WorldWideScience

Sample records for assessing anticalcification treatments

  1. Combined anticalcification treatment of bovine pericardium with decellularization and hyaluronic acid derivative.

    Science.gov (United States)

    Zhu, Deyi; Jin, Liqiang; Wang, Xuemei; Xu, Li; Liu, Tianqi

    2014-01-01

    The objective of this work was to evaluate the effect of decellularization and hyaluronic acid derivative on the improvement of anticalcification of glutaraldehyde fixed bovine pericardium (GFBP) using a rat subcutaneous implantation model A cell extraction process was employed to remove the cells and cellular components from bovine pericardium (BP), leaving a framework of largely insoluble collagen. Then acellular BP was cross-linked by glutaraldehyde solution and treated with hyaluronic acid derivative (HA-ADH) which was obtained by coupling adipic dihydrazide (ADH) on-COOH of hyaluronic acid (HA). The results of in vivo calcification tests showed that the calcium content was decreased dramatically by decellularization alone (from 28.07 ± 18.87 to 2.44 ± 0.55 μg Ca/mg dry tissue after 8 weeks' implantation), and even less concentration was shown by the combination of HA derivative treatment and decellularization (GFaBP-HA group) (0.25 ± 0.08 μg Ca/mg dry tissue after 8 weeks' implantation). In addition, GFaBP-HA group not only presented a lower degree of calcification, but also showed lower ratios of Ca/P molar, which corresponded to amorphous calcium phosphates. The obtained results indicated that GFaBP-HA was a potential candidate for the manufacture of anticalcification bioprostheses.

  2. 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.

  3. Assessment and Treatment of Paraphilias.

    Science.gov (United States)

    Seligman, Linda; Hardenburg, Stephanie A.

    2000-01-01

    Provides a description of the category of mental disorders called "paraphilias" and guidelines for assessment of people who present with paraphillic behavior. Includes a review of inventories that can facilitate diagnosis and description of paraphilias. Discusses effective approaches to treatment of these disorders as well as personal and…

  4. 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. 

  5. Diagnosis, assessment, and treatment of hypersexuality.

    Science.gov (United States)

    Kaplan, Meg S; Krueger, Richard B

    2010-03-01

    This article reviews the current evidence base for the diagnosis, assessment, and treatment of hypersexual conditions. Controversy concerning this diagnosis is discussed. Terminology and diagnostic criteria, as well as psychological, psychopharmacological, and other treatment approaches, are presented.

  6. 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......, which includes technical, economic and environmental aspects. The technical and economic assessment is performed on 5 advanced treatment technologies: sand filtration, ozone treatment, UV exclusively for disinfection of pathogenic microorganisms, Membrane Bioreactor (MBR), and UV in combination...... and three advanced treatment methods: sand filtration, ozone treatment and MBR. The technical and economic assessment showed that UV solely for disinfection purposes or ozone treatment are the most advantageous advanved treatment methods if the demands are restricted to pathogenic microorganisms. In terms...

  7. Sustainability assessment of advanced wastewater treatment technologies.

    Science.gov (United States)

    Høibye, L; Clauson-Kaas, J; Wenzel, H; Larsen, H F; Jacobsen, B N; Dalgaard, O

    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, which includes technical, economical and environmental aspects. The technical and economical assessment is performed on 5 advanced treatment technologies: sand filtration, ozone treatment, UV exclusively for disinfection of pathogenic microorganisms, membrane bioreactor (MBR) and UV in combination 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 and three advanced treatment methods; sand filtration, ozone treatment and MBR. The technical and economic assessment showed that UV solely for disinfection purposes or ozone treatment is the most advantageous advanced treatment methods if the demands are restricted to pathogenic microorganisms. In terms 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.

  8. Assessing observational studies of medical treatments

    Directory of Open Access Journals (Sweden)

    Butani Yogita

    2005-09-01

    Full Text Available Abstract Background Previous studies have assessed the validity of the observational study design by comparing results of studies using this design to results from randomized controlled trials. The present study examined design features of observational studies that could have influenced these comparisons. Methods To find at least 4 observational studies that evaluated the same treatment, we reviewed meta-analyses comparing observational studies and randomized controlled trials for the assessment of medical treatments. Details critical for interpretation of these studies were abstracted and analyzed qualitatively. Results Individual articles reviewed included 61 observational studies that assessed 10 treatment comparisons evaluated in two studies comparing randomized controlled trials and observational studies. The majority of studies did not report the following information: details of primary and ancillary treatments, outcome definitions, length of follow-up, inclusion/exclusion criteria, patient characteristics relevant to prognosis or treatment response, or assessment of possible confounding. When information was reported, variations in treatment specifics, outcome definition or confounding were identified as possible causes of differences between observational studies and randomized controlled trials, and of heterogeneity in observational studies. Conclusion Reporting of observational studies of medical treatments was often inadequate to compare study designs or allow other meaningful interpretation of results. All observational studies should report details of treatment, outcome assessment, patient characteristics, and confounding assessment.

  9. Behavioral Assessment and Treatment of Pediatric Headache

    Science.gov (United States)

    Andrasik, Frank; Schwartz, Mark S.

    2006-01-01

    Headaches are quite common in children and adolescents, and they appear to persist into adulthood in a sizable number of individuals. Assessment approaches (interview, pain diaries, and general and specific questionnaires) and behavioral treatment interventions (contingency management, relaxation, biofeedback, and cognitive behavior therapy) are…

  10. Assessment and Treatment of Pain during Treatment of Buruli Ulcer.

    Directory of Open Access Journals (Sweden)

    Janine de Zeeuw

    Full Text Available Buruli ulcer (BU is described as a relatively painless condition; however clinical observations reveal that patients do experience pain during their treatment. Knowledge on current pain assessment and treatment in BU is necessary to develop and implement a future guideline on pain management in BU.A mixed methods approach was used, consisting of information retrieved from medical records on prescribed pain medication from Ghana and Benin, and semi-structured interviews with health care personnel (HCP from Ghana on pain perceptions, assessment and treatment. Medical records (n = 149 of patients treated between 2008 and 2012 were collected between November 2012 and August 2013. Interviews (n = 11 were audio-taped, transcribed verbatim and qualitatively analyzed.In 113 (84% of the 135 included records, pain medication, mostly simple analgesics, was prescribed. In 48% of the prescriptions, an indication was not documented. HCP reported that advanced BU could be painful, especially after wound care and after a skin graft. They reported not be trained in the assessment of mild pain. Pain recognition was perceived as difficult, as patients were said to suppress or to exaggerate pain, and to have different expectations regarding acceptable pain levels. HCP reported a fear of side effects of pain medication, shortage and irregularities in the supply of pain medication, and time constraints among medical doctors for pain management.Professionals perceived BU disease as potentially painful, and predominantly focused on severe pain. Our study suggests that pain in BU deserves attention and should be integrated in current treatment.

  11. [Depression in Parkinson's disease. Assessment and treatment].

    Science.gov (United States)

    Brand, S; Dodel, R; Hautzinger, M; Gründer, G; Althaus, A; Schneider, F

    2007-06-01

    With a prevalence of 40%, depression is the most frequent psychiatric diagnosis in Parkinson's disease. Quality of life in Parkinson's patients is severely restricted. There is still no clear evidence concerning the link between these disorders - findings exist that indicate common neurodegenerative processes. At the same time depression seems to develop as a dysfunctional coping reaction to the motoric, emotional, and social restrictions of Parkinson's disease. The authors point out particular features of the depressive symptom profile in patients with Parkinson's disease and recommend a step-by-step approach to assessing depression: screening, assessment by means of the ICD-10 criteria, quantitative evaluation of depressivity, and assessment of suicidality. A survey of current treatment options is provided: pharmacological, somatic, and psychological approaches are introduced and evaluated with respect to effectiveness in this special group of patients.

  12. Assessment and Treatment of Pain during Treatment of Buruli Ulcer

    Science.gov (United States)

    Barogui, Yves T.; Sopoh, Ghislain; Phillips, Richard O.; van der Werf, Tjip S.; Loth, Susanne; Molenbuur, Bouwe; Plantinga, Mirjam; Ranchor, Adelita V.; Stienstra, Ymkje

    2015-01-01

    Background Buruli ulcer (BU) is described as a relatively painless condition; however clinical observations reveal that patients do experience pain during their treatment. Knowledge on current pain assessment and treatment in BU is necessary to develop and implement a future guideline on pain management in BU. Methodology A mixed methods approach was used, consisting of information retrieved from medical records on prescribed pain medication from Ghana and Benin, and semi-structured interviews with health care personnel (HCP) from Ghana on pain perceptions, assessment and treatment. Medical records (n = 149) of patients treated between 2008 and 2012 were collected between November 2012 and August 2013. Interviews (n = 11) were audio-taped, transcribed verbatim and qualitatively analyzed. Principal Findings In 113 (84%) of the 135 included records, pain medication, mostly simple analgesics, was prescribed. In 48% of the prescriptions, an indication was not documented. HCP reported that advanced BU could be painful, especially after wound care and after a skin graft. They reported not be trained in the assessment of mild pain. Pain recognition was perceived as difficult, as patients were said to suppress or to exaggerate pain, and to have different expectations regarding acceptable pain levels. HCP reported a fear of side effects of pain medication, shortage and irregularities in the supply of pain medication, and time constraints among medical doctors for pain management. Conclusions Professionals perceived BU disease as potentially painful, and predominantly focused on severe pain. Our study suggests that pain in BU deserves attention and should be integrated in current treatment. PMID:26402069

  13. Life cycle assessment of electronic waste treatment.

    Science.gov (United States)

    Hong, Jinglan; Shi, Wenxiao; Wang, Yutao; Chen, Wei; Li, Xiangzhi

    2015-04-01

    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. CHILD AND ADOLESCENT PSYCHOPATHY: ASSESSMENT AND TREATMENT

    Directory of Open Access Journals (Sweden)

    Lucía Halty

    2015-05-01

    Full Text Available Throughout this article we aim to defend the presence of psychopathic traits in child and adolescent population. In psychology there are two fundamental theoretical contributions to the understanding of this disorder in childhood. One focuses on the aspects of antisocial behaviour (Lynam, 1997; and the other highlights the presence of a fundamental characteristic in identifying the disorder, known as the callous unemotional trait (CU, Frick, O'Brien, Wootton & McBurnett, 1994. We also present some of the instruments that are most used in the assessment of child and adolescent psychopathy, as well as some results in the treatment of this disease.

  15. 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)

  16. Assessing efficacy of voice treatments: a guideline.

    Science.gov (United States)

    Dejonckere, P H

    2000-01-01

    The proposal of this guideline or basic protocol is an attempt to reach better agreement and uniformity concerning the methodology for functional assessment of pathological voices. The purpose is to allow relevant comparisons with the literature when presenting/publishing the results of voice treatment, e.g. a phonosurgical technique, or a new/improved instrument or procedure for investigating the pathological voice. Meta-analyses of results of voice treatments are generally limited--and even impossible--due to the major diversity in assessing functional outcomes. A minimal, multidimensional set of basic measurements is proposed, suitable for all "common" dysphonias: it includes 5 different approaches: perception (grade, roughness, breathiness), videostroboscopy (closure, regularity, mucosal wave and symmetry), acoustics (jitter, shimmer, Fo-range and softest intensity), aerodynamics (phonation quotient), and self rating by the patient. The protocol is elaborated on the base of an exhaustive review of the literature, the experience of the Committee members, and of plenary discussions within the European Laryngological Society. Instrumentation is kept to a minimum, but considered essential for professionals performing phonosurgery.

  17. Gender differences in problem severity at assessment and treatment retention.

    Science.gov (United States)

    Arfken, C L; Klein, C; di Menza, S; Schuster, C R

    2001-01-01

    Women in treatment for substance abuse have been reported to have more severe problems at assessment than men but not to differ in treatment retention. To examine gender differences in problems at assessment, 30-day retention, and treatment completion, data from Detroit's publicly funded substance abuse treatment system were used. Women had significantly more severe problems at assessment, lower 30-day retention, and lower treatment completion rates than men. These gender differences in retention remained significant even after controlling for problem severity, primary drug of abuse, and referred treatment setting. There was no evidence of improvements in women's problems at assessment or retention over time during this period. Women presented with more severe problems at assessment and were less likely to stay in treatment for 30 days or to complete treatment than men. Monitoring gender differences in problems at presentation and retention outcomes is recommended to assess local need for interventions.

  18. MODERN PRINCIPLES OF QUALITY ASSESSMENT OF CARDIOVASCULAR DISEASES TREATMENT

    Directory of Open Access Journals (Sweden)

    A. Yu. Suvorov

    2014-01-01

    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.

  19. Periodontal risk assessment, diagnosis and treatment planning.

    Science.gov (United States)

    Pihlstrom, B L

    2001-01-01

    The prevention and treatment of the periodontal diseases is based on accurate diagnosis, reduction or elimination of causative agents, risk management and correction of the harmful effects of disease. Prominent and confirmed risk factors or risk predictors for periodontitis in adults include smoking, diabetes, race, P. gingivalis, P. intermedia, low education, infrequent dental attendance and genetic influences. Several other specific periodontal bacteria, herpesviruses, increased age, male, sex, depression, race, traumatic occlusion and female osteoporosis in the presence of heavy dental calculus have been shown to be associated with loss of periodontal support and can be considered to be risk indicators of periodontitis. The presence of furcation involvement, tooth mobility, and a parafunctional habit without the use of a biteguard are associated with a poorer periodontal prognosis following periodontal therapy. An accurate diagnosis can only be made by a thorough evaluation of data that have been systematically collected by: 1) patient interview, 2) medical consultation as indicated, 3) clinical periodontal examination, 4) radiographic examination, and 5) laboratory tests as needed. Clinical signs of periodontal disease such as pocket depth, loss of clinical attachment and bone loss are cumulative measures of past disease. They do not provide the dentist with a current assessment of disease activity. In an attempt to improve the ability to predict future disease progression, several types of diagnostic tests have been studied, including host inflammatory products and mediators, enzymes, tissue breakdown products and subgingival temperature. In general, the usefulness of these tests for predicting future disease activity remains to be established in terms of sensitivity, specificity and predictive value. Although microbiological analysis of subgingival plaque is not necessary to diagnose and treat most patients with periodontitis, it is helpful when treating

  20. California Drug and Alcohol Treatment Assessment (CALDATA-1991-1993)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The California Drug and Alcohol Treatment Assessment (CALDATA) was designed to study the costs, benefits, and effectiveness of the state's alcohol and drug treatment...

  1. Sustainability assessment of advanced wastewater treatment technologies

    DEFF Research Database (Denmark)

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

    2008-01-01

    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...

  2. Intensive Stuttering Modification Therapy: A Multidimensional Assessment of Treatment Outcomes

    Science.gov (United States)

    Blomgren, Michael; Roy, Nelson; Callister, Thomas; Merrill, Ray M.

    2005-01-01

    Nineteen adults who stutter participated in a 3-week intensive stuttering modification treatment program (the Successful Stuttering Management Program [SSMP]). A series of 14 fluency and affective-based measures were assessed before treatment, immediately after treatment, and 6 months after treatment. Measures included stuttering frequency; the…

  3. Achilles tendon rupture; assessment of nonoperative treatment

    DEFF Research Database (Denmark)

    Barfod, Kristoffer Weisskirchner

    2014-01-01

    BACKGROUND: Acute Achilles tendon rupture is a frequent and potentially disabling injury. Over the past decade a change in treatment of acute Achilles tendon rupture away from operative towards non-operative treatment has taken place. However, the optimal non-operative treatment protocol remains...... and 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....

  4. Achilles tendon rupture; assessment of nonoperative treatment

    DEFF Research Database (Denmark)

    Barfod, Kristoffer Weisskirchner; Troelsen, Anders

    2014-01-01

    BACKGROUND: Acute Achilles tendon rupture is a frequent and potentially disabling injury. Over the past decade a change in treatment ofacute Achilles tendon rupture away from operative towards non-operative treatment has taken place. However, the optimal non-operative treatment protocol remains...... and 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....

  5. 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.

  6. 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...... district, Zambia. The surveys took place in December 2006 and December 2007. In addition child treatment records were reviewed. The factors that were found to be significantly associated (ptreatment of children by the CDDs were: (1) the perception of soil-transmitted helminth infections...... as having significant health importance, (2) the community-based decision to launch and subsequently implement ComDT, (3) the use of the door-to-door method of drug distribution, (4) CDDs being visited by a supervisor, (5) CDDs receiving assistance in mobilizing community members for treatment, (6) CDDs...

  7. Early assessment and treatment of myocardial infarction

    NARCIS (Netherlands)

    Hoog, V.C. de

    2015-01-01

    Although the detection and treatment of acute myocardial infarction (MI) has dramatically improved the last decades, ischemic heart disease is still a leading cause of death worldwide. Whereas mortality has declined in industrialized countries, it continues to rise in other parts of the world. There

  8. Life Cycle Assessment of Horse Manure Treatment

    Directory of Open Access Journals (Sweden)

    Ola Eriksson

    2016-11-01

    Full Text Available Horse manure consists of feces, urine, and varying amounts of various bedding materials. The management of horse manure causes environmental problems when emissions occur during the decomposition of organic material, in addition to nutrients not being recycled. The interest in horse manure undergoing anaerobic digestion and thereby producing biogas has increased with an increasing interest in biogas as a renewable fuel. This study aims to highlight the environmental impact of different treatment options for horse manure from a system perspective. The treatment methods investigated are: (1 unmanaged composting; (2 managed composting; (3 large-scale incineration in a waste-fired combined heat and power (CHP plant; (4 drying and small-scale combustion; and (5 liquid anaerobic digestion with thermal pre-treatment. Following significant data uncertainty in the survey, the results are only indicative. No clear conclusions can be drawn regarding any preference in treatment methods, with the exception of their climate impact, for which anaerobic digestion is preferred. The overall conclusion is that more research is needed to ensure the quality of future surveys, thus an overall research effort from horse management to waste management.

  9. 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.

  10. The assessment and treatment of wound pain.

    Science.gov (United States)

    Brown, Annemarie

    This article is the third in a series on wound management. Poor pain management leads to distress and can impede the healing process. This article describes the different types of pain and the psychological aspects of pain that should be taken into account when deciding on a wound-management strategy. It discusses assessment tools, along with pharmacological and non-pharmacological interventions for pain management.

  11. 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...

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

    OpenAIRE

    CORNELIA DIANA HERTIA; ANCA ELENA GURZAU; MARIA ILONA SZASZ

    2011-01-01

    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...

  13. 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...

  14. 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.

  15. Strategies for microwave thermal treatment planning, navigation, and assessment

    Science.gov (United States)

    Ryan, Thomas P.

    2011-03-01

    Thermal treatment is commonly performed interstitially in either surgical or percutaneous procedures, using microwave antenna sources at 915 or 2540 MHz. There are a number of tools or aids as well as challenges for clinicians performing these procedures in the course of patient treatment. These challenges will be present whether the procedure is surgical, laparoscopic, or percutaneous, and include treatment planning, image guidance, navigation, coregistration in 3D, and treatment assessment. Treatment planning has been used historically in hyperthermia for microwave antenna arrays, but has yet to be properly applied in thermal ablation. Image assessment of thermal treatment is not typically performed in real time, although these tools will provide the clinician with further information to understand the extent of treatment and whether further treatment is needed. 3D imaging is available, but not coregistered to patient space. Navigation has been used in many medical specialties, but is also not in the clinician's toolbox in thermal treatment. Although treatment planning will lay out the skin entry and trajectory for each antenna placed, subsequently, each antenna needs to be tracked to accurately show placement in the patient and overlaid in patient space, along with the tumor target location. Some patient treatments may consist of multiple, but sequential single placements of an antenna, and guidance is even more critical to track positions and plan for the next insertion. Lastly, real-time image assessment will show the extent and shape of the coagulated lesion and which targets may have been undertreated. If used synchronously in arrays, MW power steering may also aid in filling in the ablation as the treatment progresses. This paper will analyze the present state-of-the art as well as a strategy to incorporate the various facets of planning, guidance, and assessment of treatment. The integration of thermal treatment planning, navigation and guidance, robotics

  16. 蛋白多糖在脱细胞猪肺动脉带瓣管道中抗钙化的作用%Role of proteoglycan in anti-calcification of porcine acellular valved pulmonary artery conduits

    Institute of Scientific and Technical Information of China (English)

    郭海平; 史海峰; 李温斌; 许秀芳; 郭俊平; 靳振生; 张素玲

    2012-01-01

    AIM; To study the role of extracellular proteoglycan in anti-calcification of porcine acellular valved pulmonary conduits for trituration of better tissue-engineered pulmonary valve conduits. METHODS: Fresh porcine pulmonary valve conduits were used in Group A, acellular porcine pulmonary valve conduits in Group B and acellular deproteoglycan porcine pulmonary valve conduits in Group C. HE staining observation under light microscope, scanning electron microscopy and proteoglycan content mensuration were used. Samples were subcutaneously buried in rats for 6 weeks and then the samples extracted from rats were quantitatively analyzed for calcification using Van Kossa silver staining and qualitatively using atomic absorption photometer. RESULTS; Pathological results under optical microscopy and electron microscopy showed that porcine pulmonary artery tissue cells were well removed and collagen fibers andelastic fibers were completely maintained. Compared with Group A and Group B, proteoglycan content of extracellular matrix in Group C significantly decreased and less calcification reaction was found in Group C. Calcium content in Group C also decreased significantly. CONCLUSION; Acellular trypsin + Triton X-100 achieves cell removal. Reduction of extracellular matrix proteoglycan by hyaluronidase digestion decreases further calcification reaction of acellular porcine pulmonary valve conduits, which may provide better acellular de-matrix scaffolds for building up tissue-engineered pulmonary valve conduits.%目的:证实去除细胞外基质蛋白多糖对提高脱细胞猪肺动脉带瓣管道抗钙化性能的作用,为研制组织工程化肺动脉带瓣管道做准备.方法:实验分为3组,即A组:为新鲜猪肺动脉带瓣管道组织,B组:用胰蛋白酶+Triton X-100处理的脱细胞猪肺动脉带瓣管道组织和C组:在B组处理的基础上再经透明质酸酶消化,去除细胞外蛋白多糖基质成分的猪肺动脉带瓣管道组织,每组4份(n=4

  17. 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.

  18. 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.

  19. 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.

  20. Assessment of landfill leachate toxicity reduction after biological treatment.

    Science.gov (United States)

    Jemec, Anita; Tišler, Tatjana; Zgajnar-Gotvajn, Andreja

    2012-02-01

    In the present article, the efficiency of biological treatment of landfill leachates was evaluated by implementation of physicochemical characterisation and a complex toxicity assessment. An array of toxicity tests using bacterium Vibrio fischeri, alga Desmodesmus subspicatus, crustacean Daphnia magna, and embryo of fish Danio rerio, as well as unconventional methods using biochemical biomarkers (protein content, enzymes cholinesterase, and glutathione-S-transferase), were employed. Toxicity of leachates varied depending on the season of collection in relation to their different physicochemical characteristics. Uncommon effects of leachates on organisms, such as hormetic-like increases of algal growth and reproduction of daphnids, were identified. New approaches using the activities of enzymes were found unsuitable for routine hazard assessment of leachates. Although physicochemical parameters and toxicity decreased significantly after biological treatment, the effluents did not meet the demands of the current Slovenian legislation; thus, the existing biological treatment was found inappropriate. The development of advanced treatment techniques for landfill leachates is thus encouraged.

  1. A Review on Assessment and Treatment for Depression in Malaysia

    Directory of Open Access Journals (Sweden)

    Firdaus Mukhtar

    2011-01-01

    Full Text Available This paper aimed to review the literature on depression that focused on its assessment and treatment in Malaysia. PsycINFO, Medline, local journals were searched, and 18 published articles were included in this paper. Results indicate that research on depression in Malaysia, particularly validation studies and psychotherapy research, was weak and fragmented, with minimal empirical evidence available. Pharmacotherapy still dominated the treatment for depression, and, in terms of psychotherapy, Cognitive Behavioural Therapy (CBT was recently practiced, but only a few studies have reported on the treatment efficacy of CBT. Major limitations of studies were noted, and, consequently, the problems that are associated with the implementation and future direction of clinical and research on depression in Malaysia were discussed. In short, the contribution of empirical research on the assessment and treatment for depression remained inconsistent and fragmented and urgently in need of further empirical investigation.

  2. Assessment, management and treatment of acute fingertip injuries.

    Science.gov (United States)

    Kearney, Anthony; Canty, Louise

    2016-06-01

    Fingertip injuries with nail bed trauma can require specialist hand surgery, depending on severity. However, most of these injuries can be managed in well-equipped emergency departments by emergency nurses with an in-depth knowledge and understanding of the anatomy and physiology of the fingernail and surrounding structures, assessment and examination, pain management and treatment. This article describes the surface and underlying anatomy and physiology of the nail, the most common mechanisms of injury, relevant diagnostic investigations, and initial assessment and management. It also discusses treatment options, referral pathways, and patient discharge advice.

  3. Nutritional assessment and treatment of patients with liver cirrhosis.

    Science.gov (United States)

    Moctezuma-Velázquez, Carlos; García-Juárez, Ignacio; Soto-Solís, Rodrigo; Hernández-Cortés, Juan; Torre, Aldo

    2013-01-01

    Prevalence of chronic liver diseases, including liver cirrhosis, is increasing worldwide. The nutritional state assessment in these patients is complicated, and besides anthropometry is based on several other tools in order to be more accurate. Specific dietary recommendations are needed in patients with chronic liver diseases in order to help prevent and treat liver decompensation because malnutrition is an independent predictor of mortality. This review focuses on essential aspects in the nutritional assessment of cirrhotic patients and some general recommendations for their treatment.

  4. [Assessing environmental and economical benefits of integrated sewage treatment systems].

    Science.gov (United States)

    Li, Jin-rong; Zhang, Xiao-hong; Zhang, Hang-bin; Pan, Heng-yu; Liu, Qiang

    2015-08-01

    Sewage treatment, treated water treatment and sludge treatment are three basic units of an integrated sewage treatment system. This work assessed the influence of reusing or discharge of treated water and sludge landfill or compost on the sustainability of an integrated sewage treatment system using emergy analysis and newly proposed emergy indicators. This system's value included its environmental benefits and the products. Environmental benefits were the differences of the environmental service values before and after sewage treatment. Due to unavailability of data of the exchanged substance and energy in the internal system, products' values were attained by newly proposed substitution values. The results showed that the combination of sewage treatment, treated water reuse and sludge landfill had the strongest competitiveness, while the combination of sewage treatment, treated water reuse and earthworm compost was the most sustainable. Moreover, treated water reuse and earthworm compost were helpful for improving the sustainability of the integrated sewage treatment system. The quality of treated water and local conditions should be also considered when implementing the treated water reuse or discharge. The resources efficiency of earthworm compost unit needed to be further improved. Improved emergy indices were more suitable for integrated sewage treatment systems.

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

    Energy Technology Data Exchange (ETDEWEB)

    Byers, K.R.; Johnston, J.W.; Bennett, C.A.; Brouns, R.J.; Mullen, M.F.; Roberts, F.P.

    1983-11-01

    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.

  6. Tourette's syndrome, Part II: Contemporary approaches to assessment and treatment.

    Science.gov (United States)

    Scahill, L; Ort, S I; Hardin, M T

    1993-08-01

    Clinical assessment of a child with Tourette's syndrome (TS) includes a careful review of motor and phonic tics. In addition, commonly associated problems of such as obsessive-compulsive symptoms, or symptoms of attention deficit hyperactivity disorder (inattention, impulsiveness, and overactivity) should also be evaluated. Treatment almost always includes education of the child, family, and school personnel concerning the natural history and behavioral boundaries of the disorder. Other treatment interventions depend to a great extent on the primary source of impairment. This article, the second of two parts, presents three illustrative cases and reviews current treatment interventions for children and adolescents with TS.

  7. 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....... In total more that 20 different waste water and sludge treatment technologies are to be assessed. This paper will present the preliminary LCA results from running the induced versus avoided impact approach (mainly based on existing LCIA methodology) on one of the advanced treatment technologies, i...

  8. Contemporary Treatment of Reliability and Validity in Educational Assessment

    Science.gov (United States)

    Dimitrov, Dimiter M.

    2010-01-01

    The focus of this presidential address is on the contemporary treatment of reliability and validity in educational assessment. Highlights on reliability are provided under the classical true-score model using tools from latent trait modeling to clarify important assumptions and procedures for reliability estimation. In addition to reliability,…

  9. 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.

  10. 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.

  11. Environmental assessment of urban wastewater reuse: treatment alternatives and applications.

    Science.gov (United States)

    Meneses, Montse; Pasqualino, Jorgelina C; Castells, Francesc

    2010-09-01

    The main function of a Wastewater Treatment Plant is to minimize the environmental impact of discharging untreated water into natural water systems. Also a Wastewater Treatment Plant may get a resource from wastewater carrying out a tertiary treatment on the treated wastewater which can be reused in non-potable applications. Water reuse strategies are intended to address the problem of water scarcity without aggravating other environmental problems, thus reflecting the need of their environmental assessment. In this paper we used Life Cycle Assessment to evaluate different disinfection treatments (chlorination plus ultraviolet treatment, ozonation and ozonation plus hydrogen peroxide) and to assess the environmental advantages and drawbacks of urban wastewater reuse in non-potable applications. To do so, we compared the environmental impacts of producing 1m(3) of water for non-potable uses from reclaimed water, potable water and desalinated water sources. The calculation has used current operating data from a Wastewater Treatment Plant located in the Mediterranean area, although the results can be applied to any other plant with similar technology. The ozonation and ozonation plus hydrogen peroxide disinfection treatment technologies have similar environmental profiles. However most of the indicators are about 50% higher than the ultraviolet disinfection except for the acidification (100% higher) and photochemical oxidation (less than 5%). Non-potable uses (both agricultural and urban uses) of reclaimed water have environmental and economical advantages. Reuse of treated wastewater is particularly beneficial when it can replace desalinated water. Consequently, reclaimed water should be promoted for non-potable uses, when there is scarcity of freshwater.

  12. 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.

  13. Life Cycle Assessment of Waste Water Treatment Plants in Ireland

    Directory of Open Access Journals (Sweden)

    Greg Mcnamara

    2016-09-01

      The Urban Wastewater Treatment Directive 91/271/EEC introduced a series of measures for the purpose of protecting the environment from the adverse effects of effluent discharge from wastewater treatment plants.  There are environmental costs associated with attaining the required level of water quality set out in the directive such as greenhouse gas emissions due to energy production, and ecotoxicity from sludge application to land.  The goal of this study is to assess the environmental costs in an Irish context, focusing specifically on the effects of variation in scale and discharge limitation. Life cycle assessment is the analytical tool used to evaluate the environmental impact.  The life cycle impact assessment methodology developed by the Centre of Environmental Science, Leiden University (2010 has been adopted and implemented using GaBi 6.0 life cycle assessment software.  Two plants of varying size and location were chosen for the study. The study found that energy consumption and sludge application to land are the largest contributors to the overall environmental impact associated with the treatment process at both plants.  Economies of scale were observed in energy usage during secondary aeration.   

  14. 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.

  15. 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.

  16. Therapists' assessment and treatment of internet infidelity cases.

    Science.gov (United States)

    Hertlein, Katherine M; Piercy, Fred P

    2008-10-01

    In this study, we investigated through an Internet survey of 508 practicing marriage and family therapists which treatment decisions varied by gender of the client and background variables of therapists. The subjects responded to several typical Internet infidelity scenarios. We varied the gender of the person initiating the infidelity for half of one sample. We also asked the family therapy participants to respond to how they might assess and treat each presenting problem. They also evaluated problem severity, prognosis of the case, number of sessions necessary for treatment, and the extent to which a therapist would focus individually or relationally. Results indicate that there were differences in how therapists assessed and treated clients based on client gender, therapists' age, therapists' gender, how religious therapists reported they were, and the extent of therapists' personal experience with infidelity.

  17. Juvenile Dermatomyositis: New Developments in Pathogenesis, Assessment and Treatment

    OpenAIRE

    2009-01-01

    Juvenile dermatomyositis (JDM) is a rare, potentially life-threatening systemic autoimmune disease primarily affecting muscle and skin. Recent advances in the recognition, standardised assessment and treatment of JDM have been greatly facilitated by large collaborative research networks. Through these networks, a number of immunogenetic risk factors have now been defined, as well as a number of potential pathways identified in the aetio-pathogenesis of JDM. Myositis-associated and myositis-sp...

  18. Assessment and treatment of dizzy patients in primary health care.

    OpenAIRE

    Ekvall-Hansson, Eva

    2006-01-01

    Dizziness is a common reason for visits to primary health care, especially among elderly patients. From a physiotherapeutic perspective, this thesis aims to study the assessment and treatment of dizzy patients in primary health care. Interventions in papers I, III and IV comprised a vestibular rehabilitation programme. In paper I, patients with multisensory dizziness were randomized to intervention group or control group. At follow-up after six weeks and three months, the intervention ...

  19. Secondary negative symptoms - A review of mechanisms, assessment and treatment.

    Science.gov (United States)

    Kirschner, Matthias; Aleman, André; Kaiser, Stefan

    2016-05-23

    Negative symptoms in schizophrenia may be classified as primary or secondary. Primary negative symptoms are thought to be intrinsic to schizophrenia, while secondary negative symptoms are caused by positive symptoms, depression, medication side-effects, social deprivation or substance abuse. Most of the research on secondary negative symptoms has aimed at ruling them out in order to isolate primary negative symptoms. However, secondary negative symptoms are common and can have a major impact on patient-relevant outcomes. Therefore, the assessment and treatment of secondary negative symptoms are clinically relevant. Furthermore, understanding the mechanisms underlying secondary negative symptoms can contribute to an integrated model of negative symptoms. In this review we provide an overview of concepts, evidence, assessment and treatment for the major causes of secondary negative symptoms. We also summarize neuroimaging research relevant to secondary negative symptoms. We emphasize the relevance of recent developments in psychopathological assessment of negative symptoms, such as the distinction between amotivation and diminished expression, which have only rarely been applied in research on secondary negative symptoms.

  20. Assessment and treatment of eating disorders in children and adolescents.

    Science.gov (United States)

    Mairs, Rebecca; Nicholls, Dasha

    2016-12-01

    Feeding and eating disorders (FEDs) are serious mental health disorders that cause impairments in physical health, development, cognition and psychosocial function and can go undetected for months or years. They are characterised by disturbed eating behaviour associated with concerns about weight and shape or by disinterest in food, phobic avoidance or avoidance due to sensory aspects of food. Restrictive forms of FEDs lead to significant weight loss requiring intervention. Without specific knowledge of these conditions, they can evade detection, delaying time to diagnosis and treatment and potentially influencing outcome. This review article focuses on the key factors involved in the psychiatric assessment and treatment of four feeding or eating disorders (EDs): anorexia nervosa, avoidant-restrictive food intake disorder, bulimia nervosa and binge eating disorder. They have been chosen for discussion as they are most likely to be encountered in both a psychiatric and paediatric setting. It emphasises the importance of a family-focused, developmentally appropriate and multidisciplinary approach to care. It does not address aspects of medical assessment and treatment. Other feeding or EDs not included in this article are pica, rumination disorder, other specified feeding and eating disorder and unspecified feeding and eating disorder.

  1. 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.

  2. 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

  3. [The Helkimo index for assessing treatment results after mandibular fractures].

    Science.gov (United States)

    Härtel, J; Hellmuth, M; Hellmuth, K O

    1991-01-01

    Based on the Helkimo index we assessed the success of conservative and conservative-surgical forms of treatment for mandibular fractures in a total of 166 patients. The control group consisted of 50 probands. The Helkimo dysfunction index, which is based on various criteria, showed dysfunction in 81.9% of the patients with only slight functional impairment in 57.2% of these cases. 18.1% of the patients were clinically symptom-free. A comparison with the probands revealed no major differences in dysfunction between the two groups. Significant differences were observed only in the case of 2 isolated criteria (maximum mandibular protrusion, muscle pain). Severe dysfunction, however, was more common in the fracture patients. Based on the Helkimo occlusion index disorder were noted in 91.7% of the patients, while severe occlusion disorder were observed particularly in patients with combined mandibular body and condyle fractures (40.0%). In the control group a more favorable occlusion index was found to be due mainly to the greater number of present and/or occluding teeth. The Helkimo index, particularly the dysfunctionindex, is a very useful instrument for assessing the success of treatment measures in mandibular fracture cases. It should be more commonly used to improve the possibilites of objective comparisons between patients from different hospitals.

  4. 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.

  5. Environmental assessment of digestate treatment technologies using LCA methodology.

    Science.gov (United States)

    Vázquez-Rowe, Ian; Golkowska, Katarzyna; Lebuf, Viooltje; Vaneeckhaute, Céline; Michels, Evi; Meers, Erik; Benetto, Enrico; Koster, Daniel

    2015-09-01

    The production of biogas from energy crops, organic waste and manure has augmented considerably the amounts of digestate available in Flanders. This has pushed authorities to steadily introduce legislative changes to promote its use as a fertilising agent. There is limited arable land in Flanders, which entails that digestate has to compete with animal manure to be spread. This forces many anaerobic digestion plants to further treat digestate in such a way that it can either be exported or the nitrogen be removed. Nevertheless, the environmental impact of these treatment options is still widely unknown, as well as the influence of these impacts on the sustainability of Flemish anaerobic digestion plants in comparison to other regions where spreading of raw digestate is allowed. Despite important economic aspects that must be considered, the use of Life Cycle Assessment (LCA) is suggested in this study to identify the environmental impacts of spreading digestate directly as compared to four different treatment technologies. Results suggest relevant environmental gains when the digestate mix is treated using the examined conversion technologies prior to spreading, although important trade-offs between impact categories were observed and discussed. The promising results of digestate conversion technologies suggest that further LCA analyses should be performed to delve into, for instance, the appropriateness to shift to nutrient recovery technologies rather than digestate conversion treatments.

  6. 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...

  7. Mutual trust: the key to successful assessment and treatment.

    Science.gov (United States)

    Garberding, Virginia

    2009-01-01

    When we first meet the individual who has just had a stroke and their family members, we have an opportunity to set the stage for the individual's long-term adjustment to the effects of their cerebrovascular event. Or we can squander that opportunity. By using an empathetic approach with individuals, we can often have a dramatically positive effect on adjustment and outcome over time. Building trust can make all the difference. When an individual is compromised by stroke, the family can become the bridge between the patient and the staff by providing the vital information needed to build trust. The assessment process gives the staff an opportunity to develop a trusting relationship with the individual and their family members. Only the investment of time on the part of the staff will guarantee the opportunity to develop and establish the rapport needed for effective treatment outcomes.

  8. Seasonal Affective Disorder: An Overview of Assessment and Treatment Approaches

    Directory of Open Access Journals (Sweden)

    Sherri Melrose

    2015-01-01

    Full Text Available Seasonal affective disorder or SAD is a recurrent major depressive disorder with a seasonal pattern usually beginning in fall and continuing into winter months. A subsyndromal type of SAD, or S-SAD, is commonly known as “winter blues.” Less often, SAD causes depression in the spring or early summer. Symptoms center on sad mood and low energy. Those most at risk are female, are younger, live far from the equator, and have family histories of depression, bipolar disorder, or SAD. Screening instruments include the Seasonal Pattern Assessment Questionnaire (SPAQ. Typical treatment includes antidepressant medications, light therapy, Vitamin D, and counselling. This paper provides an overview of SAD.

  9. Angioscopic assessment of various percutaneous treatments for arteriosclerosis obliterance

    Science.gov (United States)

    Kusaba, Hiroyasu; Watanabe, Kazuo; Shiraishi, Shohzo; Sato, Takashi; Koga, Nobuhiko

    1993-06-01

    We have evaluated the angioscopic findings before and after various percutaneous techniques to treat 39 lesions in 32 cases of arteriosclerosis obliterans (ASO). We applied a laser (CL50: SLT, Japan), percutaneous transluminal angioplasty (PTA), and atherectomy -- either singly or in combination, with angioscopic luminal observation (angioscope: PF14L & PF18L Olympus, Japan) recorded before and after the treatments. In the case of a complete obstruction, we employed PTA as the first choice. We used a laser prior to PTA when the PTA guide-wire failed to penetrate the lumen. For eccentric and calcified lesions atherectomy was applied. A sufficient enlargement was obtained initially in 37 of the 39 lesions. The angioscopic observations after treatment revealed carbonization (3/5) and attachment of small thrombi (3/5) after using the laser, intimal rupture (3/8), dissection (2/8), flap formation (2/8), and attachment of small thrombi (4/8) after PTA, and attachment of small thrombi (9/19), flap formation (6/19), and dissection (2/19) after atherectomy. We established the efficacy of angioscopic assessment demonstrating beneficial clinical results. The angioscopic findings suggest that attachment of small thrombi may be responsible for a poor prognosis. Additional angioscopic observations with angiography are recommended for improved understanding of the luminal changes.

  10. Assessment of endotoxin activity in wastewater treatment plants.

    Science.gov (United States)

    Guizani, Mokhtar; Dhahbi, Mahmoud; Funamizu, Naoyuki

    2009-07-01

    Endotoxic material, commonly associated to biological reactions, is thought to be one of the most important constituents in water. This has become a very important topic because of the common interest in microbial products governed by the possible shift to water reuse for drinking purposes. In this light, this study was conducted to provide an assessment of endotoxic activity in reclaimed wastewater. A bacterial endotoxin test (LAL test) was applied to water samples from several wastewater treatment plants (WWTP) in Sapporo, Japan keeping in view the seasonal variation. Samples were taken from several points in WWTP (influent, effluent, return sludge, advanced treatment effluent). The findings of this study indicated that wastewater shows high endotoxin activity. The value of Endotoxin (Endo) to COD ratio in the effluent is usually higher than that of the influent. Moreover, it is found that wastewater contains initially endotoxic active material. Some of those chemicals are biodegradable and but most of them are non-biodegradable. Batch scale activated sludge studies were undertaken to understand the origin of endotoxic active material in the effluent. This study showed that those chemicals are mainly produced during biological reactions, more precisely during decay process. Moreover, raw wastewater (RWW) contains high amounts of organic matter having endotoxicity which remains in the effluent.

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

    Science.gov (United States)

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

    2012-03-01

    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 smokers were assessed for cue reactivity at baseline, Week 4, and Week 10 of treatment. Measures of cue reactivity included subjective craving and attention to cues after exposure to two neutral and two smoking cue environments. Overall, feasibility of using VR-NCRAS was demonstrated and these findings support the use of the cue reactivity assessment during treatment, which can inform treatment decisions.

  12. The fidelity of treatment delivery can be assessed in treatment outcome studies: a successful illustration from behavioral medicine

    NARCIS (Netherlands)

    Leeuw, M.; Goossens, M.E.J.B.; Vet, de H.C.W.; Vlaeyen, J.W.S.

    2009-01-01

    OBJECTIVES: Treatment outcome studies ought to assess the fidelity of their treatments, including treatment delivery, but practical guidelines and examples for this are lacking. Based on general recommendations in available literature, this study proposes and illustrates the design and application o

  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. 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.

  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. Obesity and Family Systems: A Family FIRO Approach to Assessment and Treatment Planning.

    Science.gov (United States)

    Doherty, William J.; Harkaway, Jill Elka

    1990-01-01

    Presents model for conceptualizing interactional patterns in families presenting for treatment of obesity and method for organizing assessment and for prioritizing treatment strategies. Uses the Family FIRO Model as a framework to organize complex assessment issues, to assign priorities for treatment of issues, and to select appropriate treatment…

  17. 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

  18. An Assessment of Resonance Treatment in WIMSD-5B

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Won Young; You, Guk Jong; Min, Byung Joo; Park, Joo Hwan [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

    2005-07-01

    WIMSD-5B is a lattice code with a depletion capability for the analysis of reactor physics problems related to a design and safety. It is released from the OECD/NEA Data Bank in 1998 and is now being used widely for thermal research and power reactor calculations. The purpose of this study is to assess and improve the resonance treatment method in WIMSD- 5B, through the introduction of a new method with a high accuracy in treating the resonance, as one of the development works for WIMS/CANDU, which is being developed for replacing WIMS-AECL, for the physics analysis of CANDU reactors. In this article, we specifically describe the recent improvements in the resonance integral method using the Carlvik's approximation. As a result, a comparison for the resonance calculation on the CANDU-6 fuel lattice was performed between the WIMSD-5B code and the WIMS/CANDU code with the 69-energy groups of the ENDF/B-VI nuclear data library and the WIMS-AECL code with the 89-energy group of the ENDF/B-VI nuclear data library.

