Академический Документы
Профессиональный Документы
Культура Документы
States House of Representatives Cost Containment Bill H.R. ing in pediatric offices: Challenge and opportunity. N Engl J
6575; and California Cost Containment Assembly Bill 1156. Med 282:843-847, 1970.
2. Cohen W: Current problems in health care. N Eng J Med 10. Kubala S and Clever LH: Acceptance of the nurse practitioner.
281:193-197, 1969. Am J Nurse 74:451-452, 1974.
3. Ford AS: The Physicians' Assistant: A National and Local 11. Schoen EJ, Erickson RJ, Barr G, et al: The role of pediatric
Analysis. New York: Praeger, 1975. nurse practitioners as viewed by California pediatricians. Calif
4. Lewis C, Resnick B, Schmidt G, et al: Activities, events, and Med 118:62-8, 1973.
outcomes in ambulatory patient care. N Engl J Med 280:645- 12. Yankauer A, Connelly JP and Feldman JJ: A survey of allied
649, 1969. health worker utilization in pediatric practice of Massachusetts
5. Lewis C and Resnick B: Nurse clinics and progressive ambula- and in the United States. Pediatrics 42:733-742, 1968.
tory patient care. N Engl J Med 277:1236-1241, 1967. 13. O'Dell ML: Physicians' perceptions of an extended role for the
6. Bystran SF, Knight CC, Soper MR, et al: An evaluation of nurse. Nurs Res 23:348-351, 1974.
nurse practitioners in chronic care clinics. Int J Nurs Stud 14. Riddick FA, Bryan JB, Gershenson MI, et al: Use of allied
11:185-194, 1974. health professionals in internists' offices. Arch Intern Med
7. Spitzer WO, Sackett DL, Sibley JC, et al: The Burlington ran- 127:924-931, 1971.
domized trial of the nurse practitioner. N Engl J Med 290:251- 15. Bates B: Doctor and nurse: Changing roles and relations. N
257, 1974. EngI J Med 283:129-134, 1970.
8. Galladay FL, Miller M and Smith KR: Allied health manpower 16. Sadler AM: The new health practitioner in primary care. J Med
strategies: Estimate of the potential gains from efficient task del- Educ 49:845-848, 1974.
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FIRST STAGE FILTER sand filtration, does achieve removals of particulates to pro-
COCONUT FIBER
duce an effluent meeting recommended WHO International
SECOND STAGE FILTER Drinking Water Standards. The significant difference be-
BURNT RICE HUSKS -BALL VALVE CONTROL tween the two approaches is the fact that the two-stage proc-
ess can handle waters of high turbidity (usually the case for
CONCRETEOTER JAR Southeast Asia), whereas the slow sand filter is limited to
relatively low raw water turbidities. Also, the two-stage
BALL VALVE CONTROL PVC 0 UK process operates at 10 to 15 times higher filtration rates than
the slow sand filter, and incorporates significant absorption
capability for removing tastes and color. Moreover, by use
METER AND GATE VALVE of additional stages higher levels of removals can be
PVC 0/4 w In_io GAL\ANIZED PIPE achieved if desired. Effluent turbidities were generally below
5 JTU (Jackson Turbidity Units) from raw water turbidities
FILTERED WATER
which ranged from 15 to 150 JTU. Coliforms removals aver-
aged 60 to 85 per cent with individual samples ranging from
STORAGE STORAGE =|STORINGE zero to 100 per cent removal, but bacteriological removals
TANK TANK _|TAqK were insufficient to reach "potable" standards without the
PUBLIC TAPS 35HP GASOLNE addition of some simple disinfection. Iron removals varied
from 80 to 95 per cent. Filter media were changed only once
INTAKE
every three to five months at the various village installations.
SCALE 1: 50
It is believed the quality of effluent from the two-stage
process represents a reasonably good quality for most vil-
FIGURE 1-Two-Stage Filtration Unit Constructed at Ban Som, lages where investment in more expensive water treatment
Changwat Korat, Thailand, 1973 (side view) plants (rapid sand filtration or slow sand filtration) simply
cannot be afforded. The two-stage filter also serves as a
The objectives of testing the filter units used for village simple first stage investment in a multi-stage development
water supply were to seek design improvements involving process to improve water supply/sanitation services in rural
greater simplicity of construction, to oversee operational areas. Further information can be obtained from the author.
problems under actual village conditions, to quantify the fil-
ter performance in improving water quality, and to evaluate REFERENCES
1. World Health Organization, Community Water Supplies-A
villager acceptance of the treated water for drinking, cook- Critical Situation. WHO Chronicle 23, No. 8, 1969.
ing, and domestic purposes. 2. World Health Organization, Community Water Supply-The
Continuous testing of the coconut fiber/burnt rice husks Next Ten Years. WHO Chronicle 25, No. 2, 1971.
filter was carried out at a number of field installations from 3. World Bank, Issues in Village Water Supply. Public Utilities
1974 to 1977. The accumulated data, using turbidity, iron, Dept. Report No. 793, Washington, DC, 1975.
4. Feacham RG: Water supplies in low-income communities of de-
and coliforms as the main parameters, show that this type of veloping countries. Journal of the Environmental Engineering
two-stage filter, while not achieving results equal to slow Division, Proceedings ASCE 101, no. EE5, 1975.