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Sample records for dynamics treatment barriers

  1. The interplay between interpersonal dynamics, treatment barriers, and larger social forces: an exploratory study of drug-using couples in Hartford, CT

    Directory of Open Access Journals (Sweden)

    Simmons Janie

    2006-05-01

    Full Text Available Abstract Background The drug treatment field tends to place emphasis on the individual rather than the individual in social context. While there are a growing number of studies indicating that drug-using intimate partners are likely to play an important role in determining treatment options, little attention has been given to the experience and complex treatment needs of illicit drug-using (heroin, cocaine, crack couples. Methods This exploratory study used in-depth interviews and ethnographic engagement to better understand the relationship between interpersonal dynamics and the treatment experience of ten relatively stable drug-using couples in Hartford, CT. Semi-structured and open-ended qualitative interviews were conducted with each couple and separately with each partner. Whenever possible, the day-to-day realities and contexts of risk were also observed via participant and non-participant observation of these couples in the community. A grounded theory approach was used to inductively code and analyze nearly 40 transcripts of 60–90 minute interviews as well as fieldnotes. Results This study builds on a concept of complex interpersonal dynamics among drug users. Interpersonal dynamics of care and collusion were identified: couples cared for each other and colluded to acquire and use drugs. Care and collusion operate at the micro level of the risk environment. Treatment barriers and inadequacies were identified as part of the risk environment at the meso or intermediate level of analysis, and larger social forces such as gender dynamics, poverty and the "War on Drugs" were identified at the macro level. Interpersonal dynamics posed problems for couples when one or both partners were interested in accessing treatment. Structural barriers presented additional obstacles with the denial of admittance of both partners to treatment programs which had a sole focus on the individual and avoided treating couples. Conclusion Detoxification and

  2. Performance of dynamic safety barriers-Structuring, modelling and visualization

    OpenAIRE

    Wikdahl, Olga

    2014-01-01

    The main objective of this master thesis is to discuss performance of dynamic safety barriers. A comprehensive literature review is performed in order to get understanding what dynamic safety barrier is. Three different concepts of dynamic safety barriers based on various meanings of dynamic were derived from the literature review: - dynamic safety barriers related to motion or physical force - dynamic safety barriers as updated barriers from dynamic risk analysis - dynamic safety ...

  3. Microscopic study on dynamic barrier in fusion reactions

    International Nuclear Information System (INIS)

    Wu Xizhen; Tian Junlong; Zhao Kai; Li Zhuxia; Wang Ning

    2004-01-01

    The authors briefly review the fusion process of very heavy nuclear systems and some theoretical models. The authors propose a microscopic transport dynamic model, i.e. the Improved Quantum Molecular Dynamic model, for describing fusion reactions of heavy systems, in which the dynamical behavior of the fusion barrier in heavy fusion systems has been studied firstly. The authors find that with the incident energy decreasing the lowest dynamic barrier is obtained which approaches to the adiabatic static barrier and with increase of the incident energy the dynamic barrier goes up to the diabatic static barrier. The authors also indicate that how the dynamical fusion barrier is correlated with the development of the configuration of fusion partners along the fusion path. Associating the single-particle potentials obtained at different stages of fusion with the Two Center Shell Model, authors can study the time evolution of the single particle states of fusion system in configuration space of single particle orbits along the fusion path. (author)

  4. SOLUTIONS TO OVERCOME BARRIERS TO IMPLEMENTATION OF TREATMENT TECHNOLOGIES

    Science.gov (United States)

    To make treatment a viable option for remediation you must first identify the barriers to implementing treatment. The primary barrier is economics. Treatment options are relatively expensive and there is a lack of funds for treatment. The cost of technologies can be lowered by 1)...

  5. Recovery post treatment: plans, barriers and motivators.

    Science.gov (United States)

    Duffy, Paul; Baldwin, Helen

    2013-01-30

    The increasing focus on achieving a sustained recovery from substance use brings with it a need to better understand the factors (recovery capital) that contribute to recovery following treatment. This work examined the factors those in recovery perceive to be barriers to (lack of capital) or facilitators of (presence of capital) sustained recovery post treatment. A purposive sample of 45 participants was recruited from 11 drug treatment services in northern England. Semi-structured qualitative interviews lasting between 30 and 90 minutes were conducted one to three months after participants completed treatment. Interviews examined key themes identified through previous literature but focused on allowing participants to explore their unique recovery journey. Interviews were transcribed and analysed thematically using a combination of deductive and inductive approaches. Participants generally reported high levels of confidence in maintaining their recovery with most planning to remain abstinent. There were indications of high levels of recovery capital. Aftercare engagement was high, often through self referral, with non substance use related activity felt to be particularly positive. Supported housing was critical and concerns were raised about the ability to afford to live independently with financial stability and welfare availability a key concern in general. Employment, often in the substance use treatment field, was a desire. However, it was a long term goal, with substantial risks associated with pursuing this too early. Positive social support was almost exclusively from within the recovery community although the re-building of relationships with family (children in particular) was a key motivator post treatment. Addressing internal factors and underlying issues i.e. 'human capital', provided confidence for continued recovery whilst motivators focused on external factors such as family and maintaining aspects of a 'normal' life i.e. 'social and physical

  6. Recovery post treatment: plans, barriers and motivators

    Directory of Open Access Journals (Sweden)

    Duffy Paul

    2013-01-01

    Full Text Available Abstract Background The increasing focus on achieving a sustained recovery from substance use brings with it a need to better understand the factors (recovery capital that contribute to recovery following treatment. This work examined the factors those in recovery perceive to be barriers to (lack of capital or facilitators of (presence of capital sustained recovery post treatment. Methods A purposive sample of 45 participants was recruited from 11 drug treatment services in northern England. Semi-structured qualitative interviews lasting between 30 and 90 minutes were conducted one to three months after participants completed treatment. Interviews examined key themes identified through previous literature but focused on allowing participants to explore their unique recovery journey. Interviews were transcribed and analysed thematically using a combination of deductive and inductive approaches. Results Participants generally reported high levels of confidence in maintaining their recovery with most planning to remain abstinent. There were indications of high levels of recovery capital. Aftercare engagement was high, often through self referral, with non substance use related activity felt to be particularly positive. Supported housing was critical and concerns were raised about the ability to afford to live independently with financial stability and welfare availability a key concern in general. Employment, often in the substance use treatment field, was a desire. However, it was a long term goal, with substantial risks associated with pursuing this too early. Positive social support was almost exclusively from within the recovery community although the re-building of relationships with family (children in particular was a key motivator post treatment. Conclusions Addressing internal factors and underlying issues i.e. ‘human capital’, provided confidence for continued recovery whilst motivators focused on external factors such as family and

  7. 3. barriers to prompt malaria treatment among under five children

    African Journals Online (AJOL)

    Esem

    strategy need to be established. Therefore, this study aimed at determining barriers to prompt malaria treatment among this vulnerable age group in Mpika district. Objective: To determine the barriers to prompt malaria treatment among children under five years of age with malaria in Mpika district. Study design: This was an ...

  8. Barriers to Successful Treatment Completion in Child Sexual Abuse Survivors

    Science.gov (United States)

    McPherson, Paul; Scribano, Philip; Stevens, Jack

    2012-01-01

    Child sexual abuse (CSA) often requires psychological treatment to address the symptoms of victim trauma. Barriers to entry and completion of counseling services can compromise long-term well-being. An integrated medical and mental health evaluation and treatment model of a child advocacy center (CAC) has the potential to reduce barriers to mental…

  9. Study of the dynamical potential barriers in heavy ion collisions

    International Nuclear Information System (INIS)

    Zhu, Long; Su, Jun; Xie, Wen-Jie; Zhang, Feng-Shou

    2013-01-01

    The nucleus–nucleus interaction potentials for the fusion reactions 16 O + 208 Pb, 64 Ni + 64 Ni, 58 Ni + 58 Ni and 16 O + 154 Sm are extracted from the improved isospin-dependent quantum molecular dynamics model. The shell correction effects are discussed. The negative shell correction energies lower potential barriers of a certain reaction. The incident energy dependence of the potential barrier is investigated for each system. A complex phenomenon of energy dependence is observed. It is also found that incident energy dependence of the barrier radius and barrier height shows opposite behaviors. The Coulomb potential shows weak energy dependence when distance of two colliding nuclei is lower than the touching distance. The isospin effects of the potential barrier are investigated. The orientation effects of the potential barrier is also discussed for the system 16 O + 154 Sm. The fusion cross sections that correspond to the equatorial orientation of 154 Sm are very low in sub-barrier region because of the high fusion barriers and the shallow potential pockets

  10. Barriers to treatment for older adults seeking psychological therapy.

    Science.gov (United States)

    Wuthrich, Viviana M; Frei, Jacqueline

    2015-07-01

    Older adults with mental health disorders underutilize mental health services more than other adults. While there are well known general barriers to help seeking across the population, specific barriers for older adults include difficulties with transportation, beliefs that it is normal to be anxious and depressed in old age, and beliefs by referrers that psychological therapy is less likely to be effective. This study examined barriers related to identifying the need for help, seeking help and participating in therapy in a clinical population of older adults. Sixty older adults (aged 60-79 years) with comorbid anxiety and unipolar mood disorders completed barriers to treatment questionnaires before and after psychological group treatment, as well as measures of cognitive ability, anxiety, depression, and quality of life at baseline. The greatest barriers to help seeking related to difficulties identifying the need for help, with 50% of the sample reporting their belief that their symptoms were normal as a major barrier. Other major barriers identified were related to: self-reliance, cost of treatment, and fear of medication replicating previous findings. The main barriers reported for difficulties in continuing therapy included not finding therapy helpful, cost of treatment, and thinking that the therapist did not understand their issues. The main barriers identified related to issues with identifying the need to seek help. More attention is needed to educate older adults and professionals about the need for, and effectiveness of, psychological therapies for older adults with anxiety and depression to reduce this barrier to help seeking.

  11. 3. barriers to prompt malaria treatment among under five children

    African Journals Online (AJOL)

    Esem

    age are accessing prompt malaria treatment at health facilities. ... been mentioned include cultural beliefs about the cause, treatment or ..... Factors Perceived by Caretakers as Barriers to Health. Care for ... Asia Pacific J Public Health. 2001 ...

  12. Treatment of barrier evolution: the SKB perspective

    International Nuclear Information System (INIS)

    Hedin, A.

    2002-01-01

    This paper serves as a point of departure for the discussions to be held within the Working Group of Technical Topic entitled 'Barriers and System Performances within a safety case: Their functioning and Evolution with Time'. The paper gives the SKB perspective of the issues to be discussed within the Working Group for this Topic. The following issues to be discussed by the Working Group are: What is the role of each barrier as a function of time or in the different time frames? What is its contribution to the overall system performance or safety as a function of time? Which are the main uncertainties on the performance of barriers in the timescales? To what extent should we enhance the robustness of barriers because of the uncertainties of some component behaviour with time? What is the requested or required performance versus the expected or realistic or conservative behaviour with time? How are these safety margins used as arguments in a safety case? What is the issue associated with the geosphere stability for different geological systems? How is barriers and system performances as a function of time evaluated (and presented and communicated) in a safety case? What kind of measures are used for siting, designing and optimising robust barriers corresponding to situations that can vary with time? Are human actions considered to be relevant? (authors)

  13. Nuclear dynamics around the barrier: from fusion to evaporation

    International Nuclear Information System (INIS)

    Simenel, Cedric

    2003-01-01

    This work is devoted to aspects of nuclear dynamics around the barrier. It is shown that for fusion reactions, the Coulomb field couples relative motion of nuclei to rotation of a deformed projectile independently of the energy and the charge of the nuclei. An experimental study of the reaction 6 He + 190 Os via gamma spectroscopy of product nuclei has shown that the break up of the 6 He is coupled to the relative motion too, a strong hindrance resulting in the fusion around and above the fusion barrier. The path to fusion after overcoming the barrier, especially the charge equilibration, have been studied in the framework of the TDHF theory via the preequilibrium GDR excited in N/Z asymmetric reactions. An application to formation of the super-heavy elements has been proposed. Finally, couplings between protons and neutrons have been shown up in mean field calculations. Their main expected effect is an emission of protons under the Coulomb barrier. (author)

  14. Barriers to female sex addiction treatment in the UK.

    Science.gov (United States)

    Dhuffar, Manpreet K; Griffiths, Mark D

    2016-12-01

    Background Over the last 20 years, behavioral addictions (e.g., addictions to gambling, playing video games, work, etc.) have become more accepted among both public and scientific communities. Addiction to sex is arguably a more controversial issue, but this does not take away from the fact that some individuals seek professional help for problematic excessive sex, irrespective of how the behavior is conceptualized. Empirical evidence suggests that among treatment seekers, men are more likely than women to seek help for sex addiction (SA). Methods Using the behavioral addiction literature and the authors' own expertise in researching female SA, this paper examines potential barriers to the treatment for female sex addicts. Results Four main types of barriers for female sex addicts not seeking treatment were identified. These comprised (a) individual barriers, (b) social barriers, (c) research barriers, and (d) treatment barriers. Conclusions Further research is needed to either confirm or disconfirm the identified barriers that female sex addicts face when seeking treatment, and if conformation is found, interested stakeholders should provide better awareness and/or see ways in which such barriers can be overcome to aid better uptake of SA services.

  15. The blood-brain barrier in migraine treatment

    DEFF Research Database (Denmark)

    Edvinsson, L; Tfelt-Hansen, P

    2008-01-01

    Salient aspects of the anatomy and function of the blood-barrier barrier (BBB) are reviewed in relation to migraine pathophysiology and treatment. The main function of the BBB is to limit the access of circulating substances to the neuropile. Smaller lipophilic substances have some access...

  16. Barriers to information provision regarding breast cancer and its treatment.

    Science.gov (United States)

    Campbell-Enns, Heather J; Woodgate, Roberta L; Chochinov, Harvey M

    2017-10-01

    Women with breast cancer require information about their cancer and its treatment during the process of treatment decision-making, yet it is unclear if there are barriers to information support. This study explores the experience of making treatment decisions in breast cancer, paying particular attention to the barriers experienced to the provision of information. Using a grounded theory methodology, semi-structured interviews were conducted with 22 women with invasive breast cancer exploring the experience of treatment decision-making. Data was organized using ATLAS.ti software and analyzed using constant comparisons. Analysis of the data showed that barriers to cancer and treatment information include intrapersonal and interpersonal communication challenges (emotional distress, patient-provider communication, "making it personal," access to information) which reside at different levels of the breast cancer experience (individual, dyad, group, organization). A model is provided to depict this experience. Women want information about their cancer and its treatment and experience barriers to information provision at various levels. Satisfactory information provision cannot occur without addressing barriers at every level. Utilizing interprofessional models of care may minimize existing barriers to information provision and empower patients to make satisfying treatment decisions that are consistent with their individual wishes.

  17. Barriers affecting adherence to radiation treatment and strategies to overcome those barriers.

    Science.gov (United States)

    Rangarajan, R; Jayaraman, K

    2017-01-01

    The WHO defines adherence as the extent to which a patient's behavior coincides with recommendations from a health-care provider. Nonadherence to cancer treatment has a major impact on the therapeutic outcome. To assess the prevalence of nonadherence to radiation regimen and to analyze the factors that affect adherence to cancer treatment. Patients receiving radiation treatment in our hospital were screened for adherence to appointment keeping and to the prescribed radiation regimen and patients who had unplanned treatment breaks during treatment were interviewed. Between January and July 2013, we identified 61 patients who had unplanned breaks during treatment. We analyzed the social, emotional, educational, economic, and therapeutic barriers that led to nonadherence. Of the 61 patients who had unplanned breaks during treatment, 54% were males and 46% were females. Fifty-seven percent of patients had head and neck cancers and 25% had gynecological cancers. Seventy-one percent of patients were planned for concurrent chemoradiation. The number of days of unplanned treatment breaks ranged from 3 to 27 days. Social and therapeutic barriers were found to be the most common factor that led to nonadherence in these patients. Identification of barriers that lead to nonadherence, designing strategies to overcome such barriers and effective communication becomes imperative to ensure uninterrupted treatment. Based on the above analysis, we have designed several strategies to improve adherence to treatment among our patients.

  18. Relaxation oscillations and transport barrier dynamics in tokamak edge plasmas

    International Nuclear Information System (INIS)

    Benkadda, Sadruddin; Beyer, Peter; Fuhr-Chaudier, Guillaume; Garbet, Xavier; Ghendrih, Philippe; Sarazin, Yanick

    2004-01-01

    Oscillations of turbulent transport of particles and energy in magnetically confined plasmas can be easily observed in simulations of a variety of turbulence models. These oscillations typically involve a mechanism of energy exchange between fluctuations and a poloidal shear flow. This kind of ''predator-prey'' mechanism is found to be not relevant for transport barrier relaxations. In RBM simulations of resistive ballooning turbulence with transport barrier, relaxation oscillations of the latter are observed even in the case of frozen poloidal shear flow. These relaxations are due to a transitory growth of a mode localized at the barrier center. A one-dimensional model for the evolution of such a mode in the presence of a shear flow describes a transitory growth of an initial perturbation. Oscillations in the case of a finite steady-state shear flow are possible due to the coupling of the mode to the dynamics of the pressure profile. (author)

  19. Surface pre-treatment for barrier coatings on polyethylene terephthalate

    Science.gov (United States)

    Bahre, H.; Bahroun, K.; Behm, H.; Steves, S.; Awakowicz, P.; Böke, M.; Hopmann, Ch; Winter, J.

    2013-02-01

    Polymers have favourable properties such as light weight, flexibility and transparency. Consequently, this makes them suitable for food packaging, organic light-emitting diodes and flexible solar cells. Nonetheless, raw plastics do not possess sufficient barrier functionality against oxygen and water vapour, which is of paramount importance for most applications. A widespread solution is to deposit thin silicon oxide layers using plasma processes. However, silicon oxide layers do not always fulfil the requirements concerning adhesion and barrier performance when deposited on films. Thus, plasma pre-treatment is often necessary. To analyse the influence of a plasma-based pre-treatment on barrier performance, different plasma pre-treatments on three reactor setups were applied to a very smooth polyethylene terephthalate film before depositing a silicon oxide barrier layer. In this paper, the influence of oxygen and argon plasma pre-treatments towards the barrier performance is discussed examining the chemical and topological change of the film. It was observed that a short one-to-ten-second plasma treatment can reduce the oxygen transmission rate by a factor of five. The surface chemistry and the surface topography change significantly for these short treatment times, leading to an increased surface energy. The surface roughness rises slowly due to the development of small spots in the nanometre range. For very long treatment times, surface roughness of the order of the barrier layer's thickness results in a complete loss of barrier properties. During plasma pre-treatment, the trade-off between surface activation and roughening of the surface has to be carefully considered.

  20. Surface pre-treatment for barrier coatings on polyethylene terephthalate

    International Nuclear Information System (INIS)

    Bahre, H; Böke, M; Winter, J; Bahroun, K; Behm, H; Hopmann, Ch; Steves, S; Awakowicz, P

    2013-01-01

    Polymers have favourable properties such as light weight, flexibility and transparency. Consequently, this makes them suitable for food packaging, organic light-emitting diodes and flexible solar cells. Nonetheless, raw plastics do not possess sufficient barrier functionality against oxygen and water vapour, which is of paramount importance for most applications. A widespread solution is to deposit thin silicon oxide layers using plasma processes. However, silicon oxide layers do not always fulfil the requirements concerning adhesion and barrier performance when deposited on films. Thus, plasma pre-treatment is often necessary. To analyse the influence of a plasma-based pre-treatment on barrier performance, different plasma pre-treatments on three reactor setups were applied to a very smooth polyethylene terephthalate film before depositing a silicon oxide barrier layer. In this paper, the influence of oxygen and argon plasma pre-treatments towards the barrier performance is discussed examining the chemical and topological change of the film. It was observed that a short one-to-ten-second plasma treatment can reduce the oxygen transmission rate by a factor of five. The surface chemistry and the surface topography change significantly for these short treatment times, leading to an increased surface energy. The surface roughness rises slowly due to the development of small spots in the nanometre range. For very long treatment times, surface roughness of the order of the barrier layer's thickness results in a complete loss of barrier properties. During plasma pre-treatment, the trade-off between surface activation and roughening of the surface has to be carefully considered. (paper)

  1. Dynamic responses of connections in road safety barriers

    International Nuclear Information System (INIS)

    Bayton, D.A.F.; Long, R.; Fourlaris, G.

    2009-01-01

    Bolted road safety barrier connections utilise slotted holes that are perpendicular to the direction of the safety barrier beam. Due to the clearance between the slotted holes and the bolts, a varying amount of slippage is seen before contact with the edge of the slot is made. The stiffness characteristics of bolted road safety barrier connections have been examined with a representative test coupon that incorporates a full size safety barrier connection slot to industry standard dimensions. Previous research work has successfully determined the stiffness characteristics of the bolted connections at quasi-static strain rates. Representative non-linear finite element models of the bolted test coupons have been constructed. When compared to the laboratory results the initial stiffness, maximum force and displacement of the bolted connections are similar to the finite element model predictions. Current investigations have moved onto strain rates comparable to those observed in actual vehicle crash tests. Explicit dynamic finite element (FE) models have been constructed and validated, using experimental data produced using a series of high strain rate laboratory tests for a number of bolt configurations

  2. Crossing the entropy barrier of dynamical zeta functions

    International Nuclear Information System (INIS)

    Aurich, R.; Bolte, J.; Matthies, C.; Sieber, M.; Steiner, F.

    1992-01-01

    Dynamical zeta functions are an important tool to quantize chaotic dynamical systems. The basic quantization rules require the computation of the zeta functions on the real energy axis, where the Euler product representations running over the classical periodic orbits usually do not converge due to the existence of the so-called entropy barrier determined by the topological entropy of the classical system. We shown that the convergence properties of the dynamical zeta functions rewritten as Dirichlet series are governed not only by the well-known topological and metric entropy, but depend crucially on subtle statistical properties of the Maslow indices and of the multiplicities of the periodic orbits that are measured by a new parameter for which we introduce the notion of a third entropy. If and only if the third entropy is nonvanishing, one can cross the entropy barrier; if it exceeds a certain value, one can even compute the zeta function in the physical region by means of a convergent Dirichlet series. A simple statistical model is presented which allows to compute the third entropy. Four examples of chaotic systems are studied in detail to test the model numerically. (orig.)

  3. Crossing the entropy barrier of dynamical zeta functions

    Energy Technology Data Exchange (ETDEWEB)

    Aurich, R.; Bolte, J.; Matthies, C.; Sieber, M.; Steiner, F. (Hamburg Univ. (Germany). 2. Inst. fuer Theoretische Physik)

    1992-01-01

    Dynamical zeta functions are an important tool to quantize chaotic dynamical systems. The basic quantization rules require the computation of the zeta functions on the real energy axis, where the Euler product representations running over the classical periodic orbits usually do not converge due to the existence of the so-called entropy barrier determined by the topological entropy of the classical system. We shown that the convergence properties of the dynamical zeta functions rewritten as Dirichlet series are governed not only by the well-known topological and metric entropy, but depend crucially on subtle statistical properties of the Maslow indices and of the multiplicities of the periodic orbits that are measured by a new parameter for which we introduce the notion of a third entropy. If and only if the third entropy is nonvanishing, one can cross the entropy barrier; if it exceeds a certain value, one can even compute the zeta function in the physical region by means of a convergent Dirichlet series. A simple statistical model is presented which allows to compute the third entropy. Four examples of chaotic systems are studied in detail to test the model numerically. (orig.).

  4. Barriers to treatment engagement for depression among Latinas.

    Science.gov (United States)

    Caplan, Susan; Whittemore, Robin

    2013-06-01

    In spite of successful treatment options for depression, the majority of Americans with severe depression do not receive treatment. Latinos are even less likely to engage in treatment than non-Hispanic Whites. The purpose of this study is to explore barriers to treatment engagement and, more specifically, how childhood adversity and gender-based violence (GBV) contribute to a lack of perceived support for treatment engagement. Experiences of GBV and childhood adversity can call into question deeply held family, cultural, and religious values, and affect the perceived quality of the therapeutic relationship and attitudes about depression treatment. A qualitative descriptive methodology was used to understand the experiences of a sample of 12 Latinas who were part of a diabetes prevention study (n = 67) and had been referred for treatment because of elevated symptoms of depression. Results indicate that the often-cited barriers to mental health care (i.e., language barriers, economic considerations, and lack of illness recognition) did not serve as deterrents for Latinas in this study. Participants recognized that they were depressed and agreed with the assessment of depression. However, none of the women followed up on the recommendation to seek care. What has emerged from this study is how cultural values, such as familismo and marianismo, and the lack of responsiveness from family and religious leaders in the context of exposure to GBV and childhood adversity created significant barriers to treatment engagement. This study highlights the need for nurses to screen for these exposures and to engage in shared decision making about treatment.

  5. Researching the barriers to HIV treatment and maternal health in ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2013-03-05

    Mar 5, 2013 ... Researching the barriers to HIV treatment and maternal health in South Africa ... between IDRC, the Canadian International Development Agency, and the Canadian Institutes of Health Research. ... One study, based on interviews with women who used maternal services, ... Careers · Contact Us · Site map.

  6. Financial barriers to utilization of screening and treatment services ...

    African Journals Online (AJOL)

    Aim: To determine financial barriers that impede the utilization of screening and treatment services for breast cancer among Nigerian women from different socioeconomic groups. Materials and Methods: A descriptive study was carried out in 2013 among women attending the oncology clinic of a tertiary institution in Enugu, ...

  7. Poor vision, refractive errors and barriers to treatment among ...

    African Journals Online (AJOL)

    Poor vision, refractive errors and barriers to treatment among commercial vehicle drivers in the Cape Coast municipality. ... were also administered to the participants to collect demographic data, history of driving and RTAs and utilization of eye care services as well as identification of the colours of the traffic light. Results: A ...

  8. Multi-level barriers to LTBI treatment: a research note.

    Science.gov (United States)

    Hill, Linda; Blumberg, Elaine; Sipan, Carol; Schmitz, Katharine; West, Joshua; Kelley, Norma; Hovell, Melbourne

    2010-08-01

    This study describes the barriers to effective and timely LTBI treatment encountered in a research study on INH adherence in Latino adolescents. Participant study logs were reviewed, results of continuing medical education pretests for medical providers were examined, and participating medical facilities were contacted in order to construct a profile of multi-level barriers to LTBI treatment. A total of 285 TST positive Latino (96%) high school students were recruited into the trial. We encountered a lack of understanding of the gravity of tuberculosis infection among both the public and providers of health care. Parents and adolescents cited competing priorities, transportation problems and financial constraints as reasons for non-compliance. Improved education of the public and physicians is needed regarding the gravity of the disease and the value of treatment, as well as public and financial support for LTBI treatment by both the government and the medical community.

  9. Creation and dynamical co-evolution of electron and ion channel transport barriers

    International Nuclear Information System (INIS)

    Newman, D.E.

    2002-01-01

    A wide variety of magnetic confinement devices have found transitions to an enhanced confinement regime. Simple dynamical models have been able to capture much of the dynamics of these barriers however an open question has been the disconnected nature of the electron thermal transport channel sometimes observed in the presence of a standard ('ion channel' barrier. By adding to simple barrier model an evolution equation for electron fluctuations we can investigate the interaction between the formation of the standard ion channel barrier and the somewhat less common electron channel barrier. Barrier formation in the electron channel is even more sensitive to the alignment of the various gradients making up the sheared radial electric field than the ion barrier is. Electron channel heat transport is found to significantly increase after the formation of the ion channel barrier but before the electron channel barrier is formed. This increased transport is important in the barrier evolution. (author)

  10. Barriers to Implementing Treatment Integrity Procedures: Survey of Treatment Outcome Researchers

    Science.gov (United States)

    Perepletchikova, Francheska; Hilt, Lori M.; Chereji, Elizabeth; Kazdin, Alan E.

    2009-01-01

    Treatment integrity refers to implementing interventions as intended. Treatment integrity is critically important for experimental validity and for drawing valid inferences regarding the relationship between treatment and outcome. Yet, it is rarely adequately addressed in psychotherapy research. The authors examined barriers to treatment integrity…

  11. Facilitators and barriers in treatment seeking for cannabis dependence.

    Science.gov (United States)

    van der Pol, Peggy; Liebregts, Nienke; de Graaf, Ron; Korf, Dirk J; van den Brink, Wim; van Laar, Margriet

    2013-12-01

    Relatively few cannabis dependent people seek treatment and little is known about determinants of treatment seeking. Treatment determinants were compared among 70 DSM-IV cannabis dependent patients and 241 non-treatment seeking DSM-IV cannabis dependent community subjects. In addition, perceived facilitators for treatment seeking were assessed in patients, whereas perceived barriers were assessed in 160/241 cannabis dependent community subjects not prepared to seek treatment (precluders), of whom 63/160 showed an objective treatment need, and 30/241 showed a subjective treatment need. Compared to non-treatment seekers, patients reported more cannabis use (176.9 versus 82.8 joints monthly), more symptoms of dependence (5.6 versus 4.5), higher perceived lack of social support (70.0% versus 41.1%), more pressure to seek treatment (58.6% versus 21.6%), a more positive attitude to treatment, and more previous treatments. In addition, patients reported more mental health problems (internalising disorders 57.1% versus 24.5%; externalising disorders 52.9% versus 35.3%) and more functional impairments (8.4 versus 4.8 monthly days out of role). Cannabis dependent 'precluders' reported desire for self-reliance (50.0%), preference for informal help (22.5%), and absent treatment need (16.9%) as their main reasons not to seek treatment, whereas cannabis dependent community subjects with a subjective treatment need mainly expressed desire for self-reliance (36.7%), treatment ineffectiveness (16.7%), and avoiding stigma (13.3%). Functional impairment, mental health problems and social pressure are important reasons to seek treatment in people with cannabis dependence. Treatment participation might improve if desire for self-reliance and the preference for informal help are considered, and perceived ineffectiveness of treatment and stigmatisation are publicly addressed. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  12. Dielectric barrier discharge plasma treatment of cellulose nanofibre surfaces

    DEFF Research Database (Denmark)

    Kusano, Yukihiro; Madsen, Bo; Berglund, Linn

    2017-01-01

    on the nanofibre surface. Ultrasonic irradiation further enhanced the wetting and oxidation of the nanofibre coating. Scanning electron microscopic observations showed skeleton-like features on the plasma-treated surface, indicating preferential etching of weaker domains, such as low-molecular weight domains......Dielectric barrier discharge plasma treatment was applied to modify cellulose nanofibre (CNF) surfaces with and without ultrasonic irradiation. The plasma treatment improved the wetting by deionised water and glycerol, and increased the contents of oxygen, carbonyl group, and carboxyl group...... and amorphous phases. Ultrasonic irradiation also improved the uniformity of the treatment. Altogether, it is demonstrated that atmospheric pressure plasma treatment is a promising technique to modify the CNF surface before composite processing....

  13. Dynamics of dielectric barrier discharges in different arrangements

    International Nuclear Information System (INIS)

    Gibalov, Valentin I; Pietsch, Gerhard J

    2012-01-01

    Based on experimental results, numerical investigations of dielectric barrier discharges (DBDs) have been performed in three basic configurations: in the volume, coplanar and surface discharge arrangements. It is shown that the DBD dynamics is the same in all arrangements and it is determined by the development of a few principal constituents, i.e. cathode- and anode-directed streamers, discharge channel, cathode layer and surface charges. It is found that the anode- and cathode-directed streamers appear with a highly conductive channel in between. The interaction of the streamers with conductive and dielectric surfaces determines the filamentary or homogeneous appearance of the discharge and its properties. The cathode-directed streamer is a self-sustaining phenomenon, which moves in a gas gap or along an electrode driven by a positive loop-back between photoemission and electron multiplication. The anode-directed streamer plays a subsidiary role. Depending on the kind of gas (electronegative or electropositive) and/or the degree of development of the cathode-directed streamer, the field strength in the conductive channels changes significantly. When the cathode-directed streamer touches the electrode surface, a cathode layer appears with parameters close to those of normal glow discharges. In volume discharge arrangements the movement of the streamers results in the appearance of Lichtenberg figures on dielectric surfaces. (paper)

  14. Unified Model of Dynamic Forced Barrier Crossing in Single Molecules

    Energy Technology Data Exchange (ETDEWEB)

    Friddle, R W

    2007-06-21

    Thermally activated barrier crossing in the presence of an increasing load can reveal kinetic rate constants and energy barrier parameters when repeated over a range of loading rates. Here we derive a model of the mean escape force for all relevant loading rates--the complete force spectrum. Two well-known approximations emerge as limiting cases; one of which confirms predictions that single-barrier spectra should converge to a phenomenological description in the slow loading limit.

  15. Study on fusion potential barrier in heavy ion reactions based on the dynamical model

    International Nuclear Information System (INIS)

    Tian Junlong; Wu Xizhen; Li Zhuxia; Wang Ning; Liu Fuhu

    2004-01-01

    Based on an improved quantum molecular dynamics model the static and dynamic potential in the entrance channel of synthesis of superheavy nuclei are studied. The dependence of the static potential (and driving potential) on mass-asymmetry is obtained. From this study authors find out that the mass-symmetric system seems to be difficult to fuse and the fusing system with the largest driving potential could be the optimal choice of the projectile-target combination. By comparing the static potential barrier with the dynamic one authors find that the latter one is lower than former one obviously, and that the dynamical potential barrier is entrance energy dependent. The maximum and minimum of dynamic potential barriers approach to the diabatic (sudden approximation) and the adiabatic static potential barriers, respectively

  16. Barriers and Promoters to Participation in the Era of Shared Treatment Decision-Making.

    Science.gov (United States)

    McCarter, Sarah P; Tariman, Joseph D; Spawn, Nadia; Mehmeti, Enisa; Bishop-Royse, Jessica; Garcia, Ima; Hartle, Lisa; Szubski, Katharine

    2016-10-01

    This study aimed to identify the barriers and promoters for participation in cancer treatment decision in the era of shared decision-making (SDM) process. A qualitative design was utilized. Nineteen nurses and 11 nurse practitioners from oncology inpatient and outpatient settings participated in semi-structured interviews. Data were analyzed using directed content analysis. The findings include practice barrier, patient barrier, institutional policy barrier, professional barrier, scope of practice barrier, insurance coverage barrier, and administrative barrier. Multidisciplinary team approach, having a nursing voice during SDM, high level of knowledge of the disease and treatment, and personal valuation of SDM participation were perceived as promoters. Oncology nurses and nurse practitioners face many barriers to their participation during SDM. Organizational support and system-wide culture of SDM are essential to achieve better cancer treatment decisions outcome. Additional studies are needed to determine the factors that can promote more participation among nurses and nurse practitioners. © The Author(s) 2016.

  17. Dynamic simulation of collisions of heavy high-speed trucks with concrete barriers

    International Nuclear Information System (INIS)

    Itoh, Yoshito; Liu, Chunlu; Kusama, Ryuichi

    2007-01-01

    Real vehicle collision experiments on full-scale road safety barriers are important to determine the outcome of a vehicle versus barrier impact accident. However, such experiments require large investment of time and money. Numerical simulation has therefore been imperative as an alternative method for testing concrete barriers. In this research, spring subgrade models were first developed to simulate the ground boundary of concrete barriers. Both heavy trucks and concrete barriers were modeled using finite element methods (FEM) to simulate dynamic collision performances. Comparison of the results generated from computer simulations and on-site full-scale experiments demonstrated that the developed models could be applied to simulate the collision of heavy trucks with concrete barriers to provide the data to design new road safety barriers and analyze existing ones

  18. Barriers to treatment access for Chagas disease in Mexico.

    Science.gov (United States)

    Manne, Jennifer M; Snively, Callae S; Ramsey, Janine M; Salgado, Marco Ocampo; Bärnighausen, Till; Reich, Michael R

    2013-01-01

    According to World Health Organization (WHO) prevalence estimates, 1.1 million people in Mexico are infected with Trypanosoma cruzi, the etiologic agent of Chagas disease (CD). However, limited information is available about access to antitrypanosomal treatment. This study assesses the extent of access in Mexico, analyzes the barriers to access, and suggests strategies to overcome them. Semi-structured in-depth interviews were conducted with 18 key informants and policymakers at the national level in Mexico. Data on CD cases, relevant policy documents and interview data were analyzed using the Flagship Framework for Pharmaceutical Policy Reform policy interventions: regulation, financing, payment, organization, and persuasion. Data showed that 3,013 cases were registered nationally from 2007-2011, representing 0.41% of total expected cases based on Mexico's national prevalence estimate. In four of five years, new registered cases were below national targets by 11-36%. Of 1,329 cases registered nationally in 2010-2011, 834 received treatment, 120 were pending treatment as of January 2012, and the treatment status of 375 was unknown. The analysis revealed that the national program mainly coordinated donation of nifurtimox and that important obstacles to access include the exclusion of antitrypanosomal medicines from the national formulary (regulation), historical exclusion of CD from the social insurance package (organization), absence of national clinical guidelines (organization), and limited provider awareness (persuasion). Efforts to treat CD in Mexico indicate an increased commitment to addressing this disease. Access to treatment could be advanced by improving the importation process for antitrypanosomal medicines and adding them to the national formulary, increasing education for healthcare providers, and strengthening clinical guidelines. These recommendations have important implications for other countries in the region with similar problems in access to

  19. Atmospheric pressure dielectric barrier discharges for sterilization and surface treatment

    Energy Technology Data Exchange (ETDEWEB)

    Chin, O. H.; Lai, C. K.; Choo, C. Y.; Wong, C. S.; Nor, R. M. [Plasma Technology Research Centre, Physics Department, Faculty of Science, University of Malaya, 50603 Kuala Lumpur (Malaysia); Thong, K. L. [Microbiology Division, Institute of Biological Sciences, Faculty of Science, University of Malaya, 50603 Kuala Lumpur (Malaysia)

    2015-04-24

    Atmospheric pressure non-thermal dielectric barrier discharges can be generated in different configurations for different applications. For sterilization, a parallel-plate electrode configuration with glass dielectric that discharges in air was used. Gram-negative bacteria (Escherichia coli and Salmonella enteritidis) and Gram-positive bacteria (Bacillus cereus) were successfully inactivated using sinusoidal high voltage of ∼15 kVp-p at 8.5 kHz. In the surface treatment, a hemisphere and disc electrode arrangement that allowed a plasma jet to be extruded under controlled nitrogen gas flow (at 9.2 kHz, 20 kVp-p) was applied to enhance the wettability of PET (Mylar) film.

  20. Electronically Induced Redox Barriers for Treatment of Groundwater

    National Research Council Canada - National Science Library

    Sale, Tom; Gilbert, David

    2006-01-01

    ...) and Colorado State University (CSU). The focus is an innovative electrolytic approach for managing redox-sensitive contaminants in groundwater, referred to as electrically induced redox barrier (e-barriers...

  1. Using a nitrogen dielectric barrier discharge for surface treatment

    International Nuclear Information System (INIS)

    Borcia, G; Anderson, C A; Brown, N M D

    2005-01-01

    In this paper, continuing previous work, we report on the installation and the testing of an experimental dielectric barrier discharge (DBD) reactor run in a controlled atmospheric pressure gaseous environment other than air. Here, the effects of a N 2 -DBD treatment on the surface of a test polymer material (UHMW polyethylene) are examined, reported, discussed and compared to results obtained previously following air-DBD treatment. Surface analysis and characterization were performed using x-ray photoelectron spectroscopy, contact angle measurement and scanning electron microscopy before and following the DBD processing described. The discharge parameters used were correlated with the changes in the surface characteristics found following DBD treatments of various durations in a nitrogen atmosphere. The work focuses on the control of the gaseous environment supporting the discharge and on the possibility of overcoming the potentially dominant effect of reactive oxygen-related species, derived from any residual air present. The results obtained underline the very high reactivity of such species in the discharge, but are encouraging in respect of the possibility of the implantation or generation of functional groups other than oxygen-related ones at the surface of interest. The processing conditions concerned simulate 'real' continuous high speed processing, allowing the planning of further experiments, where various gaseous mixtures of the type X + N 2 will be used for controlled surface functionalization

  2. Treatment of Wastewater by Ozone Produced in Dielectric Barrier Discharge

    Directory of Open Access Journals (Sweden)

    Rita Bhatta

    2015-01-01

    Full Text Available There is rapid diminishing of water resources in many countries due to, for example, population growth and constant reduction in fresh water supply. The sewage wastewater, industrial effluents, and municipal wastewater are directly and indiscriminately discharged into rivers and lakes and thus primarily cause water pollution in Nepal. This has increased the water crisis and also causes environmental deterioration. Therefore, the need for the development of an effective, cheap, and environmentally friendly process for the treatment of wastewater before discharging into aquatic environment has emerged. Treatment by ozone produced from dielectric barrier discharge is one of the emerging technologies for such application. The ozonation process is more effective for disinfection and degradation of organic pollutants from water. The current study describes the treatment of wastewater of selected site within Kathmandu. Results on various physicochemical and microbial parameters of the inlet and outlet samples are discussed. Our results showed slight increase in pH, decrease in chemical oxygen demand, and significant increase in dissolved oxygen after ozonation. Importantly, ozonation caused total reduction of fecal coliform.

  3. Barriers to Mental Health Treatment: Results from the WHO World Mental Health (WMH) Surveys

    Science.gov (United States)

    Andrade, L. H.; Alonso, J.; Mneimneh, Z.; Wells, J. E.; Al-Hamzawi, A.; Borges, G.; Bromet, E.; Bruffaerts, R.; de Girolamo, G.; de Graaf, R.; Florescu, S.; Gureje, O.; Hinkov, H. R.; Hu, C.; Huang, Y.; Hwang, I.; Jin, R.; Karam, E. G.; Kovess-Masfety, V.; Levinson, D.; Matschinger, H.; O’Neill, S.; Posada-Villa, J.; Sagar, R.; Sampson, N. A.; Sasu, C.; Stein, D.; Takeshima, T.; Viana, M. C.; Xavier, M.; Kessler, R. C.

    2014-01-01

    Background To examine barriers to initiation and continuation of mental health treatment among individuals with common mental disorders. Methods Data are from the WHO World Mental Health (WMH) Surveys. Representative household samples were interviewed face-to-face in 24 countries. Reasons to initiate and continue treatment were examined in a subsample (n= 63,678) and analyzed at different levels of clinical severity. Results Among those with a DSM-IV disorder in the past twelve months, low perceived need was the most common reason for not initiating treatment and more common among moderate and mild than severe cases. Women and younger people with disorders were more likely to recognize a need for treatment. Desire to handle the problem on one’s own was the most common barrier among respondents with a disorder who perceived a need for treatment (63.8%). Attitudinal barriers were much more important than structural barriers both to initiating and continuing treatment. However, attitudinal barriers dominated for mild-moderate cases and structural barriers for severe cases. Perceived ineffectiveness of treatment was the most commonly reported reason for treatment dropout (39.3%) followed by negative experiences with treatment providers (26.9% of respondents with severe disorders). Conclusions Low perceived need and attitudinal barriers are the major barriers to seeking and staying in treatment among individuals with common mental disorders worldwide. Apart from targeting structural barriers, mainly in countries with poor resources, increasing population mental health literacy is an important endeavor worldwide. PMID:23931656

  4. Reliability and Validity of a Treatment Barriers Scale for Individuals With Alcohol Use Disorder.

    Science.gov (United States)

    Possemato, Kyle; Funderburk, Jennifer; Spinola, Suzanne; Hutchison, Dezarie; Maisto, Stephen A; Lantinga, Larry J; Oslin, David W

    2016-01-01

    Few studies have measured addiction-specific barriers to treatment. A measurement of barriers with psychometric support that has been tested in diverse samples and that assesses multiple components of addiction treatment barriers is needed to inform providers and treatment programs. This paper aims to provide an initial psychometric investigation of a measure of barriers to seeking addictions treatment. Data were collected from 196 Veterans Affairs primary care patients with Alcohol Use Disorder that participated in a randomized clinical trial. A Principal Components Analysis revealed that the 32-item Treatment Barriers Scale (TBS) can be reduced to 14 items, measuring 4 factors: stigma, dislike of the treatment process, alcohol problem identification, and logistical concerns. Acceptable internal consistent reliability (α = .64-.76) and excellent precision of alpha (α = 0.001-0.009) was found for each subscale. Support for the measure's concurrent validity was found, for example, participants who reported more motivation to reduce their drinking perceived significantly fewer barriers to care. Support for the measure's predictive validity was also found, including that more barriers were related to future drinking among all participants and less mental health and addictions treatment visits among participants in one treatment condition. Conclusions/ Importance: Our results provide initial support for the utility of the TBS-14 among primary care patients with Alcohol Use Disorder. Use of the TBS-14 could enable healthcare providers to better understand patient-specific treatment barriers, provide corrective information on treatment misconceptions, and inform individualized treatment plans that increase patient engagement in addiction services.

  5. Utah Youth Suicide Study: Barriers to Mental Health Treatment for Adolescents

    Science.gov (United States)

    Moskos, Michelle A.; Olson, Lenora; Halbern, Sarah R.; Gray, Doug

    2007-01-01

    Forty-nine suicide cases were drawn from an original sample of 151 consecutive youth suicide deaths. We used information from 270 interviews with parents and other survivors to evaluate mental health treatment sought for and by the decedent and barriers to mental health treatment. Participants reported the same primary barriers for the decedent:…

  6. Assessing the in vivo impact of a gel sanitizer on the epidermal "barrier" dynamics

    OpenAIRE

    Henrique Silva; Sara Aguiar Silva; Hugo Ferreira; L. Monteiro Rodrigues

    2015-01-01

    Disease prevention and control depend on hand washing, in particular during epidemic surges (e.g. flu). The use of alcohol-based hand sanitizers is strongly recommended due to its high germicide effectiveness. However, its impact on skin physiology, especially on the barrier function, has not been determined, although most of the formulations include different humectants. This study evaluates the impact of a commercially available formulation on in vivo epidermal barrier dynamics. 13 young ad...

  7. Macroscopic treatment of nuclear dynamics

    International Nuclear Information System (INIS)

    Swiatecki, W.J.

    1984-05-01

    A qualitative classification of nucleus-nucleus reactions into four types is described, a consequence of the existence of up to three milestone configurations that a fusing system may be faced with. These considerations lead to phenomenological formulae for fusion and compound-nucleus cross-sections that may be compared with experiments by the use of rectilinear cross section plots. Examples of more specific model calculations of nuclear reactions employing the Chaotic Regime Dynamics are described. Some misunderstandings regarding the Wall and Wall-and-Window formulae, underlying this type of dynamics, are discussed in the appendix. 23 references

  8. Barriers to Quitting Smoking Among Substance Dependent Patients Predict Smoking Cessation Treatment Outcome.

    Science.gov (United States)

    Martin, Rosemarie A; Cassidy, Rachel N; Murphy, Cara M; Rohsenow, Damaris J

    2016-05-01

    For smokers with substance use disorders (SUD), perceived barriers to quitting smoking include concerns unique to effects on sobriety as well as usual concerns. We expanded our Barriers to Quitting Smoking in Substance Abuse Treatment (BQS-SAT) scale, added importance ratings, validated it, and then used the importance scores to predict smoking treatment response in smokers with substance use disorders (SUD) undergoing smoking treatment in residential treatment programs in two studies (n=184 and 340). Both components (general barriers, weight concerns) were replicated with excellent internal consistency reliability. Construct validity was supported by significant correlations with pretreatment nicotine dependence, smoking variables, smoking self-efficacy, and expected effects of smoking. General barriers significantly predicted 1-month smoking abstinence, frequency and heaviness, and 3-month smoking frequency; weight concerns predicted 1-month smoking frequency. Implications involve addressing barriers with corrective information in smoking treatment for smokers with SUD. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Barriers to Quitting Smoking among Substance Dependent Patients Predict Smoking Cessation Treatment Outcome

    Science.gov (United States)

    Martin, Rosemarie A.; Cassidy, Rachel; Murphy, Cara M.; Rohsenow, Damaris J.

    2016-01-01

    For smokers with substance use disorders (SUD), perceived barriers to quitting smoking include concerns unique to effects on sobriety as well as usual concerns. We expanded our Barriers to Quitting Smoking in Substance Abuse Treatment (BQS-SAT) scale, added importance ratings, validated it, and then used the importance scores to predict smoking treatment response in smokers with substance use disorders (SUD) undergoing smoking treatment in residential treatment programs in two studies (n = 184 and 340). Both components (General Barriers, Weight Concerns) were replicated with excellent internal consistency reliability. Construct validity was supported by significant correlations with pretreatment nicotine dependence, smoking variables, smoking self-efficacy, and expected effects of smoking. General Barriers significantly predicted 1-month smoking abstinence, frequency and heaviness, and 3-month smoking frequency; Weight Concerns predicted 1-month smoking frequency. Implications involve addressing barriers with corrective information in smoking treatment for smokers with SUD. PMID:26979552

  10. Barriers to Quitting Smoking among Substance Dependent Patients Predict Smoking Cessation Treatment Outcome

    OpenAIRE

    Martin, Rosemarie A.; Cassidy, Rachel; Murphy, Cara M.; Rohsenow, Damaris J.

    2016-01-01

    For smokers with substance use disorders (SUD), perceived barriers to quitting smoking include concerns unique to effects on sobriety as well as usual concerns. We expanded our Barriers to Quitting Smoking in Substance Abuse Treatment (BQS-SAT) scale, added importance ratings, validated it, and then used the importance scores to predict smoking treatment response in smokers with substance use disorders (SUD) undergoing smoking treatment in residential treatment programs in two studies (n = 18...

  11. Comparison of Langevin dynamics and direct energy barrier computation

    International Nuclear Information System (INIS)

    Dittrich, Rok; Schrefl, Thomas; Thiaville, Andre; Miltat, Jacques; Tsiantos, Vassilios; Fidler, Josef

    2004-01-01

    Two complementary methods to study thermal effects in micromagnetics are compared. On short time scales Langevin dynamics gives insight in the thermally activated dynamics. For longer time scales the 'nudged elastic band' method is applied. The method calculates a highly probable thermal switching path between two local energy minima of a micromagnetic system. Comparing the predicted thermal transition rates between ground states in small softmagnetic elements up to a size of 90x90x4.5 nm 3 gives good agreement of the methods

  12. Dynamics of dielectric barrier discharges in coplanar arrangements

    International Nuclear Information System (INIS)

    Gibalov, Valentin I; Pietsch, Gerhard J

    2004-01-01

    The development of a discharge channel in coplanar dielectric barrier arrangements is investigated numerically. Its behaviour in oxygen, like the spatial and temporal distributions of the field strength, charged and neutral particles and energy density, is described in detail. It is found that the streamer development is mainly determined by photoemission. A cathode layer appears near the position where the cathode directed streamer touches the dielectric surface. Secondary electron emission by ion collisions becomes significant and the parameters of the cathode layer are near those of a normal glow discharge. The charge transfer and energy release happen in the conductive channel of the discharge, which appears on the dielectric surface as a result of the cathode streamer development. The field strength in the conductive channel is nearly constant and about 70-100 Td in oxygen and air

  13. Dynamics of Multi-kinks in the Presence of Wells and Barriers

    International Nuclear Information System (INIS)

    Goatham, S.W.; Mannering, L.E.; Hann, R.; Krusch, S.

    2011-01-01

    Sine-Gordon kinks are non-dispersive solutions in a much studied integrable system. Recent studies on sine-Gordon kinks with space-dependent square-well-type potentials have revealed interesting dynamics of a single kink interacting with wells and barriers. In this paper, we study a class of smooth space-dependent potentials and discuss the dynamics of one kink in the presence of different wells. We also present values for the critical velocity for different types of barriers. Furthermore, we study two kinks interacting with various wells and describe interesting trajectories such as double-trapping, kink knock-out and double-escape. (authors)

  14. Effects of air dielectric barrier discharge plasma treatment time on surface properties of PBO fiber

    International Nuclear Information System (INIS)

    Wang Qian; Chen Ping; Jia Caixia; Chen, Mingxin; Li Bin

    2011-01-01

    In this paper, the effects of air dielectric barrier discharge (DBD) plasma treatment time on surface properties of poly(p-phenylene benzobisoxazole) (PBO) fiber were investigated. The surface characteristics of PBO fiber before and after the plasma treatments were analyzed by dynamic contact angle (DCA) analysis, scanning electron microscopy (SEM), atomic force microscopy (AFM) and X-ray photoelectron spectroscopy (XPS). DCA measurements indicated that the surface wettability of PBO fiber was improved significantly by increasing the fiber surface free energy via air DBD plasma treatments. The results were confirmed by the improvement of adhesion of a kind of thermoplastic resin to PBO fiber which was observed by SEM, showing that more resin was adhering evenly to the fiber surface. AFM measurement revealed that the surface topography of PBO fiber became more complicated and the surface roughness was greatly enhanced after the plasma treatments, and XPS analysis showed that some new polar groups (e.g. -O-C=O) were introduced on plasma treated PBO fiber surface. The results of this study also showed that the surface properties of PBO fiber changed with the elongation of plasma treatment time.

  15. Barriers to mental health treatment for military wives.

    Science.gov (United States)

    Lewy, Colleen S; Oliver, Celina M; McFarland, Bentson H

    2014-09-01

    An Internet-based survey sought information about barriers to mental health services for military wives. On the basis of qualitative work, an Internet-based program was created to identify military wives who may have major depressive disorder. Women (N=569, ages 18 to 56) were recruited from 45 states and eight foreign countries. Most participants (78%) reported mild to severe depression. Many (44%) reported unaddressed mental health needs. Barriers included inability to attend daytime appointments (38%), inability to find a counselor who understands the needs of military spouses (35%), inability to find a counselor the participant could trust (29%), concerns about confidentiality (26%), and lack of knowledge about where to get services (25%). The barriers reported differed markedly from those described by distressed women in the general population. Military wives are an underserved population. Knowledge of military culture is essential for civilian mental health providers working with military wives.

  16. Surface treatment of aramid fiber by air dielectric barrier discharge plasma at atmospheric pressure

    International Nuclear Information System (INIS)

    Jia Caixia; Chen Ping; Liu Wei; Li Bin; Wang Qian

    2011-01-01

    Aramid fiber samples are treated by air dielectric barrier discharge (DBD) plasma at atmospheric pressure; the plasma treatment time is investigated as the major parameter. The effects of this treatment on the fiber surface physical and chemical properties are studied by using surface characterization techniques. Scanning electron microscopy (SEM) is performed to determine the surface morphology changes, X-ray photoelectron spectroscopy (XPS) is analyzed to reveal the surface chemical composition variations and dynamic contact angle analysis (DCAA) is used to examine the changes of the fiber surface wettability. In addition, the wetting behavior of a kind of thermoplastic resin, poly(phthalazinone ether sulfone ketone) (PPESK), on aramid fiber surface is also observed by SEM photos. The study shows that there seems to be an optimum treatment condition for surface modification of aramid fiber by the air DBD plasma. In this paper, after the 12 s, 27.6 W/cm 3 plasma treatment the aramid fiber surface roughness is significantly improved, some new oxygen-containing groups such as C-O, C=O and O=C-O are generated on the fiber surface and the fiber surface wettability is greatly enhanced, which results in the better wetting behavior of PPESK resin on the plasma-treated aramid fiber.

  17. Barriers to obstetric fistula treatment in low-income countries: a systematic review.

    Science.gov (United States)

    Baker, Zoë; Bellows, Ben; Bach, Rachel; Warren, Charlotte

    2017-08-01

    To identify the barriers faced by women living with obstetric fistula in low-income countries that prevent them from seeking care, reaching medical centres and receiving appropriate care. Bibliographic databases, grey literature, journals, and network and organisation websites were searched in English and French from June to July 2014 and again from August to November 2016 using key search terms and specific inclusion and exclusion criteria for discussion of barriers to fistula treatment. Experts provided recommendations for additional sources. Of 5829 articles screened, 139 were included in the review. Nine groups of barriers to treatment were identified: psychosocial, cultural, awareness, social, financial, transportation, facility shortages, quality of care and political leadership. Interventions to address barriers primarily focused on awareness, facility shortages, transportation, financial and social barriers. At present, outcome data, though promising, are sparse and the success of interventions in providing long-term alleviation of barriers is unclear. Results from the review indicate that there are many barriers to fistula treatment, which operate at the individual, community and national levels. The successful treatment of obstetric fistula may thus require targeting several barriers, including depression, stigma and shame, lack of community-based referral mechanisms, financial cost of the procedure, transportation difficulties, gender power imbalances, the availability of facilities that offer fistula repair, community reintegration and the competing priorities of political leadership. © 2017 John Wiley & Sons Ltd.

  18. Perceived barriers to quitting smoking among alcohol dependent patients in treatment.

    Science.gov (United States)

    Asher, Marilyn K; Martin, Rosemarie A; Rohsenow, Damaris J; MacKinnon, Selene Varney; Traficante, Regina; Monti, Peter M

    2003-03-01

    Little is known about the perceived barriers to quitting smoking among alcohol abusers. In addition to the usual barriers perceived by smokers, alcohol dependent smokers may have a few barriers unique to their addictive lifestyle. The Barriers to Quitting Smoking in Substance Abuse Treatment (BQS-SAT) was administered to 96 alcohol dependent smokers in residential substance abuse treatment. The BQS-SAT is designed to assess perceived barriers to quitting smoking among alcohol abusers using eleven true-false items. One open-ended item was included to gather information about potential additional barriers. The majority of respondents reported withdrawal-related barriers such as expecting to feel irritable, anxious, restless, and about half expected intolerable urges to smoke if they were to quit smoking, as most smokers do. However, concerns about effects on sobriety and needing cigarettes to cope with feeling down were also endorsed by almost half of the patients. Total number of perceived barriers was significantly related to smoking history, expected effects from smoking, and smoking temptation but was not associated with severity of alcohol use or dependence on admission. Providing corrective feedback about these barriers could be useful when addressing smoking with patients who have alcohol abuse or dependence.

  19. Dynamical barrier for the formation of solitary waves in discrete lattices

    International Nuclear Information System (INIS)

    Kevrekidis, P.G.; Espinola-Rocha, J.A.; Drossinos, Y.; Stefanov, A.

    2008-01-01

    We consider the problem of the existence of a dynamical barrier of 'mass' that needs to be excited on a lattice site to lead to the formation and subsequent persistence of localized modes for a nonlinear Schroedinger lattice. We contrast the existence of a dynamical barrier with its absence in the static theory of localized modes in one spatial dimension. We suggest an energetic criterion that provides a sufficient, but not necessary, condition on the amplitude of a single-site initial condition required to form a solitary wave. We show that this effect is not one-dimensional by considering its two-dimensional analog. The existence of a sufficient condition for the excitation of localized modes in the non-integrable, discrete, nonlinear Schroedinger equation is compared to the dynamics of excitations in the integrable, both discrete and continuum, version of the nonlinear Schroedinger equation

  20. Dynamical barrier for the formation of solitary waves in discrete lattices

    Energy Technology Data Exchange (ETDEWEB)

    Kevrekidis, P.G. [Department of Mathematics and Statistics, University of Massachusetts, Amherst, MA 01003 (United States)], E-mail: kevrekid@math.umass.edu; Espinola-Rocha, J.A. [Department of Mathematics and Statistics, University of Massachusetts, Amherst, MA 01003 (United States); Drossinos, Y. [European Commission, Joint Research Centre, I-21020 Ispra (Vatican City State, Holy See,) (Italy); School of Mechanical and Systems Engineering, University of Newcastle upon Tyne, Newcastle upon Tyne NE1 7RU (United Kingdom); Stefanov, A. [Department of Mathematics, University of Kansas, 1460 Jayhawk Blvd., Lawrence, KS 66045-7523 (United States)

    2008-03-24

    We consider the problem of the existence of a dynamical barrier of 'mass' that needs to be excited on a lattice site to lead to the formation and subsequent persistence of localized modes for a nonlinear Schroedinger lattice. We contrast the existence of a dynamical barrier with its absence in the static theory of localized modes in one spatial dimension. We suggest an energetic criterion that provides a sufficient, but not necessary, condition on the amplitude of a single-site initial condition required to form a solitary wave. We show that this effect is not one-dimensional by considering its two-dimensional analog. The existence of a sufficient condition for the excitation of localized modes in the non-integrable, discrete, nonlinear Schroedinger equation is compared to the dynamics of excitations in the integrable, both discrete and continuum, version of the nonlinear Schroedinger equation.

  1. Role of Reynolds stress and toroidal momentum transport in the dynamics of internal transport barriers

    International Nuclear Information System (INIS)

    Kim, S. S.; Jhang, Hogun; Diamond, P. H.

    2012-01-01

    We study the interplay between intrinsic rotation and internal transport barrier (ITB) dynamics through the dynamic change of the parallel Reynolds stress. Global flux-driven gyrofluid simulations are used for this study. In particular, we investigate the role of parallel velocity gradient instability (PVGI) in the ITB formation and the back transition. It is found that the excitation of PVGI is followed by a change in the Reynolds stress which drives a momentum redistribution. This significantly influences E×B shear evolution and subsequent ITB dynamics. Nonlocal interactions among fluctuations are also observed during the PVGI excitation, resulting in turbulence suppression at the ITB.

  2. Facilitators and barriers in treatment seeking for cannabis dependence

    NARCIS (Netherlands)

    van der Pol, P.; Liebregts, N.; de Graaf, R.; Korf, D.J.; van den Brink, W.; van Laar, M.

    2013-01-01

    Background Relatively few cannabis dependent people seek treatment and little is known about determinants of treatment seeking. Methods Treatment determinants were compared among 70 DSM-IV cannabis dependent patients and 241 non-treatment seeking DSM-IV cannabis dependent community subjects. In

  3. Facilitators and barriers in treatment seeking for cannabis dependence

    NARCIS (Netherlands)

    van der Pol, Peggy; Liebregts, Nienke; de Graaf, Ron; Korf, Dirk J.; van den Brink, Wim; van Laar, Margriet

    2013-01-01

    Relatively few cannabis dependent people seek treatment and little is known about determinants of treatment seeking. Treatment determinants were compared among 70 DSM-IV cannabis dependent patients and 241 non-treatment seeking DSM-IV cannabis dependent community subjects. In addition, perceived

  4. Optimal design of wind barriers using 3D computational fluid dynamics simulations

    Science.gov (United States)

    Fang, H.; Wu, X.; Yang, X.

    2017-12-01

    Desertification is a significant global environmental and ecological problem that requires human-regulated control and management. Wind barriers are commonly used to reduce wind velocity or trap drifting sand in arid or semi-arid areas. Therefore, optimal design of wind barriers becomes critical in Aeolian engineering. In the current study, we perform 3D computational fluid dynamics (CFD) simulations for flow passing through wind barriers with different structural parameters. To validate the simulation results, we first inter-compare the simulated flow field results with those from both wind-tunnel experiments and field measurements. Quantitative analyses of the shelter effect are then conducted based on a series of simulations with different structural parameters (such as wind barrier porosity, row numbers, inter-row spacing and belt schemes). The results show that wind barriers with porosity of 0.35 could provide the longest shelter distance (i.e., where the wind velocity reduction is more than 50%) thus are recommended in engineering designs. To determine the optimal row number and belt scheme, we introduce a cost function that takes both wind-velocity reduction effects and economical expense into account. The calculated cost function show that a 3-row-belt scheme with inter-row spacing of 6h (h as the height of wind barriers) and inter-belt spacing of 12h is the most effective.

  5. Atomic oxygen dynamics in an air dielectric barrier discharge: a combined diagnostic and modeling approach

    Science.gov (United States)

    Baldus, Sabrina; Schröder, Daniel; Bibinov, Nikita; Schulz-von der Gathen, Volker; Awakowicz, Peter

    2015-06-01

    Cold atmospheric pressure plasmas are a promising alternative therapy for treatment of chronic wounds, as they have already shown in clinical trials. In this study an air dielectric barrier discharge (DBD) developed for therapeutic use in dermatology is characterized with respect to the plasma produced reactive oxygen species, namely atomic oxygen and ozone, which are known to be of great importance to wound healing. To understand the plasma chemistry of the applied DBD, xenon-calibrated two-photon laser-induced fluorescence spectroscopy and optical absorption spectroscopy are applied. The measured spatial distributions are shown and compared to each other. A model of the afterglow chemistry based on optical emission spectroscopy is developed to cross-check the measurement results and obtain insight into the dynamics of the considered reactive oxygen species. The atomic oxygen density is found to be located mostly between the electrodes with a maximum density of {{n}\\text{O}}=6× {{10}16} cm-3 . Time resolved measurements reveal a constant atomic oxygen density between two high voltage pulses. The ozone is measured up to 3 mm outside the active plasma volume, reaching a maximum value of {{n}{{\\text{O}3}}}=3× {{10}16} cm-3 between the electrodes.

  6. Learning from social media: utilizing advanced data extraction techniques to understand barriers to breast cancer treatment.

    Science.gov (United States)

    Freedman, Rachel A; Viswanath, Kasisomayajula; Vaz-Luis, Ines; Keating, Nancy L

    2016-07-01

    Past examinations of breast cancer treatment barriers have typically included registry, claims-based, and smaller survey studies. We examined treatment barriers using a novel, comprehensive, social media analysis of online, candid discussions about breast cancer. Using an innovative toolset to search postings on social networks, message boards, patient communities, and topical sites, we performed a large-scale qualitative analysis. We examined the sentiments and barriers expressed about breast cancer treatments by Internet users during 1 year (2/1/14-1/31/15). We categorized posts based on thematic patterns and examined trends in discussions by race/ethnicity (white/black/Hispanic) when this information was available. We identified 1,024,041 unique posts related to breast cancer treatment. Overall, 57 % of posts expressed negative sentiments. Using machine learning software, we assigned treatment barriers for 387,238 posts (38 %). Barriers included emotional (23 % of posts), preferences and spiritual/religious beliefs (21 %), physical (18 %), resource (15 %), healthcare perceptions (9 %), treatment processes/duration (7 %), and relationships (7 %). Black and Hispanic (vs. white) users more frequently reported barriers related to healthcare perceptions, beliefs, and pre-diagnosis/diagnosis organizational challenges and fewer emotional barriers. Using a novel analysis of diverse social media users, we observed numerous breast cancer treatment barriers that differed by race/ethnicity. Social media is a powerful tool, allowing use of real-world data for qualitative research, capitalizing on the rich discussions occurring spontaneously online. Future research should focus on how to further employ and learn from this type of social intelligence research across all medical disciplines.

  7. Sexual orientation, treatment utilization, and barriers for alcohol related problems: Findings from a nationally representative sample.

    Science.gov (United States)

    Allen, Junior Lloyd; Mowbray, Orion

    2016-04-01

    Gay, lesbian, and bisexual (GLB) individuals appear to have an increased likelihood of alcohol use disorders and treatment utilization for alcohol related problems compared to heterosexual individuals. Despite this increase, treatment utilization rates among GLB individuals remain low. In an effort to address this, our paper examined whether or not GLB individuals encounter unique barriers when pursuing treatment for alcohol related problems. Using data from the National Epidemiologic Survey on Alcohol Related Conditions (NESARC), we examined service sector specific factors, some of which included (a) utilization rates, (b) self-reported treatment barriers, and (c) whether or not there were emergent differences among GLB individuals, after controlling for socio-demographic and clinical characteristics. Findings indicated that GLB individuals reported higher severity rates for alcohol use disorders when compared to heterosexual individuals, and were significantly more likely to utilize treatment services for alcohol related problems, however, not across all treatment sectors. While similar patterns were observed when examining barriers to treatment, bisexual individuals reported significantly more barriers than heterosexual and gay/lesbian individuals. These findings underscored the importance of identifying and developing interventions that addresses treatment barriers associated with alcohol use service utilization among GLB populations, and creating improved outreach and education programs to better address stigmas associated with substance use and sexuality. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  8. Understanding the free energy barrier and multiple timescale dynamics of charge separation in organic photovoltaic cells.

    Science.gov (United States)

    Yan, Yaming; Song, Linze; Shi, Qiang

    2018-02-28

    By employing several lattice model systems, we investigate the free energy barrier and real-time dynamics of charge separation in organic photovoltaic (OPV) cells. It is found that the combined effects of the external electric field, entropy, and charge delocalization reduce the free energy barrier significantly. The dynamic disorder reduces charge carrier delocalization and results in the increased charge separation barrier, while the effect of static disorder is more complicated. Simulation of the real-time dynamics indicates that the free charge generation process involves multiple time scales, including an ultrafast component within hundreds of femtoseconds, an intermediate component related to the relaxation of the hot charge transfer (CT) state, and a slow component on the time scale of tens of picoseconds from the thermally equilibrated CT state. Effects of hot exciton dissociation as well as its dependence on the energy offset between the Frenkel exciton and the CT state are also analyzed. The current results indicate that only a small energy offset between the band gap and the lowest energy CT state is needed to achieve efficient free charge generation in OPV devices, which agrees with recent experimental findings.

  9. Understanding the free energy barrier and multiple timescale dynamics of charge separation in organic photovoltaic cells

    Science.gov (United States)

    Yan, Yaming; Song, Linze; Shi, Qiang

    2018-02-01

    By employing several lattice model systems, we investigate the free energy barrier and real-time dynamics of charge separation in organic photovoltaic (OPV) cells. It is found that the combined effects of the external electric field, entropy, and charge delocalization reduce the free energy barrier significantly. The dynamic disorder reduces charge carrier delocalization and results in the increased charge separation barrier, while the effect of static disorder is more complicated. Simulation of the real-time dynamics indicates that the free charge generation process involves multiple time scales, including an ultrafast component within hundreds of femtoseconds, an intermediate component related to the relaxation of the hot charge transfer (CT) state, and a slow component on the time scale of tens of picoseconds from the thermally equilibrated CT state. Effects of hot exciton dissociation as well as its dependence on the energy offset between the Frenkel exciton and the CT state are also analyzed. The current results indicate that only a small energy offset between the band gap and the lowest energy CT state is needed to achieve efficient free charge generation in OPV devices, which agrees with recent experimental findings.

  10. Assessing the in vivo impact of a gel sanitizer on the epidermal "barrier" dynamics

    Directory of Open Access Journals (Sweden)

    Henrique Silva

    2015-03-01

    Full Text Available Disease prevention and control depend on hand washing, in particular during epidemic surges (e.g. flu. The use of alcohol-based hand sanitizers is strongly recommended due to its high germicide effectiveness. However, its impact on skin physiology, especially on the barrier function, has not been determined, although most of the formulations include different humectants. This study evaluates the impact of a commercially available formulation on in vivo epidermal barrier dynamics. 13 young adult subjects (21.6 ± 2.6 years old were selected after informed consent. Subjects were asked to apply a commercially available alcohol gel sanitizer to one hand for 15 days. TEWL absolute values were measured on days 1, 8 and 15 and a plastic occlusion stress test (POST applied. Evaporation half-life (t1/2 evap and dynamic water mass (DWM values increased significantly on day 15 on the treated hand compared to the control hand suggesting that, in the present experimental conditions, the regular use of an alcohol-based gel sanitizer does changes the epidermal barrier. This study also confirms the usefulness of this kinetic model to detect subtle changes on in vivo TEWL dynamics.

