WorldWideScience

Sample records for assessing anticalcification treatments

  1. Assessing Anticalcification Treatments in Bioprosthetic Tissue by Using the New Zealand Rabbit Intramuscular Model

    OpenAIRE

    Wright, Gregory A.; Faught, Joelle M; Olin, Jane M

    2009-01-01

    The objective of this work was to demonstrate that the New Zealand White (NZW) rabbit intramuscular model can be used for detecting calcification in bioprosthetic tissue and to compare the calcification in the rabbit to that of native human valves. The rabbit model was compared with the commonly used Sprague–Dawley rat subcutaneous model. Eighteen rabbits and 18 rats were used to assess calcification in bioprosthetic tissue over time (7, 14, 30, and 90 d). The explanted rabbit and rat tissue ...

  2. Assessing anticalcification treatments in bioprosthetic tissue by using the New Zealand rabbit intramuscular model.

    Science.gov (United States)

    Wright, Gregory A; Faught, Joelle M; Olin, Jane M

    2009-06-01

    The objective of this work was to demonstrate that the New Zealand White (NZW) rabbit intramuscular model can be used for detecting calcification in bioprosthetic tissue and to compare the calcification in the rabbit to that of native human valves. The rabbit model was compared with the commonly used Sprague-Dawley rat subcutaneous model. Eighteen rabbits and 18 rats were used to assess calcification in bioprosthetic tissue over time (7, 14, 30, and 90 d). The explanted rabbit and rat tissue discs were measured for calcium by using atomic absorption and Raman spectroscopy. Calcium deposits on the human valve explants were assessed by using Raman spectroscopy. The results showed that the NZW rabbit model is robust for detecting calcification in a shorter duration (14 d), with less infection complications, more space to implant tissue groups (thereby reducing animal use numbers), and a more metabolically and mechanically dynamic environment than the rat subcutaneous model . The human explanted valves and rabbit explanted tissue both showed Raman peaks at 960 cm(-1) which is representative of hydroxyapatite. Hydroxyapatite is the final calcium and phosphate species in the calcification of bioprosthetic heart valves and rabbit intramuscular implants. The NZW rabbit intramuscular model is an effective model for assessing calcification in bioprosthetic tissue. PMID:19619417

  3. In vitro evaluation of anti-calcification and anti-coagulation on sulfonated chitosan and carrageenan surfaces.

    Science.gov (United States)

    Campelo, Clayton Souza; Lima, Luana Dias; Rebêlo, Luciana Magalhães; Mantovani, Diego; Beppu, Marisa Masumi; Vieira, Rodrigo Silveira

    2016-02-01

    In recent years, great effort has been devoted to the development of biomaterials that come into contact with blood. The surfaces of these materials need to be of suitable mechanical strength, and present anti-thrombogenic and anti-calcification properties. Chitosan is a natural polymer that has attracted attention due to its potential to act as a biomaterial. However, chitosan contains amino groups in its structure that may promote thrombogenesis and calcification. A strategy to reduce these properties constitutes the introduction of sulfonate groups (R-SO3-) in the chitosan chain. Another interesting biopolymer with similar characteristics to those of heparin is carrageenan, which has sulfate groups in its structure. As such, we evaluated “in vitro” calcification and thrombogenic processes on surfaces of pristine and sulfonated chitosan and on polyelectrolyte complexes (PEC) of chitosan and carrageenan. Results indicate that PEC demonstrate significant reductions in calcification and thrombogenic potential, probably due to the presence of sulfonate groups in both the carrageenan and treated chitosan. PMID:26652370

  4. Apoptosis-mediated endothelial toxicity but not direct calcification or functional changes in anti-calcification proteins defines pathogenic effects of calcium phosphate bions

    Science.gov (United States)

    Kutikhin, Anton G.; Velikanova, Elena A.; Mukhamadiyarov, Rinat A.; Glushkova, Tatiana V.; Borisov, Vadim V.; Matveeva, Vera G.; Antonova, Larisa V.; Filip’Ev, Dmitriy E.; Golovkin, Alexey S.; Shishkova, Daria K.; Burago, Andrey Yu.; Frolov, Alexey V.; Dolgov, Viktor Yu.; Efimova, Olga S.; Popova, Anna N.; Malysheva, Valentina Yu.; Vladimirov, Alexandr A.; Sozinov, Sergey A.; Ismagilov, Zinfer R.; Russakov, Dmitriy M.; Lomzov, Alexander A.; Pyshnyi, Dmitriy V.; Gutakovsky, Anton K.; Zhivodkov, Yuriy A.; Demidov, Evgeniy A.; Peltek, Sergey E.; Dolganyuk, Viatcheslav F.; Babich, Olga O.; Grigoriev, Evgeniy V.; Brusina, Elena B.; Barbarash, Olga L.; Yuzhalin, Arseniy E.

    2016-06-01

    Calcium phosphate bions (CPB) are biomimetic mineralo-organic nanoparticles which represent a physiological mechanism regulating the function, transport and disposal of calcium and phosphorus in the human body. We hypothesised that CPB may be pathogenic entities and even a cause of cardiovascular calcification. Here we revealed that CPB isolated from calcified atherosclerotic plaques and artificially synthesised CPB are morphologically and chemically indistinguishable entities. Their formation is accelerated along with the increase in calcium salts-phosphates/serum concentration ratio. Experiments in vitro and in vivo showed that pathogenic effects of CPB are defined by apoptosis-mediated endothelial toxicity but not by direct tissue calcification or functional changes in anti-calcification proteins. Since the factors underlying the formation of CPB and their pathogenic mechanism closely resemble those responsible for atherosclerosis development, further research in this direction may help us to uncover triggers of this disease.

  5. The Treatment Effectiveness Assessment (TEA

    Directory of Open Access Journals (Sweden)

    Ling W

    2013-09-01

    Full Text Available Walter Ling,1 David Farabee,1 Dagmar Liepa,2 Li-Tzy Wu3 1Integrated Substance Abuse Programs, University of California, Los Angeles, CA, 2Valley Care Medical Center, Panorama City, CA, 3Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke University Medical Center, Durham, NC, USA We have been surprised and gratified by the readers’ responses to our article, The Treatment Effectiveness Assessment (TEA: an efficient, patient-centered instrument for evaluating progress in recovery from addiction, which was published in December 2012.1 In the six months since that time, we have received numerous questions and observations about the article, and about the TEA instrument. Respondents were clinicians: physicians, counselors, therapists, nurses; as well as administrators and policy makers.  View original paper by Ling W, Farabee D, Liepa D, Wu LT. 

  6. Sustainability assessment of advanced wastewater treatment technologies

    DEFF Research Database (Denmark)

    Høibye, Linda; Clauson-Kaas, Jes; Wenzel, Henrik;

    2008-01-01

    As a consequence of the EU Water Framework Directive more focus is now on discharges of hazardous substances from wastewater treatment plants and sewers. Thus, many municipalities in Denmark may have to adopt to future advanced treatment technologies. This paper describes a holistic assessment...... with advanced oxidation. The technical assessment is based on 12 hazardous substances comprising heavy metals, organic pollutants, endocrine disruptors as well as pathogenic microorganisms. The environmental assessment is performed by life cycle assessment (LCA) comprising 9 of the specific hazardous substances...... of sustainability, sand filtration is the most advantageous method based on the technical and environmental assessment due to the low energy consumption and high efficiency with regards to removal of heavy metals. Key words | advanced wastewater treatment, life cycle assessment, MBR, ozone treatment, sand...

  7. Eating disorders: assessment and treatment.

    Science.gov (United States)

    Johnson, W G; Schlundt, D G

    1985-09-01

    Anorexia and bulimia are eating disorders affecting a significant number of adolescent and young adult women. The core symptoms of both disorders are similar and include a fear of obesity, body image disturbance, erratic eating patterns, and purging. These symptoms produce significant physical and psychologic complications. Both anorexia and bulimia appear to have a common origin in a fear of obesity and dieting. Anorectics, being "successful" dieters, lose a significant amount of weight; whereas bulimics alternate between binges and purges. Treatment for the eating disorders is gradually evolving as clinical research experience accumulates. For anorexia, hospitalization is indicated when weight falls below 15% of ideal, and most investigators agree that therapy for the core symptoms cannot be undertaken until weight is restored. During the impatient stay, a behavior modification program can effectively organize medical, nutritional, and psychologic support, and offers the quickest and most direct route to weight restoration. The nasogastric tube and total parenteral nutrition are used primarily for those who are severely emaciated or who actively resist standard modes of therapy. Inpatient treatment is most effectively and efficiently rendered in a specialized eating disorder unit. Once weight restoration is progressing, behavior therapy for core symptoms is commenced and continued on an outpatient basis. A variety of behavioral techniques are employed, and they are designed primarily to influence anorectic assumptions and beliefs. Although there may be a brief inpatient stay for initiation of treatment, the bulk of therapy for bulimia occurs on an outpatient basis. The available literature indicates that behavioral techniques and antidepressant medication are effective for the symptoms of bulimia. Early identification of core symptoms of both disorders can lead to an initiation of treatment before the core symptoms become ingrained. A potentially more effective

  8. Assessing mixed waste treatment technologies

    International Nuclear Information System (INIS)

    The US Department of Energy (DOE) is responsible for the management and treatment of its mixed low-level wastes (MLLW). As discussed earlier in this conference MLLW are regulated under both the Resource Conservation and Recovery Act and various DOE orders. During the next 5 years, DOE will manage over 1,200,000 m3 of MLLW and mixed transuranic (MTRU) waste at 50 sites in 22 states (see Table 1). The difference between MLLW and MTRU waste is in the concentration of elements that have a higher atomic weight than uranium. Nearly all of this waste will be located at 13 sites. More than 1400 individual mixed waste streams exist with different chemical and physical matrices containing a wide range of both hazardous and radioactive contaminants. Their containment and packaging vary widely (e.g., drums, bins, boxes, and buried waste). This heterogeneity in both packaging and waste stream constituents makes characterization difficult, which results in costly sampling and analytical procedures and increased risk to workers

  9. Sustainability assessment of advanced wastewater treatment technologies

    DEFF Research Database (Denmark)

    Høibye, Linda; Clauson-Kaas, Jes; Wenzel, Henrik;

    2007-01-01

    As a consequence of the EU Water Framwork Directive, more focus is now on discharges of hazardous substances from wastewater treatment plants and sewers. Thus, many municipalities in Denmark may have to adopt to future advenced treatment technologies. This paper describes a holistic assessment...... with advanced oxidation. The technical assessment is based on 12 hazardous substances comprising heavy metals, organic pollutants, endocrine disruptors as well as pathogenic microorganisms. The environmental assessment is performed by life cycle assessment (LCA) comprising 9 of the specific hazardous substances...... of sustainability, sand filtration is the most advantageous method based on the technical and environmental assessment due to the low energy consumption and high efficiency with regard to the removal of heavy metals....

  10. Adolescent Perpetrator Treatment Programs: Assessment Issues.

    Science.gov (United States)

    Abbey, Joan M.

    The value of early identification of sexually aberrant behaviors and intervention with sexually deviant minors is obvious from a community safety perspective. Early intervention also appears to have value from the offender's perspective. A research review revealed several common themes with implications for both assessment and treatment. Most…

  11. Assessment of treatment response in tuberculosis.

    Science.gov (United States)

    Rockwood, Neesha; du Bruyn, Elsa; Morris, Thomas; Wilkinson, Robert J

    2016-06-01

    Antibiotic treatment of tuberculosis has a duration of several months. There is significant variability of the host immune response and the pharmacokinetic-pharmacodynamic properties of Mycobacterium tuberculosis sub-populations at the site of disease. A limitation of sputum-based measures of treatment response may be sub-optimal detection and monitoring of Mycobacterium tuberculosis sub-populations. Potential biomarkers and surrogate endpoints should be benchmarked against hard clinical outcomes (failure/relapse/death) and may need tailoring to specific patient populations. Here, we assess the evidence supporting currently utilized and future potential host and pathogen-based models and biomarkers for monitoring treatment response in active and latent tuberculosis. Biomarkers for monitoring treatment response in extrapulmonary, pediatric and drug resistant tuberculosis are research priorities. PMID:27030924

  12. Assessment and treatment of nocturnal panic attacks.

    Science.gov (United States)

    Craske, Michelle G; Tsao, Jennie C I

    2005-06-01

    Nocturnal panic (NP), waking from sleep in a state of panic, is a common occurrence among patients with panic disorder, with 44-71% reporting at least one such attack. NP is a non-REM event that is distinct from sleep terrors, sleep apnea, nightmares or dream-induced arousals. This review outlines recent advances in the characterization of NP, as well as current approaches to the assessment and treatment of NP. In contrast to earlier work, more recent studies suggest that patients with NP do not differ from patients without NP on sleep architecture, sleep physiology, self-reported sleep quality and severity of panic disorder. However, more precise measurement of physiological precipitants and features is warranted. Assessment of NP focuses on ruling out other explanations for NP, with differential diagnosis based on interviews, sleep polysomnography and ambulatory recording of sleep. Psychological treatment (cognitive-behavioral therapy) targets misappraisals of anxiety sensations, hyperventilatory response, and conditioned reactions to internal, physical cues. Recent evidence supports the efficacy of this approach, however, controlled studies on pharmacological agents in the treatment of NP are lacking. Research is needed to examine the effects of combined cognitive-behavioral therapy and medications, compared to medication alone in the treatment of NP. PMID:15893248

  13. Life cycle assessment of electronic waste treatment

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Jinglan, E-mail: hongjing@sdu.edu.cn [Shandong Provincial Key Laboratory of Water Pollution Control and Resource Reuse, School of Environmental Science and Engineering, Shandong University, Jinan 250100 (China); Shandong University Climate Change and Health Center, Public Health School, Shandong University, Jinan 250012 (China); Shi, Wenxiao [Shandong Provincial Key Laboratory of Water Pollution Control and Resource Reuse, School of Environmental Science and Engineering, Shandong University, Jinan 250100 (China); Wang, Yutao [School of Life Science, Shandong University, Shanda South Road 27, Jinan 250100 (China); Chen, Wei [Shandong Provincial Key Laboratory of Water Pollution Control and Resource Reuse, School of Environmental Science and Engineering, Shandong University, Jinan 250100 (China); Li, Xiangzhi, E-mail: xiangzhi@sdu.edu.cn [School of Medicine, Shandong University, Jinan 250012 (China)

    2015-04-15

    Highlights: • Life cycle assessment of electronic waste recycling is quantified. • Key factors for reducing the overall environmental impact are indentified. • End-life disposal processes provide significant environmental benefits. • Efficiently reduce the improper disposal amount of e-waste is highly needed. • E-waste incineration can generate significant environmental burden. - Abstract: Life cycle assessment was conducted to estimate the environmental impact of electronic waste (e-waste) treatment. E-waste recycling with an end-life disposal scenario is environmentally beneficial because of the low environmental burden generated from human toxicity, terrestrial ecotoxicity, freshwater ecotoxicity, and marine ecotoxicity categories. Landfill and incineration technologies have a lower and higher environmental burden than the e-waste recycling with an end-life disposal scenario, respectively. The key factors in reducing the overall environmental impact of e-waste recycling are optimizing energy consumption efficiency, reducing wastewater and solid waste effluent, increasing proper e-waste treatment amount, avoiding e-waste disposal to landfill and incineration sites, and clearly defining the duties of all stakeholders (e.g., manufacturers, retailers, recycling companies, and consumers)

  14. Life cycle assessment of electronic waste treatment

    International Nuclear Information System (INIS)

    Highlights: • Life cycle assessment of electronic waste recycling is quantified. • Key factors for reducing the overall environmental impact are indentified. • End-life disposal processes provide significant environmental benefits. • Efficiently reduce the improper disposal amount of e-waste is highly needed. • E-waste incineration can generate significant environmental burden. - Abstract: Life cycle assessment was conducted to estimate the environmental impact of electronic waste (e-waste) treatment. E-waste recycling with an end-life disposal scenario is environmentally beneficial because of the low environmental burden generated from human toxicity, terrestrial ecotoxicity, freshwater ecotoxicity, and marine ecotoxicity categories. Landfill and incineration technologies have a lower and higher environmental burden than the e-waste recycling with an end-life disposal scenario, respectively. The key factors in reducing the overall environmental impact of e-waste recycling are optimizing energy consumption efficiency, reducing wastewater and solid waste effluent, increasing proper e-waste treatment amount, avoiding e-waste disposal to landfill and incineration sites, and clearly defining the duties of all stakeholders (e.g., manufacturers, retailers, recycling companies, and consumers)

  15. The effects of anticalcification treatments and hydration on the molecular dynamics of bovine pericardium collagen as revealed by 13C solid-state NMR.

    Science.gov (United States)

    deAzevedo, E R; Ayrosa, A M I B; Faria, G C; Cervantes, H J; Huster, D; Bonagamba, T J; Pitombo, R N M; Rabbani, S R

    2010-09-01

    This article describes a solid-state NMR (SSNMR) investigation of the influence of hydration and chemical cross-linking on the molecular dynamics of the constituents of the bovine pericardium (BP) tissues and its relation to the mechanical properties of the tissue. Samples of natural phenethylamine-diepoxide (DE)- and glutaraldehyde (GL)-fixed BP were investigated by (13)C cross-polarization SSNMR to probe the dynamics of the collagen, and the results were correlated to the mechanical properties of the tissues, probed by dynamical mechanical analysis. For samples of natural BP, the NMR results show that the higher the hydration level the more pronounced the molecular dynamics of the collagen backbone and sidechains, decreasing the tissue's elastic modulus. In contrast, in DE- and GL-treated samples, the collagen molecules are more rigid, and the hydration seems to be less effective in increasing the collagen molecular dynamics and reducing the mechanical strength of the samples. This is mostly attributed to the presence of cross-links between the collagen plates, which renders the collagen mobility less dependent on the water absorption in chemically treated samples. PMID:20641133

  16. MODERN PRINCIPLES OF QUALITY ASSESSMENT OF CARDIOVASCULAR DISEASES TREATMENT

    Directory of Open Access Journals (Sweden)

    A. Yu. Suvorov

    2015-09-01

    Full Text Available The most common ways of assessment of cardiovascular diseases treatment abroad, approaches to creation of such assessment methods are considered, as well as data on the principles of the assessment of treatment in Russia. Some foreign registers of acute myocardial infarction, the aim of which was therapy quality assessment, are given as examples. The problem of high-quality treatment based on data from evidence-based medicine, some legal aspects related to clinical guidelines in Russia are considered, as well as various ways of treatment quality assessment.

  17. Research in Action: Assessment and Treatment of Child Sexual Abusers.

    Science.gov (United States)

    Chaffin, Mark

    1994-01-01

    Reviews recent studies on child sexual abusers and abuser treatment and their implications for patient assessment and treatment. Reviews recidivism outcome studies from the perspective of their contributions to questions of which sort of treatments appear to be effective with which populations, and suggests that clinicians be aware of the need for…

  18. Perinatal Generalized Anxiety Disorder: Assessment and Treatment.

    Science.gov (United States)

    Misri, Shaila; Abizadeh, Jasmin; Sanders, Shawn; Swift, Elena

    2015-09-01

    Perinatal generalized anxiety disorder (GAD) has a high prevalence of 8.5%-10.5% during pregnancy and 4.4%-10.8% postpartum. Despite its attendant dysfunction in the patient, this potentially debilitating mental health condition is often underdiagnosed. This overview will provide guidance for clinicians in making timely diagnosis and managing symptoms appropriately. A significant barrier to the diagnosis of GAD in the perinatal population is difficulty in distinguishing normal versus pathological worry. Because a perinatal-specific screening tool for GAD is nonexistent, early identification, diagnosis and treatment is often compromised. The resultant maternal dysfunction can potentially impact mother-infant bonding and influence neurodevelopmental outcomes in the children. Comorbid occurrence of GAD and major depressive disorder changes the illness course and its treatment outcome. Psychoeducation is a key component in overcoming denial/stigma and facilitating successful intervention. Treatment strategies are contingent upon illness severity. Cognitive behavior therapy (CBT), relaxation, and mindfulness therapy are indicated for mild GAD. Moderate/severe illness requires pharmacotherapy and CBT, individually or in combination. No psychotropic medications are approved by the FDA or Health Canada in pregnancy or the postpartum; off-label pharmacological treatment is instituted only if the benefit of therapy outweighs its risk. SSRIs/SNRIs are the first-line treatment for anxiety disorders due to data supporting their efficacy and overall favorable side effect profile. Benzodiazepines are an option for short-term treatment. While research on atypical antipsychotics is evolving, some can be considered for severe manifestations where the response to antidepressants or benzodiazepines has been insufficient. A case example will illustrate the onset, clinical course, and treatment strategies of GAD through pregnancy and the postpartum. PMID:26125602

  19. DWTF [decontamination and waste treatment facilities] assessment

    International Nuclear Information System (INIS)

    The purpose of this study has been to evaluate the adequacy of present and proposed decontamination and waste treatment facilities (DWTF) at LLNL, to determine the cost effectiveness for proposed improvements, and possible alternatives for accomplishing these improvements. To the extent possible, we have also looked at some of the proposed environmental compliance and cleanup (ECC) projects

  20. Re-assessing community-directed treatment

    DEFF Research Database (Denmark)

    Halwindi, H.; Magnussen, Pascal; Siziya, S.;

    2015-01-01

    Cross-sectional surveys with carers, health workers, community drug distributors (CDDs) and neighbourhood health committees were conducted to identify factors associated with utilization of community-directed treatment (ComDT) of soil-transmitted helminths in children aged 12-59 months in Mazabuka...

  1. The assessment and treatment of specific phobias: a review.

    Science.gov (United States)

    Grös, Daniel F; Antony, Martin M

    2006-08-01

    Specific phobia is one of the most common and easily treated mental disorders. In this review, empirically supported assessment and treatment procedures for specific phobia are discussed. Exposure-based treatments in particular are highlighted given their demonstrated effectiveness for this condition. The format and characteristics of exposure-based treatment and predictors of treatment response are outlined to provide recommendations for maximizing outcome. In addition, several other treatments for specific phobia are reviewed and critiqued, including cognitive therapy, virtual reality, eye movement desensitization and reprocessing, applied tension, and pharmacologic treatments. The review concludes with a discussion of future directions for research. PMID:16879794

  2. Foundation-Level Dyslexia: Assessment and Treatment.

    Science.gov (United States)

    Evans, Henryka M.; Seymour, Philip H. K.

    1999-01-01

    An assessment of foundation processes was administered to 51 Scottish children with reading difficulties and to 56 reading-level-matched controls. Results suggested the foundation is in place by the reading age of 7 years and that foundation-level dyslexia is identifiable in children with reading difficulty whose reading ages fall below this…

  3. Anorexia nervosa: aetiology, assessment, and treatment.

    Science.gov (United States)

    Zipfel, Stephan; Giel, Katrin E; Bulik, Cynthia M; Hay, Phillipa; Schmidt, Ulrike

    2015-12-01

    Anorexia nervosa is an important cause of physical and psychosocial morbidity. Recent years have brought advances in understanding of the underlying psychobiology that contributes to illness onset and maintenance. Genetic factors influence risk, psychosocial and interpersonal factors can trigger onset, and changes in neural networks can sustain the illness. Substantial advances in treatment, particularly for adolescent patients with anorexia nervosa, point to the benefits of specialised family-based interventions. Adults with anorexia nervosa too have a realistic chance of achieving recovery or at least substantial improvement, but no specific approach has shown clear superiority, suggesting a combination of re-nourishment and anorexia nervosa-specific psychotherapy is most effective. To successfully fight this enigmatic illness, we have to enhance understanding of the underlying biological and psychosocial mechanisms, improve strategies for prevention and early intervention, and better target our treatments through improved understanding of specific disease mechanisms. PMID:26514083

  4. Optimizing stormwater treatment practices a handbook of assessment and maintenance

    CERN Document Server

    Erickson, Andrew J; Gulliver, John S

    2013-01-01

    Optimizing Stormwater Treatment Practices: A Handbook of Assessment and Maintenance provides the information necessary for developing and operating an effective maintenance program for stormwater treatment. The book offers instructions on how to measure the level of performance of stormwater treatment practices directly and bases proposed maintenance schedules on actual performance and historical maintenance efforts and costs. The inspection methods, which are proven in the field and have been implemented successfully, are necessary as regulatory agencies are demanding evaluations of the performance of stormwater treatment practices. The authors have developed a three-tiered approach that offers readers a standard protocol for how to determine the effectiveness of stormwater treatment practices currently in place. This book also: Provides a standard protocol for how to determine the effectiveness of stormwater treatment practices Assists readers with identifying which assessment techniques to use for stormwa...

  5. Photopneumatic Technology in Acne Treatment and Skin Rejuvenation: Histological Assessment

    OpenAIRE

    Omi, Tokuya

    2012-01-01

    Background and Aims: Recent reports indicate that a variety of light-based devices have been used for acne treatment and skin rejuvenation. A new technology combining intense pulsed light with negative pressure, photopneumatic technology, has recently attracted interest. The present study assessed acne treatment and skin rejuvenation with this novel approach

  6. Issues in the Assessment and Treatment of Obesity.

    Science.gov (United States)

    Foreyt, John P.

    1987-01-01

    Summarizes recent developments in assessment and treatment of obesity. Reviews studies on genetics and weight cycling, which demonstrate the heterogeneous etiology of obesity and help explain difficulty in losing weight or maintaining weight loss. Describes the newer treatment programs which emphasize the development of exercise behaviors,…

  7. Achilles tendon rupture; assessment of nonoperative treatment

    DEFF Research Database (Denmark)

    Barfod, Kristoffer Weisskirchner

    2014-01-01

    -related quality of life in the weight-bearing group (p=0.009). Compared to the unaffected limb, the affected limb had decreased stiffness (77%, p < 0.001) and strength (93%, p = 0.009) of the plantar flexor muscle-tendon complex. Study IV showed excellent intra-rater reliability (ICC 0.96, SEM 3.7 mm and MDC 10...... trial (RCT). In study III, the effect of immediate weight-bearing on the biomechanical properties of the plantar flexor muscle-tendon complex was investigated in an RCT. In study IV, validity, reliability and agreement of a novel ultrasound measurement of Achilles tendon length and elongation was tested...... Sweden. Immediate weight-bearing was found to be safe and recommendable in non-operative treatment of acute Achilles tendon rupture. The novel ultrasound measurement showed excellent reliability and acceptable validity and agreement....

  8. Emergency assessment and treatment planning for traumatic dental injuries.

    Science.gov (United States)

    Moule, A; Cohenca, N

    2016-03-01

    Trauma involving the dentoalveolar region is a frequent occurrence which can result in the fracturing and displacement of teeth, crushing and/or fracturing of bone and soft tissue injuries including contusions, abrasions and lacerations. This review describes the assessment of patients with these injuries, not in a didactic sense by repeating excellent already published classifications and treatment options, but by addressing questions that arise during assessment. It covers trauma first aid, examination of the patient, factors that affect treatment planning decisions, and the importance of communicating treatment options and prognosis to traumatized patients. PMID:26923446

  9. Clinical outcomes assessment in clinical trials to assess treatment of femoroacetabular impingement

    DEFF Research Database (Denmark)

    Harris-Hayes, Marcie; McDonough, Christine M; Leunig, Michael;

    2013-01-01

    Patient-reported outcome measures are an important component of outcomes assessment in clinical trials to assess the treatment of femoroacetabular impingement (FAI). This review of disease-specific measures and instruments used to assess the generic quality of life and physical activity levels of...

  10. Factors Associated with Men's Assessment of Prostate Cancer Treatment Choice.

    Science.gov (United States)

    Ross, Louie E; Howard, Daniel L; Bowie, Janice V; Thorpe, Roland J; Kinlock, Ballington L; Burt, Carol; LaVeist, Thomas A

    2016-06-01

    The objective of this study is to examine factors among a group of African American and White men in North Carolina and their assessment of prostate cancer treatment choice or belief that treatment chosen was best. A sample of men (N = 877) with a history of prostate cancer diagnosis was recruited from the North Carolina Cancer Registry during 2007-2008 and asked to participate in a telephone interview covering several measures about their initial prostate cancer treatment. Logistic regression was used to assess demographic, psychosocial, and clinical factors on whether they felt that they had chosen the best treatment for the disease. Respondents were majority White (52.7 %), married (75.9 %), and had surgery (67.9 %) as their initial treatment. At the bivariate level, factors associated with the belief that the treatment chosen was best were as follows: White race/ethnicity, higher levels of education, a more recent treatment date, having health insurance coverage, type of treatment received, higher levels of bother from side effects, greater contentment with their quality of life, and doctor discussions of the various treatment options. Similarly, the multivariate analysis showed increased odds of belief that the treatment chosen was the best among demographic (i.e., race/ethnicity, level of education, and health insurance coverage) as well as psychosocial and clinical variables (i.e., greater bother from side effects, greater contentment with their quality of life, and initial treatment received). Results suggest that demographic, psychosocial, and clinical factors play an important role for men in assessing their treatment choices for prostate cancer. PMID:25893926

  11. The Westgate Service and Related Referral, Assessment, and Treatment Processes.

    Science.gov (United States)

    Bennett, Alice L

    2015-12-01

    The formerly named "Dangerous and Severe Personality Disorder" (DSPD) units are no longer standalone services within the criminal justice system in England and Wales. These sites now provide personality disorder treatment services in the high-security prison estate as part of the new national Offender Personality Disorder (OPD) Pathway Strategy. The OPD Pathway intends to take responsibility for the assessment, treatment, and management of offenders who are likely to have a personality disorder and who present a high risk of re-offending (men and women) and serious harm to others (men). Further PD treatment and progression services are being commissioned in lower security prisons and in the community as part of the new PD Strategy. While the suitability criteria for the two male high-security PD treatment sites are the same, the individual units have their own assessment and treatment methods. This article aims to communicate the referral, assessment, and treatment methods employed within the prison-based Westgate Personality Disorder Treatment Service, HMP Frankland. PMID:24927739

  12. Performance assessment techniques for groundwater recovery and treatment systems

    Energy Technology Data Exchange (ETDEWEB)

    Kirkpatrick, G.L. [Environmental Resources Management, Inc., Exton, PA (United States)

    1993-03-01

    Groundwater recovery and treatment (pump and treat systems) continue to be the most commonly selected remedial technology for groundwater restoration and protection programs at hazardous waste sites and RCRA facilities nationwide. Implementing a typical groundwater recovery and treatment system includes the initial assessment of groundwater quality, characterizing aquifer hydrodynamics, recovery system design, system installation, testing, permitting, and operation and maintenance. This paper focuses on methods used to assess the long-term efficiency of a pump and treat system. Regulatory agencies and industry alike are sensitive to the need for accurate assessment of the performance and success of groundwater recovery systems for contaminant plume abatement and aquifer restoration. Several assessment methods are available to measure the long-term performance of a groundwater recovery system. This paper presents six assessment techniques: degree of compliance with regulatory agency agreement (Consent Order of Record of Decision), hydraulic demonstration of system performance, contaminant mass recovery calculation, system design and performance comparison, statistical evaluation of groundwater quality and preferably, integration of the assessment methods. Applying specific recovery system assessment methods depends upon the type, amount, and quality of data available. Use of an integrated approach is encouraged to evaluate the success of a groundwater recovery and treatment system. The methods presented in this paper are for engineers and corporate management to use when discussing the effectiveness of groundwater remediation systems with their environmental consultant. In addition, an independent (third party) system evaluation is recommended to be sure that a recovery system operates efficiently and with minimum expense.

  13. Reporting methods of blinding in randomized trials assessing nonpharmacological treatments.

    Directory of Open Access Journals (Sweden)

    Isabelle Boutron

    2007-02-01

    Full Text Available BACKGROUND: Blinding is a cornerstone of treatment evaluation. Blinding is more difficult to obtain in trials assessing nonpharmacological treatment and frequently relies on "creative" (nonstandard methods. The purpose of this study was to systematically describe the strategies used to obtain blinding in a sample of randomized controlled trials of nonpharmacological treatment. METHODS AND FINDINGS: We systematically searched in Medline and the Cochrane Methodology Register for randomized controlled trials (RCTs assessing nonpharmacological treatment with blinding, published during 2004 in high-impact-factor journals. Data were extracted using a standardized extraction form. We identified 145 articles, with the method of blinding described in 123 of the reports. Methods of blinding of participants and/or health care providers and/or other caregivers concerned mainly use of sham procedures such as simulation of surgical procedures, similar attention-control interventions, or a placebo with a different mode of administration for rehabilitation or psychotherapy. Trials assessing devices reported various placebo interventions such as use of sham prosthesis, identical apparatus (e.g., identical but inactivated machine or use of activated machine with a barrier to block the treatment, or simulation of using a device. Blinding participants to the study hypothesis was also an important method of blinding. The methods reported for blinding outcome assessors relied mainly on centralized assessment of paraclinical examinations, clinical examinations (i.e., use of video, audiotape, photography, or adjudications of clinical events. CONCLUSIONS: This study classifies blinding methods and provides a detailed description of methods that could overcome some barriers of blinding in clinical trials assessing nonpharmacological treatment, and provides information for readers assessing the quality of results of such trials.

  14. Treatment assessment of radiotherapy using MR functional quantitative imaging

    Institute of Scientific and Technical Information of China (English)

    Zheng; Chang; Chunhao; Wang

    2015-01-01

    Recent developments in magnetic resonance(MR) functional quantitative imaging have made it a potentially powerful tool to assess treatment response in radiation therapy. With its abilities to capture functional information on underlying tissue characteristics, MR functional quantitative imaging can be valuable in assessing treatment response and as such to optimize therapeutic outcome. Various MR quantitative imaging techniques, including diffusion weighted imaging, diffusion tensor imaging, MR spectroscopy and dynamic contrastenhanced imaging, have been investigated and found useful for assessment of radiotherapy. However, various aspects including data reproducibility, interpretation of biomarkers, image quality and data analysis impose challenges on applications of MR functional quantitative imaging in radiotherapy assessment. All of these challenging issues shall be addressed to help us understand whether MR functional quantitative imaging is truly beneficial and contributes to future development of radiotherapy. It is evident that individualized therapy is the future direction of patient care. MR functional quantitative imaging might serves as an indispensable tool towards this promising direction.

  15. Objective automatic assessment of rehabilitative speech treatment in Parkinson's disease

    OpenAIRE

    Tsanas, A; Little, M.A.; Fox, C.; Ramig, L O

    2014-01-01

    Vocal performance degradation is a common symptom for the vast majority of Parkinson's disease (PD) subjects, who typically follow personalized one-to-one periodic rehabilitation meetings with speech experts over a long-term period. Recently, a novel computer program called Lee Silverman voice treatment (LSVT) Companion was developed to allow PD subjects to independently progress through a rehabilitative treatment session. This study is part of the assessment of the LSVT Companion, aiming to ...

  16. Life cycle assessment of waste water treatment plants in Ireland

    OpenAIRE

    McNamara, Greg; Horrigan, Matthew; Phelan, Thomas; Fitzsimons, Lorna; Delaure, Yan; Corcoran, Brian; Doherty, Edelle; Clifford, Eoghan

    2014-01-01

    The European Water Act 91/271/EEC introduced a series of measures for the purpose of protecting the environment from the adverse effects of effluent discharge from Waste Water Treatment Plants (WWTP). There are environmental costs associated with attaining the required level of water quality set out in the act such as, emissions from energy production, ecotoxicity from sludge application to land. The goal of this study is to assess these costs. Life Cycle Assessment (LCA) has been the analy...

  17. Assessment of Atmospheric Pressure Plasma Treatment for Implant Osseointegration

    OpenAIRE

    Danna, Natalie R.; Beutel, Bryan G.; Nick Tovar; Lukasz Witek; Charles Marin; Bonfante, Estevam A.; Rodrigo Granato; Marcelo Suzuki; Coelho, Paulo G

    2015-01-01

    This study assessed the osseointegrative effects of atmospheric pressure plasma (APP) surface treatment for implants in a canine model. Control surfaces were untreated textured titanium (Ti) and calcium phosphate (CaP). Experimental surfaces were their 80-second air-based APP-treated counterparts. Physicochemical characterization was performed to assess topography, surface energy, and chemical composition. One implant from each control and experimental group (four in total) was placed in one ...

  18. Simulation in the assessment and treatment of violent offenders

    OpenAIRE

    Sygel, Kristina

    2016-01-01

    With the aim of ultimately reducing the burden of violent crime on society, research has identified a number of areas in which conventional methods of assessment and treatment of violent offenders may be improved. The areas examined in this thesis are gender, mental illness, and intimate partner violence, and they have been integrated with research in the field of case and computer simulation for assessment, training, and teaching. Firstly, paper-andpencil case vignettes were used...

  19. Assessment and Treatment of Co-occurring Eating Disorders in Privately Funded Addiction Treatment Programs

    OpenAIRE

    Killeen, Therese K.; Greenfield, Shelly F.; Bride, Brian E.; Cohen, Lisa; Gordon, Susan Merle; Roman, Paul M

    2011-01-01

    Privately-funded addiction treatment programs were surveyed to increase understanding of assessment and current treatment options for patients with co-occurring substance use and eating disorders. Data were collected from face-to-face interviews with program administrators of a nationally representative sample of 345 private addiction treatment programs. Although the majority of programs reported screening for eating disorders, programs varied in screening instruments used. Sixty-seven percen...

  20. Assessing treatment benefit with competing risks not affected by the randomized treatment

    OpenAIRE

    Korn, Edward L.; Dignam, James J.; Freidlin, Boris

    2014-01-01

    The comparison of overall survival curves between treatment arms will always be of interest in a randomized clinical trial involving a life-shortening disease. In some settings, the experimental treatment is only expected to affect the deaths caused by the disease, and the proportion of deaths caused by the disease is relatively low. In these settings, the ability to assess treatment-effect differences between Kaplan-Meier survival curves can be hampered by the large proportion of deaths in b...

  1. Assessment of alternatives to correct inventory difference statistical treatment deficiencies

    International Nuclear Information System (INIS)

    This document presents an analysis of alternatives to correct deficiencies in the statistical treatment of inventory differences in the NRC guidance documents and licensee practice. Pacific Northwest Laboratory's objective for this study was to assess alternatives developed by the NRC and a panel of safeguards statistical experts. Criteria were developed for the evaluation and the assessment was made considering the criteria. The results of this assessment are PNL recommendations, which are intended to provide NRC decision makers with a logical and statistically sound basis for correcting the deficiencies

  2. Assessment and treatment of childhood topographical disorientation: a case study.

    Science.gov (United States)

    Brunsdon, Ruth; Nickels, Lyndsey; Coltheart, Max; Joy, Pamela

    2007-01-01

    Topographical disorientation refers to individuals who are unable to find their way around large-scale environments in a normal manner. Childhood topographical disorientation is rarely investigated or reported. Treatment of topographical disorientation is also rare with only one reported treatment study in an adult (Davis & Coltheart, 1999) and no known description of treatment in a child. This paper reports a detailed case analysis of CA, a 6-year-old child with topographical disorientation, and a description of a treatment programme focused on training orientation in the school environment. Assessment of CA revealed mild to moderate visual agnosia in conjunction with severe impairments in general spatial learning and memory, topographical new learning and memory, and a total inability to learn new topographical routes. CA was also unable to use a mental image of his environment, a simple visual plan of his environment or a simple visual map, but was able to follow verbally mediated topographical instructions. The treatment programme focused on improving CA's topographical orientation in the school environment. The programme first involved training in recognition of major school buildings and landmarks and then focused on practical training in route finding along commonly used routes in the school environment. Clear benefits from treatment were evident. The assessment and treatment methods employed provide practical and useful ideas for management of this condition in other children. PMID:17178605

  3. Assessment and treatment of post patent ductus arteriosus ligation syndrome.

    LENUS (Irish Health Repository)

    El-Khuffash, Afif F

    2014-07-01

    To compare differences in tissue Doppler imaging, global longitudinal strain (GLS), and cardiac troponin T (cTnT) between infants with low (<200 mL\\/kg\\/min) and high (>200 mL\\/kg\\/min) left ventricular (LV) output 1 hour after duct ligation and assess the impact of milrinone treatment on cardiac output and myocardial performance.

  4. Life Cycle Assessment to Municipal Wastewater Treatment Plant

    International Nuclear Information System (INIS)

    The evaluation was done at a Municipal Wastewater Treatment Plant (MWTP), through the application of the methodology of Life Cycle Assessment (LCA) performed by using a commercial tool called SIMAPRO. The objective of this study was to apply Life Cycle Assessment (LCA) in two systems: municipal wastewater effluent without treatment and Wastewater Treatment Plant (WTP) that is operating in poor condition and has a direct discharge to a natural body, which is a threat to the environment. A LCA was done using SIMAPRO 7, in order to determine the environmental impact in each scenery was assessed, a comparison of the impacts and propose improvements to decrease, following the steps this methodology and according to the respective standardized normative (ISO 14040/ ISO 14044). In this study, most of used data have been reported by the plant from early 2010 and some data from literature. We identified the environmental impacts generated by the treatment, making emphasis on those related to the subsequent use of the water body receiving the discharge, such as eutrophication (near to 15% reduction). Likewise, a comparative analysis between the impacts in the two systems, with and without treatment by analyzing the variation in the impact categories studied. Finally within this work, alternatives of improvements, in order to reduce the identified and quantified impacts are proposed. (Author) 33 refs.

  5. Pediatric insomnia: new insights in clinical assessment and treatment options.

    Science.gov (United States)

    Bruni, Oliviero; Angriman, Marco

    2015-01-01

    Sleep disorders in children can compromise quality of life of both children and families and chronic sleep deprivations is associated with poorer developmental outcome, overweight and behavioral disturbances. Clinicians should incorporate questions about sleep into their routine health assessment, and the assessment of insomnia should follow a medical approach primary and secondary contributing factors should be assessed, as well as maladaptive behaviors related to sleep. A careful examination of sleep/wake schedule, abnormal movements or behavior during sleep, and daytime consequences of sleep disruption or deprivation is mandatory. Sleeping environment, and bedtime routines should be examined to identify behavioral issues related to sleep. Polysomnography is not routinely indicated for children with insomnia, but actigraphy can give an objective estimation of sleep parameters. The Authors propose a new classification of pediatric insomnia, based on both genetic and clinical aspects, and suggest specific treatment options, including sleep hygiene, behavioral strategies and pharmacological treatment. PMID:26742668

  6. Adolescent inhalant use prevention, assessment, and treatment: A literature synthesis.

    Science.gov (United States)

    Nguyen, Jacqueline; O'Brien, Casey; Schapp, Salena

    2016-05-01

    Inhalant use refers to the use of substances such as gases, glues, and aerosols in order to achieve intoxication, while inhalant use disorder (IUD) encompasses both DSM-IV-TR criteria for inhalant abuse and dependence. Inhalant use among adolescents is an international public health concern considering the severe medical and cognitive consequences and biopsychosocial correlates. In this paper, we summarize the current state of the literature on inhalant use among adolescents focusing on social context, prevention, assessment, and treatment strategies. Psychoeducation, skills training, and environmental supply reduction are helpful strategies for preventing adolescent inhalant use, while parent and adolescent self-report as well as physician report of medical signs and symptoms can aid in assessment and diagnosis. Although research has only begun to explore the treatment of inhalant use, preliminary findings suggest that a multimodal approach involving individual counselling (i.e., CBT brief intervention), family therapy, and activity and engagement programs is the first-line treatment, with residential treatment programs indicated for more severe presentations. The limited nature of treatments developed specifically for inhalant use combined with high prevalence rates and potential for significant impairment within the adolescent population indicate the need for further research. Research should focus on understanding the social context of use, establishing the efficacy of current adolescent substance use treatments adapted for inhalant use, and exploring long-term outcomes. PMID:26969125

  7. Neuropathic Pain Following Spinal Cord Injury: Mechanism, Assessment and Treatment

    Directory of Open Access Journals (Sweden)

    Gul Mete Civelek

    2016-04-01

    Full Text Available Spinal cord injury (SCI is a devastating disease which may cause physical, psychological and social dysfunction. Neuropathic pain (NP after SCI is common, can be seen in varying degrees and is one of the most difficultly treated problems developing after SCI. With the addition of the NP to loss of function after SCI, sleep patterns, moods and daily activities of patients are adversely affected. In order to treat pain effectively, classification of pain after SCI must be done carefully and correctly. According to classification of International Pain Study Group, pain after SCI is divided into two main groups as nociceptive and neuropathic pain. Neuropathic pain is defined as %u201Cpain occuring as a direct result of a disease or lesion directly affecting somato-sensorial system%u201D. NP after SCI can be classified according to anatomical region (above the level of lesion, at the level of lesion, below the level of lesion. Treatment of NP after SCI is often challenging and receiving response to treatment may take long time. Therefore, treatment of NP after SCI should be multifactorial. Treatment options include pharmochologic treatment, application of transcutanous electrical nerve stimulation, psychiatric treatment approaches, and surgical approaches in selected cases. In pharmachologic treatment, first line agents are tricyclic antidepresants, pregabalin and gabapentin. In this review, mechanisms and assessment and treatment of NP after SCI is discussed with the guide of current literature.

  8. TECHNOLOGICAL PROCESS ASSESSMENT OF THE DRINKING WATER TREATMENT AT TARGU-MURES WATER TREATMENT PLANT

    Directory of Open Access Journals (Sweden)

    CORNELIA DIANA HERTIA

    2011-03-01

    Full Text Available This paper intends to assess the technological process of obtaining drinking water at Targu-Mures water treatment plant. The assessment was performed before changing the technological process and four months were chosen to be analized during 2008: January, April, July and October for its efficiency analysis on treatment steps. Mures River is the water source for the water treatment plant, being characterized by unsteady flow and quality parameters with possible important variability in a very short period of time. The treatment technological process is the classic one, represented by coagulation, sedimentation, filtration and disinfection, but also prechlorination was constantly applied as additional treatment during 2008. Results showed that for the measured parameters, raw water at the water treatment plant fits into class A3 for surface waters, framing dictated by the bacterial load. The treatment processes efficiency is based on the performance calculation for sedimentation, filtration, global and for disinfection, a better conformation degree of technological steps standing out in January in comparison to the other three analyzed months. A variable non-compliance of turbidity and residual chlorine levels in the disinfected water was observed constantly. Previous treatment steps managed to maintain a low level of oxidisability, chlorine consumption and residual chlorine levels being also low. 12% samples were found inconsistent with the national legislation in terms of bacteriological quality. Measures for the water treatment plant retechnologization are taken primarily for hyperchlorination elimination, which currently constitutes a discomfort factor (taste, smell, and a generating factor of chlorination by-products.

  9. SONOGRAPHY OF CYSTIC LESIONS OF NECK: PRE - TREATMENT ASSESSMENT

    Directory of Open Access Journals (Sweden)

    Vijai

    2013-11-01

    Full Text Available ABSTRACT: Cystic masses of neck consist of a variety of pathologic entities. The precise anatomical location and imaging appearances are important for accurate diagnosis and formulating the differenti al diagnoses. The age of presentation and clinical examination narrow down the differential diagnosis. US is useful in differentiating solid from cystic neck lesions. Ultrasound is often used for pre - treatment assessment. AIM&OBJECTIVE: To use readily avai lable, relatively inexpensive, and non - ionizing radiological imaging technique for pre - treatment assessment of cystic lesions of neck. MATERIAL & METHODS: This study is conducted in department of Radio - diagnosis of TMMC &RC, TMU, Moradabad, in which we inc luded patients of all age groups and both sexes. Imaging of neck lesions was done by Ultrasound using Scanners with 7 - 10 MHz transducers on MEDISON Diagnostic ultrasound system installed in department of Radio - diagnosis, TMMC&RC, Moradabad. Analytical Test : “t” - test. RESULT: 7.5% of cases were diagnosed of having cystic lesions of the neck, having approximately same occurrence in both male and females (p>.005. CONCLUSION: Cystic lesions of the neck are commonly seen as palpable neck masses. Clinical presen tation along with imaging features, anatomical location, extent, internal composition,as assessed by US(Ultrasound help in pre - treatment assessment

  10. Preoperative Assessment of Different Treatment Modalities in Bronchial Asthma Patients

    Directory of Open Access Journals (Sweden)

    Kawther A. Azzam M.D. and **Sahar S. Khattab MD

    2003-06-01

    Full Text Available This study was performed to assess the effectiveness of acupuncture and medical therapies of bronchial asthma preoperatively. Sixty patients suffered from mild to moderate bronchial asthma and coming for elective operations were chozen from the outpatient clinic of Al-Zahraa University Hospital. Patients were randomly divided into three equal groups (n=20 each. Group I patients (drug group received oral theophylline and Salbutamol (ventolin inhaler according to the needs. Group II patients (drug +ear acupuncture group received same medical treatment as in group I and added ear acupuncture. Group III patients (drug + ear and body acupuncture group received same medical treatment as in group I and II and added ear and body acupuncture. Ventilatory function tests through spirometer and interleukin-13 estimation were performed before treatment and after two weeks of treatment. Improvement of subjective and objective parameters had occurred with significant decrease in the mean serum level of interleukin-13 and decrease in the mean number of using b-agonist puffs after two weeks of treatment in the three groups, with the best results being in group III than in group II and then in group I. Conclusion: Interleukin-13 estimation togheter with ventilatory function tests is a useful parameter for pre-operative assessment and evaluation of asthmatic patients. Also medication was significantly reduced when combined with acupuncture.

  11. Treatment of operator actions in the HTGR risk assessment study

    International Nuclear Information System (INIS)

    Methods are presented for the treatment of operator actions, developed in the AIPA risk assessment study. Some examples are given of how these methods were applied to the analysis of potential HTGR accidents. Realistic predictions of accident risks required a balanced treatment of both beneficial and detrimental actions and responses of human operators and maintenance crews. Th essential elements of the human factors methodology used in the AIPA study include event tree and fault tree analysis, time-dependent operator response and repair models, a method for quantifying common cause failure probabilities, and synthesis of relevant experience data for use in these models

  12. Rapid methods for assessing efficiency of heat treatment of milk

    OpenAIRE

    Sharma, Rajan; Rajput, Y. S.

    2012-01-01

    Two methods based on the activity of γ-glutamyl transpeptidase and lactoperoxidase are developed for assessing the efficiency of heat treatment of milk at 80 °C for 15 s. Heat treatment of milk at 80 °C (15 s) completely inactivates both milk enzymes. Under the selected assay conditions, enzyme activities are related with intensity of pink colour of product. In contrast to raw (unheated) milk which gives pink colour under the test conditions, heated milk (80 °C, 15 s) remains either white or ...

  13. Advances in the assessment and treatment of juvenile offenders

    OpenAIRE

    Robert Hoge

    2009-01-01

    "This paper provides an introduction to best practices in the assessment and treatment of juvenile offenders. Many of the guidelines presented in the paper derive from recent theory and research in criminology and psychology. Much of that research has been conducted in western societies, and it remains to be seen to what extent conclusions from that research can generalize beyond those settings. However, clinical experience suggests that many of the principles of best practice do have applica...

  14. Do Clients Retain Treatment Concepts? An Assessment of Post Treatment Adjustment of Adult Sex Offenders

    OpenAIRE

    Steven P. Sawyer; Philip J. Pettman

    2006-01-01

    This study utilized semi-structured interviews and official criminal records to assess the post-treatment functioning and re-offense rate of 153 men who completed long term outpatient sex offender treatment. The participants, age 18-72, had committed or been convicted in criminal court of sex or sex related crimes against children or adults. A total of 555 interviews were conducted with 134 of the 153 participants and official criminal records were reviewed at 67 months post-treatment. Int...

  15. ADVANCES IN THE ASSESSMENT AND TREATMENT OF JUVENILE OFFENDERS

    Directory of Open Access Journals (Sweden)

    Robert Hoge

    2009-12-01

    Full Text Available This paper provides an introduction to best practices in the assessment and treatment of juvenile offenders. Many of the guidelinespresented in the paper derive from recent theory and research in criminology and psychology. Much of that research has been conductedin western societies, and it remains to be seen to what extent conclusions from that research can generalize beyond thosesettings. However, clinical experience suggests that many of the principles of best practice do have application across a broad rangeof cultures. This paper refl ects a child welfare/rehabilitation orientation toward the treatment of the juvenile offender. As explainedbelow, current theory and research from psychology and criminology support the position that juvenile justice systems focusing onthe identifi cation and amelioration of criminogenic defi cits in the youth and their circumstances produce more positive outcomes thanother approaches, including those focusing on punitive sanctions. As well, the implications of the child welfare/rehabilitation modelfor the treatment of the youth are fully consistent with the UNICEF Guiding Principles for Organizations and Individuals Dealingwith Child Welfare and the United Nations Convention on the Right of the Child. The paper begins with a discussion of alternative approachesto the treatment of offenders within juvenile justice systems. This is followed by a brief introduction to contemporary theoryand research on the causes and correlates of youth crime and the most effi cacious approaches for addressing this serious problem.A discussion of best practices in the assessment of juvenile offenders is then presented. This includes an identifi cation of some usefulassessment instruments and procedures as well as practical guidelines in the conduct of assessments. The following section presentsa discussion of effective strategies for case planning and management, including the identifi cation of evidence-based treatments.

  16. The development and assessment of biological treatments for children.

    Science.gov (United States)

    Smith, Eve M D; Foster, Helen E; Beresford, Michael W

    2015-03-01

    The development of biological agents with specific immunological targets has revolutionized the treatment of a wide variety of paediatric diseases where traditional immunosuppressive agents have been partly ineffective or intolerable. The increasing requirement for pharmaceutical companies to undertake paediatric studies has provided impetus for studies of biologics in children. The assessment of biological agents in children to date has largely relied upon randomized controlled trials using a withdrawal design, rather than a parallel study design. This approach has been largely used due to ethical concerns, including use of placebo treatments in children with active chronic disease, and justified on the basis that treatments have usually already undergone robust assessment in related adult conditions. However, this study design limits the reliability of the data and can confuse the interpretation of safety results. Careful ongoing monitoring of safety and efficacy in real-world practice through national and international biologics registries and robust reporting systems is crucial. The most commonly used biological agents in children target tumour necrosis factor-α, interleukin-1, interleukin-6 and cytotoxic lymphocyte-associated antigen-4. These agents are most frequently used in paediatric rheumatic diseases. This review discusses the development and assessment of biologics within paediatric rheumatology with reference to the lessons learned from use in other subspecialties. PMID:24750505

  17. Sustainable Urban Drainage Systems (SUDS) treatment train assessment tool.

    Science.gov (United States)

    Jefferies, C; Duffy, A; Berwick, N; McLean, N; Hemingway, A

    2009-01-01

    This paper outlines a rationale and scoring system for the stormwater treatment train assessment tool (STTAT) which is a proposed regulatory tool for Sustainable Urban Drainage Systems (SUDS). STTAT provides guidance and regulatory consistency for developers about the requirements of planners and the Scottish Environment Protection Agency (SEPA). The tool balances the risks of pollution to the receiving water body with the treatment provided in a treatment train. It encourages developers to take SUDS into account early, avoiding any misunderstanding of SUDS requirements at the planning stage of a development. A pessimistic view on pollution risks has been adopted since there may be a change of land use on the development in the future. A realistic view has also been taken of maintenance issues and the 'survivability' of a SUDS component. The development of STTAT as a response to the requirements of the Water Framework Directive is explored, the individual scores being given in tabular format for receiving water and catchment risks. Treatment scores are proposed for single SUDS components as well as multiple components within treatment trains. STTAT has been tested on a range of sites, predominantly in Scotland where both development and receiving water information was known. The operational tool in use by SEPA is presented. PMID:19717910

  18. Do Clients Retain Treatment Concepts? An Assessment of Post Treatment Adjustment of Adult Sex Offenders

    Directory of Open Access Journals (Sweden)

    Steven P. Sawyer

    2006-12-01

    Full Text Available This study utilized semi-structured interviews and official criminal records to assess the post-treatment functioning and re-offense rate of 153 men who completed long term outpatient sex offender treatment. The participants, age 18-72, had committed or been convicted in criminal court of sex or sex related crimes against children or adults. A total of 555 interviews were conducted with 134 of the 153 participants and official criminal records were reviewed at 67 months post-treatment. Interviews occurred at regular intervals for five years following treatment discharge. Interview questions assessed participants’ ability to name re-offense precursors and coping strategies, the status of relationships with partners and family, chemical use, work adjustment, and contact with law enforcement. Participants showed positive post-treatment adjustment including the ability to name precursors and coping mechanisms that would occur early in a re-offense cycle. Results from official records review showed an overall criminal re-offense rate of 12.4%; 2.6% sex related and 9.8% non-sex related. Rates for a comparison group were 32.7%, 4.4% and 28.3%, respectively. Implications for treatment are discussed.

  19. Feasibility of Using Virtual Reality to Assess Nicotine Cue Reactivity During Treatment

    OpenAIRE

    Kaganoff, Eili; Bordnick, Patrick S.; Carter, Brian Lee

    2011-01-01

    Cue reactivity assessments have been widely used to assess craving and attention to cues among cigarette smokers. Cue reactivity has the potential to offer insights into treatment decisions; however, the use of cue reactivity in treatment studies has been limited. This study assessed the feasibility of using a virtual reality–based cue reactivity assessment approach (VR-NCRAS) during treatment. In a clinical smoking cessation treatment study, 46 treatment-seeking nicotine-dependent adult smok...

  20. Implicit Working Memory: Implications for Assessment and Treatment.

    Science.gov (United States)

    Joyce, Arthur W

    2016-01-01

    Working memory (WM) impacts a gamut of cognitive abilities, but implicit WM is typically not considered in assessment or treatment, which may explain the variability of results in reviews of WM training. The role of implicit WM in adaptive behavior is reviewed. All we do is action based. Explicit WM plays a major role when we are required to "think"; that is, when we apply previously learned perception-action linkages in new ways to unique situations. Implicit WM is involved in the automation of behavior, which occurs through interaction with cortical and subcortical systems that guide sensory-motor anticipation and the prediction of reward. This article reviews evidence that implicit WM interacts with cortical-cerebellar and cortical-basal ganglia connections to form perception-action linkages. The cerebellum forms an internal model of cortical WM, corrects the content of this internal model, and then projects the improved representation back to the cortex, where it is retained for future use. The basal ganglia also form an anticipatory system, controlling cortical access to WM by allowing or restricting the information that is released based on the probability of reward. This framework is applied to the assessment and treatment of individuals with WM deficits. The ability to automate behavior can be assessed through repeated trials of existing testing instruments, such as the Trails B and Stroop tasks. Application of skill learning emphasizing automation as an end goal offers a model for the development of new types of WM training. PMID:27191219

  1. Alternative Focal Spot Geometry for More Efficient HIFU Treatment Assessment

    Science.gov (United States)

    Kaye, Elena; Chen, Jing; Medan, Yoav; Pauly, Kim Butts

    2010-03-01

    In this work a more time efficient approach for tissue assessment with MR-ARFI is proposed. During HIFU treatments gadolinium-free assessment of treated tissue is highly desirable. MR-ARFI allows measuring tissue displacement in the focal spot. Therefore raster-scanning the ultrasound focal spot through the tissue of interest can give information about tissue stiffness in the "probed" area. To enhance efficiency of such ultrasound "probing," we replaced a conventional point focus with a line focus that allows greater area coverage during MR-ARFI acquisitions. This approach was tested in a phantom and in ex vivo bovine muscle. The results of the study showed that the line focus produces a fairly uniform line shape focal spot in both temperature and displacement maps. Using one line focus position, the displacement maps obtained in the muscle tissue well depicted the difference in displacement in the area where lesion was created. This shows great potential for line focus geometry combined with MR-ARFI as an alternative treatment assessment technique.

  2. Cost assessment of e-beam wastewater treatment

    International Nuclear Information System (INIS)

    Electron beam treatment of wastewater leads to purification by the decomposition of pollutants as a result of their reactions with highly reactive species formed from water radiolysis: hydrated electron, OH free radical and H atom. Sometimes such reactions are accompanied by the other processes, and the synergistic effect upon the use of combined methods such as electron beam with biological treatment, adsorption and others improves the effect of electron beam treatment of the wastewater purification. In the process of electron-beam treatment of wastewater there are utilized chemical transformations of pollutants induced by ionizing radiation. The key to the successful implementation of electron beam process in environmental protection depends on how to manage the economics in its application. To compete with other processes in economic evaluation, the electron beam system should be operated with cost-effective manners. To result in complete decomposition of the pollutants, sufficiently high absorbed doses are required. However, in real conditions of rather high content of pollutants in wastewater, high absorbed doses are not economically acceptable, and it is better to utilize the partial decomposition of pollutant as well as transformations of pollutant molecules that result in improving subsequent purification stages. To apply electron beam process to the treatment of industrial wastewater and disinfection of effluent from municipal wastewater plant, we accomplished the cost assessment together with the laboratory irradiation experiments. Cost assessments of industrial e-beam treatment plant for treating textile dyeing wastewater were carried out for the treatment capacity of 10 000 m3 per day. The total construction cost for this plant was USD 4M and the operation cost was not more than USD 1M per year and it was about USD 0.3 per each m3 of wastewater. Another study on the disinfection plant designed for the flow rate of 100 000 m3 effluent per day showed the

  3. Environmental performance assessment of a company of aluminum surface treatment

    Directory of Open Access Journals (Sweden)

    Susan Catieri Ramalho

    2013-08-01

    Full Text Available The purpose of this article was to evaluate the environmental performance of a medium-sized company that provides services for surface treatment of aluminum. The treatment is known as anodizing. The research method was qualitative numerical modeling. The environmental performance of the company was organized into five constructs: atmosphere, wastewater, energy and natural resources, solid waste, and legislation and management. Nineteen indicators were chosen to explain the five constructs. Ten employees of the company prioritized the constructs and evaluated the situation of the indicators by means of a scale of assessment. By means of a mathematical model, the general performance of the environmental operation was calculated at 74.5% of the maximum possible. The indicators that most contributed to the performance not to reach 100% were consumption of electricity and water consumption. The construct of worse performance was natural and energy resources. These are the priorities for future environmental improvement actions that the company may promote.

  4. Life cycle assessment of advanced waste water treatment

    DEFF Research Database (Denmark)

    Larsen, Henrik Fred; Hansen, Peter Augusto

    The EU FP6 NEPTUNE project is related to the EU Water Framework Directive and the main goal is to develop new and optimize existing waste water treatment technologies (WWTT) and sludge handling methods for municipal waste water. Besides nutrients, a special focus area is micropollutants (e...... induced impacts as compared to avoided impacts is introduced in the life cycle impact assessment (LCIA) part. Furthermore, as novel approaches, potential ecotoxicity impact from a high number of micropollutants and the potential impact from pathogens (and whole effluent toxicity) are to be included. In...

  5. Life Cycle Assessment modelling of stormwater treatment systems.

    Science.gov (United States)

    O'Sullivan, Aisling D; Wicke, Daniel; Hengen, Tyler J; Sieverding, Heidi L; Stone, James J

    2015-02-01

    Stormwater treatment technologies to manage runoff during rain events are primarily designed to reduce flood risks, settle suspended solids and concurrently immobilise metals and nutrients. Life Cycle Assessment (LCA) is scarcely documented for stormwater systems despite their ubiquitous implementation. LCA modelling quantified the environmental impacts associated with the materials, construction, transport, operation and maintenance of different stormwater treatment systems. A pre-fabricated concrete vortex unit, a sub-surface sandfilter and a raingarden, all sized to treat a functional unit of 35 m(3) of stormwater runoff per event, were evaluated. Eighteen environmental mid-point metrics and three end-point 'damage assessment' metrics were quantified for each system's lifecycle. Climate change (kg CO2 eq.) dominated net environmental impacts, with smaller contributions from human toxicity (kg 1,4-DB eq.), particulate matter formation (kg PM10 eq.) and fossil depletion (kg oil eq.). The concrete unit had the highest environmental impact of which 45% was attributed to its maintenance while impacts from the sandfilters and raingardens were dominated by their bulky materials (57%) and transport (57%), respectively. On-site infiltrative raingardens, a component of green infrastructure (GI), had the lowest environmental impacts because they incurred lower maintenance and did not have any concrete which is high in embodied CO2. Smaller sized raingardens affording the same level of stormwater treatment had the lowest overall impacts reinforcing the principle that using fewer resources reduces environmental impacts. LCA modelling can serve as a guiding tool for practitioners making environmentally sustainable solutions for stormwater treatment. PMID:25463586

  6. Traumatic brain injury: future assessment tools and treatment prospects

    Directory of Open Access Journals (Sweden)

    Steven R Flanagan

    2008-10-01

    Full Text Available Steven R Flanagan1, Joshua B Cantor2, Teresa A Ashman21New York University School of Medicine, The Rusk Institute of Rehabilitation, New York, NY, USA; 2Department of Rehabilitation Medicine, Mount Sinai School of Medicine, New York, NY, USAAbstract: Traumatic brain injury (TBI is widespread and leads to death and disability in millions of individuals around the world each year. Overall incidence and prevalence of TBI are likely to increase in absolute terms in the future. Tackling the problem of treating TBI successfully will require improvements in the understanding of normal cerebral anatomy, physiology, and function throughout the lifespan, as well as the pathological and recuperative responses that result from trauma. New treatment approaches and combinations will need to be targeted to the heterogeneous needs of TBI populations. This article explores and evaluates the research evidence in areas that will likely lead to a reduction in TBI-related morbidity and improved outcomes. These include emerging assessment instruments and techniques in areas of structural/chemical and functional neuroimaging and neuropsychology, advances in the realms of cell-based therapies and genetics, promising cognitive rehabilitation techniques including cognitive remediation and the use of electronic technologies including assistive devices and virtual reality, and the emerging field of complementary and alternative medicine.Keywords: traumatic brain injury, assessments, treatments

  7. Neuro-Developmental Assessment and Treatment for Optomotor Deficits

    Directory of Open Access Journals (Sweden)

    Graham T. Peachey, B Optom K

    2014-03-01

    Full Text Available Background: Research on optomotor and perceptual developmental deficit diagnosis, treatment, and transfer to improved academic outcomes has gone mostly unnoticed by clinical optometry until recently. The research methodology/ technology used has been modified for the clinical application of this research in the assessment and treatment of basic optomotor and perceptual deficits. Case Reports: Two case studies illustrate the clinical application of precision measurements of performance markers. The first case illustrates that basic ‘learning to read’ related deficits can be found in children with healthy eyes, clear sight, and no significant refractive problems. Case two highlights that defects, deficits, and dysfunctions can co-exist. Functional visual inefficiency presented in this case with phenomenological symptoms indicative of ‘reading to learn’ issues. The assessment of basic optomotor and perceptual markers provides an understanding of neuro-circuitry deficits. Treatable deficits and dysfunctions were managed by optometric vision therapy. Discussion: The neuro-developmental status of basic optomotor and perceptual processes can be objectively assessed, and developmental deficits can be identified and treated, with the transfer of the oculo-visual skills learned that benefit related educational areas. As the more complex schemata needed for efficient visual inspection and engagement with the educational curriculum are built on these basic optomotor and perceptual processes, developmentally, it is desirable that these deficits be treated early in the educational experience. Research on the basic neuro-developmental deficits that affect functional visual efficiency is now available and applicable. Optometric vision therapy is empowered by the availability of deficit diagnosis and management. This clinical approach is a work in progress but is currently yielding appropriate objective outcomes for a wide variety of deficits.