  19. Assessment of Lake Orta sediments phytotoxicity after the liming treatment

    Directory of Open Access Journals (Sweden)

    Daria ROSSI

    2001-08-01

    Full Text Available The paper presents results from seed germination and root elongation tests for the evaluation of Lake Orta sediment contamination. The protocol for this test was developed after a literature survey and careful investigation of the proper conditions for obtaining the germination of commercially available seeds of several plants. Cucumis sativus, Lactuca sativa, and Lepidium sativum were finally chosen and used to detect the phytotoxicity of both liquid and solid phases of Lake Orta sediments. To assess whether exchange at the water – sediment interface could represent a hazard for the environment and the actual bioavailability of the toxicants present into the sediments, the phytotoxicity of samples collected in 1992, 1994, 1996, 1997, and 1998 from selected stations was tested on seeds of three different plant species (Lactuca sativa, Lepidium sativum and Cucumis sativus. The obtained results allow drawing distribution maps of the germination index, which confirm the persistence of toxic effects. However, the lake seems to positively respond to the restoration treatment, since the more contaminated layers of sediments are presently buried under less toxic sediments.

  20. Assessing heat treatment of chicken breast cuts by impedance spectroscopy.

    Science.gov (United States)

    Schmidt, Franciny C; Fuentes, Ana; Masot, Rafael; Alcañiz, Miguel; Laurindo, João B; Barat, José M

    2017-03-01

    The aim of this work was to develop a new system based on impedance spectroscopy to assess the heat treatment of previously cooked chicken meat by two experiments; in the first, samples were cooked at different temperatures (from 60 to 90 ℃) until core temperature of the meat reached the water bath temperature. In the second approach, temperature was 80 ℃ and the samples were cooked for different times (from 5 to 55 min). Impedance was measured once samples had cooled. The examined processing parameters were the maximum temperature reached in thermal centre of the samples, weight loss, moisture and the integral of the temperature profile during the cooking-cooling process. The correlation between the processing parameters and impedance was studied by partial least square regressions. The models were able to predict the studied parameters. Our results are essential for developing a new system to control the technological, sensory and safety aspects of cooked meat products on the whole meat processing line.

  1. 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.

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

    Institute of Scientific and Technical Information of China (English)

    Vargaonkar Gauresh

    2014-01-01

    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.

  3. 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

  4. 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…

  5. Radiological Instrumentation Assessment for King County Wastewater Treatment Division

    Energy Technology Data Exchange (ETDEWEB)

    Strom, Daniel J.; McConn, Ronald J.; Brodzinski, Ronald L.

    2005-05-19

    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, capable

  6. Reliability of assessment of adherence to an antimicrobial treatment guideline

    NARCIS (Netherlands)

    Mol, PGM; Gans, ROB; Panday, PVN; Degener, JE; Laseur, M; Haaijer-Ruskamp, FM

    2005-01-01

    Assessment procedures for adherence to a guideline must be reliable and credible. The aim of this study was to explore the reliability of assessment of adherence, taking account of the professional backgrounds of the observers. A secondary analysis explored the impact of case characteristics on asse

  7. Training Needs of Rehabilitation Counselors concerning Alcohol and Other Drugs Abuse Assessment and Treatment

    Science.gov (United States)

    Ong, Lee Za; Cardoso, Elizabeth; Chan, Fong; Chronister, Julie; Chou, Chih Chin

    2007-01-01

    Forty-two rehabilitation counselors participated in a study regarding perceived training needs concerning alcohol and other drug abuse (AODA) treatment and assessment. Participants reported that 85% of consumers with whom they worked had AODA issues, yet over half rated their graduate training in AODA treatment and assessment as poor, and their…

  8. 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.

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

    NARCIS (Netherlands)

    van Slooten, Cees; Buma, Anita; Peperzak, Louis

    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

  10. 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...

  11. Wilson's disease: assessment of D-penicillamine treatment.

    OpenAIRE

    Van Caillie-Bertrand, M; Degenhart, H J; Luijendijk, I; Bouquet, J.; Sinaasappel, M.

    1985-01-01

    Serum copper and zinc concentrations and 24 hour urinary copper and zinc excretion were determined serially from the beginning of treatment with D-penicillamine in four children with Wilson's disease. The data show a progressive decrease in both serum copper and zinc concentrations in all. Urinary copper excretion gradually levelled off to approximately 50% of initial values, but zinc excretion increased. Urinary zinc:copper ratios therefore increased with the duration of treatment. Copper el...

  12. 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.

  13. 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.

  14. 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.

  15. Treatment and prognostic assessment of acute myeloid leukemia

    Directory of Open Access Journals (Sweden)

    Bannur Ramanna Nandeesh

    2016-06-01

    Full Text Available Acute myeloid leukemia (AML is a heterogeneous group of clonal malignant myeloid neoplasms. Malignant transformation of hematopoietic progenitor cell leads to clonal expansion and replacement of normal bone marrow cells with malignant cells leading to suppression of normal haematopoiesis. Advancements in our understanding of disease biology have allowed AML to be classified based on its gene expression profile, which includes previously identified cytogenetic subgroups, and distinct novel subgroups which have prognostic significance. Identification of mutations in DNMT3A and IDH 1 genes in cytogenetically normal AML (by gene sequencing helps to identify patients with poor prognosis. Redesigning the treatment regimen consisting of cytarabine and daunorubicin has improved the treatment outcomes without increase in the treatment-related mortality. Increasing the dose of daunorubicin to 90 mg/m2 improves complete remission rates without increasing treatment-related complications both in young and elderly patients. Cytarabine (200 mg/m2 in cycle I and 2 g/m2 in cycle 2 is shown to be as effective as high dose cytarabine (1000 mg/m2 twice daily in cycle 1and 2 g/m2 twice daily in cycle 2 and is associated with less treatment-related toxicities. [Int J Basic Clin Pharmacol 2016; 5(3.000: 579-586

  16. Assessing Tumor Response to Treatment in Patients with Lung Cancer Using Dynamic Contrast-Enhanced CT

    DEFF Research Database (Denmark)

    Strauch, Louise S; Eriksen, Rie Ø; Sandgaard, Michael

    2016-01-01

    after treatment. Four out of five studies that measured blood flow post anti-angiogenic treatments found that blood flow was significantly decreased. DCE-CT may be a useful tool in assessing treatment response in patients with lung cancer. It seems that particularly permeability and blood flow......The aim of this study was to provide an overview of the literature available on dynamic contrast-enhanced computed tomography (DCE-CT) as a tool to evaluate treatment response in patients with lung cancer. This systematic review was compiled according to Preferred Reporting Items for Systematic...... Reviews and Meta-Analyses (PRISMA) guidelines. Only original research articles concerning treatment response in patients with lung cancer assessed with DCE-CT were included. To assess the validity of each study we implemented Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). The initial search...

  17. Obesity: assessment, diagnosis, treatment and opportunities for its prevention

    Directory of Open Access Journals (Sweden)

    Arturo Perea-Martínez

    2014-08-01

    Full Text Available Obesity is a public health problem in the world. Its impact and poten- tial consequences on health and quality of life of individuals and their families, health systems and the global economy, has become a priority issue for governments and administrative systems. It is a multifactorial disease with well-known prenatal and postnatal origins, which offer prevention and treatment opportunities. So, is necessary the health professional have an intimate knowledge of the disease and its com- plications, also existing treatment options: behavior management for acquiring a healthy lifestyle, drugs, nutrients and bariatric surgery; to achieve contain the impact on healthy life years, life expectancy and occupational health worldwide.

  18. Patient assessment in the diagnosis, prevention, and treatment of osteoporosis.

    Science.gov (United States)

    Lata, Paul F; Elliott, Mary E

    2007-06-01

    Assessment of the patient with osteoporosis includes history and physical examination, laboratory testing, and imaging studies. Information gathered during this assessment assists clinicians in targeting strategies to prevent fractures. The medical history should contain items such as personal and family history of fractures, lifestyle, intake of substances such as vitamin D, calcium, corticosteroids, and other medications. The physical examination can reveal relevant information such as height loss and risk of falls. Bone mineral density (BMD), most commonly determined by dual-energy x-ray absorptiometry, best predicts fracture risk in patients without previous fracture. BMD testing is most efficient in women over 65 years old but is also helpful for men and women with risk factors. Serial BMD tests can identify individuals losing bone mass, but clinicians should be aware of what constitutes a significant change. Laboratory testing can detect other risk factors and can provide clues to etiology. Selection of laboratory tests should be individualized, as there is no consensus regarding which tests are optimal. Biochemical markers of bone turnover have a potential role in fracture risk assessment and in gauging response to therapy, but are not widely used at present. Clinicians should be aware of problems with vitamin D measurement, including seasonal variation, variability among laboratories, and the desirable therapeutic range. Careful assessment of the osteoporotic patient is essential in developing a comprehensive plan that reduces fracture risk and improves quality of life.

  19. How to assess treatment efficacy in Sjogren's syndrome?

    NARCIS (Netherlands)

    Vissink, Arjan; Bootsma, Hendrika; Kroese, Frans G. M.; Kallenberg, Cees G. M.

    2012-01-01

    Purpose of review This article critically reviews the current views and discusses the future challenges with regard to assessing disease progression and disease activity in Sjogren's syndrome, as a decrease of disease progression and activity is what an effective Sjogren's syndrome therapy aims for.

  20. Assessment of rehabilitation needs in colorectal cancer treatment

    DEFF Research Database (Denmark)

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

    2016-01-01

    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...

  1. Improvement treatments and criteria assessing banks the energy efficiency projects

    Directory of Open Access Journals (Sweden)

    Ryzhkova Anna Vladimirovna

    2013-05-01

    Full Text Available Stimulate bank lending to businesses for energy efficiency projects is possible by increasing the accuracy of the valuation the project and the effect of its implementation. The paper presents a sequence of procedures and appropriate assessment criteria for energy efficiency projects, which will increase the chances of success of the investment project and to ensure the financial stability of the bank.

  2. Assessment of homeopathic medicine Aconitum napellus in the treatment of anxiety in an animal model

    OpenAIRE

    Andersom Ricardo Fréz; Sâmia Ahmad El Ghandour; Samarah Hamidi El Ghandour; Gabriele Baptista Haine

    2012-01-01

    Background: Aconitum napellus is a classic resource of complementary medicine for the treatment of patients exhibiting neurological symptoms of anxiety. Aim: To assess the action of homeopathic medicine Acon in the treatment of generalized anxiety in an experimental model using rats. Methods: 48 adult (two to three months old) male Wistar rats (Rattus rattus) were randomly divided in six groups (n= 8/treatment) and given the following treatments by gastric tube along 10 days: 1) control (diaz...

  3. Assessment of AIDS Risk among Treatment Seeking Drug Abusers.

    Science.gov (United States)

    Black, John L.; And Others

    Intravenous (IV) drug abusers are at risk for contracting transmittable diseases such as acquired immunodeficiency syndrome (AIDS) and hepatitis B. This study was conducted to investigate the prevalence of risk behaviors for acquiring and transmitting AIDS and hepatitis B among treatment-seeking drug abusers (N=168). Subjects participated in a…

  4. 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.

  5. Assessment and Treatment of Selective Mutism with English Language Learners

    Science.gov (United States)

    Mayworm, Ashley M.; Dowdy, Erin; Knights, Kezia; Rebelez, Jennica

    2015-01-01

    Selective mutism (SM) is a type of anxiety disorder that involves the persistent failure to speak in contexts where speech is typically expected (e.g., school), despite speaking in other contexts (e.g., home). Research on the etiology and treatment of SM is limited, as it is a rare disorder and few clinical trials evaluating SM interventions have…

  6. Assessment and treatment of anxiety disorders in children and adolescents.

    Science.gov (United States)

    Wehry, Anna M; Beesdo-Baum, Katja; Hennelly, Meghann M; Connolly, Sucheta D; Strawn, Jeffrey R

    2015-07-01

    Recent advances in the developmental epidemiology, neurobiology, and treatment of pediatric anxiety disorders have increased our understanding of these conditions and herald improved outcomes for affected children and adolescents. This article reviews the current epidemiology, longitudinal trajectory, and neurobiology of anxiety disorders in youth. Additionally, we summarize the current evidence for both psychotherapeutic and psychopharmacologic treatments of fear-based anxiety disorders (e.g., generalized, social, and separation anxiety disorders) in children and adolescents. Current data suggest that these disorders begin in childhood and adolescence, exhibit homotypic continuity, and increase the risk of secondary anxiety and mood disorders. Psychopharmacologic trials involving selective serotonin reuptake inhibitors (SSRIs) and selective serotonin norepinephrine reuptake inhibitors (SSNRIs) are effective in pediatric patients with anxiety disorders and have generally demonstrated moderate effect sizes. Additionally, current data support cognitive behavioral therapy (CBT) for the treatment of these conditions in youth and suggest that the combination of psychotherapy + an SSRI may be associated with greater improvement than would be expected with either treatment as monotherapy.

  7. Optical Assessment of Vascular Disease Progression and Treatment

    Science.gov (United States)

    Samuels, Joshua A.

    Vascular disease manifests itself in many different forms, including chronic ulcers which do not heal, impaired blood flow to the limbs, or damage to the natural reperfusion process. The current forms of assessing vascular disease are often subjective and provide incomplete knowledge about the tissue of interest. This work focused on developing non-invasive techniques to quantitatively evaluate three specific elements of vascular disease: diabetic ulcers, venous ulcers, and peripheral arterial disease. Diffuse Near Infrared Spectroscopy (DNIRS) was used to predict healing (82% positive predictive value) in diabetic ulcers after 4 weeks of assessment (sensitivity of 0.9 and specificity of 0.86; pulcers, using a low-frequency (20kHz), low intensity (ulcers compared to wounds which do not heal (p30 seconds) belonging to patients with PAD (pvascular health and the results obtained promise to develop new clinically relevant and quantitative techniques using non-invasive optical modalities.

  8. Delirium: assessment and treatment of patients with cancer. PART 2.

    Science.gov (United States)

    Brown, Michelle; Hardy, Kersten

    Delirium at the end of life may present significant ethical dilemmas in clinical practice: whether to simply treat it in order to maximise symptom relief, with the resulting side effect being palliative sedation, or to attempt to reverse delirium and risk prolonging suffering. Determining whether the delirium can be reversed involves comprehensive assessment using established tools, which may or may not provide the answer to the question posed. This article examines the evidence surrounding several assessment tools that have been suggested as effective in identifying delirium, and the consequences of various approaches to the management of delirium in a patient with a cancer diagnosis. It also considers the impact delirium may have on the health professional and those close to the patient.

  9. Behavioral treatment of pulsatile tinnitus and headache following traumatic head injury. Objective polygraphic assessment of change.

    Science.gov (United States)

    Hegel, M T; Martin, J B

    1998-10-01

    Pulsatile tinnitus is a disorder that can be extremely disabling. Nonetheless, it has not been well-researched in the fields of psychology or behavioral therapy. This article describes the evaluation and behavioral treatment of a gentleman with pulsatile tinnitus. The evaluation included polygraphic assessment of vasomotor and electromyographic function both before and after treatment. The results show that the combination of lifestyle modifications and specific behavioral interventions were successful in modifying not only self-report indices of functioning, but also the underlying physiology related to the disorder. The potential role of the various treatment components and the value of including polygraphic assessment for informing treatment and evaluating outcome are discussed.

  10. Nocturnal enuresis: an approach to assessment and treatment.

    Science.gov (United States)

    Bayne, Aaron P; Skoog, Steven J

    2014-08-01

    On the basis of strong evidence, although primary monosymptomatic nocturnal enuresis (PMNE) is common and most children will outgrow the condition spontaneously, the psychological effect to the child can be significant and represents the main reason for treatment of these children. On the basis of international consensus panels, treatment of PMNE should be targeted toward the specific type of bedwetting patterns the child has, using bladder diary, sleep history, and daytime elimination concerns as a guide (Table 3). On the basis of international consensus panels, it is important for the primary care physician to be able to differentiate children with PMNE from children with nonmonosymptomatic nocturnal enuresis (NMNE) and secondary nocturnal enuresis. On the basis of international consensus panels, children with NMNE should have their underlying voiding or stool problem addressed before initiation of therapy for the nocturnal enuresis. On the basis of strong evidence, both the bedwetting alarm and desmopressin are considered first-line therapy for children with PMNE.

  11. Hazard Assessment Comparison of Tazhiping Landslide Before and After Treatment

    OpenAIRE

    Huang, Dong; Qiao, Jianping; Wang, Meng

    2017-01-01

    Through investigation and analysis of geological conditions and mechanical parameters of the Taziping landslide, the finite volume method was adopted, and, the rheological model was adopted to simulate the landslide and avalanche entire mass movement process. The present paper adopted the GIS platform to simulate the mass movement process before and after treatment. This paper also provided the conditions and characteristic parameters of soil deposits (thickness, speed, and stresses) during t...

  12. Assessment of airborne virus contamination in wastewater treatment plants

    OpenAIRE

    Masclaux, Frédéric; Hotz, Philipp; Gashi, Drita; Savova-Bianchi, Dessislava; Oppliger, Anne

    2014-01-01

    INTRODUCTION: Occupational exposure to bioaerosols in wastewater treatment plants (WWTP) and its consequence on workers׳ health are well documented. Most studies were devoted to enumerating and identifying cultivable bacteria and fungi, as well as measuring concentrations of airborne endotoxins, as these are the main health-related factors found in WWTP. Surprisingly, very few studies have investigated the presence and concentrations of airborne virus in WWTP. However, many enteric viruses ar...

  13. 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.

  14. 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 the blood (also called ...

  15. Breast Image Analysis for Risk Assessment, Detection, Diagnosis, and Treatment of Cancer

    NARCIS (Netherlands)

    Giger, M.L.; Karssemeijer, N.; Schnabel, J.A.

    2013-01-01

    The role of breast image analysis in radiologists' interpretation tasks in cancer risk assessment, detection, diagnosis, and treatment continues to expand. Breast image analysis methods include segmentation, feature extraction techniques, classifier design, biomechanical modeling, image registration

  16. 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.

  17. Working with an interpreter in psychiatric assessment and treatment.

    Science.gov (United States)

    Westermeyer, J

    1990-12-01

    Cross-cultural assessment and care frequently involve cross-language communication via a translator, interpreter, or bilingual worker. A resurgence of immigration, legalization of former illegal migrants, and refugee flight to the United States has increased the need for such special means of communication. Psychiatrists and other mental health professionals should develop conceptual models, skills, and experience for conducting cross-language interviews. This article provides information, terminology, and models for one aspect of this special clinical task, i.e., working with translators.

  18. Sleep disturbance in childhood epilepsy: clinical implications, assessment and treatment.

    Science.gov (United States)

    Stores, Gregory

    2013-07-01

    The ways in which sleep can affect epilepsy, and epilepsy can influence sleep and wakefulness, are described. Different forms of sleep disturbance have been reported in patients with epilepsy, depending on the type of seizure disorder. Confusions between epilepsy and non-epileptic parasomnias can be a particular diagnostic problem but they can be avoided. Untreated sleep disturbance is likely to have harmful psychological, physical and family effects. Screening for sleep disturbance should be routine, and leading, if indicated, to precise diagnosis of the underlying sleep disorder on which choice of advice and treatment depends.

  19. Monte Carlo conformal treatment planning as an independent assessment

    Energy Technology Data Exchange (ETDEWEB)

    Rincon, M.; Leal, A.; Perucha, M.; Carrasco, E. [Sevilla Univ. (Spain). Dept. Fisiologia Medica y Biofisica; Sanchez-Doblado, F. [Sevilla Univ. (Spain). Dept. Fisiologia Medica y Biofisica]|[Hospital Univ. Virgen Macarena, Sevilla (Spain). Servicio de Oncologia Radioterapica; Arrans, R.; Sanchez-Calzado, J.A.; Errazquin, L. [Hospital Univ. Virgen Macarena, Sevilla (Spain). Servicio de Oncologia Radioterapica; Medrano, J.C. [Clinica Puerta de Hierro, Madrid (Spain). Servicio de Radiofisica

    2001-07-01

    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.)

  20. 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...... 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....

  1. Assessing the treatment costs and the fertilizing value of the output products in digestate treatment systems.

    Science.gov (United States)

    Golkowska, K; Vázquez-Rowe, I; Lebuf, V; Accoe, F; Koster, D

    2014-01-01

    The objective of this paper was to advance towards finding sustainable solutions to deal with biogas digestate and contribute to faster development of the market for digestate treatment products. The study compares digestate treatment costs through four different treatment plants, estimates the potential fertilizing and humus value (PFHV) of the derived products and allocates the cash flows to show the possible regional benefits. The treatment costs for the pre-dried solid fraction of digestate ranged from €19 to €23/tonne output. These costs may be covered by vending treatment products at a price reaching at least 34-41% of their PFHV (ca €55/tonne). Treatment of raw digestate generates high operating costs (€216-247/tonne output), much higher than the PFHV of the products (ca €35-51/tonne). For such systems either the treatment has to be financially subsidized by the authorities or €13-32/tonne input should be covered by the substrate deliverers as a disposal fee. Nevertheless, a well-prepared investment concept in this field may allow the local binding of up to 80% of total cash flows. Finally, the current difficult market situation of the treatment products can be primarily improved by clearing their legal status at European level.

  2. Assessing adherence factors in patients under topical treatment: development of the Topical Therapy Adherence Questionnaire (TTAQ).

    Science.gov (United States)

    Zschocke, Ina; Mrowietz, Ulrich; Lotzin, Annett; Karakasili, Eleni; Reich, Kristian

    2014-04-01

    Medication adherence rates strongly depend on favorable disease outcomes. It is known that medication adherence rates are lower for topical treatment than for systemic treatment. However, to date no validated instrument for the assessment of adherence factors in topical treatment is available. The aim of this study was to develop a new questionnaire to assess adherence risk factors in topical treatment. The development of the Topical Therapy Adherence Questionnaire (TTAQ) and Patient Preference Questionnaire (PPQ) was based on a systematic literature review, and qualitative patient focus interviews and expert focus groups' input. The psychometric properties and comprehensibility of the TTAQ and PPQ were assessed in a feasibility study with 59 psoriasis patients. Our first preliminary results indicate that the TTAQ and PPQ are psychometrically sound and reliable measures for the assessment of factors influencing topical treatment adherence. The questionnaires are currently being further developed and various parameters (e.g., time point of assessment) are currently being tested in an exploratory pilot study with ca. 2,000 psoriasis patients receiving topical treatment in a European clinical trial. The use of the final versions of TTAQ and PPQ in clinical practice may facilitate the early identification of specific non-adherence factors in patients under topical treatment, which could enable designing and applying adherence-enhancing interventions according to the patient's individual needs.

  3. Fatigue in chronic kidney disease: Definition, assessment and treatment.

    Science.gov (United States)

    Zalai, Dora; Bohra, Miqdad

    2016-01-01

    Chronic fatigue--an overwhelming subjective feeling of mental or physical exhaustion--impacts patients' everyday functioning and quality of life, delays recovery after hemodialysis, and increases mortality. There are a number of factors that may perpetuate clinically significant fatigue among individuals with chronic kidney disease, including sleep disorders, depression, sedentary lifestyle, anemia, and chronic inflammation. Some of these factors (i.e., anemia and inflammation) are in the forefront of clinical attention, whereas the other contributing factors often remain unrecognized. This article provides a pragmatic overview of the definition, assessment, maintaining factors, and management of fatigue in chronic kidney disease. Given that chronic fatigue is a major determinant of patients' quality of life, nurses can bring about a fundamental improvement in patients' well-being if they recognize the most common fatigue-perpetuating factors and facilitate fatigue management interventions.

  4. Assessment and treatment of pica and destruction of holiday decorations.

    Science.gov (United States)

    Mitteer, Daniel R; Romani, Patrick W; Greer, Brian D; Fisher, Wayne W

    2015-12-01

    Problem behavior exhibited by individuals with autism can be disruptive to family traditions, such as decorating for the holidays. We present data for a 6-year-old girl who engaged in automatically reinforced pica and destruction of holiday decorations. Treatment was evaluated within an ABCDCD reversal design. During baseline (Phases A and B), we observed elevated rates of problem behavior. We implemented differential reinforcement of alternative behavior in Phase C to teach a response to compete with problem behavior. Little change in toy play or problem behavior occurred. In Phase D, we added a facial screen to the differential reinforcement procedures, which resulted in increases in toy play and decreases in problem behavior. Findings are discussed in terms of how interventions for problem behavior can promote alternative behavior while they facilitate household activities and traditions.

  5. Functional assessment of endoprosthesis in the treatment of bone tumors

    Directory of Open Access Journals (Sweden)

    Denis Kiyoshi Fukumothi

    Full Text Available ABSTRACT OBJECTIVES: Evaluate the functional grade of these patients and to identify the types of complications found that influenced the average life span of endoprostheses the functions of the operated limb. METHODS: We analyzed 14 post-operative cases of endoprosthesis, patients with malignant bone tumors and aggressive benign bone tumors submitted to surgery between 2004 and 2014. The evaluation system used was proposed by Enneking, recommended by the Musculoskeletal Tumor Society (MSTS, in addition to the radiologic evaluation. RESULTS: Endoprosthesis are excellent choices for the treatment of bone tumors with limb preservation in relation to pain, strength, and patient's emotional acceptance. Another factor for good results is the immediate weight-bearing capacity, generating a greater independence. CONCLUSION: The authors conclude that all patients classified the therapy as excellent/good, regardless of the type of prosthesis used, extent of injury, and/or type of tumor resection performed.

  6. [Unconventional treatment methods in multiple sclerosis and their expert assessment].

    Science.gov (United States)

    Eben, E

    1997-10-01

    Unorthodox therapies are used also by MS-patients very frequently. Not all procedures are harmless affecting only the purse. The medical expert working within the German health care system will also be called for questions of compensation of costs. A survey of some paradigmatic unorthodox treatments is given. While the law and the jurisdiction concerning the public health insurance fund pronounce clear standards in respect to the demands on the efficacy shown by modern (biomathematic) methods, it is essentially a more difficult task to bring the jurisdiction of the Federal Supreme Court (BGH) in harmony with basic requirements of a rational and scientific medicine. The interindividual and intraindividual course of MS is most variable, therefore it is very difficult to make a distinction between natural course and effects of a therapy in a single case while the only possibility to estimate individual therapeutic chance is a statistic evidence of efficacy in general.

  7. [Assessment and treatment of hyperglycemia in critically ill patients].

    Science.gov (United States)

    Viana, Marina Verçoza; Moraes, Rafael Barberena; Fabbrin, Amanda Rodrigues; Santos, Manoella Freitas; Gerchman, Fernando

    2014-01-01

    Hyperglycemia is a commonly encountered issue in critically ill patients in the intensive care setting. The presence of hyperglycemia is associated with increased morbidity and mortality, regardless of the reason for admission (e.g., acute myocardial infarction, status post-cardiovascular surgery, stroke, sepsis). However, the pathophysiology and, in particular, the treatment of hyperglycemia in the critically ill patient remain controversial. In clinical practice, several aspects must be taken into account in the management of these patients, including blood glucose targets, history of diabetes mellitus, the route of nutrition (enteral or parenteral), and available monitoring equipment, which substantially increases the workload of providers involved in the patients' care. This review describes the epidemiology, pathophysiology, management, and monitoring of hyperglycemia in the critically ill adult patient.

  8. 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...

  9. Resource utilization implications of treatment were able to be assessed from appropriately reported clinical trial data

    NARCIS (Netherlands)

    Poole-Wilson, Philip A.; Kirwan, Bridget-Anne; Voko, Zoltan; de Brouwer, Sophie; Dunselman, Peter H. J. M.; van Dalen, Frederik J.; Lubsen, Jacobus

    2007-01-01

    Background and Objective: Published clinical trial data rarely allow assessment of the health care resource utilization implications of treatment. We give an example of how these can be assessed given appropriate tabulation of data. Methods: Data from a trial comparing long-acting nifedipine gastroi

  10. 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…

  11. 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…

  12. 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…

  13. Assessment and Treatment of Severe Behavior Problems Using Choice-Making Procedures.

    Science.gov (United States)

    Harding, Jay W.; Wacker, David P.; Berg, Wendy K.; Barretto, Anjali; Rankin, Barbara

    2002-01-01

    Choice-making produces were used to identify response-reinforcer relations during assessment and treatment phases with two children (ages 4-6) with pervasive development disorders who displayed severe behavioral problems. Results were used to develop preliminary treatment packages in which access to positive reinforcement was contingent on…

  14. 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)

  15. Randomized controlled trial assessing a traditional Chinese medicine remedy in the treatment of primary dysmenorrhea

    NARCIS (Netherlands)

    Kennedy, S.; Jin, X.; Yu, H.; Zhong, S.; Magill, P.; Vliet, T. van; Kistemaker, C.; Voors, C.; Pasman, W.

    2006-01-01

    A proof-of-concept study to assess the safety and efficacy of a traditional Chinese medicine formula as treatment for primary dysmenorrhea showed no statistically significant benefit over placebo. However, some efficacy parameters suggested possible superiority of the active treatment and so a large

  16. Assessing Model Treatment of Drought Legacy Effects in the Amazon

    Science.gov (United States)

    Kolus, H. R.; Huntzinger, D. N.; Schwalm, C.; Fisher, J. B.; Cook, R. B.; Fang, Y.; Jacobson, A. R.; Michalak, A.; Schaefer, K. M.; Wei, Y.

    2015-12-01

    Extreme climate events play an important and potentially lasting role in terrestrial carbon cycling and storage. In particular, satellite and in-situ measurements have shown that forest recovery time following severe drought can extend several years beyond the return to normal climate conditions. However, terrestrial ecosystem models generally do not account for the physiological mechanisms that cause these legacy effects and, instead, assume complete and rapid vegetation recovery from drought. Using a suite of fifteen land surface models from the Multi-scale Synthesis and Terrestrial Model Intercomparison Project (MsTMIP), we assess models' ability to capture legacy effects by analyzing the spatial and temporal extent of modeled vegetation response to the 2005 Amazon drought. We compare the simulated primary production and ecosystem exchange (GPP, NPP, NEE) to previous recovery-focused analysis of satellite microwave observations of canopy backscatter. Further, we evaluate the specific model characteristics that control the timescale and magnitude of simulated vegetation recovery from drought. Since climate change is expected to increase the frequency and severity of extreme climate events, improving models' ability to simulate the legacy effects of these events will likely refine estimates of the land carbon sink and its interannual variability.

  17. Quality assessment of palm products upon prolonged heat treatment.

    Science.gov (United States)

    Tarmizi, Azmil Haizam Ahmad; Lin, Siew Wai

    2008-01-01

    Extending the frying-life of oils is of commercial and economic importance. Due to this fact, assessment on the thermal stability of frying oils could provide considerable savings to the food processors. In this study, the physico-chemical properties of five palm products mainly palm oil, single-fractionated palm olein, double-fractionated palm olein, red palm olein and palm-based shortening during 80 hours of heating at 180 degrees C were investigated. Heating properties of these products were then compared with that of high oleic sunflower oil, which was used as reference oil. The indices applied in evaluating the quality changes of oils were free fatty acid, smoke point, p-anisidine value, tocols, polar and polymer compounds. Three palm products i.e. palm oil, single-fractionated palm olein and double-fractionated palm olein were identified to be the most stable in terms of lower formation of free fatty acid, polar and polymer compounds as well as preserving higher smoke point and tocols content compared to the other three oils. The low intensity of hydrolytic and oxidative changes due to prolonged heating, suggests that these palm products are inherently suitable for frying purposes.

  18. Assessment of indoor airborne contamination in a wastewater treatment plant.

    Science.gov (United States)

    Teixeira, Juliana V; Miranda, Sandra; Monteiro, Ricardo A R; Lopes, Filipe V S; Madureira, Joana; Silva, Gabriela V; Pestana, Nazaré; Pinto, Eugénia; Vilar, Vítor J P; Boaventura, Rui A R

    2013-01-01

    The main objective of this work was to quantify and characterize the major indoor air contaminants present in different stages of a municipal WWTP, including microorganisms (bacteria and fungi), carbon dioxide, carbon monoxide, hydrogen sulfide ammonia, formaldehyde, and volatile organic compounds (VOCs). In general, the total bacteria concentration was found to vary from 60 to >52,560 colony-forming units (CFU)/m(3), and the total fungi concentration ranged from 369 to 14,068 CFU/m(3). Generally, Gram-positive bacteria were observed in higher number than Gram-negative bacteria. CO(2) concentration ranged from 251 to 9,710 ppm, and CO concentration was either not detected or presented a level of 1 ppm. H(2)S concentration ranged from 0.1 to 6.0 ppm. NH(3) concentration was <2 ppm in most samples. Formaldehyde was <0.01 ppm at all sampling sites. The total VOC concentration ranged from 36 to 1,724 μg/m(3). Among the VOCs, toluene presented the highest concentration. Results point to indoor/outdoor ratios higher than one. In general, the highest levels of airborne contaminants were detected at the primary treatment (SEDIPAC 3D), secondary sedimentation, and sludge dehydration. At most sampling sites, the concentrations of airborne contaminants were below the occupational exposure limits (OELs) for all the campaigns. However, a few contaminants were above OELs in some sampling sites.

  19. Occupational asthma: review of assessment, treatment, and compensation.

    Science.gov (United States)

    Cowl, Clayton T

    2011-03-01

    Occupational asthma refers to asthma induced by exposure in the working environment to airborne dusts, vapors, or fumes, with or without preexisting asthma. Potential triggers of occupational asthma are diverse and involve a variety of postulated mechanisms. After confirming the presence of asthma, diagnosis hinges on obtaining a detailed and accurate occupational and environmental history and documenting a temporal association of symptoms or signs with workplace exposure. Management of occupational asthma centers on prescribing standard asthma therapies in conjunction with instituting preventive strategies, such as appropriate avoidance of environmental triggers, providing work restrictions, and using environmental controls and/or personal respiratory protection. If a worker is determined to be ill or injured, there are a variety of compensation systems that are designed to protect workers financially from disability related to respiratory impairments; however, the administrative process is frequently difficult to navigate for patients and their providers. Focusing on obtaining a detailed occupational and environmental history, establishing clear objective data to substantiate illness, and estimating or apportioning workplace contribution to the condition is important for the diagnosis and treatment of this relatively common form of asthma.

  20. Treatment of Primary Pulmonary Aspergillosis: An Assessment of the Evidence

    Directory of Open Access Journals (Sweden)

    Ethan R. Stewart

    2016-09-01

    Full Text Available Aspergillus spp. are a group of filamentous molds that were first described due to a perceived similarity to an aspergillum, or liturgical device used to sprinkle holy water, when viewed under a microscope. Although commonly inhaled due to their ubiquitous nature within the environment, an invasive fungal infection (IFI is a rare outcome that is often reserved for those patients who are immunocompromised. Given the potential for significant morbidity and mortality within this patient population from IFI due to Aspergillus spp., along with the rise in the use of therapies that confer immunosuppression, there is an increasing need for appropriate initial clinical suspicion leading to accurate diagnosis and effective treatment. Voriconazole remains the first line agent for therapy; however, the use of polyenes, novel triazole agents, or voriconazole in combination with an echinocandin may also be utilized. Consideration as to which particular agent and for what duration should be made in the individual context for each patient based upon underlying immunosuppression, comorbidities, and overall tolerance of therapy.

  1. 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.

  2. ASSESSMENT OF ROOT RESORPTION DEGREE OF INCISORS AFTER ORTHODONTIC TREATMENT IN ADULTS

    Directory of Open Access Journals (Sweden)

    I. Luchian

    2012-03-01

    Full Text Available The main iatrogenic effects associated with orthodontic treatment refer to: influence of orthodontic rings on the periodontal tissue; gum retractions; the effect of the orthodontic treatment on dental root (root resorption; the effect of the orthodontic treatment on alveolar bone height; mobility and pain associated with orthodontic treatment. AIM of the study: To assess the degree of root resorption of incisors, after orthodontic treatment, on a group of 48 adults with dental-maxillary abnormalities. Materials and method: The study included 48 young adult patients, 35 women and 13 men aged 18 to 30 years, who had received fixed orthodontic treatment. To assess the degree of root resorption (changes at root level and apical contour length, apical radiographies were taken in the maxillary incisors and jaw both at the beginning and end of the orthodontic treatment. Results: Out of the 239 incisors examined at the beginning of orthodontic treatment, 163 showed code 0, meaning 88.1%, and 50 showed a slight squash apex (code 1, respectively 10.9%. Only 1% of all incisors assessed presented mild and severe root resorption. Conclusions: The results of the study show that, generally, an adult orthodontic treatment, applied for functional and aesthetic objectives, may have clinically acceptable iatrogenic effects.

  3. Social Validity Assessment of Training Methods to Improve Treatment Integrity of Special Education Service Providers.

    Science.gov (United States)

    Strohmeier, Craig; Mulé, Christina; Luiselli, James K

    2014-05-01

    We report the results of a social validity assessment that was administered to special education service providers (N = 44) to document the acceptability and effectiveness ratings of several treatment integrity training methods. The participants judged performance feedback as the most likely method to improve their treatment integrity, followed by avoidance (negative reinforcement) of supervision meetings, online training, and financial incentive. Performance feedback was also rank-ordered as most effective among the four training methods. We discuss the merits of social validity assessment in designing programs for enhancing treatment integrity among practitioners within educational and clinical settings.

  4. Multinational development of a questionnaire assessing patient satisfaction with anticoagulant treatment: the 'Perception of Anticoagulant Treatment Questionnaire' (PACT-Q©

    Directory of Open Access Journals (Sweden)

    Bousser Marie-Germaine

    2009-02-01

    Full Text Available Abstract Background The side effects and burden of anticoagulant treatments may contribute to poor compliance and consequently to treatment failure. A specific questionnaire is necessary to assess patients' needs and their perceptions of anticoagulant treatment. Methods A conceptual model of expectation and satisfaction with anticoagulant treatment was designed by an advisory board and used to guide patient (n = 31 and clinician (n = 17 interviews in French, US English and Dutch. Patients had either atrial fibrillation (AF, deep venous thrombosis (DVT, or pulmonary embolism (PE. Following interviews, three PACT-Q language versions were developed simultaneously and further pilot-tested by 19 patients. Linguistic validations were performed for additional language versions. Results Initial concepts were developed to cover three areas of interest: 'Treatment', 'Disease and Complications' and 'Information about disease and anticoagulant treatment'. After clinician and patient interviews, concepts were further refined into four domains and 17 concepts; test versions of the PACT-Q were then created simultaneously in three languages, each containing 27 items grouped into four domains: "Treatment Expectations" (7 items, "Convenience" (11 items, "Burden of Disease and Treatment" (2 items and "Anticoagulant Treatment Satisfaction" (7 items. No item was deleted or added after pilot testing as patients found the PACT-Q easy to understand and appropriate in length in all languages. The PACT-Q was divided into two parts: the first part to measure the expectations and the second to measure the convenience, burden and treatment satisfaction, for evaluation prior to and after anticoagulant treatment, respectively. Eleven additional language versions were linguistically validated. Conclusion The PACT-Q has been rigorously developed and linguistically validated. It is available in 14 languages for use with thromboembolic patients, including AF, PE and DVT patients

  5. Selection and utilization of assessment instruments in substance abuse treatment trials: the National Drug Abuse Treatment Clinical Trials Network experience

    Directory of Open Access Journals (Sweden)

    Rosa C

    2012-07-01

    Full Text Available Carmen Rosa, Udi Ghitza, Betty TaiCenter for the Clinical Trials Network, National Institute on Drug Abuse, Bethesda, MD, USAAbstract: Based on recommendations from a US Institute of Medicine report, the National Institute on Drug Abuse established the National Drug Abuse Treatment Clinical Trials Network (CTN in 1999, to accelerate the translation of science-based addiction treatment research into community-based practice, and to improve the quality of addiction treatment, using science as the vehicle. One of the CTN's primary tasks is to serve as a platform to forge bi-directional communications and collaborations between providers and scientists, to enhance the relevance of research, which generates empirical results that impact practice. Among many obstacles in moving research into real-world settings, this commentary mainly describes challenges and iterative experiences in regard to how the CTN develops its research protocols, with focus on how the CTN study teams select and utilize assessment instruments, which can reasonably balance the interests of both research scientists and practicing providers when applied in CTN trials. This commentary also discusses the process by which the CTN further selects a core set of common assessment instruments that may be applied across all trials, to allow easier cross-study analyses of comparable data.Keywords: addiction, assessment, drug abuse treatment, drug dependence, NIDA Clinical Trials Network, substance use disorder

  6. 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

  7. 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.

  8. Assessing Tumor Response to Treatment in Patients with Lung Cancer Using Dynamic Contrast-Enhanced CT

    Directory of Open Access Journals (Sweden)

    Louise S. Strauch

    2016-07-01

    Full Text Available The aim of this study was to provide an overview of the literature available on dynamic contrast-enhanced computed tomography (DCE-CT as a tool to evaluate treatment response in patients with lung cancer. This systematic review was compiled according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA guidelines. Only original research articles concerning treatment response in patients with lung cancer assessed with DCE-CT were included. To assess the validity of each study we implemented Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2. The initial search yielded 651 publications, and 16 articles were included in this study. The articles were divided into groups of treatment. In studies where patients were treated with systemic chemotherapy with or without anti-angiogenic drugs, four out of the seven studies found a significant decrease in permeability after treatment. Four out of five studies that measured blood flow post anti-angiogenic treatments found that blood flow was significantly decreased. DCE-CT may be a useful tool in assessing treatment response in patients with lung cancer. It seems that particularly permeability and blood flow are important perfusion values for predicting treatment outcome. However, the heterogeneity in scan protocols, scan parameters, and time between scans makes it difficult to compare the included studies.

  9. Blueprints for the assessment, treatment, and future study of catatonia in autism spectrum disorders.

    Science.gov (United States)

    Dhossche, Dirk Marcel; Shah, Amitta; Wing, Lorna

    2006-01-01

    The blueprints for the assessment, treatment, and future study of catatonia in autism spectrum disorders (ASDs), which are submitted in this chapter aim to increase early recognition and treatment of catatonia in ASDs, show the urgency of controlled treatment trials, and increase collaborative and interdisciplinary research into the co-occurrence of these two enigmatic disorders. Catatonia should be assessed in any patient with ASDs when there is an obvious and marked deterioration in movement, pattern of activities, self-care, and practical skills, compared with previous levels, through a comprehensive diagnostic evaluation of medical and psychiatric symptoms. A formal diagnosis should be ascertained using ASD specific criteria for catatonia that takes into account baseline symptoms like muteness, echophenomena, stereotypy, negativism, or other psychomotor abnormalities. Any underlying medical and neurological conditions should be treated, and culprit medications or other substances that may cause catatonia should be eliminated. Separate treatment blueprints are presented for mild, moderate, and severe catatonia, featuring combinations of a psychological approach developed by Shah and Wing and medical treatments that have shown efficacy in catatonia: lorazepam challenge, lorazepam trial, lorazepam continuation, and bilateral electroconvulsive therapy (ECT). These treatment modalities in themselves are well established. Side effects and complications are known and manageable. Legal, ethical, and practice guidelines governing all treatment aspects should be followed. The treatment blueprints should be viewed as best estimates pending future controlled studies. The blueprint for the future study of catatonia in ASDs describes promising clinical and preclinical research avenues. Longitudinal studies need to assess the possible effect of early recognition and adequate treatment of catatonia in ASDs in order to avoid the impairment associated with chronicity. Effects of

  10. [Prospective assessment of children with pervasive developmental disorder after 2 years of day-hospital treatment].

    Science.gov (United States)

    Poinso, F; Dubois, B; Chatel, C; Viellard, M; Bastard-Rosset, D; Girardot, A-M; Grandgeorge, P; De Martino, S; Sokolowsky, M; Salle-Collemiche, X; Da Fonseca, D

    2013-01-01

    The treatment of children with pervasive developmental disorders (PDD) has not been systematically assessed in French day-care units. In this prospective study, 11 children with a diagnosis of PDD were followed up for 2years in a day-care unit in the Marseille university hospital. The treatment they received is based on an initial assessment by the "Centre Ressources Autisme" (CRA PACA) and further included a continued observation of the child and an assessment of the child's abilities and needs. This treatment used various therapeutic approaches 10h weekly and also included parental counseling and coordinated work with schools. Treatment in our day-care unit can be categorized as eclectic, non-intensive therapy. It is based on methods such as TEACCH (Treatment and Education of Autistic and related Communication handicapped Children), Floor Time Play, speech and language therapy, developmental therapy, and psychotherapy. International studies on intensive behavioral therapies suggest that this treatment is superior to non-behavioral and/or non-intensive treatment. They suggest its efficiency is due both to the nature of the treatment (behavioral) and to its intensity (more than 25h a week). In this study, the CRA diagnosed children using the ADI and ADOS. The 11 children (mean age, 3years 5months) were tested twice, with the Vineland and CARS scales. The first assessment was on admission to the day hospital and the second was 2years later. The results showed developmental progress with a mean increase of 13.5 months at the Vineland Scale, and a decrease of the autism severity score on the CARS. The treatment presented here proves to be efficient; if compared to similar results in international studies, we obtained better results than their eclectic intensive or non-intensive treatment comparison group.

