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Decentralizing ART Services at Primary Health Care Facilities
Many countries have begun to decentralize HIV treatment to primary health care (PHC) centers to decrease the burden of providing HIV services at existing facilities while increasing access to treatment. The purpose of this technical brief is to assist national program planners, stakeholders, and implementers in designing, planning, and implementing the decentralization process and in providing ART services at PHC facilities, with the ultimate goal of achieving universal access to treatment and care in generalized HIV epidemic settings.
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In recent years, many countries, particularly those addressing a generalized HIV epidemic, have begun to decentralize HIV treatment to primary health care (PHC) centers. This effort is intended not only to increase geographic coverage of HIV clinical care, including antiretroviral treatment (ART), but also to decrease the burden of providing HIV services at existing facilities while making access to care easier for people living with HIV (PLHIV). The ultimate goal of many of these nascent efforts is to further foster a public health approach that will eventually bring universal access to HIV treatment.
Box 1. Definition of Primary Health Care
"Primary health care" refers to the ideology that the first level of contact (the primary level) is the impetus behind the delivery of health care. This process is buoyed up by the secondary level of contact, which concentrates more on the complexities of secondary care (Gaye and Nelson 2009).
Decentralization requires the expansion of small and concentrated ART programs to a greater scale, with an emphasis on increasing utilization to improve the quality of life for a significant number of PLHIV (Gilks et al. 2006). As part of the decentralization of HIV treatment, three primary scenarios have emerged:
- A visiting physician initiates ART treatment at a selected PHC center (Stein, Lewin, and Fairall 2007).
- Nurses assess patients and send blood samples for CD4 measurements and then refer those who are eligible for ART to a physician at a referral hospital or major medical center. After patients are stabilized on ART for six months, they are referred back to the initial PHC center for follow-up visits and for prescription refill (International Center for AIDS Care and Treatment Programs 2008).
- The entire ART program is driven by nurses, including initiation and client follow-up (Shumbusho et al. 2008; WHO 2004a).
Although a variety of scenarios based on these approaches and models to decentralize ART services to PHC settings exist, overall decentralization entails implementing a broad range of HIV services, including HIV counseling and testing, and care and support interventions at distal health care facilities. Providing these services, often by non-physician staff, requires:
- Policies allowing non-physicians to initiate and monitor treatment.
- Scaled expenditure for ART services at PHC centers.
- Development of a health workforce comfortable with and skilled in initiating and monitoring treatment, including treatment services for pregnant women, infants, and children.
- Effective forecasting, procurement, and supply chain management of antiretroviral (ARV) drugs, cotrimoxazole, and drugs for managing opportunistic infections.
- Expanded laboratory capacity to monitor treatment.
The purpose of this technical brief is to assist national program planners, stakeholders, and implementers in designing, planning, and implementing the decentralization process and in providing ART services at PHC facilities, with the ultimate goal of achieving universal access to treatment and care in generalized HIV epidemic settings.
Disclaimer: The author's views expressed in this publication do not necessarily reflect the views of the United States Agency for International Development or the United States Government.
Program Considerations
The information in this brief is drawn from programs in resource-limited countries that have undertaken efforts to decentralize ART services to the PHC level. The program interventions are grouped into eight major areas: 1. creating an enabling environment; 2. developing human resource capacity; 3. ensuring a continuous and secure supply of quality drugs and laboratory commodities; 4. improving the infrastructure; 5. building effective links among HIV services; 6. tapping into private-sector networks; 7. delivering quality ART services; and 8. addressing challenges that hamper service quality.
Each intervention area is described in detail below, and resources are identified at the end of this brief.
Creating an Enabling Environment
The public and private sectors both have key roles to play in the successful decentralization of ART. The public sector is the main platform for scaling-up universal access to ART services, and policies and regulations can create an environment in which program planners and managers can harness the decentralization of ART services by introducing interventions such as task shifting. To create an environment that will enable the successful decentralization of ART, program planners and policymakers should undertake the following.
Understand the context. Planning for specific HIV clinical care interventions in a country requires knowledge of the local epidemiologic landscape and the resources available to scale-up access to ART. To gain this knowledge, national HIV program planners and managers should conduct a situational analysis of ART decentralization efforts, identify geographic priorities, and determine the profile and the distribution of the private sector. In addition, the country PHC infrastructure should also be examined, including human resources, health support systems, and financial resources. This exercise should also map the availability of services while identifying the size of key population groups in need of existing clinical care and treatment (Gaye and Nelson 2009). Please see the resources page for tools to assist in these activities.
Review, adapt, and/or harmonize policy and medico-legal issues. Greater political commitment is crucial for scaling-up and strengthening PHC systems in general, and specifically for making them a central component in ART service delivery. Reviewing the country's policies for HIV clinical services is intended to inform the structuring of an environment that enables the scaling up of the national HIV response, including ART interventions. Policymakers should harmonize policies and regulations for HIV treatment to provide guidance that charts a comprehensive framework shaping all aspects of ART service delivery. Policies should provide a legal framework that enables ART program implementation at the PHC level. Program planners and managers should revise and adapt regulations that define the scope of work for nurses while clarifying roles for health practices, including task-shifting planning.
Estimate the cost of ART services and the available financial resources. Cost implications for decentralizing ART at PHC centers may be significant depending on the HIV prevalence rates, the number of health facilities to be included, staff salaries, teamwork design, local training capacity, and other operational considerations. Program managers and planners should:
- Estimate the size of the targeted population of adults and children, including pregnant women, using capture-recapture methodology (University of Pittsburgh 2009).
- Conduct a gap analysis comparing available funding and operational costs by using cost analysis for PHC.
- Estimate human development costs, including task shifting and training for nurses and non–health-care providers and hiring of additional staff as needed (WHO 2009b).
- Estimate the cost for infrastructure renovations, including furniture (WHO 2009a).
- Estimate the cost of diagnostic technologies and equipment for processing dry blood spot samples, measurement of CD4, chest radiography services, and the cost of processes for reliable transport of patient specimens to a larger site and a reliable system for the return of test results (WHO 2009a).
- Estimate the commodity procurement and supply chain costs for ensuring availability of rapid HIV test kits, tuberculosis (TB) microscopic tests, ARV drugs, including formulations for children, and cotrimoxazole (USAID | DELIVER PROJECT 2009).
- Estimate the cost of designing, implementing, and operating the monitoring, evaluation, and reporting (MER) system (World Bank 2004).
Funding for such interventions needs to address capitalization and one-time costs to begin program activities as well as continued funding to maintain services. Funding may come from a variety of sources, including the national government, the private sector, and international donors such as the Global Fund or the U.S. Government (USG).
Developing Human Resource Capacity
As a result of the response to HIV, health care systems and providers in developing countries, already saddled with overreaching demands, are asked to extend their resources even more. In addition, human resources are dwindling even though the need for them is increasing.
The development of adequate human resources is vitally important, as is developing strategies to implement HIV efforts in order to ensure the delivery of ART services (USAID 2009). Program planners and managers should undertake the following.
Build health care providers' capacity. Around the globe, especially in resource-limited settings, a shortage of skilled medical professionals is an ongoing challenge. According to the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) and the World Health Organization (WHO), physicians in many countries are still the only cadre allowed to prescribe ART. As health care workers are distinctly influenced by their professional sense of duty, a dearth of supplies as well as deficient and/or improper human resource management leads to health care workers who are disillusioned and discomfited because they are not able to properly complete their duties (WHO 2004b). To address the staff shortage, task shifting has recently been promoted as the key to solving the human resource crisis in most settings (Zachariah 2006). To build human capacity at the PHC level, program managers and planners should consider the following.
- Standardize approaches for case finding, patient monitoring, reporting systems, in-service training, supervision, and guidelines related to ART regimens for patients who qualify—based on clinical and/or CD4 cell criteria—with a simple kit system for supplying the medication (WHO 2004b).
- Expand through task shifting the pool of clinicians who provide HIV treatment services (van Rensburg et al. 2008).
- Train all health care providers, including nurses and clinical officers, in how to assess PLHIV, initiate ART, follow-up with clients, identify and manage complications, and/or refer patients to hospitals as needed; and non-health professionals (lay counselors) in how to provide counseling, use rapid HIV tests, and provide nutritional support (WHO 2008a).
- Mentor local managers and strengthen the supervision of health care delivery (Mathauer and Imhoff 2006).
Strengthen district health management. District and provincial health management structures play an important role in ART program planning and implementation. These entities often address day-to-day challenges such as poor performance, shortage of skills and low productivity, inadequate infrastructure, and laboratory and procurement supply services. Implementing quality ART activities depends on the ability of local health managers to successfully manage and monitor the decentralized PHC centers. To build capacity within PHC centers, district health management teams (DHMTs) should be trained in project management and supervision (Stein et al. 2008).
South Africa
"In Lusikisiki, a rural area of South Africa with a population of 150,000 serviced by one hospital and 12 clinics, Médecins Sans Frontières has been supporting a program to deliver human immunodeficiency virus (HIV) services through decentralization to primary health care clinics, task shifting (including nurse-initiated as opposed to physician-initiated treatment), and community support. This approach has allowed for a rapid scale-up of treatment with satisfactory outcomes...The greater proximity and acceptability of services at the clinic level has led to a faster enrollment of people into treatment and better retention of patients in treatment (2% vs. 19% lost to follow-up)" (Doescher, Ellsbury, and Hart 2000).
Family Health International's pilot project provided specialized training in HIV care and treatment to nurses. The project shifted all of its doctors' primary tasks, except for management of complex cases (including children) and monitoring and supervision, to the nurses. Nurses started 435 of their 1,000 patients on ART during the period of the pilot project, between September 2005 and March 2008, with results comparable to other projects throughout Rwanda with physician-centered care. Of the initial 1,000 patients, 88% were alive and on ART in March 2008, 6.7% had died and less than 3% were lost to follow-up with no reported cases of stopped treatment (WHO 2008b).
Improve recruitment, training, and retention. High turnover rates are of increasing concern in health care cost management and in service delivery. Health care workers' social backgrounds, ethnicity, age, gender, education, values, and beliefs are all determining factors in their deciding whether or not to take a post in a rural area. Also, the fact of growing up in a rural community has been associated with a higher probability of practicing in rural areas, and women are less prone to accept rural posts (British Columbia Ministry of Health Services 2009; Doescher, Ellsbury, and Hart 2000). To retain staff, WHO recommends that ART program planners and managers:
- Expand ongoing training capacity and clinical support and supervision at the PHC level through training, mentoring, and continuing medical education.