  8. Environmental risk assessment of Polish wastewater treatment plant activity.

    Science.gov (United States)

    Kudłak, Błażej; Wieczerzak, Monika; Yotova, Galina; Tsakovski, Stefan; Simeonov, Vasil; Namieśnik, Jacek

    2016-10-01

    Wastewater treatment plants (WWTPs) play an extremely important role in shaping modern society's environmental well-being and awareness, however only well operated and supervised systems can be considered as environmentally sustainable. For this reason, an attempt was undertaken to assess the environmental burden posed by WWTPs in major Polish cities by collecting water samples prior to and just after wastewater release points. Both classical and biological methods (Microtox(®), Ostracodtoxkit F™ and comet assay) were utilized to assess environmental impact of given WWTP. Interestingly, in some cases, water quality improvement indicated as a toxicity decrement toward one of the bio-indicating organisms makes water worse for others in the systems. This fact is particularly noticeable in case of Silesian cities where heavy industry and high population density is present. It proves that WWTP should undergo individual evaluation of pollutant removal efficiency and tuned to selectively remove pollutants of highest risk to surrounding regional ecosystems. Biotests again proved to be an extremely important tool to fully assess the impact of environmental stressors on water bodies receiving effluents from WWTPs. PMID:27376857

  9. Assessing fly ash treatment: Remediation and stabilization of heavy metals

    DEFF Research Database (Denmark)

    Lima, A.T.; Ottosen, Lisbeth M.; Ribeiro, Alexandra B.

    2012-01-01

    Fly ashes from Municipal Solid Waste (MSW), straw (ST) and co-combustion of wood (CW) are here analyzed with the intent of reusing them. Two techniques are assessed, a remediation technique and a solidification/stabilization one. The removal of heavy metals from fly ashes through the...... electrodialytic process (EDR) has been tried out before. The goal of removing heavy metals has always been the reuse of fly ash, for instance in agricultural fields (BEK). The best removal rates are here summarized and some new results have been added. MSW fly ashes are still too hazardous after treatment to even...... consider application to the soil. ST ash is the only residue that gets concentrations low enough to be reused, but its fertilizing value might be questioned. An alternative reuse for the three ashes is here preliminary tested, the combination of fly ash with mortar. Fly ashes have been substituted by...

  10. Assessments for High Dose Radionuclide Therapy Treatment Planning

    International Nuclear Information System (INIS)

    Advances in the biotechnology of cell-specific targeting of cancer, and the increased number of clinical trials involving treatment of cancer patients with radiolabeled antibodies, peptides, and similar delivery vehicles have led to an increase in the number of high-dose radionuclide therapy procedures. Optimized radionuclide therapy for cancer treatment is based on the concept of absorbed dose to the dose-limiting normal organ or tissue. The limiting normal tissue is often the red marrow, but it may sometimes be lungs, liver, intestinal tract, or kidneys. Appropriate treatment planning requires assessment of radiation dose to several internal organs and tissues, and usually involves biodistribution studies in the patient using a tracer amount of radionuclide bound to the targeting agent and imaged at sequential time points using a planar gamma camera. Time-activity curves are developed from the imaging data for the major organs tissues of concern, for the whole body, and sometimes for selected tumors. Patient-specific factors often require that dose estimates be customized for each patient. The Food and Drug Administration regulates the experimental use of investigational new drugs and requires reasonable calculation of radiation absorbed dose to the whole body and to critical organs using methods prescribed by the Medical Internal Radiation Dose (MIRD) Committee of the Society of Nuclear Medicine. Review of high-dose studies in the U.S. and elsewhere shows that (1) some studies are conducted with minimal dosimetry, (2) the marrow dose is difficult to establish and is subject to large uncertainties, and (3) despite the general availability of MIRD software, internal dosimetry methods are often inconsistent from one clinical center to another

  11. Assessments for high dose radionuclide therapy treatment planning

    International Nuclear Information System (INIS)

    Advances in the biotechnology of cell specific targeting of cancer and the increased number of clinical trials involving treatment of cancer patients with radiolabelled antibodies, peptides, and similar delivery vehicles have led to an increase in the number of high dose radionuclide therapy procedures. Optimised radionuclide therapy for cancer treatment is based on the concept of absorbed dose to the dose limiting normal organ or tissue. The limiting normal tissue is often the red marrow, but it may sometimes be the lungs, liver, intestinal tract, or kidneys. Appropriate treatment planning requires assessment of radiation dose to several internal organs and tissues, and usually involves biodistribution studies in the patient using a tracer amount of radionuclide bound to the targeting agent and imaged at sequential timepoints using a planar gamma camera. Time-activity curves are developed from the imaging data for the major organ tissues of concern, for the whole body and sometimes for selected tumours. Patient specific factors often require that dose estimates be customised for each patient. In the United States, the Food and Drug Administration regulates the experimental use of investigational new drugs and requires 'reasonable calculation of radiation absorbed dose to the whole body and to critical organs' using the methods prescribed by the Medical Internal Radiation Dose (MIRD) Committee of the Society of Nuclear Medicine. Review of high dose studies shows that some are conducted with minimal dosimetry, that the marrow dose is difficult to establish and is subject to large uncertainties. Despite the general availability of software, internal dosimetry methods often seem to be inconsistent from one clinical centre to another. (author)

  12. Assessment of Ecotoxicity of Topsoils from a Wood Treatment Site

    Institute of Scientific and Technical Information of China (English)

    M.MENCH; C.BES

    2009-01-01

    A series of 9 soil samples were taken at a timber treatment site in SW Prance where Cu sulphate and chromated copper arsenate (CCA) have been used as wood preservatives (Sites P1 to P9) and one soil sample was collected at an adjacent site on the same soil type (Site P10).Copper was a major contaminant in all topsoils,varying from 65 (Soil P5)to 2600 mg Cu kg-1 (Soil P7),exceeding background values for French sandy soils.As and Cr did not accumulate in soil,except at Site P8 (52 mg As kg-1 and 87 mg Cr kg-1) where CCA-treated posts were stacked.Soil ecotoxicity was assessed with bioassays using radish,lettuce,slug Arion rufus L.,and earthworm Dendrobaena octaedra (Savigny).There werc significantly differences in lettuce germination rate,lettuce leaf yield,radish root and leaf yields,slug herbivory,and earthworm avoidance.An additional bioassay showed higher negative impacts on bean shoot and root yields,Rhizobium nodule counts on Bean roots,and guaiacol peroxidase activity in primary Bean leaves for soil from Site P7,with and without fertilisation,than for soil from Site P10,despite both soils having a similar value for computed free ion Cu2+ activity in the soil solution (pCu2+).Beans grown in soil from Site P7 that had been fertilised showed elevated foliar Cu content and phytotoxic symptoms.Soils from Sites P7 (treatment plant) and P6 (storage of treated utility poles) had the highest ecotoxicity,whereas soil from Site P10 (high organic matter content and cation exchange capacity) had the lowest.Except at Site P10,the soil factor pCu2+ computed with soil pH and total soil Cu could be used to predict soil ecotoxicity.

  13. Cold plasma treatment in wound care: efficacy and risk assessment

    Science.gov (United States)

    Stoffels, Eva

    2007-10-01

    Cold atmospheric plasma is an ideal medium for non-destructive modification of vulnerable surfaces. One of the most promising medical applications of cold plasma treatment is wound healing. Potential advantages in wound healing have been demonstrated in vitro: the plasma does not necrotize the cells and does not affect the extracellular matrix [1], has clear bactericidal or bacteriostatic effects [2], and stimulates fibroblast cells towards faster attachment and proliferation [3]. However, safety issues, such as the potential cytotoxicity of the plasma must be clarified prior to clinical implementation. This work comprises the recent facts on sub-lethal plasma effects on mammalian cells, as well as studies on apoptosis induction and quantitative assessment of DNA damage. Fibroblast, smooth muscle and endothelial cells were treated using the standard cold plasma needle [1,2]; intra- and extracellular oxidant levels as well as the influence of the plasma on intracellular antioxidant balance were monitored using appropriate fluorescent markers [1]. We have studied long-term cellular damage was monitored using flow cytometry to determine the DNA profiles in treated cells. Dose-response curves were obtained: increased proliferation as well as apoptosis were visualized under different treatment conditions. The results from the in vitro studies are satisfying. [1] I.E. Kieft, ``Plasma needle: exploring biomedical applications of non-thermal plasmas'', PhD Thesis, Eindhoven University of Technology (2005). [2] R.E.J. Sladek, ``Plasma needle: non-thermal atmospheric plasmas in dentistry'' PhD Thesis, Eindhoven University of Technology (2006). [3] I.E. Kieft, D. Darios, A.J.M. Roks, E. Stoffels, IEEE Trans. Plasma Sci. 34(4), 2006, pp. 1331-1336.

  14. Toxicological assessment of polyhexamethylene biguanide for water treatment

    Directory of Open Access Journals (Sweden)

    Asiedu-Gyekye Isaac J.

    2015-12-01

    Full Text Available Polyhexamethylene biguanide (PHMB is an antiseptic with antiviral and antibacterial properties used in a variety of products including wound care dressings, contact lens cleaning solutions, perioperative cleansing products, and swimming pool cleaners. There are regulatory concerns with regard to its safety in humans for water treatment. We decided to assess the safety of this chemical in Sprague-Dawley rats. PHMB was administered in a single dose by gavage via a stomach tube as per the manufacturer’s instruction within a dose range of 2 mg/kg to 40 mg/kg. Subchronic toxicity studies were also conducted at doses of 2 mg/kg, 8 mg/kg and 32 mg/kg body weight and hematological, biochemical and histopathological findings of the major organs were assessed. Administration of a dose of 25.6 mg/kg, i.e. 1.6 mL of 0.4% PHMB solution (equivalent to 6.4×103 mg/L of 0.1% solution resulted in 50% mortality. Histopathological analysis in the acute toxicity studies showed that no histopathological lesions were observed in the heart and kidney samples but 30% of the animals had mild hydropic changes in zone 1 of their liver samples, while at a dosage of 32 mg/kg in the subchronic toxicity studies, 50% of the animals showed either mild hepatocyte cytolysis with or without lymphocyte infiltration and feathery degeneration. Lymphocyte infiltration was, for the first time, observed in one heart sample, whereas one kidney sample showed mild tubular damage. The acute studies showed that the median lethal dose (LD50 is 25.6 mg/kg (LC50 of 1.6 mL of 0.4% PHMB. Subchronic toxicological studies also revealed few deleterious effects on the internal organs examined, as seen from the results of the biochemical parameters evaluated. These results have implications for the use of PHMB to make water potable.

  15. Feasibility of Using Virtual Reality to Assess Nicotine Cue Reactivity during Treatment

    Science.gov (United States)

    Kaganoff, Eili; Bordnick, Patrick S.; Carter, Brian Lee

    2012-01-01

    Cue reactivity assessments have been widely used to assess craving and attention to cues among cigarette smokers. Cue reactivity has the potential to offer insights into treatment decisions; however, the use of cue reactivity in treatment studies has been limited. This study assessed the feasibility of using a virtual reality-based cue reactivity…

  16. Radiological Risk Assessment for King County Wastewater Treatment Division

    Energy Technology Data Exchange (ETDEWEB)

    Strom, Daniel J.

    2005-08-05

    Staff of the King County Wastewater Treatment Division (WTD) have concern about the aftermath of a radiological dispersion event (RDE) leading to the introduction of significant quantities of radioactive material into the combined sanitary and storm sewer system in King County, Washington. Radioactive material could come from the use of a radiological dispersion device (RDD). RDDs include "dirty bombs" that are not nuclear detonations but are explosives designed to spread radioactive material (National Council on Radiation Protection and Measurements (NCRP) 2001). Radioactive material also could come from deliberate introduction or dispersion of radioactive material into the environment, including waterways and water supply systems. This document develops plausible and/or likely scenarios, including the identification of likely radioactive materials and quantities of those radioactive materials to be involved. These include 60Co, 90Sr, 137Cs, 192Ir, 226Ra, plutonium, and 241Am. Two broad categories of scenarios are considered. The first category includes events that may be suspected from the outset, such as an explosion of a "dirty bomb" in downtown Seattle. The explosion would most likely be heard, but the type of explosion (e.g., sewer methane gas or RDD) may not be immediately known. Emergency first responders must be able to quickly detect the radioisotopes previously listed, assess the situation, and deploy a response to contain and mitigate (if possible) detrimental effects resulting from the incident. In such scenarios, advance notice of about an hour or two might be available before any contaminated wastewater reaches a treatment plant. The second category includes events that could go initially undetected by emergency personnel. Examples of such a scenario would be the inadvertent or surreptitious introduction of radioactive material into the sewer system. Intact rogue radioactive sources from industrial radiography devices, well-logging apparatus, or

  17. Distal end radius fractures: evaluation of results of various treatments and assessment of treatment choice

    Directory of Open Access Journals (Sweden)

    Vargaonkar Gauresh

    2014-07-01

    Full Text Available 【Abstract】Objective:The rapid expansion of knowledge regarding the functional anatomy of hand and wrist, increasing functional demands of senior citizens and improved methodologies of achieving and maintaining anatomic restoration of distal radius fractures has generated a renewed interest in addressing these fractures in a more precise manner. The purpose of our study was to evaluate the difference in patients function among those treated by 1 closed reduction and Plaster of Paris cast, 2 distractor application, or 3 open reduction and internal fixation with a volar plate, and to assess the treatment choice for each particular fracture type. Methods: A prospective study was carried out on 60 patients with fractures of the distal end radius. Fractures were classified according to the AO classification into type A (extra-articular, type B (partial articular and type C (complete articular. After initial evaluation patients were taken up for either conservative or operative treatment and were followed up for two years. Results: Anatomical results were evaluated according to the Sarmiento’s modification of Lindstrom Criteria, which showed that excellent results were more frequent with open reduction and internal fixation using the plating technique. Clinical and functional results were evaluated according to the demerit point system of Gartland and Werley with Sarmiento modification, which was revealed to relate with the type of treatment techniques. Conclusion: There is no customized solution for all the fractures of the distal radius. The choice of treatment should be based on the fracture type, the patient’s characteristics, the patient’s demands and the treating surgeon’s experience and preference. Key words: Distal end radius fractures; Volar plate; Radial orthofix

  18. Assessing fly ash treatment: Remediation and stabilization of heavy metals

    KAUST Repository

    Lima, A.T.

    2010-12-17

    Fly ashes from Municipal Solid Waste (MSW), straw (ST) and co-combustion of wood (CW) are here analyzed with the intent of reusing them. Two techniques are assessed, a remediation technique and a solidification/stabilization one. The removal of heavy metals from fly ashes through the electrodialytic process (EDR) has been tried out before. The goal of removing heavy metals has always been the reuse of fly ash, for instance in agricultural fields (BEK). The best removal rates are here summarized and some new results have been added. MSW fly ashes are still too hazardous after treatment to even consider application to the soil. ST ash is the only residue that gets concentrations low enough to be reused, but its fertilizing value might be questioned. An alternative reuse for the three ashes is here preliminary tested, the combination of fly ash with mortar. Fly ashes have been substituted by cement fraction or aggregate fraction. Surprisingly, better compressive strengths were obtained by replacing the aggregate fraction. CW ashes presented promising results for the substitution of aggregate in mortar and possibly in concrete. © 2010 Elsevier Ltd.

  19. Patient Guide to the Assessment and Treatment of Hypertriglyceridemia (High Triglycerides)

    Science.gov (United States)

    Assessment and Treatment of Hypertriglyceridemia (High Triglycerides) A Patient’s Guide Having high levels of triglycerides, or hypertriglyceridemia , is a common problem. Triglycerides are fats in ...

  20. Assessment and Treatment of Personality Disorders: A Behavioral Perspective

    Science.gov (United States)

    Nelson-Gray, Rosemery O.; Lootens, Christopher M.; Mitchell, John T.; Robertson, Christopher D.; Hundt, Natalie E.; Kimbrel, Nathan A.

    2009-01-01

    Personality disorders are complex and highly challenging to treatment providers; yet, for clients with these problems, there exist very few treatment options that have been supported by research. Given the lack of empirically-supported therapies for personality disorders, it can be difficult to make treatment decisions for this population. The…

  1. Radiological Instrumentation Assessment for King County Wastewater Treatment Division

    International Nuclear Information System (INIS)

    The King County Wastewater Treatment Division (WTD) have concern about the aftermath of a radiological dispersion event (RDE) leading to the introduction of significant quantities of radioactive material into its combined sanitary and storm sewer system. Radioactive material could come from the use of a radiological dispersion device (RDD). RDDs include 'dirty bombs' that are not nuclear detonations but are explosives designed to spread radioactive material. Radioactive material also could come from deliberate introduction or dispersion of radioactive material into the environment, including waterways and water supply systems. Volume 2 of PNNL-15163 assesses the radiological instrumentation needs for detection of radiological or nuclear terrorism, in support of decisions to treat contaminated wastewater or to bypass the West Point Treatment Plant (WPTP), and in support of radiation protection of the workforce, the public, and the infrastructure of the WPTP. Fixed radiation detection instrumentation should be deployed in a defense-in-depth system that provides (1) early warning of significant radioactive material on the way to the WPTP, including identification of the radionuclide(s) and estimates of the soluble concentrations, with a floating detector located in the wet well at the Interbay Pump Station and telemetered via the internet to all authorized locations; (2) monitoring at strategic locations within the plant, including (2a) the pipe beyond the hydraulic ram in the bar screen room; (2b) above the collection funnels in the fine grit facility; (2c) in the sampling tank in the raw sewage pump room; and (2d) downstream of the concentration facilities that produce 6% blended and concentrated biosolids. Engineering challenges exist for these applications. It is necessary to deploy both ultra-sensitive detectors to provide early warning and identification and detectors capable of functioning in high-dose rate environments that are likely under some scenarios

  2. Clinical application of 3D imaging for assessment of treatment outcomes

    OpenAIRE

    Cevidanes, Lucia H.C.; Oliveira, Ana Emilia Figueiredo; Grauer, Dan; Styner, Martin; Proffit, William R.

    2011-01-01

    This paper outlines the clinical application of CBCT for assessment of treatment outcomes, and discusses current work to superimpose digital dental models and 3D photographs. Superimposition of CBCTs on stable structures of reference now allow assessment of 3D dental, skeletal and soft tissue changes for both growing and non-growing patients. Additionally, we describe clinical findings from CBCT superimpositions in assessment of surgery and skeletal anchorage treatment.

  3. Current concepts in the assessment and treatment of hepatic encephalopathy.

    LENUS (Irish Health Repository)

    Cash, W J

    2012-02-01

    Hepatic encephalopathy (HE) is defined as a metabolically induced, potentially reversible, functional disturbance of the brain that may occur in acute or chronic liver disease. Standardized nomenclature has been proposed but a standardized approach to the treatment, particularly of persistent, episodic and recurrent encephalopathy associated with liver cirrhosis has not been proposed. This review focuses on the pathogenesis and treatment of HE in patients with cirrhosis. The pathogenesis and treatment of hepatic encephalopathy in fulminant hepatic failure is quite different and is reviewed elsewhere.

  4. Substituted plan analysis in the environmental impact assessment of Yongchuan wastewater treatment project

    Institute of Scientific and Technical Information of China (English)

    FANG Jun-hua

    2006-01-01

    Substituted plan in the environmental impact assessment (EIA) mainly means the treatment technology and the substituted site of plant, and it also includes the many kinds of environment protection measures. This paper will make detailed analysis on the treatment technology, the substituted site of plant, the purpose of discharged water and the dispose of sludge in the Yongchuan wastewater treatment project.

  5. Environmental impact assessment of decommissioning treatment about radioactive model plant waste ore storage site

    International Nuclear Information System (INIS)

    Aiming at decommissioning treatment project of radioactive model plant waste ore storage site, based on the detailed investigations of source terms and project description, systematic environmental impacts have been identified. The environmental impacts both during decommissioning treatment, radioactive waste transportation and after treatment are assessed. Some specific environmental protection measures are proposed so as to minimize the adverse environmental impacts. (author)

  6. Assessment of wastewater treatment plant effluent effects on fish reproduction

    Science.gov (United States)

    Wastewater treatment plant (WWTP) effluents are known contributors of chemical mixtures into the environment. Of particular concern are endocrine-disrupting compounds that can affect hypothalamic-pituitary-gonadal axis function in exposed organisms. The present study examined t...

  7. Assessment of didecyldimethylammonium chloride as a ballast water treatment method

    NARCIS (Netherlands)

    van Slooten, C.; Peperzak, L.; Buma, A.G.J.

    2015-01-01

    Ballast water-mediated transfer of aquatic invasive species is considered a major threat to marine biodiversity, marine industry and human health. A ballast water treatment is needed to comply with International Maritime Organization (IMO) ballast water discharge regulations. Didecyldimethylammonium

  8. Assessment of the Evolution of Cancer Treatment Therapies

    OpenAIRE

    Mónica Valladares; Alejandro Tres; Julio Lambea; Berta Sáez-Gutierrez; Manuel Arruebo; Nuria Vilaboa; África González-Fernández

    2011-01-01

    Cancer therapy has been characterized throughout history by ups and downs, not only due to the ineffectiveness of treatments and side effects, but also by hope and the reality of complete remission and cure in many cases. Within the therapeutic arsenal, alongside surgery in the case of solid tumors, are the antitumor drugs and radiation that have been the treatment of choice in some instances. In recent years, immunotherapy has become an important therapeutic alternative, and is now the first...

  9. Clinical features, assessment and treatment of essential tremor.

    OpenAIRE

    Panicker, J N; Pal, P K

    2003-01-01

    Essential tremor is the most common of the movement disorders, being 20 times more common than Parkinson's Disease. It is characterised by postural and kinetic tremor which maximally affects the hands. It can be assessed by physiological techniques, subjective clinical methods, objective clinical methods and handicap/disability scales. Accelerometry, spirography and handwriting assessment, volumetry and handicap/disability questionnaires are commonly used methods. Primidone and propranolol ar...

  10. Assessment of the Evolution of Cancer Treatment Therapies

    Directory of Open Access Journals (Sweden)

    Mónica Valladares

    2011-08-01

    Full Text Available Cancer therapy has been characterized throughout history by ups and downs, not only due to the ineffectiveness of treatments and side effects, but also by hope and the reality of complete remission and cure in many cases. Within the therapeutic arsenal, alongside surgery in the case of solid tumors, are the antitumor drugs and radiation that have been the treatment of choice in some instances. In recent years, immunotherapy has become an important therapeutic alternative, and is now the first choice in many cases. Nanotechnology has recently arrived on the scene, offering nanostructures as new therapeutic alternatives for controlled drug delivery, for combining imaging and treatment, applying hyperthermia, and providing directed target therapy, among others. These therapies can be applied either alone or in combination with other components (antibodies, peptides, folic acid, etc.. In addition, gene therapy is also offering promising new methods for treatment. Here, we present a review of the evolution of cancer treatments, starting with chemotherapy, surgery, radiation and immunotherapy, and moving on to the most promising cutting-edge therapies (gene therapy and nanomedicine. We offer an historical point of view that covers the arrival of these therapies to clinical practice and the market, and the promises and challenges they present.

  11. Assessment of the Evolution of Cancer Treatment Therapies

    Energy Technology Data Exchange (ETDEWEB)

    Arruebo, Manuel [Instituto de Nanociencia de Aragón (INA), Mariano Esquillor, Edif. I+D, University of Zaragoza, Zaragoza 50018 (Spain); CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Zaragoza 50018 (Spain); Vilaboa, Nuria [CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Zaragoza 50018 (Spain); Hospital Universitario La Paz-IdiPAZ, Paseo de la Castellana 261, Madrid 28046 (Spain); Sáez-Gutierrez, Berta; Lambea, Julio; Tres, Alejandro [Instituto de Nanociencia de Aragón (INA), Mariano Esquillor, Edif. I+D, University of Zaragoza, Zaragoza 50018 (Spain); Servicio de Oncología Médica, Hospital Clínico Universitario Lozano Blesa, Avda. San Juan Bosco 50009, Zaragoza (Spain); Instituto Aragonés de Ciencias de la Salud (I-CS), Avda. Gómez Laguna, 25, Zaragoza 50009 (Spain); Valladares, Mónica [Lonza Biologics Porriño, A relva s/n, Porriño (Pontevedra) 36410 (Spain); González-Fernández, África, E-mail: africa@uvigo.es [Immunology Department, Biomedical Research Center (CINBIO), University of Vigo, Campus Lagoas Marcosende, Vigo (Pontevedra) 36310 (Spain)

    2011-08-12

    Cancer therapy has been characterized throughout history by ups and downs, not only due to the ineffectiveness of treatments and side effects, but also by hope and the reality of complete remission and cure in many cases. Within the therapeutic arsenal, alongside surgery in the case of solid tumors, are the antitumor drugs and radiation that have been the treatment of choice in some instances. In recent years, immunotherapy has become an important therapeutic alternative, and is now the first choice in many cases. Nanotechnology has recently arrived on the scene, offering nanostructures as new therapeutic alternatives for controlled drug delivery, for combining imaging and treatment, applying hyperthermia, and providing directed target therapy, among others. These therapies can be applied either alone or in combination with other components (antibodies, peptides, folic acid, etc.). In addition, gene therapy is also offering promising new methods for treatment. Here, we present a review of the evolution of cancer treatments, starting with chemotherapy, surgery, radiation and immunotherapy, and moving on to the most promising cutting-edge therapies (gene therapy and nanomedicine). We offer an historical point of view that covers the arrival of these therapies to clinical practice and the market, and the promises and challenges they present.

  12. Assessment of the Evolution of Cancer Treatment Therapies

    International Nuclear Information System (INIS)

    Cancer therapy has been characterized throughout history by ups and downs, not only due to the ineffectiveness of treatments and side effects, but also by hope and the reality of complete remission and cure in many cases. Within the therapeutic arsenal, alongside surgery in the case of solid tumors, are the antitumor drugs and radiation that have been the treatment of choice in some instances. In recent years, immunotherapy has become an important therapeutic alternative, and is now the first choice in many cases. Nanotechnology has recently arrived on the scene, offering nanostructures as new therapeutic alternatives for controlled drug delivery, for combining imaging and treatment, applying hyperthermia, and providing directed target therapy, among others. These therapies can be applied either alone or in combination with other components (antibodies, peptides, folic acid, etc.). In addition, gene therapy is also offering promising new methods for treatment. Here, we present a review of the evolution of cancer treatments, starting with chemotherapy, surgery, radiation and immunotherapy, and moving on to the most promising cutting-edge therapies (gene therapy and nanomedicine). We offer an historical point of view that covers the arrival of these therapies to clinical practice and the market, and the promises and challenges they present

  13. Assessment of impacts from different waste treatment and waste disposal technologies: Regional Management Plan

    International Nuclear Information System (INIS)

    This report presents assessments of treatment and disposal technologies that appear to be appropriate for use in regional facilities in the Midwest Compact Region. Treatment technologies assessed are: compaction with a supercompactor, incineration, and incineration followed by solidification of the incinerator ash. Disposal technologies assessed are: shallow land burial, considered a baseline for comparison of other technologies, below-ground and above-ground vaults, the earth mounded concrete bunker, improved shallow land burial, modular concrete canister disposal, mined cavities, unlined and lined augered holes. The text indicates that assessment of treatment technologies sometimes depends on the disposal technology that will be used, and vice versa. However, the major thrust of assessments reported here is to evaluate the technologies without defining combinations of treatment and disposal methods. 20 refs

  14. Assessment of psychological effects of dental treatment on children

    Directory of Open Access Journals (Sweden)

    Rakesh Mittal

    2012-01-01

    Full Text Available Aim : The aim of present study is to investigate the various psychological effects on children due to dental treatment. Materials and Methods : One hundred and eighty school going children, age range between six and twelve years, were recruited into the study and divided into two groups (Group I included six to nine-year-olds and Group II included nine-to-twelve year olds. Only those children were included who underwent a certain dental treatment seven days prior to the investigation. Each child was asked a preformed set of questions. The child was allowed to explain and answer in his own way, rather than only in yes or no. The answers were recorded. After interviewing, the child was asked either to draw a picture or to write an essay related to his experience regarding the dentist and dental treatment. Results : A majority of the children (92.22% had a positive perception. The number of children having negative and neutral perceptions was comparatively much less. Younger children (Group I had a more negative experience than the older children (Group II. Only one-fourth of the children complained of some pretreatment fear (23.83%; 72.09% of the children did not have any pain during dental treatment and a majority of children (80.23% remembered their dental treatment. Conclusion : A majority of children had a positive perception of their dental treatment and the children in the younger age group had more negative perceptions than the children in the older age group.

  15. Thallium-199 myocardial scintigraphy for assessing the efficacy of drug and surgical treatment of coronary disease

    International Nuclear Information System (INIS)

    Potentialities of thallium-199 myocardial scintigraphy in evaluation of the effects of surgical and drug treatment of myocardial perfusion in coronary patients are studied. It is shown that thallium-199 myocardial scintigraphy helps assess the effect of treatment on myocardial perfusion. Positive effect of treatment manifests by decrease of myocardial perfusion defects. The method permits imaging the coronary microcirculation over the course of treatment and predicting a further course of disease

  16. Assessment tool for planning fallback Tomotherapy treatment plans

    International Nuclear Information System (INIS)

    Interruption of radiotherapy treatments in an increase the total time of the same to the detriment of tumour control. In centers that have a unique special unit as the TomoTherapy, is emphasized the difficulty to resume treatment at another unit, since the technique of helical TomoTherapy is not portable to conventional accelerators and therefore requires the planning of new dosimetry distributions emulating the initially obtained and accepted. This work evaluates the ability of an automatic planning tool to mimic TomoTherapy plans. (Author)

  17. Eating disorders in day treatment aspects of assessment and outcome

    NARCIS (Netherlands)

    Exterkate, C.C.

    2007-01-01

    Part I gives a general introduction and overview of the research with a naturalistic design that has been done in Amarum. Amarus is a specialized public health centre for the treatment of people with eating disorders where the development of Evidence Based Mental Health (EBMH) and the use of guideli

  18. TECHNOLOGY ASSESSMENT OF WETLANDS FOR MUNICIPAL WASTEWATER TREATMENT

    Science.gov (United States)

    The innovative and alternative technology provisions of the Clean Water Act of 1977 (PL 95-217) provide financial incentives to communities that use wastewater treatment alternatives to reduce costs or energy consumption over conventional systems. Some of these technologies have ...

  19. Medical tourism: assessing the evidence on treatment abroad.

    Science.gov (United States)

    Lunt, Neil; Carrera, Percivil

    2010-05-01

    The review focuses on one growing dimension of health care globalisation - medical tourism, whereby consumers elect to travel across borders or to overseas destinations to receive their treatment. Such treatments include cosmetic and dental surgery; cardio, orthopaedic and bariatric surgery; IVF treatment; and organ and tissue transplantation. The review sought to identify the medical tourist literature for out-of-pocket payments, focusing wherever possible on evidence and experience pertaining to patients in mid-life and beyond. Despite increasing media interest and coverage hard empirical findings pertaining to out-of-pocket medical tourism are rare. Despite a number of countries offering relatively low cost treatments we know very little about many of the numbers and key indicators on medical tourism. The narrative review traverses discussion on medical tourist markets, consumer choice, clinical outcomes, quality and safety, and ethical and legal dimensions. The narrative review draws attention to gaps in research evidence and strengthens the call for more empirical research on the role, process and outcomes of medical tourism. In concluding it makes suggestion for the content of such a strategy. PMID:20185254

  20. Arthroscopic Assessment and Treatment of Dancers' Knee Injuries.

    Science.gov (United States)

    Silver, Daniel M.; Campbell, Pat

    1985-01-01

    Arthroscopic examination of 16 dancers with dance-related knee injuries which defied conservative treatment showed 15 meniscal tears and 4 cases of chondromalacia patellae. Partial arthroscopic meniscectomy was used to treat the tears. The results were excellent, with 13 of the 16 returning to preoperative levels of dance activity. (MT)

  1. Physician Peer Assessments for Compliance with Methadone Maintenance Treatment Guidelines

    Science.gov (United States)

    Strike, Carol; Wenghofer, Elizabeth; Gnam, William; Hillier, Wade; Veldhuizen, Scott; Millson, Margaret

    2007-01-01

    Introduction: Medical associations and licensing bodies face pressure to implement quality assurance programs, but evidence-based models are lacking. To improve the quality of methadone maintenance treatment (MMT), the College of Physicians and Surgeons of Ontario, Canada, conducts an innovative quality assurance program on the basis of peer…

  2. Post-closure performance assessment treatment of the biosphere

    International Nuclear Information System (INIS)

    The Nirex strategy for radioactive waste disposal is based on a system of engineered and natural barriers, providing long-term isolation of the waste from those parts of the environment that are in contact with or readily available for use by humans (i.e. the biosphere). Even so, there remains the possibility that, on a timescale of thousands to tens of thousands of years, small quantities of poorly-sorbed, long-lived radionuclides may be released from the engineered disposal system, ultimately to emerge into the biosphere. Biosphere models are used in post-closure performance assessments to quantify the competing effects of dilution and accumulation processes on radionuclide concentrations in the accessible environment. Understanding biosphere processes and their time dependence is necessary not only to determine the radiological impact of possible future releases, but also to characterise the dynamics of transport in groundwater and the location, duration and extent of any such releases. Nirex is developing a new biosphere model for use in post-closure radiological assessments for the proposed Sellafield repository. A compartment modelling approach has been adopted, as in studies performed previously, but the system will be dynamic, allowing changes with time in both the properties of compartments and the transfers between compartments. The transport model considers both mass transport within the biosphere and the migration of radionuclides, thereby ensuring that a self-consistent description of the biosphere, in a spatially-extensive domain is maintained. The above approach is designed to link the assessment models used by the Nirex assessment team more closely into the Nirex biosphere research programme than has hitherto been possible with time-invariant assessment models. (author)

  3. Risk assessments of innovative technologies for treatment of mixed waste

    International Nuclear Information System (INIS)

    The mission of the US Department of Energy's (DOE'S) Mixed Waste Integrated Program (MWIP) is to develop complete and appropriate technologies for the treatment of DOE mixed low-level waste and transuranic wastes in order to ensure that all affected DOE installations and projects can come into compliance with environmental law and meet DOE's 30-yr cleanup and operational goals. The MWIP will achieve its goal by developing technologies that are in compliance with regulatory requirements, are socially and politically viable, and are cost beneficial and effective in disposed waste source term and volume reduction. The project management plan for MWIP requires that technologies be evaluated in accordance with criteria that rank technologies with regard to performance, risk, and cost-effectiveness. This paper addresses the methodology used to rank alternative mixed-water treatment technologies with regard to relative risk

  4. How assess drugs in the treatment of acute bipolar mania?

    Science.gov (United States)

    Bourin, Michel; Thibaut, Florence

    2013-01-01

    Bipolar affective disorder is a serious mental disease associated with significant morbidity and mortality. Good-quality research available to guide treatment strategies remains insufficient, particularly with regard to manic or hypomanic episodes. A critical review of the various stages of mania might be helpful for pharmaceutical companies and investigators as a prerequisite for the clinical evaluation of potential antimanic properties of medications. The main difficulty is with a comparison between anticonvulsants, antipsychotics, and mood stabilizers such as lithium (with equal efficacy in the acute phase and the prevention of recurrent manic episodes). No consensus has been reached with regard to the treatment of bouts of acute mania in various parts of the world. Controlled clinical trials have, at last, provided irrefutable evidence of the activity of lithium, which has long been used alone, as well as that of divalproate or its derivatives and, to a lesser extent, carbamazepine. The new antipsychotic agents have more recently established their efficacy, especially aripiprazole, asenapine, quetiapine; olanzapine, risperidone, and ziprasidone (not sure where the paradox is). In Europe, haloperidol is still the reference substance used in clinical trials despite the fact that it is not officially indicated in the treatment of mania. In the USA, lithium, divalproate, or antipsychotics can be prescribed as first-line treatment. In Europe, lithium remains the first-line medication, whereas divalproate and atypical antipsychotic agents are used only as second-line therapy. Although both types of medication (antipsychotics, normothymic agents, and/or anticonvulsants) have proved to be clinically effective in the management of mania by reducing the mania scores overall, the same does not apply, however, to all symptoms of mania. Factorial approaches to mania have all shown that since there are several clinical forms of mania, several clusters of manic symptoms can

  5. Liquid Effluent Retention Facility/Effluent Treatment Facility Hazards Assessment

    International Nuclear Information System (INIS)

    This document establishes the technical basis in support of Emergency Planning activities for the Liquid Effluent Retention Facility and Effluent Treatment Facility the Hanford Site. The document represents an acceptable interpretation of the implementing guidance document for DOE ORDER 5500.3A. Through this document, the technical basis for the development of facility specific Emergency Action Levels and the Emergency Planning Zone is demonstrated

  6. Eating disorders in day treatment aspects of assessment and outcome

    OpenAIRE

    Exterkate, C.C.

    2007-01-01

    Part I gives a general introduction and overview of the research with a naturalistic design that has been done in Amarum. Amarus is a specialized public health centre for the treatment of people with eating disorders where the development of Evidence Based Mental Health (EBMH) and the use of guidelines is of importance. The practice of evidence based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research. Guidelines...

  7. Treatment of Peyronies disease with brachytherapy - assessment of the results

    International Nuclear Information System (INIS)

    The treatment methods of Induratio penis plastica applied so far yield conflicting results. The Radiology Clinic at the Higher Institute Medicine - Plovdiv has reach experience with the treatment of this disease by brachytherapy alone, or combined with medicines (vitamin E and Hyalase). The purpose of the paper is to evaluate the results after a 3-year follow-up study. From 1994 to 1997, 118 men aged 40 to 72 were treated with one to three courses of local application of a special 137Cs moulage. Staging of the disease was done on the basis of criteria proposed by Alth in 1984 - location, plaque number and size, deformity of erection and pain. Brachytherapy was carried using the moulage technique with 1'37Cs applicators taking into account the homogeneity rules. The first course consisted of 5 applications of 3.75 Gy to realization a dose of 18.75 Gy. Normally the treatment ended after the first course, in cases of unsatisfactory effect it was repeated in 3 months, and rarely a third course was needed. 90 patients were treated with one course, 20 with two, and 8 with three. Complete regression was achieved in 11.9%; partial regression more than 50% in 68.6%; partial regression less than 50% in 12.7%; no improvement - 6.8% of the patients. A significant correlation was noted between the plaque size and number and the therapeutic effect. Upon plaque regression the pain decreased first, while reverse development of erection deformity was much slower. The encouraging results prove that brachytherapy is a promising and non-invasive method of treatment (author)

  8. SEPARATION ANXIETY DISORDER IN YOUTH: PHENOMENOLOGY, ASSESSMENT, AND TREATMENT

    OpenAIRE

    Ehrenreich, Jill T.; Santucci, Lauren C.; Weiner, Courtney L.

    2008-01-01

    Separation Anxiety Disorder (SAD) is the most commonly diagnosed and impairing childhood anxiety disorder, accounting for approximately 50% of the referrals for mental health treatment of anxiety disorders. While considered a normative phenomenon in early childhood, SAD has the potential to negatively impact a child’s social and emotional functioning when it leads to avoidance of certain places, activities and experiences that are necessary for healthy development. Amongst those with severe s...

  9. Mechanical assessment of grit blasting surface treatments of dental implants.

    Science.gov (United States)

    Shemtov-Yona, K; Rittel, D; Dorogoy, A

    2014-11-01

    This paper investigates the influence of surface preparation treatments of dental implants on their potential (mechanical) fatigue failure, with emphasis on grit-blasting. The investigation includes limited fatigue testing of implants, showing the relationship between fatigue life and surface damage condition. Those observations are corroborated by a detailed failure analysis of retrieved fracture dental implants. In both cases, the negative effect of embedded alumina particles related to the grit-blasting process is identified. The study also comprises a numerical simulation part of the grit blasting process that reveals, for a given implant material and particle size, the existence of a velocity threshold, below which the rough surface is obtained without damage, and beyond which the creation of significant surface damage will severely reduce the fatigue life, thus increasing fracture probability. The main outcome of this work is that the overall performance of dental implants comprises, in addition to the biological considerations, mechanical reliability aspects. Fatigue fracture is a central issue, and this study shows that uncontrolled surface roughening grit-blasting treatments can induce significant surface damage which accelerate fatigue fracture under certain conditions, even if those treatments are beneficial to the osseointegration process. PMID:25173238

  10. Verification and validation of the decision analysis model for assessment of TWRS waste treatment strategies

    International Nuclear Information System (INIS)

    This document is the verification and validation final report for the Decision Analysis Model for Assessment of Tank Waste Remediation System Waste Treatment Strategies. This model is also known as the INSIGHT Model

  11. Accuracy of self-reported tobacco assessments in a head and neck cancer treatment population

    International Nuclear Information System (INIS)

    Prospective analysis was performed of self-reported and biochemically confirmed tobacco use in 50 head and neck cancer patients during treatment. With 93.5% compliance to complete weekly self-report and biochemical confirmatory tests, 29.4% of smokers required biochemical assessment for identification. Accuracy increased by 14.9% with weekly vs. baseline self-reported assessments. Data confirm that head and neck cancer patients misrepresent true tobacco use during treatment.

  12. Monte Carlo conformal treatment planning as an independent assessment

    International Nuclear Information System (INIS)

    The wide range of possibilities available in Radiotherapy with conformal fields cannot be covered experimentally. For this reason, dosimetrical and planning procedures are based on approximate algorithms or systematic measurements. Dose distribution calculations based on Monte Carlo (MC) simulations can be used to check results. In this work, two examples of conformal field treatments are shown: A prostate carcinoma and an ocular lymphoma. The dose distributions obtained with a conventional Planning System and with MC have been compared. Some significant differences have been found. (orig.)

  13. Towards Probablistic Assessment of Hypobaric Decompression Sickness Treatment

    Science.gov (United States)

    Conkin, J.; Abercromby, A. F.; Feiveson, A. H.; Gernhardt, M. L.; Norcross, J. R.; Ploutz-Snyder, R.; Wessel, J. H., III

    2013-01-01

    INTRODUCTION: Pressure, oxygen (O2), and time are the pillars to effective treatment of decompression sickness (DCS). The NASA DCS Treatment Model links a decrease in computed bubble volume to the resolution of a symptom. The decrease in volume is realized in two stages: a) during the Boyle's Law compression and b) during subsequent dissolution of the gas phase by the O2 window. METHODS: The cumulative distribution of 154 symptoms that resolved during repressurization was described with a log-logistic density function of pressure difference (deltaP as psid) associated with symptom resolution and two other explanatory variables. The 154 symptoms originated from 119 cases of DCS during 969 exposures in 47 different altitude tests. RESULTS: The probability of symptom resolution [P(symptom resolution)] = 1 / (1+exp(- (ln(deltaP) - 1.682 + 1.089×AMB - 0.00395×SYMPTOM TIME) / 0.633)), where AMB is 1 when the subject ambulated as part of the altitude exposure or else 0 and SYMPTOM TIME is the elapsed time in min from start of the altitude exposure to recognition of a DCS symptom. The P(symptom resolution) was estimated from computed deltaP from the Tissue Bubble Dynamics Model based on the "effective" Boyle's Law change: P2 - P1 (deltaP, psid) = P1×V1/V2 - P1, where V1 is the computed volume of a spherical bubble in a unit volume of tissue at low pressure P1 and V2 is computed volume after a change to a higher pressure P2. V2 continues to decrease through time at P2, at a faster rate if 100% ground level O2 was breathed. The computed deltaP is the effective treatment pressure at any point in time as if the entire ?deltaP was just from Boyle's Law compression. DISCUSSION: Given the low probability of DCS during extravehicular activity and the prompt treatment of a symptom with options through the model it is likely that the symptom and gas phase will resolve with minimum resources and minimal impact on astronaut health, safety, and productivity.

  14. The assessment and treatment of wound pain at dressing change.

    LENUS (Irish Health Repository)

    Bell, Cassandra

    2010-01-01

    Pain is a common reason for patients with acute or chronic wounds seeking hospital admission, but it appears to be under-treated by health professionals. A quantitative descriptive study was conducted to investigate nurses\\' knowledge with regard to dressing change and wound pain. Data were collected from registered nurses (n=94). Analysis indicated a low level of knowledge with regard to pain assessment and strategies to overcome pain at dressing change, but a good knowledge of factors that contribute to pain at dressing change.

  15. Patient factors influencing dermal filler complications: prevention, assessment, and treatment

    Science.gov (United States)

    De Boulle, Koenraad; Heydenrych, Izolda

    2015-01-01

    While rare, complications do occur with the esthetic use of dermal fillers. Careful attention to patient factors and technique can do much to avoid these complications, and a well-informed practitioner can mitigate problems when they do occur. Since cosmetic surgery is usually an elective process, requested by the patient, clinical trials are complex to organize and run. For this reason, an international group of practicing physicians in the field of esthetics came together to share knowledge and to try and produce some informed guidance for their colleagues, considering the literature and also pooling their own extensive clinical experience. This manuscript aims to summarize the crucial aspects of patient selection, including absolute contraindications as well as situations that warrant caution, and also covers important considerations for the pre- and posttreatment periods as well as during the procedure itself. Guidance is given on both immediate and long-term management of adverse reactions. The majority of complications are related to accepting patients inappropriate for treatment or issues of sterility, placement, volume, and injection technique. It is clear that esthetic practitioners need an in-depth knowledge of all aspects of treatment with dermal fillers to achieve optimal outcomes for their patients. PMID:25926750

  16. Probabilistic Assessment of Hypobaric Decompression Sickness Treatment Success

    Science.gov (United States)

    Conkin, Johnny; Abercromby, Andrew F. J.; Dervay, Joseph P.; Feiveson, Alan H.; Gernhardt, Michael L.; Norcross, Jason R.; Ploutz-Snyder, Robert; Wessel, James H., III

    2014-01-01

    The Hypobaric Decompression Sickness (DCS) Treatment Model links a decrease in computed bubble volume from increased pressure (DeltaP), increased oxygen (O2) partial pressure, and passage of time during treatment to the probability of symptom resolution [P(symptom resolution)]. The decrease in offending volume is realized in 2 stages: a) during compression via Boyle's Law and b) during subsequent dissolution of the gas phase via the O2 window. We established an empirical model for the P(symptom resolution) while accounting for multiple symptoms within subjects. The data consisted of 154 cases of hypobaric DCS symptoms along with ancillary information from tests on 56 men and 18 women. Our best estimated model is P(symptom resolution) = 1 / (1+exp(-(ln(Delta P) - 1.510 + 0.795×AMB - 0.00308×Ts) / 0.478)), where (DeltaP) is pressure difference (psid), AMB = 1 if ambulation took place during part of the altitude exposure, otherwise AMB = 0; and where Ts is the elapsed time in mins from start of the altitude exposure to recognition of a DCS symptom. To apply this model in future scenarios, values of DeltaP as inputs to the model would be calculated from the Tissue Bubble Dynamics Model based on the effective treatment pressure: (DeltaP) = P2 - P1 | = P1×V1/V2 - P1, where V1 is the computed volume of a spherical bubble in a unit volume of tissue at low pressure P1 and V2 is computed volume after a change to a higher pressure P2. If 100% ground level O2 (GLO) was breathed in place of air, then V2 continues to decrease through time at P2 at a faster rate. This calculated value of (DeltaP then represents the effective treatment pressure at any point in time. Simulation of a "pain-only" symptom at 203 min into an ambulatory extravehicular activity (EVA) at 4.3 psia on Mars resulted in a P(symptom resolution) of 0.49 (0.36 to 0.62 95% confidence intervals) on immediate return to 8.2 psia in the Multi-Mission Space Exploration Vehicle. The P(symptom resolution) increased

  17. Assessment of options for the treatment of Sizewell PWR liquid effluent

    International Nuclear Information System (INIS)

    This report describes the origins of PWR liquid waste streams, their composition and rates of arising. Data has been collected from operational PWRs and estimates obtained for Sizewell B PWR liquid waste streams. Current liquid waste treatment practices are reviewed and assessments made of established and novel treatment techniques which could be applicable to Sizewell B. A short list of treatment options is given and recommendations are made relating to established treatment technologies suitable for Sizewell B and also to development work on more novel treatments which could lead to a reduction in waste disposal volumes. (author)

  18. Caries Risk Assessment/Treatment Programs in U.S. Dental Schools.

    Science.gov (United States)

    Yorty, Jack S.; Brown, K. Birgitta

    1999-01-01

    A survey of 42 U.S. dental schools was conducted to identify the number and characteristics of caries risk- assessment/treatment programs. Findings address lectures about caries risk, use of variable recall programs, categorization of risk level, early detection and treatment of lesions, and restoration of radiographically visible lesions. (DB)

  19. Practice Parameter for the Assessment and Treatment of Children and Adolescents with Obsessive-Compulsive Disorder

    Science.gov (United States)

    Journal of the American Academy of Child & Adolescent Psychiatry, 2012

    2012-01-01

    Research in etiology, neurobiology, genetics, clinical correlates, and evidence-based treatments in children and adolescents with obsessive-compulsive disorder indicate a need for the revision of the Practice Parameters for the Assessment and Treatment of Children and Adolescents with Obsessive-Compulsive Disorder first published a decade ago. The…

  20. Predicting Sex Offender Institutional Adjustment and Treatment Compliance Using the Personality Assessment Inventory

    Science.gov (United States)

    Caperton, Jennifer D.; Edens, John F.; Johnson, Judy K.

    2004-01-01

    This study examined the utility of the Personality Assessment Inventory (PAI) to identify prison inmates in a mandatory sex offender treatment program prone to engage in institutional misconduct. Archival PAI and institutional disciplinary data were coded for 137 inmates in treatment for an average of 1.59 years. The Antisocial Features scale…

  1. Assessing understandings of substance use disorders among Norwegian treatment professionals, patients and the general public

    OpenAIRE

    Vederhus, John-Kåre; Clausen, Thomas; Humphreys, Keith

    2016-01-01

    Background Beliefs about substance use disorder (SUD) shape how patients, treatment professionals and the general public view addiction and its treatment. A U.S. developed scale exists to assess such beliefs, but it has never been tested in Norway nor normed on any general population sample. Methods The Short Understanding of Substance Abuse Scale (SUSS) was translated from English to Norwegian and us...

  2. Recent Developments in the Assessment and Treatment of Pediatric Obsessive-Compulsive Disorder

    Science.gov (United States)

    Berman, Noah C.; Abramowitz, Jonathan S.

    2010-01-01

    Although tremendous strides have recently been made in the development of assessment and treatment methods for pediatric obsessive-compulsive disorder (OCD), more accurate methods for diagnosis, more effective treatments, and more refined instruments for monitoring progress during therapy are still needed. The present commentary highlights the…

  3. Adults with Attention-Deficit/ Hyperactivity Disorder: Assessment and Treatment Strategies

    Science.gov (United States)

    Wadsworth, John S.; Harper, Dennis C.

    2007-01-01

    Attention-deficit/hyperactivity disorder (ADHD) among adults is characterized by inattentiveness and impulsivity. This article provides counselors with information about the etiology, assessment, and treatment of adult ADHD. The identification of the genetic and neurological features of ADHD has led to improvements in evaluation and treatment.…

  4. Assessing treatment motivation among patients receiving antiretroviral therapy: A multidimensional approach

    OpenAIRE

    Houston, Eric; McKirnan, David J.; Cervone, Daniel; Matthew S. Johnson; Sandfort, Theo G. M.

    2011-01-01

    Using multidimensional scaling analysis (MDS), this study examined how patient conceptualisations of treatment motivation compare with theoretically-based assumptions used in current assessment approaches. Patients undergoing antiretroviral therapy for HIV/AIDS (n = 39) rated for similarity all possible pairings of 23 treatment descriptions, including descriptors of intrinsic, extrinsic, approach, and avoidance motivation. MDS analyses revealed that patient perceptions of intrinsic and extrin...

  5. Development and Use of an Eating Disorder Assessment and Treatment Protocol

    Science.gov (United States)

    Huebner, Lois A.; Weitzman, Lauren M.; Mountain, Lisa M.; Nelson, Kris L.; Oakley, Danielle R.; Smith, Michael L.

    2006-01-01

    Counseling centers have been challenged to effectively treat the growing number of college students who struggle with disordered eating. In response to this critical issue, an Eating Disorder Assessment and Treatment Protocol (EDATP) was developed to assist clinical disposition in the counseling center setting and identify treatment guidelines…

  6. Safety assessments for centralized waste treatment and disposal facility in Puspokszilagy Hungary

    International Nuclear Information System (INIS)

    The centralized waste treatment and disposal facility Puspokszilagy is a shallow land, near surface engineered type disposal unit. The site, together with its geographic, geological and hydrogeological characteristics, is described. Data are given on the radioactive inventory. The operational safety assessment and the post-closure safety assessment is outlined. (author)

  7. Cross-Cultural Adaptations of the MacArthur Competence Assessment Tool for Treatment in Iran

    OpenAIRE

    Saber; Tabatabaei; Akasheh; Sehat; Zanjani; Larijani

    2016-01-01

    Background According to general ethical and legal principles, valid consent must be obtained before starting any procedure. Objectives Due to the lack of a standard tool for assessing patients’ capacity to consent to medical treatment in Iran, the present study was carried out aiming to devise a Persian version of a cross-cultural adaptation of the MacArthur competence assessment tool. Patients...

  8. Pain Management in Intellectually Disabled Children: Assessment, Treatment, and Translational Research

    Science.gov (United States)

    Valkenburg, Abraham J.; van Dijk, Monique; de Klein, Annelies; van den Anker, Johannes N.; Tibboel, Dick

    2010-01-01

    The primary focus of pain research in intellectually disabled individuals is still on pain assessment. Several observational pain assessment scales are available, each with its own characteristics, its own target group and its own validated use. Observational studies report differences in the treatment of intra- and postoperative pain of…

  9. The Relationship between Functional Assessment and Treatment Selection for Aggressive Behaviors.

    Science.gov (United States)

    Hile, Matthew G.; Desrochers, Marcie N.

    1993-01-01

    This paper reviews the literature on functional assessment in the behavioral treatment of aggression in persons with mental retardation or developmental delays. Increased use of functional assessment and skill training is noted but no concomitant decrease in the use of intrusive procedures. (Author/DB)

  10. Project ADAPT: A Program to Assess Depression and Provide Proactive Treatment in Rural Areas

    Science.gov (United States)

    Luptak, Marilyn; Kaas, Merrie J.; Artz, Margaret; McCarthy, Teresa

    2008-01-01

    Purpose: We describe and evaluate a project designed to pilot test an evidence-based clinical intervention for assessing and treating depression in older adults in rural primary care clinics. Project ADAPT--Assuring Depression Assessment and Proactive Treatment--utilized existing primary care resources to overcome barriers to sustainability…

  11. Definition, assessment and treatment of wheezing disorders in preschool children

    DEFF Research Database (Denmark)

    Brand, P L P; Baraldi, E; Bisgaard, H;

    2008-01-01

    There is poor agreement on definitions of different phenotypes of preschool wheezing disorders. The present Task Force proposes to use the terms episodic (viral) wheeze to describe children who wheeze intermittently and are well between episodes, and multiple-trigger wheeze for children who wheeze...... both during and outside discrete episodes. Investigations are only needed when in doubt about the diagnosis. Based on the limited evidence available, inhaled short-acting beta(2)-agonists by metered-dose inhaler/spacer combination are recommended for symptomatic relief. Educating parents regarding...... preschool child with recurrent wheeze, but should be discontinued if there is no clear clinical benefit. Large well-designed randomised controlled trials with clear descriptions of patients are needed to improve the present recommendations on the treatment of these common syndromes....

  12. Assessment of rehabilitation needs in colorectal cancer treatment

    DEFF Research Database (Denmark)

    Wiedenbein, Liza; Kristiansen, Maria; Adamsen, Lis;

    2016-01-01

    clinical practices related to identification and documentation of rehabilitation needs among patients with colorectal cancer at Danish hospitals. Material and methods A retrospective clinical audit was conducted utilizing data from patient files randomly selected at surgical and oncology hospital...... departments treating colorectal cancer patients. Forty patients were included, 10 from each department. Semi-structured interviews were carried out among clinical nurse specialists. Audit data was analyzed using descriptive statistics, qualitative data using thematic analysis. Results Documentation of...... physical, psychological and social rehabilitation needs initially and at end of treatment was evident in 10% (n = 2) of surgical patient trajectories and 35% (n = 7) of oncology trajectories. Physical rehabilitation needs were documented among 90% (n = 36) of all patients. Referral to municipal...

  13. Reliability assessment and correlation analysis of evaluating orthodontic treatment outcome in Chinese patients

    OpenAIRE

    Song, Guang-Ying; Zhao, Zhi-He; Ding, Yin; Bai, Yu-Xing; Lin WANG; He, Hong; Shen, Gang; Li, Wei-Ran; Baumrind, Sheldon; Geng, Zhi; XU, TIAN-MIN

    2013-01-01

    This study aimed to assess the reliability of experienced Chinese orthodontists in evaluating treatment outcome and to determine the correlations between three diagnostic information sources. Sixty-nine experienced Chinese orthodontic specialists each evaluated the outcome of orthodontic treatment of 108 Chinese patients. Three different information sources: study casts (SC), lateral cephalometric X-ray images (LX) and facial photographs (PH) were generated at the end of treatment for 108 pat...

  14. Assessing the sustainability of wastewater treatment technologies in the petrochemical industry

    OpenAIRE

    Meerholz, A.; A C Brent, A. C.

    2013-01-01

    Selecting the most suitable industrial wastewater treatment technology is not only about providing the best technical solution at the lowest cost: it is also about sustainability (including social and environmental acceptance) and institutional feasibility. This paper demonstrates and evaluates a method that may be used for wastewater treatment technology assessment and selection in an industrial context, with a specific focus on biological wastewater treatment in a petrochemical company. The...

  15. Assessment of heat treatment of various types of milk.

    Science.gov (United States)

    Sakkas, Lambros; Moutafi, Alexandra; Moschopoulou, Ekaterini; Moatsou, Golfo

    2014-09-15

    Raw milk (RM), reconstituted condensed milk (CM) and three types of reconstituted milk powders (SMPs) were heated indirectly at 80-140°C for 4 s. Native β-lactoglobulin after 90°C treatment of RM was 1132±167 mg/L but no reliable quantities were estimated at temperatures >100°C, whereas 218±43 mg/L residual α-lactalbumin were found at 130°C. Average lactulose contents from 51 to 1549 mg/L were detected at ⩾100°C; average furosine was 1.9 and 126.5 mg/L in raw and 140°C treated milks respectively. The behaviour of heated CM was similar to that of heated RM except for higher furosine concentration. Reconstituted SMPs contained high quantities of lactulose and furosine, the ratio of which was lower than in similarly treated RM. Among the market milks analysed, the group of high-pasteurised milks was highly variable; i.e. native β-lactoglobulin was 69-2831 mg/L, lactulose 0-824 mg/L and furosine 3.3-68.8 mg/L. PMID:24767058

  16. Cancer treatment-related cardiac toxicity: prevention, assessment and management.

    Science.gov (United States)

    Fanous, Ibrahim; Dillon, Patrick

    2016-08-01

    Cancer therapies, especially anthracyclines and monoclonal antibodies, have been linked with increased rates of cardiotoxicity. The development of some cardiac side effects happens over several months, and changes in ejection fraction can be detected long before permanent damage or disability occurs. Advanced heart failure could be averted with better and earlier detection. Methodologies for early detection of cardiac changes include stress echocardiograms, cardiac velocity measurements, radionuclide imaging, cardiac MRI and several potential biomarkers. Many agents have been described for prophylaxis of cardiac events precipitated by cancer therapy. Prophylactic use of beta-blockers and ACE inhibitors may be considered for use with trastuzumab in breast cancer as tolerated. Recovery of cardiac function is possible early after the injury from a cancer therapy. Late complications for coronary artery disease, hypertension and arrhythmia are underappreciated. Treatments for severe cancer therapy-related cardiac complications follow the existing paradigms for congestive heart failure and coronary artery disease, although outcomes for cancer patients differ from outcomes for non-cancer patients. PMID:27372782

  17. Comparative assessment of the treatment of type 2 Diabetes Mellitus

    International Nuclear Information System (INIS)

    The objective of the study was to estimate the most successful way of treating patients with type 2 diabetes mellitus. A total of 87 patients with type 2 diabetes mellitus were selected for a three-month study. The patients were divided into three groups comprising 29 patients in each group, based upon the treatment regimen. Group 1 (BMI 32.3+-3.6 kg/m2) was treated with glimepiride and metformin; group 2 (BMI 27.9+-3.9) was treated with daily doses of insulin mixture 30/70 and bed-time NPH insulin; and group 3 (BMI 30.02+-4.8) was treated with a combination of three daily doses of lispo and metformin.The groups did not differ significantly in terms of sex and age. Initially, there were significant statistical differences in HbA1c (P=0.035) between the three groups (9, 21%+-1.72%; 9.21%+-1.54%; and 10, 0%+-1.73% respectively). After three months there were no statistically differences in HbA1c (P=0.66) between the groups (8.52+-1.7%; 8.03%+-1.05%; and 8.0%+-0.63%, respectively. Decreases in HbA1c were significant in all groups, but most pronounced in patients treated with lispro and metaformin (17% on average). The study results suggest the need for establishing guidelines on how to treat type 2 diabetics. (author)

  18. Endovascular and Surgical Treatment of Spinal Dural Arteriovenous Fistulas: Assessment of Post-treatment Clinical Outcome

    Science.gov (United States)

    ZOGOPOULOS, Panagiotis; NAKAMURA, Hajime; OZAKI, Tomohiko; ASAI, Katsunori; IMA, Hiroyuki; KIDANI, Tomoki; KADONO, Yoshinori; MURAKAMI, Tomoaki; FUJINAKA, Toshiyuki; YOSHIMINE, Toshiki

    2016-01-01

    Spinal dural arteriovenous fistulas (DAVFs) are the most commonly encountered vascular malformation of the spinal cord and a treatable cause of progressive para- or tetraplegia. It is an elusive pathology that tends to be under-diagnosed, due to lack of awareness among clinicians, and affects males more commonly than females, typically between the fifth and eighth decades. Early diagnosis and treatment may significantly improve outcome and prevent permanent disability and even mortality. The purpose of our retrospective, single-center study was to determine the long-term clinical and radiographic outcome of patients who have received endovascular or surgical treatment of a spinal DAVF. In particular, during a 6-year period (2009–2014) 14 patients with a spinal DAVF were treated at our department either surgically (n = 4) or endovascularly (n = 10) with detachable coils and/or glue. There was no recurrence in the follow-up period (mean: 36 months, range 3–60 months) after complete occlusion with the endovascular treatment (n = 9; 90%), while only one patient (10%) had residual flow both post-treatment and at 3-month follow-up. All four surgically treated patients (100%) had no signs of residual DAVF on follow-up magnetic resonance angiography (MRA) and/or angiography (mean follow-up period of 9 months). Since improvement or stabilization of symptoms may be seen even in patients with delayed diagnosis and substantial neurological deficits, either endovascular or surgical treatment is always justified. PMID:26466887

  19. Functional assessment and treatment of aggressive and destructive behaviors in a child victim of physical abuse.

    Science.gov (United States)

    Luiselli, J K

    1996-03-01

    This case study describes the functional assessment and treatment of aggressive and destructive behaviors in a 14-year-old male child with a history of physical abuse. Evaluation was performed in a classroom within a residential school setting. Functional assessment in forms of indirect and descriptive methods was used to generate hypotheses regarding sources of behavioral control. A treatment plan that combined multi-level differential reinforcement of other behavior (DRO) and positive reinforcement for task completion was implemented based on the outcome of functional assessment. Treatment was associated with a gradual and steady reduction in challenging behaviors with near-zero rates achieved at follow-up. This case provides an example of clinical intervention for behavior disorders commonly observed in children who have been abused physically and a hypothesis-driven model of treatment formulation. PMID:8814520

  20. Water treatment plants assessment at Talkha power plant.

    Science.gov (United States)

    El-Sebaie, Olfat D; Abd El-Kerim, Ghazy E; Ramadan, Mohamed H; Abd El-Atey, Magda M; Taha, Sahr Ahmed

    2002-01-01

    Talkha power plant is the only power plant located in El-Mansoura. It generates electricity using two different methods by steam turbine and gas turbine. Both plants drew water from River Nile (208 m3 /h). The Nile raw water passes through different treatment processes to be suitable for drinking and operational uses. At Talkha power plant, there are two purification plants used for drinking water supply (100 m3/h) and for water demineralization supply (108 m3/h). This study aimed at studying the efficiency of the water purification plants. For drinking water purification plant, the annual River Nile water characterized by slightly alkaline pH (7.4-8), high annual mean values of turbidity (10.06 NTU), Standard Plate Count (SPC) (313.3 CFU/1 ml), total coliform (2717/100 ml), fecal coliform (0-2400/100 ml), and total algae (3 x 10(4) org/I). The dominant group of algae all over the study period was green algae. The blue green algae was abundant in Summer and Autumn seasons. The pH range, and the annual mean values of turbidity, TDS, total hardness, sulfates, chlorides, nitrates, nitrites, fluoride, and residual chlorine for purified water were in compliance with Egyptian drinking water standards. All the SPC recorded values with an annual mean value of 10.13 CFU/1 ml indicated that chlorine dose and contact time were not enough to kill the bacteria. However, they were in compliance with Egyptian decree (should not exceed 50 CFU/1 ml). Although the removal efficiency of the plant for total coliform and blue green algae was high (98.5% and 99.2%, respectively), the limits of the obtained results with an annual mean values of 40/100 ml and 15.6 org/l were not in compliance with the Egyptian decree (should be free from total coliform, fecal coliform and blue green algae). For water demineralization treatment plant, the raw water was characterized by slightly alkaline pH. The annual mean values of conductivity, turbidity, and TDS were 354.6 microS/cm, 10.84 NTU, and 214

  1. Exposure assessment of residents living near a wood treatment plant

    International Nuclear Information System (INIS)

    We report the results of environmental sampling and modeling in a neighborhood adjacent to a wood processing plant. This plant used creosote and pentachlorophenol (PCP) to treat wood for over 70 years. Between 1999 and 2001, environmental samples were obtained to quantify the level of environmental contamination from the wood processing plant. Blood from 10 residents was measured for chlorinated dioxins and dibenzofurans. Soil sediment samples from drainage ditches and attic/dust samples from nearby residents' homes were tested for polychlorinated dioxins, furans, and polycyclic aromatic hydrocarbons (PAH). The dioxin congeners analysis of the 10 residents revealed elevated valued for octachlorodibenzo-p-dioxin and heptachlorodibenzo-p-dioxin compatible with PCP as the source. The levels of carcinogenic PAHs were higher than background levels and were similar to soil contamination on wood preserving sites. Wipe sampling in the kitchens of 11 homes revealed that 20 of the 33 samples were positive for octachlorinated dioxins with a mean value of 10.27 ng/m2. The soil, ditch samples, and positive wipe samples from the homes indicate a possible ongoing route of exposure to the contaminants in the homes of these residents. Modeled air exposure estimated for the wood processing waste chemicals indicate some air exposure to combustion products. The estimated air levels for benzo(a)pyrene and tetrachlorodibenzodiozin in this neighborhood exceeded the recommended levels for these compounds in some states. The quantitative data presented suggest a significant contamination of a neighborhood by wood processing waste chemicals. These findings suggest the need for more stringent regulations on waste discharges from wood treatment plants

  2. Comparative assessment of water treatment using polymeric and inorganic coagulants

    Science.gov (United States)

    Manda, Innocent K. M.; Chidya, Russel C. G.; Saka, John D. K.; Biswick, Timothy T.