  11. 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.

  12. Toxicity-based assessment of the treatment performance of wastewater treatment and reclamation processes

    Institute of Scientific and Technical Information of China (English)

    Dongbin Wei; Zhuowei Tan; Yuguo Du

    2012-01-01

    The reclamation and reuse of wastewater is one of the possible ways to relieve the serious fresh water resource crisis in China.Efficient reclamation treatment technologies ensure the safe reuse of reclaimed water.In order to screen out and evaluate technologies appropriate for reclamation treatment,a great deal of efforts have been brought to bear.In the present study,a toxicity-based method including a Photobacterium phosphorewn test for acute toxicity and SOS/umu test for genotoxicity,accompanied by the traditional physicochemical parameters DOC (dissolved organic carbon) and UV254 (absorbance at 254 nm),was used to measure the treatment performance of different reclamation processes,including the anaerobic-anoxic-oxic biological process (A2O) and subsequent physical/chemical reclamation processes (ultrafiltration,ozonation,chlorination).It was found that for the secondary effluent after the A2O process,both the toxicity and physicochemical indices had greatly decreased compared with those of the influent.However,chemical reclamation processes such as ozonation and chlorination could possibly raise toxicity levels again.Fortunately,the toxicity elevation could be avoided by optimizing the ozone dosage and using activated carbon after ozonation.It was noted that by increasing the ozone dosage to 10 mg/L and employing activated carbon with more than 10 min hydraulic retention time,toxicity elevation was controlled.Furthermore,it was shown that pre-ozonation before activated carbon and chlorination played an important role in removing organic compounds and reducing the toxicity formation potential.The toxicity test could serve as a valuable tool to evaluate the performance of reclamation processes.

  13. Enhancing behavioral health treatment and crisis management through mobile ecological momentary assessment and SMS messaging.

    Science.gov (United States)

    Smith, Brad; Harms, William D; Burres, Stephanie; Korda, Holly; Rosen, Howard; Davis, Jamie

    2012-12-01

    Many veterans returning from service in Afghanistan or Iraq suffer from post-traumatic stress disorder or mild traumatic brain injury. Treating these conditions can be challenging because of high rates of relapse and associated memory impairments. We report on a pilot study that assessed the utility of mobile health (mHealth) technologies, including personal digital assistant-based ecological momentary assessment and two-way interactive text (SMS) messaging, for providing treatment feedback to clinicians, encouraging and motivating veterans throughout treatment, and monitoring participants for relapse after treatment discharge. The results of the pilot suggest that mHealth technologies are feasible adjuncts to traditional mental treatment in the veteran population. Additional work is needed to establish the degree of clinical and economic value.

  14. Development and validation of a pharmacy migraine questionnaire to assess suitability for treatment with a triptan

    OpenAIRE

    Diener, Hans-Christoph; Dowson, Andrew; Whicker, Susan; Bacon, Teresa

    2008-01-01

    A questionnaire (Migraine Questionnaire; MQ) was developed to help pharmacists identify consumers with migraine suitable for non-prescription treatment with a triptan. Adults, who knew or thought that they had migraine, participated in three, sequential, community-based studies to validate the MQ. Overall, 1,353 subjects completed independent assessments with a pharmacist and a clinician (reference standard). The accuracy of the pharmacist assessment of suitability for a triptan was compared ...

  15. Assessment and monitoring of treatment response in adult ADHD patients: current perspectives

    Science.gov (United States)

    Ramsay, J Russell

    2017-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental syndrome that emerges in childhood or early adolescence and persists into adulthood for a majority of individuals. There are many other adults with ADHD who may not seek out evaluation and treatment until adulthood, having been able to “get by” before struggling with inattention, hyperactivity, and/or impulsivity in adulthood, in addition to facing the associated features of disorganization, poor time management, and procrastination among many others. A lifetime diagnosis of ADHD is associated with a wide range of life impairments, which makes a comprehensive and accurate diagnostic assessment essential in order to obtain appropriate treatment. Moreover, while there are effective medical and psychosocial treatments for ADHD, it is important to be able to track treatment response in order to evaluate whether adjustments in specific interventions are needed or referrals for adjunctive treatments and supports are indicated to facilitate optimal therapeutic outcomes. The goal of this article is to provide a clinically useful review of the various measures that practicing clinicians can use to aid in the diagnostic assessment and monitoring of psychosocial and medical treatment of ADHD in adult patients. This review includes various structured interviews, screening scales, adult ADHD symptom inventories, measures of associated features of ADHD, as well as ratings of impairment and functioning which can be adapted to clinicians’ practice needs in order to track treatment progress and optimize treatments for adults with ADHD. PMID:28184164

  16. Development of substance flow based Life Cycle Assessment tool for sewage sludge treatment and disposal

    DEFF Research Database (Denmark)

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

    Life Cycle Assessment (LCA) is a method to quantify environmental impacts of products or systems. It is often done by correlating material and energy demands with certain input characteristics. An attempt was made to evaluate the robustness of the substance flow based LCA for wastewater and sludge...... treatment processes correlate sufficiently with the solids content of wastewater influent, while energy use correlates with the total input volume. However, the correlations appeared to be stronger when individual treatment processes were separately analysed....

  17. Treatment planning capability assessment of a beam shaping assembly for accelerator-based BNCT

    Energy Technology Data Exchange (ETDEWEB)

    Herrera, M.S., E-mail: herrera@tandar.cnea.gov.ar [Comision Nacional de Energia Atomica, CNEA, Av. Gral. Paz 1499, San Martin (Argentina)] [Consejo Nacional de Investigaciones Cientificas y Tecnicas, CONICET, Av. Rivadavia 191, Buenos Aires (Argentina)] [Universidad Nacional de San Martin, UNSAM, Av. 25 de Mayo y Francia Buenos Aires (Argentina); Gonzalez, S.J. [Comision Nacional de Energia Atomica, CNEA, Av. Gral. Paz 1499, San Martin (Argentina)] [Consejo Nacional de Investigaciones Cientificas y Tecnicas, CONICET, Av. Rivadavia 191, Buenos Aires (Argentina); Burlon, A.A. [Comision Nacional de Energia Atomica, CNEA, Av. Gral. Paz 1499, San Martin (Argentina)] [Universidad Nacional de San Martin, UNSAM, Av. 25 de Mayo y Francia Buenos Aires (Argentina); Minsky, D.M.; Kreiner, A.J. [Comision Nacional de Energia Atomica, CNEA, Av. Gral. Paz 1499, San Martin (Argentina)] [Consejo Nacional de Investigaciones Cientificas y Tecnicas, CONICET, Av. Rivadavia 191, Buenos Aires (Argentina)] [Universidad Nacional de San Martin, UNSAM, Av. 25 de Mayo y Francia Buenos Aires (Argentina)

    2011-12-15

    Within the frame of an ongoing project to develop a folded Tandem-Electrostatic-Quadrupole accelerator facility for Accelerator-Based Boron Neutron Capture Therapy (AB-BNCT) a theoretical study was performed to assess the treatment planning capability of different configurations of an optimized beam shaping assembly for such a facility. In particular this study aims at evaluating treatment plans for a clinical case of Glioblastoma.

  18. The Reflux Disease Questionnaire: a measure for assessment of treatment response in clinical trials

    Directory of Open Access Journals (Sweden)

    Junghard Ola

    2008-04-01

    Full Text Available Abstract Background Critical needs for treatment trials in gastroesophageal reflux disease (GERD include assessing response to treatment, evaluating symptom severity, and translation of symptom questionnaires into multiple languages. We evaluated the previously validated Reflux Disease Questionnaire (RDQ for internal consistency, reliability, responsiveness to change during treatment and the concordance between RDQ and specialty physician assessment of symptom severity, after translation into Swedish and Norwegian. Methods Performance of the RDQ after translation into Swedish and Norwegian was evaluated in 439 patients with presumed GERD in a randomized, double-blind trial of active treatment with a proton pump inhibitor. Results The responsiveness was excellent across three RDQ indicators. Mean change scores in patients on active treatment were large, also reflected in effect sizes that ranged from a low of 1.05 (dyspepsia to a high of 2.05 (heartburn and standardized response means 0.99 (dyspepsia and 1.52 (heartburn. A good positive correlation between physician severity ratings and RDQ scale scores was seen. The internal consistency reliability using alpha coefficients of the scales, regardless of language, ranged from 0.67 to 0.89. Conclusion The results provide strong evidence that the RDQ is amenable to translation and represents a viable instrument for assessing response to treatment, and symptom severity.

  19. Life Cycle Assessment of urban wastewater reuse with ozonation as tertiary treatment

    Energy Technology Data Exchange (ETDEWEB)

    Munoz, Ivan [Departamento de Hidrogeologia y Quimica Analitica, Universidad de Almeria, ctra. de Sacramento s/n, La Canada de San Urbano, 04120 Almeria (Spain)], E-mail: ivanmuno@ual.es; Rodriguez, Antonio; Rosal, Roberto [Departamento de Quimica Analitica e Ingenieria Quimica, Universidad de Alcala, Madrid (Spain); Fernandez-Alba, Amadeo R. [Departamento de Hidrogeologia y Quimica Analitica, Universidad de Almeria, ctra. de Sacramento s/n, La Canada de San Urbano, 04120 Almeria (Spain)

    2009-02-01

    Life Cycle Assessment has been used to compare different scenarios involving wastewater reuse, with special focus on toxicity-related impact categories. The study is based on bench-scale experiments applying ozone and ozone in combination with hydrogen peroxide to a wastewater effluent from a Spanish sewage treatment plant. Two alternative characterisation models have been used to account for toxicity of chemical substances, namely USES-LCA and EDIP97. Four alternative scenarios have been assessed: wastewater discharge plus desalination supply, wastewater reuse without tertiary treatment, wastewater reuse after applying a tertiary treatment consisting on ozonation, and wastewater reuse after applying ozonation in combination with hydrogen peroxide. The results highlight the importance of including wastewater pollutants in LCA of wastewater systems assessing toxicity, since the contribution of wastewater pollutants to the overall toxicity scores in this case study can be above 90%. Key pollutants here are not only heavy metals and other priority pollutants, but also non-regulated pollutants such as pharmaceuticals and personal care products. Wastewater reuse after applying any of the tertiary treatments considered appears as the best choice from an ecotoxicity perspective. As for human toxicity, differences between scenarios are smaller, and taking into account the experimental and modelling uncertainty, the benefits of tertiary treatment are not so clear. From a global warming potential perspective, tertiary treatments involve a potential 85% reduction of greenhouse gas emissions when compared with desalination.

  20. Using the level of Service Inventory-Revised to improve assessment and treatment in drug court.

    Science.gov (United States)

    Guastaferro, Wendy P

    2012-08-01

    More than 2,000 drug courts in the United States provide supervision and substance-abuse treatment to thousands of offenders. Yet the treatment continuum from assessment to aftercare is underexplored. The effectiveness of the Level of Service Inventory-Revised (LSI-R) as a risk assessment tool is well established. However, fewer studies have considered its use in guiding treatment strategies. In using the LSI-R, the drug court program relied on the structured interview protocol (not the risk classification scores) to identify criminogenic needs that then helped determine placement in a high- or low-needs treatment track. To evaluate the effectiveness of these treatment placement decisions, this research used the LSI-R scores to examine individual and group differences (N = 182). Significant and substantive differences at the individual and group levels were found thus providing empirical support for using the LSI-R as a link between assessment and treatment. Implications for developing standards and practice protocols for drug courts are discussed.

  1. 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.

  2. 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.

  3. Early Adverse Events and Attrition in SSRI Treatment: A Suicide Assessment Methodology Study (SAMS) Report

    Science.gov (United States)

    Warden, Diane; Trivedi, Madhukar H.; Wisniewski, Stephen R.; Kurian, Benji; Zisook, Sidney; Kornstein, Susan G.; Friedman, Edward S.; Miyahara, Sachiko; Leuchter, Andrew F.; Fava, Maurizio; Rush, John

    2011-01-01

    Adverse events during selective serotonin reuptake inhibitor (SSRI) treatment are frequent and may lead to premature treatment discontinuation. If attrition is associated with early worsening of side effects or the frequency, intensity, or burden of side effects, interventions to maximize retention could be focused on patients with these events. Outpatient participants (n=265) with nonpsychotic major depressive disorder entered an 8-week trial with an SSRI. At baseline and week 2, specific side effects were evaluated with the Systematic Assessment for Treatment Emergent Events – Systematic Inquiry, and at week 2 the Frequency, Intensity, and Burden of Side Effects Rating globally assessed side effects. Attrition was defined by those participants who left treatment after week 2 but before week 8. No specific week 2 side effect, either treatment emergent or with worsening intensity, was independently associated with attrition. Global ratings of side effect frequency, intensity, or burden at week 2 were also not associated with subsequent attrition. Neither global ratings nor specific side effects at week 2 were related to patient attrition during SSRI treatment. Other factors appear to contribute to patient decisions about continuing with treatment. PMID:20473060

  4. Selective Mutism: A Team Approach to Assessment and Treatment in the School Setting

    Science.gov (United States)

    Ponzurick, Joan M.

    2012-01-01

    The school nurse plays a pivotal role in the assessment and treatment of selective mutism (SM), a rare disorder found in elementary school children. Due to anxiety, children with SM do not speak in uncomfortable situations, primarily the school setting. Diagnosis of SM is often missed in the formative years because the child does speak at home.…

  5. Assessment and treatment of malnutrition in Dutch geriatric practice: consensus through a modified Delphi study.

    NARCIS (Netherlands)

    Asselt, D.Z.B. van; Bokhorst-de van der Schueren, M.A. van; Cammen, T.J.M. van der; Disselhorst, L.G.; Janse, A.; Lonterman-Monasch, S.; Maas, H.A.; Popescu, M.E.; Schölzel-Dorenbos, C.J.M.; Sipers, W.M.; Veldhoven, C.M. van; Wijnen, H.H.M; Olde Rikkert, M.

    2012-01-01

    OBJECTIVE: scientific evidence regarding the optimal management of malnutrition in geriatric patients is scarce. Our aim was to develop a consensus statement for geriatric hospital practice concerning six elements: (i) definition of malnutrition, (ii) screening and assessment, (iii) treatment and mo

  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. 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…

  9. 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…

  10. Religion and End-of-Life Treatment Preferences: Assessing the Effects of Religious Denomination and Beliefs

    Science.gov (United States)

    Sharp, Shane; Carr, Deborah; Macdonald, Cameron

    2012-01-01

    We use Wisconsin Longitudinal Study data (n = 2,678) to assess the effects of religious denomination and ideology on end-of-life treatment preferences in two hypothetical terminal illness scenarios: physical pain and severe cognitive impairment. We found no statistically significant differences when comparing traditionally defined religious…

  11. The Aberrant Behavior Checklist: A Behavior Rating Scale for the Assessment of Treatment Effects.

    Science.gov (United States)

    Aman, Michael G.; And Others

    1985-01-01

    The development of a scale to assess drug and other treatment effects on severely mentally retarded individuals is described. Separate factor analyses of the data from two samples resulted in a five-factor scale: (1) Irritability, Agitation, Crying; (2) Lethargy, Social Withdrawal; (3) Stereotypic Behavior; (4) Hyperactivity, Noncompliance; and…

  12. Women are less likely to be admitted to substance abuse treatment within 30 days of assessment.

    Science.gov (United States)

    Arfken, Cynthia L; Borisova, Natalie; Klein, Chris; di Menza, Salvatore; Schuster, Charles R

    2002-01-01

    The information gathered in a centralized intake unit (CIU) allows payers and administrators to examine if there are access issues for their population. For this study, the authors examined whether there were gender differences in the rate at which people are admitted to treatment within 30 days of assessment. Of the 5,004 individuals seeking publicly-funded substance abuse treatment in Detroit for the years 1996-97, 50.3% of those assessed at the CIU actually entered treatment. Women (31% of the people assessed) had a lower rate of admission (45% for women versus 53% for men) a difference that was maintained even after controlling for known risk factors. Women who were given priority for admission (i.e., those who were pregnant, had children, or injected drugs) had a higher rate of admission than other women (73% versus 39%), but only 17% of the women presenting were included in the priority groups. Men who were injecting drugs (a priority group) also had a higher rate of admission than other men (83% versus 49%). In multivariate analysis controlling for priority groups and known risk factors, women were still less likely to be admitted to treatment within 30 days of admission than men. Establishing priorities improves the rate of admission within 30 days of assessment for those groups, but more needs to be done to improve the admission rate for women. These results demonstrate that a CIU allows administrators to monitor for access issues.

  13. The outcome of root-canal treatments assessed by cone-beam computed tomography

    NARCIS (Netherlands)

    Liang, Y.H.

    2013-01-01

    In this thesis, in-vivo and ex-vivo methods were utilized to assess the outcome of root canal treatments determined by cone-beam computed tomography (CBCT) and the reliability of the CBCT-findings. CBCT provided useful and reliable information leading to a better understanding of the outcome and fac

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

    NARCIS (Netherlands)

    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 randomiz

  15. Ethical Issues in the Assessment and Treatment of a Rational Suicidal Client.

    Science.gov (United States)

    Snipe, Rosetta M.

    1988-01-01

    Notes that rational client's decision to commit suicide may present complex ethical issues for therapist. Presents and discusses three-month account of therapy with client, from perspective of ethical values and principles upon which assessment and treatment decisions were made, and complex ethical dilemmas encountered as therapist juxtaposed…

  16. Practice Parameter for the Assessment and Treatment of Youth in Juvenile Detention and Correctional Facilities

    Science.gov (United States)

    Journal of the American Academy of Child and Adolescent Psychiatry, 2005

    2005-01-01

    This practice parameter presents recommendations for the mental health assessment and treatment of youths in juvenile detention and correctional facilities. Mental and substance-related disorders are significant public health problems affecting youths in juvenile justice settings. Sufficient time is necessary to conduct a comprehensive diagnostic…

  17. 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…

  18. Recent advances in the assessment and treatment of falls in Parkinson's disease

    OpenAIRE

    Snijders, Anke H.; Nonnekes, Jorik; Bloem, Bastiaan R.

    2010-01-01

    Falls are among the most incapacitating features of Parkinson's disease. Prevention of falls requires a systematic assessment of all contributing factors (with emphasis on freezing of gait and frontal executive dysfunction), and a multidisciplinary treatment approach tailored to the specific pathophysiology of falls for each individual patient.

  19. Recent advances in the assessment and treatment of falls in Parkinson's disease

    NARCIS (Netherlands)

    Snijders, A.H.; Nonnekes, J.; Bloem, B.R.

    2010-01-01

    Falls are among the most incapacitating features of Parkinson's disease. Prevention of falls requires a systematic assessment of all contributing factors (with emphasis on freezing of gait and frontal executive dysfunction), and a multidisciplinary treatment approach tailored to the specific pathoph

  20. Assessment and monitoring of treatment response in adult ADHD patients: current perspectives

    Directory of Open Access Journals (Sweden)

    Ramsay JR

    2017-01-01

    Full Text Available J Russell Ramsay Adult ADHD Treatment & Research Program, Perelman School of Medicine, University of Pennsylvania Philadelphia, PA, USA Abstract: Attention-deficit/hyperactivity disorder (ADHD is a neurodevelopmental syndrome that emerges in childhood or early adolescence and persists into adulthood for a majority of individuals. There are many other adults with ADHD who may not seek out evaluation and treatment until adulthood, having been able to “get by” before struggling with inattention, hyperactivity, and/or impulsivity in adulthood, in addition to facing the associated features of disorganization, poor time management, and procrastination among many others. A lifetime diagnosis of ADHD is associated with a wide range of life impairments, which makes a comprehensive and accurate diagnostic assessment essential in order to obtain appropriate treatment. Moreover, while there are effective medical and psychosocial treatments for ADHD, it is important to be able to track treatment response in order to evaluate whether adjustments in specific interventions are needed or referrals for adjunctive treatments and supports are indicated to facilitate optimal therapeutic outcomes. The goal of this article is to provide a clinically useful review of the various measures that practicing clinicians can use to aid in the diagnostic assessment and monitoring of psychosocial and medical treatment of ADHD in adult patients. This review includes various structured interviews, screening scales, adult ADHD symptom inventories, measures of associated features of ADHD, as well as ratings of impairment and functioning which can be adapted to clinicians’ practice needs in order to track treatment progress and optimize treatments for adults with ADHD. Keywords: adult attention-deficit/hyperactivity disorder, adult ADHD, pharmacotherapy, psychosocial treatment, symptoms, functional impairments, executive functions

  1. 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

  2. Comparative assessment of the environmental sustainability of existing and emerging perchlorate treatment technologies for drinking water.

    Science.gov (United States)

    Choe, Jong Kwon; Mehnert, Michelle H; Guest, Jeremy S; Strathmann, Timothy J; Werth, Charles J

    2013-05-07

    Environmental impacts of conventional and emerging perchlorate drinking water treatment technologies were assessed using life cycle assessment (LCA). Comparison of two ion exchange (IX) technologies (i.e., nonselective IX with periodic regeneration using brines and perchlorate-selective IX without regeneration) at an existing plant shows that brine is the dominant contributor for nonselective IX, which shows higher impact than perchlorate-selective IX. Resource consumption during the operational phase comprises >80% of the total impacts. Having identified consumables as the driving force behind environmental impacts, the relative environmental sustainability of IX, biological treatment, and catalytic reduction technologies are compared more generally using consumable inputs. The analysis indicates that the environmental impacts of heterotrophic biological treatment are 2-5 times more sensitive to influent conditions (i.e., nitrate/oxygen concentration) and are 3-14 times higher compared to IX. However, autotrophic biological treatment is most environmentally beneficial among all. Catalytic treatment using carbon-supported Re-Pd has a higher (ca. 4600 times) impact than others, but is within 0.9-30 times the impact of IX with a newly developed ligand-complexed Re-Pd catalyst formulation. This suggests catalytic reduction can be competitive with increased activity. Our assessment shows that while IX is an environmentally competitive, emerging technologies also show great promise from an environmental sustainability perspective.

  3. Multi-Criteria Sustainability Assessment of Urban Sludge Treatment Technologies: Method and case study

    DEFF Research Database (Denmark)

    An, Da; Xi, Beidou; Ren, Jingzheng;

    2016-01-01

    This study aims at developing a sustainability assessment framework for assessing the technologies for the treatment of urban sewage sludge based on the logarithmic fuzzy preference programming based fuzzy analytic hierarchy process (LFPPFAHP) and extension theory. LFPPFAHP was employed...... to determine the weights of the criteria for sustainability assessment, and extension theory was used to prioritize the alternative technologies for the treatment of urban sewage sludge and grade their sustainability performances. An illustrative case including three technologies (compositing, incineration......, and resource utilization) was studied by the proposed method, and compositing, incineration, and resource utilization are recognized as "Moderately Sustainable", "Not Sustainable", and "Highly Sustainable", respectively. The sustainability sequence in the descending order is resource utilization, compositing...

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

    DEFF Research Database (Denmark)

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

    chose among different waste water treatments? Which ones are most beneficial in a holistic perspective? Here, the life cycle assessment (LCA) approach as a decision supporting tool may help because its goal is to allow quantification and direct comparison of characteristics as diverse as energy......Reducing environmental problems related to wastewater effluents containing micro-pollutants requires resources in terms of energy, chemicals, infrastructure, installations for wastewater treatment, thus, involves advantages as well as disadvantages to the environment and society. But how does one...... 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...

  5. 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.

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

    Institute of Scientific and Technical Information of China (English)

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

    2014-01-01

    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 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 10.85. 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 (R250.86, P,0.000 1), while the inclusion of lateral cephalometric films and facial photographs also contributed to a more comprehensive assessment (R250.96, P,0.000 1). Grading scores for SC1LX and SC1PH were highly significantly correlated with those for SC1LX1PH (r(SC1LX)vs.(SC1LX1PH)50.96, r(SC1PH)vs.(SC1LX1PH)50.97), showing that either SC1LX or SC1PH is an excellent substitute for all three combined assessment.

  7. Assessment of the efficacy of Aspergillus sp. EL-2 in textile waste water treatment.

    Science.gov (United States)

    Gomaa, Ola M; Kareem, Hussein Abd El; Fatahy, Reham

    2012-04-01

    Fungal biomass has the ability to decolorize a wide variety of dyes successfully through a number of mechanisms. A brown rot isolate, previously identified as Aspergillus sp. EL-2, was used in the aerobic treatment of textile waste water efficiently. In the current work, the treated waste water was tested chemically using more than one combined treatment. Microbial toxicity, phytotoxicity, genotoxicity and cytotoxicity were also studied to assess the toxicity level for each treatment. The obtained data suggest that the contribution of more than one mode of treatment is essential to ensure complete destruction of the by-products. The use of gamma irradiation (25 kGy) after the bioremediation step led to the decrease of the by-products of biodegradation as observed by visible spectrum and Fourier transfer infra red spectroscopy (FT-IR). The toxicity assessment presented variable results indicating the need for more than one toxicity test to confirm the presence or absence of hazardous compounds. Brown rot fungus could be used efficiently in the treatment of textile waste water without the risk of obtaining high carcinogenic or genotoxic compounds, especially if combined treatment is employed.

  8. 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.

  9. 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. PMID:27478797

  10. Characterization of oil and gas waste disposal practices and assessment of treatment costs. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Bedient, P.B.

    1995-01-16

    This study examines wastes associated with the onshore exploration and production of crude oil and natural gas in the US. The objective of this study was to update and enhance the current state of knowledge with regard to oil and gas waste quantities, the potential environmental impact of these wastes, potential methods of treatment, and the costs associated with meeting various degrees of treatment. To meet this objective, the study consisted of three tasks: (1) the development of a production Environmental Database (PED) for the purpose of assessing current oil and gas waste volumes by state and for investigating the potential environmental impacts associated with current waste disposal practices on a local scale; (2) the evaluation of available and developing technologies for treating produced water waste streams and the identification of unit process configurations; and (3) the evaluation of the costs associated with various degrees of treatment achievable by different treatment configurations. The evaluation of feasible technologies for the treatment of produced water waste streams was handled in the context of comparing the level of treatment achievable with the associated cost of treatment. Treatment processes were evaluated for the removal of four categories of produced water contaminants: particulate material, volatile organic compounds, adsorbable organic compounds, and dissolved inorganic species. Results showed dissolved inorganic species to be the most costly to remove. The potential cost of treating all 18.3 billion barrels of produced water generated in a year amounts to some 15 billion dollars annually.

  11. 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.

  12. Assessing treatment motivation among patients receiving antiretroviral therapy: a multidimensional approach.

    Science.gov (United States)

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

    2012-01-01

    Using multidimensional scaling (MDS) analysis, 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 between 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 extrinsic motivations often differ from those based on definitions derived from common interpretations of self-determination theory. Findings also showed that patients reported motivation for avoiding treatment when they associated their medication regimens with side effects and other negatively valenced outcomes. The study describes new applications of MDS in assessing how patients perceive the relationship between treatment behaviours and specific forms of motivation, such as intrinsic and extrinsic motivations. In addition, the study suggests how MDS may be used to develop behavioural strategies aimed at helping patients follow their regimens consistently by identifying treatment conceptualisations and contexts that facilitate or impede adherence.

  13. Assessment of cytokine levels and hs-CRP in bipolar I disorder before and after treatment.

    Science.gov (United States)

    Uyanik, Vesile; Tuglu, Cengiz; Gorgulu, Yasemin; Kunduracilar, Hakan; Uyanik, Mehmet Sevki

    2015-08-30

    We aimed to assess the relationship between cytokine levels and the severity of the manic period in medication free patients. 30 Medication free patients and 28 healthy subjects (HS) were recruited. Plasma levels of pro-inflammatory, anti-inflammatory, inflammatory cytokines, and hs-CRP levels were investigated upon hospital admission, after six weeks follow up in bipolar disease manic episode and the results were compared to HS. The severity of the manic episodes was assessed according to the Young mania rating scale. TNF-α, INF-γ, IL-6 and hs-CRP levels were significantly higher in patients with manic episode of bipolar I disorder before treatment than HS. After treatment the levels of TNF-α, INF-γ, IL-6 and hs-CRP were observed to be significantly decreased. There was no difference between the levels of anti-inflammatory cytokines in patients before or after treatment of bipolar disorder and HS. hs-CRP was observed to be the only parameter correlated with clinical response. The most significant outcome of this study is the correlation between clinical outcome and hs-CRP levels in treatment naive manic episode bipolar type I patients. hs-CRP is the most consistent indicator according to pro-inflammatory, inflammatory and anti-inflammatory cytokines, in predicting treatment outcomes.

  14. 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...

  15. 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.

  16. 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

    at baseline. This implies that tumors with a higher degree of angiogenesis prior to bevacizumab-treatment retain a higher level of angiogenesis during therapy despite a greater antiangiogenic effect of bevacizumab, hinting at evasive mechanisms limiting bevacizumab efficacy in that a reversal...... 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...... of their biological behavior and relative prognosis does not occur....

  17. 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;

    2007-01-01

    -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...

  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...... 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...... magnetic resonance arthrography remains the gold standard. PERIACETABULAR OSTEOTOMY FOR SURGICAL TREATMENT OF HIP DYSPLASIA IN ADULTS: Encouraging hip joint survival and clinical outcome were reported at medium-term follow-up after periacetabular osteotomy. The small number of studies reporting the outcome...

  19. Preclinical assessment of the treatment of second-stage African trypanosomiasis with cordycepin and deoxycoformycin.

    Directory of Open Access Journals (Sweden)

    Suman K Vodnala

    Full Text Available BACKGROUND: There is an urgent need to substitute the highly toxic compounds still in use for treatment of the encephalitic stage of human African trypanosomiasis (HAT. We here assessed the treatment with the doublet cordycepin and the deaminase inhibitor deoxycoformycin for this stage of infection with Trypanosoma brucei (T.b.. METHODOLOGY/PRINCIPAL FINDINGS: Cordycepin was selected as the most efficient drug from a direct parasite viability screening of a compound library of nucleoside analogues. The minimal number of doses and concentrations of the drugs effective for treatment of T.b. brucei infections in mice were determined. Oral, intraperitoneal or subcutaneous administrations of the compounds were successful for treatment. The doublet was effective for treatment of late stage experimental infections with human pathogenic T.b. rhodesiense and T.b. gambiense isolates. Late stage infection treatment diminished the levels of inflammatory cytokines in brains of infected mice. Incubation with cordycepin resulted in programmed cell death followed by secondary necrosis of the parasites. T.b. brucei strains developed resistance to cordycepin after culture with increasing concentrations of the compound. However, cordycepin-resistant parasites showed diminished virulence and were not cross-resistant to other drugs used for treatment of HAT, i.e. pentamidine, suramin and melarsoprol. Although resistant parasites were mutated in the gene coding for P2 nucleoside adenosine transporter, P2 knockout trypanosomes showed no altered resistance to cordycepin, indicating that absence of the P2 transporter is not sufficient to render the trypanosomes resistant to the drug. CONCLUSIONS/SIGNIFICANCE: Altogether, our data strongly support testing of treatment with a combination of cordycepin and deoxycoformycin as an alternative for treatment of second-stage and/or melarsoprol-resistant HAT.

  20. Attenuation of treatment effect due to measurement variability in assessment of progression-free survival.

    Science.gov (United States)

    Hong, S; Schmitt, N; Stone, A; Denne, J

    2012-01-01

    For normally distributed data analyzed with linear models, it is well known that measurement error on an independent variable leads to attenuation of the effect of the independent variable on the dependent variable. However, for time-to-event variables such as progression-free survival (PFS), the effect of the measurement variability in the underlying measurements defining the event is less well understood. We conducted a simulation study to evaluate the impact of measurement variability in tumor assessment on the treatment effect hazard ratio for PFS and on the median PFS time, for different tumor assessment frequencies. Our results show that scan measurement variability can cause attenuation of the treatment effect (i.e. the hazard ratio is closer to one) and that the extent of attenuation may be increased with more frequent scan assessments. This attenuation leads to inflation of the type II error. Therefore, scan measurement variability should be minimized as far as possible in order to reveal a treatment effect that is closest to the truth. In disease settings where the measurement variability is shown to be large, consideration may be given to inflating the sample size of the study to maintain statistical power.

  1. 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.

  2. 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.

  3. Development and validation of a pharmacy migraine questionnaire to assess suitability for treatment with a triptan.

    Science.gov (United States)

    Diener, Hans-Christoph; Dowson, Andrew; Whicker, Susan; Bacon, Teresa

    2008-12-01

    A questionnaire (Migraine Questionnaire; MQ) was developed to help pharmacists identify consumers with migraine suitable for non-prescription treatment with a triptan. Adults, who knew or thought that they had migraine, participated in three, sequential, community-based studies to validate the MQ. Overall, 1,353 subjects completed independent assessments with a pharmacist and a clinician (reference standard). The accuracy of the pharmacist assessment of suitability for a triptan was compared with the clinician assessment. Clinicians using their standard practice determined that triptan therapy was suitable in 76.8% of cases compared with 48.8% for pharmacists using the MQ. The lack of concordance between pharmacists and clinicians in the false-positive cases (n = 113 of 660 subjects considered suitable for triptan by the pharmacists) usually related to headache diagnosis (57.5%), not safety aspects. The MQ is an effective tool for pharmacists to guide appropriate recommendation of a non-prescription triptan for migraine.

  4. Rasmussen's encephalitis: the relevance of neuropsychological assessment in patient's treatment and follow up

    Directory of Open Access Journals (Sweden)

    Guimarães Catarina Abraão

    2002-01-01

    Full Text Available Rasmussen's encephalitis is characterized by refractory epilepsy, neurological deterioration and progressive atrophy of one cerebral hemisphere. The objective of this study is to describe the importance of neuropsychological evaluation in the treatment decision and follow-up of patients with Rasmussen´s encephalitis. Neuropsychological assessment was performed in two steps. Firstly, the clinical history was obtained and the Vineland adaptative behavior scale (VABS was applied. After this first step, the patients with social maturity level equal or higher than the inferior limit underwent a battery of neuropsychological assessment. We evaluated three patients before any specific treatment was started, and six months after the intervention (surgery or plasmapheresis. Patient 1 underwent left hemispherectomy and had global improvement on second neuropsychological assessment. This suggests that the decision of performing surgery was adequate. Patients 2 and 3 underwent plasmapheresis. They did not present cognitive decline between both evaluations which suggest that our decision of postponing surgery was adequate as well. We conclude that neuropsychological assessment is important when evaluating patients with Rasmussen´s encephalitis. That is especially true for patients in whom disease progression is slow, and surgery timing has to be carefully planned.

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

    DEFF Research Database (Denmark)

    Ahmad, Amais

    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 resistance......, and are considered to be powerful tools in designing treatment strategies. The overall aim of the thesis was to develop an in vivo bacterial growth model to predict and assess the effect of dosing factor on resistance growth in order to optimize treatment strategies. Specific aims were to a) estimate pharmacodynamic...... (PD) parameters of E. coli strains representative of the Danish porcine E. coli strains, when these are exposed to tetracycline and ampicillin, b) characterize the PD effect of combined concentrations of tetracycline and ampicillin, and c) evaluate the treatment strategies that better suppress...

  6. Personality characteristics and disorders in multiple sclerosis patients: assessment and treatment.

    Science.gov (United States)

    Stathopoulou, Anastasia; Christopoulos, Platon; Soubasi, Evanthia; Gourzis, Philippos

    2010-01-01

    Multiple sclerosis (MS) is a major inflammatory and demyelinating disease of the central nervous system. Although a significant incidence and prevalence of psychological disorders in MS has been reported there is limited data on the prevalence of personality disorders (PD) in these patients. Recent findings indicate the need for early diagnosis and treatment of PD in MS patients in the interests of prognosis, conformity to treatment and patient's quality of life improvement. This article summarizes existing evidence on prevalence, types and diagnostic criteria of PD in MS, clinical manifestations of personality pathology or changes in MS patients, and instruments currently used for diagnosis and assessment of PD in this group of patients. Underlying mechanisms suggested as causes of personality changes in MS patients are also discussed. The article reviews therapeutic strategies, including pharmacotherapy and psychotherapy interventions and emphasizes the need for a multidisciplinary approach to patient's treatment.

  7. The Key to Individualized Addiction Treatment is Comprehensive Assessment and Monitoring of Symptoms and Behavioral Change

    Directory of Open Access Journals (Sweden)

    Thomas F. Hilton

    2015-10-01

    Full Text Available Modern health services now strive for individualized treatment. This approach has been enabled by the increase in knowledge derived from neuroscience and genomics. Substance use disorders are no exception to individualized treatment even though there are no gene-specific medications yet available. What is available is the ability to quickly and precisely assess and monitor biopsychosocial variables known to vary during addiction recovery and which place addicts at increased risk of relapse. Monitoring a broad spectrum of biopsychosocial health enables providers to address diverse genome-specific changes that might trigger withdrawal from treatment or recovery relapse in time to prevent that from occurring. This paper describes modern measurement tools contained in the NIH Patient-Reported Outcomes Measurement Information System (PROMIS and the NIH Toolbox and suggests how they might be applied to support recovery from alcohol and other substance use disorders in both pharmacological and abstinence-oriented modalities of care.

  8. Assessment of motivation for treatment in alcohol dependent patients who sought treatment at a specialized medical service

    Directory of Open Access Journals (Sweden)

    Oliveira Júnior Hercílio Pereira de

    2003-01-01

    Full Text Available INTRODUCTION: Motivation is deemed a critical component for interventions intended to change behaviors related to the use of alcohol and other drugs. The classification of patients in 'stages of change' can be a useful tool for the organization and improvement of treating programs. METHODS: This study assessed the stages of change using the scales URICA and SOCRATES in patients who attended two different treating programs for alcohol dependence in a specialized medical service. We performed an analysis of the association between stages of change and demographic aspects. After three months of treatment, patients were reassessed to evaluate their outcome. RESULTS: In the assessments using URICA, there was an association between stages of change and monthly income and age. There was no evidence that patients move across the stages of change. Using the scale SOCRATES, we found an association between stages of change and monthly income. In the reassessment, there was a significant movement across the stages of change. CONCLUSION: Patients who attend two different treating programs may have different motivation profiles. There was no movement congruent with the stage of change model, suggesting that patients may need more than 3 months to obtain significant changes in their motivation.

  9. 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. Obje...... an efficient and individual pain treatment on time. Knowl-edge about how time affect patients pain assessment is important for nurses in order to make patients participate in pain assessment.......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...... was difficult to use for the patients during activity as intensity of pain changed within seconds in the postoperative phase. The patients elucidated how anaesthesia affected their ability to assess pain and they described how pain medicine and severe pain over time caused variation in ability to communicate...

  10. Functional Assessment and Behavioral Treatment of Skin Picking in a Teenage Girl With Prader-Willi Syndrome

    NARCIS (Netherlands)

    Radstaake, M.; Didden, H.C.M.; Bolio, M.M.L.; Lang, R.; Lancioni, G.E.; Curfs, L.M.G

    2011-01-01

    Skin picking is common in individuals with Prader-Willi Syndrome (PWS) but few treatment studies exist. This study reports the successful functional behavioral assessment (FBA) and treatment of skin picking in a 16-year-old female with PWS. A treatment package based on FBA results consisted of diffe

  11. 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.

  12. CBCT in orthodontics: assessment of treatment outcomes and indications for its use.

    Science.gov (United States)

    Kapila, S D; Nervina, J M

    2015-01-01

    Since its introduction into dentistry in 1998, CBCT has become increasingly utilized for orthodontic diagnosis, treatment planning and research. The utilization of CBCT for these purposes has been facilitated by the relative advantages of three-dimensional (3D) over two-dimensional radiography. Despite many suggested indications of CBCT, scientific evidence that its utilization improves diagnosis and treatment plans or outcomes has only recently begun to emerge for some of these applications. This article provides a comprehensive and current review of key studies on the applications of CBCT in orthodontic therapy and for research to decipher treatment outcomes and 3D craniofacial anatomy. The current diagnostic and treatment planning indications for CBCT include impacted teeth, cleft lip and palate and skeletal discrepancies requiring surgical intervention. The use of CBCT in these and other situations such as root resorption, supernumerary teeth, temporomandibular joint (TMJ) pathology, asymmetries and alveolar boundary conditions should be justified on the basis of the merits relative to risks of imaging. CBCT has also been used to assess 3D craniofacial anatomy in health and disease and of treatment outcomes including that of root morphology and angulation; alveolar boundary conditions; maxillary transverse dimensions and maxillary expansion; airway morphology, vertical malocclusion and obstructive sleep apnoea; TMJ morphology and pathology contributing to malocclusion; and temporary anchorage devices. Finally, this article utilizes findings of these studies and current voids in knowledge to provide ideas for future research that could be beneficial for further optimizing the use of CBCT in research and the clinical practice of orthodontics.

  13. 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; Calaza, Manuel; Elmarakeby, Haitham; Heath, Lenwood S.; Long, Quan; Moore, Jonathan D.; Opiyo, Stephen Obol; Savage, Richard S.; Zhu, Jun; 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 Jr., 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.

    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 (h2=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

  14. Issues in the psychopharmacologic assessment and treatment of the orthodox Jewish patient.

    Science.gov (United States)

    Feinberg, S Shalom

    2005-12-01

    As with members of other cultural and religious groups, patients within the Orthodox Jewish community present with their own distinct clinical psychiatric issues related to their unique beliefs and practices. This article reviews the existing literature and anecdotal experience on the psychopharmacologic assessment and treatment of Orthodox Jewish patients. Specific aspects examined include this group's perceived intense stigma in receiving treatment, the priority this community places on cognitive functioning, and how the influence of Jewish laws on marriage and sexual practices impacts one's treatment decisions. The relevance of Jewish dietary laws, the Sabbath, and the community's interest in alternative treatments are also discussed. The limited ethno-psychopharmacology research related to Orthodox Jewish psychiatric patients is reviewed. We conclude that understanding issues such as these is critical if one is going to work within this cultural system in order to successfully address their mental health issues. However, the dearth of controlled research in this community needs to be addressed to provide more effective treatment.

  15. Assessing the detoxication efficiencies of wastewater treatment processes using a battery of bioassays/biomarkers.

    Science.gov (United States)

    Ma, Mei; Li, Jian; Wang, Zijian

    2005-11-01

    A battery of in vitro bioassays, including a Neutral Red (NR) assay using MCF-7 cells for predicting cytotoxic chemicals, an ethoxy resorufin-O-deethylase (EROD) activity assay using H4IIE cells to check for dioxin-like chemicals, and a recombinant gene yeast assay for screening estrogenic chemicals, was conducted to assess the removal efficiencies of trace toxic chemicals by different treatment processes in the waste water treatment plant (WWTP). The effluents were extracted by solid phase extraction (SPE) and were fractionated into three fractions based on polarities. The battery of bioassays was performed for each fraction. In the battery, the toxicities of the effluents were described according to their modes of actions (MOA) or biomarkers and the properties of the toxic chemicals were categorized by their polarities and MOAs. The proposed procedure could be used as a tool to diagnose the toxic characteristics of the complicate mixture. The results showed that cytotoxic, dioxin-like and estrogenic chemicals could be detected in all samples. In the influent, cytotoxic and dioxin-like chemicals were mainly in polar fraction and estrogenic chemicals were in non-polar and moderate-polar fractions. The secondary treatment (active sludge) could remove a small amount of these toxicants. Among different types of advanced treatments, flocculation was good enough to remove most of the cytotoxic chemicals and a combination of flocculation, ozone oxidation, and post-biological treatment could eliminate most of the dioxin-like and estrogenic chemicals.

  16. Assessing small-volume spinal cord dose for repeat spinal stereotactic body radiotherapy treatments

    Science.gov (United States)

    Ma, Lijun; Kirby, Neil; Korol, Renee; Larson, David A.; Sahgal, Arjun

    2012-12-01

    Spinal cord biologically effective dose (BED) limits are critical to safe spine stereotactic body radiotherapy (SBRT) delivery. In particular, when repeating SBRT to the same site, the problem of adding non-uniform BED distributions within small volumes of spinal cord has yet to be solved. We report a probability-based generalized BED (gBED) model to guide repeat spine SBRT treatment planning. The gBED was formulated by considering the sequential damaging probabilities of repeat spine SBRT treatments. Parameters from the standard linear-quadratic model, such as α/β = 2 Gy for the spinal cord, were applied. We tested the model based on SBRT specific spinal cord tolerance using a simulated and ten clinical repeat SBRT cases. The gBED provides a consistent solution for superimposing non-uniform dose distributions from different fractionation schemes, analogous to the BED for uniform dose distributions. Based on ten clinical cases, the gBED was observed to eliminate discrepancies in the cumulative BED of approximately 5% to 20% within small volumes (e.g. 0.1-2.0 cc) of spinal cord, as compared to a conventional calculation method. When assessing spinal cord tolerance for repeat spinal SBRT treatments, caution should be exercised when applying conventional BED calculations for small volumes of spinal cord irradiated, and the gBED potentially provides more conservative and consistently derived dose surrogates to guide safe treatment planning and treatment outcome modeling.

