering conditions. The chemical properties and morphology of the Fe@SiO2/MDOS, PE and TWP were confirmed by Fourier transform infrared spectroscopy and Scanning electron microscopy, respectively. The thermal properties of PE and TWP were evaluated by Thermogravimetric analysis. Using 1.00 mg of Fe@SiO2/MDOS nanocomposite, 2.00 mg of pristine and weathered PE were extracted from freshwater; whereas, using the same amount of the nanocomposite, 7.92 mg of pristine TWP and 6.87 mg of weathered TWP were extracted. The retrieval of weathered TWP was 13% less than that of pristine TWP, which can be attributed to the increasing hydrophilicity of weathered TWP. The results reveal that the effectiveness of the magnetic separation technique varies among different polymer types and their sizes; the weathering of MPs also influences the magnetic separation efficiency.
Keywords: degradation, magnetic separation, microplastics, polyethylene, tire wear particles, open access
Published in DiRROS: 03.05.2023; Views: 416; Downloads: 358
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Abstract: Izhodišče: Del celostne obravnave bolnika z napredovalim rakom je tudi paliativna oskrba, ki bolniku in njegovim bližnjim omogoča kakovostno življenje. Paliativna oskrba se izvaja na dveh ravneh: osnovni in specializirani. Na Onkološkem inštitutu Ljubljana v okviru specializirane paliativne oskrbe izvajamo več dejavnosti: bolnišnično obravnavo bolnikov z najkompleksnejšimi težavami, ambulantno obravnavo za zgodnjo paliativno oskrbo, konziliarno (svetovalno) dejavnost in za bolnike doma telefonsko podporo ter obiske na domu. Mobilna paliativna enota je najnovejša dejavnost, ki se izvaja od septembra 2021. Metode: Analizirali smo podatke vseh bolnikov, vključenih v specializirano paliativno oskrbo med septembrom 2021, od pričetka delovanja mobilne paliativne enote, in koncem avgusta 2022. Opazovali smo starost, spol, kraj stalnega prebivališča, diagnozo ter kraj smrti in primerjali skupino bolnikov, ki so bili obravnavani v okviru specializirane paliativne oskrbe s podporo obiskov na domu, in skupino brez nje. Rezultati: Med opazovanim obdobjem je bilo v vse dejavnosti specializirane paliativne oskrbe Onkološkega inštituta vključenih 1086 bolnikov, od tega smo pri 347 bolnikih (32 % vseh) opravili 574 obiskov na domu (povprečno 1,7 obiska na bolnika (razpon 1–8)). 317 (91 %) bolnikov je imelo svoje stalno prebivališče v osrednjeslovenski regiji, 9 % obiskov je bilo izvedenih izven meja osrednjeslovenske regije. Primerjava skupin bolnikov, napotenih v specializirano paliativno oskrbo z vključitvijo mobilne paliativne enote ali brez nje, jasno kaže večji delež umrlih v domačem okolju, kadar podporo izvajamo tudi z obiski na domu (80 % v primerjavi z 62 %). Zaključek: Mobilna paliativna enota predstavlja pomemben element mreže paliativne oskrbe in zagotavlja pogostejše umiranje v domačem okolju.
Keywords: paliativna oskrba, umiranje, mobilna paliativna enota, onkologija
Published in DiRROS: 06.12.2022; Views: 495; Downloads: 130
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Keywords: rak dojke, bolniki, zdravljenje, klinične poti
Published in DiRROS: 14.03.2022; Views: 737; Downloads: 366
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Abstract: Purpose. Writing an Advance Directive (AD) is often seen as a part of Advance Care Planning (ACP). ADs may include specific preferences regarding future care and treatment and information that provides a context for healthcare professionals and relatives in case they have to make decisions for the patient. The aim of this study was to get insight into the content of ADs as completed by patients with advanced cancer who participated in ACP conversations. Methods. A mixed methods study involving content analysis and descriptive statistics was used to describe the content of completed My Preferences forms, an AD used in the intervention arm of the ACTION trial, testing the effectiveness of the ACTION Respecting Choices ACP intervention. Results. In total, 33% of 442 patients who received the ACTION RC ACP intervention completed a My Preferences form. Document completion varied per country: 10.4% (United Kingdom), 20.6% (Denmark), 29.2% (Belgium), 41.7% (the Netherlands), 61.3% (Italy) and 63.9% (Slovenia). Content analysis showed that 'maintaining normal life' and 'experiencing meaningful relationships' were important for patients to live well. Fears and worries mainly concerned disease progression, pain or becoming dependent. Patients hoped for prolongation of life and to be looked after by healthcare professionals. Most patients preferred to be resuscitated and 44% of the patients expressed maximizing comfort as their goal of future care. Most patients preferred 'home' as final place of care. Conclusions. My Preferences forms provide some insights into patients' perspectives and preferences. However, understanding the reasoning behind preferences requires conversations with patients.
Keywords: advance care planning, psycho-oncology, medical oncology, ACTION study, cancer, end of life, dying persons
Published in DiRROS: 15.02.2021; Views: 1311; Downloads: 900
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