    2016-06-01

    Portable water plays a vital role in improving human life, particularly in controlling the spread of diseases. However, problems associated with lack of potable water are still common especially in developing countries including Malawi. Until now little information exists on the effectiveness of available commercial coagulants used by national water boards in Malawi. Therefore, this study was undertaken in Southern Region Water Board (SRWB) to investigate the efficiency of polymeric coagulants (sufdfloc 3850 and algaefloc 19s) in turbidity reduction comparative with inorganic coagulant (aluminium sulphate) at Zomba, Liwonde, Mangochi, Chikwawa and Mulanje Treatment plants. The jar test method was used to determine the effectiveness of the water coagulants. The results revealed that sudfloc 3850 was most effective in reducing turbidity at Mangochi (99.4 ± 0.06%) and Liwonde (97.2 ± 0.04%) using 0.4 mg L-1 flocculant dose. The Zomba, Mulanje and Chikwawa plants gave 19.56 ± 0.03%, 29.23 ± 0.02% and 9.43 ± 0.02% total reductions respectively. Algaefloc 19s afforded the highest turbidity reduction at Liwonde and Mangochi plants (98.66 ± 0.06 and 97.48 ± 0.05% at a dose of 0.4 and 0.6 mg L-1 respectively), while Chikwawa provided the lowest (9.52 ± 0.01%). At the Zomba and Mulanje plants 20.5 ± 0.03% and 28.4 ± 0.04% reductions were obtained respectively. The inorganic flocculant, alum provided a 99.0 ± 0.05% and 98.6 ± 0.04% reduction at a dose of 4.0 mg L-1 and 6.0 mg L-1 at Zomba and Liwonde plants respectively. The lowest reductions in turbidity were achieved at Chikwawa (7.50 ± 0.01%), Mangochi (12.97 ± 0.02%) and Mulanje (25.00 ± 0.02). The best and optimum pH ranges for polymeric and inorganic coagulants were 7.20-7.80 and 7.35 to 7.57 respectively. The results further revealed that sudfloc 3850 and algaefloc 19s achieved faster formation of heavy flocs than alum. At 0.4 mg L-1 flocculant dosage sudfloc 3850 and algaefloc 19s required ten times

  3. Dealing with ceiling baseline treatment satisfaction level in patients with diabetes under flexible, functional insulin treatment: assessment of improvements in treatment satisfaction with a new insulin analogue.

    Science.gov (United States)

    Howorka, K; Pumprla, J; Schlusche, C; Wagner-Nosiska, D; Schabmann, A; Bradley, C

    2000-01-01

    Even a small improvement in satisfaction with treatment for a chronic disease can be valuable. However, sensitive measurements instruments are needed to assess the effects of treatment changes in patients already well satisfied with baseline treatment. Such instruments were thought to be necessary to deal with ceiling effects in scores of satisfaction with functional insulin treatment (FIT) accommodating full flexibility of food intake and lifestyle in diabetes by manipulation of insulin (FIT; Howorka et al. 2000). The Status(S) version of the Diabetes Treatment Satisfaction Questionnaire (DTSQ, Bradley 1994) was extended with items measuring specific components of FIT and its psychometric properties investigated in a validation study with 171 FIT patients with diabetes. A new Change(C) version of DTSQ extended for FIT was used together with the DTSQ(S) by 52 participants in a subsequent randomised cross-over study involving new fast-acting lispro vs. regular insulin, where treatment satisfaction was the primary outcome variable. Insulin lispro use improved satisfaction (p satisfaction. However, the DTSQ(C) augmented the effects of lispro (p = 0.0001) apparent on DTSQ(S) scores and revealed significant treatment effects (p satisfaction with treatment was more apparent with DTSQ(C) than DTSQ(S) in patients who at baseline were at or near ceiling for treatment satisfaction. PMID:11284211

  4. Magnetic resonance imaging in assessment of treatment response of gamma knife for brain tumors

    Institute of Scientific and Technical Information of China (English)

    GAO Xiao; ZHANG Xue-ning; ZHANG Yun-ting; YU Chun-shui; XU De-sheng

    2011-01-01

    Objective To review the applications of magnetic resonance imaging (MRI) techniques in assessing treatment response to gamma knife radiosurgery for brain tumors.Data sources Published articles about assessing treatment response to gamma knife radiosurgery for brain tumors were selected using PubMed. The search terms were "MRI", "gamma knife" and "brain tumors".Study selection Articles regarding the MRI techniques using for early assessment of treatment response of gamma knife were selected.Results MRI techniques, especially diffusion weighted imaging, perfusion weighted imaging, magnetic resonance spectroscopy, are useful for early assessment of treatment response of gamma knife by detecting the hemodynamic, metabolic, and cellular alterations. Moreover, they can also provide important information on prognosis.Conclusions Diffusion weighted imaging, perfusion weighted imaging and magnetic resonance spectroscopy can provide early assessment of treatment response of gamma knife for brain tumors, and also information of tumor progression or recurrence earlier than conventional MRI. But there are still many questions to be answered which should be based on the development and advancement of MRI and related disciplines.

  5. Treatment of biodiversity issues in impact assessment of electricity power transmission lines: A Finnish case review

    International Nuclear Information System (INIS)

    The Environmental Impact Assessment (EIA) process concerning the route of a 400 kV power transmission line between Loviisa and Hikiae in southern Finland was reviewed in order to assess how biodiversity issues are treated and to provide suggestions on how to improve the effectiveness of treatment of biodiversity issues in impact assessment of linear development projects. The review covered the whole assessment process, including interviews of stakeholders, participation in the interest group meetings and review of all documents from the project. The baseline studies and assessment of direct impacts in the case study were detailed but the documentation, both the assessment programme and the assessment report, only gave a partial picture of the assessment process. All existing information, baseline survey and assessment methods should be addressed in the scoping phase in order to promote interaction between all stakeholders. In contrast to the assessment of the direct effects, which first emphasized impacts on the nationally important and protected flying squirrel but later expanded to deal with the assessment of impacts on ecologically important sites, the indirect and cumulative impacts of the power line were poorly addressed. The public was given the opportunity to become involved in the EIA process. However, they were more concerned with impacts on their properties and less so on biodiversity and species protection issues. This suggests that the public needs to become more informed about locally important features of biodiversity

  6. Assessing the energy and environmental performance of algae-mediated tertiary treatment of estrogenic compounds.

    Science.gov (United States)

    Colosi, Lisa M; Resurreccion, Eleazer P; Zhang, Yongli

    2015-02-01

    This study uses a systems-level modeling approach to illustrate a novel synergy between municipal wastewater treatment and large-scale algaculture for production of bio-energy, whereby algae-mediated tertiary treatment provides efficient removal of unregulated, strongly estrogenic steroid hormones from the secondary effluent. Laboratory results from previously published studies suggested that algae-mediated treatment could deliver roughly 75-85% removal of a model estrogen (17β-estradiol) within typical algae pond residence times. As such, experimental results are integrated into a comprehensive life cycle assessment (LCA) framework, to assess the environmental performance of an algae-based tertiary treatment system relative to three conventional tertiary treatments: ozonation, UV irradiation, and adsorption onto granular activated carbon. Results indicate that the algae-mediated tertiary treatment is superior to the selected benchmarks on the basis of raw energy return on investment (EROI) and normalized energy use per mass of estrogenic toxicity removed. It is the only tertiary treatment system that creates more energy than it consumes, and it delivers acceptable effluent quality for nutrient and coliform concentrations while rendering a significant reduction in estrogenic toxicity. These results highlight the dual water and energy sustainability benefits that accrue from the integration of municipal wastewater treatment and large-scale algae farming. PMID:25537081

  7. New Methodology in Life Cycle Impact Assessment (LCIA) of waste water treatment

    DEFF Research Database (Denmark)

    Larsen, Henrik Fred; Wenzel, Henrik; Hauschild, Michael

    EU research project "NEPTUNE" focusing on nutrient recycling, micro-pollutants and ecotoxicity removal, energy production, and reuse of sludge and of its resources, this paper will present the first results of the development of a new methodology for assessing advances in wastewater treatment...... including the environmental significance of micro-pollutants. The methodology is building on scientific state-of-the-art LCA complemented with aspects of specific relevance to assessing wastewater treatment like site-dependency. Special focus will be on the inclusion of impacts from micro-pollutants showing...

  8. Life-Cycle Assessment of Advanced Nutrient Removal Technologies for Wastewater Treatment.

    Science.gov (United States)

    Rahman, Sheikh M; Eckelman, Matthew J; Onnis-Hayden, Annalisa; Gu, April Z

    2016-03-15

    Advanced nutrient removal processes, while improving the water quality of the receiving water body, can also produce indirect environmental and health impacts associated with increases in usage of energy, chemicals, and other material resources. The present study evaluated three levels of treatment for nutrient removal (N and P) using 27 representative treatment process configurations. Impacts were assessed across multiple environmental and health impacts using life-cycle assessment (LCA) following the Tool for the Reduction and Assessment of Chemical and Other Environmental Impacts (TRACI) impact-assessment method. Results show that advanced technologies that achieve high-level nutrient removal significantly decreased local eutrophication potential, while chemicals and electricity use for these advanced treatments, particularly multistage enhanced tertiary processes and reverse osmosis, simultaneously increased eutrophication indirectly and contributed to other potential environmental and health impacts including human and ecotoxicity, global warming potential, ozone depletion, and acidification. Average eutrophication potential can be reduced by about 70% when Level 2 (TN = 3 mg/L; TP = 0.1 mg/L) treatments are employed instead of Level 1 (TN = 8 mg/L; TP = 1 mg/L), but the implementation of more advanced tertiary processes for Level 3 (TN = 1 mg/L; TP = 0.01 mg/L) treatment may only lead to an additional 15% net reduction in life-cycle eutrophication potential. PMID:26871301

  9. Adoption of practice guidelines and assessment tools in substance abuse treatment

    OpenAIRE

    McCarty Dennis; Saedi Goal; Fuller Bret E; Rieckmann Traci

    2010-01-01

    Abstract Background The gap between research and practice limits utilization of relevant, progressive and empirically validated strategies in substance abuse treatment. Methods Participants included substance abuse treatment programs from the Northeastern United States. Structural equation models were constructed with agency level data to explore two outcome variables: adoption of practice guidelines and assessment tools at two points in time; models also included organizational, staffing and...

  10. The world is a scary place? INvestigating Treatments and Assessment for Children after Trauma

    OpenAIRE

    Diehle, J.

    2014-01-01

    This dissertation provides new insights about treatments and assessment for children who experienced traumatic events. We investigated the comparative effectiveness of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) and Eye Movement Desensitization and Reprocessing (EMDR) by means of a randomized controlled trial (RCT). The results of this trial suggest that both treatments are effective and efficient. We did not find statistically significant between-group differences. The preparation o...

  11. Texas Christian University (TCU) Short Forms for Assessing Client Needs and Functioning in Addiction Treatment

    OpenAIRE

    SIMPSON, D. DWAYNE; Joe, George W.; KNIGHT, KEVIN; Rowan-Szal, Grace A.; GRAY, JULIE S.

    2012-01-01

    The TCU Short Forms contain a revised and expanded set of assessments for planning and managing addiction treatment services. They are formatted as brief (1-page) forms to measure client needs and functioning, including drug use severity and history (TCUDS II), criminal thinking and cognitive orientation (CTSForm), motivation and readiness for treatment (MOTForm), psychological functioning (PSYForm), social relations and functioning (SOCForm), and therapeutic participation and engagement (ENG...

  12. Fuzzy logic based risk assessment of effluents from waste-water treatment plants

    OpenAIRE

    Cabanillas, Julián; Ginebreda, Antoni; Guillén, Daniel; Martínez, Elena; Barceló, Damià; Moragas, Lucas; Robusté, Jordi; Darbra Roman, Rosa Maria

    2012-01-01

    This paper presents a new methodology to assess the risk of water effluents from waste-water treatment plants (WWTPs) based on fuzzy logic, a well-known theory to deal with uncertainty, especially in the environmental field where data are often lacking. The method has been tested using the effluent's pollution data coming from 22 waste-water treatment plants (WWTPs) located in Catalonia (NE Spain). Thirty-eight pollutants were analyzed along three campaigns performed yearly from 2008 to 2010....

  13. Incremental Validity of Neuropsychological Assessment in the Identification and Treatment of Youth with ADHD

    OpenAIRE

    PRITCHARD, ALISON E; Koriakin, Taylor; Jacobson, Lisa A.; MAHONE, E MARK

    2013-01-01

    Comprehensive neuropsychological assessments for youth with ADHD allow for thorough consideration of co-occurring disorders and provide targeted recommendations for treating ADHD and comorbid conditions. This study offers a preliminary evaluation of the added value (compared to routine care) associated with neuropsychological assessment in the identification and treatment of ADHD in youth ages 3-17 years. First, we describe a novel measure developed to evaluate broad-based outcomes for youth ...

  14. Pig manure treatment with housefly (Musca domestica) rearing – an environmental life cycle assessment

    OpenAIRE

    Roffeis, M.; Muys, B.; Almeida, J.; MATHIJS, E; Achten, W.M.J; Pastor Monllor, Berta; Velásquez Zambrano, Yelitza; Martínez Sánchez, Ana Isabel; Rojo Velasco, Santos

    2015-01-01

    The largest portion of a product’s environmental impacts and costs of manufacturing and use results from decisions taken in the conceptual design phase long before its market entry. To foster sustainable production patterns, applying life cycle assessment in the early product development stage is gaining importance. Following recent scientific studies on using dipteran fly species for waste management, this paper presents an assessment of two insect-based manure treatment systems. Considering...

  15. Technological advances in psychotherapy: implications for the assessment and treatment of obsessive compulsive disorder.

    Science.gov (United States)

    Lind, Christian; Boschen, Mark J; Morrissey, Shirley

    2013-01-01

    Obsessive compulsive disorder (OCD) is a prevalent and costly condition that causes significant functional impairment and reduced quality of life. Although treatments with demonstrated efficacy for OCD, such as cognitive behavior therapy and antidepressants, have existed for over three decades, many patients remain inadequately treated or untreated. Challenges encountered in the treatment of OCD include problems with homework compliance, frequent relapse, difficulties in simulating the spontaneous nature of intrusive thoughts, and infrequent treatment sessions. Accumulated research now indicates that computerized assessment and therapy tools can significantly improve the cost/time-effectiveness of conventional psychotherapeutic interventions for anxiety disorders such as OCD without impairing therapeutic progress and outcome. In this paper we examine the potential of such technology, address current challenges in the assessment and treatment of OCD, and provide a rationale for future research in the field. We outline the general utility of computer technology in psychotherapeutic interventions, critically evaluate the existing literature on computer-assisted assessment and treatment specific to OCD, as well as discuss potential implications of portable technology for OCD treatment delivery and outcomes. PMID:23247201

  16. Proposal of an environmental performance index to assess solid waste treatment technologies

    International Nuclear Information System (INIS)

    Highlights: ► Proposal of a new concept in waste management: Cleaner Treatment. ► Development of an index to assess quantitatively waste treatment technologies. ► Delphi Method was carried out so as to define environmental indicators. ► Environmental performance evaluation of waste-to-energy plants. - Abstract: Although the concern with sustainable development and environment protection has considerably grown in the last years it is noted that the majority of decision making models and tools are still either excessively tied to economic aspects or geared to the production process. Moreover, existing models focus on the priority steps of solid waste management, beyond waste energy recovery and disposal. So, in order to help the lack of models and tools aiming at the waste treatment and final disposal, a new concept is proposed: the Cleaner Treatment, which is based on the Cleaner Production principles. This paper focuses on the development and validation of the Cleaner Treatment Index (CTI), to assess environmental performance of waste treatment technologies based on the Cleaner Treatment concept. The index is formed by aggregation (summation or product) of several indicators that consists in operational parameters. The weights of the indicator were established by Delphi Method and Brazilian Environmental Laws. In addition, sensitivity analyses were carried out comparing both aggregation methods. Finally, index validation was carried out by applying the CTI to 10 waste-to-energy plants data. From sensitivity analysis and validation results it is possible to infer that summation model is the most suitable aggregation method. For summation method, CTI results were superior to 0.5 (in a scale from 0 to 1) for most facilities evaluated. So, this study demonstrates that CTI is a simple and robust tool to assess and compare the environmental performance of different treatment plants being an excellent quantitative tool to support Cleaner Treatment implementation.

  17. ASSESSMENT OF TREATMENT OUTCOME OF TUBERCULOSIS PATIENTS UNDER REVISED NATIONAL TUBERCULOSIS CONTROL PROGRAMME IN NANDED, MAHARASHTRA

    Directory of Open Access Journals (Sweden)

    Varthi Mahendra

    2014-02-01

    Full Text Available INTRODUCTION: Tuberculosis (TB remains a world-wide public health problem despite the fact that the causative organism was discovered more than 100 years ago and highly effective drugs and vaccine are available making TB a preventable and curable disease. OBJECTIVE: To assess the treatment outcome of tuberculosis patients under Revised National Tuberculosis control Programme. MATERIAL AND METHODS: The present record based study was conducted during July 2013-September 2013. The treatment outcome of all tuberculosis patients were assessed from the RNTCP treatment cards that were on DOTS during 1st Jan 2011 to 30th June 2012 at City Tuberculosis Center, Nanded-Waghala Municipal Corporation, Jangamwadi, Nanded. Before starting the study, the ethical approval was obtained from the Institutional Ethics Committee of the college. The data was directly entered on the Microsoft Excel regarding epidemiological variables and outcome of tuberculosis patients. The data was tabulated and analyzed by using statistical software Open Epi Version 2.3 by maintaining confidentiality. RESULTS: Thus we had included 442 TB patients. The findings of treatment outcome of TB patients were Cured 104 (23.53%, treatment completed 289 (65.38%, defaulters 20 (4.52%, treatment failures 1 (0.23%, deaths 25 (5.66% and transferred out 3 (0.68%. CONCLUSION: Our study showed the treatment outcome rates as per the expected norms RNTCP.

  18. Efficacy assessment of local doxycycline treatment in periodontal patients using multivariate chemometric approach.

    Science.gov (United States)

    Bogdanovska, Liljana; Poceva Panovska, Ana; Nakov, Natalija; Zafirova, Marija; Popovska, Mirjana; Dimitrovska, Aneta; Petkovska, Rumenka

    2016-08-25

    The aim of our study was application of chemometric algorithms for multivariate data analysis in efficacy assessment of the local periodontal treatment with doxycycline (DOX). Treatment efficacy was evaluated by monitoring inflammatory biomarkers in gingival crevicular fluid (GCF) samples and clinical indices before and after the local treatment as well as by determination of DOX concentration in GCF after the local treatment. The experimental values from these determinations were submitted to several chemometric algorithms: principal component analysis (PCA), partial least square discriminant analysis (PLS-DA) and orthogonal projection to latent structures-discriminant analysis (OPLS-DA). The data structure and the mutual relations of the selected variables were thoroughly investigated by PCA. The PLS-DA model identified variables responsible for discrimination of classes of data, before and after DOX treatment. The OPLS-DA model compared the efficacy of the two commonly used medications in periodontal treatment, chlorhexidine (CHX) and DOX, at the same time providing insight in their mechanism of action. The obtained results indicate that application of multivariate chemometric algorithms can be used as a valuable approach for assessment of treatment efficacy. PMID:27283484

  19. Assessment of the efficacy and safety of a new treatment for head lice.

    Science.gov (United States)

    Mac-Mary, Sophie; Messikh, Rafat; Jeudy, Adeline; Lihoreau, Thomas; Sainthillier, Jean-Marie; Gabard, Bernard; Schneider, Catherine; Auderset, Philippe; Humbert, Philippe

    2012-01-01

    Infestation with head lice is a widespread, persistent, and recurring issue leading to serious health problems if untreated. We are facing resistance phenomena to usual pediculicides and questions about their direct or cumulative toxicity. The aim of this trial was to assess the efficacy of a new product, free of chemical insecticides but with a physical effect. This product contains components whose antilice efficacy has already been demonstrated, as well as Andiroba oil which asphyxiates the lice and Quassia vinegar which dissolves the chitin of the nits (they are then inactivated). 30 patients with head lice infestation, aged 3-39 years, applied the treatment one to three times, 5 days apart. Cure was defined as the absence of live lice after 5, 10, or 14 days, and symptoms are usually associated with infestation. Easiness and safety of the treatment were assessed by the patients and/or their parents. Overall cure rates were 20% on D5 after one treatment, 37% on D10 after two treatments, and 90% on D14 after three treatments. Symptoms such as itch, scalp dryness, redness, and flakiness rapidly diminished. This treatment seems to be a beneficial addition or a valuable alternative to existing treatments, considering the total absence of chemical insecticides, the absence of drug-resistance induction in head lice, the absence of major toxicological risks compared with usual pediculicides, and the favourable patient use instructions. PMID:23209928

  20. Issues and challenges in the assessment, diagnosis and treatment of cardiovascular risk factors: Assessing the needs of cardiologists

    Directory of Open Access Journals (Sweden)

    Dupuis Martin

    2008-05-01

    Full Text Available Abstract Background This needs assessment, initiated by the Academy for Healthcare Education Inc. in cooperation with AXDEV Group Inc., explored the knowledge, attitudes, behavior, and skills of community-based and academic-affiliated U.S. cardiologists in the area of CV risk assessment, treatment, and management from July 2006 to December 2006. Methods The needs assessment used a multistage, mixed-method approach to collect, analyze, and verify data from two independent sources. The exploratory phase collected data from a representative sampling of U.S. cardiologists by means of qualitative panel meetings, one-on-one interviews, and quantitative questionnaires. In the validation phase, 150 cardiologists from across the United States completed a quantitative online questionnaire. Data were analyzed with standardized statistical methods. Results The needs assessment found that cardiologists have areas of weakness pertaining to their interpersonal skills, which may influence patient-physician communication and patient adherence. Cardiologists appeared to have little familiarity with or lend little credence to the concept of relative CV risk. In daily clinical practice, they faced challenges with regard to optimal patient outcome in areas of patient referral from primary-care providers, CV risk assessment and treatment, and patient monitoring. Community-based and academic-affiliated cardiologists appeared to be only moderately interested in educational interventions that pertain to CV risk-reduction strategies. Conclusion Educational interventions that target cardiologists' interpersonal skills to enhance their efficacy may benefit community-based and academic-affiliated specialists. Other desirable educational initiatives should address gaps in the patient referral process, improve patient knowledge and understanding of their disease, and provide supportive educational tools and materials to enhance patient-physician communication.

  1. Joint Estimation of Treatment and Placebo Effects in Clinical Trials with Longitudinal Blinding Assessments

    Science.gov (United States)

    Liu, Wei; Zhang, Zhiwei; Schroeder, R. Jason; Ho, Martin; Zhang, Bo; Long, Cynthia; Zhang, Hui; Irony, Telba Z.

    2016-01-01

    In some therapeutic areas, treatment evaluation is frequently complicated by a possible placebo effect (i.e., the psychobiological effect of a patient’s knowledge or belief of being treated). When a substantial placebo effect is likely to exist, it is important to distinguish the treatment and placebo effects in quantifying the clinical benefit of a new treatment. These causal effects can be formally defined in a joint causal model that includes treatment (e.g., new versus placebo) and treatmentality (i.e., a patient’s belief or mentality about which treatment she or he has received) as separate exposures. Information about the treatmentality exposure can be obtained from blinding assessments, which are increasingly common in clinical trials where blinding success is in question. Assuming that treatmentality has a lagged effect and is measured at multiple time points, this article is concerned with joint evaluation of treatment and placebo effects in clinical trials with longitudinal follow-up, possibly with monotone missing data. We describe and discuss several methods adapted from the longitudinal causal inference literature, apply them to a weight loss study, and compare them in simulation experiments that mimic the weight loss study. PMID:27110045

  2. Assessment of feasibility of endovascular treatment of ruptured intracranial aneurysms with 16-detector row CT angiography

    NARCIS (Netherlands)

    M. van der Jagt (Mathieu); H.Z. Flach (Zwenneke); H.L.J. Tanghe (Hervé); S.L.M. Bakker (Stef); M.G.M. Hunink (Myriam); P.J. Koudstaal (Peter Jan); A. van der Lugt (Aad)

    2008-01-01

    textabstractBackground: It is unclear whether 16-detector row CT angiography (CTA) can replace digital subtraction angiography (DSA) to assess the feasibility of endovascular treatment (EVT) in the acute phase after aneurysmal subarachnoid hemorrhage. Methods: We studied 80 consecutive patients with

  3. Training Needs for Substance Abuse Treatment and Assessment among Rehabilitation Counselors: California State Project

    Science.gov (United States)

    Ong, Lee Za; Lee, Dal-Yob; Cha, Grace; Arokiasamy, Charles

    2008-01-01

    One hundred rehabilitation counselors in California reported that about 90% of consumers with whom they worked with had substance abuse and cooccurring issues, yet about half rated their graduate training in substance abuse treatment and assessment as poor and their practices as marginally proficient. The correlation analysis revealed that…

  4. Texas Christian University (TCU) Short Forms for Assessing Client Needs and Functioning in Addiction Treatment

    Science.gov (United States)

    Simpson, D. Dwayne; Joe, George W.; Knight, Kevin; Rowan-Szal, Grace A.; Gray, Julie S.

    2012-01-01

    The TCU Short Forms contain a revised and expanded set of assessments for planning and managing addiction treatment services. They are formatted as brief (one-page) forms to measure client needs and functioning, including drug use severity and history (TCUDS II), criminal thinking and cognitive orientation (CTSForm), motivation and readiness for…

  5. Effects of Flame Treatment on the Interfacial Energy of Polyethylene Assessed by Contact Mechanics

    NARCIS (Netherlands)

    Song, Jing; Vancso, G. Julius

    2008-01-01

    The effects of flame treatment of low-density polyethylene (LDPE) on the work of adhesion (W) and energy release rate (G) were assessed by a custom-built adhesion testing device (ATD). The contact area and the vertical displacement between planar LDPE films and PDMS lenses (untreated and UV/ozone tr

  6. Practice Parameter for the Assessment and Treatment of Children and Adolescents with Enuresis

    Science.gov (United States)

    Fritz, Gregory; Rockney, Randy

    2004-01-01

    Enuresis is a symptom that is frequently encountered in child psychiatric evaluations. Careful assessment is required to identify specific urologic, developmental, psychosocial, and sleep-related etiologies. For most children with enuresis, however, a specific etiology cannot be determined. Treatment then involves supportive approaches,…

  7. Summary of the Practice Parameter for the Assessment and Treatment of Children and Adolescents with Enuresis

    Science.gov (United States)

    Fritz, Gregory; Rockney, Randy

    2004-01-01

    Enuresis is a symptom that is frequently encountered in child psychiatric evaluations. Careful assessment is required to identify specific urologic, developmental, psychosocial, and sleep-related etiologies. For most children with enuresis, however, a specific etiology cannot be determined. Treatment then involves supportive approaches,…

  8. Using Pretreatment and Posttreatment Assessments To Enhance and Evaluate Existing Treatment Packages.

    Science.gov (United States)

    Richman, David M.; Berg, Wendy K.; Wacker, David P.; Stephens, Tracy; Rankin, Barbara; Kilroy, Jennette

    1997-01-01

    Pretreatment assessment data were used to enhance an existing treatment package to reduce aggression and to increase the positive social interactions of a 9-year-old boy with moderate mental retardation and Hunter's syndrome. Additional reinforcements and punishment components were added and resulted in positive social interactions and suppressed…

  9. Practice Parameter for the Assessment and Treatment of Children and Adolescents with Posttraumatic Stress Disorder

    Science.gov (United States)

    Cohen, Judith A.; Bukstein, Oscar; Walter, Heather; Benson, R. Scott; Chrisman, Allan; Farchione, Tiffany R.; Hamilton, John; Keable, Helene; Kinlan, Joan; Schoettle, Ulrich; Siegel, Matthew; Stock, Saundra; Medicus, Jennifer

    2010-01-01

    This Practice Parameter reviews the evidence from research and clinical experience and highlights significant advances in the assessment and treatment of posttraumatic stress disorder since the previous Parameter was published in 1998. It highlights the importance of early identification of posttraumatic stress disorder, the importance of…

  10. Best Practices for Mental Health in Child Welfare: Screening, Assessment, and Treatment Guidelines

    Science.gov (United States)

    Romanelli, Lisa Hunter; Landsverk, John; Levitt, Jessica Mass; Leslie, Laurel K.; Hurley, Maia M.; Bellonci, Christopher; Gries, Leonard T.; Pecora, Peter J.; Jensen, Peter S.

    2009-01-01

    The Best Practices for Mental Health in Child Welfare Consensus Conference focused on developing guidelines in five key areas (screening and assessment, psychosocial interventions, psychopharmacologic treatment, parent engagement, and youth empowerment) related to children's mental health. This paper provides an overview of issues related to the…

  11. Practice Parameter for the Assessment and Treatment of Children and Adolescents with Bipolar Disorder

    Science.gov (United States)

    Journal of the American Academy of Child and Adolescent Psychiatry, 2007

    2007-01-01

    This practice parameter reviews the literature on the assessment and treatment of children and adolescents with bipolar disorder. The parameter focuses primarily on bipolar 1 disorder because that is the type most often studied in juveniles. The presentation of bipolar disorder in youth, especially children, is often considered atypical compared…

  12. Case Study: Optimality Theory and the Assessment and Treatment of Phonological Disorders.

    Science.gov (United States)

    Barlow, Jessica A.

    2001-01-01

    A case study of a 3-year-old with a phonological disorder is used to demonstrate the application of optimality theory to the assessment and treatment. A tutorial of the theory is provided and then several prototypical error patterns evident in the child's productions are analyzed within the framework. (Contains references.) (Author/CR)

  13. Attention Deficit Hyperactivity Disorder among Asian American Families: Challenges in Assessment and Treatment

    Science.gov (United States)

    Pham, Andy V.

    2013-01-01

    Studies addressing assessment and treatment of attention deficit hyperactivity disorder (ADHD) have primarily been focused on Caucasian populations, although a growing number of studies have included ethnic minority populations, particularly Hispanic and African American children. Findings regarding the relationship between ADHD diagnosis and race…

  14. Assessment and treatment of insomnia in adult patients with alcohol use disorders.

    Science.gov (United States)

    Brower, Kirk J

    2015-06-01

    Insomnia in patients with alcohol dependence has increasingly become a target of treatment due to its prevalence, persistence, and associations with relapse and suicidal thoughts, as well as randomized controlled studies demonstrating efficacy with behavior therapies and non-addictive medications. This article focuses on assessing and treating insomnia that persists despite 4 or more weeks of sobriety in alcohol-dependent adults. Selecting among the various options for treatment follows a comprehensive assessment of insomnia and its multifactorial causes. In addition to chronic, heavy alcohol consumption and its effects on sleep regulatory systems, contributing factors include premorbid insomnia; co-occurring medical, psychiatric, and other sleep disorders; use of other substances and medications; stress; environmental factors; and inadequate sleep hygiene. The assessment makes use of history, rating scales, and sleep diaries as well as physical, mental status, and laboratory examinations to rule out these factors. Polysomnography is indicated when another sleep disorder is suspected, such as sleep apnea or periodic limb movement disorder, or when insomnia is resistant to treatment. Sobriety remains a necessary, first-line treatment for insomnia, and most patients will have some improvement. If insomnia-specific treatment is needed, then brief behavioral therapies are the treatment of choice, because they have shown long-lasting benefit without worsening of drinking outcomes. Medications work faster, but they generally work only as long as they are taken. Melatonin agonists; sedating antidepressants, anticonvulsants, and antipsychotics; and benzodiazepine receptor agonists each have their benefits and risks, which must be weighed and monitored to optimize outcomes. Some relapse prevention medications may also have sleep-promoting activity. Although it is assumed that treatment for insomnia will help prevent relapse, this has not been firmly established. Therefore

  15. [Assessment on the COD discharge status of municipal wastewater treatment plant in a city of China].

    Science.gov (United States)

    Zhou, Yu-Hua; Lu, Yan-Na; Zhang, Yu; Zhu, Jing; Lei, Jing; Shen, Chen; Wu, Xue-Fang

    2014-10-01

    Based on the statistical theory, the paper collected routine monitoring data for 3 years of 11 municipal wastewater treatment plants with secondary treatment or enhanced secondary treatment in a northern city in China, and analysis of the discharge concentration distribution of COD showed a Delta-lognormal distribution. On this basis, referring to the formulation methods of water pollutant discharge limits used in the USA, the paper studied and assessed the discharge status of COD of the municipal wastewater treatment plants in the city, including the daily maximum and the monthly average discharge status, and came to the conclusion that the daily maximum discharge status met the first grade A class discharge standard (50 mg · L(-1)) required by the Discharge Standard of Pollutants for Municipal Wastewater Treatment Plant (GB 18918-2002). Meanwhile, the assessment conclusion was obtained for the monthly average discharge status, and the conclusions were discussed. The assessment method and the conclusions in this paper might provide reference for formulation and revision of water discharge standards. PMID:25693413

  16. Reliability assessment and correlation analysis of evaluating orthodontic treatment outcome in Chinese patients.

    Science.gov (United States)

    Song, Guang-Ying; Zhao, Zhi-He; Ding, Yin; Bai, Yu-Xing; Wang, Lin; He, Hong; Shen, Gang; Li, Wei-Ran; Baumrind, Sheldon; Geng, Zhi; Xu, Tian-Min

    2014-03-01

    This study aimed to assess the reliability of experienced Chinese orthodontists in evaluating treatment outcome and to determine the correlations between three diagnostic information sources. Sixty-nine experienced Chinese orthodontic specialists each evaluated the outcome of orthodontic treatment of 108 Chinese patients. Three different information sources: study casts (SC), lateral cephalometric X-ray images (LX) and facial photographs (PH) were generated at the end of treatment for 108 patients selected randomly from six orthodontic treatment centers throughout China. Six different assessments of treatment outcome were made by each orthodontist using data from the three information sources separately and in combination. Each assessment included both ranking and grading for each patient. The rankings of each of the 69 judges for the 108 patients were correlated with the rankings of each of the other judges yielding 13 873 Spearman rs values, ranging from -0.08 to +0.85. Of these, 90% were greater than 0.4, showing moderate-to-high consistency among the 69 orthodontists. In the combined evaluations, study casts were the most significant predictive component (R(2)=0.86, P<0.000 1), while the inclusion of lateral cephalometric films and facial photographs also contributed to a more comprehensive assessment (R(2)=0.96, P<0.000 1). Grading scores for SC+LX and SC+PH were highly significantly correlated with those for SC+LX+PH (r(SC+LX)vs.(SC+LX+PH)=0.96, r(SC+PH)vs.(SC+LX+PH)=0.97), showing that either SC+LX or SC+PH is an excellent substitute for all three combined assessment. PMID:24136673

  17. Assessing and reporting heterogeneity in treatment effects in clinical trials: a proposal

    Directory of Open Access Journals (Sweden)

    Kent David M

    2010-08-01

    Full Text Available Abstract Mounting evidence suggests that there is frequently considerable variation in the risk of the outcome of interest in clinical trial populations. These differences in risk will often cause clinically important heterogeneity in treatment effects (HTE across the trial population, such that the balance between treatment risks and benefits may differ substantially between large identifiable patient subgroups; the "average" benefit observed in the summary result may even be non-representative of the treatment effect for a typical patient in the trial. Conventional subgroup analyses, which examine whether specific patient characteristics modify the effects of treatment, are usually unable to detect even large variations in treatment benefit (and harm across risk groups because they do not account for the fact that patients have multiple characteristics simultaneously that affect the likelihood of treatment benefit. Based upon recent evidence on optimal statistical approaches to assessing HTE, we propose a framework that prioritizes the analysis and reporting of multivariate risk-based HTE and suggests that other subgroup analyses should be explicitly labeled either as primary subgroup analyses (well-motivated by prior evidence and intended to produce clinically actionable results or secondary (exploratory subgroup analyses (performed to inform future research. A standardized and transparent approach to HTE assessment and reporting could substantially improve clinical trial utility and interpretability.

  18. Recent Trends In The Methods Of Safety Assessment Of Rad Waste Treatment And Disposal

    International Nuclear Information System (INIS)

    Radioactive waste management system involves a huge variety of processes and activities. This includes; collection and segregation, pretreatment, treatment, conditioning, storage and finally disposal. To assure the safety of the different facility of each step in the waste management system, the operator should prepare a safety analysis report to be assessed by the national regulatory body. The content of the safety analysis report must include all data about the site, facility design, operational phase, waste materials, and safety assessment methodologies. Safety assessment methodologies are iterative processes involving site-specific, prospective modeling evaluations of the pre-operational, operational, and post-closure time in case of disposal facilities. The safety assessment focuses primarily on a decision about compliance with performance objectives, rather than the much more difficult problem of predicting actual radiological impacts on the public at far future times. The recent organization processes of the safety assessment are improved by the ISAM working group from IAEA for waste disposal site. These safety assessment methodologies have been modified within SADRWMS IAEA project for the establishment of safety methodologies for the pre-disposal facilities (treatment and storage facilities) and the disposal site.

  19. Evaluation of agreement and correlation of three occlusal indices in an assessment of orthodontic treatment need

    Directory of Open Access Journals (Sweden)

    Đorđević Jelena

    2011-01-01

    Full Text Available Background/Aim. Occlusal indices are quantitative diagnostic indicators of malocclusion severity, orthodontic treatment need, complexity and outcome. The aim of this study was to determine correlations and agreement among three occlusal indices: the Index of Orthodontic Treatment Need (IOTN, the Peer Assessment Rating Index (PAR and the Index of Complexity, Outcome and Need (ICON in evaluating orthodontic treatment need. Methods. A total eighty study models of patients referred to the Department of Orthodontics, School of Dentistry, Belgrade, were assessed in this retrospective study. Malocclusions of various types and severity in the permanent dentition were included. Results. The Aesthetic and the Dental Health Component of IOTN determined orthodontic treatment need in 25% and 51% of the patients, respectively. PAR determined orthodontic treatment need in 59% and ICON in 53% of patients. The Aesthetic Component of IOTN and ICON had the highest correlation (Spearman's correlation coefficient 0.95, p < 0.01. Correlations between indices were 0.44 to 0.61 with statistical significance (p < 0.01. The agreement between indices, calculated using Kappa statistics, was 0.22 to 0.63. Conclusion. The most critical in malocclusion assessment was PAR. The Aesthetic Component of IOTN and ICON correlated highly (p < 0.01. Correlations between other pairs of indices were moderate (p < 0.01. The Aesthetic Component of IOTN and ICON had substantial agreement, whereas agreement between other indices was fair or moderate. ICON could replace PAR and IOTN. Application of occlusal indices enables objective evaluation of orthodontic treatment need and easier determination of the treatment priorities.

  20. The Improvement and Completion of Outcome index: A new assessment system for quality of orthodontic treatment

    Science.gov (United States)

    Hong, Mihee; Kook, Yoon-Ah; Kim, Myeng-Ki; Lee, Jae-Il; Kim, Hong-Gee

    2016-01-01

    Objective Given the considerable disagreement between the Peer Assessment Rating (PAR) index and the American Board of Orthodontics Cast-Radiograph Evaluation, we aimed to develop a novel assessment system―the Improvement and Completion of Outcome (ICO) index―to evaluate the outcome of orthodontic treatment. Methods Sixteen criteria from 4 major categories were established to represent the pretreatment malocclusion status, as well as the degree of improvement and level of completion of outcome during/after treatment: dental relationship (arch length discrepancy, irregularity, U1-SN, and IMPA); anteroposterior relationship (overjet, right and left molar position, ANB); vertical relationship (anterior overbite, anterior open-bite, lateral open-bite, SN-MP); and transverse relationship (dental midline discrepancy, chin point deviation, posterior cross-bite, occlusal plane cant). The score for each criterion was defined from 0 or −1 (worst) to 5 (ideal value or normal occlusion) in gradations of 1. The sum of the scores in each category indicates the area and extent of the problems. Improvement and completion percentages were estimated based on the pre- and post-treatment total scores and the maximum total score. If the completion percentage exceeded 80%, treatment outcome was considered successful. Results Two cases, Class I malocclusion and skeletal Class III malocclusion, are presented to represent the assessment procedure using the ICO index. The difference in the level of improvement and completion of treatment outcome can be clearly explained by using 2 percentage values. Conclusions Thus, the ICO index enables the evaluation of the quality of orthodontic treatment objectively and consecutively throughout the entire treatment process.

  1. Clinical use of high-efficiency hemodialysis treatments: long-term assessment.

    Science.gov (United States)

    Bosch, Juan P; Lew, Susie Q; Barlee, Viroj; Mishkin, Gary J; von Albertini, Beat

    2006-01-01

    Significant technological changes in blood flow rate, dialyzer membrane permeability, bicarbonate dialysate, and ultrafiltration-controlled delivery systems permitted the implementation of 3 modifications to conventional hemodialysis as follows: high-efficiency hemodialysis (HEHD), high-flux hemodialysis (HFHD), and double-high-flux hemodiafiltration (HDF). The impact of these techniques on the quantity of the treatment administered and treatment time were assessed. One hundred and eighty-three patients were enrolled over 6 years. Monthly Kt/Vurea and dialysis treatment time were compared among the treatment techniques. In vivo extracorporeal clearances were measured for the dialyzers used. In vivo kinetically derived effective dialyzer clearances were calculated from Kt/V. Patient survival and standardized mortality ratio (SMR) were determined for each treatment modality. Treatment time averaged 192+/-28, 176+/-29, and 159+/-32 min, Kt/Vurea averaged 1.33+/-.34, 1.29+/-.30, 1.41+/-.32, and in vivo delivered urea clearance averaged 222+/-51, 272+/-34, and 333+/-43 mL/min for HEHD, HFHD, and HDF, respectively. These results were achieved even in patients with body weights in excess of 80 kgs. Net ultrafiltration rate during the treatment reached 20-30 mL/min, without clinical untoward effects. Blood flow rate ranged between 450-650 mL/min in all patients. Kaplan-Meier Survival analysis yielded a significant difference when high-efficiency treatments were compared with USRDS outcomes. Standardized mortality ratio analysis showed significance for only HDF vs. USRDS. High-efficiency treatments can provide the same quantity of treatment in a shorter period of time without affecting mortality. The increased spectrum of solutes removal provided by HFHD and HDF may be a further advantage of these treatments. PMID:16441831

  2. FDG-PET/CT in the Assessment of Treatment Response after Oncologic Treatment of Head and Neck Squamous Cell Carcinoma

    Science.gov (United States)

    Keski-Säntti, Harri; Mustonen, Timo; Schildt, Jukka; Saarilahti, Kauko; Mäkitie, Antti A

    2014-01-01

    BACKGROUND In many centers, 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) is used to monitor treatment response after definitive (chemo)radiotherapy [(C)RT] for head and neck squamous cell carcinoma (HNSCC), but its usefulness remains somewhat controversial. We aimed at assessing the accuracy of FDG-PET/CT in detecting residual disease after (C)RT. METHOD All HNSCC patients with FDG-PET/CT performed to assess treatment response 10–18 weeks after definitive (C)RT at our institution during 2008–2010 were included. The patient charts were reviewed for FDG-PET/CT findings, histopathologic findings, and follow-up data. The median follow-up time for FDG-PET/CT negative patients was 26 months. RESULTS Eighty-eight eligible patients were identified. The stage distribution was as follows: I, n = 1; II, n = 15; III, n = 17; IV, n = 55. The negative predictive value, positive predictive value, specificity, sensitivity, and accuracy of FDG-PET/CT in detecting residual disease were 87%, 81%, 94%, 65%, and 85%, respectively. The corresponding specific figures for the primary tumor site were 91%, 71%, 94%, 59%, and 86% and for the neck 93%, 100%, 100%, 75%, and 94%, respectively. CONCLUSIONS In patients who have received definitive (C)RT for HNSCC, post-treatment FDG-PET/CT has good potential to guide clinical decision-making. Patients with negative scan can safely be followed up clinically only, while positive scan necessitates tissue biopsies or a neck dissection to rule out residual disease. PMID:25210484

  3. Twenty years of percutaneous treatments for cystic echinococcosis: a preliminary assessment of their use and safety.

    Science.gov (United States)

    Brunetti, E; Troia, G; Garlaschelli, A L; Gulizia, R; Filice, C

    2004-12-01

    Image-guided percutaneous treatments for echinococcal cysts were introduced in the mid-eighties. Today they represent a third therapeutic option, after surgery and benzimidazole derivatives. Two types of percutaneous treatments are available, based on the destruction of the germinal layer or the evacuation of the endocyst. To assess the extent of their use and their safety, a Medline search of the literature on this subject was performed. The number of cysts treated, their anatomical sites, the complications and, length of follow-up (when available), were all examined. The results show that percutaneous treatments for cystic echinococcosis are safe and efficacious in selected anatomical sites, provided basic safety issues are correctly addressed. However, before drawing final conclusions, a more detailed analysis of the literature is needed. Percutaneous treatments could be simplified and made more effective if a scolecidal agent could be found that melts the entire endocyst without causing harm to the biliary epithelium. PMID:16044692

  4. Life cycle assessment of wastewater treatment options for small and decentralized communities.

    Science.gov (United States)

    Machado, A P; Urbano, L; Brito, A G; Janknecht, P; Salas, J J; Nogueira, R

    2007-01-01

    Sustainability has strong implications on the practice of engineering. Life cycle assessment (LCA) is an appropriate methodology for assessing the sustainability of a wastewater treatment plant design. The present study used a LCA approach for comparing alternative wastewater treatment processes for small and decentralised rural communities. The assessment was focused on two energy-saving systems (constructed wetland and slow rate infiltration) and a conventional one (activated sludge process). The low environmental impact of the energy-saving wastewater treatment plants was demonstrated, the most relevant being the global warming indicator. Options for reduction of life cycle impacts were assessed including materials used in construction and operational lifetime of the systems. A 10% extension of operation lifetime of constructed wetland and slow rate infiltration systems led to a 1% decrease in CO2 emissions, in both systems. The decrease in the abiotic depletion was 5 and 7%, respectively. Also, replacing steel with HDPE in the activated sludge tank resulted in a 1% reduction in CO2 emission and 1% in the abiotic depletion indicator. In the case of the Imhoff tank a 1% reduction in CO2 emissions and 5% in the abiotic depletion indicator were observed when concrete was replaced by HDPE. PMID:17802833

  5. Adrenal incidentalomas: A guide to assessment, treatment and follow-up.

    Science.gov (United States)

    Paschou, Stavroula A; Vryonidou, Andromachi; Goulis, Dimitrios G

    2016-10-01

    Adrenal incidentalomas are clinically unsuspected lesions that are detected in adrenal glands during imaging procedures for other causes. With widespread use of imaging - both computed tomography (CT) and magnetic resonance imaging (MRI) - adrenal incidentalomas are now a common clinical problem. The two main clinical issues to be determined in this setting are the risk of malignancy and the hormonal activity of these lesions. The answers to these two questions, along with the clinical characteristics of each individual patient and co-morbidities, will guide the treatment strategy, which can vary from simple follow-up to surgical resection. The objective of this article is to present updated information on the definition, prevalence, imaging and functional features of adrenal incidentalomas and to provide a guide to their optimal assessment, treatment and follow-up. This review collected, analyzed and qualitatively re-synthesized information regarding: (1) the various clinical entities known as "adrenal incidentalomas", (2) the initial assessment of risk of malignancy, (3) the initial assessment of whether the lesion is hormonally active or non-functioning, (4) the absolute and relative indications for surgical treatment, (5) the follow-up of patients who are not deemed to need surgical treatment after initial assessment, and (6) the post-operative follow-up of patients who undergo surgical treatment. The evidence calls for clinicians to bear in mind the Hippocratian advice "ωϕελέειν ή μη βλάπτειν" ("first do no harm"). PMID:27621243

  6. The accurate assessment and physiotherapeutic treatment of rotator cuff myofascial Pain Syndrome: A case report

    Directory of Open Access Journals (Sweden)

    B. B. Barker

    2011-02-01

    Full Text Available Management  of  patients  with  rotator  cuff  myofascial  pain syndrome varies  and  successful  intervention  is  dependent  on accurate assessment. The aim of this case report is to show the importance of accurate assessment  and  clinical  reasoning  in  the  physiotherapeutic management  of a  patient  suffering  from  ante-cubital  and  anterior shoulder  pain.  The  patient was  referred  for  physiotherapy  after proving refractory  to  treatment  with  non-steroidal anti-inflammatory medication. The physiotherapist diagnosed a rotator cuff myofascial pain syndrome and treatment proceeded on that basis. Treatment consisted of twitch-obtaining dry needling, myofascial release and exercise therapy.  The result was a change in the harryman rotator cuff functional Assessment Scale score from 22/52 to 43/52 over eight treatments. Strength was regained and subjective pain report on the visual rating scale was improved to 1/10. The case study highlights the importance of accurate assessment and consideration of alternative myofascial sources for pain even in circumstances which initially seem trauma related. Precise diagnosis of the cause - in this case rotator cuff myofascial pain syndrome – will result in effective treatment being administered.

  7. Identification and assessment of site treatment plan implementation opportunities for emerging technologies

    Energy Technology Data Exchange (ETDEWEB)

    Bernard, E.A. [Sandia National Labs., Germantown, MD (United States)

    1995-12-31

    The Department of Energy (DOE), in response to the 1992 Federal Facility Compliance Act, has prepared Site Treatment Plans (STP) for the approximately 2,000 waste streams identified within its mixed waste inventory Concurrently, emerging mixed waste treatment technologies are in final development. This paper defines a three-phase process to identify and assess implementation opportunities for these emerging technologies within the STP. It highlights the first phase, functional matching of expected treatment capabilities with proposed treatment requirements. Matches are based on treatment type, regulated contaminant and waste matrix type, for both capabilities and requirements. Results identify specific waste streams and volumes that could be treated by each emerging technology. A study for Plasma Hearth Process, Delphi DETOX{sup sm}, Supercritical Water Oxidation and Vitrification shows that about 200,000 ml of DOE`s mixed waste inventory can potentially be treated by one or more of these emerging technologies. Actual implementations are small fractions of the treatable inventory. Differences between potential and actual implementations must be minimized to accrue optimum benefit from implementation of emerging or alternative treatment technologies. Functional matching is the first phase in identifying and quantifying benefits, addressing technology system and treatment issues, and providing, in part, the basis for STP implementation decisions. DOE, through EM`s Office of Technology Development, has funded this work.

  8. Identification and assessment of site treatment plan implementation opportunities for emerging technologies

    International Nuclear Information System (INIS)

    The Department of Energy (DOE), in response to the 1992 Federal Facility Compliance Act, has prepared Site Treatment Plans (STP) for the approximately 2,000 waste streams identified within its mixed waste inventory Concurrently, emerging mixed waste treatment technologies are in final development. This paper defines a three-phase process to identify and assess implementation opportunities for these emerging technologies within the STP. It highlights the first phase, functional matching of expected treatment capabilities with proposed treatment requirements. Matches are based on treatment type, regulated contaminant and waste matrix type, for both capabilities and requirements. Results identify specific waste streams and volumes that could be treated by each emerging technology. A study for Plasma Hearth Process, Delphi DETOXsm, Supercritical Water Oxidation and Vitrification shows that about 200,000 ml of DOE's mixed waste inventory can potentially be treated by one or more of these emerging technologies. Actual implementations are small fractions of the treatable inventory. Differences between potential and actual implementations must be minimized to accrue optimum benefit from implementation of emerging or alternative treatment technologies. Functional matching is the first phase in identifying and quantifying benefits, addressing technology system and treatment issues, and providing, in part, the basis for STP implementation decisions. DOE, through EM's Office of Technology Development, has funded this work

  9. Multicriteria assessment of advanced treatment technologies for micropollutants removal at large-scale applications.

    Science.gov (United States)

    Bui, X T; Vo, T P T; Ngo, H H; Guo, W S; Nguyen, T T

    2016-09-01

    With the introduction and discharge of thousands of new micropollutants (MPs) every year, traditional water and wastewater treatment plants may be incapable of tackling them all. With their low concentrations and diversity in nature, MP removal encounters numerous challenges. Although some MPs are effectively eliminated via conventional treatment methods, most of them can easily escape and are retained in the discharged effluent. Therefore, advanced methods such as (i) adsorption, (ii) oxidation and advanced oxidation processes (O3 and O3-based advanced oxidation processes, UV/H2O2), (iii) membrane processes, and (iv) membrane bioreactors, become an inevitable approach. Despite the unsurprisingly vast number of papers on MP treatment available at present, most of these studies were carried out at a laboratory scale while only a few pilot- and full-scale studies have experimented. Nevertheless, an in-depth assessment of real-world MP treatment methods is extremely crucial for practitioners. To date, no paper has been dedicated to look at this issue. Therefore, this paper aims to review these large-scale treatment methods. First, the paper goes through the regulations and standards which deal with MPs in water courses. It will then assess these methods in various case-studies with reference to different criteria towards serving as a reference for further practical applications. PMID:27198651

  10. Quantitative MR imaging in planning and assessing novel cancer treatments Radiotherapy

    CERN Document Server

    Baustert, I C

    2001-01-01

    Novel treatments in cancer, like conformal radiotherapy and anticancer drugs, require new MRI techniques to assess their benefits and potential. In conformal radiotherapy, MRI can be used to measure the shape and dose of the conformed radiation field in dose sensitive gel test-objects thus validating the predicted dose computed by complex programs. In antiangiogenic drug treatment, the vascular dysfunction of the tumour can be assessed by MRI prior to treatment. Response to treatment may also be monitored by measuring the changes in vascular function. In this thesis, MRI of polyacrylamide gels is investigated as a 3D dosimeter for conformal radiotherapy treatment planning. Quantitative MRI sequences capable of measuring the wide range of T2 values typically expected in gel dosimetry, are identified. Different T2 measurement methods are compared in terms of accuracy, signal to noise ratio and acquisition time. Examples of a complex dose distribution in 2D and 3D are presented and compared to the planned dose p...

  11. From P-Values to Objective Probabilities in Assessing Medical Treatments.

    Directory of Open Access Journals (Sweden)

    David Kault

    Full Text Available The assessment of the effectiveness of a treatment in a clinical trial, depends on calculating p-values. However, p-values are only indirect and partial indicators of a genuine effect. Particularly in situations where publication bias is very likely, assessment using a p-value of 0.05 may not be sufficiently cautious. In other situations it seems reasonable to believe that assessment based on p-values may be unduly conservative. Assessments could be improved by using prior information. This implies using a Bayesian approach to take account of prior probability. However, the use of prior information in the form of expert opinion can allow bias. A method is given here that applies to assessments already included or likely to be included in the Cochrane Collaboration, excluding those reviews concerning new drugs. This method uses prior information and a Bayesian approach, but the prior information comes not from expert opinion but simply from the distribution of effectiveness apparent in a random sample of summary statistics in the Cochrane Collaboration. The method takes certain types of summary statistics and their confidence intervals and with the help of a graph, translates this into probabilities that the treatments being trialled are effective.

  12. Assessment of impacts from different waste treatment and waste disposal technologies: Regional Management Plan

    International Nuclear Information System (INIS)

    This report presents assessments of treatment and disposal technologies that appear to be appropriate for use in regional facilities in the Midwest Compact Region. The treatment technologies assessed: compaction with a supercompactor; incineration; and incineration followed by solidfication of the incinerator ash. The disposal technologies assessed are: shallow land burial, considered a baseline for comparison of other technologies; below-ground vaults; abov-groudn vaults; the earth mounded concrete bunker, a technology developed in France; improved shallow land burial, essentially deeper burial; modular concrete canister disposal; mined cavities (both new and existing); and unlined augered holes; and lined augered holes. The teatment technologies are assessed primarily in terms of the their impact on the waste management system, and generally not comparatively. The dispoal technologies are assessed relative to the present standard practice shallow land burial; shallow land burial was slected as a frame of reference because it has an experience base spanning several decades, not because of any preferential characteristics. 20 refs., 5 tabs

  13. EDXRF as an analytical tool in art. Case studies from pigment identification and treatment assessment

    International Nuclear Information System (INIS)

    Energy dispersive X-ray fluorescence (EDXRF) was employed for the identification of pigments decorating Hellenistic figurines, and the assessment of the efficiency of a treatment with barium hydroxide applied to stone. Elements present in the colored areas of the figurines, as well as the treated stone was identified by EDXRF. These data together with complementary information obtained by Fourier transform infrared spectroscopy (FTIR) and X-ray diffraction analysis (XRD) led to the identification of several precious pigments. As far as the treatment efficiency is concerned, EDXRF analysis revealed that barium is unevenly distributed on the treated surface and reaches a maximum depth of 2.5 mm. (author)

  14. Quality indicators for treatment of respiratory tract infections? An assessment by Danish general practitioners

    DEFF Research Database (Denmark)

    Hansen, Malene Plejdrup; Bjerrum, Lars; Gahrn-Hansen, Bente;

    2013-01-01

    Background: In 2008, a set of 41 quality indicators for antibiotic treatment of respiratory tract infections (RTIs) in general practice were developed in an international setting as part of the European project HAPPY AUDIT. Objectives: To investigate Danish general practitioners' (GPs') assessment...... of 62 (61%) responded. Quality indicators focusing on the frequency of prescribing of narrow-spectrum penicillin were rated as suitable by more than 80% of the Danish GPs, while quality indicators concerning cephalosporins or quinolones were rated suitable by less than half of the GPs. The antibiotic...... treatment of RTIs, only a few of them were rated suitable by the GPs, who are supposed to use them....

  15. The new criterion for cardiac resynchronization therapy treatment assessed by two channels impedance cardiography

    International Nuclear Information System (INIS)

    The cardiac resynchronization therapy is an effective treatment for systolic failure patients. Independent electrical stimulation of left and right ventricle corrects mechanical ventricular dyssynchrony. About 30–40% treated patients do not respond to therapy. In order to improve clinical outcome authors propose the two channels impedance cardiography for assessment of ventricular dyssynchrony. The proposed method is intended for validation of patients diagnosis and optimization of pacemaker settings for cardiac resynchronization therapy. The preliminary study has showed that bichannel impedance cardiography is a promising tool for assessment of ventricular dyssynchrony.

  16. African American Patients' Psychosocial Support Needs and Barriers to Treatment: Patient Needs Assessment.

    Science.gov (United States)

    Davey, Maureen P; Bilkins, Brianna; Diamond, Guy; Willis, Alliric I; Mitchell, Edith P; Davey, Adam; Young, Faith M

    2016-09-01

    This study assessed adult patient's psychosocial support needs and treatment barriers in an urban diverse cancer center. A needs assessment was conducted with a convenience sample of adult oncology patients (n = 113; 71.7 % African American). Most patients were parenting school-age children and worried about them (96 %); 86.7 % would attend a family support program. Among patients who were married or partnered (68 %), 63.7 % were concerned about communication, coping, and emotional support; 53.9 % would attend a couple support program. Patients identified similar treatment barriers: transportation, babysitting for younger children, convenience of time/place, and refreshments. Findings suggest that behavioral health care providers should be available to screen cancer patients and improve access to appropriate psychosocial oncology support programs. PMID:26048632

  17. Impact of Heterobasidion spp. root rot in conifer trees and assessment of stump treatment

    OpenAIRE

    Wang, Liying

    2012-01-01

    In the thesis four studies were conducted to understand the impact of Heterobasidion spp. on Picea abies, Pinus sylvestris, and Larix × eurolepis in southern Sweden, and the efficacy of stump treatment against infection in order to economically assess control measures. The ability of secondary spread of H. parviporum inoculated on Norway spruce stumps created at precommercial thinning (PCT) was investigated. Stumps with a minimum diameter of 2.5 cm were able to transfer infection to adjace...

  18. Cross-section Trichometry: A Clinical Tool for Assessing the Progression and Treatment Response of Alopecia

    OpenAIRE

    Wikramanayake, Tongyu Cao; Mauro, Lucia M.; Tabas, Irene A; Chen, Anne L.; Llanes, Isabel C; Jimenez, Joaquin J

    2012-01-01

    Background: To properly assess the progression and treatment response of alopecia, one must measure the changes in hair mass, which is influenced by both the density and diameter of hair. Unfortunately, a convenient device for hair mass evaluation had not been available to dermatologists until the recent introduction of the cross-section trichometer, which directly measures the cross-sectional area of an isolated bundle of hair. Objective: We sought to evaluate the accuracy and sensitivity of...

  19. Metric qualities of the cognitive behavioral assessment for outcome evaluation to estimate psychological treatment effects

    OpenAIRE

    Bertolotti, Giorgio; Michielin, Paolo; Vidotto, Giulio; Sanavio, Ezio; Bottesi, Gioia; Bettinardi, Ornella; Zotti, Anna Maria

    2015-01-01

    Background Cognitive behavioral assessment for outcome evaluation was developed to evaluate psychological treatment interventions, especially for counseling and psychotherapy. It is made up of 80 items and five scales: anxiety, well-being, perception of positive change, depression, and psychological distress. The aim of the study was to present the metric qualities and to show validity and reliability of the five constructs of the questionnaire both in nonclinical and clinical subjects. Metho...

  20. ASSESSMENT OF THE RESULTS FROM ARTHROSCOPIC SURGICAL TREATMENT FOR TRAUMATIC ANTERIOR SHOULDER DISLOCATION: FIRST EPISODE

    OpenAIRE

    Miyazaki, Alberto Naoki; Fregoneze, Marcelo; Santos, Pedro Doneux; da Silva, Luciana Andrade; do Val Sella, Guilherme; Botelho, Vinicius; Duarte, Clodoaldo; Checchia, Sergio Luiz

    2015-01-01

    Objective: To assess the clinical results obtained of patients who underwent arthroscopic surgical treatment following a first episode of traumatic anterior shoulder dislocation. Methods: Between August 2000 and October 2008, 14 shoulders of 14 patients were treated by the Shoulder and Elbow Group of Santa Casa Hospital, São Paulo. Thirteen patients (93%) were male and one (7%) was female; their ages ranged from 17 to 41 years, with a mean of 28 years. All of the patients evaluated were regul...

  1. Use of Q methodology to assess the concerns of adult female individuals seeking orthodontic treatment

    OpenAIRE

    Lin, Feiou

    2015-01-01

    Linjie Yao,1 Xingqiao Xu,2 Zhenyu Ni,3 Minling Zheng,3 Feiou Lin3 1Department of Pedodontics, 2Department of Oral and Maxillofacial Surgery, 3Department of Orthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, People’s Republic of China Background: Orthodontic treatment may cause functional restrictions, discomfort, and pain, which may lead to dental anxiety and noncooperation among patients. This study aimed to assess the concerns of adult female p...

  2. Use of Q methodology to assess the concerns of adult female individuals seeking orthodontic treatment

    OpenAIRE

    Yao L; Xu X; Ni Z; Zheng M; Lin F

    2015-01-01

    Linjie Yao,1 Xingqiao Xu,2 Zhenyu Ni,3 Minling Zheng,3 Feiou Lin3 1Department of Pedodontics, 2Department of Oral and Maxillofacial Surgery, 3Department of Orthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, People’s Republic of China Background: Orthodontic treatment may cause functional restrictions, discomfort, and pain, which may lead to dental anxiety and noncooperation among patients. This study aimed to assess the concerns of adult female patie...

  3. An impact assessment methodology for urban surface runoff quality following best practice treatment

    OpenAIRE

    Ellis, John Bryan; Revitt, D. Mike; Lundy, Lian

    2012-01-01

    The paper develops an easy to apply desk-based semi-quantitative approach for the assessment of residual receiving water quality risks associated with urban surface runoff following its conveyance through best practice sustainable drainage systems (SUDS). The innovative procedure utilises an integrated geographical information system (GIS)-based pollution index approach based on surface area impermeability, runoff concentrations/loadings and individual SUDS treatment performance potential to ...