- Improve the engagement of staff by increasing incentives (for example, in terms of housing and salary) to stay in rural areas and by incorporating a period of time where the health care worker who is trained at the expense of the public is required to serve in a public health capacity.
Ensuring a Continuous and Secure Supply of Quality Drugs and Laboratory Commodities
Efficient and effective supply chains are critical to the provision of quality ART services that depend on the continuous availability of life-saving ARV drugs, laboratory reagents, supplies for diagnosis and monitoring of patients on ART, and other medicines and supplies for care and treatment. Antiretroviral treatment program planners, managers, and implementers should establish a secure and reliable supply chain. Successful provision of health services at the PHC level requires the ability to effectively quantify, procure, and distribute drugs and other health commodities to PHC centers through existing supply chain structures (Population Council 2009; WHO 2008b). National program managers, DHMTs, and local managers at PHC centers should:
Strengthen existing supply chain performance. To strengthen supply chain management of commodities needed for HIV diagnosis, treatment, and care, logistics managers should:
- Improve technical capacity for forecasting demand for ART services and quantifying commodity requirements at the national level.
- Coordinate procurement lead times and shipment delivery schedules at the national level to ensure uninterrupted supply and to maintain adequate stock levels for the program.
- Establish standardized inventory control procedures for reporting, ordering, and distributing ARVs and laboratory supplies, including HIV test kits and blood sample collection commodities, at all levels of the health system.
- Promote effective and efficient in-country distribution systems and procedures that ensure timely delivery of commodities to service delivery points.
- Monitor storage conditions and practices at all storage facilities and service delivery points to maintain the quality of ARVs and lab supplies.
- Establish a logistics management information system for collecting, reporting, and analyzing data on consumption and stock levels of ARVs and other commodities at the facility and national levels.
Establish reliable laboratory services (WHO 2008c). Establishment of appropriate clinical laboratory services in resource-limited settings is feasible, but may be challenging when technical knowledge, quality assurance training, access to repair services, and monetary resources are limited (Scott et al. 2007). There is usually an insufficient infrastructure to maintain long-term operation of modern clinical laboratory instruments, retain skilled personnel, and provide enough funds for reagents and maintenance. To provide laboratory services that support ART decentralization efforts, program planners and implementers should:
- Define the essential laboratory services that include the minimum lab tests needed to offer comprehensive HIV services.
- Establish regular quality management and provide standard operating procedures (SOPs) for blood sample collection.
- Establish a relationship with the district hospital laboratory or any other laboratory service provider, along with detailed transportation services for patient specimens and a calendar with hours of collection and delivery of results.
- Put in place laboratory safety measures and ensure that they are known by all staff, including post-exposure prophylaxis in case of an occupational needle stick injury.
- Develop a duty roster for collecting specimens and ensuring that results are registered into patients' clinical records.
- Establish purchasing and inventory SOPs by providing a clear plan for maintaining a supply of test kits and other consumables, including phlebotomy and blood tube supplies, so that stockouts do not occur.
- Disseminate specific guidance on quality assurance for rapid testing and for the specimen collection for CD4, toxicity monitoring viral load measurements (if available), and pediatric virologic testing.
Improving the Infrastructure
Because PHC centers provide a broad range of services to a large segment of the population, they offer an opportunity to implement a sustainable continuum of care across different areas of service delivery (Walley et al. 2008). Studies have shown that, as the number of people accessing ARV services grows, space at PHC centers can become inadequate for patient waiting areas, consulting rooms, and counseling services (Population Council 2009). To introduce ART services at PHC centers, program planners and implementers should:
- Assess the need for improvements in physical space, equipment, utilities, waste management, transport, and communications, and address the gaps identified.
- Provide sufficient space and ventilation to control the spread of TB and other airborne pathogens.
- Maintain the privacy of clinical consulting rooms.
- Ensure that adequate space and systems are in place so that HIV status is not identifiable to others in any way.
Building Effective Links Among HIV Services
The WHO recognizes that people are more likely to adhere to treatment when they receive comprehensive services. When decentralizing ART efforts, program planners, managers, and implementers should:
Linkage in the context of decentralization of ART refers to a relationship between HIV treatment services at PHC centers, community services, and a district hospital. Integration can be defined as "the management and delivery of health services so that clients receive a continuum of preventive and curative services, according to their needs over time and across different levels of the health system (WHO 2008b).
Expand the entry points to ART and care. Program managers and implementers should:
- Introduce provider-initiated counseling and testing (PITC) for pregnant women who attend PHC facilities, including virological tests for early infant diagnostic through dry blood drop collection techniques in pediatric health sections, such as under-five immunization and services for sick children.
- Offer routine PITC to patients presenting with TB and sexually transmitted infections (STIs), and to any other client seeking medical attention.
- Ensure integration of HIV testing and prevention of mother-to-child transmission (PMTCT) into antenatal care (ANC), and assess the need to integrate pediatric screening into routine well-child care visits (e.g., immunizations).
Integrate cotrimoxazole prophylaxis into ART services. The WHO recommends that program managers integrate cotrimoxazole prophylaxis into their package of standard care for HIV-infected adults receiving ART (WHO 2009c). Cotrimoxazole prophylaxis is also recommended for all HIV-exposed infants around four to six weeks of age, on first contact with a PHC center.
Provide wrap-around services. Program managers should incorporate the following into ART efforts:
- Nutritional support, including infant feeding. The WHO recommends exclusive breastfeeding for infants of HIV-infected women for the first six months of life unless replacement feeding is acceptable, feasible, affordable, sustainable, and safe for mothers and their infants before the first six months. Otherwise, all HIV-infected women should avoid breastfeeding. HIV-infected adults should be provided with nutritional support, including counseling, supplements, and food.
- Family planning for all HIV-infected men and women. Antiretroviral treatment program planners and implementers should provide counseling and family planning services to people living with HIV. Implementers should also provide information on the effectiveness and safety of contraceptive methods to prevent pregnancy and HIV transmission.
Establish strong linkages. Program managers should put in place a referral network and coordination between service providers and different levels of the health system, and forge relationships between PHC centers and communities through supportive mechanisms and other community-based organizations.
Tapping into Private Sector Networks
Non-state providers of health care, whether philanthropic or commercial, exist outside the public sector and also provide primary health contacts with the health system to poor and rich alike (Baru 1998). The private sector includes health care providers ranging from traditional healers, to private health care facilities, to more complex entities such as hospitals, supply chain management systems, and specialized laboratories. The private sector offers an important potential complementary effort to public sector HIV efforts.
Studies have shown that lower-income households are more likely to spend a higher proportion of their income on private-sector care than do higher-income houses. However, the rich tend to access higher-quality services than the poor. Engaging the private sector in the provision of ART has become increasingly important. A first step in finding common ground is identifying private sector partners who can provide these services. A variety of formally and informally trained and licensed private providers are in practice, including physicians, nurses, midwives, and paramedical staff, such as clinical officers and physician assistants. In resource-limited settings, the private sector also includes such health care practitioners as traditional healers, traditional birth attendants, and market drug sellers, all of whom are less regulated.
BOX 4. Definitions of Non-State Providers and Alternative Health Care Providers
Non-state providers encompass both formal (e.g., nongovernmental [NGO]-run medical clinics) and informal providers (e.g., traditional healers). Market-based, for-profit providers (from large firms to small entrepreneurs) as well as nonprofit providers (e.g., NGOs and faith-based organizations) are included in this definition.
Alternative health care providers are those who are not licensed as health care providers. They may provide advice and/or drugs or vaccines. They commonly work in the patient's home, the community at large, and at PHCs. Included under this title are community health workers and traditional healers, among others (IDS Health and Development Information 2008).
To involve private health care providers, program planners and implementers should undertake the following.
- Take an inventory of private health care providers in all areas of service delivery, including clinical services, supply chain management, and specialized laboratories, to identify, assess, and select local service providers, including medical practitioners, clinical officers, nurses, traditional leaders, home-based care volunteers, and community treatment supporters.
- Develop a mechanism to monitor and regulate private sector activity at national, regional, and local levels. These efforts should include plans to routinely monitor private sector prescribing practices to ensure that they are compliant with national guidelines related to regimen selection and initiation of treatment. These efforts should also specifically address the role of private pharmacists in ARV distribution.
- Enable smaller providers, who may have greatest coverage of the poor, to come together and form a network. The network can interact with governments and donors in order to benefit from technical assistance, and to build a strong referral system that can help ensure continuous care between health care providers and public health facilities.
- Train and build human capacity and ensure technical monitoring by including qualified private sector providers in public sector or donor-funded ART trainings, or by facilitating clinical mentorship between public and private sector providers.
Delivering Quality ART Services
The WHO recommends efficient and decentralized services as a key strategy in moving toward universal access to HIV treatment. This requires a public health approach to scaling-up services, with an emphasis on simple, standardized regimens and formularies; algorithmic clinical decision making; effective supervision; program monitoring and evaluation; and patient follow-up. Key steps to delivering quality ART services include:
Advantages include flexible access, shorter waiting times, greater confidentiality, and greater sensitivity to user needs. Private health care professionals provide quality of care, and they are close to the communities.
Challenges include dual practice, in which experienced service providers devote more attention to their private practices than to public facilities where they are still employed full-time; the unregulated services tariff fees; and the unpredictable ". . . quality of care offered by providers who are not regulated, not qualified, or are informal" (Rao, Nundy, and Dua 2005).
Build community capacity and promote ART services. To achieve this goal, program planners and implementers can use the following process.
- Create awareness of the benefits of ART and the demand for formal health services through information, education, and communication activities such as radio and television spots and print messages, as well as public campaigns.
- Reinforce support for civil society organizations and networks, particularly associations of PLHIV and organizations working to combat common misconceptions and myths around HIV.
- Train community health workers to provide basic clinical care and support.
- Implement ART adherence activities to increase ART literacy so that communities and clients are fully informed and aware of the prerequisites needed to initiate ART, as well as the costs and benefits of ART.
Support continuous quality improvement. Quality improvement (QI) is "an approach to quality management that builds upon traditional quality assurance methods by emphasizing the organization and systems: focuses on the 'process' rather than the individual; recognizes both internal and external 'customers'; promotes the need for objective data to analyze and improve processes" (Medical University of South Carolina 2009).
Quality improvement is designed to improve service systems and processes through the routine use of health and program data for meeting patient and program needs (National Committee for Quality Assurance 2007).
