Across the United States, road palliatives are applied to roads for maintenance operations that improve road safety. In the winter, solid rock salts and brine solutions are used to reduce the accumulation of snow and ice, while in the summer, dust suppressants are used to minimize fugitive dust emissions. Many of these products are chloride-based salts that have been linked to freshwater salinization, toxicity to aquatic organisms, and damage to infrastructure. To minimize these impacts, organic products have been gaining attention, though their widespread adoption has been limited due to their higher cost. In some states, using produced water from conventionally drilled oil and gas wells (OGPWs) on roads is permitted as a cost-effective alternative to commercial products, despite its typically elevated concentrations of heavy metals, radioactivity, and organic micropollutants. In this study, 17 road palliatives used for winter and summer road maintenance were collected and their chemical composition and potential human toxicity were characterized. Results from this study demonstrated that liquid brine solutions had elevated levels of trace metals (Zn, Cu, Sr, Li) that could pose risks to human and environmental health. The radium activity of liquid calcium chloride products was comparable to the activity of OGPWs and could be a significant source of radium to the environment. The organic fractions of evaluated OGPWs and chloride-based products posed little risk to human health. However, organic-based dust suppressants regulated toxicity pathways related to xenobiotic metabolism, lipid metabolism, endocrine disruption, and oxidative stress, indicating their use could lead to environmental harm and health risks to operators handing these products and residents living near treated roads.
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http://dx.doi.org/10.1016/j.envpol.2023.122184 | DOI Listing |
Am J Emerg Med
January 2025
Departments of Emergency Medicine and Critical Care Medicine, Stanford Health Care, 900 Welch Road, Palo Alto, CA 94304, USA.
Background: Critically ill ED patients on life support may undergo transition to comfort care as decided by the surrogate decision maker. When several hours are needed for loved ones to arrive and say farewell before initiating comfort care ("delayed comfort care"), these patients require prolonged ED stays or costly intensive care unit (ICU) admissions.
Methods: A novel ED observation unit (EDOU)-based delayed comfort care pathway for ED patients on invasive mechanical ventilation and/or vasopressors was created in 2013 at Stanford Hospital.
Geriatrics (Basel)
January 2025
Research Centre for Palliative Care, Death and Dying, Palliative and Supportive Services, College of Nursing and Health Sciences, Flinders University, Adelaide, SA 5042, Australia.
: This study aimed to explore self-care understanding and behaviours among aged-care workers in Australia. It was conducted as part of a project to co-produce a self-care resource for the Australian aged-care workforce. : Semi-structured interviews with eleven aged-care staff and a focus group with four staff at an aged-care facility were undertaken to understand how staff understand and practice self-care and how death and dying affect workers.
View Article and Find Full Text PDFJ Geriatr Oncol
January 2025
Section of Hematology/Oncology, Atrium Health Wake Forest Baptist Comprehensive Cancer Center, NC, USA. Electronic address:
Introduction: Therapeutic advances have allowed more adults aged ≥60 years with acute myeloid leukemia (AML) to receive life-prolonging treatments, with improvement in overall survival. In contrast to other cancers, the onset of AML is often sudden, high-risk treatment decisions must be made quickly, and survival is often compromised due to aging-related conditions (e.g.
View Article and Find Full Text PDFBMC Palliat Care
January 2025
Department of Post-Acute and Continuing Care, SingHealth Community Hospitals, 10 Hospital Boulevard Singapore, Singapore, 168582, Singapore.
Background: Singapore has an ageing population. End-of-life care and advance care planning are becoming increasingly important. To assess advance care planning engagement, valid tools are required.
View Article and Find Full Text PDFAge Ageing
January 2025
Medicine Clinical Board, University Hospital of Wales Cardiff, Cardiff, UK.
In response to increased focus on the issue of Assisted Dying (AD) in the UK due to the presentation of The Terminally Ill Adults (End of Life) Bill 2024-25 [1] and bills before parliaments in the Isle of Man, Guernsey and Scotland, the British Geriatric Society (BGS) recently developed a position statement opposing legalisation of AD in the UK [2]. We set out our key reasoning behind this position, namely the current adverse health and social care context and significant concern about whether effective safeguards can be created to protect older people with complex needs from undue harms. The BGS asks for improved, personalised, multidisciplinary care for older people at the end of their lives, including high-quality palliative and end-of-life care.
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