  4. Economic assessment of energy recovery from different sewage treatment options: summary report

    International Nuclear Information System (INIS)

    Energy recovery from sewage sludge waste treatment is examined critically to establish whether it can become a commercially viable proposition. Biogas-fired combined heat and power (CHP) plants using methane from sewage are assessed in terms of economic viability. Without inclusion in the United Kingdom's Non-Fossil Fuel Obligation subsidy, biogas-fired CHP plants are shown not to be economically viable. High maintenance costs are identified as a factor leading to the failure of these schemes. (UK)

  5. Environmental integrated impact assessment for waste treatment activity: methodology and case-study application

    International Nuclear Information System (INIS)

    A literature method for the environmental integrated impact assessment, according to the IPPC Directive, has been critically analysed and adjusted in order to be used for the environmental performance assessment of waste treatment activities. The assessment parameters, sorted in eight treatment and combined pollution categories, have been partly redefined and re balanced. The adjusted methodology has been applied to a real case-study, a chemical- physical waste treatment plant, in order to calculate the current performance (Actual Integrated Index) and the ideal performance (Actual Integrated Index) achievable by technical and operational improvements. The adjusted methodology has also been used as a decision support system, in order to estimate the value of the expected environmental performances improvement after the execution achievable from the introduction of a single one or a set of improvement actions. The valuation of the Integrated Index percentage reduction, along with the action achievable, made the best actions able to be identified, both in comparative way and in the cost-effective one. The results, 50 as Effective Integrated Index and 42 as Ideal Integrated Index, in a 10-100 scale, show a medium impact level and point out an appreciable improvement margin on all the environmental performances, especially in air emission control and water consumption

  6. Handover of patient information from the crisis assessment and treatment team to the inpatient psychiatric unit.

    Science.gov (United States)

    Waters, Amanda; Sands, Natisha; Keppich-Arnold, Sandra; Henderson, Kathryn

    2015-06-01

    Handover, or the communication of patient information between clinicians, is a fundamental component of health care. Psychiatric settings are dynamic environments relying on timely and accurate communication to plan care and manage risk. Crisis assessment and treatment teams are the primary interface between community and mental health services in many Australian and international health services, facilitating access to assessment, treatment, and admission to hospital. No previous research has investigated the handover between crisis assessment and treatment teams and inpatient psychiatric units, despite the importance of handover to care planning. The aim of the present study was to identify the nature and types of information transferred during these handovers, and to explore how these guides initial care planning. An observational, exploratory study design was used. A 20-item handover observation tool was used to observe 19 occasions of handover. A prospective audit was undertaken on clinical documentation arising from the admission. Clinical information, including psychiatric history and mental state, were handed over consistently; however, information about consumer preferences was reported less consistently. The present study identified a lack of attention to consumer preferences at handover, despite the current focus on recovery-oriented models for mental health care, and the centrality of respecting consumer preferences within the recovery paradigm. PMID:25438620

  7. Assessing methods for dealing with treatment switching in randomised controlled trials: a simulation study

    Directory of Open Access Journals (Sweden)

    Latimer Nicholas

    2011-01-01

    Full Text Available Abstract Background We investigate methods used to analyse the results of clinical trials with survival outcomes in which some patients switch from their allocated treatment to another trial treatment. These included simple methods which are commonly used in medical literature and may be subject to selection bias if patients switching are not typical of the population as a whole. Methods which attempt to adjust the estimated treatment effect, either through adjustment to the hazard ratio or via accelerated failure time models, were also considered. A simulation study was conducted to assess the performance of each method in a number of different scenarios. Results 16 different scenarios were identified which differed by the proportion of patients switching, underlying prognosis of switchers and the size of true treatment effect. 1000 datasets were simulated for each of these and all methods applied. Selection bias was observed in simple methods when the difference in survival between switchers and non-switchers were large. A number of methods, particularly the AFT method of Branson and Whitehead were found to give less biased estimates of the true treatment effect in these situations. Conclusions Simple methods are often not appropriate to deal with treatment switching. Alternative approaches such as the Branson & Whitehead method to adjust for switching should be considered.

  8. Framework for feasibility assessment and performance analysis of riverbank filtration systems for water treatment

    KAUST Repository

    Sharma, Saroj K.

    2012-03-01

    Bank filtration (BF) is an attractive, robust and reliable water treatment technology. It has been used in Europe and USA for a long time; however experience with this technology so far is site specific. There are no guidelines or tools for transfer of this technology to other locations, specifically to developing countries. A four-step methodology was developed at UNESCO-IHE to analyse feasibility and to predict the performance of BF for water treatment. This included (i) hydraulic simulation using MODFLOW; (ii) determination of share of bank filtrate using NASRI BF simulator; (iii) prediction of water quality from a BF system using the water quality guidelines developed and (iv) comparison of the costs of BF systems and existing conventional surface water treatment systems for water treatment. The methodology was then applied to assess feasibility of BF in five cities in Africa. It was found that in most of the cities studied BF is a feasible and attractive option from hydraulic, water quality as well as operational cost considerations. Considerable operational and maintenance costs saving can be achieved and water quality can be further improved by switching from conventional chemical-based surface water treatment to BF or at least by replacing some of the treatment units with BF systems. © IWA Publishing 2012.

  9. Incremental validity of neuropsychological assessment in the identification and treatment of youth with ADHD.

    Science.gov (United States)

    Pritchard, Alison E; Koriakin, Taylor; Jacobson, Lisa A; Mahone, E Mark

    2014-01-01

    Comprehensive neuropsychological assessments for youth with ADHD allow for thorough consideration of co-occurring disorders and provide targeted recommendations for treating ADHD and comorbid conditions. This study offers a preliminary evaluation of the added value (compared to routine care) associated with neuropsychological assessment in the identification and treatment of ADHD in youth ages 3-17 years. First we describe a novel measure developed to evaluate broad-based outcomes for youth with ADHD following neuropsychological assessment. Next we compare parent ratings of child symptoms and quality of life between two groups of youth with ADHD: those who have recently received neuropsychological assessments (NP+), and those who have not (NP-). Participants were surveyed again 5 months after baseline to assess changes in symptoms, quality of life, and service utilization. While both groups experienced significant improvements in behavioral/emotional symptoms, the NP+ group had greater initiation of parent behavior management training and special education services and greater initiation of medication management over the follow-up period, compared with the NP- group. Satisfaction with neuropsychological assessment was high overall but slightly decreased over the course of the follow-up period. The findings offer preliminary support for the incremental efficacy of neuropsychological evaluation in the diagnosis and management of ADHD. PMID:24345262

  10. Longitudinal assessment of treatment effects on pulmonary ventilation using 1H/3He MRI multivariate templates

    Science.gov (United States)

    Tustison, Nicholas J.; Contrella, Benjamin; Altes, Talissa A.; Avants, Brian B.; de Lange, Eduard E.; Mugler, John P.

    2013-03-01

    The utitlity of pulmonary functional imaging techniques, such as hyperpolarized 3He MRI, has encouraged their inclusion in research studies for longitudinal assessment of disease progression and the study of treatment effects. We present methodology for performing voxelwise statistical analysis of ventilation maps derived from hyper­ polarized 3He MRI which incorporates multivariate template construction using simultaneous acquisition of IH and 3He images. Additional processing steps include intensity normalization, bias correction, 4-D longitudinal segmentation, and generation of expected ventilation maps prior to voxelwise regression analysis. Analysis is demonstrated on a cohort of eight individuals with diagnosed cystic fibrosis (CF) undergoing treatment imaged five times every two weeks with a prescribed treatment schedule.

  11. Assessment of dissociation in Bosnian treatment-seeking refugees in Denmark

    DEFF Research Database (Denmark)

    Palic, Sabina; Carlsson, Jessica; Armour, Cherie;

    2015-01-01

    Background: Dissociative experiences are common in traumatized individuals, and can sometimes be mistaken for psychosis. It is difficult to identify pathological dissociation in the treatment of traumatized refugees, because there is a lack of systematic clinical descriptions of dissociative...... phenomena in refugees. Furthermore, we are currently unaware of how dissociation measures perform in this clinical group. Aims: To describe the phenomenology of dissociative symptoms in Bosnian treatment-seeking refugees in Denmark. Method: As a part of a larger study, dissociation was assessed...... systematically in 86 Bosnian treatment-seeking refugees using a semi-structured clinical interview (Structured Interview for Disorders of Extreme Stress-dissociation subscale; SIDES-D) and a self-report scale (Dissociative Experiences Scale; DES). Results: The SIDES-D indicated twice as high prevalence of...

  12. ASSESSING PROTECTING EFFICIENCY OF SOME SURFACE TREATMENTS ON FIR WOOD AFTER 7 YEARS OUTDOOR EXPOSURE

    Directory of Open Access Journals (Sweden)

    Emanuela BELDEAN

    2015-12-01

    Full Text Available Performance of wood preservatives or coatings as surface treatments products is closely connected to different needs and requirements. This paper investigated the protective efficiency of such products, on fir wood exposed outdoors for 7 years, in a modified L-joint test. The evaluation refers to degradation as result of the combined action of the biotic and non-biotic factors, active in use class 3. Two common non-destructive methods were used to evaluate the wood exposed outdoors: visual assessment and microscopic evaluation. Rating of the exposed faces showed that untreated control samples presented the most severe biological degradation and cracking. Surface bioprotection minimised discolouration and was generally a beneficial treatment prior coating. The surface treatments investigated in this paper generally delayed the degradation phenomena but could not provide an efficient protection over a long exposure period.

  13. Practice parameter for the assessment and treatment of children and adolescents with schizophrenia.

    Science.gov (United States)

    McClellan, Jon; Stock, Saundra

    2013-09-01

    This Practice Parameter reviews the literature on the assessment and treatment of children and adolescents with schizophrenia. Early-onset schizophrenia is diagnosed using the same criteria as in adults and appears to be continuous with the adult form of the disorder. Clinical standards suggest that effective treatment includes antipsychotic medications combined with psychoeducational, psychotherapeutic, and educational interventions. Since this Practice Parameter was last published in 2001, several controlled trials of atypical antipsychotic agents for early-onset schizophrenia have been conducted. However, studies suggest that many youth with early-onset schizophrenia do not respond adequately to available agents and are vulnerable to adverse events, particularly metabolic side effects. Further research is needed to develop more effective and safer treatments. PMID:23972700

  14. Assessing performance of manufactured treatment devices for the removal of phosphorus from urban stormwater.

    Science.gov (United States)

    Sample, David J; Grizzard, Thomas J; Sansalone, John; Davis, Allen P; Roseen, Robert M; Walker, Jane

    2012-12-30

    Nutrients such as nitrogen and phosphorus in urban runoff can be controlled through a variety of nonstructural and structural controls commonly known as best management practices (BMPs). Manufactured treatment devices (MTDs) are structural BMPs that may be used in portions of a site, often when space is limited. MTDs use a variety of technologies to achieve potentially greater treatment efficiency while reducing spatial requirements. However, verifying the performance of MTDs is difficult because of the variability of runoff water quality, the variability in treatment technologies, and the lack of standardized protocols for field testing. Performance testing of MTDs has focused almost exclusively upon removal of sediment; however MTDs are now being applied to the task of removing other constituents of concern, including nutrients such as phosphorus. This paper reviews current methods of assessing treatment performance of MTDs and introduces the Virginia Technology Assessment Protocol (VTAP), a program developed to evaluate the removal of phosphorus by MTDs. The competing goals of various stakeholders were considered when developing the VTAP. A conceptual framework of the tradeoffs considered is presented; these tradeoffs require compromise among the competing interests in order that innovation proceeds and benefits accrue. The key strengths of VTAP are also presented and compared with other existing programs. PMID:23079117

  15. Assessing the Value of New Treatments for Hepatitis C: Are International Decision Makers Getting this Right?

    Science.gov (United States)

    Woods, Beth; Faria, Rita; Griffin, Susan

    2016-05-01

    Health systems worldwide are facing difficult choices about the use of a series of highly effective but costly new treatments for hepatitis C. In this paper we discuss how the National Institute for Health and Care Excellence in England and Wales, the Common Drug Review in Canada and the Pharmaceutical Benefits Advisory Committee (PBAC) in Australia have approached the appraisal of these drugs. We argue that with the exception of the PBAC, assessments of the new drugs have not adequately accounted for their large financial burden. Given the potential health system impact of reimbursing these drugs, the use of lower cost-effectiveness thresholds should be considered. None of the decision-making processes included a comparison of the full range of treatment pathways. In particular, comparisons of using the new drugs as first- versus second-line drugs were omitted from all appraisals, as were comparisons with delayed treatment strategies whereby treatment is withheld until more severe disease stages. Omission of comparators leads to inaccurate estimates of cost effectiveness and potentially sub-optimal decision making. Lessons learned from these appraisals should be considered in future appraisals, particularly the upcoming assessments of the 'blockbuster' PCSK9 inhibitors for hypercholesterolaemia. PMID:26714687

  16. Assessment and Treatment of Abuse Risk in Opioid Prescribing for Chronic Pain

    Directory of Open Access Journals (Sweden)

    Robert N. Jamison

    2011-01-01

    Full Text Available Opioid analgesics provide effective treatment for noncancer pain, but many physicians have concerns about adverse effects, tolerance, and addiction. Misuse of opioids is prominent in patients with chronic back pain and early recognition of misuse risk could help physicians offer adequate patient care while implementing appropriate levels of monitoring to reduce aberrant drug-related behaviors. In this review, we discuss opioid abuse and misuse issues that often arise in the treatment of patients with chronic back pain and present an overview of assessment and treatment strategies that can be effective in improving compliance with the use of prescription opioids for pain. Many persons with chronic back pain have significant medical, psychiatric and substance use comorbidities that affect treatment decisions and a comprehensive evaluation that includes a detailed history, physical, and mental health evaluation is essential. Although there is no “gold standard” for opioid misuse risk assessment, several validated measures have been shown to be useful. Controlled substance agreements, regular urine drug screens, and interventions such as motivational counseling have been shown to help improve patient compliance with opioids and to minimize aberrant drug-related behavior. Finally, we discuss the future of abuse-deterrent opioids and other potential strategies for back pain management.

  17. Assessment of Response to Lithium Maintenance Treatment in Bipolar Disorder: A Consortium on Lithium Genetics (ConLiGen) Report

    OpenAIRE

    Manchia, Mirko; Adli, Mazda; Akula, Nirmala; Ardau, Raffaella; Aubry, Jean-Michel; Backlund, Lena; Banzato, Claudio Em; Bernhard T. Baune; Bellivier, Frank; Bengesser, Susanne; Biernacka, Joanna M; Brichant-Petitjean, Clara; Bui, Elise; Calkin, Cynthia V.; Cheng, Andrew Tai Ann

    2013-01-01

    Objective: The assessment of response to lithium maintenance treatment in bipolar disorder (BD) is complicated by variable length of treatment, unpredictable clinical course, and often inconsistent compliance. Prospective and retrospective methods of assessment of lithium response have been proposed in the literature. In this study we report the key phenotypic measures of the “Retrospective Criteria of Long-Term Treatment Response in Research Subjects with Bipolar Disorder” scale currently us...

  18. Assessment of adult hip dysplasia and the outcome of surgical treatment

    DEFF Research Database (Denmark)

    Troelsen, Anders

    2012-01-01

    Hip dysplasia and hip joint deformities in general are recognized as possible precursors of osteoarthritic development. Early and correct identification of hip dysplasia is important in order to offer timely joint preserving treatment. In the contemporary literature, several controversies exist......, and some of these were the focus of this doctoral thesis. Categorized into subjects, the major findings and their possible importance are listed below. DIAGNOSTIC ASSESSMENT OF HIP DYSPLASIA: A multi-observer study quantified the variability of different methods for diagnostic assessment of hip dysplasia...... and osteoarthritis and resulted in general recommendations regarding diagnostic assessment of hip dysplasia. Pelvic tilt was shown to differ significantly between the supine and weight-bearing positions in patients with dysplastic hip joints. This is a finding that adds controversy to the application of neutral...

  19. An impact assessment methodology for urban surface runoff quality following best practice treatment.

    Science.gov (United States)

    Ellis, J Bryan; Revitt, D Michael; Lundy, Lian

    2012-02-01

    The paper develops an easy to apply desk-based semi-quantitative approach for the assessment of residual receiving water quality risks associated with urban surface runoff following its conveyance through best practice sustainable drainage systems (SUDS). The innovative procedure utilises an integrated geographical information system (GIS)-based pollution index approach based on surface area impermeability, runoff concentrations/loadings and individual SUDS treatment performance potential to evaluate the level of risk mitigation achievable by SUDS drainage infrastructure. The residual impact is assessed through comparison of the determined pollution index with regulatory receiving water quality standards and objectives. The methodology provides an original theoretically based procedure which complements the current acute risk assessment approaches being widely applied within pluvial flood risk management. PMID:22227301

  20. Influence of data collection schemes on the Life Cycle Assessment of a municipal wastewater treatment plant

    DEFF Research Database (Denmark)

    Yoshida, Hiroko; Clavreul, Julie; Scheutz, Charlotte;

    2014-01-01

    A Life Cycle Assessment (LCA) of a municipal wastewater treatment plant (WWTP) was conducted to illustrate the effect of an emission inventory data collection scheme on the outcomes of an environmental impact assessment. Due to their burden in respect to data collection, LCAs often rely heavily on...... Registry), compliance with national discharge limits, and a state-of-the-art emission data collection scheme conducted at the same WWTP. Parameter uncertainty for each collection scheme was assessed through Monte Carlo simulation. The comparison of the results confirmed that LCA results depend heavily on......, an LCA based on the data collection scheme underestimates impact potential due to limitations of substance coverage. Besides differences between data collection schemes, the results showed that 3-13,500% of the impacts came from background systems, such as from the provisioning of fuel, electricity...

  1. Parent-assessed quality of life among adolescents undergoing orthodontic treatment: a 12-month follow-up

    OpenAIRE

    Lucas Guimarães Abreu; Camilo Aquino Melgaço; Mauro Henrique Nogueira Guimaraes Abreu; Elizabeth Maria Bastos Lages; Saul Martins Paiva

    2015-01-01

    Objective: To assess parents' and caregivers' view of the first twelve months of adolescents' orthodontic treatment with fixed appliances and to assess the evaluative properties of the Brazilian version of the Parental-Caregiver Perceptions Questionnaire (P-CPQ) in the orthodontic setting. Methods: Data from a sample of 96 parents and caregivers of adolescents undergoing orthodontic treatment with fixed appliances were collected by means of P-CPQ. Assessments were performed before banding and...

  2. Assessment of adult hip dysplasia and the outcome of surgical treatment.

    Science.gov (United States)

    Troelsen, Anders

    2012-06-01

    Hip dysplasia and hip joint deformities in general are recognized as possible precursors of osteoarthritic development. Early and correct identification of hip dysplasia is important in order to offer timely joint preserving treatment. In the contemporary literature, several controversies exist, and some of these were the focus of this doctoral thesis. Categorized into subjects, the major findings and their possible importance are listed below. DIAGNOSTIC ASSESSMENT OF HIP DYSPLASIA: A multi-observer study quantified the variability of different methods for diagnostic assessment of hip dysplasia and osteoarthritis and resulted in general recommendations regarding diagnostic assessment of hip dysplasia. Pelvic tilt was shown to differ significantly between the supine and weight-bearing positions in patients with dysplastic hip joints. This is a finding that adds controversy to the application of neutral pelvic positioning during assessment of hip deformities because pelvic tilt affects the appearance of acetabular version. Weight-bearing assessment of acetabular version showed the presence of retroversion in 33% of dysplastic hips. The establishment of retroversion as a rather frequent entity in dysplastic hips is contradictory to the historical finding that hip dysplasia is characterized by insufficient anterior and lateral coverage. In general, the findings have important implications for orthopedic surgeons and radiologists dealing with diagnostic assessment of painful hips in young adults, and for surgeons planning and performing joint-preserving periacetabular osteotomies. ASSESSMENT OF ACETABULAR LABRAL TEARS IN HIP DYSPLASIA: The roles of ultrasound and clinical tests in acetabular labral tear diagnostics were established. After overcoming an initial learning curve, ultrasound investigation was highly reliable in diagnosing labral tears, whereas only a positive impingement or FABER test was reliable in identifying a labral tear. It seems that non-invasive and

  3. Benefits and risks of emerging technologies: integrating life cycle assessment and decision analysis to assess lumber treatment alternatives.

    Science.gov (United States)

    Tsang, Michael P; Bates, Matthew E; Madison, Marcus; Linkov, Igor

    2014-10-01

    Assessing the best options among emerging technologies (e.g., new chemicals, nanotechnologies) is complicated because of trade-offs across benefits and risks that are difficult to quantify given limited and fragmented availability of information. This study demonstrates the integration of multicriteria decision analysis (MCDA) and life cycle assessment (LCA) to address technology alternative selection decisions. As a case study, prioritization of six lumber treatment alternatives [micronized copper quaternary (MCQ); alkaline copper quaternary (ACQ); water-borne copper naphthenate (CN); oil-borne copper naphthenate (CNo); water-borne copper quinolate (CQ); and water-borne zinc naphthenate (ZN)] for military use are considered. Multiattribute value theory (MAVT) is used to derive risk and benefit scores. Risk scores are calculated using a cradle-to-gate LCA. Benefit scores are calculated by scoring of cost, durability, and corrosiveness criteria. Three weighting schemes are used, representing Environmental, Military and Balanced stakeholder perspectives. Aggregated scores from all three perspectives show CQ to be the least favorable alterative. MCQ is identified as the most favorable alternative from the Environmental stakeholder perspective. From the Military stakeholder perspective, ZN is determined to be the most favorable alternative, followed closely by MCQ. This type of scoring and ranking of multiple heterogeneous criteria in a systematic and transparent way facilitates better justification of technology selection and regulation. PMID:25209330

  4. Classification of treatment-related mortality in children with cancer: a systematic assessment.

    Science.gov (United States)

    Alexander, Sarah; Pole, Jason D; Gibson, Paul; Lee, Michelle; Hesser, Tanya; Chi, Susan N; Dvorak, Christopher C; Fisher, Brian; Hasle, Henrik; Kanerva, Jukka; Möricke, Anja; Phillips, Bob; Raetz, Elizabeth; Rodriguez-Galindo, Carlos; Samarasinghe, Sujith; Schmiegelow, Kjeld; Tissing, Wim; Lehrnbecher, Thomas; Sung, Lillian

    2015-12-01

    Treatment-related mortality is an important outcome in paediatric cancer clinical trials. An international group of experts in supportive care in paediatric cancer developed a consensus-based definition of treatment-related mortality and a cause-of-death attribution system. The reliability and validity of the system was tested in 30 deaths, which were independently assessed by two clinical research associates and two paediatric oncologists. We defined treatment-related mortality as death occurring in the absence of progressive cancer. Of the 30 reviewed deaths, the reliability of classification for treatment-related mortality was noted as excellent by clinical research associates (κ=0·83, 95% CI 0·60-1·00) and paediatric oncologists (0·84, 0·63-1·00). Criterion validity was established because agreement between the consensus classifications by clinical research associates and paediatric oncologists was almost perfect (0·92, 0·78-1·00). Our approach should allow comparison of treatment-related mortality across trials and across time. PMID:26678213

  5. Assessment of the efficiency and economic viability of various methods of treatment of sanitary landfill leachate.

    Science.gov (United States)

    Gupta, S K; Singh, Gurdeep

    2007-12-01

    This study assesses the efficiency of various physico-chemical, biological and other tertiary methods for treating leachate. An evaluation study on the treatability of the leachate from methane phase bed (MPB) reactor indicated that at an optimum hydraulic retention time of 6 days, the efficiency of the reactor in terms of biological oxygen demand (BOD) and chemical oxygen demand (COD) removal was 91.29 and 82.69%, respectively. Recycling of the treated leachate through the municipal solid waste layers in the leachate recycling unit (LRU) resulted in a significant increase in the biodegradation of organics present in the leachate. Optimum BOD and COD removal efficiencies were achieved at the third recycle; additional recycling of the leachate did not produce any significant improvement. Physico-chemical treatment of the leachate demonstrated that alum and lime (Option 2) were more economical than coagulants lime and MgCO(3). A cost analysis of the economics of the various treatments revealed that the alternative treatment consisting of a MPB bed followed by a LRU and aerated lagoon is the most cost-effective treatment. However, the alternative consisting of a MPB followed by the LRU and a soil column, which is slightly more costly, would be the most appropriate treatment when adequate land is readily available. PMID:17505905

  6. Crowdsourced assessment of common genetic contribution to predicting anti-TNF treatment response in rheumatoid arthritis.

    Science.gov (United States)

    Sieberts, Solveig K; Zhu, Fan; García-García, Javier; Stahl, Eli; Pratap, Abhishek; Pandey, Gaurav; Pappas, Dimitrios; Aguilar, Daniel; Anton, Bernat; Bonet, Jaume; Eksi, Ridvan; Fornés, Oriol; Guney, Emre; Li, Hongdong; Marín, Manuel Alejandro; Panwar, Bharat; Planas-Iglesias, Joan; Poglayen, Daniel; Cui, Jing; Falcao, Andre O; Suver, Christine; Hoff, Bruce; Balagurusamy, Venkat S K; Dillenberger, Donna; Neto, Elias Chaibub; Norman, Thea; Aittokallio, Tero; Ammad-Ud-Din, Muhammad; Azencott, Chloe-Agathe; Bellón, Víctor; Boeva, Valentina; Bunte, Kerstin; Chheda, Himanshu; Cheng, Lu; Corander, Jukka; Dumontier, Michel; Goldenberg, Anna; Gopalacharyulu, Peddinti; Hajiloo, Mohsen; Hidru, Daniel; Jaiswal, Alok; Kaski, Samuel; Khalfaoui, Beyrem; Khan, Suleiman Ali; Kramer, Eric R; Marttinen, Pekka; Mezlini, Aziz M; Molparia, Bhuvan; Pirinen, Matti; Saarela, Janna; Samwald, Matthias; Stoven, Véronique; Tang, Hao; Tang, Jing; Torkamani, Ali; Vert, Jean-Phillipe; Wang, Bo; Wang, Tao; Wennerberg, Krister; Wineinger, Nathan E; Xiao, Guanghua; Xie, Yang; Yeung, Rae; Zhan, Xiaowei; Zhao, Cheng; Greenberg, Jeff; Kremer, Joel; Michaud, Kaleb; Barton, Anne; Coenen, Marieke; Mariette, Xavier; Miceli, Corinne; Shadick, Nancy; Weinblatt, Michael; de Vries, Niek; Tak, Paul P; Gerlag, Danielle; Huizinga, Tom W J; Kurreeman, Fina; Allaart, Cornelia F; Louis Bridges, S; Criswell, Lindsey; Moreland, Larry; Klareskog, Lars; Saevarsdottir, Saedis; Padyukov, Leonid; Gregersen, Peter K; Friend, Stephen; Plenge, Robert; Stolovitzky, Gustavo; Oliva, Baldo; Guan, Yuanfang; Mangravite, Lara M; Bridges, S Louis; Criswell, Lindsey; Moreland, Larry; Klareskog, Lars; Saevarsdottir, Saedis; Padyukov, Leonid; Gregersen, Peter K; Friend, Stephen; Plenge, Robert; Stolovitzky, Gustavo; Oliva, Baldo; Guan, Yuanfang; Mangravite, Lara M

    2016-01-01

    Rheumatoid arthritis (RA) affects millions world-wide. While anti-TNF treatment is widely used to reduce disease progression, treatment fails in ∼one-third of patients. No biomarker currently exists that identifies non-responders before treatment. A rigorous community-based assessment of the utility of SNP data for predicting anti-TNF treatment efficacy in RA patients was performed in the context of a DREAM Challenge (http://www.synapse.org/RA_Challenge). An open challenge framework enabled the comparative evaluation of predictions developed by 73 research groups using the most comprehensive available data and covering a wide range of state-of-the-art modelling methodologies. Despite a significant genetic heritability estimate of treatment non-response trait (h(2)=0.18, P value=0.02), no significant genetic contribution to prediction accuracy is observed. Results formally confirm the expectations of the rheumatology community that SNP information does not significantly improve predictive performance relative to standard clinical traits, thereby justifying a refocusing of future efforts on collection of other data. PMID:27549343

  7. Cross-Cultural Adaptations of the MacArthur Competence Assessment Tool for Treatment in Iran

    Directory of Open Access Journals (Sweden)

    Saber

    2016-01-01

    Full Text Available Background According to general ethical and legal principles, valid consent must be obtained before starting any procedure. Objectives Due to the lack of a standard tool for assessing patients’ capacity to consent to medical treatment in Iran, the present study was carried out aiming to devise a Persian version of a cross-cultural adaptation of the MacArthur competence assessment tool. Patients and Methods By reviewing different methods of cultural translation and adaptation for assessment tools, and due to the lack of consensus on its processes, we selected Wild’s model as one of the most comprehensive methods in this regard. Wild’s (2005 10-stage model includes preparation, forward translation, reconciliation of the forward translation, back translation of reconciliation, back translation review, cognitive debriefing and cognitive review, and finalization, proofreading and final reporting. Using this model, we translated the MacArthur assessment tool and made it adaptable to Iranian patients. Results The MacArthur assessment tool is not dependent on any specific culture and language. As a result, if translation and its scientific adaptation are done based on an integrated and detailed model, the tool can be used for every culture and language. In other words, this tool is not culture-specific; so, it is applicable in cases where a translation is needed, and it can be culturally adapted to suit different societies. Conclusions In the present study, we are able to focus on and prove the efficacy and benefits of this measurement tool.

  8. Environmental evaluation of transfer and treatment of excess pig slurry by life cycle assessment.

    Science.gov (United States)

    Lopez-Ridaura, Santiago; Werf, Hayo van der; Paillat, Jean Marie; Le Bris, Bertrand

    2009-02-01

    Slurry management is a central topic in the agronomic and environmental analysis of intensive livestock production systems. The objective of this study is to compare the environmental performance of two scenarios of collective slurry management for the disposal of excess nitrogen from animal manure. The scenarios are the transfer of slurry and its injection to crop land, and the treatment of slurry in a collective biological treatment station. The study is based on a real case in the West of France, where a group of farmers is developing a collective plan for the disposal of almost 7000 m(3) of excess pig slurry. The evaluation is carried out by Life Cycle Assessment, where emissions and resource consumption are quantified and aggregated into four environmental impact categories: eutrophication, acidification, climate change, and non-renewable energy use. Ammonia emitted is the most important contributor to acidification and eutrophication, while methane contributes most to climate change. Both ammonia and methane are mostly emitted during the storage of slurry and, in the case of the treatment scenario, also during composting the solid fraction of the slurry. The two management strategies are similar with respect to climate change, whereas eutrophication and acidification are twice as large for treatment relative to transfer. Electricity needed for the treatment process is the main contributor to non-renewable energy use for the treatment scenario, while the transfer scenario represents a net energy saving, as energy saved by the reduction of mineral fertiliser use more than compensates for the energy needed for transport and injection of slurry. The overall environmental performance of transfer is better than that of treatment, as it involves less acidification, eutrophication and non-renewable energy use. The method employed and the results obtained in this study can provide elements for a transparent discussion of the advantages and disadvantages of contrasting

  9. The Assessment of Radioactive Liquid Waste Treatment Generated From The Fuel Reprocessing Plant Using Chemical Coagulation Method

    International Nuclear Information System (INIS)

    Reprocessing of nuclear spent fuel produced 8 lot of radioactive liquid waste still bearing uranium and transuranium. The assessment of the radioactive liquid waste treatment with FeCI3 as coagulant has been done. Decontamination factor and separation efficiency can be calculated from known activities of initial and post-treatment wastes. It can be concluded that some factors i.e. pH of treatment process, quantity of coagulant, mixing rate, and mixing time have influenced the treatment product

  10. Weighing environmental advantages and disadvantages of advanced wastewater treatment of micro-pollutants using environmental life cycle assessment

    DEFF Research Database (Denmark)

    Wenzel, Henrik; Larsen, Henrik Fred; Clauson-Kaas, Jes;

    2008-01-01

    Much research and development effort is directed towards advances in municipal wastewater treatment aiming at reducing the effluent content of micro-pollutants and pathogens. The objective is to further reduce the eco-toxicity, hormone effects and pathogenic effects of the effluent. Such further......-off was investigated using Life Cycle Assessment (LCA) methodology and based on a literature review of advanced treatment performance. The LCA evaluation comprised sand filtration, ozonation and MBRs and assessed the effect of extending existing tertiary treatment with these technologies on a variety of micro-pollutants......; life cycle assessment; MBR; micro-pollutants; ozonation; sand filtration....

  11. Assessing racial/ethnic disparities in chemotherapy treatment among breast cancer patients in context of changing treatment guidelines

    OpenAIRE

    Silva, Abigail; Rauscher, Garth H.; Hoskins, Kent; Rao, Ruta; Ferrans, Carol Estwing

    2013-01-01

    Conflicting study results with regards to racial/ethnic disparities in chemotherapy use among breast cancer patients may be due to the different sample populations, treatment data sources, and treatment eligibility definitions used. This study examined chemotherapy disparity in the context of changing treatment guidelines and explored factors that may help explain treatment differences observed.

  12. Use of Q methodology to assess the concerns of adult female individuals seeking orthodontic treatment

    Directory of Open Access Journals (Sweden)

    Yao L

    2015-01-01

    Full Text Available Linjie Yao,1 Xingqiao Xu,2 Zhenyu Ni,3 Minling Zheng,3 Feiou Lin3 1Department of Pedodontics, 2Department of Oral and Maxillofacial Surgery, 3Department of Orthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, People’s Republic of China Background: Orthodontic treatment may cause functional restrictions, discomfort, and pain, which may lead to dental anxiety and noncooperation among patients. This study aimed to assess the concerns of adult female patients with respect to such treatment.Patients and methods: We conducted an explorative study using Q methodology among 40 adult female patients with different educational and social backgrounds in Wenzhou, People’s Republic of China. We asked participants to rank a set of 41 statements about seeking orthodontic treatment on an 11-point scale from “agree most” to “disagree most”. The collected data were analyzed using the PQ Method 2.35 program. We extracted significant viewpoints using centroid factor extraction and varimax rotation.Results: We identified major factors based on how the patients ranked statements. Patients in group 1 worried about lack of information about orthodontic treatment, and may have suffered from dental phobia; patients in group 2 were all single women, and they were worried that the braces might lower their chances of finding a partner; patients in group 3 worried about appearance and speech with braces; and patients in group 4 worried about cost, pain, and dental hygiene. The remaining participants who had other viewpoints did not load to any of these four groups.Conclusion: The concerns of adult female individuals seeking orthodontic treatment are complex. A significant feature of this study was using Q methodology to analyze the psychological characteristics of the patients. This study identified four typical characterizations that are associated with each group, and our findings may aid orthodontists in improving doctor

  13. Obesity and Surgical Treatment – A Cost-Effectiveness Assessment for Sweden

    Directory of Open Access Journals (Sweden)

    Sixten Borg

    2014-07-01

    Full Text Available Background:The rising trend in the prevalence of obesity has during the past decades become a major public health concern in many countries, as obesity may lead to comorbidities and death. A frequent used marker for obesity is the Body Mass Index (BMI. The cost of treatment for obesity related diseases has become a heavy burden on national health care budget in many countries. While diet and exercise are the cornerstones of weight management, pharmaco­therapy is often needed to achieve and maintain desired weight loss.  In some cases of extreme obesity, bariatric surgery may be recommended. It is expected to increase by 50% in Sweden.Objective: The overall objective was to develop a cost-effectiveness model using the best available evidence to assess the cost-effectiveness of gastric bypass (GBP surgical treatments for obesity in adult patients, in comparison with conventional treatment (CT, in Sweden from a healthcare perspective. With the model we also seeked to identify the lower cut-off point using BMI criteria, for the surgical intervention to be cost-effective. Methods:A micro-simulation model with an underlying Markov methodology was developed, that simulates individual patients. It simulates the outcomes of the patients in terms of treatment costs, life years, and quality adjusted life years (QALY over his/her remaining lifetime. The costs are presented in SEK in the year 2006 price level (1 SEK ≈ 0.11 EUR ≈ 0.14 USD.Results: We estimated that the incremental cost per QALY gained will not exceed SEK 33,000 per QALY in patients with BMI < 35. In patients with BMI > 35 kg/m2, gastric bypass surgery has lower costs compared to conventional treatment. Conclusion: Gastric bypass surgery is a cost-effective intervention compared to conventional treatment consisting of watchful waiting, diet and exercise.

  14. Methodology for assessment of low level laser therapy (LLLT) irradiation parameters in muscle inflammation treatment

    Science.gov (United States)

    Mantineo, M.; Pinheiro, J. P.; Morgado, A. M.

    2013-11-01

    Several studies in human and animals show the clinical effectiveness of low level laser therapy (LLLT) in reducing some types of pain, treating inflammation and wound healing. However, more scientific evidence is required to prove the effectiveness of LLLT since many aspects of the cellular and molecular mechanisms triggered by irradiation of injured tissue with laser remain unknown. Here, we present a methodology that can be used to evaluate the effect of different LLLT irradiation parameters on the treatment of muscle inflammation on animals, through the quantification of four cytokines (TNF-α, IL-1β, IL-2 and IL-6) in systemic blood and histological analysis of muscle tissue. We have used this methodology to assess the effect of LLLT parameters (wavelength, dose, power and type of illumination) in the treatment of inflammation induced in the gastrocnemius muscle of Wistar rats. Results obtained for laser dose evaluation with continuous illumination are presented.

  15. Brave new worlds--review and update on virtual reality assessment and treatment in psychosis.

    Science.gov (United States)

    Veling, Wim; Moritz, Steffen; van der Gaag, Mark

    2014-11-01

    In recent years, virtual reality (VR) research on psychotic disorders has been initiated. Several studies showed that VR can elicit paranoid thoughts about virtual characters (avatars), both in patients with psychotic disorders and healthy individuals. Real life symptoms and VR experiences were correlated, lending further support to its validity. Neurocognitive deficits and difficulties in social behavior were found in schizophrenia patients, not only in abstract tasks but also using naturalistic virtual environments that are more relevant to daily life, such as a city or encounters with avatars. VR treatments are conceivable for most dimensions of psychotic disorders. There is a small but expanding literature on interventions for delusions, hallucinations, neurocognition, social cognition, and social skills; preliminary results are promising. VR applications for assessment and treatment of psychotic disorders are in their infancy, but appear to have a great potential for increasing our understanding of psychosis and expanding the therapeutic toolbox. PMID:25193975

  16. Life cycle assessment of sewage sludge treatment and its use on land

    DEFF Research Database (Denmark)

    Yoshida, Hiroko

    multi-focused, as renewable energy and nutrient recovery have been added to the list beyond sanitation and stabilisation of sewage sludge. In order to organise and quantify environmental benefits and associated burdens, in order to facilitate an informed decision making process, life cycle assessments......Sewage sludge is generated as an end-product of wastewater treatment processes, and its management holds importance in the operation of wastewater treatment plants from both an economic and an environmental point of view. At the same time, the management of sewage sludge is becoming increasingly...... collection schemes: a compulsory environmental information disclosure requirement, a pollutant discharge monitoring requirement and state-of-the-art on-site data collection. While adequately capturing impacts in relation to global warming and marine eutrophication, an LCA based on existing data sources might...

  17. How Do We Assess Dissociation in Treatment Seeking Refugees in the West?

    DEFF Research Database (Denmark)

    Palic, Sabina; Elklit, Ask; Armour, Cherie; Carlsson, Jessica

    Not enough attention is paid to dissociation in treatment of traumatized refugees in western countries. Knowledge about the assessment, the extent, and the content of dissociation in this group is lacking. An evaluation of measures and description of dissociative symptoms was carried out in 86...... Bosnian treatment seeking refugees with the dissociation subscale of the Structured Interview for Disorders of Extreme Stress (SIDES-D), the self-report version of the SIDES-D (SIDES-D-SR), the Dissociative Experiences Scale (DES), and the DES-Taxon. The DES correlated strongly with the SIDES-D but they...... showed only moderate classification agreement. The DES was found to be the preferred measure since the SIDES-D seemed to partly tap correlates of lasting psychiatric illness. The DES-Taxon functioned well as an abbreviated version of the DES. Thirty percent of the group was estimated to have pathological...

  18. Comorbidity of LD and ADHD: implications of DSM-5 for assessment and treatment.

    Science.gov (United States)

    DuPaul, George J; Gormley, Matthew J; Laracy, Seth D

    2013-01-01

    Attention-deficit/hyperactivity disorder (ADHD) and learning disability (LD) can co-occur for a significant minority of children with each disorder. A total of 17 studies (2001-2011) examining ADHD-LD comorbidity were reviewed, revealing a higher mean comorbidity rate (45.1%) than has been obtained previously. Higher comorbidity may be the result of including students with writing disorders, not just reading and/or math disabilities. Proposed DSM-5 criteria for both disorders will likely affect comorbidity rates; however, it is unclear whether such rates will increase or decrease. Regardless of the specific impact of DSM revisions, academic skill and/or performance deficits should be assessed for students with ADHD as part of screening, comprehensive evaluation, and treatment monitoring. Comprehensive intervention services for students with comorbid ADHD and LD will require empirically supported treatment strategies that address both disorders and that are implemented across school and home settings. PMID:23144063

  19. Documentation assessment, Project C-018H, 200-E area effluent treatment facility

    International Nuclear Information System (INIS)

    Project C-018H is one of the fourteen subprojects to the Hanford Environmental Compliance (HEC) Project. Project C-018H provides treatment and disposal for the 242-A Evaporator and PUREX plant process condensate waste streams. This project used the Integrated Management Team (IMT) approach proposed by RL. The IMT approach included all affected organizations on the project team to coordinate and execute all required project tasks, while striving to integrate and satisfy all technical, operational, functional, and organizational objectives. The HEC Projects were initiated in 1989. Project C-018H began in early 1990, with completion of construction currently targeted for mid-1995. This assessment was performed to evaluate the effectiveness of the management control on design documents and quality assurance records developed and submitted for processing, use, and retention for the Project. The assessment focused primarily on the overall adequacy and quality of the design documentation currently being submitted to the project document control function

  20. Life cycle assessment of pig slurry treatment technologies for nutrient redistribution in Denmark

    DEFF Research Database (Denmark)

    ten Hoeve, Marieke; Hutchings, Nicholas John; Peters, Gregory;

    2014-01-01

    Animal slurry management is associated with a range of impacts on fossil resource use and the environment. The impacts are greatest when large amounts of nutrient-rich slurry from livestock production cannot be adequately utilised on adjacent land. To facilitate nutrient redistribution, a range of...... different technologies are available. This study comprised a life cycle assessment of the environmental impacts from handling 1000. kg of pig slurry ex-animal. Application of untreated pig slurry onto adjacent land was compared with using four different treatment technologies to enable nutrient...... combination of values derived from the literature and simulations with the Farm-N model for Danish agricultural and climatic conditions. The environmental impact categories assessed were climate change, freshwater eutrophication, marine eutrophication, terrestrial acidification, natural resource use, and soil...

  1. Telepractice in the Assessment and Treatment of Individuals with Aphasia: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Nerissa Hall

    2013-06-01

    Full Text Available Telepractice involves the application of technology to deliver services over a geographical distance. Studies in which telepractice procedures were used in the assessment or treatment of individuals with aphasia were reviewed. Systematic searches identified 10 studies meeting inclusion criteria. These studies were evaluated in terms of the: (a characteristics of the participants, (b technology utilized (c, services delivered via telepractice (d, research methodology, and (e results and conclusions of the study. Telepractice was used by speech-language pathologists and the allied health professionals to assist with the delivery of services to participants with aphasia by their caretakers or clinicians. The services delivered included appraisal, diagnostic assessments, interventions, and consultation. This review suggests that telepractice is a viable method of service delivery for individuals with aphasia and warrants additional research. Guidelines for practitioners and potential directions for future research are discussed.

  2. Life-cycle assessment of a waste refinery process for enzymatic treatment of municipal solid waste

    DEFF Research Database (Denmark)

    Tonini, Davide; Astrup, Thomas

    2012-01-01

    production and saving fossil resources. This is especially important with respect to residual waste (i.e. the remains after source-separation and separate collection) which in Denmark is typically incinerated. In this paper, a life-cycle assessment and energy balance of a pilot-scale waste refinery for the...... enzymatic treatment of municipal solid waste (MSW) is presented. The refinery produced a liquid (liquefied organic materials and paper) and a solid fraction (non-degradable materials) from the initial waste. A number of scenarios for the energy utilization of the two outputs were assessed. Co-combustion in...... refinery was mainly associated with the opportunity to decrease energy and enzyme consumption....

  3. Life-cycle assessment of a waste refinery process for enzymatic treatment of municipal solid waste

    DEFF Research Database (Denmark)

    Tonini, Davide; Astrup, Thomas

    2012-01-01

    enzymatic treatment of municipal solid waste (MSW) is presented. The refinery produced a liquid (liquefied organic materials and paper) and a solid fraction (non-degradable materials) from the initial waste. A number of scenarios for the energy utilization of the two outputs were assessed. Co-combustion in......Decrease of fossil fuel dependence and resource saving has become increasingly important in recent years. From this perspective, higher recycling rates for valuable materials (e.g. metals) as well as energy recovery from waste streams could play a significant role substituting for virgin material...... production and saving fossil resources. This is especially important with respect to residual waste (i.e. the remains after source-separation and separate collection) which in Denmark is typically incinerated. In this paper, a life-cycle assessment and energy balance of a pilot-scale waste refinery for the...

  4. Environmental assessment for liquid waste treatment at the Nevada Test Site, Nye County, Nevada

    International Nuclear Information System (INIS)

    This environmental assessment (EA) examines the potential impacts to the environment from treatment of low-level radioactive liquid and low-level mixed liquid and semi-solid wastes generated at the Nevada Test Site (NTS). The potential impacts of the proposed action and alternative actions are discussed herein in accordance with the National Environmental Policy Act (NEPA) of 1969, as amended in Title 42 U.S.C. (4321), and the US Department of Energy (DOE) policies and procedures set forth in Title 10 Code of Federal Regulations (CFR) Part 1021 and DOE Order 451.1, ''NEPA Compliance Program.'' The potential environmental impacts of the proposed action, construction and operation of a centralized liquid waste treatment facility, were addressed in the Final Environmental Impact Statement for the Nevada Test Site and Off-Site Locations in the State of Nevada. However, DOE is reevaluating the need for a centralized facility and is considering other alternative treatment options. This EA retains a centralized treatment facility as the proposed action but also considers other feasible alternatives

  5. Ceriodaphnia and Chironomus in situ toxicity tests assessing the wastewater treatment efficacy of constructed wetlands

    International Nuclear Information System (INIS)

    In situ toxicity tests were designed for Ceriodaphnia dubia and Chironomus tentans as part of a larger study designed to assess the effectiveness of constructed wetlands for the treatment of wastewater produced by oil production at Suncor OSG. The artificial wetlands were 50m long by 3m wide, with three replicates of the control and the treatment. Each wetland had four sample sites equidistant along its length, creating a gradient of treatment from site A being the most toxic to site D being the least toxic. Each test was conducted twice during the summer of 1994. Both the Ceriodaphnia and Chironomus test cages were a flow through design to allow for maximal exposure to the water within the wetlands. Mortality and reproduction were used as endpoints for Ceriodaphnia, whereas mortality and growth were used as endpoints for the Chironomus test. Test durations were fifteen and ten days respectively. Chironomus had very high mortality along the entire wetlands whereas Ceriodaphnia survival and fecundity increased along the length of the treatment wetlands. Both organisms had low mortality and high growth/fecundity in the control wetlands

  6. Mass balance to assess the efficiency of a mechanical-biological treatment

    International Nuclear Information System (INIS)

    Using mechanical-biological treatment of residual municipal solid waste, it is possible to significantly lower landfill volume and gas and leachate emissions. Moreover, the landfill characteristics are improved. The performance of the Mende (France) mechanical-biological treatment plant is assessed via mass balances coupled with manual sorting according to the MODECOMTM methodology and biochemical methane potential after 90 days of incubation. The site includes mechanical sorting operations, a rotary sequential bioreactor, controlled aerobic stabilisation corridors, maturation platforms, and a sanitary landfill site for waste disposal in separated cells. Results showed that several steps could be improved: after a first sieving step, about 12% of the potentially biodegradable matter is landfilled directly without any treatment; mechanical disintegration of papers and cardboards in the rotary sequential bioreactor is insufficient and leads to a high proportion of papers and cardboards being landfilled without further treatment. Two fine fractions go through stabilisation and maturation steps. At the end of the maturation step, about 54% of the potentially biodegradable matter is degraded. The biochemical methane potential after 90 days of incubation is reduced by 81% for one of the two fine fractions and reduced by 88% for the other one. Considering the whole plant, there is a reduction of nearly 20% DM of the entering residual municipal solid waste

  7. Clinical Assessment of Tribulus terrestris Extract in the Treatment of Female Sexual Dysfunction.

    Science.gov (United States)

    Gama, Carlos Rb; Lasmar, Ricardo; Gama, Gustavo F; Abreu, Camila S; Nunes, Carlos P; Geller, Mauro; Oliveira, Lisa; Santos, Alessandra

    2014-01-01

    This is a qualitative-quantitative study based on hospital records of female patients of reproductive age, presenting sexual dysfunction, and treated with 250 mg Tribulus terrestris extract (1 tablet thrice daily for 90 days). Safety monitoring included vital signs, physical examination, laboratory tests, and occurrence of adverse events. Efficacy analysis included results of the Female Sexual Function Index (FSFI), dehydroepiandrosterone (DHEA) levels together with total and free testosterone, and the patient and physician assessments. There was a statistically significant improvement in total FSFI scores (P terrestris extract is safe and effective in the treatment of female sexual dysfunction. PMID:25574150

  8. NeuroVRAC--a comprehensive approach to virtual reality-based neurological assessment and treatment systems.

    Science.gov (United States)

    Valvoda, Jakob T; Assenmacher, Ingo; Dohle, Christian; Kuhlen, Torsten; Bischof, Christian

    2003-01-01

    We describe a comprehensive software-oriented approach to virtual reality-based neuroscientific systems in order to establish an easy to use framework for neuroscientific assessment and treatment. We have defined a process model and implemented the NeuroVRAC authoring tool for design and execution of experiments in virtual environments. Our system enables the modeling of virtual world objects and the definition of events, which are used to control the experimental process. We have included the virtual test person concept to enhance the sense of presence during the execution of virtual reality-based neuroscientific experiments. PMID:15455927

  9. Some considerations on the treatment of uncertainties in risk assessment for practical decision making

    International Nuclear Information System (INIS)

    This paper discusses the challenges involved in the representation and treatment of uncertainties in risk assessment, taking the point of view of its use in support to decision making. Two main issues are addressed: (1) how to faithfully represent and express the knowledge available to best support the decision making and (2) how to best inform the decision maker. A general risk-uncertainty framework is presented which provides definitions and interpretations of the key concepts introduced. The framework covers probability theory as well as alternative representations of uncertainty, including interval probability, possibility and evidence theory.

  10. Platelet production and platelet destruction: assessing mechanisms of treatment effect in immune thrombocytopenia

    OpenAIRE

    Barsam, Sarah J.; Psaila, Bethan; Forestier, Marc; Page, Lemke K.; Sloane, Peter A.; Geyer, Julia T.; Villarica, Glynis O.; Ruisi, Mary M.; Gernsheimer, Terry B.; Beer, Juerg H.; Bussel, James B.

    2011-01-01

    This study investigated the immature platelet fraction (IPF) in assessing treatment effects in immune thrombocytopenia (ITP). IPF was measured on the Sysmex XE2100 autoanalyzer. The mean absolute-IPF (A-IPF) was lower for ITP patients than for healthy controls (3.2 vs 7.8 × 109/L, P < .01), whereas IPF percentage was greater (29.2% vs 3.2%, P < .01). All 5 patients with a platelet response to Eltrombopag, a thrombopoietic agent, but none responding to an anti-FcγRIII antibody, had correspondi...

  11. Radiation therapy in treatment of children non-lymphoblastic non-Hodgkin's lymphomas: clinical assessment

    International Nuclear Information System (INIS)

    The results of combined treatment were analysed retrospectively in 85 children with nonlymphoblastic non-Hodgkin's lymphomas (NHL) of 1-2-3 stages (Ann-Arbor). The importance of involved-field radiation therapy (IFRT) combined with ACOP, MEV, COP chemotherapy was assessed. All patients experienced high grade nonlymphoblastic subtypes of NHL as follows: follicular center cells, undifferentiated, immunoblastic (Lukes-Collins classification). Adjuvant IFRT resulted in significantly increased rate of 5-year overall and disease-free survival and diminished relapse frequency

  12. Quality-of-life assessment in patients undergoing treatment for oesophageal carcinoma.

    Science.gov (United States)

    O'Hanlon, D M; Harkin, M; Karat, D; Sergeant, T; Hayes, N; Griffin, S M

    1995-12-01

    In a prospective study of 69 patients being treated for oesophageal carcinoma, quality of life was assessed with the Rotterdam Symptom Checklist, a dysphagia score and an activities of daily living questionnaire. Significant correlations were found between the results of the Rotterdam Symptom Checklist, the dysphagia score and most aspects of the activities of daily living questionnaire. Eighteen patients underwent surgery, 43 radiotherapy or intubation, and eight a combination of surgery and other therapy. Patients undergoing surgery were significantly younger and had better scores in all parameters examined before operation, including significantly better scores in 'knowledge and communication' and 'mobility and fatigue'. The dysphagia score fell significantly after intervention both in patients undergoing surgery alone and in those receiving palliative therapy. The activities of daily living questionnaire showed significant improvements in two parameters in the surgical group ('self-care' and 'eating and drinking') and in none of the parameters assessed in the palliation group in 16 weeks. Quality-of-life assessment is useful in assessing quality of care and patient well-being after the diagnosis and treatment of oesophageal carcinoma. PMID:8548241

  13. TSD-DOSE: A radiological dose assessment model for treatment, storage, and disposal facilities

    International Nuclear Information System (INIS)

    Past practices at US Department of Energy (DOE) field facilities resulted in the presence of trace amounts of radioactive materials in some hazardous chemical wastes shipped from these facilities. In May 1991, the DOE Office of Waste Operations issued a nationwide moratorium on shipping all hazardous waste until procedures could be established to ensure that only nonradioactive hazardous waste would be shipped from DOE facilities to commercial treatment, storage, and disposal (TSD) facilities. To aid in assessing the potential impacts of shipments of mixed radioactive and chemically hazardous wastes, a radiological assessment computer model (or code) was developed on the basis of detailed assessments of potential radiological exposures and doses for eight commercial hazardous waste TSD facilities. The model, called TSD-DOSE, is designed to incorporate waste-specific and site-specific data to estimate potential radiological doses to on-site workers and the off-site public from waste-handling operations at a TSD facility. The code is intended to provide both DOE and commercial TSD facilities with a rapid and cost-effective method for assessing potential human radiation exposures from the processing of chemical wastes contaminated with trace amounts of radionuclides

  14. 4D cone beam CT-based dose assessment for SBRT lung cancer treatment

    Science.gov (United States)

    Cai, Weixing; Dhou, Salam; Cifter, Fulya; Myronakis, Marios; Hurwitz, Martina H.; Williams, Christopher L.; Berbeco, Ross I.; Seco, Joao; Lewis, John H.

    2016-01-01

    The purpose of this research is to develop a 4DCBCT-based dose assessment method for calculating actual delivered dose for patients with significant respiratory motion or anatomical changes during the course of SBRT. To address the limitation of 4DCT-based dose assessment, we propose to calculate the delivered dose using time-varying (‘fluoroscopic’) 3D patient images generated from a 4DCBCT-based motion model. The method includes four steps: (1) before each treatment, 4DCBCT data is acquired with the patient in treatment position, based on which a patient-specific motion model is created using a principal components analysis algorithm. (2) During treatment, 2D time-varying kV projection images are continuously acquired, from which time-varying ‘fluoroscopic’ 3D images of the patient are reconstructed using the motion model. (3) Lateral truncation artifacts are corrected using planning 4DCT images. (4) The 3D dose distribution is computed for each timepoint in the set of 3D fluoroscopic images, from which the total effective 3D delivered dose is calculated by accumulating deformed dose distributions. This approach is validated using six modified XCAT phantoms with lung tumors and different respiratory motions derived from patient data. The estimated doses are compared to that calculated using ground-truth XCAT phantoms. For each XCAT phantom, the calculated delivered tumor dose values generally follow the same trend as that of the ground truth and at most timepoints the difference is less than 5%. For the overall delivered dose, the normalized error of calculated 3D dose distribution is generally less than 3% and the tumor D95 error is less than 1.5%. XCAT phantom studies indicate the potential of the proposed method to accurately estimate 3D tumor dose distributions for SBRT lung treatment based on 4DCBCT imaging and motion modeling. Further research is necessary to investigate its performance for clinical patient data.

  15. CLINICAL ASSESSMENT OF THE EFFECT OF LOW LEVEL LASER TREATMENT OF ORAL MUCOSA DECUBITUS ULCERS

    Directory of Open Access Journals (Sweden)

    Hristina Lalabonova

    2013-10-01

    Full Text Available Decubitus ulcers in the oral mucosa tend to be very painful causing discomforting sensation in patients in speaking and eating. Low energy lasers can provide an alternative method for the treatment of these ulcers.The aim of the present paper was to assess clinically the healing effect of low level laser irradiation on oral mucosa decubitus ulcers.Material and methods: A total of 90 patients with decubitus ulcers were treated in the present study; they were randomly assigned to three groups: group I included 30 patients treated with low level laser (LLL irradiation (wavelength of irradiation 658 nm; group II - 30 patients treated with laser irradiation of 904 nm; and group III (controls - 30 patients who received a standard conventional treatment with "granofurin" and "solcoseryl".The treatment sessions in all three groups were administered once daily. The patients in groups I and II were irradiated with focused irradiation at an angle from a distance using a conically shaped light probe 3 mm in diameter. The irradiated area was 0.5 cm2. The light was focused on the oral mucosa ulcer and the surrounding inflamed mucosa at a distance of 0.5 to 1 cm. Diode lasers were used in the study. The dosage of irradiation was 1.2 J/cm2.Results and discussion: The treatment effect was evaluated by changes in the studied parameters: pain intensity, erythema, and epithelialization. They were assessed at baseline, and at days 1, 3 and 5. Conclusions: LLLT administered with the proposed methodology manages pain rapidly and accelerates the process of epithelialization of decubitus ulcers in the soft tissues of the mouth.

  16. Communication subjective assessments of patients undergoing compulsory treatment with the severity of negative symptoms and cognitive functioning level

    Directory of Open Access Journals (Sweden)

    Kabanov T.N.

    2015-04-01

    Full Text Available The article presents the results of studies on the relationship of subjective assessments of the mentally ill with the severity of negative symptoms and cognitive functioning level. The features of patients perception of various aspects of compulsory treatment and subjective satisfaction with treatment. In a study of 94 male patients with a diagnosis of organic mental disorder and schizophrenia was used diagnostic system, consisting of patopsihologicheskogo study, formal survey map, the scale of assessment of negative symptoms SANS, questionnaire symptom levels SCL-90, self-existing problems, as well as - in Test authoring tool sheet to treatment and hospital stay (VG Bulygin, Kabanov, TN, 2011. The differences in subjective assessments of aspects of compulsory treatment and social functioning of patients with varying degrees of severity of negative symptoms and dependence of subjective assessments of the level of cognitive functioning.

  17. Assessment of the nutrient removal effectiveness of floating treatment wetlands applied to urban retention ponds.

    Science.gov (United States)

    Wang, Chih-Yu; Sample, David J

    2014-05-01

    The application of floating treatment wetlands (FTWs) in point and non-point source pollution control has received much attention recently. Although the potential of this emerging technology is supported by various studies, quantifying FTW performance in urban retention ponds remains elusive due to significant research gaps. Actual urban retention pond water was utilized in this mesocosm study to evaluate phosphorus and nitrogen removal efficiency of FTWs. Multiple treatments were used to investigate the contribution of each component in the FTW system with a seven-day retention time. The four treatments included a control, floating mat, pickerelweed (Pontederia cordata L.), and softstem bulrush (Schoenoplectus tabernaemontani). The water samples collected on Day 0 (initial) and 7 were analyzed for total phosphorus (TP), total particulate phosphorus, orthophosphate, total nitrogen (TN), organic nitrogen, ammonia nitrogen, nitrate-nitrite nitrogen, and chlorophyll-a. Statistical tests were used to evaluate the differences between the four treatments. The effects of temperature on TP and TN removal rates of the FTWs were described by the modified Arrhenius equation. Our results indicated that all three FTW designs, planted and unplanted floating mats, could significantly improve phosphorus and nitrogen removal efficiency (%, E-TP and E-TN) compared to the control treatment during the growing season, i.e., May through August. The E-TP and E-TN was enhanced by 8.2% and 18.2% in the FTW treatments planted with the pickerelweed and softstem bulrush, respectively. Organic matter decomposition was likely to be the primary contributor of nutrient removal by FTWs in urban retention ponds. Such a mechanism is fostered by microbes within the attached biofilms on the floating mats and plant root surfaces. Among the results of the four treatments, the FTWs planted with pickerelweed had the highest E-TP, and behaved similarly with the other two FTW treatments for nitrogen removal

  18. A benefit-risk assessment of dapoxetine in the treatment of premature ejaculation.

    Science.gov (United States)

    Hutchinson, Kate; Cruickshank, Kelly; Wylie, Kevan

    2012-05-01

    Premature ejaculation (PE) is considered to be the most common sexual problem affecting men, despite the likelihood that it is under-diagnosed. It is a complex condition with many physical and psychological components, making management complicated. It is important to develop treatments for PE as it adversely affects quality of life for individuals and partners. Dapoxetine is a short-acting selective serotonin reuptake inhibitor (SSRI) that has been developed principally for the treatment of PE. It is considered more suitable for the treatment of PE than other SSRIs as it can be used as an 'on demand' treatment to be taken a few hours before an expected sexual encounter, reducing the possibility of adverse effects. Dapoxetine may represent a breakthrough in the treatment of PE as it is the first drug to be licensed for this indication. This review attempts to present a balanced benefit-risk assessment of dapoxetine by examining the evidence from phase III clinical trials, focusing on its efficacy in prolonging intravaginal ejaculatory latency time (IELT), patient sexual satisfaction and safety in patients with PE. The benefits and risks of other therapies that are used to treat PE off-licence are also reviewed. There has only been one study to date that directly compares dapoxetine to another therapy, paroxetine, for this indication. It was found that dapoxetine is most effective at a dose of 60 mg in increasing IELT compared with placebo. All studies have also found that dapoxetine is well tolerated as an 'on-demand' therapy and with continual dosing; however, there are little data regarding possible long-term adverse effects. Findings of the dapoxetine development programme demonstrated that dapoxetine is associated with vasovagal-mediated (neurocardiogenic) syncope. No other associated significant cardiovascular adverse events were identified. Further research is needed to directly compare dapoxetine with other therapies and to investigate the outcomes of

  19. Treatment process and toxicities assessment of wastewater issued from anaerobic digestion of household wastes.

    Science.gov (United States)

    Djelal, Hayet; Tahrani, Leyla; Fathallah, Salem; Cabrol, Audrey; Mansour, Hedi Ben

    2014-02-01

    Modern society grapples with large amounts of household waste. The anaerobic digestion of this waste offers a promising source for energy-rich biogas production but generates high toxic effluents that require treatment before reuse or disposal into the environment. This study aimed to investigate three techniques, namely coagulation/flocculation, electro-coagulation, and activated sludge, in terms of efficiency in the treatment of these effluents. It also aimed to assess their toxicity effects on the germination and growth of durum wheat Triticum aestivum L. seeds before and after 6 days of treatment. Activated sludge was most efficient in reducing chemical oxygen demand, turbidity, and conductivity (95.7 %, 15.8 %, and 37.5 %, respectively). The effluent treated with this technique induced a marked delay in germination (low mean time of germination) and a significant reduction in the percentages of seed germination and root and leaf growths. It was also noted to strongly induce lipid peroxidation in roots and leaves, which presumably explained the germination/growth inhibition of the wheat seeds. The effluent also induced marked lipid peroxidation effects and strongly inhibited the activities of butyrylcholinesterase in mice bone marrows. The effluent shows a high ability to inhibit the growth of three microalgae; these endpoints are useful tools to biomonitor the physico-chemical quality of this wastewater. Overall, while no significant alterations were observed in terms of animal and vegetable toxicities when the effluent was treated by coagulation/flocculation, activated sludge treatment proved efficient in reducing the toxicities induced by the untreated effluents. The results indicate that the application of this technique is promising with regards to attaining efficient, eco-friendly, and cost-effective strategies for the management and treatment of household waste. PMID:24072641

  20. DIFFERENCES IN ASSESSMENT OF RISK AMONG TWO GROUPS OF INSTITUTIONAL TREATMENT BENEFICIARIES

    Directory of Open Access Journals (Sweden)

    Ivana Jeđud

    2009-12-01

    Full Text Available This paper addresses a determination of differences between examinees, according to areas of risks and total risk of the assessmentinstrument Youth Level of Service/Case Management Inventory (YLS/CMI, Hoge, Andrews, Leschield, 2002, within youth offenders,placed according to the Act on Juvenile Court and those placed in institution according to the Family Act and the Social Welfare Act.The study has been carried out on a sample of 418 examinees from 14 welfare and treatment institutions for children with behaviordisorders in the Republic of Croatia. Through analysis of variance and discriminatory analysis statistically signifi cant differences onrisk scores have been identifi ed between examinees with social welfare and family measures and those with juvenile court measure.Youth with juvenile court measures have been estimated with higher scores concerning risk factors. This paper establishes differencesbetween these two groups of examinees relating areas of risk assessed by the instrument used in the research. Gained results could bea good foundation for the differentiation of the treatment based on the assessment of specifi c risks and needs of youth-at-risk.

  1. Assessing hyperthermic treatment success by two-dimensional ultrasound textural analysis (Invited Paper)

    Science.gov (United States)

    Youssef, A. M.; Schlaps, D.; Zuna, I.; Van Kaick, G.; Lorenz, W. J.

    1987-09-01

    In hyperthermia treatment, ability to predict complete tissue temperature fields from a limited sampled temperatures or non invasively is greatly desirable to assess treatment success. Non uniform heating of the lesion causes less pronounced cell kill in inadequately heated regions. Tissues were suspended in a temperature controlled water bath, the temperature of the bath is increased at different high rates to ensure no tissue variations. Two thermistors were inserted at the upper and lower edges of the region of interest (ROI) with-in the tissue sample. A real time sector ultrasound image along with the radio frequency signal are accessed in real time at different temperatures of the (ROI). First and second order grey level statistics were calculated for fresh liver kidney and brain (cow) tissues in the temperature range of 32-47°C. The average temperature in the (ROI) is correlated with the calculated parameters. Entropy is a sensitive parameter to assess the uniformity of heating. Possibility of in vivo study, and to predict long term hyperthermic effects via the calculation of backscattering coefficient is further investigated. A multi-layered model is also presented to aid in spatially resolving temperature dependent acoustic parameters.