To improve the quality of ART services, program managers and implementers should focus on the key processes and functions within PHC centers, and determine how they can achieve desired outcomes through the following activities (WHO 2008c).
- Developing and implementing a QI plan that follows national guidelines and methodically describes how it will identify specific areas for improvement and deliver ART services that better meet patients' needs.
- Developing PHC center-specific strategies, based on local data collected on ART activities, that can be used to inform updates or changes to current systems to improve quality of care.
- Introducing an organizational culture of QI at the PHC level by establishing a QI team, building staff capacity and motivation, dedicating time to measure clinic performance, and stressing the importance of complete documentation to help determine whether or not patients are getting the care they deserve.
Implement sound MER systems. It is widely accepted that MER systems enhance delivery of high-quality care, including treatment for women, men, and children, while providing population-level information for program decision making. The ability of PHC staff to implement and use these MER systems in their daily work is critical to improving the quality of data collection, analysis, and reporting patterns (MEASURE Evaluation and UNAIDS 2009). The WHO recommends ART program managers and implementers proceed as follows.
- Establish simple, standardized, but flexible MER systems.
- Set national standards for minimum data and tools needed to monitor ART services at PHC centers (i.e., standardized ART cards, and pre- and ART registers).
- Formally enroll each HIV-infected patient into HIV care and maintain a longitudinal medical record for each HIV-infected patient.
- Make appointments and actively follow-up on missed appointments.
- Track HIV patients transferring in or out of PHC facilities.
- Monitor referral and linkages of HIV patients to home and community services.
- Integrate monitoring of ART to other HIV services such as PMTCT, TB, STIs, and maternal and child health care.
- Establish space, file storage, and other infrastructure needed for monitoring.
- Maintain confidentiality and security of patient records.
Addressing Challenges that Hamper Service Quality
BOX 6. Reducing stigma and discrimination
In Zambia, a referral system exists among community-based care providers, support groups, PLHIV networks, community leaders, youth groups, and ART facilities and health clinics. PLHIV work in ARV clinics and are coordinators within the community. This has promoted higher levels of adherence to treatment, lower rates of clients lost to follow-up, and has minimized stigma (Horizons-Population Council and International AIDS Alliance 2007).
ART programs will benefit from addressing wider social issues that have an impact on access and quality of services, including the presence of poverty, hunger, gender discrimination, and stigma, all of which present barriers to successful treatment and contribute to the spread of the infection. To address these challenges, program managers and implementers should undertake the following.
Implement activities to address gender-based inequalities. Social norms in some settings lead men to ignore health issues, thus preventing many men from receiving ART on a timely basis. These barriers vary across settings and within populations, and they often create different sets of issues for the community. To address these barriers, the Joint United Nations Programme on HIV and AIDS recommends that ART program planners and implementers do the following (UNAIDS 2007).
- Develop information education and communication materials that promote ART in communities.
- Increase community awareness campaigns at places such as bars and sports venues to reach out to men and boys.
- Support faith-based organizations and prayer facilities to promote ART and address misconceptions and myths.
Address stigma and discrimination at PHC centers. Even though there is widespread HIV-related stigma and discrimination, with negative effects in terms of public health and the rights of patients, these issues are largely ignored in the majority of national responses to HIV (UNAIDS 2007). To address these issues, HIV program managers and implementers should do the following.
- Empower PLHIV with education about HIV and activities that foster direct or indirect interaction among affected groups and key audiences.
- Provide leadership on the necessity of reducing stigma and discrimination in national HIV responses.
- Conduct community awareness campaigns to fight against stigma and discrimination and their negative consequences, as well as fear of acquiring HIV through casual contact, and linking HIV with behavior that is considered immoral or improper.
The USG, through PEPFAR, and its international partners, such as the Global Fund to Fight AIDS, Tuberculosis, and Malaria, has significantly contributed to achieving universal access to ART services in many generalized HIV epidemic settings. As a result of these efforts, many lives have been prolonged and individuals have been able to actively contribute to the development of their communities. However, in many countries, ART services have, for the most part, been available only at large, urban health care facilities where physicians provide services, effectively excluding coverage for most rural populations. To address this issue, some countries have begun to introduce ART services at the PHC level. The information in this technical brief can be used as a tool for national ART planners and managers, as well as implementing organizations, in successfully undertaking similar efforts.
The following resources (with hyperlinks) provide up-to-date information, guidelines, tools, and recommendations for addressing the decentralization of care for HIV.
1. Family Health International's (FHI's) Strategies for Expanded and Comprehensive Response (ECR) to a National HIV/AIDS Epidemic, 2001
Note: Although this document focuses on expanding HIV/AIDS treatment, rather than specifically decentralizing it, it covers many important subjects that are relevant for considering decentralizing ART.
Module 2: Technical Strategies
Module 3: Operationalizing ECR: Administration and Management
Module 5: Human Capacity Development
Module 6: Costing and Use of Resources
Module 7: Managing the Supply of Drugs and Commodities
Module 8: Measuring for Impact Overview
2. Towards Universal Access by 2010: How WHO is Working with Countries to Scale-up HIV Prevention, Treatment, Care and Support, 2006 (PDF, 995 KB)
3. The WHO Operations Manual: For Delivery of HIV Prevention, Care and Treatment at Primary Health Centres in High-prevalence, Resource-constrained Settings, 2008
4. Health System Assessment
The Demographic and Health Surveys website offers country-based health statistics and examples of how particular countries have previously conducted health system assessments.
John Snow Incorporated's Tool to Assess Site Readiness for ART, or for Assessment of Current ART Site (PDF, 248 KB)
5. Costing
John Snow Incorporated's DELIVER Project Costing Tools: HIV Test Assessment and Costs Assessment (PDF, 249 KB)
John Snow Incorporated's DELIVER Project Costing Tools: ARV Costs/Facts Sheets (PDF, 1.85 MB)
6. Quality Assurance and Quality Improvement (QAQI)
FHI's QAQI Checklists (PDF, 4.36 MB)
The FHI QAQI Clinical Facility and Services Assessment Field Guide (PDF, 138 KB)
7. Task Shifting and Integrated Management of Adult Illness/Integrated Management of Child Illness (IMAI/IMCI)
WHO's IMAI/IMCI Health Center and Primary Care Guidelines-Module 1: IMAI/IMCI Chronic HIV Care with ARV Therapy and Prevention (PDF, 2.15 MB)
WHO's IMCI Chart Booklet for High HIV Settings
WHO's Pre-ART, ART, ANC and L&D Registers (PDF, 230 KB)
WHO's HIV Care/ART Card (PDF, 211 KB)
Baru, R. V. 1998. Private Health Care in India: Social Characteristics and Trends. New Delhi: Sage Publications. British Columbia Ministry of Health Services. 2009. Physician Compensation Branch.
Doescher, M., K. Ellsbury, and L. Hart. 2000. The distribution of rural female generalist physicians in the United States. Journal of Rural Health 16(2): 111-8.
Gaye, P. A., and D. Nelson. 2009. Effective scale-up: avoiding the same old traps. Human Resources for Health 7(2).
Gilks, C. F., et al. 2006. The WHO public health approach to antiretroviral treatment against HIV in resource-limited settings. The Lancet 368: 505-10.
Horizons-Population Council and International AI DS Alliance. 2007. The Involvement of People Living with HIV/AIDS in the Delivery of Community-Based Prevention, Care and Support Services in Zambia: A Diagnostic Study.
IDS Health and Development Information. 2008. Non-State Health Care Providers.
International Center for AIDS Care and Treatment Programs (ICAP). 2008. HIV Services Expand to Primary Health Care Facilities in Rural South Africa.
Mathauer, I., and I. Imhoff. 2006. Health worker motivation in Africa: the role of non-financial incentives and human resource management tools. Human Resources for Health 4(24).
MEASURE Evaluation and UNAIDS. 2009. Panel 3: Framework for Monitoring and Evaluation of AIDS Programmes.
Medical University of South Carolina. 2009. Family Medicine/ Rural Clerkship.
National Committee for Quality Assurance. 2007. Multicultural Health Care: A Quality Improvement Guide.
Population Council. 2009. Exploring Current Practices in Pediatric ARV Rollout and Integration with Early Childhood Programs in South Africa.
Rao, K. S., M. Nundy, and A. S. Dua. 2005. Delivery of health services in the private sector. In: Financing and Delivery of Health Care Services in India. New Delhi: Government of India, Ministry of Health and Family Welfare, 89–91.
Scott, M. G., et al. 2007. Establishing a simple and sustainable quality assurance program and clinical chemistry services in Eritrea. Clinical Chemistry 53(11): 1945-53.
Shumbusho, F., et al. 2008. Task shifting to achieve universal access to HI V care: evaluation of a pilot program of antiretroviral treatment service delivery by nurses in Rwanda. Presentation, PEPFAR 2008 HIV/AIDS Implementers' Meeting, Kampala, Uganda, June 3–7, 2008.
Stein, J., S. Lewin, and L. Fairall. 2007. Hope is the pillar of the universe: health care providers' experiences of delivering antiretroviral therapy in primary health care cinics in the Free State Province of South Africa. Social Science & Medicine 64(4): 954-64.
Stein, J., et al. 2008. Building capacity for antiretroviral delivery in South Africa: a qualitative evaluation of the PALSA PLUS Nurse Training Programme. BMC Health Services Research 8: 240.
UNAIDS. 2007. Reducing HIV Stigma and Discrimination: A Critical Part of National AIDS Programmes. (PDF, 1.07 MB)
University of Pittsburgh. 2009. Capture-Recapture.
USAID. 2009. Achieving a Sustainable Workforce: The Human Resources for Health Action Framework.
van Rensburg, D. H. C. J., et al. 2008. Human resource development and antiretroviral treatment in Free State Province, South Africa. Human Resources for Health 6, 15–18.
Walley, J., et al. 2008. Primary health care: making Alma-Ata a reality. The Lancet 372(964): 1001-7.
WHO. 2004a. Chronic HIV Care With ARV Therapy and Prevention. Geneva: WHO. (PDF, 2.15 MB)
WHO. 2004b. Ensuring Equitable Access to Antiretroviral Treatment for Women: WHO/UNAIDS Policy Statement. Geneva: WHO.
WHO. 2008b. Integrated Health Services—What and Why? (PDF, 324 KB)
WHO. 2008c. Operations Manual for Delivery of HIV Prevention, Care and Treatment at Primary Health Centres in High-Prevalence, Resource-Constrained Settings. Geneva: WHO.