  11. Under-the-barrier dynamics in laser-induced relativistic tunneling.

    Science.gov (United States)

    Klaiber, Michael; Yakaboylu, Enderalp; Bauke, Heiko; Hatsagortsyan, Karen Z; Keitel, Christoph H

    2013-04-12

    The tunneling dynamics in relativistic strong-field ionization is investigated with the aim to develop an intuitive picture for the relativistic tunneling regime. We demonstrate that the tunneling picture applies also in the relativistic regime by introducing position dependent energy levels. The quantum dynamics in the classically forbidden region features two time scales, the typical time that characterizes the probability density's decay of the ionizing electron under the barrier (Keldysh time) and the time interval which the electron spends inside the barrier (Eisenbud-Wigner-Smith tunneling time). In the relativistic regime, an electron momentum shift as well as a spatial shift along the laser propagation direction arise during the under-the-barrier motion which are caused by the laser magnetic field induced Lorentz force. The momentum shift is proportional to the Keldysh time, while the wave-packet's spatial drift is proportional to the Eisenbud-Wigner-Smith time. The signature of the momentum shift is shown to be present in the ionization spectrum at the detector and, therefore, observable experimentally. In contrast, the signature of the Eisenbud-Wigner-Smith time delay disappears at far distances for pure quasistatic tunneling dynamics.

  12. Valuing the subsurface pathogen treatment barrier in water recycling via aquifers for drinking supplies

    CSIR Research Space (South Africa)

    Page, D

    2010-03-01

    Full Text Available , using the same risk-based approach that is used for public water supplies. For each of the sites, the aquifer treatment barrier was assessed for its log10 removal capacity much like for other water treatment technologies. This information...

  13. Treatment gap and barriers for mental health care: A cross-sectional community survey in Nepal.

    Directory of Open Access Journals (Sweden)

    Nagendra P Luitel

    Full Text Available There is limited research on the gap between the burden of mental disorders and treatment use in low- and middle-income countries.The aim of this study was to assess the treatment gap among adults with depressive disorder (DD and alcohol use disorder (AUD and to examine possible barriers to initiation and continuation of mental health treatment in Nepal.A three-stage sampling technique was used in the study to select 1,983 adults from 10 Village Development Committees (VDCs of Chitwan district. Presence of DD and AUD were identified with validated versions of the Patient Health Questionnaire (PHQ-9 and Alcohol Use Disorder Identification Test (AUDIT. Barriers to care were assessed with the Barriers to Access to Care Evaluation (BACE.In this sample, 11.2% (N = 228 and 5.0% (N = 96 screened positive for DD and AUD respectively. Among those scoring above clinical cut-off thresholds, few had received treatment from any providers; 8.1% for DD and 5.1% for AUD in the past 12 months, and only 1.8% (DD and 1.3% (AUD sought treatment from primary health care facilities. The major reported barriers to treatment were lacking financial means to afford care, fear of being perceived as "weak" for having mental health problems, fear of being perceived as "crazy" and being too unwell to ask for help. Barriers to care did not differ based on demographic characteristics such as age, sex, marital status, education, or caste/ethnicity.With more than 90% of the respondents with DD or AUD not participating in treatment, it is crucial to identify avenues to promote help seeking and uptake of treatment. Given that demographic characteristics did not influence barriers to care, it may be possible to pursue general population-wide approaches to promoting service use.

  14. Direct Visualization of Barrier Crossing Dynamics in a Driven Optical Matter System.

    Science.gov (United States)

    Figliozzi, Patrick; Peterson, Curtis W; Rice, Stuart A; Scherer, Norbert F

    2018-04-25

    A major impediment to a more complete understanding of barrier crossing and other single-molecule processes is the inability to directly visualize the trajectories and dynamics of atoms and molecules in reactions. Rather, the kinetics are inferred from ensemble measurements or the position of a transducer ( e. g., an AFM cantilever) as a surrogate variable. Direct visualization is highly desirable. Here, we achieve the direct measurement of barrier crossing trajectories by using optical microscopy to observe position and orientation changes of pairs of Ag nanoparticles, i. e. passing events, in an optical ring trap. A two-step mechanism similar to a bimolecular exchange reaction or the Michaelis-Menten scheme is revealed by analysis that combines detailed knowledge of each trajectory, a statistically significant number of repetitions of the passing events, and the driving force dependence of the process. We find that while the total event rate increases with driving force, this increase is due to an increase in the rate of encounters. There is no drive force dependence on the rate of barrier crossing because the key motion for the process involves a random (thermal) radial fluctuation of one particle allowing the other to pass. This simple experiment can readily be extended to study more complex barrier crossing processes by replacing the spherical metal nanoparticles with anisotropic ones or by creating more intricate optical trapping potentials.

  15. Activated barrier crossing dynamics in the non-radiative decay of NADH and NADPH

    Energy Technology Data Exchange (ETDEWEB)

    Blacker, Thomas S., E-mail: t.blacker@ucl.ac.uk [Centre for Mathematics and Physics in the Life Sciences and Experimental Biology (CoMPLEX), University College London, London WC1E 6BT (United Kingdom); Department of Physics and Astronomy, University College London, London WC1E 6BT (United Kingdom); Research Department of Cell and Developmental Biology, University College London, London WC1E 6BT (United Kingdom); Marsh, Richard J., E-mail: richard.marsh@ucl.ac.uk [Department of Physics and Astronomy, University College London, London WC1E 6BT (United Kingdom); Duchen, Michael R., E-mail: m.duchen@ucl.ac.uk [Research Department of Cell and Developmental Biology, University College London, London WC1E 6BT (United Kingdom); Bain, Angus J., E-mail: a.bain@ucl.ac.uk [Centre for Mathematics and Physics in the Life Sciences and Experimental Biology (CoMPLEX), University College London, London WC1E 6BT (United Kingdom); Department of Physics and Astronomy, University College London, London WC1E 6BT (United Kingdom)

    2013-08-30

    Highlights: ► NADH and NADPH have a high rate of non-radiative excited state decay. ► Conformational relaxation is shown to be a significant non-radiative pathway. ► The Kramers equation describes the barrier crossing dynamics of the relaxation. ► Conformational restriction upon enzyme binding will alter NAD(P)H lifetimes. - Abstract: In live tissue, alterations in metabolism induce changes in the fluorescence decay of the biological coenzyme NAD(P)H, the mechanism of which is not well understood. In this work, the fluorescence and anisotropy decay dynamics of NADH and NADPH were investigated as a function of viscosity in a range of water–glycerol solutions. The viscosity dependence of the non-radiative decay is well described by Kramers and Kramers–Hubbard models of activated barrier crossing over a wide viscosity range. Our combined lifetime and anisotropy analysis indicates common mechanisms of non-radiative relaxation in the two emitting states (conformations) of both molecules. The low frequencies associated with barrier crossing suggest that non-radiative decay is mediated by small scale motion (e.g. puckering) of the nicotinamide ring. Variations in the fluorescence lifetimes of NADH and NADPH when bound to different enzymes may therefore be attributed to differing levels of conformational restriction upon binding.

  16. A Multiple Indicators Multiple Causes (MIMIC) model of internal barriers to drug treatment in China.

    Science.gov (United States)

    Qi, Chang; Kelly, Brian C; Liao, Yanhui; He, Haoyu; Luo, Tao; Deng, Huiqiong; Liu, Tieqiao; Hao, Wei; Wang, Jichuan

    2015-03-01

    Although evidence exists for distinct barriers to drug abuse treatment (BDATs), investigations of their inter-relationships and the effect of individual characteristics on the barrier factors have been sparse, especially in China. A Multiple Indicators Multiple Causes (MIMIC) model is applied for this target. A sample of 262 drug users were recruited from three drug rehabilitation centers in Hunan Province, China. We applied a MIMIC approach to investigate the effect of gender, age, marital status, education, primary substance use, duration of primary drug use, and drug treatment experience on the internal barrier factors: absence of problem (AP), negative social support (NSS), fear of treatment (FT), and privacy concerns (PC). Drug users of various characteristics were found to report different internal barrier factors. Younger participants were more likely to report NSS (-0.19, p=0.038) and PC (-0.31, p<0.001). Compared to other drug users, ice users were more likely to report AP (0.44, p<0.001) and NSS (0.25, p=0.010). Drug treatment experiences related to AP (0.20, p=0.012). In addition, differential item functioning (DIF) occurred in three items when participant from groups with different duration of drug use, ice use, or marital status. Individual characteristics had significant effects on internal barriers to drug treatment. On this basis, BDAT perceived by different individuals could be assessed before tactics were utilized to successfully remove perceived barriers to drug treatment. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  17. Hydraulic performance of permeable barriers for in situ treatment of contaminated groundwater

    International Nuclear Information System (INIS)

    Smyth, D.J.A.; Shikaze, S.G.; Cherry, J.A.

    1997-01-01

    The passive interception and in situ treatment of dissolved contaminants in groundwater by permeable reactive barriers has recently gained favor at an increasing number of sites as an alternative to conventional approaches to groundwater remediation such as the pump-and-treat method. Permeable reactive barriers have two essential functions. The first is that the barriers must be installed in a position such that all of the plume passes through the reactive system. The second function is to achieve acceptable treatment of the contamination by physical, chemical or biological means within or downgradient of the barrier. In this paper, issues associated with the hydraulic performance of permeable reaction barriers are evaluated using a three-dimensional groundwater flow model. The efficiency of plume capture by permeable wall and funnel-and-gate systems is examined for some generic and for site-specific hydrogeologic systems. The results have important implications to decisions pertaining to the selection, design and installation of permeable reactive barrier systems

  18. Spontaneous harm reduction: a barrier for substance-dependent individuals seeking treatment?

    Directory of Open Access Journals (Sweden)

    Fontanella Bruno José Barcellos

    2005-01-01

    Full Text Available OBJETIVE: Greater information regarding motivations and treatment barriers faced by substance-dependent individuals has clinical and public health implications. This study aimed to formulate hypotheses regarding psychological, social and family variables that can be constructed as motivations or subjective barriers for the early seeking of formal treatment. METHODS: A qualitative study was conducted in an intentional sample (selected through saturation and variety of types of 13 substance-dependent individuals who sought treatment. In-depth, semi-structured interviews were conducted using open questions, and the transcribed data were subjected to qualitative analysis. RESULTS: Four types of spontaneous harm reduction measures were identified, according to the subjective logic of each participant: having some periods at rest (not using and recovering from adverse effects; caretaking by close acquaintances (relatives, partners, drug dealers and alcoholic beverage sellers; selectivity regarding substance source, type and means of administration; establishing "healthy" limits of ingestion. CONCLUSIONS: The measures identified might represent barriers to the early seeking of treatment but might also represent spontaneous learning of abilities beneficial to future treatment. Health care professionals should take into consideration their existence and should address them in clinical settings. Issues representative of the formulated categories should be presented in structured questionnaires used in future quantitative studies of barriers to treatment in this population.

  19. Spontaneous harm reduction: a barrier for substance-dependent individuals seeking treatment?

    Directory of Open Access Journals (Sweden)

    Bruno José Barcellos Fontanella

    2005-12-01

    Full Text Available OBJETIVE: Greater information regarding motivations and treatment barriers faced by substance-dependent individuals has clinical and public health implications. This study aimed to formulate hypotheses regarding psychological, social and family variables that can be constructed as motivations or subjective barriers for the early seeking of formal treatment. METHODS: A qualitative study was conducted in an intentional sample (selected through saturation and variety of types of 13 substance-dependent individuals who sought treatment. In-depth, semi-structured interviews were conducted using open questions, and the transcribed data were subjected to qualitative analysis. RESULTS: Four types of spontaneous harm reduction measures were identified, according to the subjective logic of each participant: having some periods at rest (not using and recovering from adverse effects; caretaking by close acquaintances (relatives, partners, drug dealers and alcoholic beverage sellers; selectivity regarding substance source, type and means of administration; establishing "healthy" limits of ingestion. CONCLUSIONS: The measures identified might represent barriers to the early seeking of treatment but might also represent spontaneous learning of abilities beneficial to future treatment. Health care professionals should take into consideration their existence and should address them in clinical settings. Issues representative of the formulated categories should be presented in structured questionnaires used in future quantitative studies of barriers to treatment in this population.

  20. Electron dynamics and plasma jet formation in a helium atmospheric pressure dielectric barrier discharge jet

    Energy Technology Data Exchange (ETDEWEB)

    Algwari, Q. Th. [Centre for Plasma Physics, School of Maths and Physics, Queen' s University Belfast, University Road, Belfast, Northern Ireland BT7 1NN (United Kingdom); Electronic Department, College of Electronics Engineering, Mosul University, Mosul 41002 (Iraq); O' Connell, D. [Centre for Plasma Physics, School of Maths and Physics, Queen' s University Belfast, University Road, Belfast, Northern Ireland BT7 1NN (United Kingdom); York Plasma Institute, Department of Physics, University of York, York YO10 5DD (United Kingdom)

    2011-09-19

    The excitation dynamics within the main plasma production region and the plasma jets of a kHz atmospheric pressure dielectric barrier discharge (DBD) jet operated in helium was investigated. Within the dielectric tube, the plasma ignites as a streamer-type discharge. Plasma jets are emitted from both the powered and grounded electrode end; their dynamics are compared and contrasted. Ignition of these jets are quite different; the jet emitted from the powered electrode is ignited with a slight time delay to plasma ignition inside the dielectric tube, while breakdown of the jet at the grounded electrode end is from charging of the dielectric and is therefore dependent on plasma production and transport within the dielectric tube. Present streamer theories can explain these dynamics.

  1. System dynamics in complex psychiatric treatment organizations.

    Science.gov (United States)

    Rosenheck, R

    1988-05-01

    One of the major challenges facing contemporary psychiatry is the coordination of diverse services through organizational integration. With increasing frequency, psychiatric treatment takes place in complex treatment systems composed of multiple inpatient and outpatient programs. Particularly in public health care systems serving the chronically ill, contemporary practice demands a broad spectrum of programs, often geographically dispersed, that include crisis intervention teams, day treatment programs, substance abuse units, social rehabilitation programs and halfway houses (Bachrach 1983; Turner and TenHoor 1978). Individualized treatment planning often requires that a particular patient participate in two or more specialized programs either simultaneously or in a specified sequence. As a consequence of this specialization, treatment fragmentation has emerged as a significant clinical problem, and continuity of care has been highlighted as a valuable but elusive ingredient of optimal treatment. This paper will describe the dynamic interactions that result when several such programs are united under a common organizational roof. Using a large VA Psychiatry Service as an example, I will outline the hierarchical structure characteristic of such an organization, as well as the persistent pulls toward both integration and fragmentation that influence its operation.

  2. Barriers to accessing substance abuse treatment in Mexico: national comparative analysis by migration status

    Science.gov (United States)

    2014-01-01

    Background We examined Mexican migrants’ perceived barriers to entering substance abuse treatment and potential differences by gender. Methods This study analyzed a subset of household data collected in Mexico in 2011 via the Encuesta Nacional de Adicciones (National Survey of Addictions). A sample of 1,143 individuals who reported using illicit drugs was analyzed using multivariate negative binomial models to determine direct and moderated relationships of gender, migrant status, and drug dependence with perceived barriers to accessing treatment. Results Significant findings included disparities in drug dependence by migrant status. Compared with non-migrant men, women who have traveled to the United States was associated with fewer (1.3) barriers to access treatment. Fewer barriers to access care were associated with individuals residing in other regions of the country, compared to those living in Mexico City. Conclusions Drug dependence, gender, migration status and regional location are factors associated with access to needed treatment. Implications for health care policy to develop treatment services infrastructure and for future research are discussed in the context of ongoing drug policy reform in Mexico. PMID:25074067

  3. Barriers to Pelvic Floor Physical Therapy Regarding Treatment of High-Tone Pelvic Floor Dysfunction.

    Science.gov (United States)

    Zoorob, Dani; Higgins, Margaret; Swan, Kimberly; Cummings, Jennifer; Dominguez, Sarah; Carey, Erin

    Chronic pelvic pain is a prevalent and debilitating condition with a wide range of etiologies. An estimated 30% to 70% of chronic pelvic cases involve musculoskeletal component pain including high-tone pelvic floor dysfunction (HTPFD). Pelvic floor physical therapy has been shown to be a beneficial treatment for HTPFD, yet many patients do not have access to this treatment. The objective of this study was to identify the barriers preventing patients from following through with the first-line management, physical therapy. Participants with a diagnosis of HTPFD (n = 154) were identified from the list of referrals sent from the obstetrics and gynecology department to an affiliated PFPT center. Participants were contacted and asked to complete a phone survey addressing demographics and perceived barriers to care. Responses were collected in REDCap. Univariate and bivariate analyses were performed using a statistical analysis software. Seventy surveys were completed. The top barriers identified by participants were financial constraints (51.4%), perceived lack of utility (37.1%), time constraints (30.0%), and travel issues (18.6%); 84.4% of participants had 1 or more comorbid pain condition. Whereas 51.4% expressed some level of anxiety regarding the PFPT option, only 9.6% of participants did not start treatment because of fear of treatment. The majority of treatment barriers identified were concrete restraints, with insurance noncoverage and time constraints being the top issues. A fair number of participants expressed anxiety about the treatment or felt they received unclear explanations of the treatment. These are areas in which providers can potentially alleviate some barriers to care.

  4. Computing the blood brain barrier (BBB) diffusion coefficient: A molecular dynamics approach

    Energy Technology Data Exchange (ETDEWEB)

    Shamloo, Amir, E-mail: shamloo@sharif.edu; Pedram, Maysam Z.; Heidari, Hossein; Alasty, Aria, E-mail: aalasti@sharif.edu

    2016-07-15

    Various physical and biological aspects of the Blood Brain Barrier (BBB) structure still remain unfolded. Therefore, among the several mechanisms of drug delivery, only a few have succeeded in breaching this barrier, one of which is the use of Magnetic Nanoparticles (MNPs). However, a quantitative characterization of the BBB permeability is desirable to find an optimal magnetic force-field. In the present study, a molecular model of the BBB is introduced that precisely represents the interactions between MNPs and the membranes of Endothelial Cells (ECs) that form the BBB. Steered Molecular Dynamics (SMD) simulations of the BBB crossing phenomenon have been carried out. Mathematical modeling of the BBB as an input-output system has been considered from a system dynamics modeling viewpoint, enabling us to analyze the BBB behavior based on a robust model. From this model, the force profile required to overcome the barrier has been extracted for a single NP from the SMD simulations at a range of velocities. Using this data a transfer function model has been obtained and the diffusion coefficient is evaluated. This study is a novel approach to bridge the gap between nanoscale models and microscale models of the BBB. The characteristic diffusion coefficient has the nano-scale molecular effects inherent, furthermore reducing the computational costs of a nano-scale simulation model and enabling much more complex studies to be conducted. - Highlights: • Molecular dynamics simulation of crossing nano-particles through the BBB membrane at different velocities. • Recording the position of nano-particle and the membrane-NP interaction force profile. • Identification of a frequency domain model for the membrane. • Calculating the diffusion coefficient based on MD simulation and identified model. • Obtaining a relation between continuum medium and discrete medium.

  5. Human Skin Barrier Structure and Function Analyzed by Cryo-EM and Molecular Dynamics Simulation.

    Science.gov (United States)

    Lundborg, Magnus; Narangifard, Ali; Wennberg, Christian L; Lindahl, Erik; Daneholt, Bertil; Norlén, Lars

    2018-04-24

    In the present study we have analyzed the molecular structure and function of the human skin's permeability barrier using molecular dynamics simulation validated against cryo-electron microscopy data from near native skin. The skin's barrier capacity is located to an intercellular lipid structure embedding the cells of the superficial most layer of skin - the stratum corneum. According to the splayed bilayer model (Iwai et al., 2012) the lipid structure is organized as stacked bilayers of ceramides in a splayed chain conformation with cholesterol associated with the ceramide sphingoid moiety and free fatty acids associated with the ceramide fatty acid moiety. However, knowledge about the lipid structure's detailed molecular organization, and the roles of its different lipid constituents, remains circumstantial. Starting from a molecular dynamics model based on the splayed bilayer model, we have, by stepwise structural and compositional modifications, arrived at a thermodynamically stable molecular dynamics model expressing simulated electron microscopy patterns matching original cryo-electron microscopy patterns from skin extremely closely. Strikingly, the closer the individual molecular dynamics models' lipid composition was to that reported in human stratum corneum, the better was the match between the models' simulated electron microscopy patterns and the original cryo-electron microscopy patterns. Moreover, the closest-matching model's calculated water permeability and thermotropic behaviour were found compatible with that of human skin. The new model may facilitate more advanced physics-based skin permeability predictions of drugs and toxicants. The proposed procedure for molecular dynamics based analysis of cellular cryo-electron microscopy data might be applied to other biomolecular systems. Copyright © 2018. Published by Elsevier Inc.

  6. Role of secondary emission on discharge dynamics in an atmospheric pressure dielectric barrier discharge

    Energy Technology Data Exchange (ETDEWEB)

    Tay, W. H.; Kausik, S. S.; Yap, S. L.; Wong, C. S., E-mail: cswong@um.edu.my [Plasma Technology Research Centre, Department of Physics, Faculty of Science, University of Malaya, 50603 Kuala Lumpur (Malaysia)

    2014-04-15

    The discharge dynamics in an atmospheric pressure dielectric barrier discharge (DBD) is studied in a DBD reactor consisting of a pair of stainless steel parallel plate electrodes. The DBD discharge has been generated by a 50 Hz ac high voltage power source. The high-speed intensified charge coupled device camera is used to capture the images of filaments occurring in the discharge gap. It is observed that frequent synchronous breakdown of micro discharges occurs across the discharge gap in the case of negative current pulse. The experimental results reveal that secondary emissions from the dielectric surface play a key role in the synchronous breakdown of plasma filaments.

  7. Managing childhood eczema: qualitative study exploring carers' experiences of barriers and facilitators to treatment adherence.

    Science.gov (United States)

    Santer, Miriam; Burgess, Hana; Yardley, Lucy; Ersser, Steven J; Lewis-Jones, Sue; Muller, Ingrid; Hugh, Catherine; Little, Paul

    2013-11-01

    To explore parents and carers' experiences of barriers and facilitators to treatment adherence in childhood eczema Childhood eczema is common and causes significant impact on quality of life for children and their families, particularly due to sleep disturbance and itch. Non-adherence to application of topical treatments is the main cause of treatment failure. Qualitative interview study. Qualitative interviews were carried out with 31 carers from 28 families of children with eczema. Participants were recruited through primary care and included if they had a child aged 5 or less with a diagnosis of eczema. Interviews were carried out between December 2010-May 2011. Data were analysed using a constant comparative approach. Barriers to treatment adherence included carer beliefs around eczema treatment, the time consuming nature of applying topical treatments, and child resistance to treatment. Families employed a range of strategies in an attempt to work around children's resistance to treatment with varying success. Strategies included involving the child in treatment, distracting the child during treatment, or making a game of it, using rewards, applying treatment to a sleeping child or, in a few cases, physically restraining the child. Some carers reduced frequency of applications in an attempt to reduce child resistance. Regular application of topical treatments to children is an onerous task, particularly in families where child resistance develops. Early recognition and discussion of resistance and better awareness of the strategies to overcome this may help carers to respond positively and avoid establishing habitual confrontation. © 2013 Blackwell Publishing Ltd.

  8. Hybridization of natural systems with advanced treatment processes for organic micropollutant removals: New concepts in multi-barrier treatment

    KAUST Repository

    Sudhakaran, Sairam; Maeng, Sungkyu; Amy, Gary L.

    2013-01-01

    ). With the depletion of water resources and high demand for power and chemical usage, efforts need to be made to judiciously use advanced treatment processes. There is a new interest in multiple barriers with synergies in which two coupled processes can function as a

  9. Structural modification of the skin barrier by OH radicals: a reactive molecular dynamics study for plasma medicine

    International Nuclear Information System (INIS)

    Van der Paal, J; Verlackt, C C; Yusupov, M; Neyts, E C; Bogaerts, A

    2015-01-01

    While plasma treatment of skin diseases and wound healing has been proven highly effective, the underlying mechanisms, and more generally the effect of plasma radicals on skin tissue, are not yet completely understood. In this paper, we perform ReaxFF-based reactive molecular dynamics simulations to investigate the interaction of plasma generated OH radicals with a model system composed of free fatty acids, ceramides, and cholesterol molecules. This model system is an approximation of the upper layer of the skin (stratum corneum). All interaction mechanisms observed in our simulations are initiated by H-abstraction from one of the ceramides. This reaction, in turn, often starts a cascade of other reactions, which eventually lead to the formation of aldehydes, the dissociation of ceramides or the elimination of formaldehyde, and thus eventually to the degradation of the skin barrier function. (paper)

  10. Stigma as a barrier to treatment for child acute malnutrition in Marsabit County, Kenya.

    Science.gov (United States)

    Bliss, Jessica Robin; Njenga, Martin; Stoltzfus, Rebecca Joyce; Pelletier, David Louis

    2016-01-01

    Acute malnutrition affects millions of children each year, yet global coverage of life-saving treatment through the community-based management of acute malnutrition (CMAM) is estimated to be below 15%. We investigated the potential role of stigma as a barrier to accessing CMAM. We surveyed caregivers bringing children to rural health facilities in Marsabit County, Kenya, divided into three strata based on the mid-upper arm circumference of the child: normal status (n = 327), moderate acute malnutrition (MAM, n = 241) and severe acute malnutrition (SAM, n = 143). We used multilevel mixed effects logistic regression to estimate the odds of reporting shame as a barrier to accessing health care. We found that the most common barriers to accessing child health care were those known to be universally problematic: women's time and labour constraints. These constituted the top five most frequently reported barriers regardless of child acute malnutrition status. In contrast, the odds of reporting shame as a barrier were 3.64 (confidence interval: 1.66-8.03, P stigma is an under-recognized barrier to accessing CMAM and may constrain programme coverage. In light of the large gap in coverage of CMAM, there is an urgent need to understand the sources of acute malnutrition-associated stigma and adopt effective means of de-stigmatization. © 2015 John Wiley & Sons Ltd.

  11. [Gender and accessibility barriers to treatment in alcohol abuse patients in the Autonomous Region of Valencia].

    Science.gov (United States)

    Tomás-Dols, Sofía; Valderrama-Zurián, Juan Carlos; Vidal-Infer, Antonio; Samper-Gras, Teresa; Hernández-Martínez, Ma Carmen; Torrijo-Rodrigo, Ma José

    2007-01-01

    This study aimed at identifying the factors that contribute to delaying the access of alcohol abuse patients to specific treatment centres in the Autonomous Region of Valencia (Spain). 563 patients from Addictive Behaviours Units (UCA) and Alcohology Units (UA) were interviewed. A survey was conducted which included items on previous requested treatment in other centres and on barriers of accessibility to treatment in specific ambulatory centres. A descriptive analysis and t-student and ANOVA with Scheffé post-hoc tests were carried out. 59.7% of respondents said they had requested previous treatment in non-specific resources due to physical or psychical trouble that they now relate to their alcohol use although they did not do so at the time, in addition to being motivated by their own alcohol abuse (42.8%). The most attended resources were Primary Care and Specialist Unit Care. Women showed a higher demand for treatment in Mental Health Services (p gender differences in barriers that delay access to treatment do exist. It is necessary to build gender-adapted intervention guidelines to be used in Primary Care and Mental Health services to reduce the accessibility barriers to treatment.

  12. Barriers to implementation of treatment guidelines for ADHD in adults with substance use disorder

    NARCIS (Netherlands)

    Matthys, Frieda; Soyez, Veerle; van den Brink, Wim; Joostens, Peter; Tremmery, Sabine; Sabbe, Bernard

    2014-01-01

    Attention deficit hyperactivity disorder (ADHD) is common among adult patients with a substance use disorder, yet often goes undetected. This is a qualitative study to explore implementation barriers to a guideline developed in Belgium for the recognition and treatment of ADHD in adult patients with

  13. Barriers and Delays in Tuberculosis Diagnosis and Treatment Services: Does Gender Matter?

    Directory of Open Access Journals (Sweden)

    Wei-Teng Yang

    2014-01-01

    Full Text Available Background. Tuberculosis (TB remains a global public health problem with known gender-related disparities. We reviewed the quantitative evidence for gender-related differences in accessing TB services from symptom onset to treatment initiation. Methods. Following a systematic review process, we: searched 12 electronic databases; included quantitative studies assessing gender differences in accessing TB diagnostic and treatment services; abstracted data; and assessed study validity. We defined barriers and delays at the individual and provider/system levels using a conceptual framework of the TB care continuum and examined gender-related differences. Results. Among 13,448 articles, 137 were included: many assessed individual-level barriers (52% and delays (42%, 76% surveyed persons presenting for care with diagnosed or suspected TB, 24% surveyed community members, and two-thirds were from African and Asian regions. Many studies reported no gender differences. Among studies reporting disparities, women faced greater barriers (financial: 64% versus 36%; physical: 100% versus 0%; stigma: 85% versus 15%; health literacy: 67% versus 33%; and provider-/system-level: 100% versus 0% and longer delays (presentation to diagnosis: 45% versus 0% than men. Conclusions. Many studies found no quantitative gender-related differences in barriers and delays limiting access to TB services. When differences were identified, women experienced greater barriers and longer delays than men.

  14. Barriers and delays in tuberculosis diagnosis and treatment services: does gender matter?

    Science.gov (United States)

    Yang, Wei-Teng; Gounder, Celine R; Akande, Tokunbo; De Neve, Jan-Walter; McIntire, Katherine N; Chandrasekhar, Aditya; de Lima Pereira, Alan; Gummadi, Naveen; Samanta, Santanu; Gupta, Amita

    2014-01-01

    Background. Tuberculosis (TB) remains a global public health problem with known gender-related disparities. We reviewed the quantitative evidence for gender-related differences in accessing TB services from symptom onset to treatment initiation. Methods. Following a systematic review process, we: searched 12 electronic databases; included quantitative studies assessing gender differences in accessing TB diagnostic and treatment services; abstracted data; and assessed study validity. We defined barriers and delays at the individual and provider/system levels using a conceptual framework of the TB care continuum and examined gender-related differences. Results. Among 13,448 articles, 137 were included: many assessed individual-level barriers (52%) and delays (42%), 76% surveyed persons presenting for care with diagnosed or suspected TB, 24% surveyed community members, and two-thirds were from African and Asian regions. Many studies reported no gender differences. Among studies reporting disparities, women faced greater barriers (financial: 64% versus 36%; physical: 100% versus 0%; stigma: 85% versus 15%; health literacy: 67% versus 33%; and provider-/system-level: 100% versus 0%) and longer delays (presentation to diagnosis: 45% versus 0%) than men. Conclusions. Many studies found no quantitative gender-related differences in barriers and delays limiting access to TB services. When differences were identified, women experienced greater barriers and longer delays than men.

  15. Readiness and barriers to adopt evidence-based practices for substance abuse treatment in Mexico

    OpenAIRE

    Horigian, Viviana E.; Espinal, Paula S.; Alonso, Elizabeth; Verdeja, Rosa E.; Duan, Rui; Usaga, Ingrid M.; Pérez-López, Alejandro; Marín-Navarrete, Rodrigo; Feaster, Daniel J.

    2016-01-01

    ABSTRACT: Introduction: Evidence shows a lag in adoption of evidence-based practices (EBPs) for substance abuse treatment and supports the need for studying the factors involved in this worldwide problem. Objective: This study aimed to assess the readiness and barriers to adopt EBPs for substance abuse in a sample of outpatient treatment centers of a newly created Mexican Clinical Trials Network. Method: An online survey was administered to directors (n = 8) and clinicians (n = 40) from se...

  16. Understanding the perceptions of and emotional barriers to infertility treatment: a survey in four European countries.

    Science.gov (United States)

    Domar, Alice; Gordon, Keith; Garcia-Velasco, Juan; La Marca, Antonio; Barriere, Paul; Beligotti, Fabiola

    2012-04-01

    Infertility can significantly impact women's lives and personal relationships. Despite the negative impact of infertility, a significant number of women who are struggling to conceive do not consult a physician. This cross-sectional survey was conducted to determine the emotional impact of infertility on women to identify which aspects of fertility treatment contribute to the psychological stress experienced by so many patients and to identify barriers to seeking treatment. Women (n = 445; 18-44 years) who had received fertility treatment within the past 2 years or were having trouble conceiving but had not received treatment, completed a 15-min survey online. Participants were from France (n = 108), Germany (n = 111), Italy (n = 112) and Spain (n = 114). Responses indicated that infertility causes a range of emotions and can strain relationships. Women who had received treatment were more likely to feel hopeful (26 versus 21%) and closer to their partner than women not in treatment (33 versus 19%, P barrier to treatment. This study has provided insight into the physical and psychological challenges of infertility treatments and permitted a better understanding of the factors that impact patient lives. A treatment protocol with minimal injections and provision of additional information may lessen the emotional impact and challenges of infertility and contribute to patient satisfaction with fertility treatment protocols.

  17. Barriers and facilitators of treatment for depression in a latino community: a focus group study.

    Science.gov (United States)

    Uebelacker, Lisa A; Marootian, Beth A; Pirraglia, Paul A; Primack, Jennifer; Tigue, Patrick M; Haggarty, Ryan; Velazquez, Lavinia; Bowdoin, Jennifer J; Kalibatseva, Zornitsa; Miller, Ivan W

    2012-02-01

    We conducted focus groups with Latinos enrolled in a Medicaid health plan in order to ask about the barriers to and facilitators of depression treatment in general as well as barriers to participation in depression telephone care management. Telephone care management has been designed for and tested in primary care settings as a way of assisting physicians with caring for their depressed patients. It consists of regular brief contacts between the care manager and the patient; the care manager educates, tracks, and monitors patients with depression, coordinates care between the patient and primary care physician, and may provide short-term psychotherapy. We conducted qualitative analyses of four focus groups (n = 30 participants) composed of Latinos who endorsed having been depressed themselves or having had a close friend or family member with depression, stress, nervios, or worries. Within the area of barriers and facilitators of receiving care for depression, we identified the following themes: vulnerability, social connection and engagement, language, culture, insurance/money, stigma, disengagement, information, and family. Participants discussed attitudes toward: importance of seeking help for depression, specific types of treatments, healthcare providers, continuity and coordination of care, and phone calls. Improved understanding of barriers and facilitators of depression treatment in general and depression care management in particular for Latinos enrolled in Medicaid should lead to interventions better able to meet the needs of this particular group.

  18. Barriers and Facilitators of Partner Treatment of Chlamydia: A Qualitative Investigation with Prescribers and Community Pharmacists

    Directory of Open Access Journals (Sweden)

    Helen Wood

    2018-02-01

    Full Text Available Chlamydia trachomatis is the most frequently-notified sexually transmitted infection in Australia. Effective and timely partner treatment of chlamydia is essential to reduce overall prevalence and the burden of infection. Currently in most of Australia, the only avenue for partner treatment of chlamydia (“standard partner therapy” is a tedious, and often inconvenient, process. The barriers and facilitators of standard partner therapy, and newer models of accelerated partner therapy (APT, need to be identified in the Australian setting. Additionally, the potential role of community pharmacists need to be explored. Semi-structured interview guides for two key stakeholder groups (prescribers and pharmacists were developed and piloted. Eleven prescribers (general practitioners, sexual health clinicians and nurse practitioners and twelve pharmacists practicing in the Perth metropolitan region were interviewed. Key reported barriers to standard partner therapy were lack of or delayed chlamydia testing. Key facilitators included ability to test and educate sexual partner. Key barriers for APT included prescribers’ legal responsibility and potential for medication-related adverse effects. Healthcare provider consultation and chlamydia testing were seen as potential facilitators of APT. Pharmacists were receptive to the idea of expanding their role in chlamydia treatment, however, barriers to privacy must be overcome in order to be acceptable to prescribers and pharmacists.

  19. Predictors of treatment utilization and barriers to treatment utilization among individuals with lifetime cannabis use disorder in the United States.

    Science.gov (United States)

    Kerridge, Bradley T; Mauro, Pia M; Chou, S Patricia; Saha, Tulshi D; Pickering, Roger P; Fan, Amy Z; Grant, Bridget F; Hasin, Deborah S

    2017-12-01

    To present information on predictors of treatment utilization and barriers to treatment utilization among individuals with lifetime DSM-5 cannabis use disorder (CUD). Face-to-face survey of a representative sample of the adult US general population (n=36,309). Treatment rates for CUD were low in this general population survey (13.7%). Severity of CUD and comorbidity of other lifetime drug use disorders were significant predictors of lifetime treatment utilization for CUD. Preference for self-reliance, minimizing problems, fear of stigma, and financial and structural issues were among the most frequently endorsed reasons for respondents not seeking treatment when they perceived the need for treatment among individuals with lifetime CUD, regardless of whether they eventually utilized treatment at some time in their lives. Given the rising prevalence of CUD in the US over the past decade and currently low treatment rates for CUD, increased provision for services for CUD appears critically needed, especially those that screen for and treat, when present, other drug use disorders. Programs to reduce stigma and financial barriers are needed, as well as programs to increase awareness among the general public, health care professionals about the nature and seriousness of CUD, and the availability and effectiveness of treatment for this disorder. Copyright © 2017. Published by Elsevier B.V.

  20. Understanding clinician perception of common presentations in South Asians seeking mental health treatment and determining barriers and facilitators to treatment.

    Science.gov (United States)

    Rastogi, Pramit; Khushalani, Sunil; Dhawan, Swaran; Goga, Joshana; Hemanth, Naveena; Kosi, Razia; Sharma, Rashmi K; Black, Betty S; Jayaram, Geetha; Rao, Vani

    2014-02-01

    Little is known about the presentation of mental health symptoms among South Asians living in the US. To explore mental health symptom presentation in South Asians in the US and to identify facilitators and barriers to treatment. Focus group study. Four focus groups were conducted with 7-8 participants in each group. All participants (N = 29) were clinicians who had been involved in the care of South Asian patients with emotional problems and/or mental illness in the US. Qualitative content analysis. Key themes identified included: generational differences in symptom presentation, stress was the most common symptom for younger South Asians (40 years of age). Substance abuse and verbal/physical/sexual abuse were not uncommon but were often not reported spontaneously. Stigma and denial of mental illness were identified as major barriers to treatment. Facilitators for treatment included use of a medical model and conducting systematic but patient-centered evaluations. South Asians living in the US present with a variety of mental health symptoms ranging from stress associated with acculturation to major mental illnesses. Facilitating the evaluation and treatment of South Asians with mental illness requires sensitivity to cultural issues and use of creative solutions to overcome barriers to treatment. Copyright © 2013 Elsevier B.V. All rights reserved.

  1. Structural and cultural barriers to the adoption of smoking cessation services in addiction treatment organizations.

    Science.gov (United States)

    Knudsen, Hannah K; Studts, Jamie L; Boyd, Sara; Roman, Paul M

    2010-07-01

    Few studies have examined associations between the availability of smoking cessation services in addiction treatment organizations and specific cultural, staffing, and resource barriers. Telephone interviews were conducted with administrators of 897 addiction treatment organizations in the United States. These data revealed that few programs had adopted the full bundle of five recommended tobacco-related intake procedures, and that less than half of programs offered any smoking cessation services. Barriers to adoption of the intake bundle and availability of services included organizational culture and low levels of staff skills. Adoption of cessation services was associated with center type, location in a hospital setting, levels of care, and organizational size. Although a substantial proportion of organizations offer smoking cessation services, expansion of these services and greater adoption of tobacco-related intake procedures are needed to address the needs of nicotine-dependent individuals in addiction treatment.

  2. QT dynamics during treatment with sertindole

    DEFF Research Database (Denmark)

    Nielsen, Jimmi; Wang, Fan; Graff, Claus

    2015-01-01

    be revealed by dynamic measures of the QT interval such as the ratio of QT variability to heart rate variability (variability ratio [VR]). The aim of this study was to investigate the effect of sertindole on QT dynamics. METHODS: QTc and the VR were assessed in an observational study using 24-hour Holter...... monitoring at baseline and after 3 weeks of treatment with sertindole 16 mg. The VR was calculated by dividing the standard deviation of QT intervals with the standard deviation of heart rates. Outcome measures were compared using paired t-test. RESULTS: A total of 18 patients participated in the study, two...... were excluded from further analysis due to low amplitude of the T-wave. When patients were shifted to sertindole, the VR increased from 0.192 (SD 0.045) to 0.223 (SD 0.061), p = 0.02. The QTcF interval increased from 388 (SD 16) to 403 ms (SD 14), p = 0.002. There was no difference in heart rate 78 bpm...

  3. Permeable Reactive Barriers: a multidisciplinary approach of a new emerging sustainable groundwater treatment technology

    Energy Technology Data Exchange (ETDEWEB)

    Diels, L.; Bastiaens, L. [Vito, Mol (BL); O' Hannessin, S. [EnviroMetal Technologies Inc., Ontario (Canada); Cortina, J.L. [Univ. Politecnica de Catalunya, Barcelona (Spain). Dept. d' Enginyeria Quimica; Alvarez, P.J. [Univ. of Iowa, Iowa-City (United States). Center for Biocatalysis and Bioprocessing; Ebert, M. [Christian-Albrechts Univ. Kiel (Germany). Inst. fuer Geowissenschaften; Schad, H. [I.M.E.S. GmbH, Amtzell (Germany)

    2003-07-01

    Permeable reactive barriers or zones are becoming an interesting sustainable and cost-effective technology for in situ treatment of contaminated groundwater. The technology is based on chemical processes as the dehalogenating activity of zerovalent iron, biological processes in bioscreens or reactive zones and on sorption technology (e.g. heavy metal adsorption or adsorption on granular activated carbon). Three technical sessions will be devoted to this nowadays becoming mature technology. This special session intends to pay attention to the discussion about some questions related to PRBs. These include the sustainability (e.g. life time and clogging) especially for zerovalent iron barriers, the need and quality of feasibility tests, drawbacks and restrictions of PRBs. Combined with long term performance monitoring os these systems will be discussed. Further attention will be paid to cost evaluation and the relationship between zerovalent barriers and bacterial growth. Also attention will be paid to new reactive materials (e.g. activated carbon for organics and inorganic materials for heavy metals) and consequences (e.g. environmental impact). Finally the session will combine al these approaches in a discussion about combined barriers or multibarriers for treatment of mixed pollution (e.g. landfill leachates contaminated groundwater). Specialists involved in these subjects will introduce these topics and allow for a large and intensive discussion to improve future applications of this technology. (orig.)

  4. Barriers to antiretroviral treatment access for injecting drug users living with HIV in Chennai, South India.

    Science.gov (United States)

    Chakrapani, Venkatesan; Velayudham, Jaikumar; Shunmugam, Murali; Newman, Peter A; Dubrow, Robert

    2014-01-01

    India's National AIDS Control Organization provides free antiretroviral treatment (ART) to people living with HIV (PLHIV), including members of marginalized groups such as injecting drug users (IDUs). To help inform development of interventions to enhance ART access, we explored barriers to free ART access at government ART centers for IDUs living with HIV in Chennai by conducting three focus groups (n = 19 IDUs) and four key informant interviews. Data were explored using framework analysis to identify categories and derive themes. We found interrelated barriers at the family and social, health-care system, and individual levels. Family and social level barriers included lack of family support and fear of societal discrimination, as well as unmet basic needs, including food and shelter. Health-care system barriers included actual or perceived unfriendly hospital environment and procedures such as requiring proof of address and identity from PLHIV, including homeless IDUs; provider perception that IDUs will not adhere to ART, resulting in ART not being initiated; actual or perceived inadequate counseling services and lack of confidentiality; and lack of effective linkages between ART centers, needle/syringe programs, and drug dependence treatment centers. Individual-level barriers included active drug use, lack of self-efficacy in ART adherence, low motivation to initiate ART stemming from a fatalistic attitude, and inadequate knowledge about ART. These findings indicate that to facilitate IDUs gaining access to ART, systemic changes are needed, including steps to make the environment and procedures at government ART centers more IDU-friendly and steps to decrease HIV- and drug use-related stigma and discrimination faced by IDUs from the general public and health-care providers. Housing support for homeless IDUs and linkage of IDUs with drug dependence treatment are also essential.

  5. State Medicaid Coverage for Tobacco Cessation Treatments and Barriers to Accessing Treatments - United States, 2015-2017.

    Science.gov (United States)

    DiGiulio, Anne; Jump, Zach; Yu, Annie; Babb, Stephen; Schecter, Anna; Williams, Kisha-Ann S; Yembra, Debbie; Armour, Brian S

    2018-04-06

    Cigarette smoking prevalence among Medicaid enrollees (25.3%) is approximately twice that of privately insured Americans (11.8%), placing Medicaid enrollees at increased risk for smoking-related disease and death (1). Medicaid spends approximately $39 billion annually on treating smoking-related diseases (2). Individual, group, and telephone counseling and seven Food and Drug Administration (FDA)-approved medications* are effective in helping tobacco users quit (3). Although state Medicaid coverage of tobacco cessation treatments improved during 2014-2015, coverage was still limited in most states (4). To monitor recent changes in state Medicaid cessation coverage for traditional (i.e., nonexpansion) Medicaid enrollees, the American Lung Association collected data on coverage of a total of nine cessation treatments: individual counseling, group counseling, and seven FDA-approved cessation medications † in state Medicaid programs during July 1, 2015-June 30, 2017. The American Lung Association also collected data on seven barriers to accessing covered treatments, such as copayments and prior authorization. As of June 30, 2017, 10 states covered all nine of these treatments for all enrollees, up from nine states as of June 30, 2015; of these 10 states, Missouri was the only state to have removed all seven barriers to accessing these cessation treatments. State Medicaid programs that cover all evidence-based cessation treatments, remove barriers to accessing these treatments, and promote covered treatments to Medicaid enrollees and health care providers would be expected to reduce smoking, smoking-related disease, and smoking-attributable federal and state health care expenditures (5-7).

  6. Treatment of obesity in children: Parent's perceived emotional barriers as predictor of change in body fat.

    Science.gov (United States)

    Steinsbekk, Silje; Odegård, Rønnaug; Wichstrøm, Lars

    2011-01-01

    Research supports the use of family-based interventions in the treatment of obesity in children, but there is a lack of knowledge about what factors affect parents' ability to carry out the lifestyle changes necessary to reduce their child's obesity. The aim of the present study was to examine whether parents' self-efficacy, perceived emotional barriers, subjective norms, and attitudes could predict change in their children's body fat at 6 month and 2 year follow-ups after a family-based treatment of obesity. Body Mass Index Standard Deviation Scores (BMI SDS) were calculated and body fat (dual-energy X-ray absorptiometry) were measured in 99 treatment-seeking children with obesity (ages 7-12; 48 girls, 51 boys; mean BMI SDS = 2.99) at baseline, after 6 month and after 2 year follow-up. Parental cognitions regarding diet and physical activity were examined by parent-completed questionnaires. Structural equation modeling (SEM) was used to test whether the selected health cognitions could predict treatment outcome. Parental perceived emotional barriers was a significant predictor of change in body fat at 6 month (β = -.32, p = .001) and 2 year (β = -.38, p = .002) follow-up when the initial body fat values were controlled. Self-efficacy, subjective norms and attitudes did not improve the amount of variance explained. Parents' perceived emotional barriers significantly predict change in total body fat in children treated for obesity. In order to increase treatment-efficacy, perceived emotional barriers should be addressed. © 2011 Asian Oceanian Association for the Study of Obesity . Published by Elsevier Ltd. All rights reserved.

  7. Modeling the Response of Human Altered Natural Barrier Island Dynamics Along Assateague Island National Seashore to Climate Change

    Science.gov (United States)

    Carroll, A.; McNamara, D.; Schupp, C.

    2009-12-01

    Assateague Island National Seashore comprises a long barrier island located off the coasts of Maryland and Virginia. Geological evidence suggests that over recent centuries Assateague Island has steadily transgressed up the continental shelf in response to rising sea level. More recently, the natural barrier island dynamics governing Assateague’s evolution have been altered by human activity in three ways: the construction of a jetty and the subsequent interruption of alongshore sediment transport on the north end of Assateague and both the ongoing and abandoned maintenance of a continuous dune system along portions of Assateague with the concomitant modification to overwash dynamics. It is unclear how these varied human alterations to the natural barrier island dynamics will influence the response of Assateague to climate change induced shifts in forcing such as increased rates of sea level rise and changing storm patterns. We use LIDAR detected morphological data of Assateague Island as initial conditions in an alongshore extended model for barrier island dynamics including beach erosion, island overwash and inlet cutting during storms, and beach accretion, tidal delta growth and dune and vegetation growth between storms to explore the response of the various human altered segments of Assateague Island to forcing changes. Traditional models exploring barrier island evolution contain only cross-shore dynamics therefore lacking important alongshore-spatial dynamics in aeolian and surf zone sediment transport. Results show that including alongshore dynamics alter the steady state of Assateague relative to simulations that only include cross-shore dynamics. Results will also be presented exploring the potential for regime shifts in steady state behavior under various scenarios for the rate of sea level rise and storm climate and varying management strategies.

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

    Science.gov (United States)

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

    2016-09-01

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

  9. Barriers to prompt and effective malaria treatment among the poorest population in Kenya

    Directory of Open Access Journals (Sweden)

    Okungu Vincent

    2010-05-01

    Full Text Available Abstract Background Prompt access to effective malaria treatment is central to the success of malaria control worldwide, but few fevers are treated with effective anti-malarials within 24 hours of symptoms onset. The last two decades saw an upsurge of initiatives to improve access to effective malaria treatment in many parts of sub-Saharan Africa. Evidence suggests that the poorest populations remain least likely to seek prompt and effective treatment, but the factors that prevent them from accessing interventions are not well understood. With plans under way to subsidize ACT heavily in Kenya and other parts of Africa, there is urgent need to identify policy actions to promote access among the poor. This paper explores access barriers to effective malaria treatment among the poorest population in four malaria endemic districts in Kenya. Methods The study was conducted in the poorest areas of four malaria endemic districts in Kenya. Multiple data collection methods were applied including: a cross-sectional survey (n = 708 households; 24 focus group discussions; semi-structured interviews with health workers (n = 34; and patient exit interviews (n = 359. Results Multiple factors related to affordability, acceptability and availability interact to influence access to prompt and effective treatment. Regarding affordability, about 40 percent of individuals who self-treated using shop-bought drugs and 42 percent who visited a formal health facility reported not having enough money to pay for treatment, and having to adopt coping strategies including borrowing money and getting treatment on credit in order to access care. Other factors influencing affordability were seasonality of illness and income sources, transport costs, and unofficial payments. Regarding acceptability, the major interrelated factors identified were provider patient relationship, patient expectations, beliefs on illness causation, perceived effectiveness of treatment, distrust in

  10. Benefits of and Barriers to Pharmacogenomics-Guided Treatment for Major Depressive Disorder.

    Science.gov (United States)

    Ahmed, Ahmed T; Weinshilboum, Richard; Frye, Mark A

    2018-05-01

    Antidepressants have reduced the symptom burden for many Major Depressive Disorder (MDD) patients, but drug-related side effects and treatment resistance continue to present major challenges. Pharmacogenomics represents one approach to enhance antidepressant efficacy and avoid adverse reactions, but concerns remain with regard to the overall "value equation," and several barriers must be overcome to achieve the full potential of MDD pharmacogenomics. © 2018 American Society for Clinical Pharmacology and Therapeutics.

  11. Globalization of the automobile industry in China: dynamics and barriers in greening of the road transportation

    International Nuclear Information System (INIS)

    Gan Lin

    2003-01-01

    This article describes the state of the automobile industry and urban road transportation management in China. It reviews how the automobile industry is evolving to respond to challenges in economic development, environmental regulations, and technological change. The dynamics and barriers resulting from technological change of automobiles in response to reduction of exhaust emissions and energy-efficiency improvement are analyzed. It is argued that consideration of externality costs should be integrated in automobile industrial policymaking and transportation management. Efforts need to be made to use more economic incentives for emissions reduction, and to promote technological change for cleaner vehicle development. This paper questions the current government policy of encouraging private car ownership, and suggests that improvement in public transportation systems, stronger emissions control, and technology innovation on environmental friendly automobile technologies would be relevant to China's drive toward sustainable transportation development. Social inequities resulted from automobile use is also stressed in the analysis

  12. Globalization of the automobile industry in China. Dynamics and barriers in the greening of road transportation

    Energy Technology Data Exchange (ETDEWEB)

    Gan, Lin

    2001-08-01

    This article describes the state of the automobile industry and urban road transportation management in China. It reviews how the automobile industry is evolving to respond to challenges in economic development, environmental regulations, and technological change. The dynamics and barriers resulting from technological change of the automobile in response to reduction of exhaust emissions and energy-efficiency improvement are analyzed. It is argued that consideration of externality costs should be integrated in automobile industrial policy making and transport management. This paper questions the current government policy of encouraging private car ownership, and suggests that improvement in public transportation systems and stronger emissions control would be relevant to China's drive toward sustainable transportation development. (author)

  13. Globalization of the automobile industry in China: dynamics and barriers in greening of the road transportation

    Energy Technology Data Exchange (ETDEWEB)

    Lin Gan [Center for International Climate and Environmental Research, Oslo (Norway)

    2003-05-01

    This article describes the state of the automobile industry and urban road transportation management in China. It reviews how the automobile industry is evolving to respond to challenges in economic development, environmental regulations, and technological change. The dynamics and barriers resulting from technological change of automobiles in response to reduction of exhaust emissions and energy-efficiency improvement are analysed. It is argued that consideration of externality costs should be integrated in automobile industrial policymaking and transportation management. Efforts need to be made to use more economic incentives for emissions reduction, and to promote technological change for cleaner vehicle development. This paper questions the current government policy of encouraging private car ownership, and suggests that improvement in public transportation systems, stronger emissions control, and technology innovation on environmental friendly automobile technologies would be relevant to China's drive toward sustainable transportation development. Social inequities resulted from automobile use is also stressed in the analysis. (author)

  14. Globalization of the automobile industry in China: dynamics and barriers in greening of the road transportation

    Energy Technology Data Exchange (ETDEWEB)

    Gan Lin E-mail: lin.gan@cicero.uio.no

    2003-05-01

    This article describes the state of the automobile industry and urban road transportation management in China. It reviews how the automobile industry is evolving to respond to challenges in economic development, environmental regulations, and technological change. The dynamics and barriers resulting from technological change of automobiles in response to reduction of exhaust emissions and energy-efficiency improvement are analyzed. It is argued that consideration of externality costs should be integrated in automobile industrial policymaking and transportation management. Efforts need to be made to use more economic incentives for emissions reduction, and to promote technological change for cleaner vehicle development. This paper questions the current government policy of encouraging private car ownership, and suggests that improvement in public transportation systems, stronger emissions control, and technology innovation on environmental friendly automobile technologies would be relevant to China's drive toward sustainable transportation development. Social inequities resulted from automobile use is also stressed in the analysis.

  15. Spatio-temporal dynamics of the white-eye square superlattice pattern in dielectric barrier discharge

    International Nuclear Information System (INIS)

    Wei, Lingyan; Dong, Lifang; Feng, Jianyu; Liu, Weibo; Fan, Weili; Pan, Yuyang

    2016-01-01

    We report on the first investigation of the white-eye square superlattice pattern (WESSP) in a dielectric barrier discharge system. The evolution of patterns with increasing voltage is given. A phase diagram of WESSP as functions of gas pressure p and argon concentration φ is presented. The spatio-temporal dynamics of the WESSP is studied by using an intensified charge-coupled device camera and photomultipliers. Results show that the WESSP consists of four different transient sublattices, whose discharge sequence is small spots—spots on the line—halos—central spots in each half voltage cycle. The discharge moment and position of each sublattice are dependent upon the field of the wall charges produced by all sublattices discharged previously. (paper)

  16. A Novel Dynamic Neonatal Blood-Brain Barrier on a Chip.

    Directory of Open Access Journals (Sweden)

    Sudhir P Deosarkar

    Full Text Available Studies of neonatal neural pathologies and development of appropriate therapeutics are hampered by a lack of relevant in vitro models of neonatal blood-brain barrier (BBB. To establish such a model, we have developed a novel blood-brain barrier on a chip (B3C that comprises a tissue compartment and vascular channels placed side-by-side mimicking the three-dimensional morphology, size and flow characteristics of microvessels in vivo. Rat brain endothelial cells (RBEC isolated from neonatal rats were seeded in the vascular channels of B3C and maintained under shear flow conditions, while neonatal rat astrocytes were cultured under static conditions in the tissue compartment of the B3C. RBEC formed continuous endothelial lining with a central lumen along the length of the vascular channels of B3C and exhibited tight junction formation, as measured by the expression of zonula occludens-1 (ZO-1. ZO-1 expression significantly increased with shear flow in the vascular channels and with the presence of astrocyte conditioned medium (ACM or astrocytes cultured in the tissue compartment. Consistent with in vivo BBB, B3C allowed endfeet-like astrocyte-endothelial cell interactions through a porous interface that separates the tissue compartment containing cultured astrocytes from the cultured RBEC in the vascular channels. The permeability of fluorescent 40 kDa dextran from vascular channel to the tissue compartment significantly decreased when RBEC were cultured in the presence of astrocytes or ACM (from 41.0 ± 0.9 x 10-6 cm/s to 2.9 ± 1.0 x 10-6 cm/s or 1.1±0.4 x 10-6 cm/s, respectively. Measurement of electrical resistance in B3C further supports that the addition of ACM significantly improves the barrier function in neonatal RBEC. Moreover, B3C exhibits significantly improved barrier characteristics compared to the transwell model and B3C permeability was not significantly different from the in vivo BBB permeability in neonatal rats. In summary, we

  17. Acceptability of psychological treatment to Chinese- and Caucasian-Australians: Internet treatment reduces barriers but face-to-face care is preferred.

    Science.gov (United States)

    Choi, Isabella; Sharpe, Louise; Li, Stephen; Hunt, Caroline

    2015-01-01

    Internet treatments have the potential to improve access, especially for cultural groups who face considerable treatment barriers. This study explored the perceived barriers and likelihood of using Internet and face-to-face treatments for depression among Chinese and Caucasian Australian participants. Three-hundred ninety-five (289 Chinese, 106 Caucasian) primary care patients completed a questionnaire about depression history, previous help-seeking, perceived barriers to Internet and face-to-face treatment, and likelihood of using either treatment for depressive symptoms. Internet treatment reduced perceived barriers (including stigma, lack of motivation, concerns of bringing up upsetting feelings, time constraints, transport difficulties, and cost) for both groups to a similar degree, except for time constraints. There were heightened concerns about the helpfulness, suitability, and confidentiality of Internet treatments. Chinese participants and individuals with a probable depression history reported increased perceived barriers across treatments. Both Chinese and Caucasian groups preferred face-to-face treatment across depression severity. However, when age was controlled, there were no significant concerns about Internet treatment, and face-to-face treatment was only preferred for severe depression. Only 12 % of the entire sample refused to try Internet treatment for depression. Endorsement of perceived Internet treatment barriers (including concerns of bringing up upsetting feelings, that treatment would be unhelpful or unsuitable, lack of motivation, cost, cultural sensitivity, and confidentiality) reduced the likelihood to try Internet treatments. Internet treatment reduced perceived treatment barriers across groups, with encouraging support for Internet treatment as an acceptable form of receiving help. Negative concerns about Internet treatment need to be addressed to encourage use.

  18. Plasma treatment of polyethylene tubes in continuous regime using surface dielectric barrier discharge with water electrodes

    Science.gov (United States)

    Galmiz, Oleksandr; Zemánek, Miroslav; Pavliňák, David; Černák, Mirko

    2018-05-01

    Combining the surface dielectric barrier discharges generated in contact with water based electrolytes, as the discharge electrodes, we have designed a new type of surface electric discharge, generating thin layers of plasma which propagate along the treated polymer surfaces. The technique was aimed to achieve uniform atmospheric pressure plasma treatment of polymeric tubes and other hollow bodies. The results presented in this work show the possibility of such system to treat outer surface of polymer materials in a continuous mode. The technical details of experimental setup are discussed as well as results of treatment of polyethylene tubes are shown.

  19. Barriers to free antiretroviral treatment access for female sex workers in Chennai, India.

    Science.gov (United States)

    Chakrapani, Venkatesan; Newman, Peter A; Shunmugam, Murali; Kurian, Abraham K; Dubrow, Robert

    2009-11-01

    India's National AIDS Control Organization (NACO) provides free first-line antiretroviral treatment (ART) at government centers for people living with HIV. To assist in developing policies and programs to ensure equity in ART access, we explored barriers to ART access among female sex workers (FSWs) living with HIV in Chennai. Between August and November 2007, we conducted three focus group discussions and two key informant interviews. Data were explored using framework analysis to identify categories and derive themes. We found interrelated barriers at the family/social, health care system/programmatic, and individual levels. Major barriers included fear of adverse consequences of disclosure of HIV status due to stigma and discrimination associated with HIV and sex work, lack of family support, negative experiences with health care providers, lack of adequate counseling services at government centers and by outreach workers employed by nongovernmental organizations (NGOs), perceived biased treatment of FSWs who are not referred by NGOs, lack of adequate knowledge about ART, and fatalism. Barriers can be addressed by: creating effective measures to reduce stigma associated with HIV/AIDS and sex work at the familial, societal, and health care system levels; incorporating information about ART into targeted interventions among FSWs; training counselors at government hospitals and NGO outreach workers on treatment issues; improving infrastructure and staffing levels at government centers to allow adequate time and privacy for counseling; and implementing government mass media campaigns on ART availability. Finally, it is crucial that NACO begin monitoring ART coverage of FSWs and other marginalized populations to ensure equitable ART access.

  20. Examples of Department of Energy Successes for Remediation of Contaminated Groundwater: Permeable Reactive Barrier and Dynamic Underground Stripping ASTD Projects

    International Nuclear Information System (INIS)

    Purdy, C.; Gerdes, K.; Aljayoushi, J.; Kaback, D.; Ivory, T.

    2002-01-01

    Since 1998, the Department of Energy's (DOE) Office of Environmental Management has funded the Accelerated Site Technology Deployment (ASTD) Program to expedite deployment of alternative technologies that can save time and money for the environmental cleanup at DOE sites across the nation. The ASTD program has accelerated more than one hundred deployments of new technologies under 76 projects that focus on a broad spectrum of EM problems. More than 25 environmental restoration projects have been initiated to solve the following types of problems: characterization of the subsurface using chemical, radiological, geophysical, and statistical methods; treatment of groundwater contaminated with DNAPLs, metals, or radionuclides; and other projects such as landfill covers, purge water management systems, and treatment of explosives-contaminated soils. One of the major goals of the ASTD Program is to deploy a new technology or process at multiple DOE sites. ASTD projects are encouraged to identify subsequent deployments at other sites. Some of the projects that have successfully deployed technologies at multiple sites focusing on cleanup of contaminated groundwater include: Permeable Reactive Barriers (Monticello, Rocky Flats, and Kansas City), treating uranium and organics in groundwater; and Dynamic Underground Stripping (Portsmouth, and Savannah River), thermally treating DNAPL source zones. Each year more and more new technologies and approaches are being used at DOE sites due to the ASTD program. DOE sites are sharing their successes and communicating lessons learned so that the new technologies can replace the baseline or standard approaches at DOE sites, thus expediting cleanup and saving money

  1. LONG-TERM GEOCHEMICAL BEHAVIOR OF A ZEROVALENT IRON PERMEABLE REACTIVE BARRIER FOR THE TREATMENT OF HEXAVALENT CHROMIUM IN GROUNDWATER

    Science.gov (United States)

    Passive, in-situ reactive barriers have proven to be viable, cost-effective systems for the remediation of Cr-contaminated groundwater at some sites. Permeable reactive barriers (PRBs) are installed in the flow-path of groundwater, most typically as vertical treatment walls. Re...

  2. The effect of topical treatments for CRS on the sinonasal epithelial barrier.

    Science.gov (United States)

    Ramezanpour, M; Rayan, A; Smith, J L P; Vreugde, S

    2017-06-01

    Several topical treatments are used in the management of Chronic Rhinosinusitis (CRS), some of which the safety and efficacy has yet to be determined. The purpose of this study was to investigate the effect of commonly used topical treatments on the sinonasal epithelial barrier. Normal saline (0.9% Sodium Chloride), hypertonic saline (3% Sodium Chloride), FESS Sinu-Cleanse Hypertonic, FLO Sinus Care and Budesonide 1 mg/ 2 ml were applied to the apical side of air-liquid interface (ALI) cultures of primary human nasal epithelial cells (HNECs) from CRS patients (n=3) and non-CRS controls (n=3) for 24 hours. Epithelial barrier structure and function was assessed using trans-epithelial electrical resistance (TEER), measuring the passage of Fluorescein Isothiocyanate labelled Dextrans (FITC-Dextrans) and assessing the expression of the tight junction protein Zona Occludens-1 (ZO-1) using immunofluorescence. Toxicity was assessed using a Lactate Dehydrogenase (LDH) assay. Data was analysed using ANOVA, followed by Tukey HSD post hoc test. Hypertonic solution and budesonide significantly increased TEER values in CRS derived HNECs. In contrast, FESS Sinu-Cleanse Hypertonic significantly reduced TEER 5 minutes after application of the solution followed by an increase in paracellular permeability of FITC-Dextrans (30 minutes) and increased LDH levels 6 hours after application of the solution. Our findings confirm that isotonic and hypertonic saline solutions do not compromise epithelial barrier function in vitro but underscore the importance of examining safety and efficacy of over-the-counter wash solutions.

  3. Investigation of barriers to clinical practice guideline-recommended pharmacotherapy in the treatment of COPD.

    Directory of Open Access Journals (Sweden)

    Price L

    2007-06-01

    Full Text Available Background: The adoption of clinical practice guideline recommendations for COPD is suboptimal. Determining the barriers to the implementation of these practice guidelines may help improve patient care.Objective: To determine whether barriers to the use of pharmacotherapy according to practice guidelines are related primarily to patient or prescriber factors.Methods: Retrospective cohort study. Members of a health maintenance organization identified as having spirometry-defined COPD ranging from stage II to IV. Electronic medical records were reviewed for documentation of the following: 1 patient affordability issues, 2 history of an adverse drug reaction, 3 history of inefficacy to therapy, and 4 prescription history.Results: A total of 111 medical records were reviewed. There were 51% of patients who had not filled medications that had been prescribed in accordance with guidelines and 43% did not have the guideline recommended medications prescribed in the previous year. Only 4% and 2% of patients had documented inefficacy and affordability issues, respectively. There were no reported cases of adverse drug reactions. Conclusions: This study provides insight to the acceptance of COPD treatment recommendations by patients and providers. Further research is needed to design interventions to reduce barriers and optimize COPD treatment.

  4. Dynamic model based on voltage transfer curve for pattern formation in dielectric barrier glow discharge

    Energy Technology Data Exchange (ETDEWEB)

    Li, Ben; He, Feng; Ouyang, Jiting, E-mail: jtouyang@bit.edu.cn [School of Physics, Beijing Institute of Technology, Beijing 100081 (China); Duan, Xiaoxi [Research Center of Laser Fusion, CAEP, Mianyang 621900 (China)

    2015-12-15

    Simulation work is very important for understanding the formation of self-organized discharge patterns. Previous works have witnessed different models derived from other systems for simulation of discharge pattern, but most of these models are complicated and time-consuming. In this paper, we introduce a convenient phenomenological dynamic model based on the basic dynamic process of glow discharge and the voltage transfer curve (VTC) to study the dielectric barrier glow discharge (DBGD) pattern. VTC is an important characteristic of DBGD, which plots the change of wall voltage after a discharge as a function of the initial total gap voltage. In the modeling, the combined effect of the discharge conditions is included in VTC, and the activation-inhibition effect is expressed by a spatial interaction term. Besides, the model reduces the dimensionality of the system by just considering the integration effect of current flow. All these greatly facilitate the construction of this model. Numerical simulations turn out to be in good accordance with our previous fluid modeling and experimental result.

  5. Trajectory approach to dissipative quantum phase space dynamics: Application to barrier scattering

    International Nuclear Information System (INIS)

    Hughes, Keith H.; Wyatt, Robert E.

    2004-01-01

    The Caldeira-Leggett master equation, expressed in Lindblad form, has been used in the numerical study of the effect of a thermal environment on the dynamics of the scattering of a wave packet from a repulsive Eckart barrier. The dynamics are studied in terms of phase space trajectories associated with the distribution function, W(q,p,t). The equations of motion for the trajectories include quantum terms that introduce nonlocality into the motion, which imply that an ensemble of correlated trajectories needs to be propagated. However, use of the derivative propagation method (DPM) allows each trajectory to be propagated individually. This is achieved by deriving equations of motion for the partial derivatives of W(q,p,t) that appear in the master equation. The effects of dissipation on the trajectories are studied and results are shown for the transmission probability. On short time scales, decoherence is demonstrated by a swelling of trajectories into momentum space. For a nondissipative system, a comparison is made of the DPM with the 'exact' transmission probability calculated from a fixed grid calculation

  6. Dynamic Characteristics of Positive Pulsed Dielectric Barrier Discharge for Ozone Generation in Air

    International Nuclear Information System (INIS)

    Wei Linsheng; Peng Bangfa; Li Ming; Zhang Yafang; Hu Zhaoji

    2016-01-01

    A comprehensive dynamic model consisting of 66 reactions and 24 species is developed to investigate the dynamic characteristics of ozone generation by positive pulsed dielectric barrier discharge (DBD) using parallel-plate reactor in air. The electron energy conservation equation is coupled to the electron continuity equation, the heavy species continuity equation, and Poisson's equation for a better description. The reliability of the model is experimentally confirmed. The model can be used to predict the temporal and spatial evolution of species, as well as streamer propagation. The simulation results show that electron density increases nearly exponentially in the direction to the anode at the electron avalanche. Streamer propagation velocity is about 5.26 × 10 4 m/s from anode to cathode in the simulated condition. The primary positive ion, negative ion, and excited species are O 2 + , O 3 − and O 2 ( 1 Δg) in pulsed DBD in air, respectively. N 2 O has the largest density among nitrogen oxides. e and N 2 + densities in the streamer head increase gradually to maximum values with the development of the streamer. Meanwhile, the O 2 + , O, O 3 , N 2 (A 3 Σ) and N 2 O densities reach maximum values in the vicinity of the anode. (paper)

  7. Potential facilitators and barriers to adopting standard treatment guidelines in clinical practice.

    Science.gov (United States)

    Sharma, Sangeeta; Pandit, Ajay; Tabassum, Fauzia

    2017-04-18

    Purpose The purpose of this paper is to assess medicines information sources accessed by clinicians, if sources differed in theory and practice and to find out the barriers and facilitators to effective guideline adoption. Design/methodology/approach In all, 183 doctors were surveyed. Barriers and facilitators were classified as: communication; potential adopters; innovation; organization characteristics and environmental/social/economic context. Findings Most of the clinicians accessed multiple information sources including standard treatment guidelines, but also consulted seniors/colleagues in practice. The top three factors influencing clinical practice guideline adoption were innovation characteristics, environmental context and individual characteristics. The respondents differed in the following areas: concerns about flexibility offered by the guideline; denying patients' individuality; professional autonomy; insights into gaps in current practice and evidence-based practice; changing practices with little or no benefit. Barriers included negative staff attitudes/beliefs, guideline integration into organizational structures/processes, time/resource constraints. Fearing third parties (government and insurance companies) restricting medicines reimbursement and poor liability protection offered by the guidelines emerged as the barriers. Facilitators include aligning organizational structures/processes with the innovation; providing leadership support to guide diffusion; increasing awareness and enabling early innovation during pre/in-service training, with regular feedback on outcomes and use. Practical implications Guideline adoption in clinical practice is partly within doctors' control. There are other key prevailing factors in the local context such as environmental, social context, professional and organizational culture affecting its adoption. Organizational policy and accreditation standards necessitating adherence can serve as a driver. Originality

  8. Barriers for identification and treatment of problem drinkers in primary care.

    Science.gov (United States)

    Coloma-Carmona, Ainhoa; Carballo, José Luis; Tirado-González, Sonia

    Due to the lack of studies in the Spanish population, this study aims to analyze the barriers perceived by health professionals from different Spanish health centers when attempting to identify and treat problem drinkers and the importance given to this aspect, as well as analyzing the possible differences as a function of the professionals' health teams. We also analyze the psychometric properties of the questionnaire used to assess these barriers. The participants included 107 health professionals: 62.7% belonged to the medical team and 32.4% to the nursing team. After we had reviewed previous studies, collecting the main barriers referred to in them, participants completed an ad hoc questionnaire. The main barriers found were the belief that patients will lie about their actual consumption and will not identify its negative consequences, and the belief that they will reject participating in an intervention for their alcohol consumption. No significant differences between doctors and nurses were found in any of the barriers assessed. The results provide empirical evidence of the reliability of the test for the assessment by both teams of professionals. Studies are needed to examine in greater depth these conclusions, extending the number of variables studied to determine a more complete profile of the health professionals who are reluctant to incorporate the assessment and treatment of problem drinkers in their consultation. This could help to improve the design of programs to facilitate and encourage its implementation in primary care. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  9. Influence of pairing correlations on the probability and dynamics of tunneling through the barrier in fission and fusion of complex nuclei

    International Nuclear Information System (INIS)

    Lazarev, Yu.A.