  2. Atomoxetine treatment and ADHD-related difficulties as assessed by adolescent patients, their parents and physicians

    Directory of Open Access Journals (Sweden)

    Lehmann Martin

    2009-08-01

    Full Text Available Abstract Background The degree of ADHD-related difficulties – reflecting overall impairment, social functioning, and quality of life – may be perceived differently by adolescent patients, parents and physicians. The primary aim of this study was to investigate ADHD-related difficulties during atomoxetine treatment, as perceived by the three different raters. Secondary objectives focused on effectiveness and tolerability of atomoxetine treatment in a population of adolescent patients with ADHD. Methods Adolescents with ADHD, aged 12–17 years, received open-label atomoxetine (0.5–1.2 mg/kg/day up to 24 weeks. ADHD-related difficulties at various times of the day were rated using the Global Impression of Perceived Difficulties (GIPD instrument. Inter-rater agreement was analyzed using Cohen's Kappa with 95% confidence intervals (95% CI. ADHD-Rating Scale (ADHD-RS and Clinical Global Impression Severity (GGI-S scores were assessed by the investigator; and spontaneous adverse events, vital signs and laboratory parameters were collected for tolerability assessments. Results 159 patients received atomoxetine. Patients' baseline mean GIPD total ratings were significantly lower than parents' and physicians' scores (12.5 [95%CI 11.6;13.5] vs. 17.2 [16.2;18.2] and 18.8 [17.8;19.8]. For all raters, GIPD scores significantly improved over time. Changes were greatest within the first two weeks. Kappa coefficients varied between 0.186 [0.112;0.259] and 0.662 [0.529;0.795], with strongest agreements between parent and physician assessments, and significant improvements of patient/physician agreements over time (based on 95% CIs. ADHD-RS and CGI-S scores significantly improved over the course of the study (based on 95% CIs. Tolerability results were consistent with earlier reports. Conclusion ADHD-related difficulties were perceived differently by the raters in this open-label trial, but consistently improved during atomoxetine treatment. The GIPD

  3. Methods to assess the biodistribution of radiolabelled somatostatin analogues and treatment response of neuroendocrine tumours

    Science.gov (United States)

    Gnanasegaran, Gopinath

    Introduction: During the past decade, proof of the principle that somatostatin receptors can be successfully used for in vivo targeting of neuroendocrine tumours (NETs) has been provided. These tumours are imaged with 111Indium-pentetreotide and treated with 90Yttrium labeled somatostatin analogues. The aim of this study was to assess (a) the biodistribution and residency of 90Y labelled agents using the brehmsstrahlung imaging technique (b) the tumour response to various treatment modalities using a simplified scintigraphic method [Functional SPECT tumour volume (STV)]. Material and methods: 1) 19 patients with NETs were imaged with 111In-pentetreotide and 14 of them underwent treatment with 90Y-lanreotide. The rest underwent treatment with 90Y-SMT. All the patients were imaged 24 hours post-therapy. Brehmsstrahlung images obtained post therapies were used to assess the 90Y-lanreotide biodistribution in 14 patients and the 5 patients treated with 90Y-SMT, comparing them with 111In-pentetreotide. 2) In 42 patients with NETs a retrospective analysis was performed of the 111In-pentetreotide imaging and CT scan in patients treated with different therapies. A simplified scintigraphic method using 111In-pentetreotide SPECT liver imaging was used to monitor changes in tumour response and to determine how this correlates with CT scan and clinical response. Results: 1) 90Y-lanreotide and 90Y-SMT (with amino acids) have much lower uptake in the kidney (p 0.000 and 0.041 respectively) than 111In-pentetreotide. G Gnanasegaran MD 2 2) 22/42 patients had a good clinical response. A mean fall in total functional STV of 37% was seen in patients with symptomatic relief and a mean increase of 72 % was seen in patients with no symptomatic relief STV predicted the clinical outcome in 34 patients (81%) and CT predicted the outcome in 21 (50%) patients. Conclusion: There was a difference in biodistribution between 111In-pentetreotide and 90Y-lanreotide/ 90Y-SMT, especially in the

  4. Assessing Treatment-Resistant Posttraumatic Stress Disorder: The Emory Treatment Resistance Interview for PTSD (E-TRIP)

    OpenAIRE

    Dunlop, Boadie W; Kaye, Joanna L.; Cole Youngner; Barbara Rothbaum

    2014-01-01

    Patients with posttraumatic stress disorder (PTSD) who fail to respond to established treatments are at risk for chronic disability and distress. Although treatment-resistant PTSD (TR-PTSD) is a common clinical problem, there is currently no standard method for evaluating previous treatment outcomes. Development of a tool that could quantify the degree of resistance to previously provided treatments would inform research in patients with PTSD. We conducted a systematic review of PTSD treatme...

  5. A New Tool to Assess Treatment Fidelity and Evaluation of Treatment Fidelity across 10 Years of Health Behavior Research

    Science.gov (United States)

    Borrelli, Belinda; Sepinwall, Deborah; Ernst, Denise; Bellg, Albert J.; Czajkowski, Susan; Breger, Rosemary; DeFrancesco, Carol; Levesque, Chantal; Sharp, Daryl L.; Ogedegbe, Gbenga; Resnick, Barbara; Orwig, Denise

    2005-01-01

    A. Bellg, B. Borrelli, et al. (2004) previously developed a framework that consisted of strategies to enhance treatment fidelity of health behavior interventions. The present study used this framework to (a) develop a measure of treatment fidelity and (b) use the measure to evaluate treatment fidelity in articles published in 5 journals over 10…

  6. Life cycle assessment of four potable water treatment plants in northeastern Colombia

    Directory of Open Access Journals (Sweden)

    Oscar Orlando Ortiz Rodriguez

    2016-04-01

    Full Text Available There is currently great concern about the processes that directly or indirectly contribute to the potential for global warming, such as stratospheric ozone depletion or acidification. In this context, and provided that treated water is a basic public utility in urban centers around the world as well as in some rural areas, its impact on the environment is of great interest. Therefore, this study applied the environmental methodology of Life Cycle Assessment (LCA to evaluate the environmental loads of four potable water treatment plants (PWTPs located in northeastern Colombia following the international guidelines delineated in ISO 14040. The different stages of the drinking water process were thoroughly assessed, from the catchment point through pumping to the distribution network. The functional unit was defined as 1 m3 of drinking water produced at the plant. The data were analyzed through the database Ecoinvent v.3.01, and modeled and processed in the software LCA-Data Manager. The results showed that in plants PLA-CA and PLA-PO, the flocculation process has the highest environmental load, which is mostly attributable to the coagulant agent, with a range between 47-73% of the total impact. In plants PLA-TON and PLA-BOS, electricity consumption was identified as the greatest impact source, with percentages ranging from 67 to 85%. Treatment processes and techniques, bioclimatic conditions and culturally driven consumption behavior varied from region to region. Furthermore, changes in treatment processes and techniques are likely to affect the environment during all stages of a plant’s operational cycle.

  7. Assessing the impacts of changes in treatment technology on energy and greenhouse gas balances for organic waste and wastewater treatment using historical data

    DEFF Research Database (Denmark)

    Hansen, Jens Aage; Poulsen, Tjalfe

    2009-01-01

    Historical data on organic waste and wastewater treatment during the period of 1970ĝ€"2020 were used to assess the impact of treatment on energy and greenhouse gas (GHG) balances. The assessment included the waste fractions: Sewage sludge, food waste, yard waste and other organic waste (paper...... production from the remaining organic municipal waste. Wastewater treatment has changed from direct discharge of untreated wastewater to full organic matter and nutrient (N, P) removal combined with anaerobic digestion of the sludge for biogas production with power and heat generation. These changes in......, plastic, etc.). Data were collected from Aalborg, a municipality located in Northern Denmark. During the period from 1970ĝ€"2005, Aalborg Municipality has changed its waste treatment strategy from landfilling of all wastes toward composting of yard waste and incineration with combined heat and power...

  8. Joint preserving surgery versus arthrodesis in operative treatment of patients with neuromuscular polyneuropathy: questionnaire assessment.

    Science.gov (United States)

    Napiontek, Marek; Pietrzak, Krzysztof

    2015-02-01

    The purpose of the paper was to present the results of surgical treatment of foot deformities in peripheral neuropathies using bone procedures: both joint preserving and with joint arthrodesis. The study included 26 patients, 14 males and 12 females (43 feet). The age of the patients at surgery ranged from 5 to 55 years (average 23 years). The follow-up ranged from 0.5 to 15 years (average 4.3 years). Seventeen patients presented Charcot-Marie-Tooth disease, three Friedreich's ataxia and six peripheral motor and sensory neuropathies of undetermined nature. Sixteen patients had bilateral procedures. Four patients had to be re-operated during the follow-up. The patients were divided into four groups depending on the age and the surgical technique applied. The groups I and II (9 children, 17 feet) included patients with growth plate still present in the foot just before surgery. In the groups III and IV (17 adults, 26 feet), bone growth was completed. The assessment of all patients based on a modified AOFAS scale ranged from 44 to 105 points (mean 83.7; SD 17.5). The assessment on the subjective scale ranged from 3 to 10 points (mean 7.4; SD 2.1). The assessment of quality of life on the WOMAC scale ranged from 0 to 41 points (mean 15.7; SD 13.2). All patients stated that they would decide to undergo the treatment again. For groups I and II, joint preserving surgeries gave better results; however, the results could not be statistically confirmed. The results for the groups III and IV were inconclusive as to which surgical techniques should be preferred, arthrodesis or joint preserving. The results show that none of the surgical techniques used for correction of foot deformities in motor-sensory polyneuropathies seems to be preferable. PMID:24968792

  9. Assessing Compliance With Mercaptopurine Treatment in Younger Patients With Acute Lymphoblastic Leukemia in First Remission | Division of Cancer Prevention

    Science.gov (United States)

    This randomized phase III trial studies compliance to a mercaptopurine treatment intervention compared to standard of care in younger patients with acute lymphoblastic leukemia in remission. Assessing ways to help patients who have acute lymphoblastic leukemia to take their medications as prescribed may help them in taking their medications more consistently and may improve treatment outcomes. |

  10. Twenty -year post-treatment assessment of class II division 1 malocclusion treated with non-extraction approach

    Directory of Open Access Journals (Sweden)

    Ashok Karad

    2013-01-01

    This article describes twenty-year post-treatment assessment of a class II division 1 malocclusion case, treated in the late mixed dentition stage, with the non-extraction treatment approach - molar-inserted headgear along with a fixed appliance therapy.

  11. Youth Top Problems: Using Idiographic, Consumer-Guided Assessment to Identify Treatment Needs and to Track Change during Psychotherapy

    Science.gov (United States)

    Weisz, John R.; Chorpita, Bruce F.; Frye, Alice; Ng, Mei Yi; Lau, Nancy; Bearman, Sarah Kate; Ugueto, Ana M.; Langer, David A.; Hoagwood, Kimberly E.

    2011-01-01

    Objective: To complement standardized measurement of symptoms, we developed and tested an efficient strategy for identifying (before treatment) and repeatedly assessing (during treatment) the problems identified as most important by caregivers and youths in psychotherapy. Method: A total of 178 outpatient-referred youths, 7-13 years of age, and…

  12. Phototherapy in vitiligo: Assessing the compliance, response and patient′s perception about disease and treatment

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    Shakthisri Kandaswamy

    2013-01-01

    Full Text Available Context: Vitiligo is a chronic, benign, but emotionally frustrating autoimmune disorder of depigmentation, with an incidence of 0.25-2.5% in India, the treatment of which is equally frustrating to the patient, as well as the doctor. Phototherapy is the first line treatment in many cases, which needs to be given at frequent sittings for long periods of time. As there is no satisfactory, short term treatment, many vitiligo patients, though enthusiastic in the beginning, become defaulters after a few weeks or months. Aims: This study was conducted to assess the compliance to phototherapy (PUVA and NB-UVB, determine the reasons for non-compliance, to calculate the overall response to phototherapy and to know about the patients′ perception about improvement of lesions. Materials and Methods: All files of the patients who attended phototherapy for Vitiligo in the department for a period of 4 years from January 2007 were analyzed and the patients were contacted via mail or telephone and were made to answer questionnaire regarding their disease. Conclusions: At the end of this retrospective questionnaire based study we concluded that only a quarter of the patients underwent regular phototherapy, among which the younger patients and those with widespread disease and facial lesions were more compliant. Educational status and sex had no impact on default status.

  13. Assessment and treatment of Spanish-speaking sex offenders: special considerations.

    Science.gov (United States)

    Cullen, K; Travin, S

    1990-01-01

    While there is an expanding body of literature pertaining to the special considerations related to the treatment of Hispanic patients whose primary language is Spanish, there is virtually no information reported to aid in the assessment and treatment of Hispanic and primarily Spanish-speaking sex offenders. Beyond the obvious problems posed by differences in language, there are a host of transcultural factors that may impact on the evaluation and engagement of this patient population when they are also largely psychologically unsophisticated and from a low socioeconomic level. The experiences in modifying and implementing a special program to accommodate the needs of this patient group is presented. Reticence to discuss sexuality in a group setting, the relationship between therapists and patients as effected by rules of social etiquette, and the reluctance to criticize other members in the group were prominent features attributed to religious and cultural factors. The authors consider it a necessity to be sensitive to these subtle nuances in order to provide adequate treatment. PMID:2103007

  14. A minimally invasive treatment for zygomatic fracture with intraoperative assessment using ultrasonography

    International Nuclear Information System (INIS)

    In the department of plastic and reconstructive surgery of Tokyo Women's Medical University and Tokyo Metropolitan Hiroo General Hospital, twenty-one patients with zygomatic fracture were surgically treated by semi-closed reduction with intraoperative assessment using ultrasonography in the period of April, 2002 to December, 2005. Ultrasonic imaging was carried out at three areas: the infraorbital rim, the zygomatic arch and the frontal wall of maxilla. Only one skin incision was made and that was at the lateral eyebrow region and the reduction was performed by inserting an elevator beneath the zygomatic arch. Just after the reduction, the ultrasound examination was performed intraoperatively and the bone alignment was assessed. When the reduction was accurate, the zygomatic-frontal suture was fixated with a micro-plate and zygoma-to-zygoma pinning with Kirshner wire was performed. In all cases, accurate reduction was obtained. In 5 of the 21 cases, the Digital Imaging and Communications in Medicine (DICOM) data of the CT was analyzed with 3D imaging software (V-works, CyberMed Co., Korea). The results revealed that post-operative movement of the bone fragment was minimal. The current study suggests that a semi-closed reduction of zygomatic fracture with intraoperative assessment using ultrasonography could be an alternative minimally invasive method'' for the treatment of the zygomatic fracture. (author)

  15. Rapid and Quantitative Assessment of Cancer Treatment Response Using In Vivo Bioluminescence Imaging

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    Alnawaz Rehemtulla

    2000-01-01

    Full Text Available Current assessment of orthotopic tumor models in animals utilizes survival as the primary therapeutic end point. In vivo bioluminescence imaging (BLI is a sensitive imaging modality that is rapid and accessible, and may comprise an ideal tool for evaluating antineoplastic therapies [1 ]. Using human tumor cell lines constitutively expressing luciferase, the kinetics of tumor growth and response to therapy have been assessed in intraperitoneal [2], subcutaneous, and intravascular [3] cancer models. However, use of this approach for evaluating orthotopic tumor models has not been demonstrated. In this report, the ability of BLI to noninvasively quantitate the growth and therapeuticinduced cell kill of orthotopic rat brain tumors derived from 9L gliosarcoma cells genetically engineered to stably express firefly luciferase (9LLuc was investigated. Intracerebral tumor burden was monitored over time by quantitation of photon emission and tumor volume using a cryogenically cooled CCD camera and magnetic resonance imaging (MRI, respectively. There was excellent correlation (r=0.91 between detected photons and tumor volume. A quantitative comparison of tumor cell kill determined from serial MRI volume measurements and BLI photon counts following 1,3-bis(2-chloroethyl-1-nitrosourea (BCNU treatment revealed that both imaging modalities yielded statistically similar cell kill values (P=.951. These results provide direct validation of BLI imaging as a powerful and quantitative tool for the assessment of antineoplastic therapies in living animals.

  16. Health Technology Assessment of Belimumab: A New Monoclonal Antibody for the Treatment of Systemic Lupus Erythematosus

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    Maria Lucia Specchia

    2014-01-01

    Full Text Available Objective. Systemic lupus erythematosus (SLE is treated with anti-inflammatory and immunosuppressive drugs and off-label biologics. Belimumab is the first biologic approved after 50 years as an add-on therapy for active disease. This paper summarizes a health technology assessment performed in Italy. Methods. SLE epidemiology and burden were assessed using the best published international and national evidences and efficacy and safety of belimumab were synthesized using clinical data. A cost-effectiveness analysis was performed by a lifetime microsimulation model comparing belimumab to standard of care (SoC. Organizational and ethical implications were discussed. Results. Literature review showed that SLE affects 47 per 100,000 people for a total of 28,500 patients in Italy, 50% of whom are affected by active form of the disease despite SoC. These patients, if autoantibodies and anti-dsDNA positive with low complement, are eligible for belimumab. SLE determines work disability and a 2–5-fold increase in mortality. Belimumab with SoC may prevent 4,742 flares in three years being cost-effective with an incremental cost-effectiveness ratio of €32,859 per quality adjusted life year gained. From the organizational perspective, the development of clear and comprehensive clinical pathways is crucial. Conclusions. The assessment supports the use of belimumab into the SLE treatment paradigm in Italy.

  17. Family Assessment/Treatment/Evaluation Methods Integrated for Helping Teen Suicide Attempters/Families in Short Term Psychiatric Hospitalization Programs.

    Science.gov (United States)

    Shepard, Suzanne

    The assessment process can be integrated with treatment and evaluation for helping teenage suicide attempters and families in short term psychiatric hospitalization programs. The method is an extremely efficient way for the therapist to work within a given time constraint. During family assessment sufficient information can be gathered to…

  18. Assessing Client Progress Session by Session in the Treatment of Social Anxiety Disorder: The Social Anxiety Session Change Index

    Science.gov (United States)

    Hayes, Sarah A.; Miller, Nathan A.; Hope, Debra A.; Heimberg, Richard G.; Juster, Harlan R.

    2008-01-01

    Frequent assessment during therapy can improve treatments and provide accountability. However, clinicians often do not monitor progress because of the time it takes to administer and score assessments. In response, the Social Anxiety Session Change Index (SASCI) was developed. The SASCI is a short, easily administered rating of subjective…

  19. Implementation of blinded outcome assessment in the Effective Verruca Treatments trial (EverT) – lessons learned

    OpenAIRE

    Cockayne, Sarah; Hewitt, Catherine; Hashmi, Farina; Hicks, Kate; Concannon, Michael; McIntosh, Caroline; Thomas, Kim; Hall, Jill; Watson, Judith; Torgerson, David; Watt, Ian

    2016-01-01

    Background Trials using inadequate levels of blinding may report larger effect sizes than blinded studies. It has been suggested that blinded outcome assessment in open trials may in some cases be undertaken by assessments of photographs. The aim of this paper is to explore the effect of using different methods to assess the primary outcome in the EVerT (Effective Verruca Treatments) trial. It also aims to give an overview of the experiences of using digital photographs within the trial. Meth...

  20. Life Cycle Assessment: A Tool for Evaluating and Comparing Different Treatment Options for Plastic Wastes from Old Television Sets

    OpenAIRE

    Dodbiba, G.; Furuyama, T.; Takahashi, K.; Sadaki, J; Fujita, T.

    2007-01-01

    In the present work, energy recovery and mechanical recycling, two treatment options for plastic wastes from discarded television sets, have been assessed and compared in the context of the life cycle assessment methodology (LCA). The environmental impact of each option was assessed by calculating the depletion of abiotic resources (ADP) and the global warming potential (GWP). Then, the indicators were compared, and the option with the smaller environmental impact was selected. The main findi...

  1. Urinary proteome analysis enables assessment of renoprotective treatment in type 2 diabetic patients with microalbuminuria

    Directory of Open Access Journals (Sweden)

    Zürbig Petra

    2010-11-01

    Full Text Available Abstract Background Previously the angiotensin II receptor blocker Irbesartan has been demonstrated to reduce the risk for progression from microalbuminuria to macroalbuminuria in type 2 diabetic patients. The purpose of this study was to evaluate the effect of treatment with Irbesartan in type 2 diabetic patients with microalbuminuria on the urinary proteome. Methods High-resolution capillary-electrophoresis coupled to mass-spectrometry (CE-MS was used to profile the low-molecular-weight proteome in urine of a subgroup of patients from a two year randomized irbesartan versus placebo therapy trial, which included hypertensive type 2 diabetic patients with microalbuminuria on ongoing antihypertensive medication (IRMA2-substudy. Results We demonstrate that the therapy with 300 mg Irbesartan daily over a period of two years results in significant changes of the urinary proteome. Both, a classifier developed previously that consists of urinary peptides indicative of chronic kidney disease, as well as several individual peptides changed significantly after treatment. These changes were not observed in the placebo-treated individuals. Most prominent are changes of urinary collagen fragments associated with progression of diabetic nephropathy, indicating normalization in urinary peptides. Conclusion CE-MS analysis of urine enabled identification of peptides as potential surrogate markers for renoprotection in microalbuminuric type 2 diabetic patients, which show persistent improvement after longterm treatment with Irbesartan. The results suggest that a major benefit of treatment by Irbesartan may be improvement of collagen turnover, reduction of fibrosis. They further suggest that urinary proteome analysis could be utilized to assess potential benefit of therapeutic intervention, providing statistically significant results even on a small population.

  2. Assessment of potential greenhouse gas mitigation of available household solid waste treatment technologies

    Directory of Open Access Journals (Sweden)

    Hoang Minh Giang

    2013-11-01

    Full Text Available Current household solid waste treatment practices in most cities in Vietnam caused a great amount of direct greenhouse gas (GHG emissions. Available solid waste treatment technologies should be seriously taken  into consideration as a wedge of GHG mitigation in waste sector base on presently Vietnamese economic conditions. This study aim to evaluate the potential amount of GHG mitigation from current domestic solid waste treatment technologies in Vietnam including landfills and composting from various management scenarios. In oder to use Tier 2 model of IPCC 2006 for GHG estimation from landfills, an analysis on current household solid waste management system of the city was obtained by using material flow analysis approach. A case study in Hanoi, the capital city of Vietnam was carried out in this research. As a result, there was a reduced of over 70% of the amount of CH4 emissions and  up to 53% of total GHG saving (CO2-eq from avoiding organic waste to landfill. In addition, applying an energy recovery from LFG system to available landfills would lead to aproximately 75% of GHG saved compare to current emission of waste sector.Doi: http://dx.doi.org/10.12777/wastech.1.1.10-16Citation: Giang, H.M.,Luong, N.D., and Huong, L.T.M.2013. Assessment of potential greenhouse gas mitigation of available household solid waste treatment technologies. . Waste Technology 1(1:6-9. Doi: http://dx.doi.org/10.12777/wastech.1.1.10-16

  3. Assessment of radiobiological metrics applied to patient-specific QA process of VMAT prostate treatments.

    Science.gov (United States)

    Clemente-Gutiérrez, Francisco; Pérez-Vara, Consuelo; Clavo-Herranz, María H; López-Carrizosa, Concepción; Pérez-Regadera, José; Ibáñez-Villoslada, Carmen

    2016-01-01

    VMAT is a powerful technique to deliver hypofractionated prostate treatments. The lack of correlations between usual 2D pretreatment QA results and the clini-cal impact of possible mistakes has allowed the development of 3D verification systems. Dose determination on patient anatomy has provided clinical predictive capability to patient-specific QA process. Dose-volume metrics, as evaluation crite-ria, should be replaced or complemented by radiobiological indices. These metrics can be incorporated into individualized QA extracting the information for response parameters (gEUD, TCP, NTCP) from DVHs. The aim of this study is to assess the role of two 3D verification systems dealing with radiobiological metrics applied to a prostate VMAT QA program. Radiobiological calculations were performed for AAPM TG-166 test cases. Maximum differences were 9.3% for gEUD, -1.3% for TCP, and 5.3% for NTCP calculations. Gamma tests and DVH-based comparisons were carried out for both systems in order to assess their performance in 3D dose determination for prostate treatments (high-, intermediate-, and low-risk, as well as prostate bed patients). Mean gamma passing rates for all structures were bet-ter than 92.0% and 99.1% for both 2%/2 mm and 3%/3 mm criteria. Maximum discrepancies were (2.4% ± 0.8%) and (6.2% ± 1.3%) for targets and normal tis-sues, respectively. Values for gEUD, TCP, and NTCP were extracted from TPS and compared to the results obtained with the two systems. Three models were used for TCP calculations (Poisson, sigmoidal, and Niemierko) and two models for NTCP determinations (LKB and Niemierko). The maximum mean difference for gEUD calculations was (4.7% ± 1.3%); for TCP, the maximum discrepancy was (-2.4% ± 1.1%); and NTCP comparisons led to a maximum deviation of (1.5% ± 0.5%). The potential usefulness of biological metrics in patient-specific QA has been explored. Both systems have been successfully assessed as potential tools for evaluating the clinical

  4. Pain assessment in time to get pain treatment on time – patients’ perspective of time during pain assessment after spine surgery

    DEFF Research Database (Denmark)

    Kaptain, Kirsten; Bregnballe, Vibeke; Dreyer, Pia

    Background: Despite advances in medicine, pharmaceutical and technical knowledge, patients still have postop-erative pain after spine surgery. Studies show that patient participation has positive effect on treatment outcomes and patients require quick individual and efficient pain treatment....... Objective: This study explored how spine surgery patients experienced participation in assessment of their postoperative pain. Design: This study had a qualitative approach with a phenomenological-hermeneutic perspective. Data was collected via semi-structured interviews of 15 patients and was analysed via...

  5. Assessment of the Self-Perception of Dental Appearance, Its Comparison with Orthodontist’s Assessment and Demand for Treatment in Eastern Nepalese Patients

    OpenAIRE

    Varun Pratap Singh; Amita Sharma; Deepak Kumar Roy

    2014-01-01

    Aims. The aim of this study was to assess the self-perception of dental appearance among Eastern Nepalese patients using aesthetic component (AC) of the index of orthodontic treatment need (IOTN) and to compare it with that of an orthodontist's assessment using the same scale and determine whether gender, area of residence, and level of education influence subject's self-perception and orthodontist's ratings. Methods. A total of 252 subjects (equal number of male and female) were conveniently...

  6. Assessment of periodontal status in dental fluorosis subjects using community periodontal index of treatment needs

    Directory of Open Access Journals (Sweden)

    Vandana K

    2007-01-01

    Full Text Available Background: Periodontitis is multifactorial in nature. The various determinants of periodontal disease are age, sex, race, socioeconomic status, and risk factors including tobacco usage and oral hygiene status. However, there is inconsistent epidemiological data on the periodontal status of subjects living in high-fluoride areas. The aim of the study was to investigate the effect of dental fluorosis on the periodontal status using community periodontal index of treatment needs (CPITN, as a clinical study. The purpose of this study is to determine the periodontal status using CPITN index in a population aged between 15 and 74 years residing in the high-fluoride areas of Davangere district. The possible reasons for the susceptibility of this population to periodontal disease are discussed. Materials and Methods: 1029 subjects, aged between 15 and 74 years suffering from dental fluorosis were assessed for their periodontal status. Clinical parameters recorded were OHI-S to assess the oral hygiene status, Jackson′s fluorosis index to assess the degree of fluorosis and CPITN index to assess the periodontal status where treatment need was excluded. Results: Gingivitis and periodontitis were more common in females (65.9% and 32.8%, respectively than in males (75.1% and 24.2%, respectively. Periodontitis was significantly more common in females. As the age advanced from 15 to 55 years and above, gingivitis reduced from 81.0 to 42.9% and periodontitis increased steadily from 18.0 to 57.1%, which was significant. Periodontitis was high in subjects with poor oral hygiene (81.3%, compared to those with good oral hygiene (14.5%, which was significant. As the degree of fluorosis increased, severity of gingivitis reduced and periodontitis increased, i.e., with A degree fluorosis, gingivitis was 89.4% and periodontitis 8.5%, but with F degree fluorosis the former was 64% and the latter 35.8%, which was statistically significant. Conclusion: The results

  7. Medical and health economic assessment of radiosurgery for the treatment of brain metastasis

    Directory of Open Access Journals (Sweden)

    von der Schulenburg, Johann-Matthias

    2009-03-01

    Full Text Available Background: Radiotherapy for patients suffering from malignant neoplasms has developed greatly during the past decades. Stereotactic radiosurgery (SRS is one important radiotherapeutic option which is defined by a single and highly focussed application of radiation during a specified time interval. One of its important indications is the treatment of brain metastases. Objectives: The objective of this HTA is to summarise the current literature concerning the treatment of brain metastasis and to compare SRS as a single or additional treatment option to alternative treatment options with regard to their medical effectiveness/efficacy, safety and cost-effectiveness as well as their ethical, social and legal implications. Methods: A structured search and hand search of identified literature are performed from January 2002 through August 2007 to identify relevant publications published in English or German. Studies targeting patients with single or multiple brain metastases are included. The methodological quality of included studies is assessed according to quality criteria, based on the criteria of evidence based medicine. Results: Of 1,495 publications 15 medical studies meet the inclusion criteria. Overall study quality is limited and with the exception of two randomized controlleed trials (RCT and two meta-analyses only historical cohort studies are identified. Reported outcome measures are highly variable between studies. Studies with high methodological quality provide evidence, that whole-brain radiotherapy (WBRT in addition to SRS and SRS in addition to WBRT is associated with improved local tumour control rates and neurological function. However, only in patients with single brain metastasis, RPA-class 1 (RPA = Recursive partitioning analysis and certain primary tumour entities, this combination of SRS and WBRT is associated with superior survival compared to WBRT alone. Studies report no significant differences in adverse events between

  8. Selecting measures for balance and mobility to improve assessment and treatment of individuals after stroke.

    Science.gov (United States)

    Kegelmeyer, Deb A; Kloos, Anne D; Siles, Amelia B

    2014-01-01

    Assessment of individuals with stroke using reliable and valid outcome measures is a key component of the treatment planning process. Health care professionals may have difficulty selecting balance and mobility measures given the large number of measures to choose from. This article utilizes a case-based approach to describe the benefits of using a common set of outcome measures and a process for selecting optimal measures across body structure/function, activity, and participation domains of the International Classification of Functioning, Disability and Health (ICF) model and stages of stroke recovery. Specific measures for use in acute care, rehabilitation, outpatient, and home health care settings are discussed based on StrokEDGE task force recommendations by the Neurology Section of the American Physical Therapy Association. PMID:25150662

  9. Assessment of Antimicrobial Treatment Strategies in Pig Production Using Mathematical Models

    DEFF Research Database (Denmark)

    Ahmad, Amais

    , composition of strains, and increased excretion of strains on growth and levels of resistant strains were assessed. It was found that the complex relationship between antimicrobial concentration and bacterial growth from in vitro experiments was better explained by PD parameters than single point estimate......The phenomenon of antimicrobial resistance (AMR) is well established, but its persistent increase and alarming proportions threaten the ability of antimicrobials to treat infections. AMR has become a major issue in veterinary antimicrobial use, specifically in food production animals, due to the...... treatment strategies. Dosing factors, along with the in vivo epidemiological parameters, govern the relation between resistance and antimicrobial use. Mathematical modeling and simulation techniques have been used over the past two decades to evaluate the effect of these factors on the development of...

  10. Virtual Reality in the Assessment and Treatment of Weight-Related Disorders.

    Science.gov (United States)

    Wiederhold, Brenda K; Riva, Giuseppe; Gutiérrez-Maldonado, José

    2016-02-01

    Virtual Reality (VR) has, for the past two decades, proven to be a useful adjunctive tool for both assessment and treatment of patients with eating disorders and obesity. VR allows an individual to enter scenarios that simulate real-life situations and to encounter food cues known to trigger his/her disordered eating behavior. As well, VR enables three-dimensional figures of the patient's body to be presented, helping him/her to reach an awareness of body image distortion and then providing the opportunity to confront and correct distortions, resulting in a more realistic body image and a decrease in body image dissatisfaction. In this paper, we describe seminal studies in this research area. PMID:26882323

  11. Assessment of tumor oxygenation and its impact on treatment response in bevacizumab-treated recurrent glioblastoma

    DEFF Research Database (Denmark)

    Bonekamp, David; Mouridsen, Kim; Radbruch, Alexander;

    2016-01-01

    oxygenation appears to be worsened despite vascular normalization. Accordingly, hazards for both progression and death are found elevated in patients with a greater reduction of tumor metabolic rate of oxygen in response to bevacizumab and patients with higher intratumoral tumor metabolic rate of oxygen at......Antiantiogenic therapy with bevacizumab in recurrent glioblastoma is currently understood to both reduce microvascular density and to prune abnormal tumor microvessels. Microvascular pruning and the resulting vascular normalization are hypothesized to reduce tumor hypoxia and increase supply of...... systemic therapy to the tumor; however, the underlying pathophysiological changes and their timing after treatment initiation remain controversial. Here, we use a novel dynamic susceptibility contrast MRI-based method, which allows simultaneous assessment of tumor net oxygenation changes reflected by the...

  12. Hygienic assessment of the ozone formation resulting from electron beam treatment of materials

    International Nuclear Information System (INIS)

    The results of hygienic assessment of the ozone formation resulting from electron beam treatment of electric cables and wires with polymer isolation are presented. The investigations have been carried out with the use of the EhlV-1 accelerator. Electron energy constitutes 0.7 MeV. Ozone concentrations have been determined in the region close to accelerators, at working places, in air ducts and in the free air. A formula for calculation of ozone concentration in ventilation effluents is given. It is shown that at modern doMestic cable plants with a number of accelerators equalling 4-6 daily eff:.uent of ozone reaches 26-38 kg, and annual effluent - 7-10 t. The data obtained on ozone formation have been used to prevent the unfavourable effect of its high concentrations on personnel and environment

  13. Practice Guidelines for the Assessment of Clinically Significant Treatment Outcomes in the Children's Mental Health System.

    Science.gov (United States)

    Chomycz, Suzanne; Schmidt, Fred

    2016-01-01

    The use of program evaluation to monitor client change and improve intervention effectiveness is gaining increasing importance in the mental health field. However, there is a lack of literature available in community-based clinics for those who desire to evaluate the effectiveness of services. Through this article the authors review the literature on the best methods to assess clinically significant treatment outcomes in community-based children's mental health services. The strengths and weaknesses of commonly recommended methods of evaluating change are discussed (i.e., reliable change index, percentage of improvement, normative comparisons, and effect size) using a dataset from a community-based parenting program (N = 308). PMID:26086975

  14. [Dysfunction in attention deficit hyperactivity disorder: assessment and response to treatment].

    Science.gov (United States)

    Fernandez-Jaen, A; Martin Fernandez-Mayoralas, D; Fernandez-Perrone, A L; Calleja-Perez, B; Albert, J; Lopez-Martin, S; Lopez-Arribas, S

    2016-02-21

    Attention deficit hyperactivity disorder (ADHD) is a heterogeneous, symptomatically complex disorder. Its cardinal symptom, the presence of dysexecutive problems, emotional dysregulation of many of them and its own comorbidity, among others, will condition its clinical expression and the dysfunction. Classifying ADHD as a 'disorder' calls for an accurate assessment of the terms 'dysfunction' or 'repercussion'. The progress made in the classification and quantification of the symptoms characterising ADHD should be applied to measuring and objectifying dysfunction. Considering dysfunction as a simple interference, however clear it may be, could lead to an overestimation of the diagnosis of this disorder. Just as its estimation is essential for a diagnosis, it is also necessary for the correct evaluation of the efficacy of the therapeutic interventions, especially in the medium and long term. Further studies are needed in this sense to appraise the efficacy of the treatments, whether pharmacological or not, in different domains (social relationship, learning, self-esteem, quality of life, accidents, etc.). PMID:26922963

  15. Assessment of prostatic fiducial marker introduction: patient morbidity, staff satisfaction and improved treatment field placement

    International Nuclear Information System (INIS)

    Increased accuracy when using fiducial markers for prostate localisation is well documented. This project aimed to establish the improvement in accuracy when using gold markers for daily prostate localisation, to assess patient satisfaction and morbidity from the transrectal implantation of gold seed markers and establish staff attitudes towards the newly introduced processes. Twenty patients with prostate cancer had three gold seeds implanted into the base, apex and central zone of the prostate transrectally using ultrasound guidance. Surveys were conducted to assess staff and patient satisfaction with the process of gold seed localisation. The gold markers were used to localise the prostate on a daily basis using megavoltage electronic portal imaging. Measurements were taken to establish the increase in accuracy when using gold fiducial markers compared with using the surrounding bony anatomy. Inter-fraction motion (1 standard deviation (SD)) of the fiducial markers was 2.20, 4.28 and 4.27 mm in the LR, SI and AP directions, respectively. Intra-fraction prostate motion (1 SD) was measured as 0.8 mm LR, 1.1 mm SI and 2.0 mm AP. The patient survey showed that the insertion and associated side effects were acceptable, with 5% of patients stating that the seed insertion was worse than the prostate biopsy, and 23.1% of patients experienced short duration (1–2 days) haematuria. The staff survey showed that daily online image guidance was achievable without affecting patient throughput. Thirty percent of treatment staff believed that performing online daily localisation did not add any extra time to a standard treatment, and the remaining 70% thought that the added time was minimal (2–4 min). Gold fiducial markers are an accurate, reliable and tolerable method of daily prostate localisation.

  16. Assessment of Wastewater Discharge Impact from a Sewage Treatment Plant on Lagoon Water, Lagos, Nigeria

    Directory of Open Access Journals (Sweden)

    Ezechiel Longe

    2010-05-01

    Full Text Available The aim of this study was to assess the wastewater discharge impact from the University of Lagos campus treatment plant on the lagoon system . In order to achieve this objective water samples were collected from nine sites and analyzed for different wastewater quality variables. The field survey was carried out between July and November in order to capture both the wet and dry seasons. Average removal efficiencies of measured parameters from treated effluents are 26% for Total Dissolved Solids (TDS, 73% for Biological Oxygen Demand (BOD, 65.8% for Chemical Oxygen Demand (COD and 72% for Total Nitrogen (Total N for the wet season campaign. During the dry season average rem oval efficiencies of measured parameters are 54% for TDS, 54% for BOD, 39% for COD and 42% for Total N. These values are lower than values obtained for the wet season except for TDS. Most parameters in effluents exceeded the National Environmental Protection Regulations, Effluent Limitation standards for discharge into river bodies. Average concentrations of TDS, BOD and COD in lagoon water show higher concentrations than in the treated effluent and are above the regulatory requirements. The research recommends further study on the possible influence of water dynamics and sampling methods on water quality of the lagoon. The overall results from this research conclude that the lagoon is being polluted by effluents discharge from the university treatment plant thereby exposing the health of local residents who use it for recreation and for food production purposes.

  17. Toxicological and chemical assessment of arsenic-contaminated groundwater after electrochemical and advanced oxidation treatments.

    Science.gov (United States)

    Radić, Sandra; Crnojević, Helena; Vujčić, Valerija; Gajski, Goran; Gerić, Marko; Cvetković, Želimira; Petra, Cvjetko; Garaj-Vrhovac, Vera; Oreščanin, Višnja

    2016-02-01

    Owing to its proven toxicity and mutagenicity, arsenic is regarded a principal pollutant in water used for drinking. The objective of this study was the toxicological and chemical evaluation of groundwater samples obtained from arsenic enriched drinking water wells before and after electrochemical and ozone-UV-H2O2-based advanced oxidation processes (EAOP). For this purpose, acute toxicity test with Daphnia magna and chronic toxicity test with Lemna minor L. were employed as well as in vitro bioassays using human peripheral blood lymphocytes (HPBLs). Several oxidative stress parameters were estimated in L.minor. Physicochemical analysis showed that EAOP treatment was highly efficient in arsenic but also in ammonia and organic compound removal from contaminated groundwater. Untreated groundwater caused only slight toxicity to HPBLs and D. magna in acute experiments. However, 7-day exposure of L. minor to raw groundwater elicited genotoxicity, a significant growth inhibition and oxidative stress injury. The observed genotoxicity and toxicity of raw groundwater samples was almost completely eliminated by EAOP treatment. Generally, the results obtained with L. minor were in agreement with those obtained in the chemical analysis suggesting the sensitivity of the model organism in monitoring of arsenic-contaminated groundwater. In parallel to chemical analysis, the implementation of chronic toxicity bioassays in a battery is recommended in the assessment of the toxic and genotoxic potential of such complex mixtures. PMID:26580737

  18. Seasonal assessment, treatment and removal of heavy metal concentrations in a tropical drinking water reservoir

    Directory of Open Access Journals (Sweden)

    Mustapha Moshood Keke

    2016-06-01

    Full Text Available Heavy metals are present in low concentrations in reservoirs, but seasonal anthropogenic activities usually elevate the concentrations to a level that could become a health hazard. The dry season concentrations of cadmium, copper, iron, lead, mercury, nickel and zinc were assessed from three sites for 12 weeks in Oyun reservoir, Offa, Nigeria. Triplicate surface water samples were collected and analysed using atomic absorption spectrophotometry. The trend in the level of concentrations in the three sites is site C > B > A, while the trend in the levels of the concentrations in the reservoir is Ni > Fe > Zn > Pb > Cd > Cu > Hg. Ni, Cd, Pb and Hg were found to be higher than the WHO guidelines for the metals in drinking water. The high concentration of these metals was from anthropogenic watershed run-off of industrial effluents, domestic sewages and agricultural materials into the reservoir coming from several human activities such as washing, bathing, fish smoking, especially in site C. The health effects of high concentration of these metals in the reservoir were highlighted. Methods for the treatment and removal of the heavy metals from the reservoir during water purification such as active carbon adsorption, coagulation-flocculation, oxidation-filtration, softening treatment and reverse osmosis process were highlighted. Other methods that could be used include phytoremediation, rhizofiltration, bisorption and bioremediation. Watershed best management practices (BMP remains the best solution to reduce the intrusion of the heavy metals from the watershed into the reservoir.

  19. Design-a-wetland: a tool for generating and assessing constructed wetland designs for wastewater treatment

    International Nuclear Information System (INIS)

    Full text: Full text: The hydrological cycle is a key cycle affected by current and predicted climate change. Wetlands are one of the key ecosystems within the hydrological cycle and could contribute significantly in facing the challenges of climate change, such as water shortage. The impact of wetlands on greenhouse gas emissions is much debated and, conversely, the impact of climate change on wetlands also raises many questions. There have been many attempts to harness and integrate the natural capacities of wetlands into constructed systems. These systems are especially designed for multiple purposes. They can be used for wastewater treatment and reuse, and have the potential to increase sustainability by changing land and water use practices. This project generates a 'Design-A-Wetland' prototype model, designed to facilitate decision-making in the creation of constructed wetlands. Constructed wetlands are specifically tailored to their end use; water treatment fish and fowl habitat, flood buffer zones, or sequestration of greenhouse gases. This project attempts to answer the following questions: Can a single integrated decision model be created for the design and assessment of artificial wetlands, provided either entry or exit standards are known and specified?; Can the elements of a system of interfacing the model with public consultation be specified?; The project identifies model schematics and lays the groundwork for modelling suited to the wide variety of inputs required for decision making

  20. Life Cycle Assessment of mechanical biological pre-treatment of Municipal Solid Waste: a case study.

    Science.gov (United States)

    Beylot, Antoine; Vaxelaire, Stéphane; Zdanevitch, Isabelle; Auvinet, Nicolas; Villeneuve, Jacques

    2015-05-01

    The environmental performance of mechanical biological pre-treatment (MBT) of Municipal Solid Waste is quantified using Life Cycle Assessment (LCA), considering one of the 57 French plants currently in operation as a case study. The inventory is mostly based on plant-specific data, extrapolated from on-site measurements regarding mechanical and biological operations (including anaerobic digestion and composting of digestate). The combined treatment of 46,929 tonnes of residual Municipal Solid Waste and 12,158 tonnes of source-sorted biowaste (as treated in 2010 at the plant) generates 24,550 tonnes CO2-eq as an impact on climate change, 69,943kg SO2-eq on terrestrial acidification and 19,929kg NMVOC-eq on photochemical oxidant formation, in a life-cycle perspective. On the contrary MBT induces environmental benefits in terms of fossil resource depletion, human toxicity (carcinogenic) and ecotoxicity. The results firstly highlight the relatively large contribution of some pollutants, such as CH4, emitted at the plant and yet sometimes neglected in the LCA of waste MBT. Moreover this study identifies 4 plant-specific operation conditions which drive the environmental impact potentials induced by MBT: the conditions of degradation of the fermentable fraction, the collection of gaseous flows emitted from biological operations, the abatement of collected pollutants and NOx emissions from biogas combustion. Finally the results underline the relatively large influence of the operations downstream the plant (in particular residuals incineration) on the environmental performance of waste MBT. PMID:25708404

  1. Contrast enhanced ultrasonography in assessing the treatment response to transarterial chemoembolization in patients with hepatocellular carcinoma.

    Science.gov (United States)

    Sparchez, Zeno; Mocan, Tudor; Radu, Pompilia; Anton, Ofelia; Bolog, Nicolae

    2016-03-01

    The last decades have known continuous development of therapeutic strategies in hepatocellular carcinoma (HCC). Unfortunately the disease it still not diagnosed until it is already at an intermediate or even an advanced disease. In these circumstances transarterial chemoembolization (TACE) is considered an effective treatment for HCC. The most important independent prognostic factor of both disease free survival and overall survival is the presence of complete necrosis. Therefore, treatment outcomes are dictated by the proper use of radiological imaging. Current guidelines recommend contrast enhanced computer tomography (CECT) as the standard imaging technique for evaluating the therapeutic response in patients with HCC after TACE. One of the most important disadvantage of CECT is the overestimation of tumor response. As an attempt to overcome this limitation contrast enhanced ultrasound (CEUS) has gained particular attention as an imaging modality in HCC patients after TACE. Of all available imaging modalities, CEUS performs better in the early and very early assessment of TACE especially after lipiodol TACE. As any other imaging techniques CEUS has disadvantages especially in hypovascular tumors or in cases of tumor multiplicity. Not far from now the current limitations of CEUS will be overcome by the new CEUS techniques that are already tested in clinical practice such as dynamic CEUS with quantification, three-dimensional CEUS or fusion techniques. PMID:26962561

  2. Assessing the estrogenic potency in a Portuguese wastewater treatment plant using an integrated approach

    Institute of Scientific and Technical Information of China (English)

    Mário S.Diniz; Rita Maurício; Mira Petrovic; Maria J.López De Alda; Leonor Amaral; Isabel Peres; Damiá Barceló; Fernando Santana

    2010-01-01

    The estrogenic potency of a wastewater treatment plant (WWTP) was evaluated using chemical and biological analyses,which showed that after the station treatment processes some of the selected endocrine disruptor compounds (EDCs) were still present in the treated effluent (e.g.,bisphenol A,alkylphenols,estrone).Thus,the most common endocrine EDCs were identified and quantified and the overall estrogenicity of the treated effluent assessed by integrating the results.Male goldfish (Carassius auratus) were used as biological indicators in a 28-day experiment.Viteliogenin (Vtg),gonadosomatic and hepatosomatic indices,steroids (17β-estradiol and 11-ketotestosterone) and histopathology were biomarkers used in fish to evaluate WWTP treated effluent estrogenicity,in combination with instrumental analyses.The results showed a significant increase (P<0.01) in plasma and liver Vtg,which were significantly correlated (r = 0.66;P<0.01).The gonadosmatic index was significantly (P<0.01) reduced in exposed fish.The steroid analyses revealed significant elevations in 17β-estradiol and depressed 11-ketotestosterone concentrations.The histological examinations show changes in exposed fish gonads,such as regressed testes and in some cases (43% to 75%) the development of ovo-testis in fish exposed to 50% and 100% treated effluent.

  3. Image processing and quantitative assessment in computer tomography for non-surgical treatment of brain tumours

    International Nuclear Information System (INIS)

    Using the EMI computer tomographic (CT) system, EMI-1010, a series of new programmes were developed for the digital analysis of the CT images in order to make a more objective and quantitative assessment possible of two non-surgical methods of treatment of brain tumours such as irradiation and chemotherapy. Amongst the various therapeutic effects demonstrable from the CT data, a reduction of the mass effect was found to lower the average CT number, with a dilatation of the cisterns and ventricles. In contrast, an improvement in the amount of perifocal oedema increased the average CT number of the region, however the changes in CT number of the tumour itself may be variable. The separate evaluation of these factors, therefore, gives more information about the results of the treatment than a simple analysis of the histogram of the region. Circumscribed tumours are fairly well evaluated with our programme for the statistical analysis of the volume and the CT weight of tumours and the degree of contrast enhancement using histograms and subtraction scans. For the digital analysis of the ventricular system, the subarachnoid space, perifocal oedema, and irregularly shaped infiltrating tumours, our programmes for the character-image print-out and edge correction for the partial-volume effect of skull and air are much more useful than the CRT display for data extraction and geographic-pattern recognition. (Author)

  4. Life cycle assessment applied to wastewater treatment: state of the art.

    Science.gov (United States)

    Corominas, Ll; Foley, J; Guest, J S; Hospido, A; Larsen, H F; Morera, S; Shaw, A

    2013-10-01

    Life cycle assessment (LCA) is a technique to quantify the impacts associated with a product, service or process from cradle-to-grave perspective. Within the field of wastewater treatment (WWT) LCA was first applied in the 1990s. In the pursuit of more environmentally sustainable WWT, it is clear that LCA is a valuable tool to elucidate the broader environmental impacts of design and operation decisions. With growing interest from utilities, practitioners, and researchers in the use of LCA in WWT systems, it is important to make a review of what has been achieved and describe the challenges for the forthcoming years. This work presents a comprehensive review of 45 papers dealing with WWT and LCA. The analysis of the papers showed that within the constraints of the ISO standards, there is variability in the definition of the functional unit and the system boundaries, the selection of the impact assessment methodology and the procedure followed for interpreting the results. The need for stricter adherence to ISO methodological standards to ensure quality and transparency is made clear and emerging challenges for LCA applications in WWT are discussed, including: a paradigm shift from pollutant removal to resource recovery, the adaptation of LCA methodologies to new target compounds, the development of regional factors, the improvement of the data quality and the reduction of uncertainty. Finally, the need for better integration and communication with decision-makers is highlighted. PMID:23969400

  5. Human Laboratory Settings for Assessing Drug Craving; Implications for the Evaluation of Treatment Efficacy

    Directory of Open Access Journals (Sweden)

    Zahra Alam Mehrjerdi

    2011-04-01

    Full Text Available Research on assessing craving in laboratory settings often involves inducing and then measuring craving in subjects. Cue-induced craving is studied in laboratory settings using the cue reactivity paradigm, in which drug-related photos, videos, evocative scripts, olfactory cues, and paraphernalia may induce craving. Cue-induced craving evoked by drug-related stimuli could be associated with relapse and recurrence of drug addiction. In this article, the authors review different methods of assessing craving in laboratory settings and explain how human laboratory settings can bridge the gap between randomized clinical trials (RCTs and animal models on pharmacological treatments for drug dependence. The brief reviewed literature provides strong evidence that laboratory-based studies of craving may improve our understanding of how subjective reports of drug craving are related to objective measures of drug abuse and laboratory settings provide an opportunity to measure the degree to which they co-vary during pharmacological interventions. This issue has important implications inclinical studies.

  6. Probabilistic risk assessment for back-end facilities: Improving the treatment of fire and explosion scenarios

    International Nuclear Information System (INIS)

    The nuclear reprocessing facilities at Sellafield are a key component of the International business of BNFL. The operations carried out at the site extend from the receipt and storage of irradiated fuel, chemical reprocessing, plutonium and uranium finishing, through mixed oxide fuel production. Additionally there are a wide range of supporting processes including solid waste encapsulation, vitrification, liquid waste evaporation and treatment. Decommissioning of the site's older facilities is also proceeding. The comprehensive range of these activities requires that the safety assessment team keeps up to date with developments in the field, as well as conducting and sponsoring appropriate research into methodologies and modelling in order to deliver a cost effective, timely service. This paper will review the role of Probabilistic Risk Assessment (PRA) in safety cases for operations at Sellafield and go on to describe some areas of PRA methodology development in the UK and in which BNFL is a contributor. Finally the paper will summarise some specific areas of methodology development associated with improving the modelling of fire and explosion hazards which are specific to BNFL. (author)

  7. Life-cycle assessment of a waste refinery process for enzymatic treatment of municipal solid waste.

    Science.gov (United States)

    Tonini, D; Astrup, T

    2012-01-01

    Decrease of fossil fuel dependence and resource saving has become increasingly important in recent years. From this perspective, higher recycling rates for valuable materials (e.g. metals) as well as energy recovery from waste streams could play a significant role substituting for virgin material production and saving fossil resources. This is especially important with respect to residual waste (i.e. the remains after source-separation and separate collection) which in Denmark is typically incinerated. In this paper, a life-cycle assessment and energy balance of a pilot-scale waste refinery for the enzymatic treatment of municipal solid waste (MSW) is presented. The refinery produced a liquid (liquefied organic materials and paper) and a solid fraction (non-degradable materials) from the initial waste. A number of scenarios for the energy utilization of the two outputs were assessed. Co-combustion in existing power plants and utilization of the liquid fraction for biogas production were concluded to be the most favourable options with respect to their environmental impacts (particularly global warming) and energy performance. The optimization of the energy and environmental performance of the waste refinery was mainly associated with the opportunity to decrease energy and enzyme consumption. PMID:21940157

  8. Sustainability assessment of tertiary wastewater treatment technologies: a multi-criteria analysis.

    Science.gov (United States)

    Plakas, K V; Georgiadis, A A; Karabelas, A J

    2016-01-01

    The multi-criteria analysis gives the opportunity to researchers, designers and decision-makers to examine decision options in a multi-dimensional fashion. On this basis, four tertiary wastewater treatment (WWT) technologies were assessed regarding their sustainability performance in producing recycled wastewater, considering a 'triple bottom line' approach (i.e. economic, environmental, and social). These are powdered activated carbon adsorption coupled with ultrafiltration membrane separation (PAC-UF), reverse osmosis, ozone/ultraviolet-light oxidation and heterogeneous photo-catalysis coupled with low-pressure membrane separation (photocatalytic membrane reactor, PMR). The participatory method called simple multi-attribute rating technique exploiting ranks was employed for assigning weights to selected sustainability indicators. This sustainability assessment approach resulted in the development of a composite index as a final metric, for each WWT technology evaluated. The PAC-UF technology appears to be the most appropriate technology, attaining the highest composite value regarding the sustainability performance. A scenario analysis confirmed the results of the original scenario in five out of seven cases. In parallel, the PMR was highlighted as the technology with the least variability in its performance. Nevertheless, additional actions and approaches are proposed to strengthen the objectivity of the final results. PMID:27054724

  9. Assessment of the effectiveness of low level laser in the treatment of alveolar osteitis

    Directory of Open Access Journals (Sweden)

    Jovanović Goran

    2011-01-01

    Full Text Available Background/Aim. Alveolar osteitis (AO is the extraction wound healing disorder with a presence of severe pain. Low level laser therapy stimulates cell metabolism and microcirculation, have has pronounced analgesic, antiedematous and anti-inflammatory effect and speeds up wound healing process. The aim of this study was to present results of clinical research that examined the effectiveness of low level laser in pain relief and healing of extraction wounds with alveolar osteitis in the lower jaw which was formed on the second day after tooth extraction. Methods. The study was conducted on 60 subjects divided into the study and the control group. In both groups extraction wounds were processed in similar way, except that in the study group was applied daily treatment of low level laser with a total of eight sessions of radiation, while in the control group extraction wounds were dressed with zinc oxide eugenol paste, which was changed every 48 hours up to the pain cessation. Measurement of pain intensity was done with a visual analogue scale (VAS 10 min prior to processing of extraction wounds and daily for the next eight days. Assessment of the effectiveness of low level laser on healing of extraction wounds was performed on the day eight of the treatment. Results. On the day five after beginning of the treatment of extraction wounds with alveolar osteitis in the patients of the study group a lower average value of pain as compared to the control group was registered. This difference was increased within the following days. Extraction wounds healing in the study group was more successful and faster than in the control group. Conclusion. This study suggested that the reduction of pain was more pronounced in the patients with alveolar osteitis whose extraction wounds were subjected to low level laser radiation in comparison to those in which extraction wounds were treated with zinc oxide eugenol paste.

  10. Radioiodine (I-131) treatment for uncomplicated hyperthyroidism: An assessment of optimal dose and cost-effectiveness

    International Nuclear Information System (INIS)

    Aim: Radioiodine (I-131) is increasingly being considered for the treatment of hyperthyroidism but there is no general agreement for the initial dose. To determine the cost-effectiveness and optimal dose of I-131 to cure disease, we prospectively studied the outcome of radioiodine therapy of 423 patients. Material and Methods: Any of the fixed doses of 6, 8, 10, 12 or 15 mCi of I-131 was administered to the patients relating to thyroid gland size. The individual was excluded from this study who had multinodular goitre and autonomous toxic nodule. Patients were classified as cured if the clinical and biochemical status was either euthyroid or hypothyroid at one year without further treatment by antithyroid drugs or radioiodine. The costs were assessed by analyzing the total cost of care including office visit, laboratory testing, radioiodine treatment, average conveyance and income loss of patient and attendant and thyroxine replacement for a period of 2 years from the day of I-131 administration. Results: The results showed a progressive increase of cure rate from the doses of 6, 8 and 10 mCi by 67%, 76.5% and 85.7% respectively but the cure rate for the doses of 12 and 15 mCi was 87.9% and 88.8% respectively. Cure was directly related to the dose between 6 and 10 mCi but at higher doses the cure rate was increased marginally at the expense of increased total body radiation. There was little variation in total costs, but was higher for low dose-therapy and the cost proportion between the 6 mCi regimen and 10 mCi regimen was 1.04:1. Conclusion: We could conclude that an initial 10 mCi of I-131 may be the optimal dose for curing hyperthyroidism and will also limit the total costs

  11. Malignant gliomas: current perspectives in diagnosis, treatment, and early response assessment using advanced quantitative imaging methods

    International Nuclear Information System (INIS)

    Malignant gliomas consist of glioblastomas, anaplastic astrocytomas, anaplastic oligodendrogliomas and anaplastic oligoastrocytomas, and some less common tumors such as anaplastic ependymomas and anaplastic gangliogliomas. Malignant gliomas have high morbidity and mortality. Even with optimal treatment, median survival is only 12–15 months for glioblastomas and 2–5 years for anaplastic gliomas. However, recent advances in imaging and quantitative analysis of image data have led to earlier diagnosis of tumors and tumor response to therapy, providing oncologists with a greater time window for therapy management. In addition, improved understanding of tumor biology, genetics, and resistance mechanisms has enhanced surgical techniques, chemotherapy methods, and radiotherapy administration. After proper diagnosis and institution of appropriate therapy, there is now a vital need for quantitative methods that can sensitively detect malignant glioma response to therapy at early follow-up times, when changes in management of nonresponders can have its greatest effect. Currently, response is largely evaluated by measuring magnetic resonance contrast and size change, but this approach does not take into account the key biologic steps that precede tumor size reduction. Molecular imaging is ideally suited to measuring early response by quantifying cellular metabolism, proliferation, and apoptosis, activities altered early in treatment. We expect that successful integration of quantitative imaging biomarker assessment into the early phase of clinical trials could provide a novel approach for testing new therapies, and importantly, for facilitating patient management, sparing patients from weeks or months of toxicity and ineffective treatment. This review will present an overview of epidemiology, molecular pathogenesis and current advances in diagnoses, and management of malignant gliomas

  12. LILW repository in Slovenia: uncertainty treatment in performance assessment of Slovenian generic safety case

    International Nuclear Information System (INIS)

    The Slovenian Agency for Radwaste Management has founded and developed a PA team, which has been educated also through the scholarship and other help of the IAEA, to perform performance assessment calculations for Slovene LILW repository safety case. The team has gone through several steps of the performance assessment procedure, starting with scenario generation and ending with radionuclide transport calculations for each of selected scenarios. To do this, two Slovene sites have been chosen and preliminary designs of a near surface and an underground repository have been made. In 2004, the team was asked to concentrate on the part of confidence building process concerning the treatment of uncertainty for the post closure assessment. The team has thus treated all kinds of uncertainty in PA/SA: scenario uncertainty, model (conceptual model, mathematical model, computer code) uncertainty, data/parameter uncertainty and subjective uncertainty, each of these groups in a specific way, recognised by the international practice. We used deterministic calculations to address scenario and model uncertainties. Scenarios, which have thus been calculated, were: normal evolution scenario with progressive engineered barrier system degradation, cap failure scenario, instant failure of all engineered barriers, climate-change scenario, inadvertent human intrusion scenario - all of them assuming different paths through the biosphere. Model uncertainties have also been addressed by deterministic calculations: calculations of different conceptual models and comparison of results, combining numerical solutions with theoretical ones and using different computer codes for the same conceptual models. Data/parameter uncertainties have been treated through sensitivity analysis (single parameter variation - deterministic) and multi-parameter variation (stochastic calculations), using all available site-specific data. Subjective uncertainty we have addressed through thorough international

  13. Validation of the patient benefit index for the assessment of patient-relevant benefit in the treatment of psoriasis.

    Science.gov (United States)

    Feuerhahn, Julia; Blome, Christine; Radtke, Marc; Augustin, Matthias

    2012-08-01

    Empirical evidence of the efficacy of drugs and therapeutic procedures becomes more important in industrial countries. The assessment of patient benefit from the patient's perspective is of particular relevance. The Patient Benefit Index (PBI) for skin diseases is a validated instrument to assess patient-relevant benefit in patients with skin diseases. So far, no instrument for the assessment of patient-relevant needs and benefits in patients with psoriasis has been published. Objective of the study was the validation of an instrument to assess patient benefit in psoriasis treatment. Patient-relevant treatment needs and benefits in psoriasis patients were recorded with the PBI questionnaire in two studies conducted in 2007. Treatment goals and benefits were used to calculate an importance-weighted PBI. Data of n = 2,009 patients in the cross-sectional study and n = 93 patients in the longitudinal study were used to test validity, feasibility and reliability of the PBI. The PBI was feasible with a rate of missing values ≤1.5 % in PNQ and ≤2.0 % in PBQ. The subscales of the PBI were internally consistent (Cronbach's alpha = 0.68-0.87). The PBI showed convergent validity regarding the quality of life, psoriasis area and severity index, and two single questions on treatment benefit used in the longitudinal study. The PBI is a suitable instrument for the assessment of patient-reported benefit in the treatment of psoriasis. PMID:22722916

  14. The acute treatment of migraine in adults: the american headache society evidence assessment of migraine pharmacotherapies.

    Science.gov (United States)

    Marmura, Michael J; Silberstein, Stephen D; Schwedt, Todd J

    2015-01-01

    The study aims to provide an updated assessment of the evidence for individual pharmacological therapies for acute migraine treatment. Pharmacological therapy is frequently required for acutely treating migraine attacks. The American Academy of Neurology Guidelines published in 2000 summarized the available evidence relating to the efficacy of acute migraine medications. This review, conducted by the members of the Guidelines Section of the American Headache Society, is an updated assessment of evidence for the migraine acute medications. A standardized literature search was performed to identify articles related to acute migraine treatment that were published between 1998 and 2013. The American Academy of Neurology Guidelines Development procedures were followed. Two authors reviewed each abstract resulting from the search and determined whether the full manuscript qualified for review. Two reviewers studied each qualifying full manuscript for its level of evidence. Level A evidence requires at least 2 Class I studies, and Level B evidence requires 1 Class I or 2 Class II studies. The specific medications - triptans (almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan [oral, nasal spray, injectable, transcutaneous patch], zolmitriptan [oral and nasal spray]) and dihydroergotamine (nasal spray, inhaler) are effective (Level A). Ergotamine and other forms of dihydroergotamine are probably effective (Level B). Effective nonspecific medications include acetaminophen, nonsteroidal anti-inflammatory drugs (aspirin, diclofenac, ibuprofen, and naproxen), opioids (butorphanol nasal spray), sumatriptan/naproxen, and the combination of acetaminophen/aspirin/caffeine (Level A). Ketoprofen, intravenous and intramuscular ketorolac, flurbiprofen, intravenous magnesium (in migraine with aura), and the combination of isometheptene compounds, codeine/acetaminophen and tramadol/acetaminophen are probably effective (Level B). The antiemetics prochlorperazine

  15. Malignant gliomas: current perspectives in diagnosis, treatment, and early response assessment using advanced quantitative imaging methods

    Directory of Open Access Journals (Sweden)

    Ahmed R

    2014-03-01

    Full Text Available Rafay Ahmed,1 Matthew J Oborski,2 Misun Hwang,1 Frank S Lieberman,3 James M Mountz11Department of Radiology, 2Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA; 3Department of Neurology and Department of Medicine, Division of Hematology/Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USAAbstract: Malignant gliomas consist of glioblastomas, anaplastic astrocytomas, anaplastic oligodendrogliomas and anaplastic oligoastrocytomas, and some less common tumors such as anaplastic ependymomas and anaplastic gangliogliomas. Malignant gliomas have high morbidity and mortality. Even with optimal treatment, median survival is only 12–15 months for glioblastomas and 2–5 years for anaplastic gliomas. However, recent advances in imaging and quantitative analysis of image data have led to earlier diagnosis of tumors and tumor response to therapy, providing oncologists with a greater time window for therapy management. In addition, improved understanding of tumor biology, genetics, and resistance mechanisms has enhanced surgical techniques, chemotherapy methods, and radiotherapy administration. After proper diagnosis and institution of appropriate therapy, there is now a vital need for quantitative methods that can sensitively detect malignant glioma response to therapy at early follow-up times, when changes in management of nonresponders can have its greatest effect. Currently, response is largely evaluated by measuring magnetic resonance contrast and size change, but this approach does not take into account the key biologic steps that precede tumor size reduction. Molecular imaging is ideally suited to measuring early response by quantifying cellular metabolism, proliferation, and apoptosis, activities altered early in treatment. We expect that successful integration of quantitative imaging biomarker assessment into the early phase of clinical trials could provide a novel approach for testing new therapies

  16. Savannah River Site Tank 48H Waste Treatment Project Technology Readiness Assessment

    International Nuclear Information System (INIS)

    One of U.S. Department of Energy's (DOE) primary missions at Savannah River Site (SRS) is to retrieve and treat the high level waste (HLW) remaining in SRS tanks and close the F and H tank farms. At present, a significant impediment to timely completion of this mission is the presence of significant organic chemical contamination in Tank 48H. Tank 48H is a 1.3 million gallon tank with full secondary containment, located and interconnected within the SRS tank system. However, the tank has been isolated from the system and unavailable for use since 1983, because its contents - approximately 250,000 gallons of salt solution containing Cs-137 and other radioisotopes - are contaminated with nearly 22,000 Kg of tetraphenylborate, a material which can release benzene vapor to the tank head space in potentially flammable concentrations. An important element of the DOE SRS mission is to remove, process, and dispose of the contents of Tank 48H, both to eliminate the hazard it presents to the SRS H-Tank Farm and to return Tank 48H to service. Tank 48H must be returned to service to support operation of the Salt Waste Processing Facility, to free up HLW tank space, and to allow orderly tank closures per Federal Facility Agreement commitments. The Washington Savannah River Company (WSRC), the SRS prime contractor, has evaluated alternatives and selected two processes, Wet Air Oxidation (WAO) and Fluidized Steam Bed Reforming (FBSR) as candidates for Tank 48H processing. Over the past year, WSRC has been testing and evaluating these two processes, and DOE is nearing a final technology selection in late 2007. In parallel with WSRC's ongoing work, DOE convened a team of independent qualified experts to conduct a Technology Readiness Assessment (TRA). The purpose of the TRA was to determine the maturity level of the Tank 48H treatment technology candidates - WAO and FBSR. The methodology used for this TRA is based on detailed guidance for conducting TRAs contained in the Department

  17. Values of functional indexes in assessment of efficacy of osteoarthritis treatment with Chondrolon and Zel T in polyclinic

    Directory of Open Access Journals (Sweden)

    O Y Maiko

    2009-01-01

    Full Text Available Objective. To study change of knee joints functional disability in pts with predominantly I-II stage of knee osteoarthritis (OA with clinical tests and WOMAC index for assessment of efficacy of treatment with Chondrolon and Zel T in polyclinic. Material and methods. 70 pts with I and II stage of OA according to Kellgren-Lawrence aged from 40 to 67 years were included. They were divided in 2 groups (30 pts in group I and40 pts in group II. Group I pts were treated with Chondrolon and group II pts – with Zel T. Treatment efficacy was assessed with WOMAC index, functional Lequesne index, pain on VAS at rest and at movement, knee mobility, time of walking for 30 m and walking stairs. Results. Positive changes of all parameters were revealed in both groups: significant improvement of pain on VAS, functional tests, Lequesne index, WOMAC scales was achieved. During treatment with Zel T improvement of the efficacy measures increased slower, mainly after 12 weeks of treatment (during treatment with Chondrolon – after8 weeks. Both drugs provided functional improvement assessed by WOMAC index butChondrolon was more effective. Conclusion. Chondrolon and Zel T can be used for treatment of OA at I or II stage with moderate knee joints functional disability. Course of treatment with Zel T should be continued not less than 3 months and with Chondrolon – 2 months.