WHO. 2009a. Cost Effectiveness and Resource Allocation. (PDF, 269 KB)
WHO. 2009b. Department of Health Systems Financing: The Costs of Scaling Up Interventions and Systems. (PDF, 151 KB)
WHO. 2009c. Guidelines on Co-trimoxazole Prophylaxis for HIV-related Infections Among Children, Adolescents and Adults.
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Special thanks to Robert Ferris, Margaret Brewinski, Thomas Minor, and B. Ryan Phelps with USAID's treatment technical working group for their insight and support.
Recommended Citation
Diese Mulamba, A. Fullem, L. Hirschhorn, C. Allers, R. Oser, and B. Rau. Decentralizing Antiretroviral Treatment Services at Primary Health Care Facilities: A Guide to Expanding Access and Care in Resource-Limited, Generalized HIV Epidemic Settings. Arlington, Va.: USAID | AIDSTAR-One Project, Task Order 1, 2010.


text:
A synthetic, non-composited microporous membrane comprises a continuous array of crystalline molecular sieve material. A method is also provided for the preparation of the membrane, and methods are provided for using the membrane as a catalyst, or as a non-catalytic separation membrane for liquid or gaseous mixtures.
1. A non-composited, microporous membrane comprising a continuous array of crystalline molecular sieve material.
2. The membrane of claim 1 wherein the molecular sieve material has composition in terms of mole ratios of oxides as follows:
X2 O3 :(n)YO2
wherein X is a trivalent element selected from the group consisting of aluminum, boron, iron and gallium and combinations thereof; Y is a tetravalent element selected from the group consisting of silicon, germanium, titanium, and combinations thereof; and n is at least 2.
3. The membrane of claim 2 wherein X is aluminum and Y is silicon.
4. The membrane of claim 2 wherein the membrane consists essentially of silica.
5. The membrane of claim 2 wherein n is from about 20 to about 10,000.
6. The membrane of claim 1 wherein the molecular sieve material is a zeolite.
7. The membrane of claim 1 wherein the molecular sieve material is selected from the group consisting of aluminophosphates, silicoaluminophosphates, metaloaluminophosphates or metaloaluminophosphosilicates.
8. The membrane of claim 1 wherein the chemical properties of the membrane are adjusted so that the membrane has low catalytic activity and the membrane has gas or liquid separation properties.
9. The membrane of claim 8 wherein the catalytic activity of the membrane is reduced by incorporating alkali or alkaline earth metal into the membrane.
10. The membrane of claim 9 wherein the metal is selected from the group consisting of Mg, Ca, Sr, Ba, Na, K, Li, Rb and Cs.
11. The membrane of claim 8 wherein the separation properties of the membrane are adjusted by depositing into the membrane a compound selected from the group consisting of metal oxides, phosphorus compounds, silicon compounds, organic compounds, coke and alkali or alkaline earth metal cations.
12. The membrane of claim 1 wherein the membrane is catalytically active.
13. The membrane of claim 1 wherein a metal having a catalytic function is incorporated into the membrane.
14. The membrane of claim 13 wherein the metal function is selected from the group consisting of Pd, Pt, Ru, Mo, W, Ni, Fe and Ag.
15. The membrane of claim 1 wherein the membrane is monocrystalline.
16. The membrane of claim 1 wherein the membrane is polycrystalline.
17. The membrane of claim 1 wherein the thickness dimension of the membrane is from about 0.1 μ to about 400 μ.
The invention relates to membranes having molecular sieve properties and/or catalytic activity and a process for producing the membranes.
Membrane separation technology is a rapidly expanding field. Organic and inorganic materials have been used as membranes in a variety of separation processes, such as microfiltration, ultrafiltration, dialysis, electrodialysis, reverse osmosis and gas permeation. Most membranes have been made from organic polymers with pore sizes ranging from 10 to 1000 angstroms. Membranes have also been made from inorganic materials such as ceramics, metals, clay and glasses.
Synthetic zeolites have been used as adsorptive separation agents for gases or liquids or as catalysts and have usually been used in the form of granules or pellets often incorporated with a binder such as clay or alumina. The potential of zeolites as components in microporous membranes has not been fully explored.
Zeolites have also been used as components in composite membranes. In such membranes, in addition to the presence of a zeolite phase, the membrane material always contains a second phase with distinctly different chemical composition, physical properties, chemical properties and morphology. As a result of the presence of different phases, the separation properties of composite membranes are determined by the individual properties of the different phases and of the phase boundaries. (Demertzes et al., J. Chem. Soc., Faraday Trans. 1, 82, 3647 (1986). Examples of such non-zeolitic phases are polymeric materials and inorganic materials such as glasses, silica or alumina.
Composite membranes or filters of materials such as paper and polymers which may contain dispersed particles of zeolites have been described, for example, in U.S. Pat. Nos. 3,266,973, 3,791,969, 4,012,206, 4,735,193, 4,740,219 and European Patent Application 254758.
U.S. Pat. No. 4,699,892 describes a composite membrane having an ultrathin film of a cage-shaped zeolite of from 10 to several hundred angstroms in thickness on a porous support of metal, inorganic material or polymeric material.
Non-composited inorganic membranes are described, for example, in U.S. Pat. Nos. 3,392,103, 3,499,537, 3,628,669 and 3,791,969.
U.S. Pat. No. 3,392,103 describes membranes made from hydrous metal oxide ceramics such as aluminum oxide. U.S. Pat. No. 3,499,537 discloses membranes of pressed and sintered aluminum vanadate powder. U.S. Pat. No. 3,628,669 discloses silica membranes made by leaching thin inorganic glass films. U.S. Pat. No. 3,791,969 describes membranes of flocculated sodium exfoliated vermiculite.
Other non-composited membranes described in U.S. Pat. Nos. 3,413,219, 4,238,590 require some manner of supporting material. U.S. Pat. No. 3,413,219 discloses the preparation of membranes from colloidal hydrous oxide which is formed on a permeable substrate. U.S. Pat. No. 4,238,590 discloses silicic acid heteropolycondensates suitable for use as membranes but which are not self-supporting and are stretched over porous or net-like supporting material.
It is therefore an object of the invention to provide a pure and spatially continuous molecular sieve membrane. It is also an object to provide a material of macroscopic dimensions, composed only of a zeolitic phase, and having adequate mechanical strength to maintain its macroscopic structural integrity and capable of carrying out molecular sieve action.
The invention is a synthetic, non-composited, microporous membrane comprising a continuous array of crystalline molecular sieve material. The molecular sieve may have a composition in terms of mole ratios of oxides as follows:
X2 O3 :(n)YO2
wherein X is a trivalent element of at least one member selected from the group consisting of aluminum, boron, iron and gallium. Y is a tetravalent element of at least one member selected from the group consisting of silicon, germanium and titanium; and, n is at least about 2.
The crystalline material may also be an aluminophosphate, silicoaluminophosphate, metaloaluminophosphate or metaloaluminophosphosilicate.
Also in accordance with the invention, a method is provided for preparing the microporous membrane. A chemical mixture capable of forming the crystalline molecular sieve material is prepared and the mixture is formed into a thin, uncomposited, cohesive, continuous membrane, dried and calcined.
A method is also provided for using the membrane for the separation of the components of a gaseous or liquid mixture having at least two components. The mixture is contacted with an upstream face of the membrane under separation conditions such that at least one component of the mixture has a greater steady state permeability through the membrane than at least one of the remaining component(s) of the mixture. After contact of the mixture with the membrane and passage through the membrane, the component with the greater permeability is collected on the downstream side of the membrane.
A method is also provided for using the membrane as a catalyst. The membrane is rendered catalytically active and a feedstock is passed through the upstream face of the membrane under catalytic conditions. For cases where all or at least one of the reaction products have higher permeability than the reactant(s), they will emerge from the downstream side of the membrane. In equilibrium limited reactions, this will lead to higher single-pass conversion of the reactant(s) than normally observed and allowed by thermodynamic equilibrium constraints. At least one or all of the reaction products are collected on the downstream side of the membrane. Other advantages can be realized, for example, when one or all of the products inhibit or poison the desired reaction, or when they would undergo undesired secondary reactions.
The microporous zeolitic membranes of the invention advantageously have unique molecular sieve and/or catalytic properties due to the well defined pore structure of zeolites. The membranes have the advantages of having different properties from traditionally used granular form zeolites, and from composited membranes which include zeolites. These different properties result from the sheet-like structure of the membranes and the composition of pure zeolite in the membrane.
For a better understanding of the present invention, together with other and further objects, reference is made to the following description, taken together with the accompanying drawings, and its scope will be pointed out in the appended claims.
FIG. 1 is a graph of a Si-NMR spectrum of the crystalline membrane.
FIG. 2a shows the membrane surface which was exposed to the non-porous substrate during crystallization.
FIG. 2b shows the membrane surface which was exposed to the synthesis mixture.
FIG. 2c shows crystal intergrowth on the surface of a large single crystal.
FIG. 2d is a higher magnification of the view of FIG. 2c.
FIG. 3 illustrates the membrane affixed in a Wicke-Kallenbach cell.
Zeolite materials, both natural and synthetic, have been demonstrated in the past to have catalytic properties for various types of hydrocarbon conversion. Certain zeolitic materials are ordered, porous, crystalline aluminosilicates having a definite crystalline structure as determined by X-ray diffraction, within which there are a large number of smaller cavities and channels or pores. These cavities and pores are uniform in size within a specific zeolitic material. Since the dimensions of these pores are such as to accept for adsorption molecules of certain dimensions while rejecting those of larger dimensions, these materials have come to be known as "molecular sieves" and are utilized in a variety of ways to take advantage of these properties.
Zeolites typically have uniform pore diameters of about 3 angstroms to about 10 angstroms. The chemical composition of zeolites can vary widely and they typically consist of SiO2 in which some of the silicon atoms may be replaced by tetravalent ions such as Ti or Ge, by trivalent ions such as Al, B, Ga, Fe, or by bivalent ions such as Be, or by a combination of any of the aforementioned ions. When there is substitution by bivalent or trivalent ions, cations such as Na, K, Ca, NH4 or H are also present.
Representative examples of siliceous zeolites are small pore zeolites such as NaA, CaA, Erionite; medium pore zeolites such as ZSM-5, ZSM-11, ZSM-22, ZSM-23, ZSM-48, ZSM-12, zeolite beta; and large pore zeolites such as zeolite L, ZSM-4 (omega), NaX, NaY, CaY, REY, US-Y, ZSM-20, and mordenite.