  17. 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

  18. Bioanalytical assessment of the formation of disinfection byproducts in a drinking water treatment plant.

    Science.gov (United States)

    Neale, Peta A; Antony, Alice; Bartkow, Michael E; Farré, Maria José; Heitz, Anna; Kristiana, Ina; Tang, Janet Y M; Escher, Beate I

    2012-09-18

    Disinfection of drinking water is the most successful measure to reduce water-borne diseases and protect health. However, disinfection byproducts (DBPs) formed from the reaction of disinfectants such as chlorine and monochloramine with organic matter may cause bladder cancer and other adverse health effects. In this study the formation of DBPs through a full-scale water treatment plant serving a metropolitan area in Australia was assessed using in vitro bioanalytical tools, as well as through quantification of halogen-specific adsorbable organic halogens (AOXs), characterization of organic matter, and analytical quantification of selected regulated and emerging DBPs. The water treatment train consisted of coagulation, sand filtration, chlorination, addition of lime and fluoride, storage, and chloramination. Nonspecific toxicity peaked midway through the treatment train after the chlorination and storage steps. The dissolved organic matter concentration decreased after the coagulation step and then essentially remained constant during the treatment train. Concentrations of AOXs increased upon initial chlorination and continued to increase through the plant, probably due to increased chlorine contact time. Most of the quantified DBPs followed a trend similar to that of AOXs, with maximum concentrations observed in the final treated water after chloramination. The mostly chlorinated and brominated DBPs formed during treatment also caused reactive toxicity to increase after chlorination. Both genotoxicity with and without metabolic activation and the induction of the oxidative stress response pathway showed the same pattern as the nonspecific toxicity, with a maximum activity midway through the treatment train. Although measured effects cannot be directly translated to adverse health outcomes, this study demonstrates the applicability of bioanalytical tools to investigate DBP formation in a drinking water treatment plant, despite bioassays and sample preparation not

  19. Implications of attachment theory and research for the assessment and treatment of eating disorders.

    Science.gov (United States)

    Tasca, Giorgio A; Ritchie, Kerri; Balfour, Louise

    2011-09-01

    In this paper, we review the research literature on attachment and eating disorders and suggest a framework for assessing and treating attachment functioning in patients with an eating disorder. Treatment outcomes for individuals with eating disorders tend to be moderate. Those with attachment-associated insecurities are likely to be the least to benefit from current symptom-focused therapies. We describe the common attachment categories (secure, avoidant, anxious), and then describe domains of attachment functioning within each category: affect regulation, interpersonal style, coherence of mind, and reflective functioning. We also note the impact of disorganized mental states related to loss or trauma. Assessing these domains of attachment functioning can guide focused interventions in the psychotherapy of eating disorders. Case examples are presented to illustrate assessment, case formulation, and group psychotherapy of eating disorders that are informed by attachment theory. Tailoring treatments to improve attachment functioning for patients with an eating disorder will likely result in better outcomes for those suffering from these particularly burdensome disorders.

  20. Economic assessment of sludge handling and environmental impact of sludge treatment in a reed bed system.

    Science.gov (United States)

    Nielsen, Steen

    2015-01-01

    The effect on the environment of the establishment and operation of a sludge treatment reed bed system (STRB) is quite limited compared to mechanical sludge dewatering, with its accompanying use of energy and chemicals. The assessment presented here of the investment, operation and maintenance costs of a typical STRB, and of the related environmental impact, is based on the experiences gained from the operation of a large number of STRB in Denmark. There are differences in the environmental perspectives and costs involved in mechanical sludge dewatering and disposal on agricultural land compared to STRB. The two treatment methods were considered for comparison based on a treatment capacity of 550 tons of dry solids per year and with land application of the biosolids in Denmark. The initial capital cost for STRB is higher than a conventional mechanical system; however, an STRB would provide significant power and operating-cost savings, with a significant saving in the overall cost of the plant over 20-30 years. The assessment focuses on the use of chemicals, energy and greenhouse gas emissions and includes emptying, sludge residue quality and recycling. STRB with direct land application is the most cost-effective scenario and has the lowest environmental impact. A sludge strategy consisting of an STRB will be approximately DKK 536,894-647,636 cheaper per year than the option consisting of a new screw press or decanter.

  1. Assessment of Antiretroviral Treatment Adherence among Children Attending Care at a Tertiary Hospital in Southeastern Nigeria

    Directory of Open Access Journals (Sweden)

    Cletus Akahara

    2017-01-01

    Full Text Available Background. Adherence is the strongest predictor of successful treatment outcome among children infected with HIV. Our aim was to assess the antiretroviral drugs adherence status of HIV-infected children attending care at a tertiary hospital in Southeastern Nigeria. Method. The study involved a cross-sectional survey of 210 HIV-infected children attending care at a tertiary hospital in Southeastern Nigeria using self-report method of assessment. Optimal ART adherence is defined as patient taking not missing more than 1 dose of combined antiretroviral therapy medication in the preceding 2 weeks prior to the study. Result. A majority of the subjects 191 (91% had good adherence. There was a significant relationship between adherence and patient educational level (p=0.004, duration of treatment (p=0.001, drug administrator (p=0.005, and orphan status (p=0.001. The motivating factor for adherence was “not falling sick as before” while stigma was the most discouraging factor. Conclusion. The adherence level in this study was good. Stigma was an important reason given by patient/caregivers for nonadherence. There is need for concerted effort in addressing this barrier to improve adherence and prevent the emergence of drug resistance and treatment failure.

  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

    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......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...

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

    Energy Technology Data Exchange (ETDEWEB)

    Pfingston, M.; Arnish, J.; LePoire, D.; Chen, S.-Y.

    1998-10-14

    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.

  4. Assessment of wastewater treatment alternatives for small communities: An analytic network process approach.

    Science.gov (United States)

    Molinos-Senante, María; Gómez, Trinidad; Caballero, Rafael; Hernández-Sancho, Francesc; Sala-Garrido, Ramón

    2015-11-01

    The selection of the most appropriate wastewater treatment (WWT) technology is a complex problem since many alternatives are available and many criteria are involved in the decision-making process. To deal with this challenge, the analytic network process (ANP) is applied for the first time to rank a set of seven WWT technology set-ups for secondary treatment in small communities. A major advantage of ANP is that it incorporates interdependent relationships between elements. Results illustrated that extensive technologies, constructed wetlands and pond systems are the most preferred alternatives by WWT experts. The sensitivity analysis performed verified that the ranking of WWT alternatives is very stable since constructed wetlands are almost always placed in the first position. This paper showed that ANP analysis is suitable to deal with complex decision-making problems, such as the selection of the most appropriate WWT system contributing to better understand the multiple interdependences among elements involved in the assessment.

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

    DEFF Research Database (Denmark)

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

    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...... dissociation. The most common dissociative symptoms in treatement seeking refugees are discussed, and characteristics of the presumably “dissociated” pre- and post-war personality, which was spontanously observed during the clnical interviews...

  6. 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.

  7. 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.

  8. Quality assessment of diagnosis and antibiotic treatment of infectious diseases in primary care

    DEFF Research Database (Denmark)

    Saust, Laura Trolle; Monrad, Rikke Nygaard; Hansen, Malene Plejdrup;

    2016-01-01

    for diagnosis and antibiotic use in patients with infectious diseases in primary care. We extracted information about (1) type of infection; (2) target for quality assessment; (3) methodology used for developing the QIs; and (4) whether the QIs were developed for a national or international application. The QIs......OBJECTIVE: To identify existing quality indicators (QIs) for diagnosis and antibiotic treatment of patients with infectious diseases in primary care. DESIGN: A systematic literature search was performed in PubMed and EMBASE. We included studies with a description of the development of QIs...

  9. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-01-01

    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.

  11. Application of analytic hierarchy process in a waste treatment technology assessment in Mexico.

    Science.gov (United States)

    Taboada-González, Paul; Aguilar-Virgen, Quetzalli; Ojeda-Benítez, Sara; Cruz-Sotelo, Samantha

    2014-09-01

    The high per capita generation of solid waste and the environmental problems in major rural communities of Ensenada, Baja California, have prompted authorities to seek alternatives for waste treatment. In the absence of a selection methodology, three technologies of waste treatment with energy recovery (an anaerobic digester, a downdraft gasifier, and a plasma gasifier) were evaluated, taking the broader social, political, economic, and environmental issues into considerations. Using the scientific literature as a baseline, interviews with experts, decision makers and the community, and waste stream studies were used to construct a hierarchy that was evaluated by the analytic hierarchy process. In terms of the criteria, judgments, and assumptions made in the model, the anaerobic digester was found to have the highest rating and should consequently be selected as the waste treatment technology for this area. The study results showed low sensitivity, so alternative scenarios were not considered. The methodology developed in this study may be useful for other governments who wish to assess technologies to select waste treatment.

  12. Assessment of homeopathic medicine Aconitum napellus in the treatment of anxiety in an animal model

    Directory of Open Access Journals (Sweden)

    Andersom Ricardo Fréz

    2012-04-01

    Full Text Available Background: Aconitum napellus is a classic resource of complementary medicine for the treatment of patients exhibiting neurological symptoms of anxiety. Aim: To assess the action of homeopathic medicine Acon in the treatment of generalized anxiety in an experimental model using rats. Methods: 48 adult (two to three months old male Wistar rats (Rattus rattus were randomly divided in six groups (n= 8/treatment and given the following treatments by gastric tube along 10 days: 1 control (diazepam 1 mg/kg/day; 2 negative control (0.15 mL saline solution/day; 3 ACH6 (0.15 mL Acon (6cH/day; 4 ACH12 (0.15 mL Acon 12cH/day; 5 ACH30 (0.15 mL Acon 30cH/day; and 6 ALC30 (0.15 mL 30% cereal alcohol/day. Behavioral effects were blindly and randomly assessed in elevated plus maze (EPM and open field test. Results: Acon in dilutions 12cH and 30cH exhibited possible anxiolytic effects on the central nervous system (CNS since they increased the number of entries in the EPM open arms (12cH and 30cH and the permanence time in the EPM open arms (30cH only. In the open field test the homeopathic preparations did not show effects on the locomotor system of rats. Conclusion: Dilutions 12cH and 30cH of Acon exhibited anxiolytic effects on the CNS in an animal experimental model.

  13. 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.

  14. 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.

  15. Ecotoxicological assessment and evaluation of a pine bark biosorbent treatment of five landfill leachates.

    Science.gov (United States)

    Ribé, Veronica; Nehrenheim, Emma; Odlare, Monica; Gustavsson, Lillemor; Berglind, Rune; Forsberg, Ake

    2012-10-01

    When selecting a landfill leachate treatment method the contaminant composition of the leachate should be considered in order to obtain the most cost-effective treatment option. In this study the filter material pine bark was evaluated as a treatment for five landfill leachates originating from different cells of the same landfill in Sweden. The objective of the study was to determine the uptake, or release, of metals and dissolved organic carbon (DOC) during a leaching test using the pine bark filter material with the five different landfill leachates. Furthermore the change of toxicity after treatment was studied using a battery of aquatic bioassays assessing luminescent bacteria (Vibrio fischeri) acute toxicity (30-min Microtox®), immobility of the crustacean Daphnia magna, growth inhibition of the algae Pseudokirchneriella subcapitata and the aquatic plant Lemna minor; and genotoxicity with the bacterial Umu-C assay. The results from the toxicity tests and the chemical analysis were analyzed in a Principal Component Analysis and the toxicity of the samples before and after treatment was evaluated in a toxicity classification. The pine bark filter material reduced the concentrations of metal contaminants from the landfill leachates in the study, with some exceptions for Cu and Cd. The Zn uptake of the filter was high for heavily contaminated leachates (≥73%), although some desorption of zinc occurred in less contaminated waters. Some of the leachates may require further treatment due to discharge into a natural recipient in order to reduce the risk of possible biological effects. The difference in pH changes between the different leachates was probably due to variations in buffering capacity, affected by physicochemical properties of the leachate. The greatest desorption of phenol during filtration occurred in leachates with high conductivity or elevated levels of metals or salts. Generally, the toxicity classification of the leachates implies that although

  16. Decentralized peri-urban wastewater treatment technologies assessment integrating sustainability indicators.

    Science.gov (United States)

    Mena-Ulecia, Karel; Hernández, Heykel Hernández

    2015-01-01

    Selection of treatment technologies without considering the environmental, economic and social factors associated with each geographical context risks the occurrence of negative impacts that were not properly foreseen, working against the sustainable performance of the technology. The principal aim of this study was to evaluate 12 technologies for decentralized treatment of domestic wastewater applicable to peri-urban communities using sustainability approaches and, at the same time, continuing a discussion about how to address a more integrated assessment of overall sustainability. For this, a set of 13 indicators that embody the environmental, economic and social approach for the overall sustainability assessment were used by means of a target plot diagram as a tool for integrating indicators that represent a holistic analysis of the technologies. The obtained results put forward different degrees of sustainability, which led to the selection of: septic tank+land infiltration; up-flow anaerobic reactor+high rate trickling filter and septic tank+anaerobic filter as the most sustainable and attractive technologies to be applied in peri-urban communities, according to the employed indicators.

  17. Assessment and risk reduction of infectious pathogens on chiropractic treatment tables

    Directory of Open Access Journals (Sweden)

    Husbands Chris

    2007-06-01

    Full Text Available Abstract Background To investigate the presence of pathogenic microbes on chiropractic treatment tables in one outpatient teaching clinic. Additional aims were to test inexpensive disinfectants on tables that may kill microbes and suggest infection control measures for chiropractic offices, clinics and classrooms. The aim of the study was to assess the presence of pathogenic microbes on treatment tables in one outpatient teaching clinic and determine a simple behavioral model for infection control including table disinfection and accepted hand washing and sanitizing protocols. Methods 10 treatment tables were selected and sampled for possible microbial flora on face and hand pieces. Samples were cultured on MacConky's agar and mannitol salt agar, labeled and incubated for up to 48 hours. Confirmatory testing of microbes to determine if drug resistant flora were present was performed. Among tables tested, 5 were selected to test disinfectants. One-half of the face piece and 1 hand piece were treated with two different wipes and then post-tested for microbes. Results Pathogenic microbes were present on chiropractic treatment tables including methicillin-resistant Staph aureus. Simple disinfectants neutralized the pathogens. A rudimentary disinfection procedure and infection control measures are suggested based on the findings. Conclusion Pathogenic microbes may be present on chiropractic treatment tables and can be effectively killed with proper disinfecting. Hand washing/sanitizing is an important measure in infection control as is table disinfecting. Rudimentary behavioral changes to improve chiropractic clinic infection control are needed. More comprehensive behavioral models are needed. All teaching clinics and private chiropractic offices should adopt infection control practices including routine table disinfecting and hand sanitizing. Effective measures can be put in place at minimal costs. Accrediting bodies of chiropractic institutions

  18. CBCT in orthodontics: assessment of treatment outcomes and indications for its use

    Science.gov (United States)

    Nervina, J M

    2015-01-01

    Since its introduction into dentistry in 1998, CBCT has become increasingly utilized for orthodontic diagnosis, treatment planning and research. The utilization of CBCT for these purposes has been facilitated by the relative advantages of three-dimensional (3D) over two-dimensional radiography. Despite many suggested indications of CBCT, scientific evidence that its utilization improves diagnosis and treatment plans or outcomes has only recently begun to emerge for some of these applications. This article provides a comprehensive and current review of key studies on the applications of CBCT in orthodontic therapy and for research to decipher treatment outcomes and 3D craniofacial anatomy. The current diagnostic and treatment planning indications for CBCT include impacted teeth, cleft lip and palate and skeletal discrepancies requiring surgical intervention. The use of CBCT in these and other situations such as root resorption, supernumerary teeth, temporomandibular joint (TMJ) pathology, asymmetries and alveolar boundary conditions should be justified on the basis of the merits relative to risks of imaging. CBCT has also been used to assess 3D craniofacial anatomy in health and disease and of treatment outcomes including that of root morphology and angulation; alveolar boundary conditions; maxillary transverse dimensions and maxillary expansion; airway morphology, vertical malocclusion and obstructive sleep apnoea; TMJ morphology and pathology contributing to malocclusion; and temporary anchorage devices. Finally, this article utilizes findings of these studies and current voids in knowledge to provide ideas for future research that could be beneficial for further optimizing the use of CBCT in research and the clinical practice of orthodontics. PMID:25358833

  19. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  1. Tridimensional assessment of adductor spasmodic dysphonia pre- and post-treatment with Botulinum toxin.

    Science.gov (United States)

    Dejonckere, P H; Neumann, K J; Moerman, M B J; Martens, J P; Giordano, A; Manfredi, C

    2012-04-01

    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 performed on voices of 19 patients diagnosed with adductor spasmodic dysphonia (SD), before and after treatment with Botulinum toxin. The speech material consisted of 40 short sentences phonetically selected for constant voicing. Seven perceptual parameters (traditional and dedicated) were blindly rated by a panel of experienced clinicians. Nine acoustic measures (mainly based on voicing evidence and periodicity) were achieved by a special analysis program suited for strongly irregular signals and validated with synthesized deviant voices. Patients also filled in a VHI-questionnaire. Significant improvement is shown by all three approaches. The traditional GRB perceptual parameters appear to be adequate for these patients. Conversely, the special acoustic analysis program is successful in objectivating the improved regularity of vocal fold vibration: the basic jitter remains the most valuable parameter, when reliably quantified. The VHI is well suited for the voice-related quality of life. Nevertheless, when considering pre-therapy and post-therapy changes, the current study illustrates a complete lack of correlation between the perceptual, acoustic, and self-assessment dimensions. Assessment of SD-voices needs to be tridimensional.

  2. A review of the assessment and treatment of anger and aggression in offenders with intellectual disability.

    Science.gov (United States)

    Taylor, J L

    2002-05-01

    Rates of aggression amongst people with intellectual disability (ID) have been found to be high in studies conducted on several continents across a number of service settings. Aggression is the primary reason for people with ID to be admitted or re-admitted to institutional settings, and it is also the main reason for individuals in this client group to be prescribed behaviour-control drugs. Anger is a significant activator of aggression, but little is known about the emotional aspects of the lives of people with ID. There are many reasons for this, but a lack of reliable and validated assessment measures is chief among them. The present review found that very little work has been conducted to date concerning the development of robust tools for assessing anger and aggression in this population. A narrative review of interventions for reducing aggression and anger in people with ID showed that there is virtually no evidence to support the use of psychotropic medications. Research has shown that behavioural interventions can be effective; however, they are intrusive and have not been tested in naturalistic settings with higher-functioning clients and low-frequency aggression. More recently, cognitive-behavioural interventions have shown promise, but the mechanisms for effective change have yet to be delineated. Priority research questions relating to assessment, treatment and therapeutic skills in working with anger and aggression problems are offered by the present review.

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

    Directory of Open Access Journals (Sweden)

    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.

  4. Integrated monitoring and assessment of soil restoration treatments in the Lake Tahoe Basin.

    Science.gov (United States)

    Grismer, M E; Schnurrenberger, C; Arst, R; Hogan, M P

    2009-03-01

    Revegetation and soil restoration efforts, often associated with erosion control measures on disturbed soils, are rarely monitored or otherwise evaluated in terms of improved hydrologic, much less, ecologic function and longer term sustainability. As in many watersheds, sediment is a key parameter of concern in the Tahoe Basin, particularly fine sediments less than about ten microns. Numerous erosion control measures deployed in the Basin during the past several decades have under-performed, or simply failed after a few years and new soil restoration methods of erosion control are under investigation. We outline a comprehensive, integrated field-based evaluation and assessment of the hydrologic function associated with these soil restoration methods with the hypothesis that restoration of sustainable function will result in longer term erosion control benefits than that currently achieved with more commonly used surface treatment methods (e.g. straw/mulch covers and hydroseeding). The monitoring includes cover-point and ocular assessments of plant cover, species type and diversity; soil sampling for nutrient status; rainfall simulation measurement of infiltration and runoff rates; cone penetrometer measurements of soil compaction and thickness of mulch layer depths. Through multi-year hydrologic and vegetation monitoring at ten sites and 120 plots, we illustrate the results obtained from the integrated monitoring program and describe how it might guide future restoration efforts and monitoring assessments.

  5. Phase Angle, an Alternative Physiological Tool to Assess Wound Treatment in Chronic Nonhealing Wounds

    Science.gov (United States)

    Moore, Michael F.; Dobson, Nanci; Castelllino, Lisa; Kapp, Susan

    2011-01-01

    Background This exploratory study was conducted in an effort to demonstrate that bioelectrical impedance analysis (BIA) phase angle measurement is a novel tool for monitoring the effectiveness of a wound care regimen at a regional level and is valuable in comparing that status with the overall metabolic health of the patient. Isolating and measuring the extent to which nutritional supplementation contributes to the healing process is difficult and confounded by the many treatment modalities patients undergo. Objective The authors conducted a limited exploratory study to determine whether regional phase angle measurements accurately reflected the status of chronic nonhealing wounds. This information would potentially provide the ability to quantitatively evaluate of the role of nutritional supplementation in wounds of varying etiologies by comparing regional BIA phase angle measurement with overall BIA phase angle measurement. Methods Eleven patients with wounds of varying etiologies were selected to participate. Each patient underwent a treatment regimen specific to his or her condition, and all patients were given JUVEN® nutritional supplement. Results and Conclusion In all patients, the BIA phase angle measurement mirrored the health of the wound and provided an accurate tool for assessing the regional tissue health, a valuable insight in measuring the effectiveness of a systemic treatment. PMID:24527159

  6. [Neurolymphomatosis: diagnosis of extension and assessment of response to treatment with PET-CT].

    Science.gov (United States)

    Durán, C; Infante, J R; Serrano, J; Rayo, J I; García, L; Domínguez, M L; Sánchez, R

    2009-01-01

    Neurolymphomatosis is a rare neurological manifestation of non-Hodgkin's lymphoma (NHL) and it may be its first and sole manifestation. Diagnosis is often difficult and nerve biopsy is generally required. However, this it is not always possible to perform or is not conclusive. We present the case of a 66-year-old woman diagnosed with giant B-cell NHL. After 6 cycles of chemotherapy, imaging and molecular biology techniques showed complete remission. At four months after treatment, the patient complained of low back pain of radicular distribution. CT and MRI imaging showed signs of lymphoproliferative activity of L5 and also lesions to thoracic nerve roots. A PET-CT was requested in order to complete the diagnosis and plan the treatment. Imaging confirmed the presence of tumor recurrence with neurolymphomatosis and also indicated lesions on the chest and abdominal level. Thus, it was decided to start a new line of chemotherapy, without performing the histological study through biopsy. This case illustrates the important role played by PET-CT imaging in neurolymphomatosis diagnosis. This technique can help the patient avoid more aggressive procedures, such as a biopsy, and can also be useful in the follow-up and assessment of the treatment response to NHL-diagnosed patients.

  7. Children's stress during a restorative dental treatment: assessment using salivary cortisol measurements.

    Science.gov (United States)

    Akyuz, S; Pince, S; Hekin, N

    1996-01-01

    Dental environment may be a source of stress for the young patient. Such stressful conditions may provoke fear in anxious children. It is well known that stress produces an activation adrenal steroid secretion. Among the methods for assessing child dental fear, measurement of salivary cortisol level is a simple method, because especially in children, sampling of saliva is easy, and cortisol levels in saliva closely mirror serum free cortisol levels, independent of salivary flow rate. For this study, the salivary cortisol levels of 8 children (mean age 5.6 yr) were measured receiving initial dental treatment. Saliva samples were collected via cotton rolls placed to the floor of the mouth at four stages; prior to treatment, during cavitation, placement of the liner and the restoration. Statistical comparison of the results were done by Student-t test. The increase in salivary cortisol levels during cavitation at the first and secondary appointments were significant (p0.05). The results of this study suggest that in restorative procedures, mostly it is the cavitation step that creates stress and anxiety in children. Knowledge of the most stressful condition may be helpful for the dentist to prepare the child to treatment steps.

  8. A risk-benefit assessment of pharmacological treatments for panic disorder.

    Science.gov (United States)

    Bennett, J A; Moioffer, M; Stanton, S P; Dwight, M; Keck, P E

    1998-06-01

    Panic disorder, a psychiatric disorder characterised by frequent panic attacks, is the most common anxiety disorder, affecting 2 to 6% of the general population. No one line of treatment has been found to be superior, making a risk-benefit assessment of the treatments available useful for treating patients. Choice of treatment depends on a number of issues, including the adverse effect profile, efficacy and the presence of concomitant syndromes. Tricyclic antidepressants (TCAs) are beneficial in the treatment of panic disorder. They have a proven efficacy, are affordable and are conveniently administered. Adverse effects, including jitteriness syndrome, bodyweight gain, anticholinergic effects and orthostatic hypotension are commonly associated with TCAs, but can be managed successfully. Selective serotonin (5-hydroxytryptamine; 5HT) reuptake inhibitors are also potential first line agents and are well tolerated and effective, with a favourable adverse effects profile. There is little risk in overdose or of anticholinergic effects. Adverse effects include sedation, dyspepsia and headache early in treatment, and sexual dysfunction and increased anxiety, but these can be effectively managed with proper dosage escalation and management. Benzodiazepines are an effective treatment, providing short-term relief of panic-related symptoms. Patients respond to treatment quickly, providing rapid relief of symptoms. Adverse effects include ataxia and drowsiness, and cognitive and psycho-motor impairment. There are reservations over their first-line use because of concerns regarding abuse and dependence. Monoamine oxidase inhibitors, because of their adverse effects profile, potential drug interactions, dietary restrictions, gradual onset of effect and overdose risk, are not considered to be first-line agents. They are effective however, and should be considered for patients with refractory disease. Valproic acid (valproate sodium), while not intensively studied, shows

  9. 77 FR 6567 - Assessment of Analgesic Treatment of Chronic Pain-A Public Workshop; Request for Comments

    Science.gov (United States)

    2012-02-08

    ... HUMAN SERVICES Food and Drug Administration Assessment of Analgesic Treatment of Chronic Pain--A Public... analgesics in the treatment of chronic non-cancer pain (CNCP). The focus of the presentations and discussions... during the open session of the meeting, please email your registration to...

  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. Single-Participant Assessment of Treatment Mediators: Strategy Description and Examples from a Behavioral Activation Intervention for Depressed Adolescents

    Science.gov (United States)

    Gaynor, Scott T.; Harris, Amanda

    2008-01-01

    Determining the means by which effective psychotherapy works is critical. A generally recommended strategy for identifying the potential causal variables is to conduct group-level statistical tests of treatment mediators. Herein the case is made for also assessing mediators of treatment outcome at the level of the individual participant.…

  12. Assessment of laboratory methods used in the diagnosis of congenital toxoplasmosis after maternal treatment with spiramycin in pregnancy

    OpenAIRE

    2014-01-01

    Background The different laboratory methods used in the diagnosis of congenital toxoplasmosis have variable sensitivity and specificity. There is no evidence to prove that maternal treatment reduces the risk of fetal infection. The purpose of this study was to assess methods for the confirmation of congenital toxoplasmosis after maternal treatment with spiramycin during pregnancy, and to evaluate the effect of this treatment on clinical manifestations of the disease in newborns (NB). Methods ...

  13. Treatments for hyperemesis gravidarum and nausea and vomiting in pregnancy: a systematic review and economic assessment.

    Science.gov (United States)

    O'Donnell, Amy; McParlin, Catherine; Robson, Stephen C; Beyer, Fiona; Moloney, Eoin; Bryant, Andrew; Bradley, Jennifer; Muirhead, Colin; Nelson-Piercy, Catherine; Newbury-Birch, Dorothy; Norman, Justine; Simpson, Emma; Swallow, Brian; Yates, Laura; Vale, Luke

    2016-01-01

    BACKGROUND Nausea and vomiting in pregnancy (NVP) affects up to 85% of all women during pregnancy, but for the majority self-management suffices. For the remainder, symptoms are more severe and the most severe form of NVP - hyperemesis gravidarum (HG) - affects 0.3-1.0% of pregnant women. There is no widely accepted point at which NVP becomes HG. OBJECTIVES This study aimed to determine the relative clinical effectiveness and cost-effectiveness of treatments for NVP and HG. DATA SOURCES MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, PsycINFO, Commonwealth Agricultural Bureaux (CAB) Abstracts, Latin American and Caribbean Health Sciences Literature, Allied and Complementary Medicine Database, British Nursing Index, Science Citation Index, Social Sciences Citation Index, Scopus, Conference Proceedings Index, NHS Economic Evaluation Database, Health Economic Evaluations Database, China National Knowledge Infrastructure, Cochrane Database of Systematic Reviews and Database of Abstracts of Reviews of Effects were searched from inception to September 2014. References from studies and literature reviews identified were also examined. Obstetric Medicine was hand-searched, as were websites of relevant organisations. Costs came from NHS sources. REVIEW METHODS A systematic review of randomised and non-randomised controlled trials (RCTs) for effectiveness, and population-based case series for adverse events and fetal outcomes. Treatments: vitamins B6 and B12, ginger, acupressure/acupuncture, hypnotherapy, antiemetics, dopamine antagonists, 5-hydroxytryptamine receptor antagonists, intravenous (i.v.) fluids, corticosteroids, enteral and parenteral feeding or other novel treatment. Two reviewers extracted data and quality assessed studies. Results were narratively synthesised; planned meta-analysis was not possible due to heterogeneity and incomplete reporting. A simple economic evaluation considered

  14. 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

  15. Efficiency of the CATIE and BACS neuropsychological batteries in assessing cognitive effects of antipsychotic treatments in schizophrenia.

    Science.gov (United States)

    Hill, S Kristian; Sweeney, John A; Hamer, Robert M; Keefe, Richard S E; Perkins, Diana O; Gu, Hongbin; McEvoy, Joseph P; Lieberman, Jeffrey A

    2008-03-01

    Efficient and reliable assessments of cognitive treatment effects are essential for the comparative evaluation of procognitive effects of pharmacologic therapies. Yet, no studies have addressed the sensitivity and efficiency with which neurocognitive batteries evaluate cognitive abilities before and after treatment. Participants were primarily first episode schizophrenia patients who completed baseline (n = 367) and 12-week (n = 219) assessments with the BACS (Brief Assessment of Cognition in Schizophrenia) and CATIE (Clinical Antipsychotic Trials of Intervention Effectiveness) neuropsychological batteries in a clinical trial comparing olanzapine, quetiapine, and risperidone. Exploratory factor analysis revealed that performance on both batteries was characterized by a single factor of generalized cognitive deficit for both baseline performance and cognitive change after treatment. Both batteries estimated similar levels of change following treatment, although the BACS battery required half the administration time. Because a unitary factor characterized baseline cognitive abilities in early psychosis as well as cognitive change after treatment with atypical antipsychotic medications, short batteries such as the BACS may efficiently provide sufficient assessment of procognitive treatment effects with antipsychotic medications. Assessment of cognitive effects of adjunctive therapies targeting specific cognitive domains or impairments may require more extensive testing of the domains targeted to maximize sensitivity for detecting specific predicted cognitive outcomes.

  16. 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

  17. Different Teams, Same Conclusions? A Systematic Review of Existing Clinical Guidelines for the Assessment and Treatment of Tinnitus in Adults

    Science.gov (United States)

    Fuller, Thomas E.; Haider, Haula F.; Kikidis, Dimitris; Lapira, Alec; Mazurek, Birgit; Norena, Arnaud; Rabau, Sarah; Lardinois, Rachelle; Cederroth, Christopher R.; Edvall, Niklas K.; Brueggemann, Petra G.; Rosing, Susanne N.; Kapandais, Anestis; Lungaard, Dorte; Hoare, Derek J.; Cima, Rilana F. F

    2017-01-01

    Background: Though clinical guidelines for assessment and treatment of chronic subjective tinnitus do exist, a comprehensive review of those guidelines has not been performed. The objective of this review was to identify current clinical guidelines, and compare their recommendations for the assessment and treatment of subjective tinnitus in adults. Method: We systematically searched a range of sources for clinical guidelines (as defined by the Institute of Medicine, United States) for the assessment and/or treatment of subjective tinnitus in adults. No restrictions on language or year of publication were applied to guidelines. Results: Clinical guidelines from Denmark, Germany, Sweden, The Netherlands, and the United States were included in the review. There was a high level of consistency across the guidelines with regard to recommendations for audiometric assessment, physical examination, use of a validated questionnaire(s) to assess tinnitus related distress, and referral to a psychologist when required. Cognitive behavioral treatment for tinnitus related distress, use of hearing aids in instances of hearing loss and recommendations against the use of medicines were consistent across the included guidelines. Differences between the guidelines centered on the use of imaging in assessment procedures and sound therapy as a form of treatment for tinnitus distress respectively. Conclusion: Given the level of commonality across tinnitus guidelines from different countries the development of a European guideline for the assessment and treatment of subjective tinnitus in adults seems feasible. This guideline would have the potential to benefit the large number of clinicians in countries where clinical guidelines do not yet exist, and would support standardization of treatment for patients across Europe. PMID:28275357

  18. 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...... 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...

  19. Current practice in assessment and treatment of bronchial asthma in young males in Italy.

    Science.gov (United States)

    Ferrante, E; Pantaleo, C; Quatela, M; Fuso, L; Basso, S; Pistelli, R

    2000-10-01

    The aim of the study was to evaluate, in a sample of young asthmatics in Italy, the current practice in assessment and treatment of asthma after the publication of guidelines. Young soldiers who declared bronchial asthma at the beginning of the compulsory military service were evaluated. One-hundred and thirty-eight subjects with confirmed asthma were selected. Sixty-seven subjects (48.5%) had had at last one spirometry, and only one subject had underwent peak flow monitoring at home; most of the subjects (96.8%) had had prick tests. More of the 50% of the subjects with bronchial obstruction or with severe bronchial hyperresponsiveness, with clinical moderate or severe asthma, had used only bronchodilators or no therapy at all in the preceding year. In this sample of young asthmatics, the lung function tests were still underutilized for the diagnosis and follow-up of bronchial asthma; moreover, the inhaled anti-inflammatory drugs were still underutilized.

  20. Ecotoxicity Assessment of Stabilized Sewage Sludge from Municipal Sewage Treatment Plant

    Science.gov (United States)

    Włodarczyk, Elżbieta; Próba, Marta; Wolny, Lidia

    2016-09-01

    Aim of this study was to evaluate the ecotoxicity of municipal sewage sludge conditioned with polyelectrolytes, taken from selected sewage treatment plant. Using the bioindication analysis overall toxicity was assessed, which allows to know the total toxicity of all the harmful substances contained in sewage sludge, in many cases acting synergistically. To prepare a sample of sludge for the basic test, all analyses were performed with a ratio of liquid to solid of 10:1 (water extract). Daphnia pulex biological screening test was used. A dilution series of an water extract of sludge were prepared to include within its scope the lowest concentration that causes 100% effect and the highest producing less than 10% of the effect within a specified range of the assay. The results of the test were read after 24 and 48 hours. Based on the research and analysis of test results it proved that the sewage sludge conditioned with polyelectrolytes exhibit the characteristics of eco-toxic.

  1. Wastewater treatment and public health in Nunavut: a microbial risk assessment framework for the Canadian Arctic

    DEFF Research Database (Denmark)

    Daley, Kiley; Jamieson, Rob; Rainham, Daniel

    2017-01-01

    . This review offers a conceptual framework and evaluation of current knowledge to enable the first microbial risk assessment of exposure scenarios associated with food-harvesting and recreational activities in Arctic communities, where simplified wastewater systems are being operated.......Wastewater management in Canadian Arctic communities is influenced by several geographical factors including climate, remoteness, population size, and local food-harvesting practices. Most communities use trucked collection services and basic treatment systems, which are capable of only low...... into the terrestrial and aquatic environment at random times. Northern communities rely heavily on their local surroundings as a source of food, drinking water, and recreation, thus creating the possibility of human exposure to wastewater effluent. Human exposure to microbial hazards present in municipal wastewater...

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

    Science.gov (United States)

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

    2012-11-15

    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. Whereas 9 compounds have been detected in more than 70% of the samples analyzed, 7 compounds have been found at levels equal or higher than the river Environmental Quality Standards set by the Water Framework Directive. Upon combination of both criteria (presence and concentration), compounds of greatest environmental concern in the WWTP studied are nickel, the herbicide diuron, and the endocrine disruptors nonyl and octylphenol. It is remarkable the low variability of the pollutant concentration just differing for the case of nickel and zinc. These low values of exposure together with other pollutants' characteristics provide a medium or low risk assessment for all the WWTPs. The results of this new method have been compared with COMMPS procedure, a solid method developed in the context of the Water Framework Directive, and they show that the fuzzy model is more conservative than COMMPS. This is due to different reasons: the fuzzy model takes into account the persistence of chemical compounds whereas COMMPS does not; the fuzzy model includes the weights provided by an expert group inquired in previous works and also considers the uncertainty of the environmental data, avoiding the crisp values and offering a range of overlapping between the different fuzzy sets. However, the results even if being more conservative with fuzzy logic, are in good agreement with a solid methodology such as the COMMPS procedure.

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

    Science.gov (United States)

    Yoshida, Hiroko; Clavreul, Julie; Scheutz, Charlotte; Christensen, Thomas H

    2014-06-01

    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 existing emission and operational data, which are gathered under either compulsory monitoring or reporting requirements under law. In this study, an LCA was conducted using three input data sources: Information compiled under compulsory disclosure requirements (the European Pollutant Release and Transfer 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 input data coverage. Due to the threshold on reporting value, the E-PRTR did not capture the impact for particulate matter emission, terrestrial acidification, or terrestrial eutrophication. While the current practice can capture more than 90% of non-carcinogenic human toxicity and marine eutrophication, 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, and chemicals, which do not need to be disclosed currently under E-PRTR. The incidental release of pollutants was also assessed by employing a scenario-based approach, the results of which demonstrated that these non-routine emissions could increase overall WWTP greenhouse gas emissions by between 113 and 210%. Overall, current data collection schemes have the potential to provide standardized data collection and form the basis for a sound environmental impact assessment, but

  4. Assessing Donor Site Complications of Iliac Crest Bone Graft in Treatment of Scaphoid Nonunion

    Directory of Open Access Journals (Sweden)

    Davod Jafari

    2016-07-01

    Full Text Available Background Bone grafting is a common surgical technique to augment bone regeneration in orthopedic surgery. Autologous bone graft harvesting is the reliable treatment option and iliac crest is the most common harvesting site for healing bone fractures. However, the results of iliac crest bone graft harvesting are associated with morbidity and a number of complications. Objectives The aim of this study was to assess donor site complications of scaphoid nonunion, to find clinical outcomes and the impact of iliac crest bone graft on age, gender, pain, numbness, itching, nerve injury and scar appearance of patients. Methods In a prospective review of 61 cases of iliac crest bone graft procedures at the Shafa hospital from 2013 to 2014, complications including pain, infection, hematoma, stress fracture, hypertrophic scars, numbness area and itching were assessed clinically. Results Pain identified as the most common complication. The most common complications following postoperative pain at the donor site that reduced after six weeks were: numbness 3.27%, unsatisfactory scar appearance 3.27% and itching discomfort 1.63%. Conclusions Harvesting of iliac crest bone graft can be the ideal way to prepare graft procedures required surgery scaphoid nonunion fractures with minimal complications. Nevertheless, with an adequate preoperative planning and appropriate surgical technique, the prevalence of these complications can be reduced.

  5. Zebrafish and clean water technology: assessing soil bioretention as a protective treatment for toxic urban runoff.

    Science.gov (United States)

    McIntyre, J K; Davis, J W; Incardona, J P; Stark, J D; Anulacion, B F; Scholz, N L

    2014-12-01

    Urban stormwater contains a complex mixture of contaminants that can be acutely toxic to aquatic biota. Green stormwater infrastructure (GSI) is a set of evolving technologies intended to reduce impacts on natural systems by slowing and filtering runoff. The extent to which GSI methods work as intended is usually assessed in terms of water quantity (hydrology) and quality (chemistry). Biological indicators of GSI effectiveness have received less attention, despite an overarching goal of protecting the health of aquatic species. Here we use the zebrafish (Danio rerio) experimental model to evaluate bioinfiltration as a relatively inexpensive technology for treating runoff from an urban highway with dense motor vehicle traffic. Zebrafish embryos exposed to untreated runoff (48-96h; six storm events) displayed an array of developmental abnormalities, including delayed hatching, reduced growth, pericardial edema, microphthalmia (small eyes), and reduced swim bladder inflation. Three of the six storms were acutely lethal, and sublethal toxicity was evident across all storms, even when stormwater was diluted by as much as 95% in clean water. As anticipated from exposure to cardiotoxic polycyclic aromatic hydrocarbons (PAHs), untreated runoff also caused heart failure, as indicated by circulatory stasis, pericardial edema, and looping defects. Bioretention treatment dramatically improved stormwater quality and reversed nearly all forms of developmental toxicity. The zebrafish model therefore provides a versatile experimental platform for rapidly assessing GSI effectiveness.

  6. 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.

  7. 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.

  8. Pharmacological manipulation of gastric juice: thrombelastographic assessment and implications for treatment of gastrointestinal haemorrhage.

    Science.gov (United States)

    Patchett, S E; O'Donoghue, D P

    1995-03-01

    The impairment of formation and maintenance of a formed fibrin clot contributes to the prolonged bleeding and high incidence of rebleeding in upper gastrointestinal haemorrhage. To investigate the basis for the use of drug therapy in gastric bleeding, this study used thrombelastography to determine the effects of pharmacological manipulation of gastric juice on coagulation and fibrinolysis. The thrombelastograph is a mechanical device that provides a visual assessment of all stages of coagulation and fibrinolysis. The effects of fresh and pharmacologically changed gastric juice was assessed after its addition to fresh whole blood in the thrombelastograph cuvette. Pharmacological manipulation was achieved through alkalisation or through addition of tranexamic acid, aprotinin, or sucralfate. Fresh gastric juice delayed clot formation, decreased maximum clot amplitude, and stimulated clot lysis. Alkalisation inhibited the lytic effects of fresh gastric juice and improved the induced abnormalities in coagulation. Tranexamic acid partially inhibited gastric juice induced clot lysis but did not exhibit a beneficial effect on coagulation. Sucralfate, and to a lesser extent aprotinin significantly inhibited fibrinolysis but exacerbated the detrimental effect of gastric juice on the parameters of coagulation. Alkalisation of gastric juice reduces the adverse effect on coagulation and fibrinolysis. Tranexamic acid, aprotinin, and sucralfate can all reduce or inhibit clot lysis, but the adverse effects on clot formation may outweigh any potential benefit in the treatment of gastrointestinal bleeding.

  9. 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.

  10. [Importance of voice quality evaluation in the assessment of treatment outcome after endolaryngeal microsurgery].

    Science.gov (United States)

    Siupsinskiene, Nora

    2002-01-01

    The aim of the study was to compare subjective and quantitative voice characteristics changes after endolaryngeal microsurgery with respect to different postoperative follow-up term. We evaluated 80 surgically-treated patients aged 14-81 years (mean 42.6+/-13.8 years) with benign vocal cord (VC) lesions (polyps, n=37; cysts, n=16; Reinke's edema, n=18; papilomata, n=9). Patients were evaluated three times - before operation, less than two weeks (mean 1.0+/-0.4) following the operation and more than two weeks (mean 6.5+/-3.9) following the operation. Control group consisted of 122 healthy voice patients. Subjective voice evaluation composed of experts assessment (GRBAS hoarseness scale, visual analogue scale (VAS) of voice quality) and patients self-evaluation (VAS, voice handicap index, and the impression of what repercussions the voice problem has on professional life and emotions). Seven quantitative voice parameters obtained from voice range profile, laryngostroboscopy and registering of maximum phonation time were analyzed as well as overall vocal dysfunction degree (VDD). The data of second postoperative examination were statistically significantly better compared to the first postoperative follow-up (pvoice (G=0) was found for 13.8% (11), quantitatively (VDD=0) for 22.5% (18) of patients, during the second - 63.8% (51) and 53.8% (43). The best results were for patients with vocal cords polyps. The complex voice assessment may be useful for evaluation of voice function recovery and efficacy of surgical treatment.