  18. Municipal wastewater treatment by biofiltration: comparisons of various treatment layouts. Part 1: assessment of carbon and nitrogen removal.

    Science.gov (United States)

    Rocher, Vincent; Paffoni, Catherine; Gonçalves, Alexandre; Guérin, Sabrina; Azimi, Sam; Gasperi, Johnny; Moilleron, Régis; Pauss, André

    2012-01-01

    One of the largest wastewater treatment plants in the Paris conurbation (240,000 m(3)/d) has been studied over several years in order to provide technical and economical information about biological treatment by biofiltration. Biofiltration systems are processes in which carbon and nitrogen pollution of wastewater are treated by ascendant flow through immersed fixed cultures. This paper, focused on technical information, aims: (1) to compare performances of the three biological treatment layouts currently used in biofiltration systems: upstream denitrification (UD), downstream denitrification (DD) and combined upstream-downstream denitrification (U-DD) layouts; and (2) to describe in detail each treatment step. Our study has shown that more than 90% of the carbon and ammoniacal pollution is removed during biological treatment, whatever the layout used. Nitrate, produced during nitrification, is then reduced to atmospheric nitrogen. This reduction is more extensive when the denitrification stage occurs downstream from the treatment (DD layout with methanol addition), whereas it is only partial when it is inserted upstream from the treatment (UD layout - use of endogenous carbonaceous substrate). So, the UD layout leads to a nitrate concentration that exceeds the regulatory threshold in the effluent, and the treatment must be supplemented with a post-denitrification step (U-DD layout). Our work has also shown that the optimal ammonium-loading rate is about 1.1-1.2 kg N-NH(4)(+) per m(3) media (polystyrene) and day. For denitrification, the optimal nitrate-loading rate is about 2.5 kg N per m(3) media (expanded clay) and day in the case of DD with methanol, and is about 0.25 kg N-NO(3)(-) per m(3) media and day in the case of UD with exogenous carbonaceous substrate. PMID:22508136

  19. Life cycle assessment applied to wastewater treatment; Analyse de cycle de vie appliquee aux systemes de traitement des eaux usees

    Energy Technology Data Exchange (ETDEWEB)

    Renou, S.

    2006-01-15

    Nowadays, the environmental performances of wastewater treatment systems are not properly analyzed. Thus, the development of an exhaustive and reliable method is needed to help stakeholders to choose the best environmental solutions. Life cycle assessment (LCA) was selected as a starting point to answer this problem. LCA has been tested. This tool is essential to analyze the environmental performances of wastewater treatment systems. In order to fulfill our goal, the best compromise seems to be the association of LCA, to assess global impacts, with others methodologies, to assess local impacts. Finally, a software has been developed to compare urban sludge treatment and recovering process trains. Two impacts, energy and greenhouse effect, are currently included in. The software and its development steps are described and illustrated through two case studies. This tool has made LCA easier to apply and more useful to wastewater field stakeholders. (author)

  20. Development and description of measurement properties of an instrument to assess treatment burden among patients with multiple chronic conditions

    Directory of Open Access Journals (Sweden)

    Tran Viet-Thi

    2012-07-01

    Full Text Available Abstract Background Patients experience an increasing treatment burden related to everything they do to take care of their health: visits to the doctor, medical tests, treatment management and lifestyle changes. This treatment burden could affect treatment adherence, quality of life and outcomes. We aimed to develop and validate an instrument for measuring treatment burden for patients with multiple chronic conditions. Methods Items were derived from a literature review and qualitative semistructured interviews with patients. The instrument was then validated in a sample of patients with chronic conditions recruited in hospitals and general practitioner clinics in France. Factor analysis was used to examine the questionnaire structure. Construct validity was studied by the relationships between the instrument's global score, the Treatment Satisfaction Questionnaire for Medication (TSQM scores and the complexity of treatment as assessed by patients and physicians. Agreement between patients and physicians was appraised. Reliability was determined by a test-retest method. Results A sample of 502 patients completed the Treatment Burden Questionnaire (TBQ, which consisted of 7 items (2 of which had 4 subitems defined after 22 interviews with patients. The questionnaire showed a unidimensional structure. The Cronbach's α was 0.89. The instrument's global score was negatively correlated with TSQM scores (rs = -0.41 to -0.53 and positively correlated with the complexity of treatment (rs = 0.16 to 0.40. Agreement between patients and physicians (n = 396 was weak (intraclass correlation coefficient 0.38 (95% confidence interval 0.29 to 0.47. Reliability of the retest (n = 211 patients was 0.76 (0.67 to 0.83. Conclusions This study provides the first valid and reliable instrument assessing the treatment burden for patients across any disease or treatment context. This instrument could help in the development of treatment strategies that are both

  1. Psychosocial assessment and monitoring in the new era of non-interferon-alpha hepatitis C virus treatments.

    Science.gov (United States)

    Rowan, Paul J; Bhulani, Nizar

    2015-09-01

    Chronic hepatitis C virus (HCV) is a global concern. With the 2014 Food and Drug Administration approvals of two direct-acting antiviral (DAA) regimens, ledipasvir/sofosbuvir regimen and the ombitasvir/paritaprevir/ritonavir and dasabuvir regimen, we may now be in the era of all-pill regimens for HCV. Until this development, interferon-alpha along with Ribavirin has remained part of the standard of care for HCV patients. That regimen necessitates psychosocial assessment of factors affecting treatment eligibility, including interferon-alpha-related depressive symptoms, confounding psychiatric conditions, and social aspects such as homelessness affecting treatment eligibility. These factors have delayed as much as 70% of otherwise eligible candidates from interferon-based treatment, and have required treating physicians to monitor psychiatric as well as medical side effects throughout treatment. All-pill DAA regimens with the efficaciousness that would preclude reliance upon interferon-alpha or ribavirin have been anticipated for years. Efficacy studies for these recently approved DAA regimens provide evidence to assess the degree that psychosocial assessment and monitoring will be required. With shorter treatment timelines, greatly reduced side effect profiles, and easier regimens, psychosocial contraindications are greatly reduced. However, current or recent psychiatric comorbidity, and drug-drug interactions with psychiatric drugs, will require some level of clinical attention. Evidence from these efficacy studies tentatively demonstrate that the era of needing significant psychosocial assessment and monitoring may be at an end, as long as a manageable handful of clinical issues are managed. PMID:26380046

  2. Psychosocial assessment and monitoring in the new era of non-interferon-alpha hepatitis C virus treatments

    Institute of Scientific and Technical Information of China (English)

    Paul; J; Rowan; Nizar; Bhulani

    2015-01-01

    Chronic hepatitis C virus(HCV) is a global concern. With the 2014 Food and Drug Administration approvals of two direct-acting antiviral(DAA) regimens, ledipasvir/sofosbuvir regimen and the ombitasvir/paritaprevir/ritonavir and dasabuvir regimen, we may now be in the era of all-pill regimens for HCV. Until this development, interferon-alpha along with Ribavirin has remained part of the standard of care for HCV patients. That regimen necessitates psychosocial assessment of factors affecting treatment eligibility, including interferon-alpharelated depressive symptoms, confounding psychiatric conditions, and social aspects such as homelessness affecting treatment eligibility. These factors have delayed as much as 70% of otherwise eligible candidates from interferon-based treatment, and have required treating physicians to monitor psychiatric as well as medical side effects throughout treatment. Allpill DAA regimens with the efficaciousness that would preclude reliance upon interferon-alpha or ribavirin have been anticipated for years. Efficacy studies for these recently approved DAA regimens provide evidence to assess the degree that psychosocial assessment and monitoring will be required. With shorter treatment timelines, greatly reduced side effect profiles, and easier regimens, psychosocial contraindications are greatly reduced. However, current or recent psychiatric comorbidity, and drug-drug interactions with psychiatric drugs, will require some level of clinical attention. Evidence from these efficacy studies tentatively demonstrate that the era of needing significant psychosocial assessment and monitoring may be at an end, as long as a manageable handful of clinical issues are managed.

  3. RELATIONSHIP BETWEEN ASSESSED RISK AREAS WITH INDIVIDUAL, FAMILY AND OTHER CHARACTERISTICS OF FEMALE MINORS FROM DIFFERENT TREATMENT PROGRAMS

    Directory of Open Access Journals (Sweden)

    Antonija Žižak

    2010-12-01

    Full Text Available The purpose of this paper is familiarizing with, so far insuffi ciently explored, specifi c characteristics of female children and youthwith behavioral disorders in the Republic of Croatia. The study was conducted on a sample of 237 female children and youth withbehaviour disorders who, at the time of research, were included in institutional treatment, day treatment or community treatmentprograms (three subsamples. Specifi c goals of the paper are related to determination of the level and specifi c areas of risk and thesignifi cance of differences in the assessed risk levels for benefi ciaries across multiple types of treatment. Further goal is to researchrelationships between the estimated areas of risk with other, for treatment important areas, such as strengths, needs, family life circumstancesand individual characteristics of minors. The instrument Youth Level of Service/Case Management Inventory (YLS/CMIwas applied. It’s intention is to assess level of risk and needs of children and youth in order to determine required level of service aswell as prediction of treatment outcome and future behavior. To process the obtained data, robust discriminant analysis and quasicorrelation analysis were used. Robust discriminatory analysis fortifi es statistically signifi cant difference in almost all observed riskareas between examinees from three subsamples. Results of quasy correlation analysis indicate the existence of signifi cant relationshipsbetween assessed areas of risk and other assessed and for treatment important areas. The highest correlation among quasycanonical factors is obtained for the association of areas of risk and characteristics of minors, what indicates the extreme complexityof the population of female minors with behavioral disorders, as seen entirety and by subsamples. In accordance with levels of risk,treatment needs and responsiveness, suggestions about the components of treatment for each of the three groups of female

  4. Redefining psychopathy? : Is there a need for a reformulation of the concept, assessment and treatment of psychopathic traits?

    OpenAIRE

    Gullhaugen, Aina Sundt

    2012-01-01

    Redefining psychopathy? Is there a need for a reformulation of the concept, assessment, and treatment of psychopathic traits? The concept of psychopathy is unlike most other mental disorders in the lack of observations of vulnerability and pain in those affected. Rather, the psychopath’s callous and self-centered ways are known to evoke suffering in others. Measures are developed to identify these characteristics in a reliable way. However, increased accuracy has not led to better treatment....

  5. Sleep Onset Problems in Two Children with Mild Intellectual Disability and Epilepsy: Assessment and Treatment in the Home Setting

    OpenAIRE

    Maas, A.P.H.M.; R. Didden; Moor, J.M.H. de; Renier, W O; Curfs, L.M.G.

    2005-01-01

    Sleep problems such as bedtime difficulties, frequent night waking and excessive daytime sleepiness are prevalent in children with epilepsy. In the present study, functional assessment of sleep onset problems in two young children with epilepsy was performed. Effects of bedtime fading and antipsychotic medication (pipamperon) in a 6-year-old boy, and melatonin in an 8-year-old girl were assessed on sleep latency. Treatment resulted in a marked decrease in sleep latency in both cases and effec...

  6. Recent advances in pathogenesis, assessment, and treatment of atherosclerosis [version 1; referees: 3 approved

    Directory of Open Access Journals (Sweden)

    J. David Spence

    2016-07-01

    Full Text Available In recent years, there have been a number of advances in the pathogenesis and treatment of atherosclerosis and in assessing prognosis in carotid atherosclerosis. Risk stratification to improve vascular prevention by identifying patients most likely to benefit from intensive therapy is much improved by measuring carotid plaque burden. In patients with asymptomatic carotid stenosis, a number of modalities can be used to identify the 10-15% who could benefit from endarterectomy or stenting. Transcranial Doppler embolus detection, echolucency and ulceration on 3D ultrasound, intraplaque hemorrhage on magnetic resonance imaging (MRI, and reduced cerebrovascular reserve are useful already; new approaches including plaque texture on ultrasound and imaging of plaque inflammation and early calcification on positron emission tomography/computed tomography (PET/CT are in development. The discovery that the intestinal microbiome produces vasculotoxic metabolites from dietary constituents such as carnitine in meat (particularly red meat and phosphatidylcholine from egg yolk and other sources has revolutionized nutritional aspects of vascular prevention. Because many of these vasculotoxic metabolites are removed by the kidney, it is particularly important in patients with renal failure to limit their intake of red meat and egg yolk. A new approach to lowering low-density lipoprotein (LDL cholesterol by blocking the action of an enzyme that destroys LDL receptors promises to revolutionize vascular prevention once less costly treatments are developed, and a new approach to vascular prevention—“treating arteries instead of risk factors”—shows promise but requires randomized trials. These advances all promise to help in the quest to prevent strokes in high-risk patients.

  7. Life cycle assessment of pig slurry treatment technologies for nutrient redistribution in Denmark.

    Science.gov (United States)

    ten Hoeve, Marieke; Hutchings, Nicholas J; Peters, Gregory M; Svanström, Magdalena; Jensen, Lars S; Bruun, Sander

    2014-01-01

    Animal slurry management is associated with a range of impacts on fossil resource use and the environment. The impacts are greatest when large amounts of nutrient-rich slurry from livestock production cannot be adequately utilised on adjacent land. To facilitate nutrient redistribution, a range of different technologies are available. This study comprised a life cycle assessment of the environmental impacts from handling 1000 kg of pig slurry ex-animal. Application of untreated pig slurry onto adjacent land was compared with using four different treatment technologies to enable nutrient redistribution before land application: (a) separation by mechanical screw press, (b) screw press separation with composting of the solid fraction, (c) separation by decanter centrifuge, and (d) decanter centrifuge separation with ammonia stripping of the liquid fraction. Emissions were determined based on a combination of values derived from the literature and simulations with the Farm-N model for Danish agricultural and climatic conditions. The environmental impact categories assessed were climate change, freshwater eutrophication, marine eutrophication, terrestrial acidification, natural resource use, and soil carbon, nitrogen and phosphorus storage. In all separation scenarios, the liquid fraction was applied to land on the pig-producing (donor) farm and the solid fraction transported to a recipient farm and utilised for crop production. Separation, especially by centrifuge, was found to result in a lower environmental impact potential than application of untreated slurry to adjacent land. Composting and ammonia stripping either slightly increased or slightly decreased the environmental impact potential, depending on the impact category considered. The relative ranking of scenarios did not change after a sensitivity analysis in which coefficients for field emissions of nitrous oxide, ammonia and phosphorus were varied within the range cited in the literature. Therefore, the best

  8. Pressure assessment in intercavernous embedding of bulboperineal urethra for treatment of urinary incontinence after prostatic operation

    Institute of Scientific and Technical Information of China (English)

    Li-Xin QIAN; Hong-Fei WU; Yuan-Geng SHUI; Wei ZHANG; Shuang-Guan CHENG; Min GU; Zheng-Quan XU

    2001-01-01

    Aim: To put forward criteria for the pressure assessment in the operation of intercavemous embedding of bulboperineal urethra for the treatment of urinary incontinence after prostatic operation. Methods: A Fl4 urethral catheter is inserted during the operation and upon suturing the corpora cavemosa centrally, the catheter is slowly pushed in and pulled out in order that the operator feels a certain degree of close-fit resistance. The degree of tightness of the stitches,which regulate the compression pressure, is adjusted in accordance with this close-fit sensation. To further ascertain the adequacy of the force of compression, the bladder is filled with 300 ml physiological saline and observe the appropriateness (size and continuity) of the outflow stream when the lower abdomen is depressed with a pressure of 80-90 cm H2O. The operation was given to six patients suffered from urinary incontinence for 20 or more months after prostatic operation. Results: Five cases achieved complete recovery, while the therapeutic effect of the 6th one was not satisfactory. A second stage operation was carried out 3 months later with the addition of one more stitch both proximally and distally to reinforce the compression force. The condition was improved dramatically. The follow-up period averaged 3.5 years. Conclusion: The adequacy of the compression pressure exerted by the juxtaposed corpora cavernosa is the key point determining the outcome of the operation. The measures for assessing the compression pressure suggested by the authors are helpful in obtaining the good results of the present paper (6/6 success) as compared with 25/34success in the previous report.

  9. Sleep problems in general practice: a national survey of assessment and treatment routines of general practitioners in Norway.

    Science.gov (United States)

    Sivertsen, Børge; Nordhus, Inger H; Bjorvatn, Bjørn; Pallesen, Ståle

    2010-03-01

    The aim of the current national survey of all general practitioners (GPs) practising in Norway was to explore assessment, treatment practice and perceived efficacy of treatment of sleep problems in general practice. A short questionnaire, including self-report measures of the frequency and routines of treatment and assessment of sleep problems, was sent to all 4049 GPs in Norway, of whom 1465 (36.7%) provided valid responses. The prevalence of sleep problems among patients in general practice was estimated to be 11.2%, of which almost two-thirds were believed to be caused by a medical condition. Anamnestic information and blood tests were the most common assessment of sleep problems, whereas GPs rarely referred patients to all-night polysomnographic recording. Sleep hygiene advices were the most commonly used treatment strategy, whereas hypnotics were believed to have the best short-term efficacy. Antidepressives were considered to be the best option for long-term management of sleep problems. About one-third of the patients were prescribed benzodiazepines or 'Z-drugs' for more than 6 months. This study demonstrates that sleep problems are recognized by GPs, but despite evidence that non-pharmacological treatment is superior in the long-term management of insomnia, the current study shows that hypnotics are still considered by GPs to be the most successful treatment. PMID:19732316

  10. Assessment of the Presence of Triclosan in Wastewater Treatment Plants in the Czech Republic and Alternative Fungal Treatment

    Czech Academy of Sciences Publication Activity Database

    Křesinová, Zdena; Žebrák, R.; Langová, J.; Cajthaml, Tomáš; Barret, L. M. (ed.)

    Vol. 3. New York: Nova Science Publishers, Inc, 2015, s. 69-80. ISBN 978-1-63482-467-5 R&D Projects: GA TA ČR TE01020218; GA ČR(CZ) GA15-02328S Institutional support: RVO:61388971 Keywords : triclosan * wastewater treatment plants * monitoring Subject RIV: EE - Microbiology, Virology

  11. Adequacy of Antidepressant Treatment by Psychiatric Residents: The Antidepressant Treatment History Form as a Possible Assessment Tool

    Science.gov (United States)

    Dew, Rachel Elizabeth; Kramer, Stephen I.; McCall, W. Vaughn

    2005-01-01

    Objective: Facility in psychopharmacology is a major goal of psychiatric residency. This study assesses the adequacy of pharmacotherapy provided to depressed patients in a resident clinic. Methods: Charts of all 285 patients seen in an outpatient triage clinic during 2000 were reviewed. One hundred twelve patients had diagnoses of major…

  12. Toward the elimination of lymphatic filariasis by 2020: treatment update and impact assessment for the endgame.

    Science.gov (United States)

    Rebollo, Maria P; Bockarie, Moses J

    2013-07-01

    Lymphatic filariasis (LF) is an important public health problem endemic in 73 countries, where it is a major cause of acute and chronic morbidity and a significant impediment to socioeconomic development. It is targeted for elimination by 2020, through preventive chemotherapy using albendazole in combination with either ivermectin or diethylcarbamazine citrate. Preventive chemotherapy enables the regular and coordinated administration of safe, single-dose medications delivered through mass drug administration (MDA). Many countries are now scaling down MDA activities after achieving 100% geographic coverage and instituting monitoring and evaluation procedures to establish the impact of several consecutive rounds of MDA and determine if transmission has been interrupted. At the same time, countries yet to initiate MDA for elimination of LF will adopt improved mapping and coverage assessment protocols to accelerate the efforts for achieving global elimination by 2020. This review provides an update on treatment for LF and describes the current global status of the elimination efforts, transmission control processes and strategies for measuring impact and continuing surveillance after MDA has ceased. PMID:23879610

  13. Assessing the ecotoxicity of metal nano-oxides with potential for wastewater treatment.

    Science.gov (United States)

    Nogueira, V; Lopes, I; Rocha-Santos, T A P; Rasteiro, M G; Abrantes, N; Gonçalves, F; Soares, A M V M; Duarte, A C; Pereira, R

    2015-09-01

    The rapid development of nanotechnology and the increasing use of nanomaterials (NMs) raise concern about their fate and potential effects in the environment, especially for those that could be used for remediation purposes and that will be intentionally released to the environment. Despite the remarkable emerging literature addressing the biological effects of NMs to aquatic organisms, the existing information is still scarce and contradictory. Therefore, aimed at selecting NMs for the treatment of organic and inorganic effluents, we assessed the potential toxicity of NiO (100 and 10-20 nm), Fe2O3 (≈85 × 425 nm), and TiO2 (Lemna minor, Daphnia magna, Brachionus plicatilis, and Artemia salina. Also a mutagenic test was performed with two Salmonella typhimurium strains. Suspensions of each NM, prepared with the different test media, were characterized by dynamic light scattering (DLS) and eletrophoretic light scattering (ELS). For the assays with marine species, no toxicity was observed for all the compounds. In opposite, statistically significant effects were produced on all freshwater species, being D. magna the most sensitive organism. Based on the results of this study, the tested NMs can be classified in a decreasing order of toxicity NiO (100 nm) > NiO (10-20 nm) > TiO2 ( Fe2O3, allowing to infer that apparently Fe2O3 NMs seems to be the one with less risks for receiving aquatic systems. PMID:25940480

  14. Adequacy assessment studies of improved circular clarifier for type-II settling for storm water treatment.

    Science.gov (United States)

    Ahuja, Nandita; Pophali, Girish R

    2013-10-01

    The adequacy of an improved circular clarifier was assessed for solids-liquid separation of chemically treated storm water. The storm water was treated with alum and polyelectrolyte to enhance settling. The performance of the clarifier was studied under various operating conditions by varying suspended solids concentrations and turbidity, and the hydraulic retention time. It was observed that the clarifier worked at an optimum hydraulic retention time of 1.5 hours for initial suspended solids concentration of less than 500 mg/L. However, for treatment of storm water with suspended solids concentration more than 500 mg/L, the hydraulic retention time needs to be selected taking the required effluent turbidity and effluent usage into consideration, i.e. for high turbidity removal an optimum hydraulic retention time of 2 hours must be used against a hydraulic retention time of 1.5 hours for a relatively low turbidity removal. Thus, the clarifier can be effectively used on field scale for solids-liquid separation of flocculent suspensions. PMID:25906594

  15. Aging assessment of nuclear air-treatment system HEPA filters and adsorbers

    International Nuclear Information System (INIS)

    A Phase I aging assessment of high-efficiency particulate air (HEPA) filters and activated carbon gas adsorption units (adsorbers) was performed by the Pacific Northwest Laboratory (PNL) as part of the US Nuclear Regulatory Commission's (NRC) Nuclear Plant Aging Research (NPAR) Program. Information concerning design features; failure experience; aging mechanisms, effects, and stressors; and surveillance and monitoring methods for these key air-treatment system components was compiled. Over 1100 failures, or 12 percent of the filter installations, were reported as part of a Department of Energy (DOE) survey. Investigators from other national laboratories have suggested that aging effects could have contributed to over 80 percent of these failures. Tensile strength tests on aged filter media specimens indicated a decrease in strength. Filter aging mechanisms range from those associated with particle loading to reactions that alter properties of sealants and gaskets. Low radioiodine decontamination factors associated with the Three Mile Island (TMI) accident were attributed to the premature aging of the carbon in the adsorbers. Mechanisms that can lead to impaired adsorber performance include oxidation as well as the loss of potentially available active sites as a result of the adsorption of pollutants. Stressors include heat, moisture, radiation, and airborne particles and contaminants

  16. The Role of MR Enterography in Assessing Crohn's Disease Activity and Treatment Response.

    Science.gov (United States)

    Moy, Matthew P; Sauk, Jenny; Gee, Michael S

    2016-01-01

    MR enterography (MRE) has become the primary imaging modality in the assessment of Crohn's disease (CD) in both children and adults at many institutions in the United States and worldwide, primarily due to its noninvasiveness, superior soft tissue contrast, and lack of ionizing radiation. MRE technique includes distention of the small bowel with oral contrast media with the acquisition of T2-weighted, balanced steady-state free precession, and multiphase T1-weighted fat suppressed gadolinium contrast-enhanced sequences. With the introduction of molecule-targeted biologic agents into the clinical setting for CD and their potential to reverse the inflammatory process, MRE is increasingly utilized to evaluate disease activity and response to therapy as an imaging complement to clinical indices or optical endoscopy. New and emerging MRE techniques, such as diffusion-weighted imaging (DWI), magnetization transfer, ultrasmall superparamagnetic iron oxide- (USPIO-) enhanced MRI, and PET-MR, offer the potential for an expanded role of MRI in detecting occult disease activity, evaluating early treatment response/resistance, and differentiating inflammatory from fibrotic strictures. Familiarity with MR enterography is essential for radiologists and gastroenterologists as the technique evolves and is further incorporated into the clinical management of CD. PMID:26819611

  17. The Role of MR Enterography in Assessing Crohn’s Disease Activity and Treatment Response

    Directory of Open Access Journals (Sweden)

    Matthew P. Moy

    2016-01-01

    Full Text Available MR enterography (MRE has become the primary imaging modality in the assessment of Crohn’s disease (CD in both children and adults at many institutions in the United States and worldwide, primarily due to its noninvasiveness, superior soft tissue contrast, and lack of ionizing radiation. MRE technique includes distention of the small bowel with oral contrast media with the acquisition of T2-weighted, balanced steady-state free precession, and multiphase T1-weighted fat suppressed gadolinium contrast-enhanced sequences. With the introduction of molecule-targeted biologic agents into the clinical setting for CD and their potential to reverse the inflammatory process, MRE is increasingly utilized to evaluate disease activity and response to therapy as an imaging complement to clinical indices or optical endoscopy. New and emerging MRE techniques, such as diffusion-weighted imaging (DWI, magnetization transfer, ultrasmall superparamagnetic iron oxide- (USPIO- enhanced MRI, and PET-MR, offer the potential for an expanded role of MRI in detecting occult disease activity, evaluating early treatment response/resistance, and differentiating inflammatory from fibrotic strictures. Familiarity with MR enterography is essential for radiologists and gastroenterologists as the technique evolves and is further incorporated into the clinical management of CD.

  18. Comparative assessment of raw and digested pig slurry treatment in bioelectrochemical systems.

    Science.gov (United States)

    Cerrillo, Míriam; Oliveras, Judit; Viñas, Marc; Bonmatí, August

    2016-08-01

    Both raw and anaerobically digested pig slurries were investigated in batch assays in two chambered bioelectrochemical systems (BES) run in Microbial Fuel Cell (MFC) and Microbial Electrolysis Cell (MEC) mode. Chemical Oxygen Demand (COD) removal, nitrogen recovery, cation transport and anode microbial population evolutions were assessed. The Anaerobic Digestion-MEC (AD-MEC) integrated system achieved the highest COD removal (60% in 48h); while the maximum NH4(+) removal efficiency (40%, with an ammonia flux of 8.86g N-NH4(+) d(-1)m(-2)) was achieved in MFC mode fed with digested pig slurry in 24h. On the other hand, the high pH (12.1) achieved in MEC mode (NaCl solution as catholyte), could favour ammonium recovery in a subsequent stripping and absorption process. Ammonia was the main cation involved in maintaining the electroneutrality between both compartments. Regarding microbial population, Desulfuromonadaceae, a known family of exoelectrogenic bacteria, was enriched under MEC mode, whereas hydrogenotrophic and methylotrophic methanogen phylotypes belonging to Thermoplasmatales were also favoured against acetotrophic Methanosaetaceae. From these results, the integration of anaerobic digestion in BES seems to be an interesting alternative for the treatment of complex substrates, since a polished effluent can be obtained and ammonium can be simultaneously recovered for further reuse as fertilizer. PMID:27093494

  19. Initial assessment and treatment with the Airway, Breathing, Circulation, Disability, Exposure (ABCDE approach

    Directory of Open Access Journals (Sweden)

    Thim T

    2012-01-01

    Full Text Available Troels Thim1,2, Niels Henrik Vinther Krarup1,4, Erik Lerkevang Grove1, Claus Valter Rohde3, Bo Løfgren1,41Department of Cardiology, Aarhus University Hospital, Aarhus, 2Department of Internal Medicine, Regional Hospital of Randers, Randers, 3Department of Anestesiology, Aarhus University Hospital, Aarhus, 4Research Center for Emergency Medicine, Aarhus University Hospital, Aarhus, DenmarkAbstract: The Airway, Breathing, Circulation, Disability, Exposure (ABCDE approach is applicable in all clinical emergencies for immediate assessment and treatment. The approach is widely accepted by experts in emergency medicine and likely improves outcomes by helping health care professionals focusing on the most life-threatening clinical problems. In an acute setting, high-quality ABCDE skills among all treating team members can save valuable time and improve team performance. Dissemination of knowledge and skills related to the ABCDE approach are therefore needed. This paper offers a practical “how-to” description of the ABCDE approach.Keywords: emergency medicine, general medicine, internal medicine, multiple trauma, multiple injury

  20. Water quantity and quality assessment on a tertiary treatment wetland in a tropical climate.

    Science.gov (United States)

    Sun, Guangzhi; Saeed, Tanveer; Zhang, Guangxin; Sivakugan, Nagaratnam

    2015-01-01

    This study aimed to assess the quantity and quality of water in a surface flow constructed wetland in Australia's far north Queensland. Owing to tropical climate in the region, the wetland provided dual functions: retention of a treated wastewater for zero discharge during the dry season and tertiary treatment prior to discharge during the wet season. Rainfall data, permeability of wetland soil, evaporation, inflow and outflow were analysed in a water balance analysis; the results showed that based on a 72-year-average rainfall pattern, daily wastewater inflow of 85 m(3)/d is the maximum this wetland can cope with without breaching its discharge certificate. In water quality analysis, the K-C* model was used to predict changes of biochemical oxygen demand (BOD, suspended solids (SS), total nitrogen (TN), total phosphorus (TP) and faecal coliforms (FC) in the wetland. Model predictions were compared with field sampling results. It was found that the wetland was effective in removing FC (>99.9%), TN (70.7%) and TP (68.2%), for which the predictions by the K-C* model were consistent with field testing results. However, significant disparities between the predictions and testing results were found for BOD and SS. A revised K-C* equation was proposed to account for the internal generation of organics in constructed wetlands with a long retention time. PMID:25746641

  1. Assessment of duodenal circular drainage in treatment of superior mesenteric artery syndrome

    Institute of Scientific and Technical Information of China (English)

    Wei-Liang Yang; Xin-Chen Zhang

    2008-01-01

    AIM: To assess the clinical value of duodenal circular drainage for superior mesenteric artery syndrome (SMAS).METHODS: Forty-seven cases of SMAS were treated with duodenal circular drainage from 1959 to 2001.Clinical data were analyzed retrospectively.RESULTS: In this group, good effects were achieved in 39 cases treated with duodenal circular drainage after 2-15 years of follow-up. The other eight cases were first treated with anterior repositioning of the duodenum (two cases), duodenojejunostomy (five cases), subtotal gastrectomy and billroth 11 gastrojejunostomy (one case), but vomiting was not relieved until duodenal circular drainage was performed again. A follow-up study of 8-10 years revealed satisfactory results in these eight patients.CONCLUSION: In SMAS, if the reversed peristalsis is strong and continuous, and vomiting occurs frequently,the symptom can not be relieved even if the obstruction of duodenum is removed surgically. The key treatment is the relief of reversed peristalsis. The duodenal circular drainage can resolve the drainage direction of duodenal content, thus relieving the symptom of vomiting.

  2. ASSESSMENT OF FACTORS INFLUENCING ORAL HEALTH STATUS AND TREATMENT NEEDS AMONG MALAYALI TRIBAL POPULATION AT JAVADHU HILLS, INDIA

    OpenAIRE

    Kirankumar B; Khaja Amjad; Ibrahim; Saleh Nasser; Shailarani; Sweta Ramrao

    2014-01-01

    AIM: The purpose of the study was to assess the oral health Status, factors influencing them and treatment needs of Malayali tribes at Javadhu hills in Polur Taluk, Tamilnadu. METHODOLOGY: A descriptive cross sectional study was conducted to assess the oral health status of totally 710 subjects in four different age groups of 12yrs, 15yrs, 35-44yrs, 65-74yrs old were using the W.H.O oral health assessment methodology 1997. Before the start of the study, an ethical clearanc...

  3. The treatment of uncertainty in performance assessment and safety case development

    International Nuclear Information System (INIS)

    This paper presents the results of a review of the treatment of uncertainty in performance assessment (PA) and safety-case development, carried out as part of the European Commission (EC) project PAMINA (Performance Assessment Methodologies In Application to Guide the Development of the Safety Case). Information on the treatment of uncertainties was gathered from PAMINA participants and several other organisations using a questionnaire, and via a limited wider review of the literature. The questionnaire responses obtained represent 16 disposal programmes in 13 countries, including all of the countries with advanced programmes to implement deep geological disposal, allowing the review to give wide coverage of global activity. A two-day workshop was held in Brussels in March 2007, in which PAMINA participants reviewed an initial document which summarised the questionnaire results. Work plans were formulated for the remainder of the PAMINA programme. The 16 programmes represented are at diverse phases of maturity: four are at the conceptual development or feasibility stage, seven are at the site selection or site characterisation stage, two are at the licensing stage, one is at the construction stage, one has an operational repository, and one is at the decommissioning/closure stage. There is also wide variation in the development of regulations concerning the treatment of uncertainty for deep geological disposal of radioactive waste, with several countries having no specific regulations. The review indicates that there is a high level of consensus with respect to the nature of uncertainties in PAs and how they should be classified, although this is sometimes masked by variations in terminology and differences in the way uncertainties are treated in programmes. A system of classification is set out in this review, with reference to the nature of uncertainties. The review discusses how the principal classes of uncertainty are treated in PAs and safety cases. While

  4. Municipal wastewater treatment by biofiltration: comparisons of various treatment layouts. Part 2: assessment of the operating costs in optimal conditions.

    Science.gov (United States)

    Rocher, Vincent; Paffoni, Catherine; Gonçalves, Alexandre; Azimi, Sam; Pauss, André

    2012-01-01

    This work aims to compare the operation costs (energy, reagents, waste management) for the three layouts usually used in wastewater treatment plants incorporating biofilters, using technical and economical data acquired during 10 years of operation of a Parisian plant (Seine Centre, 240,000 m(3) d(-1) -800,000 equivalent inhabitants). The final objective is to establish general economical data and tendencies that can be translated from our study to any biofiltration plant. Our results evidenced the savings achieved through the treatment process combining upstream and downstream denitrification. To use this layout reduced the operating costs by some 10% as compared with conventional processing only comprising downstream denitrification. Operating costs were respectively estimated at 37 and 34 €/1,000 m(3) for downstream denitrification and combining upstream and downstream denitrification layouts. PMID:22508137

  5. Measurement Tools and Target Symptoms/Skills Used to Assess Treatment Response for Individuals with Autism Spectrum Disorder

    Science.gov (United States)

    Bolte, Erin Elizabeth; Diehl, Joshua John

    2013-01-01

    This study examined the measurement tools and target symptoms/skills used to assess treatment response during Autism Spectrum Disorder (ASD) intervention trials from 2001 through 2010. Data from 195 prospective trials were analyzed. There were 289 unique measurement tools, of which 61.6% were used only once, and 20.8 % were investigator-designed.…

  6. Bupropion in breast milk: an exposure assessment for potential treatment to prevent post-partum tobacco use

    OpenAIRE

    Haas, J; Kaplan, C.; Barenboim, D; Jacob, P.; Benowitz, N.

    2004-01-01

    Objectives: To assess potential infant exposure to bupropion and its active metabolites in breast milk such as would occur during treatment to prevent post-partum relapse to tobacco use, and to compare the concentrations of bupropion in urine and saliva with plasma and breast milk.

  7. The Role of Psychodynamic Assessment in Diagnosis and Treatment of Personality Disorders: Reliability and Validity of the Developmental profile

    NARCIS (Netherlands)

    T. Ingenhoven (Theo)

    2009-01-01

    markdownabstract__Abstract__ The aim of this thesis is to improve our understanding of the role of psychodynamic models, and their assessment procedures, in diagnosis and treatment of patients with personality disorders. In this introduction we briefly describe the current status of personality dis

  8. Optical coherence tomography for the assessment of pericardium covered stents for the treatment of degenerated saphenous vein grafts

    NARCIS (Netherlands)

    P. Tyczynski (Pawel); N. Kukreja (Neville); R.J.M. van Geuns (Robert Jan); J.J. Wykrzykowska (Joanna); M.N. Sheppard (Mary); C. di Mario (Carlo)

    2010-01-01

    textabstractAims: Pre- and post-interventional optical coherence tomography (OCT) assessment of degenerated saphenous vein grafts (SVG) treated with implantation of pericardium covered stents. Percutaneous treatment of SVG represents one of the major challenges of current percutaneous coronary inter

  9. [The methodological basis of expert assessment of unfavourable outcomes of the stomatological treatment in the framework of civil law proceedings].

    Science.gov (United States)

    Pigolkin, Iu I; Murzova, T V; Mirzoev, Kh M

    2011-01-01

    The authors discuss peculiarities of the performance of forensic medical expertise in the cases of unfavourable outcomes of the stomatological treatment. The methodological basis of expert assessment has been created to be applied in situations related to the unfavourable outcomes of dental care. PMID:22384707

  10. Assessment of potential impacts of municipal solid waste treatment alternatives by using life cycle approach: a case study in Vietnam.

    Science.gov (United States)

    Thanh, Nguyen Phuc; Matsui, Yasuhiro

    2013-10-01

    In Vietnam, most of municipal solid waste (MSW) is disposed of at open dumping and landfill sites, and the methane gas from waste is the un-ignorable source of greenhouse gas (GHG) emission. It is indispensable to explore the possibility for GHG mitigation in MSW management. The objective of this study was to estimate alternative waste treatment practices towards the GHG emission mitigation, energy consumption and generation, reduction of landfill volume, and various benefits for proposing the appropriate selection by scenario analyses for representative Vietnam's cities. Impacts were calculated by utilizing life cycle assessment (LCA) method. A literature review survey on the current applicability of LCA database for assessing impacts from waste sector in developing countries, especially for Vietnam, was carried out. This study assessed the contribution of alternative solid waste treatment practices. The result showed that, except investment and operation costs, incineration with energy recovery seems the suitable alternative for treating waste from representative cities of Vietnam according to reduction of GHG emission and waste burden to landfill sites and energy recovery and generation. Besides, MSW composition was identified as an important factor directly influencing to impacts as well as other products and benefits of waste treatment alternatives. Reliable data on waste composition are indispensable for assessing to choose, improve, or plan the waste treatment practices towards sustainable development. PMID:23475528

  11. Practice Parameter for the Assessment and Treatment of Children and Adolescents with Attention-Deficit/Hyperactivity Disorder

    Science.gov (United States)

    Journal of the American Academy of Child & Adolescent Psychiatry, 2007

    2007-01-01

    This practice parameter describes the assessment and treatment of children and adolescents with attention-deficit/hyperactivity disorder (ADHD) based on the current scientific evidence and clinical consensus of experts in the field. This parameter discusses the clinical evaluation for ADHD, comorbid conditions associated with ADHD, research on the…

  12. The School Psychologist's Primer on Childhood Depression: A Review of Research Regarding Epidemiology, Etiology, Assessment, and Treatment

    Science.gov (United States)

    Ruderman, Matthew A.; Stifel, Skye W. F.; O'Malley, Meagan; Jimerson, Shane R.

    2013-01-01

    The purpose of this article is to provide school psychologists with a synthesis of important information regarding the epidemiology, etiology, assessment, and treatment of childhood depression. A review of the recent research and relevant literature is summarized reflecting the contemporary knowledge regarding depression during childhood and…

  13. Assessment of The Lymphatic System of the Genitalia Using Magnetic Resonance Lymphography Before and After Treatment of Male Genital Lymphedema

    Science.gov (United States)

    Lu, Qing; Jiang, Zhaohua; Zhao, Zizhou; Wu, Lianming; Wu, Guangyu; Suo, Shiteng; Xu, Jianrong

    2016-01-01

    Abstract Treatment for chronic male genital lymphedema (GL) is limited. No standard treatment or validated instrument to assess GL is available. The aim of this study was to explore whether magnetic resonance lymphography (MRL) could be used to assess GL, select proper treatment for patients, and monitor postoperative progress. This is a retrospective analysis of a prospectively acquired cohort of men with GL presenting for MRL over a 7-year period. Thirty-six of 47 eligible men were included. All men were offered preoperative and postoperative MRL and assigned a morphology and function classification. Men with mild, moderate, and severe nodal dysfunction underwent complex decongestive physiotherapy (CDP), lymphoveneous microsurgery, and surgical excision, respectively. The volume reductions in the genitalia of patients with mild and moderate nodal dysfunction were recorded and compared using Student t test. The abnormal superficial and deep lymphatic vessels in the lymphedematous genitalia were detected by MRL, and inguinal lymph node dysfunction was classified by MRL. Seven patients with mild dysfunction who underwent CDP showed a more significant mean volume reduction in the genitalia than did 9 patients with moderate dysfunction. Three patients with hyperplasia and moderate dysfunction who underwent microsurgical operations and 17 patients with hypoplasia and moderate or severe nodal dysfunction who underwent surgical excision had excellent cosmetic results with no lymphedema at the 3- to 5-year follow-up. MRL can be used to assess morphological and functional lymphatic abnormalities in GL, preoperatively select appropriate treatment, and postoperatively evaluate treatment outcomes. PMID:27227943

  14. Dental anxiety among adult patients and its correlation with self-assessed dental status and treatment needs

    International Nuclear Information System (INIS)

    Objective: To evaluate the dental anxiety levels and to assess its correlation with self-assessed dental status and treatment needs of patients. Methods: The study was conducted at the Out Patient Department of Dr. Ishrat-ul-Ebad Khan Institute of Oral Health Sciences, Karachi. Using non-probability quota sampling, the study included the first 32 patients between 18 and 35 years of age, visiting the facility. Over a period of one month (22 working days) 704 patients comprised the study population. They were interviewed using a structured questionnaire to self-assess their dental anxiety levels, oral health status and treatment needs. The data was analysed using SPSS 17.0 with descriptive frequencies and chi-square test. Results: Of the total participants, 650 (92.32%) patients provided consent. Average dental anxiety scale score was 12.46, representing high anxiety score. There were 174 (26.8%) smokers; only 234 (36%) had visited a dentist less than a year ago; 385 (59.2%) considered their dental health to be satisfactory; 306 (47.1%) thought of their treatment needs to be little'; 222 (34.2%) brushed their teeth twice daily. Dental anxiety was statistically significant with treatment needs and dental status. Relation of tooth-brushing with last dental visit and treatment needs was also found to be significant. Conclusion: A high level of dental anxiety was observed among the study population. The dental professionals should seek ways to help dentally anxious individuals. (author)

  15. Risky Assessments: Participant Suicidality and Distress Associated with Research Assessments in a Treatment Study of Suicidal Behavior

    Science.gov (United States)

    Reynolds, Sarah K.; Lindenboim, Noam; Comtois, Katherine Anne; Murray, Angela; Linehan, Marsha M.

    2006-01-01

    The purpose of this study was to examine patterns of self-reported suicidality and distress during research assessments in a sample of 63 women meeting criteria for borderline personality disorder and current and chronic suicidality. The risk management protocol we used during the two-year study period (University of Washington Risk Assessment…

  16. AACAP Official Action. Summary of the practice parameters for the assessment and treatment of children, adolescents, and adults with ADHD.

    Science.gov (United States)

    Dulcan, M K; Benson, R S

    1997-09-01

    This summary of the practice parameters describes the assessment, differential diagnosis, and treatment of children, adolescents, and adults who present with symptoms of attention-deficit/hyperactivity disorder. The rationales for specific recommendations are based on a review of the scientific literature and clinical consensus which is contained in the complete document. Assessment includes clinical interviews with the child and parents and standardized rating scales from parent and teachers. Testing of intelligence and academic achievement is usually required. Comorbidity is common. The cornerstones of treatment are support and education of parents, appropriate school placement, and psychopharmacology. The primary medications are psychostimulants, but antidepressants and alpha-adrenergic agonists are used in special circumstances. Other treatments such as behavior modification, school consultation, family therapy, and group therapy address remaining symptoms. PMID:9291734

  17. Digital technologies to support planning, treatment, and fabrication processes and outcome assessments in implant dentistry. Summary and consensus statements. The 4th EAO consensus conference 2015

    DEFF Research Database (Denmark)

    Hämmerle, Christoph H F; Cordaro, Luca; van Assche, Nele;

    2015-01-01

    OBJECTIVE: The task of this working group was to assess the existing knowledge in computer-assisted implant planning and placement, fabrication of reconstructions applying computers compared to traditional fabrication, and assessments of treatment outcomes using novel imaging techniques. MATERIAL...

  18. Guidance for treatment of variability and uncertainty in ecological risk assessments of contaminated sites

    International Nuclear Information System (INIS)

    Uncertainty is a seemingly simple concept that has caused great confusion and conflict in the field of risk assessment. This report offers guidance for the analysis and presentation of variability and uncertainty in ecological risk assessments, an important issue in the remedial investigation and feasibility study processes. This report discusses concepts of probability in terms of variance and uncertainty, describes how these concepts differ in ecological risk assessment from human health risk assessment, and describes probabilistic aspects of specific ecological risk assessment techniques. The report ends with 17 points to consider in performing an uncertainty analysis for an ecological risk assessment of a contaminated site

  19. Guidance for treatment of variability and uncertainty in ecological risk assessments of contaminated sites

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-06-01

    Uncertainty is a seemingly simple concept that has caused great confusion and conflict in the field of risk assessment. This report offers guidance for the analysis and presentation of variability and uncertainty in ecological risk assessments, an important issue in the remedial investigation and feasibility study processes. This report discusses concepts of probability in terms of variance and uncertainty, describes how these concepts differ in ecological risk assessment from human health risk assessment, and describes probabilistic aspects of specific ecological risk assessment techniques. The report ends with 17 points to consider in performing an uncertainty analysis for an ecological risk assessment of a contaminated site.

  20. Echocardiographic Assessment of Ischaemic Mitral Regurgitation, Mechanism, Severity, Impact on Treatment Strategy and Long Term Outcome

    Science.gov (United States)

    Naser, Nabil; Dzubur, Alen; Kusljugic, Zumreta; Kovacevic, Katarina; Kulic, Mehmed; Sokolovic, Sekib; Terzic, Ibrahim; Haxihibeqiri-Karabdic, Ilirijana; Hondo, Zorica; Brdzanovic, Snjezana; Miseljic, Sanja

    2016-01-01

    Introduction: The commonest mitral regurgitation etiologies are degenerative (60%), rheumatic post-inflammatory, 12%) and functional (25%). Due to the large number of patients with acute MI, the incidence of ischaemic MR is also high. Ischaemic mitral regurgitation is a complex multifactorial disease that involves left ventricular geometry, the mitral annulus, and the valvular/subvalvular apparatus. Ischaemic mitral regurgitation is an important consequence of LV remodeling after myocardial infarction. Research Objectives: The objective of this study is to determine the role of echocardiography in detecting and assessment of mitral regurgitation mechanism, severity, impact on treatment strategy and long term outcome in patients with myocardial infarction during the follow up period of 5 years. Also one of objectives to determine if the absence or presence of ischaemic MR is associated with increased morbidity and mortality in patients with myocardial infarction. Patients and methods: The study covered 138 adult patients. All patients were subjected to echocardiography evaluation after acute myocardial infarction during the period of follow up for 5 years. The patients were examined on an ultrasound machine Philips iE 33 xMatrix, Philips HD 11 XE, and GE Vivid 7 equipped with all cardiologic probes for adults and multi-plan TEE probes. We evaluated mechanisms and severity of mitral regurgitation which includes the regurgitant volume (RV), effective regurgitant orifice area (EROA), the regurgitant fraction (RF), Jet/LA area, also we measured the of vena contracta width (VC width cm) for assessment of IMR severity, papillary muscles anatomy and displacement, LV systolic function ± dilation, LV regional wall motion abnormality WMA, LV WMI, Left ventricle LV remodeling, impact on treatment strategy and long term mortality. Results: We analyzed and follow up 138 patients with previous (>16 days) Q-wave myocardial infarction by ECG who underwent TTE and TEE

  1. Performance assessment of the BEBIG MultiSource high dose rate brachytherapy treatment unit.

    Science.gov (United States)

    Palmer, Antony; Mzenda, Bongile

    2009-12-21

    A comprehensive system characterisation was performed of the Eckert & Ziegler BEBIG GmbH MultiSource High Dose Rate (HDR) brachytherapy treatment unit with an (192)Ir source. The unit is relatively new to the UK market, with the first installation in the country having been made in the summer of 2009. A detailed commissioning programme was devised and is reported including checks of the fundamental parameters of source positioning, dwell timing, transit doses and absolute dosimetry of the source. Well chamber measurements, autoradiography and video camera analysis techniques were all employed. The absolute dosimetry was verified by the National Physical Laboratory, UK, and compared to a measurement based on a calibration from PTB, Germany, and the supplied source certificate, as well as an independent assessment by a visiting UK centre. The use of the 'Krieger' dosimetry phantom has also been evaluated. Users of the BEBIG HDR system should take care to avoid any significant bend in the transfer tube, as this will lead to positioning errors of the source, of up to 1.0 mm for slight bends, 2.0 mm for moderate bends and 5.0 mm for extreme curvature (depending on applicators and transfer tube used) for the situations reported in this study. The reason for these errors and the potential clinical impact are discussed. Users should also note the methodology employed by the system for correction of transit doses, and that no correction is made for the initial and final transit doses. The results of this investigation found that the uncorrected transit doses lead to small errors in the delivered dose at the first dwell position, of up to 2.5 cGy at 2 cm (5.6 cGy at 1 cm) from a 10 Ci source, but the transit dose correction for other dwells was accurate within 0.2 cGy. The unit has been mechanically reliable, and source positioning accuracy and dwell timing have been reproducible, with overall performance similar to other existing HDR equipment. The unit is capable of high

  2. Is treatment of atrial fibrillation in primary care based on thromboembolic risk assessment?

    NARCIS (Netherlands)

    Rutten, Frans H; Hak, Eelko; Stalman, Wim A B; Verheij, Theo J M; Hoes, Arno W

    2003-01-01

    BACKGROUND: Antithrombotic treatment in atrial fibrillation should be guided by the risk of thromboembolic events. Although practice studies have shown underutilization of antithrombotics, it is not clear whether physicians make use of thromboembolic risk stratification in their treatment decisions,

  3. Assessment of a sewage sludge treatment on cadmium, copper and zinc bioavailability in barley, ryegrass and earthworms

    Energy Technology Data Exchange (ETDEWEB)

    Renoux, Agnes Y. [Sanexen Environmental Services Inc., 1471 Lionel-Boulet Boulevard, Varennes, Quebec J3X 1P7 (Canada)]. E-mail: arenoux@sanexen.com; Rocheleau, Sylvie [Biotechnology Research Institute, National Research Council of Canada, 6100 Royalmount Avenue, Montreal, Quebec H4P 2R2 (Canada); Sarrazin, Manon [Biotechnology Research Institute, National Research Council of Canada, 6100 Royalmount Avenue, Montreal, Quebec H4P 2R2 (Canada); Sunahara, Geoffrey I. [Biotechnology Research Institute, National Research Council of Canada, 6100 Royalmount Avenue, Montreal, Quebec H4P 2R2 (Canada)]. E-mail: geoffrey.sunahara@cnrc-nrc.gc.ca; Blais, Jean-Francois [Institut national de la recherche scientifique (INRS-ETE), Centre Eau, Terre et Environnement, 490 rue de la Couronne street, Quebec, Quebec G1K 9A9 (Canada)]. E-mail: blaisjf@ete.inrs.ca

    2007-01-15

    The toxicity and bioavailability of metals were assessed to verify the efficiency of a new chemical leaching process (METIX-AC) to minimize the risk of metals found in municipal sewage sludge. For this purpose, sludge samples were spiked with cadmium, copper and/or zinc before being treated using METIX-AC. The sludge decontamination resulted in a removal of spiked metals (79-89%), in a decrease of the more labile fractions, and in a corresponding increase of the residual fraction. The toxicity observed after exposure of two plant species, barley (Hordeum vulgare) and ryegrass (Lolium perenne), and a terrestrial invertebrate, Eisenia andrei, to sludge-soil mixtures, disappeared after treatment, although the adverse effects were minor before treatment. The sludge treatment also significantly decreased the bioaccumulation of cadmium, copper, and zinc in the exposed species. For cadmium, maximum tissue concentrations of 0.45 {+-} 0.08 mg/kg in barley, 0.79 {+-} 0.27 mg/kg in ryegrass, and 21.82 {+-} 1.85 mg/kg in earthworm exposed to sludge before treatment decreased after treatment to values similar to those observed with negative controls. - Assessment of a sewage sludge treatment on metal bioavailability as measured by metal speciation, toxicity and bioaccumulation.

  4. Assessing the effect of different treatments on decomposition rate of dairy manure.

    Science.gov (United States)

    Khalil, Tariq M; Higgins, Stewart S; Ndegwa, Pius M; Frear, Craig S; Stöckle, Claudio O

    2016-11-01

    Confined animal feeding operations (CAFOs) contribute to greenhouse gas emission, but the magnitude of these emissions as a function of operation size, infrastructure, and manure management are difficult to assess. Modeling is a viable option to estimate gaseous emission and nutrient flows from CAFOs. These models use a decomposition rate constant for carbon mineralization. However, this constant is usually determined assuming a homogenous mix of manure, ignoring the effects of emerging manure treatments. The aim of this study was to measure and compare the decomposition rate constants of dairy manure in single and three-pool decomposition models, and to develop an empirical model based on chemical composition of manure for prediction of a decomposition rate constant. Decomposition rate constants of manure before and after an anaerobic digester (AD), following coarse fiber separation, and fine solids removal were determined under anaerobic conditions for single and three-pool decomposition models. The decomposition rates of treated manure effluents differed significantly from untreated manure for both single and three-pool decomposition models. In the single-pool decomposition model, AD effluent containing only suspended solids had a relatively high decomposition rate of 0.060 d(-1), while liquid with coarse fiber and fine solids removed had the lowest rate of 0.013 d(-1). In the three-pool decomposition model, fast and slow decomposition rate constants (0.25 d(-1) and 0.016 d(-1) respectively) of untreated AD influent were also significantly different from treated manure fractions. A regression model to predict the decomposition rate of treated dairy manure fitted well (R(2) = 0.83) to observed data. PMID:27479239

  5. Integrated environmental assessment of tertiary and residuals treatment--LCA in the wastewater industry.

    Science.gov (United States)

    Beavis, P; Lundie, S

    2003-01-01

    In the wastewater industry, decision-makers lack access to an environmental tool that can assist in further informing the non-financial analysis of a system. Such a tool should incorporate impacts beyond the effluent quality and look at the supporting processes of a plant as well as plant specific operations. Life Cycle Assessment can provide the means to fill a gap in pertinent information towards more sustainable decision-making. The project "Best Practice LCA in the Wastewater Industry" is commissioned by the CRC for Waste Management and Pollution Control at UNSW with representatives from Sydney Water Corporation (SWC), NSW Department of Land and Water Conservation and the NSW Department of Public Works. Two case studies were researched to provide a post-implementation review of changes in wastewater. Case study 1: The conversion from chlorine gas to hypochlorite and UV disinfection has been completed for several inland wastewater plants at SWC. A review of operational data for each of the options has been incorporated into an LCA of each technology. Under efficient dosing conditions, disinfection with the hypochlorite system has the minimum environmental impact. Case study 2 deals with the conversion from anaerobic to aerobic digestion. Aerobic digestion minimises release of nutrients into a sidestream to be further treated in the plant. However conversion results in more biosolids production and higher electricity requirements. This study includes a consideration of the environmental impacts of biosolids production and application. On the basis of the extended boundary including consideration of reflux composition, energy requirements and biosolids quality to potentially offset fertiliser production, anaerobic digestion performs best in 6 out of 9 impact categories. These results suggest that environmental LCA has a role in informing decision-making on unit process and treatment train selection by quantifying aspects on non-financial criteria. Also

  6. Statistical Assessment of Proton Treatment Plans Under Setup and Range Uncertainties

    Energy Technology Data Exchange (ETDEWEB)

    Park, Peter C.; Cheung, Joey P.; Zhu, X. Ronald [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Lee, Andrew K. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Sahoo, Narayan [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Tucker, Susan L. [Department of Bioinformatics and Computational Biology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Liu, Wei; Li, Heng; Mohan, Radhe; Court, Laurence E. [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Dong, Lei, E-mail: dong.lei@scrippshealth.org [Scripps Proton Therapy Center, San Diego, California (United States)

    2013-08-01

    Purpose: To evaluate a method for quantifying the effect of setup errors and range uncertainties on dose distribution and dose–volume histogram using statistical parameters; and to assess existing planning practice in selected treatment sites under setup and range uncertainties. Methods and Materials: Twenty passively scattered proton lung cancer plans, 10 prostate, and 1 brain cancer scanning-beam proton plan(s) were analyzed. To account for the dose under uncertainties, we performed a comprehensive simulation in which the dose was recalculated 600 times per given plan under the influence of random and systematic setup errors and proton range errors. On the basis of simulation results, we determined the probability of dose variations and calculated the expected values and standard deviations of dose–volume histograms. The uncertainties in dose were spatially visualized on the planning CT as a probability map of failure to target coverage or overdose of critical structures. Results: The expected value of target coverage under the uncertainties was consistently lower than that of the nominal value determined from the clinical target volume coverage without setup error or range uncertainty, with a mean difference of −1.1% (−0.9% for breath-hold), −0.3%, and −2.2% for lung, prostate, and a brain cases, respectively. The organs with most sensitive dose under uncertainties were esophagus and spinal cord for lung, rectum for prostate, and brain stem for brain cancer. Conclusions: A clinically feasible robustness plan analysis tool based on direct dose calculation and statistical simulation has been developed. Both the expectation value and standard deviation are useful to evaluate the impact of uncertainties. The existing proton beam planning method used in this institution seems to be adequate in terms of target coverage. However, structures that are small in volume or located near the target area showed greater sensitivity to uncertainties.

  7. Assessing Side Effects of Pharmacotherapy Treatment of Bipolar Disorder: A 20-Year Review of the Literature

    Science.gov (United States)

    Matson, Johnny L.; Gonzalez, Melissa L.; Smith, Kimberly R.; Terlonge, Cindy; Thorson, Ryan T.; Dixon, Dennis R.

    2006-01-01

    A substantial literature on the effective treatment of bipolar disorder has begun to appear, particularly in the last 20 years.The majority of treatments studied have employed medications, particularly mood stabilizers, a typical antipsychotics and antidepressants. Most treatments produce side effects and medications are no exception. A review of…

  8. Logical Functional Analysis in the Assessment and Treatment of Eating Disorders

    Science.gov (United States)

    Ghaderi, Ata

    2007-01-01

    Cognitive behaviour therapy (CBT) is now suggested to be the treatment of choice for bulimia nervosa. However, it is also known than no more than approximately 50% of patients recover after receiving CBT. When the first-line manual-based treatment fails, the therapist should use other empirically supported treatments, and if they do not work or…

  9. Development and validation of an instrument to assess treatment adherence for each individual drug taken by a patient

    Science.gov (United States)

    Sidorkiewicz, Stéphanie; Tran, Viet-Thi; Cousyn, Cécile; Perrodeau, Elodie; Ravaud, Philippe

    2016-01-01

    Objective To develop and validate an instrument to assess adherence to each individual drug taken by patients undergoing long-term treatment. Design Multicentre prospective observational validation study. Setting Six general practitioners' clinics and 6 university hospitals in Paris, France. Participants Patients 18 years and older receiving at least one long-term treatment. Methods The instrument was developed from a literature search and interviews with experts. Clarity and wording were assessed during pilot testing with 51 patients. The tool was validated in a sample of consecutive patients. We assessed agreement between adherence measured with our tool and drug diaries and compared measurements from our instrument with (1) the Lu instrument; (2) the Adherence Estimator (AE); (3) patient's adherence assessed by physicians; (4) the Morisky Medication Adherence Scale-4 items (MMAS-4); and (5) the Treatment Burden Questionnaire (TBQ). Reliability was assessed by a test–retest method. Results A total of 243 patients taking 961 drugs were recruited in 2014. We found good agreement between adherence measured by our tool and drug diaries (intraclass correlation coefficient (ICC) 0.69, 95% CI 0.34 to 0.91) and a linear relationship between measurement with our tool and (1) the Lu instrument (p<0.01); (2) 2 items of the AE (perceived need for medication (p<0.01) and concerns about medication (p<0.01)); (3) patients' adherence assessed by their physicians (p<0.01); (4) the MMAS-4 (p<0.01) and (5) the TBQ (p<0.01). Reliability of the retest was good (ICC 0.67, 95% CI 0.42 to 0.85). Conclusions We developed an instrument with acceptable validity and reliability to assess adherence for each drug taken by patients, usable in hospital and primary care settings. PMID:27165645

  10. Using Descriptive Assessment in the Treatment of Bite Acceptance and Food Refusal

    Science.gov (United States)

    Casey, Sean D.; Perrin, Christopher J.; Lesser, Aaron D.; Perrin, Stefanie H.; Casey, Cheryl L.; Reed, Gregory K.

    2009-01-01

    The feeding behaviors of two children who maintained failure to thrive diagnoses and displayed food refusal are assessed in their homes. Descriptive assessments are used to identify schedules of consequence provided by each child's care providers for bite acceptance and food refusal behaviors. Assessments reveal rich schedules of praise and access…

  11. Evidence-Based Assessment of Child Obsessive Compulsive Disorder: Recommendations for Clinical Practice and Treatment Research

    Science.gov (United States)

    Lewin, Adam B.; Piacentini, John

    2010-01-01

    Obsessive-compulsive disorder (OCD) presents heterogeneously and can be difficult to assess in youth. This review focuses on research-supported assessment approaches for OCD in childhood. Content areas include pre-visit screening, diagnostic establishment, differential diagnosis, assessment of comorbid psychiatric conditions, tracking symptom…

  12. SLUDGE TREATMENT PROJECT PHASE 1 SLUDGE STORAGE OPTIONS ASSESSMENT OF T PLANT VERSUS ALTERNATE STORAGE FACILITY

    Energy Technology Data Exchange (ETDEWEB)

    RUTHERFORD WW; GEUTHER WJ; STRANKMAN MR; CONRAD EA; RHOADARMER DD; BLACK DM; POTTMEYER JA

    2009-04-29

    The CH2M HILL Plateau Remediation Company (CHPRC) has recommended to the U.S. Department of Energy (DOE) a two phase approach for removal and storage (Phase 1) and treatment and packaging for offsite shipment (Phase 2) of the sludge currently stored within the 105-K West Basin. This two phased strategy enables early removal of sludge from the 105-K West Basin by 2015, allowing remediation of historical unplanned releases of waste and closure of the 100-K Area. In Phase 1, the sludge currently stored in the Engineered Containers and Settler Tanks within the 105-K West Basin will be transferred into sludge transport and storage containers (STSCs). The STSCs will be transported to an interim storage facility. In Phase 2, sludge will be processed (treated) to meet shipping and disposal requirements and the sludge will be packaged for final disposal at a geologic repository. The purpose of this study is to evaluate two alternatives for interim Phase 1 storage of K Basin sludge. The cost, schedule, and risks for sludge storage at a newly-constructed Alternate Storage Facility (ASF) are compared to those at T Plant, which has been used previously for sludge storage. Based on the results of the assessment, T Plant is recommended for Phase 1 interim storage of sludge. Key elements that support this recommendation are the following: (1) T Plant has a proven process for storing sludge; (2) T Plant storage can be implemented at a lower incremental cost than the ASF; and (3) T Plant storage has a more favorable schedule profile, which provides more float, than the ASF. Underpinning the recommendation of T Plant for sludge storage is the assumption that T Plant has a durable, extended mission independent of the K Basin sludge interim storage mission. If this assumption cannot be validated and the operating costs of T Plant are borne by the Sludge Treatment Project, the conclusions and recommendations of this study would change. The following decision-making strategy, which is

  13. SLUDGE TREATMENT PROJECT PHASE 1 SLUDGE STORAGE OPTIONS. ASSESSMENT OF T PLANT VERSUS ALTERNATE STORAGE FACILITY

    International Nuclear Information System (INIS)

    The CH2M HILL Plateau Remediation Company (CHPRC) has recommended to the U.S. Department of Energy (DOE) a two phase approach for removal and storage (Phase 1) and treatment and packaging for offsite shipment (Phase 2) of the sludge currently stored within the 105-K West Basin. This two phased strategy enables early removal of sludge from the 105-K West Basin by 2015, allowing remediation of historical unplanned releases of waste and closure of the 100-K Area. In Phase 1, the sludge currently stored in the Engineered Containers and Settler Tanks within the 105-K West Basin will be transferred into sludge transport and storage containers (STSCs). The STSCs will be transported to an interim storage facility. In Phase 2, sludge will be processed (treated) to meet shipping and disposal requirements and the sludge will be packaged for final disposal at a geologic repository. The purpose of this study is to evaluate two alternatives for interim Phase 1 storage of K Basin sludge. The cost, schedule, and risks for sludge storage at a newly-constructed Alternate Storage Facility (ASF) are compared to those at T Plant, which has been used previously for sludge storage. Based on the results of the assessment, T Plant is recommended for Phase 1 interim storage of sludge. Key elements that support this recommendation are the following: (1) T Plant has a proven process for storing sludge; (2) T Plant storage can be implemented at a lower incremental cost than the ASF; and (3) T Plant storage has a more favorable schedule profile, which provides more float, than the ASF. Underpinning the recommendation of T Plant for sludge storage is the assumption that T Plant has a durable, extended mission independent of the K Basin sludge interim storage mission. If this assumption cannot be validated and the operating costs of T Plant are borne by the Sludge Treatment Project, the conclusions and recommendations of this study would change. The following decision-making strategy, which is

  14. Effects of respiration on target and critical structure positions during treatment assessed with movie-loop electronic portal imaging

    International Nuclear Information System (INIS)

    Purpose: To determine the extent of organ and target motion due to patient respiration during chest radiotherapy using electronic portal imaging, to examine these effects on treatment volumes and to show that simulation and treatment port films do not reflect this range of motion. Materials and Methods: Twenty four patients consisting of 17 tangential breast and 7 AP-PA lung field arrangements were imaged during daily radiation treatment. Eight to 10 sequential movie-loop images were acquired during each field of each fraction with a liquid ion chamber electronic portal imaging device (EPID). Motion relative to the reference image was assessed orthogonally to the central axis of the beam. In tangential breast images, cranial, caudad and lateral lung-chest wall landmarks were used; for AP-PA lung, visible tumor, mediastinum and bronchus. Inter and intra-fractional landmark displacements were determined through off-line analysis. Intra-fractional displacements, determined from multiple images within one fraction, indicate motion of the landmark during treatment. Inter-fractional data represents motion between treatment fractions as seen in routine portal film imaging. The effects on treatment volumes were assessed for the largest displacements using the EPID data together with CT reconstruction. Results: The mean, maximum and standard deviation (σ) for observed respiration induced displacements in the cranio-caudad (CC) and lateral directions relative to the beam are summarized both within (intra) and between (inter) fractions: These data indicate that while the mean displacements are small, the standard deviations are significant and the maximum motion observed during a fraction due to respiration may exceed 3 cm in certain cases. In addition, the intra-fractional displacements significantly exceed the inter-fractional displacements, which suggests that anatomical motion is not fully quantified in routine portal imaging. In lung treatments where the largest

  15. Life cycle assessment of an intensive sewage treatment plant in Barcelona (Spain) with focus on energy aspects.

    Science.gov (United States)

    Bravo, L; Ferrer, I

    2011-01-01

    Life Cycle Assessment was used to evaluate environmental impacts associated to a full-scale wastewater treatment plant (WWTP) in Barcelona Metropolitan Area, with a treatment capacity of 2 million population equivalent, focussing on energy aspects and resources consumption. The wastewater line includes conventional pre-treatment, primary settler, activated sludge with nitrogen removal, and tertiary treatment; and the sludge line consists of thickening, anaerobic digestion, cogeneration, dewatering and thermal drying. Real site data were preferably included in the inventory. Environmental impacts of the resulting impact categories were determined by the CLM 2 baseline method. According to the results, the combustion of natural gas in the cogeneration engine is responsible for the main impact on Climate Change and Depletion of Abiotic Resources, while the combustion of biogas in the cogeneration unit accounts for a minor part. The results suggest that the environmental performance of the WWTP would be enhanced by increasing biogas production through improved anaerobic digestion of sewage sludge. PMID:22097019

  16. ByMuR model: interaction among risks and uncertainty treatment in long-term multi-hazard/risk assessments

    Science.gov (United States)

    Selva, J.