Zeolites include wide variety of positive ion-containing crystalline aluminosilicates. These aluminosilicates can be described as a rigid three-dimensional framework of SiO4 and AlO4 in which the tetrahedra are cross-linked by the sharing of oxygen atoms whereby the ratio of the total aluminum and silicon atoms to oxygen atoms is 1:2. The electrovalence of the tetrahedra containing aluminum is balanced by the inclusion in the crystal of the cation, for example an alkali metal or an alkaline earth metal cation. This can be expressed wherein the ratio of aluminum to the number of various cations, such as Ca/2, Sr/2, Na, K or Li, is equal to unity. One type of cation may be exchanged either entirely or partially with another type of cation utilizing ion exchange techniques in a conventional manner. By means of such cation exchange, it has been possible to vary the properties of a given aluminosilicate by suitable selection of the cation. The spaces between the tetrahedra are occupied by molecules of water prior to dehydration.
Prior art techniques have resulted in the formation of a great variety of synthetic zeolites. The zeolites have come to be designated by letter or other convenient symbols, as illustrated by zeolite A (U.S. Pat. No. 2,882,243), zeolite X (U.S. Pat. No. 2,882,244), zeolite Y (U.S. Pat. No. 3,130,007), zeolite beta (U.S. Pat. No. 3,308,069), zeolite ZK-5 (U.S. Pat. No. 3,247,195), zeolite ZK-4 (U.S. Pat. No. 3,314,752), zeolite ZSM-5 (U.S. Pat. No. 3,702,886), ZSM-5/ZSM-11 intermediate (U.S. Pat. No. 4,229,424), zeolite ZSM-23 (U.S. Pat. No. 4,076,842), zeolite ZSM-11 (U.S. Pat. No. 3,709,979), zeolite ZSM-12 (U.S. Pat. No. 3,832,449), zeolite ZSM-20 (U.S. Pat. No. 3,972,983), ZSM-35 (U.S. Pat. No. 4,016,245), ZSM-38 (U.S. Pat. No. 4,046,859), and zeolite ZSM-48 (U.S. Pat. No. 4,375,573), merely to name a few. All of the above patents are incorporated herein by reference.
The silicon/aluminum atomic ratio of a given zeolite is often variable. For example, zeolite X can be synthesized with silicon/aluminum atomic ratios of from 1 to 1.5; zeolite Y, from 1.5 to about 3. In some zeolites, the upper limit of the silicon/aluminum atomic ratio is unbounded. ZSM-5 is one such example wherein the silicon/aluminum atomic ratio is at least 12. U.S. Pat. No. 3,941,871 (Re. 29,948) discloses a porous crystalline silicate made from a reaction mixture containing no deliberately added aluminum in the recipe and exhibiting the X-ray diffraction pattern characteristic of ZSM-5 type zeolites. U.S. Pat. Nos. 4,061,724, 4,073,865 and 4,104,294 describe crystalline silicas of varying aluminum and metal content. These zeolites can consist essentially of silica, containing only traces or no detectable amounts of aluminum.
Another class of molecular sieves consists of AlO2 � PO2 units (AlPO4) whose Al or P constituents optionally may be substituted by other elements such as Si (called silicoaluminophosphates or SAPO3 s), or metals (called metaloaluminophosphates or MeAPO's) or combinations thereof (called metaloaluminophosphosilicates or MeAPSO's). As with aluminosilicates, the ALPO4 's, SAPO's, MeAPO's and MeAPSO's are crystalline and have ordered pore structures which accept certain molecules while rejecting others and they are often considered to be zeolitic materials.
Aluminum phosphates ar taught in U.S. Pat. Nos. 4,310,440 and 4,385,994 for example. These aluminum phosphate materials have essentially electroneutral lattices. U.S. Pat. No. 3,801,704 teaches an aluminum phosphate treated in a certain way to impart acidity.
The crystalline silicoaluminophosphates useful for the membranes of the invention have molecular sieve framework which may exhibit ion-exchange properties and may be converted to material having intrinsic catalytic activity.
Silicoaluminophosphates of various structures are taught in U.S. Pat. No. 4,440,871. Aluminosilicates containing phosphorous, i.e. silicoaluminophosphates of particular structures are taught in U.S. Pat. Nos. 3,355,246 (i.e. ZK-21) and 3,791,964 (i.e. ZK-22). Other teachings of silicoaluminophosphates and their synthesis include U.S. Pat. Nos. 4,673,559 (two-phase synthesis method); 4,623,527 (MCM-10); 4,639,358 (MCM-1); 4,647,442 (MCM-2); 4,664,897 (MCM-4); 4,638,357 (MCM-5); and 4,632,811 (MCM-3). All of the above patents are incorporated herein by reference.
A method for synthesizing crystalline metaloaluminophosphates (MeAPO's) is shown in U.S. Pat. No. 4,713,227, and an antimonophosphoaluminate and the method for its synthesis are taught in U.S. Pat. No. 4,619,818. U.S. Pat. No. 4,567,029 teaches metalloaluminophosphates, and titaniumaluminophosphate and the method for its synthesis are taught in U.S. Pat. No. 4,500,651.
Compositions comprising crystals having a framework topology after heating at 110� C. or higher giving an X-ray diffraction pattern indicating pore windows formed by 18 tetrahedral members of about 12-13 Angstroms in diameter are taught in U.S. Pat. No. 4,880,611.
The membranes of the invention consist essentially of only molecular sieve material, as contrasted with prior art composite membranes which can contain various amounts of molecular sieve material composited with other materials. The zeolitic membrane may contain a single zeolite or mixtures of zeolites. The membrane can be mono-crystalline or polycrystalline. "Monocrystalline" is intended to mean consisting of a single crystal. "Polycrystalline" is intended to mean consisting of a continuous intergrowth of many crystals.
The membrane can be produced, for example, by synthesis under hydrothermal conditions on a non-porous substrate forming surface, such as a polymer, a metal or glass. Suitable polymer surfaces are, for example, fluorocarbon polymers such as tetrafluoroethylene (TFE) and fluorinated ethylene-propylene polymers (FEP). Suitable metal surfaces are, for example, silver, nickel, aluminum and stainless steel. A thin layer of metal on glass or an organic polymer or other material may be used as the forming surface. A thin layer of a polymer film on glass or other material may also be used as the forming surface. The forming surface may have various configurations. For example, the surface may be flat, curved, a hollow cylinder or honeycomb-shaped.
Although amorphous materials can be used as substrates for crystal growth, monocrystalline surfaces can also be used. The synthesis can also be achieved by mechanical compression of a powder form zeolite, followed by chemical treatment.
In forming the membranes of the invention, a non-porous surface is contacted with a chemical mixture capable of forming the desired crystalline material under crystallization conditions. After a period of time under suitable conditions, a cohesive membrane of crystallized material forms on the nonporous substrate surface. The thickness dimension of the membrane may vary from about 0.1 micron to about 400 microns depending upon the length of time the surface is contacted with the chemical mixture and the amount of mixture provided. Other means such as varying the temperature or the ratio of crystallization mixture to forming surface area are also effective in adjusting the membrane thickness to a desired dimension.
The time of contacting of the surface with the reaction mixture may be from about 0.5 hrs. to about 1000 hrs., preferably from about 1 hr. to about 100 hrs.; at a temperature of from about 50� C. to about 250� C., preferably from about 110� C. to about 200� C.; and at a pressure from about 1 atm to about 100 atm, preferably from about 1 atm to about 15 atm.
After the desired period of time, the substrate, now coated with crystalline material, is removed from contact with the chemical mixture, washed with distilled water and allowed to dry.
The layer of crystalline material may be removed from the non-porous surface by various means depending upon the material chosen for the forming surface. The layer may be separated from polymeric surfaces, for example, by mechanical means such as careful scraping or peeling. Removal from metal surfaces may be accomplished with the use of solvents such as acetone, or by dissolving the metal with acid such as aqueous hydrochloric or nitric acid. With a support consisting of metal or metallized material such as aluminum on glass or teflon, treatment with an aqueous mineral acid can be employed.
The membrane material may also be calcined before or after removal from the substrate for example in an inert atmosphere or in air at from about 200� to about 700� C. for about 1 hr. to about 50 hrs.
The membrane may also be treated to adjust its catalytic properties before or after removal from the surface, for example by steaming and/or ion exchange. Low or zero catalytic activity can be obtained by incorporating alkali or alkaline earth cations into the membrane.
Catalytic activity can be increased by methods known in the art such as by increasing the aluminum content or by introducing a hydrogenation-dehydrogenation function into the membrane.
The original ions, i.e. cations or anions, of the synthesized membrane can be replaced in accordance with techniques well known in the art, at least in part, by ion exchange with other cations or anions. Preferred replacing cations include metal ions, hydrogen ions, hydrogen precursor, e.g. ammonium ions and mixtures thereof. Particularly preferred cations include hydrogen, rare earth metals and metals of Groups IIA, IIIA, IVA, IB, IIB, IIIB, IVB, VIB and VIII of the Periodic Table of the Elements.
Typical ion exchange technique would be to contact the synthesized membrane with a salt of the desired replacing ion or ions. Examples of such salts of cations include the halides, e.g., chlorides, nitrates and sulfates.
Cations may be incorporated into the membrane to neutralize acid sites or to adjust the diffusion properties; preferred cations to be incorporated for these purposes include metals of Groups IA and IIA of the Periodic Table of the Elements, for example, sodium, potassium, magnesium, barium, lithium, strontium, rubidium and cesium.
The diffusive properties of the membrane such as permeation rate and selectivity, depend on the geometric properties, particularly the thickness, and the particular zeolite that constitutes the membrane. A given membrane can be further modified by subsequent treatment that changes the diffusion properties. Examples of such treatments are: deposition of coke or organic compounds, such as pyridine or other carbonaceous material, at the exterior or interior of the zeolite pores, deposition of silica or silicon compounds via treatment with SiCl4 or Si(OR)4 followed by calcination, treatment with phosphorus compounds, incorporation of metal salts or oxides, such as of Mg, Mo, W, Sb, or other oxides such as silicon dioxide, or ion exchange, e.g., with K, Rb, Cs, or Ag.
It is also contemplated that a metal function can be incorporated into the membrane, such as Pd, Pt, Ru, Mo, W, Ni, Fe, Ag, etc. These metal-containing membranes may have essentially no acid activity, or they may have substantial acid activity to provide for dual-functional catalysis. The catalytic activity of the membrane can be adjusted from essentially zero to high activity, depending on the particular use thereof.