    1986-01-01

    An analytically solvable model is used to study the potential barrier penetrability in the case when the gap parameter Δ is treated as a dynamical variable governed by the least action principle. It is found that, as compared to the standard (BCS) approach, the dynamical treatment of pairing results in a considerably weakened dependence of the fission barrier penetrability on the intensity of pairing correlations in the initial state (Δ 0 ), on the barrier height, and on the energy of the initial state. On this basis, a more adequate explanation is proposed for typical order-of-magnitude values of the empirical hidrance factors for groun-state spontaneous fission of odd nuclei. It is also shown that a large enhancement of superfluidity in tunneling - the inherent effect of the dynamical treatment of pairing - strongly facilitates deeply subbarier fusion of complex nuclei. Finally, an analysis is given for the probability of spontaneous fission from K-isomeric quasiparticle (q-p) states in even-even heavy nuclei. The relative change of the partial spontaneous fission half-life in going from the ground-state to a high-spin q-p isomeric state, T* sf /T sf , is found to be strongly dependent on whether or not there takes place the dynamically induced enhancement of superfluidity in tunneling. Measurements of T* sf /T sf provide thus a unique possibility of verifying theoretical predictions about the strong, inverse-square Δ dependence of the effective inertia associated with large-scale subbarrier rearrangements of nuclei

  10. Barriers to Implementing Treatment Integrity Procedures in School Psychology Research: Survey of Treatment Outcome Researchers

    Science.gov (United States)

    Sanetti, Lisa M. Hagermoser; DiGennaro Reed, Florence D.

    2012-01-01

    Treatment integrity data are essential to drawing valid conclusions in treatment outcome studies. Such data, however, are not always included in peer-reviewed research articles in school psychology or related fields. To gain a better understanding of why treatment integrity data are lacking in the school psychology research, we surveyed the…

  11. Accurate determination of blood–brain barrier permeability using dynamic contrast-enhanced T1-weighted MRI

    DEFF Research Database (Denmark)

    Cramer, Stig P; Larsson, Henrik B W

    2014-01-01

    Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is increasingly used to estimate permeability in situations with subtle blood-brain barrier (BBB) leakage. However, the method's ability to differentiate such low values from zero is unknown, and no consensus exists on optimal selection...

  12. Patterns of geographic mobility predict barriers to engagement in HIV care and antiretroviral treatment adherence.

    Science.gov (United States)

    Taylor, Barbara S; Reyes, Emily; Levine, Elizabeth A; Khan, Shah Z; Garduño, L Sergio; Donastorg, Yeycy; Hammer, Scott M; Brudney, Karen; Hirsch, Jennifer S

    2014-06-01

    Migration and geographic mobility increase risk for HIV infection and may influence engagement in HIV care and adherence to antiretroviral therapy. Our goal is to use the migration-linked communities of Santo Domingo, Dominican Republic, and New York City, New York, to determine the impact of geographic mobility on HIV care engagement and adherence to treatment. In-depth interviews were conducted with HIV+Dominicans receiving antiretroviral therapy, reporting travel or migration in the past 6 months and key informants (n=45). Mobility maps, visual representations of individual migration histories, including lifetime residence(s) and all trips over the past 2 years, were generated for all HIV+ Dominicans. Data from interviews and field observation were iteratively reviewed for themes. Mobility mapping revealed five distinct mobility patterns: travel for care, work-related travel, transnational travel (nuclear family at both sites), frequent long-stay travel, and vacation. Mobility patterns, including distance, duration, and complexity, varied by motivation for travel. There were two dominant barriers to care. First, a fear of HIV-related stigma at the destination led to delays seeking care and poor adherence. Second, longer trips led to treatment interruptions due to limited medication supply (30-day maximum dictated by programs or insurers). There was a notable discordance between what patients and providers perceived as mobility-induced barriers to care and the most common barriers found in the analysis. Interventions to improve HIV care for mobile populations should consider motivation for travel and address structural barriers to engagement in care and adherence.

  13. Patient navigation pathway and barriers to treatment seeking in cancer in India: a qualitative inquiry.

    Science.gov (United States)

    Pati, Sanghamitra; Hussain, Mohammad Akhtar; Chauhan, Abhimanyu Singh; Mallick, Diptimayee; Nayak, Sukdev

    2013-12-01

    Cancer is a leading cause of mortality worldwide. Early diagnosis and treatment of cancer may curb the growing burden of the disease. Understanding cancer patients' navigation pathways for seeking treatment is important in order to facilitate early diagnosis and treatment. With this background we conducted a hospital-based cross-sectional study comprising 68 randomly selected cancer inpatients in a tertiary cancer specialty hospital in Odisha, India, to explore the treatment-seeking pathways of the cancer patients and the barriers and enablers in seeking treatment. Financial constraint is one of the major reasons for the delay in accessing treatment, even when patients are suspected of or diagnosed with cancer. Low awareness of the presenting signs and symptoms of cancer and limited knowledge of the availability of cancer diagnosis and treatment facilities are major factors contributing to delay. Family and friends' support is found to be the major enabling factor toward seeking treatment. Generation of awareness of cancer among the general population and primary-care practitioners - including those in alternative systems of medicine - is important. Information on diagnostic and treatment services appears to be a felt need. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. Evidence-based dentistry for planning restorative treatments: barriers and potential solutions.

    Science.gov (United States)

    Afrashtehfar, K I; Eimar, H; Yassine, R; Abi-Nader, S; Tamimi, F

    2017-11-01

    Evidence-based dentistry (EBD) can help provide the best treatment option for every patient, however, its implementation in restorative dentistry is very limited. This study aimed at assessing the barriers preventing the implementation of EBD among dental undergraduate and graduate students in Montreal, and explore possible solutions to overcome these barriers. A cross-sectional survey was conducted by means of a paper format self-administrated questionnaire distributed among dental students. The survey assessed the barriers and potential solutions for implementation of an evidence-based practice. Sixty-one students completed the questionnaire. Forty-one percent of respondents found evidence-based literature to be the most reliable source of information for restorative treatment planning, however, only 16% used it. They considered that finding reliable information was difficult and they sometimes encountered conflicting information when consulting different sources. Dental students had positive attitudes towards the need for better access to evidence-based literature to assist learning and decision making in restorative treatment planning and to improve treatment outcomes. Even for dentists trained in EBD, online searching takes too much time, and even though it can provide information of better quality than personal intuition, it might not be enough to identify the best available evidence. Even though dental students are aware of the importance of EBD in restorative dentistry they rarely apply the concept, mainly due to time constraints. For this reason, implementation of EBD would probably require faster access to evidence-based knowledge. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Dynamic behaviour of a flexible membrane tsunami Barrier with Dyneema®

    NARCIS (Netherlands)

    Hofland, B.; Marissen, R.; Bergsma, O.K.

    2016-01-01

    Proof-of-concept model tests on a novel self-deploying on-shore tsunami barrier were executed. The tsunami barrier consists of a membrane, floater and cables that are stored underground. Due to buoyancy the barrier self-deploys when struck by a tsunami. The membrane and cables consist of the strong,

  16. A general treatment of dynamic integrity constraints

    NARCIS (Netherlands)

    de Brock, EO

    This paper introduces a general, set-theoretic model for expressing dynamic integrity constraints, i.e., integrity constraints on the state changes that are allowed in a given state space. In a managerial context, such dynamic integrity constraints can be seen as representations of "real world"

  17. Locally advanced oral cavity squamous cell carcinoma: Barriers related to effective treatment

    Directory of Open Access Journals (Sweden)

    K C Lakshmaiah

    2015-01-01

    Full Text Available Background: Oral cavity cancer is a significant health problem in India. Majority of patients present with locally advanced disease requiring multimodality treatment. Compliance to recommended treatment is an important factor affecting outcome. Aims: The aim was to evaluate the outcome of locally advanced oral cavity cancer patients with regards to treatment adherence and to assess reasons of noncompliance. Materials and Methods: This was a prospective observational study. We included patients referred to Department of Medical Oncology for induction chemotherapy in view of locally advanced oral cavity cancer. Results: Only 15 (26% patients completed planned treatment schedule. Their 1 year overall survival was 93%. The remaining 43 patients who received inadequate treatment had a dismal 21% 1 year overall survival. Illiteracy, poverty, long waiting list for surgery, prolonged delay for health scheme treatment plan approval and dissatisfaction with attitude of hospital staffs are major barriers related to effective treatment of these patients. Conclusions: A detailed discussion with patient and their relatives regarding recommended treatment, proper implementation of health schemes, increasing trained manpower to avoid long waiting list for surgery, provision of additional financial support for family member accompanying the patient and a sympathetic approach toward patients are needed to help these patients overcome the battle.

  18. Influence of dielectric barrier discharge treatment on mechanical and dyeing properties of wool

    Science.gov (United States)

    Rahul, NAVIK; Sameera, SHAFI; Md Miskatul, ALAM; Md Amjad, FAROOQ; Lina, LIN; Yingjie, CAI

    2018-06-01

    Physical and chemical properties of wool surface significantly affect the absorbency, rate of dye bath exhaustion and fixation of the industrial dyes. Hence, surface modification is a necessary operation prior to coloration process in wool wet processing industries. Plasma treatment is an effective alternative for physiochemical modification of wool surface. However, optimum processing parameters to get the expected modification are still under investigation, hence this technology is still under development in the wool wet processing industries. Therefore, in this paper, treatment parameters with the help of simple dielectric barrier discharge plasma reactor and air as a plasma gas, which could be a promising combination for treatment of wool substrate at industrial scale were schematically studied, and their influence on the water absorbency, mechanical, and dyeing properties of twill woven wool fabric samples are reported. It is expected that the results will assist to the wool coloration industries to improve the dyeing processes.

  19. Hybridization of natural systems with advanced treatment processes for organic micropollutant removals: New concepts in multi-barrier treatment

    KAUST Repository

    Sudhakaran, Sairam

    2013-07-01

    In the past, emphasis has been on individual treatment processes comprising conventional treatment (coagulation, sedimentation, and filtration) followed by advanced treatment processes (adsorption, ion-exchange, oxidation, and membrane separation). With the depletion of water resources and high demand for power and chemical usage, efforts need to be made to judiciously use advanced treatment processes. There is a new interest in multiple barriers with synergies in which two coupled processes can function as a hybrid process. Within the context of this paper, the hybrid processes include a natural treatment process coupled with an advanced process. Pilot/full-scale studies have shown efficient removal of OMPs by these hybrid processes. With this hybridization, the usage of resources such as power and chemicals can be reduced. In this study, coupling/hybridization of aquifer recharge and recovery (ARR) with oxidation (O3), advanced oxidation process which involves OH radicals (AOP), nanofiltration (NF), reverse osmosis (RO) and granular activated carbon (GAC) adsorption for OMP removal was studied. O3 or AOP as a pre-treatment and GAC, NF, RO, or UV/chlorination as a post-treatment to ARR was studied. NF can be replaced by RO for removal of OMPs since studies have shown similar performance of NF to RO for removal of many OMPs, thereby reducing costs and providing a more sustainable approach. © 2013 Elsevier Ltd.

  20. Assertive community treatment: facilitators and barriers to implementation in routine mental health settings.

    Science.gov (United States)

    Mancini, Anthony D; Moser, Lorna L; Whitley, Rob; McHugo, Gregory J; Bond, Gary R; Finnerty, Molly T; Burns, Barbara J

    2009-02-01

    This study identified barriers and facilitators to the high-fidelity implementation of assertive community treatment. As part of a multistate implementation project for evidence-based practices, training and consultation were provided to 13 newly implemented assertive community treatment teams in two states. Model fidelity was assessed at baseline and at six, 12, 18, and 24 months. Key informant interviews, surveys, and monthly on-site visits were used to monitor implementation processes related to barriers and facilitators. Licensing processes of the state mental health authority provided critical structural supports for implementation. These supports included a dedicated Medicaid billing structure, start-up funds, ongoing fidelity monitoring, training in the model, and technical assistance. Higher-fidelity sites had effective administrative and program leadership, low staff turnover, sound personnel practices, and skilled staff, and they allocated sufficient resources in terms of staffing, office space, and cars. Lower-fidelity sites were associated with insufficient resources, prioritization of fiscal concerns in implementation, lack of change culture, poor morale, conflict among staff, and high staff turnover. In cross-state comparisons, the specific nature of fiscal policies, licensing processes, and technical assistance appeared to influence implementation. State mental health authorities can play a critical role in assertive community treatment implementation but should carefully design billing mechanisms, promote technical assistance centers, link program requirements to fidelity models, and limit bureaucratic requirements. Successful implementation at the organizational level requires committed leadership, allocation of sufficient resources, and careful hiring procedures.

  1. Reactive barrier technologies for treatment of contaminated groundwater at Rocky Flats

    International Nuclear Information System (INIS)

    Marozas, D.C.; Bujewski, G.E.; Castaneda, N.

    1997-01-01

    The U.S. Department of Energy (DOE) Office of Science and Technology Subsurface Contaminants Focus Area is supporting the investigation of reactive barrier technologies to mitigate the risks associated with mixed organic/radioactive waste at several DOE sites. Groundwater from a small contaminated plume at the Rocky Flats Environmental Technology Site (RFETS) is being used to evaluate passive reactive material treatment. Permeable reactive barriers which intercept contaminants and destroy the VOC component while containing radionuclides are attractive for a number of reasons relating to public and regulatory acceptance. In situ treatment keeps contaminants away from the earth's surface, there is no above-ground treatment equipment that could expose workers and the public and operational costs are expected to be lower than currently used technologies. This paper will present results from preliminary site characterization and in-field small-scale column testing of reactive materials at RFETS. Successful demonstration is expected to lead to full-scale implementation of the technology at several DOE sites, including Rocky Flats

  2. Institutional stakeholder perceptions of barriers to addiction treatment under Mexico's drug policy reform.

    Science.gov (United States)

    Werb, Dan; Strathdee, Steffanie A; Meza, Emilo; Rangel Gomez, Maria Gudelia; Palinkas, Lawrence; Medina-Mora, Maria Elena; Beletsky, Leo

    2017-05-01

    Mexico has experienced disproportionate drug-related harms given its role as a production and transit zone for illegal drugs destined primarily for the USA. In response, in 2009, the Mexican federal government passed legislation mandating pre-arrest diversion of drug-dependent individuals towards addiction treatment. However, this federal law was not specific about how the scale-up of the addiction treatment sector was to be operationalised. We therefore conducted in-depth qualitative interviews with key 'interactors' in fields affected by the federal legislation, including participants from the law enforcement, public health, addiction treatment, and governmental administration sectors. Among 19 participants from the municipal, state and federal levels were interviewed and multiple barriers to policy reform were identified. First, there is a lack of institutional expertise to implement the reform. Second, the operationalisation of the reform was not accompanied by a coordinated action plan. Third, the law is an unfunded mandate. Institutional barriers are likely hampering the implementation of Mexico's policy reform. Addressing the concerns expressed by interactors through the scale-up of services, the provision of increased training and education programmes for stakeholders and a coordinated action plan to operationalise the policy reform are likely needed to improve the policy reform process.

  3. Comparing barriers to mental health treatment and substance use disorder treatment among individuals with comorbid major depression and substance use disorders.

    Science.gov (United States)

    Mojtabai, Ramin; Chen, Lian-Yu; Kaufmann, Christopher N; Crum, Rosa M

    2014-02-01

    Barriers to both mental health and substance use disorder treatments have rarely been examined among individuals with comorbid mental health and substance use disorders. In a sample of 393 adults with 12-month major depressive episodes and substance use disorders, we compared perceived barriers to these two types of treatments. Data were drawn from the 2005-2011 U.S. National Surveys on Drug Use and Health. Overall, the same individuals experienced different barriers to mental health treatment versus substance use disorder treatment. Concerns about negative views of the community, effects on job, and inconvenience of services were more commonly reported as reasons for not receiving substance use disorder treatment. Not affording the cost of care was the most common barrier to both types of treatments, but more commonly reported as a barrier to mental health treatment. Improved financial access through the Affordable Care Act and parity legislation and integration of mental health and substance use disorder services may help to reduce treatment barriers among individuals with comorbid mental health and substance disorders. © 2013.

  4. Complete and incomplete fusion dynamics of {sup 6,7}Li + {sup 159}Tb reactions near the Coulomb barrier

    Energy Technology Data Exchange (ETDEWEB)

    Gautam, Manjeet Singh [Thapar University, School of Physics and Materials Science, Patiala (India); Indus Degree College, Department of Physics, Kinana, Jind, Haryana (India); Grover, Neha; Sharma, Manoj K. [Thapar University, School of Physics and Materials Science, Patiala (India)

    2017-01-15

    The complete fusion (CF) and incomplete fusion (ICF) cross-sections are estimated for {sup 6,} {sup 7}Li + {sup 159}Tb reactions using the energy-dependent Woods-Saxon potential model (EDWSP model) and dynamical cluster-decay model (DCM). The CF data of the {sup 6}Li + {sup 159}Tb({sup 7}Li + {sup 159}Tb) reaction at above barrier energies is suppressed with reference to expectations of the EDWSP model by 25% (20%) which is smaller than the reported data by ∝ 9% (6%). This suppression is correlated with the projectile breakup effect. The projectiles {sup 6,7}Li are loosely bound systems, which may break up into charged fragments prior to reaching the fusion barrier and subsequently one of the fragment is captured by the target leading to the suppression of fusion data at above barrier energies. The sum of CF and ICF, which is termed as total fusion cross-section (TF), removes the discrepancies between theoretical predictions and the above barrier complete fusion data and hence is adequately explained via the EDWSP model over a wide range of energy spread across the Coulomb barrier. In addition to fusion, the decay mechanism of {sup 6}Li + {sup 159}Tb reaction is studied within the framework of the dynamical cluster-decay model (DCM). The breakup of the projectile ({sup 6}Li) in the entrance channel indicates the presence of ICF, which is investigated further using the collective clusterization approach of DCM. The present theoretical analysis suggests that a larger barrier modification is needed to address the fusion data of chosen reactions in the below barrier energy region. (orig.)

  5. Zebrafish as a visual and dynamic model to study the transport of nanosized drug delivery systems across the biological barriers.

    Science.gov (United States)

    Li, Ye; Miao, Xiaoqing; Chen, Tongkai; Yi, Xiang; Wang, Ruibing; Zhao, Haitao; Lee, Simon Ming-Yuen; Wang, Xueqing; Zheng, Ying

    2017-08-01

    With the wide application of nanotechnology to drug delivery systems, a simple, dynamic and visual in vivo model for high-throughput screening of novel formulations with fluorescence markers across biological barriers is desperately needed. In vitro cell culture models have been widely used, although they are far from a complimentary in vivo system. Mammalian animal models are common predictive models to study transport, but they are costly and time consuming. Zebrafish (Danio rerio), a small vertebrate model, have the potential to be developed as an "intermediate" model for quick evaluations. Based on our previously established coumarin 6 nanocrystals (C6-NCs), which have two different sizes, the present study investigates the transportation of C6-NCs across four biological barriers, including the chorion, blood brain barrier (BBB), blood retinal barrier (BRB) and gastrointestinal (GI) barrier, using zebrafish embryos and larvae as in vivo models. The biodistribution and elimination of C6 from different organs were quantified in adult zebrafish. The results showed that compared to 200nm C6-NCs, 70nm C6-NCs showed better permeability across these biological barriers. A FRET study suggested that intact C6-NCs together with the free dissolved form of C6 were absorbed into the larval zebrafish. More C6 was accumulated in different organs after incubation with small sized NCs via lipid raft-mediated endocytosis in adult zebrafish, which is consistent with the findings from in vitro cell monolayers and the zebrafish larvae model. C6-NCs could be gradually eliminated in each organ over time. This study demonstrated the successful application of zebrafish as a simple and dynamic model to simultaneously assess the transport of nanosized drug delivery systems across several biological barriers and biodistribution in different organs, especially in the brain, which could be used for central nervous system (CNS) drug and delivery system screening. Copyright © 2017 Elsevier B

  6. Changes in the blood-nerve barrier after sciatic nerve cold injury: indications supporting early treatment

    Directory of Open Access Journals (Sweden)

    Hao Li

    2015-01-01

    Full Text Available Severe edema in the endoneurium can occur after non-freezing cold injury to the peripheral nerve, which suggests damage to the blood-nerve barrier. To determine the effects of cold injury on the blood-nerve barrier, the sciatic nerve on one side of Wistar rats was treated with low temperatures (3-5°C for 2 hours. The contralateral sciatic nerve was used as a control. We assessed changes in the nerves using Evans blue as a fluid tracer and morphological methods. Excess fluid was found in the endoneurium 1 day after cold injury, though the tight junctions between cells remained closed. From 3 to 5 days after the cold injury, the fluid was still present, but the tight junctions were open. Less tracer leakage was found from 3 to 5 days after the cold injury compared with 1 day after injury. The cold injury resulted in a breakdown of the blood-nerve barrier function, which caused endoneurial edema. However, during the early period, the breakdown of the blood-nerve barrier did not include the opening of tight junctions, but was due to other factors. Excessive fluid volume produced a large increase in the endoneurial fluid pressure, prevented liquid penetration into the endoneurium from the microvasculature. These results suggest that drug treatment to patients with cold injuries should be administered during the early period after injury because it may be more difficult for the drug to reach the injury site through the microcirculation after the tissue fluid pressure becomes elevated.

  7. Dynamic Characteristics of Positive Pulsed Dielectric Barrier Discharge for Ozone Generation in Air

    Science.gov (United States)

    Wei, Linsheng; Peng, Bangfa; Li, Ming; Zhang, Yafang; Hu, Zhaoji

    2016-02-01

    A comprehensive dynamic model consisting of 66 reactions and 24 species is developed to investigate the dynamic characteristics of ozone generation by positive pulsed dielectric barrier discharge (DBD) using parallel-plate reactor in air. The electron energy conservation equation is coupled to the electron continuity equation, the heavy species continuity equation, and Poisson's equation for a better description. The reliability of the model is experimentally confirmed. The model can be used to predict the temporal and spatial evolution of species, as well as streamer propagation. The simulation results show that electron density increases nearly exponentially in the direction to the anode at the electron avalanche. Streamer propagation velocity is about 5.26 × 104 m/s from anode to cathode in the simulated condition. The primary positive ion, negative ion, and excited species are O2+, O3- and O2(1Δg) in pulsed DBD in air, respectively. N2O has the largest density among nitrogen oxides. e and N2+ densities in the streamer head increase gradually to maximum values with the development of the streamer. Meanwhile, the O2+, O, O3, N2(A3Σ) and N2O densities reach maximum values in the vicinity of the anode. supported by National Natural Science Foundation of China (Nos. 51366012 and 11105067), Jiangxi Province Young Scientists (Jinggang Star) Cultivation Plan of China (No. 20133BCB23008), Natural Science Foundation of Jiangxi, China (No. 20151BAB206047) and Jiangxi Province Higher School Science and Technology Landing Plan of China (No. KJLD-14015)

  8. Epistemological and Treatment Implications of Nonlinear Dynamics

    Science.gov (United States)

    Stein, A. H.

    The treatment implications of understanding mind as solely epiphenomenal to nonlinearly founded neurobiology are discussed. G. Klimovsky's epistemological understanding of psychoanalysis as a science is rejected and treatment approaches integrating W. R. Bion's and D. W. Winnicott's work are supported.

  9. Dynamics of the pedestal structure in the edge transport barrier in CHS

    International Nuclear Information System (INIS)

    Kado, S.; Oishi, T.; Tanaka, S.

    2006-10-01

    The dynamic behavior of the edge pedestal in the edge transport barrier (ETB) formation discharge (H-mode) in the compact helical system (CHS) is investigated. Edge Harmonic Oscillations (EHOs) having a fundamental frequency of 2-4.5 kHz, depending on the magnetic configuration, and their second harmonic are observed when the density gradient of the pedestal reaches a certain threshold. There are two groups of so-called EHOs in the CHS. One is located in the edge region where the ι=1 surface exists, and the other is in the core region (although we also call it EHO in this paper) around the half radius where the ι=0.5 surface exists. The magnetic probe signal is revealed to reflect the latter mode, showing the poloidal mode number of 2, while that for the edge BES channel is 1. The density build-up saturates simultaneously with the increase of EHOs in the edge BES channel, which suggests that to a considerable extend the mode increases the particle transport. (author)

  10. Challenging fission dynamics around the barrier: The case of {sup 34}S + {sup 186}W

    Energy Technology Data Exchange (ETDEWEB)

    Kozulin, E.M.; Itkis, I.; Knyazheva, G.; Novikov, K.; Bogachev, A.; Dmitriev, S.; Loktev, T. [Joint Institute for Nuclear Research, Flerov Laboratory of Nuclear Reactions, Dubna (Russian Federation); Vardaci, E. [Dipartamento di Scienze Fisiche, Napoli (Italy); INFN, Napoli (Italy); Harca, I.M. [Joint Institute for Nuclear Research, Flerov Laboratory of Nuclear Reactions, Dubna (Russian Federation); Horia Hulubei National Institute for R and D in Physics and Nuclear Engineering (IFIN-HH), Bucharest - Magurele (Romania); Universitatea din Bucuresti, Facultatea de Fizica, Bucharest (Romania); Schmitt, C.; Piot, J. [GANIL, CEA/DSM-CNRS/IN2P3, Bd Henri Becquerel, BP 55027, Caen (France); Azaiez, F.; Matea, I.; Verney, D.; Gottardo, A. [Universite Paris-Saclay, IPN, CNRS/IN2P3, Orsay (France); Dorvaux, O. [Universite de Strasbourg, IPHC, CNRS/IN2P3, Strasbourg (France); Chubarian, G. [Texas A and M University, Cyclotron Institute, College Station, TX (United States); Trzaska, W.H. [Accelerator Laboratory of University of Jyvaskyla (JYFL), Jyvaskyla (Finland); Hanappe, F. [Universite Libre de Bruxelles (ULB), Bruxelles (Belgium); Borcea, C.; Calinescu, S.; Petrone, C. [Horia Hulubei National Institute for R and D in Physics and Nuclear Engineering (IFIN-HH), Bucharest - Magurele (Romania)

    2016-09-15

    The current status of fission dynamics studies in heavy-ion collisions around the Coulomb barrier is illustrated with the {sup 34}S + {sup 186}W reaction. The fission-fragment mass and total kinetic energy were measured at the ALTO facility at IPN Orsay, France, with a dedicated set-up using the (v, E) approach. The measurement reveals the presence of an asymmetric fission component on top of a predominantly symmetric distribution. The asymmetric structure, pointed out for the first time, is discussed along with results of previous experiments studying the same reaction. While these analyses suggested the contribution from either quasi-fission or pre-equilibrium fission, we offer an alternative interpretation, in terms of shell-driven compound-nucleus fission. The present measurement demonstrates the critical influence of resolution when addressing puzzling cases, situated at the crossroads of the various channels opened in a heavy-ion collision. Current status in the field clearly calls for innovative measurements involving manifold correlations and new observables. The outcome of the attempt done in this work in this direction, based on the coincident measurement of prompt γ-rays is reported, and encouraging perspectives are discussed. (orig.)

  11. Dynamics of 28,30S i* compound nuclei formed at sub-barrier energies

    Science.gov (United States)

    Kaur, Manpreet; Singh, Bir Bikram; Kaur, Sarbjeet

    2018-05-01

    The decay of 28S i* and 30S i* compound nuclei (CN) formed at sub-barrier energies, in the reactions induced by stable projectile 16O and exotic projectile 18O, respectively, has been investigated within the quantum mechanical fragmentation theory based dynamical cluster-decay model (DCM). The collective potential energy surface shows that xα-type (x is an integer) clusters are minimized in the decay of 28S i* while in case of 30S i* in addition to xα-type clusters, np-xα (n, p are neutron and proton, respectively) type clusters are also minimized. These minimized fragments have more preformation probability P0, which is an important factor through which nuclear structure effects of decaying CN are probed, within DCM. The results show that light particles (LPs) are contributing mostly in the fusion cross-section, σfusion. In case of 30S i*, the contribution of 1n is highest and more compared to 4He in case of 28S i*, which seems to play an important role in fusion enhancement. The DCM calculated σfusion for both the CN formed with same Ec.m. = 7.0 MeV gives more value for σfusion of 30S i*, in agreement with the experimental data.

  12. Evaluation of Coverage and Barriers to Access to MAM Treatment in West Pokot County, Kenya

    International Nuclear Information System (INIS)

    Basquin, Cecile; Imelda, Awino; Gallagher, Maureen

    2014-01-01

    Full text: Despite an increased number of nutrition treatment coverage assessments conducted, they often focus on Severe Acute Malnutrition (SAM) treatment. In a recent experience in Kenya, Action Against Hunger| ACF International (ACF) conducted a coverage assessment to evaluate access to SAM and Moderate Acute Malnutrition (MAM) treatment. ACF supports the Ministry of Health (MoH) in delivering SAM and MAM treatment at health facility level through an Integrated Management of Acute Malnutrition (IMAM) programme in West Pokot county since 2011. In order to evaluate the coverage of Outpatient Therapeutic Programme (OTP) and Supplementary Feeding Programme (SFP) components, the Simplified Lot Quality Assurance Sampling Evaluation of Access and Coverage (SLEAC) methodology was used. The goals of the coverage assessment were i) to estimate coverage for OTP and SFP; ii) to identify barriers to access to SAM and MAM treatment; iii) to evaluate whether any differences exist between barriers to access to SAM versus to MAM treatment as SFP coverage and uptake of MAM services were never assessed before; and iv) to build local capacities in assessing coverage and to provide recommendations for the MoH-led IMAM programme. With the support of the Coverage Monitoring Network (CMN), ACF led the SLEAC assessment as part of an on-the-job training exercise for MoH and partners in July 2013, covering all of West Pokot county. SLEAC is a rapid and low-resource survey method that uses a three-tier classification approach to evaluate and classify coverage, i.e., low coverage: < 20%; moderate: 20% -50%; and high coverage: ≤ 50%. In a first sampling stage, villages in each of the four sub-counties were randomly selected using systematic sampling. In a second sampling stage, in order to also assess MAM coverage, a house-to-house approach was applied to identify all or near all acutely malnourished children using Mid Upper Arm Circumference (MUAC) tape and identification of bilateral

  13. Barriers to initiating tuberculosis treatment in sub-Saharan Africa: a systematic review focused on children and youth.

    Science.gov (United States)

    Sullivan, Brittney J; Esmaili, B Emily; Cunningham, Coleen K

    2017-01-01

    Tuberculosis (TB) is the deadliest infectious disease globally, with 10.4 million people infected and more than 1.8 million deaths in 2015. TB is a preventable, treatable, and curable disease, yet there are numerous barriers to initiating treatment. These barriers to treatment are exacerbated in low-resource settings and may be compounded by factors related to childhood. Timely initiation of tuberculosis (TB) treatment is critical to reducing disease transmission and improving patient outcomes. The aim of this paper is to describe patient- and system-level barriers to TB treatment initiation specifically for children and youth in sub-Saharan Africa through systematic review of the literature. This review was conducted in October 2015 in accordance with preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Six databases were searched to identify studies where primary or secondary objectives were related to barriers to TB treatment initiation and which included children or youth 0-24 years of age. A total of 1490 manuscripts met screening criteria; 152 met criteria for full-text review and 47 for analysis. Patient-level barriers included limited knowledge, attitudes and beliefs regarding TB, and economic burdens. System-level barriers included centralization of services, health system delays, and geographical access to healthcare. Of the 47 studies included, 7 evaluated cost, 19 health-seeking behaviors, and 29 health system infrastructure. Only 4 studies primarily assessed pediatric cohorts yet all 47 studies were inclusive of children. Recognizing and removing barriers to treatment initiation for pediatric TB in sub-Saharan Africa are critical. Both patient- and system-level barriers must be better researched in order to improve patient outcomes.

  14. Improving Hydrophobicity of Glass Surface Using Dielectric Barrier Discharge Treatment in Atmospheric Air

    International Nuclear Information System (INIS)

    Fang Zhi; Qiu Yuchang; Wang Hui; Kuffel, E

    2007-01-01

    Non-thermal plasmas under atmospheric pressure are of great interest in industrial applications, especially in material surface treatment. In this paper, the treatment of a glass surface for improving hydrophobicity using the non-thermal plasma generated by dielectric barrier discharge (DBD) at atmospheric pressure in ambient air is conducted, and the surface properties of the glass before and after the DBD treatment are studied by using contact angle measurement, surface resistance measurement and wet flashover voltage tests. The effects of the applied voltage and time duration of DBD on the surface modification are studied, and the optimal conditions for the treatment are obtained. It is found that a layer of hydrophobic coating is formed on the glass surface after spraying a thin layer of silicone oil and undergoing the DBD treatment, and the improvement of hydrophobicity depends on DBD voltage and treating time. It seems that there exists an optimum treating time for a certain applied voltage of DBD during the surface treatment. The test results of thermal aging and chemical aging show that the hydrophobic layer has quite stable characteristics. The interaction mechanism between the DBD plasma and the glass surface is discussed. It is concluded that CH 3 and large molecule radicals can react with the radicals in the glass surface to replace OH, and the hydrophobicity of the glass surface is improved accordingly

  15. Dielectric Barrier Discharge Plasma-Induced Photocatalysis and Ozonation for the Treatment of Wastewater

    International Nuclear Information System (INIS)

    Sun, Mok Young; Jin-Oh, Jo; Heon-Ju, Lee

    2008-01-01

    The physicochemical processes of dielectric barrier discharge (DBD) such as in-situ formation of chemically active species and emission of ultraviolet (UV)/visible light were utilized for the treatment of a simulated wastewater formed with Acid Red 4 as the model organic contaminant. The chemically active species (mostly ozone) produced in the DBD reactor were well distributed in the wastewater using a porous gas diffuser, thereby increasing the gas-liquid contact area. For the purpose of making the best use of the light emission, a titanium oxide-based photocatalyst was incorporated in the wastewater treating system. The experimental parameters chosen were the voltage applied to the DBD reactor, the initial pH of the wastewater, and the concentration of hydrogen peroxide added to the wastewater. The results have clearly shown that the present system capable of degrading organic contaminants in two ways (photocatalysis and ozonation) may be a promising wastewater treatment technology.

  16. Dielectric Barrier Discharge Plasma-Induced Photocatalysis and Ozonation for the Treatment of Wastewater

    Science.gov (United States)

    Mok, Young Sun; Jo, Jin-Oh; Lee, Heon-Ju

    2008-02-01

    The physicochemical processes of dielectric barrier discharge (DBD) such as in-situ formation of chemically active species and emission of ultraviolet (UV)/visible light were utilized for the treatment of a simulated wastewater formed with Acid Red 4 as the model organic contaminant. The chemically active species (mostly ozone) produced in the DBD reactor were well distributed in the wastewater using a porous gas diffuser, thereby increasing the gas-liquid contact area. For the purpose of making the best use of the light emission, a titanium oxide-based photocatalyst was incorporated in the wastewater treating system. The experimental parameters chosen were the voltage applied to the DBD reactor, the initial pH of the wastewater, and the concentration of hydrogen peroxide added to the wastewater. The results have clearly shown that the present system capable of degrading organic contaminants in two ways (photocatalysis and ozonation) may be a promising wastewater treatment technology.

  17. Reel-to-Reel Atmospheric Pressure Dielectric Barrier Discharge (DBD Plasma Treatment of Polypropylene Films

    Directory of Open Access Journals (Sweden)

    Lukas JW Seidelmann

    2017-03-01

    Full Text Available Atmospheric pressure plasma treatment of the surface of a polypropylene film can significantly increase its surface energy and, thereby improve the printability of the film. A laboratory-scale dielectric barrier discharge (DBD system has therefore been developed, which simulates the electrode configuration and reel-to-reel web transport mechanism used in a typical industrial-scale system. By treating the polypropylene in a nitrogen discharge, we have shown that the water contact angle could be reduced by as much as 40° compared to the untreated film, corresponding to an increase in surface energy of 14 mNm−1. Ink pull-off tests showed that the DBD plasma treatment resulted in excellent adhesion of solvent-based inks to the polypropylene film.

  18. From microscopic to macroscopic dynamics in mean-field theory: effect of neutron skin on fusion barrier and dissipation

    Energy Technology Data Exchange (ETDEWEB)

    Lacroix, D

    2001-07-01

    In this work, we introduce a method to reduce the microscopic mean-field theory to a classical macroscopic dynamics at the initial stage of fusion reaction. We show that TDHF (Time-dependent Hartree-Fock) could be a useful tool to infer information on the fusion barrier as well as on one-body dissipation effect. We apply the reduction of information to the case of head-on reaction between a {sup 16}O and {sup 16,22,24,28}O in order to quantify the effect of neutron skin on fusion. We show that the precise determination of fusion barrier requires, in addition to the relative distance between center of mass, the introduction of an additional collective coordinate that explicitly breaks the neutron-proton symmetry. With this additional collective variable, we obtain a rather precise determination of the barrier position, height and diffuseness as well as one-body friction. (author)

  19. Systemic barriers accessing HIV treatment among people who inject drugs in Russia: a qualitative study.

    Science.gov (United States)

    Sarang, Anya; Rhodes, Tim; Sheon, Nicolas

    2013-10-01

    Achieving 'universal access' to antiretroviral HIV treatment (ART) in lower income and transitional settings is a global target. Yet, access to ART is shaped by local social condition and is by no means universal. Qualitative studies are ideally suited to describing how access to ART is socially situated. We explored systemic barriers to accessing ART among people who inject drugs (PWID) in a Russian city (Ekaterinburg) with a large burden of HIV treatment demand. We undertook 42 in-depth qualitative interviews with people living with HIV with current or recent experience of injecting drug use. Accounts were analysed thematically, and supplemented here with an illustrative case study. Three core themes were identified: 'labyrinthine bureaucracy' governing access to ART; a 'system Catch 22' created by an expectation that access to ART was conditional upon treated drug use in a setting of limited drug treatment opportunity; and 'system verticalization', where a lack of integration across HIV, tuberculosis (TB) and drug treatment compromised access to ART. Taken together, we find that systemic factors play a key role in shaping access to ART with the potential adverse effects of reproducing treatment initiation delay and disengagement from treatment. We argue that meso-level systemic factors affecting access to ART for PWID interact with wider macro-level structural forces, including those related to drug treatment policy and the social marginalization of PWID. We note the urgent need for systemic and structural changes to improve access to ART for PWID in this setting, including to simplify bureaucratic procedures, foster integrated HIV, TB and drug treatment services, and advocate for drug treatment policy reform.

  20. Dynamics of {sup 58}Ni + {sup 54}Fe → {sup 112}Xe* reaction across the Coulomb barrier

    Energy Technology Data Exchange (ETDEWEB)

    Kaur, Manpreet; Sharma, Manoj K. [Thapar University, School of Physics and Materials Science, Patiala (India)

    2014-03-15

    The dynamical cluster-decay model (DCM) has been applied to study the decay of the {sup 112}Xe* compound nucleus formed in the massive heavy-ion reaction {sup 58}Ni + {sup 54}Fe at energies across the Coulomb barrier with E{sub c.m.} ∼ 85-110 MeV. The calculations are done for spherical fragmentation as well as by including deformation and orientation degrees of freedom of the decaying fragments. DCM-based cross sections give a nice description of the experimental fusion excitation function σ{sub ER}, within one parameter fitting, the neck length parameter (ΔR), whose value remains within the range of nuclear proximity interaction. The barrier height corresponding to the neck length parameter brings into the picture the barrier modification which enables us to address the data particularly at below barrier energies. The role of excitation energy (or temperature), deformations, orientations, angular momentum and diffuseness parameter is investigated to understand the dynamics of the {sup 58}Ni + {sup 54}Fe reaction. Finally the N/Z dependence of the fragmentation structure of different compound systems formed via {sup 58}Ni beam (projectile) is explored. (orig.)

  1. Financial barriers to utilization of screening and treatment services for breast cancer: an equity analysis in Nigeria.

    Science.gov (United States)

    Okoronkwo, I L; Ejike-Okoye, P; Chinweuba, A U; Nwaneri, A C

    2015-01-01

    To determine financial barriers that impede the utilization of screening and treatment services for breast cancer among Nigerian women from different socioeconomic groups. A descriptive study was carried out in 2013 among women attending the oncology clinic of a tertiary institution in Enugu, Southeast Nigeria. Data were collected from 270 women using an interviewer-administered questionnaire. The links between the influence of socioeconomic factors on barriers to the utilization of breast cancer screening and treatment services were examined. A total of 270 women were studied. The mean age was 34.69 (Standard deviation = 5.07) years. Half of the study participants were single 141 (51.3%), while 105 (38.2%) were married. Cost of medical treatment and not having insurance coverage was major financial barriers to utilization of screening and treatment services. The least poor and poor socioeconomic status (SES) groups utilized screening services and treatment more frequently than the very poor and poorest SES groups ( P = 0.034). There was no significant difference in the utilization of the different treatment options among the different socioeconomic groups with the exception of surgery (χ² = 11.397; P = 0.000). Financial barriers limit the ability of women, especially the poorest SES group, to utilize screening and treatment services for early diagnosis and treatment of breast cancer. Interventions that will improve financial risk protection for women with breast cancer or at risk of breast cancer are needed to ensure equitable access to screening and treatment services.

  2. EDX and ion beam treatment studies of filamentary in situ MgB2 wires with Ti barrier

    International Nuclear Information System (INIS)

    Rosova, A.; Kovac, P.; Husek, I.; Kopera, L.

    2011-01-01

    Highlights: → SiC-doped MgB 2 wires with Ti barrier showed good Jc in magnetic field. → Explanation why the Ti barrier fits to SiC-doped MgB 2 filaments. → Ti barrier getters Si from SiC-doped filaments and improve their properties. → Si accumulated in an inner layer of Ti barrier protects filaments from Cu diffusion. → Ion beam treatment helps to discover microstructure of complicated systems. - Abstract: In situ SiC-doped filamentary MgB 2 wires (with the diameter of 0.860 and 0.375 mm) with Cu stabilization separated by Ti barrier layers supported by outer SS sheath and annealed at 800 deg. C/0.5 h have been studied by combination of EDX analysis and ion beam selective etching. It was found that several Ti-Cu inter-metallic compounds were created by Cu-Ti interdiffusion and thus the barrier protection against Cu penetration into the superconducting filaments is limited. We showed an advantage of Ti use as the barrier material in our wires. Ti getters silicon out from the superconducting filament, what purges superconducting MgB 2 from Si and creates an additional Si-rich layer in inner part of Ti barrier which prevents Cu diffusion more effectively.

  3. Modulating the skin barrier function by DMSO: molecular dynamics simulations of hydrophilic and hydrophobic transmembrane pores

    NARCIS (Netherlands)

    den Otter, Wouter K.; Notman, R.; Anwar, J.; Noro, M.G.; Briels, Willem J.

    2008-01-01

    The dense lipid bilayers at the outer surface of the skin represent the primary barrier to molecules penetrating the human skin. One approach to overcome this barrier, with promising applications in administering medicinal drugs to the body, is to employ chemical permeability enhancers. How these

  4. Study of spatiotemporal dynamics of a nanosecond atmospheric-pressure dielectric barrier discharge in millimeter-long air gaps

    Energy Technology Data Exchange (ETDEWEB)

    Malashin, M. V.; Moshkunkov, S. I.; Khomich, V. Yu.; Shershunova, E. A., E-mail: eshershunova@gmail.com [Russian Academy of Sciences, Institute for Electrophysics and Electric Power (Russian Federation)

    2017-02-15

    The spatiotemporal dynamics of a nanosecond atmospheric-pressure dielectric barrier discharge in 1- to 3-mm-long air gaps was studied experimentally. By using a segmented electrode, data on the time evolution of the discharge in different regions of the discharge gap were obtained. The uniformity of the discharge over the cross section is estimated by analyzing the spatial distribution of its glow.

  5. Changes in skin barrier during treatment with systemic alitretinoin: focus on skin susceptibility and stratum corneum ceramides

    DEFF Research Database (Denmark)

    Jungersted, J.M.; Høgh, Julie Kaae; Hellgren, Lars

    2010-01-01

    ) was performed on the volar forearm and evaluated by trans-epidermal water loss (TEWL), erythema, and a cyanoacrylate skin sample was obtained for lipid analysis. We found no significant changes in response to SLS irritation as evaluated by TEWL and erythema, after treatment with alitretinoin for 2 months......Alitretinoin is a new drug for systemic treatment of chronic hand eczema. Previous functional tests of skin topically treated with retinoids have indicated impaired skin barrier function, but no data are available on barrier parameters after systemic alitretinoin treatment. To investigate...

  6. Barriers and Facilitators of Mental Health Treatment-Seeking in U.S. Active Duty Soldiers With Sexual Assault Histories.

    Science.gov (United States)

    Zinzow, Heidi M; Britt, Thomas W; Pury, Cynthia L S; Jennings, Kristen; Cheung, Janelle H; Raymond, Mary Anne

    2015-08-01

    Despite significant mental health needs among sexual assault (SA) victims in the military, little is known about treatment-seeking patterns or factors associated with service use. This study examined service use behavior, barriers, and facilitators of mental health treatment-seeking in an active duty sample of 927 U.S. Army soldiers with mental health problems. SA victims (n = 113) did not differ from non-victims on barriers or facilitators after adjusting for demographic and mental health variables, with stigma rated as the largest barrier. Most SA victims (87.6%) had sought informal support and 59.3% had sought formal treatment. One third of treatment-seekers had dropped out of treatment. Multivariate logistic regression analyses identified several correlates of treatment-seeking among SA victims: Black race (OR = 7.57), SA during the military (OR = 4.34), positive treatment beliefs (OR = 2.22), social support for treatment (OR = 2.14), self-reliance (OR = 0.47), and stigma towards treatment seekers (OR = 0.43). Mental health symptoms were not associated with treatment seeking. Findings suggested that treatment-facilitating interventions should focus on improving recognition of mental health symptoms, altering perceptions related to self-reliance, and reducing stigma. Interventions should also enlist support for treatment-seeking from unit members, leaders, and significant others. © 2015 International Society for Traumatic Stress Studies.

  7. Fifteen-year Assessment of a Permeable Reactive Barrier for Treatment of Chromate and Trichloroethylene in Groundwater

    Science.gov (United States)

    The fifteen-year performance of a granular iron, permeable reactive barrier (PRB; Elizabeth City, North Carolina) is reviewed with respect to contaminant treatment (hexavalent chromium and trichloroethylene) and hydraulic performance. Due to in-situ treatment of the chromium sou...

  8. Surface Treatment of Polypropylene Films Using Dielectric Barrier Discharge with Magnetic Field

    International Nuclear Information System (INIS)

    Wang Changquan; Zhang Guixin; Wang Xinxin; Chen Zhiyu

    2012-01-01

    Atmospheric pressure non-thermal plasma is of interest for industrial applications. In this study, polypropylene (PP) films are modified by a dielectric barrier discharge (DBD) with a non-uniform magnetic field in air at atmospheric pressure. The surface properties of the PP films before and after a DBD treatment are studied by using contact angle measurement, atomic force microscopy (AFM) and X-ray photoelectron spectroscopy (XPS). The effect of treatment time on the surface modification with and without a magnetic field is investigated. It is found that the hydrophilic improvement depends on the treatment time and magnetic field. It is also found that surface roughness and oxygen-containing groups are introduced onto the PP film surface after the DBD treatment. Surface roughness and oxygen-containing polar functional groups of the PP films increase with the magnetic induction density. The functional groups are identified as C-O, C=O and O-C=O by using XPS analysis. It is concluded that the hydrophilic improvement of PP films treated with a magnetic field is due to a greater surface roughness and more oxygen-containing groups. (plasma technology)

  9. How Greek nurses perceive and overcome the barriers in implementing treatment for pressure ulcers: 'against the odds'.

    Science.gov (United States)

    Kaba, E; Kelesi, M; Stavropoulou, A; Moustakas, D; Fasoi, G

    2017-09-01

    Although the occurrence of pressure ulcers (PUs) is now considered as an indicator of poor quality nursing care, questions and concerns remain regarding situations where PUs were unavoidable, irrespective of the care provided. The aim of this study was to explore Greek nurses' perceptions about the barriers involved and to identify the factors that influence care planning in PU treatment. A grounded theory approach was used and semi-structured interviews were conducted with nurses who provided pressure care to clients in a rehabilitation centre in Greece. Data were analysed using the constant comparative method. We interviewed seven nurses. Findings revealed one main category entitled 'anarchy' in delivery of care consisted of the following three subcategories: interdisciplinary conflicts; total trust in traditional knowledge; and devaluation of other's work/role and a core category 'Against the odds': the perceived value of prevention and treatment can overcome the barriers in treating PUs. This study gives an overview of the views and beliefs of nurses about the problems and barriers involved in PU prevention and treatment. The study reveals that although some barriers to good practice may exist, nurses can hold a positive attitude toward PU prevention and treatment, and their perceived value of prevention and treatment may help nurses to overcome the barriers in managing PUs.

  10. Barriers perceived by nurses in the optimal treatment of postoperative pain

    Directory of Open Access Journals (Sweden)

    Medrzycka-Dabrowka Wioletta

    2017-08-01

    Full Text Available It is currently estimated that the lack of adequate pain management affects 80% of the global population and the phenomenon poses a serious problem in more than 150 countries. On a national level, the greatest burden of inadequate treatment is borne, among others, by elderly patients. The purpose of the paper was to compare the prevalence of barriers to optimum post-operative pain management in elderly patients, observed by nurses in a clinical, provincial and municipal hospital in Poland. The research project was a multi-center one and took over a year. The study was questionnaire-based. It used the Polish version of the Nurses’ Perceived Obstacles to Pain Assessment and Management Practices questionnaire. The study included a total of 1602 nurses working at a clinical, provincial and municipal hospital.

  11. Psychometric Properties of the Barriers to Treatment Participation Scale-Expectancies

    NARCIS (Netherlands)

    Nanninga, Marieke; Jansen, Danielle E. M. C.; Kazdin, Alan E.; Knorth, Erik J.; Reijneveld, Sijmen A.

    Expectations concerning barriers to children's psychosocial care seem to be major drivers when seeking help, but validated questionnaires measuring expectations are not available. Therefore, this study examined the psychometric properties of the parent and adolescent versions of the Barriers to

  12. Barriers to community-based drug dependence treatment: implications for police roles, collaborations and performance indicators

    Science.gov (United States)

    Ma, Yi; Du, Chunhua; Cai, Thomas; Han, Qingfeng; Yuan, Huanhuan; Luo, Tingyan; Ren, Guoliang; Mburu, Gitau; Wang, Bangyuan; Golichenko, Olga; Zhang, Chaoxiong

    2016-01-01

    Introduction Worldwide, people who use drugs (PWUD) are among the populations at highest risk for HIV infection. In China, PWUD are primarily sentenced to compulsory detainment centres, in which access to healthcare, including HIV treatment and prevention services, is limited or non-existent. In 2008, China's 2008 Anti-Drug Law encouraged the development and use of community-based drug dependence rehabilitation, yet there is limited evidence evaluating the efficacy and challenges of this model in China. In this study, we explore these challenges and describe how cooperation between law enforcement and health departments can meet the needs of PWUD. Methods In 2015, we conducted semi-structured, in-depth interviews with all four staff members and 16 clients of the Ping An Centre No. 1 for community-based drug treatment, three local police officers and three officials from the local Centre for Disease Control. Interviews explored obstacles in implementing community-based drug dependence treatment and efforts to resolve these difficulties. Transcripts were coded and analyzed with qualitative data analysis software (MAXQDA 11). Results We identified three challenges to community-based drug treatment at the Ping An Centre No. 1: (1) suboptimal coordination among parties involved, (2) a divergence in attitudes towards PWUD and harm reduction between law enforcement and health officials and (3) conflicting performance targets for police and health officials that undermine the shared goal of treatment. We also identified the take-home methadone maintenance treatment model at the Ping An Centre No. 1 as an example of an early successful collaboration between the police, the health department and PWUD. Conclusions To overcome barriers to effective community-based drug treatment, we recommend aligning the goals of law enforcement and public health agencies towards health-based performance indicators. Furthermore, tensions between PWUD and police need to be addressed and trust

  13. Optimal control of HIV/AIDS dynamic: Education and treatment

    Science.gov (United States)

    Sule, Amiru; Abdullah, Farah Aini

    2014-07-01

    A mathematical model which describes the transmission dynamics of HIV/AIDS is developed. The optimal control representing education and treatment for this model is explored. The existence of optimal Control is established analytically by the use of optimal control theory. Numerical simulations suggest that education and treatment for the infected has a positive impact on HIV/AIDS control.

  14. The advantages and barriers in the implementation of a substance dependence treatment information system (SDTIS

    Directory of Open Access Journals (Sweden)

    Sima Ajami

    2015-01-01

    Full Text Available Addiction is a phenomenon that causes structural changes in different systems of society. Studies show for planning of addiction prevention and treatment, it is necessary to create an information management system. Substance dependence information systems refer to systems which collect, analyse and report data related to substance dependence information. The aim of this study was to identify advantages and barriers to implement Substance Dependence Treatment Information System (SDTIS. This study was a narrative review. Our review divided into three phases: literature collection, assessing, and selection. We employed the following keywords and their combinations in different areas of articles. In this study, 22 of collected articles and reports were selected based on their relevancy. We found many advantages for a substance dependence treatment information system such as recording sufficient, complete and accurate information and easy and timely access to them and monitoring and enhancing the quality of care received by patients. But we may face some concerns for implementing this information system like taking time and funds from client services, being expensive or even problems regarding the quality of data contained in these information systems. There are some important problems in the way of implementing. In order to overcome these issues, we need to raise community awareness.

  15. Non-pharmacological treatment of ankylosing spondylitis: Barriers to effective implementation of recommendations in Morocco

    Directory of Open Access Journals (Sweden)

    Abderrazak Hajjioui

    2014-01-01

    Full Text Available This cross-sectional study aimed to describe non-pharmacological treatment modalities in Moroccan patients with ankylosing spondylitis (AS, and to approach physical therapy implementation barriers. 61 patients with AS according to New York classification criteria were included in the study. Socio-demographic data and clinical characteristics were collected and different therapeutic modalities, including physical therapy were investigated. The mean age of the patients was 38.20 (SD 12.36 years with a male/female ratio of 1.5. 55 (90% patients received pharmacological therapy, 37 (60.7% received physical therapy, 5(8.2% underwent surgery and 36 (59% tried at least one type of complementary medicine (medicine plants, sand baths, acupuncture, fire needles, and cupping. Patients’ major expectations from physical therapy were improving their functional status (86.5%, and reducing their pain (59.5%. Most patients (86.49% were satisfied of their physical therapy and 56.8% practiced home exercises. Reasons for nonattendance to physical therapy for the remaining 24 patients were nonprescription (58.3%, lack of financial resources (20.8%, geographical remoteness from rehabilitation centers (4% and lack of motivation (17%. Non-pharmacological treatment, especially based on exercise and education, is an integral part of the comprehensive management of AS. However, it is not efficiently implemented in Morocco and more effort should be made to develop this both efficient and relatively inexpensive component of AS treatment.

  16. Mineral oil barrier sequential polymer treatment for recycled paper products in food packaging

    Science.gov (United States)

    Paul, Uttam C.; Fragouli, Despina; Bayer, Ilker S.; Mele, Elisa; Conchione, Chiara; Cingolani, Roberto; Moret, Sabrina; Athanassiou, Athanassia

    2017-01-01

    Recycled cellulosic paperboards may include mineral oils after the recycle process, which together with their poor water resistance limit their use as food packaging materials. In this work, we demonstrate that a proper functionalization of the recycled paper with two successive polymer treatments, imposes a mineral oil migration barrier and simultaneously renders it waterproof and grease resistant, making it an ideal material for food contact. The first poly (methyl methacrylate) treatment penetrates the paper network and creates a protective layer around every fiber, permitting thus the transformation of the paperboard to a hydrophobic material throughout its thickness, reducing at the same time the mineral oil migration. Subsequently, the second layer with a cyclic olefin copolymer fills the open pores of the surface, and reduces the mineral oil hydrocarbons migration at levels below those proposed by the BMEL. Online liquid chromatography-gas chromatography coupled with flame ionization detection quantitatively demonstrate that this dual functional treatment prevents the migration of both saturated (mineral oil saturated hydrocarbons) and aromatic hydrocarbon (mineral oil aromatic hydrocarbons) mineral oils from the recycled paperboard to a dry food simulant.

  17. The advantages and barriers in the implementation of a substance dependence treatment information system (SDTIS).

    Science.gov (United States)

    Ajami, Sima; Mellat-Karkevandi, Zahra

    2015-11-01

    Addiction is a phenomenon that causes structural changes in different systems of society. Studies show for planning of addiction prevention and treatment, it is necessary to create an information management system. Substance dependence information systems refer to systems which collect, analyse and report data related to substance dependence information. The aim of this study was to identify advantages and barriers to implement Substance Dependence Treatment Information System (SDTIS). This study was a narrative review. Our review divided into three phases: literature collection, assessing, and selection. We employed the following keywords and their combinations in different areas of articles. In this study, 22 of collected articles and reports were selected based on their relevancy. We found many advantages for a substance dependence treatment information system such as recording sufficient, complete and accurate information and easy and timely access to them and monitoring and enhancing the quality of care received by patients. But we may face some concerns for implementing this information system like taking time and funds from client services, being expensive or even problems regarding the quality of data contained in these information systems. There are some important problems in the way of implementing. In order to overcome these issues, we need to raise community awareness.

  18. Barriers to innovation in human rabies prophylaxis and treatment: A causal analysis of insights from key opinion leaders and literature.

    Science.gov (United States)

    van de Burgwal, L H M; Neevel, A M G; Pittens, C A C M; Osterhaus, A D M E; Rupprecht, C E; Claassen, E

    2017-12-01

    Rabies is an essentially 100% fatal, zoonotic disease, caused by Lyssaviruses. Currently, the disease is vaccine-preventable with pre- and post-exposure prophylaxis (PrEP and PEP). Still, rabies virus is estimated to cause up to 60,000 human deaths annually, of which the vast majority occurs in rural Asia and Africa, due to the inaccessibility of prophylaxis and non-existence of treatment. Despite these unmet clinical needs, rabies control mainly focuses on the sylvatic reservoir and drug innovation receives relatively little attention compared to other neglected tropical diseases (NTDs). As such, the lag of innovation in human rabies prophylaxis and treatment cannot be explained by limited return on investment alone. Strategies countering rabies-specific innovation barriers are important for the acceleration of innovation in human rabies prophylaxis and treatment. Barriers throughout society, science, business development and market domains were identified through literature review and 23 semi-structured interviews with key opinion leaders worldwide. A subsequent root cause analysis revealed causal relations between innovation barriers and a limited set of root causes. Finally, prioritization by experts indicated their relative importance. Root causes, which are fundamental to barriers, were aggregated into four types: market and commercial, stakeholder collaboration, public health and awareness, and disease trajectory. These were found in all domains of the innovation process and thus are relevant for all stakeholders. This study identifies barriers that were not previously described in this specific context, for example the competition for funding between medical and veterinary approaches. The results stress the existence of barriers beyond the limited return on investment and thereby explain why innovation in human rabies medication is lagging behind NTDs with a lower burden of disease. A re-orientation on the full spectrum of barriers that hinder innovation in

  19. Determinants of High Blood Pressure and Barriers to Diagnosis and Treatment in Dar es Salaam, Tanzania

    Science.gov (United States)

    ZACK, Rachel M.; IREMA, Kahema; KAZONDA, Patrick; LEYNA, Germana H.; LIU, Enju; SPIEGELMAN, Donna; FAWZI, Wafaie; NJELEKELA, Marina; KILLEWO, Japhet; DANAEI, Goodarz

    2017-01-01

    Objectives We assessed prevalence and determinants of high blood pressure, and barriers to diagnosis and treatment, in Dar es Salaam, Tanzania. Methods We surveyed and screened 2,174 community-dwelling adults aged ≥40 years in 2014 and conducted a follow-up after one year. Results Median blood pressure was 131/81 mmHg and hypertension prevalence was 37%. Mean adjusted difference in SBP was 4.0 mmHg for overweight, 6.3 mmHg for obese class I, and 10.5 mmHg for obese class II/III compared with normal weight participants. Those who were physically inactive had 4.8 mmHg higher SBP compared to those with more than 24 hours of moderate or vigorous activity per week. Drinkers of at least 10 grams of alcohol per day had 4.5 mmHg higher SBP than did non-drinkers. Among hypertensives, 48% were diagnosed, 22% were treated, and 10% were controlled. Hypertensives without health insurance were 12% less likely to be diagnosed than insured hypertensives. Of referred participants, 68% sought care, but only 27% were on treatment and 8% had controlled blood pressure at follow-up. Reasons for not seeking care included lack of symptoms, cost of visit, and lack of time. Reasons for not being on treatment included lack of symptoms, not being prescribed treatment, and having finished one course of treatment. Conclusions Major risk factors for hypertension in Dar es Salaam are overweight, obesity, inadequate physical activity, and limited access to quality medical care. Increased insurance coverage and community-based screening, along with quality medical care and patient education, may help control this burgeoning epidemic. PMID:27648720

  20. Microscopic approach of molecular dynamics. Applications to reactions near the barrier; Approches microscopiques de la dynamique nucleaire. Applications aux reactions autour de la barriere

    Energy Technology Data Exchange (ETDEWEB)

    Simenel, C.; Avez, B. [CEA Saclay, Dept. d' Astrophysique, de Physique des Particules de Physique Nucleaire et de l' Instrumentation Associee (DSM/DAPNIA/SPhN), 91- Gif sur Yvette (France); Lacroix, D. [GANIL, 14 - Caen (France)

    2007-07-01

    This lecture introduces several microscopic approaches to nuclear dynamics. Our goal is to provide a good description of low energy heavy ions collisions. We study both the formalism and the practical application of the time-dependent Hartree-Fock (TDHF) theory. The TDHF approach gives a mean field dynamics of the system under the assumption of independent particles. As an example, we study the fusion of both spherical and deformed nuclei with TDHF. We also show that nucleon transfer may occur between nuclei below the barrier. These studies allow us to specify the field of applications of TDHF in one hand, and, in the other hand, its intrinsic limitations, as for instance the fact that there is no fusion by tunnel effect with TDHF. It is then important to get rid of the independent particle assumption. We finally present some approaches to go beyond TDHF, including for instance pairing and/or collision term between nucleons, though only few realistic applications have been performed so far. (authors)

  1. Chemical dynamics between wells across a time-dependent barrier: Self-similarity in the Lagrangian descriptor and reactive basins.

    Science.gov (United States)

    Junginger, Andrej; Duvenbeck, Lennart; Feldmaier, Matthias; Main, Jörg; Wunner, Günter; Hernandez, Rigoberto

    2017-08-14

    In chemical or physical reaction dynamics, it is essential to distinguish precisely between reactants and products for all times. This task is especially demanding in time-dependent or driven systems because therein the dividing surface (DS) between these states often exhibits a nontrivial time-dependence. The so-called transition state (TS) trajectory has been seen to define a DS which is free of recrossings in a large number of one-dimensional reactions across time-dependent barriers and thus, allows one to determine exact reaction rates. A fundamental challenge to applying this method is the construction of the TS trajectory itself. The minimization of Lagrangian descriptors (LDs) provides a general and powerful scheme to obtain that trajectory even when perturbation theory fails. Both approaches encounter possible breakdowns when the overall potential is bounded, admitting the possibility of returns to the barrier long after the trajectories have reached the product or reactant wells. Such global dynamics cannot be captured by perturbation theory. Meanwhile, in the LD-DS approach, it leads to the emergence of additional local minima which make it difficult to extract the optimal branch associated with the desired TS trajectory. In this work, we illustrate this behavior for a time-dependent double-well potential revealing a self-similar structure of the LD, and we demonstrate how the reflections and side-minima can be addressed by an appropriate modification of the LD associated with the direct rate across the barrier.

  2. Missed treatment opportunities and barriers to comprehensive treatment for sexual violence survivors in Kenya: a mixed methods study.

    Science.gov (United States)

    Gatuguta, Anne; Merrill, Katherine G; Colombini, Manuela; Soremekun, Seyi; Seeley, Janet; Mwanzo, Isaac; Devries, Karen

    2018-06-19

    In Kenya, most sexual violence survivors either do not access healthcare, access healthcare late or do not complete treatment. To design interventions that ensure optimal healthcare for survivors, it is important to understand the characteristics of those who do and do not access healthcare. In this paper, we aim to: compare the characteristics of survivors who present for healthcare to those of survivors reporting violence on national surveys; understand the healthcare services provided to survivors; and, identify barriers to treatment. A mixed methods approach was used. Hospital records for survivors from two referral hospitals were compared with national-level data from the Kenya Demographic and Health Survey 2014, and the Violence Against Children Survey 2010. Descriptive summaries were calculated and differences in characteristics of the survivors assessed using chi-square tests. Qualitative data from six in-depth interviews with healthcare providers were analysed thematically. Among the 543 hospital respondents, 93.2% were female; 69.5% single; 71.9% knew the perpetrator; and 69.2% were children below 18 years. Compared to respondents disclosing sexual violence in nationally representative datasets, those who presented at hospital were less likely to be partnered, male, or assaulted by an intimate partner. Data suggest missed opportunities for treatment among those who did present to hospital: HIV PEP and other STI prophylaxis was not given to 30 and 16% of survivors respectively; 43% of eligible women did not receive emergency contraceptive; and, laboratory results were missing in more than 40% of the records. Those aged 18 years or below and those assaulted by known perpetrators were more likely to miss being put on HIV PEP. Qualitative data highlighted challenges in accessing and providing healthcare that included stigma, lack of staff training, missing equipment and poor coordination of services. Nationally, survivors at higher risk of not accessing

  3. A submesoscale coherent vortex in the Ligurian Sea: From dynamical barriers to biological implications

    Science.gov (United States)

    Bosse, Anthony; Testor, Pierre; Mayot, Nicolas; Prieur, Louis; D'Ortenzio, Fabrizio; Mortier, Laurent; Le Goff, Hervé; Gourcuff, Claire; Coppola, Laurent; Lavigne, Héloïse; Raimbault, Patrick

    2017-08-01

    In June 2013, a glider equipped with oxygen and fluorescence sensors has been used to extensively sample an anticyclonic Submesoscale Coherent Vortex (SCV) in the Ligurian Sea (NW Mediterranean Sea). Those measurements are complemented by full-depth CTD casts (T, S, and oxygen) and water samples documenting nutrients and phytoplankton pigments within the SCV and outside. The SCV has a very homogeneous core of oxygenated waters between 300 and 1200 m formed 4.5 months earlier during the winter deep convection event. It has a strong dynamical signature with peak velocities at 700 m depth of 13.9 cm s-1 in cyclogeostrophic balance. The eddy has a small radius of 6.2 km corresponding to high Rossby number of -0.45. The vorticity at the eddy center reaches -0.8f. Cross-stream isopycnic diffusion of tracers between the eddy core and the surroundings is found to be very limited due to dynamical barriers set by the SCV associated with a diffusivity coefficient of about 0.2 m2 s-1. The deep core is nutrients-depleted with concentrations of nitrate, phosphate, and silicate, 13-18% lower than the rich surrounding waters. However, the nutriclines are shifted of about 20-50 m toward the surface thus increasing the nutrients availability for phytoplankton. Chlorophyll-a concentrations at the deep chlorophyll maximum are subsequently about twice bigger as compared to outside. Pigments further reveal the predominance of nanophytoplankton inside the eddy and an enhancement of the primary productivity. This study demonstrates the important impact of postconvective SCVs on nutrients distribution and phytoplankton community, as well as on the subsequent primary production and carbon sequestration.Plain Language SummaryDue to harsh meteorological conditions in winter, a few places of the world's ocean experience an intense cooling of their surface waters that start to sink in a process called oceanic deep convection. It is crucial for the functioning of the ocean, but also the marine

  4. Adjunctive Effect of Autologus Platelet-Rich Fibrin to Barrier Membrane in the Treatment of Periodontal Intrabony Defects.

    Science.gov (United States)

    Panda, Saurav; Sankari, Malaiappan; Satpathy, Anurag; Jayakumar, Doraiswamy; Mozzati, Marco; Mortellaro, Carmen; Gallesio, Giorgia; Taschieri, Silvio; Del Fabbro, Massimo

    2016-05-01

    Autologous platelet-rich fibrin (PRF) and barrier membranes in the treatment of intrabony defects in chronic periodontitis patients have shown significant clinical benefits. This study evaluates the additive effect of autologous PRF in combination with a barrier membrane versus the use of barrier membrane alone for the treatment of intrabony defects in chronic periodontitis patients. A randomized split-mouth design was used. Sixteen patients with 32 paired intrabony defects were included. In each patient 1 defect was treated using a resorbable collagen membrane along with PRF (test group) and the other defect by guided tissue regeneration alone (control group). The following clinical parameters were measured at baseline and after 9 months: plaque index, modified sulcus bleeding index, probing pocket depth, clinical attachment level, and gingival marginal level. The radiographic defect depth was also assessed at baseline and after 9 months. Test group showed a statistically significant improvement for probing depth (P = 0.002), clinical attachment level (P = 0.001), and radiographic defect depth (P < 0.001) after 9 months as compared with the control sites. Radiographic defect depth reduction was 58.19 ± 13.24% in the test group as compared with 24.86 ± 9.94% reduction in the control group. The adjunctive use of PRF in combination with barrier membrane is more effective in the treatment of intrabony defects in chronic periodontitis as compared with barrier membrane alone.