    2012-12-01

    Multi-risk approaches have been recently proposed to assess and compare different risks in the same target area. The key point of multi-risk assessments are the development of homogeneous risk definitions and the treatment of risk interaction. The lack of treatment of interaction may lead to significant biases and thus to erroneous risk hierarchization, which is one of primary output of risk assessments for decision makers. Within the framework of the Italian project "ByMuR - Bayesian Multi-Risk assessment", a formal model (ByMuR model) to assess multi-risk for a target area is under development, aiming (i) to perform multi-risk analyses treating interaction between different hazardous phenomena, accounting for possible effects of interaction at hazard, vulnerability and exposure levels, and (ii) to explicitly account for all uncertainties (aleatory and epistemic) through a Bayesian approach, allowing a meaningful comparison among different risks. The model is meant to be general, but it is targeted to the assessment of volcanic, seismic and tsunami risks for the city of Naples (Italy). Here, it is presented the preliminary development of the ByMuR model. The applicability of the methodology is demonstrated through illustrative examples, in which the effects of uncertainties and the bias in single-risk estimation induced by the assumption of independence among risks are explicitly assessed. An extensive application of this methodology at regional and sub-regional scale would allow to identify where a given interaction has significant effects in long-term risk assessments, and thus when multi-risk analyses should be considered in order to provide unbiased risk estimations.

  17. Understanding the neurobiology, assessment, and treatment of substances of abuse and dependence: a guide for the critical care nurse.

    Science.gov (United States)

    Genung, Vanessa

    2012-03-01

    What do I as a critical care nurse do? Nurses, by virtue of being trained in health promotion, and also because they interact with patients, families, and communities, have firsthand opportunities to play an active role in practicing primary prevention. To avoid the first occurrence of substance abuse, assess community need, assess facility needs, and identify potential risk. Identify the magnitude of the problem. Intervene early with the youth and at-risk populations. Refer patients and their families to mental health specialists. Provide education to patients, families, communities. To reduce occurrences of substance abuse, practicing secondary prevention requires prompt action in the earliest moments of recognizing a problem and directing patients to early intervention and rehabilitation. Screening your patients, providing brief education, and prompt referral constitutes early intervention. To retard the progress of the disease, practice tertiary prevention by providing education, counseling, and support to the afflicted in achieving and maintaining sobriety through medication compliance and rehabilitative group and counseling work. The goal of intervention in the lives of substance abusers is to stop drug use, avoid relapse, and sustain recovery. After years of research, NIDA has identified 13 fundamental principles to effective drug abuse treatment. 1. Addiction is a complex but treatable disease that affects brain function and behavior. 2. No single treatment is appropriate for everyone. 3. Treatment needs to be readily available. 4. Effective treatment attends to multiple needs of the individual, not just his or her drug abuse. 5. Remaining in treatment for an adequate period of time is critical. 6. Counseling--individual and/or group--and other behavioral therapies are the most commonly used forms of drug abuse treatment. 7. Medications are an important element of treatment for many patients, especially when combined with counseling and other behavioral

  18. Treatment choice for osteoarthritis of the knee joint according to semi-automatic MRI based assessment of disease severity

    International Nuclear Information System (INIS)

    Objective assessment of disease severity of osteoarthritis of the knee joint (OA knee) is fundamental to establish adequate treatment system. Regrettably, there is no such a reliable system. Grading system based upon X-ray findings or measurement of joint space narrowing is widely used method for this purpose but they are still far from satisfaction. Our previous study elucidated that measuring irregularity of the contour of the femoral condyle on MRI (irregularity index) using newly developed software enabled us to assess disease severity of OA objectively. Advantages of this system are expressing severity by metric variable and semi-automatic character. In the present study, we examined relationship between treatment selection and irregularity index. Sixty-one medial type OA knees that received total knee arthroplasty (TKA), arthroscopic surgery (AS), and conservative treatment (CT) were involved. Their x-ray grading, irregularity index were recorded at the time of corresponding treatment. Irregularity index of each group were compared. As for AS group, pre- and post-operative knee score employing JOA score were also examined to study relationship between irregularity index and improvement of knee score. All the four parameters that represent irregularity of femoral condyle were significantly higher in TKA group than in AS group, whereas no significant difference was observed between AS group and CT group. Negative correlation was observed between irregularity index and improvement of knee score after arthroscopic surgery. Although treatment selection was determined by skillful knee surgeon in this series, irregularity index could indicate adequate timing of TKA. It also served as an indicator to predict outcome of arthroscopic surgery, and could be used as to show limitation of arthroscopic surgery. Our new system to assess disease severity of OA knee can serve as an index to determine treatment options. (author)

  19. Value of subtraction MRI in assessing treatment response following image-guided loco-regional therapies for hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Aim: To compare contrast-enhanced subtraction magnetic resonance imaging (MRI) with contrast-enhanced standard MRI in assessing treatment response following loco-regional therapies for hepatocellular carcinoma (HCC). Method and materials: Institutional review board approval was obtained and informed consent was waived for this retrospective study. All patients were analysed from our institution’s liver tumour database that had loco-regional HCC therapy and the following: (1) a contrast-enhanced MRI ≤6 weeks post-treatment, (2) an unenhanced T1-weighted high-signal treatment zone (TZ) ≥1 cm, (3) follow-up contrast-enhanced MRI performed ≥6 months post-treatment. Randomized standard and subtraction TZ datasets were independently assessed by three blinded radiology readers for either complete treatment necrosis or residual disease. The standard of reference (SOR) comprised a consensus read by two radiologists with knowledge of the follow-up MRI and all available clinical data. Statistical analyses were performed using receiver operating characteristics (ROC), t-test, and kappa statistic. Results: Twenty-six patients (19 male and seven female patients; mean age 60 years, standard deviation 10.9 years, range 46–88 years) had a total of 45 corresponding HCCs and TZs. For ROC, the area under the curve (AUC) was 0.93 (subtraction protocol) versus 0.90 (standard protocol; p = 0.49). For the t-test, the mean reader confidence level was 4.4, 3.6, and 4.4 (subtraction protocol) versus 3, 3, and 3.7 (standard protocol; p ≤ 0.011). The kappa statistic for reader-to-SOR agreement was 0.83, 0.63, and 0.71 (subtraction protocol) versus 0.51, 0.36, and 0.64 (standard protocol). Conclusion: Subtraction MRI significantly improves the reader confidence level in the assessment of treatment response following loco-regional therapies for HCC.

  20. Outcome in adolescent idiopathic scoliosis after brace treatment and surgery assessed by means of the Scoliosis Research Society Instrument 24

    OpenAIRE

    Weigert, Karen Petra; Nygaard, Linda Marie; Christensen, Finn Bjarke; Hansen, Ebbe Stender; Bünger, Cody

    2005-01-01

    A retrospectively designed long-term follow-up study of adolescent idiopathic scoliosis (AIS) patients who had completed treatment, of at least 2 years, by means of brace, surgery, or both brace and surgery. This study is to assess the outcome after treatment for AIS by means of the Scoliosis Research Society Outcome Instrument 24 (SRS 24). One hundred and eighteen AIS patients (99 females and 19 males), treated at the Aarhus University Hospital from January 1, 1987 to December 31, 1997, were...

  1. Phototherapy in Vitiligo: Assessing the Compliance, Response and Patient's Perception about Disease and Treatment

    OpenAIRE

    Shakthisri Kandaswamy; Nahid Akhtar; Surya Ravindran; Smitha Prabhu; Shenoi, Shrutakirthi D

    2013-01-01

    Context: Vitiligo is a chronic, benign, but emotionally frustrating autoimmune disorder of depigmentation, with an incidence of 0.25-2.5% in India, the treatment of which is equally frustrating to the patient, as well as the doctor. Phototherapy is the first line treatment in many cases, which needs to be given at frequent sittings for long periods of time. As there is no satisfactory, short term treatment, many vitiligo patients, though enthusiastic in the beginning, become defaulters after ...

  2. Effects of Heat-treatments on the Mechanical Strength of Coated YSZ: An Experimental Assessment

    DEFF Research Database (Denmark)

    Toftegaard, Helmuth Langmaack; Sørensen, Bent F.; Linderoth, Søren;

    2009-01-01

    The mechanical strength of thin, symmetric sandwich specimens consisting of a dense yttria-stabilized zirconia (YSZ) substrate coated with a porous NiO–YSZ layer at both major faces was investigated. Specimens were loaded in uniaxial tension to failure following heat treatments at various tempera...... temperatures. In comparison with the YSZ material, the failure strength of coated specimens was found to increase for heat treatments at 1100°C, but decreased again with further increased heat-treatment temperatures....

  3. Assessing methods for dealing with treatment switching in randomised controlled trials: a simulation study

    OpenAIRE

    Latimer Nicholas; Lambert Paul C; Morden James P; Abrams Keith R; Wailoo Allan J

    2011-01-01

    Abstract Background We investigate methods used to analyse the results of clinical trials with survival outcomes in which some patients switch from their allocated treatment to another trial treatment. These included simple methods which are commonly used in medical literature and may be subject to selection bias if patients switching are not typical of the population as a whole. Methods which attempt to adjust the estimated treatment effect, either through adjustment to the hazard ratio or v...

  4. The assessment of fidelity in a motor speech-treatment approach

    OpenAIRE

    Hayden, Deborah; Namasivayam, Aravind Kumar; Ward, Roslyn

    2015-01-01

    Objective To demonstrate the application of the constructs of treatment fidelity for research and clinical practice for motor speech disorders, using the Prompts for Restructuring Oral Muscular Phonetic Targets (PROMPT) Fidelity Measure (PFM). Treatment fidelity refers to a set of procedures used to monitor and improve the validity and reliability of behavioral intervention. While the concept of treatment fidelity has been emphasized in medical and allied health sciences, documentation of pro...

  5. Assessment of potential greenhouse gas mitigation of available household solid waste treatment technologies

    OpenAIRE

    Hoang Minh Giang; guyen Duc Luong; Luong Thi Mai Huong

    2013-01-01

    Current household solid waste treatment practices in most cities in Vietnam caused a great amount of direct greenhouse gas (GHG) emissions. Available solid waste treatment technologies should be seriously taken  into consideration as a wedge of GHG mitigation in waste sector base on presently Vietnamese economic conditions. This study aim to evaluate the potential amount of GHG mitigation from current domestic solid waste treatment technologies in Vietnam including landfills and compost...

  6. Bioenergetics of immune cells to assess rheumatic disease activity and efficacy of glucocorticoid treatment

    OpenAIRE

    Kuhnke, A; Burmester, G.; Krauss, S.; Buttgereit, F

    2003-01-01

    Objective: To investigate whether activity and glucocorticoid treatment of rheumatic diseases are reflected by selected parameters of cellular energy metabolism of peripheral blood mononuclear cells (PBMC).

  7. Ecotoxicological assessment of grey water treatment systems with Daphnia magna and Chironomus riparius.

    Science.gov (United States)

    Hernández Leal, L; Soeter, A M; Kools, S A E; Kraak, M H S; Parsons, J R; Temmink, H; Zeeman, G; Buisman, C J N

    2012-03-15

    In order to meet environmental quality criteria, grey water was treated in four different ways: 1) aerobic 2) anaerobic+aerobic 3) aerobic+activated carbon 4) aerobic+ozone. Since each treatment has its own specific advantages and disadvantages, the aim of this study was to compare the ecotoxicity of differently treated grey water using Chironomus riparius (96 h test) and Daphnia magna (48 h and 21d test) as test organisms. Grey water exhibited acute toxicity to both test organisms. The aerobic and combined anaerobic+aerobic treatment eliminated mortality in the acute tests, but growth of C. riparius was still affected by these two effluents. Post-treatment by ozone and activated carbon completely removed the acute toxicity from grey water. In the chronic toxicity test the combined anaerobic+aerobic treatment strongly affected D. magna population growth rate (47%), while the aerobic treatment had a small (9%) but significant effect. Hence, aerobic treatment is the best option for biological treatment of grey water, removing most of the toxic effects of grey water. If advanced treatment is required, the treatment with either ozone or GAC were shown to be very effective in complete removal of toxicity from grey water. PMID:22197265

  8. The treatment of sorption and retardation in the assessment of geological barriers to contaminant transport

    International Nuclear Information System (INIS)

    The approaches used in long-term performance assessments to determine the impact of sorption in the geosphere on retarding the movement of radioactive contaminants have been reviewed. A comparison is made between the approaches used in the 1994 assessment of the Whiteshell Research Area in Canada and in similar assessments conducted in other countries. The long-term performance assessments reviewed were the AECL-EIS, the TVO-92 assessment conducted in Finland, the PNC-H3 project from Japan , the SKI Project-90 and SKB-91 assessments performed in Sweden, the Kristallin-1 assessment done in Switzerland, and the NIREX-95 assessment performed in the United Kingdom. In each of these assessments, the effect of sorption in the geosphere on contaminant transport was assessed using the 'Kd concept'. The sorption data were selected to reflect the anticipated effects of the reference geochemical conditions of the site being assessed. A number of approaches were taken to account for the uncertainty in the values selected for the sorption coefficients. Contaminant transport was modelled using a continuous porous medium approach or a dual-porosity approach, with the latter being more widely used. In both approaches, the retardation of contaminant transport due to sorption on the host solid is described by a retardation factor. In the present report, sorption values used in the assessments were compared and differences between the values selected for similar materials and geochemical conditions were noted, particularly for the redoxsensitive elements. A comparison of retardation factors required the introduction of a 'utilization factor' into the retardation equation to account for the effects of matrix diffusion on retardation. The comparison illustrated the impact of time dependence on retardation in the matrix diffusion approach vis-a-vis the time-independent retardation approach used in the AECL-EIS. (author)

  9. Application of Stabilization Pond Effluent Quality Parameters in Assessing Treatment Efficiency, Disposal Safety and Irrigation Suitability

    Directory of Open Access Journals (Sweden)

    A. Kanda

    2013-09-01

    Full Text Available Physico-chemical and microbiological parameters of treated pond effluent and effluent-receiving stream water were assessed for their suitability for irrigation and effluent for discharge safety. The study was done at stabilization ponds in northern Zimbabwe. Monthly effluent and stream water samples were collected between May and October, 2011 from the 5th maturation pond outlet of a 2A-4F-5M stabilization pond system and at a point that was 4 km downstream. Overall pond treatment efficiency estimates were >89% with respect to BOD5, TSS and faecal coliforms (FCs. Mean treated effluent parameters (22.18±1.64mg/L BOD5, 17.00±1.19mg/L TSS and 37.33±2.99 cfu/100 mL FCs were significantly lower (p<0.05 than safe surface disposal limits. Treated effluent and stream water were both non-saline (mean electrical conductivity: effluent = 779.50±37.79 &mu S/cm and stream water = 470.33±41.83 &muS/cm with a low sodium hazard (mean SAR: pond effluent = 1.71±0.06 and stream water = 1.08±0.10. Residual Sodium Carbonate (RSC values were negative indicating safe water. Non-toxic levels of Cl- and Na+ were observed in stream water but slight restrictions for irrigation use were observed for the effluent. Effluent was slightly alkaline (pH 8.30±0.13 and safe. Stream water and effluent quality parameters were significantly different (p<0.05 except for FCs, CO32-, Cd2+, K++, Pb2+ and PO43-. Treated effluent was suitable for both surface discharge and for irrigation. Strong relationships were observed between effluent parameters and also between stream water parameters. Treated effluent from Woodbrook waste stabilization ponds can periodically be used for irrigation. This may help to restore stream water quality with a view to public health protection and environmental preservation.

  10. Effect of a perspective-taking intervention on the consideration of pain assessment and treatment decisions

    Directory of Open Access Journals (Sweden)

    Wandner LD

    2015-11-01

    Full Text Available Laura D Wandner,1 Calia A Torres,2 Emily J Bartley,1 Steven Z George,3 Michael E Robinson1 1Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, 2Department of Clinical Psychology, University of Alabama, Tuscaloosa, AL, 3Department of Physical Therapy, University of Florida, Gainesville, FL, USA Objectives: Pain is often poorly managed, highlighting the need to better understand and treat patients' pain. Research suggests that pain is assessed and treated differently depending on patient sex, race, and/or age. Perspective-taking, whereby one envisions the perspective of another, has been found to reduce racial disparities in pain management. This study used virtual human (VH technology to examine whether a perspective-taking intervention impacts pain management decisions. Methods: Ninety-six participants were randomized to an online treatment or control group and viewed 16 video clips of VHs with standardized levels of pain. Participants provided ratings on the VHs' pain intensity and their willingness to administer opioids to them. The intervention group received a brief perspective-taking intervention that consisted of having participants imagine how the patient's suffering could affect his/her life, whereas the control group was asked to wait for the next VH videos to load. A LENS model analysis was used to investigate both group level (nomothetic and individual level (idiographic decision policies. A LENS model of analysis is typically used as an analog method for capturing how groups of people and individuals use information in their environment to form judgments. Results: Nomothetic results found that participants rated pain higher and were more likely to prescribe opioids to VHs postintervention, irrespective of group. Idiographic results, however, found that the use of cues to make pain management decisions was mitigated by the perspective-taking group. The participants in the perspective-taking group

  11. Effects of high-dose fenfluramine treatment on monoamine uptake sites in rat brain: Assessment using quantitative autoradiography

    International Nuclear Information System (INIS)

    Fenfluramine is an amphetamine derivative that in humans is used primarily as an anorectic agent in the treatment of obesity. In rats, subchronic high-dose d,l-fenfluramine treatment (24 mg/kg subcutaneously, twice daily for 4 days) causes long-lasting decreases in brain serotonin (5HT), its metabolite 5-hydroxyindoleacetic acid, and high-affinity 5HT uptake sites. Moreover, this high-dose treatment regimen causes both selective long-lasting decreases in fine-caliber 5HT-immunoreactive axons and appearance of other 5HT-immunoreactive axons with morphology characteristic of degenerating axons. Determination of the potential neurotoxic effects of fenfluramine treatment using immunohistochemistry is limited from the perspectives that staining is difficult to quantify and that it relies on presence of the antigen (in this case 5HT), and the 5HT-depleting effects of fenfluramine are well known. In the present study, we used quantitative in vitro autoradiography to assess, in detail, the density and regional distribution of [3H]paroxetine-labeled 5HT and [3H]mazindol-labeled catecholamine uptake sites in response to the high-dose fenfluramine treatment described above. Because monoamine uptake sites are concentrated on monoamine-containing nerve terminals, decreases in uptake site density would provide a quantitative assessment of potential neurotoxicity resulting from this fenfluramine treatment regimen. Marked decreases in densities of [3H]paroxetine-labeled 5HT uptake sites occurred in brain regions in which fenfluramine treatment decreased the density of 5HT-like immunostaining when compared to saline-treated control rats. These included cerebral cortex, caudate putamen, hippocampus, thalamus, and medial hypothalamus

  12. Effects of high-dose fenfluramine treatment on monoamine uptake sites in rat brain: Assessment using quantitative autoradiography

    Energy Technology Data Exchange (ETDEWEB)

    Appel, N.M.; Mitchell, W.M.; Contrera, J.F.; De Souza, E.B. (NIDA Addiction Research Center, Baltimore, MD (USA))

    1990-01-01

    Fenfluramine is an amphetamine derivative that in humans is used primarily as an anorectic agent in the treatment of obesity. In rats, subchronic high-dose d,l-fenfluramine treatment (24 mg/kg subcutaneously, twice daily for 4 days) causes long-lasting decreases in brain serotonin (5HT), its metabolite 5-hydroxyindoleacetic acid, and high-affinity 5HT uptake sites. Moreover, this high-dose treatment regimen causes both selective long-lasting decreases in fine-caliber 5HT-immunoreactive axons and appearance of other 5HT-immunoreactive axons with morphology characteristic of degenerating axons. Determination of the potential neurotoxic effects of fenfluramine treatment using immunohistochemistry is limited from the perspectives that staining is difficult to quantify and that it relies on presence of the antigen (in this case 5HT), and the 5HT-depleting effects of fenfluramine are well known. In the present study, we used quantitative in vitro autoradiography to assess, in detail, the density and regional distribution of (3H)paroxetine-labeled 5HT and (3H)mazindol-labeled catecholamine uptake sites in response to the high-dose fenfluramine treatment described above. Because monoamine uptake sites are concentrated on monoamine-containing nerve terminals, decreases in uptake site density would provide a quantitative assessment of potential neurotoxicity resulting from this fenfluramine treatment regimen. Marked decreases in densities of (3H)paroxetine-labeled 5HT uptake sites occurred in brain regions in which fenfluramine treatment decreased the density of 5HT-like immunostaining when compared to saline-treated control rats. These included cerebral cortex, caudate putamen, hippocampus, thalamus, and medial hypothalamus.

  13. Strategies of assessing and quantifying radiation treatment metabolic tumor response using F18 FDG Positron Emission Tomography (PET)

    International Nuclear Information System (INIS)

    The use of positron emission tomography (PET) using F-18 labeled fluorodeoxyglucose (FDG) for both oncology disease staging and radiation therapy target volume delineation has steadily increased over the last decade, and FDG-PET is today readily available in all major medical centers. The goal of anti tumor treatment, including chemotherapy and/or radiation therapy is to diminish a tumor cell population, ideally to the state of total eradication. Reducing the number of viable tumor cells can lead to a reduction in anatomical tumor size, and may also be correlated with decreased FDG uptake. Efforts to assess tumor response to therapy have attempted to describe and quantify changes in glucose utilization, also referred to as metabolic tumor response. In this review, an attempt is made to present and discuss methodologies to assess and quantify tumor metabolic response to radiation therapy or chemoradiation treatment courses.

  14. Recent Advances in Imaging of the Axial Skeleton in Spondyloarthritis for Diagnosis, Assessment of Treatment Effect, and Prognostication

    DEFF Research Database (Denmark)

    Pedersen, Susanne Juhl; Maksymowych, Walter P

    2015-01-01

    In the last few years, many studies have investigated the role of imaging for improved diagnosis, assessment of treatment effects, and determining prognosis in patients with axial spondyloarthritis (SpA). Recent research has primarily focused on the utility of magnetic resonance imaging (MRI) for...... improved diagnosis of patients with non-radiographic axial SpA, and in particular on the classification utility of the MRI criteria as defined by the Assessment of Spondyloarthritis International Society (ASAS). New and more sensitive methods for evaluation of MRI of the sacroiliac joints have been...... developed and have provided insight into effects of treatment on structural progression and the interrelationships between different lesions visualized by MRI. This review gives an overview of the recent advances in imaging of the axial skeleton in axial SpA from a clinical perspective....

  15. Quantitative assessment of the removal of indicator bacteria in full-scale treatment plants

    NARCIS (Netherlands)

    Hijnen, W.A.M.; Medema, Gerriet Jan; Kooij, D. van der

    2004-01-01

    The elimination of thermotolerant coliforms (Coli44) and spores of sulphite-reducing clostridia (SSRC) in full-scale water treatment was determined by large volume sampling. The objective was to determine the elimination capacity of full-scale treatment processes for micro-organisms, both vegetative

  16. Regional assessment of treatment in lung cancer using lung perfusion and ventilation images

    International Nuclear Information System (INIS)

    In 30 patients with lung cancer undergoing non-surgical treatment, we performed perfusion lung imaging using 99mTc-MAA and inhalation lung studies using Technegas before and after treatment and evaluated regional perfusion and ventilation status in the lung regions where bronchogenic carcinoma was located. Regional ventilation status was preserved rather than perfusion counterpart (V>P) in 18 patients (18/30=60.0%) before treatment, while the former was better than the latter in 27 patients (27/30=90.0%) after treatment, indicating that regional ventilation status improved more significantly than regional perfusion counterpart after treatment (P=0.005). We also classified the therapeutic effect for regional perfusion and ventilation status as improved, unchanged, or worsened, respectively; improvement in regional perfusion status was observed in 17 patients (56.7%) and that in regional ventilation status in 24 patients (80.0%). There was a statistically significant correlation between improved regional perfusion and ventilation status (P=0.0018) when therapeutic effect was recognized. The patients who showed improvement in regional perfusion status after treatment always showed improved regional ventilation status, but 7 patients showed either unchanged or worsened regional perfusion status after treatment, although regional ventilation status was improved. In conclusion the pulmonary vascular beds seem more vulnerable to bronchogenic carcinoma and improvement in regional perfusion status was revealed to be more difficult than that in regional ventilation status after treatment. (author)

  17. Test Anxiety: Theory, Assessment, and Treatment. The Series in Clinical and Community Psychology.

    Science.gov (United States)

    Spielberger, Charles D., Ed.; Vagg, Peter R., Ed.

    It is not surprising that a broad array of treatment programs have been developed to reduce test anxiety, since the consequences can be serious. The contributions in this volume review and evaluate the theory of test anxiety, its measurement, its manifestations, and possible treatments and their outcomes. The following chapters are included: (1)…

  18. Enamel remineralization assessment after treatment with three different remineralizing agents using surface microhardness: An in vitro study

    OpenAIRE

    Shishir Shetty; Mithra N. Hegde; Bopanna, Thimmaiah P

    2014-01-01

    Aim: The aim of this study is to evaluate the enamel remineralization after treatment with three different remineralizing agents using surface microhardness assessment. Materials and Methods: This in vitro study involves 50 enamel samples divided into five groups of 10 samples each. The positive control group consisted of intact enamel and a negative control group consisted of demineralized enamel samples. All groups excluding the positive control group were subjected to demineralization ...

  19. The use of targeted therapies in pancreatic neuroendocrine tumours: patient assessment, treatment administration, and management of adverse events

    OpenAIRE

    Cummins, Meredith; Pavlakis, Nick

    2013-01-01

    Together with the use of novel oral targeted therapies, a multidisciplinary approach can be used to effectively treat patients with advanced pancreatic neuroendocrine tumours (pNETs). Here we review the integration of the oncology nurse to the newly developed oral treatment setting for patients with pNETs. From the outset, the nurse must be involved in various processes, including performance of baseline assessments (e.g. blood pathology, cardiac and lung function testing, patient history) an...

  20. Selection of a bioassay battery to assess toxicity in the affluents and effluents of three water-treatment plants

    OpenAIRE

    Paola Bohórquez-Echeverry; Marcela Duarte-Castañeda; Nubia León-López; Claudia Campos-Pinilla; Fabián Caicedo-Carrascal; Myriam Vásquez-Vásquez

    2012-01-01

    The assessment of water quality includes the analysis of both physical-chemical and microbiological parameters. However,none of these evaluates the biological effect that can be generated in ecosystems or humans. In order to define the most suitable organismsto evaluate the toxicity in the affluent and effluent of three drinking-water treatment plants, five acute toxicity bioassays were used,incorporating three taxonomic groups of the food chain. Materials and methods. The bioassays used were...

  1. Patients’ preference for triptans and other medications as a tool for assessing the efficacy of acute treatments for migraine

    OpenAIRE

    Dowson, A. J.; Tepper, S. J.; Dahlöf, C.

    2005-01-01

    Oral triptans are effective and well tolerated acute treatments for migraine, but clinical differences between them are small and difficult to measure in conventional clinical trials. Patient preference assesses a global measure of efficacy and tolerability, and may be a more sensitive means of distinguishing between these drugs. In a series of studies, patients consistently expressed a clear preference for triptans over their usual non–triptan acute medications, e.g., analgesics and ergotami...

  2. The Treatment Effectiveness Assessment (TEA: an efficient, patient-centered instrument for evaluating progress in recovery from addiction

    Directory of Open Access Journals (Sweden)

    Ling W

    2012-12-01

    Full Text Available Walter Ling,1 David Farabee,1 Dagmar Liepa,2 Li-Tzy Wu31Integrated Substance Abuse Programs, University of California, Los Angeles, CA, USA; 2Valley Care Medical Center, Panorama City, CA, USA; 3Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke University Medical Center, Durham, NC, USAAbstract: The fields of addiction medicine and addiction research have long sought an efficient yet comprehensive instrument to assess patient progress in treatment and recovery. Traditional tools are expensive, time consuming, complex, and based on topics that clinicians or researchers think are important. Thus, they typically do not provide patient-centered information that is meaningful and relevant to the lives of patients with substance use disorders. To improve our ability to understand patients’ progress in treatment from their perspectives, the authors and colleagues developed a patient-oriented assessment instrument that has considerable advantages over existing instruments: brevity, simplicity, ease of administration, orientation to the patient, and cost (none. The resulting Treatment Effectiveness Assessment (TEA elicits patient responses that help the patient and the clinician quickly gauge patient progress in treatment and in recovery, according to the patients’ sense of what is important within four domains established by prior research. Patients provide both numerical responses and representative details on their substance use, health, lifestyle, and community. No software is required for data entry or scoring, and no formal training is required to administer the TEA. This article describes the development of the TEA and the initial phases of its application in clinical practice and in research.Keywords: substance use disorders, global treatment progress, brief instrument, patient-centered

  3. A strategic assessment of cervical cancer prevention and treatment services in 3 districts of Uttar Pradesh, India

    Directory of Open Access Journals (Sweden)

    Dzuba Ilana

    2005-12-01

    Full Text Available Abstract Background Despite being a preventable disease, cervical cancer claims the lives of almost half a million women worldwide each year. India bears one-fifth of the global burden of the disease, with approximately 130,000 new cases a year. In an effort to assess the need and potential for improving the quality of cervical cancer prevention and treatment services in Uttar Pradesh, a strategic assessment was conducted in three of the state's districts: Agra, Lucknow, and Saharanpur. Methods Using an adaptation of stage one of the World Health Organization's Strategic Approach to Improving Reproductive Health Policies and Programmes, an assessment of the quality of cervical cancer services was carried out by a multidisciplinary team of stakeholders. The assessment included a review of the available literature, observations of services, collection of hospital statistics and the conduct of qualitative research (in-depth interviews and focus group discussions to assess the perspectives of women, providers, policy makers and community members. Results There were gaps in provider knowledge and practices, potentially attributable to limited provider training and professional development opportunities. In the absence of a state policy on cervical cancer, screening of asymptomatic women was practically absent, except in the military sector. Cytology-based cancer screening tests (i.e. pap smears were often used to help diagnose women with symptoms of reproductive tract infections but not routinely screen asymptomatic women. Access to appropriate treatment of precancerous lesions was limited and often inappropriately managed by hysterectomy in many urban centers. Cancer treatment facilities were well equipped but mostly inaccessible for women in need. Finally, policy makers, community members and clients were mostly unaware about cervical cancer and its preventable nature, although with information, expressed a strong interest in having services

  4. Methodological approach to determine minor, considerable, and major treatment effects in the early benefit assessment of new drugs.

    Science.gov (United States)

    Skipka, Guido; Wieseler, Beate; Kaiser, Thomas; Thomas, Stefanie; Bender, Ralf; Windeler, Jürgen; Lange, Stefan

    2016-01-01

    At the beginning of 2011, the early benefit assessment of new drugs was introduced in Germany with the Act on the Reform of the Market for Medicinal Products (AMNOG). The Federal Joint Committee (G-BA) generally commissions the Institute for Quality and Efficiency in Health Care (IQWiG) with this type of assessment, which examines whether a new drug shows an added benefit (a positive patient-relevant treatment effect) over the current standard therapy. IQWiG is required to assess the extent of added benefit on the basis of a dossier submitted by the pharmaceutical company responsible. In this context, IQWiG was faced with the task of developing a transparent and plausible approach for operationalizing how to determine the extent of added benefit. In the case of an added benefit, the law specifies three main extent categories (minor, considerable, major). To restrict value judgements to a minimum in the first stage of the assessment process, an explicit and abstract operationalization was needed. The present paper is limited to the situation of binary data (analysis of 2 × 2 tables), using the relative risk as an effect measure. For the treatment effect to be classified as a minor, considerable, or major added benefit, the methodological approach stipulates that the (two-sided) 95% confidence interval of the effect must exceed a specified distance to the zero effect. In summary, we assume that our approach provides a robust, transparent, and thus predictable foundation to determine minor, considerable, and major treatment effects on binary outcomes in the early benefit assessment of new drugs in Germany. After a decision on the added benefit of a new drug by G-BA, the classification of added benefit is used to inform pricing negotiations between the umbrella organization of statutory health insurance and the pharmaceutical companies. PMID:26134089

  5. Preliminary engineering assessment of treatment alternatives for groundwater from the Hanford 200 Area 200-BP-5 plumes

    International Nuclear Information System (INIS)

    This report presents the results of the Preliminary Engineering Assessment of Treatment Alternatives (PEATA), an engineering evaluation of potential treatment alternatives for groundwater extracted from the 200-BP-5 Area's 216-BY Cribs and 216-B-5 Reverse Well plumes. The primary objective of the PEATA was to identify treatment technologies that are worth further consideration (i.e., treatability testing or a more refined engineering evaluation). It will also provide a basis for evaluating the results of the treatability testing that is currently being conducted on the presumptive remedy of ion exchange with disposal of spent resin and will serve as a guide for selection of other technologies for additional testing. Because there are little data or past experience with groundwater similar to the BY-Crib and B-5 Reverse Well Plumes, treatment efficiencies cannot be predicted with certainty and rigorous treatment system designs and costs cannot be developed. This applies to all alternatives, including the presumptive remedy of ion exchange. The approach for this study was to develop conceptual designs and approximate costs for the treatment technologies that were most likely to be effective on the BY-Crib and B-5 Reverse Well groundwater

  6. Assessment of outcome of an ADHD treatment program using parent feedback

    Directory of Open Access Journals (Sweden)

    Hemamali Perera

    2010-12-01

    Full Text Available Background Attention deficit hyperactivity disorder (ADHD is a common behaviour disorder in children where the associated aggressive tendencies, learning difficulties and poor social skills pose a substantial burden of care on the parents. However, in traditional clinical practice, parental expectation of outcome of treatment is rarely considered. Aims This study prospectively analysed an outpatient treatment programme for children with ADHD, where parents provided feedback on the outcome of treatment. Methods Parents completed structured formats to provide information on presenting complaints, outcome at 3 months and 6 months after commencing treatment and side effects of the drug methylphenidate. Parents also attended psycho-educational and support groups. Results Of the 102 patients, parents reported a positive outcome in the majority. There was significantly better improvement in symptoms of ADHD at 6 months when compared to 3 months of treatment (p<0.005. Also, hyperactivity improved more than attention deficit and impulsiveness at the end of 6 months, though persistence of learning difficulties (50% and disruptive behaviour were causes for dissatisfaction about treatment. The commonest side effect was poor appetite (49%, though none of the children had identifiable weight loss. Conclusions Close involvement of parents in monitoring outcome of treatment of ADHD helps to focus on aspects of care relevant to them.

  7. Assessment of single and combined X-ray and colchicine treatment on Trichosanthes anguina L

    International Nuclear Information System (INIS)

    The results of the present experiment on combined treatment with 18 kR X-rays followed by treatment with 0.25, 0.50 and 1.00 per cent aqueous solution of colchicine on white fruit colour variety of T. anguina have been found to be very interesting. The treatments have led to an increase in surviving plants till maturity, reduction in percentage of pollen mother cells with chromosomal aberrations and increase in pollen fertility. Analysis of root tip mitosis has shown that treatment with X-rays produces dicentric bridge and fragment while only polyploid cells were observed after treatment with colchicine. Combined treatment with X-rays and colchicine, produces both chromosomal aberrations and polyploid cells. Simultaneously, it reduces the percentage of cells with chromosomal aberrations and those with polyploid chromosome numbers. Desirable variability in seed number, seed weight and size, seed oil and punicic acid content were observed in both combined and individual treatment. (author). 6 refs., 3 tabs

  8. Assessment of bone tissue during treatment dentoalveolar anomalies in children with scoliosis

    Directory of Open Access Journals (Sweden)

    Samoilenko A.V.

    2012-01-01

    Full Text Available The purpose of the study was to develop a rational method of treatment dentoalveolar anomalies aimed at reducing relapses dentoalveolar anomalies, duration of treatment, depending on bone density in patients with scoliosis. Scoliosis is often associated with osteopenia and impaired metabolism of connective tissue that manifested reduced bone mineral density and changes in metabolic status, impaired synthesis of the major structural components of connective tissue, resulting integral reaction to a combination of two abnormal situations - osteopenia and scoliotic deformity. Prevalence dentoalveolar anomalies abnormalities among patients with scoliosis reaches 81.6%, in most cases accompanied by gingivitis. Therefore, the need for orthodontic treatment in these patients is quite high. When scoliosis orthodontic treatment has an impact on pathologically changed bone, so the retention period of orthodontic treatment need prescriptions that enhance the adaptive capacity of the body and promote reparative bone formation and development of pathogenetically substantiated complex preventive measures aimed at improving the effectiveness of treatment and prevention of dentoalveolar anomalies recurrence. A biometric study of control and diagnostic models of the jaws, biochemical oral fluid, determining bone density by ultrasonic osteography, the timing of orthodontic treatment in patients, with jaw abnormalities suffering from scoliosis and various sites of varying severity. We have developed medical centers showed high efficiency, which showed an increase density and improve bone metabolism.

  9. Prodding the Beast: Assessing the Impact of Treatment-Induced Metastasis.

    Science.gov (United States)

    Ebos, John M L

    2015-09-01

    The arsenal of treatments for most cancers fit broadly into the categories of surgery, chemotherapy, radiation, and targeted therapy. All represent proven and successful strategies, yet each can trigger local (tumor) and systemic (host) processes that elicit unwanted, often opposing, influences on cancer growth. Under certain conditions, nearly all cancer treatments can facilitate metastatic spread, often in parallel (and sometimes in clear contrast) with tumor reducing benefits. The paradox of treatment-induced metastasis (TIM) is not new. Supporting preclinical studies span decades, but are often overlooked. With recent evidence of prometastatic effects following treatment with targeted agents blocking the tumor microenvironment, a closer inspection of this literature is warranted. The TIM phenomena may diminish the impact of effective therapies and play a critical role in eventual resistance. Alternatively, it may simply exemplify the gap between animal and human studies, and therefore have little impact for patient disease and treatment. This review will focus on the preclinical model systems used to evaluate TIM and explore the mechanisms that influence overall treatment efficacy. Understanding the role of TIM in established and emerging drug treatment strategies may help provide rationales for future drug combination approaches with antimetastatic agents to improve outcomes and reduce resistance. PMID:26229121

  10. Efficacy of three treatment protocols for adolescents with social anxiety disorder: a 5-year follow-up assessment.

    Science.gov (United States)

    Garcia-Lopez, Luis-Joaquin; Olivares, Jose; Beidel, Deborah; Albano, Anne-Marie; Turner, Samuel; Rosa, Ana I

    2006-01-01

    Few studies have reported long-term follow-up data in adults and even fewer in adolescents. The purpose of this work is to report on the longest follow-up assessment in the literature on treatments for adolescents with social phobia. A 5-year follow-up assessment was conducted with subjects who originally received either Cognitive Behavioral Group Therapy for Adolescents (CBGT-A), Social Effectiveness Therapy for Adolescents--Spanish version (SET-Asv), or Intervención en Adolescentes con Fobia Social--Treatment for Adolescents with Social Phobia (IAFS) in a controlled clinical trial. Twenty-three subjects completing the treatment conditions were available for the 5-year follow-up. Results demonstrate that subjects treated either with CBGT-A, SET-Asv and IAFS continued to maintain their gains after treatments were terminated. Either the CBGT-A, SET-Asv and IAFS can provide lasting effects to the majority of adolescents with social anxiety. Issues that may contribute to future research and clinical implications are discussed. PMID:16464703

  11. Assessing the quality of proton PBS treatment delivery using machine log files: comprehensive analysis of clinical treatments delivered at PSI Gantry 2

    Science.gov (United States)

    Scandurra, D.; Albertini, F.; van der Meer, R.; Meier, G.; Weber, D. C.; Bolsi, A.; Lomax, A.

    2016-02-01

    Pencil beam scanning (PBS) proton therapy requires the delivery of many thousand proton beams, each modulated for position, energy and monitor units, to provide a highly conformal patient treatment. The quality of the treatment is dependent on the delivery accuracy of each beam and at each fraction. In this work we describe the use of treatment log files, which are a record of the machine parameters for a given field delivery on a given fraction, to investigate the integrity of treatment delivery compared to the nominal planned dose. The dosimetry-relevant log file parameters are used to reconstruct the 3D dose distribution on the patient anatomy, using a TPS-independent dose calculation system. The analysis was performed for patients treated at Paul Scherrer Institute on Gantry 2, both for individual fields and per series (or plan), and delivery quality was assessed by determining the percentage of voxels in the log file dose distribution within  +/-  1% of the nominal dose. It was seen that, for all series delivered, the mean pass rate is 96.4%. Furthermore, this work establishes a correlation between the delivery quality of a field and the beam position accuracy. This correlation is evident for all delivered fields regardless of individual patient or plan characteristics. We have also detailed further usefulness of log file analysis within our clinical workflow. In summary, we have highlighted that the integrity of PBS treatment delivery is dependent on daily machine performance and is specifically highly correlated with the accuracy of beam position. We believe this information will be useful for driving machine performance improvements in the PBS field.

  12. Decision tree analysis to assess the cost-effectiveness of yttrium microspheres for treatment of hepatic metastases from colorectal cancer

    International Nuclear Information System (INIS)

    Full text: The aim is to determine the cost-effectiveness of yttrium microsphere treatment of hepatic metastases from colorectal cancer, with and without FDG-PET for detection of extra-hepatic disease. A decision tree was created comparing two strategies for yttrium treatment with chemotherapy, one incorporating PET in addition to CT in the pre-treatment work-up, to a strategy of chemotherapy alone. The sensitivity and specificity of PET and CT were obtained from the Federal Government PET review. Imaging costs were obtained from the Medicare benefits schedule with an additional capital component added for PET (final cost $1200). The cost of yttrium treatment was determined by patient-tracking. Previously published reports indicated a mean gain in life-expectancy from treatment of 0.52 years. Patients with extra-hepatic metastases were assumed to receive no survival benefit. Cost effectiveness was expressed as incremental cost per life-year gained (ICER). Sensitivity analysis determined the effect of prior probability of extra-hepatic disease on cost-savings and cost-effectiveness. The cost of yttrium treatment including angiography, particle perfusion studies and bed-stays, was $10530. A baseline value for prior probability of extra-hepatic disease of 0.35 gave ICERs of $26,378 and $25,271 for the no-PET and PET strategies respectively. The PET strategy was less expensive if the prior probability of extra-hepatic metastases was greater than 0.16 and more cost-effective if above 0.28. Yttrium microsphere treatment is less cost-effective than other interventions for colon cancer but comparable to other accepted health interventions. Incorporating PET into the pre-treatment assessment is likely to save costs and improve cost-effectiveness. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

  13. Economic assessment of preeclampsia : Screening, diagnosis, treatment options, and long term outcomes - A systematic review

    NARCIS (Netherlands)

    Zakiyah, Neily; Van Asselt, Antoinette D.; Baker, Philip N.; Postma, Maarten J.

    2015-01-01

    OBJECTIVES: Provide a comprehensive overview of the existing evidence on the health economics of screening, diagnosis, and treatment options in preeclampsia. METHODS: A systematic literature search was undertaken using three electronic databases (MEDLINE, Embase, Cochrane) to identify all English la

  14. Safety assessment of sugar dusting treatments by analysis of hygienic behavior in honey bee colonies

    Directory of Open Access Journals (Sweden)

    Stevanovic Jevrosima

    2011-01-01

    Full Text Available The hygienic behavior in honey bees is a dominant natural defense mechanism against brood diseases. In this study, the influence of sugar dusting treatments on hygienic behavior was evaluated in 44 strong honey bee colonies. Three doses of pulverized sugar, 20, 30 and 40 g, each applied at three-, seven- and fourteen-day intervals were tested. The percentage of cleaned cells (PCC in the total number of those with pin-killed brood served as a measure of the hygienic potential. The effect was dependent on the frequency of treatments: all doses applied every third and seventh day significantly (p<0.001 decreased the PCC in comparison with the untreated control colonies. Nevertheless, sugar did not threaten the hygienic potential, as PPC values remained above 94% following all treatments. Thus, it can be concluded that the tested sugar treatments are safe and can be justifiably implemented into integrated pest management strategies to control Varroa destructor.

  15. Soil Aquifer Treatment: Assessment and Applicability of Primary Effluent Reuse in Developing Countries

    NARCIS (Netherlands)

    Abel, C.D.T.

    2014-01-01

    This thesis showed that soil aquifer treatment (SAT) is an effective polishing technology for reuse of primary effluent. The study experimentally revealed relatively high removal of suspended solids, bulk organic matter, nutrients, pharmaceutically active compounds and pathogens indicators under var

  16. Assessment of Orthodontic Treatment Needs among Children in Doiwala Region, Uttarakhand, Indi

    Directory of Open Access Journals (Sweden)

    Seema Diwan, Sanjeeva Kumar, Vartika Saxena, Deepak Goel

    2013-01-01

    Conclusion: The need for orthodontic treatment among children of Doiwala region is comparable to other populations. In this region, there is high prevalence of severe occlusal features in older age groups.

  17. Assessment of nutrient removal in vegetated and unvegetated gravel bed mesocosm treatment wetlands

    International Nuclear Information System (INIS)

    Constructed wetlands are being considered more frequently as an option for wastewater treatment around the world. However, widespread application of this technology requires further understanding of the system performance. Such knowledge is necessary to develop improved models, better characterize the essential treatment processes and improve the reliability in performance. The goal of achieving predictable levels of wastewater amelioration with minimal performance variability is an essential part of securing regulatory approval for treatment wetland systems. Laboratory mesocosms or unit-wetlands are being utilized and novel in-situ calibration methods are being applied to reference and compare kinetics of wastewater contaminant transformations. Tracer studies are being applied to reference plant and biofilm development within and between mesocosms with respect to carbon and nitrogen. Through detailed characterization of these unit wetlands, aspects of nutrient removal are being systematically examined. This paper will highlight the unit-wetland approach and experimental results juxtaposed the relevant literature surrounding wetland treatment of wastewater. (author)

  18. Assessment of wastewater treatment plant effluent on fish reproduction utilizing the adverse outcome pathway conceptual framework

    Science.gov (United States)

    Wastewater treatment plant (WWTP) effluents are a known contributor of chemical mixture inputs into the environment. Whole effluent testing guidelines were developed to screen these complex mixtures for acute toxicity. However, efficient and cost-effective approaches for screenin...

  19. Assessing the impact of an eating disorders treatment team approach with college students.

    Science.gov (United States)

    Mitchell, Sharon L; Klein, Jessalyn; Maduramente, Althea

    2015-01-01

    An interdisciplinary treatment team approach is considered the standard of care for individuals with eating disorders; however, there is limited research on the efficacy of such teams. This study used retrospective chart review to compare client characteristics and treatment utilization for college students treated with psychotherapy alone versus an interdisciplinary treatment team approach (i.e., a mental health counselor, a physician, and a dietitian). Clients with prior counseling histories, a bulimia nervosa diagnosis, or a personality disorder diagnosis were more likely to be referred to the eating disorders treatment team. Female counselors were more likely than male counselors to refer clients to the team. Overall, findings suggest that the team approach is associated with students staying in therapy longer and terminating therapy in a planned fashion. PMID:25298146

  20. Continuous fungal treatment of non-sterile veterinary hospital effluent: pharmaceuticals removal and microbial community assessment

    OpenAIRE

    Badia-Fabregat, Marina; Lucas, Daniel; M. A. PEREIRA; Alves, M. M.; Pennanen, Taina; Fritze, Hannu; Rodríguez-Mozaz, Sara; Barceló, Damià; Vicent, Teresa; Caminal, Glòria

    2016-01-01

    Source point treatment of effluents with a high load of pharmaceutical active compounds (PhACs), such as hospital wastewater, is a matter of discussion among the scientific community. Fungal treatments have been reported to be successful in degrading this type of pollutants and, therefore, the white-rot fungus Trametes versicolor was applied for the removal of PhACs from veterinary hospital wastewater. Sixty-six percent removal was achieved in a non-sterile batch bioreactor inoculated with T....

  1. Health Technology Assessment for Rare Diseases: Evaluation of Preferences toward treatments for Patients with Haemophilia

    OpenAIRE

    Scalone, Luciana

    2008-01-01

    Rationale Despite the success of recent investments in health technology for the treatment in hemophilic patients, today, inhibitor development is a major complication of hemophilia treatment, as inhibitors increase the risk of uncontrollable bleeding, make surgery more problematic, increase the risk of severe physical disabilities, reduce wellbeing, and represent a potential cause of premature mortality. The introduction of new options, such as immune tolerance induction and the use ...

  2. Social anxiety disorder in children and adolescents: assessment, maintaining factors, and treatment

    OpenAIRE

    Cederlund, Rio

    2013-01-01

    The present dissertation consists of three empirical studies on social anxiety disorder (SAD) in a sample of Swedish children and adolescents. Based on findings made in a large behavior treatment study, the thesis contributes to the field of research on childhood SAD by investigating a factor that maintains the disorder, ways to measure and screen for diagnosis, and the treatment of the disorder. Study I investigated whether giving an educational course to the parents of socially anxious chil...

  3. Assessment and treatment of mood disorders in the context of substance abuse

    OpenAIRE

    Tolliver, Bryan K.; Anton, Raymond F.

    2015-01-01

    Recognition and management of mood symptoms in individuals using alcohol and/or other drugs represent a daily challenge for clinicians in both inpatient and outpatient treatment settings. Diagnosis of underlying mood disorders in the context of ongoing substance abuse requires careful collection of psychiatric history, and is often critical for optimal treatment planning and outcomes. Failure to recognize major depression or bipolar disorders in these patients can result in increased relapse ...

  4. Medical and health economic assessment of radiosurgery for the treatment of brain metastasis

    OpenAIRE

    von der Schulenburg, Johann-Matthias; Willich, Stefan N.; Vauth, Christoph; Ernst, Iris; Schwarzbach, Christoph; Bockelbrink, Angelina; Müller-Riemenschneider, Falk

    2009-01-01

    Background Radiotherapy for patients suffering from malignant neoplasms has developed greatly during the past decades. Stereotactic radiosurgery (SRS) is one important radiotherapeutic option which is defined by a single and highly focussed application of radiation during a specified time interval. One of its important indications is the treatment of brain metastases . Objectives The objective of this HTA is to summarise the current literature concerning the treatment of b...

  5. Level of analysis issues in assessing treatment beliefs in substance abuse clinics

    OpenAIRE

    & Jacqueline K. Mitchelson; Marcus W. Dickson; Cynthia L. Arfken; Agius, Elizabeth

    2007-01-01

    The current study applies the growing literature in the organizational sciences regarding levels of analysis issues to the analysis of substance abuse treatment beliefs. Research on clinicians' beliefs in substance abuse treatment is often based on the assumption that the beliefs are sufficiently shared by clinicians within a clinic and sufficiently vary across clinics that they can be treated as a group-level phenomenon. Further, efforts to introduce new innovations are often focused at the ...

  6. Assessment of incineration and melting treatment technologies for RWMC buried waste

    Energy Technology Data Exchange (ETDEWEB)

    Geimer, R.; Hertzler, T.; Gillins, R. (Science Applications International Corp., Idaho Falls, ID (United States)); Anderson, G.L. (EG and G Idaho, Inc., Idaho Falls, ID (United States))

    1992-02-01

    This report provides an identification, description, and ranking evaluation of the available thermal treatment technologies potentially capable of treating the Idaho National Engineering Laboratory Radioactive Waste Management Complex (RWMC) buried mixed waste. The ranking evaluation focused separately upon incinerators for treatment of combustible wastes and melters for noncombustible wastes. The highest rank incinerators are rotary kilns and controlled air furnaces, while the highest rank melters are the hearth configuration plasma torch, graphite electrode arc, and joule-heated melters. 4 refs.

  7. Assessment of outcome of an ADHD treatment program using parent feedback

    OpenAIRE

    Hemamali Perera; Kamal Chandima Jeewandara; Sudharshi Seneviratne; Chandima Guruge

    2010-01-01

    Background Attention deficit hyperactivity disorder (ADHD) is a common behaviour disorder in children where the associated aggressive tendencies, learning difficulties and poor social skills pose a substantial burden of care on the parents. However, in traditional clinical practice, parental expectation of outcome of treatment is rarely considered. Aims This study prospectively analysed an outpatient treatment programme for children with ADHD, where parents provided feedback on the outcome of...

  8. A clinical study of metastasized rectal cancer treatment: assessing a multimodal approach

    OpenAIRE

    Jung, Michaela; Holmqvist, Annica; Sun, Xiao-Feng; Albertsson, Maria

    2014-01-01

    Metastasized rectal cancer has long been considered incurable. During recent years, the treatment of rectal cancer patients has been improved, and nowadays, a subgroup of patients might even be cured. The aim of this study was to investigate the optimal timing of treatment in a multimodal therapy schedule in order to see whether the addition of bevacizumab (Avastin) to conventional chemotherapy was effective. The study included 39 patients with metastatic rectal cancer between 2009 and 2011, ...

  9. Assessment and Treatment of Abuse Risk in Opioid Prescribing for Chronic Pain

    OpenAIRE

    Juliana Serraillier; Jamison, Robert N.; Edward Michna

    2011-01-01

    Opioid analgesics provide effective treatment for noncancer pain, but many physicians have concerns about adverse effects, tolerance, and addiction. Misuse of opioids is prominent in patients with chronic back pain and early recognition of misuse risk could help physicians offer adequate patient care while implementing appropriate levels of monitoring to reduce aberrant drug-related behaviors. In this review, we discuss opioid abuse and misuse issues that often arise in the treatment of patie...

  10. Assessing GHG emissions from sludge treatment and disposal routes: the method behind GESTABoues tool

    OpenAIRE

    Pradel, M.; Reverdy, A.L.

    2012-01-01

    In 2007, 1 100 000 tons of sewage sludge were produced in France. This figure is constantly increasing and sludges have to be eliminated. Four disposal routes are currently possible: land spreading (directly or after composting), incineration, incineration with household wastes and landfilling. These different disposal routes as well as the sludge treatments produce greenhouse gases (GHG). To help stakeholders to better understand the carbon footprint of sludge treatment and disposal options,...

  11. A global economic model to assess the cost-effectiveness of new treatments for advanced breast cancer in Canada.

    Science.gov (United States)

    Beauchemin, C; Letarte, N; Mathurin, K; Yelle, L; Lachaine, J

    2016-06-01

    Objective Considering the increasing number of treatment options for metastatic breast cancer (MBC), it is important to develop high-quality methods to assess the cost-effectiveness of new anti-cancer drugs. This study aims to develop a global economic model that could be used as a benchmark for the economic evaluation of new therapies for MBC. Methods The Global Pharmacoeconomics of Metastatic Breast Cancer (GPMBC) model is a Markov model that was constructed to estimate the incremental cost per quality-adjusted life years (QALY) of new treatments for MBC from a Canadian healthcare system perspective over a lifetime horizon. Specific parameters included in the model are cost of drug treatment, survival outcomes, and incidence of treatment-related adverse events (AEs). Global parameters are patient characteristics, health states utilities, disutilities, and costs associated with treatment-related AEs, as well as costs associated with drug administration, medical follow-up, and end-of-life care. The GPMBC model was tested and validated in a specific context, by assessing the cost-effectiveness of lapatinib plus letrozole compared with other widely used first-line therapies for post-menopausal women with hormone receptor-positive (HR+) and epidermal growth factor receptor 2-positive (HER2+) MBC. Results When tested, the GPMBC model led to incremental cost-utility ratios of CA$131 811 per QALY, CA$56 211 per QALY, and CA$102 477 per QALY for the comparison of lapatinib plus letrozole vs letrozole alone, trastuzumab plus anastrozole, and anastrozole alone, respectively. Results of the model testing were quite similar to those obtained by Delea et al., who also assessed the cost-effectiveness of lapatinib in combination with letrozole in HR+/HER2 + MBC in Canada, thus suggesting that the GPMBC model can replicate results of well-conducted economic evaluations. Conclusions The GPMBC model can be very valuable as it allows a quick and valid assessment of the cost

  12. Assessment of Evidence Base from Medical Debriefs Data on Space Motion Sickness Incidence and Treatment

    Science.gov (United States)

    Younker, D.R.; Daniels, V.R.; Boyd, J.L.; Putcha, L.

    2008-01-01

    An objective of this data compilation and analysis project is to examine incidence and treatment efficacy of common patho-physiological disturbances during spaceflight. Analysis of medical debriefs data indicated that astronauts used medications to alleviate symptoms of four major ailments for which astronauts received treatment for sleep disturbances, space motion sickness (SMS), pain (headache, back pain) and sinus congestion. In the present data compilation and analysis project on SMS treatment during space missions, subject demographics (gender, age, first-time or repeat flyer), incidence and severity of SMS symptoms and subjective treatment efficacy from 317 crewmember debrief records were examined from STS-1 through STS-89. Preliminary analysis of data revealed that 50% of crew members reported SMS symptoms on at least one flight and 22% never experienced it. In addition, there were 387 medication dosing episodes reported, and promethazine was the most commonly used medication. Results of analysis of symptom check lists, medication use/efficacy and gender and flight record differences in incidence and treatment efficacy will be presented. Evidence gaps for treatment efficacy along with medication use trend analysis will be identified.

  13. Depression in young people: description, assessment and evidence-based treatment

    OpenAIRE

    Carr, Alan

    2008-01-01

    OBJECTIVE: The literature on depression in children and adolescents was reviewed to provide an update for clinicians. REVIEW PROCESS: Literature of particular relevance to evidence-based practice was selected for critical review. Meta-analyses and controlled trials were prioritized for review along with key assessment instruments. OUTCOMES: An up-to-date overview of clinical features, epidemiology, prognosis, aetiology, assessment and intervention was provided. CONCLUSIONS: Depression in chil...

  14. A comprehensive geriatric assessment screening questionnaire (CGA-GOLD) for older people undergoing treatment for cancer

    OpenAIRE

    Whittle, AK; Kalsi, Tania; Babic-Illman, G; Wang, Yanzhong; Fields, Paul; Ross, Paul; Maisey, Nick; Hughes, Simon; Kwan, WH; Harari, Danielle

    2016-01-01

    Oncology services do not routinely assess broader needs of older people with cancer. This study evaluates a comprehensive geriatric assessment and comorbidity screening questionnaire (CGA-GOLD) covering evidence-based domains and quality of life (EORTC-QLQ-C30). Patients aged 65+ attending oncology services were recruited into (1) Observational cohort (completed CGA-GOLD, received standard oncology care), (2) Intervention cohort (responses categorised ‘low-risk’, ‘high-risk’, ‘possible need’ ...

  15. Health Technology Assessment of Belimumab: A New Monoclonal Antibody for the Treatment of Systemic Lupus Erythematosus

    OpenAIRE

    2014-01-01

    Objective. Systemic lupus erythematosus (SLE) is treated with anti-inflammatory and immunosuppressive drugs and off-label biologics. Belimumab is the first biologic approved after 50 years as an add-on therapy for active disease. This paper summarizes a health technology assessment performed in Italy. Methods. SLE epidemiology and burden were assessed using the best published international and national evidences and efficacy and safety of belimumab were synthesized using clinical data. A cost...

  16. The study of potable water treatment process in Algeria (boudouaou station) -by the application of life cycle assessment (LCA).

    Science.gov (United States)

    Mohamed-Zine, Messaoud-Boureghda; Hamouche, Aksas; Krim, Louhab

    2013-01-01

    Environmental impact assessment will soon become a compulsory phase in future potable water production projects, in algeria, especially, when alternative treatment processes such sedimentation ,coagulation sand filtration and Desinfection are considered. An impact assessment tool is therefore developed for the environmental evaluation of potable water production. in our study The evaluation method used is the life cycle assessment (LCA) for the determination and evaluation of potential impact of a drink water station ,near algiers (SEAL-Boudouaoua).LCA requires both the identification and quantification of materials and energy used in all stages of the product's life, when the inventory information is acquired, it will then be interpreted into the form of potential impact " eco-indicators 99" towards study areas covered by LCA, using the simapro6 soft ware for water treatment process is necessary to discover the weaknesses in the water treatment process in order for it to be further improved ensuring quality life. The main source shown that for the studied water treatment process, the highest environmental burdens are coagulant preparation (30% for all impacts), mineral resource and ozone layer depletion the repartition of the impacts among the different processes varies in comparison with the other impacts. Mineral resources are mainly consumed during alumine sulfate solution preparation; Ozone layer depletion originates mostly from tetrachloromethane emissions during alumine sulfate production. It should also be noted that, despite the small doses needed, ozone and active Carbone treatment generate significant impacts with a contribution of 10% for most of the impacts.Moreover impacts of energy are used in producing pumps (20-25 GHC) for plant operation and the unitary processes (coagulation, sand filtration decantation) and the most important impacts are localized in the same equipment (40-75 GHC) and we can conclude that:- Pre-treatment, pumping and EDR (EDR: 0

  17. Parent-assessed quality of life among adolescents undergoing orthodontic treatment: a 12-month follow-up

    Directory of Open Access Journals (Sweden)

    Lucas Guimarães Abreu

    2015-10-01

    Full Text Available Objective: To assess parents' and caregivers' view of the first twelve months of adolescents' orthodontic treatment with fixed appliances and to assess the evaluative properties of the Brazilian version of the Parental-Caregiver Perceptions Questionnaire (P-CPQ in the orthodontic setting.Methods:Data from a sample of 96 parents and caregivers of adolescents undergoing orthodontic treatment with fixed appliances were collected by means of P-CPQ. Assessments were performed before banding and bracket bonding (T1 and 12 months after placement of fixed appliances (T2. Statistical analysis included Wilcoxon signed-rank test for the overall P-CPQ score and Bonferroni correction for P-CPQ subscales. The evaluative properties of the P-CPQ were assessed through responsiveness calculation and the minimally clinical important difference (MCID.Results: Among the 96 participants, 76 were mothers of patients, 16 were fathers, and four were other family members. Adolescents' mean age was 11.49 ± 0.50 years. Most families earned equal to or less than three times the Brazilian monthly minimum wage. There was significant improvement in the emotional and social well-being subscales (p< 0.001, which contributed to improve patient's overall quality of life (p< 0.001. Reductions in scores were associated with clinically meaningful moderate changes in the overall score as well as in the emotional and social well-being subscales. The MCID was 6.16 for the P-CPQ overall score.Conclusion:Parents and caregivers reported significant improvement in the quality of life of adolescents undergoing orthodontic treatment with fixed appliances.

  18. Assessing the temporal stability of surface functional groups introduced by plasma treatments on the outer shells of carbon nanotubes

    Science.gov (United States)

    Merenda, Andrea; Ligneris, Elise des; Sears, Kallista; Chaffraix, Thomas; Magniez, Kevin; Cornu, David; Schütz, Jürg A.; Dumée, Ludovic F.