The membranes can be used for separation of gaseous or liquid mixtures or catalytic applications which combine chemical conversion of the reactant with in situ separation of the products.
A variety of gaseous or liquid mixtures may be separated using the membrane. Examples of mixtures advantageously separated are oxygen and nitrogen, hydrogen and carbon monoxide, linear and branched paraffins, hydrogen and methane, p-xylene and m- and/or o-xylene.
When separation of the components of a gaseous or liquid mixture is to be accomplished, a low or zero activity zeolitic membrane is preferably used. Siliceous zeolites of low or zero activity contain no or only trace amounts of two- or three-valent metal ions; or when they contain substantial amount of such ions, their catalytic activity can be reduced to the desired low level by cation exchange with alkali or alkaline earth cations, by thermal or steam treatment, by treatment with phosphorus compounds and steaming, or by replacement of the three-valent ions, e.g., Al, by four-valent ions, e.g., Si, by treatment with hexafluorosilicate, SiCl4, etc. Aluminophosphate molecular sieves also have low if any catalytic activity.
Catalytic applications can combine chemical conversion of one or more reactants with in situ separation. Such separation may involve, for example, the separation of one or all of the products from the reactant(s).
For use in a catalytic process, (i) a catalytically inactive membrane may be combined with an active catalyst, or (ii) the membrane itself may be catalytically active. As an example of the first case (i), a Pt on Al2 O3 catalyst is contained in a tubular reactor whose walls consist at least partly of a catalytically inactive zeolitic membrane chosen to selectively permeate hydrogen.
Dehydrogenation of alkanes is an example of a catalytic process which may be accomplished by passing an alkane feed through the tubular reactor; the effluent contains alkene in greater than equilibrium concentration. In this waY, for example, propane may be converted to propylene. In the second case (ii), the zeolitic membrane possesses catalytic activity, either acid activity, or metal activity, or both. The acid activity of siliceous zeolites can be adjusted by the amount of three-valent substituents, especially aluminum, by the degree of cation exchange from salt form to hydrogen form or by thermal or steam treatment. The acid activity of AlPO4 - type zeolites can be increased by incorporation of activating agents such as silica. An example utilizing the acid activity of the membrane is the dealkylation of ethylbenzene to benzene and ethylene. Utilizing the higher permeation rate of ethylene alone or of ethylene and benzene, a higher degree of dealkylation in greater selectivity is obtained.
Activity may be correlated with acid character. Silicious zeolites may be considered to contain SiO4 -tetrahedra. Substitution by a trivalent element such as aluminum introduces a negative charge which must be balanced. If this is done by a proton, the material is acidic. The charge may also be balanced by cation exchange with alkali or alkaline earth metal cations.
One measure of catalytic activity may be termed the Alpha Value. The Alpha Value is an approximate indication of the catalyst acid activity and it gives the relative rate constant (rate of normal hexane conversion per volume of catalyst per unit time). It is based on the activity of the highly active silica-alumina cracking catalyst taken as an Alpha of 1 (Rate Constant=0.016 sec1). The Alpha Test is described in U.S. Pat. No. 3,354,078, in the Journal of Catalvsis. Vol. 4, p. 527 (1965); Vol. 6, p. 278 (1966); and Vol. 61, p. 395 (1980), each incorporated herein by reference as to that description. The experimental conditions of the test used herein include a constant temperature of 538� C. and a variable flow rate as described in detail in the Journal of Catalysis, Vol. 61, p. 395 (1980).
The crystalline membranes of the present invention are readily convertible to catalytically active material for a variety of organic, e.g. hydrocarbon, compound conversion processes. Such conversion processes include, as non-limiting examples, cracking hydrocarbons with reaction conditions including a temperature of from about 300� C. to about 700� C., a pressure of from about 0.1 atmosphere (bar) to about 30 atmospheres and a weight hourly space velocity of from about 0.1-1 to about 20 hr-1 ; dehydrogenating hydrocarbon compounds with reaction conditions including a temperature of from about 300� C. to about 700� C., a pressure of from about 0.1 atmosphere to about 10 atmospheres and a weight hourly space velocity of from about 0.1 to about 20, converting paraffins to aromatics with reaction conditions including a temperature of from about 100� C. to about 700� C., a pressure of from about 0.1 atmosphere to about 60 atmospheres, a weight hourly space velocity of from about 0.5 to about 400 and a hydrogen/hydrocarbon mole ratio of from about 0 to about 20; converting olefins to aromatics, e.g. benzene, toluene and xylenes, with reaction conditions including a temperature of from about 100� C. to about 700� C., a pressure of from about 0.1 atmosphere to about 60 atmospheres, a weight hourly space velocity of from about 0.5 to about 400 and a hydrogen/hydrocarbon mole ratio of from about 0 to about 20; converting alcohols, e.g. methanol, or ethers, e.g. dimethylether, or mixtures thereof to hydrocarbons including olefins and/or aromatics with reaction conditions including a temperature of from about 275� C. to about 600� C., a pressure of from about 0.5 atmosphere to about 50 atmospheres and a liquid hourly space velocity of from about 0.5 to about 100; isomerizing xylene feedstock components with reaction conditions including a temperature of from about 230� C. to about 510� C., a pressure of from about 3 atmospheres to about 35 atmospheres, a weight hourly space velocity of from about 0.1 to about 200 and a hydrogen/hydrocarbon mole ratio of from about 0 to about 100; disproportionating toluene with reaction conditions including a temperature of from about 200� C. to about 760� C., a pressure of from about atmospheric to about 60 atmospheres and a weight hourly space velocity of from about 0.08 to about 20; alkylating aromatic hydrocarbons, e.g. benzene and alkylbenzenes in the presence of an alkylating agent, e.g. olefins, formaldehyde, alkyl halides and alcohols, with reaction conditions including a temperature of from about 250� C. to about 500� C., a pressure of from about atmospheric to about 200 atmospheres, a weight hourly space velocity of from about 2 to about 2000 and an aromatic hydrocarbon/alkylating agent mole ratio of from about 1/1 to about 20/1; and transalkylating aromatic hydrocarbons in the presence of polyalkylaromatic hydrocarbons with reaction conditions including a temperature of from about 340� C. to about 500� C., a pressure of from about atmospheric to about 200 atmospheres, a weight hourly space velocity of from about 10 to about 1000 and an aromatic hydrocarbon/polyalkylaromatic hydrocarbon mole ratio of from about 1/1 to about 6/1.
In general, therefore, catalytic conversion conditions over a catalyst comprising the membrane in active form include a temperature of from about 100� C. to about 760� C., a pressure of from about 0.1 atmosphere (bar) to about 200 atmospheres (bar), a weight hourly space velocity of from about 0.08 hr-1 to about 2000 hr-1 and a hydrogen/organic, e.g. hydrocarbon compound of from 0 to about 100.
In order to more fully illustrate the nature of the invention and the manner of practicing same, the following examples are presented.
To prepare the initial batch composition, the procedure outlined by Hayhurst and Lee (Proceedings of the 7th International Zeolite Conference, Murakami, Y., Iijima, A, Ward, I.W.Ed., p. 113, Elsevier, Tokyo, 1986) was followed. The following is a list of the reagents used: Ludox AS-40 (DuPont) aqueous colloidal silica solution as the silica source, 50% by weight sodium hydroxide solution (Baker, reagent grade), tetrapropylammonium bromide (Aldrich), distilled water.
The tetrapropylammonium bromide, 3.475 gm, was dissolved in 50.0 gm distilled water by stirring in a polyethylene container. 0.90 gm sodium hydroxide solution was added. The resulting solution was subsequently diluted with 54.6 gm distilled water. 37.55 gm of the silica source was slowly added with continuous stirring. About 40 ml of the suspension was poured into a 45 ml polytetrafluoroethylene (TN) (Teflon) lined autoclave (Parr Model 4744). The molar composition was:
2.2 Na2 O �100 SiO2 �2832 H2 O �5.22 TPA Br
A polytetrafluoroethylene (TN) slab (80 mm �25 mm �2.5 mm) was immersed in the solution and placed vertically along the axis of the cylindrical vessel. The autoclave was sealed and placed in a convection oven, which was preheated at 180� C.
In a second autoclave, a vycor frit, approximately 1.5 cm in diameter, already mounted inside a pyrex tube (Corning Glass) was immersed in the synthesis solution.
The autoclaves were removed from the oven after 9 days and quenched with water. The TN slab was recovered, washed with distilled water and dried at room temperature. The slab and the vycor frit with surrounding pyrex tube were observed to be covered with a uniform layer of crystallized material.
The layer of crystalline material was removed from the TN surfaces by carefully scraping with a spatula. No solid particles were found suspended in the remaining solution or settled on the bottom of the container.
The resulting membranous material was calcined in nitrogen at 560� C. and in air at 600� C. to decompose and burn the organic template. No cracks generated by the calcination process were observed.
Segments of the zeolite membrane greater than 1 cm2 were selected for characterization by electron microscopy, X-ray diffraction, Silicon-NMR and hexane sorption. The membrane was crushed to powder form for X-ray and Silicon-NMR tests. It was introduced uncrushed into the sorption apparatus for hexane sorption measurements.
The X-ray diffraction pattern was shown to be that of pure ZSM-5. The Si-NMR spectrum, FIG. 1, showed silanols as the only non-ZSM-5 framework silicons. Spectra with 30 and 300s relaxation delays were obtained to be certain no dense phases were present. Silanols, whose identity was established by crosspolarization, are seen as a broad peak at about -103 ppm. Their concentration is about 1.5 SiOH/unit cell or about 1/3 what is normally present in a high silica/alumina ZSM-5 made from TPABr. The hexane sorption capacity, measured at 90� C. and crosspolarization, are seen as a broad peak at about -103 ppm. 110.8 torr hexane partial pressure, was found to be 112.0 mg/gm of zeolite, i.e., slightly higher than the sorption capacity of standard small ZSM-5 crystals.
FIG. 2 shows the distinct morphologies of the two membrane surfaces. FIG. 2a corresponds to the membrane surface exposed to the teflon support. FIG. 2b corresponds to the surface exposed to the synthesis mixture. Although the teflon side surface consists of a layer of apparently loosely held crystals of less than 0.1 μm size, the solution surface consists of a continuous array of densely packed and intergrown (twinned) crystals, 10 to 100 μm in size. The intergrowth is better shown on the surface of a large single crystal (FIG. 2c). The surface of the same crystal at even higher magnification is shown in FIG. 2d. This is partly coated with small particles, which may or may not have the ZSM-5 microstructure.