  5. Barriers and facilitators to ED physician use of the test and treatment for BPPV.

    Science.gov (United States)

    Kerber, Kevin A; Forman, Jane; Damschroder, Laura; Telian, Steven A; Fagerlin, Angela; Johnson, Patricia; Brown, Devin L; An, Lawrence C; Morgenstern, Lewis B; Meurer, William J

    2017-06-01

    The test and treatment for benign paroxysmal positional vertigo (BPPV) are evidence-based practices supported by clinical guideline statements. Yet these practices are underutilized in the emergency department (ED) and interventions to promote their use are needed. To inform the development of an intervention, we interviewed ED physicians to explore barriers and facilitators to the current use of the Dix-Hallpike test (DHT) and the canalith repositioning maneuver (CRM). We conducted semi-structured in-person interviews with ED physicians who were recruited at annual ED society meetings in the United States. We analyzed data thematically using qualitative content analysis methods. Based on 50 interviews with ED physicians, barriers that contributed to infrequent use of DHT/CRM that emerged were (1) prior negative experiences or forgetting how to perform them and (2) reliance on the history of present illness to identify BPPV, or using the DHT but misattributing patterns of nystagmus. Based on participants' responses, the principal facilitator of DHT/CRM use was prior positive experiences using these, even if infrequent. When asked which clinical supports would facilitate more frequent use of DHT/CRM, participants agreed supports needed to be brief, readily accessible, and easy to use, and to include well-annotated video examples. Interventions to promote the use of the DHT/CRM in the ED need to overcome prior negative experiences with the DHT/CRM, overreliance on the history of present illness, and the underuse and misattribution of patterns of nystagmus. Future resources need to be sensitive to provider preferences for succinct information and video examples.

  6. Challenges for providing health care in traumatized populations: barriers for PTSD treatments and the need for new developments.

    Science.gov (United States)

    Kazlauskas, Evaldas

    2017-01-01

    There is a growing recognition about the effects of traumatic experiences on mental health worldwide. With ongoing conflicts, natural disasters, interpersonal violence, and other traumatic events it is estimated that approximately 70% of the global population have been exposed to at least one lifetime traumatic experience. Research shows a substantial proportion of survivors, especially in low- and middle-income countries, would have a posttraumatic stress disorder (PTSD). During recent decades effective evidence-based treatments for PTSD have been developed. However, there are significant barriers to mental health services and trauma-informed treatments are not easily available for trauma survivors. From the perspective of social psychotraumatology several core barriers to trauma treatments were identified, including the lack of acknowledgment, and avoidance of disclosure. The need for cultural sensitivity in PTSD treatments, the potential of alternative ways of treatment delivery, and the involvement of non-professional volunteers are proposed as directions for future developments in the field.

  7. Obsessive-compulsive disorder in African American children and adolescents: Risks, resiliency, and barriers to treatment.

    Science.gov (United States)

    Williams, Monnica T; Jahn, Matthew E

    2017-01-01

    Obsessive-compulsive disorder (OCD) is a serious condition that remains understudied in ethnoracial minority populations. The presence of OCD and the individual, familial, and cultural factors that influence this condition can interfere with healthy development and cause lifelong disability. To date, there has not been a single published research article focused on OCD in African American youth. Ethnic and racial minorities with OCD are underrepresented or altogether absent from treatment centers and research studies, although evidence suggests that OCD may be particularly persistent in these populations. This article reviews risk factors, protective factors, and barriers to treatment in African American children and adolescents with OCD. This review conceptualizes cultural differences in symptomology, low income, reduced access to care, racism, and mental health stigma, as risk factors. Also discussed are the roles of family factors in the development and maintenance of the disorder, including family accommodations, conflictual family communication, and parenting styles. Potential protective factors are also examined, including a positive ethnic identity, social support, present-centered time orientation, and religious communities. Implications of findings are discussed. There is an urgent need for research to understand the needs of African American children and adolescents with OCD. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  8. A Community-Engaged Assessment of Barriers and Facilitators to Rapid Stroke Treatment

    Science.gov (United States)

    Nemeth, Lynne S.; Jenkins, Carolyn; Jauch, Edward C.; Conway, Sharon; Pearlman, Adam; Spruill, Ida J.; Brown, Lynette J.; Linnen, Joyce; Linnen, Florene; Andrews, Jeannette O.

    2016-01-01

    Treatment for acute ischemic stroke must be initiated within hours of stroke symptom onset, and the sooner it is administered, the better. In South Carolina, 76% of the population can access expert stroke care, and rural hospitals may provide specialized treatment using telemedicine, but many stroke sufferers seek care too late to achieve full benefit. Using a community-engaged approach in a southern rural community, we explored barriers and facilitators to early stroke care and implications for improvement. The Community-Engaged Assessment to facilitate Stroke Elimination (CEASE) study was guided by a community advisory group to ensure community centeredness and local relevance. In a qualitative descriptive study, eight focus groups were conducted including 52 individuals: recent stroke survivors, family members, emergency medical personnel, hospital emergency department staff, primary care providers, and community leaders. From analysis of focus group transcripts came six themes: lack of trust in healthcare system and providers; weak relationships fueled by poor communication; low health literacy; financial limitations related to health care; community-based education; and faith as a message of hope. A hierarchy model for improving early community-based stroke care was developed through consensus dialogue by community representatives and the research team. This model can be used to inform a community-partnered, stake-holder-informed intervention to improve stroke care in a rural southern community with the goal of improving stroke education, care, and outcome. PMID:27545591

  9. Implementation of a permeable reactive barrier for treatment of groundwater impacted by strontium-90

    International Nuclear Information System (INIS)

    Przepiora, A.; Bodine, D.; Dollar, P.; Smith, P.

    2014-01-01

    A funnel and gate permeable reactive barrier (PRB) system was constructed to treat strontium-90 (Sr- 90) in groundwater migrating from a legacy waste disposal area into an adjacent wetland. The PRB system was designed to contain and direct the Sr-90 impacted groundwater into treatment 'gates' containing zeolite using a low permeability 'funnel' sections constructed with soil-bentonite slurry. The constructed PRB met all dimension and permeability specifications. Initial performance monitoring results indicate that the PRB captured the Sr-90 impacted groundwater plume and the beta radiation values in groundwater emerging from the treatment gates ranged from 35 to 86 Becquerel's per litre (Bq/L), equivalent to a reduction by 88% to 99% from the influent values. Those initial performance results were influenced by residual impacts present in the aquifer material prior to PRB installation. It is anticipated that the clean-up target of 5 Bq/L will be achieved with time as treated groundwater emerging from the PRB flushes through the downgradient aquifer zone. (author)

  10. Growth and male reproduction improvement of non-thermal dielectric barrier discharge plasma treatment on chickens

    Science.gov (United States)

    Jiao Zhang, Jiao; Luong Huynh, Do; Chandimali, Nisansala; Kang, Tae Yoon; Kim, Nameun; Mok, Young Sun; Kwon, Taeho; Jeong, Dong Kee

    2018-05-01

    This study investigated whether plasma treatment of fertilized eggs before hatching could affect the growth and reproduction of chickens. Three point five-day-incubated fertilized eggs exposed to non-thermal dielectric barrier discharge plasma at 2.81 W of power for 2 min resulted in the highest growth in chickens. Plasma growth-promoting effect was regulated by the reactive oxygen species homeostasis and the improvement of energy metabolism via increasing serum hormones and adenosine triphosphate levels which were resulted from the regulation of genes involved in antioxidant defense, hormone biosynthesis and energetic metabolism. Interestingly, plasma-treated male chickens conspicuously grew faster than females. Further, aspects of male reproductive system (testosterone level and sperm quality) were improved by the plasma treatment but female reproduction (estradiol and progesterone levels, egg-laying rate and egg weight) had no significant changes. Unfortunately, offspring whose parents were the optimal plasma-treated chickens did not show any difference on growth characteristics and failed to inherit excellent growth features from their parents. Our results suggest a new method to improve the growth rate and male reproductive capacity in poultry but it is only effective in the plasma direct-treated generation.

  11. Oxygen plasma etching of graphene: A first-principles dynamical inspection of the reaction mechanisms and related activation barriers

    Science.gov (United States)

    Koizumi, Kenichi; Boero, Mauro; Shigeta, Yasuteru; Oshiyama, Atsushi; Dept. of Applied Physics Team; Institute of Physics and Chemistry of Strasbourg (IPCMS) Collaboration; Department Of Materials Engineering Science Collaboration

    2013-03-01

    Oxygen plasma etching is a crucial step in the fabrication of electronic circuits and has recently received a renovated interest in view of the realization of carbon-based nanodevices. In an attempt at unraveling the atomic-scale details and to provide guidelines for the control of the etching processes mechanisms, we inspected the possible reaction pathways via reactive first principles simulations. These processes involve breaking and formation of several chemical bonds and are characterized by different free-energy barriers. Free-energy sampling techniques (metadynamics and blue moon), used to enhance the standard Car-Parrinello molecular dynamics, provide us a detailed microscopic picture of the etching of graphene surfaces and a comprehensive scenario of the activation barriers involved in the various steps. MEXT, Japan - contract N. 22104005

  12. Poloidal rotation dynamics, radial electric field, and neoclassical theory in the jet internal-transport-barrier region.

    Science.gov (United States)

    Crombé, K; Andrew, Y; Brix, M; Giroud, C; Hacquin, S; Hawkes, N C; Murari, A; Nave, M F F; Ongena, J; Parail, V; Van Oost, G; Voitsekhovitch, I; Zastrow, K-D

    2005-10-07

    Results from the first measurements of a core plasma poloidal rotation velocity (upsilontheta) across internal transport barriers (ITB) on JET are presented. The spatial and temporal evolution of the ITB can be followed along with the upsilontheta radial profiles, providing a very clear link between the location of the steepest region of the ion temperature gradient and localized spin-up of upsilontheta. The upsilontheta measurements are an order of magnitude higher than the neoclassical predictions for thermal particles in the ITB region, contrary to the close agreement found between the determined and predicted particle and heat transport coefficients [K.-D. Zastrow, Plasma Phys. Controlled Fusion 46, B255 (2004)]. These results have significant implications for the understanding of transport barrier dynamics due to their large impact on the measured radial electric field profile.

  13. Influence of thermal barrier effect of grain boundaries on bulk cascades in alpha-zirconium revealed by molecular dynamics simulation

    Energy Technology Data Exchange (ETDEWEB)

    Jin, Yanan; Lai, Wensheng, E-mail: wslai@tsinghua.edu.cn

    2016-03-15

    The effect of grain boundaries (GBs) on bulk cascades in nano-structured alpha-zirconium has been studied by molecular dynamics (MD) simulations. It turns out that the existence of GBs increases the defect productivity in grains, suggesting that the GBs may act as a thermal barrier and postpone the annihilation of defects within grains. Moreover, it is found that the thermal barrier effect of GBs facilitates the shift of symmetric tilt GBs to the grain with higher temperature, and the smaller the tilt angle is, the easier the boundary shift will be. Thus, the influence of GBs on radiation damage in the nano-structured materials comes from the competition between damage increase in grains and defect annihilation at GBs.

  14. Treatment of EDTA contained reactor coolant using water dielectric barrier discharge plasma

    International Nuclear Information System (INIS)

    Song, Sang Heon; Kwon, Daniel; Kim, Gon Ho

    2005-01-01

    EDTA (Ethylene Diamine Tetraacetic Acid) is used as a main absorbent for the metal ion in the secondary loop of the nuclear reactor. Dissolving the wasted EDTA with low cost, therefore, is important issue for the maintenance of the nuclear power reactor and the protection of environment. EDTA is not easily biodegradable, furthermore these methods could make remained another pollutant as complex chemical compounds. Compared to chemical method, the physical methods, using the energetic particles and UVs, are more favorable because they dissociate the bonds of organic compounds directly without the secondary chemical reactions during the treatment. Recently, high energy electron beam, the plasma torch, and the water breakdown by high voltage pulse are applied to treatment of the waste water contained chemicals. Here consideration is narrow down to improve the interaction between the plasma and the chemical bonds of EDTA because the energetic particles; activated radicals, and UVs, are abundant in plasmas. The new method adapted of the water DBD (dielectric barrier discharge) which plasma generates directly on the top of the water contained EDTA is proposed. The application of DBD plasmas has been extended for cleaning the organic compounds from the contaminated surface and also for removing volatile organic chemicals (VOC) such as NO x and SO x from the exhausted gases. Here, the water DBD reactor (SEMTECH, SD-DWG-04-1) is consisted that the one electrode is a ceramic insulator and another one is the water itself. Interestingly, the one electrode, the water, is not the solid dielectric electrode. In this study, therefore, the characteristics with driving frequency are considered and the feasibility of this new method for the DBD treatment of EDTA contained water is demonstrated

  15. A comparative study of core and edge transport barrier dynamics of DIII-D and TFTR tokamak plasmas

    International Nuclear Information System (INIS)

    Synakowski, E.J.; Beer, M.; Bell, R.E.

    2001-01-01

    Confinement bifurcations and subsequent plasma dynamics in the TFTR core and the DIII-D core and edge are compared in order to identify a common physics basis. Observations suggest a framework in which ExB shear plays a dominant role in the barrier dynamics. In TFTR, bifurcations from the reverse shear (RS) into the enhanced reverse shear (ERS) regime with high power balanced neutral beam heating (above 25 MW at 4.8 T) resemble edge H mode transitions observed on DIII-D. In both, radial electric field (E r ) excursions precede confinement changes and are manifest as localized changes in the impurity poloidal rotation. Reduced transport follows the excursions, and in both cases strong E r shear is reinforced by the plasma pressure. These characteristics are contrasted with DIII-D negative central shear (NCS) barrier evolution with unidirectional beam injection. There, the improved confinement region can develop slowly, depending on the neutral beam input power and torque. Rapid expansion and deepening of this region follows an increase in the neutral beam heating power. The initial formation phase is modulated by confinement steps and interruptions. An analog for these steps is found in TFTR RS plasmas. Although these do not dominate the TFTR plasma evolution during low power (7 MW) heating, they can represent significant transport reductions when additional heating is applied. In both devices, no strong excursion in E r precedes these latter confinement bifurcations. The triggering event of these steps may be related to current profile relaxation, but it is not always connected with simple integral or half-integer values of the minimum in the q profile. Finally, variations of E r and the ExB shear through the application of unidirectional injection on TFTR yielded plasmas with confinement characteristics and barrier dynamics similar to those of DIII-D NCS plasmas. The data underscore that the physics responsible for the enhanced confinement states is fundamentally

  16. A comparative study of core and edge transport barrier dynamics of DIII-D and TFTR tokamak plasmas

    International Nuclear Information System (INIS)

    Synakowski, E.J.; Beer, M.A.; Bell, R.E.

    1999-01-01

    Confinement bifurcations and subsequent plasma dynamics in the TFTR core and the DIII-D core and edge are compared in order to identify a common physics basis. Observations suggest a framework in which ExB shear plays a dominant role in the barrier dynamics. In TFTR, bifurcations from the reverse shear (RS) into the enhanced reverse shear (ERS) regime with high power balanced neutral beam heating (above 25 MW at 4.8 T) resemble edge H mode transitions observed on DIII-D. In both, radial electric field (E r ) excursions precede confinement changes and are manifest as localized changes in the impurity poloidal rotation. Reduced transport follows the excursions, and in both cases strong E r shear is reinforced by the plasma pressure. These characteristics are contrasted with DIII-D negative central shear (NCS) barrier evolution with unidirectional beam injection. There, the improved confinement region can develop slowly, depending on the neutral beam input power and torque. Rapid expansion and deepening of this region follows an increase in the neutral beam heating power. The initial formation phase is modulated by confinement steps and interruptions. An analog for these steps is found in TFTR RS plasmas. Although these do not dominate the TFTR plasma evolution during low power (7 MW) heating, they can represent significant transport reductions when additional heating is applied. In both devices, no strong excursion in E r precedes these latter confinement bifurcations. The triggering event of these steps may be related to current profile relaxation, but it is not always connected with simple integral or half-integer values of the minimum in the q profile. Finally, variations of E r and the ExB shear through the application of unidirectional injection on TFTR yielded plasmas with confinement characteristics and barrier dynamics similar to those of DIII-D NCS plasmas. The data underscore that the physics responsible for the enhanced confinement states is fundamentally

  17. Barriers to access to antiretroviral treatment in Mozambique, as perceived by patients and health workers in urban and rural settings.

    NARCIS (Netherlands)

    Posse, M.E.; Baltussen, R.M.P.M.

    2009-01-01

    This study identifies, ranks, and compares factors perceived as barriers to accessing antiretroviral treatment (ART) in urban and rural settings in Mozambique. Data were collected between March and July 2008. It consisted of 13 focus group discussions and a structured questionnaire administered to

  18. A Social-Ecological View of Barriers and Facilitators for HIV Treatment Adherence: Interviews with Puerto Rican HIV Patients.

    Directory of Open Access Journals (Sweden)

    Eida M Castro

    Full Text Available To identify perceived barriers and facilitators for HAART adherence among people living with HIV/AIDS in Southern Puerto Rico using a Social Ecological framework.Individual in-depths interviews were conducted with 12 HIV patients with a history of HAART non-adherence. Interviews were audio-taped and transcribed. Content analysis was performed for each transcribed interview by three independent coders using a codebook. Using Atlas TI, super-codes and families were generated to facilitate the categorization tree as well as grounded analyses and density estimates.Most participants reported a monthly income of $500 or less (n = 7, a high school education level (n = 7, being unemployed (n = 9 and being recipients of government health insurance (n = 11. Three out of six women reported living alone with their children and most men informed living with their parents or other relatives (n = 4. For the grounded analyses, the top four sub-categories linked to high number of quotations were mental health barriers (G = 32 followed by treatment regimen (G = 28, health system (G = 24 and interpersonal relations (G = 16. The top four sub-categories linked to high number of codes are treatment regimen (D = 4, health status perception (D = 3, interpersonal relations (D = 3 and health system (D = 3.The results of this study suggest the interconnection of HIV treatment adherence barriers at various system levels. Future studies on HIV treatment barriers should explore these interactions and investigate the possible synergistic effect on non-adherent behavior.

  19. Leadership as a predictor of stigma and practical barriers toward receiving mental health treatment: a multilevel approach.

    Science.gov (United States)

    Britt, Thomas W; Wright, Kathleen M; Moore, Dewayne

    2012-02-01

    The present research examined positive and negative leadership behaviors as predictors of stigma and practical barriers to mental health treatment. Soldiers completed measures of noncommissioned officer (NCO) and officer leadership, stigma, and practical barriers to getting mental health treatment at 2, 3, and 4 months following a 15-month deployment to Afghanistan. The results revealed that positive and negative NCO and officer leader behaviors were predictive of overall stigma and barriers to care (collapsed across the three time periods), with only NCO positive and negative behaviors being uniquely predictive of stigma when included in the same model with officer behaviors. In addition, negative and positive NCO leader behaviors were predictive of stigma within participants over the course of the three month time period, and positive NCO leader behaviors were inversely related to practical barriers to mental health treatment within participants across the same time period. The results are discussed in terms of how different leader behaviors may be linked to different factors influencing a soldier's decision to seek mental health treatment.

  20. Implementing solutions to barriers to on-site HIV testing in substance abuse treatment: a tale of three facilities.

    Science.gov (United States)

    Hood, Kristina B; Robertson, Angela A; Baird-Thomas, Connie

    2015-04-01

    Due to the scarcity of resources for implementing rapid on-site HIV testing, many substance abuse treatment programs do not offer these services. This study sought to determine whether addressing previously identified implementation barriers to integrating on-site rapid HIV testing into the treatment admissions process would increase offer and acceptance rates. Results indicate that it is feasible to integrate rapid HIV testing into existing treatment programs for substance abusers when resources are provided. Addressing barriers such as providing start-up costs for HIV testing, staff training, addressing staffing needs to reduce competing job responsibilities, and helping treatment staff members overcome their concerns about clients' reactions to positive test results is paramount for the integration and maintenance of such programs. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Altered free radical metabolism in acute mountain sickness: implications for dynamic cerebral autoregulation and blood-brain barrier function

    DEFF Research Database (Denmark)

    Bailey, D M; Evans, K A; James, P E

    2008-01-01

    We tested the hypothesis that dynamic cerebral autoregulation (CA) and blood-brain barrier (BBB) function would be compromised in acute mountain sickness (AMS) subsequent to a hypoxia-mediated alteration in systemic free radical metabolism. Eighteen male lowlanders were examined in normoxia (21% O...... developed clinical AMS (AMS+) and were more hypoxaemic relative to subjects without AMS (AMS-). A more marked increase in the venous concentration of the ascorbate radical (A(*-)), lipid hydroperoxides (LOOH) and increased susceptibility of low-density lipoprotein (LDL) to oxidation was observed during...

  2. Dynamics of the edge transport barrier at plasma biasing on the CASTOR tokamak

    Czech Academy of Sciences Publication Activity Database

    Stöckel, Jan; Spolaore, M.; Peleman, P.; Brotánková, Jana; Horáček, Jan; Dejarnac, Renaud; Devynck, P.; Ďuran, Ivan; Gunn, J. P.; Hron, Martin; Kocan, M.; Martines, E.; Pánek, Radomír; Sharma, A.; Van Oost, G.

    2006-01-01

    Roč. 12, č. 6 (2006), s. 19-23 ISSN 1562-6016. [International Conference on Plasma Physics and Technology/11th./. Alushta, 11.9.2006-16.9.2006] Institutional research plan: CEZ:AV0Z20430508 Keywords : tokamak * plasma * transport barrier * relaxations Subject RIV: BL - Plasma and Gas Discharge Physics http:// vant .kipt.kharkov.ua/TABFRAME.html

  3. Assessment of existing sediment transport models for sand barrier dynamics under wave and currents

    Digital Repository Service at National Institute of Oceanography (India)

    Thuy, T.T.V.; Nghiem, L.T.; Jayakumar, S.; Nielsen, P.

    The paper summarizes morphology changes over rippled sand barriers under wave and wave combined current of 27 laboratorial experiments. Data of 4 wave conditions (H=10cm, T=1s; H=12cm, T=1s; H=12cm, T=1.5s; H=14cm, T=1.5s) and 6 currents (Q= 10, -10...

  4. Adsorbability Enhancement of Macroporous Resin by Dielectric Barrier Discharge Plasma Treatment to Phenol in Water

    Directory of Open Access Journals (Sweden)

    Shoufeng Tang

    2016-01-01

    Full Text Available In order to enhance the adsorption efficiency and economize the use of macroporous resin, we have treated it with the dielectric barrier discharge (DBD plasma to improve its adsorbing capacity for phenol. The effects of operation conditions, for instance, applied voltage, treated time, and air flow rate on resin, were investigated by adsorption kinetics and isotherms. Results showed that the adsorption data were in good agreement with the pseudo-second-order and Freundlich equation. Experimental results showed that the modified resin was 156.5 mg/g and 39.2% higher than the untreated sample, when the modified conditions were conducted for discharge voltage 20 kV, treatment time 45 min, and air flow rate 1.2 L/min. The resin was characterized by FTIR and nitrogen adsorption isotherms before and after the DBD processes. It was found that the reason for the enhancement of resin adsorbability was attributed to the DBD plasma changing the surface physical and chemical structure.

  5. SURFACE-ALTERED ZEOLITES AS PERMEABLE BARRIERS FOR IN SITU TREATMENT OF CONTAMINATED GROUNDWATER

    International Nuclear Information System (INIS)

    Bowman, Robert S.; Li, Zhaohui; Roy, Stephen J.; Burt, Todd; Johnson, Timothy L.; Johnson, Richard L.

    1999-01-01

    The overall objective of this effort is to develop and test a zeolite-based permeable barrier system for containing and remediating contaminated groundwater. The projected product is an engineered and tested permeable barrier system that can be adopted by the commercial sector

  6. Application of three pollination techniques and of hormone treatments for overcoming interspecific crossing barriers in Tulipa

    NARCIS (Netherlands)

    Creij, van M.G.M.; Kerckhoffs, D.M.F.J.; Tuyl, van J.M.

    1997-01-01

    In tulip, interspecific crossing is restricted by both pre-fertilization and post-fertilization barriers. In order to introduce traits from wild species into the cultivar assortment these barriers must be bypassed. By application of embryo rescue techniques, unique hybrids have been obtained of

  7. Measuring effectiveness of three postfire hillslope erosion barrier treatments, western Montana, USA

    Science.gov (United States)

    Peter R. Robichaud; Frederick B. Pierson; Robert E. Brown; Joseph W. Wagenbrenner

    2008-01-01

    After the Valley Complex Fire burned 86 000 ha in western Montana in 2000, two studies were conducted to determine the effectiveness of contour-felled log, straw wattle, and hand-dug contour trench erosion barriers in mitigating postfire runoff and erosion. Sixteen plots were located across a steep, severely burned slope, with a single barrier installed in 12 plots (...

  8. SURFACE-ALTERED ZEOLITES AS PERMEABLE BARRIERS FOR IN SITU TREATMENT OF CONTAMINATED GROUNDWATER

    Energy Technology Data Exchange (ETDEWEB)

    Robert S. Bowman; Zhaohui Li; Stephen J. Roy; Todd Burt; Timothy L. Johnson; Richard L. Johnson

    1999-08-30

    The overall objective of this effort is to develop and test a zeolite-based permeable barrier system for containing and remediating contaminated groundwater. The projected product is an engineered and tested permeable barrier system that can be adopted by the commercial sector.

  9. The Hepatitis C treatment experience: Patients' perceptions of the facilitators of and barriers to uptake, adherence and completion.

    Science.gov (United States)

    Sublette, Victoria A; Smith, Sian K; George, Jacob; McCaffery, Kirsten; Douglas, Mark W

    2015-01-01

    This study explores the perceptions of patients receiving treatment for Hepatitis C to determine what factors influence their decision to commence treatment, ability to maintain adherence and complete their treatment program. Semi-structured interview techniques were used in a qualitative study of 20 patients undergoing treatment for Chronic Hepatitis C (CHC). To explore patients' perceived barriers and facilitators of Hepatitis C treatment adherence and completion. Analysis of patient interviews identified four key themes: (1) motivations for commencing CHC treatment - fear of death and ridding themselves of stigma and shame; (2) the influential role of provider communication - patients reported that information and feedback that was personalised to their needs and lifestyles was the most effective for improving adherence to treatment; (3) facilitators of treatment adherence and completion - social, emotional and practical support improved adherence and completion, as did temporarily ceasing employment; (4) barriers to treatment adherence and completion - these included side effects, stigma, a complicated dosing schedule and limitations of the public healthcare system. To increase treatment adherence and completion rates, a patient-centred approach is required that addresses patients' social, practical, and emotional support needs and adaptive coping strategies.

  10. Elimination of Pasteurella pneumotropica from a Mouse Barrier Facility by Using a Modified Enrofloxacin Treatment Regimen

    Science.gov (United States)

    Towne, Justin W; Wagner, April M; Griffin, Kurt J; Buntzman, Adam S; Frelinger, Jeffrey A; Besselsen, David G

    2014-01-01

    Multiple NOD.Cg-Prkdcscid Il2rgtm1WjlTg(HLA-A2.1)Enge/Sz (NSG/A2) transgenic mice maintained in a mouse barrier facility were submitted for necropsy to determine the cause of facial alopecia, tachypnea, dyspnea, and sudden death. Pneumonia and soft-tissue abscesses were observed, and Pasteurella pneumotropica biotype Jawetz was consistently isolated from the upper respiratory tract, lung, and abscesses. Epidemiologic investigation within the facility revealed presence of this pathogen in mice generated or rederived by the intramural Genetically Engineered Mouse Model (GEMM) Core but not in mice procured from several approved commercial vendors. Epidemiologic data suggested the infection originated from female or vasectomized male ND4 mice obtained from a commercial vendor and then comingled by the GEMM Core to induce pseudopregnancy in female mice for embryo implantation. Enrofloxacin delivered in drinking water (85 mg/kg body weight daily) for 14 d was sufficient to clear bacterial infection in normal, breeding, and immune-deficient mice without the need to change the antibiotic water source. This modified treatment regimen was administered to 2400 cages of mice to eradicate Pasteurella pneumotropica from the facility. Follow-up PCR testing for P. pneumotropica biotype Jawetz remained uniformly negative at 2, 6, 12, and 52 wk after treatment in multiple strains of mice that were originally infected. Together, these data indicate that enrofloxacin can eradicate P. pneumotropica from infected mice in a less labor-intensive approach that does not require breeding cessation and that is easily adaptable to the standard biweekly cage change schedule for individually ventilated cages. PMID:25255075

  11. Elimination of Pasteurella pneumotropica from a mouse barrier facility by using a modified enrofloxacin treatment regimen.

    Science.gov (United States)

    Towne, Justin W; Wagner, April M; Griffin, Kurt J; Buntzman, Adam S; Frelinger, Jeffrey A; Besselsen, David G

    2014-09-01

    Multiple NOD. Cg-Prkdc(scid)Il2rg(tm1Wjl)Tg(HLA-A2.1)Enge/Sz (NSG/A2) transgenic mice maintained in a mouse barrier facility were submitted for necropsy to determine the cause of facial alopecia, tachypnea, dyspnea, and sudden death. Pneumonia and soft-tissue abscesses were observed, and Pasteurella pneumotropica biotype Jawetz was consistently isolated from the upper respiratory tract, lung, and abscesses. Epidemiologic investigation within the facility revealed presence of this pathogen in mice generated or rederived by the intramural Genetically Engineered Mouse Model (GEMM) Core but not in mice procured from several approved commercial vendors. Epidemiologic data suggested the infection originated from female or vasectomized male ND4 mice obtained from a commercial vendor and then comingled by the GEMM Core to induce pseudopregnancy in female mice for embryo implantation. Enrofloxacin delivered in drinking water (85 mg/kg body weight daily) for 14 d was sufficient to clear bacterial infection in normal, breeding, and immune-deficient mice without the need to change the antibiotic water source. This modified treatment regimen was administered to 2400 cages of mice to eradicate Pasteurella pneumotropica from the facility. Follow-up PCR testing for P. pneumotropica biotype Jawetz remained uniformly negative at 2, 6, 12, and 52 wk after treatment in multiple strains of mice that were originally infected. Together, these data indicate that enrofloxacin can eradicate P. pneumotropica from infected mice in a less labor-intensive approach that does not require breeding cessation and that is easily adaptable to the standard biweekly cage change schedule for individually ventilated cages.

  12. Barriers to Employment Among Social Security Disability Insurance Beneficiaries in the Mental Health Treatment Study.

    Science.gov (United States)

    Milfort, Roline; Bond, Gary R; McGurk, Susan R; Drake, Robert E

    2015-12-01

    This study examined barriers to employment among Social Security Disability Insurance (SSDI) beneficiaries who received comprehensive vocational and mental health services but were not successful in returning to work. This study examined barriers to employment among 430 SSDI beneficiaries with mental disorders who received evidence-based vocational and mental health services for two years but worked less than one month or not at all. Comprehensive care teams, which included employment specialists, made consensus judgments for each participant, identifying the top three barriers to employment from a checklist of 14 common barriers. Teams most frequently identified three barriers to employment: poorly controlled symptoms of mental illness (55%), nonengagement in supported employment (44%), and poorly controlled general medical problems (33%). Other factors were identified much less frequently. Some SSDI beneficiaries, despite having access to comprehensive services, continued to experience psychiatric impairments, difficulty engaging in vocational services, and general medical problems that limited their success in employment.

  13. Perception of Barriers to the Diagnosis and Receipt of Treatment for Neuropsychiatric Disturbances After Traumatic Brain Injury.

    Science.gov (United States)

    Albrecht, Jennifer S; O'Hara, Lyndsay M; Moser, Kara A; Mullins, C Daniel; Rao, Vani

    2017-12-01

    To explore perceptions of barriers and facilitators to the diagnosis and receipt of treatment for neuropsychiatric disturbances (NPDs) after traumatic brain injury (TBI). Qualitative study using semistructured interviews and focus groups. A clinic specializing in the treatment of TBI NPDs, an urban trauma center, and a large urban academic hospital. A sample (N=33) of health care providers (n=10) who treat individuals with TBI, persons with TBI (n=18), and caregivers (n=5). Not applicable. Topic guides for the interviews and focus groups were guided by previous literature, clinical experience, and the goals of the project and focused on the 3 most common TBI NPDs: depression, anxiety, and posttraumatic stress disorder. The interviews and focus groups were audio-recorded and transcribed verbatim. We performed a conventional content analysis on the transcripts and grouped concepts into overall themes, incorporating feedback from stakeholders. Patient education, insurance, provider type, time since TBI, caregiver support, and recognition or screening for TBI NPDs were the most frequently mentioned barriers or facilitators to the diagnosis and treatment of TBI NPDs by both interview and focus group participants. We grouped these and other frequently mentioned concepts into 3 broad themes: education, access, and support. Each of these themes is explored in depth and supported with direct quotations. This study explored patient, caregiver, and health care provider and identified barriers and facilitators to the diagnosis and receipt of treatment for TBI NPDs. Barriers included poor provider education on TBI NPDs and limited access to care due to lack of insurance, transportation, and income. Facilitators included patient education on TBI NPDs and strong caregiver support. Future studies should develop and pilot interventions aimed at quality of care that address the identified barriers and facilitators. Copyright © 2017 American Congress of Rehabilitation Medicine

  14. Dynamical barrier and isotope effects in the simplest substitution reaction via Walden inversion mechanism

    Science.gov (United States)

    Zhao, Zhiqiang; Zhang, Zhaojun; Liu, Shu; Zhang, Dong H.

    2017-02-01

    Reactions occurring at a carbon atom through the Walden inversion mechanism are one of the most important and useful classes of reactions in chemistry. Here we report an accurate theoretical study of the simplest reaction of that type: the H+CH4 substitution reaction and its isotope analogues. It is found that the reaction threshold versus collision energy is considerably higher than the barrier height. The reaction exhibits a strong normal secondary isotope effect on the cross-sections measured above the reaction threshold, and a small but reverse secondary kinetic isotope effect at room temperature. Detailed analysis reveals that the reaction proceeds along a path with a higher barrier height instead of the minimum-energy path because the umbrella angle of the non-reacting methyl group cannot change synchronously with the other reaction coordinates during the reaction due to insufficient energy transfer from the translational motion to the umbrella mode.

  15. Effects of sea-level rise on barrier island groundwater system dynamics: ecohydrological implications

    Science.gov (United States)

    Masterson, John P.; Fienen, Michael N.; Thieler, E. Robert; Gesch, Dean B.; Gutierrez, Benjamin T.; Plant, Nathaniel G.

    2014-01-01

    We used a numerical model to investigate how a barrier island groundwater system responds to increases of up to 60 cm in sea level. We found that a sea-level rise of 20 cm leads to substantial changes in the depth of the water table and the extent and depth of saltwater intrusion, which are key determinants in the establishment, distribution and succession of vegetation assemblages and habitat suitability in barrier islands ecosystems. In our simulations, increases in water-table height in areas with a shallow depth to water (or thin vadose zone) resulted in extensive groundwater inundation of land surface and a thinning of the underlying freshwater lens. We demonstrated the interdependence of the groundwater response to island morphology by evaluating changes at three sites. This interdependence can have a profound effect on ecosystem composition in these fragile coastal landscapes under long-term changing climatic conditions.

  16. Disruption of the blood–brain barrier in pigs naturally infected with Taenia solium, untreated and after anthelmintic treatment

    Science.gov (United States)

    Guerra-Giraldez, Cristina; Marzal, Miguel; Cangalaya, Carla; Balboa, Diana; Orrego, Miguel Ángel; Paredes, Adriana; Gonzales-Gustavson, Eloy; Arroyo, Gianfranco; García, Hector H.; González, Armando E.; Mahanty, Siddhartha; Nash, Theodore E.

    2014-01-01

    Neurocysticercosis is a widely prevalent disease in the tropics that causes seizures and a variety of neurological symptoms in most of the world. Experimental models are limited and do not allow assessment of the degree of inflammation around brain cysts. The vital dye Evans Blue (EB) was injected into 11 pigs naturally infected with Taenia solium cysts to visually identify the extent of disruption of the blood brain barrier. A total of 369 cysts were recovered from the 11 brains and classified according to the staining of their capsules as blue or unstained. The proportion of cysts with blue capsules was significantly higher in brains from pigs that had received anthelmintic treatment 48 and 120 h before the EB infusion, indicating a greater compromise of the blood brain barrier due to treatment. The model could be useful for understanding the pathology of treatment-induced inflammation in neurocysticercosis. PMID:23684909

  17. Mapping the Barriers and Facilitators of HCV Treatment Initiation in Methadone Maintenance Therapy Patients: Implications for Intervention Development.

    Science.gov (United States)

    Bass, Sarah Bauerle; Jessop, Amy; Maurer, Laurie; Gashat, Muhamed; Al Hajji, Mohammed; Gutierrez, Mercedes

    2018-01-01

    An estimated 70-90% of current methadone users have Hepatitis C (HCV). Current treatments have few side effects and can cure infection in 8-12 weeks, but less than 10% of methadone patients initiate treatment. Engaging this group in treatment is an important strategy to lower both morbidity and mortality from liver disease and eliminate a significant reservoir of HCV in communities. To understand how to address this treatment gap we used commercial marketing techniques called perceptual mapping and vector message modeling to analyze survey data from 100 HCV+ methadone patients from four centers in Philadelphia. Results were used to understand barriers and facilitators to treatment initiation and to devise targeted message strategies to adapt to a mobile health communication intervention. Results indicate that focusing on how treatment can make one feel "in charge", positive interactions with healthcare providers, the positive attributes of the new vs. old HCV treatments, and providing strategies to address tangible barriers to getting treatment, would be important to address in a communication intervention. These marketing methods allow for focusing on specific variables to "move" the group toward a treatment decision, making them an innovative technique to use in developing highly targeted health communication messages.

  18. Prediction of Groundwater Quality Improvement Down-Gradient of In Situ Permeable Treatment Barriers and Fully-Remediated Source Zones. ESTCP Cost and Performance Report

    National Research Council Canada - National Science Library

    Johnson, Paul C; Carlson, Pamela M; Dahlen, Paul

    2008-01-01

    In situ permeable treatment barriers (PTB) are designed so that contaminated groundwater flows through an engineered treatment zone within which contaminants are eliminated or the concentrations are significantly reduced...

  19. A sensitivity-based approach to optimize the surface treatment of a low-height tramway noise barrier

    Science.gov (United States)

    Jolibois, Alexandre

    Transportation noise has become a main nuisance in urban areas, in the industrialized world and across the world, to the point that according to the World Health Organization 65% of the European population is exposed to excessive noise and 20% to night-time levels that may harm their health. There is therefore a need to find new ways to mitigate transportation noise in urban areas. In this work, a possible device to achieve this goal is studied: a low-height noise barrier. It consists of a barrier typically less than one meter high placed close to the source, designed to decrease significantly the noise level for nearby pedestrians and cyclists. A numerical method which optimizes the surface treatment of a low-height barrier in order to increase its insertion loss is presented. Tramway noise barriers are especially studied since the noise sources are in this case close to the ground and would be attenuated more by the barrier. The acoustic behavior of the surface treatment is modeled via its admittance. It can be itself described by a few parameters (flow resistivity, geometrical dimensions...), which can then be optimized. It is proposed to couple porous layers and micro-perforated panel (MPP) resonators in order to take advantage of their different acoustic properties. Moreover, the optimization is achieved using a sensitivity-based method, since in this framework the gradient of the attenuation can be evaluated accurately and efficiently. Several shapes are considered: half-cylinder, quarter-cylinder, straight wall, T-shape and square shape. In the case of a half-cylindrical geometry, a semi-analytical solution for the sound field in terms of a series of cylindrical waves is derived, which simplifies the sensitivity calculation and optimization process. The boundary element method (BEM) is used to evaluate the attenuation for the remaining shapes, and in this case the sensitivity is evaluated using the adjoint state approach. For all considered geometries, it is

  20. PERMEABLE REACTIVE BARRIERS FOR IN-SITU TREATMENT OF ARSENIC-CONTAMINATED GROUNDWATER

    Science.gov (United States)

    Laboratory and field research has shown that permeable reactive barriers (PRBs) containing a variety of materials can treat arsenic (As) contaminated groundwater. Sites where these PRBs are located include a mine tailings facility, fertilizer and chemical manufacturing sites, a...

  1. Effects of Dielectric Barrier Discharge Plasma Treatment on Pentachlorophenol Removal of Granular Activated Carbon

    International Nuclear Information System (INIS)

    Ji Puhui; Qu Guangzhou; Li Jie

    2013-01-01

    The pentachlorophenol (PCP) adsorbed granular activated carbon (GAC) was treated by dielectric barrier discharge (DBD) plasma. The effects of DBD plasma on the structure of GAC and PCP decomposition were analyzed by N 2 adsorption, thermogravimetric, scanning electron microscopy (SEM), X-ray photoelectron spectroscopy (XPS) and gas chromatography mass spectrometry (GC-MS). The experimental data of adsorption kinetics and thermodynamics of PCP on GAC were fitted with different kinetics and isotherm models, respectively. The results indicate that the types of N 2 adsorption isotherm of GAC are not changed by DBD plasma, while the specific surface area and pore volume increase after DBD plasma treatment. It is found that the weight loss of the saturated GAC is the highest, on the contrary, the weight loss of DBD treated GAC is the least because of reduced PCP residue on the GAC. The XPS spectra and SEM image suggest that some PCP on the GAC is removed by DBD plasma, and the surface of GAC treated by DBD plasma presents irregular and heterogeneous morphology. The GC-MS identification of by-products shows that two main dechlorination intermediate products, tetrachlorophenol and trichlorophenol, are distinguished. The fitting results of experimental data of adsorption kinetics and thermodynamics indicate that the pseudo-first-order and pseudo-second order models can be used for the prediction of the kinetics of virgin GAC and DBD treated GAC for PCP adsorption, and the Langmuir isotherm model fits better with the data of adsorption isotherm than the Freundlich isotherm in the adsorption of PCP on virgin GAC and DBD treated GAC

  2. Medication assisted treatment in US drug courts: results from a nationwide survey of availability, barriers and attitudes.

    Science.gov (United States)

    Matusow, Harlan; Dickman, Samuel L; Rich, Josiah D; Fong, Chunki; Dumont, Dora M; Hardin, Carolyn; Marlowe, Douglas; Rosenblum, Andrew

    2013-01-01

    Drug treatment courts are an increasingly important tool in reducing the census of those incarcerated for non-violent drug offenses; medication assisted treatment (MAT) is proven to be an effective treatment for opioid addiction. However, little is known about the availability of and barriers to MAT provision for opioid-addicted people under drug court jurisdiction. Using an online survey, we assessed availability, barriers, and need for MAT (especially agonist medication) for opioid addiction in drug courts. Ninety-eight percent reported opioid-addicted participants, and 47% offered agonist medication (56% for all MAT including naltrexone). Barriers included cost and court policy. Responses revealed significant uncertainty, especially among non-MAT providing courts. Political, judicial and administrative opposition appear to affect MAT's inconsistent use and availability in drug court settings. These data suggest that a substantial, targeted educational initiative is needed to increase awareness of the treatment and criminal justice benefits of MAT in the drug courts. Copyright © 2013 Elsevier Inc. All rights reserved.

  3. Barriers in Access to the Treatment for People with Gambling Disorders. Are They Different from Those Experienced by People with Alcohol and/or Drug Dependence?

    Science.gov (United States)

    Dąbrowska, Katarzyna; Moskalewicz, Jacek; Wieczorek, Łukasz

    2017-06-01

    A prevalence of gambling disorders is diversified depending on the region of the world. Almost three quarters of pathological gamblers had never sought a professional treatment as well as an assistance in self-help groups. Reasons why they do not initiate a treatment are complex. The aim of the article is to compare barriers to the treatment for people with gambling disorders found in presented study and barriers to alcohol and drug treatment identified in the available literature. The semi structured interviews were applied and conducted with people with gambling disorders, social workers, therapists employed in the addiction treatment facilities, General Practitioners and psychiatrists. Selection of the respondents was based on purposive sampling. In total, 90 interviews were completed. Respondents identified individual barriers as well as structural ones. Individual barriers include internal resistance and a fear of the treatment. In turn structural barriers apply to the organization of the therapy, infrastructure, personnel, and the therapeutic program. A comparison of barriers experienced by people with gambling disorders and substance use disorders showed that they are largely similar, but people with gambling disorders also experience specific barriers. Empirical studies focused specifically on treatment needs of people experiencing gambling disorders may improve an offer of help for them. More adequate treatment options could contribute to the increasing in the number of people who start the treatment. It can result in improving their quality of life and may have positive impact on public health.

  4. Managing treatment for end-stage renal disease--a qualitative study exploring cultural perspectives on facilitators and barriers to treatment adherence.

    Science.gov (United States)

    Griva, K; Ng, H J; Loei, J; Mooppil, N; McBain, H; Newman, S P

    2013-01-01

    Although adherence to hemodialysis (HD) regimes is important to maximise good clinical outcomes, it remains suboptimal and not well understood, particularly for those in non-Western settings and patients from Asian cultures. This qualitative study sought to explore cultural perspectives on facilitators and barriers to treatment adherence in HD patients. A descriptive exploratory design was used for the study, incorporating individual semi-structured interviews (n = 17) and three focus groups (n = 20). Each interview/focus group was audio-taped and transcribed verbatim, and coding was conducted by two coders using an iterative process. Study participants identified personal and social/contextual factors as major barriers or facilitators of treatment adherence. Barriers include time consumption, forgetfulness, concerns about safety, poor knowledge/understanding, poor communication and lack of control/social pressure. Participants also identified facilitators, both internal (self-initiated) and external (initiated by family, health care professional and peers) to ensure treatment adherence. These included support from family members and social obligation towards others, risk perception, establishment of routines and peer support. Internal and external factors can hinder or facilitate adherence to diet, fluid and medications in the context of dialysis. Several of these barriers/facilitators can be effectively addressed in the context of interventions and psycho-educational programmes.

  5. Up and down the sanitation ladder: Harmonizing the treatment and multiple-barrier perspectives on risk reduction in wastewater irrigated agriculture

    DEFF Research Database (Denmark)

    Keraita, Bernard; Drechsel, P.; Konradsen, Flemming

    2010-01-01

    This paper discusses two prominent perspectives in the debate on risk reduction in wastewater irrigation; reliance on conventional wastewater treatment and the multiple-barrier approach. The treatment perspective is based on water-quality standards for wastewater irrigation with treatment...... considered the ultimate risk reductionmeasure. The somewhat broader multiple-barrier perspective supports the use of a combination of pre-farm, on-farm and postfarm barriers, including, where possible, wastewater treatment, to meet required health targets. The discussion in this paper shows that each...

  6. Barrier Systems

    NARCIS (Netherlands)

    Heteren, S. van

    2015-01-01

    Barrier-system dynamics are a function of antecedent topography and substrate lithology, Relative sea-level (RSL) changes, sediment availability and type, climate, vegetation type and cover, and various aero- and hydrodynamic processes during fair-weather conditions and extreme events. Global change

  7. Facial dynamics and emotional expressions in facial aging treatments.

    Science.gov (United States)

    Michaud, Thierry; Gassia, Véronique; Belhaouari, Lakhdar

    2015-03-01

    Facial expressions convey emotions that form the foundation of interpersonal relationships, and many of these emotions promote and regulate our social linkages. Hence, the facial aging symptomatological analysis and the treatment plan must of necessity include knowledge of the facial dynamics and the emotional expressions of the face. This approach aims to more closely meet patients' expectations of natural-looking results, by correcting age-related negative expressions while observing the emotional language of the face. This article will successively describe patients' expectations, the role of facial expressions in relational dynamics, the relationship between facial structures and facial expressions, and the way facial aging mimics negative expressions. Eventually, therapeutic implications for facial aging treatment will be addressed. © 2015 Wiley Periodicals, Inc.

  8. Converse Barrier Certificate Theorems

    DEFF Research Database (Denmark)

    Wisniewski, Rafael; Sloth, Christoffer

    2016-01-01

    This paper shows that a barrier certificate exists for any safe dynamical system. Specifically, we prove converse barrier certificate theorems for a class of structurally stable dynamical systems. Other authors have developed a related result by assuming that the dynamical system has neither...

  9. Dynamics of Db isotopes formed in reactions induced by 238U, 248Cm, and 249Bk across the Coulomb barrier

    Science.gov (United States)

    Kaur, Gurjit; Sandhu, Kirandeep; Kaur, Amandeep; Sharma, Manoj K.

    2018-05-01

    The dynamical cluster decay model is employed to investigate the decay of *265Db and *267Db nuclei, formed in the 27Al+238U , 18O+249Bk , and 19F+248Cm hot fusion reactions at energies around the Coulomb barrier. First, the fission dynamics of the 27Al+238U reaction is explored by investigating the fragmentation and preformation yield of the reaction. The symmetric mass distribution of the fission fragments is observed for *265Db nucleus, when static β2 i deformations are used within hot optimum orientation approach. However, the mass split gets broaden for the use of β2 i-dynamical hot configuration of the fragments and becomes clearly asymmetric for the cold-static-deformed approach. Within the application of cold orientations of fragments, a new fission channel is observed at mass asymmetry η =0.29 . In addition to 238U-induced reaction, the work is carried out to address the fission and neutron evaporation cross sections of *267Db nucleus formed via 19F+248Cm and 18O+249Bk reactions, besides a comprehensive analysis of fusion and capture processes. Higher fusion cross sections and compound nucleus formation probabilities (PCN) are obtained for the 18O+249Bk reaction, as larger mass asymmetry in the entrance channel leads to reduced Coulomb factor. Finally, the role of sticking (IS) and nonsticking (INS) moments of inertia is analyzed for the 4 n and 5 n channels of *267Db nuclear system.

  10. Professional perspectives on systemic barriers to admission avoidance: learning from a system dynamics study of older people's admission pathways.

    Science.gov (United States)

    Walsh, Bronagh; Lattimer, Valerie; Wintrup, Julie; Brailsford, Sally

    2015-06-01

    There is debate worldwide about the best way to manage increased healthcare demand within ageing populations, particularly rising rates of unplanned and avoidable hospital admissions. To understand health and social care professionals' perspectives on barriers to admission avoidance throughout the admissions journey, in particular: the causes of avoidable admissions in older people; drivers of admission and barriers to use of admission avoidance strategies; and improvements to reduce unnecessary admissions. A qualitative framework analysis of interview data from a System dynamics (SD) modelling study. Semi-structured interviews were conducted with twenty health and social care professionals with experience of older people's admissions. The interviews were used to build understanding of factors facilitating or hindering admission avoidance across the admissions system. Data were analysed using framework analysis. Three overarching themes emerged: understanding the needs of the patient group; understanding the whole system; and systemwide access to expertise in care of older people. There were diverse views on the underlying reasons for avoidable admissions and recognition of the need for whole-system approaches to service redesign. Participants recommended system redesign that recognises the specific needs of older people, but there was no consensus on underlying patient needs or specific service developments. Access to expertise in management of older and frailer patients was seen as a barrier to admission avoidance throughout the system. Providing access to expertise and leadership in care of frail older people across the admissions system presents a challenge for service managers and nurse educators but is seen as a prerequisite for effective admission avoidance. System redesign to meet the needs of frail older people requires agreement on causes of avoidable admission and underlying patient needs. © 2014 John Wiley & Sons Ltd.

  11. Understanding groundwater dynamics on barrier islands using geochronological data: An example from North Stradbroke Island, South-east Queensland

    Science.gov (United States)

    Hofmann, Harald; Newborn, Dean; Cartwright, Ian

    2017-04-01

    Freshwater lenses underneath barrier islands are dynamic systems affected by changing sea levels and groundwater use. They are vulnerable to contamination and over-abstraction. Residence times of fresh groundwater in barrier islands are poorly understood and have mostly been assessed by modelling approaches and estimates without fundamental validation with geochronological data. Assessing residence time and recharge rates will improve significantly our understanding of hydrological processes of coastal environments that will in turn allow us to make informed decisions on groundwater use and environmental protection. This project focused on groundwater recharge rates and residence times of the fresh water aquifer system of North Stradbroke Island, south-east Queensland, Australia. Groundwater bores, wetlands and submarine groundwater discharge points in the tidal areas (wonky holes) were sampled along a transect across the island and were analysed for major ion chemistry and stable isotopes (δ2H, δ18O, δ13C) in combination with 3H and 14C analysis. Calculated 3H using a 95% exponential-piston flow model and 14C ages range from 12 to >100 years and modern to 3770 years, respectively, indicating a highly heterogeneous aquifer system with mixing from low and high conductive areas. The major ion chemistry in combination with stable and radiogenic isotopes suggests that a significant groundwater component derives from the fractured rock basement and older sedimentary formations underlying the sand dunes of the island. The results help refining the conceptual and numerical groundwater flow model for North Stradbroke island in this particular case but also demonstrate the possible complexity of barrier island hydrogeology.

  12. Reaction dynamics studies for the system 7Be + 208Pb at Coulomb barrier energies

    Directory of Open Access Journals (Sweden)

    Mazzocco M.

    2017-01-01

    Full Text Available The scattering process of the Radioactive Ion Beam 7Be from a 208Pb target was measured at three near-barrier energies. The quasi-elastic angular distributions were analyzed within the framework of the optical model to extract the reaction cross sections. The results are compared with those obtained for the reactions induced by the mirror projectile 7Li and by the lightest particle-stable lithium isotope 6Li on the same target. The angular distributions for the production of the two 7Be constituent clusters, namely 3He and 4He, were also measured. In agreement with what observed for the interaction of 7Be with lighter targets, the production of the heavier helium isotope resulted to be much more abundant than that of its lighter counterpart.

  13. Reaction dynamics studies for the system 7Be + 208Pb at Coulomb barrier energies

    Science.gov (United States)

    Mazzocco, M.; Boiano, A.; Boiano, C.; La Commara, M.; Manea, C.; Parascandolo, C.; Pierroutsakou, D.; Strano, E.; Torresi, D.; Acosta, L.; Di Meo, P.; Fernandez-Garcia, J. P.; Glodariu, T.; Grebosz, J.; Guglielmetti, A.; Marquinez-Duran, G.; Martel, I.; Nicoletto, M.; Pakou, A.; Sánchez-Benítez, A. M.; Sava, T.; Sgouros, O.; Signorini, C.; Soramel, F.; Soukeras, V.; Stroe, L.

    2017-11-01

    The scattering process of the Radioactive Ion Beam 7Be from a 208Pb target was measured at three near-barrier energies. The quasi-elastic angular distributions were analyzed within the framework of the optical model to extract the reaction cross sections. The results are compared with those obtained for the reactions induced by the mirror projectile 7Li and by the lightest particle-stable lithium isotope 6Li on the same target. The angular distributions for the production of the two 7Be constituent clusters, namely 3He and 4He, were also measured. In agreement with what observed for the interaction of 7Be with lighter targets, the production of the heavier helium isotope resulted to be much more abundant than that of its lighter counterpart.

  14. Dynamic /sup 99m/Tc-DTPA radioaerosol lung scanning for the evaluation of alveolar-capillary barrier permeability

    Energy Technology Data Exchange (ETDEWEB)

    Maini, C L; Marchetti, L; Bonetti, M G; Giordano, A; Pistelli, R; Antonelli Incalzi, R

    1987-01-01

    Pulmonary clearance of small droplet /sup 99m/Tc-DTPA radioaerosol was studied in 100 patients (12 normal subjects, N; 10 asymptomatic healthy smoker, FA; 31 patients with interstitial lung diseases, IP; 47 patients with chronic obstructive lung disease, BPCO). The first seven minutes of clearance were described with the function At=Ao*exp(-K*t) and the time constant K was considered representative of the /sup 99m/Tc-DTPA clearance rate and hence of the alveolar-capillary barrier permeability. Groups FA, IP and BPCO showed a significant (p<0.05) or a highly significant (p<0.01) increase in permeability when compared to group N. No correlation was found between permeability and bronchial obstraction tests. The following conclusions were drawn: 1) /sup 99m/Tc-DTPA dynamic lung scanning is an easy, non-invasive method to assess derangements of alveolar-capillary barrier permeability secondary to epithelial damage; 2) permeability increase is a very early effect of cigarette smoke damafe to the epithelium; 3) other mechanisms of epithelial injury are present in diffuse lung disease; 4) while the clinical role of this new pathophysiological test is not yet clear, it is likely that it may become a very early marker of pulmonary epithelial damage in diffuse lung disease. 35 refs.

  15. Dynamic 99mTc-DTPA radioaerosol lung scanning for the evaluation of alveolar-capillary barrier permeability

    International Nuclear Information System (INIS)

    Maini, C.L.; Marchetti, L.; Bonetti, M.G.; Giordano, A.; Pistelli, R.; Antonelli Incalzi, R.

    1987-01-01

    Pulmonary clearance of small droplet 99m Tc-DTPA radioaerosol was studied in 100 patients (12 normal subjects, N; 10 asymptomatic healthy smoker, FA; 31 patients with interstitial lung diseases, IP; 47 patients with chronic obstructive lung disease, BPCO). The first seven minutes of clearance were described with the function At=Ao*exp(-K*t) and the time constant K was considered representative of the 99m Tc-DTPA clearance rate and hence of the alveolar-capillary barrier permeability. Groups FA, IP and BPCO showed a significant (p 99m Tc-DTPA dynamic lung scanning is an easy, non-invasive method to assess derangements of alveolar-capillary barrier permeability secondary to epithelial damage; 2) permeability increase is a very early effect of cigarette smoke damafe to the epithelium; 3) other mechanisms of epithelial injury are present in diffuse lung disease; 4) while the clinical role of this new pathophysiological test is not yet clear, it is likely that it may become a very early marker of pulmonary epithelial damage in diffuse lung disease

  16. RNase L Interacts with Filamin A To Regulate Actin Dynamics and Barrier Function for Viral Entry

    Science.gov (United States)

    Siddiqui, Mohammad Adnan; Dayal, Shubham; Naji, Merna; Ezelle, Heather J.; Zeng, Chun; Zhou, Aimin; Hassel, Bret A.

    2014-01-01

    ABSTRACT The actin cytoskeleton and its network of associated proteins constitute a physical barrier that viruses must circumvent to gain entry into cells for productive infection. The mechanisms by which the physical signals of infection are sensed by the host to activate an innate immune response are not well understood. The antiviral endoribonuclease RNase L is ubiquitously expressed in a latent form and activated upon binding 2-5A, a unique oligoadenylate produced during viral infections. We provide evidence that RNase L in its inactive form interacts with the actin-binding protein Filamin A to modulate the actin cytoskeleton and inhibit virus entry. Cells lacking either RNase L or Filamin A displayed increased virus entry which was exacerbated in cells lacking both proteins. RNase L deletion mutants that reduced Filamin A interaction displayed a compromised ability to restrict virus entry, supporting the idea of an important role for the RNase L-Filamin A complex in barrier function. Remarkably, both the wild type and a catalytically inactive RNase L mutant were competent to reduce virus entry when transfected into RNase L-deficient cells, indicating that this novel function of RNase L is independent of its enzymatic activity. Virus infection and RNase L activation disrupt its association with Filamin A and release RNase L to mediate its canonical nuclease-dependent antiviral activities. The dual functions of RNase L as a constitutive component of the actin cytoskeleton and as an induced mediator of antiviral signaling and effector functions provide insights into its mechanisms of antiviral activity and opportunities for the development of novel antiviral agents. PMID:25352621

  17. Application of Nanofibrillated Cellulose on BOPP/LDPE Film as Oxygen Barrier and Antimicrobial Coating Based on Cold Plasma Treatment

    Directory of Open Access Journals (Sweden)

    Peng Lu

    2018-05-01

    Full Text Available The application of nanofibrillated cellulose (NC films in packaging industry has been hindered by its lack of heat-sealing ability. Incorporation of NC films with the biaxially oriented polypropylene/low density polyethylene (BOPP/LDPE laminates can take advantage of each material and endow the films with novel functions for food packaging applications. In this study, a coating that consists of NC and nisin was applied onto a cold plasma treated BOPP/LDPE film to fabricate a novel active packaging with an improved oxygen barrier performance and an added antimicrobial effect. The results showed that cold plasma treatment improved the surface hydrophilicity of BOPP/LDPE films for better attachment of the coatings. NC coatings significantly enhanced oxygen barrier property of the BOPP/LDPE film, with an oxygen transmission rate as low as 24.02 cc/m2·day as compared to that of the non-coated one (67.03 cc/m2·day. The addition of nisin in the coating at a concentration of 5 mg/g caused no significant change in barrier properties but imparted the film excellent antimicrobial properties, with a growth inhibition of L. monocytogenes by 94%. All films exhibit satisfying mechanical properties and transparency, and this new film has the potential to be used as antimicrobial and oxygen barrier packaging.

  18. Consequences of unburned hydrocarbons on microstreamer dynamics and chemistry during plasma remediation of NO sub x using dielectric barrier discharges

    CERN Document Server

    Dorai, R

    2003-01-01

    Atmospheric pressure plasmas, and dielectric barrier discharges (DBDs) in particular, are being investigated for their use in the remediation of nitrogen oxides (NO sub x) from automotive exhausts. In their normal mode of operation, DBDs consist of a large density of short-lived filamentary microdischarges. Localized energy deposition results in spatially nonuniform gas temperatures and species densities which initiate advective and diffusive transport. Diesel exhausts, one of the major sources of NO sub x , typically contain unburned hydrocarbons (UHCs) which significantly influence the NO sub x chemistry during plasma remediation. In this paper, we discuss results from a computational investigation of the consequences of UHC chemistry on radial transport dynamics and remediation of NO sub x. In the presence of UHCs, radicals such as O and OH are dominantly consumed in the microstreamer region and their transport to larger radii is reduced. As a result, the conversion of NO to NO sub 2 is mainly restricted t...

  19. Calcium phosphate cement as a "barrier-graft" for the treatment of human periodontal intraosseous defects

    Directory of Open Access Journals (Sweden)

    Rajesh J

    2009-01-01

    Full Text Available Background : Calcium phosphate cements (CPC are apparently good candidates for periodontal treatment by virtue of their biocompatibility, mouldability and osteoconductivity. However, the clinical efficacy in this regard has not been established. This study is aimed at the evaluation of the efficacy of a formulation of CPC in healing human periodontal intraosseous defects in comparison with hydroxyapatite ceramic granules. Materials and Methods : In this clinical study, 60 patients with periodontal defects were divided into 2 test groups and 1 control group. The defect sites in the test groups were repaired with CPC and hydroxyapatite ceramic granules (HAG. Debridement alone was given in the control group. The progress was assessed at 3, 6, 9 and 12 months observation intervals through soft tissue parameters (probing depth, attachment level and gingival recession. Results: CPC showed significantly better outcome. Probing depth reduction values of CPC, HAG and Control at 6 months were 5.40 ± 1.43, 3.75 ± 1.71 and 2.90 ± 1.48, and those at 12 months were 6.20 ± 1.80, 4.5 ± 1.91 and 2.95 ± 1.73. Clinical attachment gain values of CPC, HAG and Control at 6 months were 5.15 ± 1.50, 3.45 ± 1.96 and 2.25 ± 1.52, and those at 12 months were 5.80 ± 2.02, 3.55 ± 2.06 and 2.30 ± 1.78, In both cases the P value was < 0.001 showing high significance. The gingival recession over 12 months, for the CPC group is lesser than that in the HAG group and the value for the control group is marginally higher than both. Soft-tissue measurements were appended by postoperative radiographs and surgical re-entry in selected cases. Conclusions: Calcium phosphate cement is found to be significantly better than hydroxyapatite ceramic granules. The material could be considered as a "barrier-graft".

  20. A Tracer Test to Characterize Treatment of TCE in a Permeable Reactive Barrier

    Science.gov (United States)

    A tracer test was conducted to characterize the flow of ground water surrounding a permeable reactive barrier constructed with plant mulch (a biowall) at the OU-1 site on Altus Air Force Base, Oklahoma. This biowall is intended to intercept and treat ground water contaminated by ...

  1. Superresolution and Fluorescence Dynamics Evidence Reveal That Intact Liposomes Do Not Cross the Human Skin Barrier.

    Directory of Open Access Journals (Sweden)

    Jes Dreier

    Full Text Available In this study we use the combination of super resolution optical microscopy and raster image correlation spectroscopy (RICS to study the mechanism of action of liposomes as transdermal drug delivery systems in human skin. Two different compositions of liposomes were applied to newly excised human skin, a POPC liposome and a more flexible liposome containing the surfactant sodium cholate. Stimulated emission depletion microscopy (STED images of intact skin and cryo-sections of skin treated with labeled liposomes were recorded displaying an optical resolution low enough to resolve the 100 nm liposomes in the skin. The images revealed that virtually none of the liposomes remained intact beneath the skin surface. RICS two color cross correlation diffusion measurements of double labeled liposomes confirmed these observations. Our results suggest that the liposomes do not act as carriers that transport their cargo directly through the skin barrier, but mainly burst and fuse with the outer lipid layers of the stratum corneum. It was also found that the flexible liposomes showed a greater delivery of the fluorophore into the stratum corneum, indicating that they functioned as chemical permeability enhancers.

  2. Laboratory studies and model simulations of sorbent material behavior for an in-situ passive treatment barrier

    International Nuclear Information System (INIS)

    Aloysius, D.; Fuhrmann, M.

    1995-01-01

    This paper presents a study combining laboratory experiments and model simulations in support of the design and construction of a passive treatment barrier (or filter wall) for retarding the migration of Sr-90 within a water-bearing surficial sand and gravel layer. Preliminary evaluation was used to select materials for column testing. A one-dimensional finite-difference model was used to simulate the laboratory column results and extrapolation of the calibrated model was then used to assess barrier performance over extended time frames with respect to Sr-90 breakthrough and loading on the filter media. The final results of the study showed that 20 by 50 mesh clinoptilolite will attenuate Sr-90 with a maximum life expentancy of approximately 10 years. This time period is based on allowable limits of Sr-90 activity on the filter media and is also a function of site-specific conditions

  3. Comparison of Tillandsia usneoides (Spanish moss) water and leachate dynamics between urban and pristine barrier island maritime oak forests

    Science.gov (United States)

    Van Stan, J. T.; Stubbins, A.; Reichard, J. S.; Wright, K.; Jenkins, R. B.

    2013-12-01

    Epiphyte coverage on forest canopies can drastically alter the volume and chemical composition of rainwater reaching soils. Along subtropical and tropical coastlines Tillandisa usneoides L. (Spanish moss), in particular, can envelop urban and natural tree crowns. Several cities actively manage their 'moss' covered forest to enhance aesthetics in the most active tourist areas (e.g., Savannah GA, St. Augustine FL, Charleston SC). Since T. usneoides survives through atmospheric water and solute exchange from specialized trichomes (scales), we hypothesized that T. usneoides water storage dynamics and leachate chemistry may be altered by exposure to this active urban atmosphere. 30 samples of T. usneoides from managed forests around the tourist center of Savannah, Georgia, USA were collected to compare with 30 samples from the pristine maritime live oak (Quercus virginiana Mill.) forests of a nearby undeveloped barrier island (St. Catherines Island, Georgia, USA). Maximum water storage capacities were determined via submersion (for all 60 samples) along with dissolved ion (DI) and organic matter (DOM) concentrations (for 15 samples each) after simulated throughfall generation using milliQ ultrapurified water. Further, DOM quality was evaluated (for 15 samples each) using absorbance and fluorescence spectroscopy (EEMS). Results show significant alterations to water storage dynamics, DI, DOM, and DOM quality metrics under urban atmospheric conditions, suggesting modified C and water cycling in urban forest canopies that may, in turn, influence intrasystem nutrient cycles in urban catchment soils or streams via runoff.

  4. Barriers to Accessing Detox Facilities, Substance Use Treatment, and Residential Services among Women Impacted by Commercial Sexual Exploitation & Trafficking.

    Science.gov (United States)

    Gerassi, Lara B

    2017-10-06

    More than 50% of women entering substance use treatment in the U.S. reported having traded sex for money or drugs. Women's participation in addiction treatment and related services is essential to their recovery and increased safety, stabilization, and quality of life. This paper's aim is to explore the barriers related to accessing detox facilities and essential services including substance use treatment and residential services for women impacted by commercial sexual exploitation (CSE). Data are drawn from a larger, community-based, grounded theory study. In-depth interview data were collected from 30 adult women who traded sex as adults (through maximum variation and snowball sampling), as well as 20 service providers who come into contact with adult women who trade sex (through nominations and purposive sampling). Finding suggest that women often encountered sobriety requirements, which created barriers to accessing addiction treatment or residential services. Some organizations' policies required evicting women if they were caught using, which created additional challenges for women who relapsed. Women wanted to avoid becoming "dopesick" on the streets or at home, which partially contributed to them needing to maintain their addiction. Consequently, some returned to sex trading, thus increasing their risk of trafficking. Some women engaged in creative strategies, such as claiming they were suicidal, in order to access the detox facilities in hospitals. Some women indicated they were only able to detox when they were forced to do so in jail or prison, often without medical assistance. Implications to improve health care delivery for this population are discussed.

  5. Treatment with a barrier-strengthening moisturizer prevents relapse of hand-eczema. An open, randomized, prospective, parallel group study.

    Science.gov (United States)

    Lodén, Marie; Wirén, Karin; Smerud, Knut; Meland, Nils; Hønnås, Helge; Mørk, Gro; Lützow-Holm, Claus; Funk, Jörgen; Meding, Birgitta

    2010-11-01

    Hand eczema influences the quality of life. Management strategies include the use of moisturizers. In the present study the time to relapse of eczema during treatment with a barrier-strengthening moisturizer (5% urea) was compared with no treatment (no medical or non-medicated preparations) in 53 randomized patients with successfully treated hand eczema. The median time to relapse was 20 days in the moisturizer group compared with 2 days in the no treatment group (p = 0.04). Eczema relapsed in 90% of the patients within 26 weeks. No difference in severity was noted between the groups at relapse. Dermatology Life Quality Index (DLQI) increased significantly in both groups; from 4.7 to 7.1 in the moisturizer group and from 4.1 to 7.8 in the no treatment group (p < 0.01) at the time of relapse. Hence, the application of moisturizers seems to prolong the disease-free interval in patients with controlled hand eczema. Whether the data is applic-able to moisturizers without barrier-strengthening properties remains to be elucidated.