  11. Pyro-chemistry within Europart assessment of the studies on spent fuel treatment processes collective work

    Energy Technology Data Exchange (ETDEWEB)

    Bourg, S. [CEA Valrho, 30 - Marcoule (France); Madic, C. [CEA Saclay, 91 - Gif sur Yvette (France); Caravaca, C. [CIEMAT (Spain); Finne, J. [Electricite de France (EDF), 75 - Paris (France); Angelis, G. de [ENEA, Bologna (Italy); Malmbeck, R. [ITU, JRC (Germany); Lewin, B.G. [NEXIA Solutions (United Kingdom); Uhlir, J. [Nuclear Research Institute (NRI) (Czech Republic); Inoue, T. [CRIEPI (Japan); Luca, V. [ANSTO (Australia)

    2007-07-01

    In the continuation of PYROREP (FP5), the pyrochemical domain of EUROPART (FP6) involves today 7 European participants and 2 international partners in order to assess treatment processes which could be used in a broad variety of fuel cycles: molten salt reactor spent fuel, metallic, oxide, carbide or nitride fuels from any reactors. Indeed, a pyrochemical process is not sensitive to radiolysis, and obviously to temperature effects, and could afford to treat fuels after a short cooling period, even at high concentrations. Within EUROPART, the chemistry of actinides and of some fission products was studied in depth in either chloride or fluoride molten salts. Laboratory-scale demonstration experiments were used in order to assess electrolytic processes in molten chlorides and liquid-liquid reductive extraction in molten fluoride/liquid aluminum. An electrolysis process is also under development in molten fluoride. To complete the studies, the development of devices and the modeling of processes are taken into consideration. In order to be fitted for acceptance, a process has to produce minimal quantities of wastes, compatible with storage constraints. Therefore, decontamination techniques, as well as materials suitable for disposal, have to be developed. Fission products precipitation by carbonate and phosphate, and filtration on zeolites were studied. Some original confinement matrices such as sodalite or pollucite were also studied. Integration studies have been carried out in order to evaluate and to compare some selected process flowsheets and possibly to redirect development programs. (authors)

  12. Comparison of methods for assessing reverse osmosis membrane treatment of shrimp process water.

    Science.gov (United States)

    Casani, Sandra; Hansen, Tina B; Christensen, Jakob; Knøchel, Susanne

    2005-04-01

    Interest in reuse of process water from the food industry has reinforced the importance of controlling and monitoring the effectiveness and reliability of treatment systems regarding removal of organic matter and microorganisms. The ability of adenosine triphosphate bioluminescence, conductivity, turbidometry, absorbance, and multichannel fluorescence spectroscopy for indirectly monitoring the integrity of a reverse osmosis membrane when treating process water recovered from peeling in a shrimp processing line was evaluated. This study demonstrated that reverse osmosis was capable of removing bacteria (ca. 7 log CFU ml(-1)) to the levels required by the regulatory authorities for water recycling within the same food unit operation. Adenosine triphosphate and turbidometry showed a higher sensitivity for detecting compromising conditions at the treatment system (0.1% concentration of feed in permeate) and a better correlation with the aerobic count at lower levels than the other methods investigated. The sensitivity for assessing membrane integrity of conductivity and multichannel fluorescence was 1% of feed in permeate. Impact of feed variations was best leveled out in the permeates for turbidity measurements. Multichannel fluorescence spectroscopy may require laborious calibration procedures and expertise regarding data analysis and interpretation of results, which are not always available in food industries. Absorbance did not respond to changes in membrane integrity and was not well correlated to the aerobic count because of the poor sensitivity of this method for these purposes.

  13. Intradialytic parenteral nutrition treatment and biochemical marker assessment for malnutrition in adolescent maintenance hemodialysis patients.

    Science.gov (United States)

    Orellana, Pamela; Juarez-Congelosi, Marisa; Goldstein, Stuart L

    2005-07-01

    Protein-energy malnutrition (PEM) is a significant cause of morbidity and mortality for patients receiving maintenance hemodialysis. Minimal study has evaluated therapeutic options for and biochemical marker assessment of pediatric patient PEM. In 2001, we expanded the indications for intradialytic parenteral nutrition (IDPN) treatment of PEM to all maintenance hemodialysis patients, regardless of etiology, who had a >10% weight loss and were at less than the 90th percentile of ideal body weight. Nine patients received thrice weekly IDPN from 3 to 22 months with minimal side effects. Six patients had weight and body mass index increase, 1 patient stopped losing weight, and 2 patients continued to lose weight during the initial 5 months of IDPN therapy. Cohort subanalysis showed that all patients with organic PEM responded to IDPN therapy, whereas patients with psychosocial causes of PEM did not. The normalized protein catabolic rate increased significantly for patients whose condition responded to IDPN therapy, whereas serum albumin did not change. The current study suggests that IDPN is effective treatment of organic causes of PEM in pediatric patients receiving maintenance hemodialysis and that normalized protein catabolic rate may be superior to serum albumin as a marker of nutrition status. The observation that IDPN was not sufficient to reverse PEM in patients with psychosocial PEM causes should direct caregivers to address the relevant underlying causes as well as to provide intensive nutrition therapy.

  14. Assessment of Deep Partial Thickness Burn Treatment with Keratin Biomaterial Hydrogels in a Swine Model

    Directory of Open Access Journals (Sweden)

    D. Poranki

    2016-01-01

    Full Text Available Partial thickness burns can advance to full thickness after initial injury due to inadequate tissue perfusion and increased production of inflammatory cytokines, which has been referred to as burn wound progression. In previous work, we demonstrated that a keratin biomaterial hydrogel appeared to reduce burn wound progression. In the present study, we tested the hypothesis that a modified keratin hydrogel could reduce burn wound progression and speed healing. Standardized burn wounds were created in Yorkshire swine and treated within 30 minutes with keratin hydrogel (modified and unmodified, collagen hydrogel, or silver sulfadiazine (SSD. Digital images of each wound were taken for area measurements immediately prior to cleaning and dressing changes. Wound tissue was collected and assessed histologically at several time points. Wound area showed a significant difference between hydrogels and SSD groups, and rates of reepithelialization at early time points showed an increase when keratin treatment was used compared to both collagen and SSD. A linear regression model predicted a time to wound closure of approximately 25 days for keratin hydrogel while SSD treatment required 35 days. There appeared to be no measurable differences between the modified and unmodified formulations of keratin hydrogels.

  15. 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.

  16. Life cycle assessment of introducing an anaerobic digester in a municipal wastewater treatment plant in Spain.

    Science.gov (United States)

    Blanco, David; Collado, Sergio; Laca, Adriana; Díaz, Mario

    2016-01-01

    Anaerobic digestion (AD) is being established as a standard technology to recover some of the energy contained in the sludge in wastewater treatment plants (WWTPs) as biogas, allowing an economy in electricity and heating and a decrease in climate gas emission. The purpose of this study was to quantify the contributions to the total environmental impact of the plant using life cycle assessment methodology. In this work, data from real operation during 2012 of a municipal WWTP were utilized as the basis to determine the impact of including AD in the process. The climate change human health was the most important impact category when AD was included in the treatment (Scenario 1), especially due to fossil carbon dioxide emissions. Without AD (Scenario 2), increased emissions of greenhouse gases, mostly derived from the use of electricity, provoked a rise in the climate change categories. Biogas utilization was able to provide 47% of the energy required in the WWTP in Scenario 1. Results obtained make Scenario 1 the better environmental choice by far, mainly due to the use of the digested sludge as fertilizer.

  17. Computerized acoustic assessment of treatment efficacy of nebulized epinephrine and albuterol in RSV bronchiolitis

    Directory of Open Access Journals (Sweden)

    Talmon Gil

    2007-06-01

    Full Text Available Abstract Aim We evaluated the use of computerized quantification of wheezing and crackles compared to a clinical score in assessing the effect of inhaled albuterol or inhaled epinephrine in infants with RSV bronchiolitis. Methods Computerized lung sounds analysis with quantification of wheezing and crackles and a clinical score were used during a double blind, randomized, controlled nebulized treatment pilot study. Infants were randomized to receive a single dose of 1 mgr nebulized l-epinephrine or 2.5 mgr nebulized albuterol. Computerized quantification of wheezing and crackles (PulmoTrack® and a clinical score were performed prior to, 10 minutes post and 30 minutes post treatment. Results were analyzed with Student's t-test for independent samples, Mann-Whitney U test and Wilcoxon test. Results 15 children received albuterol, 12 received epinephrine. The groups were identical at baseline. Satisfactory lung sounds recording and analysis was achieved in all subjects. There was no significant change in objective quantification of wheezes and crackles or in the total clinical scores either within the groups or between the groups. There was also no difference in oxygen saturation and respiratory distress. Conclusion Computerized lung sound analysis is feasible in young infants with RSV bronchiolitis and provides a non-invasive, quantitative measure of wheezing and crackles in these infants. Trial registration number: ClinicalTrials.gov NCT00361452

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. Agomelatine in the treatment of major depressive disorder: an assessment of benefits and risks.

    Science.gov (United States)

    Gahr, Maximilian

    2014-09-01

    Agomelatine (AGM) was approved for the treatment of major depressive disorder (MDD) in adults by the European Medicines Agency (EMA) in February 2009. It is an analogue of melatonin and features a unique pharmacodynamic profile with agonism on both types of melatonergic receptors (MT1/MT2) and antagonism at serotonergic 5-HT2C receptors. There is, however, an ongoing debate regarding the efficacy and safety of this novel antidepressant agent, originally evoked by claims of a significant publication bias underlying the assessment of AGM being an effective antidepressant. Indeed, two recent comprehensive metaanalyses of published and unpublished clinical trials found evidence for a relevant publication bias. However, due to its statistically significant advantage over placebo based on the results of these metaanalyses AGM must be referred to as an effective antidepressant agent in the acute phase of MDD. However, the effect sizes of AGM in the treatment of MDD were evaluated as being small in comparison to other antidepressant agents. In addition, there is insufficient evidence for the efficacy of AGM in relapse prevention of MDD. Apart from efficacy issues, AGM appears to have the potential to exhibit severe hepatotoxicity (the EMA has identified AGM-associated "hepatotoxic reactions" as a new safety concern in September 2013) that is currently poorly understood. Considering these aspects, it seems inappropriate to evaluate AGM as an antidepressant agent of first choice. Nevertheless, its unique mechanism of action with particular sleep modulating effects may represent a specific treatment strategy for patients with particular characteristics; further studies with thorough characterization of patients are needed to test this hypothesis.

  3. 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.

  4. Optimization of low energy sonication treatment for granular activated carbon colonizing biomass assessment.

    Science.gov (United States)

    Saccani, G; Bernasconi, M; Antonelli, M

    2014-01-01

    This study is aimed at optimizing a low energy sonication (LES) treatment for granular activated carbon (GAC)-colonizing biomass detachment and determination, evaluating detachment efficiency and the effects of ultrasound exposure on bacterial cell viability. GAC samples were collected from two filters fed with groundwater. Conventional heterotrophic plate count (HPC) and fluorescence microscopy with a double staining method were used to evaluate cell viability, comparing two LES procedures, without and with periodical bulk substitution. A 20 min LES treatment, with bulk substitution after cycles of 5 min as maximum treatment time, allowed to recover 87%/100% of attached biomass, protecting detached bacteria from ultrasound damaging effects. Observed viable cell inactivation rate was 6.5/7.9% cell/min, with membrane-compromised cell damage appearing to be even higher (11.5%/13.1% cell/min). Assessing bacterial detachment and damaging ultrasound effects, fluorescence microscopy turned out to be more sensitive compared to conventional HPC. The optimized method revealed a GAC-colonizing biomass of 9.9 x 10(7) cell/gGAC for plant 1 and 8.8 x 10(7) cell/gGAC for plant 2, 2 log lower than reported in literature. The difference between the two GAC-colonizing biomasses is higher in terms of viable cells (46.3% of total cells in plant 1 GAC-colonizing biomass compared to the 33.3% in plant 2). Studying influent water contamination through multivariate statistical analyses, apossible combined toxic and genotoxic effect of chromium VI and trichloroethylene was suggested as a reason for the lower viable cell fraction observed in plant 2 GAC-colonizing population.

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

    Directory of Open Access Journals (Sweden)

    Varun Pratap Singh

    2014-01-01

    Full Text Available 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 selected. The average ages of subjects were 22.33±2.114 years. The level of subject’s perception and orthodontist’s assessment was analyzed by nonparametric Chi square test. Kappa coefficient was done to verify its agreement. The Spearman’s correlation test was used to check the association of educational level and age. Mann-Whitney test was used to check the associations of sex and areas of residence. Results. The demand for treatment was significantly associated with the perception of the subject and orthodontist’s assessment. However, age, gender, and educational level were statistically insignificant in influencing subject perception and orthodontist’s assessment. Conclusion. Patient’s self-perception should be given equal importance while planning orthodontic treatment.

  6. Importance of food waste pre-treatment efficiency for global warming potential in life cycle assessment of anaerobic digestion systems

    DEFF Research Database (Denmark)

    Carlsson, My; Naroznova, Irina; Møller, Jacob

    2015-01-01

    A need for improvement of food waste (FIAT) pre-treatment methods has been recognized, but few life cycle assessments (LCA) of FIN management systems have considered the pre-treatment with respect to input energy, loss of organic material and nutrients for anaerobic digestion (AD) and/or further...... treatment of the refuse. The objective of this study was to investigate how FW pre-treatment efficiency impacts the environmental performance of waste management, with respect to global warming potential (GWP). The modeling tool EASETECH was used to perform consequential LCA focusing on the impact...

  7. 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

  8. 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

    that the organic waste quantity and composition is the same in 1970 and 2005, the technology change over this time period has resulted in a progression from a net annual GHG emission of 200 kg CO2-eq. capita ĝ€"1 in 1970 to a net saving of 170 kg CO 2-eq. capitaĝ€"1 in 2005 for management of urban organic wastes.......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...

  9. Time- and Site-Dependent Life Cycle Assessment of Thermal Waste Treatment

    Energy Technology Data Exchange (ETDEWEB)

    Hellweg, Stefanie; Hofstetter, Thomas B.; Hungerbuehler, Konrad [Swiss Federal Inst. of Technology (ETH), Zuerich (Switzerland). Chemical Engineering Dept.

    2002-12-01

    The high living standard of many industrial countries has directly lead to an increase in the amount of municipal solid waste generated. Parallel to this increase in waste, there has been a raising demand for environmentally benign waste treatment processes. In Switzerland, the predominant way of treatment is incineration. Since the environmental impact of waste incineration depends on the technology used, a comprehensive assessment of the different thermal processes is necessary. In order to determine the environmental impact, we propose a model that quantifies the emissions and resource use resulting from the incineration of waste using different technologies, the landfills for the incineration residues, the transport of waste, related infrastructure, as well as the production of ancillary products. Using the Life-Cycle Assessment (LCA) methodology, we performed a case study that compared the conventional grate technology to new high temperature processes recovering metals and vitrifying the incineration residues. The results show that if the plant is equipped with a modern gas purification system the incineration process itself is not a key environmental problem of the system considered. Using the energy gained from waste incineration as the functional unit, the environmental impacts of incineration plants are comparable to that of a conventional power plant. If long-term time horizons are considered, the critical aspect is the release of heavy metals from the landfilled incineration residues. Due to the better quality of the solid outputs new technologies have a lower potential for environmental impact than the conventional grate technology. This, however, depends on the time horizon considered. With a temporal system boundary of 100 years, the grate technology appears better, because new technologies generally use more energy and short-term emissions are of minor importance no matter what technology is used. The evaluation of waste incineration technologies

  10. 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)

  11. The Allocation of Sexually Transgressive Juveniles to Intensive Specialized Treatment: An Assessment of the Application of RNR Principles.

    Science.gov (United States)

    Ter Beek, Ellis; van der Rijken, Rachel E A; Kuiper, Chris H Z; Hendriks, Jan; Stams, Geert Jan J M

    2016-12-01

    The aim of this study was to compare results of and develop guidelines for mandatory allocation of sexually transgressive juveniles to Multisystemic Therapy - Problem Sexual Behavior (MST-PSB), Secure Youth Care (SYC), or Forensic Youth Care (FYC), based on the risk-need-responsivity model. Results of current allocation showed a population with relatively less treatment needs to receive community-based MST-PSB, compared with populations receiving residential SYC and FYC. Furthermore, estimated recidivism risk levels did not always support the need for risk reduction by the imposition of limitation of freedom of movement and maximum supervision, provided by all three treatment modalities. Based on the assessed sexual recidivism risk, 38% of the juveniles in FYC, 7% in SYC, and 24% in MST-PSB received treatment that was too intensive, which is considered detrimental to motivation and development. Future allocation practices could benefit from assessing treatment needs and recidivism risk, by use of an actuarial tool.

  12. 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

    has the best balance between prevented and induced impacts, and sand filtration proved to have a net environmental benefit under the assumptions used in the study. But the outcome of the study suggests that this is not always the case for ozonation and MBR. Keywords: advanced wastewater treatment; LCA......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...

  13. TYROSINEMIA TYPE-I - CONSIDERATIONS OF TREATMENT STRATEGY AND EXPERIENCES WITH RISK ASSESSMENT, DIET AND TRANSPLANTATION

    NARCIS (Netherlands)

    VANSPRONSEN, FJ; SMIT, GPA; WIJBURG, FA; THOMASSE, Y; VISSER, G; HEYMANS, HSA

    1995-01-01

    The rapid development of new modes of treatment including organ transplantation, enzyme inhibition, enzyme replacement, liver cell transplantation and gene therapy necessitates knowledge about the results of all modes of treatment to allow decisions on treatment strategies. In hereditary tyrosinaemi

  14. 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

  15. ASSESSMENT OF SEVERITY, TREATMENT AND OUTCOME OF ORGANOPHOSPHORUS POISONING: A DESCRIPTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Chandra Indira

    2015-05-01

    Full Text Available BACKGROUND : Organophophorous poisoning constitutes one of the most frequent poisoning in clinical practice all over the country and especially in this area where agriculture is the chief economic occupation. Acute organophophorous poisoning ranks foremost in the list of agents which causes acute pesticide poisoning in the developing countries. Acute poisoning, accidental or due to deliberate ingestion or inhalation of these organophosphate chemicals is an important and one of the most common medical emergencies. Hence the present stud y is undertaken to assess severity of poisoning, management and outcome of organophosphorous poisoning cases admitted in Government General Hospital, Kakinada, A. P. AIMS/OBJECTIVES: 1. Assessment of severity of Organophosphorous poisoning according to Dri esbach’s criteria 2. To study the morbidity and mortality in these patients. MATERIALS AND METHOD S: In this descriptive study fifty patients with organophosphorous insecticide poisoning were evaluated by clinical examination. They were investigated, treate d and their treatment outcome were analyzed. RESULTS: 1. Chlorpyriphos and monocrotophos(together 66% were the most commonly used pesticides. 2. 82% cases reached the hospital within 6 hours for commencement of treatment and were mostly of moderate to se vere degree of OP poisoning while mild cases of accidental poisoning reached after 12 hours. Hence the mortality is high in the former group only. 3. When the severity of poisoning was graded by applying Dreisbach's criteria at the time of admission 34% ha d severe degree of poisoning, 26% had moderate poisoning while 40% of cases presented with mild degree of poisoning. (Most of the cases were accidental inhalation and skin contact exposure. 4. Among the patients belonging to moderate to severe degree of p oisoning 30% of patients were put on assisted mechanical ventilation, indications being uncontrolled pulmonary secretions, continuing hypoxia, not

  16. Flood Stress as a Technique to Assess Preventive Insecticide and Fungicide Treatments for Protecting Trees against Ambrosia Beetles

    OpenAIRE

    Ranger, Christopher M.; Peter B Schultz; Reding, Michael E.; Frank, Steven D.; Debra E. Palmquist

    2016-01-01

    Ambrosia beetles tunnel into the heartwood of trees where they cultivate and feed upon a symbiotic fungus. We assessed the effectiveness of flood stress for making Cercis canadensis L. and Cornus florida L. trees attractive to attack as part of insecticide and fungicide efficacy trials conducted in Ohio and Virginia. Since female ambrosia beetles will not begin ovipositing until their symbiotic fungus is established within the host, we also assessed pre-treatment of trees with permethrin, azo...

  17. 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.

  18. 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.

  19. 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

  20. Investigation of PPCPs in wastewater treatment plants in Greece: occurrence, removal and environmental risk assessment.

    Science.gov (United States)

    Kosma, Christina I; Lambropoulou, Dimitra A; Albanis, Triantafyllos A

    2014-01-01

    In the present work, an extensive study on the presence of eighteen pharmaceuticals and personal care products (PPCPs) in eight wastewater treatment plants (WWTPs) of Greece has been conducted. The study covered four sampling periods over 1-year, where samples (influents; effluents) from eight WWTPs of various cities in Greece were taken. All WWTPs investigated are equipped with conventional activated sludge treatment. A common pre-concentration step based on SPE was applied, followed by LC-UV/Vis-ESI-MS. Further confirmation of positive findings was accomplished by using LC coupled to a high resolution Orbitrap mass spectrometer. The results showed the occurrence of all target compounds in the wastewater samples with concentrations up to 96.65 μg/L. Paracetamol, caffeine, trimethoprim, sulfamethoxazole, carbamazepine, diclofenac and salicylic acid were the dominant compounds, while tolfenamic acid, fenofibrate and simvastatin were the less frequently detected compounds with concentrations in effluents below the LOQ. The removal efficiencies showed that many WWTPs were unable to effectively remove most of the PPCPs investigated. Finally, the study provides an assessment of the environmental risk posed by their presence in wastewaters by means of the risk quotient (RQ). RQs were more than unity for various compounds in the effluents expressing possible threat for the aquatic environment. Triclosan was found to be the most critical compound in terms of contribution and environmental risk, concluding that it should be seriously considered as a candidate for regulatory monitoring and prioritization on a European scale on the basis of realistic PNECs. The results of the extensive monitoring study contributed to a better insight on PPCPs in Greece and their presence in influent and effluent wastewaters. Furthermore, the unequivocal identification of two transformation products of trimethoprim in real wastewaters by using the advantages of the LTQ Orbitrap capabilities

  1. Indoor and outdoor air quality assessment of four wastewater treatment plants.

    Science.gov (United States)

    Lee, Joung Ae; Johnson, John C; Reynolds, Stephen J; Thorne, Peter S; O'Shaughnessy, Patrick T

    2006-01-01

    The study assessed the air quality of four wastewater treatment plants (WWTPs) by monitoring levels of hydrogen sulfide (H2S) and endotoxin. Samples were taken over a 1-year period (2001-2002). The unit operations at each WWTP were categorized as: (a) grit removal, (b) primary clarification, (c) biological treatment, (d) secondary clarification, (e) sludge dewatering, and (f) digestion. Temperature and humidity were monitored simultaneously, whereas airborne H2S and endotoxin were monitored at each of the six unit operations in each plant. Carbonaceous biochemical oxygen demand (CBOD) and total incoming flow of the day of visit were also recorded. The geometric means of H2S concentration were less than 1 ppm and endotoxin ranged from 6-1247 EU/m3. A mixed model analysis of covariance (ANCOVA) was used for the statistical analysis. While temperature was not associated with the levels of both contaminants, humidity was influential on the level of H2S (p < 0.01) but not of endotoxin. CBOD did not affect the levels of either contaminant; however, incoming flows showed an association with the levels of H2S (p < 0.05). The concentrations of H2S in the six unit operations were statistically different, whereas endotoxin did not show any differences in concentrations between units. Individual comparisons proved that concentrations of H2S in the grit removal and sludge dewatering unit operations were statistically higher than the other operations. Overall, the concentrations of H2S varied depending on total incoming flow, humidity, and different unit operations. This trend was not observed for endotoxin. The results showed that the factors analyzed affected concentrations of H2S and endotoxin differently. Therefore, different control methods for endotoxin and H2S need to be considered to effectively reduce their concentrations at WWTPs.

  2. Assessing the efficacy of a modified assertive community-based treatment programme in a developing country

    Directory of Open Access Journals (Sweden)

    Botha Ulla A

    2010-09-01

    Full Text Available Abstract Background A number of recently published randomized controlled trials conducted in developed countries have reported no advantage for assertive interventions over standard care models. One possible explanation could be that so-called "standard care" has become more comprehensive in recent years, incorporating some of the salient aspects of assertive models in its modus operandi. Our study represents the first randomised controlled trial assessing the effect of a modified assertive treatment service on readmission rates and other measures of outcome in a developing country. Methods High frequency service users were randomized into an intervention (n = 34 and a control (n = 26 group. The control group received standard community care and the active group an assertive intervention based on a modified version of the international model of assertive community treatment. Study visits were conducted at baseline and 12 months with demographic and illness information collected at visit 1 and readmission rates documented at study end. Symptomatology and functioning were measured at both visits using the PANSS, CDSS, ESRS, WHO-QOL and SOFAS. Results At 12 month follow-up subjects receiving the assertive intervention had significantly lower total PANSS (p = 0.02 as well as positive (p Conclusions Our results indicate that assertive interventions in a developing setting where standard community mental services are often under resourced can produce significant outcomes. Furthermore, these interventions need not be as expensive and comprehensive as international, first-world models in order to reduce inpatient days, improve psychopathology and overall levels of functioning in patients with severe mental illness.

  3. The OPTIMA Study: Assessing a New Cinacalcet (Sensipar/Mimpara) Treatment Algorithm for Secondary Hyperparathyroidism

    Science.gov (United States)

    Messa, Piergiorgio; Macário, Fernando; Yaqoob, Magdi; Bouman, Koen; Braun, Johann; von Albertini, Beat; Brink, Hans; Maduell, Francisco; Graf, Helmut; Frazão, João M.; Bos, Willem Jan; Torregrosa, Vicente; Saha, Heikki; Reichel, Helmut; Wilkie, Martin; Zani, Valter J.; Molemans, Bart; Carter, Dave; Locatelli, Francesco

    2008-01-01

    Background and objectives: Cinacalcet, a novel calcimimetic, targets the calcium-sensing receptor to lower parathyroid hormone (PTH), calcium, and phosphorus levels in dialysis patients with secondary hyperparathyroidism (SHPT). This study compared the efficacy of a cinacalcet-based regimen with unrestricted conventional care (vitamin D and phosphate binders) for achieving the stringent National Kidney Foundation Kidney Disease Outcomes Quality Initiative (KDOQI) targets for dialysis patients. Study design: In this multicenter, open-label study, hemodialysis patients with poorly controlled SHPT were randomized to receive conventional care (n = 184) or a cinacalcet-based regimen (n = 368). Doses of cinacalcet, vitamin D sterols, and phosphate binders were adjusted during a 16-wk dose-optimization phase with the use of algorithms that allowed cinacalcet to be used with adjusted doses of vitamin D. The primary end point was the proportion of patients with mean intact PTH ≤300 pg/ml during a 7-wk efficacy assessment phase. Results: A higher proportion of patients receiving the cinacalcet-based regimen versus conventional care achieved the targets for PTH (71% versus 22%, respectively; P < 0.001), Ca × P (77% versus 58%, respectively; P < 0.001), calcium (76% versus 33%, respectively; P < 0.001), phosphorus (63% versus 50%, respectively; P = 0.002), and PTH and Ca × P (59% versus 16%, respectively, P < 0.001), and allowed a 22% reduction in vitamin D dosage in patients receiving vitamin D at baseline. Achievement of targets was greatest in patients with less severe disease (intact PTH range, 300 to 500 pg/ml) and the cinacalcet dose required was lower in these patients (median = 30 mg/d). Conclusions: Compared with conventional therapy, a cinacalcet-based treatment algorithm increased achievement of KDOQI treatment targets in dialysis patients in whom conventional therapy was no longer effective in controlling this disease. PMID:18178780

  4. Assessment of airborne nanoparticles present in industry of aluminum surface treatments.

    Science.gov (United States)

    Santos, R J; Vieira, M T

    2017-03-01

    Conventional industrial processes are emission sources of unintended nanoparticles which are potentially harmful for the environment and human health. The aim of this study is to assess airborne nanoparticle release from aluminum surface treatment processes in various workplaces. Two direct reading instruments, a scanning mobility particle sizer to measure size distribution and a nanoparticle surface area monitoring to measure the surface area of particles deposited in the human lung, were employed to perform area monitoring. The lacquering paint was the process which released the highest concentration of particles from 10-487 nm (7.06 × 10(6) particles/cm(3)). The lacquering baths process emitted particles of the largest average size (76.9 nm) and the largest surface area deposited in the human lung (167.4 µm(2)/cm(3)). Conversely, the anodizing bath process generated particles of the smallest average size (44.3 nm) and the lowest human lung-deposited surface area (1.2 µm(2)/cm(3)). The total number of particles and the surface area can only be fairly correlated for environments in which the surface area presented higher values. The transmission electron microscopy analysis confirmed the presence of aluminum oxide particles of different dimensions near the LB and AB areas and polymeric-based particles near the LP areas. The findings of this study indicated that lacquering and anodizing surface treatments are indeed responsible for the emission of airborne nanoparticles. It also highlights the importance of control strategies as a means of protecting workers' health and environment.

  5. 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.

  6. Typologies of prescription opioid use in a large sample of adults assessed for substance abuse treatment.

    Directory of Open Access Journals (Sweden)

    Traci C Green

    Full Text Available BACKGROUND: As a population, non-medical prescription opioid users are not well-defined. We aimed to derive and describe typologies of prescription opioid use and nonmedical use using latent class analysis in an adult population being assessed for substance abuse treatment. METHODS: Latent class analysis was applied to data from 26,314 unique respondents, aged 18-70, self-reporting past month use of a prescription opioid out of a total of 138,928 cases (18.9% collected by the Addiction Severity Index-Multimedia Version (ASI-MV®, a national database for near real-time prescription opioid abuse surveillance. Data were obtained from November 2005 through December 2009. Substance abuse treatment, criminal justice, and public assistance programs in the United States submitted data to the ASI-MV database (n = 538. Six indicators of the latent classes derived from responses to the ASI-MV, a version of the ASI modified to collect prescription opioid abuse and chronic pain experience. The latent class analysis included respondent home ZIP code random effects to account for nesting of respondents within ZIP code. RESULTS: A four-class adjusted latent class model fit best and defined clinically interpretable and relevant subgroups: Use as prescribed, Prescribed misusers, Medically healthy abusers, and Illicit users. Classes varied on key variables, including race/ethnicity, gender, concurrent substance abuse, duration of prescription opioid abuse, mental health problems, and ASI composite scores. Three of the four classes (81% of respondents exhibited high potential risk for fatal opioid overdose; 18.4% exhibited risk factors for blood-borne infections. CONCLUSIONS: Multiple and distinct profiles of prescription opioid use were detected, suggesting a range of use typologies at differing risk for adverse events. Results may help clinicians and policy makers better focus overdose and blood-borne infection prevention efforts and intervention strategies

  7. 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.

  8. Developmental kinesiology: three levels of motor control in the assessment and treatment of the motor system.

    Science.gov (United States)

    Kobesova, Alena; Kolar, Pavel

    2014-01-01

    Three levels of sensorimotor control within the central nervous system (CNS) can be distinguished. During the neonatal stage, general movements and primitive reflexes are controlled at the spinal and brain stem levels. Analysis of the newborn's spontaneous general movements and the assessment of primitive reflexes is crucial in the screening and early recognition of a risk for abnormal development. Following the newborn period, the subcortical level of the CNS motor control emerges and matures mainly during the first year of life. This allows for basic trunk stabilization, a prerequisite for any phasic movement and for the locomotor function of the extremities. At the subcortical level, orofacial muscles and afferent information are automatically integrated within postural-locomotor patterns. Finally, the cortical (the highest) level of motor control increasingly becomes activated. Cortical control is important for the individual qualities and characteristics of movement. It also allows for isolated segmental movement and relaxation. A child with impaired cortical motor control may be diagnosed with developmental dyspraxia or developmental coordination disorder. Human ontogenetic models, i.e., developmental motor patterns, can be used in both the diagnosis and treatment of locomotor system dysfunction.

  9. Identification of organic compounds and ecotoxicological assessment of sewage treatment plants (STP) effluents.

    Science.gov (United States)

    Aguayo, Sonia; Muñoz, M Jesús; de la Torre, Ana; Roset, Jaime; de la Peña, Eduardo; Carballo, Matilde

    2004-07-26

    An integrated approach combining chemistry and biological methods was conducted to assess the toxicity of seven sewage treatment plant effluents. Solid phase concentration procedures were applied to facilitate the study of organic micro pollutants. A chemical analysis was performed by GC/MS. Organic fraction toxicity was determined by using bioassays such as Daphnia magna and Chlorella vulgaris tests and sub-lethal effects were also evaluated by using Salmonella typhimurium Test (mutagenicity), recombinant yeast screen (estrogenicity), and Oryzias latipes embryo-larval test. More than 49 compounds were detected in the organic fraction due to the various inputs of each effluents. The most frequently detected compounds in the effluents were bisphenol A (BPA), octylphenol (OP), 1,2-benzenedicarboxylic acid, bis(2-ethylhexyl) ester (DEHP) and 1,2-benzenedicarboxylic acid, bis(methylpropyl) ester (DBP). Biological assays showed toxicity effects on D. magna tests in all samples, whereas toxicity on C. vulgaris or S. typhimurium tests were not observed. Estrogenicity and teratogenicity were observed in several samples. The cause-effect relationship could not be established given the high chemical complexity of the effluents and the lack of information available on 70% of the detected compounds subsequent to reviewing various data bases. Nevertheless, due to the high chemical variability revealed by STP effluents, bioassay sets may provide a very useful amount of information for detecting potential toxicity risks.

  10. [Assessment of thoracic sympathectomy by transpleural posterolateral and thoracoscopic approach in surgical treatment of Raynaud's syndrome].

    Science.gov (United States)

    Czyzewski, Damian; Dobosz, Jolanta; Wojtacha, Jacek; Kozielski, Jerzy; Lipka, Mariusz; Lazar-Czyzewska, Barbara

    2004-01-01

    Operative treatment of patients with Raynaud's Syndrome is rarely used, and is recommended by most authors only in the case of disthrophic changes or so advanced symptoms, which disturb normal social and daily life. Recently, thoracoscopic sympathectomy is applied more frequently. The aim of this study was to assess the usefulness of thoracoscopic sympathectomy by the presentation of early and long-term outcome of 43 thoracic and eight lumbar sympathectomies performed in 41 patients with Raynaud's Syndrome. Transpleural posterio-lateral thoracotomy was performed 29 times in 27 patients, whereas thoracoscopic sympatectomy 14 times in 8 patients. Surgical techniques, early and long-term results were discussed. Based on early and long-term outcome, there were no significant differences between applied surgical techniques. Moreover, thoracoscopic sympathectomy was safe in the aspect of a short duration as well as good therapeutic and cosmetic effect of the procedure. It should be applied instead of others, so far used methods, with the exception of patients with massive pleural adhesions, which need thoracotomy.

  11. VISUAL PERCEPTION OF THE CHILDREN WITH PLEXUS BRACHIALIS DAMAGE – ASSESSMENT AND TREATMENT

    Directory of Open Access Journals (Sweden)

    Dragana M. KLJAJIKJ

    2012-03-01

    Full Text Available Interpersonal communication, psychosocial and mental development of personality and its all other functions take place through the motor control. The most common neurological syndrome is a type of peripheral paresis/paralysis of plexus bracialis, which in most cases occurs at birth and significantly compromises the growth and development of the upper extremities and affects the psychomotor performance. The aim of this study was to evaluate the level of visual perception in children with lesion of plexus brachialis and the effect of the somatopedic treatment over the level of increase of the visual perception. The study sample was consisted of 60 preschool children accommodated at the Rehabilitation Centre “Dr. Miroslav Zotović” in Belgrade (experimental group and examiners that followed regular checkups and had discontinuity in their therapy (control group. For the research purposes, we used The Test for Visual Perception Assessment. By analyzing the results, we concluded that in both, in the first and the second measuring there was a statistically significant correlation between the experimental and the control groups (I measuring: p<0.001, r = 0.408; II measuring: p <0.001, r = 0.593.

  12. 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

  13. Post-Heat Treatment and Mechanical Assessment of Polyvinyl Alcohol Nanofiber Sheet Fabricated by Electrospinning Technique

    Directory of Open Access Journals (Sweden)

    Mahir Es-saheb

    2014-01-01

    Full Text Available Polyvinyl alcohol (PVA sheets based nanofibers were produced by electrospinning technique. Postheat treatment of the produced PVA sheets with temperatures both below and above Tg to improve the mechanical properties of this material is conducted. The morphology, microstructures, and thermal degradation of the nanofibers sheets produced were investigated using scanning electron microscopy (SEM, transmission electron microscope (TEM, and thermal gravimetric analysis (TGA. Produced nanofibers are compact, and entangled with each other, with diameters from around 150 to 210. Some mechanical characteristics of the successfully produced PVA sheets, and heat-treated, are then conducted and assessed employing uniaxial tensile tests at different speeds ranging from 1 mm/min to 100 mm/min. The tensile test results obtained show that the PVA sheets are strain rate sensitive with increasing strength as the speed (i.e., strain rate increases. The yield tensile stress ranges from 2.411 to 6.981 MPa, the ductility (i.e., elongation percent from ∼21 to 60%, and Young modulus ranges from 103 to 0.137 KPa. However, for heat-treated samples, it is found that the yield strength increases almost by ∼35–40% more than the values of untreated cases with values reaching up to about 3.627–9.63 MPa.

  14. Ecotoxicity Assessment of Stabilized Sewage Sludge from Municipal Sewage Treatment Plant

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    Włodarczyk Elżbieta

    2016-09-01

    Full Text Available Aim of this study was to evaluate the ecotoxicity of municipal sewage sludge conditioned with polyelectrolytes, taken from selected sewage treatment plant. Using the bioindication analysis overall toxicity was assessed, which allows to know the total toxicity of all the harmful substances contained in sewage sludge, in many cases acting synergistically. To prepare a sample of sludge for the basic test, all analyses were performed with a ratio of liquid to solid of 10:1 (water extract. Daphnia pulex biological screening test was used. A dilution series of an water extract of sludge were prepared to include within its scope the lowest concentration that causes 100% effect and the highest producing less than 10% of the effect within a specified range of the assay. The results of the test were read after 24 and 48 hours. Based on the research and analysis of test results it proved that the sewage sludge conditioned with polyelectrolytes exhibit the characteristics of eco-toxic.

  15. Questionnaire based assessment of patients' acceptability of leukocytapheresis for the treatment of inflammatory bowel disease.

    Science.gov (United States)

    Nagase, Kazuko; Fukuanga, Ken; Yokoyama, Yoko; Kamikozuru, Koji; Miwa, Hiroto; Nakamura, Shiro

    2013-10-01

    The aim of the present study was to assess patients' acceptance of therapeutic leukocytapheresis known as cytapheresis (CAP) for the treatment of an active flare of inflammatory bowel disease (IBD). A questionnaire was sent to 155 IBD patients who had been treated with CAP for an active flare of IBD at the IBD center of Hyogo College of Medicine between January 2009 and July 2012. In the questionnaire, patients were asked to evaluate CAP including efficacy, safety, unfavorable features and their willingness to be retreated with CAP for a subsequent IBD flare-up. Seventy-eight percent (112 of 155 patients) including 86 with ulcerative colitis and 26 with Crohn's disease completed the questionnaire. The need for coming to hospital for CAP, needle pain during blood access, sparing time for CAP process were scored by 57%, 58%, and 58.9% of the patients, respectively as unfavorable. Patients highly favored the safety of CAP, the sum of very and relatively favorable was 89%, higher than for efficacy (68%). Seventy-two percent of patients favored retreatment with CAP. In binary logistic regression analysis, the levels of satisfaction for efficacy (P disease. Patient's acceptability for CAP appeared to be determined by the balance of these factors.

  16. Musculoskeletal Simulation for Assessment of Effect of Movement-Based Structure-Modifying Treatment Strategies

    Directory of Open Access Journals (Sweden)

    Tien Tuan Dao

    2015-01-01

    Full Text Available The better understanding of the complex mechanism between neural motor control and its resulting joint kinematics and muscle forces allows a better elucidation of the mechanisms behind body growth, aging progression, and disease development. This study aimed at investigating the impact of movement-based structure-modifying treatment strategies on joint kinematics, muscle forces, and muscle synergies of the gait with instrumented implant. A patient-specific musculoskeletal model was used to quantitatively assess the deviations of joint and muscle behaviors between the normal gait and 4 gait modifications (bouncy, medial thrust, midcrouch, and mtp (i.e., gait with forefoot strike. Moreover, muscle synergy analysis was performed using EMG-based nonnegative matrix factorization. Large variation of 19 degrees and 190 N was found for knee flexion/extension and lower limb muscle forces, respectively. EMG-based muscle synergy analysis revealed that the activation levels of the vastus lateralis and tibialis anterior are dominant for the midcrouch gait. In addition, an important contribution of semimembranosus to the medial thrust and midcrouch gaits was also observed. In fact, such useful information could allow a better understanding of the joint function and muscle synergy strategies leading to deeper knowledge of joint and muscle mechanisms related to neural voluntary motor commands.

  17. Liposomal oxymatrine in hepatic fibrosis treatment: formulation, in vitro and in vivo assessment.

    Science.gov (United States)

    Zhang, Shujuan; Wu, Jun; Wang, Hua; Wang, Tiechuang; Jin, Lina; Shu, Dandan; Shan, Weiguang; Xiong, Subin

    2014-06-01

    The aim was to develop a liposomal oxymatrine conjugating D-alpha tocopheryl polyethylene glycol 1000 succinate (OMT-LIP) for enhanced therapeutics of hepatic fibrosis. OMT-LIP was prepared using the remote loading method. The influences of formulation compositions on the encapsulation efficiency of OMT-LIP were investigated. Mean particle size, zeta potential, morphology, in vitro release, fibrotic liver targeting, and therapeutics of OMT-LIP were thoroughly assessed. The intraliposomal buffer composition and concentration, extraliposomal phase composition and pH, types of phospholipid, lipid molar ratio composition, and theoretical drug loading are crucial factors to entrap OMT into liposomes. The optimum OMT-LIP presented spherically unilamellar microstructures with entrapment efficiency of 79.7 ± 3.9%, mean particle size of 121.6 ± 52.9 nm, and zeta potential of -5.87 mV. OMT-LIP significantly increased the accumulation of OMT in the fibrotic liver with an 11.5-fold greater AUC than OMT solution in the dimethylnitrosamine (DMN)-induced hepatic fibrosis animals. OMT-LIP could be a potential strategy to improve treatment outcomes for hepatic fibrosis, showing the protective effects to mice given CCl4 and the enhanced therapeutics to mice with either DMN or CCl4-induced hepatic fibrosis.

  18. Analysis of Frequency of Use of Different Scar Assessment Scales Based on the Scar Condition and Treatment Method

    OpenAIRE

    Bae, Seong Hwan; Bae, Yong Chan

    2014-01-01

    Analysis of scars in various conditions is essential, but no consensus had been reached on the scar assessment scale to select for a given condition. We reviewed papers to determine the scar assessment scale selected depending on the scar condition and treatment method. We searched PubMed for articles published since 2000 with the contents of the scar evaluation using a scar assessment scale with a Journal Citation Report impact factor >0.5. Among them, 96 articles that conducted a scar evalu...

  19. Assessment of the Possibility of Improvement of Dairy Wastewater Treatment System Operation

    OpenAIRE

    Hercog, Jernej

    2009-01-01

    The thesis deals with the issue of dairy wastewater from the viewpoint of successful elimination of organic and inorganic components in physical and biological treatment processes in pre-treatment systems. Theoretically, the thesis covers the definitions and explanations of biological wastewater treatment, and deals with treatment processes in the sequencing batch reactor as well as the tertiary treatment level for the removal of nitrogen and phosphorus compounds. Furthermore, the thesis cove...

  20. From Custody to Community: Development of Assessment and Treatment for Juveniles Serving Sentences for Sex Offences in an Irish Context

    Science.gov (United States)

    Slattery, Peter; Cherry, Joan; Swift, Aaron; Tallon, Mary; Doyle, Ian

    2012-01-01

    The Baseline Project provided an assessment package and treatment for juveniles (aged 16-21 years) serving sentences for sexual offences, and was the only such programme available in Ireland (ROI). It was a venture between the Northside Inter-Agency Project and the Psychology Department of the Irish Prison Service and worked with juveniles on a…

  1. Enumeration of faecal indicator bacteria in large water volumes using on site membrane filtration to assess water treatment efficiency

    NARCIS (Netherlands)

    Hijnen, W.A.M.; Veendaal, D.; Speld, W.M.H. van der; Visser, Ate; Hoogenboezem, W.; Kooij, D. van der

    2000-01-01

    Sample volumes as tested in routine microbiological methods for determining the presence and absence of faecal indicator bacteria in water are too small to assess the actual concentration in the last stages of a water treatment. Consequently no accurate information can be obtained about the removal

  2. 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…

  3. Practice Parameter for the Assessment and Treatment of Children and Adolescents with Reactive Attachment Disorder of Infancy and Early Childhood

    Science.gov (United States)

    Journal of the American Academy of Child and Adolescent Psychiatry, 2005

    2005-01-01

    This parameter reviews the current status of reactive attachment disorder with regard to assessment and treatment. Attachment is a central component of social and emotional development in early childhood, and disordered attachment is defined by specific patterns of abnormal social behavior in the context of "pathogenic care." Clinically relevant…

  4. 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

    Energy Technology Data Exchange (ETDEWEB)

    Al-Jaseem, Q.Kh., E-mail: qjassem@kacst.edu.sa [Nuclear Science Research Institute (NSRI), King Abdulaziz City for Science and Technology (KACST), P.O. Box 6086, Riyadh 11442 (Saudi Arabia); Almasoud, Fahad I. [Nuclear Science Research Institute (NSRI), King Abdulaziz City for Science and Technology (KACST), P.O. Box 6086, Riyadh 11442 (Saudi Arabia); Ababneh, Anas M. [Physics Dept., Faculty of Science, Islamic University in Madinah, Al-Madinah, P.O. Box 170 (Saudi Arabia); Al-Hobaib, A.S. [Nuclear Science Research Institute (NSRI), King Abdulaziz City for Science and Technology (KACST), P.O. Box 6086, Riyadh 11442 (Saudi Arabia)

    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 0.23 Bq/L, which exceeds the international limit of 0.185 Bq/L (5 pCi/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 6750 Bq/kg, respectively, which exceed the national limit of 1000 Bq/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 2–18 Bq/m{sup 3} and 70–1000 nSv/h, respectively. The annual effective dose was calculated and the average values was found to be 0.3 mSv which is below the 1 mSv limit. - Highlights: • Radiological assessment of groundwater treatment plant was performed. • Radium Removal efficiency was calculated for different stages during water treatment. • Radium concentrations in sludge were measured and found to exceed the national limit for radioactive waste. • Air radon concentrations and dose rates were monitored in the water treatment plant. • The Reverse Osmosis (RO) unit was found to record the highest air radon concentrations and dose rates.