The thickness of the membrane was estimated to be about 250 μm.
Some permeability properties of the membrane of Example A were determined in a Wicke-Kallenbach cell, operated in the steady state mode (FIG. 3). Both sides of the membrane were glued with epoxy resin onto the perimeter of two Pyrex tubes, 1 cm in diameter. The membrane material extending beyond the external surface of the tubes was destroyed. A thick layer of epoxy resin was applied to the external surface of the junction to provide extra mechanical support and eliminate the possibility of gas leaks. The temperature limit of the epoxy resin used is 120� C. The Wicke-Kallenbach cell was incorporated in a standard flow apparatus, capable of operating at atmospheric or subatmospheric pressure. The permeability coefficient (P) of a component across the membrane is defined as the ratio of the flux/unit area to the external concentration gradient of the component. It is related to the Wicke-Kallenbach diffusion coefficient (Dwk) by the expression: P=Kh *Dwk (Matson et al., Chem. Eng. Sci. 38, 503 (1983)) where Kh is the Henry's Law constant. This expression is only valid in the Henry's Law regime. It reflects the fact that the true but not directly measurable driving force for diffusion, which is the intracrystalline concentration gradient, differs from the external concentration gradient due to the equilibrium partitioning of the adsorbate established between the membrane surface and the external gas phase (Koresh, et al., J. Chem. Soc., Faraday Trans. 1, 82, 2057 (1986)). For a bicomponent feed stream, the selectivity is defined as the permeability ratio. Except for a few data collected at 23� C., permeabilities were measured at 49� C. and 1 atm total pressure on both sides of the membrane. The flow rate of the feed side was 249 cc/min and that of the permeate side was 14.1 cc/min. Helium was used as a carrier gas of the permeate.
Permeability coefficients and selectivities were calculated for three bicomponent gas mixtures:
______________________________________Feed # Composition (mole %)______________________________________1 21% O2 /79% N22 49.4% H2 /50.6% CO3 9.5% n-C6 /16.6% 2,2-DMB/helium balance (normal hexane/2,2-dimethylbutane)______________________________________
The following permeability coefficients and selectivities were determined:
__________________________________________________________________________ Temp Perm. Comp.Feed # (�C.) (mole %) P1 (cm2 /s) P2 (cm2 /s) Selectivity__________________________________________________________________________1 49 .46 � .01/1.62 � .04 1.31 � 10-4 1.22 � 10-4 1.07 � .052 23 2.12 � .05/1.36 � .05 2.63 � 10-4 1.63 � 10-4 1.62 � .042 49 2.20 � .02/1.48 � .01 2.59 � 10-4 1.92 � 10-4 1.54 � .013 49 .335 � .002/.0354 � .0007 1.96 � 10-4 1.14 � 10-5 17.2 � 1.5__________________________________________________________________________
The data indicate that the composition of the recovery stream differs from the composition of the feed stream. The membrane is shown to separate O2 and N2, H2 and CO, and hexane and 2,2-dimethylbutane. This indicates that the zeolitic membrane can discriminate between permeates at the molecular level. The selectivities observed for the H2 /CO and hexane/2,2-dimethylbutane feeds strongly suggest that most of the transport across the membrane takes place in the shape selective pores of the ZSM-5 lattice.
The same synthesis mixture and conditions described in Example A were used except that the crystallization time was varied.
The thickness of the membranes formed was found to be a function of the crystallization time as shown in Table 1. It is apparent that long crystallization times lead to membranes of greater thickness.
TABLE 1______________________________________ Crystallization Time, Membrane ThicknessExample Days Microns______________________________________1 0.3 202 1 1503 2 2104 4 230______________________________________
Experiment A was repeated except that a 25�25 mm flat silver plate was used instead of the teflon plate. A ZSM-5 membrane formed on the surface of the silver plate.
The silver plate was washed with water and dried at room temperature. The crystallized zeolite membrane could be readily removed from the support plate by wetting the surface with acetone at room temperature.
Example A was repeated using a 25x25 mm flat nickel plate. At the end of the crystallization period, the nickel plate was found to be coated with a thin ZSM-5 zeolite membrane.
Example A was repeated using a flat plate made of #316 stainless steel. Zeolite crystallization again occurred on the surface of the stainless steel plate in the form of a thin membrane.
Examples 1-4 illustrate that the thickness of the membrane can be adjusted by varying the crystallization time. This is not intended to mean that the thickness cannot be adjusted in other ways also. Examples 5-7 illustrate the use of various types of support plates, however, the invention is not limited to these.
While there have been described what are presently believed to be the preferred embodiments of the invention, those skilled in the art will realize that changes and modifications may be made thereto without departing from the spirit of the invention, and it is intended to claim all such changes and modifications as fall within the true scope of the invention.
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2013 Oscars: Watch Jennifer Lawrence Falls Down Accepting Best Actress Award
Gorgeous and talented 22-year-old Jennifer Lawrence just won big — and fell hard — at the 2013 Oscars. We're not sure if it was the train on her gorgeous pink Dior Couture gown, the fact that she hadn't eaten anything before the long awards show, or just plain nerves, but homegirl went down while trying to get up to the stage to accept her Academy Award for Best Actress on February 24, 2013. She even made a joke about it before getting into her thank yous, "You guys are just standing up 'cause you feel bad that I fell, and that's really embarrassing, but thank you!" Aww, we love her!
MORE Jennifer Lawrence: Sh&% Jennifer Lawrene Says


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Good morning everyone!
My parents are coming to visit today! What does this mean exactly? It means I get another weekend of quality family time, along with food from the farm. It also means my hands may permanently have the smell of clorox and windex from the amount of cleaning I've done in the last 24 hours.
Since I'm on official "race rest" until Sunday morning and my roommate is saving her energy for a big bachelorette bash later tonight, we spent last night getting in some roommate bonding time. Much like every other night of the week. I've been told we're like an old married couple. So what? A quiet night in with a wholesome dinner, a movie, and early bed time is a rockin' good time on a Friday night.
Wait… what?
We decided on watching Young Adult. It was either that or Girl With the Dragon Tattoo. But we both felt the need for something light.
Or so we thought that's what we were getting into. "Light" is what the trailers for Young Adult portrayed it as. Definitely not what it was. It ended up being a "grass is greener on the other side" sort of movie that ended with the same feeling as it began with. I've had better.
Alright, time to break out that windex one last time and finish my laundry. When the 'rents give an estimated arrival time, it really means they'll show up about three hours before then.
You think I'm kidding.
Filed under: Uncategorized | Tagged: carb loading, Chi Town Half Marathon, I heart carbs, rest day, staying in on a Friday night | 17 Comments »


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Well folks, here it is: The long-awaited music video for Lady Gaga's "Applause"!
Immediately of the gate, the "Applause" single suffered after being rushed to market early last week. A few low quality leaks and some early bad buzz forced the hand of Lady Gaga and her camp—she stated on Good Morning America today that her intent was for the single and video to drop simultaneously—and put her squarely in a competition she couldn't win: A showdown with the reigning Queen of Pop, Miss Katy Perry. Not surprisingly, Perry's anthemic "Roar" trounced Gaga out of the gate in terms of sales, leading more than a few cultural critics to label Gaga as being yesterday's news.
With the benefit of a little bit of hindsight, though, it appears as if the events of last week—which also includes a very public, increasingly nasty fight with Perez Hilton—have returned Gaga to her most familiar and comfortable position: The underdog. Gaga and her unwaveringly loyal band of Little Monsters originally drew their strength from being perceived as outcasts, and now that the Katycats have asserted their (temporary?) dominance, one could argue that a sense of balance has been restored to the pop culture universe. No longer saddled with such a tremendous burden of expectations, things now seem to be primed for this to be the big week for "Applause."
Gaga will be opening the 2013 VMAs this Sunday, August 25, with a performance of "Applause," and the Mother Monster herself also debuted her latest music video for the track this morning. Directed by the Dutch photographers Inez And Vinoodh, it is the first official video statement of her ARTPOP project. And arty, it most certainly is!


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Below is the poem entitled I Was Wrong which was written by poet
Arowolo. Please feel free to comment on this poem. However, please remember, PoetrySoup is a place of encouragement and growth.
Read Poems by
Olusegun Arowolo
To have sent you out of the home,I was wrong
though I didn`t have the mind of doing it,
Your false accusation was a serious hit,
I was vexed and constantly slapped you for long,
Yet,the love that we share its still very strong,
I was drunk and almost fell into the pit,
You held and pulled me up and placed me on ~seat,
This baffled me and made me sing a new song.
For long,I`ve abandoned you and made you cry,
Please,let the old love burn in your heart like fire,
And allow me take you on my wings and fly!,
Fly..over hills to fulfill your heart desire,
For having pain and sorrow,I can`t deny,
Please!forgive me and let`s move a step higher.
CONTEST:"I Was Wrong" sponsored by Nancy Jones.


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This is a 1961 Morgan plus 4. Car is a very solid example. Same ownership for 30 years, always garaged. For more details call... More
This Morgan is a very rare and desirable example that just completed a meticulous professional restoration to a Show/Driver level. Includes a soft top... More
The rarest of the different body styles offered by Morgan. A three position Drophead Coupe....top up, top down, top half way up (but open... More
MORGAN: 1961 Plus 4 two-seater, very solid, runs and drives, nice driver. 440-546-9121, OH; [email]... More
MORGAN: 1961 Plus 4 drophead, very clean, green with beige interior, wire wheels. 203-377-6746, CT; see photos and description at: www.newenglandclassics.com... More


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Looking for a New Car. Drummers' Advice Wanted
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Silver Member
Join Date: Apr 2010
Location: South Florida
Posts: 685
Looking for a New Car. Drummers' Advice Wanted
Hey all.
My dad and I are looking at some used, recent-model cars since I've had the same car since I started driving, almost five years ago ('97 Avalon) and I'm starting to need something a little more reliable, with a warranty, and that I can transport my drums in with a bit more ease.
I'm looking at some of the hatchbacks including the VW Golf, Mazda 3, Toyota Matrix, etc. as well as some crossovers and smaller SUV's such as the Toyota RAV4, Honda CRV, Kia Sportage, Honda Element, Mitsubishi Outlander, etc.
Is there anything you guys can tell me about these cars, as well as suggest anything else in those classes that we may have overlooked or not given enough consideration to?
How do you guys feel about Scion xB's and xD's? I was looking favorably upon those...