  6. Blood-brain barrier transport of drugs for the treatment of brain diseases.

    Science.gov (United States)

    Gabathuler, Reinhard

    2009-06-01

    The central nervous system is a sanctuary protected by barriers that regulate brain homeostasis and control the transport of endogenous compounds into the brain. The blood-brain barrier, formed by endothelial cells of the brain capillaries, restricts access to brain cells allowing entry only to amino acids, glucose and hormones needed for normal brain cell function and metabolism. This very tight regulation of brain cell access is essential for the survival of neurons which do not have a significant capacity to regenerate, but also prevents therapeutic compounds, small and large, from reaching the brain. As a result, various strategies are being developed to enhance access of drugs to the brain parenchyma at therapeutically meaningful concentrations to effectively manage disease.

  7. On the possibility of high-velocity tidal sterams as dynamic barriers to longshore sediment transport: evidence from the continental shelf off the Gulf of Kutch, India

    Digital Repository Service at National Institute of Oceanography (India)

    Nair, R.R.; Hashimi, N.H.; Rao, V.P

    and clay minerals. The distinct differences have resulted because the high-velocity (2 to 2.5 knots) tidal stream at the gulf mouth acts as a dynamic barrier inhibiting sediment transport across the month. Differences in the distribution of sand size...

  8. Full quantum treatment of charge dynamics in amorphous molecular semiconductors

    Science.gov (United States)

    de Vries, Xander; Friederich, Pascal; Wenzel, Wolfgang; Coehoorn, Reinder; Bobbert, Peter A.

    2018-02-01

    We present a treatment of charge dynamics in amorphous molecular semiconductors that accounts for the coupling of charges to all intramolecular phonon modes in a fully quantum mechanical way. Based on ab initio calculations, we derive charge transfer rates that improve on the widely used semiclassical Marcus rate and obtain benchmark results for the mobility and energetic relaxation of electrons and holes in three semiconductors commonly applied in organic light-emitting diodes. Surprisingly, we find very similar results when using the simple Miller-Abrahams rate. We conclude that extracting the disorder strength from temperature-dependent charge transport studies is very possible but extracting the reorganization energy is not.

  9. Barriers and enablers to implementing clinical treatment protocols for fever, hyperglycaemia, and swallowing dysfunction in the Quality in Acute Stroke Care (QASC) Project--a mixed methods study.

    Science.gov (United States)

    Dale, Simeon; Levi, Christopher; Ward, Jeanette; Grimshaw, Jeremy M; Jammali-Blasi, Asmara; D'Este, Catherine; Griffiths, Rhonda; Quinn, Clare; Evans, Malcolm; Cadilhac, Dominique; Cheung, N Wah; Middleton, Sandy

    2015-02-01

    The Quality in Acute Stroke Care (QASC) trial evaluated systematic implementation of clinical treatment protocols to manage fever, sugar, and swallow (FeSS protocols) in acute stroke care. This cluster-randomised controlled trial was conducted in 19 stroke units in Australia. To describe perceived barriers and enablers preimplementation to the introduction of the FeSS protocols and, postimplementation, to determine which of these barriers eventuated as actual barriers. Preimplementation: Workshops were held at the intervention stroke units (n = 10). The first workshop involved senior clinicians who identified perceived barriers and enablers to implementation of the protocols, the second workshop involved bedside clinicians. Postimplementation, an online survey with stroke champions from intervention sites was conducted. A total of 111 clinicians attended the preimplementation workshops, identifying 22 barriers covering four main themes: (a) need for new policies, (b) limited workforce (capacity), (c) lack of equipment, and (d) education and logistics of training staff. Preimplementation enablers identified were: support by clinical champions, medical staff, nursing management and allied health staff; easy adaptation of current protocols, care-plans, and local policies; and presence of specialist stroke unit staff. Postimplementation, only five of the 22 barriers identified preimplementation were reported as actual barriers to adoption of the FeSS protocols, namely, no previous use of insulin infusions; hyperglycaemic protocols could not be commenced without written orders; medical staff reluctance to use the ASSIST swallowing screening tool; poor level of engagement of medical staff; and doctors' unawareness of the trial. The process of identifying barriers and enablers preimplementation allowed staff to take ownership and to address barriers and plan for change. As only five of the 22 barriers identified preimplementation were reported to be actual barriers at

  10. Nonoperative dynamic treatment of acute achilles tendon rupture

    DEFF Research Database (Denmark)

    Barfod, Kristoffer Weisskirchner; Bencke, Jesper; Bloch Lauridsen, Hanne

    2014-01-01

    BACKGROUND: Dynamic rehabilitation has been suggested to be an important part of nonoperative treatment of acute Achilles tendon rupture that results in functional outcome and rerupture rates comparable with those of operative treatment. However, the optimal role of weight-bearing during early re...... Score (ATRS) after one year. Secondary outcomes included heel-rise work, health-related quality of life, and the rerupture rate. Outcome assessors were blinded to the intervention. RESULTS: Thirty patients were randomized to each group; twenty-nine in the weight-bearing group and twenty......, the total heel-rise work performed by the injured limb relative to that by the uninjured limb was 53% in the weight-bearing group and 58% in the control group (p = 0.37). There were three reruptures in the weight-bearing group and two in the control group (p = 1.0). CONCLUSIONS: The ATRS and heel-rise work...

  11. Role of Transporters in Central Nervous System Drug Delivery and Blood-Brain Barrier Protection: Relevance to Treatment of Stroke

    Directory of Open Access Journals (Sweden)

    Hrvoje Brzica

    2017-03-01

    Full Text Available Ischemic stroke is a leading cause of morbidity and mortality in the United States. The only approved pharmacologic treatment for ischemic stroke is thrombolysis via recombinant tissue plasminogen activator (r-tPA. A short therapeutic window and serious adverse events (ie, hemorrhage, excitotoxicity greatly limit r-tPA therapy, which indicates an essential need to develop novel stroke treatment paradigms. Transporters expressed at the blood-brain barrier (BBB provide a significant opportunity to advance stroke therapy via central nervous system delivery of drugs that have neuroprotective properties. Examples of such transporters include organic anion–transporting polypeptides (Oatps and organic cation transporters (Octs. In addition, multidrug resistance proteins (Mrps are transporter targets in brain microvascular endothelial cells that can be exploited to preserve BBB integrity in the setting of stroke. Here, we review current knowledge on stroke pharmacotherapy and demonstrate how endogenous BBB transporters can be targeted for improvement of ischemic stroke treatment.

  12. Toward Enteral Nutrition in the Treatment of Pediatric Crohn Disease in Canada: A Workshop to Identify Barriers and Enablers

    Directory of Open Access Journals (Sweden)

    Johan Van Limbergen

    2015-01-01

    Full Text Available The treatment armamentarium in pediatric Crohn disease (CD is very similar to adult-onset CD with the notable exception of the use of exclusive enteral nutrition (EEN [the administration of a liquid formula diet while excluding normal diet], which is used more frequently by pediatric gastroenterologists to induce remission. In pediatric CD, EEN is now recommended by the pediatric committee of the European Crohn’s and Colitis Organisation and the European Society for Paediatric Gastroenterology Hepatology and Nutrition as a first-choice agent to induce remission, with remission rates in pediatric studies consistently >75%. To chart and address enablers and barriers of use of EEN in Canada, a workshop was held in September 2014 in Toronto (Ontario, inviting pediatric gastroenterologists, nurses and dietitians from most Canadian pediatric IBD centres as well as international faculty from the United States and Europe with particular research and clinical expertise in the dietary management of pediatric CD. Workshop participants ranked the exclusivity of enteral nutrition; the health care resources; and cost implications as the top three barriers to its use. Conversely, key enablers mentioned included: standardization and sharing of protocols for use of enteral nutrition; ensuring sufficient dietetic resources; and reducing the cost of EEN to the family (including advocacy for reimbursement by provincial ministries of health and private insurance companies. Herein, the authors report on the discussions during this workshop and list strategies to enhance the use of EEN as a treatment option in the treatment of pediatric CD in Canada.

  13. Social barriers to diagnosis and treatment of breast cancer in patients presenting at a teaching hospital in Ibadan, Nigeria.

    Science.gov (United States)

    Pruitt, Liese; Mumuni, Tolulope; Raikhel, Eugene; Ademola, Adeyinka; Ogundiran, Temidayo; Adenipekun, Adeniyi; Morhason-Bello, Imran; Ojengbede, Oladosu A; Olopade, Olufunmilayo I

    2015-01-01

    Globally, breast cancer is the most frequent malignancy in women, and stage at diagnosis is a key determinant of outcome. In low- to middle-income countries, including Nigeria, advanced stage diagnosis and delayed treatment represent a significant problem. That social barriers contribute to delay has been noted in previous research; however, few specific factors have been studied. Using semi-structured interviews, this study identifies social barriers to diagnosis and treatment for patients who presented at University College Hospital Ibadan, Nigeria. Transcripts from the interviews were coded and analysed thematically. Thirty-one patients and five physicians were interviewed. The median age of patients was 51 (range: 28 to above 80), 83% were Christian and 17% were Muslim. Preliminary analysis showed that delays in diagnosis reflected a lack of education as well as the utilisation of non-physician medical services such as pharmacists. Delays in treatment were often due to fear of unanticipated surgery and cost. The majority of women did not know the cause of their breast cancer, but some believed it was caused by a spiritual affliction. This study suggests that further education and awareness of breast cancer for both patients and providers is needed in order to increase early stage diagnosis.

  14. Gas sorption and barrier properties of polymeric membranes from molecular dynamics and Monte Carlo simulations.

    Science.gov (United States)

    Cozmuta, Ioana; Blanco, Mario; Goddard, William A

    2007-03-29

    It is important for many industrial processes to design new materials with improved selective permeability properties. Besides diffusion, the molecule's solubility contributes largely to the overall permeation process. This study presents a method to calculate solubility coefficients of gases such as O2, H2O (vapor), N2, and CO2 in polymeric matrices from simulation methods (Molecular Dynamics and Monte Carlo) using first principle predictions. The generation and equilibration (annealing) of five polymer models (polypropylene, polyvinyl alcohol, polyvinyl dichloride, polyvinyl chloride-trifluoroethylene, and polyethylene terephtalate) are extensively described. For each polymer, the average density and Hansen solubilities over a set of ten samples compare well with experimental data. For polyethylene terephtalate, the average properties between a small (n = 10) and a large (n = 100) set are compared. Boltzmann averages and probability density distributions of binding and strain energies indicate that the smaller set is biased in sampling configurations with higher energies. However, the sample with the lowest cohesive energy density from the smaller set is representative of the average of the larger set. Density-wise, low molecular weight polymers tend to have on average lower densities. Infinite molecular weight samples do however provide a very good representation of the experimental density. Solubility constants calculated with two ensembles (grand canonical and Henry's constant) are equivalent within 20%. For each polymer sample, the solubility constant is then calculated using the faster (10x) Henry's constant ensemble (HCE) from 150 ps of NPT dynamics of the polymer matrix. The influence of various factors (bad contact fraction, number of iterations) on the accuracy of Henry's constant is discussed. To validate the calculations against experimental results, the solubilities of nitrogen and carbon dioxide in polypropylene are examined over a range of

  15. Dual-dermal-barrier fashion flaps for the treatment of sacral pressure sores.

    Science.gov (United States)

    Hsiao, Yen-Chang; Chuang, Shiow-Shuh

    2015-02-01

    The sacral region is one of the most vulnerable sites for the development of pressure sores. Even when surgical reconstruction is performed, there is a high chance of recurrence. Therefore, the concept of dual-dermal-barrier fashion flaps for sacral pressure sore reconstruction was proposed. From September 2007 to June 2010, nine patients with grade IV sacral pressures were enrolled. Four patients received bilateral myocutaneous V-Y flaps, four patients received bilateral fasciocutaneous V-Y flaps, and one patient received bilateral rotation-advanced flaps for sacral pressure reconstruction. The flaps were designed based on the perforators of the superior gluteal artery in one patient's reconstructive procedure. All flaps' designs were based on dual-dermal-barrier fashion. The mean follow-up time was 16 months (range = 12-25). No recurrence was noted. Only one patient had a complication of mild dehiscence at the middle suture line, occurring 2 weeks after the reconstructive surgery. The dual-dermal fashion flaps are easily duplicated and versatile. The study has shown minimal morbidity and a reasonable outcome.

  16. The Role of Relationship Dynamics and Gender Inequalities As Barriers to HIV-Serostatus Disclosure: Qualitative Study among Women and Men Living with HIV in Durban, South Africa

    Directory of Open Access Journals (Sweden)

    Divya S. Bhatia

    2017-07-01

    Full Text Available BackgroundThis qualitative study investigated gender power inequalities as they contribute to relationship dynamics and HIV-serostatus disclosure among men and women living with HIV in Durban, South Africa. HIV serodiscordance among men and women within stable partnerships contributes to high HIV incidence in southern Africa, yet disclosure rates remain low. Given the emphasis on prevention for HIV-serodiscordant couples, this research supports the urgent need to explore how best to support couples to recognize that they are part of this priority population and to access appropriate prevention and treatment.MethodsThirty-five in-depth individual interviews were conducted with 15 HIV-positive men and 20 HIV-positive women (not couples receiving care at public-sector clinics near Durban. A structured coding scheme was developed to investigate men’s and women’s attitudes toward HIV-serostatus disclosure and behaviors of sharing (or not sharing HIV serostatus with a partner. Narratives were analyzed for barriers and facilitators of disclosure through the lens of sociocultural gender inequality, focusing on reasons for non-disclosure.ResultsAmong 35 participants: median age was 33 years (men and 30 years (women; average years since HIV diagnosis was 1 (men and 1.5 (women. Four themes related to gender inequality and HIV-serostatus disclosure emerged: (1 Men and women fear disclosing to partners due to concerns about stigma and relationship dissolution, (2 suspicions and mistrust between partners underlies decisions for non-disclosure, (3 unequal, gendered power in relationships causes differential likelihood and safety of disclosure among men and women, and (4 incomplete or implicit disclosure are strategies to navigate disclosure challenges. Findings illustrate HIV-serostatus disclosure as a complex process evolving over time, rather than a one-time event.ConclusionPartner communication about HIV serostatus is infrequent and complicated

  17. Access to treatment for substance-using women in the Republic of Georgia: socio-cultural and structural barriers.

    Science.gov (United States)

    Otiashvili, David; Kirtadze, Irma; O'Grady, Kevin E; Zule, William; Krupitsky, Evgeny; Wechsberg, Wendee M; Jones, Hendrée E

    2013-11-01

    In the Republic of Georgia, women comprise under 2% of patients in substance use treatment and to date there has been no empirical research to investigate what factors may facilitate or hinder their help-seeking behaviour or access to treatment services. This study included secondary analysis of in-depth interviews with 55 substance-using women and 34 providers of health-related services. The roles and norms of women in Georgian society were identified as major factors influencing their help-seeking behaviour. Factors that had a negative impact on use of drug treatment services included an absence of gender-specific services, judgmental attitudes of service providers, the cost of treatment and a punitive legal position in regard to substance use. Having a substance-using partner served as an additional factor inhibiting a woman's willingness to seek assistance. Within the context of orthodox Georgian society, low self-esteem, combined with severe family and social stigma play a critical role in creating barriers to the use of both general health and substance-use-treatment services for women. Education of the public, including policy makers and health care providers is urgently needed to focus on addiction as a treatable medical illness. The need for more women centred services is also critical to the provision of effective treatment for substance-using women. Copyright © 2013 Elsevier B.V. All rights reserved.

  18. Effect of dielectric barrier discharge treatment on surface nanostructure and wettability of polylactic acid (PLA) nonwoven fabrics

    Science.gov (United States)

    Ren, Yu; Xu, Lin; Wang, Chunxia; Wang, Xiaona; Ding, Zhirong; Chen, Yuyue

    2017-12-01

    Polylactic acid (PLA) nonwoven fabrics are treated with atmospheric dielectric barrier discharge (DBD) plasma to improve surface wettability. Scanning electron microscopy (SEM) and atomic force microscopy (AFM) show that micro- to nano-scale textures appear on the treated PLA surfaces dependent on the treatment time. X-ray photoelectron spectroscopy (XPS) analysis reveals that the DBD plasma treatments result in decreased carbon contents and increased oxygen contents as well as slightly increased nitrogen contents. The water contact angle decreases sharply with the increase of the DBD plasma treatment time. The super hydrophilic PLA surfaces (the water contact angle reached 0°) are obtained when the treatment time is longer than 90 s. Ninety days after the DBD plasma treatment, the XPS analysis shows that Csbnd O/Csbnd N and Cdbnd O/Osbnd Cdbnd O percentages decline for all treatment groups. However, the water contact angle is kept constant at 0° for the groups treated above 90 s, which could be due to the oxidized nano-structured layer on the DBD plasma treated PLA surfaces.

  19. Depression Screening and Education: Options to Reduce Barriers to Treatment (DESEO): protocol for an educational intervention study.

    Science.gov (United States)

    Sanchez, Katherine; Eghaneyan, Brittany H; Trivedi, Madhukar H

    2016-07-29

    Barriers to depression treatment among Hispanic populations include persistent stigma, inadequate doctor patient communication (DPC) and resultant sub-optimal use of anti-depressant medications. Stigma is primarily perpetuated due to inadequate disease literacy and cultural factors. Common concerns about depression treatments among Hispanics include fears about the addictive and harmful properties of antidepressants, worries about taking too many pills, and the stigma attached to taking psychotropic medications. The current manuscript presents the study protocol for the Depression Screening and Education: Options to Reduce Barriers to Treatment (DESEO) study funded by the Center for Medicare and Medicaid Services (CMS) Grants to Support the Hispanic Health Services Research Grant Program. DESEO will implement universal screening with a self-report depression screening tool (the 9-item Patient Health Questionnaire (PHQ-9)) that is presented through a customized web application and a Depression Education Intervention (DEI) designed to increase disease literacy, and dispel myths about depression and its treatment among Hispanic patients thus reducing stigma and increasing treatment engagement. This project will be conducted at one community health center whose patient population is majority Hispanic. The target enrollment for recruitment is 350 patients over the 24-month study period. A one-group, pretest-posttest design will be used to asses knowledge of depression and its treatment and related stigma before, immediately after, and one month post intervention. Primary care settings often are the gateway to identifying undiagnosed mental health disorders, particularly for people with comorbid physical health conditions. This study is unique in that it aims to examine the specific role of patient education as an intervention to increase engagement in depression treatment. By participating in the DEI, it is expected that patients will have time to understand treatment

  20. The stochastic system approach for estimating dynamic treatments effect.

    Science.gov (United States)

    Commenges, Daniel; Gégout-Petit, Anne

    2015-10-01

    The problem of assessing the effect of a treatment on a marker in observational studies raises the difficulty that attribution of the treatment may depend on the observed marker values. As an example, we focus on the analysis of the effect of a HAART on CD4 counts, where attribution of the treatment may depend on the observed marker values. This problem has been treated using marginal structural models relying on the counterfactual/potential response formalism. Another approach to causality is based on dynamical models, and causal influence has been formalized in the framework of the Doob-Meyer decomposition of stochastic processes. Causal inference however needs assumptions that we detail in this paper and we call this approach to causality the "stochastic system" approach. First we treat this problem in discrete time, then in continuous time. This approach allows incorporating biological knowledge naturally. When working in continuous time, the mechanistic approach involves distinguishing the model for the system and the model for the observations. Indeed, biological systems live in continuous time, and mechanisms can be expressed in the form of a system of differential equations, while observations are taken at discrete times. Inference in mechanistic models is challenging, particularly from a numerical point of view, but these models can yield much richer and reliable results.

  1. Long range personalized cancer treatment strategies incorporating evolutionary dynamics.

    Science.gov (United States)

    Yeang, Chen-Hsiang; Beckman, Robert A

    2016-10-22

    Current cancer precision medicine strategies match therapies to static consensus molecular properties of an individual's cancer, thus determining the next therapeutic maneuver. These strategies typically maintain a constant treatment while the cancer is not worsening. However, cancers feature complicated sub-clonal structure and dynamic evolution. We have recently shown, in a comprehensive simulation of two non-cross resistant therapies across a broad parameter space representing realistic tumors, that substantial improvement in cure rates and median survival can be obtained utilizing dynamic precision medicine strategies. These dynamic strategies explicitly consider intratumoral heterogeneity and evolutionary dynamics, including predicted future drug resistance states, and reevaluate optimal therapy every 45 days. However, the optimization is performed in single 45 day steps ("single-step optimization"). Herein we evaluate analogous strategies that think multiple therapeutic maneuvers ahead, considering potential outcomes at 5 steps ahead ("multi-step optimization") or 40 steps ahead ("adaptive long term optimization (ALTO)") when recommending the optimal therapy in each 45 day block, in simulations involving both 2 and 3 non-cross resistant therapies. We also evaluate an ALTO approach for situations where simultaneous combination therapy is not feasible ("Adaptive long term optimization: serial monotherapy only (ALTO-SMO)"). Simulations utilize populations of 764,000 and 1,700,000 virtual patients for 2 and 3 drug cases, respectively. Each virtual patient represents a unique clinical presentation including sizes of major and minor tumor subclones, growth rates, evolution rates, and drug sensitivities. While multi-step optimization and ALTO provide no significant average survival benefit, cure rates are significantly increased by ALTO. Furthermore, in the subset of individual virtual patients demonstrating clinically significant difference in outcome between

  2. Microsecond-pulsed dielectric barrier discharge plasma stimulation of tissue macrophages for treatment of peripheral vascular disease

    Energy Technology Data Exchange (ETDEWEB)

    Miller, V., E-mail: vmiller@coe.drexel.edu; Lin, A.; Brettschneider, J.; Fridman, G.; Fridman, A. [AJ Drexel Plasma Institute, Drexel University, Camden, New Jersey 08103 (United States); Kako, F.; Gabunia, K.; Kelemen, S.; Autieri, M. [Department of Physiology, Independence Blue Cross Cardiovascular Research Center, Temple University School of Medicine, Philadelphia, Pennsylvania 19140 (United States)

    2015-12-15

    Angiogenesis is the formation of new blood vessels from pre-existing vessels and normally occurs during the process of inflammatory reactions, wound healing, tissue repair, and restoration of blood flow after injury or insult. Stimulation of angiogenesis is a promising and an important step in the treatment of peripheral artery disease. Reactive oxygen species have been shown to be involved in stimulation of this process. For this reason, we have developed and validated a non-equilibrium atmospheric temperature and pressure short-pulsed dielectric barrier discharge plasma system, which can non-destructively generate reactive oxygen species and other active species at the surface of the tissue being treated. We show that this plasma treatment stimulates the production of vascular endothelial growth factor, matrix metalloproteinase-9, and CXCL 1 that in turn induces angiogenesis in mouse aortic rings in vitro. This effect may be mediated by the direct effect of plasma generated reactive oxygen species on tissue.

  3. Identifying barriers to mental health system improvements: an examination of community participation in assertive community treatment programs

    Directory of Open Access Journals (Sweden)

    Wakefield Patricia A

    2011-11-01

    Full Text Available Abstract Background Integrating the best available evidence into program standards is essential if system-wide improvements in the delivery of community-based mental health services are to be achieved. Since the beginning of the Assertive Community Treatment (ACT program movement, program standards have included a role for the community. In particular, ACT program standards have sought to ensure that members of the local community are involved in governance and that former clients participate in service delivery as "Peer Support Specialists". This paper reports on the extent to which ACT program standards related to community participation have been implemented and identifies barriers to full compliance. Methods Qualitative and quantitative data were collected through a telephone survey of ACT Program Coordinators in Ontario, Canada, using a census sample of the existing 66 ACT programs. A thematic approach to content analysis was used to analyze respondents' qualitative comments. Quantitative data were analyzed using SPSS 16.0 and included means, frequencies, independent t-tests and Pearson Correlations. Results An 85% response rate was achieved. Of the 33 program standards, the two that received the lowest perceived compliance ratings were the two standards directly concerning community participation. Specifically, the standard to have a functioning Community Advisory Body and the standard requiring the inclusion of a Peer Support Specialist. The three major themes that emerged from the survey data with respect to the barriers to fully implementing the Community Advisory Body were: external issues; standard related issues; and, organizational/structural related issues. The three major themes concerning barriers to implementing the Peer Support Specialist role were: human resource related issues; organizational/structural related issues; and, standard related issues. Conclusions The reasons for low compliance of ACT programs with community

  4. Converse Barrier Certificate Theorem

    DEFF Research Database (Denmark)

    Wisniewski, Rafael; Sloth, Christoffer

    2013-01-01

    This paper presents a converse barrier certificate theorem for a generic dynamical system.We show that a barrier certificate exists for any safe dynamical system defined on a compact manifold. Other authors have developed a related result, by assuming that the dynamical system has no singular...... points in the considered subset of the state space. In this paper, we redefine the standard notion of safety to comply with generic dynamical systems with multiple singularities. Afterwards, we prove the converse barrier certificate theorem and illustrate the differences between ours and previous work...

  5. Mapping of barley alpha-amylases and outer subsite mutants reveals dynamic high-affinity subsites and barriers in the long substrate binding cleft

    DEFF Research Database (Denmark)

    Kandra, L.; Abou Hachem, Maher; Gyemant, G.

    2006-01-01

    Subsite affinity maps of long substrate binding clefts in barley alpha-amylases, obtained using a series of maltooligosaccharides of degree of polymerization of 3-12, revealed unfavorable binding energies at the internal subsites -3 and -5 and at subsites -8 and +3/+4 defining these subsites...... as binding barriers. Barley a-amylase I mutants Y105A and T212Y at subsite -6 and +4 resulted in release or anchoring of bound substrate, thus modifying the affinities of other high-affinity subsites (-2 and +2) and barriers. The double mutant Y105A-T212Y displayed a hybrid subsite affinity profile......, converting barriers to binding areas. These findings highlight the dynamic binding energy distribution and the versatility of long maltooligosaccharide derivatives in mapping extended binding clefts in a-amylases....

  6. The barriers to patient-driven treatment in mental health: why patients may choose to follow their own path.

    Science.gov (United States)

    Greenall, Paul

    2006-01-01

    The paper aims to explore the barriers that currently exist to patient-driven treatment within the field of mental health care and reform. This study represents action learning research using grounded theory to explore a possible causal basis for recidivism related to non-compliance with medication. Interviews addressed concerns from the literature around perceived barriers to patient-driven treatment evidenced by non-compliance with medically recommended pharmaceutical treatment. Results were correlated to look for emergent themes that were used to form the basis for subsequent interview questions. An analysis of the resulting emergent themes illustrated the importance of participatory treatment and coaching rather than medically applied paternalistic care, which is seen as encouraging learned helplessness on the part of patients. Similar helplessness was also revealed in clinicians themselves. Patients' awareness of their own needs and demands for more services place clients and the caregivers at odds over appropriate care in an environment of limited resources. The research was limited to only a small number of interviewees in one institution, all of whom were closely associated with mental illness in various capacities. The grounded theory nature of the research does, however, provide a framework for more research in other institutions to test and further explore some of the findings. The study demonstrated a reinforcement of Maslow's theory of needs hierarchy. The study illustrated a step-wise approach to treatment to decrease the rate of failure and recidivism in mental health care. The provision of a stable living environment was viewed as instrumental in improving patients' compliance with pharmaceutical treatment. An action plan was therefore created to initiate the support of a transitional/emergency house by various community groups in partnership with pharmaceutical manufacturing companies. Recidivism in mental health-created by non-compliance in

  7. Poster – 12: Radiological assessment of the secondary barrier shielding for IMRT treatments delivered through patient inhomogeneities

    Energy Technology Data Exchange (ETDEWEB)

    Haseeb, Syed Abdul; Ahmad, Syed Bilal; Mirza, Sikander Majid [Pakistan Institute of Engineering and Applied Science, Nilore, Islamabad, Pakistan, Sunnybrook Health Sciences Center, Toronto, ON, Canada & Pakistan Institute of Engineering and Applied Science, Nilore, Islamabad, Pakistan, Pakistan Institute of Engineering and Applied Science, Nilore, Islamabad (Pakistan)

    2016-08-15

    Purpose: To assess the impact of radiation treatment delivery through patient inhomogeneities on the secondary barrier shielding requirements in IMRT treatments using Monte Carlo Simulations. Materials and Methods: Scatter factors were calculated at a distance of 1m from the center of a virtual phantom in Geant4.10.01. Phantom (30×30×30 cm{sup 3}) was inserted with lung (30×30×8 cm{sup 3}), stainless steel (5×5×5 cm{sup 3}) and aluminum (5×5×5 cm{sup 3}) to represent the inhomogeneities. Scatter factor was defined according to the NCRP-151 recommendations and was calculated for angles of 3° to 120° with respect to the beam’s central axis. A virtual radiation source, with energy sampled from a histogram representing 6 MV FFF beam, was used for irradiation with a field size of 15×15 cm{sup 2} and SSD of 100 cm. Results: Irradiation through the inhomogeneity affects the patient scattered dose. For high Z material inhomogeneities the scattered dose is reduced due to significant attenuation of the primary radiation. On the other hand if the inhomogeneity is a low Z material such as lung the scattered dose is higher by a maximum of 26%. The average increase in scatter factors for the lung phantom was 17% for angles between 3° and 63° compared to the homogeneous water phantom. Conclusions: In IMRT type treatments delivered through low density patient inhomogeneities (lung) the scattered dose increases significantly. Considering a large proportion of patients receiving radiation therapy for lung cancers the increase in the scattered dose should be incorporated in the shielding calculations for the secondary barriers.

  8. Poster – 12: Radiological assessment of the secondary barrier shielding for IMRT treatments delivered through patient inhomogeneities

    International Nuclear Information System (INIS)

    Haseeb, Syed Abdul; Ahmad, Syed Bilal; Mirza, Sikander Majid

    2016-01-01

    Purpose: To assess the impact of radiation treatment delivery through patient inhomogeneities on the secondary barrier shielding requirements in IMRT treatments using Monte Carlo Simulations. Materials and Methods: Scatter factors were calculated at a distance of 1m from the center of a virtual phantom in Geant4.10.01. Phantom (30×30×30 cm 3 ) was inserted with lung (30×30×8 cm 3 ), stainless steel (5×5×5 cm 3 ) and aluminum (5×5×5 cm 3 ) to represent the inhomogeneities. Scatter factor was defined according to the NCRP-151 recommendations and was calculated for angles of 3° to 120° with respect to the beam’s central axis. A virtual radiation source, with energy sampled from a histogram representing 6 MV FFF beam, was used for irradiation with a field size of 15×15 cm 2 and SSD of 100 cm. Results: Irradiation through the inhomogeneity affects the patient scattered dose. For high Z material inhomogeneities the scattered dose is reduced due to significant attenuation of the primary radiation. On the other hand if the inhomogeneity is a low Z material such as lung the scattered dose is higher by a maximum of 26%. The average increase in scatter factors for the lung phantom was 17% for angles between 3° and 63° compared to the homogeneous water phantom. Conclusions: In IMRT type treatments delivered through low density patient inhomogeneities (lung) the scattered dose increases significantly. Considering a large proportion of patients receiving radiation therapy for lung cancers the increase in the scattered dose should be incorporated in the shielding calculations for the secondary barriers.

  9. Patient-reported financial barriers to adherence to treatment in neurology

    Directory of Open Access Journals (Sweden)

    Moura LMVR

    2016-11-01

    Full Text Available Lidia MVR Moura,1 Eli L Schwamm,1 Valdery Moura Junior,1 Michael P Seitz,1 Daniel B Hoch,1 John Hsu,2,3 Lee H Schwamm1 1Department of Neurology, 2Mongan Institute for Health Policy, Massachusetts General Hospital, 3Department of Medicine and Department of Health Care Policy, Harvard Medical School, Boston, MA, USA Objective: Many effective medical therapies are available for treating neurological diseases, but these therapies tend to be expensive and adherence is critical to their effectiveness. We used patient-reported data to examine the frequency and determinants of financial barriers to medication adherence among individuals treated for neurological disorders. Patients and methods: Patients completed cross-sectional surveys on iPads as part of routine outpatient care in a neurology clinic. Survey responses from a 3-month period were collected and merged with administrative sources of demographic and clinical information (eg, insurance type. We explored the association between patient characteristics and patient-reported failure to refill prescription medication due to cost in the previous 12 months, termed here as “nonadherence”. Results: The population studied comprised 6075 adults who were presented between July and September 2015 for outpatient neurology appointments. The mean age of participants was 56 (standard deviation: 18 years, and 1613 (54% were females. The patients who participated in the surveys (2992, 49% were comparable to nonparticipants with respect to gender and ethnicity but more often identified English as their preferred language (94% vs 6%, p<0.01. Among respondents, 9.8% (n=265 reported nonadherence that varied by condition. These patients were more frequently Hispanic (16.7% vs 9.8% white, p=0.01, living alone (13.9% vs 8.9% cohabitating, p<0.01, and preferred a language other than English (15.3% vs 9.4%, p=0.02. Conclusion: Overall, the magnitude of financial barriers to medication adherence appears to vary

  10. Gender differences in substance abuse treatment and barriers to care among persons with substance use disorders with and without comorbid major depression.

    Science.gov (United States)

    Chen, Lian-Yu; Strain, Eric C; Crum, Rosa M; Mojtabai, Ramin

    2013-01-01

    To compare substance use disorders (SUD) treatment patterns and barriers to such treatment among men and women with SUD with and without comorbid major depressive episodes (MDE) in a community sample. Using data from adult participants in the National Survey on Drug Use and Health 2005-2010, we investigated differences by sex in the association of MDE comorbidity with SUD on patterns of, perceived unmet need for, and the perceived barriers to SUD treatments. Compared with participants with SUD without MDE, both men and women with comorbid SUD and MDE were more likely to use SUD services or to report an unmet need for such treatment. Sex modified the association of comorbidity and treatment patterns: males with MDE comorbidity had a greater likelihood of emergency room visits and use of inpatient services than females. Barriers to substance treatment were remarkably similar for males and females in both the SUD without MDE group and with MDE group, with attitudinal factors being the most common barriers. Comorbidity with MDE seems to be an important predictor of service utilization and perceived need for SUD treatment in both men and women. The association of comorbidity with the use of some types of services, however, seems to vary according to sex. The findings have implications for the design of sex-specific SUD treatment programs.

  11. Dentist-Perceived Barriers and Attractors to Cognitive-Behavioral Treatment Provided by Mental Health Providers in Dental Practices.

    Science.gov (United States)

    Heyman, R E; Wojda, A K; Eddy, J M; Haydt, N C; Geiger, J F; Slep, A M Smith

    2018-02-01

    Over 1 in 5 dental patients report moderate to severe dental fear. Although the efficacy of cognitive-behavioral treatment (CBT) for dental fear has been examined in over 20 randomized controlled trials-with 2 meta-analyses finding strong average effect sizes ( d > 1)-CBT has received almost no dissemination beyond the specialty clinics that tested it. The challenge, then, is not how to treat dental fear but how to disseminate and implement such an evidence-based treatment in a way that recognizes the rewards and barriers in the US health care system. This mixed-method study investigated the potential of disseminating CBT through care from a mental health provider from within the dental home, a practice known as evidence-based collaborative care (EBCC). Two preadoption studies were conducted with practicing dentists drawn from a self-organized Practice-Based Research Network in the New York City metropolitan area. The first comprised 3 focus groups ( N = 17), and the second involved the administration of a survey ( N = 46). Focus group participants agreed that CBT for dental fear is worthy of consideration but identified several concerns regarding its appeal, feasibility, and application in community dental practices. Survey participants indicated endorsement of factors promoting the use of EBCC as a mechanism for CBT dissemination, with no factors receiving less than 50% support. Taken together, these findings indicate that EBCC may be a useful framework through which an evidence-based treatment for dental fear treatment can be delivered.

  12. Focused ultrasound-induced blood-brain barrier opening to enhance temozolomide delivery for glioblastoma treatment: a preclinical study.

    Directory of Open Access Journals (Sweden)

    Kuo-Chen Wei

    Full Text Available The purpose of this study is to assess the preclinical therapeutic efficacy of magnetic resonance imaging (MRI-monitored focused ultrasound (FUS-induced blood-brain barrier (BBB disruption to enhance Temozolomide (TMZ delivery for improving Glioblastoma Multiforme (GBM treatment. MRI-monitored FUS with microbubbles was used to transcranially disrupt the BBB in brains of Fisher rats implanted with 9L glioma cells. FUS-BBB opening was spectrophotometrically determined by leakage of dyes into the brain, and TMZ was quantitated in cerebrospinal fluid (CSF and plasma by LC-MS\\MS. The effects of treatment on tumor progression (by MRI, animal survival and brain tissue histology were investigated. Results demonstrated that FUS-BBB opening increased the local accumulation of dyes in brain parenchyma by 3.8-/2.1-fold in normal/tumor tissues. Compared to TMZ alone, combined FUS treatment increased the TMZ CSF/plasma ratio from 22.7% to 38.6%, reduced the 7-day tumor progression ratio from 24.03 to 5.06, and extended the median survival from 20 to 23 days. In conclusion, this study provided preclinical evidence that FUS BBB-opening increased the local concentration of TMZ to improve the control of tumor progression and animal survival, suggesting its clinical potential for improving current brain tumor treatment.

  13. Treatment of Candida albicans biofilms with low-temperature plasma induced by dielectric barrier discharge and atmospheric pressure plasma jet

    International Nuclear Information System (INIS)

    Koban, Ina; Welk, Alexander; Meisel, Peter; Holtfreter, Birte; Kocher, Thomas; Matthes, Rutger; Huebner, Nils-Olaf; Kramer, Axel; Sietmann, Rabea; Kindel, Eckhard; Weltmann, Klaus-Dieter

    2010-01-01

    Because of some disadvantages of chemical disinfection in dental practice (especially denture cleaning), we investigated the effects of physical methods on Candida albicans biofilms. For this purpose, the antifungal efficacy of three different low-temperature plasma devices (an atmospheric pressure plasma jet and two different dielectric barrier discharges (DBDs)) on Candida albicans biofilms grown on titanium discs in vitro was investigated. As positive treatment controls, we used 0.1% chlorhexidine digluconate (CHX) and 0.6% sodium hypochlorite (NaOCl). The corresponding gas streams without plasma ignition served as negative treatment controls. The efficacy of the plasma treatment was determined evaluating the number of colony-forming units (CFU) recovered from titanium discs. The plasma treatment reduced the CFU significantly compared to chemical disinfectants. While 10 min CHX or NaOCl exposure led to a CFU log 10 reduction factor of 1.5, the log 10 reduction factor of DBD plasma was up to 5. In conclusion, the use of low-temperature plasma is a promising physical alternative to chemical antiseptics for dental practice.

  14. Treatment of Candida albicans biofilms with low-temperature plasma induced by dielectric barrier discharge and atmospheric pressure plasma jet

    Energy Technology Data Exchange (ETDEWEB)

    Koban, Ina; Welk, Alexander; Meisel, Peter; Holtfreter, Birte; Kocher, Thomas [Unit of Periodontology, Dental School, University of Greifswald, Rotgerberstr. 8, 17475 Greifswald (Germany); Matthes, Rutger; Huebner, Nils-Olaf; Kramer, Axel [Institute for Hygiene and Environmental Medicine, University of Greifswald, Walther-Rathenau-Str. 49 a, 17487 Greifswald (Germany); Sietmann, Rabea [Institute of Microbiology, University of Greifswald, Friedrich-Ludwig-Jahn-Str. 15, 17487 Greifswald (Germany); Kindel, Eckhard; Weltmann, Klaus-Dieter, E-mail: ina.koban@uni-greifswald.d [Leibniz Institute for Plasma Science and Technology (INP), Felix-Hausdorff-Str. 2, 17489 Greifswald (Germany)

    2010-07-15

    Because of some disadvantages of chemical disinfection in dental practice (especially denture cleaning), we investigated the effects of physical methods on Candida albicans biofilms. For this purpose, the antifungal efficacy of three different low-temperature plasma devices (an atmospheric pressure plasma jet and two different dielectric barrier discharges (DBDs)) on Candida albicans biofilms grown on titanium discs in vitro was investigated. As positive treatment controls, we used 0.1% chlorhexidine digluconate (CHX) and 0.6% sodium hypochlorite (NaOCl). The corresponding gas streams without plasma ignition served as negative treatment controls. The efficacy of the plasma treatment was determined evaluating the number of colony-forming units (CFU) recovered from titanium discs. The plasma treatment reduced the CFU significantly compared to chemical disinfectants. While 10 min CHX or NaOCl exposure led to a CFU log{sub 10} reduction factor of 1.5, the log{sub 10} reduction factor of DBD plasma was up to 5. In conclusion, the use of low-temperature plasma is a promising physical alternative to chemical antiseptics for dental practice.

  15. Early-phase dynamics in coral recovery following cyclone disturbance on the inshore Great Barrier Reef, Australia

    Science.gov (United States)

    Sato, Yui; Bell, Sara C.; Nichols, Cassandra; Fry, Kent; Menéndez, Patricia; Bourne, David G.

    2018-06-01

    Coral recovery (the restoration of abundance and composition of coral communities) after disturbance is a key process that determines the resilience of reef ecosystems. To understand the mechanisms underlying the recovery process of coral communities, colony abundance and size distribution were followed on reefs around Pelorus Island, located in the inshore central region of the Great Barrier Reef, following a severe tropical cyclone in 2011 that caused dramatic loss of coral communities. Permanent quadrats (600 m2) were monitored biannually between 2012 and 2016, and individual coral colonies were counted, sized and categorized into morphological types. The abundance of coral recruits and coral cover were also examined using permanent quadrats and random line intercept transects, respectively. The number of colonies in the smallest size class (4-10 cm) increased substantially during the study period, driving the recovery of coral populations. The total number of coral colonies 5 yr post-cyclone reached between 73 and 122% of pre-cyclone levels though coral cover remained between 16 and 31% of pre-cyclone levels, due to the dominance of small coral colonies in the recovering communities. Temporal transitions of coral demography (i.e., colony-size distributions) illustrated that the number of recently established coral populations overtook communities of surviving colonies. Coral recruits (coral recovery. A shift in morphological composition of coral communities was also observed, with the relative abundance of encrusting corals reduced post-cyclone in contrast to their dominance prior to the disturbance. This study identifies the fine-scale processes involved in the initial recovery of coral reefs, providing insights into the dynamics of coral demography that are essential for determining coral reef resilience following major disturbance.

  16. [Barriers to ART initiation in HIV infected subjects and with treatment indication in Spain. Why don't they start their treatment? Bridgap Study].

    Science.gov (United States)

    Viciana-Fernández, Pompeyo; Falcó, Vicenç; Castaño, Manuel; de los Santos-Gil, Ignacio; Olalla-Sierra, Julián; Hernando, Asunción; Deig, Elisabet; Clotet, Bonaventura; Knobel, Hernando; Podzamczer, Daniel; Pedrol, Pere Domingo

    2015-01-01

    In Spain, HIV treatment guidelines are well known and generally followed. However, in some patients there are no plans to initiate ART despite having treatment indications. The current barriers to ART initiation are presented. A cross-sectional survey including every HIV infected patient in care in 19 hospitals across Spain in 2012, with ≥1 indication to start ART according to 2011 national treatment guidelines, who had not been scheduled for ART initiation. Reasons for deferring treatment were categorized as follows (non-exclusive categories): a) The physician thinks the indication is not absolute and prefers to defer it; b) The patient does not want to start it; c) The physician thinks ART must be started, but there is some limitation to starting it, and d) The patient has undetectable viral load in absence of ART. A total of 256 patients, out of 784 originally planned, were included. The large majority (84%) were male, median age 39 years, 57% MSM, 24% heterosexuals, and 16% IDUs. Median time since HIV diagnosis was 3 years, median CD4 count, 501 cells/mm3, median viral load 4.4 log copies/ml. Main ART indications were: CD4 count ART indication were on it. The most frequent barriers among those who did not receive it were physician-related, suggesting that the relevance of the conditions that indicate ART may need reinforcing. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  17. Patient and healthcare provider barriers to hypertension awareness, treatment and follow up: a systematic review and meta-analysis of qualitative and quantitative studies.

    Directory of Open Access Journals (Sweden)

    Rasha Khatib

    Full Text Available BACKGROUND: Although the importance of detecting, treating, and controlling hypertension has been recognized for decades, the majority of patients with hypertension remain uncontrolled. The path from evidence to practice contains many potential barriers, but their role has not been reviewed systematically. This review aimed to synthesize and identify important barriers to hypertension control as reported by patients and healthcare providers. METHODS: Electronic databases MEDLINE, EMBASE and Global Health were searched systematically up to February 2013. Two reviewers independently selected eligible studies. Two reviewers categorized barriers based on a theoretical framework of behavior change. The theoretical framework suggests that a change in behavior requires a strong commitment to change [intention], the necessary skills and abilities to adopt the behavior [capability], and an absence of health system and support constraints. FINDINGS: Twenty-five qualitative studies and 44 quantitative studies met the inclusion criteria. In qualitative studies, health system barriers were most commonly discussed in studies of patients and health care providers. Quantitative studies identified disagreement with clinical recommendations as the most common barrier among health care providers. Quantitative studies of patients yielded different results: lack of knowledge was the most common barrier to hypertension awareness. Stress, anxiety and depression were most commonly reported as barriers that hindered or delayed adoption of a healthier lifestyle. In terms of hypertension treatment adherence, patients mostly reported forgetting to take their medication. Finally, priority setting barriers were most commonly reported by patients in terms of following up with their health care providers. CONCLUSIONS: This review identified a wide range of barriers facing patients and health care providers pursuing hypertension control, indicating the need for targeted multi

  18. Treatment of poly(ethylene terephthalate) foils by atmospheric pressure air dielectric barrier discharge and its influence on cell growth

    Science.gov (United States)

    Kuzminova, Anna; Vandrovcová, Marta; Shelemin, Artem; Kylián, Ondřej; Choukourov, Andrei; Hanuš, Jan; Bačáková, Lucie; Slavínská, Danka; Biederman, Hynek

    2015-12-01

    In this contribution an effect of dielectric barrier discharge (DBD) sustained in air at atmospheric pressure on surface properties of poly(ethylene terephthalate) (PET) foils is studied. It is found that exposure of PET to DBD plasma leads to rapid changes of surface chemical composition, wettability, surface morphology as well as mechanical properties of PET surface. In addition, based on biological tests that were performed using two cell types (Saos-2 human osteoblast-like cells and HUVEC human umbilical vein endothelial cells), it may be concluded that DBD plasma treatment positively influences cell growth on PET. This effect was found to be connected predominantly with increased surface energy and oxygen content of the surface of treated PET foils.

  19. Mental Health of Prisoners: Identifying Barriers to Mental Health Treatment and Medication Continuity

    Science.gov (United States)

    Connell, Nadine M.

    2014-01-01

    Objectives. We assessed mental health screening and medication continuity in a nationally representative sample of US prisoners. Methods. We obtained data from 18 185 prisoners interviewed in the 2004 Survey of Inmates in State and Federal Correctional Facilities. We conducted survey logistic regressions with Stata version 13. Results. About 26% of the inmates were diagnosed with a mental health condition at some point during their lifetime, and a very small proportion (18%) were taking medication for their condition(s) on admission to prison. In prison, more than 50% of those who were medicated for mental health conditions at admission did not receive pharmacotherapy in prison. Inmates with schizophrenia were most likely to receive pharmacotherapy compared with those presenting with less overt conditions (e.g., depression). This lack of treatment continuity is partially attributable to screening procedures that do not result in treatment by a medical professional in prison. Conclusions. A substantial portion of the prison population is not receiving treatment for mental health conditions. This treatment discontinuity has the potential to affect both recidivism and health care costs on release from prison. PMID:25322306

  20. Are religion and spirituality barriers or facilitators to treatment for HIV: a systematic review of the literature.

    Science.gov (United States)

    Medved Kendrick, Haley

    2017-01-01

    Much attention has been given to the relationship between religion/spirituality (R/S) and HIV in recent years, but comparatively little has been explored in regard to R/S and HIV testing, retention in care, and adherence to medication. Religious views concerning HIV risk behavior pose challenges to communication and education about sexual health in religious communities and may serve as barriers to HIV treatment and care. Conversely, religious coping and spiritual well-being, as well as social support could serve as facilitators to HIV treatment and care. This study aims to fill a gap in the literature by addressing the following questions: (1) what dimensions of R/S have been found to be factors associated with HIV outcomes?; (2) which R/S factors function as barriers or facilitators to care among people living with HIV (PLWH)?; and (3) which R/S factors, if any, vary across socio-demographic groups? Thirty-three empirical articles were identified for systematic review. Of the 33 empirical studies included, 24 studies found that at least one measure of R/S was associated with better adherence and clinical health outcomes. Twelve studies found at least one measure of R/S to be associated with poorer adherence and clinical health outcomes. Seven of the studies found at least one R/S measure to have no significant association with outcomes. Though all of the studies included in this review focused on R/S experiences of PLWH, there was very little consistency in regard to measurement of R/S. Studies in this review included a wide range of R/S measures, including beliefs, religious/spiritual practices, R/S coping, organizational religion, and many more. Of the 33 studies reviewed, only 9 focused on unique populations such as women, people with histories of substance abuse, immigrants, etc. Findings from this review highlight opportunities for more studies in various populations using standardized R/S measures.

  1. Dynamics of Nutrients Transport in Onsite Wastewater Treatment Systems

    Science.gov (United States)

    Toor, G.; De, M.

    2013-05-01

    Domestic wastewater is abundant in nutrients¬ that originate from various activities in the households. In developed countries, wastewater is largely managed by (1) centralized treatment where wastewater from large population is collected, treated, and discharged and (2) onsite treatment where wastewater is collected from an individual house, treated, and dispersed onsite; this system is commonly known as septic system or onsite wastewater treatment system (OWTS) and consist of a septic tank (collects wastewater) and drain-field (disperses wastewater in soil). In areas with porous sandy soils, the transport of nutrients from drain-field to shallow groundwater is accelerated. To overcome this limitation, elevated disposal fields (commonly called mounds) on top of the natural soil are constructed to provide unsaturated conditions for wastewater treatment. Our objective was to study the dynamics of nitrogen (N) and phosphorus (P) transport in the vadose zone and groundwater in traditional and advanced OWTS. Soil water samples were collected from the vadose zone by using suction cup lysimeters and groundwater samples were collected by using piezometers. Collected samples (wastewater, soil-water, groundwater) were analyzed for various water quality parameters. The pH (4.39-4.78) and EC (0.28-0.34 dS/m) of groundwater was much lower than both wastewater and soil-water. In contrast to >50 mg/L of ammonium-N in wastewater, concentrations in all lysimeters (0.02-0.81 mg/L) and piezometers (0.01-0.82 mg/L) were 99% disappeared (primarily nitrified) in the vadose zone (20 mg/L in the vadose zones of traditional systems (drip dispersal and gravel trench). Concentrations of chloride showed a distinct pattern of nitrate-N breakthrough in vadose zone and groundwater; the groundwater nitrate-N was elevated upto 19.2 mg/L after wastewater delivery in tradional systems. Total P in the wastewater was ~10 mg/L, but low in all lysimeters (0.046-1.72 mg/L) and piezometers (0.01-0.78 mg

  2. Evaluation of Polyurethane Membrane as a Barrier in Treatment of Intrabony Defects

    Directory of Open Access Journals (Sweden)

    Haghighati F

    2000-05-01

    Full Text Available Clinical healing following guided tissue regeneration (GTR in intrabony pockets using a"npolyurethane membrane was compared to healing following gingival flap surgery (GFS."nTen patients with adult periodontitis and the presence of intrabony defects were selected. Oral hygenic"ntreatments were performed during a 4- weeks period prior to surgery."nOne intrabony defects on each patient was randomly chosen to be treated according to the guided tissue"nregeneration (GTR procedure. The other side received the control treatment GFS. Test group received"nthe GTP treatment including polyurethane membrane after reflecting the flap and curettage of defect."nHowever, flap surgery and curettage were done in control group."nThe patients were evaluated for changes in probing depth (PD, clinical attachment level (CAL,"nrecession changes in crestai resorting, and defect bone fill. Clinical examinations were performed again 6"nmonths post operatively."nThe average of (PD, (CAL and defect depth (DD before surgery in test group was 3.23, 13.87 and 7.3"nmm respectively and in control group was 3.1, 8.9, 7.4 mm. After 6 months the average of (PD, (CAL"nand (DD was 1.69, 1.68, 3.5 mm, respectively and in control group was 1.24, 1.09, and 2.90mm."nTest group and control group showed successful results in treatment of intrabony defects. Test group"nshowed better results than control."nNo significant difference was observed between two treatment procedures from the point of view of"npocket depth reduction, attachment gain, and recession."nThe bony fill and crestai resorption results suggest similar clinical potential of GTR procedures"ncompared to GFS in treatment of intrabony pocket. However, in order to gain future insight, larger"nsamples and longer observation periods should be evaluated.

  3. Treatment with Entinostat Heals Experimental Cholera by Affecting Physical and Chemical Barrier Functions of Intestinal Epithelia.

    Science.gov (United States)

    Sarker, Protim; Banik, Atanu; Stromberg, Roger; Gudmundsson, Gudmundur H; Raqib, Rubhana; Agerberth, Birgitta

    2017-07-01

    We have shown previously that oral treatment with sodium butyrate or phenylbutyrate in an experimental model of shigellosis improves clinical outcomes and induces the expression of the antimicrobial peptide CAP-18 in the large intestinal epithelia. In a subsequent study, we found that entinostat, an aroylated phenylenediamine compound, has similar therapeutic potential against shigellosis. In this study, we aimed to evaluate entinostat as a potential candidate for host-directed therapy against cholera in an experimental model. Vibrio cholerae -infected rabbits were treated with two different dose regimens of entinostat: either 0.5 mg twice daily for 2 days or 1 mg once daily for 2 days. The effects of treatment on clinical outcomes and V. cholerae shedding (CFU count in stool) were observed. Immunohistochemical analysis was carried out to assess CAP-18 expression in ileal and jejunal mucosae. The serum zonulin level was measured by an enzyme-linked immunosorbent assay (ELISA) to evaluate gut permeability. Infection of rabbits with V. cholerae downregulated CAP-18 expression in the ileal epithelium; the expression was replenished by oral treatment with entinostat at either dose regimen. The level of zonulin, a marker of gut permeability, in serum was upregulated after infection, and this upregulation was counteracted after treatment with entinostat. Entinostat treatment also led to recovery from cholera and a decline in the V. cholerae count in stool. In conclusion, the improved clinical outcome of cholera for rabbits treated with entinostat is associated with the induction of CAP-18 and the reduction of gut epithelial permeability. Copyright © 2017 American Society for Microbiology.

  4. Treatment of poly(ethylene terephthalate) foils by atmospheric pressure air dielectric barrier discharge and its influence on cell growth

    Energy Technology Data Exchange (ETDEWEB)

    Kuzminova, Anna [Department of Macromolecular Physics, Faculty of Mathematics and Physics, Charles University, V Holešovickách 2, 180 00 Praha 8 (Czech Republic); Vandrovcová, Marta [Institute of Physiology, Academy of Sciences of the Czech Republic, Vídeňská 1083, 142 20 Prague 4 (Czech Republic); Shelemin, Artem [Department of Macromolecular Physics, Faculty of Mathematics and Physics, Charles University, V Holešovickách 2, 180 00 Praha 8 (Czech Republic); Kylián, Ondřej, E-mail: ondrej.kylian@gmail.com [Department of Macromolecular Physics, Faculty of Mathematics and Physics, Charles University, V Holešovickách 2, 180 00 Praha 8 (Czech Republic); Choukourov, Andrei; Hanuš, Jan [Department of Macromolecular Physics, Faculty of Mathematics and Physics, Charles University, V Holešovickách 2, 180 00 Praha 8 (Czech Republic); Bačáková, Lucie [Institute of Physiology, Academy of Sciences of the Czech Republic, Vídeňská 1083, 142 20 Prague 4 (Czech Republic); Slavínská, Danka; Biederman, Hynek [Department of Macromolecular Physics, Faculty of Mathematics and Physics, Charles University, V Holešovickách 2, 180 00 Praha 8 (Czech Republic)

    2015-12-01

    Highlights: • Effect of atmospheric pressure DBD plasma on PET foils was investigated. • DBD treatment causes increase in surface density of O-containing functional groups. • DBD plasma causes increase of wettability, roughness and complex modulus of PET. • DBD treatment positively influences cells growth on PET. • Enhancement of cell growth on treated PET depends on the cell type. - Abstract: In this contribution an effect of dielectric barrier discharge (DBD) sustained in air at atmospheric pressure on surface properties of poly(ethylene terephthalate) (PET) foils is studied. It is found that exposure of PET to DBD plasma leads to rapid changes of surface chemical composition, wettability, surface morphology as well as mechanical properties of PET surface. In addition, based on biological tests that were performed using two cell types (Saos-2 human osteoblast-like cells and HUVEC human umbilical vein endothelial cells), it may be concluded that DBD plasma treatment positively influences cell growth on PET. This effect was found to be connected predominantly with increased surface energy and oxygen content of the surface of treated PET foils.

  5. Non-­‐pharmacological treatment of ankylosing spondylitis: Barriers to effective implementation of recommendations in Morocco

    Directory of Open Access Journals (Sweden)

    Abderrazak Hajjioui

    2014-05-01

    Full Text Available This cross-sectional study aimed to describe non--‐pharmacological treatment modalities in Moroccan patients with ankylosing spondylitis (AS, and to approach physical therapy implementation barriers. 61 patients with AS according to New York classification criteria were included in the study. Socio-demographic data and clinical characteristics were collected and different therapeutic modalities, including physical therapy were investigated. The mean age of the patients was 38.20 (SD 12.36 years with a male/female ratio of 1.5. 55 (90% patients received pharmacological therapy, 37 (60.7% received physical therapy, 5(8.2% underwent surgery and 36 (59% tried at least one type of complementary medicine (medicine plants, sand baths, acupuncture, fire needles, and cupping. Patients’ major expectations from physical therapy were improving their functional status (86.5%, and reducing their pain (59.5%. Most patients (86.49% were satisfied of their physical therapy and 56.8% practiced home exercises. Reasons for nonattendance to physical therapy for the remaining 24 patients were nonprescription (58.3%, lack of financial resources (20.8%, geographical remoteness from rehabilitation centers (4% and lack of motivation (17%. Non-pharmacological treatment, especially based on exercise and education, is an integral part of the comprehensive management of AS. However, it is not efficiently implemented in Morocco and more effort should be made to develop this both efficient and relatively inexpensive component of AS treatment.

  6. Dynamic treatment of fission and fusion in two dimensions

    International Nuclear Information System (INIS)

    Nazareth, R.A.M.S.

    1977-01-01

    The barrier penetrability in two dimensions for nuclear fusion and fission phenomena is studied. The equations of fission static trajectories (minimum potential) in Hofmann formalism are derived and the influence of inertia parameters on the penetrability is verified. For fusion case, a realistic potential for exactly penetrability calculation is proposed. The transverse momentum to the fusion and the unidimensional calculation in classical approximation by choose the trajectory which turn into maximum the penetrability are considered. The exact penetrability is compared with calculation in the classical approximation which takes in account the possibility of appearing discontinuity in the barrier along of fusion pathway. (M.C.K.) [pt

  7. Barriers to implementing evidence-based practices in addiction treatment programs: comparing staff reports on Motivational Interviewing, Adolescent Community Reinforcement Approach, Assertive Community Treatment, and Cognitive-behavioral Therapy.

    Science.gov (United States)

    Amodeo, M; Lundgren, L; Cohen, A; Rose, D; Chassler, D; Beltrame, C; D'Ippolito, M

    2011-11-01

    This qualitative study explored barriers to implementing evidence-based practices (EBPs) in community-based addiction treatment organizations (CBOs) by comparing staff descriptions of barriers for four EBPs: Motivational Interviewing (MI), Adolescent Community Reinforcement Approach (A-CRA), Assertive Community Treatment (ACT), and Cognitive-behavioral Therapy (CBT). The CBOs received CSAT/SAMHSA funding from 2003 to 2008 to deliver services using EBPs. Phone interview responses from 172 CBO staff directly involved in EBP implementation were analyzed using content analysis, a method for making inferences and developing themes from the systematic review of participant narratives (Berelson, 1952). Staff described different types of barriers to implementing each EBP. For MI, the majority of barriers involved staff resistance or organizational setting. For A-CRA, the majority of barriers involved specific characteristics of the EBP or client resistance. For CBT, the majority of barriers were associated with client resistance, and for ACT, the majority of barriers were associated with resources. EBP designers, policy makers who support EBP dissemination and funders should include explicit strategies to address such barriers. Addiction programs proposing to use specific EBPs must consider whether their programs have the organizational capacity and community capacity to meet the demands of the EBP selected. Copyright © 2011 Elsevier Ltd. All rights reserved.

  8. Creation of a subsurface permeable treatment barrier using in situ redox manipulation

    International Nuclear Information System (INIS)

    Fruchter, J.S.; Cole, C.R.; Williams, M.D.

    1997-01-01

    The goal of in situ redox manipulation is to create a permeable treatment zone in the subsurface for remediating redox-sensitive contaminants in groundwater. The permeable treatment zone is created just downstream of the contaminant plume or contaminant source through the injection of reagents and/or microbial nutrients to alter the redox potential of the aquifer fluids and sediments. Contaminant plumes migrating through this manipulated zone can then be destroyed or immobilized. In a field test at the Hanford Site, ∼77,000 L of buffered sodium dithionite solution were successfully injected into the unconfined aquifer at the 100-H Area in September 1995. The target contaminant was chromate. No significant plugging of the well screen or the formation was detected during any phase of the test. Dithionite was detected in monitoring wells at least 7.5 m from the injection point. Data were obtained from all three phases of the test (i.e., injection, reaction, withdrawal). Preliminary core data show that from 60% to 100% of the available reactive iron in the targeted aquifer sediments was reduced by the injected dithionite. One year after the injection, groundwater in the treatment zone remains anoxic. Total and hexavalent chromium levels in groundwater have been reduced from a preexperiment concentration of ∼60 μg/L to below the detection limit of the analytical methods

  9. Overcoming the barriers to effective treatment for attention-deficit/hyperactivity disorder: a neuro-educational approach.

    Science.gov (United States)

    Monastra, Vincent J

    2005-10-01

    Despite specific diagnostic criteria, published practice guidelines for assessing patients, and the availability of effective pharmacological treatments for children diagnosed with attention-deficit/hyperactivity disorder (AD/HD), a review of prescription practices in the United States indicates that as few as 25-50% of these patients receive even minimal medical treatment for this condition. Because untreated children with AD/HD are at increased risk for psychoactive substance abuse, criminal behavior, and other social problems as adults, the provision of effective care during childhood is essential. In order to clarify the factors impeding treatment during childhood and develop a targeted intervention to overcome these barriers, two studies involving 1514 families were conducted. Each family included one child diagnosed with AD/HD. Factors associated with treatment failure or non-compliance with medical advice included: dissatisfaction with a diagnostic process limited to brief observation, interview, and review of behavior rating scales; fear of stimulant medication; lack of medication response within the first month; development of side-effects during the first month; lack of understanding of the reasons stimulants were being prescribed for a child, and insufficient clinical response. Based on these findings, an intervention program consisting of a comprehensive evaluation process (that included neuropsychological and neurophysiological tests of attention, and medical screening for other health problems associated with inattention and hyperactivity) and parent education about the medical causes of AD/HD, the biochemical action of medications, the relationship between dietary habits and attention, and the educational rights of children with AD/HD was conducted. Following completion of this three session intervention, 95% of patients complied with medical recommendations, initiated pharmacological treatment, and continued medication for a 2-year follow-up period

  10. Lie Algebraic Treatment of Linear and Nonlinear Beam Dynamics

    Energy Technology Data Exchange (ETDEWEB)

    Alex J. Dragt; Filippo Neri; Govindan Rangarajan; David Douglas; Liam M. Healy; Robert D. Ryne

    1988-12-01

    The purpose of this paper is to present a summary of new methods, employing Lie algebraic tools, for characterizing beam dynamics in charged-particle optical systems. These methods are applicable to accelerator design, charged-particle beam transport, electron microscopes, and also light optics. The new methods represent the action of each separate element of a compound optical system, including all departures from paraxial optics, by a certain operator. The operators for the various elements can then be concatenated, following well-defined rules, to obtain a resultant operator that characterizes the entire system. This paper deals mostly with accelerator design and charged-particle beam transport. The application of Lie algebraic methods to light optics and electron microscopes is described elsewhere (1, see also 44). To keep its scope within reasonable bounds, they restrict their treatment of accelerator design and charged-particle beam transport primarily to the use of Lie algebraic methods for the description of particle orbits in terms of transfer maps. There are other Lie algebraic or related approaches to accelerator problems that the reader may find of interest (2). For a general discussion of linear and nonlinear problems in accelerator physics see (3).

  11. A system for EPID-based real-time treatment delivery verification during dynamic IMRT treatment.

    Science.gov (United States)

    Fuangrod, Todsaporn; Woodruff, Henry C; van Uytven, Eric; McCurdy, Boyd M C; Kuncic, Zdenka; O'Connor, Daryl J; Greer, Peter B

    2013-09-01

    To design and develop a real-time electronic portal imaging device (EPID)-based delivery verification system for dynamic intensity modulated radiation therapy (IMRT) which enables detection of gross treatment delivery errors before delivery of substantial radiation to the patient. The system utilizes a comprehensive physics-based model to generate a series of predicted transit EPID image frames as a reference dataset and compares these to measured EPID frames acquired during treatment. The two datasets are using MLC aperture comparison and cumulative signal checking techniques. The system operation in real-time was simulated offline using previously acquired images for 19 IMRT patient deliveries with both frame-by-frame comparison and cumulative frame comparison. Simulated error case studies were used to demonstrate the system sensitivity and performance. The accuracy of the synchronization method was shown to agree within two control points which corresponds to approximately ∼1% of the total MU to be delivered for dynamic IMRT. The system achieved mean real-time gamma results for frame-by-frame analysis of 86.6% and 89.0% for 3%, 3 mm and 4%, 4 mm criteria, respectively, and 97.9% and 98.6% for cumulative gamma analysis. The system can detect a 10% MU error using 3%, 3 mm criteria within approximately 10 s. The EPID-based real-time delivery verification system successfully detected simulated gross errors introduced into patient plan deliveries in near real-time (within 0.1 s). A real-time radiation delivery verification system for dynamic IMRT has been demonstrated that is designed to prevent major mistreatments in modern radiation therapy.

  12. A system for EPID-based real-time treatment delivery verification during dynamic IMRT treatment

    Energy Technology Data Exchange (ETDEWEB)

    Fuangrod, Todsaporn [Faculty of Engineering and Built Environment, School of Electrical Engineering and Computer Science, the University of Newcastle, NSW 2308 (Australia); Woodruff, Henry C.; O’Connor, Daryl J. [Faculty of Science and IT, School of Mathematical and Physical Sciences, the University of Newcastle, NSW 2308 (Australia); Uytven, Eric van; McCurdy, Boyd M. C. [Division of Medical Physics, CancerCare Manitoba, 675 McDermot Avenue, Winnipeg, Manitoba R3E 0V9 (Canada); Department of Physics and Astronomy, University of Manitoba, Winnipeg, Manitoba R3T 2N2 (Canada); Department of Radiology, University of Manitoba, Winnipeg, Manitoba R3T 2N2 (Canada); Kuncic, Zdenka [School of Physics, University of Sydney, Sydney, NSW 2006 (Australia); Greer, Peter B. [Faculty of Science and IT, School of Mathematical and Physical Sciences, the University of Newcastle, NSW 2308, Australia and Department of Radiation Oncology, Calvary Mater Newcastle Hospital, Locked Bag 7, Hunter region Mail Centre, Newcastle, NSW 2310 (Australia)

    2013-09-15

    Purpose: To design and develop a real-time electronic portal imaging device (EPID)-based delivery verification system for dynamic intensity modulated radiation therapy (IMRT) which enables detection of gross treatment delivery errors before delivery of substantial radiation to the patient.Methods: The system utilizes a comprehensive physics-based model to generate a series of predicted transit EPID image frames as a reference dataset and compares these to measured EPID frames acquired during treatment. The two datasets are using MLC aperture comparison and cumulative signal checking techniques. The system operation in real-time was simulated offline using previously acquired images for 19 IMRT patient deliveries with both frame-by-frame comparison and cumulative frame comparison. Simulated error case studies were used to demonstrate the system sensitivity and performance.Results: The accuracy of the synchronization method was shown to agree within two control points which corresponds to approximately ∼1% of the total MU to be delivered for dynamic IMRT. The system achieved mean real-time gamma results for frame-by-frame analysis of 86.6% and 89.0% for 3%, 3 mm and 4%, 4 mm criteria, respectively, and 97.9% and 98.6% for cumulative gamma analysis. The system can detect a 10% MU error using 3%, 3 mm criteria within approximately 10 s. The EPID-based real-time delivery verification system successfully detected simulated gross errors introduced into patient plan deliveries in near real-time (within 0.1 s).Conclusions: A real-time radiation delivery verification system for dynamic IMRT has been demonstrated that is designed to prevent major mistreatments in modern radiation therapy.

  13. A system for EPID-based real-time treatment delivery verification during dynamic IMRT treatment

    International Nuclear Information System (INIS)

    Fuangrod, Todsaporn; Woodruff, Henry C.; O’Connor, Daryl J.; Uytven, Eric van; McCurdy, Boyd M. C.; Kuncic, Zdenka; Greer, Peter B.

    2013-01-01

    Purpose: To design and develop a real-time electronic portal imaging device (EPID)-based delivery verification system for dynamic intensity modulated radiation therapy (IMRT) which enables detection of gross treatment delivery errors before delivery of substantial radiation to the patient.Methods: The system utilizes a comprehensive physics-based model to generate a series of predicted transit EPID image frames as a reference dataset and compares these to measured EPID frames acquired during treatment. The two datasets are using MLC aperture comparison and cumulative signal checking techniques. The system operation in real-time was simulated offline using previously acquired images for 19 IMRT patient deliveries with both frame-by-frame comparison and cumulative frame comparison. Simulated error case studies were used to demonstrate the system sensitivity and performance.Results: The accuracy of the synchronization method was shown to agree within two control points which corresponds to approximately ∼1% of the total MU to be delivered for dynamic IMRT. The system achieved mean real-time gamma results for frame-by-frame analysis of 86.6% and 89.0% for 3%, 3 mm and 4%, 4 mm criteria, respectively, and 97.9% and 98.6% for cumulative gamma analysis. The system can detect a 10% MU error using 3%, 3 mm criteria within approximately 10 s. The EPID-based real-time delivery verification system successfully detected simulated gross errors introduced into patient plan deliveries in near real-time (within 0.1 s).Conclusions: A real-time radiation delivery verification system for dynamic IMRT has been demonstrated that is designed to prevent major mistreatments in modern radiation therapy

  14. New approaches to the pharmacological treatment of obesity: can they break through the efficacy barrier?

    Science.gov (United States)

    Kennett, G A; Clifton, P G

    2010-11-01

    In this review we assess the range of centrally active anorectics that are either in human clinical trials, or are likely to be so in the near future. We describe their weight loss efficacy, mode of action at both pharmacological and behavioural levels, where understood, together with the range of side effects that might be expected in clinical use. We have however evaluated these compounds against the considerably more rigorous criteria that are now being used by the Federal Drugs Agency and European Medicines Agency to decide approvals and market withdrawals. Several trends are evident. Recent advances in the understanding of energy balance control have resulted in the exploitation of a number of new targets, some of which have yielded promising data in clinical trials for weight loss. A second major trend is derived from the hypothesis that improved weight loss efficacy over current therapy is most likely to emerge from treatments targeting multiple mechanisms of energy balance control. This reasoning has led to the development of a number of new treatments for obesity where multiple mechanisms are targeted, either by a single molecule, such as tesofensine, or through drug combinations such as qnexa, contrave, empatic, and pramlintide+metreleptin. Many of these approaches also utilise advances in formulation technology to widen safety margins. Finally, the practicality of peptide therapies for obesity has become better validated in recent studies and this may allow more rapid exploitation of novel targets, rather than awaiting the development of orally available small molecules. We conclude that novel, more efficacious and better tolerated treatments for obesity may become available in the near future. Copyright © 2010 Elsevier Inc. All rights reserved.