    2016-01-01

    Plasma treatments are emerging as superior efficiency treatment for high surface to volume ratio materials to tune functional group densities and alter crystallinity due to their ability to interact with matter at the nanoscale. The purpose of this study is to assess for the first time the long term stability of surface functional groups introduced across the surface of carbon nanotube materials for a series of oxidative, reductive and neutral plasma treatment conditions. Both plasma duration dose matrix based exposures and time decay experiments, whereby the surface energy of the materials was evaluated periodically over a one-month period, were carried out. Although only few morphological changes across the graphitic planes of the carbon nanotubes were found under the uniform plasma treatment conditions, the time dependence of pertinent work functions, supported by Raman analysis, suggested that the density of polar groups decreased non-linearly over time prior to reaching saturation from 7 days post treatment. This work provides critical considerations on the understanding of the stability of functional groups introduced across high specific surface area nano-materials used for the design of nano-composites, adsorptive or separation systems, or sensing materials and where interfacial interactions are key to the final materials performance. PMID:27507621

  19. Factors affecting adherence to the treatment regimen of tuberculosis patients: Assessing the efficiency of health belief model constructs

    Directory of Open Access Journals (Sweden)

    Mahmood Karimy

    2014-07-01

    Full Text Available Background: Low adherence to the treatment regimen in tuberculosis patients has been recognized as a major threat for tuberculosis (TB control program. Thus, the present study was conducted to assess the factors affecting adherence to the treatment regimen of TB patients via Health Belief Model (HBM. Methods: In this cross-sectional study,110 tuberculosis patients attending anti-TB center in Zabol were selected and included in the study using census method. Data were collected using Health Belief Model (HBM questionnaire and reviewing the patients' medical files. The collected data were analyzed by SPSS software using t-test, ANOVA and multiple regression analysis with 95 % confidence level. Results: The mean age of the participants was 55.7±18.6 years. 89% of the patients had pulmonary tuberculosis and 11% had extra-pulmonary tuberculosis. The multiple regression analysis showed knowledge, self-efficacy, perceived benefits and perceived threat were significant predictors of adherence to the treatment regimen. The HBM constructs accounted for 29% of the variance observed in adherence to the treatment regimen. Conclusion: The findings of the study highlight the need to increase awareness and change the patients’ beliefs about the risks of low adherence to the treatment regimen in patients.

  20. Assessing the temporal stability of surface functional groups introduced by plasma treatments on the outer shells of carbon nanotubes

    Science.gov (United States)

    Merenda, Andrea; Ligneris, Elise Des; Sears, Kallista; Chaffraix, Thomas; Magniez, Kevin; Cornu, David; Schütz, Jürg A.; Dumée, Ludovic F.

    2016-08-01

    Plasma treatments are emerging as superior efficiency treatment for high surface to volume ratio materials to tune functional group densities and alter crystallinity due to their ability to interact with matter at the nanoscale. The purpose of this study is to assess for the first time the long term stability of surface functional groups introduced across the surface of carbon nanotube materials for a series of oxidative, reductive and neutral plasma treatment conditions. Both plasma duration dose matrix based exposures and time decay experiments, whereby the surface energy of the materials was evaluated periodically over a one-month period, were carried out. Although only few morphological changes across the graphitic planes of the carbon nanotubes were found under the uniform plasma treatment conditions, the time dependence of pertinent work functions, supported by Raman analysis, suggested that the density of polar groups decreased non-linearly over time prior to reaching saturation from 7 days post treatment. This work provides critical considerations on the understanding of the stability of functional groups introduced across high specific surface area nano-materials used for the design of nano-composites, adsorptive or separation systems, or sensing materials and where interfacial interactions are key to the final materials performance.

  1. Assessment and treatment of mood disorders in the context of substance abuse.

    Science.gov (United States)

    Tolliver, Bryan K; Anton, Raymond F

    2015-06-01

    Recognition and management of mood symptoms in individuals using alcohol and/or other drugs represent a daily challenge for clinicians in both inpatient and outpatient treatment settings. Diagnosis of underlying mood disorders in the context of ongoing substance abuse requires careful collection of psychiatric history, and is often critical for optimal treatment planning and outcomes. Failure to recognize major depression or bipolar disorders in these patients can result in increased relapse rates, recurrence of mood episodes, and elevated risk of completed suicide. Over the past decade, epidemiologic research has clarified the prevalence of comorbid mood disorders in substance-dependent individuals, overturning previous assumptions that depression in these patients is simply an artifact of intoxication and/or withdrawal, therefore requiring no treatment. However, our understanding of the bidirectional relationships between mood and substance use disorders in terms of their course(s) of illness and prognoses remains limited. Like-wise, strikingly little treatment research exists to guide clinical decision making in co-occurring mood and substance use disorders, given their high prevalence and public health burden. Here we overview what is known and the salient gaps of knowledge where data might enhance diagnosis and treatment of these complicated patients. PMID:26246792

  2. The definition and treatment of scenarios in a probabilistic systems assessment

    Energy Technology Data Exchange (ETDEWEB)

    Andres, T.H.; Goodwin, B.W

    1998-03-01

    Concepts for the disposal of nuclear waste generally involve the use of multiple barriers, both man-made and natural, to isolate the waste from man's environment for very long periods of time. To assess the safety of these concepts, postclosure safety assessments are conducted to study the types, ranges and probabilities of potential impacts caused by wastes penetrating these barriers. Within the Canadian context, postclosure safety assessments must estimate radiological risk for comparison with regulatory criteria. The definition of radiological risk introduces a requirement to identify and then evaluate scenarios that describe quantitatively the possible behaviour of a disposal system and its surroundings for at least 10{sup 4} years. This report examines the connection between the identification and evaluation of scenarios. It shows how a large collection of factors can be combined to form simple scenarios, and how a large number of simple scenarios can be grouped into a manageably small number of compound scenarios. The compound scenarios, notably the 'central' scenario, can be evaluated using a probabilistic systems assessment code such as SYVAC3 (SYstems Variability Analysis Code, generation 3) to estimate the radiological risk and other environmental impacts. Examples are taken from a long-term performance assessment study to demonstrate a pragmatic application of the procedure. (author)

  3. The definition and treatment of scenarios in a probabilistic systems assessment

    International Nuclear Information System (INIS)

    Concepts for the disposal of nuclear waste generally involve the use of multiple barriers, both man-made and natural, to isolate the waste from man's environment for very long periods of time. To assess the safety of these concepts, postclosure safety assessments are conducted to study the types, ranges and probabilities of potential impacts caused by wastes penetrating these barriers. Within the Canadian context, postclosure safety assessments must estimate radiological risk for comparison with regulatory criteria. The definition of radiological risk introduces a requirement to identify and then evaluate scenarios that describe quantitatively the possible behaviour of a disposal system and its surroundings for at least 104 years. This report examines the connection between the identification and evaluation of scenarios. It shows how a large collection of factors can be combined to form simple scenarios, and how a large number of simple scenarios can be grouped into a manageably small number of compound scenarios. The compound scenarios, notably the 'central' scenario, can be evaluated using a probabilistic systems assessment code such as SYVAC3 (SYstems Variability Analysis Code, generation 3) to estimate the radiological risk and other environmental impacts. Examples are taken from a long-term performance assessment study to demonstrate a pragmatic application of the procedure. (author)

  4. Comparative assessment of two Artemisinin based combination Therapies in the treatment of Uncomplicated Malaria among University students in Nigeria

    Directory of Open Access Journals (Sweden)

    Okonta Matthew J

    2013-06-01

    Full Text Available Background: In line with the recommendation of artemisininbased combination therapy (ACT by WHO in the effective treatment of uncomplicated malaria, African nations including Nigeria changed their malaria treatment policy to combination therapies. To date, about 15 African nations adopted artesunate /amodiaquine (AA as their first line agent while Nigeria adopted artemether /lumefantrine (AL. Objective: The objective of this study is to compare the treatment outcome among patients treated with AA to those treated with AL for acute uncomplicated malaria. Method: The study was conducted at Nnamdi Azikiwe University campuses using quantitative methods. Two hundered and ninety six patients were randomly allocated to one of two treatment group- AA and AL with 148 patients per group. All the patients were educated about the drugs and adherence. Adherence and treatment outcomes including parasite clearance and the drugs’ effects on biochemical parameters among others were assessed by follow up visits on third, seventh, fourteenth and twenty eighth-day post treatment. Data were analysed using Cox Regression model on SPSS 17.0. Result: Both drugs were well adhered to and tolerated. One case of Steven Johnson-like reaction was observed with AL. Fever resolution and parasite clearance was similar in both groups with adequate clinical and parasitological response (ACPR by day 28 for AL and AA being 70.3% and 85.1% respectively. Conclusion: Our findings is in favour of higher efficacy of AA with respect to their ACPR. More controlled studies will be needed to ascertain the adoption of AL as first line drug in malaria treatment in Nigeria.

  5. Identification of imaging biomarkers for the assessment of tumour response to different treatments in a preclinical glioma model

    International Nuclear Information System (INIS)

    Hypoxia-inducible factor 1α (HIF-1α) activity is one of the major players in hypoxia-mediated glioma progression and resistance to therapies, and therefore the focus of this study was the evaluation of HIF-1α modulation in relation to tumour response with the purpose of identifying imaging biomarkers able to document tumour response to treatment in a murine glioma model. U251-HRE-mCherry cells expressing Luciferase under the control of a hypoxia responsive element (HRE) and mCherry under the control of a constitutive promoter were used to assess HIF-1α activity and cell survival after treatment, both in vitro and in vivo, by optical, MRI and positron emission tomography imaging. This cell model can be used to monitor HIF-1α activity after treatment with different drugs modulating transduction pathways involved in its regulation. After temozolomide (TMZ) treatment, HIF-1α activity is early reduced, preceding cell cytotoxicity. Optical imaging allowed monitoring of this process in vivo, and carbonic anhydrase IX (CAIX) expression was identified as a translatable non-invasive biomarker with potential clinical significance. A preliminary in vitro evaluation showed that reduction of HIF-1α activity after TMZ treatment was comparable to the effect of an Hsp90 inhibitor, opening the way for further elucidation of its mechanism of action. The results of this study suggest that the U251-HRE-mCherry cell model can be used for the monitoring of HIF-1α activity through luciferase and CAIX expression. These cells can become a useful tool for the assessment and improvement of new targeted tracers for potential theranostic procedures. (orig.)

  6. Identification of imaging biomarkers for the assessment of tumour response to different treatments in a preclinical glioma model

    Energy Technology Data Exchange (ETDEWEB)

    Lo Dico, A.; Martelli, C. [University of Milan, Department of Pathophysiology and Transplantation, Milan (Italy); University of Milan, Centre of Molecular and Cellular Imaging-IMAGO, Milan (Italy); Valtorta, S.; Belloli, S. [National Researches Council (CNR), Institute of Molecular Bioimaging and Physiology (IBFM), Segrate, MI (Italy); IRCCS San Raffaele Scientific Institute, Experimental Imaging Center, Milan (Italy); Raccagni, I.; Moresco, R.M. [IRCCS San Raffaele Scientific Institute, Experimental Imaging Center, Milan (Italy); University of Milano-Bicocca, Department of Health Sciences, Monza (Italy); Diceglie, C. [University of Milan, Department of Pathophysiology and Transplantation, Milan (Italy); University of Milan, Doctorate School of Molecular Medicine, Milan (Italy); Gianelli, U.; Bosari, S. [University of Milan, Department of Pathophysiology and Transplantation, Milan (Italy); Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Division of Pathology, Milan (Italy); Vaira, V. [Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Division of Pathology, Milan (Italy); Istituto Nazionale Genetica Molecolare ' ' Romeo ed Enrica Invernizzi' ' (INGM), Milan (Italy); Politi, L.S. [IRCCS San Raffaele Scientific Institute, Neuroradiology Department and Neuroradiology Research Group, Milan (Italy); Lucignani, G. [University of Milan, Centre of Molecular and Cellular Imaging-IMAGO, Milan (Italy); University of Milan, Department of Health Sciences, Milan (Italy); San Paolo Hospital, Department of Diagnostic Services, Unit of Nuclear Medicine, Milan (Italy); Ottobrini, L. [University of Milan, Department of Pathophysiology and Transplantation, Milan (Italy); University of Milan, Centre of Molecular and Cellular Imaging-IMAGO, Milan (Italy); National Researches Council (CNR), Institute of Molecular Bioimaging and Physiology (IBFM), Segrate, MI (Italy)

    2015-03-27

    Hypoxia-inducible factor 1α (HIF-1α) activity is one of the major players in hypoxia-mediated glioma progression and resistance to therapies, and therefore the focus of this study was the evaluation of HIF-1α modulation in relation to tumour response with the purpose of identifying imaging biomarkers able to document tumour response to treatment in a murine glioma model. U251-HRE-mCherry cells expressing Luciferase under the control of a hypoxia responsive element (HRE) and mCherry under the control of a constitutive promoter were used to assess HIF-1α activity and cell survival after treatment, both in vitro and in vivo, by optical, MRI and positron emission tomography imaging. This cell model can be used to monitor HIF-1α activity after treatment with different drugs modulating transduction pathways involved in its regulation. After temozolomide (TMZ) treatment, HIF-1α activity is early reduced, preceding cell cytotoxicity. Optical imaging allowed monitoring of this process in vivo, and carbonic anhydrase IX (CAIX) expression was identified as a translatable non-invasive biomarker with potential clinical significance. A preliminary in vitro evaluation showed that reduction of HIF-1α activity after TMZ treatment was comparable to the effect of an Hsp90 inhibitor, opening the way for further elucidation of its mechanism of action. The results of this study suggest that the U251-HRE-mCherry cell model can be used for the monitoring of HIF-1α activity through luciferase and CAIX expression. These cells can become a useful tool for the assessment and improvement of new targeted tracers for potential theranostic procedures. (orig.)

  7. Improving China's antiretroviral treatment program: assessing current and future performance using the principals of ethics

    Institute of Scientific and Technical Information of China (English)

    YIN Wen-yuan; ZHANG Fu-jie; Naomi Juniper; WU Zun-you

    2009-01-01

    @@ The global commitment to providing antiretroviral therapy (ART) to people living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) in low-income countries has raised hope that the increasing momentum in the fight against the worldwide HIV/AIDS pandemic will be sufficient to control it. However, improved availability of subsidized antiretroviral (ARV) treatments in low-income countries raises complex ethical issues.1,2 In many resource-constrained countries the number of individuals infected with HIV in need of treatment far exceeds the supply of ARV medication. Resource allocation decisions can be made on the basis of many epidemiological,ethical, or preferential treatment priority criteria,Healthcare systems and funding in low-income countries are limited, requiring a step-by-step aipproach to scalingup programs to reach their stated aims.

  8. Assessment of rehabilitation needs in colorectal cancer treatment: Results from a mixed audit and qualitative study in Denmark.

    Science.gov (United States)

    Wiedenbein, Liza; Kristiansen, Maria; Adamsen, Lis; Hjort, Dorte; Hendriksen, Carsten

    2016-06-01

    Background Systematic assessments of cancer patients' rehabilitation needs are a prerequisite for devising appropriate survivorship programs. Little is known about the fit between needs assessment outlined in national rehabilitation policies and clinical practice. This study aimed to explore clinical practices related to identification and documentation of rehabilitation needs among patients with colorectal cancer at Danish hospitals. Material and methods A retrospective clinical audit was conducted utilizing data from patient files randomly selected at surgical and oncology hospital departments treating colorectal cancer patients. Forty patients were included, 10 from each department. Semi-structured interviews were carried out among clinical nurse specialists. Audit data was analyzed using descriptive statistics, qualitative data using thematic analysis. Results Documentation of physical, psychological and social rehabilitation needs initially and at end of treatment was evident in 10% (n = 2) of surgical patient trajectories and 35% (n = 7) of oncology trajectories. Physical rehabilitation needs were documented among 90% (n = 36) of all patients. Referral to municipal rehabilitation services was documented among 5% (n = 2) of all patients. Assessments at surgical departments were shaped by the inherent continuous assessment of rehabilitation needs within standardized fast-track colorectal cancer surgery. In contrast, the implementation of locally developed assessment tools inspired by the distress thermometer (DT) in oncology departments was challenged by a lack of competencies and funding, impeding integration of data into patient files. Conclusion Consensus must be reached on how to ensure more systematic, comprehensive assessments of rehabilitation needs throughout clinical cancer care. Fast-track surgery ensures systematic documentation of physical needs, but the lack of inclusion of data collected by the DT in oncological departments

  9. Improving quality of malaria treatment services: assessing inequities in consumers' perceptions and providers' behaviour in Nigeria

    Directory of Open Access Journals (Sweden)

    Obikeze Eric

    2010-10-01

    Full Text Available Abstract Background Information about quality of malaria treatment services of different healthcare providers is needed to know how to improve the treatment of malaria since inappropriate service provision leads to increased burden of malaria. Hence, the study determined the technical and perceived quality of malaria treatment services of different types of providers in three urban and three rural areas in southeast Nigeria. Methods Questionnaire was used to interview randomly selected healthcare providers about the technical quality of their malaria treatment services. Exit polls were used to obtain information about perceived quality from consumers. A socio-economic status (SES index and comparison of data between urban and rural areas was used to examine socio-economic status and geographic differences in quality of services. Results The lowest technical quality of services was found from patent medicine dealers. Conversely, public and private hospitals as well as primary healthcare centres had the highest quality of services. Householders were least satisfied with quality of services of patent medicine dealers and pharmacy shops and were mostly satisfied with services rendered by public and private hospitals. The urbanites were more satisfied with the overall quality of services than the rural dwellers. Conclusion These findings provide areas for interventions to equitably improve the quality of malaria treatment services, especially for patent medicine dealers and pharmacy shops, that are two of the most common providers of malaria treatment especially with the current change of first line drugs from the relatively inexpensive drugs to the expensive artemisinin-based combination therapy, so as to decrease inappropriate drug prescribing, use, costs and resistance to artemisinin-based combination therapy.

  10. Understanding and assessing the impact of treatment in diabetes: the Treatment-Related Impact Measures for Diabetes and Devices (TRIM-Diabetes and TRIM-Diabetes Device

    Directory of Open Access Journals (Sweden)

    Lessard Suzanne

    2009-09-01

    Full Text Available Abstract Purpose Diabetes is a debilitating illness requiring lifelong management. Treatments can be varied in terms of mode of administration as well as type of agent. Unfortunately, most patient reported outcome measures currently available to assess the impact of treatment are specific to diabetes type, treatment modality or delivery systems and are designed to be either a HRQoL or treatment satisfaction measure. To address these gaps, the Treatment Related Impact Measure-Diabetes and Device measures were developed. This paper presents the item development and validation of the TRIM Diabetes/Device. Methods Patient interviews were conducted to collect the patient perspective and ensure high content validity. Interviews were hand coded and qualitatively analyzed to identify common themes. A conceptual model of the impact of diabetes medication was developed and preliminary items for the TRIM-Diabetes/Device were generated and cognitively debriefed. Validation data was collected via an on-line survey and analyzed according to an a priori statistical analysis plan to validate the overall score as well as each domain. Item level criteria were used to reduce the preliminary item pool. Next, factor analysis to identify structural domains was performed. Reliability and validity testing was then performed. Results One hundred and five patients were interviewed in focus groups, individual interviews and for cognitive debriefing. Five hundred seven patients participated in the validation study. Factor analysis identified seven domains: Treatment Burden, Daily Life; Diabetes Management; Psychological Health; Compliance and Device Function and Bother. Internal consistency reliability coefficients of the TRIM-Diabetes/Device ranged from 0.80 and 0.94. Test-retest reliability of the TRIM-Diabetes/Device ranged from 0.71 to 0.89. All convergent and known groups validity hypotheses were met for the TRIM-Diabetes/Device total scores and sub-scales. Conclusion

  11. Practice parameter for the assessment and treatment of children and adolescents with eating disorders.

    Science.gov (United States)

    Lock, James; La Via, Maria C

    2015-05-01

    This Practice Parameter reviews evidence-based practices for the evaluation and treatment of eating disorders in children and adolescents. Where empirical support is limited, clinical consensus opinion is used to supplement systematic data review. The Parameter focuses on the phenomenology of eating disorders, comorbidity of eating disorders with other psychiatric and medical disorders, and treatment in children and adolescents. Because the database related to eating disorders in younger patients is limited, relevant literature drawn from adult studies is included in the discussion. PMID:25901778

  12. Common-Cause Failure Treatment in Event Assessment: Basis for a Proposed New Model

    Energy Technology Data Exchange (ETDEWEB)

    Dana Kelly; Song-Hua Shen; Gary DeMoss; Kevin Coyne; Don Marksberry

    2010-06-01

    Event assessment is an application of probabilistic risk assessment in which observed equipment failures and outages are mapped into the risk model to obtain a numerical estimate of the event’s risk significance. In this paper, we focus on retrospective assessments to estimate the risk significance of degraded conditions such as equipment failure accompanied by a deficiency in a process such as maintenance practices. In modeling such events, the basic events in the risk model that are associated with observed failures and other off-normal situations are typically configured to be failed, while those associated with observed successes and unchallenged components are assumed capable of failing, typically with their baseline probabilities. This is referred to as the failure memory approach to event assessment. The conditioning of common-cause failure probabilities for the common cause component group associated with the observed component failure is particularly important, as it is insufficient to simply leave these probabilities at their baseline values, and doing so may result in a significant underestimate of risk significance for the event. Past work in this area has focused on the mathematics of the adjustment. In this paper, we review the Basic Parameter Model for common-cause failure, which underlies most current risk modelling, discuss the limitations of this model with respect to event assessment, and introduce a proposed new framework for common-cause failure, which uses a Bayesian network to model underlying causes of failure, and which has the potential to overcome the limitations of the Basic Parameter Model with respect to event assessment.

  13. Clinical Assessment of the Efficiency of Low Level Laser Therapy in the Treatment of Oral Lichen Planus

    Directory of Open Access Journals (Sweden)

    Hanaa M. Elshenawy

    2015-10-01

    Full Text Available BACKGROUND: Oral lichen planus (OLP is a chronic inflammatory disease of the oral mucosa of uncertain etiology. AIM: To evaluate the effect of using low level laser therapy (LLLT (970 nm Siro laser Advance for the treatment of symptomatic (OLP. SUBJECTS AND METHODS: The present study was conducted on ten patients suffering from persistent oral lichen planus (OLP.Patients were treated with diode laser (970nm for the symptomatic relief of pain and burning sensation. The patients were assessed before, during and after the completion of the laser treatment which was done twice weekly for two successive months with maximum of ten sessions. The assessment was performed using visual analogue scale (VAS and clinical investigation for each patient. RESULTS: Detailed significant reduction in lesion size and showed complete remission of burning sensation and pain. No reported complications or therapy side effects were observed in any of the treated patients. CONCLUSION: Diode laser therapy seems to be an effective adjunctive treatment modality for relieving pain and clinical symptoms of OLP.

  14. Assessing and optimizing health-related quality of life during and after cancer treatment in adolescents and young adults

    Directory of Open Access Journals (Sweden)

    Szalda D

    2014-12-01

    Full Text Available Dava Szalda,1 Esther Kim,2 Jill P Ginsberg1,2 1Division of Oncology, The Children's Hospital of Philadelphia, 2Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA Abstract: Adolescent and young adults (AYAs with cancer have needs unique from their pediatric or adult counterparts at diagnosis, during treatment, and throughout survivorship care. Healthcare teams may find it difficult to assess and manage the complex psychosocial needs of AYA patients, however, attention to the multi-faceted care of the AYA oncology patient may directly affect health outcomes and quality of life. Comprehensive AYA care therefore must be maximized during treatment and in transition to survivorship care by including assessments of general health, sexual health, mental health, health behaviors, and conversations concerning transition to survivorship and adulthood with AYA patients. Identifying and treating issues that arise in the AYA population may help promote adherence to treatment, engagement in follow-up care, and ultimately quality of life for this unique group of patients. Keywords: quality of life, sexual health, health behaviors, mental health, transition, survivorship

  15. Cancer immunotherapy and immune-related response assessment: The role of radiologists in the new arena of cancer treatment

    Energy Technology Data Exchange (ETDEWEB)

    Nishino, Mizuki, E-mail: Mizuki_Nishino@DFCI.HARVARD.EDU [Department of Radiology, Brigham and Women' s Hospital and Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02215 (United States); Tirumani, Sree H.; Ramaiya, Nikhil H. [Department of Radiology, Brigham and Women' s Hospital and Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02215 (United States); Hodi, F. Stephen [Department of Medical Oncology and Department of Medicine, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, 450 Brookline Ave., Boston, MA 02215 (United States)

    2015-07-15

    Highlights: • The successful clinical application of cancer immunotherapy has opened a new arena for the treatment of advanced cancers. • Cancer immunotherapy is associated with a variety of important radiographic features in the assessments of tumor response and immune-related adverse events. • The state-of-the art knowledge of immunotherapy and the related radiologic manifestations are essential for radiologists. - Abstract: The recent advances in the clinical application of anti-cancer immunotherapeutic agents have opened a new arena for the treatment of advanced cancers. Cancer immunotherapy is associated with a variety of important radiographic features in the assessments of tumor response and immune-related adverse events, which calls for radiologists’ awareness and in-depth knowledge on the topic. This article will provide the state-of-the art review and perspectives of cancer immunotherapy, including its molecular mechanisms, the strategies for immune-related response assessment on imaging and their pitfalls, and the emerging knowledge of radiologic manifestations of immune-related adverse events. The cutting edge clinical and radiologic investigations are presented to provide future directions.

  16. Cancer immunotherapy and immune-related response assessment: The role of radiologists in the new arena of cancer treatment

    International Nuclear Information System (INIS)

    Highlights: • The successful clinical application of cancer immunotherapy has opened a new arena for the treatment of advanced cancers. • Cancer immunotherapy is associated with a variety of important radiographic features in the assessments of tumor response and immune-related adverse events. • The state-of-the art knowledge of immunotherapy and the related radiologic manifestations are essential for radiologists. - Abstract: The recent advances in the clinical application of anti-cancer immunotherapeutic agents have opened a new arena for the treatment of advanced cancers. Cancer immunotherapy is associated with a variety of important radiographic features in the assessments of tumor response and immune-related adverse events, which calls for radiologists’ awareness and in-depth knowledge on the topic. This article will provide the state-of-the art review and perspectives of cancer immunotherapy, including its molecular mechanisms, the strategies for immune-related response assessment on imaging and their pitfalls, and the emerging knowledge of radiologic manifestations of immune-related adverse events. The cutting edge clinical and radiologic investigations are presented to provide future directions

  17. Feasibility assessment of using oxygen-enhanced magnetic resonance imaging for evaluating the effect of pharmacological treatment in COPD

    Energy Technology Data Exchange (ETDEWEB)

    Morgan, Alexandra R., E-mail: alex.morgan@bioxydyn.com [Bioxydyn Ltd, Manchester (United Kingdom); Centre for Imaging Sciences and Biomedical Imaging Institute, Manchester Academic Health Sciences Centre, University of Manchester, Manchester (United Kingdom); Parker, Geoff J.M.; Roberts, Caleb [Bioxydyn Ltd, Manchester (United Kingdom); Centre for Imaging Sciences and Biomedical Imaging Institute, Manchester Academic Health Sciences Centre, University of Manchester, Manchester (United Kingdom); Buonaccorsi, Giovanni A.; Maguire, Niall C. [Bioxydyn Ltd, Manchester (United Kingdom); Hubbard Cristinacce, Penny L. [Centre for Imaging Sciences and Biomedical Imaging Institute, Manchester Academic Health Sciences Centre, University of Manchester, Manchester (United Kingdom); Singh, Dave; Vestbo, Jørgen [University of Manchester, Medicines Evaluation Unit, Manchester Academic Health Sciences Centre, University Hospital of South Manchester, Manchester (United Kingdom); Bjermer, Leif [Department of Respiratory Medicine and Allergology, Skåne University Hospital, Lund (Sweden); Jögi, Jonas [Department of Clinical Physiology, Skåne University Hospital and Lund University, Lund (Sweden); Taib, Ziad; Sarv, Janeli; Bruijnzeel, Piet L.B.; Olsson, Lars E.; Bondesson, Eva [AstraZeneca R and D, Mölndal (Sweden); Nihlén, Ulf [Department of Respiratory Medicine and Allergology, Skåne University Hospital, Lund (Sweden); AstraZeneca R and D, Mölndal (Sweden); McGrath, Deirdre M. [Centre for Imaging Sciences and Biomedical Imaging Institute, Manchester Academic Health Sciences Centre, University of Manchester, Manchester (United Kingdom); Young, Simon S. [AstraZeneca R and D, Alderley Park (United Kingdom); and others

    2014-11-15

    Highlights: • We investigate physiologic response to standard COPD treatment regimes using OE-MRI. • We assess the potential role of OE-MRI in future drug development studies. • In COPD, OE-MRI parameters showed response to single-dose formoterol. • OE-MRI parameters showed response to 8-week formoterol/budesonide treatment. • OE-MRI measurements are feasible in a small-scale multi-center trial setting. - Abstract: Objectives: Oxygen-enhanced MRI (OE-MRI) biomarkers have potential value in assessment of COPD, but need further evaluation before treatment-induced changes can be interpreted. The objective was to evaluate how OE-MRI parameters of regional ventilation and oxygen uptake respond to standard pharmacological interventions in COPD, and how the response compares to that of gold standard pulmonary function tests. Materials and methods: COPD patients (n = 40), mean FEV{sub 1} 58% predicted normal, received single-dose inhaled formoterol 9 μg, or placebo, followed by 8 weeks treatment bid with a combination of budesonide and formoterol Turbuhaler{sup ®} 320/9 μg or formoterol Turbuhaler{sup ®}. OE-MRI biomarkers were obtained, as well as X-ray computed tomography (CT) biomarkers and pulmonary function tests, in a two-center study. An ANCOVA statistical model was used to assess effect size of intervention measurable in OE-MRI parameters of lung function. Results: OE-MRI data were successfully acquired at both study sites. 8-week treatment with budesonide/formoterol significantly decreased lung wash-out time by 31% (p < 0.01), decreased the change in lung oxygen level upon breathing pure oxygen by 13% (p < 0.05) and increased oxygen extraction from the lung by 58% (p < 0.01). Single-dose formoterol increased both lung wash-out time (+47%, p < 0.05) and lung oxygenation time (+47%, p < 0.05). FEV{sub 1} was improved by single-dose formoterol (+12%, p < 0.001) and 8 weeks of budesonide/formoterol (+ 18%, p < 0.001), consistent with published studies

  18. Feasibility assessment of using oxygen-enhanced magnetic resonance imaging for evaluating the effect of pharmacological treatment in COPD

    International Nuclear Information System (INIS)

    Highlights: • We investigate physiologic response to standard COPD treatment regimes using OE-MRI. • We assess the potential role of OE-MRI in future drug development studies. • In COPD, OE-MRI parameters showed response to single-dose formoterol. • OE-MRI parameters showed response to 8-week formoterol/budesonide treatment. • OE-MRI measurements are feasible in a small-scale multi-center trial setting. - Abstract: Objectives: Oxygen-enhanced MRI (OE-MRI) biomarkers have potential value in assessment of COPD, but need further evaluation before treatment-induced changes can be interpreted. The objective was to evaluate how OE-MRI parameters of regional ventilation and oxygen uptake respond to standard pharmacological interventions in COPD, and how the response compares to that of gold standard pulmonary function tests. Materials and methods: COPD patients (n = 40), mean FEV1 58% predicted normal, received single-dose inhaled formoterol 9 μg, or placebo, followed by 8 weeks treatment bid with a combination of budesonide and formoterol Turbuhaler® 320/9 μg or formoterol Turbuhaler®. OE-MRI biomarkers were obtained, as well as X-ray computed tomography (CT) biomarkers and pulmonary function tests, in a two-center study. An ANCOVA statistical model was used to assess effect size of intervention measurable in OE-MRI parameters of lung function. Results: OE-MRI data were successfully acquired at both study sites. 8-week treatment with budesonide/formoterol significantly decreased lung wash-out time by 31% (p < 0.01), decreased the change in lung oxygen level upon breathing pure oxygen by 13% (p < 0.05) and increased oxygen extraction from the lung by 58% (p < 0.01). Single-dose formoterol increased both lung wash-out time (+47%, p < 0.05) and lung oxygenation time (+47%, p < 0.05). FEV1 was improved by single-dose formoterol (+12%, p < 0.001) and 8 weeks of budesonide/formoterol (+ 18%, p < 0.001), consistent with published studies. Conclusions: In COPD, OE

  19. Considerations for a Human Rights Impact Assessment of a Population Wide Treatment for HIV Prevention Intervention.

    Science.gov (United States)

    Hanefeld, Johanna; Bond, Virginia; Seeley, Janet; Lees, Shelley; Desmond, Nicola

    2015-12-01

    Increasing attention is being paid to the potential of anti-retroviral treatment (ART) for HIV prevention. The possibility of eliminating HIV from a population through a universal test and treat intervention, where all people within a population are tested for HIV and all positive people immediately initiated on ART, as part of a wider prevention intervention, was first proposed in 2009. Several clinical trials testing this idea are now in inception phase. An intervention which relies on universally testing the entire population for HIV will pose challenges to human rights, including obtaining genuine consent to testing and treatment. It also requires a context in which people can live free from fear of stigma, discrimination and violence, and can access services they require. These challenges are distinct from the field of medical ethics which has traditionally governed clinical trials and focuses primarily on patient researcher relationship. This paper sets out the potential impact of a population wide treatment as prevention intervention on human rights. It identifies five human right principles of particular relevance: participation, accountability, the right to health, non-discrimination and equality, and consent and confidentiality. The paper proposes that explicit attention to human rights can strengthen a treatment as prevention intervention, contribute to mediating likely health systems challenges and offer insights on how to reach all sections of the population. PMID:26524615

  20. Assessing quality of nursing care as a confounding variable in an outcome study on neurodevelopmental treatment

    NARCIS (Netherlands)

    Hafsteinsdottir, Thora B.; Kruitwagen, Cas; Strijker, Karin; van der Weide, Lies; Grypdonck, Maria H. F.

    2007-01-01

    When planning a study measuring the effects of a neurodevelopmental treatment (NDT), we were confronted with the methodological problem that while measuring the effects of NDT, a rival hypothesis is that the decision to implement the NDT might be related to the quality of nursing care. Therefore, we

  1. Environmental Assessment Offsite Thermal Treatment of Low-Level Mixed Waste

    Energy Technology Data Exchange (ETDEWEB)

    N/A

    1999-05-06

    The U.S. Department of Energy (DOE), Richland Operations Office (RL) needs to demonstrate the economics and feasibility of offsite commercial treatment of contact-handled low-level mixed waste (LLMW), containing polychlorinated biphenyls (PCBS) and other organics, to meet existing regulatory standards for eventual disposal.

  2. A practical approach to assess clinical planning tradeoffs in the design of individualized IMRT treatment plans.

    NARCIS (Netherlands)

    Monshouwer, R.; Hoffmann, A.L.; Kunze-Busch, M.C.; Bussink, J.; Kaanders, J.H.A.M.; Huizenga, H.

    2010-01-01

    BACKGROUND AND PURPOSE: To investigate the tradeoffs between organ at risk sparing and tumour coverage for IMRT treatment of lung tumours, and to develop a tool for clinical use to graphically represent these tradeoffs. MATERIAL AND METHODS: For 5 patients with inoperable non-small cell lung cancer

  3. Assessment and Treatment of Insomnia in Adults: A Guide for Clinicians

    Science.gov (United States)

    Milner, Catherine E.; Belicki, Kathryn

    2010-01-01

    Insomnia leads to disrupted sleep and daytime fatigue. Many people who have this disorder look to the medical profession for treatment; however, it has been demonstrated that psychological approaches are usually more efficacious over the long term. Furthermore, such interventions are safe, cost effective, brief, and do not require extensive…

  4. Environmental and cost life cycle assessment of disinfection options for municipal wastewater treatment

    Science.gov (United States)

    This document summarizes the data collection, analysis, and results for a base case wastewater treatment (WWT) plant reference model. The base case is modeled after the Metropolitan Sewer District of Greater Cincinnati (MSDGC) Mill Creek Plant. The plant has an activated sludge s...

  5. The Acoustic Voice Quality Index: Toward Improved Treatment Outcomes Assessment in Voice Disorders

    Science.gov (United States)

    Maryn, Youri; De Bodt, Marc; Roy, Nelson

    2010-01-01

    Voice practitioners require an objective index of dysphonia severity as a means to reliably track treatment outcomes. To ensure ecological validity however, such a measure should survey both sustained vowels and continuous speech. In an earlier study, a multivariate acoustic model referred to as the Acoustic Voice Quality Index (AVQI), consisting…

  6. Water treatment system for utilities: Phase 1 -- Technology assessment. Interim report

    International Nuclear Information System (INIS)

    A conceptual design for a water treatment system to reduce pollutants in manhole and vault water is presented as an alternative to current water disposal practices. Runoff and groundwater seepage that collects in vaults and manholes contains, or is likely to contain, concentrations of pollutants in excess of regulatory guidelines. Pollutants commonly present in storm water runoff consist of lead, cadmium, oil, grease and asbestos. The conceptual design presents the basis for a water treatment system that will reduce pollutant concentrations to levels below regulatory thresholds. The water treatment system is relatively inexpensive, small and simple to operate. A strainer is used to remove gross particulates, which are then stored for disposal. Utilizing centrifugal force, vault and manhole water is separated into constituent fractions including fine particulates, inorganics and oils. Fine particulates are stored with gross particulates for disposal. Chemical fixation is used to stabilize inorganics. Organic substances are stored for disposal. The water treatment system uses a granular activated carbon filter as an effluent polish to adsorb the remaining pollutants from the effluent water stream. The water can be discharged to the street or storm drain and the pollutants are stored for disposal as non-hazardous waste. This system represents a method to reduce pollutant volumes, reduced disposal costs and reduce corporate environmental liability. It should be noted that the initial phase of the development process is still in progress. This report is presented to reflect work in progress and as such should be considered preliminary

  7. HABITAT QUALITY ASSESSMENT OF TWO WETLAND TREATMENT SYSTEMS IN THE ARID WEST A PILOT STUDY

    Science.gov (United States)

    The use of wetland treatment systems (WTS) for treating municipal wastewater is increasing in the United States, but little is known about the ability of these systems to duplicate or sustain wetland functions. his pilot study was designed to examine methods and the usefulness of...

  8. HABITAT QUALITY ASSESSMENT OF TWO WETLAND TREATMENT SYSTEMS IN MISSISSIPPI - A PILOT STUDY

    Science.gov (United States)

    The use of wetland treatment systems (WTS), or constructed wetlands, for treating municipal wastewater is increasing in the United States, but little is known about the ability of these systems to duplicate or sustain wetland functions. he pilot study was designed to examine meth...

  9. HABITAT QUALITY ASSESSMENT OF TWO WETLAND TREATMENT SYSTEMS IN FLORIDA - A PILOT STUDY

    Science.gov (United States)

    The use of constructed wetland treatment systems (WTS) for treating municipal wastewater is increasing in the United States, but little documentation exists concerning the ability of these systems to duplicate or sustain wetland functions. ilot study was designed primarily to exa...

  10. Assessment and Treatment of Anorexia Nervosa and Bulimia in School Age Children.

    Science.gov (United States)

    Peters, Carole; And Others

    1984-01-01

    Anorexia nervosa and bulimia are major concerns for high school students, especially females. These syndromes interfere with normal functioning and social development and can be life-threatening. Definitions, characteristics, symptoms, and treatment approaches for these two eating disorders are discussed, and suggestions for involvement of the…

  11. Practice parameter for the assessment and treatment of children and adolescents with tic disorders.

    Science.gov (United States)

    Murphy, Tanya K; Lewin, Adam B; Storch, Eric A; Stock, Saundra

    2013-12-01

    Tic disorders, including Tourette's disorder, present with a wide range of symptom severity and associated comorbidity. This Practice Parameter reviews the evidence from research and clinical experience in the evaluation and treatment of pediatric tic disorders. Recommendations are provided for a comprehensive evaluation to include common comorbid disorders and for a hierarchical approach to multimodal interventions. PMID:24290467

  12. Hepatocellular Carcinoma: Review of Epidemiology, Screening, Imaging Diagnosis, Response Assessment, and Treatment.

    Science.gov (United States)

    Clark, Toshimasa; Maximin, Suresh; Meier, Jeffrey; Pokharel, Sajal; Bhargava, Puneet

    2015-01-01

    Hepatocellular carcinoma is a common malignancy for which prevention, screening, diagnosis, treatment, and surveillance demand a multidisciplinary approach. Knowledge of the underlying pathophysiology as well as advances in clinical management should be employed by radiologists to effectively communicate with hepatologists, surgeons, and oncologists. In this review article, we present recent developments in the clinical management of hepatocellular carcinoma. PMID:25979220

  13. Cole–Cole Parameter Characterization of Urea and Potassium for Improving Dialysis Treatment Assessment

    DEFF Research Database (Denmark)

    Jensen, Peter Damsgaard; Meaney, Paul M.; Epstien, Neil R.;

    2012-01-01

    In this letter, we investigate the characteristics of the dielectric properties of urea and ions such as potassium and sodium, which are the principal molecules studied during dialysis treatment. The method involves measuring the electrical properties of varying concentrations of the constituent...

  14. Tobacco alkaloids reduction by casings added/enzymatic hydrolysis treatments assessed through PLSR analysis.

    Science.gov (United States)

    Lin, Shunshun; Zhang, Xiaoming; Song, Shiqing; Hayat, Khizar; Eric, Karangwa; Majeed, Hamid

    2016-03-01

    Based on encouraged development of potential reduced-exposure products (PREPs) by the US Institute of Medicine, casings (glucose and peptides) added treatments (CAT) and enzymatic (protease and xylanase) hydrolysis treatments (EHT) were developed to study their effect on alkaloids reduction in tobacco and cigarette mainstream smoke (MS) and further investigate the correlation between sensory attributes and alkaloids. Results showed that the developed treatments reduced nicotine by 14.5% and 24.4% in tobacco and cigarette MS, respectively, indicating that both CAT and EHT are potentially effective for developing lower-risk cigarettes. Sensory and electronic nose analysis confirmed the significant influence of treatments on sensory and cigarette MS components. PLSR analysis demonstrated that tobacco alkaloids were positively correlated to the off-taste, irritation and impact attributes, and negatively correlated to the aroma and softness attributes. Additionally, nicotine and anabasine from tobacco leaves positively contributed to the impact attribute, while they negatively contributed to the aroma attribute (P<0.05). Meanwhile, most alkaloids in cigarette MS positively contributed to the impact and irritation attributes (P<0.05). Hence, this study paved a way to better understand the correlation between tobacco alkaloids and sensory attributes. PMID:26739812

  15. Psychiatric treatment as anti-stigma intervention: Objective assessment of stigma by families

    Directory of Open Access Journals (Sweden)

    Amresh Shrivastava

    2014-10-01

    Full Text Available Background: Stigma related to mental illness is linked with suicide, violence, and lack of self-care, and thus should be treated as a clinical condition. For effective intervention, objective information about the impact of stigma is required in order to offer the best client-centered care. Objective: The present study seeks to answer the question of how stigma and discrimination are perceived to be experienced by their patient family members, to determine factors helpful for development of anti-stigma intervention programs. Materials and Methods: Three hundred family members of patients with schizophrenia provided their perceptions on aspects of stigma including anti-stigma interventions. There were two types of intervention strategies suggested (1 clinical measures and (2 public health measures. The predominant strategy was clinical measures which encompassed areas of availability of treatment, complete treatment, relapse prevention, and early intervention. Results: Furthermore, caregivers' emotional involvement (64.8% in treatment was seen as an important measure to reduce stigma. No social and public awareness is going to bring change in patients' lives if stigma is not addressed at an individual level in a client-centric manner. Conclusion: The responses of patient relatives clearly bring out this opinion when they suggest potential treatment components as intervention measures.

  16. [ASSESSMENT OF EFFICACY OF MELATONIN IN SURGICAL TREATMENT OF COLON TUMORS].

    Science.gov (United States)

    Pliss, M M; Sedov, V M; Fishman, M B

    2015-01-01

    Melatonin is neurohormone, which is involved in regulation of many functions of an organism, including the digestive system. Therefore the authors offered to include this hormone as a preconditioner factor in surgical treatment of colon tumors using laparotomy and laparoscopy. Preoperative application of melatonin allowed shortening the terms of postoperative period and hospital stay. PMID:26983264

  17. Photo-Fenton-like treatment of K-acid: assessment of treatability, toxicity and oxidation products.

    Science.gov (United States)

    Olmez-Hanci, Tugba; Arslan-Alaton, Idil; Gelegen, Ozlem

    2014-01-01

    Photo-Fenton-like treatment of the commercially important naphthalene sulphonate K-acid (2-naphthylamine-3,6,8-trisulphonic acid) was investigated using UV-C, UV-A and visible light irradiation. Changes in toxicity patterns were followed by the Vibrio fischeri bioassay. Rapid and complete degradation of K-acid accompanied with nearly complete oxidation and mineralization rates (>90%) were achieved for all studied irradiation types. On the other hand, detoxification was rather limited and did not change significantly during photo-Fenton-like treatment. Several oxidation products could be identified via liquid chromatograph-mass spectrometer analyses, such as desulphonated and hydroxylated naphthalene derivatives, quinones, and ring-opening as well as dimerization products. Photo-Fenton-like treatment of K-acid with UV-C, UV-A and visible light irradiation occurred through a series of hydroxylation and desulphonation reactions, followed by ring cleavage. A common degradation pathway for photo-Fenton-like treatment of K-acid using different irradiation types was proposed. PMID:25259495

  18. Violence risk assessment and psychological treatment in correctional and forensic settings: Advances in research and practice.

    Science.gov (United States)

    Magaletta, Philip R; VandenBos, Gary R

    2016-08-01

    This article is an introduction to the special section "Correctional and Criminal Justice Psychology." The eight articles in this issue advance the goals of delivering and assessing psychological services within the legal and correctional systems and achieving lasting change in individuals, groups, and systems. (PsycINFO Database Record PMID:27504641

  19. Assessment and Treatment of Aggressive Behavior without a Clear Social Function

    Science.gov (United States)

    Ringdahl, Joel E.; Call, Nathan A.; Mews, Jayme B.; Boelter, Eric W.; Christensen, Tory J.

    2008-01-01

    We conducted functional analyses of two individuals' aggressive behavior. Results of each of the initial functional analyses were inconclusive with respect to the role of social reinforcers in the maintenance of the behavior. Further assessment was conducted to clarify the role of social reinforcers. One individual's results suggested social…

  20. Tridimensional assessment of adductor spasmodic dysphonia pre- and post-treatment with Botulinum toxin

    NARCIS (Netherlands)

    Dejonckere, P. H.; Neumann, K. J.; Moerman, M. B. J.; Giordano, A.; Manfredi, C.; Martens, J.P.

    2012-01-01

    Spasmodic dysphonia voices form, in the same way as substitution voices, a particular category of dysphonia that seems not suited for a standardized basic multidimensional assessment protocol, like the one proposed by the European Laryngological Society. Thirty-three exhaustive analyses were perform

  1. Brief Trauma and Mental Health Assessments for Female Offenders in Addiction Treatment

    Science.gov (United States)

    Rowan-Szal, Grace A.; Joe, George W.; Bartholomew, Norma G.; Pankow, Jennifer; Simpson, D. Dwayne

    2012-01-01

    Increasing numbers of women in prison raise concerns about gender-specific problems and needs severity. Female offenders report higher trauma as well as mental and medical health complications than males, but large inmate populations and limited resources create challenges in administering proper diagnostic screening and assessments. This study…

  2. Brief Antecedent Assessment and Treatment of Tics in the General Education Classroom: A Preliminary Investigation

    Science.gov (United States)

    Watson, T.; Dufrene, Brad; Weaver, Adam; Butler, Tonya; Meeks, Caroline

    2005-01-01

    The purpose of this study was to determine if specific classroom antecedents were associated with motor and vocal tics in two males diagnosed with Tourette's syndrome. A functional assessment consisting of teacher and student interviews, direct observations, brief functional analysis, and confirmatory naturalistic observations indicated that…

  3. Virtual Reality Cue Reactivity Assessment: A Comparison of Treatment- vs. Nontreatment-Seeking Smokers

    Science.gov (United States)

    Bordnick, Patrick S.; Yoon, Jin H.; Kaganoff, Eili; Carter, Brian

    2013-01-01

    Objectives: The cue-reactivity paradigm has been widely used to assess craving among cigarette smokers. Seeking to replicate and expand on previous virtual reality (VR) nicotine cue-reactivity research on nontreatment-seeking smokers, the current study compared subjective reports of craving for cigarettes when exposed to smoking (proximal and…

  4. Diagnostic Assessment and Treatment of Reading Difficulties: A Case Study of Dyslexia

    Science.gov (United States)

    Oviedo, Paula Outon; Gonzalez, Rebeca Abal

    2013-01-01

    Dyslexia is a specific learning disability in reading and writing, which requires adequate early intervention to prevent future school failure. We describe the diagnostic assessment of a 7-year-old boy labelled "dyslexic", the evaluation of his family, social, medical, developmental, and academic status as a preliminary for the design and…

  5. Eating Disorders of the Adolescent: Current Issues in Etiology, Assessment, and Treatment.

    Science.gov (United States)

    Phelps, LeAdelle; Bajorek, Ellen

    1991-01-01

    Literature on the prevalence, symptomatology, and etiology of anorexia nervosa and bulimia in adolescents is reviewed. The school psychologist is in an essential position to help the adolescent and family. Assessment, consultation, and intervention strategies are discussed for the school psychologist, and psychological and pharmacological…

  6. Consensus for tinnitus patient assessment and treatment outcome measurement : Tinnitus Research Initiative meeting, Regensburg, July 2006

    NARCIS (Netherlands)

    Langguth, B.; Goodey, R.; Azevedo, A.; Bjorne, A.; Cacace, A.; Crocetti, A.; Del Bo, L.; De Ridder, D.; Diges, I.; Elbert, T.; Flor, H.; Herraiz, C.; Ganz Sanchez, T.; Eichhammer, P.; Figueiredo, R.; Hajak, G.; Kleinjung, T.; Landgrebe, M.; Londero, A.; Lainez, M. J. A.; Mazzoli, M.; Meikle, M. B.; Melcher, J.; Rauschecker, J. P.; Sand, P. G.; Struve, M.; Van de Heyning, P.; Van Dijk, P.; Vergara, R.; Langguth, B; Hajak, G; Kleinjung, T; Cacace, A; Moller, AR

    2007-01-01

    There is widespread recognition that consistency between research centres in the ways that patients with tinnitus are assessed and outcomes following interventions are measured would facilitate more effective co-operation and more meaningful evaluations and comparisons of outcomes. At the first Tinn

  7. Radiological assessment of water treatment processes in a water treatment plant in Saudi Arabia: Water and sludge radium content, radon air concentrations and dose rates.

    Science.gov (United States)

    Al-Jaseem, Q Kh; Almasoud, Fahad I; Ababneh, Anas M; Al-Hobaib, A S

    2016-09-01

    There is an increase demand for clean water sources in Saudi Arabia and, yet, renewable water resources are very limited. This has forced the authorities to explore deep groundwater which is known to contain large concentrations of radionuclides, mainly radium isotopes. Lately, there has been an increase in the number of water treatment plants (WTPs) around the country. In this study, a radiological assessment of a WTP in Saudi Arabia was performed. Raw water was found to have total radium activity of 0.23Bq/L, which exceeds the international limit of 0.185Bq/L (5pCi/L). The WTP investigated uses three stages of treatment: flocculation/sedimentation, sand filtration and reverse osmosis. The radium removal efficiency was evaluated for each stage and the respective values were 33%, 22% and 98%. Moreover, the activity of radium in the solid waste generated from the WTP in the sedimentation and sand filtrations stages were measured and found to be 4490 and 6750Bq/kg, respectively, which exceed the national limit of 1000Bq/kg for radioactive waste. A radiological assessment of the air inside the WTP was also performed by measuring the radon concentrations and dose rates and were found in the ranges of 2-18Bq/m(3) and 70-1000nSv/h, respectively. The annual effective dose was calculated and the average values was found to be 0.3mSv which is below the 1mSv limit. PMID:27169731

  8. Assessment of the Efficacy of Cardio-Metabolic Pathology Treatment and of the Medical Recommendations Adherence in a Military Population

    Directory of Open Access Journals (Sweden)

    Lăcrămioara Ana MOLDOVAN

    2008-12-01

    Full Text Available Aim: To assess the efficacy of cardio-metabolic diseases treatment, the compliance to treatment, and to evaluate the obtained results compared to the previous published ones.Methods: A screening was conducted in the military population, including male and female with age at least 20 years, with of without: diabetes, impaired fasting glucose, obesity, hypertension, dyslipidemia. The anthropometrics parameters, body fat percent, and blood pressure were evaluated. The following data were collected: glycemia, lipid profile, renal and hepatic function, level of physical activity, smoking status, personal associated diseases. The compliance to treatment was noted in percentages declared by patient in a survey. The IRIS 2 score of insulin resistance and cardiovascular risk using EURO’98 charts, Framingham Score and SCORE system were calculated. The metabolic syndrome diagnosis was performed using the International Diabetes Federation 2005 criteria. Results: 338 persons were investigated; the majority were males, 192 with normal glycemia. The objectives of the treatment were reached in < 50% cases for each pathological aspect. A negative correlation was found between anthropometric parameters and the compliance to diet and physical exercise, and positive correlation between bodyweight, high cardiovascular risk and medication. The study showed the same pattern of the treatment as in other studies, with a low compliance to medical nutrition therapy and with low percentage in witch the objective for cardio-metabolic pathology are reached. Conclusions: An active and sustained attitude is necessary to promote a healthy lifestyle in the respect of improvement of treatment and prevention of metabolic and cardiovascular morbidity and mortality.

  9. Isokinetic muscle assessment after treatment of pectoralis major muscle rupture using surgical or non-surgical procedures

    Directory of Open Access Journals (Sweden)

    Anna Maria Fleury

    2011-01-01

    Full Text Available INTRODUCTION: Rupture of the pectoralis major muscle appears to be increasing in athletes. However, the optimal treatment strategy has not yet been established. OBJECTIVES: To compare the isokinetic shoulder performance after surgical treatment to that after non-surgical treatment for pectoralis major muscle rupture. METHODS: We assessed 33 pectoralis major muscle ruptures (18 treated non-surgically and 15 treated surgically. Horizontal abduction and adduction as well as external and internal rotation at 60 and 120 degrees/s were tested in both upper limbs. Peak torque, total work, contralateral deficiency, and the peak torque agonist-to-antagonist ratio were measured. RESULTS: Contralateral muscular deficiency did not differ between the surgical and non-surgical treatment modalities. However, the surgical group presented twice the number of athletes with clinically acceptable contralateral deficiency (<20% for internal rotators compared to the non-surgical group. The peak torque ratio between the external and internal rotator muscles revealed a similar deficit of the external rotation in both groups and on both sides (surgical, 61.60% and 57.80% and non-surgical, 62.06% and 54.06%, for the dominant and non-dominant sides, respectively. The peak torque ratio revealed that the horizontal adduction muscles on the injured side showed similar weakness in both groups (surgical, 86.27%; non-surgical, 98.61%. CONCLUSIONS: This study included the largest single series of athletes reported to date for this type of injury. A comparative analysis of muscular strength and balance showed no differences between the treatment modalities for pectoralis major muscle rupture. However, the number of significant clinical deficiencies was lower in the surgical group than in the non-surgical group, and both treatment modalities require greater attention to the rehabilitation process, especially for the recovery of muscle strength and balance.

  10. Welding fumes - assessment of gas treatment equipment; Fumees de soudage - evaluation des equipements de traitement des gaz

    Energy Technology Data Exchange (ETDEWEB)

    Marsteau, St. [Institut National de Recherche et de Securite (INRS), 75 - Paris (France)

    2007-03-15

    Arc welding produces pollutant particle and gas emissions. Whilst many studies have permitted analysis of the particle phase composition, improvement of its collection and assessment of its filtration efficiency, there has been little research into gas emission treatment. However, purification equipment manufacturers now incorporate an active charcoal stage for this purpose. INRS has conducted a study to establish a state-of-the-art review of proposed gas purification solutions and assess their performance characteristics. Analysis of the supplier offer revealed that only carbon adsorbents are currently offered; Tests performed on two media and on representative equipment showed that adsorbent implementation was in fact unsuited to the gaseous pollutants emitted by welding processes. (authors)

  11. Developing Guidelines on the Assessment and Treatment of Delirium in Older Adults at the End of Life

    OpenAIRE

    Brajtman, Susan; Wright, David; Hogan, David B.; Allard, Pierre; Bruto, Venera; Burne, Deborah; Gage, Laura; Pierre R Gagnon; Sadowski, Cheryl A; Helsdingen, Sherri; Wilson, Kimberley

    2011-01-01

    Background and Purpose Delirium at the end of life is common and can have serious consequences on an older person’s quality of life and death. In spite of the importance of detecting, diagnosing, and managing delirium at the end of life, comprehensive clinical practice guidelines (CPG) are lacking. Our objective was to develop CPG for the assessment and treatment of delirium that would be applicable to seniors receiving end-of-life care in diverse settings. Methods Using as a starting point t...

  12. Weekly assessment of worry: an adaptation of the Penn State Worry Questionnaire for monitoring changes during treatment

    OpenAIRE

    Stoeber, Joachim; Bittencourt, Jussara

    1998-01-01

    An adaptation of the Penn State Worry Questionnaire (PSWQ) [Meyer, T. J., Miller, M. L., Metzger, R. L. and Borkovec, T. D. (1990). Development and validation of the Penn State Worry Questionnaire. Behaviour Research and Therapy, 28, 487-495.] for weekly assessment of worry was evaluated in a brief treatment study. Cognitive restructuring techniques were taught to 28 nonclinical high-worriers, 14 of whom served as a control group in a lagged waiting-list design. Results showed that the Penn S...

  13. Assessment of Response to Lithium Maintenance Treatment in Bipolar Disorder: A Consortium on Lithium Genetics (ConLiGen Report.

    Directory of Open Access Journals (Sweden)

    Mirko Manchia

    Full Text Available The assessment of response to lithium maintenance treatment in bipolar disorder (BD is complicated by variable length of treatment, unpredictable clinical course, and often inconsistent compliance. Prospective and retrospective methods of assessment of lithium response have been proposed in the literature. In this study we report the key phenotypic measures of the "Retrospective Criteria of Long-Term Treatment Response in Research Subjects with Bipolar Disorder" scale currently used in the Consortium on Lithium Genetics (ConLiGen study.Twenty-nine ConLiGen sites took part in a two-stage case-vignette rating procedure to examine inter-rater agreement [Kappa (κ] and reliability [intra-class correlation coefficient (ICC] of lithium response. Annotated first-round vignettes and rating guidelines were circulated to expert research clinicians for training purposes between the two stages. Further, we analyzed the distributional properties of the treatment response scores available for 1,308 patients using mixture modeling.Substantial and moderate agreement was shown across sites in the first and second sets of vignettes (κ = 0.66 and κ = 0.54, respectively, without significant improvement from training. However, definition of response using the A score as a quantitative trait and selecting cases with B criteria of 4 or less showed an improvement between the two stages (ICC1 = 0.71 and ICC2 = 0.75, respectively. Mixture modeling of score distribution indicated three subpopulations (full responders, partial responders, non responders.We identified two definitions of lithium response, one dichotomous and the other continuous, with moderate to substantial inter-rater agreement and reliability. Accurate phenotypic measurement of lithium response is crucial for the ongoing ConLiGen pharmacogenomic study.

  14. ASSESSMENT OF WASTE TREATMENT AND ENERGY RECOVERY FROM DAIRY INDUSTRIAL WASTE BY ANAEROBIC DIGESTION

    Directory of Open Access Journals (Sweden)

    Richa Kothari, Virendra Kumar, and Vineet Veer Tyagi

    2011-01-01

    Full Text Available Waste treatment with simultaneous energy generation was studied in anaerobic digester using dairy industry waste (sludge, influent as substrate. No pretreatment or solid liquid separation was applied. Batch fermentation experiments were performed with three different substrates at organic pollution load (OPL under mesophilic range of temperature (30_+C. Experimental data evidence the effectiveness of waste on both the removal efficiency in terms of substrate degradation and biogas yield, particularly at higher loading rates. Among the three substrates evaluated, alternative substrates showed comparatively effective performance in comparison to conventional one. However, COD removal efficiency was also found to be effective in operated environment. The described process provides the dual benefit of waste treatment with simultaneous green energy generation in the form of biogas utilizing it as substrate.

  15. Norm assessment in water treatment systems/Pocos de Caldas-BR case

    Energy Technology Data Exchange (ETDEWEB)

    Ferreira, A.M. [Universidade Federal de Alfenas (UNIFAL), MG (Brazil); Villegas, R.A.S.; Fukuma, H.T. [Comissao Nacional de Energia Nuclear (CNEN), Rio de Janeiro, RJ (Brazil)

    2015-07-01

    NORM is the acronym used to refer to naturally occurring radioactive materials. Besides being objects of study and monitoring such materials can be used as raw material or as by-products or waste of industrial activities. Oil and gas, mining and water treatment are examples of facilities that can handle NORM. In such cases, their concentration at significant levels from the perspective of environmental and occupational radiation protection may occur. This study aims to evaluate the presence of the natural radioactive {sup 238}U and {sup 232}Th series in the treatment of city water elements Pocos de Caldas - MG (water, materials and waste). The study can serve as an indication of the necessity of a more detailed review in the locally and in the country on this radiological issue. (author)

  16. NORM assessment in water treatment systems/ Poços de Caldas –BR case

    International Nuclear Information System (INIS)

    NORM is the acronym used to refer to naturally occurring radioactive materials. Besides being objects of study and monitoring such materials can be used as raw material or as by-products or waste of industrial activities. Oil and gas, mining and water treatment are examples of facilities that can handle NORM. In such cases, their concentration at significant levels from the perspective of environmental and occupational radiation protection may occur. This study aims to evaluate the presence of the natural radioactive 238U and 232Th series in the treatment of city water elements Poços de Caldas - MG (water, materials and waste). The study can serve as an indication of the necessity of a more detailed review in the locally and in the country on this radiological issue. (authors)

  17. Comparative life cycle assessment of wastewater treatment in Denmark including sensitivity and uncertainty analysis

    DEFF Research Database (Denmark)

    Niero, Monia; Pizzol, Massimo; Gundorph Bruun, Henrik;

    2014-01-01

    Wastewater treatment has nowadays multiple functions and produces both clean effluents and sludge, which is increasingly seen as a resource rather than a waste product. Technological as well as management choices influence the performance of wastewater treatment plants (WWTPs) on the multiple...... considering system expansion to model the avoided impacts achievable in different end-of-life scenarios for sludge: combustion with energy production versus agricultural application. To account for the variability in quality of effluents and sludge, and to address the related uncertainties, Monte Carlo...... agricultural soils appear as a more sustainable alternative compared to the incineration of sludge. However, the uncertainty and sensitivity analysis showed that robust conclusions could not be drawn on the eutrophication and toxicity-related impact categories. © 2013 Elsevier Ltd. All rights reserved...

  18. Practice parameter for the assessment and treatment of children and adolescents with autism spectrum disorder.

    Science.gov (United States)

    Volkmar, Fred; Siegel, Matthew; Woodbury-Smith, Marc; King, Bryan; McCracken, James; State, Matthew

    2014-02-01

    Autism spectrum disorder is characterized by patterns of delay and deviance in the development of social, communicative, and cognitive skills that arise in the first years of life. Although frequently associated with intellectual disability, this condition is distinctive in its course, impact, and treatment. Autism spectrum disorder has a wide range of syndrome expression and its management presents particular challenges for clinicians. Individuals with an autism spectrum disorder can present for clinical care at any point in development. The multiple developmental and behavioral problems associated with this condition necessitate multidisciplinary care, coordination of services, and advocacy for individuals and their families. Early, sustained intervention and the use of multiple treatment modalities are indicated. PMID:24472258

  19. Treatment of uncertainty and developing conceptual models for environmental risk assessments and radioactive waste disposal safety cases

    Energy Technology Data Exchange (ETDEWEB)

    El-Ghonemy, Hamdi; Watts, Len; Fowler, Linda [British Nuclear Fuels plc, Environmental Risk Assessments, Risley (United Kingdom)

    2005-01-01

    The common approach to performing quantitative risk assessments in the contaminated land industry in the UK lacks a formal methodology for the treatment of the full range of uncertainties and for documenting decisions regarding the development of conceptual models and the selection of computer codes. The approach presented here represents an alternative, more detailed, and systematic approach for developing conceptual models and addressing uncertainties when undertaking contaminated land risk assessments. It is intended that the advantages of this approach are recognised by practitioners in the contaminated land industry and adopted, where appropriate, to help improve the quality of contaminated land risk assessments. The identification of features, events, and processes (FEPs) has been applied to safety assessments of deep geological and near-surface disposal of radioactive wastes. One of the primary benefits of using this approach is in the development of conceptual models. The approach identifies the FEPs that need to be addressed during the development of conceptual models and in the selection of suitable computer codes that can be used to represent the conceptual models. This approach has been applied by BNFL at the low-level radioactive waste disposal site at Drigg in Cumbria and is currently being adopted for a contaminated land study at the Sellafield site, also in Cumbria. This paper presents the advantages of using FEPs in the development of conceptual models and the treatment of uncertainties. The paper also discusses the application of this approach to contaminated land studies and provides an example to demonstrate the application of the approach. BNFL's approach at the Drigg site involves the identification of components (features) and phenomena (events and processes) that govern interactions and dependencies between the components by arranging them in a matrix format. (Author)

  20. Treatment of uncertainty and developing conceptual models for environmental risk assessments and radioactive waste disposal safety cases.

    Science.gov (United States)

    El-Ghonemy, Hamdi; Watts, Len; Fowler, Linda

    2005-01-01

    The common approach to performing quantitative risk assessments in the contaminated land industry in the UK lacks a formal methodology for the treatment of the full range of uncertainties and for documenting decisions regarding the development of conceptual models and the selection of computer codes. The approach presented here represents an alternative, more detailed, and systematic approach for developing conceptual models and addressing uncertainties when undertaking contaminated land risk assessments. It is intended that the advantages of this approach are recognised by practitioners in the contaminated land industry and adopted, where appropriate, to help improve the quality of contaminated land risk assessments. The identification of features, events, and processes (FEPs) has been applied to safety assessments of deep geological and near-surface disposal of radioactive wastes. One of the primary benefits of using this approach is in the development of conceptual models. The approach identifies the FEPs that need to be addressed during the development of conceptual models and in the selection of suitable computer codes that can be used to represent the conceptual models. This approach has been applied by BNFL at the low-level radioactive waste disposal site at Drigg in Cumbria and is currently being adopted for a contaminated land study at the Sellafield site, also in Cumbria. This paper presents the advantages of using FEPs in the development of conceptual models and the treatment of uncertainties. The paper also discusses the application of this approach to contaminated land studies and provides an example to demonstrate the application of the approach. BNFL's approach at the Drigg site involves the identification of components (features) and phenomena (events and processes) that govern interactions and dependencies between the components by arranging them in a matrix format. PMID:15607782