Thanks in advance!
Yamaha Stage Custom Birch in Honey Amber
14" Club
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Program Director: Jim Harding, Ph.D.
Division of Environmental Studies & Management
Program offered:
BS in Natural Resources Management
Green Mountain College offers a comprehensive degree in Natural Resources Management. This degree is designed to prepare students for the challenging responsibilities required of land managers in public agencies, resource specialists in non-governmental organizations, and consultants working in the private sector. Students interested in pursuing professions in forestry, wildlife, and park management will benefit from this degree.
Graduates of this program will meet the requirements for government employment at the GS-5 level in one of the main federal land management agencies: National Park Service, U.S. Forest Service, Bureau of Land Management, U.S. Fish and Wildlife Service. Graduates of this degree will also be able to pursue graduate study in fields such as natural resources, forestry, wildlife biology, recreation management, or public policy. Graduates will gain specific skills in conducting forest and wildlife inventories, working with geographic information systems (GIS), and developing resource plans. Students will learn how to manage natural resources for multiple values including timber, wildlife, wilderness, recreation, energy production and others. Additional expertise can be gained in conservation biology, forest ecology, and environmental law.
Learning Outcomes for Natural Resource Management Majors
The successful student will:
Understand the scope and relationship of the federal land management system.
Be fluent in the pertinent environmental and natural resources legislation guiding public land management.
Be able to collect, manipulate, and work with spatial data, including GIS.
Understand basic biological and ecological functions (e.g., photosynthesis, forest succession, predator-prey, relationships, etc.).
Measure and mathematically analyze natural resource data.
Conduct a comprehensive forest stand inventory.
Be attuned to the current issues in natural resources management.
Appreciate the complexity of multiple-use, resource management.
The fundamental components of truly effective natural resources management are those skills found at the intersection of the natural and social sciences. This degree is not about producing biologists or environmental scientists. Nor is this degree intended to develop aspiring bureaucrats or government agents. Rather, a degree in natural resources management demands a solid understanding of our natural environment and our dependence upon that environment for a host of amenities. To this end, natural resource managers must be prepared to weigh the consequences of many different options affecting both the natural environment and the people who depend on that environment for their livelihood, their recreation, or their physical well-being.
Requirements for a BS in Natural Resources Management
Professional Core
| Choose any four-credit lab course, options include:
BIO 1034: From Fins to Fingers
BIO 1035: Disease and Disorder: History, Humans, and Hope
BIO 1036: Solar Powered Life: The Biology of Plants
BIO 1037: The Four Seasons
CHE 1021: General Chemistry I
ELA 1017: Introduction to Environmental Chemistry
GLG 1011: Introduction to Geology
NRM 1001: Introduction to Natural Resource Management
BIO 2025: Ecology
ENV 2010: Introduction to Geographic Information Systems
ENV 2011: Public Policy and the Environment
NRM 2015: Natural Resources Field Experiences
NRM 2020: Data Analysis and Modeling
NRM 4052: Natural Resources Mgmt Capstone and Exam
NRM 4053: Natural Resources Mgmt. Internship*
| 4
Credits: 28
| Choose three of the following courses:
ENV 3011: Environmental Law
ENV 3014: Watershed Management & Policy
ENV 3016: Land Use Planning
ENV 3023: Human Ecology
ENV 3025: Animal Ethics
NRM 3065: Hunting: History, Ethics & Management
NRM 3082: Forest Policy and Management
NRM 4030: Environmental Conflict Management
REC 3161: Philosophy of Recreation on Public Lands
REC 3175: Ecotourism
REC 4010: Mgmt. of Outdoor and Adventure Programs
Credits: 9-10
| Choose three of the following courses:
BIO 3013: Botany
BIO 3021: Conservation Biology
BIO 3023: Vertebrate Population Monitoring
BIO 3025: Advanced Topics in Ecology
BIO 3027: Forest Ecology and Management
BIO 3012: Topics in Organismal Biology
CHE 3005: Advanced Environmental Chemistry
CHE 3012: Special Topics in Chemistry (Limnology)
GLG 2031: Soils
GLG 3010: Climate Dynamics
NRM 3075: Silviculture
NRM 4025: Resource Impacts and Management
| 4
Credits: 9-10


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The investment landscape is filled with financial products. Before you invest in a particular product, take the time to understand it—and assess whether it's really suitable for you. Keep in mind that all financial products carry risk, even if it's the risk that a product's financial return may not keep pace with inflation.
Financial Product Basics
Get in-depth information on the following financial products:
Tracking Your Investments
Take these steps to make sure you're on top of your investments. Keeping track of them can help prevent minor mistakes from turning into big problems.
Before You Invest
If a salesperson is trying to sell you an investment, check them out by following these steps.
Asset Allocation
You can invest your portfolio to achieve the dual goals of growth and safety by distributing your investments among the three major asset classes: equity, fixed income and cash or cash equivalents.
When you diversify, you divide the money you've allocated to a particular asset class, such as stocks, among various categories of investments that belong to that asset class. Diversification, with its emphasis on variety, allows you to manage nonsystematic risk by tapping into the potential strength of different subclasses, which, like the larger asset classes, tend to do better in some periods than in others.
Additional Resources
Financial Investor Quiz
We recently surveyed investors to get an idea of what people know—and what people may not know—about investing. This quiz includes some of the questions from our survey, and explains the correct answers. Take the quiz to see how you stack up.
Dollar-Cost Averaging
Making small, regular monthly investments can be a great way to meet your financial goals. By regularly investing small amounts, say $50 a month, you take advantage of the market's ups and downs. Over the long-term, you buy more shares when their costs are low and fewer when they are high. See page 79 of Money and Mobility for more information.
U.S. Savings Bonds
Savings bonds can be purchased from the U.S. Treasury, at banks and credit unions, and are often offered by employers through payroll deduction.
Smart Bond Investing
You've heard it before: asset allocation is the foundation of prudent investing. You've probably heard this before, too—your portfolio should contain a mixture of stocks and bonds. This is sound advice. But do you understand the critical characteristics of bonds? This comprehensive guide provides a wealth of information about investing in bonds and bond funds.
Old Stock and Bond Certificates (SEC)
An old stock or bond certificate may still be valuable even if it no longer trades under the name printed on the certificate.
Lost or Stolen Stock Certificates (SEC)
Brokerage firms, banks, transfer agents, and corporations have procedures in place to help investors replace lost or stolen certificates.
Stock Certificates, Proving Ownership (SEC)
If you are trying to establish whether you or a family member own securities or not, here are some steps you can take.
CDs: Tips for Investors (SEC)
Before you consider purchasing a CD from your bank or brokerage firm, make sure you fully understand all of its terms. Carefully read the disclosure statements, including any fine print. And don't be dazzled by high yields. Ask questions—and demand answers—before you invest. These tips can help you assess what features make sense for you.
REITS are entities that invest in different kinds of real estate or real estate related assets. Learn more.
Reverse Mortgages
Reverse mortgages allow older homeowners to convert part of the equity in their homes into cash. Learn more.
Oil and Gas Investments
Oil and gas investments are limited partnerships and other ventures that invest in exploration, drilling and distribution of oil and gas. Read this alert from the SEC for more information.
Off-exchange Foreign Currency (FOREX)
Off-exchange Foreign Currency (FOREX) involves trading in non-U.S. currencies. Take the National Futures Association's e-learning program for retail forex trading.


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Brand Tracking | Analytics | Influence
Integrate our proven data into your applications and systems.
The Tweettronics Social Media API makes available social media metrics and sophisticated analysis to your systems.
- Create and Manage topic profiles
- Data from Twitter
- Focus a topic on a geographic area
- Obtain metrics on sentiment, volume, or reach
- Identify people with the most influence and impact on topic
- Obtain the most used phrases and words in a topic,
and in each of the positive and negative Tweets
- Obtain most mentioned URLs and domains
- Influence Assessment on Individuals - Coming!
- RESTful application
- Cloud hosted system


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Hang tight!
Recipe by McCormick®
"These classic cookies are crisp on the outside and chewy on the inside and full of cinnamon flavor."
Watch video tips and tricks
2 3/4 cups
2 teaspoons
McCormick® Cream of Tartar
1 teaspoon
baking soda
1 3/4 cups
sugar, divided
1/2 cup
butter, softened
1/2 cup
2 teaspoons
McCormick® Pure Vanilla Extract
1 tablespoon
McCormick® Ground Cinnamon
My youngest son and I followed the recipe exactly, using butter flavored shortening. I did make a little more of the cinnamon/sugar mix and I made it heavy on the cinnamon as I REALLY coat my cookie balls. This cookie turned out nicely--just what a Snickerdoodle should be. NOTE: I got 36 cookies out of one recipe. My cookies were just right at exactly nine minutes.
Wasn't crazy about the taste it didn't taste like my usual snickerdoodles ..wont be using again
31 Ratings
These are the perfect Snickerdoodles! I love that the recipe uses butter and shortening, keeps the cookies soft! Thanks McCormick! My family loves these!
My son is in the Army National Guard, stationed in Egypt and his favorite cookies were always store bought snicker doodles. I made this recipe and sent them to him for Christmas and him along with alot of other soldiers loved them. Thank you for letting me make some of our U.S. Soldiers happy.
very good and easy recipe. For Christmas cookies I mix the cinnamon and white sugar with green or red sugar crystals. They're one of the family favorites.
This cookie was good. We read one of the reviews and substitued the butter shortening for the butter. It is a nice light cookie with a good texture. Thank you for sharing. This will be my snicker doodle recipe from here on out.
Excellent! I made a batch with 1/2 tsp of salt, and I thought it was even better (I had used unsalted butter).
Amazing! I was concerned when rolling in the cinnamon sugar mixture that the sugar wasn't sticking enough but that wasn't the case. They are delicious.
* Percent Daily Values are based on a 2,000 calorie diet.
McCormick(R) Snickerdoodles
Serving Size: 1/30 of a recipe
Servings Per Recipe: 30
Amount Per Serving
Calories: 151
Calories from Fat: 62
Hard to believe, but many kids will be back in school at the end of the month. Get ready.
You won't believe all the things you can do with cauliflower. It's a great low-carb option.
Delicious recipes, party ideas, and cooking tips! Get a year of Allrecipes magazine for $7.99!
Pump up the flavor with this delicious, healthier oven-fried chicken.
The kick of herbs and spices gives this chili amazing flavor, with less fat.
This hearty stew is fresh and flavorful, and makes a great comfort-food meal.