  15. Hydroxyurea for the Treatment of Sickle Cell Disease: Efficacy, Barriers, Toxicity, and Management in Children

    Science.gov (United States)

    Strouse, John J.; Heeney, Matthew M.

    2012-01-01

    Hydroxyurea is the only approved medication in the United States for the treatment of sickle cell anemia (HbSS) and is widely used in children despite an indication limited to adults. We review the evidence of efficacy and safety in children with reference to pivotal adult studies. This evidence and expert opinion form the basis for recommended guidelines for the use of hydroxyurea in children including indications, dosing, therapeutic and safety monitoring, and interventions to improve adherence. However, there are substantial gaps in our knowledge to be addressed by on-going and planned studies in children. PMID:22517797

  16. A study in the surface treatment of the barrier of a nuclear fuel protector

    Energy Technology Data Exchange (ETDEWEB)

    Song, Yo Seung; Chang, Si Young; Lee, Du Hyung; Noh, Bong Hyun; Kim, Ye Na [Korea Aerospace University, Goyang (Korea, Republic of)

    2009-06-15

    Materials used in the nuclear power plant, such as pipe, are needed to endure severe corrosion because they could expose the high temperature coolant under radiation. Up to now, the HT9 steel(12Cr-1MoVW) which is one of Ferritic Martensite Stainless steels has been applied because of its high swelling resistance. However, its applications are limited to the temperature of approximately 500 .deg. C. Therefore, it has been strongly demanded that the materials have excellent corrosion resistance concurrent with high mechanical properties such as fracture toughness and irradiation resistance at higher temperatures of more than 500 .dec. C for high efficiency of operating reactor. In order to overcome the corrosion problem of irradiated HT9 steel causing severe environmental problem, particularly, the ceramic coating methods could be applied. Recently, plasma electrolytic oxidation (PEO) emerged as a novel technique being capable of thick, dense and hard oxide ceramic coatings on the surface of light materials. In this study, we focused on applying the newly developed coating method, Plasma Electrolytic Oxidation (PEO) which was mainly developed for non-ferrous materials such as Al, Mg and Ti, for the HT9 steel. And then, we investigated and evaluated the possibility of application of PEO method for HT9 steel treated with/without aluminum cladding based on the microstructure observation of coatings formed under various processing parameters such as current ratio, electrolyte and time. Plasma Electrolytic Oxidation (PEO) treatment, which is an advancement of the conventional electrochemical anodizing treatment and leads to the local formation of a plasma by a spark on the metal surface, is expected to be a promising surface treatment that can overcome the drawbacks of HT9 steel. We applied PEO treatment for HT9 steel. We tried to find the effect of processing parameters, such as coating time, current ratio and electrolyte, on PEO coatings of HT9 steel, and also studied

  17. Barriers to Effective Postmenopausal Osteoporosis Treatment: A Qualitative Study of Patients’ and Practitioners’ Views

    Science.gov (United States)

    2016-01-01

    Background Only a minority of patients at high risk for osteoporotic fracture receive treatment. Objective Study patients’ and physicians’ views regarding postmenopausal osteoporosis (PMO) to identify impediments to good care. Methods A qualitative study involving 18 physicians and 37 women (age 57–87) with PMO. Results All women interviewed considered PMO to be somewhat normal wear-and-tear associated with old age. The women identified a large number of "causes" for osteoporosis but finally viewed it as chance. They all described its progression as slow. Three representations of PMO severity were identified: some women tended to interpreted it as benign (21), others tended to dramatize it (11), and the rest were uncertain (5). These representations did not appear linked to age or fracture. Even the women who associated fracture and PMO were uncertain of the link between them. Fractures were considered to be random events, independent of osteoporosis. Women received general life-style recommendations from their physicians positively, but did not connect them specifically to osteoporosis. Indeed, these recommendations, along with the fear of side effects, the absence of tangible results of treatments, the view of PMO as a natural process, and the representations of PMO severity are factors that may deter treatments and impact compliance. As for the physicians, they identified eight risk factors, recognizing menopause as central to PMO and recognized the link between risk of fracture and PMO. However, some considered the impact of fractures to be limited in time, and viewed PMO as a "benign" disease. Seeing the progression of PMO as slow and inevitable reduced their urgency to diagnose and treat it as compared to other diseases. Some physicians acknowledged limited mastery of the existing therapeutic arsenal and unsuccessful handling of patient compliance. Conclusion Women’s and physicians’ perspectives on PMO converged to trivialize postmenopausal

  18. Feasibility Of Coupling Permeable Bio-Barriers And Electrokinetics For The Treatment Of Diesel Hydrocarbons Polluted Soils

    International Nuclear Information System (INIS)

    Ramírez, Esperanza Mena; Jiménez, Cristina Sáez; Camacho, José Villaseñor; Rodrigo, Manuel A.Rodrigo; Cañizares, Pablo

    2015-01-01

    Highlights: • Electrokinetics and a biobarrier were combined to remediate of a diesel polluted soil. • pH gradients did not affect the biobarrier activity located in soil central position. • Microorganisms were partially detached from the biobarrier and moved across the soil. • An anionic surfactant helped the contact between pollutant and microorganisms. • A 39% of the diesel biodegradable fraction was homogeneously removed across the soil. - Abstract: In this study, the remediation of a diesel hydrocarbon-polluted clay soil using an electrochemical-biological combined technology is assessed. The polluted soil was subjected to an electrokinetic (EK) treatment with a biological permeable reactive barrier. A lab-scale electrochemical cell for soil treatment was used. The biological barrier placed in the soil was a biofilm reactor previously adapted for diesel degradation. A batch experiment of 336 h was conducted in a synthetic clay soil spiked with 10 g·kg −1 of diesel and a constant voltage gradient of 1.0 V cm −1 . Sodium dodecyl sulphate was used as an anionic surfactant in the cathodic well to allow for hydrocarbon emulsification during the treatment. At the end of the experiment, extreme pH values were observed near the electrodes. However, the pH remained constant at approximately 7.7 in the central biobarrier zone, which allowed for biological processes. Biological growth was observed in the biobarrier, and a part of the biofilm was detached and transported through the soil in both directions. Furthermore, the surfactant was transported across the soil due to electromigration and electroosmosis, which resulted in diesel emulsification. The combination of biological and EK phenomena finally resulted in a homogenous hydrocarbon removal of approximately 27% in the polluted soil, which indicated a 39% removal of the diesel biodegradable fraction. Due to the electroosmotic flow and the biological degradation, some of the water, surfactant and

  19. Recent advancements in liposomes targeting strategies to cross blood-brain barrier (BBB) for the treatment of Alzheimer's disease.

    Science.gov (United States)

    Agrawal, Mukta; Ajazuddin; Tripathi, Dulal K; Saraf, Swarnlata; Saraf, Shailendra; Antimisiaris, Sophia G; Mourtas, Spyridon; Hammarlund-Udenaes, Margareta; Alexander, Amit

    2017-08-28

    In this modern era, with the help of various advanced technologies, medical science has overcome most of the health-related issues successfully. Though, some diseases still remain unresolved due to various physiological barriers. One such condition is Alzheimer; a neurodegenerative disorder characterized by progressive memory impairment, behavioral abnormalities, mood swing and disturbed routine activities of the person suffering from. It is well known to all that the brain is entirely covered by a protective layer commonly known as blood brain barrier (BBB) which is responsible to maintain the homeostasis of brain by restricting the entry of toxic substances, drug molecules, various proteins and peptides, small hydrophilic molecules, large lipophilic substances and so many other peripheral components to protect the brain from any harmful stimuli. This functionally essential structure creates a major hurdle for delivery of any drug into the brain. Still, there are some provisions on BBB which facilitate the entry of useful substances in the brain via specific mechanisms like passive diffusion, receptor-mediated transcytosis, carrier-mediated transcytosis etc. Another important factor for drug transport is the selection of a suitable drug delivery systems like, liposome, which is a novel drug carrier system offering a potential approach to resolving this problem. Its unique phospholipid bilayer structure (similar to physiological membrane) had made it more compatible with the lipoidal layer of BBB and helps the drug to enter the brain. The present review work focused on various surface modifications with functional ligand (like lactoferrin, transferrin etc.) and carrier molecules (such as glutathione, glucose etc.) on the liposomal structure to enhance its brain targeting ability towards the successful treatment of Alzheimer disease. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Barriers to treatment seeking for anxiety disorders: initial data on the role of mental health literacy.

    Science.gov (United States)

    Coles, Meredith E; Coleman, Shannon L

    2010-01-01

    Anxiety disorders represent the single largest mental health problem in the United States [Greenberg et al., 1999. J Clin Psychiatry 60:427-435; Rice and Miller, 1998. Br J Psychiatry 173:4-9]. However most individuals with anxiety disorders never seek treatment [Henderson et al., 2002. Can J Psychiatry 47:819-824; Mojtabai et al., 2002. Arch Gen Psychiatry 59:77-84; Roness et al., 2005. Acta Psychiatr Scand 111:51-58]. Deficits in the ability to recognize anxiety disorders and beliefs about them, (i.e., "mental health literacy") may contribute to low levels of help seeking. Survey data assessing mental health literacy for multiple anxiety disorders and for depression were collected from 284 undergraduate students enrolled in psychology courses at a public university in the United States. Specifically, respondents were presented with vignettes portraying individuals experiencing various forms of mental illness and were asked to label the disorder, its cause and whether or not they would recommend treatment. Findings showed that social phobia and obsessive compulsive disorder (OCD) were associated with recognition rates that were generally high and similar to depression (approximately 80%). In contrast, less than half of the respondents labeled panic disorder or generalized anxiety disorder (GAD) correctly. Symptoms of OCD were attributed to mental illness by approximately 50% of respondents, but such attributions were rare for the other anxiety disorders studied (anxiety disorders and according to perceptions of the causes of symptoms. Given that the current sample was well-educated young adults, mental health literacy of the general public may be even lower.

  1. Social and structural barriers for adherence to methadone maintenance treatment among Vietnamese opioid dependence patients.

    Science.gov (United States)

    Tran, Bach Xuan; Nguyen, Long Hoang; Tran, Tung Thanh; Latkin, Carl A

    2018-01-01

    Methadone maintenance treatment (MMT) services may reduce the risk of HIV transmission if patients completely adhere to the treatment. Identifying adherence patterns and potential related factors is vital for the sustainability of MMT program in Vietnam. This study examined social and structural factors associated with adherence to MMT among patients in different service delivery models. A total of 510 patients at three MMT clinics in Hanoi were interviewed. Measures of self-reported adherence included the number of missed doses in the past 7 days and the level of adherence in the past 30 days using a visual analog scale (VAS) scoring from 0 (non-adherence) to 100 (perfect adherence). Multivariate regressions were employed to identify factors associated with non-adherence to MMT. A total of 17.7% of participants reported incomplete MMT adherence in the last 30 days and 8.3% reported missing a dose in the last seven days, respectively. Living with HIV/AIDS, poor self-care and usual activities, and disclosure of health issues to spouses or intimate partners were associated with non-adherence. Those patients with pain or depression were more likely to report better adherence. Disclosing health status to spouse/partner increased the risk of incomplete adherence, while disclosing to friends reduced the number of missed dose in the last seven days. Patients attending clinics with comprehensive services had a lower VAS score of adherence compared to those enrolling in clinics with only MMT and general health care. Sustaining the compliance of patients to MMT is principal in the rapid expansion of this service in Vietnam. It is necessary to address the complexity of health care demands of drug users, their difficulties to be rehabilitated into workforce and society, and the stigmatization to maximize the outcomes of MMT program.

  2. Solving the Blood-Brain Barrier Challenge for the Effective Treatment of HIV Replication in the Central Nervous System.

    Science.gov (United States)

    Bertrand, Luc; Nair, Madhavan; Toborek, Michal

    2016-01-01

    Recent decades mark a great progress in the treatment of HIV infection. What was once a deadly disease is now a chronic infection. However, HIV-infected patients are prone to develop comorbidities, which severely affect their daily functions. For example, a large population of patients develop a variety of neurological and cognitive complications, called HIV associated neurological disorders (HAND). Despite efficient repression of viral replication in the periphery, evidence shows that the virus can remain active in the central nervous system (CNS). This low level of replication is believed to result in a progression of neurocognitive dysfunction in infected individuals. Insufficient viral inhibition in the brain results from the inability of several treatment drugs in crossing the blood-brain barrier (BBB) and reaching therapeutic concentrations in the CNS. The current manuscript discusses several strategies that are being developed to enable therapeutics to cross the BBB, including bypassing BBB, inhibition of efflux transporters, the use of active transporters present at the BBB, and nanotechnology. The increased concentration of therapeutics in the CNS is desirable to prevent viral replication; however, potential side effects of anti-retroviral drugs need also to be taken into consideration.

  3. How Readable Is BPH Treatment Information on the Internet? Assessing Barriers to Literacy in Prostate Health.

    Science.gov (United States)

    Koo, Kevin; Yap, Ronald L

    2017-03-01

    Information about benign prostatic hyperplasia (BPH) has become increasingly accessible on the Internet. Though the ability to find such material is encouraging, its readability and impact on informing patient decision making are not known. To evaluate the readability of Internet-based information about BPH in the context of website ownership and Health on the Net certification, three search engines were queried daily for 1 month with BPH-related keywords. Website ownership data and Health on the Net certification status were verified. Three readability analyses were performed: SMOG test, Dale-Chall readability formula, and Fry readability graph. An adjusted SMOG calculation was performed to reduce overestimation from medical jargon. After a total of 270 searches, 52 websites met inclusion criteria. Mean SMOG grade was 10.6 ( SD = 1.4) and 10.2 after adjustment. Mean Dale-Chall score was 9.1 ( SD = 0.6), or Grades 13 to 15. Mean Fry graph coordinates (173 syllables, 5.1 sentences) corresponded to Grade 15. Seven sites (13%) were at or below the average adult reading level based on SMOG; none of the sites qualified based on the other tests. Readability was significantly poorer for academic versus commercial sites and for Health on the Net-certified versus noncertified sites. In conclusion, online information about BPH treatment markedly exceeds the reading comprehension of most U.S. adults. Websites maintained by academic institutions and certified by the Health on the Net standard have more difficult readability. Efforts to improve literacy with respect to urological health should target content readability independent of reliability.

  4. Barriers to accessing and using health insurance cards among methadone maintenance treatment patients in northern Vietnam.

    Science.gov (United States)

    Tran, Bach Xuan; Boggiano, Victoria L; Nguyen, Cuong Tat; Nguyen, Long Hoang; Le Nguyen, Anh Tuan; Latkin, Carl A

    2017-07-17

    Methadone maintenance treatment (MMT) patients face unique costs associated with their healthcare expenditures. As such, it is important that these patients have access to health insurance (HI) to help them pay for both routine and unforeseen health services. In this study, we explored factors related to health insurance enrollment and utilization among MMT patients, to move Vietnam closer to universal coverage among this patient population. A cross-sectional study was conducted with 1003 patients enrolled in MMT in five clinics in Hanoi and Nam Dinh provinces. Patients were asked a range of questions about their health, health expenditures, and health insurance access and utilization. We used multivariate logistic regressions to determine factors associated with health insurance access among participants. The majority of participants (nearly 80%) were not currently enrolled in health insurance at the time of the study. Participants from rural regions were significantly more likely than urban participants to report difficulty using HI. Family members of participants from rural regions were more likely to have overall poor service quality through health insurance compared with family members of participants from urban regions. Overall, 37% of participants endorsed a lack of information about HI, nearly 22% of participants reported difficulty accessing HI, 22% reported difficulty using HI, and more than 20% stated they had trouble paying for HI. Older, more highly educated, and employed participants were more likely to have an easier time accessing HI than their younger, less well educated, and unemployed counterparts. HIV-positive participants were more likely to have sufficient information about health insurance options. Our study highlights the dearth of health insurance utilization among MMT patients in northern Vietnam. It also sheds light on factors associated with increased access to and utilization of health insurance among this underserved population. These

  5. Anaerobic dynamic membrane bioreactors for high strength wastewater treatment

    NARCIS (Netherlands)

    Ersahin, M.E.; Gimenez Garcia, J.B.; Ozgun, H.; Tao, Y.; Van Lier, J.B.

    2013-01-01

    A laboratory scale external anaerobic dynamic membrane bioreactor (AnDMBR) treating high strength wastewater was operated to assess the effect of gas sparging velocity and organic loading rate on removal efficiency and dynamic membrane (DM) filtration characteristics. An increase in gas sparging

  6. Recognizing Family Dynamics in the Treatment of Chronic Fatigue Syndrome

    Science.gov (United States)

    Sperry, Len

    2012-01-01

    Chronic fatigue syndrome (CFS) is an increasingly common chronic medical condition that affects not only patients but also their families. Because family dynamics, particularly the family life cycle, can and does influence the disease process, those providing counseling to CFS patients and their families would do well to recognize these dynamics.…

  7. Identifying Barriers to Appropriate Use of Metabolic/Bariatric Surgery for Type 2 Diabetes Treatment: Policy Lab Results

    Science.gov (United States)

    Rubin, Jennifer K.; Hesketh, Rachel; Martin, Adam; Herman, William H.; Rubino, Francesco

    2016-01-01

    Despite increasing recognition of the efficacy, safety, and cost-effectiveness of bariatric/metabolic surgery in the treatment of type 2 diabetes, few patients who may be appropriate candidates and may benefit from this type of surgery avail themselves of this treatment option. To identify conceptual and practical barriers to appropriate use of surgical procedures, a Policy Lab was hosted at the 3rd World Congress on Interventional Therapies for Type 2 Diabetes on 29 September 2015. Twenty-six stakeholders participated in the Policy Lab, including academics, clinicians, policy-makers, industry leaders, and patient representatives. Participants were provided with a summary of available evidence about the cost-effectiveness of bariatric/metabolic surgery and the costs of increasing the use of bariatric/metabolic surgery, using U.K. and U.S. scenarios as examples of distinct health care systems. There was widespread agreement among this group of stakeholders that bariatric/metabolic surgery is a legitimate and cost-effective approach to the treatment of type 2 diabetes in obese patients. The following four building blocks were identified to facilitate policy changes: 1) communicating the scale of the costs and harms associated with rising prevalence of type 2 diabetes; 2) properly articulating the role of bariatric/metabolic surgery for certain population groups; 3) identifying new funding sources for bariatric/metabolic surgery; and 4) incorporating bariatric/metabolic surgery into the appropriate clinical pathways. Although more research is needed to identify specific clinical scenarios for the prioritization of bariatric/metabolic surgery, the case appears to be strong enough to engage relevant policy-makers and practitioners in a concerted discussion of how to better use metabolic surgical resources in conjunction with other interventions in good diabetes practice. PMID:27222554

  8. Radiation-Induced Astrogliosis and Blood-Brain Barrier Damage Can Be Abrogated Using Anti-TNF Treatment

    International Nuclear Information System (INIS)

    Wilson, Christy M.; Gaber, M. Waleed; Sabek, Omaima M.; Zawaski, Janice A.; Merchant, Thomas E.

    2009-01-01

    Purpose: In this article, we investigate the role of tumor necrosis factor-alpha (TNF) in the initiation of acute damage to the blood-brain barrier (BBB) and brain tissue following radiotherapy (RT) for CNS tumors. Methods and Materials: Intravital microscopy and a closed cranial window technique were used to measure quantitatively BBB permeability to FITC-dextran 4.4-kDa molecules, leukocyte adhesion (Rhodamine-6G) and vessel diameters before and after 20-Gy cranial radiation with and without treatment with anti-TNF. Immunohistochemistry was used to quantify astrogliosis post-RT and immunofluorescence was used to visualize protein expression of TNF and ICAM-1 post-RT. Recombinant TNF (rTNF) was used to elucidate the role of TNF in leukocyte adhesion and vessel diameter. Results: Mice treated with anti-TNF showed significantly lower permeability and leukocyte adhesion at 24 and 48 h post-RT vs. RT-only animals. We observed a significant decrease in arteriole diameters at 48 h post-RT that was inhibited in TNF-treated animals. We also saw a significant increase in activated astrocytes following RT that was significantly lower in the anti-TNF-treated group. In addition, immunofluorescence showed protein expression of TNF and ICAM-1 in the cerebral cortex that was inhibited with anti-TNF treatment. Finally, administration of rTNF induced a decrease in arteriole diameter and a significant increase in leukocyte adhesion in venules and arterioles. Conclusions: TNF plays a significant role in acute changes in BBB permeability, leukocyte adhesion, arteriole diameter, and astrocyte activation following cranial radiation. Treatment with anti-TNF protects the brain's microvascular network from the acute damage following RT.

  9. Listening to Those at the Frontline: Patient and Healthcare Personnel Perspectives on Tuberculosis Treatment Barriers and Facilitators in High TB Burden Regions of Argentina

    Directory of Open Access Journals (Sweden)

    Sarah J. Iribarren

    2014-01-01

    Full Text Available Purpose. In Argentina, tuberculosis (TB control measures have not achieved key treatment targets. The purpose of this study was to identify modes of treatment delivery and explore patient and healthcare personnel perceptions of barriers and facilitators to treatment success. Methods. We used semistructured group and individual interviews for this descriptive qualitative study. Eight high burden municipalities were purposively selected. Patients in treatment for active TB (n=16, multidisciplinary TB team members (n=26, and TB program directors (n=12 at local, municipal, regional, and national levels were interviewed. Interviews were recorded, transcribed verbatim, and analyzed using thematic analysis. Results. Modes of treatment delivery varied across municipalities and types of healthcare facility and were highly negotiated with patients. Self-administration of treatment was common in hospital-based and some community clinics. Barriers to TB treatment success were concentrated at the system level. This level relied heavily on individual personal commitment, and many system facilitators were operating in isolation or in limited settings. Conclusions. We outline experiences and perspectives of the facilitating and challenging factors at the individual, structural, social, and organizational levels. Establishing strong patient-healthcare personnel relationships, responding to patient needs, capitalizing on community resources, and maximizing established decentralized system could mitigate some of the barriers.

  10. Barriers to biomedical care and use of traditional medicines for treatment of cervical cancer: an exploratory qualitative study in northern Uganda.

    Science.gov (United States)

    Mwaka, A D; Okello, E S; Orach, C G

    2015-07-01

    Use of traditional medicines for treatment of cancers has increased worldwide. We used a qualitative approach to explore barriers to biomedical care and reasons for use of traditional medicines for the treatment of cervical cancer in Gulu, northern Uganda. We carried out 24 focus group discussions involving men and women aged 18-59 years. We employed content analyses technique in data analysis. Traditional medicines were used mainly due to barriers to biomedical care for cervical cancer. The barriers included health system factors, for example long distances to health facilities and unavailability of medicines; health workers' factors, for example negative attitudes towards patients and demands for bribes; individual patient's factors, for example inability to pay for medical care; and socio-cultural beliefs about superiority of traditional medicines and perceived greater privacy in accessing traditional healers. Barriers to biomedical care and community beliefs in the effectiveness of traditional medicines encourage use of traditional medicines for treatment of cervical cancer but might hinder help-seeking at biomedical facilities. There is need for targeted culturally sensitive awareness campaign to promote effectiveness of modern medicine and to encourage cautious use of traditional medicines in the treatment of cervical cancer. © 2014 The Authors. European Journal of Cancer Care published by John Wiley & Sons Ltd.

  11. Barriers to tuberculosis and human immunodeficiency virus treatment guidelines adherence among nurses initiating and managing anti-retroviral therapy in KwaZulu-Natal and North West provinces

    Directory of Open Access Journals (Sweden)

    Lufuno Makhado

    2018-03-01

    Conclusion: This qualitative study identified that nurses have substantial concerns over guideline adherence. If NIMART trained nurses’ barriers inhibiting adherence to treatment guidelines cannot be remedied, patient outcomes may suffer and South Africa will struggle to meet the 90-90-90 targets.

  12. Addiction treatment staff perceptions of training as a facilitator or barrier to implementing evidence-based practices: a national qualitative research study.

    Science.gov (United States)

    D'Ippolito, Melinda; Lundgren, Lena; Amodeo, Maryann; Beltrame, Clelia; Lim, Lynn; Chassler, Deborah

    2015-01-01

    This qualitative effort examines training-related facilitators and barriers to implementing evidence-based practices (EBPs) in 285 community-based addiction treatment organizations (CBOs) nationwide that were funded by the Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment (SAMHSA/CSAT) to implement EBPs. Using qualitative interviews, the authors explored staff (N = 514) descriptions of training as a facilitator or barrier to implementation. Training-related factors were described 663 times as facilitators (by 440 staff) and 233 times as barriers (by 170 staff). Responses were coded using content analysis. Specific characteristics of the training received, such as access to expert knowledge and quality, as well as ongoing training were described as central facilitating factors to EBP implementation. Key reasons training was perceived as a barrier included the amount of training; the training did not fit current staff and/or organizational needs; the training for some EBPs was perceived to be too demanding; and the difficulty accessing training. Since government funders of addiction treatments require that CBOs implement EBPs and they provide training resources, the quality, flexibility, and accessibility of the available training needs to be promoted throughout the addiction treatment network. Only 17% of CBOs reported that they used the SAMHSA-funded ATTC (Addiction Technology Transfer Center) training centers and 42% used SAMHSA technical assistance. Hence, federally funded resources for training were not always used.

  13. VA residential substance use disorder treatment program providers' perceptions of facilitators and barriers to performance on pre-admission processes.

    Science.gov (United States)

    Ellerbe, Laura S; Manfredi, Luisa; Gupta, Shalini; Phelps, Tyler E; Bowe, Thomas R; Rubinsky, Anna D; Burden, Jennifer L; Harris, Alex H S

    2017-04-04

    these domains. Efficient screening processes, effective patient flow, and available beds were perceived to facilitate shorter wait times, while lack of beds, poor staffing levels, and lengths of stay of existing patients were thought to lengthen wait times. Accessible outpatient services, strong patient outreach, and strong encouragement of pre-admission outpatient treatment emerged as facilitators of engagement while waiting; poor staffing levels, socioeconomic barriers, and low patient motivation were viewed as barriers. Metrics for pre-admission processes can be helpful for monitoring residential SUD treatment programs. Interviewing program management and staff about drivers of performance metrics can play a complementary role by identifying innovative and other strong practices, as well as high-value targets for quality improvement. Key facilitators of high-performing facilities may offer programs with lower performance useful strategies to improve specific pre-admission processes.

  14. Significance and problems of the dynamic CT scan for the diagnosis and treatment of cerebral infarctions

    International Nuclear Information System (INIS)

    Morita, Akio; Teraoka, Akira

    1985-01-01

    Dynamic CT scan is a very useful method for the diagnosis of cerebral infarctions and other ischemic disorders. We have used this method for 1) the ultra-early stage diagnosis of major infarctions, 2) the detection of the recanalization and the disruption of the blood-brain barrier, and 3) the detection of latent ischemic lesions. In this report we discussed the clinical cases and the usual use of this dynamic CT scan. We used a GE CT/T8800 scanner for dynamic CT scanning. Manual bolus-contrast-medium injection was done simultaneously with the first scanning, and 6 sequential scannings (scan time: 4.8 s; scan interval: 1.4 s) were done on the same slice level. Especially in major infarctions (e.g., MCA occlusion), OM 40 was the most preferred slice. In cases of ultra-early stage infarctions (i.e., no abnormal lesions in non-enhanced CT), we used this dynamic CT scan immediately after the non-enhanced CT; we could thus obtain information on the ischemic lesions and the ischemic degree. After that we repeated this examination on Days 3, 7, and 14 for the evaluation of the recanalization and blood-brain-barrier disruption. In the cases of TIA and impending or progressing strokes, dynamic CT scan could disclose latent ischemic lesions; in there instances, we treated the patients with intensive to prevent the prognosis from worsening. These benefits and also some problems were discussed. (author)

  15. Biological permeable reactive barriers coupled with electrokinetic soil flushing for the treatment of diesel-polluted clay soil.

    Science.gov (United States)

    Mena, Esperanza; Ruiz, Clara; Villaseñor, José; Rodrigo, Manuel A; Cañizares, Pablo

    2015-01-01

    Removal of diesel from spiked kaolin has been studied in the laboratory using coupled electrokinetic soil flushing (EKSF) and bioremediation through an innovative biological permeable reactive barriers (Bio-PRBs) positioned between electrode wells. The results show that this technology is efficient in the removal of pollutants and allows the soil to maintain the appropriate conditions for microorganism growth in terms of pH, temperature, and nutrients. At the same time, EKSF was demonstrated to be a very interesting technology for transporting pollutants, microorganisms and nutrients, although results indicate that careful management is necessary to avoid the depletion of nutrients, which are effectively transported by electro-migration. After two weeks of operation, 30% of pollutants are removed and energy consumption is under 70 kWh m(-3). Main fluxes (electroosmosis and evaporation) and changes in the most relevant parameters (nutrients, diesel, microorganisms, surfactants, moisture conductivity and pH) during treatment and in a complete post-study analysis are studied to give a comprehensive description of the most relevant processes occurring in the soil (pollutant transport and biodegradation). Copyright © 2014 Elsevier B.V. All rights reserved.

  16. Attaining 2D Black Phosphorus and Investigations into Floating-Electrode Dielectric Barrier Discharge Treatment of Solutions

    Science.gov (United States)

    Smith, Joshua Benjamin

    -ray diffraction, transmission electron microscopy, and Raman spectroscopy have confirmed successful growth of 2D black phosphorus from red phosphorus thin films for potential uses in 2D semiconductor applications. Additionally, this work discusses some of the chemistry occurring in solution as a result of nonthermal plasma treatment from a floating-electrode dielectric barrier discharge (FE-DBD) configuration. Nonthermal plasma generation allows for the treatment of heat sensitive materials. This has opened up the field to numerous clinical applications of nonthermal plasma treatment including sterilization and wound healing along with potentials in dentistry, dermatology, and even food industries. FE-DBD plasma treatment of water was found to provide a wide-range antimicrobial solution that remained active following 2 years of aging. This plasma-treated water was found to generate a number of ROS/RNS and the formation of these components was studied and verified with UV/Vis and ESR spectroscopy. Enhanced effects were observed when cell culture medium was plasma treated, suggesting the formation of additional reactive species from the plasma treatment of a variety of biomolecules. It is essential to understand these effects for a number of reasons. The possibility to generate a wide range of antimicrobial solutions from air, water, and basic biomolecules could provide a solution for those bacteria that have developed antibiotic resistances. Simultaneously, information into the reaction mechanisms of this FE-DBD plasma treatment can be investigated. All of the applications mentioned above involve complex networks of basic biomolecules, from skin tissue to bacteria cell walls. This work analyzes the effects of plasma treatment on several biomolecule solutions and simultaneously takes aim at understanding some of the potential mechanisms of plasma treatment. Studies were carried out using NMR and GC/MS. This information was used to investigate the possible targeted areas for FE

  17. Evaluating Changes to Blood-Brain Barrier Integrity in Brain Metastasis over Time and after Radiation Treatment

    Directory of Open Access Journals (Sweden)

    Donna H. Murrell

    2016-06-01

    Full Text Available INTRODUCTION: The incidence of brain metastasis due to breast cancer is increasing, and prognosis is poor. Treatment is challenging because the blood-brain barrier (BBB limits efficacy of systemic therapies. In this work, we develop a clinically relevant whole brain radiotherapy (WBRT plan to investigate the impact of radiation on brain metastasis development and BBB permeability in a murine model. We hypothesize that radiotherapy will decrease tumor burden and increase tumor permeability, which could offer a mechanism to increase drug uptake in brain metastases. METHODS: Contrast-enhanced magnetic resonance imaging (MRI and high-resolution anatomical MRI were used to evaluate BBB integrity associated with brain metastases due to breast cancer in the MDA-MB-231-BR-HER2 model during their natural development. Novel image-guided microirradiation technology was employed to develop WBRT treatment plans and to investigate if this altered brain metastatic growth or permeability. Histology and immunohistochemistry were performed on whole brain slices corresponding with MRI to validate and further investigate radiological findings. RESULTS: Herein, we show successful implementation of microirradiation technology that can deliver WBRT to small animals. We further report that WBRT following diagnosis of brain metastasis can mitigate, but not eliminate, tumor growth in the MDA-MB-231-BR-HER2 model. Moreover, radiotherapy did not impact BBB permeability associated with metastases. CONCLUSIONS: Clinically relevant WBRT is not curative when delivered after MRI-detectable tumors have developed in this model. A dose of 20 Gy in 2 fractions was not sufficient to increase tumor permeability such that it could be used as a method to increase systemic drug uptake in brain metastasis.

  18. Hurricane Harvey rapid response: observations of infragravity wave dynamics and morphological change during inundation of a barrier island cut

    Science.gov (United States)

    Anarde, K.; Figlus, J.; Dellapenna, T. M.; Bedient, P. B.

    2017-12-01

    Prior to landfall of Hurricane Harvey on August 25, 2017, instrumentation was deployed on the seaward and landward sides of a barrier island on the central Texas Gulf Coast to collect in-situ hydrodynamic measurements during storm impact. High-resolution devices capable of withstanding extreme conditions included inexpensive pressure transducers and tilt current meters mounted within and atop (respectively) shallow monitoring wells. In order to link measurements of storm hydrodynamics with the morphological evolution of the barrier, pre- and post-storm digital elevation models were generated using a combination of unmanned aerial imagery, LiDAR, and real-time kinematic GPS. Push-cores were collected and analyzed for grain size and sedimentary structure to relate hydrodynamic observations with the local character of storm-generated deposits. Observations show that at Hog Island, located approximately 160 miles northeast of Harvey's landfall location, storm surge inundated an inactive storm channel. Infragravity waves (0.003 - 0.05 Hz) dominated the water motion onshore of the berm crest over a 24-hour period proximate to storm landfall. Over this time, approximately 50 cm of sediment accreted vertically atop the instrument located in the backshore. Storm deposits at this location contained sub-parallel alternating laminae of quartz and heavy mineral-enriched sand. While onshore progression of infragravity waves into the back-barrier was observed over several hours prior to storm landfall, storm deposits in the back-barrier lack the characteristic laminae preserved in the backshore. These field measurements will ultimately be used to constrain and validate numerical modeling schemes that explore morphodynamic conditions of barriers in response to extreme storms (e.g., XBeach, CSHORE). This study provides a unique data set linking extreme storm hydrodynamics with geomorphic changes during a relatively low surge, but highly dissipative wave event.

  19. In-situ treatment of a mixed hydrocarbon plume through a permeable reactive barrier and enhanced bio-remediation

    International Nuclear Information System (INIS)

    Aglietto, I.; Bretti, L.L.

    2005-01-01

    Groundwater is frequently polluted with mixtures of contaminants that are amenable to different types of remediation. One example is the combination of petroleum hydrocarbons (mostly BTEX) and chlorinated solvents (chlorinated ethenes and propanes), as it occurs in the groundwater beneath the industrial site that is the objective of the present case study. The site is located in Italy near a main river (Arno), which is supposed to be the final recipient of the contamination and where a possible exposure might take place. The aim of the treatment is the plume containment within the site boundaries in order to avoid further migration of the contaminants towards the river. The design of the remediation system was based on an extensive site characterization that included - but was not limited to - the following information: geological and geochemical, microbiological and hydrological data, together with analytical data (i.e. contaminant concentrations). Pilot tests were also implemented in order to collect the necessary parameters for the full-scale treatment design and calibration. The site was contaminated by a mixed plume of more than 30 different contaminants, ranging from BTEX, to MTBE, to PAH, to chlorinated solvents. The concentration peaks were in the order of 1-100 mg/l for each contaminant. Petroleum hydrocarbons are quickly degradable through oxidative mechanisms (especially aerobic biodegradation), whereas fully-chlorinated compounds are only degradable via reductive pathways. A mixed plume of both types of contaminants therefore requires a combined approach with the application of different treatment technologies. The remediation strategy elaborated combines a permeable reactive barrier (PRB) in a funnel and gate configuration for the down-gradient plume containment, with the enhanced bio-remediation of the contaminants for the control of the plume boundaries and for the abatement of the concentration peaks. Pilot tests were carried out in order to assess

  20. Imaging and modification of the tumor vascular barrier for improvement in magnetic nanoparticle uptake and hyperthermia treatment efficacy

    Science.gov (United States)

    Hoopes, P. Jack; Petryk, Alicia A.; Tate, Jennifer A.; Savellano, Mark S.; Strawbridge, Rendall R.; Giustini, Andrew J.; Stan, Radu V.; Gimi, Barjor; Garwood, Michael

    2013-02-01

    The predicted success of nanoparticle based cancer therapy is due in part to the presence of the inherent leakiness of the tumor vascular barrier, the so called enhanced permeability and retention (EPR) effect. Although the EPR effect is present in varying degrees in many tumors, it has not resulted in the consistent level of nanoparticle-tumor uptake enhancement that was initially predicted. Magnetic/iron oxide nanoparticles (mNPs) have many positive qualities, including their inert/nontoxic nature, the ability to be produced in various sizes, the ability to be activated by a deeply penetrating and nontoxic magnetic field resulting in cell-specific cytotoxic heating, and the ability to be successfully coated with a wide variety of functional coatings. However, at this time, the delivery of adequate numbers of nanoparticles to the tumor site via systemic administration remains challenging. Ionizing radiation, cisplatinum chemotherapy, external static magnetic fields and vascular disrupting agents are being used to modify the tumor environment/vasculature barrier to improve mNP uptake in tumors and subsequently tumor treatment. Preliminary studies suggest use of these modalities, individually, can result in mNP uptake improvements in the 3-10 fold range. Ongoing studies show promise of even greater tumor uptake enhancement when these methods are combined. The level and location of mNP/Fe in blood and normal/tumor tissue is assessed via histopathological methods (confocal, light and electron microscopy, histochemical iron staining, fluorescent labeling, TEM) and ICP-MS. In order to accurately plan and assess mNP-based therapies in clinical patients, a noninvasive and quantitative imaging technique for the assessment of mNP uptake and biodistribution will be necessary. To address this issue, we examined the use of computed tomography (CT), magnetic resonance imaging (MRI), and Sweep Imaging With Fourier Transformation (SWIFT), an MRI technique which provides a

  1. Influence of heat treatment on hole transfer dynamics in core-shell quantum dot/organic hole conductor hybrid films

    Science.gov (United States)

    Sun, Mingye; Zheng, Youjin; Zhang, Lei; Zhao, Liping; Zhang, Bing

    2017-08-01

    The influence of heat treatment on hole transfer (HT) processes from the CdSe/ZnS and CdSe/CdS/ZnS quantum dots (QDs) to 4,4‧,4″-Tris(carbazol-9-yl)-triphenylamine (TCTA) in QD/TCTA hybrid films has been researched with time-resolved photoluminescence (PL) spectroscopy. The PL dynamic results demonstrated a heat-treatment-temperature-dependent HT process from the core-shell CdSe QDs to TCTA. The HT rates and efficiencies can be effectively increased due to reduced distance between core-shell CdSe QDs and TCTA after heat treatment. The CdS shell exhibited a more obvious effect on HT from the core-shell CdSe QDs to TCTA than on electron transfer to TiO2, due to higher barrier for holes to tunnel through CdS shell and larger effective mass of holes in CdS than electrons. These results indicate that heat treatment would be an effective means to further optimize solid-state QD sensitized solar cells and rational design of CdS shell is significant.

  2. Barrier Island Dynamics Using Mass Center Analysis: A New Way to Detect and Track Large-Scale Change

    Directory of Open Access Journals (Sweden)

    Paul Paris

    2014-01-01

    Full Text Available A geographic information system (GIS was used to introduce and test a new method for quantitatively characterizing topographic change. Borrowing from classic Newtonian mechanics, the concept of a body’s center of mass is applied to the geomorphic landscape, and the barrier island environment in particular, to evaluate the metric’s potential as a proxy for detecting, tracking and visualizing change. Two barrier islands along North Carolina’s Outer Banks are used to test this idea: Core Banks, uninhabited and largely-undeveloped, and Hatteras Island, altered by the presence of a protective dune system. Findings indicate that for Core Banks, the alongshore change in the center of mass is in accord with dominate littoral transport and wind conditions. Cross-shore change agrees with independent estimates for the island migration rates. This lends credence to our assertion that the mass center metric has the potential to be a viable proxy for describing wholesale barrier migration and would be a valuable addition to the already-established ocean shoreline and subaerial volume metrics. More research is, however, required to demonstrate efficacy.

  3. Using dissolved gas analysis to investigate the performance of an organic carbon permeable reactive barrier for the treatment of mine drainage

    Science.gov (United States)

    Williams, R.L.; Mayer, K.U.; Amos, R.T.; Blowes, D.W.; Ptacek, C.J.; Bain, J.G.

    2007-01-01

    The strongly reducing nature of permeable reactive barrier (PRB) treatment materials can lead to gas production, potentially resulting in the formation of gas bubbles and ebullition. Degassing in organic C based PRB systems due to the production of gases (primarily CO2 and CH4) is investigated using the depletion of naturally occurring non-reactive gases Ar and N2, to identify, confirm, and quantify chemical and physical processes. Sampling and analysis of dissolved gases were performed at the Nickel Rim Mine Organic Carbon PRB, which was designed for the treatment of groundwater contaminated by low quality mine drainage characterized by slightly acidic pH, and elevated Fe(II) and SO4 concentrations. A simple 4-gas degassing model was used to analyze the dissolved gas data, and the results indicate that SO4 reduction is by far the dominant process of organic C consumption within the barrier. The data provided additional information to delineate rates of microbially mediated SO4 reduction and confirm the presence of slow and fast flow zones within the barrier. Degassing was incorporated into multicomponent reactive transport simulations for the barrier and the simulations were successful in reproducing observed dissolved gas trends.

  4. Neutrophil-Mediated Delivery of Therapeutic Nanoparticles across Blood Vessel Barrier for Treatment of Inflammation and Infection

    OpenAIRE

    Chu, Dafeng; Gao, Jin; Wang, Zhenjia

    2015-01-01

    Endothelial cells form a monolayer in lumen of blood vessels presenting a great barrier for delivery of therapeutic nanoparticles (NPs) into extravascular tissues where most diseases occur, such as inflammation disorders and infection. Here, we report a strategy for delivering therapeutic NPs across this blood vessel barrier by nanoparticle in situ hitchhiking activated neutrophils. Using intravital microscopy of TNF-α-induced inflammation of mouse cremaster venules and a mouse model of acute...

  5. [Barriers to implementing screening, brief intervention and referral to treatment for substance use in HIV/AIDS health services in Peru].

    Science.gov (United States)

    Hoffman, Kim A; Beltrán, Jessica; Ponce, Javier; García-Fernandez, Lisset; Calderón, María; Muench, John; Benites, Carlos; Soto, Leslie; McCarty, Dennis; Fiestas, Fabián

    2016-01-01

    Screening and treatment for substance use among people living with HIV/AIDS (PLWHA) is highly recommended. Nevertheless, in Peru healthcare for PLWHA does not include a standardized or systematic assessment to identify substance use. The aim of this study was to assess the feasibility of implementing screening, brief intervention and referral to treatment (SBIRT) in healthcare settings attending people living with PLWHA. After providing training in SBIRT for PLWHA's healthcare personnel (including nurses and physicians) focus groups were conducted to explore knowledge, beliefs and perceived barriers to implementation and interviews were conducted to assess the barriers and facilitators of two tertiary hospitals in Lima, Peru. focus groups and interviews' thematic coding revealed three dimensions: 1) the unknown extent of substance use within PLWHA, 2) space and time limitations hinder completion of brief interventions during routine visits, and 3) insufficient access to substance use treatment appropriate for HIV patients. Multiple barriers, including lack of awareness of substance use problems, limited space and time of providers, and lack of specialized services to refer patients for treatment make it difficult to implement SBIRT in the Peruvian healthcare system.

  6. Adaptation and translation of mental health interventions in Middle Eastern Arab countries: a systematic review of barriers to and strategies for effective treatment implementation.

    Science.gov (United States)

    Gearing, Robin E; Schwalbe, Craig S; MacKenzie, Michael J; Brewer, Kathryne B; Ibrahim, Rawan W; Olimat, Hmoud S; Al-Makhamreh, Sahar S; Mian, Irfan; Al-Krenawi, Alean

    2013-11-01

    All too often, efficacious psychosocial evidence-based interventions fail when adapted from one culture to another. International translation requires a deep understanding of the local culture, nuanced differences within a culture, established service practices, and knowledge of obstacles and promoters to treatment implementation. This research investigated the following objectives to better facilitate cultural adaptation and translation of psychosocial and mental health treatments in Arab countries: (1) identify barriers or obstacles; (2) identify promoting strategies; and (3) provide clinical and research recommendations. This systematic review of 22 psychosocial or mental health studies in Middle East Arab countries identified more barriers (68%) than promoters (32%) to effective translation and adaptation of empirically supported psychosocial interventions. Identified barriers include obstacles related to acceptability of the intervention within the cultural context, community and system difficulties, and problems with clinical engagement processes. Whereas identified promoter strategies centre on the importance of partnering and working within the local and cultural context, the need to engage with acceptable and traditional intervention characteristics, and the development of culturally appropriate treatment strategies and techniques. Although Arab cultures across the Middle East are unique, this article provides a series of core clinical and research recommendations to assist effective treatment adaptation and translation within Arab communities in the Middle East.

  7. Hataedock treatment has preventive therapeutic effects for atopic dermatitis through skin barrier protection in Dermatophagoides farinae-induced NC/Nga mice.

    Science.gov (United States)

    Cha, Ho-Yeol; Ahn, Sang-Hyun; Cheon, Jin-Hong; Park, Sun-Young; Kim, Kibong

    2017-07-12

    Hataedock treatment is traditionally used for the purpose of preventing the future skin disease by feeding herbal extracts to the newborn in traditional Chinese and Korean medicine. This study investigated the preventive therapeutic effects of Hataedock (HTD) treatment for atopic dermatitis (AD) through skin barrier protection in Dermatophagoides farinae-induced NC/Nga mice. To the HTD treatment group, the extract of Coptis japonica Makino and Glycyrrhiza uralensis Fischer, which analyzed with High Performance Liquid Chromatography (HPLC)-fingerprint for quality consistency, was administered orally to the 3-week-old mice before inducing AD. After that, Dermatophagoides farinae was applied except the control group to induce AD-like skin lesions. We confirmed the effects of HTD on morphological changes, protection of skin barrier, regulation of Th2 differentiation, inflammation regulation and induction of apoptosis through histochemistry, immunohistochemistry, and Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay. HTD effectively reduced edema, angiogenesis and skin lesion. HTD also increased the levels of liver X receptor (LXR) and filaggrin but decreased the level of protein kinase C (PKC) (pprotection of skin barrier. Therefore, HTD may have potential applications for alternative and preventive treatment in the management of AD. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  8. Checks for quality control of wedge dynamics in treatment units and the planning system

    International Nuclear Information System (INIS)

    Mateos Salvador, P.; Rodriguez Lopez, B.; Font Gelabert, J.; Hernandez Rodriguez, J.; Arino Gil, A.

    2013-01-01

    The objective of this study is to verify the implementation of enhanced dynamic wedge (EDW) vary in the Eclipse planning system and the experimental determination of the parameters that define the dosimetry characteristics of enhanced dynamic wedge of our treatment units. (Author)

  9. Influence of argon/oxygen atmospheric dielectric barrier discharge treatment on desizing and scouring of poly (vinyl alcohol) on cotton fabrics

    International Nuclear Information System (INIS)

    Peng Shujing; Gao Zhiqiang; Sun Jie; Yao Lan; Qiu Yiping

    2009-01-01

    The effect of argon/oxygen atmospheric dielectric barrier discharge (DBD) treatment on desizing and scouring of polyvinyl alcohol (PVA) on cotton fabric was studied with respect to the treatment duration of 1, 2, 4 and 6 min. X-ray photoelectron spectroscopy (XPS) analysis indicated that oxygen concentration increased for the plasma treated PVA film. Solubility measurement revealed that plasma treatment increased PVA solubility in hot washing but less effective in cold washing. Scanning electron microscopy (SEM) showed that the fiber surfaces were as clean as unsized fibers after 6 min treatment followed by hot washing. Wickability analysis indicated that the capillary heights of plasma treated fabrics increased significantly as the plasma treatment duration increased. The results of the yarn tensile strength test showed that the plasma treatment did not have a negative effect on fabric tensile strength.

  10. Dynamics

    CERN Document Server

    Goodman, Lawrence E

    2001-01-01

    Beginning text presents complete theoretical treatment of mechanical model systems and deals with technological applications. Topics include introduction to calculus of vectors, particle motion, dynamics of particle systems and plane rigid bodies, technical applications in plane motions, theory of mechanical vibrations, and more. Exercises and answers appear in each chapter.

  11. Double barrier system for an in situ conversion process

    Science.gov (United States)

    McKinzie, Billy John [Houston, TX; Vinegar, Harold J [Bellaire, TX; Cowan, Kenneth Michael [Sugar land, TX; Deeg, Wolfgang Friedrich Johann [Houston, TX; Wong, Sau-Wai [Rijswijk, NL

    2009-05-05

    A barrier system for a subsurface treatment area is described. The barrier system includes a first barrier formed around at least a portion of the subsurface treatment area. The first barrier is configured to inhibit fluid from exiting or entering the subsurface treatment area. A second barrier is formed around at least a portion of the first barrier. A separation space exists between the first barrier and the second barrier.

  12. Dynamics of {sup 40,48}Ca+{sup 238}U→{sup 278,286}112{sup ⁎} reactions across the Coulomb barrier using dynamical cluster decay model

    Energy Technology Data Exchange (ETDEWEB)

    Sandhu, Kirandeep; Kaur, Gurvinder; Sharma, Manoj K., E-mail: msharma@thapar.edu

    2014-01-15

    The role of deformations and related orientations (optimum or compact) is investigated in reference to dynamics of {sup 40,48}Ca+{sup 238}U→{sup 278,286}112{sup ⁎} reactions using dynamical cluster decay model (DCM). The use of quadrupole and hexadecapole deformations in the decay of compound system suggest that the degree of compactness changes with addition of higher order deformations. The decay cross-sections are calculated in reference to the available data, including β{sub 2}-static deformations within ‘optimum’ orientation approach. The comparative analysis of spherical, β{sub 2}-static and dynamic alongwith β{sub 4}-static deformations is investigated at comparable center of mass energy of 230 MeV for both nuclei. To address the specific role of optimized orientations in the decay of {sup 278}112{sup ⁎} and {sup 286}112{sup ⁎} nuclei, the calculations are done using equatorial compact and polar elongated orientations. Using hot equatorial collisions, symmetric fission is observed as the dominant decay mode across the barrier, which otherwise becomes asymmetric for cold elongated approach. The calculated cross-sections match nicely with experimental data using hot configuration but the same are overestimated for the use of cold (polar) orientation approach at deep sub-barrier region. This overestimation in the deep sub-barrier region may be associated with the quasi-fission decay channel. The contribution of QF in both {sup 278}112{sup ⁎} and {sup 286}112{sup ⁎} nuclei are predicted through the overestimated cross-sections being more for neutron-deficient {sup 278}112{sup ⁎} nucleus, in agreement with experimental results. Larger barrier modification ΔV{sub B} is observed at sub-barrier energies for both isotopes of Z=112 nucleus. Also the contribution of ΔV{sub B} at lower incident energies is relatively higher for cold elongated polar configuration as compared to hot compact equatorial configuration, causing overestimation of cross

  13. Barriers to free antiretroviral treatment access among kothi-identified men who have sex with men and aravanis (transgender women) in Chennai, India.

    Science.gov (United States)

    Chakrapani, Venkatesan; Newman, Peter A; Shunmugam, Murali; Dubrow, Robert

    2011-12-01

    The Indian government provides free antiretroviral treatment (ART) for people living with HIV. To assist in developing policies and programs to advance equity in ART access, we explored barriers to ART access among kothis (men who have sex with men [MSM] whose gender expression is feminine) and aravanis (transgender women, also known as hijras) living with HIV in Chennai. In the last quarter of 2007, we conducted six focus groups and four key-informant interviews. Data were explored using framework analysis to identify categories and derive themes. We identified barriers to ART access at the family/social-level, health care system-level, and individual-level; however, we found these barriers to be highly interrelated. The primary individual-level barrier was integrally linked to the family/social and health care levels: many kothis and aravanis feared serious adverse consequences if their HIV-positive status were revealed to others. Strong motivations to keep one's HIV-positive status and same-sex attraction secret were interconnected with sexual prejudice against MSM and transgenders, and HIV stigma prevalent in families, the health care system, and the larger society. HIV stigma was present within kothi and aravani communities as well. Consequences of disclosure, including rejection by family, eviction from home, social isolation, loss of subsistence income, and maltreatment (although improving) within the health care system, presented powerful disincentives to accessing ART. Given the multi-level barriers to ART access related to stigma and discrimination, interventions to facilitate ART uptake should address multiple constituencies: the general public, health care providers, and the kothi and aravani communities. India needs a national policy and action plan to address barriers to ART access at family/social, health care system, and individual levels for aravanis, kothis, other subgroups of MSM and other marginalized groups.

  14. "That is why I stopped the ART": patients' & providers' perspectives on barriers to and enablers of HIV treatment adherence in a South African workplace programme.

    Science.gov (United States)

    Dahab, Mison; Charalambous, Salome; Hamilton, Robin; Fielding, Katherine; Kielmann, Karina; Churchyard, Gavin J; Grant, Alison D

    2008-02-18

    As ART programmes in African settings expand beyond the pilot stages, adherence to treatment may become an increasing challenge. This qualitative study examines potential barriers to, and facilitators of, adherence to ART in a workplace programme in South Africa. We conducted key informant interviews with 12 participants: six ART patients, five health service providers (HSPs) and one human resources manager. The main reported barriers were denial of existence of HIV or of one's own positive status, use of traditional medicines, speaking a different language from the HSP, alcohol use, being away from home, perceived severity of side-effects, feeling better on treatment and long waiting times at the clinic. The key facilitators were social support, belief in the value of treatment, belief in the importance of one's own life to the survival of one's family, and the ability to fit ART into daily life schedules. Given the reported uncertainty about the existence of HIV disease and the use of traditional medicines while on ART, despite a programme emphasising ART counselling, there is a need to find effective ways to support adherence to ART even if the individual does not accept biomedical concepts of HIV disease or decides to use traditional medicines. Additionally, providers should identify ways to minimize barriers in communication with patients with whom they have no common language. Finally, dissatisfaction with clinical services, due to long waiting times, should be addressed.

  15. "That is why I stopped the ART": Patients' & providers' perspectives on barriers to and enablers of HIV treatment adherence in a South African workplace programme

    Directory of Open Access Journals (Sweden)

    Kielmann Karina

    2008-02-01

    Full Text Available Abstract Background As ART programmes in African settings expand beyond the pilot stages, adherence to treatment may become an increasing challenge. This qualitative study examines potential barriers to, and facilitators of, adherence to ART in a workplace programme in South Africa. Methods We conducted key informant interviews with 12 participants: six ART patients, five health service providers (HSPs and one human resources manager. Results The main reported barriers were denial of existence of HIV or of one's own positive status, use of traditional medicines, speaking a different language from the HSP, alcohol use, being away from home, perceived severity of side-effects, feeling better on treatment and long waiting times at the clinic. The key facilitators were social support, belief in the value of treatment, belief in the importance of one's own life to the survival of one's family, and the ability to fit ART into daily life schedules. Conclusion Given the reported uncertainty about the existence of HIV disease and the use of traditional medicines while on ART, despite a programme emphasising ART counselling, there is a need to find effective ways to support adherence to ART even if the individual does not accept biomedical concepts of HIV disease or decides to use traditional medicines. Additionally, providers should identify ways to minimize barriers in communication with patients with whom they have no common language. Finally, dissatisfaction with clinical services, due to long waiting times, should be addressed.

  16. The intriguing role of Rifaximin in gut barrier chronic inflammation and in the treatment of Crohn's disease.

    Science.gov (United States)

    Lopetuso, Loris R; Napoli, Marco; Rizzatti, Gianenrico; Gasbarrini, Antonio

    2018-06-04

    The gastrointestinal tract acts as a functional unit organized as a semipermeable multilayer system, in which commensal gut microbiota represents the anatomical barrier. Recently,, several studies have highlighted the involvement of gut microbiota in IBD pathogenesis, in sustaining gut barrier chronic inflammation, and in conditioning disease course and therapeutical response. This evidence provides a rationale for treating patients with gut microbiota modifiers. Among these, Rifaximin represents a non-traditional antibiotic able to act as a "eubiotic" on intestinal barrier. Area covered: The purpose of this narrative review is to explore the impact of Rifaximin on gut barrier and gut microbiota in IBD, in particular in Crohn's disease, and to analyze its potential therapeutic applications. Expert opinion: The possibility of a beneficial activity of Rifaximin in chronic intestinal inflammation and Crohn's disease has been debated and evaluated with different studies having obtained promising but still preliminary data. Larger trials are therefore needed. This gut-specific antibiotic could represent an alternative to systemic antibiotics thanks to its favorable safety profile and promising efficacy data. Rifaximin could exert, when appropriate, a synergic effect with immunomodulators in IBD, acting on both the microbial and immunological sides of gut barrier impairment.

  17. Electron internal transport barrier formation and dynamics in the plasma core of the TJ-II stellarator

    Energy Technology Data Exchange (ETDEWEB)

    Estrada, T [Laboratorio Nacional de Fusion por Confinamiento Magnetico, Asociacion Euratom-CIEMAT, 28040 Madrid (Spain); Krupnik, L [Institute of Plasma Physics, NSC ' KIPT' , Kharkov (Ukraine); Dreval, N [Institute of Plasma Physics, NSC ' KIPT' , Kharkov (Ukraine); Melnikov, A [Institute of Nuclear Fusion, RRC ' Kurchatov Institute' , Moscow, Russia (Russian Federation); Khrebtov, S M [Institute of Plasma Physics, NSC ' KIPT' , Kharkov (Ukraine); Hidalgo, C [Laboratorio Nacional de Fusion por Confinamiento Magnetico, Asociacion Euratom-CIEMAT, 28040 Madrid (Spain); Milligen, B van [Laboratorio Nacional de Fusion por Confinamiento Magnetico, Asociacion Euratom-CIEMAT, 28040 Madrid (Spain); Castejon, F [Laboratorio Nacional de Fusion por Confinamiento Magnetico, Asociacion Euratom-CIEMAT, 28040 Madrid (Spain); AscasIbar, E [Laboratorio Nacional de Fusion por Confinamiento Magnetico, Asociacion Euratom-CIEMAT, 28040 Madrid (Spain); Eliseev, L [Institute of Nuclear Fusion, RRC ' Kurchatov Institute' , Moscow, Russia (Russian Federation); Chmyga, A A [Institute of Plasma Physics, NSC ' KIPT' , Kharkov (Ukraine); Komarov, A D [Institute of Plasma Physics, NSC ' KIPT' , Kharkov (Ukraine); Kozachok, A S [Institute of Plasma Physics, NSC ' KIPT' , Kharkov (Ukraine); Tereshin, V [Institute of Plasma Physics, NSC ' KIPT' , Kharkov (Ukraine)

    2004-01-01

    The influence of magnetic topology on the formation of electron internal transport barriers (e-ITBs) has been studied experimentally in electron cyclotron heated plasmas in the stellarator TJ-II. e-ITB formation is characterized by an increase in core electron temperature and plasma potential. The positive radial electric field increases by a factor of 3 in the central plasma region when an e-ITB forms. The experiments reported demonstrate that the formation of an e-ITB depends on the magnetic configuration. Calculations of the modification of the rotational transform due to plasma current lead to the interpretation that the formation of an e-ITB can be triggered by positioning a low order rational surface close to the plasma core region. In configurations without any central low order rational, no barrier is formed for any accessible value of heating power. Different mechanisms associated with neoclassical/turbulent bifurcations and kinetic effects are put forward to explain the impact of magnetic topology on radial electric fields and confinement.

  18. Doubly Robust Estimation of Optimal Dynamic Treatment Regimes

    DEFF Research Database (Denmark)

    Barrett, Jessica K; Henderson, Robin; Rosthøj, Susanne

    2014-01-01

    We compare methods for estimating optimal dynamic decision rules from observational data, with particular focus on estimating the regret functions defined by Murphy (in J. R. Stat. Soc., Ser. B, Stat. Methodol. 65:331-355, 2003). We formulate a doubly robust version of the regret-regression appro......We compare methods for estimating optimal dynamic decision rules from observational data, with particular focus on estimating the regret functions defined by Murphy (in J. R. Stat. Soc., Ser. B, Stat. Methodol. 65:331-355, 2003). We formulate a doubly robust version of the regret......-regression approach of Almirall et al. (in Biometrics 66:131-139, 2010) and Henderson et al. (in Biometrics 66:1192-1201, 2010) and demonstrate that it is equivalent to a reduced form of Robins' efficient g-estimation procedure (Robins, in Proceedings of the Second Symposium on Biostatistics. Springer, New York, pp....... 189-326, 2004). Simulation studies suggest that while the regret-regression approach is most efficient when there is no model misspecification, in the presence of misspecification the efficient g-estimation procedure is more robust. The g-estimation method can be difficult to apply in complex...

  19. Dispersed droplet dynamics during produced water treatment in oil industry

    NARCIS (Netherlands)

    van Eijkeren, D.F.

    2016-01-01

    For Lagrangian particle tracking applied to swirling flow produced water treatment the influence of the history force is investigated. In the expression for the history force an existing Reynolds number dependent kernel is adapted and validated for a range of experimental data for settling spheres.

  20. The Future of Opioid Agonist Therapies in Ukraine: A Qualitative Assessment of Multilevel Barriers and Ways Forward to Promote Retention in Treatment.

    Science.gov (United States)

    Bojko, Martha J; Mazhnaya, Alyona; Marcus, Ruthanne; Makarenko, Iuliia; Islam, Zahedul; Filippovych, Sergey; Dvoriak, Sergii; Altice, Frederick L

    2016-07-01

    Opioid agonist therapies (OAT) to treat opioid addiction in people who inject drugs (PWID) began in Ukraine in 2004. Scale-up of OAT, however, has been hampered by both low enrollment and high attrition. To better understand the factors influencing OAT retention among PWID in Ukraine, qualitative data from 199 PWIDs were collected during 25 focus groups conducted in five Ukrainian cities from February to April 2013. The experiences of PWID who were currently or previously on OAT or currently trying to access OAT were analyzed to identify entry and retention barriers encountered. Transcribed data were analyzed using a grounded theory approach. Individual beliefs about OAT, particularly misaligned treatment goals between clients and providers, influenced PWID's treatment seeking behaviors. Multiple programmatic and structural issues, including inconvenient hours and treatment site locations, complicated dosing regimens, inflexible medication dispensing guidelines, and mistreatment by clinic and medical staff also strongly influenced OAT retention. Findings suggest the need for both programmatic and policy-level structural changes such as revising legal regulations covering OAT dispensing, formalizing prescription dosing policies and making OAT more available through other sites, including primary care settings as a way to improve treatment retention. Quality improvement interventions that target treatment settings could also be deployed to overcome healthcare delivery barriers. Additional patient education and medical professional development around establishing realistic treatment goals as well as community awareness campaigns that address the myths and fears associated with OAT can be leveraged to overcome individual, family and community-level barriers. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Multifunctional Nanocarriers for diagnostics, drug delivery and targeted treatment across blood-brain barrier: perspectives on tracking and neuroimaging

    Directory of Open Access Journals (Sweden)

    Estrada Giovani

    2010-03-01

    Full Text Available Abstract Nanotechnology has brought a variety of new possibilities into biological discovery and clinical practice. In particular, nano-scaled carriers have revolutionalized drug delivery, allowing for therapeutic agents to be selectively targeted on an organ, tissue and cell specific level, also minimizing exposure of healthy tissue to drugs. In this review we discuss and analyze three issues, which are considered to be at the core of nano-scaled drug delivery systems, namely functionalization of nanocarriers, delivery to target organs and in vivo imaging. The latest developments on highly specific conjugation strategies that are used to attach biomolecules to the surface of nanoparticles (NP are first reviewed. Besides drug carrying capabilities, the functionalization of nanocarriers also facilitate their transport to primary target organs. We highlight the leading advantage of nanocarriers, i.e. their ability to cross the blood-brain barrier (BBB, a tightly packed layer of endothelial cells surrounding the brain that prevents high-molecular weight molecules from entering the brain. The BBB has several transport molecules such as growth factors, insulin and transferrin that can potentially increase the efficiency and kinetics of brain-targeting nanocarriers. Potential treatments for common neurological disorders, such as stroke, tumours and Alzheimer's, are therefore a much sought-after application of nanomedicine. Likewise any other drug delivery system, a number of parameters need to be registered once functionalized NPs are administered, for instance their efficiency in organ-selective targeting, bioaccumulation and excretion. Finally, direct in vivo imaging of nanomaterials is an exciting recent field that can provide real-time tracking of those nanocarriers. We review a range of systems suitable for in vivo imaging and monitoring of drug delivery, with an emphasis on most recently introduced molecular imaging modalities based on optical

  2. Blood-brain barrier permeation and efflux exclusion of anticholinergics used in the treatment of overactive bladder.

    Science.gov (United States)

    Chancellor, Michael B; Staskin, David R; Kay, Gary G; Sandage, Bobby W; Oefelein, Michael G; Tsao, Jack W

    2012-04-01

    Overactive bladder (OAB) is a common condition, particularly in the elderly. Anticholinergic agents are the mainstay of pharmacological treatment of OAB; however, many anticholinergics can cross the blood-brain barrier (BBB) and may cause central nervous system (CNS) effects, including cognitive deficits, which can be especially detrimental in older patients. Many anticholinergics have the potential to cause adverse CNS effects due to muscarinic (M(1)) receptor binding in the brain. Of note, permeability of the BBB increases with age and can also be affected by trauma, stress, and some diseases and medications. Passive crossing of a molecule across the BBB into the brain is dependent upon its physicochemical properties. Molecular characteristics that hinder passive BBB penetration include a large molecular size, positive or negative ionic charge at physiological pH, and a hydrophilic structure. Active transport across the BBB is dependent upon protein-mediated transporter systems, such as that of permeability-glycoprotein (P-gp), which occurs only for P-gp substrates, such as trospium chloride, darifenacin and fesoterodine. Reliance on active transport can be problematic since genetic polymorphisms of P-gp exist, and many commonly used drugs and even some foods are P-gp inhibitors or are substrates themselves and, due to competition, can reduce the amount of the drug that is actively transported out of the CNS. Therefore, for drugs that are preferred not to cross into the CNS, such as potent anticholinergics intended for the bladder, it is optimal to have minimal passive crossing of the BBB, although it may also be beneficial for the drug to be a substrate for an active efflux transport system. Anticholinergics demonstrate different propensities to cross the BBB. Darifenacin, fesoterodine and trospium chloride are substrates for P-gp and, therefore, are actively transported away from the brain. In addition, trospium chloride has not been detected in cerebrospinal

  3. Dynamic glucose enhanced (DGE) MRI for combined imaging of blood-brain barrier break down and increased blood volume in brain cancer.

    Science.gov (United States)

    Xu, Xiang; Chan, Kannie W Y; Knutsson, Linda; Artemov, Dmitri; Xu, Jiadi; Liu, Guanshu; Kato, Yoshinori; Lal, Bachchu; Laterra, John; McMahon, Michael T; van Zijl, Peter C M

    2015-12-01

    Recently, natural d-glucose was suggested as a potential biodegradable contrast agent. The feasibility of using d-glucose for dynamic perfusion imaging was explored to detect malignant brain tumors based on blood brain barrier breakdown. Mice were inoculated orthotopically with human U87-EGFRvIII glioma cells. Time-resolved glucose signal changes were detected using chemical exchange saturation transfer (glucoCEST) MRI. Dynamic glucose enhanced (DGE) MRI was used to measure tissue response to an intravenous bolus of d-glucose. DGE images of mouse brains bearing human glioma showed two times higher and persistent changes in tumor compared with contralateral brain. Area-under-curve (AUC) analysis of DGE delineated blood vessels and tumor and had contrast comparable to the AUC determined using dynamic contrast enhanced (DCE) MRI with GdDTPA, both showing a significantly higher AUC in tumor than in brain (P blood volume and permeability with respect to normal brain. We expect DGE will provide a low-risk and less expensive alternative to DCE MRI for imaging cancer in vulnerable populations, such as children and patients with renal impairment. © 2015 Wiley Periodicals, Inc.

  4. Dynamic Glucose Enhanced (DGE) MRI for Combined Imaging of Blood Brain Barrier Break Down and Increased Blood Volume in Brain Cancer

    Science.gov (United States)

    Xu, Xiang; Chan, Kannie WY; Knutsson, Linda; Artemov, Dmitri; Xu, Jiadi; Liu, Guanshu; Kato, Yoshinori; Lal, Bachchu; Laterra, John; McMahon, Michael T.; van Zijl, Peter C.M.