  5. Assessment of the nature of residual masses at end of treatment in lymphoma patients using volume perfusion computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Syha, R.; Gruenwald, L.; Spira, D.; Ketelsen, D.; Claussen, C.D.; Horger, M. [Eberhard Karls University, Department of Diagnostic Radiology, Tuebingen (Germany); Horger, T. [Technische Universitaet Muenchen, M2 - Lehrstuhl fuer Numerische, Garching (Germany); Vogel, W. [Eberhard Karls University, Department of Medical Oncology and Haematology, Tuebingen (Germany)

    2014-03-15

    To determine the diagnostic benefit of volume perfusion computed tomography (VPCT) at end of treatment for response assessment in lymphoma patients. Seventy-five patients with different lymphoma subtypes were included: 50/75 patients had residual masses at end of treatment, 26/50 patients underwent VPCT at baseline and at end of treatment, and 24/50 patients only had end-of-treatment VPCTs. We evaluated the size of the main lymphoma mass, its blood flow (BF), blood volume (BV) and k-trans, calculated ratios (baseline and end of treatment) as well as sensitivity/specificity/negative (NPV)/positive predictive values (PPV). For VPCT at end of treatment, a cutoff threshold between responders and non-responders was calculated. For patients undergoing VPCT at baseline and end of treatment, reduction in size, BF, BV and k-trans was significant (P < 0.001). Identification of non-response was reached at: <53 % reduction in size (sensitivity/specificity/accuracy/PPV/NPV of 88.89 %/62.5 %/80.77 %/84.21 %/71.43 %), <15 % reduction of BF (sensitivity/specificity/accuracy/PPV/NPV of 100 %/37.5 %/80.77 %/0.26 %/100 %), or <45 % reduction of k-trans (sensitivity/specificity/accuracy/PPV/NPV of 88.89 %/75 %/84.62 %/88.89 %/75 %). In the subgroup undergoing VPCT at end of treatment, BF >18.51 ml/100 ml indicated non-responsiveness (sensitivity 92.86 %, specificity 72.73 %, accuracy 84 %, PPV 81.25 %, NPV 88.89 %). VPCT seems adequate for assessment of lymphoma response at end of treatment. The degree of residual lymphoma perfusion at end of treatment helps to identify patients likely to remain in remission 1 year after completion of therapy. (orig.)

  6. Treatment referral for sex offenders based on clinical judgment versus actuarial risk assessment: match and analysis of mismatch.

    Science.gov (United States)

    Smid, Wineke J; Kamphuis, Jan Henk; Wever, Edwin C; Van Beek, Daan

    2013-07-01

    The Risk Need Responsivity (RNR) principles (Andrews & Bonta, 2010) dictate that higher risk sex offenders should receive more intensive treatment. The present study investigates how clinically based treatment assignment relates to risk level in a sex offender sample from The Netherlands. Correlational analyses served to identify sources of mismatches: that is, variables differing significantly in their relation between treatment selection and risk level. Our study sample consisted of 194 convicted rapists and 214 convicted child molesters. All participants' criminal files were retrospectively coded in terms of the items of the STATIC-99R, PCL: SV, and SVR-20. A low to moderate correlation was observed between clinical treatment selection and actuarial risk levels. A substantial part of the sex offenders, especially child molesters, received overly intensive treatment and another substantial part, especially rapists, received treatment of lesser intensity than indicated by their risk levels. General violent and antisocial risk factors seemed to be underemphasized in the clinical evaluation of sex offenders, especially rapists. A negative attitude toward intervention was negatively associated with clinical treatment selection. It is concluded that clinical treatment selection leads to an insufficient match between risk level and treatment level and systematic use of validated structured risk assessment instruments is necessary to ensure optimal adherence to the risk principle.

  7. 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

  8. ENVIRONMENTAL ASSESSMENT OF BARRIER CAPABILITIES OF SMALL MUNICIPAL WASTEWATER TREATMENT PLANTS IN VOLOGDA REGION

    Directory of Open Access Journals (Sweden)

    Kulakov Artem Alekseevich

    2012-12-01

    Full Text Available The findings of the research project that encompasses 137 small municipal wastewater treatment plants (WWTP are presented in the paper. The source data for the research is the official statistical reporting according to Form № 2-TP (water submitted in 2010, as well as the information on completed and approved projects that demonstrate admissible discharge standards. The method of environmental assessment of barrier capabilities of municipal WWTP based on six major indicators (TSS, BOD, N-NH4+, N-NO2-, N-NO3-, P-PO43- is proposed to ensure compliance with the present-day environmental standards. The maximal likelihood of incompliance with the pre-set standards is demonstrated by phosphorus phosphate (97 %, ammonium nitrogen (95 % and nitrite nitrogen (79 %. The substances that demonstrate their maximal excessive content in the wastewater include phosphorus phosphate (its content exceeds the admissible standard 18-fold, ammonium nitrogen (21.7-fold excess and nitrite nitrogen (7.6-fold excess.This overview indicates a low possibility of compliance of the content of N-NH4+, N-NO2-, and P-PO43- with the environmental standards that extend to biological WWTPs. The highest relative excess of the admissible content of admixtures is typical for the plants that have a design capacity of 600-800 m3/day and that process 50-200 m3/day. The lowest relative excess of the admissible content of admixtures is typical for the plants that have a design capacity of over 1,000 m3/day and that process over 500 m3/day. The average relative excess of the admissible content of admixtures for all plants equals to 8.4 times. The ecological assessment of the barrier capabilities of small municipal WWTPs has proven that their compliance with the standards of admissible content of N-NH4+, N-NO2-, and P-PO43- in the wastewater is impossible to attain in practice.

  9. Cognitive-behavioral treatment for chronic nightmares in trauma-exposed persons: assessing physiological reactions to nightmare-related fear.

    Science.gov (United States)

    Rhudy, Jamie L; Davis, Joanne L; Williams, Amy E; McCabe, Klanci M; Bartley, Emily J; Byrd, Patricia M; Pruiksma, Kristi E

    2010-04-01

    Cognitive-behavioral treatments (CBTs) that target nightmares are efficacious for ameliorating self-reported sleep problems and psychological distress. However, it is important to determine whether these treatments influence objective markers of nightmare-related fear, because fear and concomitant physiological responses could promote nightmare chronicity and sleep disturbance. This randomized, controlled study (N=40) assessed physiological (skin conductance, heart rate, facial electromyogram) and subjective (displeasure, fear, anger, sadness, arousal) reactions to personally relevant nightmare imagery intended to evoke nightmare-related fear. Physiological assessments were conducted at pretreatment as well as 1-week, 3-months, and 6-months posttreatment. Results of mixed effects analysis of variance models suggested treatment reduced physiological and subjective reactions to nightmare imagery, gains that were generally maintained at the 6-month follow-up. Potential implications are discussed.

  10. A benefit-risk assessment of agomelatine in the treatment of major depression.

    Science.gov (United States)

    Howland, Robert H

    2011-09-01

    Agomelatine is an antidepressant drug that is a synthetic analogue of the hormone melatonin. It stimulates the activity of melatonin MT(1) and MT(2) receptors and inhibits the activity of serotonin 5HT(2C) receptor subtypes. The objective of this article is to critically review and evaluate the benefits and risks of agomelatine for the treatment of major depression. The published literature through April 2011 for articles relating to agomelatine, together with unpublished data on agomelatine available from the European Medicines Agency, the US FDA, US ClinicalTrials.gov and the Novartis Clinical Trial Results Database are reviewed. The antidepressant efficacy of agomelatine has been systematically assessed in ten short-term, placebo-controlled studies and three longer-term, placebo-controlled, relapse prevention studies. Five short-term trials demonstrated clinically modest, but statistically significant, benefits over placebo, although two of these studies reported opposite effects for 25 mg versus 50 mg doses. The other five short-term trials did not find agomelatine more effective than placebo, but in two of these studies the active control drug was more effective than placebo. A meta-analysis of six European trials demonstrated a small, statistically significant, marginally clinically relevant difference in efficacy favouring agomelatine over placebo. The only placebo-controlled study in elderly patients did not demonstrate a significant benefit for agomelatine. Agomelatine was shown to be more effective than placebo in one of three relapse prevention studies. Agomelatine was generally well tolerated compared with placebo. Its adverse effect profile is different to that of other antidepressant drugs, but its overall tolerability in studies with other antidepressants as active control drugs did not appear to be substantially better than the controls. Agomelatine is contraindicated in patients with impaired liver function and in patients taking drugs that

  11. 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

  12. 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…

  13. Chemometrics quality assessment of wastewater treatment plant effluents using physicochemical parameters and UV absorption measurements.

    Science.gov (United States)

    Platikanov, S; Rodriguez-Mozaz, S; Huerta, B; Barceló, D; Cros, J; Batle, M; Poch, G; Tauler, R

    2014-07-01

    Chemometric techniques like Principal Component Analysis (PCA) and Partial Least Squares Regression (PLS) are used to explore, analyze and model relationships among different water quality parameters in wastewater treatment plants (WWTP). Different data sets generated by laboratory analysis and by an automatic multi-parametric monitoring system with a new designed optical device have been investigated for temporal variations on water quality parameters measured in the water influent and effluent of a WWTP over different time scales. The obtained results allowed the discovery of the more important relationships among the monitored parameters and of their cyclic dependence on time (daily, monthly and annual cycles) and on different plant management procedures. This study intended also the modeling and prediction of concentrations of several water components and parameters, especially relevant for water quality assessment, such as Dissolved Organic Matter (DOM), Total Organic Carbon (TOC) nitrate, detergent, and phenol concentrations. PLS models were built to correlate target concentrations of these constituents with UV spectra measured in samples collected at (1) laboratory conditions (in synthetic water mixtures); and at (2) WWTP conditions (in real water samples from the plant). Using synthetic water mixtures, specific wavelengths were selected with the aim to establish simple and reliable prediction models, which gave good relative predictions with errors of around 3-4% for nitrates, detergent and phenols concentrations and of around 15% for the DOM in external validation. In the case of nitrate and TOC concentrations modeling in real water samples from the effluent of the WWTP using the reduced spectral data set, results were also promising with low prediction errors (less than 20%).

  14. Sequential chemical-biological processes for the treatment of industrial wastewaters: review of recent progresses and critical assessment.

    Science.gov (United States)

    Guieysse, Benoit; Norvill, Zane N

    2014-02-28

    When direct wastewater biological treatment is unfeasible, a cost- and resource-efficient alternative to direct chemical treatment consists of combining biological treatment with a chemical pre-treatment aiming to convert the hazardous pollutants into more biodegradable compounds. Whereas the principles and advantages of sequential treatment have been demonstrated for a broad range of pollutants and process configurations, recent progresses (2011-present) in the field provide the basis for refining assessment of feasibility, costs, and environmental impacts. This paper thus reviews recent real wastewater demonstrations at pilot and full scale as well as new process configurations. It also discusses new insights on the potential impacts of microbial community dynamics on process feasibility, design and operation. Finally, it sheds light on a critical issue that has not yet been properly addressed in the field: integration requires complex and tailored optimization and, of paramount importance to full-scale application, is sensitive to uncertainty and variability in the inputs used for process design and operation. Future research is therefore critically needed to improve process control and better assess the real potential of sequential chemical-biological processes for industrial wastewater treatment.

  15. Assessment of the calibration of periodontal diagnosis and treatment planning among dental students at three dental schools.

    Science.gov (United States)

    Lane, Brittany A; Luepke, Paul; Chaves, Eros; Maupome, Gerardo; Eckert, George J; Blanchard, Steven; John, Vanchit

    2015-01-01

    Calibration in diagnosis and treatment planning is difficult to achieve due to variations that exist in clinical interpretation. To determine if dental faculty members are consistent in teaching how to diagnose and treat periodontal disease, variations among dental students can be evaluated. A previous study reported high variability in diagnoses and treatment plans of periodontal cases at Indiana University School of Dentistry. This study aimed to build on that one by extending the research to two additional schools: Marquette University School of Dentistry and West Virginia University School of Dentistry. Diagnosis and treatment planning by 40 third- and fourth-year dental students were assessed at each of the schools. Students were asked to select the diagnosis and treatment plans on a questionnaire pertaining to 11 cases. Their responses were compared using chi-square tests, and multirater kappa statistics were used to assess agreement between classes and between schools. Logistic regression models were used to evaluate the effects of school, class year, prior experience, and GPA/class rank on correct responses. One case had a statistically significant difference in responses between third- and fourth-year dental students. Kappas for school agreement and class agreement were low. The students from Indiana University had higher diagnosis and treatment agreements than the Marquette University students, and the Marquette students fared better than the West Virginia University students. This study can help restructure future periodontal courses for a better understanding of periodontal diagnosis and treatment planning.

  16. Development of adjustment functions to assess combined safety effects of multiple treatments on rural two-lane roadways.

    Science.gov (United States)

    Park, Juneyoung; Abdel-Aty, Mohamed

    2015-02-01

    Numerous studies have attempted to evaluate the safety effectiveness of specific single treatment on roadways by estimating crash modification factors (CMFs). However, there is a need to also assess safety effects of multiple treatments since multiple treatments are usually simultaneously applied to roadways. Due to the lack of sufficient CMFs of multiple treatments, the Highway Safety Manual (HSM) provides combining method for multiple CMFs. However, it is cautioned in the HSM and related sources that combined safety effect of multiple CMFs may be over or under estimated. Moreover, the literature did not evaluate the accuracy of the combining method using CMFs obtained from the same study area. Thus, the main objectives of this research are: (1) to estimate CMFs and crash modification functions (CM Functions) for two single treatments (shoulder rumble strips, widening (1-9ft) shoulder width) and combination (installing shoulder rumble strips+widening shoulder width) using the observational before-after with empirical Bayes (EB) method and (2) to develop adjustment factors and functions to assess combined safety effects of multiple treatments based on the accuracy of the combined CMFs for multiple treatments estimated by the existing combining method. Data was collected for rural two-lane roadways in Florida and Florida-specific safety performance functions (SPFs) were estimated for different crash types and severities. The CM Functions and adjustment functions were developed using linear and nonlinear regression models. The results of before-after with EB method show that the two single treatments and combination are effective in reducing total and SVROR (single vehicle run-off roadway) crashes. The results indicate that the treatments were more safety effective for the roadway segments with narrower original shoulder width in the before period. It was found that although the CMFs for multiple treatments (i.e., combination of two single treatments) were generally

  17. The road to tuberculosis treatment in rural Nepal: a qualitative assessment of 26 journeys.

    NARCIS (Netherlands)

    Asbroek, A.H.A. ten; Bijlsma, M.W.; Malla, P.; Shresta, B.; Delnoij, D.M.J.

    2008-01-01

    Background: The fact that tuberculosis can be treated with the DOTS strategy (Directly Observed Treatment, Short-course) is not enough to control the disease. Patients have to find their way to tuberculosis treatment first. To better understand the route to tuberculosis treatment in rural Nepal we i

  18. The road to tuberculosis treatment in rural Nepal: A qualitative assessment of 26 journeys

    NARCIS (Netherlands)

    A.H.A. ten Asbroek (Augustinus); M.W. Bijlsma (Merijn); P. Malla (Puspha); B. Shrestha (Binjwala); D.M.J. Delnoij (Diana)

    2008-01-01

    textabstractBackground. The fact that tuberculosis can be treated with the DOTS strategy (Directly Observed Treatment, Short-course) is not enough to control the disease. Patients have to find their way to tuberculosis treatment first. To better understand the route to tuberculosis treatment in rura

  19. 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

  20. Comparative and integrative environmental assessment of advanced wastewater treatment processes based on an average removal of pharmaceuticals.

    Science.gov (United States)

    Igos, Elorri; Benetto, Enrico; Venditti, Silvia; Köhler, Christian; Cornelissen, Alex

    2013-01-01

    Pharmaceuticals are normally barely removed by conventional wastewater treatments. Advanced technologies as a post-treatment, could prevent these pollutants reaching the environment and could be included in a centralized treatment plant or, alternatively, at the primary point source, e.g. hospitals. In this study, the environmental impacts of different options, as a function of several advanced treatments as well as the centralized/decentralized implementation options, have been evaluated using Life Cycle Assessment (LCA) methodology. In previous publications, the characterization of the toxicity of pharmaceuticals within LCA suffers from high uncertainties. In our study, LCA was therefore only used to quantify the generated impacts (electricity, chemicals, etc.) of different treatment scenarios. These impacts are then weighted by the average removal rate of pharmaceuticals using a new Eco-efficiency Indicator EFI. This new way of comparing the scenarios shows significant advantages of upgrading a centralized plant with ozonation as the post-treatment. The decentralized treatment option reveals no significant improvement on the avoided environmental impact, due to the comparatively small pollutant load coming from the hospital and the uncertainties in the average removal of the decentralized scenarios. When comparing the post-treatment technologies, UV radiation has a lower performance than both ozonation and activated carbon adsorption.

  1. 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.

  2. Environmental assessment of nutrient recycling from biological pig slurry treatment--impact of fertilizer substitution and field emissions.

    Science.gov (United States)

    Brockmann, Doris; Hanhoun, Mary; Négri, Ophélie; Hélias, Arnaud

    2014-07-01

    Pig slurry treatment is an important means in reducing nitrogen loads applied to farmland. Solid phase separation prior to biological treatment further allows for recovering phosphorus with the solid phase. The organic residues from the pig slurry treatment can be applied as organic fertilizers to farmland replacing mineral fertilizers. The environmental impacts of nutrient recycling from aerobic, biological pig slurry treatment were evaluated applying the life cycle assessment (LCA) methodology. LCA results revealed that direct field emissions from organic fertilizer application and the amount of avoided mineral fertilizers dominated the environmental impacts. A modified plant available nitrogen calculation (PAN) was introduced taking into account calculated nitrogen emissions from organic fertilizer application. Additionally, an equation for calculating the quantity of avoided mineral fertilizers based on the modified PAN calculation was proposed, which accounted for nitrogen emissions from mineral fertilizer application.

  3. Real-World Assessment of Clinical Outcomes in Patients with Lower-Risk Myelofibrosis Receiving Treatment with Ruxolitinib

    Directory of Open Access Journals (Sweden)

    Keith L. Davis

    2015-01-01

    Full Text Available Few trial-based assessments of ruxolitinib in patients with lower-risk myelofibrosis (MF have been conducted, and no studies have made such assessments in a real-world population. We assessed changes in spleen size and constitutional symptoms during ruxolitinib treatment using a retrospective, observational review of anonymized US medical record data of patients diagnosed with IPSS low-risk (n=25 or intermediate-1-risk (n=83 MF. The majority of patients were male (low risk, 60%; intermediate-1 risk, 69%. Most patients (92% and 77% were still receiving ruxolitinib at the medical record abstraction date (median observation/exposure time, 8 months. The proportion of patients with moderate or severe palpable splenomegaly (≥10 cm decreased from diagnosis (56% to best response (12%. Fatigue was reported in 47% of patients and was the most common constitutional symptom. For most symptoms in both risk groups, shifts in the distribution of severity from more to less severe from diagnosis to best response were observed. Both patients with low-risk and intermediate-1-risk MF experienced a substantial decrease in spleen size with ruxolitinib treatment in real-world settings. For most symptoms examined, there were distinct improvements in the distribution of severity during ruxolitinib treatment. These findings suggest that patients with lower-risk MF may benefit clinically from ruxolitinib treatment.

  4. Melanin index in assessing the treatment efficacy of 1064 nm Q switched Nd-Yag laser in nevus of Ota

    Directory of Open Access Journals (Sweden)

    Gomathy Sethuraman

    2013-01-01

    Full Text Available Background: Q-switched neodymium-yttrium aluminium-garnet (Q switched Nd-Yag laser has been used in the treatment of nevus of Ota in all skin types with variable success rate. Data with an objective assessment parameter to this laser treatment is lacking. Objective: To evaluate the utility of melanin index in assessing the treatment response and also determine the efficacy and safety of the Q-switched Nd-Yag laser (1064-nm in the treatment of nevus of Ota in Fitzpatrick skin types IV and V. Materials and Methods: A total of 35 patients treated with Nd-Yag laser were studied. The objective improvement (pigment clearance was determined by melanin index from two fixed points: A1, 2 cm below the pupil at the mid pupillary line (when the gaze is fixed; A2, the most prominent part of zygoma. The melanin index in these two areas was recorded as M1 and M2, respectively. The subjective clinical improvement was determined by the physician and the patient global assessment score. Results: The mean baseline melanin indices M1 and M2 were 59.54 ± 9.72 and 59.02 ± 9.16, respectively. At the last visit the mean M1 and M2 decreased to 53.8 ± 8.55 (P 50% pigment clearance. Conclusion: The melanin index, a simple non-invasive parameter is useful in assessing the treatment response more objectively. The 1064-nm Q-switched Nd-Yag laser offers good improvement in patients with nevus of Ota in darker skin types IV/V.

  5. Melanin Index in Assessing the Treatment Efficacy of 1064 nm Q Switched Nd-Yag Laser in Nevus of Ota

    Science.gov (United States)

    Sethuraman, Gomathy; Sharma, Vinod K; Sreenivas, Vishnubhatla

    2013-01-01

    Background: Q-switched neodymium-yttrium aluminium-garnet (Q switched Nd-Yag) laser has been used in the treatment of nevus of Ota in all skin types with variable success rate. Data with an objective assessment parameter to this laser treatment is lacking. Objective: To evaluate the utility of melanin index in assessing the treatment response and also determine the efficacy and safety of the Q-switched Nd-Yag laser (1064-nm) in the treatment of nevus of Ota in Fitzpatrick skin types IV and V. Materials and Methods: A total of 35 patients treated with Nd-Yag laser were studied. The objective improvement (pigment clearance) was determined by melanin index from two fixed points: A1, 2 cm below the pupil at the mid pupillary line (when the gaze is fixed); A2, the most prominent part of zygoma. The melanin index in these two areas was recorded as M1 and M2, respectively. The subjective clinical improvement was determined by the physician and the patient global assessment score. Results: The mean baseline melanin indices M1 and M2 were 59.54 ± 9.72 and 59.02 ± 9.16, respectively. At the last visit the mean M1 and M2 decreased to 53.8 ± 8.55 (P 50% pigment clearance. Conclusion: The melanin index, a simple non-invasive parameter is useful in assessing the treatment response more objectively. The 1064-nm Q-switched Nd-Yag laser offers good improvement in patients with nevus of Ota in darker skin types IV/V. PMID:24470713

  6. Systematic review and assessment of systematic reviews examining the effect of periodontal treatment on glycemic control in patients with diabetes

    Science.gov (United States)

    Iguchi, Shinya; Suzuki, Daigo; Kawano, Eisuke; Sato, Shuichi

    2017-01-01

    Objetives There have been several systematic reviews(SRs) on whether periodontal treatment for an individual with both periodontal disease and diabetes can improve diabetes outcomes. The purpose of this investigation was to conduct a systematic review (SR) of previous meta-analyses, and to assess the methodological quality of the SRs examining the effects of periodontal treatment and diabetes. (PROSPERO Registration # CRD 42015023470). Study Design We searched five electronic databases and identified previous meta-analyses of randomized controlled trials published through July 2015. In cases where the meta-analysis did not meet our criteria, the meta-analyses were recalculated. General characteristics of each included trial were abstracted, analyzed, and compared. The mean difference, 95% confidence intervals (CIs) and the I2 statistic were abstracted or recalculated. The Assessment of Multiple Systematic Reviews Instrument (AMSTAR) was used to assess methodological quality. Results Of the 475 citations screened, nine systematic reviews were included. In total, 13 meta-analyses included in nine SRs were examined. In comparability analyses, meta-analyses in four SRs did not meet our criteria, and were recalcuated. Of these 13 meta-analyses, 10 suggested significant effects of periodontal treatment on HbA1c improvement. Mean differences found in the 13 meta-analyses ranged from -0.93 to 0.13. AMSTAR assessment revealed six SRs with moderate and three with high overall quality. Conclusions We can conclude that there is a significant effect of periodontal treatment on improvement of HbA1c in diabetes patients, although the effect size is extremely small. In addition to the small effect size, not all SRs could be considered of high quality. Key words:Periodontal treatment, diabetes, HbA1c, systematic review, systematic review of systematic reviews, evidence-based medicine, AMSTAR. PMID:28160589

  7. Development and assessment of an integrated ecological modelling framework to assess the effect of investments in wastewater treatment on water quality.

    Science.gov (United States)

    Holguin-Gonzalez, Javier E; Boets, Pieter; Everaert, Gert; Pauwels, Ine S; Lock, Koen; Gobeyn, Sacha; Benedetti, Lorenzo; Amerlinck, Youri; Nopens, Ingmar; Goethals, Peter L M

    2014-01-01

    Worldwide, large investments in wastewater treatment are made to improve water quality. However, the impacts of these investments on river water quality are often not quantified. To assess water quality, the European Water Framework Directive (WFD) requires an integrated approach. The aim of this study was to develop an integrated ecological modelling framework for the River Drava (Croatia) that includes physical-chemical and hydromorphological characteristics as well as the ecological river water quality status. The developed submodels and the integrated model showed accurate predictions when comparing the modelled results to the observations. Dissolved oxygen and nitrogen concentrations (ammonium and organic nitrogen) were the most important variables in determining the ecological water quality (EWQ). The result of three potential investment scenarios of the wastewater treatment infrastructure in the city of Varaždin on the EWQ of the River Drava was assessed. From this scenario-based analysis, it was concluded that upgrading the existing wastewater treatment plant with nitrogen and phosphorus removal will be insufficient to reach a good EWQ. Therefore, other point and diffuse pollution sources in the area should also be monitored and remediated to meet the European WFD standards.

  8. Value of subtraction MRI in assessing treatment response following image-guided loco-regional therapies for hepatocellular carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Winters, S.D. [Department of Radiology and Diagnostic Imaging, Royal Alexandra Hospital, Edmonton (Canada); Department of Radiology and Diagnostic Imaging, University of Alberta Hospital, Edmonton (Canada); 1 Canadian Field Hospital, Department of National Defence, Government of Canada (Canada); Jackson, S. [Department of Radiology and Diagnostic Imaging, University of Alberta Hospital, Edmonton (Canada); Armstrong, G.A. [Department of Radiology and Diagnostic Imaging, Royal Alexandra Hospital, Edmonton (Canada); Department of Radiology and Diagnostic Imaging, University of Alberta Hospital, Edmonton (Canada); Birchall, I.W. [Department of Radiology and Diagnostic Imaging, University of Alberta Hospital, Edmonton (Canada); Lee, K.H.Y. [Department of Radiology and Diagnostic Imaging, Royal Alexandra Hospital, Edmonton (Canada); Low, G., E-mail: timgy@yahoo.com [Department of Radiology and Diagnostic Imaging, University of Alberta Hospital, Edmonton (Canada)

    2012-07-15

    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.

  9. Assessing theoretical predictors of long-term medication adherence: patients' treatment-related beliefs, experiential feedback and habit development.

    Science.gov (United States)

    Alison Phillips, L; Leventhal, Howard; Leventhal, Elaine A

    2013-01-01

    Patient non-adherence to medication is a pervasive problem that contributes to poor patient health and high healthcare costs. Basic research and interventions have focused thus far on behaviour initiation factors, such as patients' illness and treatment beliefs. This paper proposes two processes that occur after behaviour initiation that are theorised to contribute to prediction of long-term medication adherence: 'coherence' of patients' beliefs from experiences with treatment and habit development. Seventy-one hypertensive patients reported their treatment-related beliefs, experiences related to treatment efficacy and medication-taking habit strength in a baseline interview. Patients then used an electronic monitoring pill bottle for approximately one month. Patients' medication habit-strength was the strongest predictor of all adherence measures, explaining 6-27% incremental variance in adherence to that explained by patients' treatment-related beliefs. Patients' beliefs and experiences did not predict overall adherence, even for patients with 'weaker' habits. However, patients' experiences were found to predict intentional non-adherence and habit strength was found to predict unintentional adherence. Practitioners may assess patients' medication-taking habits to get an initial view of their likely adherence to long-term medications. Future research should assess the current theoretical predictions in a hypertension inception sample and in populations with symptomatic conditions.

  10. Four-dimensional (4D) Motion Detection to Correct Respiratory Effects in Treatment Response Assessment Using Molecular Imaging Biomarkers

    Science.gov (United States)

    Schreibmann, Eduard; Crocker, Ian; Schuster, David M.; Curran, Walter J.; Fox, Tim

    2014-01-01

    Observing early metabolic changes in positron emission tomography (PET) is an essential tool to assess treatment efficiency in radiotherapy. However, for thoracic regions, the use of three-dimensional (3D) PET imaging is unfeasible because the radiotracer activity is smeared by the respiratory motion and averaged during the imaging acquisition process. This motion-induced degradation is similar in magnitude with the treatment-induced changes, and the two occurrences become indiscernible. We present a customized temporal-spatial deformable registration method for quantifying respiratory motion in a four-dimensional (4D) PET dataset. Once the motion is quantified, a motion-corrected (MC) dataset is created by tracking voxels to eliminate breathing-induced changes in the 4D imaging scan. The 4D voxel-tracking data is then summed to yield a 3D MC-PET scan containing only treatment-induced changes. This proof of concept is exemplified on both phantom and clinical data, where the proposed algorithm tracked the trajectories of individual points through the 4D datasets reducing motion to less than 4 mm in all phases. This correction approach using deformable registration can discern motion blurring from treatment-induced changes in treatment response assessment using PET imaging. PMID:24000982

  11. 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...

  12. 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

  13. Post-Traumatic Stress Disorder among Cardiac Patients: Prevalence, Risk Factors, and Considerations for Assessment and Treatment

    Directory of Open Access Journals (Sweden)

    Heather Tulloch

    2014-12-01

    Full Text Available There is increasing awareness of the impact of post-traumatic stress disorder (PTSD on physical health, particularly cardiovascular disease. We review the literature on the role of trauma in the development of cardiovascular risk factors and disease, aftermath of a cardiac event, and risk for recurrence in cardiac patients. We explore possible mechanisms to explain these relationships, as well as appropriate assessment and treatment strategies for this population. Our main conclusion is that screening and referral for appropriate treatments are important given the high prevalence rates of PTSD in cardiac populations and the associated impact on morbidity and mortality.

  14. 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...

  15. Assessment of coercive and noncoercive pressures to enter drug abuse treatment.

    Science.gov (United States)

    Marlowe, D B; Kirby, K C; Bonieskie, L M; Glass, D J; Dodds, L D; Husband, S D; Platt, J J; Festinger, D S

    1996-10-01

    This paper reports preliminary data derived from a standardized interview scoring procedure for detecting and characterizing coercive and noncoercive pressures to enter substance abuse treatment. Coercive and noncoercive pressures stemming from multiple psychosocial domains are operationalized through recourse to established behavioral principles. Inter-rater reliability for the scoring procedure was exceptional over numerous rater trials. Substantive analyses indicate that, among clients in outpatient cocaine treatment, 'coercion' is operative in multiple psychosocial domains, and that subjects perceive legal pressures as exerting substantially less influence over their decisions to enter treatment than informal psychosocial pressures. Implications for drug treatment planning, legal and ethical issues, and directions for future research are proposed.

  16. 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.

  17. Intervention Validity of Social Behavior Rating Scales: Features of Assessments that Link Results to Treatment Plans

    Science.gov (United States)

    Elliott, Stephen N.; Gresham, Frank M.; Frank, Jennifer L.; Beddow, Peter A., III

    2008-01-01

    The term "intervention validity" refers to the extent to which assessment results can be used to guide the selection of interventions and evaluation of outcomes. In this article, the authors review the defining attributes of rating scales that distinguish them from other assessment tools, assumptions regarding the use of rating scales to measure…

  18. Flood Stress as a Technique to Assess Preventive Insecticide and Fungicide Treatments for Protecting Trees against Ambrosia Beetles.

    Science.gov (United States)

    Ranger, Christopher M; Schultz, Peter B; Reding, Michael E; Frank, Steven D; Palmquist, Debra E

    2016-08-18

    Ambrosia beetles tunnel into the heartwood of trees where they cultivate and feed upon a symbiotic fungus. We assessed the effectiveness of flood stress for making Cercis canadensis L. and Cornus florida L. trees attractive to attack as part of insecticide and fungicide efficacy trials conducted in Ohio and Virginia. Since female ambrosia beetles will not begin ovipositing until their symbiotic fungus is established within the host, we also assessed pre-treatment of trees with permethrin, azoxystrobin, and potassium phosphite on fungal establishment and beetle colonization success. Permethrin reduced attacks on flooded trees, yet no attacks occurred on any of the non-flooded trees. Fewer galleries created within flooded trees pre-treated with permethrin, azoxystrobin, and potassium phosphite contained the purported symbiotic fungus; foundress' eggs were only detected in flooded but untreated trees. While pre-treatment with permethrin, azoxystrobin, and potassium phosphite can disrupt colonization success, maintaining tree health continues to be the most effective and sustainable management strategy.

  19. Practice Parameter for the Assessment and Treatment of Children and Adolescents With Reactive Attachment Disorder and Disinhibited Social Engagement Disorder.

    Science.gov (United States)

    Zeanah, Charles H; Chesher, Tessa; Boris, Neil W

    2016-11-01

    This Practice Parameter is a revision of a previous Parameter addressing reactive attachment disorder that was published in 2005. It reviews the current status of reactive attachment disorder (RAD) and disinhibited social engagement disorder (DESD) with regard to assessment and treatment. Attachment is a central component of social and emotional development in early childhood, and disordered attachment is defined by specific patterns of abnormal social behavior in the context of "insufficient care" or social neglect. Assessment requires direct observation of the child in the context of his or her relationships with primary caregivers. Treatment requires establishing an attachment relationship for the child when none exists and ameliorating disturbed social relatedness with non-caregivers when evident.

  20. 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 fun...

  1. Quality assessment of diagnosis and antibiotic treatment of infectious diseases in primary care: a systematic review of quality indicators

    OpenAIRE

    Saust, Laura Trolle; Monrad, Rikke Nygaard; Hansen, Malene Plejdrup; Arpi, Magnus; Bjerrum, Lars

    2016-01-01

    Objective To identify existing quality indicators (QIs) for diagnosis and antibiotic treatment of patients with infectious diseases in primary care. Design A systematic literature search was performed in PubMed and EMBASE. We included studies with a description of the development of QIs for diagnosis and antibiotic use in patients with infectious diseases in primary care. We extracted information about (1) type of infection; (2) target for quality assessment; (3) methodology used for developi...

  2. Different methodological approaches to the assessment of in vivo efficacy of three artemisinin-based combination antimalarial treatments for the treatment of uncomplicated falciparum malaria in African children

    Directory of Open Access Journals (Sweden)

    Zongo Issaka

    2008-08-01

    Full Text Available Abstract Background Use of different methods for assessing the efficacy of artemisinin-based combination antimalarial treatments (ACTs will result in different estimates being reported, with implications for changes in treatment policy. Methods Data from different in vivo studies of ACT treatment of uncomplicated falciparum malaria were combined in a single database. Efficacy at day 28 corrected by PCR genotyping was estimated using four methods. In the first two methods, failure rates were calculated as proportions with either (1a reinfections excluded from the analysis (standard WHO per-protocol analysis or (1b reinfections considered as treatment successes. In the second two methods, failure rates were estimated using the Kaplan-Meier product limit formula using either (2a WHO (2001 definitions of failure, or (2b failure defined using parasitological criteria only. Results Data analysed represented 2926 patients from 17 studies in nine African countries. Three ACTs were studied: artesunate-amodiaquine (AS+AQ, N = 1702, artesunate-sulphadoxine-pyrimethamine (AS+SP, N = 706 and artemether-lumefantrine (AL, N = 518. Using method (1a, the day 28 failure rates ranged from 0% to 39.3% for AS+AQ treatment, from 1.0% to 33.3% for AS+SP treatment and from 0% to 3.3% for AL treatment. The median [range] difference in point estimates between method 1a (reference and the others were: (i method 1b = 1.3% [0 to24.8], (ii method 2a = 1.1% [0 to21.5], and (iii method 2b = 0% [-38 to19.3]. The standard per-protocol method (1a tended to overestimate the risk of failure when compared to alternative methods using the same endpoint definitions (methods 1b and 2a. It either overestimated or underestimated the risk when endpoints based on parasitological rather than clinical criteria were applied. The standard method was also associated with a 34% reduction in the number of patients evaluated compared to the number of patients enrolled. Only 2% of the sample size

  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.

  5. 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

  6. Occurrence, fate and risk assessment of parabens and their chlorinated derivatives in an advanced wastewater treatment plant.

    Science.gov (United States)

    Li, Wenhui; Shi, Yali; Gao, Lihong; Liu, Jiemin; Cai, Yaqi

    2015-12-30

    In the present study, parabens, p-hydroxybenzoic acid (PHBA) and chlorinated derivatives, were simultaneously determined in wastewater and sludge samples along the whole process in an advanced wastewater treatment plant (WWTP). Nine target compounds were detected in this WWTP, and methylparaben and PHBA were the dominant compounds in these samples. It is noteworthy that octylparaben with longer chain was firstly detected in this work. Mass balance results showed that 91.8% of the initial parabens mass loading was lost mainly due to degradation, while the contribution of sorption and output of primary and excess sludge was much less (7.5%), indicating that biodegradation played a significant role in the removal of parabens during the conventional treatment process. Specifically, parabens were mainly degraded in the anaerobic tank, and PHBA could be effectively removed at high rates after the advanced treatment. However, both biodegradation and adsorption accounted for minor contribution to the removal of chlorinated parabens during conventional treatment process, and they were only scantly removed by conventional treatment (33.9-40.7%) and partially removed by advanced treatment (59.2-82.8%). Risk assessment indicated that parabens and their chlorinated derivatives in second and tertiary effluent are not likely to produce biological effects on aquatic ecosystems.

  7. Assessment

    Institute of Scientific and Technical Information of China (English)

    Geoff Brindley

    2005-01-01

    @@ Introduction TERMINOLOGY AND KEY CONCEPTS The term assessment refers to a variety of ways of collecting information on a learner's language ability or achievement. Although testing and assessment are often used interchangeably, the latter is an umbrella term encompassing measurement instruments administered on a ‘one-off’ basis such as tests, as well as qualitative methods of monitoring and recording student learning such as observation, simulations of project work. Assessment is also distinguished from evaluation which is concerned with the overall language programme and not just with what individual students have learnt. Proficiency assessment refers to the assessment of general language abilities acquired by the learner independent of a course of study.This kind of assessment is often done through the administration of standardised commercial language-proficency tests. On the other hand, assessment of achievement aims to establish what a student had learned in relation to a particular course or curriculum (thus frequently carried out by the teacher) .Achievement assesssment may be based either on the specific content of the course or on the course objectives (Hughes 1989).

  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. Assessment of topical versus oral ivermectin as a treatment for head lice.

    Science.gov (United States)

    Ahmad, Hesham M; Abdel-Azim, Eman S; Abdel-Aziz, Rasha T

    2014-01-01

    Many medications are available for treatment of pediculosis capitis including ivermectin. Our aim is to compare the efficacy and safety of topical versus oral ivermectin in treatment of pediculosis capitis. Sixty-two patients with proved head lice infestation were included and divided into group I (31 patients; received single topical application of 1% ivermectin) and group II (31 patients; received single dose of oral ivermectin). Treatment was repeated after 1 week for nonresponders. At 1 week after treatment, the eradication rates and improvement of pruritus were significantly higher among patients who received topical than oral ivermectin. When a second treatment, topical or oral, was given to nonresponders, the cure rates of infestation and pruritus was 100% and 97% among patients treated with topical and oral ivermectin, respectively with no significant difference between the two groups. This study suggests that both topical and oral ivermectin demonstrate high efficacy and tolerability in treatment of pediculosis capitis. However, a single treatment with topical ivermectin provides significantly higher cure of infestation and faster relief of pruritus than oral ivermectin. In addition, whether topical or oral ivermectin is used to treat head lice, a second dose is required in some cases to ensure complete eradication.

  10. The road to tuberculosis treatment in rural Nepal: A qualitative assessment of 26 journeys

    Directory of Open Access Journals (Sweden)

    Malla Puspha

    2008-01-01

    Full Text Available Abstract Background The fact that tuberculosis can be treated with the DOTS strategy (Directly Observed Treatment, Short-course is not enough to control the disease. Patients have to find their way to tuberculosis treatment first. To better understand the route to tuberculosis treatment in rural Nepal we interviewed twenty-six patients under treatment. Methods In semi-structured interviews patients shared their disease history and health seeking behaviour. The analysis focused on the encounters with the health care system before enrolment in the tuberculosis treatment program. Results Patient routes often started in the medical shop and led via intricate routes with multiple providers to facilities with higher qualified and more competent staff where tuberculosis was diagnosed. Several factors influenced the route to tuberculosis treatment. Besides known patients factors (such as severity of complaints, the ability to pay for services, availability of services and peer support for choosing a provider specific health services factors were also identified. These included the perceived quality, costs and service level of a provider, and lack of provider initiated referral. Self referral because of waned trust in the provider was very common. In contrast, once tuberculosis was considered a possible diagnosis, referral to diagnostic testing and tuberculosis treatment was prompt. Conclusion Patient routes towards tuberculosis treatment are characterised by self referral and include both private and public health care providers. Once tuberculosis is suspected referral for diagnosis and treatment is prompt. Given the importance of the private practitioners in the patient routes, quality improvement initiatives need to address not only the public sector but the private health care sector as well.

  11. 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.

  12. Comprehensive Cognitive Assessments are not Necessary for the Identification and Treatment of Learning Disabilities.

    Science.gov (United States)

    Fletcher, Jack M; Miciak, Jeremy

    2017-02-01

    There is considerable controversy about the necessity of cognitive assessment as part of an evaluation for learning and attention problems. The controversy should be adjudicated through an evaluation of empirical research. We review five sources of evidence commonly provided as support for cognitive assessment as part of the learning disability (LD) identification process, highlighting significant gaps in empirical research and where existing evidence is insufficient to establish the reliability and validity of cognitive assessments used in this way. We conclude that current evidence does not justify routine cognitive assessment for LD identification. As an alternative, we offer an instructional conceptualization of LD: a hybrid model that directly informs intervention and is based on documenting low academic achievement, inadequate response to intensive interventions, and a consideration of exclusionary factors.

  13. Assessment of quality of life during treatment of pediatric oncology patients

    Directory of Open Access Journals (Sweden)

    Prerna Batra

    2014-01-01

    Full Text Available Background: The objective of this study was to assess health-related quality of life (HRQOL of pediatric cancer patients and their parents in North India. Materials and Methods: Seventy-five cancer children were assessed for HRQOL, using Lansky play performance scale and health utility index-2 (HUI-2. Fifty-seven patients were followed-up after 4 months after therapy and reassessed. Their parents were also assessed using World Health Organisation (WHO QOL BREF. Seventy five controls were also assessed and compared. Results: Lansky and HUI-2 scores of patients, as well as WHO QOL BREF of parents were significantly poor in cancer patients when compared to controls. There was significant improvement after therapy in patients with lymphomas and miscellaneous tumors. Pain and self-care were found to be maximally affected domains on HUI-2. Conclusions: Large prospective multicenter studies may be undertaken and hence that need based interventions can be planned.