    2015-01-01

    Purpose Recently, natural d-glucose was suggested as a potential biodegradable contrast agent. The feasibility of using d-glucose for dynamic perfusion imaging was explored to detect malignant brain tumors based on blood brain barrier breakdown. Methods Mice were inoculated orthotopically with human U87-EGFRvIII glioma cells. Time-resolved glucose signal changes were detected using chemical exchange saturation transfer (glucoCEST) MRI. Dynamic glucose enhanced (DGE) MRI was used to measure tissue response to an intravenous bolus of d-glucose. Results DGE images of mouse brains bearing human glioma showed two times higher and persistent changes in tumor compared to contralateral brain. Area-under-curve (AUC) analysis of DGE delineated blood vessels and tumor and had contrast comparable to the AUC determined using dynamic contrast enhanced (DCE) MRI with GdDTPA, both showing a significantly higher AUC in tumor than in brain (pblood volume and permeability with respect to normal brain. We expect DGE will provide a low-risk and less expensive alternative to DCE MRI for imaging cancer in vulnerable populations, such as children and patients with renal impairment. PMID:26404120

  5. Electron-impact ionization of atomic hydrogen: dynamical variational treatment

    Energy Technology Data Exchange (ETDEWEB)

    Defrance, P.; Lecointre, J. [Institute of Condensed Matter and Nanosciences, Universite Catholique de Louvain, Louvain-la-Neuve (Belgium); Kereselidze, T.; Machavariani, Z.S. [Department of Exact and Natural Sciences, Tbilissi State University, Tbilissi (Georgia)

    2011-10-15

    A simple and straightforward calculating scheme is proposed for electron-impact single and multiple ionization of atoms. The method is based on the application of the Hulthen-Kohn dynamical variational principle. An effective charge seen by the scattered electron is determined for a certain type of trial wave functions mathematically in a rigorous way excluding any empirical assumptions. Validity of the elaborated approach is assessed by calculating triply differential cross section (TDCS) for electron-impact ionization of hydrogen. It is shown that, inclusion of the effective charge into the calculation reduces height of a 'binary peak' in comparison with the first Born approximation result. The height of a 'recoil peak' depends on the sign of the effective charge. The calculated TDCS are compared with the available experimental data and with the results of sophisticated theories and agreement is found. (authors)

  6. Barriers to treatment and control of hypertension among hypertensive participants: A community based cross-sectional mixed method study in municipalities of Kathmandu, Nepal

    Directory of Open Access Journals (Sweden)

    Surya Devkota

    2016-08-01

    Full Text Available AbstractIntroduction: Despite the established evidence on benefits of controlling raised blood pressure and development of several guidelines on detection and management of hypertension, people often have untreated or uncontrolled hypertension. In this context, we undertook this study to identify the barriers existing in hypertension treatment and control in the municipalities of Kathmandu district in Nepal. Methods: This was a community based, cross-sectional mixed method study conducted in the municipalities of Kathmandu district in Nepal between January and July 2015. Among 587 randomly selected participants, the aware hypertensive participants were further assessed for the treatment and control of hypertension. For qualitative component, 20 participants having uncontrolled hypertension took part in two focused group discussions and two cardiac physicians participated in in-depth interviews.Results: Out of 587 participants screened, 191 (32.5% were identified as hypertensive. Among 191 hypertensive participants, 118 (61.8% were aware of their problem. Of the 118 aware hypertensive participants, 93 (78.8% were taking medicines, and among those treated, 46 (49.6% had controlled hypertension. Proportions of participants taking anti-hypertensive medications varied significantly with age groups, ethnicity, occupation and income. Hypertension control was significantly associated with use of combination therapy, adherence to medication, follow-up care, counseling by healthcare providers and waiting time in hospital. Being worried that the medicine needs to be taken life-long, perceived side effects of drugs, non-adherence to medication, lost to follow-up, inadequate counseling from physician, and lack of national guidelines for hypertension treatment were the most commonly cited barriers for treatment and control of hypertension in qualitative component of the research.Conclusion: Large proportion of the hypertensive population has the untreated and

  7. [Alcohol withdrawal syndrome dynamics during treatment with nooclerin (deanoli aceglumas)].

    Science.gov (United States)

    Agibalova, T V; Buzik, O Zh; Rychkova, O V; Smyshlyaev, A V; Rumbesht, V V

    2018-01-01

    To study the efficacy of nooclerin (deanoli aceglumas) in alcohol withdrawal syndrome assessed by clinical and biochemical characteristics. A multicenter, open, randomized, comparative study of nooclerin in the complex treatment of alcohol withdrawal syndrome included 90 patients. The patients were randomized into nooclerin group (n=55) and control group (n=35). Nooclerin reduced alcohol withdrawal symptoms more significantly throughout the whole study period. There were significant between-group differences on the Clinical Institute Withdrawal Assessment of Alcohol Scale (CIWA-Ar) and the Multidimensional Fatigue Inventory (МFI-20). However, patients exhibited no excessive activity. No adverse side-effects were observed.

  8. Optimization of multi-stage dynamic treatment regimes utilizing accumulated data.

    Science.gov (United States)

    Huang, Xuelin; Choi, Sangbum; Wang, Lu; Thall, Peter F

    2015-11-20

    In medical therapies involving multiple stages, a physician's choice of a subject's treatment at each stage depends on the subject's history of previous treatments and outcomes. The sequence of decisions is known as a dynamic treatment regime or treatment policy. We consider dynamic treatment regimes in settings where each subject's final outcome can be defined as the sum of longitudinally observed values, each corresponding to a stage of the regime. Q-learning, which is a backward induction method, is used to first optimize the last stage treatment then sequentially optimize each previous stage treatment until the first stage treatment is optimized. During this process, model-based expectations of outcomes of late stages are used in the optimization of earlier stages. When the outcome models are misspecified, bias can accumulate from stage to stage and become severe, especially when the number of treatment stages is large. We demonstrate that a modification of standard Q-learning can help reduce the accumulated bias. We provide a computational algorithm, estimators, and closed-form variance formulas. Simulation studies show that the modified Q-learning method has a higher probability of identifying the optimal treatment regime even in settings with misspecified models for outcomes. It is applied to identify optimal treatment regimes in a study for advanced prostate cancer and to estimate and compare the final mean rewards of all the possible discrete two-stage treatment sequences. Copyright © 2015 John Wiley & Sons, Ltd.

  9. Quantum treatment of the Ar-HI photodissociation dynamics

    International Nuclear Information System (INIS)

    Lopez-Lopez, Sergio; Prosmiti, Rita; Garcia-Vela, Alberto

    2004-01-01

    A wave packet simulation of the ultraviolet photolysis dynamics of Ar-HI(v=0) is reported. Cluster photodissociation is started from two different initial states, namely, the ground van der Waals (vdW) and the first excited vdW bending state, associated with the Ar-I-H and Ar-H-I isomeric forms of the system, respectively. Formation of Ar-I radical products is investigated over the energy range of the cluster absorption spectrum. It is found that the yield of bound Ar-I radical complexes is typically 90%-100% and 70%-80% for the initial states associated with the Ar-I-H and Ar-H-I isomers, respectively. This result is in agreement with the experimentally observed time-of-flight spectrum of the hydrogen fragment produced after Ar-HI photodissociation. The high Ar-I yield is explained mainly by the small amount of energy available for the radical that is converted into internal energy in the photofragmentation process, which enhances the Ar-I survival probability. Quantum interference effects manifest themselves in structures in the angular distribution of the hydrogen fragment, and in pronounced rainbow patterns in the rotational distributions of the Ar-I radical

  10. Initial treatment seeking from professional health care providers for eating disorders: A review and synthesis of potential barriers to and facilitators of "first contact".

    Science.gov (United States)

    Regan, Pamela; Cachelin, Fary M; Minnick, Alyssa M

    2017-03-01

    The objective of this study is to provide a comprehensive review of empirical research exploring barriers to and facilitators of initial treatment seeking ("first contact") from professional health care providers by adults and young adults with eating disorders (EDs). A search of databases PsycINFO and MEDLINE using the terms "treatment" and "eating disorder*" yielded 9,468 peer-reviewed articles published from January 1945 to June 2016. Screening identified 31 articles meeting the following criteria: (1) participants were 16 or older and presented with a self-reported or clinically diagnosed ED; (2) studies focused on (a) initial treatment seeking (b) for an ED (c) from professional health care providers; (3) articles were empirical, and (4) peer reviewed. Quantitative studies revealed few consistent correlates of treatment seeking, perhaps because most variables were examined in only one or two investigations. Variables with some degree of predictive utility (i.e., produced significant results in multiple studies) were age (older), ethnicity (nonethnic minority), ED type (anorexia, purging BN), specific ED-related behaviors (i.e., purging), and time spent on a treatment waitlist following referral (less). Although BMI was one of the most investigated variables, it did not predict treatment seeking. Qualitative studies revealed the following perceived barriers: (1) personal feelings of shame/fear, (2) ED-related beliefs/perceptions, (3) lack of access/availability, and (4) aspects of the treatment process. Perceived facilitators included (1) health-related concerns, (2) emotional distress, and (3) social support. Implications for clinical practice and areas for further research are discussed. Results highlight the need for shared definitions and methodologies across studies of treatment seeking. © 2017 Wiley Periodicals, Inc.

  11. Institutional dynamics and barriers in wind energy development. A case study of Tamil Nadu and Andhra Pradesh, India

    Energy Technology Data Exchange (ETDEWEB)

    Jagadeesh, Anumakonda

    1999-09-01

    In India, there was a boom in 1995-96 when 282 MW windfarms were set up in Tamil Nadu and the capacity in Andhra Pradesh increased by 39 MW. Then there was a steady decline in the windfarm development in both states. The case study described in this report attempts to trace the reasons for the boom and the factors that have contributed to the slump in windfarm development in these two states. The role of institutions in determining the effectiveness of national and regional public sector initiatives to promote and disseminate wind energy in the two states is discussed. The study also examines the financial, technical, transaction and institutional barriers, which inhibit the diffusion of wind energy in the states. It is suggested that important measures must be taken if wind energy is to develop rapidly in the two states. The result of the case study may be used to improve public policy intervention in disseminating wind energy in India. It may also be relevant to multilateral and bilateral aid agencies in their projects and/or programmes to promote cost-effective wind energy technology dissemination in developing countries. 25 refs., 6 tabs.

  12. Dynamic behavior of transport in normal and reversed shear plasmas with internal barriers in JT-60U

    International Nuclear Information System (INIS)

    Neudatchin, Sergi V.; Takizuka, Tomonori; Shirai, Hiroshi; Fujita, Takaaki; Isayama, Akihiko; Kamada, Yutaka; Koide, Yoshihiko

    2001-12-01

    Transport evolution in normal shear (NrS) and reversed shear (RS) JT-60U tokamak plasmas with internal transport barrier (ITB) is described as a combination of various fast and slow time scale processes. Abrupt in time (ms time scale) and wide in space (∼0.3 of minor radius) variations of electron and ion heat diffusivities χ e,i (δχ e,i ), which are called ITB-events and seen as simultaneous rise and decay of electron and ion temperatures in two spatial zones, are found for weak ITBs in both NrS and RS plasmas. Profiles of δχ e in RS plasmas with strong ITBs are usually localized near ITB foot inside smaller space region. The maximum of the heat flux variation is located near position of the minimum of safety factor in various RS plasmas, and variation is extended in positive shear region. Inward and outward heat pulse propagations created by the jump of χ e and the sawtooth-like crash are analyzed. Small values of χ e and the absence of heat pinch are found inside strong ITBs. Another non-local abrupt variations of χ e inside most of the plasma volume, including significant part of weak ITB inside RS zone of RS plasmas, are seen at the ELM-induced H-L transition and the L-H recovery. (author)

  13. Numerical investigation on the dynamics and evolution mechanisms of multiple-current-pulse behavior in homogeneous helium dielectric-barrier discharges at atmospheric pressure

    Directory of Open Access Journals (Sweden)

    Yuhui Zhang

    2018-03-01

    Full Text Available A systematic investigation on the dynamics and evolution mechanisms of multiple-current-pulse (MCP behavior in homogeneous dielectric barrier discharge (HDBD is carried out via fluid modelling. Inspecting the simulation results, two typical discharge regimes, namely the MCP-Townsend regime and MCP-glow regime, are found prevailing in MCP discharges, each with distinctive electrical and dynamic properties. Moreover, the evolution of MCP behavior with external parameters altering are illustrated and explicitly discussed. It is revealed that the discharge undergoes some different stages as external parameters vary, and the discharge in each stage follows a series of distinctive pattern in morphological characteristics and evolution trends. Among those stages, the pulse number per half cycle is perceived to observe non-monotonic variations with applied voltage amplitude (Vam and gap width (dg increasing, and a merging effect among pulses, mainly induced by the enhanced contribution of sinusoidal component to the total current, is considered responsible for such phenomenon. The variation of incipient discharge peak phase (Φpm is dominated by the value of Vam as well as the proportion of total applied voltage that drops across the gas gap. Moreover, an abnormal, dramatic elevation in Jpm with dg increasing is observed, which could be evinced by the strengthened glow discharge structure and therefore enhanced space charge effect.

  14. Measurement of brain perfusion, blood volume, and blood-brain barrier permeability, using dynamic contrast-enhanced T(1)-weighted MRI at 3 tesla

    DEFF Research Database (Denmark)

    Larsson, Henrik B W; Courivaud, Frédéric; Rostrup, Egill

    2009-01-01

    Assessment of vascular properties is essential to diagnosis and follow-up and basic understanding of pathogenesis in brain tumors. In this study, a procedure is presented that allows concurrent estimation of cerebral perfusion, blood volume, and blood-brain permeability from dynamic T(1)-weighted...... on a pixel-by-pixel basis of cerebral perfusion, cerebral blood volume, and blood-brain barrier permeability.......Assessment of vascular properties is essential to diagnosis and follow-up and basic understanding of pathogenesis in brain tumors. In this study, a procedure is presented that allows concurrent estimation of cerebral perfusion, blood volume, and blood-brain permeability from dynamic T(1)-weighted...... imaging of a bolus of a paramagnetic contrast agent passing through the brain. The methods are applied in patients with brain tumors and in healthy subjects. Perfusion was estimated by model-free deconvolution using Tikhonov's method (gray matter/white matter/tumor: 72 +/- 16/30 +/- 8/56 +/- 45 mL/100 g...

  15. Neutrophil-Mediated Delivery of Therapeutic Nanoparticles across Blood Vessel Barrier for Treatment of Inflammation and Infection.

    Science.gov (United States)

    Chu, Dafeng; Gao, Jin; Wang, Zhenjia

    2015-12-22

    Endothelial cells form a monolayer in lumen of blood vessels presenting a great barrier for delivery of therapeutic nanoparticles (NPs) into extravascular tissues where most diseases occur, such as inflammation disorders and infection. Here, we report a strategy for delivering therapeutic NPs across this blood vessel barrier by nanoparticle in situ hitchhiking activated neutrophils. Using intravital microscopy of TNF-α-induced inflammation of mouse cremaster venules and a mouse model of acute lung inflammation, we demonstrated that intravenously (iv) infused NPs made from denatured bovine serum albumin (BSA) were specifically internalized by activated neutrophils, and subsequently, the neutrophils containing NPs migrated across blood vessels into inflammatory tissues. When neutrophils were depleted using anti-Gr-1 in a mouse, the transport of albumin NPs across blood vessel walls was robustly abolished. Furthermore, it was found that albumin nanoparticle internalization did not affect neutrophil mobility and functions. Administration of drug-loaded albumin NPs markedly mitigated the lung inflammation induced by LPS (lipopolysaccharide) or infection by Pseudomonas aeruginosa. These results demonstrate the use of an albumin nanoparticle platform for in situ targeting of activated neutrophils for delivery of therapeutics across the blood vessel barriers into diseased sites. This study demonstrates our ability to hijack neutrophils to deliver nanoparticles to targeted diseased sites.

  16. Rapid survey protocol that provides dynamic information on reef condition to managers of the Great Barrier Reef.

    Science.gov (United States)

    Beeden, R J; Turner, M A; Dryden, J; Merida, F; Goudkamp, K; Malone, C; Marshall, P A; Birtles, A; Maynard, J A

    2014-12-01

    Managing to support coral reef resilience as the climate changes requires strategic and responsive actions that reduce anthropogenic stress. Managers can only target and tailor these actions if they regularly receive information on system condition and impact severity. In large coral reef areas like the Great Barrier Reef Marine Park (GBRMP), acquiring condition and impact data with good spatial and temporal coverage requires using a large network of observers. Here, we describe the result of ~10 years of evolving and refining participatory monitoring programs used in the GBR that have rangers, tourism operators and members of the public as observers. Participants complete Reef Health and Impact Surveys (RHIS) using a protocol that meets coral reef managers' needs for up-to-date information on the following: benthic community composition, reef condition and impacts including coral diseases, damage, predation and the presence of rubbish. Training programs ensure that the information gathered is sufficiently precise to inform management decisions. Participants regularly report because the demands of the survey methodology have been matched to their time availability. Undertaking the RHIS protocol we describe involves three ~20 min surveys at each site. Participants enter data into an online data management system that can create reports for managers and participants within minutes of data being submitted. Since 2009, 211 participants have completed a total of more than 10,415 surveys at more than 625 different reefs. The two-way exchange of information between managers and participants increases the capacity to manage reefs adaptively, meets education and outreach objectives and can increase stewardship. The general approach used and the survey methodology are both sufficiently adaptable to be used in all reef regions.

  17. Identification of barriers to the prevention and treatment of heat-related illness in Latino farmworkers using activity-oriented, participatory rural appraisal focus group methods.

    Science.gov (United States)

    Lam, Michelle; Krenz, Jennifer; Palmández, Pablo; Negrete, Maria; Perla, Martha; Murphy-Robinson, Helen; Spector, June T

    2013-10-24

    Heat-related illness (HRI) is an important cause of non-fatal illness and death in farmworkers. We sought to identify potential barriers to HRI prevention and treatment in Latino farmworkers. We conducted three semi-structured focus group discussions with 35 Latino farmworkers in the Central Washington, USA area using participatory rural appraisal techniques. Interviews were audio taped and transcribed in Spanish. Three researchers reviewed and coded transcripts and field notes, and investigator triangulation was used to identify relevant themes and quotes. Although the majority of participants in our study reported never receiving formal HRI training, most participants were aware that extreme heat can cause illness and were able to accurately describe HRI symptoms, risk factors, and certain prevention strategies. Four main observations regarding farmworkers' HRI-relevant beliefs and attitudes were identified: 1) farmworkers subscribe to varying degrees to the belief that cooling treatments should be avoided after heat exposure, with some believing that such treatments should be avoided after heat exposure, and others encouraging the use of such treatments; 2) the desire to lose weight may be reflected in behaviors that promote increased sweating; 3) highly caffeinated energy drinks are preferred to increase work efficiency and maintain alertness; and 4) the location of drinking water at work (e.g. next to restrooms) and whether water is clean, but not necessarily chemically-treated, are important considerations in deciding whether to drink the water provided at worksites. We identified potential barriers to HRI prevention and treatment related to hydration, certain HRI treatments, clothing use, and the desire to lose weight among Latino farmworkers. Strategies to address potential barriers to HRI prevention and treatment in this population may include engineering, administrative, and health education and health promotion strategies at individual, workplace

  18. Biologic Treatments for Sports Injuries II Think Tank-Current Concepts, Future Research, and Barriers to Advancement, Part 1: Biologics Overview, Ligament Injury, Tendinopathy.

    Science.gov (United States)

    LaPrade, Robert F; Geeslin, Andrew G; Murray, Iain R; Musahl, Volker; Zlotnicki, Jason P; Petrigliano, Frank; Mann, Barton J

    2016-12-01

    Biologic therapies, including stem cells, platelet-rich plasma, growth factors, and other biologically active adjuncts, have recently received increased attention in the basic science and clinical literature. At the 2015 AOSSM Biologics II Think Tank held in Colorado Springs, Colorado, a group of orthopaedic surgeons, basic scientists, veterinarians, and other investigators gathered to review the state of the science for biologics and barriers to implementation of biologics for the treatment of sports medicine injuries. This series of current concepts reviews reports the summary of the scientific presentations, roundtable discussions, and recommendations from this think tank. © 2016 The Author(s).

  19. The role of the blood–brain barrier in the development and treatment of migraine and other pain disorders

    Science.gov (United States)

    DosSantos, Marcos F.; Holanda-Afonso, Rosenilde C.; Lima, Rodrigo L.; DaSilva, Alexandre F.; Moura-Neto, Vivaldo

    2014-01-01

    The function of the blood–brain barrier (BBB) related to chronic pain has been explored for its classical role in regulating the transcellular and paracellular transport, thus controlling the flow of drugs that act at the central nervous system, such as opioid analgesics (e.g., morphine) and non-steroidal anti-inflammatory drugs. Nonetheless, recent studies have raised the possibility that changes in the BBB permeability might be associated with chronic pain. For instance, changes in the relative amounts of occludin isoforms, resulting in significant increases in the BBB permeability, have been demonstrated after inflammatory hyperalgesia. Furthermore, inflammatory pain produces structural changes in the P-glycoprotein, the major efflux transporter at the BBB. One possible explanation for these findings is the action of substances typically released at the site of peripheral injuries that could lead to changes in the brain endothelial permeability, including substance P, calcitonin gene-related peptide, and interleukin-1 beta. Interestingly, inflammatory pain also results in microglial activation, which potentiates the BBB damage. In fact, astrocytes and microglia play a critical role in maintaining the BBB integrity and the activation of those cells is considered a key mechanism underlying chronic pain. Despite the recent advances in the understanding of BBB function in pain development as well as its interference in the efficacy of analgesic drugs, there remain unknowns regarding the molecular mechanisms involved in this process. In this review, we explore the connection between the BBB as well as the blood–spinal cord barrier and blood–nerve barrier, and pain, focusing on cellular and molecular mechanisms of BBB permeabilization induced by inflammatory or neuropathic pain and migraine. PMID:25339863

  20. The role of the blood-brain barrier in the development and treatment of migraine and other pain disorders

    Directory of Open Access Journals (Sweden)

    Marcos Fabio DosSantos

    2014-10-01

    Full Text Available The function of the blood-brain barrier (BBB related to chronic pain has been explored by its classical role in regulating the transcellular and paracellular transport, thus controlling the flow of drugs that act at the central nervous system, such as the opioid analgesics (e.g., morphine and non-steroidal anti-inflammatory drugs (NSAIDs. Nonetheless, recent studies have raised the possibility that changes in the BBB permeability might be associated with chronic pain. For instance, changes in the relative amounts of occludin isoforms, resulting in significant increases in the BBB permeability, have been demonstrated after inflammatory hyperalgesia. Furthermore, inflammatory pain produces structural changes in the P-glycoprotein (P-gp, the major efflux transporter at the BBB. One possible explanation for these findings is the action of substances typically released at the site of peripheral injuries that could lead to changes in the brain endothelial permeability, including: substance P, calcitonin gene related peptide (CGRP and IL- 1β. Interestingly, inflammatory pain also results in microglial activation, which potentiates the BBB damage. In fact, astrocytes and microglia play a critical role in maintaining the BBB integrity and the activation of those cells is considered a key mechanism underlying chronic pain. Despite the recent advances in the understanding of BBB function in pain development as well as its interference in the efficacy of analgesic drugs, there remain unknowns regarding the molecular mechanisms involved in this process. In this review, we explore the connection between the BBB as well as the blood-spinal cord barrier (BSCB and blood-nerve barrier (BNB and pain, focusing on cellular and molecular mechanisms of BBB permeabilization induced by inflammatory or neuropathic pain and migraine.

  1. Cancer treatment scheduling and dynamic heterogeneity in social dilemmas of tumour acidity and vasculature.

    Science.gov (United States)

    Kaznatcheev, Artem; Vander Velde, Robert; Scott, Jacob G; Basanta, David

    2017-03-14

    Tumours are diverse ecosystems with persistent heterogeneity in various cancer hallmarks like self-sufficiency of growth factor production for angiogenesis and reprogramming of energy metabolism for aerobic glycolysis. This heterogeneity has consequences for diagnosis, treatment and disease progression. We introduce the double goods game to study the dynamics of these traits using evolutionary game theory. We model glycolytic acid production as a public good for all tumour cells and oxygen from vascularisation via vascular endothelial growth factor production as a club good benefiting non-glycolytic tumour cells. This results in three viable phenotypic strategies: glycolytic, angiogenic and aerobic non-angiogenic. We classify the dynamics into three qualitatively distinct regimes: (1) fully glycolytic; (2) fully angiogenic; or (3) polyclonal in all three cell types. The third regime allows for dynamic heterogeneity even with linear goods, something that was not possible in prior public good models that considered glycolysis or growth factor production in isolation. The cyclic dynamics of the polyclonal regime stress the importance of timing for anti-glycolysis treatments like lonidamine. The existence of qualitatively different dynamic regimes highlights the order effects of treatments. In particular, we consider the potential of vascular normalisation as a neoadjuvant therapy before follow-up with interventions like buffer therapy.

  2. Treatment of abdominal cellulite and circumference reduction with radiofrequency and dynamic muscle activation.

    Science.gov (United States)

    Wanitphakdeedecha, Rungsima; Iamphonrat, Thanawan; Thanomkitti, Kanchalit; Lektrakul, Nittaya; Manuskiatti, Woraphong

    2015-01-01

    Cellulite is a frequent skin condition for which treatment remains a challenge. A wide variety of treatments are available but most procedures offer suboptimal clinical effect and/or delayed therapeutic outcome. Only few therapeutic options have proven efficacy in the treatment of cellulite. To determine the efficacy and the safety profiles of radiofrequency and dynamic muscle activation technology in treatment of abdominal cellulite and circumference reduction. Twenty-five females with abdominal cellulite received 6 weekly radiofrequency and dynamic muscle activation treatments. Treatment areas included the abdomen and both sides of flanks. Subjects were evaluated using standardized photographs, and measurements of body weight and abdominal circumference at baseline, before every treatment visit, and 1 week and four weeks after the final treatment. Subcutaneous tissue thickness was recorded by ultrasound at baseline and 4 weeks after completion of treatment protocol. Physicians' evaluation and patient's satisfaction of clinical improvement were also measured. All subjects completed the treatment protocol and attended every follow-up visits. There was significant abdominal circumference reduction of 2.96 and 2.52 cm at 1-, and 4-week follow-up visits (p last treatment, the average circumferential reduction was sustained. Most of the patients were rated to have 25-49% improvement at 5th treatment, and 1- and 4-week follow-up visits. Ninety-two percent of the patients were satisfied with the treatment outcome. Radiofrequency provided beneficial effects on the reduction of abdomen and cellulite appearance. The benefit of muscle activation is yet to be determined.

  3. The Dynamic Locking Blade Plate : innovation in the treatment of femoral neck fractures

    NARCIS (Netherlands)

    Roerdink, W.H.

    2011-01-01

    The scope of this thesis was to describe the design and development of the Dynamic Locking Blade Plate (DLBP), an improved internal fixation (IF) device for intracapsular hip fractures. This thesis focuses on intracapsular hip fractures since the results of current surgical treatment of this type of

  4. TREATMENT OF NONADIABATIC TRANSITIONS BY DENSITY-MATRIX EVOLUTION AND MOLECULAR-DYNAMICS SIMULATIONS

    NARCIS (Netherlands)

    MAVRI, J; BERENDSEN, HJC

    1994-01-01

    A density matrix evolution (DME) method (H.J.C. Berendsen and J. Mavri, J. Phys. Chem., 97 (1993) 13469) to simulate the dynamics of quantum systems embedded in a classical environment is presented. The DME method allows treatment of nonadiabatic transitions. As numerical examples the collinear

  5. [Adaptogenic potentialities of dynamic magnetotherapy in the treatment and prevention of ENT pathology in ailing children].

    Science.gov (United States)

    Bolotova, N V; Grinkevich, A V; Grishchenko, T P; Raĭgorodskiĭ, Iu M; Tupkin, V D

    2007-01-01

    Efficacy of dynamic magnetotherapy (in transcranial and adrenal variants) for treatment of ENT pathology and prevention of its exacerbations is demonstrated in 126 ailing children. Mechanism of action of this magnetotherapy is due to formation of adequate adaptation reactions raising resistance to pathogens.

  6. Effects of Antiparasitic Treatment on Dynamically and Statically Tested Cognitive Skills over Time

    Science.gov (United States)

    Grigorenko, Elena L.; Sternberg, Robert J.; Jukes, Mathew; Alcock, Katie; Lambo, Jane; Ngorosho, Damaris; Nokes, Catherine; Bundy, Donald A.

    2006-01-01

    The main objective of this work was to investigate two testing procedures, repeated static tests and dynamic testing, that can more clearly demonstrate the impact of treatment for parasites in children. Rural Tanzanian children were assessed for the presence/absence and burden of helminth parasites and assigned to one of three…

  7. Electric Characteristic Enhancement of an AZO/Si Schottky Barrier Diode with Hydrogen Plasma Surface Treatment and AlxOx Guard Ring Structure

    Directory of Open Access Journals (Sweden)

    Chien-Yu Li

    2018-01-01

    Full Text Available In this study, the design and fabrication of AZO/n-Si Schottky barrier diodes (SBDs with hydrogen plasma treatment on silicon surface and AlxOx guard ring were presented. The Si surface exhibited less interface defects after the cleaning process following with 30 w of H2 plasma treatment that improved the switching properties of the following formed SBDs. The rapid thermal annealing experiment also held at 400 °C to enhance the breakdown voltage of SBDs. The edge effect of the SBDs was also suppressed with the AlxOx guard ring structure deposited by the atomic layer deposition (ALD at the side of the SBDs. Experimental results show that the reverse leakage current was reduced and the breakdown voltage increased with an addition of the AlxOx guard ring. The diode and fabrication technology developed in the study were applicable to the realization of SBDs with a high breakdown voltage (>200 V, a low reverse leakage current density (≤72 μA/mm2@100 V, and a Schottky barrier height of 1.074 eV.

  8. Electric Characteristic Enhancement of an AZO/Si Schottky Barrier Diode with Hydrogen Plasma Surface Treatment and AlxOx Guard Ring Structure

    Science.gov (United States)

    Li, Chien-Yu; Cheng, Min-Yu; Houng, Mau-Phon; Yang, Cheng-Fu; Liu, Jing

    2018-01-01

    In this study, the design and fabrication of AZO/n-Si Schottky barrier diodes (SBDs) with hydrogen plasma treatment on silicon surface and AlxOx guard ring were presented. The Si surface exhibited less interface defects after the cleaning process following with 30 w of H2 plasma treatment that improved the switching properties of the following formed SBDs. The rapid thermal annealing experiment also held at 400 °C to enhance the breakdown voltage of SBDs. The edge effect of the SBDs was also suppressed with the AlxOx guard ring structure deposited by the atomic layer deposition (ALD) at the side of the SBDs. Experimental results show that the reverse leakage current was reduced and the breakdown voltage increased with an addition of the AlxOx guard ring. The diode and fabrication technology developed in the study were applicable to the realization of SBDs with a high breakdown voltage (>200 V), a low reverse leakage current density (≤72 μA/mm2@100 V), and a Schottky barrier height of 1.074 eV. PMID:29316726

  9. Barriers to successful treatment of alcohol addiction as perceived by healthcare professionals in Thailand – a Delphi study about obstacles and improvement suggestions

    Directory of Open Access Journals (Sweden)

    Kulnaree Hanpatchaiyakul

    2016-08-01

    Full Text Available Background: Many Thai people experiencing alcohol addiction do not seek help, and those who do often have inadequate access to treatment. There are few research studies focusing on alcohol addiction treatment in Thailand. Objective: The purpose of the current study was to identify barriers to the treatment of alcohol addiction and to collect experts’ suggestions for improving treatment in Thailand. The Delphi technique was used to achieve consensual agreement among an expert panel within the field of alcohol addiction and treatment. Design: Three rounds of a Delphi survey were completed by a panel of experts in alcohol addiction, including physicians, nurses, social workers, psychologists, healthcare officers, and an Alcoholics Anonymous member. The open-ended answers provided by 34 experts in the first round resulted in 60 statements, which were later grouped into three themes. After three rounds of questionnaires, 51 statements were accepted as consensus. Results: Thirty-two experts participated in all three Delphi rounds. Over 80% of participants were particularly concerned about five obstacles to alcohol addiction treatment. The majority of suggestions from the expert panel were related to patients’ right to treatment and the national policy for reducing the negative effects of alcohol. According to the results of the present study, the experts suggested that the treatment of alcohol addiction should be continuous from primary care to tertiary care, and convenient pathways should be established in healthcare services. The experts would also like to increase the number of healthcare providers and improve their knowledge and skills in working with people experiencing alcohol addiction. Conclusions: Equal rights to health and treatment for people experiencing alcohol addiction in Thailand require policy improvements, as well as acceptance and awareness of alcohol addiction from both the public and policymakers.

  10. Fixed and dynamic predictors of treatment process in therapeutic communities for substance abusers in Belgium.

    Science.gov (United States)

    Goethals, Ilse; Vanderplasschen, Wouter; Vandevelde, Stijn; Broekaert, Eric

    2012-10-11

    Research on substance abuse treatment services in general reflects substantial attention to the notion of treatment process. Despite the growing popularity of process studies, only a few researchers have used instruments specifically tailored to measure the therapeutic community (TC) treatment process, and even fewer have investigated client attributes in relation to early TC treatment process experiences. The aim of the current study is to address this gap by exploring clients' early in-treatment experiences and to determine the predictors that are related to the treatment process, using a TC-specific multidimensional instrument. Data was gathered among 157 adults in five TCs in Flanders (Belgium). Descriptive statistics were used to explore clients' early in-treatment experiences and multiple linear regressions were conducted to determine the fixed and dynamic predictors of Community Environment and Personal Development and Change (two indicators of TC treatment process). Clients reveal a more positive first-month response to TC social processes than to personal-development processes that require self-reflection and insight. The variance in clients' ratings of Community Environment was primarily due to dynamic client factors, while the variance in clients' ratings of Personal Development and Change was only related to fixed client factors. Suitability for treatment was the strongest predictor of Community Environment ratings, whereas a judicial referral more strongly predicted Personal Development and Change scores. Special attention should be devoted to suitability for treatment as part of motivational assessment as this seems to be a very strong predictor of how clients react to the initiation stage of TC treatment. To help improve clients' (meta-)cognitive skills needed to achieve insight and self-reflection and perhaps speed up the process of recovery, the authors suggest the introduction of (meta-)cognitive training strategies in the pre-program and/or the

  11. The Blood-Brain Barrier: An Engineering Perspective

    Directory of Open Access Journals (Sweden)

    Andrew eWong

    2013-08-01

    Full Text Available It has been more than 100 years since Paul Ehrlich reported that various water-soluble dyes injected into the circulation did not enter the brain. Since Ehrlich’s first experiments, only a small number of molecules, such as alcohol and caffeine have been found to cross the blood-brain barrier, and it remains the major roadblock to treatment of many central nervous system diseases. At the same time, many central nervous system diseases are associated with disruption of the blood-brain barrier that can lead to changes in permeability, modulation of immune cell transport, and trafficking of pathogens into the brain. Therefore advances in our understanding of the structure and function of the blood-brain barrier are key to advances in treatment of a wide range of central nervous system diseases. Over the past 10 years it has become recognized that the blood-brain barrier is a complex dynamic system that involves biomechanical and biochemical signaling between the vascular system and the brain. Here we reconstruct the structure, function, and transport properties of the blood-brain barrier from an engineering perspective. New insight into the physics of the blood-brain barrier could ultimately lead to clinical advances in the treatment of central nervous system diseases.

  12. Evaluating the effect of smoking cessation treatment on a complex dynamical system.

    Science.gov (United States)

    Bekiroglu, Korkut; Russell, Michael A; Lagoa, Constantino M; Lanza, Stephanie T; Piper, Megan E

    2017-11-01

    To understand the dynamic relations among tobacco withdrawal symptoms to inform the development of effective smoking cessation treatments. Dynamical system models from control engineering are introduced and utilized to evaluate complex treatment effects. We demonstrate how dynamical models can be used to examine how distinct withdrawal-related processes are related over time and how treatment influences these relations. Intensive longitudinal data from a randomized placebo-controlled smoking cessation trial (N=1504) are used to estimate a dynamical model of withdrawal-related processes including momentary craving, negative affect, quitting self-efficacy, and cessation fatigue for each of six treatment conditions (nicotine patch, nicotine lozenge, bupropion, patch + lozenge, bupropion + lozenge, and placebo). Estimation and simulation results show that (1) withdrawal measurements are interrelated over time, (2) nicotine patch + nicotine lozenge showed reduced cessation fatigue and enhanced self-efficacy in the long-term while bupropion + nicotine lozenge was more effective at reducing negative affect and craving, and (3) although nicotine patch + nicotine lozenge had a better initial effect on cessation fatigue and self-efficacy, nicotine lozenge had a stronger effect on negative affect and nicotine patch had a stronger impact on craving. This approach can be used to provide new evidence illustrating (a) the total impact of treatment conditions (via steady state values) and (b) the total initial impact (via rate of initial change values) on smoking-related outcomes for separate treatment conditions, noting that the conditions that produce the largest change may be different than the conditions that produce the fastest change. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Focused Ultrasound-Induced Blood-Brain Barrier Opening: Association with Mechanical Index and Cavitation Index Analyzed by Dynamic Contrast-Enhanced Magnetic-Resonance Imaging.

    Science.gov (United States)

    Chu, Po-Chun; Chai, Wen-Yen; Tsai, Chih-Hung; Kang, Shih-Tsung; Yeh, Chih-Kuang; Liu, Hao-Li

    2016-09-15

    Focused ultrasound (FUS) with microbubbles can temporally open the blood-brain barrier (BBB), and the cavitation activities of microbubbles play a key role in the BBB-opening process. Previous attempts used contrast-enhanced magnetic resonance imaging (CE-MRI) to correlate the mechanical index (MI) with the scale of BBB-opening, but MI only partially gauged acoustic activities, and CE-MRI did not fully explore correlations of pharmacodynamic/pharmacokinetic behaviors. Recently, the cavitation index (CI) has been derived to serve as an indicator of microbubble-ultrasound stable cavitation, and may also serve as a valid indicator to gauge the level of FUS-induced BBB opening. This study investigates the feasibility of gauging FUS-induced BBB opened level via the two indexes, MI and CI, through dynamic contrast-enhanced (DCE)-MRI analysis as well as passive cavitation detection (PCD) analysis. Pharmacodynamic/pharmacokinetic parameters derived from DCE-MRI were characterized to identify the scale of FUS-induced BBB opening. Our results demonstrated that DCE-MRI can successfully access pharmacodynamic/pharmacokinetic BBB-opened behavior, and was highly correlated both with MI and CI, implying the feasibility in using these two indices to gauge the scale of FUS-induced BBB opening. The proposed finding may facilitate the design toward using focused ultrasound as a safe and reliable noninvasive CNS drug delivery.

  14. Barriers to initiation of antiretroviral treatment in rural and urban areas of Zambia: a cross-sectional study of cost, stigma, and perceptions about ART.

    Science.gov (United States)

    Fox, Matthew P; Mazimba, Arthur; Seidenberg, Phil; Crooks, Denise; Sikateyo, Bornwell; Rosen, Sydney

    2010-03-06

    While the number of HIV-positive patients on antiretroviral therapy (ART) in resource-limited settings has increased dramatically, some patients eligible for treatment do not initiate ART even when it is available to them. Understanding why patients opt out of care, or are unable to opt in, is important to achieving the goal of universal access. We conducted a cross-sectional survey among 400 patients on ART (those who were able to access care) and 400 patients accessing home-based care (HBC), but who had not initiated ART (either they were not able to, or chose not to, access care) in two rural and two urban sites in Zambia to identify barriers to and facilitators of ART uptake. HBC patients were 50% more likely to report that it would be very difficult to get to the ART clinic than those on ART (RR: 1.48; 95% CI: 1.21-1.82). Stigma was common in all areas, with 54% of HBC patients, but only 15% of ART patients, being afraid to go to the clinic (RR: 3.61; 95% CI: 3.12-4.18). Cost barriers differed by location: urban HBC patients were three times more likely to report needing to pay to travel to the clinic than those on ART (RR: 2.84; 95% CI: 2.02-3.98) and 10 times more likely to believe they would need to pay a fee at the clinic (RR: 9.50; 95% CI: 2.24-40.3). In rural areas, HBC subjects were more likely to report needing to pay non-transport costs to attend the clinic than those on ART (RR: 4.52; 95% CI: 1.91-10.7). HBC patients were twice as likely as ART patients to report not having enough food to take ART being a concern (27% vs. 13%, RR: 2.03; 95% CI: 1.71-2.41), regardless of location and gender. Patients in home-based care for HIV/AIDS who never initiated ART perceived greater financial and logistical barriers to seeking HIV care and had more negative perceptions about the benefits of the treatment. Future efforts to expand access to antiretroviral care should consider ways to reduce these barriers in order to encourage more of those medically eligible

  15. Dynamics of HPV viral loads reflect the treatment effect of photodynamic therapy in genital warts.

    Science.gov (United States)

    Hu, Zhili; Liu, Lishi; Zhang, Wenjing; Liu, Hui; Li, Junpeng; Jiang, Lifen; Zeng, Kang

    2018-03-01

    Photodynamic therapy (PDT) has demonstrated good clinical cure rates and low recurrence rates in the treatment of genital warts. Human papillomavirus (HPV) genotypes and viral load assays can reflect the status of persistent or latent infection and serve as a predictor of infection clearance. Specimens from 41 patients with HPV infection were obtained, and the HPV genotypes and viral load were analyzed using real-time polymerase chain reaction (PCR) assays. Traditional treatment, such as radiofrequency, microwave, or surgical therapy, was used to remove the visible lesions, and then PDT treatment was performed every week. HPV DNA testing was performed at every patient visit and the frequency of PDT treatment was determined by changes in HPV viral loads. HPV viral loads decreased significantly after PDT treatment. There were significant differences in HPV viral loads between pretherapy and three or six rounds of PDT treatment. Significant differences were also observed between single and multiple type HPV infection after six rounds of PDT treatment. Patients with single type HPV infection had significantly higher rates of negative HPV DNA test results, as compared with patients with multiple infections after six rounds of PDT treatment; however, there was no difference in recurrence rates between the two groups. Dynamic monitoring of HPV genotypes and viral loads can be used to guide PDT treatment and indicate PDT treatment efficacy in eliminating HPV. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. A novel method for prediction of dynamic smiling expressions after orthodontic treatment: a case report.

    Science.gov (United States)

    Dai, Fanfan; Li, Yangjing; Chen, Gui; Chen, Si; Xu, Tianmin

    2016-02-01

    Smile esthetics has become increasingly important for orthodontic patients, thus prediction of post-treatment smile is necessary for a perfect treatment plan. In this study, with a combination of three-dimensional craniofacial data from the cone beam computed tomography and color-encoded structured light system, a novel method for smile prediction was proposed based on facial expression transfer, in which dynamic facial expression was interpreted as a matrix of facial depth changes. Data extracted from the pre-treatment smile expression record were applied to the post-treatment static model to realize expression transfer. Therefore smile esthetics of the patient after treatment could be evaluated in pre-treatment planning procedure. The positive and negative mean values of error for prediction accuracy were 0.9 and - 1.1 mm respectively, with the standard deviation of ± 1.5 mm, which is clinically acceptable. Further studies would be conducted to reduce the prediction error from both the static and dynamic sides as well as to explore automatically combined prediction from the two sides.

  17. Interest of Supportive and Barrier Protective Skin Care Products in the Daily Prevention and Treatment of Cutaneous Toxicity During Radiotherapy for Breast Cancer.

    Science.gov (United States)

    Berger, Antoine; Regueiro, Carlos; Hijal, Tarek; Pasquier, David; De La Fuente, Cristina; Le Tinier, Florence; Coche-Dequeant, Bernard; Lartigau, Eric; Moyal, Dominique; Seité, Sophie; Bensadoun, René-Jean

    2018-01-01

    As many as 50% of patients with cancer develop acute skin reactions to some degree with radiotherapy. Proactive skin care is often recommended to minimise these skin reactions and maintain the integrity of the epidermal barrier; nevertheless, no consensual guidelines are systematically used. This multicentre, observational, prospective study evaluated the tolerability and benefit of supportive and barrier protective skin care products in preventing radiotherapy-induced skin reactions in 253 women initiating radiotherapy (exclusive or adjuvant) for breast cancer. Patients received a kit of 5 commercially available skin care products before the first radiotherapy treatment. The following variables were assessed: cutaneous adverse events, investigator-assessed skin reactions (oedema, erythema, dryness, desquamation) before and after radiotherapy course, investigator, and patient opinion on products benefit. Results were analysed by frequency of product use (heavy versus low). Average age was 60 years (range: 34-85). Over 92% of patients reported good to excellent tolerance on irradiated skin for each product. During the 6-week radiotherapy period, we observed that heavy product users had less skin reactions than the low users, particularly within 10 days of radiotherapy initiation (8% versus 18%; p  = .031). Positive physician's opinion on product use was more frequent for high (66.6%) versus low (32%) users. Patient-assessed patient benefit index was generally >1, indicating relevant treatment benefit, with a tendency for better benefit in high versus low users. These results support recommendations to use skin care products to minimise the impact of secondary cutaneous reactions with radiotherapy cancer treatment.

  18. Interest of Supportive and Barrier Protective Skin Care Products in the Daily Prevention and Treatment of Cutaneous Toxicity During Radiotherapy for Breast Cancer

    Directory of Open Access Journals (Sweden)

    Antoine Berger

    2018-01-01

    Full Text Available Purpose: As many as 50% of patients with cancer develop acute skin reactions to some degree with radiotherapy. Proactive skin care is often recommended to minimise these skin reactions and maintain the integrity of the epidermal barrier; nevertheless, no consensual guidelines are systematically used. This multicentre, observational, prospective study evaluated the tolerability and benefit of supportive and barrier protective skin care products in preventing radiotherapy-induced skin reactions in 253 women initiating radiotherapy (exclusive or adjuvant for breast cancer. Methods: Patients received a kit of 5 commercially available skin care products before the first radiotherapy treatment. The following variables were assessed: cutaneous adverse events, investigator-assessed skin reactions (oedema, erythema, dryness, desquamation before and after radiotherapy course, investigator, and patient opinion on products benefit. Results were analysed by frequency of product use (heavy versus low. Results: Average age was 60 years (range: 34-85. Over 92% of patients reported good to excellent tolerance on irradiated skin for each product. During the 6-week radiotherapy period, we observed that heavy product users had less skin reactions than the low users, particularly within 10 days of radiotherapy initiation (8% versus 18%; p  = .031. Positive physician’s opinion on product use was more frequent for high (66.6% versus low (32% users. Patient-assessed patient benefit index was generally >1, indicating relevant treatment benefit, with a tendency for better benefit in high versus low users. Conclusions: These results support recommendations to use skin care products to minimise the impact of secondary cutaneous reactions with radiotherapy cancer treatment.

  19. DC-pulse atmospheric-pressure plasma jet and dielectric barrier discharge surface treatments on fluorine-doped tin oxide for perovskite solar cell application

    Science.gov (United States)

    Tsai, Jui-Hsuan; Cheng, I.-Chun; Hsu, Cheng-Che; Chen, Jian-Zhang

    2018-01-01

    Nitrogen DC-pulse atmospheric-pressure plasma jet (APPJ) and nitrogen dielectric barrier discharge (DBD) were applied to pre-treat fluorine-doped tin oxide (FTO) glass substrates for perovskite solar cells (PSCs). Nitrogen DC-pulse APPJ treatment (substrate temperature: ~400 °C) for 10 s can effectively increase the wettability, whereas nitrogen DBD treatment (maximum substrate temperature: ~140 °C) achieved limited improvement in wettability even with increased treatment time of 60 s. XPS results indicate that 10 s APPJ, 60 s DBD, and 15 min UV-ozone treatment of FTO glass substrates can decontaminate the surface. A PSC fabricated on APPJ-treated FTO showed the highest power conversion efficiency (PCE) of 14.90%; by contrast, a PSC with nitrogen DBD-treated FTO shows slightly lower PCE of 12.57% which was comparable to that of a PSC on FTO treated by a 15 min UV-ozone process. Both nitrogen DC-pulse APPJ and nitrogen DBD can decontaminate FTO substrates and can be applied for the substrate cleaning step of PSC.

  20. Physical illness in patients with severe mental disorders. II. Barriers to care, monitoring and treatment guidelines, plus recommendations at the system and individual level

    Science.gov (United States)

    DE HERT, MARC; COHEN, DAN; BOBES, JULIO; CETKOVICH-BAKMAS, MARCELO; LEUCHT, STEFAN; M. NDETEI, DAVID; W. NEWCOMER, JOHN; UWAKWE, RICHARD; ASAI, ITSUO; MÖLLER, HANS-JURGEN; GAUTAM, SHIV; DETRAUX, JOHAN; U. CORRELL, CHRISTOPH

    2011-01-01

    Physical disorders are, compared to the general population, more prevalent in people with severe mental illness (SMI). Although this excess morbidity and mortality is largely due to modifiable lifestyle risk factors, the screening and assessment of physical health aspects remains poor, even in developed countries. Moreover, specific patient, provider, treatment and system factors act as barriers to the recognition and to the management of physical diseases in people with SMI. Psychiatrists can play a pivotal role in the improvement of the physical health of these patients by expanding their task from clinical psychiatric care to the monitoring and treatment of crucial physical parameters. At a system level, actions are not easy to realize, especially for developing countries. However, at an individual level, even simple and very basic monitoring and treatment actions, undertaken by the treating clinician, can already improve the problem of suboptimal medical care in this population. Adhering to monitoring and treatment guidelines will result in a substantial enhancement of physical health outcomes. Furthermore, psychiatrists can help educate and motivate people with SMI to address their suboptimal lifestyle, including smoking, unhealthy diet and lack of exercise. The adoption of the recommendations presented in this paper across health care systems throughout the world will contribute to a significant improvement in the medical and related psychiatric health outcomes of patients with SMI. PMID:21633691

  1. Design of Thermochromic Polynorbornene Bearing Spiropyran Chromophore Moieties: Synthesis, Thermal Behavior and Dielectric Barrier Discharge Plasma Treatment

    Directory of Open Access Journals (Sweden)

    Saleh A. Ahmed

    2017-11-01

    Full Text Available A new class of thermochromic polynorbornene with pendent spiropyran moieties has been synthesized. Functionalization of norbornene monomers with spirobenzopyran moieties has been achieved using Steglich esterification. These new monomeric materials were polymerized via Ring Opening Metathesis Polymerization (ROMP. In spite of their poor solubility, polynorbornenes with spirobenzopyran exhibited thermochromic behavior due to the conversion of their closed spiropyran moieties to the open merocyanine form. Moreover, these polymers displayed bathochromic shifts in their optical response, which was attributed to the J-aggregation of the attached merocyanine moieties that were associated with their high concentration in the polymeric chain. The surface of the obtained polymers was exposed to atmospheric pressure air Dielectric Barrier Discharge (DBD plasma system, which resulted in the reduction of the surface porosity and converted some surface area into completely non-porous regions. Moreover, the plasma system created some areas with highly ordered J-aggregates of the merocyanine form in thread-like structures. This modification of the polymers’ morphology may alter their applications and allow for these materials to be potential candidates for new applications, such as non-porous membranes for reverse osmosis, nanofiltration, or molecular separation in the gas phase.

  2. Effect of thermal treatment on the characteristics of iridium Schottky barrier diodes on n-Ge (1 0 0)

    International Nuclear Information System (INIS)

    Chawanda, A.; Coelho, S.M.M.; Auret, F.D.; Mtangi, W.; Nyamhere, C.; Nel, J.M.; Diale, M.

    2012-01-01

    Highlights: ► Ir/n-Ge (1 0 0) Schottky diodes were characterized using I–V, C–V and SEM techniques under various annealing conditions. ► The variation of the electrical and structural properties can be due to effects phase transformation during annealing. ► Thermal stability of these diodes is maintained up to 500 °C anneal. ► SEM results depicts that the onset temperature for agglomeration in 20 nm Ir/n-Ge (1 0 0) system occurs between 600 and 700 °C. - Abstract: Iridium (Ir) Schottky barrier diodes were deposited on bulk grown (1 0 0) Sb-doped n-type germanium by using the electron beam deposition system. Electrical characterization of these contacts using current–voltage (I–V) and capacitance–voltage (C–V) measurements was performed under various annealing conditions. The variation of the electrical properties of these Schottky diodes can be attributed to combined effects of interfacial reaction and phase transformation during the annealing process. Thermal stability of the Ir/n-Ge (1 0 0) was observed up to annealing temperature of 500 °C. Furthermore, structural characterization of these samples was performed by using a scanning electron microscopy (SEM) at different annealing temperatures. Results have also revealed that the onset temperature for agglomeration in a 20 nm Ir/n-Ge (1 0 0) system occurs between 600 and 700 °C.

  3. Experimental Methods and Transport Models for Drug Delivery across the Blood-Brain Barrier

    OpenAIRE

    Fu, Bingmei M

    2012-01-01

    The blood-brain barrier (BBB) is a dynamic barrier essential for maintaining the micro-environment of the brain. Although the special anatomical features of the BBB determine its protective role for the central nervous system (CNS) from blood-born neurotoxins, however, the BBB extremely limits the therapeutic efficacy of drugs into the CNS, which greatly hinders the treatment of major brain diseases. This review summarized the unique structures of the BBB, described a variety of in vivo and i...

  4. Evaluation of Lambda-Cyhalothrin and Pyriproxyfen Barrier Treatments for Aedes albopictus (Diptera: Culicidae) Management in Urbanized Areas of New Jersey.

    Science.gov (United States)

    Unlu, Isik; Williams, Gregory M; Rochlin, Ilia; Suman, Devi; Wang, Yi; Chandel, Kshitij; Gaugler, Randy

    2018-02-28

    Mosquito control programs in the United States are still searching for best management practices to control the Asian tiger mosquito, Aedes albopictus (Skuse; Diptera: Culicidae). Most intervention methods for this species are either labor intensive (e.g., source reduction) or short-term (e.g., ultra-low-volume adulticiding). We investigated the effectiveness of barrier spray pesticide applications within urban and suburban residential yards in New Jersey as a control strategy using a before-after-control-impact (BACI) approach. Applications of Demand CSR pyrethroid (9.7% AI lambda-cyhalothrin) only or combined Demand CSR and Archer IGR insect growth regulator (1.3% AI pyriproxyfen) applications resulted in significant and similar decreases in adult mosquito abundance post-treatment ranging from 78 to 74% respectively, compared with the untreated control. Both insecticides exceeded the 70% reduction threshold considered as effective for Ae. albopictus control for 2 to 4 wk. However, applications of Archer IGR alone did not reduce adult mosquito abundance. The field study results were supported by laboratory no-choice bioassays using treated leaf foliage. Our study is the first data driven evidence of the residual efficacy of barrier pesticide applications in New Jersey with lambda-cyhalothrin that provided significant reductions in adult Ae. albopictus populations for an extended duration.

  5. Converse Theorems for Safety and Barrier Certificates

    OpenAIRE

    Ratschan, Stefan

    2017-01-01

    An important tool for proving safety of dynamical systems is the notion of a barrier certificate. In this paper we prove that every robustly safe ordinary differential equation has a barrier certificate. Moreover, we show a construction of such a barrier certificate based on a set of states that is reachable in finite time.

  6. Experimental Study on Vacuum Dynamic Consolidation Treatment of Soft Soil Foundation

    Science.gov (United States)

    Fu-lai, Ni; Xin, Wen; Xiao-bin, Zhang; Wei, Li

    2017-11-01

    In view of the deficiency of the saturated silt clay foundation reinforced by the dynamic consolidation method, combination the project of soft foundation treatment test area in Tangshan, the reaserch analysed indexes, included groundwater level, pore water pressure, settlement about soil layer and so on, by use of field tests and indoor geotechnical tests, The results showed that the whole reinforcement effect with vacuum dynamic compaction method to blow fill foundation is obvious, due to the result of vacuum precipitation, generally, the excess pore water pressure can be dissipated by 90% above in 2 days around and the effective compaction coefficient can reached more than 0.9,the research work in soft foundation treatment engineering provide a new method and thought to similar engineering.

  7. Finding the loopholes: a cross-sectional qualitative study of systemic barriers to treatment access for women drug court participants.

    Science.gov (United States)

    Morse, Diane S; Silverstein, Jennifer; Thomas, Katherine; Bedel, Precious; Cerulli, Catherine

    2015-12-01

    Therapeutic diversion courts seek to address justice-involved participants' underlying problems leading to their legal system involvement, including substance use disorder, psychiatric illness, and intimate partner violence. The courts have not addressed systemic hurdles, which can contribute to a cycle of substance use disorder and recidivism, which in turn hinder health and wellness. The study purpose is to explore the systemic issues faced by women participants in drug treatment court from multiple perspectives to understand how these issues may relate to health and wellness in their lives. Qualitative thematic framework analysis of five separate focus groups consisting of female drug treatment court participants, community providers, and court staff ( n = 25). Themes were mapped across the socio-ecological framework and contextualized according to social determinants of health. Numerous systemic factors impacted women's access to treatment. Laws and legal policies (governance) excluded those who could potentially have benefitted from therapeutic court and did not allow consideration of parenting issues. Macroeconomic policies limit housing options for those with convictions. Social policies limited transportation, education, and employment options. Public policies limited healthcare and social protection and ability to access available resources. Culture and societal values, including stigma, limited treatment options. By understanding the social determinant of health for women in drug treatment court and stakeholder's perceptions, the legal system can implement public policy to better address the health needs of women drug court participants.

  8. DYNAMICS OF THE FUNCTIONAL STATUS OF PATIENTS IN THE TREATMENT OF CLAVICLE FRACTURES BY TRANSOSSEOUS OSTEOSYNTHESIS

    Directory of Open Access Journals (Sweden)

    V. A. Shchurov

    2013-01-01

    Full Text Available Purpose - assessment of the dynamics of the state, blood supply regenerate bone, muscle contractility of the arm and forearm in patients with clavicle fractures during the treatment with external fixation device. Material and methods. Authors studied 38 patients during the treatment by Ilizarov method. The muscle dynamometry, Doppler ultrasound, psychophysiological study using SF-36 test were performed. Results. The strength of the humeral and forearm muscles on the side of damage was reduced and increased by 50-80% of the conditional baseline during transosseous fixation. The high rate of blood flow in the area of injury was characteristic during the first week in the fixation period. In the process of the treatment and recovery of muscle contractility its value normalized. The treatment of clavicle fractures by Ilizarov method allows in the early period of fixation to restore the ability of patients to self-service, to reduce the influence of pain limiting factor, improves mood and health of patients.

  9. Dynamic re-immunization of off-treatment childhood cancer survivors: An implementation feasibility study.

    Directory of Open Access Journals (Sweden)

    Jennifer H Han

    Full Text Available There are no universally approved re-vaccination guidelines for non-transplant pediatric cancer survivors. We hypothesized that by utilizing a response-based re-vaccination schedule, we could tailor vaccine schedules in off-treatment cancer survivors. Pre-vaccination antibody levels were obtained in 7 patients at an average of 20 days after the end of treatment date. In those without protective antibody levels, we administered vaccines 3 months after completion of treatment. Revaccinating patients 3 months after the end of treatment date resulted in protective antibody levels for most vaccines. We showed, on a preliminary basis, that vaccinating non-transplanted pediatric cancer survivors can be dynamically implemented in children with recovering immune function.

  10. Dynamics of pollution-indicator and heterotrophic bacteria in sewage treatment lagoons.

    OpenAIRE

    Legendre, P; Baleux, B; Troussellier, M

    1984-01-01

    The spatio-temporal dynamics of pollution-indicator bacteria and aerobic heterotrophic bacteria were studied in the sewage treatment lagoons of an urban wastewater center after 26 months of biweekly sampling at eight stations in these lagoons. Robust statistical methods of time-series analysis were used to study successional steps (through chronological clustering) and rhythmic behavior through time (through contingency periodogram). The aerobic heterotrophic bacterial community showed two ty...

  11. Complex dynamics of an SEIR epidemic model with saturated incidence rate and treatment

    Science.gov (United States)

    Khan, Muhammad Altaf; Khan, Yasir; Islam, Saeed

    2018-03-01

    In this paper, we describe the dynamics of an SEIR epidemic model with saturated incidence, treatment function, and optimal control. Rigorous mathematical results have been established for the model. The stability analysis of the model is investigated and found that the model is locally asymptotically stable when R0 1. The proposed model may possess a backward bifurcation. The optimal control problem is designed and obtained their necessary results. Numerical results have been presented for justification of theoretical results.

  12. A dynamic model for infectious diseases: The role of vaccination and treatment

    International Nuclear Information System (INIS)

    Raja Sekhara Rao, P.; Naresh Kumar, M.

    2015-01-01

    Understanding dynamics of an infectious disease helps in designing appropriate strategies for containing its spread in a population. Recent mathematical models are aimed at studying dynamics of some specific types of infectious diseases. In this paper we propose a new model for infectious diseases spread having susceptible, infected, and recovered populations and study its dynamics in presence of incubation delays and relapse of the disease. The influence of treatment and vaccination efforts on the spread of infection in presence of time delays are studied. Sufficient conditions for local stability of the equilibria and change of stability are derived in various cases. The problem of global stability is studied for an important special case of the model. Simulations carried out in this study brought out the importance of treatment rate in controlling the disease spread. It is observed that incubation delays have influence on the system even under enhanced vaccination. The present study has clearly brought out the fact that treatment rate even in presence of time delays would contain the disease as compared to popular belief that eradication can only be done through vaccination

  13. Effect of thermal treatment on the characteristics of iridium Schottky barrier diodes on n-Ge (1 0 0)

    Energy Technology Data Exchange (ETDEWEB)

    Chawanda, A., E-mail: albert.chawanda@up.ac.za [Department of Physics, University of Pretoria, 0002 (South Africa); Department of Physics, Midlands State University, Bag 9055, Gweru (Zimbabwe); Coelho, S.M.M.; Auret, F.D.; Mtangi, W. [Department of Physics, University of Pretoria, 0002 (South Africa); Nyamhere, C. [Department of Physics, Nelson Mandela Metropolitan University, Box 77000, Port Elizabeth 6031 (South Africa); Nel, J.M.; Diale, M. [Department of Physics, University of Pretoria, 0002 (South Africa)

    2012-02-05

    Highlights: Black-Right-Pointing-Pointer Ir/n-Ge (1 0 0) Schottky diodes were characterized using I-V, C-V and SEM techniques under various annealing conditions. Black-Right-Pointing-Pointer The variation of the electrical and structural properties can be due to effects phase transformation during annealing. Black-Right-Pointing-Pointer Thermal stability of these diodes is maintained up to 500 Degree-Sign C anneal. Black-Right-Pointing-Pointer SEM results depicts that the onset temperature for agglomeration in 20 nm Ir/n-Ge (1 0 0) system occurs between 600 and 700 Degree-Sign C. - Abstract: Iridium (Ir) Schottky barrier diodes were deposited on bulk grown (1 0 0) Sb-doped n-type germanium by using the electron beam deposition system. Electrical characterization of these contacts using current-voltage (I-V) and capacitance-voltage (C-V) measurements was performed under various annealing conditions. The variation of the electrical properties of these Schottky diodes can be attributed to combined effects of interfacial reaction and phase transformation during the annealing process. Thermal stability of the Ir/n-Ge (1 0 0) was observed up to annealing temperature of 500 Degree-Sign C. Furthermore, structural characterization of these samples was performed by using a scanning electron microscopy (SEM) at different annealing temperatures. Results have also revealed that the onset temperature for agglomeration in a 20 nm Ir/n-Ge (1 0 0) system occurs between 600 and 700 Degree-Sign C.

  14. A new treatment of the heat transport equation with a transport barrier and applications to ECRH experiments in Tore Supra

    Energy Technology Data Exchange (ETDEWEB)

    Zou, X.L.; Giruzzi, A.G.; Bouquey, F.; Clary, J.; Darbos, C.; Lennholm, M.; Magne, R.; Segui, J.L. [CEA Cadarache, Dept. de Recherches sur la Fusion Controlee, 13 - Saint-Paul-lez-Durance (France); Clemencon, A. [MIT, Electrochemical Energy Laboratory, Cambridge, MA (United States); Guivarch, C. [Ecole Nationale des Ponts et Chaussees, 77 - Marne-la-Vallee (France)

    2004-07-01

    An exact analytical solution of the electron heat diffusion equation in a cylinder has been found with a step-like diffusion coefficient, plus a monomial increase in the radial direction and a constant damping term. This model is sufficiently general to describe heat diffusion in the presence of a critical gradient threshold or a transport barrier, superimposed to the usual trend of increasing heat diffusivity from the plasma core to the edge. This type of representation allows us to see some well-known properties of heat transport phenomena in a different light. For instance, it has been shown that the contributions of the Eigenmodes to the time dependent solution grow at speeds that depend on the Eigenmode order i.e. at the beginning of the heating phase all the Eigenmodes are equally involved, whereas at the end only the lower order ones are left. This implies, e.g., that high frequency modulation experiments provide a characterization of transport phenomena that is intrinsically different with respect to power balance analysis of a stationary phase. It is particularly useful to analyse power switch on/off events and whenever high frequency modulations are not technically feasible. Low-frequency (1-2 Hz) ECRH modulation experiments have been performed on Tore Supra. A large jump (a factor of 8) in the heat diffusivity has been clearly identified at the ECRH power deposition layer. The amplitude and phase of several harmonics of the Fourier transform of the modulated temperature, as well as the time evolution of the modulated temperature have been reproduced by the analytical solution. The jump is found to be much weaker at lower ECRH power (one gyrotron)

  15. Ammonia oxidizing bacteria community dynamics in a pilot-scale wastewater treatment plant.

    Directory of Open Access Journals (Sweden)

    Xiaohui Wang

    Full Text Available BACKGROUND: Chemoautotrophic ammonia oxidizing bacteria (AOB have the metabolic ability to oxidize ammonia to nitrite aerobically. This metabolic feature has been widely used, in combination with denitrification, to remove nitrogen from wastewater in wastewater treatment plants (WWTPs. However, the relative influence of specific deterministic environmental factors to AOB community dynamics in WWTP is uncertain. The ecological principles underlying AOB community dynamics and nitrification stability and how they are related are also poorly understood. METHODOLOGY/PRINCIPAL FINDINGS: The community dynamics of ammonia oxidizing bacteria (AOB in a pilot-scale WWTP were monitored over a one-year period by Terminal Restriction Fragment Length Polymorphism (T-RFLP. During the study period, the effluent ammonia concentrations were almost below 2 mg/L, except for the first 60 days, indicting stable nitrification. T-RFLP results showed that, during the test period with stable nitrification, the AOB community structures were not stable, and the average change rate (every 15 days of AOB community structures was 10% ± 8%. The correlations between T-RFLP profiles and 10 operational and environmental parameters were tested by Canonical Correlation Analysis (CCA and Mantel test. The results indicated that the dynamics of AOB community correlated most strongly with Dissolved Oxygen (DO, effluent ammonia, effluent Biochemical Oxygen Demand (BOD and temperature. CONCLUSIONS/SIGNIFICANCE: This study suggests that nitrification stability is not necessarily accompanied by a stable AOB community, and provides insight into parameters controlling the AOB community dynamics within bioreactors with stable nitrification.

  16. Supportive-Expressive Dynamic Psychotherapy in the Community Mental Health System: A Pilot Effectiveness Trial for the Treatment of Depression

    Science.gov (United States)

    Connolly Gibbons, Mary Beth; Thompson, Sarah M.; Scott, Kelli; Schauble, Lindsay A.; Mooney, Tessa; Thompson, Donald; Green, Patricia; MacArthur, Mary Jo; Crits-Christoph, Paul

    2013-01-01

    The goal of the current article is to present the results of a randomized pilot investigation of a brief dynamic psychotherapy compared with treatment-as-usual (TAU) in the treatment of moderate-to-severe depression in the community mental health system. Forty patients seeking services for moderate-to-severe depression in the community mental health system were randomized to 12 weeks of psychotherapy, with either a community therapist trained in brief dynamic psychotherapy or a TAU therapist. Results indicated that blind judges could discriminate the dynamic sessions from the TAU sessions on adherence to dynamic interventions. The results indicate moderate-to-large effect sizes in favor of the dynamic psychotherapy over the TAU therapy in the treatment of depression. The Behavior and Symptom Identification Scale-24 showed that 50% of patients treated with dynamic therapy moved into a normative range compared with only 29% of patients treated with TAU. PMID:22962971

  17. Use of implicit persuasion in decision making about adjuvant cancer treatment: A potential barrier to shared decision making

    NARCIS (Netherlands)

    Engelhardt, Ellen G.; Pieterse, Arwen H.; van der Hout, Anja; de Haes, Hanneke J. C. J. M.; Kroep, Judith R.; Quarles van Ufford-Mannesse, Patricia; Portielje, Johanneke E. A.; Smets, Ellen M. A.; Stiggelbout, Anne M.

    2016-01-01

    Shared decision making (SDM) is widely advocated, especially for preference-sensitive decisions like those on adjuvant treatment for early-stage cancer. Here, decision making involves a subjective trade-off between benefits and side-effects, and therefore, patients' informed preferences should be

  18. Efficacy of Elimination of Pasteurella pneumotropica from a Mouse Specific Pathogen-Free Barrier Breeding Unit through Treatment with Enrofloxacin

    DEFF Research Database (Denmark)

    Østergaard, Grete; Arnorsdottir, Stefania Embla; Schumacher-Petersen, Camilla

    2010-01-01

    , and enrofloxacin (EF) was chosen as the most appropriate antibiotic to treat this infection. Various doses of EF were tested for toxic effects on NMRI-mice prior to the treatment, and since no negative effects of EF, regardlessof dose tested, were observed, the highest dose of 150 mg/kg body weight was chosen...

  19. Treatment of poly(ethylene terephthalate) foils by atmospheric pressure air dielectric barrier discharge and its influence on cell growth

    Czech Academy of Sciences Publication Activity Database

    Kuzminova, A.; Vandrovcová, Marta; Shelemin, A.; Kylián, O.; Choukourov, A.; Hanuš, J.; Bačáková, Lucie; Slavínská, D.; Biederman, H.

    2015-01-01

    Roč. 357, part A (2015), s. 689-695 ISSN 0169-4332 R&D Projects: GA ČR(CZ) GBP108/12/G108 Institutional support: RVO:67985823 Keywords : plasma treatment * DBD plasma * cells growth Subject RIV: JJ - Other Materials Impact factor: 3.150, year: 2015

  20. Changes in skin barrier during treatment with systemic alitretinoin: focus on skin susceptibility and stratum corneum ceramides

    DEFF Research Database (Denmark)

    Jungersted, Jakob Mutanu; Høgh, Julie Kaae; Hellgren, Lars

    2010-01-01

    ) was performed on the volar forearm and evaluated by trans-epidermal water loss (TEWL), erythema, and a cyanoacrylate skin sample was obtained for lipid analysis. We found no significant changes in response to SLS irritation as evaluated by TEWL and erythema, after treatment with alitretinoin for 2 months...

  1. Research on Crack-Filling Heat Treatment and Hydrogen Permeation Test of Self-healing Tritium Permeation Barriers

    Science.gov (United States)

    Liu, Dawei; Wang, Yan; Zhang, Ying; Ouyang, Taoyuan; Zhou, Tong; Fang, Xuanwei; Suo, Jinping

    2018-03-01

    A TiC + mixture (TiC/Al2O3 (1:1 wt.%)) +Al2O3 self-healing triple layer coating (TLC) was designed and manufactured by our group, and the crack-filling heat treatment process had been roughly explored in the past. In this work, the accelerating test with a thick TiC + mixture (TiC/Al2O3 (1:1 wt.%)) double-layer coating (DLC) was carried out. The DLC coating warped when the heat treatment temperature was lower than 550 °C, which was rare in similar researches, and it crushed into fan-shaped pieces when the treatment temperature was higher than 650 °C. The two different spalling failures were explained by weight gain, porosity and stress analyses. The heating rate had a significant effect. The bonding strength and hydrogen permeation of the TLC samples were also tested. Remaining at 650 °C for 40 h was proved to be an optimal crack-filling heat treatment process, considering the hydrogen resistance.