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

    OpenAIRE

    Maria Lucia Specchia; Chiara de Waure; Maria Rosaria Gualano; Andrea Doria; Giuseppe Turchetti; Lara Pippo; Francesco Di Nardo; Silvio Capizzi; Chiara Cadeddu; Flavia Kheiraoui; Luca Iaccarino; Francesca Pierotti; Ilaria Palla; Maria Assunta Veneziano; Daniela Gliubizzi

    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...

  15. 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.

  16. Interpersonal Subtypes of Anxiety Disorder Patients: Relationship to Assessment and Treatment Variables.

    Science.gov (United States)

    Pitman, Seth R; Hilsenroth, Mark J

    2016-07-01

    We attempted to replicate earlier findings of interpersonal subtypes in patients with anxiety disorder (Psychotherapy. 2011;48:304-310) and examine whether these subtypes are characterized by different types of pathology and respond differently to treatment. Interpersonal problems were measured by the Inventory of Interpersonal Problems (Inventory of Interpersonal Problems Manual. San Antonio, TX: Psychological Cooperation; 2000) in a sample of 31 patients with anxiety disorder. Results demonstrated the existence of 4 interpersonal subtypes. The subtypes did not differ in severity of anxiety and global levels of symptoms at pretreatment or in Reliable Change Index of anxiety symptoms over the course of treatment. However, they were significantly different in terms of overall interpersonal problems (p = 0.004). Regarding treatment variables, half of the patients in the nonassertive cluster discontinued treatment prematurely. The number of psychotherapy sessions attended was significantly different across the 4 clusters (p = 0.04), with socially avoidant patients attending significantly greater number of sessions.

  17. 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, ...

  18. Hyperspectral Imaging of Functional Patterns for Disease Assessment and Treatment Monitoring

    Energy Technology Data Exchange (ETDEWEB)

    Demos, S; Hattery, D; Hassan, M; Aleman, K; Little, R; Yarchoan, R; Gandjbakhche, A

    2003-12-05

    We have designed and built a six-band multi-spectral NIR imaging system used in clinical testing on cancer patients. From our layered tissue model, we create blood volume and blood oxygenation images for patient treatment monitoring.

  19. 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

  20. Economic assessment of preeclampsia : Screening, diagnosis, treatment options, and long term outcomes, a systematic review

    NARCIS (Netherlands)

    Zakiyah, N.; Van Asselt, A.; Baker, P.; Postma, M.J.

    2014-01-01

    Objectives: To 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

  1. Continuous fungal treatment of non-sterile veterinary hospital effluent: pharmaceuticals removal and microbial community assessment.

    Science.gov (United States)

    Badia-Fabregat, Marina; Lucas, Daniel; Pereira, Maria Alcina; Alves, Madalena; Pennanen, Taina; Fritze, Hannu; Rodríguez-Mozaz, Sara; Barceló, Damià; Vicent, Teresa; Caminal, Glòria

    2016-03-01

    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. versicolor pellets. On the other hand, the study of microbial communities by means of DGGE and phylogenetic analyses led us to identify some microbial interactions and helped us moving to a continuous process. PhAC removal efficiency achieved in the fungal treatment operated in non-sterile continuous mode was 44 % after adjusting the C/N ratio with respect to the previously calculated one for sterile treatments. Fungal and bacterial communities in the continuous bioreactors were monitored as well.

  2. 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...

  3. [Comparative assessment of conservative treatment of chronic prostatitis with application of complex unit andro-gin].

    Science.gov (United States)

    Golubchikova, V A; Alekseev, M Ia; Sitnikov, N V; Kochetov, A G; Podgornyĭ, V F

    2000-01-01

    The Andro-Gin unit used in combined treatment of 78 patients with chronic prostatitis (CP) and 16 women with chronic interstitial cystitis with inflammation in the internal genitalia (56.5% of the patients had sexual and spermatogenesis disorders) employed effects of simultaneous exposure to local magnetic field, electrostimulation of the small pelvis organs and prostate with introduction of contact rectal electrode, neurostimulation of pathogenic zones, low-intensity laser and light-diode radiator and color impulse therapy. Control group consisted of 85 patients with CP who received conventional physiotherapy. The comparative analysis has shown high efficiency of the unit Andro-Gin in the treatment of CP and its complications. Laboratory and clinical convalescence and persistent remission was registered in 98% of the patients of the study group. Combined treatment using Andro-Gin is twice more effective than other treatments.

  4. 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.

  5. CBCT in orthodontics: assessment of treatment outcomes and indications for its use

    OpenAIRE

    S. D. Kapila; Nervina, J M

    2014-01-01

    Since its introduction into dentistry in 1998, CBCT has become increasingly utilized for orthodontic diagnosis, treatment planning and research. The utilization of CBCT for these purposes has been facilitated by the relative advantages of three-dimensional (3D) over two-dimensional radiography. Despite many suggested indications of CBCT, scientific evidence that its utilization improves diagnosis and treatment plans or outcomes has only recently begun to emerge for some of these applications....

  6. Study to assess the role of bromocriptine in treatment of diabetes mellitus

    OpenAIRE

    Anuj Kumar Pathak; Subodh Kumar; Manish Kumar; Harihar Dikshit

    2016-01-01

    Background: Bromocriptine is a dopamine D2 receptor agonist and a sympatholytic agent used very frequently in treatment of hyperprolactinemia, Parkinsonism and acromegaly. Its quick release formulation has been approved for treatment of type 2 diabetes mellitus as an adjunct to diet and exercise. This study evaluated the antihyperglycemic effect of quick release bromocriptine in alloxan induced diabetic rats. Methods: 24 albino rats were taken and divided into four groups of six rats in ea...

  7. 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.

  8. 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.

  9. The effect of using assessment instruments on substance-abuse outpatients' adherence to treatment: A multi-centre randomised controlled trial

    NARCIS (Netherlands)

    Raes, V.; Jong, C.A.J. de; Bacquer, D. De; Broekaert, E.; Maeseneer, J. De

    2011-01-01

    Background: Drop-out is an important problem in the treatment of substance use disorder. The focus of this study was to investigate the effectiveness of within treatment assessment with feedback directly to patients with multiple substance use disorder on outpatient individual treatment adherence. F

  10. The effect of using assessment instruments on substance-abuse outpatients' adherence to treatment: a multi-centre randomised controlled trial.

    NARCIS (Netherlands)

    Raes, V.; Jong, C.A.J. de; Bacquer, D. De; Broekaert, E.; Maeseneer, J. De

    2011-01-01

    BACKGROUND: Drop-out is an important problem in the treatment of substance use disorder. The focus of this study was to investigate the effectiveness of within treatment assessment with feedback directly to patients with multiple substance use disorder on outpatient individual treatment adherence. F

  11. Measuring somatic symptoms with the CES-D to assess depression in cancer patients after treatment : Comparison among patients with oral/oropharyngeal, gynecological, colorectal, and breast cancer

    NARCIS (Netherlands)

    van Wilgen, C.P.; Dijkstra, P.U.; Stewart, R.E.; Ranchor, A.V.; Roodenburg, J.L.N.

    2006-01-01

    There is a high prevalence of depression after cancer treatment. In the literature, several authors have raised questions about assessing somatic symptoms to explore depression after cancer treatment. These somatic sequelae are a consequence of cancer treatment and should cause higher depression rat

  12. Assessing the application of advanced oxidation processes, and their combination with biological treatment, to effluents from pulp and paper industry.

    Science.gov (United States)

    Merayo, Noemí; Hermosilla, Daphne; Blanco, Laura; Cortijo, Luis; Blanco, Angeles

    2013-11-15

    The closure of water circuits within pulp and paper mills has resulted in a higher contamination load of the final mill effluent, which must consequently be further treated in many cases to meet the standards imposed by the legislation in force. Different treatment strategies based on advanced oxidation processes (ozonation and TiO2-photocatalysis), and their combination with biological treatment (MBR), are herein assessed for effluents of a recycled paper mill and a kraft pulp mill. Ozone treatment achieved the highest efficiency of all. The consumption of 2.4 g O3 L(-1) resulted in about a 60% COD reduction treating the effluent from the kraft pulp mill at an initial pH=7; although it only reached about a 35% COD removal for the effluent of the recycled paper mill. Otherwise, photocatalysis achieved about a 20-30% reduction of the COD for both type of effluents. In addition, the effluent from the recycled paper mill showed a higher biodegradability, so combinations of these AOPs with biological treatment were tested. As a result, photocatalysis did not report any significant COD reduction improvement whether being performed as pre- or post-treatment of the biological process; whereas the use of ozonation as post-biological treatment enhanced COD removal a further 10%, summing up a total 90% reduction of the COD for the combined treatment, as well as it also supposed an increase of the presence of volatile fatty acids, which might ultimately enable the resultant wastewater to be recirculated back to further biological treatment.

  13. Randomised trial assessing the impact of framing of fracture risk and osteoporosis treatment benefits in patients undergoing bone densitometry

    Science.gov (United States)

    Kalluru, Rama; Petrie, Keith J; Grey, Andrew; Nisa, Zaynah; Horne, Anne M; Gamble, Greg D; Bolland, Mark J

    2017-01-01

    Objectives The accuracy of patients' perception of risk is important for decisions about treatment in many diseases. We framed the risk of fracture and benefits of treatment in different ways and assessed the impact on patients' perception of fracture risk and intentions to take medication. Design Randomised trial of 4 different presentations of fracture risk and likely benefits from osteoporosis treatment. Setting Academic centre. Participants 200 patients undergoing bone densitometry. Intervention Presentation that framed the patient's absolute fracture risk either as the chance of having or not having an event, with their likely benefits from osteoporosis treatment in natural frequencies or numbers needed to treat. Outcomes Participants' views about their fracture risk and the need for osteoporosis treatment. Results The median 5-year fracture risk threshold participants regarded as high enough to consider preventative medication was 50–60%, and did not change substantially after the presentation. The median (Q1, Q3) 5-year risk initially estimated by participants was 20% (10, 50) for any fracture and 19% (10, 40) for hip fracture. 61% considered their fracture risk was low or very low, and 59–67% considered their fracture risk was lower than average. These participant estimates were 2–3 times higher than Garvan calculator estimates for any fracture, and 10–20 times higher for hip fracture. Participant estimates of fracture risk halved after the presentation, but remained higher than the Garvan estimates (1.5–2 times for any fracture, 5–10 times for hip fracture). There was no difference in these outcomes between the randomised groups. Participants' intentions about taking medication to prevent fractures were not substantially affected by receiving information about fracture risk and treatment benefits. Conclusions Altering the framing of estimated fracture risks and treatment benefits had little effect on participants' perception of the need to take

  14. 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.

  15. 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

    2013-12-19

    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

  16. 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)

  17. Modelling the catchment-scale environmental impacts of wastewater treatment in an urban sewage system for CO₂ emission assessment.

    Science.gov (United States)

    Mouri, Goro; Oki, Taikan

    2010-01-01

    Water shortages and water pollution are a global problem. Increases in population can have further acute effects on water cycles and on the availability of water resources. Thus, wastewater management plays an important role in mitigating negative impacts on natural ecosystems and human environments and is an important area of research. In this study, we modelled catchment-scale hydrology, including water balances, rainfall, contamination, and urban wastewater treatment. The entire water resource system of a basin, including a forest catchment and an urban city area, was evaluated synthetically from a spatial distribution perspective with respect to water quantity and quality; the Life Cycle Assessment (LCA) technique was applied to optimize wastewater treatment management with the aim of improving water quality and reducing CO₂ emissions. A numerical model was developed to predict the water cycle and contamination in the catchment and city; the effect of a wastewater treatment system on the urban region was evaluated; pollution loads were evaluated quantitatively; and the effects of excluding rainwater from the treatment system during flooding and of urban rainwater control on water quality were examined. Analysis indicated that controlling the amount of rainwater inflow to a wastewater treatment plant (WWTP) in an urban area with a combined sewer system has a large impact on reducing CO₂ emissions because of the load reduction on the urban sewage system.

  18. 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.

  19. 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.

  20. Evaluation of the Treatment Process of Landfill Leachate Using the Toxicity Assessment Method

    Directory of Open Access Journals (Sweden)

    Aifeng Qiu

    2016-12-01

    Full Text Available Landfill leachate is composed of a complex composition with strong biological toxicity. The combined treatment process of coagulation and sedimentation, anaerobics, electrolysis, and aerobics was set up to treat landfill leachate. This paper explores the effect of different operational parameters of coagulation and sedimentation tanks and electrolytic cells, while investigating the combined process for the removal efficiency of physicochemical indices after processing the landfill leachate. Meanwhile, a battery of toxicity tests with Vibrio fischeri, zebrafish larvae, and embryos were conducted to evaluate acute toxicity and calculated the toxicity reduction efficiency after each treatment process. The combined treatment process resulted in a 100% removal efficiency of Cu, Cd and Zn, and a 93.50% and an 87.44% removal efficiency of Ni and Cr, respectively. The overall removal efficiency of chemical oxygen demand (COD, ammonium nitrogen (NH4+-N, and total nitrogen (TN were 93.57%, 97.46% and 73.60%, respectively. In addition, toxicity test results showed that the acute toxicity of landfill leachate had also been reduced significantly: toxicity units (TU decreased from 84.75 to 12.00 for zebrafish larvae, from 82.64 to 10.55 for zebrafish embryos, and from 3.41 to 0.63 for Vibrio fischeri. The combined treatment process was proved to be an efficient treatment method to remove heavy metals, COD, NH4+-N, and acute bio-toxicity of landfill leachate.

  1. Biomarkers to assess the efficiency of treatment with platinum-based drugs: what can metallomics add?

    Science.gov (United States)

    Araujo, Thiago de O; Costa, Lilian T; Fernandes, Janaina; Aucélio, Ricardo Queiroz; de Campos, Reinaldo Calixto

    2014-12-01

    Since the approval of cisplatin as an antineoplastic drug, the medical and the scientific communities have been concerned about the side effects of platinum-based drugs, and this has been the dose-limiting factor that leads to reduced treatment efficiency. Another important issue is the intrinsic or acquired resistance of some patients to treatment. Identifying proper biomarkers is crucial in evaluating the efficiency of a treatment, assisting physicians in determining, at early stages, whether or not the patient presents resistance to the drug, minimizing severe side effects, and allowing them to redirect the established course of chemotherapy. A great effort is being made to identify biomarkers that can be used to predict the outcome of the treatment of cancer patients with platinum-based drugs. In this context, the metallomic approach has not yet been used to its full potential. Since the basis of these drugs is platinum, the monitoring of biomarkers containing this metal should be the natural approach to evaluate treatment progress. This review intends to show where the research in this field stands and points out some gaps that can be filled by metallomics.

  2. Assessment of Reclamation Treatments of Abandoned Farmland in an Arid Region of China

    Directory of Open Access Journals (Sweden)

    Haichang Yang

    2016-11-01

    Full Text Available Reclamation of abandoned farmland is crucial to a sustainable agriculture in arid regions. This study aims to evaluate the impact of different reclamation treatments on abandoned salinized farmland. We investigated four artificial reclamation treatments, continuous cotton (CC, continuous alfalfa (CA, tree-wheat intercropping (TW and trees (TS, which were conducted in 2011–2012 in the Manasi River Basin of Xinjiang Province, China. Soil nutrient, microorganism and enzyme activity were examined in comparison with natural succession (CK in an integrated analysis on soil fertility improvement and soil salinization control with these reclamations. Results indicate that the four artificial reclamation treatments are more effective approaches than natural restoration to reclaim abandoned farmland. TW and CA significantly increased soil nutrient content compared to CK. CC reduced soil salinity to the lowest level among all treatments. TW significantly enhanced soil enzyme activity. All four artificial reclamations increased soil microbial populations and soil microbial biomass carbon. TW and CA had the greatest overall optimal effects among the four treatments in terms of the ecological outcomes. If both economic benefits and ecological effects are considered, TW would be the best reclamation mode. The findings from this study will assist in selecting a feasible method for reclamation of abandoned farmland for sustainable agriculture in arid regions.

  3. 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

  4. Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report.

    Science.gov (United States)

    Barlow, Sarah E

    2007-12-01

    To revise 1998 recommendations on childhood obesity, an Expert Committee, comprised of representatives from 15 professional organizations, appointed experienced scientists and clinicians to 3 writing groups to review the literature and recommend approaches to prevention, assessment, and treatment. Because effective strategies remain poorly defined, the writing groups used both available evidence and expert opinion to develop the recommendations. Primary care providers should universally assess children for obesity risk to improve early identification of elevated BMI, medical risks, and unhealthy eating and physical activity habits. Providers can provide obesity prevention messages for most children and suggest weight control interventions for those with excess weight. The writing groups also recommend changing office systems so that they support efforts to address the problem. BMI should be calculated and plotted at least annually, and the classification should be integrated with other information such as growth pattern, familial obesity, and medical risks to assess the child's obesity risk. For prevention, the recommendations include both specific eating and physical activity behaviors, which are likely to promote maintenance of healthy weight, but also the use of patient-centered counseling techniques such as motivational interviewing, which helps families identify their own motivation for making change. For assessment, the recommendations include methods to screen for current medical conditions and for future risks, and methods to assess diet and physical activity behaviors. For treatment, the recommendations propose 4 stages of obesity care; the first is brief counseling that can be delivered in a health care office, and subsequent stages require more time and resources. The appropriateness of higher stages is influenced by a patient's age and degree of excess weight. These recommendations recognize the importance of social and environmental change to reduce

  5. 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.

  6. Seasonal occurrence, removal efficiencies and preliminary risk assessment of multiple classes of organic UV filters in wastewater treatment plants.

    Science.gov (United States)

    Tsui, Mirabelle M P; Leung, H W; Lam, Paul K S; Murphy, Margaret B

    2014-04-15

    Organic ultraviolet (UV) filters are applied widely in personal care products (PCPs), but the distribution and risks of these compounds in the marine environment are not well known. In this study, the occurrence and removal efficiencies of 12 organic UV filters in five wastewater treatment plants (WWTPs) equipped with different treatment levels in Hong Kong, South China, were investigated during one year and a preliminary environmental risk assessment was carried out. Using a newly developed simultaneous multiclass quantification liquid chromatography-tandem mass spectrometry (LC-MS/MS) method, butyl methoxydibenzoylmethane (BMDM), 2,4-dihydroxybenzophenone (BP-1), benzophenone-3 (BP-3), benzophenone-4 (BP-4) and 2-ethyl-hexyl-4-trimethoxycinnamate (EHMC) were frequently (≥80%) detected in both influent and effluent with mean concentrations ranging from 23 to 1290 ng/L and 18-1018 ng/L, respectively; less than 2% of samples contained levels greater than 1000 ng/L. Higher concentrations of these frequently detected compounds were found during the wet/summer season, except for BP-4, which was the most abundant compound detected in all samples in terms of total mass. The target compounds behaved differently depending on the treatment level in WWTPs; overall, removal efficiencies were greater after secondary treatment when compared to primary treatment with >55% and 70% removal), respectively. Reverse osmosis was found to effectively eliminate UV filters from effluent (>99% removal). A preliminary risk assessment indicated that BP-3 and EHMC discharged from WWTPs may pose high risk to fishes in the local environment.

  7. 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.)

  8. Protocol: Personality assessment as a support for referral and case-work in treatment for substance use disorders (PASRC-study

    Directory of Open Access Journals (Sweden)

    Pedersen Mads K

    2008-04-01

    Full Text Available Abstract Background Assessment of co-morbid personality disorders in substance use disorders may lead to important insights concerning individual patients. However, little is known about the potential value of routine personality disorder assessment in a clinical context. Methods Patients are adults with past-year substance dependence seeking treatment at a centralized intake unit for substance abusers in the City of Copenhagen. A randomized controlled trial of assessment of personality disorders and individual feedback vs. a general life situation interview. Patients are followed at 3 and 6 months post-treatment Discussion If routine personality assessment improves outcomes of substance abuse treatment, the clinical implication is to increase the use of personality disorder assessment in substance abuse treatment settings. Trial registration Current controlled trials ISRCTN39851689

  9. Open multicenter trial with Madopar HBS in parkinsonian patients. Preliminary assessment after short-term treatment.

    Science.gov (United States)

    Jansen, E N; Meerwaldt, J D; Heersema, T; van Manen, J; Speelman, J D

    1987-01-01

    In 23 patients with idiopathic Parkinson's disease presenting with severe fluctuations in motor performance and 'on-off' phenomena after long-term treatment with levodopa, the standard form of Madopar was replaced by the controlled-release form Madopar HBS. The Meerwaldt's patient card has been used to evaluate the frequency and intensity of response swings. Only 2 patients, who suffered from clear-cut 'end-of-dose' deterioration, significantly benefited by this switch from standard Madopar to Madopar HBS. Eight patients had a minimal or not essential improvement of the parkinsonian symptomatology and/or of the response fluctuations. Thirteen patients returned to their previous standard Madopar treatment after deterioration of parkinsonian symptoms or increase of dyskinesia under the HBS treatment. The overall increase in dosage of levodopa with Madopar HBS was 54% in comparison with the initial standard Madopar dosage.

  10. Benefit-risk assessment of orlistat in the treatment of obesity.

    Science.gov (United States)

    Sumithran, Priya; Proietto, Joseph

    2014-08-01

    Orlistat, an inhibitor of intestinal lipase, has been available for the treatment of obesity for nearly two decades. In conjunction with a hypocaloric diet, orlistat treatment results in a placebo-subtracted reduction in body weight of around 3 kg at 1 year, and increases the likelihood of achieving clinically significant (≥5%) weight loss by around 20%. Orlistat-induced weight loss also confers modest improvements in systolic and diastolic blood pressure, low-density lipoprotein (LDL) cholesterol, glycemic parameters, and progression to diabetes in people with impaired glucose tolerance. Overall, it has a good safety profile, and serious adverse events (including reports of severe kidney and liver injury) are rare. However, a high rate of gastrointestinal side effects limits adherence to treatment.

  11. Assessment and treatment for insomnia and fatigue in the symptomatic menopausal woman with psychiatric comorbidity.

    Science.gov (United States)

    Alexander, Jeanne Leventhal; Neylan, Thomas; Kotz, Krista; Dennerstein, Lorraine; Richardson, Gregg; Rosenbaum, Robert

    2007-11-01

    Studies and treatments for the symptomatic menopausal woman with sleep complaints have been reviewed elsewhere. This article, as part of the clinical review series on the comorbid symptomatic menopausal woman, aims to examine the evidence for diagnosis and treatment of women who present with distressing sleep symptoms that they attribute to menopause. The etiology of these symptoms may be a psychiatric disorder, a pre- or co-existing problem with sleep, or a dynamic interaction among one of these and/or a symptomatic menopause. The relationship between sleep disturbance and cognitive complaints, mood problems, fatigue and low energy will be reviewed. The new research on sleep, clinical consequences of insomnia of various types, the impact of sleep disturbance on morbidity and functioning--in the context of the midlife woman in the menopausal transition--will be explored along with the evidence for different treatment strategies for these sleep problems.

  12. 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.

  13. Assessing clinical trials of Internet addiction treatment: a systematic review and CONSORT evaluation.

    Science.gov (United States)

    King, Daniel L; Delfabbro, Paul H; Griffiths, Mark D; Gradisar, Michael

    2011-11-01

    Although there is ongoing debate concerning the clinical status of Internet addiction, and the quality of the extant literature in this emerging field is not optimal, several clinical trials of both pharmacological and psychological treatments for Internet addiction have been published in recent years. A systematic review investigating the reporting quality of eight treatment studies is presented. Reporting quality was defined according to the 2010 Consolidating Standards of Reporting Trials (CONSORT) statement. An evaluation of the reviewed studies highlighted several key limitations, including (a) inconsistencies in the definition and diagnosis of Internet addiction, (b) a lack of randomization and blinding techniques, (c) a lack of adequate controls or other comparison groups, and (d) insufficient information concerning recruitment dates, sample characteristics, and treatment effect sizes. It is concluded that improvements in future studies' design and reporting would be of significant benefit to both researchers and clinicians, and to the overall positioning of Internet addiction in the behavioral addiction field.

  14. Thyroid hormone treatment among pregnant women with subclinical hypothyroidism: US national assessment

    Science.gov (United States)

    Maraka, Spyridoula; Mwangi, Raphael; Yao, Xiaoxi; Sangaralingham, Lindsey R; Singh Ospina, Naykky M; O’Keeffe, Derek T; De Ycaza, Ana E Espinosa; Rodriguez-Gutierrez, Rene; Coddington, Charles C; Stan, Marius N; Brito, Juan P; Montori, Victor M

    2017-01-01

    Objective To estimate the effectiveness and safety of thyroid hormone treatment among pregnant women with subclinical hypothyroidism. Design Retrospective cohort study. Setting Large US administrative database between 1 January 2010 and 31 December 2014. Participants 5405 pregnant women with subclinical hypothyroidism, defined as untreated thyroid stimulating hormone (TSH) concentration 2.5-10 mIU/L. Exposure Thyroid hormone therapy. Main outcome measure Pregnancy loss and other pre-specified maternal and fetal pregnancy related adverse outcomes. Results Among 5405 pregnant women with subclinical hypothyroidism, 843 with a mean pre-treatment TSH concentration of 4.8 (SD 1.7) mIU/L were treated with thyroid hormone and 4562 with a mean baseline TSH concentration of 3.3 (SD 0.9) mIU/L were not treated (Ppre-eclampsia (1.61, 1.10 to 2.37); other pregnancy related adverse outcomes were similar between the two groups. The adjusted odds of pregnancy loss were lower in treated women than in untreated women if their pre-treatment TSH concentration was 4.1-10 mIU/L (odds ratio 0.45, 0.30 to 0.65) but not if it was 2.5-4.0 mIU/L (0.91, 0.65 to 1.23) (P<0.01). Conclusion Thyroid hormone treatment was associated with decreased risk of pregnancy loss among women with subclinical hypothyroidism, especially those with pre-treatment TSH concentrations of 4.1-10 mIU/L. However, the increased risk of other pregnancy related adverse outcomes calls for additional studies evaluating the safety of thyroid hormone treatment in this patient population. PMID:28122781

  15. 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.

  16. Social franchising of TB care through private GPs in Myanmar: an assessment of treatment results, access, equity and financial protection.

    Science.gov (United States)

    Lönnroth, Knut; Aung, Tin; Maung, Win; Kluge, Hans; Uplekar, Mukund

    2007-05-01

    This article assesses whether social franchising of tuberculosis (TB) services in Myanmar has succeeded in providing quality treatment while ensuring equity in access and financial protection for poor patients. Newly diagnosed TB patients receiving treatment from private general practitioners (GPs) belonging to the franchise were identified. They were interviewed about social conditions, health seeking and health care costs at the time of starting treatment and again after 6 months follow-up. Routine data were used to ascertain clinical outcomes as well as to monitor trends in case notification. The franchisees contributed 2097 (21%) of the total 9951 total new sputum smear-positive pulmonary cases notified to the national TB programme in the study townships. The treatment success rate for new smear-positive cases was 84%, close to the World Health Organization target of 85% and similar to the treatment success of 81% in the national TB programme in Myanmar. People from the lower socio-economic groups represented 68% of the TB patients who access care in the franchise. Financial burden related to direct and indirect health care costs for tuberculosis was high, especially among the poor. Patients belonging to lower socio-economic groups incurred on average costs equivalent to 68% of annual per capita household income, with a median of 28%. However, 83% of all costs were incurred before starting treatment in the franchise, while 'shopping' for care. During treatment in the franchise, the cost of care was relatively low, corresponding to a median proportion of annual per capita income of 3% for people from lower socio-economic groups. This study shows that highly subsidized TB care delivered through a social franchise scheme in the private sector in Myanmar helped reach the poor with quality services, while partly protecting them from high health care expenditure. Extended outreach to others parts of the private sector may reduce diagnostic delay and patient costs

  17. EFFECTIVENESS OF NUTRITIONAL TREATMENT ASSESSED BY THE QUALITY OF THE DIET IN PATIENTS WITH CHRONIC CORONARY ARTERY DISEASE.

    Science.gov (United States)

    Cardoso, Dilui; Moraes, Glaucia; Rosa, Glorimar; Bello Moreira, Annie Seixas

    2015-09-01

    The effectiveness of nutritional treatment is important protective factor for the prevention of recurrences of cardiovascular diseases. The goal of this study was to assess the effectiveness of nutritional treatment and to know the eating pattern and the quality of an adjuvant diet for optimized clinical treatment in patients with chronic coronary artery disease (CCAD). This is a clinical trial with a three-month duration conducted with 116 patients of both sexes with (CCAD) in secondary prevention. The patients underwent nutritional treatment and blood pressure, anthropometric, biochemical and dietetic (24-hour recall) measures were collected. The Brazilian Healthy Eating Index (BHEI-R) was calculated for assessing diet quality. The average age was 62.5 ± 7.8 years. The nutritional treatment reduced: weight -1.5 ± 2.3 kg; p < 0.01; body mass index -0.5 ± 0.9 kg/m2; p < 0.01; waist circumference -2.0 ± 0.1cm; p < 0.01; neck circumference -0.8 ± 0.1; p < 0.01 cm; concentrations of plasma insulin -1.3 ± 0.5mU/ mL p < 0.03, glycated hemoglobin -0.4 ± 0.1 mg/dL; p < 0.01 (- 0,004 mmol/L), and HOMA-IR (-0.8 ± 3.9; p < 0.03); and increased insulin sensitivity 6.64 ± 23,9 x10-3; p < 0.01. The nutritional treatment increased HDL-cholesterol concentrations in patients who adhered to the diet after BHEI-R control 1.7 ± 1.4 mg/dL; p = 0.04 (0,04 mmol/L). Three-month nutritional treatment promoted reduction of saturated fats consumption (-1.9 ± 0.5%; p=<0.01), cholesterol (-67.7 ± 18.6 mg/d; p < 0.01), and sodium(815.2 ± 146.5 mg/d; p < 0.01); and 20.7% of the patients finished the study with a healthy diet. The intensive nutritional treatment was effective in reducing anthropometric measures and improving glycemic control.

  18. Functional assessment and treatment of perseverative speech about restricted topics in an adolescent with Asperger syndrome.

    Science.gov (United States)

    Fisher, Wayne W; Rodriguez, Nicole M; Owen, Todd M

    2013-01-01

    A functional analysis showed that a 14-year-old boy with Asperger syndrome displayed perseverative speech (or "restricted interests") reinforced by attention. To promote appropriate speech in a turn-taking format, we implemented differential reinforcement (DR) of nonperseverative speech and DR of on-topic speech within a multiple schedule with stimuli that signaled the contingencies in effect and who was to select the topic. Both treatments reduced perseverative speech, but only DR of on-topic speech increased appropriate turn taking during conversation. Treatment effects were maintained when implemented by family members and novel therapists.

  19. 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.

  20. Omeprazole versus ranitidine in the medical treatment of acute upper gastrointestinal bleeding: assessment by early repeat endoscopy.

    Science.gov (United States)

    Fasseas, P; Leybishkis, B; Rocca, G

    2001-12-01

    The purpose of this study was to assess the effects of acid suppression in patients with upper gastrointestinal bleeding using early repeat endoscopy. Ninety-two patients with the diagnosis of acute upper gastrointestinal bleeding (endoscopically verified), entered a single-blind, randomised study comparing two treatment groups: omeprazole (40 mg orally daily) to ranitidine (50 mg intravenously four times daily). The lesions considered were gastric ulcers, duodenal ulcers and erosive gastritis. All patients were candidates for medical treatment. The parameters assessed included: 1) stabilisation of the lesion by repeat endoscopy at 7.0 +/- 3.0 days, 2) bleeding recurrence, 3) duration of stay in the intermediate medical care unit. For erosive gastritis only parameters 2 and 3 were considered. The study was limited to the hospitalisation period. Endoscopic stabilisation rate at 7.0 +/- 3.0 days for duodenal lesions was higher in the omeprazole group (71% vs 37%, p=0.03), but there was no significant difference for gastric lesions (50% vs 54%, NS). The overall bleeding recurrence rate (0% vs 17%, p=0.013) and the duration of stay (3.9 vs 6.4 days, p<0.01) were significantly lower in the omeprazole group. Our study suggests that omeprazole is more effective than ranitidine in the pharmacological treatment of acute upper gastrointestinal bleeding.

  1. Assessment of Periodontopathogens in Subgingival Biofilm of Banded and Bonded Molars in Early Phase of Fixed Orthodontic Treatment.

    Science.gov (United States)

    Mártha, Krisztina; Lőrinczi, Lilla; Bică, Cristina; Gyergyay, Réka; Petcu, Blanka; Lazăr, Luminița

    2016-03-01

    To assess the prevalence and occurrence of eleven periodontopathogens in subgingival biofilm of banded and bonded molars during the first period of fixed orthodontic treatment. Subjects were selected from patients referred to orthodontic treatment and were divided in two groups: group A comprised fifteen patients (14.4±2.45 years of age) who received orthodontic bands on first permanent molars and group B of ten patients (15.7±1.87 years of age) with directly bonded tubes on the labial surface of the same teeth. Subgingival sample collection was performed before bands and tubes application and 4-7 weeks after attachment placement. DNA-strip tehnique was used to assess the presence of eleven putative periodontopathogens at each time point. Fusobacterium nucleatum, Eikenella corrodens and Capnocytophaga spp. were found in a large number of samples, other periodontopathogens were present in a smaller rate. The 4-7 weeks after attachment placement a slight increase of putative species was observed in both groups. The presence of orthodontic tubes and bands influence the accumulation and composition of subgingival microbiota. Higher level of oral hygiene should be achieved before and during orthodontic treatment in order to prevent any side effects on periodontal tissues.

  2. 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.

  3. A comparative assessment of intensive and extensive wastewater treatment technologies for removing emerging contaminants in small communities.

    Science.gov (United States)

    Matamoros, Víctor; Rodríguez, Yolanda; Albaigés, Joan

    2016-01-01

    Ecosystem pollution due to the lack of or inefficient wastewater treatment coverage in small communities is still a matter of great concern, even in developed countries. This study assesses the seasonal performance of 4 different full-scale wastewater technologies that have been used in small communities (<2000 population equivalent) for more than 10 years in terms of emerging contaminant (EC), chemical oxygen demand (COD), total suspended solids (TSS) and NH4-N removal efficiency. The studied technologies, which were selected due to their widespread use, included two intensive treatment systems (an extended aeration system (AS) and a rotating biological contactor (RBC)) and two extensive treatment systems (a constructed wetland (CW) and a waste stabilization pond (WSP)), all located in north-eastern Spain. The studied compounds belonged to the groups of pharmaceuticals, sunscreen compounds, fragrances, antiseptics, flame retardants, surfactants, pesticides and plasticizers. The 25 ECs occurred in wastewater at concentrations ranging from undetectable to 80 μg L(-1). The average removal efficiency was 42% for the CW, 62% for the AS, 63% for the RBC and 82% for the WSP. All the technologies except the WSP system showed seasonal variability in the removal of ECs. The ecotoxicological assessment study revealed that, whilst all the technologies were capable of decreasing the aquatic risk, only the WSP yielded no risk in both seasons.

  4. Skin tears: state of the science: consensus statements for the prevention, prediction, assessment, and treatment of skin tears©.

    Science.gov (United States)

    LeBlanc, Kimberly; Baranoski, Sharon

    2011-09-01

    The appropriate management of patients with skin tears is an ongoing challenge for healthcare professionals. Skins tears are often painful, acute wounds resulting from trauma to the skin and are largely preventable. Healthcare professionals must be able to identify individuals at risk for skin tears and aid in the prevention of these wounds and in their treatment when they occur. Despite preliminary studies that suggest skin tears may be more prevalent than pressure ulcers, there remains a paucity of literature to guide prevention, assessment, and treatment of skin tears. As a result, these wounds are often mismanaged and misdiagnosed, leading to complications, including pain, infection, and delayed wound healing. In addition, skin tears increase caregiver time and facility costs, cause anxiety for patients and families, and may reflect poorly on the quality of care delivered in a facility. In an effort to shift awareness toward this largely unheeded healthcare issue, a consensus panel of 13 internationally recognized key opinion leaders convened to establish consensus statements on the prevention, prediction, assessment, and treatment of skin tears. The initial consensus panel meeting was held in January 2011 and was made possible by an unrestricted educational grant from Hollister Wound Care. This document details the consensus definition and statements, as well as recommendations for future research and steps toward establishing a validated, comprehensive program for managing skin tears.

  5. 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

  6. Post-Concussion Tools to Assist with Assessment, Treatment, and Return to Duty

    Science.gov (United States)

    2014-12-01

    together academic physiotherapists, bioengineers in the field of balance assessment, NIH program managers for balance rehabilitation (NIDCD...to three groups of Fort Rucker Elementary School teachers, 26 Aug, 2013, USAARL. COL Smyrski briefed BG Edens (USACR/SC) regarding spatial...Nothing to Report.  Technologies or techniques . Nothing to Report.  Inventions, patent applications, and/or licenses. SYSTEM AND METHOD FOR

  7. The Unfairness of Equal Treatment: Objectivity in L2 Testing and Dynamic Assessment

    Science.gov (United States)

    Lantolf, James P.; Poehner, Matthew E.

    2013-01-01

    This paper considers dynamic assessment (DA) as it relates to second language (L2) development. DA is grounded in Vygotsky's (1987) sociocultural theory of mind, which holds that human consciousness emerges as a result of participation in culturally organized social activities where mediation plays a key role in guiding development. In DA, the…

  8. 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…

  9. 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

  10. Practitioner Review: Adolescent Alcohol Use Disorders--Assessment and Treatment Issues

    Science.gov (United States)

    Perepletchikova, Francheska; Krystal, John H.; Kaufman, Joan

    2008-01-01

    Background: Alcohol use disorders in adolescents are associated with significant morbidity and mortality. Over the past decade, there has been a burgeoning of research on adolescent alcohol use disorders. Methods: A summary of the alcohol assessment tools is provided, and randomized studies reviewed and synthesized to provide an overview of state…

  11. Further Commentary on Mitochondrial Dysfunction in Autism Spectrum Disorder: Assessment and Treatment Considerations

    Science.gov (United States)

    Dager, Stephen R.; Corrigan, Neva M.; Estes, Annette; Shaw, Dennis W. W.

    2012-01-01

    The authors respond to a recent letter (Rossignol and Frye 2011) critical of their paper, "Proton magnetic resonance spectroscopy and MRI reveal no evidence for brain mitochondrial dysfunction in children with autism spectrum disorder" (Corrigan et al. 2011). Further considerations regarding the assessment of mitochondrial dysfunction in autism…

  12. 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

  13. 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…

  14. 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…

  15. Relationships of Cognitive Components of Test Anxiety to Test Performance: Implications for Assessment and Treatment.

    Science.gov (United States)

    Bruch, Monroe A.; And Others

    1983-01-01

    Assessed the degree to which components of test-taking strategies, covert self-statements, and subjective anxiety during an exam provide increments in prediction of test performance of undergraduates (N=72). Results showed that only test-taking strategies provided a significant increment to multiple-choice and essay test performance but not math…

  16. 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…

  17. Clinical Assessment Instruments in the Treatment of Child Abuse and Neglect.

    Science.gov (United States)

    Rittner, Barbara; Wodarski, John S.

    1995-01-01

    A variety of objective measures have been developed to assess child abuse and neglect and that can be used by practitioners with minimal disruption in terms of time, energy, cost, and ease of use. Reviews instruments that child welfare workers, specifically, and practitioners involved in children's services, in general, can use in the assessment…

  18. 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...

  19. Home Relaxation Practice in Hypertension Treatment: Objective Assessment and Compliance Induction.

    Science.gov (United States)

    Hoelscher, Timothy J.; And Others

    1986-01-01

    Evaluated compliance with individualized relaxation, group relaxation, group relaxation plus contingency contracting for home practice, or a waiting list in hypertension treatment. All conditions showed significantly greater reductions in blood pressure than waiting list controls but did not differ from each other. Self-reports exceeded monitored…

  20. 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…

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

    DEFF Research Database (Denmark)

    Andersen, Sten Peder; Mischak, Harald; Zürbig, Petra;

    2010-01-01

    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 w...

  2. Assessing Treatment Integrity in Acceptance and Commitment Therapy: Strategies and Suggestions

    Science.gov (United States)

    Plumb, Jennifer C.; Vilardaga, Roger

    2010-01-01

    In this paper, we briefly review the current literature on treatment integrity and discuss the relevance of this procedure for detecting, measuring and ensuring that the proposed mechanisms of change in cognitive behavior therapy, in this case of acceptance and commitment therapy (ACT; S.C. Hayes, Strosahl, & Wilson, 1999), take place. We discuss…

  3. 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

  4. Pre-eclampsia Diagnosis and Treatment Options : A Review of Published Economic Assessments

    NARCIS (Netherlands)

    Zakiyah, Neily; Postma, Maarten J.; Baker, Philip N.; van Asselt, Antoinette D. I.

    2015-01-01

    Pre-eclampsia is a pregnancy complication affecting both mother and fetus. Although there is no proven effective method to prevent pre-eclampsia, early identification of women at risk of pre-eclampsia could enhance appropriate application of antenatal care, management and treatment. Very little is k

  5. Tumor microvascular changes in antiangiogenic treatment : Assessment by magnetic resonance contrast media of different molecular weights

    NARCIS (Netherlands)

    Turetschek, K; Preda, A; Novikov, [No Value; Brasch, RC; Weinmann, HJ; Wunderbaldinger, P; Roberts, TPL

    2004-01-01

    Purpose: To test magnetic resonance (MR) contrast media of different molecular weights (MWs) for their potential to characterize noninvasively microvascular changes in an experimental tumor treatment model. Materials and Methods: MD-MBA-435, a poorly differentiated human breast cancer cell line, was

  6. MRI for assessing and predicting response to neoadjuvant treatment in rectal cancer

    NARCIS (Netherlands)

    Beets-Tan, Regina G H; Beets, Geerard L

    2014-01-01

    Guidelines recommend MRI as part of the staging work-up of patients with rectal cancer because it can identify high-risk groups requiring preoperative treatment. Phenomenal tumour responses have been observed with current chemoradiotherapy regimens-even complete regression in 25% of patients. For th

  7. Assessments of Student-Teacher Relationships in Residential Treatment Center Schools

    Science.gov (United States)

    Rudasill, Kathleen Moritz; Gonshak, Amy B.; Pössel, Patrick; Nichols, Andrew; Stipanovic, Natalie

    2013-01-01

    Students in residential treatment center (RTC) schools are likely to have histories of extreme or ongoing relational trauma (e.g., abuse and neglect by primary caregivers), have substantial interpersonal and relationship problems, and exhibit many high-risk behaviors. Accordingly, these students may have particular difficulty forming positive…

  8. Assessment and Treatment of Foot-Shoe Fetish Displayed by a Man with Autism

    Science.gov (United States)

    Dozier, Claudia L.; Iwata, Brian A.; Worsdell, April S.

    2011-01-01

    Results of a functional analysis indicated that a man diagnosed with autism engaged in bizarre sexual behavior in the presence of women wearing sandals. Several treatments proved to be ineffective or impractical. By contrast, a response-interruption/time-out procedure quickly eliminated the problem behavior in multiple settings. (Contains 1…

  9. 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 (Palkaloids in cigarette MS positively contributed to the impact and irritation attributes (Palkaloids and sensory attributes.

  10. Definition, assessment and treatment of wheezing disorders in preschool children: an evidence-based approach.

    Science.gov (United States)

    Brand, P L P; Baraldi, E; Bisgaard, H; Boner, A L; Castro-Rodriguez, J A; Custovic, A; de Blic, J; de Jongste, J C; Eber, E; Everard, M L; Frey, U; Gappa, M; Garcia-Marcos, L; Grigg, J; Lenney, W; Le Souëf, P; McKenzie, S; Merkus, P J F M; Midulla, F; Paton, J Y; Piacentini, G; Pohunek, P; Rossi, G A; Seddon, P; Silverman, M; Sly, P D; Stick, S; Valiulis, A; van Aalderen, W M C; Wildhaber, J H; Wennergren, G; Wilson, N; Zivkovic, Z; Bush, A

    2008-10-01

    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 causative factors and treatment is useful. Exposure to tobacco smoke should be avoided; allergen avoidance may be considered when sensitisation has been established. Maintenance treatment with inhaled corticosteroids is recommended for multiple-trigger wheeze; benefits are often small. Montelukast is recommended for the treatment of episodic (viral) wheeze and can be started when symptoms of a viral cold develop. Given the large overlap in phenotypes, and the fact that patients can move from one phenotype to another, inhaled corticosteroids and montelukast may be considered on a trial basis in almost any 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.

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

    DEFF Research Database (Denmark)

    Andersen, Sten Peder; Mischak, Harald; Zürbig, Petra;

    2010-01-01

    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....

  12. Scintimetric assessment of synovitis activity during treatment with disease modifying antirheumatic drugs

    DEFF Research Database (Denmark)

    Olsen, N; Halberg, P; Halskov, O;

    1988-01-01

    In a double blind trial of 36 patients with rheumatoid arthritis a new scintimetric method was applied to three comparable patient groups before and after eight months' treatment with levamisole, penicillamine, or azathioprine. Technetium-99m pyrophosphate scintigraphy of both hands was performed...

  13. 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…

  14. 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.

  15. Ecotoxicological assessment of grey water treatment systems with Daphnia magna and Chironomus riparius

    NARCIS (Netherlands)

    Hernádez Leal, L.; Soeter, A.M.; Kools, S.A.E.; Kraak, M.H.S.; Parsons, J.R.; Temmink, H.; Zeeman, G.; Buisman, C.J.N.

    2012-01-01

    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 ecotoxi

  16. Monte Carlo assessment of boron neutron capture therapy for the treatment of breast cancer

    Directory of Open Access Journals (Sweden)

    Mundy Daniel W.

    2005-01-01

    Full Text Available For a large number of women who are diagnosed with breast cancer every year the avail able treatment options are effective, though physically and mentally taxing. This work is a starting point of a study of the efficacy of boron neutron capture therapy as an alternative treatment for HER-2+ breast tumors. Using HER-2-specific monoclonal anti bodies coupled with a boron-rich oligomeric phosphate diester, it may be possible to deliver sufficient amounts of 10B to a tumor of the breast to al low for selective cell destruction via irradiation by thermal neutrons. A comprehensive computational model (MCNP for thermal neutron irradiation of the breast is described, as well as the results of calculations made using this model, in order to determine the optimum boron concentration within the tumor for an effective boron neutron capture therapy treatment, as compared with traditional X-ray radiotherapy. The results indicate that a boron concentration of 50-60 mg per gram of tumor tissue is optimal when considering treatment times, dose distributions and skin sparing. How ever these results are based upon best-guess assumptions that must be experimentally verified.

  17. 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.

  18. Assessment of antibacterial activity of different treatment modalities in deciduous teeth: an in vitro study

    Directory of Open Access Journals (Sweden)

    Esra Yesiloz Gokcen

    2016-11-01

    Full Text Available In recent years, different biotechnological materials and modalities with antibacterial activity are being developed for oral cavity disinfection. However, the antimicrobial effects of all these materials have not been studied and understood in detail. Thus, the aim of this study was to compare the antibacterial activity of ozone therapy with dentine-bonding agents (containing antibacterial monomer 12-meth-acryloyloxydodecylpyridinium bromide (MDPB and 10-methacryloyloxydecyl dihydrogen phosphate (MDP and Ca(OH2 for deciduous teeth in vitro. The antibacterial effectiveness of the studied materials was determined by using a tooth cavity model on cylindrical cavities created in 90 deciduous second mandibular molars. Streptococcus mutans suspension was inoculated in the cavities. The teeth were distributed into six study groups (five different modalities and a negative control group. Dentine samples, which were collected from the cavities before and after the treatment sessions, were microbiologically evaluated and the materials’ antibacterial activities were compared. There were statistically significiant differences in the S. mutans counts before and after treatment (P < 0.05. In terms of antibacterial efficiency, 60-second O3 treatment was found to be the most successful method, followed by 30-second O3, Clearfil Protect Bond (containing MDPB, Clearfil SE Bond (containing MDP and Ca(OH2 treatment. The results from this study suggested that longer exposure to ozone might have more beneficial effects in terms of antibacterial activity for reducing the levels of S. mutans.

  19. Level of analysis issues in assessing treatment beliefs in substance abuse clinics.

    Science.gov (United States)

    Mitchelson, Jacqueline K; Dickson, Marcus W; Arfken, Cynthia L; Agius, Elizabeth

    2007-12-01

    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 group or clinic level without testing this assumption, which can lead to failure to adopt or to successfully implement the innovation. We tested the assumption of sharedness by examining if there was sufficient agreement about treatment beliefs within clinics, within groups of clinics or within groups of clinicians to justify treating these aggregations as meaningful groups. Using three statistical approaches to examining level of analysis (Within and Between Analysis (WABA I), Intraclass Correlation Coefficients (ICC(1)), and r(wg)), we found that variability in treatment beliefs largely occurred at the individual rather than at the tested aggregate levels of analysis. These findings serve as an example of the importance of testing the assumption of shared perceptions in future research.

  20. Level of analysis issues in assessing treatment beliefs in substance abuse clinics

    Science.gov (United States)

    Mitchelson, Jacqueline K.; Dickson, Marcus W.; Arfken, Cynthia L.; Agius, Elizabeth

    2010-01-01

    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 group or clinic level without testing this assumption, which can lead to failure to adopt or to successfully implement the innovation. We tested the assumption of sharedness by examining if there was sufficient agreement about treatment beliefs within clinics, within groups of clinics or within groups of clinicians to justify treating these aggregations as meaningful groups. Using three statistical approaches to examining level of analysis (Within and Between Analysis (WABA I), Intraclass Correlation Coefficients (ICC(1)), and rwg), we found that variability in treatment beliefs largely occurred at the individual rather than at the tested aggregate levels of analysis. These findings serve as an example of the importance of testing the assumption of shared perceptions in future research. PMID:17570604

  1. Wearable textile platform for assessing stroke patient treatment in daily life conditions

    NARCIS (Netherlands)

    Lorussi, Frederico; Carbonaro, Nicola; De Rossi, Danilo; Paradiso, Rita; Veltink, Peter H.; Tognetti, Alessandro

    2016-01-01

    Monitoring physical activities during post-stroke rehabilitation in daily life may help physicians to optimize and tailor the training program for patients. The European research project INTERACTION (FP7-ICT-2011-7-287351) evaluated motor capabilities in stroke patients during the recovery treatment

  2. Legal Issues in the Assessment and Treatment of Individuals with Dual Diagnosis.

    Science.gov (United States)

    Bersoff, Donald N.; And Others

    1994-01-01

    Discusses difficult legal, ethical, and professional issues confronting psychologists who work with people with dual diagnoses. Outlines applicable constitutional principles in context of discussing right to institutional services and to refuse treatment, describes statutes that go beyond constitutional protections, and highlights issues that…

  3. Assessment of Options for the Treatment of Nitrate Salt Wastes at Los Alamos National Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Robinson, Bruce Alan [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Funk, David John [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Stevens, Patrice Ann [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-03-17

    This paper summarizes the methodology used to evaluate options for treatment of the remediated nitrate salt waste containers at Los Alamos National Laboratory. The method selected must enable treatment of the waste drums, which consist of a mixture of complex nitrate salts (oxidizer) improperly mixed with sWheat Scoop®1, an organic kitty litter and absorbent (fuel), in a manner that renders the waste safe, meets the specifications of waste acceptance criteria, and is suitable for transport and final disposal in the Waste Isolation Pilot Plant located in Carlsbad, New Mexico. A Core Remediation Team was responsible for comprehensively reviewing the options, ensuring a robust, defensible treatment recommendation. The evaluation process consisted of two steps. First, a prescreening process was conducted to cull the list on the basis for a decision of feasibility of certain potential options with respect to the criteria. Then, the remaining potential options were evaluated and ranked against each of the criteria in a consistent methodology. Numerical scores were established by consensus of the review team. Finally, recommendations were developed based on current information and understanding of the scientific, technical, and regulatory situation. A discussion of the preferred options and documentation of the process used to reach the recommended treatment options are presented.

  4. Late-life depression: systematic assessment of care needs as a basis for treatment

    NARCIS (Netherlands)

    Houtjes, W.; Meijel, B. van; Deeg, D.J.H.

    2011-01-01

    Research shows that most of the variance in depression severity levels in late life can be explained by the unmet psychological needs of patients, more in particular the care needs of patients related with psychological distress. This case report describes the treatment of an 84-year-old patient suf

  5. Cingulate metabolites during pain and morphine treatment as assessed by magnetic resonance spectroscopy

    Directory of Open Access Journals (Sweden)

    Hansen TM

    2014-05-01

    Full Text Available Tine Maria Hansen,1 Anne Estrup Olesen,2 Carsten Wiberg Simonsen,1 Asbjørn Mohr Drewes,2,3 Jens Brøndum Frøkjær11Mech-Sense, Department of Radiology, 2Mech-Sense, Department of Gastroenterology, 3Center for Sensory-Motor Interaction, Department of Health Science and Technology, Aalborg University, Aalborg, DenmarkBackground: Experimental investigation of cerebral mechanisms underlying pain and analgesia are important in the development of methods for diagnosis and treatment of pain. The aim of the current study was to explore brain metabolites in response to pain and treatment with morphine.Methods: Proton magnetic resonance spectroscopy of the anterior cingulate cortex was performed in 20 healthy volunteers (13 males and seven females, aged 24.9±2.6 years during rest and acute pain before and during treatment with 30 mg of oral morphine or placebo in a randomized, double-blinded, cross-over study design. Pain was evoked by skin stimulation applied to the right upper leg using a contact heat-evoked potential stimulator.Results: Data from 12 subjects were valid for analysis. Painful stimulation induced an increase in N-acetylaspartate/creatine compared with rest (F=5.5, P=0.04. During treatment with morphine, painful stimulation induced decreased glutamate/creatine (F=7.3, P=0.02, myo-inositol/creatine (F=8.38, P=0.02, and N-acetylaspartate/creatine (F=13.8, P=0.004 concentrations, whereas an increase in the pain-evoked N-acetylaspartate/creatine concentration (F=6.1, P=0.04 was seen during treatment with placebo.Conclusion: This explorative study indicates that neuronal metabolites in the anterior cingulate cortex, such as N-acetylaspartate, glutamate, and myo-inositol, could be related to the physiology of pain and treatment with morphine. This experimental method has the potential to enable the study of brain metabolites involved in pain and its treatment, and may in the future be used to provide further insight into these mechanisms

  6. 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)

  7. Cancer immunotherapy and immune-related response assessment: The role of radiologists in the new arena of cancer treatment.

    Science.gov (United States)

    Nishino, Mizuki; Tirumani, Sree H; Ramaiya, Nikhil H; Hodi, F Stephen

    2015-07-01

    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.

  8. Varying properties of in situ heat treatment of a tar sands formation based on assessed viscosities

    Energy Technology Data Exchange (ETDEWEB)

    Karanikas, John Michael; Vinegar, Harold J

    2014-03-04

    A method for treating a tar sands formation includes providing heat to at least part of a hydrocarbon layer in the formation from a plurality of heaters located in the formation. The heat is allowed to transfer from the heaters to at least a portion of the formation. A viscosity of one or more zones of the hydrocarbon layer is assessed. The heating rates in the zones are varied based on the assessed viscosities. The heating rate in a first zone of the formation is greater than the heating rate in a second zone of the formation if the viscosity in the first zone is greater than the viscosity in the second zone. Fluids are produced from the formation through the production wells.

  9. A randomized prospective study to assess the efficacy of two cold-therapy treatments following carpal tunnel release.

    Science.gov (United States)

    Hochberg, J

    2001-01-01

    A prospective randomized study was performed comparing the efficacy of controlled cold therapy (CCT) with the efficacy of ice therapy in the postoperative treatment of 72 patients with carpal tunnel syndrome. Immediately after surgery, patients applied either a temperature-controlled cooling blanket (CCT) or a standard ice pack over their surgical dressings. Pain was assessed by visual analog scale and swelling by wrist circumference preoperatively, immediately after surgery, and on postoperative day 3. Patients kept log books of daily treatment times. Narcotic use (of Vicodin ES) was determined by pill count at day 3 and by daily log book recordings. Patients who used CCT showed significantly greater reduction in pain, edema (wrist circumference), and narcotic use at postoperative day 3 than did those using ice therapy. This study indicates that after carpal tunnel surgery, the use of CCT, compared with traditional ice therapy, provides patients with greater comfort and lessens the need for narcotics.

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

    OpenAIRE

    Mustapha Moshood Keke; Ewulum Joy Chinenye

    2016-01-01

    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...

  11. Pharmacological manipulation of gastric juice: thrombelastographic assessment and implications for treatment of gastrointestinal haemorrhage.

    OpenAIRE

    Patchett, S E; O'Donoghue, D P

    1995-01-01

    The impairment of formation and maintenance of a formed fibrin clot contributes to the prolonged bleeding and high incidence of rebleeding in upper gastrointestinal haemorrhage. To investigate the basis for the use of drug therapy in gastric bleeding, this study used thrombelastography to determine the effects of pharmacological manipulation of gastric juice on coagulation and fibrinolysis. The thrombelastograph is a mechanical device that provides a visual assessment of all stages of coagula...

  12. New Light on Chromotherapy: Grakov's ‘Virtual Scanning’ System of Medical Assessment and Treatment

    Directory of Open Access Journals (Sweden)

    Alex Hankey

    2007-01-01

    Full Text Available Virtual Scanning incorporates novel uses of colored light into its system of health assessment and therapy. Independent investigations of its effectiveness in Russia and the UK have revealed unique abilities to correct incipient and fully developed chronic conditions. As such it forms an important new addition to the field of Chromotherapy. It differs from most others, in that its development depended on discoveries in neuroscience by its inventor, and subsequent application of new models in computational neuroscience.

  13. Liposomal Oxymatrine in Hepatic Fibrosis Treatment: Formulation, In Vitro and In Vivo Assessment

    OpenAIRE

    Zhang, Shujuan; Wu, Jun; Wang, Hua; Wang, Tiechuang; Jin, Lina; Shu, Dandan; Shan, Weiguang; Xiong, Subin

    2014-01-01

    The aim was to develop a liposomal oxymatrine conjugating d-alpha tocopheryl polyethylene glycol 1000 succinate (OMT-LIP) for enhanced therapeutics of hepatic fibrosis. OMT-LIP was prepared using the remote loading method. The influences of formulation compositions on the encapsulation efficiency of OMT-LIP were investigated. Mean particle size, zeta potential, morphology, in vitro release, fibrotic liver targeting, and therapeutics of OMT-LIP were thoroughly assessed. The intraliposomal buff...

  14. 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.

  15. Variation of D-dimer values as assessment of pulmonary thromboembolism during adulticide treatment of heartworm disease in dogs.

    Science.gov (United States)

    Carretón, E; Morchón, R; González-Miguel, J; Simón, F; Juste, M C; Montoya-Alonso, J A

    2013-07-01

    Dirofilaria immitis adult worms lodged in the pulmonary arteries are the causative agent of heartworm disease, characterized by endarteritis and obstruction of the blood flow. Dying worms form embolic fragments which trigger thrombosis. Thus, pulmonary thromboembolism is an inevitable consequence of successful adulticide therapy. Clinical signs of pulmonary thromboembolisms are highly variable and non-specific, and its diagnosis is often difficult to obtain. The D-dimer assay is considered the marker of choice for dogs with a suspicion of pulmonary thromboembolism. The aim of the present study was to evaluate the variation of D-dimer and platelets in 15 heartworm-infected dogs during the adulticide treatment with ivermectin, doxycycline and melarsomine. Nine dogs were considered to have a low parasite burden and 6 had a high burden. Measurements were carried out on days 0, 60, and afterwards weekly on days 67, 75, 82, 91, 98, 106, 113, 120, and finally on day 271 after treatment. 40% of dogs showed pathological concentrations of D-dimer and 40% showed slight or mild thrombocytopenia on day 0. The levels of D-dimer decreased by day 60, probably due to the joint action of the ivermectin, doxycycline and exercise restriction. All dogs with high parasite burden showed elevated values of D-dimer on several occasions during the treatment, reaching the highest values the first and second week after the injections of melarsomine. Only 33.3% of the dogs with low parasite burden showed elevated D-dimer levels at some point during the treatment, and all of them showed undetectable levels from the third week after the first injection of melarsomine. On day 271, all dogs showed undetectable levels of D-dimer. There was no correlation between thrombocytopenia and levels of D-dimer during the treatment. The evaluation of serum D-dimer appears to be a supportive test in the assessment and monitoring of pulmonary thromboembolism in dogs with heartworm disease during the adulticide

  16. 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.

  17. TBI ADAPTER: traumatic brain injury assessment diagnosis advocacy prevention and treatment from the emergency room--a prospective observational study.

    Science.gov (United States)

    Ganti, Latha; Daneshvar, Yasamin; Bodhit, Aakash; Ayala, Sarah; Patel, Pratik S; Lottenberg, Lawrence L; York, Donna; Counsell, Colleen; Peters, Keith R

    2015-04-01

    There is no standard treatment algorithm for patients who present to the emergency department (ED) with acute traumatic brain injury (TBI). This is in part because of the heterogeneity of the injury pattern and the patient profile, and the lack of evidence-based guidelines, especially for mild TBI in adults. As TBI is seen more and more frequently in the ED, a standardized assessment would be beneficial in terms of efficiency. The authors present their ED approach to mild TBI evaluation in the ED, along with results to date. These data represent a prospective observational cohort study, where each patient provided individual, written informed consent.

  18. 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.

  19. Range of technology choices in life cycle assessment of environmental treatment technologies

    DEFF Research Database (Denmark)

    Henriksen, Trine; Astrup, Thomas Fruergaard; Damgaard, Anders

    of specification of the technological and geographical coverage of the study. For example, for global warming potential, the global maximum value is 2.6 times larger than the global minimum value and, for human toxicity, carcinogenic, the global maximum value is 45 times larger than the global minimum value......Limited data availability and local differences of environmental treatment technologies lead to the use of sub-optimal data and choices of single datasets, where multiple data choices may be representative. The use of data not representing the entire coverage of an LCA study can cause a bias....... This conclusions was described in a step-wise approach for representative data choices and modelling. The outcomes shed light on the potential spread caused by discrete data choices in the modelling of environmental treatment technologies....

  20. 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.

  1. Histological assessment of ovaries and uterus of rats subjected to nandrolone decanoate treatment.

    Science.gov (United States)

    Gerez, Juliana Rubira; Frei, Fernando; Camargo, Isabel Cristina Cherici

    2005-07-01

    This study aimed to analyze the effects of nandrolone decanoate on the ovaries and uterus of adult females rats. This drug was administered intraperitoneally, at one, two and three doses of 3 mg nandrolone decanoate/kg of body weight, respectively, in the first, second and third week of treatment. The females of the control group received a physiological solution. The rats treated with nandrolone decanoate showed estral acyclicity and there was destruction of follicular units and an absence of corpus luteum in the ovaries. In the uterus, the drug promoted morphological alterations, characterized by vacuolated epithelium and endometrial stroma fibrosis. Ovary, uterus and pituitary weights were not affected by the steroid treatment. Nandrolone decanoate affects the sexual cycle and promotes histological alterations in the ovaries and uterus of adult female rats.

  2. Hearing Assessment after Treatment of Nasopharyngeal Carcinoma with CRT and IMRT Techniques

    Directory of Open Access Journals (Sweden)

    Chung-Feng Hwang

    2015-01-01

    Full Text Available Objectives. This study analyzed the long-term hearing loss after treatment of primary nasopharyngeal carcinoma to elucidate its causal factors. Methods. Ninety-two nasopharyngeal carcinoma patients were treated with radiotherapy or chemoradiotherapy. Pure tone audiometry was performed before the therapy and annually up to 9 years after completing treatment. The hearing thresholds were corrected for age-related deterioration and compared to the results without adjusting for age. Results. The mean air and bone conduction threshold with and without correction for age-related deterioration differed significantly 2–9 years after completing radiotherapy p72 cGy resulted in more severe hearing loss than <72 cGy p<0.05. Conclusion. Hearing loss after completing therapy should be corrected for age-related hearing deterioration to reveal the true extent to which the loss is a therapeutic complication. Both the radiation modality used and the dose were significantly associated with hearing loss.

  3. Applying the polarity rapid assessment method to characterize nitrosamine precursors and to understand their removal by drinking water treatment processes.

    Science.gov (United States)

    Liao, Xiaobin; Bei, Er; Li, Shixiang; Ouyang, Yueying; Wang, Jun; Chen, Chao; Zhang, Xiaojian; Krasner, Stuart W; Suffet, I H Mel

    2015-12-15

    Some N-nitrosamines (NAs) have been identified as emerging disinfection by-products during water treatment. Thus, it is essential to understand the characteristics of the NA precursors. In this study, the polarity rapid assessment method (PRAM) and the classical resin fractionation method were studied as methods to fractionate the NA precursors during drinking water treatment. The results showed that PRAM has much higher selectivity for NA precursors than the resin approach. The normalized N-nitrosodimethylamine formation potential (NDMA FP) and N-nitrosodiethylamine (NDEA) FP of four resin fractions was at the same level as the average yield of the bulk organic matter whereas that of the cationic fraction by PRAM showed 50 times the average. Thus, the cationic fraction was shown to be the most important NDMA precursor contributor. The PRAM method also helped understand which portions of the NA precursor were removed by different water treatment processes. Activated carbon (AC) adsorption removed over 90% of the non-polar PRAM fraction (that sorbs onto the C18 solid phase extraction [SPE] cartridge) of NDMA and NDEA precursors. Bio-treatment removed 80-90% of the cationic fraction of PRAM (that is retained on the cation exchange SPE cartridge) and 40-60% of the non-cationic fractions. Ozonation removed 50-60% of the non-polar PRAM fraction of NA precursors and transformed part of them into the polar fraction. Coagulation and sedimentation had very limited removal of various PRAM fractions of NA precursors.

  4. An assessment of the use of native and denatured forms of okra seed proteins as coagulants in drinking water treatment.

    Science.gov (United States)

    Jones, Alfred Ndahi; Bridgeman, John

    2016-10-01

    The effects of temperature, storage time and water pH on the coagulation performance of okra seed protein in water treatment were assessed. In a jar test experiment, okra salt extract achieved a notable improvement in treatment efficiency with storage time and showed good performance in quality after thermal treatment at 60, 97 and 140 °C temperatures for 6, 4 and 2 hours, respectively. The performance improvement of more than 8% is considered to be due to the denaturation and subsequent removal of coagulation-hindering proteins in okra seed. Furthermore, the results of a sodium dodecyl sulphate polyacrylamide gel electrophoresis analysis show two distinctive bands of protein responsible for the coagulation process after denaturation. It was further shown that at optimal coagulant dose, the pH of the treated water remained unaffected as a result of the protein's buffering capability during coagulation. Therefore, denatured okra seed exhibited improved performance compared to the native crude extract and offers clear benefits as a water treatment coagulant.

  5. 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.

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

    Science.gov (United States)

    Manchia, Mirko; Adli, Mazda; Akula, Nirmala; Ardau, Raffaella; Aubry, Jean-Michel; Backlund, Lena; Banzato, Claudio EM.; Baune, Bernhard T.; Bellivier, Frank; Bengesser, Susanne; Biernacka, Joanna M.; Brichant-Petitjean, Clara; Bui, Elise; Calkin, Cynthia V.; Cheng, Andrew Tai Ann; Chillotti, Caterina; Cichon, Sven; Clark, Scott; Czerski, Piotr M.; Dantas, Clarissa; Zompo, Maria Del; DePaulo, J. Raymond; Detera-Wadleigh, Sevilla D.; Etain, Bruno; Falkai, Peter; Frisén, Louise; Frye, Mark A.; Fullerton, Jan; Gard, Sébastien; Garnham, Julie; Goes, Fernando S.; Grof, Paul; Gruber, Oliver; Hashimoto, Ryota; Hauser, Joanna; Heilbronner, Urs; Hoban, Rebecca; Hou, Liping; Jamain, Stéphane; Kahn, Jean-Pierre; Kassem, Layla; Kato, Tadafumi; Kelsoe, John R.; Kittel-Schneider, Sarah; Kliwicki, Sebastian; Kuo, Po-Hsiu; Kusumi, Ichiro; Laje, Gonzalo; Lavebratt, Catharina; Leboyer, Marion; Leckband, Susan G.; López Jaramillo, Carlos A.; Maj, Mario; Malafosse, Alain; Martinsson, Lina; Masui, Takuya; Mitchell, Philip B.; Mondimore, Frank; Monteleone, Palmiero; Nallet, Audrey; Neuner, Maria; Novák, Tomás; O’Donovan, Claire; Ösby, Urban; Ozaki, Norio; Perlis, Roy H.; Pfennig, Andrea; Potash, James B.; Reich-Erkelenz, Daniela; Reif, Andreas; Reininghaus, Eva; Richardson, Sara; Rouleau, Guy A.; Rybakowski, Janusz K.; Schalling, Martin; Schofield, Peter R.; Schubert, Oliver K.; Schweizer, Barbara; Seemüller, Florian; Grigoroiu-Serbanescu, Maria; Severino, Giovanni; Seymour, Lisa R.; Slaney, Claire; Smoller, Jordan W.; Squassina, Alessio; Stamm, Thomas; Steele, Jo; Stopkova, Pavla; Tighe, Sarah K.; Tortorella, Alfonso; Turecki, Gustavo; Wray, Naomi R.; Wright, Adam; Zandi, Peter P.; Zilles, David; Bauer, Michael; Rietschel, Marcella; McMahon, Francis J.

    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 used in the Consortium on Lithium Genetics (ConLiGen) study. Materials and Methods 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. Results 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). Conclusions 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. PMID:23840348

  7. Predictors of Substance Abuse Assessment and Treatment Completion for Parents Involved with Child Welfare: One State's Experience in Matching across Systems.

    Science.gov (United States)

    Traube, Dorian E; He, Amy S; Zhu, Limei; Scalise, Christine; Richardson, Tyrone

    2015-01-01

    To date, few studies have examined the effect of interagency collaboration on substance abuse assessment ity of Southern California and treatment completion for parents who are involved in child welfare. The purpose of this paper is to: (1) describe a statewide, interagency collaborative program aimed at providing targeted substance abuse assessment and treatment to parents engaged in the child welfare system; (2) document the specialized assessment and treatment outcomes for parents engaged through this collaborative program; and (3) determine factors related to successful treatment completion for parents involved in the child welfare system. This is a retrospective study of an open cohort of 13,829 individuals admitted to the New Jersey Child Protection Substance Abuse Initiative (CPSAI) program from October 1, 2009, through September 30, 2010. Data were drawn from two unique administrative data sources. Multivariate Cox regression models were used to explore factors related to successfil treatment completion for parents involved in the child welfare system. Trend analysis for the total sample in the CPSAI program revealed that, of the 10,909 individuals who received a CPSAI assessment, 59% were referred to treatment. Of those referred to treatment, 40% enrolled in a treatment program. Once enrolled in a treatment program, 55% completed or were in the process of completing substance abuse treatment. These findings suggest that when adequate screening and treatment is available through a streamlined process, many of the ethnic and gender disparities present among other populations of individuals seeking treatment are minimized. Utilizing inherent child welfare case factors appears to be an important motivating element that aids parents during the assessment and treatment process.

  8. Environmental Assessment and Finding of No Significant Impact: On-Site Treatment of Low Level Mixed Waste

    Energy Technology Data Exchange (ETDEWEB)

    N/A

    1999-03-22

    The Department of Energy (DOE) has prepared an environmental assessment (EA) (DOE/EA-1292) to evaluate the proposed treatment of low level mixed waste (LLMW) at the Rocky Flats Environmental Technology Site (Site). The purpose of the action is to treat LLMW in order to meet the Land Disposal Restrictions specified by the Resource Conservation and Recovery Act and the waste acceptance criteria of the planned disposal site(s). Approximately 17,000 cubic meters (m{sup 3}) of LLMW are currently stored at the Site. Another 65,000 m{sup 3}of LLMW are likely to be generated by Site closure activities (a total of 82,000 m{sup 3} of LLMW). About 35,000 m{sup 3} can be directly disposed of off-site without treatment, and most of the remaining 47,000 m{sup 3} of LLMW can be treated at off-site treatment, storage, and disposal facilities. However, some LLMW will require treatment on-site, either because it does not meet shipping requirements or because off-site treatment is not available for these particular types of LLMW. Currently, this LLMW is stored at the Site pending the development and implementation of effective treatment processes. The Site needs to treat this LLMW on-site prior to shipment to off-site disposal facilities, in order to meet the DOE long-term objective of clean up and closure of the Site. All on-site treatment of LLMW would comply with applicable Federal and State laws designed to protect public health and safety and to enhance protection of the environment. The EA describes and analyzes the environmental effects of the proposed action (using ten mobile treatment processes to treat waste on-site), and the alternatives of treating waste onsite (using two fixed treatment processes), and of taking no action. The EA was the subject of a public comment period from February 3 to 24, 1999. No written or other comments regarding the EA were received.

  9. Assessment of the natural course and treatment of premalignant uterine cervical lesions in pregnancy

    Directory of Open Access Journals (Sweden)

    Šljivančanin Dragiša

    2013-01-01

    Full Text Available Introduction. Premalignant changes of the uterine cervix occur with similar frequency during pregnancy and in non­pregnant women. Due to the fact that any surgery on the cervix can jeopardize pregnancy, it is important to define the protocol of procedures for the treatment of these changes during pregnancy. Objective. The aim of the study was to investigate the natural course of premalignant cervical changes during pregnancy and the impact of their treatment on the pregnancy course. Methods. Study involved all patients with colposcopically, cytologically and hystopathologically diagnosed premalignant cervical changes during pregnancy from 2002 to 2008. Patients were divided into two groups according to the applied treatment during pregnancy: surgery or monitoring by regular colposcopic and cytological examinations. The two groups were compared concerning treatment outcome, persistence or regression of changes and pregnancy duration. Results. Study involved 58 patients. Spontaneous remission of lesions occurred after pregnancy in 63.79% of cases. Highgrade squamous intraepithelial lesion (H­SIL demonstrated a higher rate of persistency in comparison with low­grade squamous intraepithelial lesion (L­SIL (χ2=25.115; p<0.05. Only one finding of L­SIL progressed into H­SIL in the monitored group. Patients who underwent conization during pregnancy had a significantly more frequent preterm deliveries (χ2=14.369; p<0.05. Conclusion. The obtained high rate of spontaneous regression of cervical changes after pregnancy as well as the lower incidence of preterm births in patients who were not treated by conization during pregnancy, confirm that patients with premalignant cervical changes should be, if invasion is excluded, under follow­up throughout pregnancy by regular colposcopic and cytological examinations. Therapeutic conization, due to numerous complications, should be performed only when there is a suspected presence of a more severe form of

  10. Chemical and bioanalytical assessments on drinking water treatments by quaternized magnetic microspheres.

    Science.gov (United States)

    Shi, Peng; Ma, Rong; Zhou, Qing; Li, Aimin; Wu, Bing; Miao, Yu; Chen, Xun; Zhang, Xuxiang

    2015-03-21

    This study aimed to compare the toxicity reduction performance of conventional drinking water treatment (CT) and a treatment (NT) with quaternized magnetic microspheres (NDMP) based on chemical analyses. Fluorescence excitation-emission-matrix combined with parallel factor analysis identified four components in source water of different rivers or lake, and the abundance of each component differed greatly among the different samples. Compared with the CT, the NT evidently reduced the concentrations of dissolved organic carbon, adsorbable organic halogens (AOX), bromide and disinfection by-products. Toxicological evaluation indicated that the NT completely eliminated the cytotoxicity, and greatly reduced the genotoxicity and oxidative stress of all raw water. In contrast, the CT increased the cytotoxicity of Taihu Lake and the Zhongshan River water, genotoxicity of Taihu Lake and the Mangshe River water, as well as the levels of superoxide dismutase and malondialdehyde of the Mangshe River water. Correlation analysis indicated that the AOX of the treated samples was significantly correlated with the genotoxicity and glutathione concentration, but exhibited no correlation with either of them for all the samples. As it can effectively reduce pollutant levels and the toxicities of drinking water, NDMP might be widely used for drinking water treatment in future.

  11. Augmented Reality: A Brand New Challenge for the Assessment and Treatment of Psychological Disorders.

    Science.gov (United States)

    Chicchi Giglioli, Irene Alice; Pallavicini, Federica; Pedroli, Elisa; Serino, Silvia; Riva, Giuseppe

    2015-01-01

    Augmented Reality is a new technological system that allows introducing virtual contents in the real world in order to run in the same representation and, in real time, enhancing the user's sensory perception of reality. From another point of view, Augmented Reality can be defined as a set of techniques and tools that add information to the physical reality. To date, Augmented Reality has been used in many fields, such as medicine, entertainment, maintenance, architecture, education, and cognitive and motor rehabilitation but very few studies and applications of AR exist in clinical psychology. In the treatment of psychological disorders, Augmented Reality has given preliminary evidence to be a useful tool due to its adaptability to the patient needs and therapeutic purposes and interactivity. Another relevant factor is the quality of the user's experience in the Augmented Reality system determined from emotional engagement and sense of presence. This experience could increase the AR ecological validity in the treatment of psychological disorders. This paper reviews the recent studies on the use of Augmented Reality in the evaluation and treatment of psychological disorders, focusing on current uses of this technology and on the specific features that delineate Augmented Reality a new technique useful for psychology.

  12. Augmented Reality: A Brand New Challenge for the Assessment and Treatment of Psychological Disorders

    Science.gov (United States)

    Chicchi Giglioli, Irene Alice; Pallavicini, Federica; Pedroli, Elisa; Serino, Silvia; Riva, Giuseppe

    2015-01-01

    Augmented Reality is a new technological system that allows introducing virtual contents in the real world in order to run in the same representation and, in real time, enhancing the user's sensory perception of reality. From another point of view, Augmented Reality can be defined as a set of techniques and tools that add information to the physical reality. To date, Augmented Reality has been used in many fields, such as medicine, entertainment, maintenance, architecture, education, and cognitive and motor rehabilitation but very few studies and applications of AR exist in clinical psychology. In the treatment of psychological disorders, Augmented Reality has given preliminary evidence to be a useful tool due to its adaptability to the patient needs and therapeutic purposes and interactivity. Another relevant factor is the quality of the user's experience in the Augmented Reality system determined from emotional engagement and sense of presence. This experience could increase the AR ecological validity in the treatment of psychological disorders. This paper reviews the recent studies on the use of Augmented Reality in the evaluation and treatment of psychological disorders, focusing on current uses of this technology and on the specific features that delineate Augmented Reality a new technique useful for psychology. PMID:26339283

  13. Cancer treatment outcome prediction by assessing temporal change: application to cervical cancer

    Science.gov (United States)

    Prescott, Jeffrey W.; Zhang, Dongqing; Wang, Jian Z.; Mayr, Nina A.; Yuh, William T. C.; Saltz, Joel; Gurcan, Metin

    2008-03-01

    In this paper a novel framework is proposed for the classification of cervical tumors as susceptible or resistant to radiation therapy. The classification is based on both small- and large-scale temporal changes in the tumors' magnetic resonance imaging (MRI) response. The dataset consists of 11 patients who underwent radiation therapy for advanced cervical cancer. Each patient had dynamic contrast-enhanced (DCE)-MRI studies before treatment and early into treatment, approximately 2 weeks apart. For each study, a T1-weighted scan was performed before injection of contrast agent and again 75 seconds after injection. Using the two studies and the two series from each study, a set of tumor region of interest (ROI) features were calculated. These features were then exhaustively searched for the most separable set of three features based on a treatment outcome of local control or local recurrence. The dimensionality of the three-feature set was then reduced to two dimensions using principal components analysis (PCA). Finally, the classification performance was tested using three different classification procedures: support vector machines (SVM), linear discriminant analysis (LDA), and k-nearest neighbor (KNN). The most discriminatory features were those of volume, standard deviation, skewness, kurtosis, and fractal dimension. Combinations of these features resulted in 100% classification accuracy using each of the three classifiers.

  14. Augmented Reality: A Brand New Challenge for the Assessment and Treatment of Psychological Disorders

    Directory of Open Access Journals (Sweden)

    Irene Alice Chicchi Giglioli

    2015-01-01

    Full Text Available Augmented Reality is a new technological system that allows introducing virtual contents in the real world in order to run in the same representation and, in real time, enhancing the user’s sensory perception of reality. From another point of view, Augmented Reality can be defined as a set of techniques and tools that add information to the physical reality. To date, Augmented Reality has been used in many fields, such as medicine, entertainment, maintenance, architecture, education, and cognitive and motor rehabilitation but very few studies and applications of AR exist in clinical psychology. In the treatment of psychological disorders, Augmented Reality has given preliminary evidence to be a useful tool due to its adaptability to the patient needs and therapeutic purposes and interactivity. Another relevant factor is the quality of the user’s experience in the Augmented Reality system determined from emotional engagement and sense of presence. This experience could increase the AR ecological validity in the treatment of psychological disorders. This paper reviews the recent studies on the use of Augmented Reality in the evaluation and treatment of psychological disorders, focusing on current uses of this technology and on the specific features that delineate Augmented Reality a new technique useful for psychology.

  15. Combined biological and chemical assessment of estrogenic activities in wastewater treatment plant effluents.

    Science.gov (United States)

    Aerni, Hans-Rudolf; Kobler, Bernd; Rutishauser, Barbara V; Wettstein, Felix E; Fischer, René; Giger, Walter; Hungerbühler, Andreas; Marazuela, M Dolores; Peter, Armin; Schönenberger, René; Vögeli, A Christiane; Suter, Marc J-F; Eggen, Rik I L

    2004-02-01

    Five wastewater treatment plant effluents were analyzed for known endocrine disrupters and estrogenicity. Estrogenicity was determined by using the yeast estrogen screen (YES) and by measuring the blood plasma vitellogenin (VTG) concentrations in exposed male rainbow trout (Oncorhynchus mykiss). While all wastewater treatment plant effluents contained measurable concentrations of estrogens and gave a positive response with the YES, only at two sites did the male fish have significantly increased VTG blood plasma concentrations after the exposure, compared to pre-exposure concentrations. Estrone (E1) concentrations ranged up to 51 ng L(-1), estradiol (E2) up to 6 ng L(-1), and ethinylestradiol (EE2) up to 2 ng L(-1) in the 90 samples analyzed. Alkylphenols, alkylphenolmonoethoxylates and alkylphenoldiethoxylates, even though found at microg L(-1) concentrations in effluents from wastewater treatment plants with a significant industrial content, did not contribute much to the overall estrogenicity of the samples taken due to their low relative potency. Expected estrogenicities were calculated from the chemical data for each sample by using the principle of concentration additivity and relative potencies of the various chemicals as determined with the yeast estrogen screen. Measured and calculated estradiol equivalents gave the same order of magnitude and correlated rather well (R(2)=0.6).

  16. Options Assessment Report: Treatment of Nitrate Salt Waste at Los Alamos National Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Robinson, Bruce Alan [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Stevens, Patrice Ann [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2015-12-17

    This report documents the methodology used to select a method of treatment for the remediated nitrate salt (RNS) and unremediated nitrate salt (UNS) waste containers at Los Alamos National Laboratory (LANL). The method selected should treat the containerized waste in a manner that renders the waste safe and suitable for transport and final disposal in the Waste Isolation Pilot Plant (WIPP) repository, under specifications listed in the WIPP Waste Acceptance Criteria (DOE/CBFO, 2013). LANL recognizes that the results must be thoroughly vetted with the New Mexico Environment Department (NMED) and that a modification to the LANL Hazardous Waste Facility Permit is a necessary step before implementation of this or any treatment option. Likewise, facility readiness and safety basis approvals must be received from the Department of Energy (DOE). This report presents LANL’s preferred option, and the documentation of the process for reaching the recommended treatment option for RNS and UNS waste, and is presented for consideration by NMED and DOE.

  17. Options assessment report: Treatment of nitrate salt waste at Los Alamos National Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Robinson, Bruce Alan [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Stevens, Patrice Ann [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2015-09-16

    This report documents the methodology used to select a method of treatment for the remediated nitrate salt (RNS) and unremediated nitrate salt (UNS) waste containers at Los Alamos National Laboratory (LANL). The method selected should treat the containerized waste in a manner that renders the waste safe and suitable for transport and final disposal in the Waste Isolation Pilot Plant (WIPP) repository, under specifications listed in the WIPP Waste Acceptance Criteria (DOE/CBFO, 2013). LANL recognized that the results must be thoroughly vetted with the New Mexico Environment Department (NMED) and the a modification to the LANL Hazardous Waste Facility Permit is a necessary step before implementation of this or any treatment option. Likewise, facility readiness and safety basis approvals must be received from the Department of Energy (DOE). This report presents LANL's preferred option, and the documentation of the process for reaching the recommended treatment option for RNS and UNS waste, and is presented for consideration by NMED and DOE.

  18. Superimpositional assessment of treatment-associated changes in the temporomandibular joint and the mandibular symphysis.

    Science.gov (United States)

    Baumrind, S; Korn, E L; Isaacson, R J; West, E E; Molthen, R

    1983-12-01

    This article analyzes differences in the measured displacement of the condyle and of progonion when different vectors of force are delivered to the maxilla in the course of non-full-banded, Phase 1, mixed-dentition treatment for the correction of Class II malocclusion. The 238-case sample is identical to that for which changes in other parameters of facial form have been reported previously. Relative to superimposition on anterior cranial base and measured in a Frankfort-plane-determined coordinate system, we have attempted to identify and quantitate (1) the displacement of each structure which results from local remodeling and (2) the displacement of each structure which occurs as a secondary consequence of changes in other regions of the skull. We have also attempted to isolate treatment effects from those attributable to spontaneous growth and development. At the condyle, we note that in all three treatment groups and in the control group there is a small but real downward and backward displacement of the glenoid fossa. This change is not treatment induced but, rather, is associated with spontaneous growth and development. (See Fig. 5.) Some interesting differences in pattern of "growth at the condyle" were noted between samples. In the intraoral (modified activator) sample, there were small but statistically significant increases in growth rate as compared to the untreated group of Class II controls. To our surprise, similar statistically significant increases over the growth rate of the control group were noted in the cervical sample. (See Table III, variables 17 and 18.) Small but statistically significant differences between treatments were also noted in the patterns of change at pogonion. As compared to the untreated control group, the rate of total displacement in the modified activator group was significantly greater in the forward direction, while the rate of total displacement in the cervical group was significantly greater in the downward direction

  19. Assessment of service quality of public antiretroviral treatment (ART clinics in South Africa: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Kinkel Hans F

    2012-07-01

    Full Text Available Abstract Background In South Africa the ever increasing demand for antiretroviral treatment (ART runs the risk of leading to sub-optimal care in public sector ART clinics that are overburdened and under resourced. This study assessed the quality of ART services to identify service areas that require improvement. Methods A cross-sectional study was carried out at 16 of 17 public ART clinics in the target area in greater Pretoria, South Africa. Trained participant observers presented as ART qualifying HIV positive patients that required a visit to assess treatment readiness. They evaluated each facility on five different occasions between June and November 2009, assessing the time it took to get an appointment, the services available and accessed, service quality and the duration of the visit. Services (reception area, clinician’s consultation, HIV counselling, pharmacy, nutrition counselling and social worker’s assessment were assessed against performance standards that apply to all clinics. Service quality was expressed as scores for clinic performance (CPS and service performance (SPS, defined as the percentage of performance standards met per clinic and service area. Results In most of the clinics (62.5% participant observers were able to obtain an appointment within one week, although on the day of their visit essential services could not always be accessed. The median CPS of the assessed facilities was 68.5 with four clinics not meeting minimum standards (CPS > 60. The service areas that performed least well were the clinician’s consultation (SPS 67.3 and HIV counselling (SPS 70.7. Most notably, clinicians performed a physical examination in only 41.1% of the visits and rarely did a complete TB symptom screening. Counsellors frequently failed to address prevention of HIV transmission. Conclusions Overall public sector ART clinics in greater Pretoria were easily accessible and their services were of an acceptable quality. However

  20. Site specific risk assessment of an energy-from-waste thermal treatment facility in Durham Region, Ontario, Canada. Part A: Human health risk assessment.

    Science.gov (United States)

    Ollson, Christopher A; Knopper, Loren D; Whitfield Aslund, Melissa L; Jayasinghe, Ruwan

    2014-01-01

    The regions of Durham and York in Ontario, Canada have partnered to construct an energy-from-waste thermal treatment facility as part of a long term strategy for the management of their municipal solid waste. This paper presents the results of a comprehensive human health risk assessment for this facility. This assessment was based on extensive sampling of baseline environmental conditions (e.g., collection and analysis of air, soil, water, and biota samples) as well as detailed site specific modeling to predict facility-related emissions of 87 identified contaminants of potential concern. Emissions were estimated for both the approved initial operating design capacity of the facility (140,000 tonnes per year) and for the maximum design capacity (400,000 tonnes per year). For the 140,000 tonnes per year scenario, this assessment indicated that facility-related emissions are unlikely to cause adverse health risks to local residents, farmers, or other receptors (e.g., recreational users). For the 400,000 tonnes per year scenarios, slightly elevated risks were noted with respect to inhalation (hydrogen chloride) and infant consumption of breast milk (dioxins and furans), but only during predicted 'upset conditions' (i.e. facility start-up, shutdown, and loss of air pollution control) that represent unusual and/or transient occurrences. However, current provincial regulations require that additional environmental screening would be mandatory prior to expansion of the facility beyond the initial approved capacity (140,000 tonnes per year). Therefore, the potential risks due to upset conditions for the 400,000 tonnes per year scenario should be more closely investigated if future expansion is pursued.