  2. Delineation and segmentation of cerebral tumors by mapping blood-brain barrier disruption with dynamic contrast-enhanced CT and tracer kinetics modeling-a feasibility study

    International Nuclear Information System (INIS)

    Bisdas, S.; Vogl, T.J.; Yang, X.; Koh, T.S.; Lim, C.C.T.

    2008-01-01

    Dynamic contrast-enhanced (DCE) imaging is a promising approach for in vivo assessment of tissue microcirculation. Twenty patients with clinical and routine computed tomography (CT) evidence of intracerebral neoplasm were examined with DCE-CT imaging. Using a distributed-parameter model for tracer kinetics modeling of DCE-CT data, voxel-level maps of cerebral blood flow (F), intravascular blood volume (v i ) and intravascular mean transit time (t 1 ) were generated. Permeability-surface area product (PS), extravascular extracellular blood volume (v e ) and extraction ratio (E) maps were also calculated to reveal pathologic locations of tracer extravasation, which are indicative of disruptions in the blood-brain barrier (BBB). All maps were visually assessed for quality of tumor delineation and measurement of tumor extent by two radiologists. Kappa (κ) coefficients and their 95% confidence intervals (CI) were calculated to determine the interobserver agreement for each DCE-CT map. There was a substantial agreement for the tumor delineation quality in the F, v e and t 1 maps. The agreement for the quality of the tumor delineation was excellent for the v i , PS and E maps. Concerning the measurement of tumor extent, excellent and nearly excellent agreement was achieved only for E and PS maps, respectively. According to these results, we performed a segmentation of the cerebral tumors on the base of the E maps. The interobserver agreement for the tumor extent quantification based on manual segmentation of tumor in the E maps vs. the computer-assisted segmentation was excellent (κ = 0.96, CI: 0.93-0.99). The interobserver agreement for the tumor extent quantification based on computer segmentation in the mean images and the E maps was substantial (κ = 0.52, CI: 0.42-0.59). This study illustrates the diagnostic usefulness of parametric maps associated with BBB disruption on a physiology-based approach and highlights the feasibility for automatic segmentation of

  3. Cultured cells of the blood-brain barrier from apolipoprotein B-100 transgenic mice: effects of oxidized low-density lipoprotein treatment.

    Science.gov (United States)

    Lénárt, Nikolett; Walter, Fruzsina R; Bocsik, Alexandra; Sántha, Petra; Tóth, Melinda E; Harazin, András; Tóth, Andrea E; Vizler, Csaba; Török, Zsolt; Pilbat, Ana-Maria; Vígh, László; Puskás, László G; Sántha, Miklós; Deli, Mária A

    2015-07-17

    The apolipoprotein B-100 (ApoB-100) transgenic mouse line is a model of human atherosclerosis. Latest findings suggest the importance of ApoB-100 in the development of neurodegenerative diseases and microvascular/perivascular localization of ApoB-100 protein was demonstrated in the cerebral cortex of ApoB-100 transgenic mice. The aim of the study was to characterize cultured brain endothelial cells, pericytes and glial cells from wild-type and ApoB-100 transgenic mice and to study the effect of oxidized low-density lipoprotein (oxLDL) on these cells. Morphology of cells isolated from brains of wild type and ApoB-100 transgenic mice was characterized by immunohistochemistry and the intensity of immunolabeling was quantified by image analysis. Toxicity of oxLDL treatment was monitored by real-time impedance measurement and lactate dehydrogenase release. Reactive oxygen species and nitric oxide production, barrier permeability in triple co-culture blood-brain barrier model and membrane fluidity were also determined after low-density lipoprotein (LDL) or oxLDL treatment. The presence of ApoB-100 was confirmed in brain endothelial cells, while no morphological change was observed between wild type and transgenic cells. Oxidized but not native LDL exerted dose-dependent toxicity in all three cell types, induced barrier dysfunction and increased reactive oxygen species (ROS) production in both genotypes. A partial protection from oxLDL toxicity was seen in brain endothelial and glial cells from ApoB-100 transgenic mice. Increased membrane rigidity was measured in brain endothelial cells from ApoB-100 transgenic mice and in LDL or oxLDL treated wild type cells. The morphological and functional properties of cultured brain endothelial cells, pericytes and glial cells from ApoB-100 transgenic mice were characterized and compared to wild type cells for the first time. The membrane fluidity changes in ApoB-100 transgenic cells related to brain microvasculature indicate

  4. Insights into Adherence among a Cohort of Adolescents Aged 12–20 Years in South Africa: Reported Barriers to Antiretroviral Treatment

    Directory of Open Access Journals (Sweden)

    Mhairi Maskew

    2016-01-01

    Full Text Available Adolescents experience disproportionately high rates of poor ART outcomes compared to adults despite prolonged use of antiretroviral therapy in Southern African treatment programs, presenting a significant challenge to national attempts to meet the UNAIDS 90-90-90 targets for 2020. This cohort study among adolescents aged 12–20 years accessing ART care at two urban public-sector clinics in Johannesburg between September and November 2013 aimed to identify factors potentially associated with poor attendance at clinic visits. Patients were followed up through routine medical records to identify missed visits (failing to attend clinic within 30 days of scheduled visit date up to 2 years after enrolment. We enrolled 126 adolescents on ART for a median of 6.3 years (IQR: 2.7–8.4. A total of 47 (38% adolescents missed a scheduled visit within 24 months of enrolment. Older adolescents (18–20 years were more likely to miss a visit compared to adolescents aged 12–14 years (risk ratio (RR = 1.72; 95% CI: 1.00–2.95. Those who were identified to have difficulty in taking medication (RR = 1.57; 95% CI: 1.13–2.18 as a barrier to care were more likely to miss a visit compared to adolescents who did not. Awareness of treatment fatigue, challenges to taking ART, and caregiver difficulties is important when considering interventions to improve treatment outcomes among adolescents.

  5. Use of implicit persuasion in decision making about adjuvant cancer treatment: A potential barrier to shared decision making.

    Science.gov (United States)

    Engelhardt, Ellen G; Pieterse, Arwen H; van der Hout, Anja; de Haes, Hanneke J C J M; Kroep, Judith R; Quarles van Ufford-Mannesse, Patricia; Portielje, Johanneke E A; Smets, Ellen M A; Stiggelbout, Anne M

    2016-10-01

    Shared decision making (SDM) is widely advocated, especially for preference-sensitive decisions like those on adjuvant treatment for early-stage cancer. Here, decision making involves a subjective trade-off between benefits and side-effects, and therefore, patients' informed preferences should be taken into account. If clinicians consciously or unconsciously steer patients towards the option they think is in their patients' best interest (i.e. implicit persuasion), they may be unwittingly subverting their own efforts to implement SDM. We assessed the frequency of use of implicit persuasion during consultations and whether the use of implicit persuasion was associated with expected treatment benefit and/or decision making. Observational study design in which consecutive consultations about adjuvant systemic therapy with stage I-II breast cancer patients treated at oncology outpatient clinics of general teaching hospitals and university medical centres were audiotaped, transcribed and coded by two researchers independently. In total, 105 patients (median age = 59; range: 35-87 years) were included. A median of five (range: 2-10) implicitly persuasive behaviours were employed per consultation. The number of behaviours used did not differ by disease stage (P = 0.07), but did differ by treatment option presented (P = 0.002) and nodal status (P = 0.01). About 50% of patients with stage I or node-negative disease were steered towards undergoing chemotherapy, whereas 96% of patients were steered towards undergoing endocrine therapy, irrespective of expected treatment benefit. Decisions were less often postponed if more implicit persuasion was used (P = 0.03). Oncologists frequently use implicit persuasion, steering patients towards the treatment option that they think is in their patients' best interest. Expected treatment benefit does not always seem to be the driving force behind implicit persuasion. Awareness of one's use of these steering behaviours

  6. Barriers to treatment of failed or interferon ineligible patients in the era of DAA: single center study

    Directory of Open Access Journals (Sweden)

    Kwang Il Seo

    2017-03-01

    Full Text Available Background/Aims Interferon-based treatment is not appropriate for a large number of patients with chronic hepatitis C for various medical and social reasons. Newly developed directly acting antivirals (DAAs have been used to treat chronic hepatitis C without severe adverse effects and have achieved a sustained viral response (SVR rate of 80-90% with short treatment duration. We were interested to determine whether all patients who failed to respond to or were ineligible for interferon-based therapy could be treated with DAAs. Methods Medical records of patients with positive serum anti-hepatitis C virus (HCV or HCV RNA between January 2009 and December 2013 were reviewed. Demographic, clinical, and treatment data were collected for analysis. Results A total of 876 patients were positive for both anti-HCV and HCV RNA. Of these, 244 patients were eligible for interferon, although this was associated with relapse in 39 (16% of patients. In total, 130 patients stopped interferon therapy (67% adverse effects, 28% non-adherent, 4% malignancy, 1% alcohol abuse and 502 patients were ineligible (66% medical contraindications, 25% non-adherent, 5% socioeconomic problems. Among 671 patients who were ineligible for or failed to respond to interferon therapy, more than 186 (27.7% could not be treated with DAA due to financial, social, or cancer-related conditions. Conclusions Newly developed DAAs are a promising treatment for patients with chronic hepatitis C who are ineligible for or failed to respond to interferon-based therapy. Nevertheless, not all chronic hepatitis C patients can be treated with DAAs due to various reasons.

  7. Early Methylprednisolone Treatment Can Stabilize the Blood-Optic Nerve Barrier in a Rat Model of Anterior Ischemic Optic Neuropathy (rAION).

    Science.gov (United States)

    Huang, Tzu-Lun; Wen, Yao-Tseng; Chang, Chung-Hsing; Chang, Shu-Wen; Lin, Kuan-Hung; Tsai, Rong-Kung

    2017-03-01

    We investigated whether methylprednisolone (MP) treatment halting retinal ganglion cell (RGC) death and having anti-inflammatory effect over a narrow therapeutic window affects the integrity of the blood-optic nerve barrier (BOB) in a rat model of ischemic optic neuropathy (rAION). The optic nerve (ON) vascular permeability was determined by Evans blue extravasation. Changes in the levels of TNF-α and IL-1β cytokines were analyzed using quantitative RT-PCR (qRT-PCR) from day 1 to day 5 post-rAION. Rats were treated with MP starting on days 0, 1, 2, and 7 post-rAION. The survival and apoptosis of the RGCs were determined by fluoroGold labeling and TUNEL assay, and the visual function was assessed with flash visual-evoked potentials (FVEPs) 4 weeks postinfarct. Inflammation of the ON was detected by immunohistochemical staining of ED1. Macrophage recruitment in the ON was significantly reduced, which was compatible with the reduction in ON vascular permeability, after MP treatment starting on days 0 and 1 postinsult compared to PBS treatment (both, P < 0.05). There was significant reduction in TNF-α and IL-1β expression in MP-treated rats (all, P < 0.05). The survival number and antiapoptotic effect on RGCs, and the P1-N2 FVEP amplitude significantly improved with MP treatment starting on days 0 and 1 (all, P < 0.05). Early treatment with MP halts RGC death and mitigates macrophage infiltration with decreased expression of proinflammatory cytokines in acute rAION. The very narrow therapeutic window is related to the quick stabilization of the disrupted BOB by early application of MP.

  8. Time-dependent theoretical treatments of the dynamics of electrons and nuclei in molecular systems

    International Nuclear Information System (INIS)

    Deumens, E.; Diz, A.; Longo, R.; Oehrn, Y.

    1994-01-01

    An overview is presented of methods for time-dependent treatments of molecules as systems of electrons and nuclei. The theoretical details of these methods are reviewed and contrasted in the light of a recently developed time-dependent method called electron-nuclear dynamics. Electron-nuclear dynamics (END) is a formulation of the complete dynamics of electrons and nuclei of a molecular system that eliminates the necessity of constructing potential-energy surfaces. Because of its general formulation, it encompasses many aspects found in other formulations and can serve as a didactic device for clarifying many of the principles and approximations relevant in time-dependent treatments of molecular systems. The END equations are derived from the time-dependent variational principle applied to a chosen family of efficiently parametrized approximate state vectors. A detailed analysis of the END equations is given for the case of a single-determinantal state for the electrons and a classical treatment of the nuclei. The approach leads to a simple formulation of the fully nonlinear time-dependent Hartree-Fock theory including nuclear dynamics. The nonlinear END equations with the ab initio Coulomb Hamiltonian have been implemented at this level of theory in a computer program, ENDyne, and have been shown feasible for the study of small molecular systems. Implementation of the Austin Model 1 semiempirical Hamiltonian is discussed as a route to large molecular systems. The linearized END equations at this level of theory are shown to lead to the random-phase approximation for the coupled system of electrons and nuclei. The qualitative features of the general nonlinear solution are analyzed using the results of the linearized equations as a first approximation. Some specific applications of END are presented, and the comparison with experiment and other theoretical approaches is discussed

  9. Implementation of random set-up errors in Monte Carlo calculated dynamic IMRT treatment plans

    International Nuclear Information System (INIS)

    Stapleton, S; Zavgorodni, S; Popescu, I A; Beckham, W A

    2005-01-01

    The fluence-convolution method for incorporating random set-up errors (RSE) into the Monte Carlo treatment planning dose calculations was previously proposed by Beckham et al, and it was validated for open field radiotherapy treatments. This study confirms the applicability of the fluence-convolution method for dynamic intensity modulated radiotherapy (IMRT) dose calculations and evaluates the impact of set-up uncertainties on a clinical IMRT dose distribution. BEAMnrc and DOSXYZnrc codes were used for Monte Carlo calculations. A sliding window IMRT delivery was simulated using a dynamic multi-leaf collimator (DMLC) transport model developed by Keall et al. The dose distributions were benchmarked for dynamic IMRT fields using extended dose range (EDR) film, accumulating the dose from 16 subsequent fractions shifted randomly. Agreement of calculated and measured relative dose values was well within statistical uncertainty. A clinical seven field sliding window IMRT head and neck treatment was then simulated and the effects of random set-up errors (standard deviation of 2 mm) were evaluated. The dose-volume histograms calculated in the PTV with and without corrections for RSE showed only small differences indicating a reduction of the volume of high dose region due to set-up errors. As well, it showed that adequate coverage of the PTV was maintained when RSE was incorporated. Slice-by-slice comparison of the dose distributions revealed differences of up to 5.6%. The incorporation of set-up errors altered the position of the hot spot in the plan. This work demonstrated validity of implementation of the fluence-convolution method to dynamic IMRT Monte Carlo dose calculations. It also showed that accounting for the set-up errors could be essential for correct identification of the value and position of the hot spot

  10. Implementation of random set-up errors in Monte Carlo calculated dynamic IMRT treatment plans

    Science.gov (United States)

    Stapleton, S.; Zavgorodni, S.; Popescu, I. A.; Beckham, W. A.

    2005-02-01

    The fluence-convolution method for incorporating random set-up errors (RSE) into the Monte Carlo treatment planning dose calculations was previously proposed by Beckham et al, and it was validated for open field radiotherapy treatments. This study confirms the applicability of the fluence-convolution method for dynamic intensity modulated radiotherapy (IMRT) dose calculations and evaluates the impact of set-up uncertainties on a clinical IMRT dose distribution. BEAMnrc and DOSXYZnrc codes were used for Monte Carlo calculations. A sliding window IMRT delivery was simulated using a dynamic multi-leaf collimator (DMLC) transport model developed by Keall et al. The dose distributions were benchmarked for dynamic IMRT fields using extended dose range (EDR) film, accumulating the dose from 16 subsequent fractions shifted randomly. Agreement of calculated and measured relative dose values was well within statistical uncertainty. A clinical seven field sliding window IMRT head and neck treatment was then simulated and the effects of random set-up errors (standard deviation of 2 mm) were evaluated. The dose-volume histograms calculated in the PTV with and without corrections for RSE showed only small differences indicating a reduction of the volume of high dose region due to set-up errors. As well, it showed that adequate coverage of the PTV was maintained when RSE was incorporated. Slice-by-slice comparison of the dose distributions revealed differences of up to 5.6%. The incorporation of set-up errors altered the position of the hot spot in the plan. This work demonstrated validity of implementation of the fluence-convolution method to dynamic IMRT Monte Carlo dose calculations. It also showed that accounting for the set-up errors could be essential for correct identification of the value and position of the hot spot.

  11. Influence of a BGaN back-barrier on DC and dynamic performances of an AlGaN/GaN HEMT: simulation study

    Science.gov (United States)

    Guenineche, Lotfi; Hamdoune, Abdelkader

    2016-05-01

    In this paper, we study the effect of a BGaN back-barrier on the DC and RF performances of an AlGaN/GaN high electron mobility transistor. Using TCAD Silvaco, we examine some variations of thickness and boron concentration in the BGaN back-barrier layer. First, we fix the thickness of the back-barrier layer at 5 nm and we vary the concentration of the boron in BGaN from 1% to 4%. Second, we fix the concentration of the boron in BGaN to only 2% and we vary the thickness of the back-barrier layer from 20 nm to 110 nm. The BGaN back-barrier layer creates an electrostatic barrier under the channel layer and improves the performances of the device by improving the electron confinement in the two-dimensional electron gas. The DC and AC characteristics are improved, respectively, by a greater concentration of boron and by a thicker BGaN layer. For 4% boron concentration and 5 nm thick back-barrier layer, we obtain a maximum drain current of 1.1 A, a maximum transconductance of 480 mS mm-1, a cut-off frequency of 119 GHz, and a maximum oscillation frequency of 311 GHz.

  12. 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

    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......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...... 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...

  13. Effect of Additions of Ceramic Nanoparticles and Gas-Dynamic Treatment on Al Casting Alloys

    Directory of Open Access Journals (Sweden)

    Konstantin Borodianskiy

    2015-12-01

    Full Text Available In recent years, improving the mechanical properties of metals has become the main challenge in the modern materials and metallurgical industry. An alloying process is usually used to achieve advanced performance of metals. This paper, however, describes an alternative approach. Modification with ceramic nanoparticles, gas-dynamic treatment (GDT and a combined treatment were investigated on a hypoeutectic Al-Si A356 alloy. Microstructural studies revealed the refinement of coarse α-Al grains and the formation of distributed eutectic Si particles. Subsequent testing of the mechanical properties revealed improvement after applying each of the treatments. The best results were obtained after modification with TiCN nanoparticles followed by GDT; the tensile strength and elongation of the A356 alloys increased by 18% and 19%, respectively.

  14. Diagnosis and treatment of dynamic collapse of the cricotracheal ligament in thoroughbred racehorses.

    Science.gov (United States)

    Kelly, Padraig G; Pollock, Patrick J

    2015-02-01

    To describe (1) diagnosis of dynamic collapse of the cricotracheal ligament in a group of horses and (2) treatment and outcome of affected horses. Retrospective case series. Thoroughbred horses (n = 8). Of 600 over ground dynamic endoscopic examinations performed, 8 Thoroughbred horses had cricotracheal ligament collapse (CTLC); 5 were 2 years old and in early training and 2 were mature horses in full work. CTLC was diagnosed if circumferential collapse of the cricotracheal ligament was identified during exercise. Seven horses had repeat endoscopic examination. Two horses unresponsive to conservative management were treated surgically. Multiple abnormalities of the upper portion of the respiratory tract were identified along with CTLC in all five 2-year-old horses and resolution of CTLC was observed after treatment for upper airway inflammation. No concurrent respiratory abnormality was identified in the 2 mature horses. Surgical reduction of the cricotracheal space and imbrication of the cricotracheal ligament of these 2 horses resulted in resolution of clinical signs of CTLC. CTLC is a rare cause of dynamic obstruction in Thoroughbred racehorses. Resolution may occur after adaptation to training and after inflammation of the respiratory tract is resolved, but for horses with persistent CTLC, surgical reduction of the cricotracheal space and imbrication of the cricotracheal ligament may result in resolution of clinical signs. © Copyright 2014 by The American College of Veterinary Surgeons.

  15. A laser-treatment condition of plasma-sprayed zirconia thermal barrier coatings on nickel-base superalloy substrate

    International Nuclear Information System (INIS)

    Kondo, Yasuo; Fukaya, Kiyoshi; Miyamoto, Yoshiaki

    1987-06-01

    In order to seal the surface pores, two plasma-sprayed zirconia coatings (containing 8 wt.% CaC 2 and 8 wt.% Y 2 O 3 ) of about 200 microns thickness were partially melted with a CO 2 laser. Preliminary experiment had shown that the laser beam with a power density of 35 W/mm 2 could melt plasma-sprayed zirconia to depth of 50 to 80 microns at a scanning speed of about 300 mm/min. There was little porosity in the laser-treated region. However, straiations and mud-flat cracking of about 50 microns in depth were produced by the laser-treatment. Numerous fine particles of a few microns diameter were formed on the laser-treated surface, and microcracks were propagated between these fine particles. In the CaC 2 /ZrO 2 ceramic coating system, calcium content of the laser-treated region became less compared with that of the nontreated region. While, in the Y 2 O 3 /ZrO 2 system, yttrium distribution in the laser-treated area was more uniform than that in the nontreated area. This indicates that Y 2 O 3 /ZrO 2 system is more stable than CaC 2 /ZrO 2 system to laser treatment. (author)

  16. Assessing supply-side barriers to uptake of intermittent preventive treatment for malaria in pregnancy: a qualitative study and document and record review in two regions of Uganda.

    Science.gov (United States)

    Rassi, Christian; Graham, Kirstie; Mufubenga, Patrobas; King, Rebecca; Meier, Joslyn; Gudoi, Sam Siduda

    2016-07-04

    Intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP), provided as part of routine antenatal care (ANC), is one of three malaria-in-pregnancy prevention and control mechanisms recommended by the World Health Organization (WHO). However, despite high ANC attendance and increased efforts to address known obstacles, IPTp uptake figures have remained low. This study aimed to identify and assess barriers that continue to impede IPTp uptake in Uganda, in particular for women who attend ANC. The paper focuses on supply-side barriers, i.e., challenges relating to the health service provider. In-depth interviews were conducted in two regions of Uganda in November 2013 and April/May 2014 with four different target audiences: seven district health officials, 15 health workers, 19 women who had attended ANC, and five opinion leaders. In addition, a document and record review was carried out at four health facilities. Guidelines with regard to IPTp provision in Uganda have been shown to be inconsistent and, at the time of the research, did not reflect the most recent WHO policy recommendation. There is a lack of training and supervision opportunities for health workers, resulting in poor knowledge of IPTp guidelines and uncertainty about the safety and efficacy of SP. ANC is not consistently offered in health facilities, leading to some women being denied services. While strengthening of the supply chain appears to have reduced the occurrence of stock-outs of SP in public facilities, stock-outs reportedly continue to occur in the private sector. There are also sources of data inaccuracy along the data recording and reporting chain, limiting policy makers' ability to react adequately to trends and challenges. Given the high ANC attendance rates in Uganda, supply-side barriers are likely to account for many missed opportunities for the provision of IPTp in Uganda. Improvements will require consistent provision of ANC, implementation of current

  17. Drivers and barriers among householders to managing domestic wastewater treatment systems in the Republic of Ireland; implications for risk prevention behaviour

    Science.gov (United States)

    Devitt, Catherine; O'Neill, Eoin; Waldron, Richard

    2016-04-01

    Septic systems that are malfunctioning, improperly sited or designed, present a contamination risk to drinking water sources, and subsequently, to human health. However, the international literature identifies gaps in householder knowledge regarding the function and maintenance requirements of septic systems, and also the potential health and environmental risk implications. Allied with householder fears related to the financial cost of risk management, these factors tend to reduce concern to recognise a malfunctioning system. In the Republic of Ireland, three-quarters of households in rural areas utilise an individual domestic wastewater treatment system (or septic system). Consequently, a significant portion of rural households that rely on groundwater sources via private-well use are at risk. Ireland reports one of the highest crude incidence rates of Verotoxigenic Escherichia coli (VTEC) infection in the European Union, and waterborne transmission related to contact with untreated or poorly treated water from private water sources is a factor in its transmission. Following recent Irish legislative change that places a duty of care on individual householders to ensure a proper system functioning, this exploratory study examines perceptions towards the risk management of septic systems among Irish householders. Using qualitative research methods, four focus groups selected on the basis of geographical variation, and two semi-structured interviews were conducted. While most householders agreed that poorly maintained septic systems represented a threat to the environment and to public health, none reported to having a regular maintenance routine in place. Thematic analysis revealed the drivers and barriers to septic system maintenance, and preferences of householders pertaining to communication on septic systems. The Health Belief Model is employed to help understand results. Results suggest that householder capacity to engage in regular risk management is reduced

  18. NS3 protease polymorphisms and genetic barrier to drug resistance of distinct hepatitis C virus genotypes from worldwide treatment-naïve subjects.

    Science.gov (United States)

    Vidal, L L; Soares, M A; Santos, A F

    2016-11-01

    Hepatitis C virus (HCV) NS3 protease inhibitors have been primarily designed against genotype 1, the one with the lowest response to dual therapy. However, less evidence of their efficacy on non-1 genotypes is available, and any such information is mostly concentrated on genotypes 2-4. This study evaluated HCV protease resistance profiles in the major six HCV genotypes and identified genetic barrier (GB) profiles to each available protease inhibitor across HCV strains from different locations worldwide. We obtained 15 099 HCV sequences from treatment-naïve subjects retrieved at the Los Alamos HCV Sequence Database. The wild-type codons of different HCV genotypes were used to analyse the smallest number of nucleotide substitution steps required for changing that codon to the closest one associated with drug resistance. The 36L and 175L RAVs were found as genetic signatures of genotypes 2-5, while the 80K RAV was found in all genotype 5 sequences. Genotypes 4 and 6 showed a higher GB to RAV mutations conferring resistance to telaprevir, while genotypes 2-5 presented baseline resistance to that drug, carrying the 36L mutation. Genotype 4 had a higher GB to simeprevir resistance, requiring three substitutions to acquire the 155K mutation. Subtype 1b showed a higher GB than subtype 1a to resistance for most PIs, with RAVs at codons 36 and 155. Geographic disparities were also found in frequencies of certain RAVs in genotypes 2 and 3. Under a scenario of unprecedented evolution of anti-HCV direct-acting agents, the genetic composition of the circulating HCV sequences should be evaluated worldwide to choose the most appropriate/feasible therapeutic schemes with the highest genetic barriers to resistance. © 2016 John Wiley & Sons Ltd.

  19. Multireference second order perturbation theory with a simplified treatment of dynamical correlation.

    Science.gov (United States)

    Xu, Enhua; Zhao, Dongbo; Li, Shuhua

    2015-10-13

    A multireference second order perturbation theory based on a complete active space configuration interaction (CASCI) function or density matrix renormalized group (DMRG) function has been proposed. This method may be considered as an approximation to the CAS/A approach with the same reference, in which the dynamical correlation is simplified with blocked correlated second order perturbation theory based on the generalized valence bond (GVB) reference (GVB-BCPT2). This method, denoted as CASCI-BCPT2/GVB or DMRG-BCPT2/GVB, is size consistent and has a similar computational cost as the conventional second order perturbation theory (MP2). We have applied it to investigate a number of problems of chemical interest. These problems include bond-breaking potential energy surfaces in four molecules, the spectroscopic constants of six diatomic molecules, the reaction barrier for the automerization of cyclobutadiene, and the energy difference between the monocyclic and bicyclic forms of 2,6-pyridyne. Our test applications demonstrate that CASCI-BCPT2/GVB can provide comparable results with CASPT2 (second order perturbation theory based on the complete active space self-consistent-field wave function) for systems under study. Furthermore, the DMRG-BCPT2/GVB method is applicable to treat strongly correlated systems with large active spaces, which are beyond the capability of CASPT2.

  20. Design of a Dynamic Spinal Implant for the treatment of Early Onset Scoliosis

    Energy Technology Data Exchange (ETDEWEB)

    Gonzalez Alvarez, A.; Shepherd, D.; Dearn, K.

    2016-07-01

    GSDyn (Growing Spine Dynamic) is a novel implant that has been designed and manufactured to mechanically correct three dimensional spinal deformities in children with Early Onset Scoliosis (EOS). The innovative element of the implant is the lengthening mechanism that allows the elongation surgeries to be easier, faster and less invasive procedures than with other mechanical implants on the market, as they can be performed under local anaesthetics and with a surgical incision of less than one centimetre. It also includes a dynamic system to prevent implant breakage and anchor loosening, two of the most common complications occurring in this treatment. The development of the implant has been guided by spinal surgeons. Finite Element Analysis has been performed to evaluate the behaviour of the device under different loading conditions and two working prototypes have been successfully manufactured. (Author)

  1. Treatment of humeroulnar subluxation with a dynamic proximal ulnar osteotomy: a review of 13 cases

    International Nuclear Information System (INIS)

    Gilson, S.D.; Piermattei, D.L.; Schwarz, P.D.

    1989-01-01

    Humeroulnar subluxation was treated surgically in 13 dogs with 18 affected elbows using a proximal osteotomy of the ulna that allowed the ulna to elongate dynamically. Distal humeroulnar subluxation was secondary to premature closure of the distal ulnar physis in 16 elbows. One distal subluxation was secondary to a radioulnar synostosis, and one proximal subluxation developed after premature closure of the distal radial physis. The mean follow-up time was 22 months. Twenty-eight percent of the elbows were judged to have excellent results, 22% good results, 50% fair results, and none was judged to have a poor outcome. The presenting lameness grade and the severity of preoperative and postoperative humeroulnar subluxation had significant correlations with the prognosis. Associated orthopedic abnormalities and complications of concurrent surgical procedures affected the outcome in several dogs. Overall, the dynamic proximal ulnar osteotomy was a simple and effective technique for the treatment of uncomplicated humeroulnar subluxation

  2. Surface modification of thermoplastic poly(vinyl alcohol)/saponite nanocomposites via surface-initiated atom transfer radical polymerization enhanced by air dielectric discharges barrier plasma treatment

    International Nuclear Information System (INIS)

    Zhen Weijun; Lu Canhui

    2012-01-01

    To improve the water resistance of thermoplastic poly(vinyl alcohol)/saponite nanocomposites (TPVA), a simple two-step method was developed for the covalent immobilization of atom transfer radical polymerization (ATRP) initiators on the TPVA surfaces enhanced by air dielectric barrier discharges (DBD) plasma treatment, and hydrophobic poly(methyl methacrylate) (PMMA) brushes were then grafted onto the surface of TPVA via surface-initiated atom transfer radical polymerization (SI-ATRP). The chemical composition, morphology and hydrophobicity of the modified TPVA surfaces were characterized by X-ray photoelectron spectroscopy (XPS) and scanning electron microscopy (SEM), respectively. The water resistance of the surface-functionalized PMMA was evaluated by the contact angle and water adsorption method. It was shown that air DBD plasma treatment activated the TPVA surface and accelerated the immobilization of ATRP initiator on the TPVA surface. Compared with TPVA control, TPVA modified by SI-ATRP can be grafted well-defined and covalently tethered network PMMA brushes onto the surface and the hydrophobicity of TPVA were significantly enhanced.

  3. Surface Treatment of PEOT/PBT (55/45 with a Dielectric Barrier Discharge in Air, Helium, Argon and Nitrogen at Medium Pressure

    Directory of Open Access Journals (Sweden)

    Pieter Cools

    2018-03-01

    Full Text Available This work describes the surface modification of 300PEO-PEOT/PBT 55/45 thin films using a medium pressure dielectric barrier discharge system operated in argon, helium, nitrogen or dry air to improve cell-surface interactions of this established biomaterial. The first part of the paper describes the optimization of the plasma processing parameters using water contact angle goniometry. The optimized samples are then characterized for changes in surface topography and surface chemical composition using atomic force microscopy (AFM and X-ray fluorescence spectroscopy (XPS respectively. For all plasma treatments, a pronounced increase in surface wettability was observed, of which the extent is dependent on the used plasma discharge gas. Except for dry air, only minor changes in surface topography were noted, while XPS confirmed that the changes in wettability were mainly chemical in nature with the incorporation of 5–10% of extra oxygen as a variety of polar groups. Similarly, for the nitrogen plasma, 3.8% of nitrogen polar groups were additionally incorporated. Human foreskin fibroblast (HFF in vitro analysis showed that within the first 24 h after cell seeding, the effects on cell-surface interactivity were highly dependent on the used discharge gas, nitrogen plasma treatment being the most efficient. Differences between untreated and plasma-treated samples were less pronounced compared to other biodegradable materials, but a positive influence on cell adhesion and proliferation was still observed.

  4. GPs' perspectives of type 2 diabetes patients' adherence to treatment: A qualitative analysis of barriers and solutions

    Directory of Open Access Journals (Sweden)

    Sabbe Bernard

    2005-05-01

    Full Text Available Abstract Background The problem of poor compliance/adherence to prescribed treatments is very complex. Health professionals are rarely being asked how they handle the patient's (poor therapy compliance/adherence. In this study, we examine explicitly the physicians' expectations of their diabetes patients' compliance/adherence. The objectives of our study were: (1 to elicit problems physicians encounter with type 2 diabetes patients' adherence to treatment recommendations; (2 to search for solutions and (3 to discover escape mechanisms in case of frustration. Methods In a descriptive qualitative study, we explored the thoughts and feelings of general practitioners (GPs on patients' compliance/adherence. Forty interested GPs could be recruited for focus group participation. Five open ended questions were derived on the one hand from a similar qualitative study on compliance/adherence in patients living with type 2 diabetes and on the other hand from the results of a comprehensive review of recent literature on compliance/adherence. A well-trained diabetes nurse guided the GPs through the focus group sessions while an observer was attentive for non-verbal communication and interactions between participants. All focus groups were audio taped and transcribed for content analysis. Two researchers independently performed the initial coding. A first draft with results was sent to all participants for agreement on content and comprehensiveness. Results General practitioners experience problems with the patient's deficient knowledge and the fact they minimize the consequences of having and living with diabetes. It appears that great confidence in modern medical science does not stimulate many changes in life style. Doctors tend to be frustrated because their patients do not achieve the common Evidence Based Medicine (EBM objectives, i.e. on health behavior and metabolic control. Relevant solutions, derived from qualitative studies, for better compliance

  5. Assessment of Blood-Brain Barrier Permeability by Dynamic Contrast-Enhanced MRI in Transient Middle Cerebral Artery Occlusion Model after Localized Brain Cooling in Rats

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eun Soo [Department of Radiology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068 (Korea, Republic of); Lee, Seung-Koo [Department of Radiology, Yonsei University College of Medicine, Seoul 03722 (Korea, Republic of); Kwon, Mi Jung [Department of Pathology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068 (Korea, Republic of); Lee, Phil Hye [Department of Neurology, Yonsei University College of Medicine, Seoul 03722 (Korea, Republic of); Ju, Young-Su [Department of Industrial Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068 (Korea, Republic of); Yoon, Dae Young [Department of Radiology, Hallym University Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul 05355 (Korea, Republic of); Kim, Hye Jeong [Department of Radiology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul 07441 (Korea, Republic of); Lee, Kwan Seop [Department of Radiology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068 (Korea, Republic of)

    2016-11-01

    The purpose of this study was to evaluate the effects of localized brain cooling on blood-brain barrier (BBB) permeability following transient middle cerebral artery occlusion (tMCAO) in rats, by using dynamic contrast-enhanced (DCE)-MRI. Thirty rats were divided into 3 groups of 10 rats each: control group, localized cold-saline (20℃) infusion group, and localized warm-saline (37℃) infusion group. The left middle cerebral artery (MCA) was occluded for 1 hour in anesthetized rats, followed by 3 hours of reperfusion. In the localized saline infusion group, 6 mL of cold or warm saline was infused through the hollow filament for 10 minutes after MCA occlusion. DCE-MRI investigations were performed after 3 hours and 24 hours of reperfusion. Pharmacokinetic parameters of the extended Tofts-Kety model were calculated for each DCE-MRI. In addition, rotarod testing was performed before tMCAO, and on days 1-9 after tMCAO. Myeloperoxidase (MPO) immunohisto-chemistry was performed to identify infiltrating neutrophils associated with the inflammatory response in the rat brain. Permeability parameters showed no statistical significance between cold and warm saline infusion groups after 3-hour reperfusion 0.09 ± 0.01 min{sup -1} vs. 0.07 ± 0.02 min{sup -1}, p = 0.661 for K{sup trans}; 0.30 ± 0.05 min{sup -1} vs. 0.37 ± 0.11 min{sup -1}, p = 0.394 for kep, respectively. Behavioral testing revealed no significant difference among the three groups. However, the percentage of MPO-positive cells in the cold-saline group was significantly lower than those in the control and warm-saline groups (p < 0.05). Localized brain cooling (20℃) does not confer a benefit to inhibit the increase in BBB permeability that follows transient cerebral ischemia and reperfusion in an animal model, as compared with localized warm-saline (37℃) infusion group.

  6. Assessment of Blood-Brain Barrier Permeability by Dynamic Contrast-Enhanced MRI in Transient Middle Cerebral Artery Occlusion Model after Localized Brain Cooling in Rats

    International Nuclear Information System (INIS)

    Kim, Eun Soo; Lee, Seung-Koo; Kwon, Mi Jung; Lee, Phil Hye; Ju, Young-Su; Yoon, Dae Young; Kim, Hye Jeong; Lee, Kwan Seop

    2016-01-01

    The purpose of this study was to evaluate the effects of localized brain cooling on blood-brain barrier (BBB) permeability following transient middle cerebral artery occlusion (tMCAO) in rats, by using dynamic contrast-enhanced (DCE)-MRI. Thirty rats were divided into 3 groups of 10 rats each: control group, localized cold-saline (20℃) infusion group, and localized warm-saline (37℃) infusion group. The left middle cerebral artery (MCA) was occluded for 1 hour in anesthetized rats, followed by 3 hours of reperfusion. In the localized saline infusion group, 6 mL of cold or warm saline was infused through the hollow filament for 10 minutes after MCA occlusion. DCE-MRI investigations were performed after 3 hours and 24 hours of reperfusion. Pharmacokinetic parameters of the extended Tofts-Kety model were calculated for each DCE-MRI. In addition, rotarod testing was performed before tMCAO, and on days 1-9 after tMCAO. Myeloperoxidase (MPO) immunohisto-chemistry was performed to identify infiltrating neutrophils associated with the inflammatory response in the rat brain. Permeability parameters showed no statistical significance between cold and warm saline infusion groups after 3-hour reperfusion 0.09 ± 0.01 min -1 vs. 0.07 ± 0.02 min -1 , p = 0.661 for K trans ; 0.30 ± 0.05 min -1 vs. 0.37 ± 0.11 min -1 , p = 0.394 for kep, respectively. Behavioral testing revealed no significant difference among the three groups. However, the percentage of MPO-positive cells in the cold-saline group was significantly lower than those in the control and warm-saline groups (p < 0.05). Localized brain cooling (20℃) does not confer a benefit to inhibit the increase in BBB permeability that follows transient cerebral ischemia and reperfusion in an animal model, as compared with localized warm-saline (37℃) infusion group

  7. Assessment of blood-brain barrier permeability by dynamic contrast-enhanced MRI in transient middle cerebral artery occlusion model after localized brain cooling in rats

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eun Soo; Lee, Kwan Seop; Kwon, Mi Jung; Ju, Young Su [Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang (Korea, Republic of); Lee, Seung Koo; Lee, Phil Hye [Yonsei University College of Medicine, Seoul (Korea, Republic of); Yoon, Dae Young [Dept. of Radiology, Hallym University Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul (Korea, Republic of); Kim, Hye Jeong [Dept. of Radiology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul (Korea, Republic of)

    2016-09-15

    The purpose of this study was to evaluate the effects of localized brain cooling on blood-brain barrier (BBB) permeability following transient middle cerebral artery occlusion (tMCAO) in rats, by using dynamic contrast-enhanced (DCE)-MRI. Thirty rats were divided into 3 groups of 10 rats each: control group, localized cold-saline (20 .deg. ) infusion group, and localized warm-saline (37 .deg. ) infusion group. The left middle cerebral artery (MCA) was occluded for 1 hour in anesthetized rats, followed by 3 hours of reperfusion. In the localized saline infusion group, 6 mL of cold or warm saline was infused through the hollow filament for 10 minutes after MCA occlusion. DCE-MRI investigations were performed after 3 hours and 24 hours of reperfusion. Pharmacokinetic parameters of the extended Tofts-Kety model were calculated for each DCE-MRI. In addition, rotarod testing was performed before tMCAO, and on days 1-9 after tMCAO. Myeloperoxidase (MPO) immunohisto-chemistry was performed to identify infiltrating neutrophils associated with the inflammatory response in the rat brain. Permeability parameters showed no statistical significance between cold and warm saline infusion groups after 3-hour reperfusion 0.09 ± 0.01 min{sup -1} vs. 0.07 ± 0.02 min{sup -1},p = 0.661 for K{sup trans}; 0.30 ± 0.05 min{sup -1} vs. 0.37 ± 0.11 min{sup -1},p = 0.394 for kep, respectively. Behavioral testing revealed no significant difference among the three groups. However, the percentage of MPO-positive cells in the cold-saline group was significantly lower than those in the control and warm-saline groups (p < 0.05). Localized brain cooling (20 .deg. ) does not confer a benefit to inhibit the increase in BBB permeability that follows transient cerebral ischemia and reperfusion in an animal model, as compared with localized warm-saline (37 .deg. ) infusion group.

  8. Assessment of blood-brain barrier permeability by dynamic contrast-enhanced MRI in transient middle cerebral artery occlusion model after localized brain cooling in rats

    International Nuclear Information System (INIS)

    Kim, Eun Soo; Lee, Kwan Seop; Kwon, Mi Jung; Ju, Young Su; Lee, Seung Koo; Lee, Phil Hye; Yoon, Dae Young; Kim, Hye Jeong

    2016-01-01

    The purpose of this study was to evaluate the effects of localized brain cooling on blood-brain barrier (BBB) permeability following transient middle cerebral artery occlusion (tMCAO) in rats, by using dynamic contrast-enhanced (DCE)-MRI. Thirty rats were divided into 3 groups of 10 rats each: control group, localized cold-saline (20 .deg. ) infusion group, and localized warm-saline (37 .deg. ) infusion group. The left middle cerebral artery (MCA) was occluded for 1 hour in anesthetized rats, followed by 3 hours of reperfusion. In the localized saline infusion group, 6 mL of cold or warm saline was infused through the hollow filament for 10 minutes after MCA occlusion. DCE-MRI investigations were performed after 3 hours and 24 hours of reperfusion. Pharmacokinetic parameters of the extended Tofts-Kety model were calculated for each DCE-MRI. In addition, rotarod testing was performed before tMCAO, and on days 1-9 after tMCAO. Myeloperoxidase (MPO) immunohisto-chemistry was performed to identify infiltrating neutrophils associated with the inflammatory response in the rat brain. Permeability parameters showed no statistical significance between cold and warm saline infusion groups after 3-hour reperfusion 0.09 ± 0.01 min -1 vs. 0.07 ± 0.02 min -1 ,p = 0.661 for K trans ; 0.30 ± 0.05 min -1 vs. 0.37 ± 0.11 min -1 ,p = 0.394 for kep, respectively. Behavioral testing revealed no significant difference among the three groups. However, the percentage of MPO-positive cells in the cold-saline group was significantly lower than those in the control and warm-saline groups (p < 0.05). Localized brain cooling (20 .deg. ) does not confer a benefit to inhibit the increase in BBB permeability that follows transient cerebral ischemia and reperfusion in an animal model, as compared with localized warm-saline (37 .deg. ) infusion group

  9. Barriers and enablers to the provision of alcohol treatment among Aboriginal Australians: a thematic review of five research projects.

    Science.gov (United States)

    Gray, Dennis; Wilson, Mandy; Allsop, Steve; Saggers, Sherry; Wilkes, Edward; Ober, Coralie

    2014-09-01

    To review the results of five research projects commissioned to enhance alcohol treatment among Aboriginal Australians, and to highlight arising from them. Drafts of the papers were workshopped by project representatives, final papers reviewed and results summarised. Lessons arising were identified and described. While the impact of the projects varied, they highlight the feasibility of adapting mainstream interventions in Aboriginal Australian contexts. Outcomes include greater potential to: screen for those at risk; increase community awareness; build capacity and partnerships between organisations; and co-ordinate comprehensive referral networks and service provision. Results show a small investment can produce sustainable change and positive outcomes. However, to optimise and maintain investment, cultural difference needs to be recognised in both planning and delivery of alcohol interventions; resources and funding must be responsive to and realistic about the capacities of organisations; partnerships need to be formed voluntarily based on respect, equality and trust; and practices and procedures within organisations need to be formalised. There is no simple way to reduce alcohol-related harm in Aboriginal communities. However, the papers reviewed show that with Aboriginal control, modest investment and respectful collaboration, service enhancements and improved outcomes can be achieved. Mainstream interventions need to be adapted to Aboriginal settings, not simply transferred. The lessons outlined provide important reflections for future research. © 2014 Australasian Professional Society on Alcohol and other Drugs.

  10. A computational tool integrating host immunity with antibiotic dynamics to study tuberculosis treatment.

    Science.gov (United States)

    Pienaar, Elsje; Cilfone, Nicholas A; Lin, Philana Ling; Dartois, Véronique; Mattila, Joshua T; Butler, J Russell; Flynn, JoAnne L; Kirschner, Denise E; Linderman, Jennifer J

    2015-02-21

    While active tuberculosis (TB) is a treatable disease, many complex factors prevent its global elimination. Part of the difficulty in developing optimal therapies is the large design space of antibiotic doses, regimens and combinations. Computational models that capture the spatial and temporal dynamics of antibiotics at the site of infection can aid in reducing the design space of costly and time-consuming animal pre-clinical and human clinical trials. The site of infection in TB is the granuloma, a collection of immune cells and bacteria that form in the lung, and new data suggest that penetration of drugs throughout granulomas is problematic. Here we integrate our computational model of granuloma formation and function with models for plasma pharmacokinetics, lung tissue pharmacokinetics and pharmacodynamics for two first line anti-TB antibiotics. The integrated model is calibrated to animal data. We make four predictions. First, antibiotics are frequently below effective concentrations inside granulomas, leading to bacterial growth between doses and contributing to the long treatment periods required for TB. Second, antibiotic concentration gradients form within granulomas, with lower concentrations toward their centers. Third, during antibiotic treatment, bacterial subpopulations are similar for INH and RIF treatment: mostly intracellular with extracellular bacteria located in areas non-permissive for replication (hypoxic areas), presenting a slowly increasing target population over time. Finally, we find that on an individual granuloma basis, pre-treatment infection severity (including bacterial burden, host cell activation and host cell death) is predictive of treatment outcome. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. Information barriers

    International Nuclear Information System (INIS)

    Fuller, J.L.; Wolford, J.

    2001-01-01

    Full text: An information barrier (IB) consists of procedures and technology that prevent the release of sensitive information during a joint inspection of a sensitive nuclear item, and provides confidence that the measurement system into which it has been integrated functions exactly as designed and constructed. Work in the U.S. on radiation detection system information barriers dates back at least to 1990, even though the terminology is more recent. In January 1999 the Joint DoD-DOE Information Barrier Working Group was formed in the United States to help coordinate technical efforts related to information barrier R and D. This paper presents an overview of the efforts of this group, by its Chairs, as well as recommendations for further information barrier R and D. Progress on the demonstration of monitoring systems containing IBs is also provided. From the U.S. perspective, the basic, top-level functional requirements for the information barrier portion of an integrated radiation signature-information barrier inspection system are twofold: The host must be assured that his classified information is protected from disclosure to the inspecting party; and The inspecting party must be confident that the integrated inspection system measures, processes, and presents the radiation-signature-based measurement conclusion in an accurate and reproducible manner. It is the position of the United States that in the absence of any agreement to share classified nuclear weapons design information in the conduct of an inspection regime, the requirement to protect host country classified warhead design information is paramount and admits no tradeoff versus the confidence provided to the inspecting party in the accuracy and reproducibility of the measurements. The U.S. has reached an internal consensus on several critical design elements that define a general standard for radiation signature information barrier design. These criteria have stood the test of time under intense

  12. Facilitators and barriers for retention in HIV care between testing and treatment in Asia-A study in Bangladesh, Indonesia, Lao, Nepal, Pakistan, Philippines and Vietnam.

    Directory of Open Access Journals (Sweden)

    Sushil Koirala

    Full Text Available The need for efficient retention in HIV care is more evident than ever because of the expansion of earlier ART initiation and the shift towards 'Test and Treat'. This study assesses factors affecting participation in the HIV care cascade among people living with HIV (PLHIV in the Asia-Pacific Region.A total of 7843 PLHIV aged 18-50 years were recruited using targeted and venue-based sampling between October 1, 2012, and May 31, 2013, across 59 sites in 7 countries (Bangladesh, Indonesia, Lao People's Democratic Republic (Lao PDR, Nepal, Pakistan, Philippines and Vietnam. Statistically significant associations between demographic and health system determinants, and various steps in the HIV care cascade were computed using a generalized structural equation model.A high proportion of PLHIV (40-51% presented late for HIV care and delayed linkage to care in all seven countries. However, once PLHIV enrolled in care, retention in the various steps of the care cascade including adherence to antiretroviral treatment (ART was satisfactory. The proportion still engaged in HIV care at 36 months post HIV diagnosis, varied from 78% in Nepal to >90% in Lao PDR. Similarly, the proportion of ART initiation who also were adherent to ART ranged from 91% in Bangladesh to >95% in Philippines/ Vietnam and from 70% in Lao PDR to 89% in the Philippines respectively. The following factors enhanced the likelihood of ART initiation and high adherence to HIV care and ART: good client-provider communication, high HIV treatment literacy, a referral from a health worker and TB/HIV co-infection. The following barriers were identified: young age, sex work, imprisonment, transgender identity, illiteracy, rural residence, alcohol/ injecting drug use, perceived poor health status, lack of health insurance, fear of confidentiality breach, self-referral for HIV testing, and public hospital as the place of HIV diagnosis.HIV programme planners should ensure easy access to HIV testing

  13. Facilitators and barriers for retention in HIV care between testing and treatment in Asia-A study in Bangladesh, Indonesia, Lao, Nepal, Pakistan, Philippines and Vietnam.

    Science.gov (United States)

    Koirala, Sushil; Deuba, Keshab; Nampaisan, Oranuch; Marrone, Gaetano; Ekström, Anna Mia

    2017-01-01

    The need for efficient retention in HIV care is more evident than ever because of the expansion of earlier ART initiation and the shift towards 'Test and Treat'. This study assesses factors affecting participation in the HIV care cascade among people living with HIV (PLHIV) in the Asia-Pacific Region. A total of 7843 PLHIV aged 18-50 years were recruited using targeted and venue-based sampling between October 1, 2012, and May 31, 2013, across 59 sites in 7 countries (Bangladesh, Indonesia, Lao People's Democratic Republic (Lao PDR), Nepal, Pakistan, Philippines and Vietnam). Statistically significant associations between demographic and health system determinants, and various steps in the HIV care cascade were computed using a generalized structural equation model. A high proportion of PLHIV (40-51%) presented late for HIV care and delayed linkage to care in all seven countries. However, once PLHIV enrolled in care, retention in the various steps of the care cascade including adherence to antiretroviral treatment (ART) was satisfactory. The proportion still engaged in HIV care at 36 months post HIV diagnosis, varied from 78% in Nepal to >90% in Lao PDR. Similarly, the proportion of ART initiation who also were adherent to ART ranged from 91% in Bangladesh to >95% in Philippines/ Vietnam and from 70% in Lao PDR to 89% in the Philippines respectively. The following factors enhanced the likelihood of ART initiation and high adherence to HIV care and ART: good client-provider communication, high HIV treatment literacy, a referral from a health worker and TB/HIV co-infection. The following barriers were identified: young age, sex work, imprisonment, transgender identity, illiteracy, rural residence, alcohol/ injecting drug use, perceived poor health status, lack of health insurance, fear of confidentiality breach, self-referral for HIV testing, and public hospital as the place of HIV diagnosis. HIV programme planners should ensure easy access to HIV testing and earlier

  14. Floating barrier

    Energy Technology Data Exchange (ETDEWEB)

    1968-05-06

    This floating barrier consists of relatively long elements which can be connected to form a practically continuous assembly. Each element consists of an inflatable tube with an apron of certain height, made of impregnated fabric which is resistant to ocean water and also to hydrocarbons. Means for connecting one element to the following one, and means for attaching ballast to the apron are also provided.

  15. Dynamic modelling of substrate degradation for urban wastewater treatment by sequencing batch reactor

    International Nuclear Information System (INIS)

    Dere, T.; Demirci, Y.; Cekim, M.

    2014-01-01

    This paper presents the dynamic modelling of substrate degradation for urban wastewater treatment by a pilot-scaled sequencing batch reactor including experimental data of a long-term experimental work performed at different operation conditions. During the study, pH, chemical oxygen demand (COD), total nitrogen (TN) and total phosphorus (TP) were measured to investigate SBR treatment performance. Optimum operation times were determined and kinetic constant (k) was calculated (0.60 h-1) with using experimental results for urban wastewater. The Model Simulation estimates were very good fit with the experimental data under organic loading degradation conditions model simulation predictions well match with the experimental results under disturbed organic loading conditions. (author)

  16. Barriers to improvements in energy efficiency

    Energy Technology Data Exchange (ETDEWEB)

    Reddy, A.K.N.

    1991-10-01

    To promote energy-efficiency improvements, actions may be required at one or more levels -- from the lowest level of the consumer (residential, commercial, industrial, etc.) through the highest level of the global agencies. But barriers to the implementation of energy-efficiency improvements exist or can arise at all these levels. Taking up each one of these barriers in turn, the paper discusses specific measures that can contribute to overcoming the barriers. However, a one-barrier-one-measure approach must be avoided. Single barriers may in fact involve several sub-barriers. Also, combinations of measures are much more effective in overcoming barriers. In particular, combinations of measures that simultaneously overcome several barriers are most successful. The paper discusses the typology of barriers, explores their origin and suggests measures that by themselves or in combination with other measures, will overcome these barriers. Since most of the barriers dealt with can be found in the barriers'' literature, any originality in the paper lies in its systematic organization, synoptic view and holistic treatment of this issue. This paper is intended to initiate a comprehensive treatment of barriers, their origins and the measures that contribute to overcoming them. Hopefully, such a treatment will facilitate the implementation of energy-efficiency improvements involving a wide diversity of ever-changing energy end uses and consumer preferences.

  17. Barriers to improvements in energy efficiency

    Energy Technology Data Exchange (ETDEWEB)

    Reddy, A.K.N.

    1991-10-01

    To promote energy-efficiency improvements, actions may be required at one or more levels -- from the lowest level of the consumer (residential, commercial, industrial, etc.) through the highest level of the global agencies. But barriers to the implementation of energy-efficiency improvements exist or can arise at all these levels. Taking up each one of these barriers in turn, the paper discusses specific measures that can contribute to overcoming the barriers. However, a one-barrier-one-measure approach must be avoided. Single barriers may in fact involve several sub-barriers. Also, combinations of measures are much more effective in overcoming barriers. In particular, combinations of measures that simultaneously overcome several barriers are most successful. The paper discusses the typology of barriers, explores their origin and suggests measures that by themselves or in combination with other measures, will overcome these barriers. Since most of the barriers dealt with can be found in the ``barriers`` literature, any originality in the paper lies in its systematic organization, synoptic view and holistic treatment of this issue. This paper is intended to initiate a comprehensive treatment of barriers, their origins and the measures that contribute to overcoming them. Hopefully, such a treatment will facilitate the implementation of energy-efficiency improvements involving a wide diversity of ever-changing energy end uses and consumer preferences.

  18. Modeling social transmission dynamics of unhealthy behaviors for evaluating prevention and treatment interventions on childhood obesity.

    Science.gov (United States)

    Frerichs, Leah M; Araz, Ozgur M; Huang, Terry T-K

    2013-01-01

    Research evidence indicates that obesity has spread through social networks, but lever points for interventions based on overlapping networks are not well studied. The objective of our research was to construct and parameterize a system dynamics model of the social transmission of behaviors through adult and youth influence in order to explore hypotheses and identify plausible lever points for future childhood obesity intervention research. Our objectives were: (1) to assess the sensitivity of childhood overweight and obesity prevalence to peer and adult social transmission rates, and (2) to test the effect of combinations of prevention and treatment interventions on the prevalence of childhood overweight and obesity. To address the first objective, we conducted two-way sensitivity analyses of adult-to-child and child-to-child social transmission in relation to childhood overweight and obesity prevalence. For the second objective, alternative combinations of prevention and treatment interventions were tested by varying model parameters of social transmission and weight loss behavior rates. Our results indicated child overweight and obesity prevalence might be slightly more sensitive to the same relative change in the adult-to-child compared to the child-to-child social transmission rate. In our simulations, alternatives with treatment alone, compared to prevention alone, reduced the prevalence of childhood overweight and obesity more after 10 years (1.2-1.8% and 0.2-1.0% greater reduction when targeted at children and adults respectively). Also, as the impact of adult interventions on children was increased, the rank of six alternatives that included adults became better (i.e., resulting in lower 10 year childhood overweight and obesity prevalence) than alternatives that only involved children. The findings imply that social transmission dynamics should be considered when designing both prevention and treatment intervention approaches. Finally, targeting adults may

  19. Modeling social transmission dynamics of unhealthy behaviors for evaluating prevention and treatment interventions on childhood obesity.

    Directory of Open Access Journals (Sweden)

    Leah M Frerichs

    Full Text Available Research evidence indicates that obesity has spread through social networks, but lever points for interventions based on overlapping networks are not well studied. The objective of our research was to construct and parameterize a system dynamics model of the social transmission of behaviors through adult and youth influence in order to explore hypotheses and identify plausible lever points for future childhood obesity intervention research. Our objectives were: (1 to assess the sensitivity of childhood overweight and obesity prevalence to peer and adult social transmission rates, and (2 to test the effect of combinations of prevention and treatment interventions on the prevalence of childhood overweight and obesity. To address the first objective, we conducted two-way sensitivity analyses of adult-to-child and child-to-child social transmission in relation to childhood overweight and obesity prevalence. For the second objective, alternative combinations of prevention and treatment interventions were tested by varying model parameters of social transmission and weight loss behavior rates. Our results indicated child overweight and obesity prevalence might be slightly more sensitive to the same relative change in the adult-to-child compared to the child-to-child social transmission rate. In our simulations, alternatives with treatment alone, compared to prevention alone, reduced the prevalence of childhood overweight and obesity more after 10 years (1.2-1.8% and 0.2-1.0% greater reduction when targeted at children and adults respectively. Also, as the impact of adult interventions on children was increased, the rank of six alternatives that included adults became better (i.e., resulting in lower 10 year childhood overweight and obesity prevalence than alternatives that only involved children. The findings imply that social transmission dynamics should be considered when designing both prevention and treatment intervention approaches. Finally

  20. Modification of TiO{sub 2} powder via atmospheric dielectric barrier discharge treatment for high performance lithium-ion battery anodes

    Energy Technology Data Exchange (ETDEWEB)

    Chuang, Shang-I; Yang, Hao; Chen, Hsien-Wei; Duh, Jenq-Gong, E-mail: jgd@mx.nthu.edu.tw

    2015-12-01

    The main objective of this study is to improve the electrochemical performances of TiO{sub 2} Li-ion anode material by introducing plasma treatment on TiO{sub 2} powder. A specially designed atmospheric dielectric barrier discharge plasma generator feasible to modify powders is proposed. The rate capacity of 20 min plasma-treated TiO{sub 2} anode revealed nearly 20% increment as compared to that of pristine TiO{sub 2} at the rates of 0.5, 1, 2, 5, 10 C. As-treated TiO{sub 2} was first analyzed by the X-ray diffractometer and high resolution transmission electron microscope confirmed that there was no noticeable surface morphology and microstructure change from plasma treatment. In addition, plasma-treated TiO{sub 2} was reduced with increasing treatment duration. Significant amount of excited argon (Ar{sup ∗}) and excitation of a nitrogen second positive system (N{sub 2}{sup ∗}) were discovered using optical emission spectroscopy (OES). It was believed that Ar{sup ∗} and N{sub 2}{sup ∗} contributed to TiO{sub 2} surface reduction as companied by formation of oxygen vacancy. A higher amount of oxygen vacancy increases the chance of allowing excited nitrogen to dope onto surface of TiO{sub 2} particle. Electrochemical properties of TiO{sub 2} were raised due to the production of oxygen vacancy and nitrogen doping. These findings enhance the understanding of the atmospheric plasma treatment on the potential application of TiO{sub 2} anode material in Li-ion battery. - Highlights: • A plasma generator was developed and proposed for modifying TiO{sub 2} powder in enhancing its electrochemical property. • The plasma treated TiO{sub 2} revealed 20% increment in capacity under different C-rates. • Plasma diagnosis was performed providing an insight of how plasma treatment is effective in TiO{sub 2} surface modification.

  1. Dose conformation to the spine during palliative treatments using dynamic wedges

    Energy Technology Data Exchange (ETDEWEB)

    Ormsby, Matthew A., E-mail: Matthew.Ormsby@usoncology.com [West Texas Cancer Center at Medical Center Hospital, Odessa, TX (United States); Herndon, R. Craig; Kaczor, Joseph G. [West Texas Cancer Center at Medical Center Hospital, Odessa, TX (United States)

    2013-07-01

    Radiation therapy is commonly used to alleviate pain associated with metastatic disease of the spine. Often, isodose lines are manipulated using dynamic or physical wedges to encompass the section of spine needing treatment while minimizing dose to normal tissue. We will compare 2 methods used to treat the entire thoracic spine. The first method treats the thoracic spine with a single, nonwedged posterior-anterior (PA) field. Dose is prescribed to include the entire spine. Isodose lines tightly conform to the top and bottom vertebrae, but vertebrae between these 2 received more than enough coverage. The second method uses a combination of wedges to create an isodose line that mimics the curvature of the thoracic spine. This “C”-shaped curvature is created by overlapping 2 fields with opposing dynamic wedges. Machine constraints limit the treatment length and therefore 2 isocenters are used. Each of the 2 PA fields contributes a portion of the total daily dose. This technique creates a “C”-shaped isodose line that tightly conforms to the thoracic spine, minimizing normal tissue dose. Spinal cord maximum dose is reduced, as well as mean dose to the liver, esophagus, and heart.

  2. Myeloma Cell Dynamics in Response to Treatment Supports a Model of Hierarchical Differentiation and Clonal Evolution.

    Science.gov (United States)

    Tang, Min; Zhao, Rui; van de Velde, Helgi; Tross, Jennifer G; Mitsiades, Constantine; Viselli, Suzanne; Neuwirth, Rachel; Esseltine, Dixie-Lee; Anderson, Kenneth; Ghobrial, Irene M; San Miguel, Jesús F; Richardson, Paul G; Tomasson, Michael H; Michor, Franziska

    2016-08-15

    Since the pioneering work of Salmon and Durie, quantitative measures of tumor burden in multiple myeloma have been used to make clinical predictions and model tumor growth. However, such quantitative analyses have not yet been performed on large datasets from trials using modern chemotherapy regimens. We analyzed a large set of tumor response data from three randomized controlled trials of bortezomib-based chemotherapy regimens (total sample size n = 1,469 patients) to establish and validate a novel mathematical model of multiple myeloma cell dynamics. Treatment dynamics in newly diagnosed patients were most consistent with a model postulating two tumor cell subpopulations, "progenitor cells" and "differentiated cells." Differential treatment responses were observed with significant tumoricidal effects on differentiated cells and less clear effects on progenitor cells. We validated this model using a second trial of newly diagnosed patients and a third trial of refractory patients. When applying our model to data of relapsed patients, we found that a hybrid model incorporating both a differentiation hierarchy and clonal evolution best explains the response patterns. The clinical data, together with mathematical modeling, suggest that bortezomib-based therapy exerts a selection pressure on myeloma cells that can shape the disease phenotype, thereby generating further inter-patient variability. This model may be a useful tool for improving our understanding of disease biology and the response to chemotherapy regimens. Clin Cancer Res; 22(16); 4206-14. ©2016 AACR. ©2016 American Association for Cancer Research.

  3. Dynamic Stabilisation in the Treatment of Degenerative Disc Disease with Modic Changes

    Directory of Open Access Journals (Sweden)

    Olcay Eser

    2013-01-01

    Full Text Available Objective. Posterior dynamic stabilization is an effective alternative to fusion in the treatment of chronic instability and degenerative disc disease (DDD of the lumbar spine. This study was undertaken to investigate the efficacy of dynamic stabilization in chronic degenerative disc disease with Modic types 1 and 2. Modic types 1 and 2 degeneration can be painful. Classic approach in such cases is spine fusion. We operated 88 DDD patients with Modic types 1 and 2 via posterior dynamic stabilization. Good results were obtained after 2 years of followup. Methods. A total of 88 DDD patients with Modic types 1 and 2 were selected for this study. The patients were included in the study between 2004 and 2010. All of them were examined with lumbar anteroposterior (AP and lateral X-rays. Lordosis of the lumbar spine, segmental lordosis, and ratio of the height of the intervertebral disc spaces (IVSs were measured preoperatively and at 3, 12, and 24 months after surgery. Magnetic resonance imaging (MRI analysis was carried out, and according to the data obtained, the grade of disc degeneration was classified. The quality of life and pain scores were evaluated by visual analog scale (VAS score and Oswestry Disability Index (ODI preoperatively and at 3, 12, and 24 months after surgery. Appropriate statistical method was chosen. Results. The mean 3- and 12-month postoperative IVS ratio was significantly greater than that of the preoperative group (P0.05. Furthermore, the mean preoperative and 1 and 2 postoperative angles of lumbar lordosis and segmental lordosis were not significantly different (P>0.05. The mean VAS score and ODI, 3, 12, and 24 months after surgery, decreased significantly, when compared with the preoperative scores in the groups (P=0.000. Conclusion. Dynamic stabilization in chronic degenerative disc disease with Modic types 1 and 2 was effective.

  4. What do parents perceive are the barriers and facilitators to accessing psychological treatment for mental health problems in children and adolescents? A systematic review of qualitative and quantitative studies.

    Science.gov (United States)

    Reardon, Tessa; Harvey, Kate; Baranowska, Magdalena; O'Brien, Doireann; Smith, Lydia; Creswell, Cathy

    2017-06-01

    A minority of children and adolescents with mental health problems access treatment. The reasons for poor rates of treatment access are not well understood. As parents are a key gatekeeper to treatment access, it is important to establish parents' views of barriers/facilitators to accessing treatment. The aims of this study are to synthesise findings from qualitative and quantitative studies that report parents' perceptions of barriers/facilitators to accessing treatment for mental health problems in children/adolescents. A systematic review and narrative synthesis were conducted. Forty-four studies were included in the review and were assessed in detail. Parental perceived barriers/facilitators relating to (1) systemic/structural issues; (2) views and attitudes towards services and treatment; (3) knowledge and understanding of mental health problems and the help-seeking process; and (4) family circumstances were identified. Findings highlight avenues for improving access to child mental health services, including increased provision that is free to service users and flexible to their needs, with opportunities to develop trusting, supportive relationships with professionals. Furthermore, interventions are required to improve parents' identification of mental health problems, reduce stigma for parents, and increase awareness of how to access services.

  5. Validation of an analytical method for simultaneous high-precision measurements of greenhouse gas emissions from wastewater treatment plants using a gas chromatography-barrier discharge detector system.

    Science.gov (United States)

    Pascale, Raffaella; Caivano, Marianna; Buchicchio, Alessandro; Mancini, Ignazio M; Bianco, Giuliana; Caniani, Donatella

    2017-01-13

    Wastewater treatment plants (WWTPs) emit CO 2 and N 2 O, which may lead to climate change and global warming. Over the last few years, awareness of greenhouse gas (GHG) emissions from WWTPs has increased. Moreover, the development of valid, reliable, and high-throughput analytical methods for simultaneous gas analysis is an essential requirement for environmental applications. In the present study, an analytical method based on a gas chromatograph (GC) equipped with a barrier ionization discharge (BID) detector was developed for the first time. This new method simultaneously analyses CO 2 and N 2 O and has a precision, measured in terms of relative standard of variation RSD%, equal to or less than 6.6% and 5.1%, respectively. The method's detection limits are 5.3ppm v for CO 2 and 62.0ppb v for N 2 O. The method's selectivity, linearity, accuracy, repeatability, intermediate precision, limit of detection and limit of quantification were good at trace concentration levels. After validation, the method was applied to a real case of N 2 O and CO 2 emissions from a WWTP, confirming its suitability as a standard procedure for simultaneous GHG analysis in environmental samples containing CO 2 levels less than 12,000mg/L. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. Study of MRI features of intracranial tuberculosis and its dynamic evolution during antituberculous treatment

    International Nuclear Information System (INIS)

    Guo Lifang; Lu Yan; Zhou Xinhua; He Wei; Xie Ruming; Xu Jinping; Ning Fenggang; Zhou Zhen; Zhao Zegang

    2014-01-01

    Objective: To explore MRI features of intracranial tuberculosis, and the dynamic evolution of intracranial tuberculosis during antituberculous treatment. Methods: From September 2009 to February 2012, seventy-two patients with intracranial tuberculosis were reviewed retrospectively. Intracranial tuberculosis lesions were divided into 3 categories: pure parenchymal tuberculosis, tuberculous meningitis and hybrid type with both parenchymal tuberculosis and tuberculous meningitis. The MRI characteristics of these lesions were analysed. According to the lesion size, pure parenchymal tuberculosis was divided into 3 subtypes: 0.3 cm or less was defined as miliary, >0.3 cm and <1.0 cm as nodule, greater than or equal to 1.0 cm as tuberculoma. Serial follow-up scans were performed in 36 patients, and dynamic MRI changes in the process of anti-tuberculosis treatment during 3 to 6 months were observed. The disappearance rate of the lesions was calculated and statistically analysed by using Chi-square test. Results: There were 883 lesions in 38 cases with parenchymal tuberculosis. Multiple lesions distributed widely, 423 lesions (47.9%) ≤0.3 cm, 330 lesions (37.4%) between 0.3-1.0 cm, and 130 lesions (14.7%) ≥ 1.0 cm. Twenty-four cases with tuberculous meningitis showed meningeal enhancement at basilar cistern. Ten cases with hybrid type presented both parenchymal tuberculosis and meningitis. Among 36 patients with serial MRI follow-up scans, 22 cases were pure parenchymal tuberculosis. The disappearance rates of military, nodules and tuberculomas were 52.2% (59/113), 33.3% (33/99) and 0, respectively, after 3 months treatment. The disappearance rates were 87.6% (99/113), 50.5% (50/99) and 18.2% (2/11), respectively, after 6 months treatment. Disappearance rate of miliary lesions was obviously higher than that of nodules at both 3 and 6 months, and the difference was statistically significant,(χ 2 =7.657, 34.786, P<0.01). Nine lesions of parenchymal tuberculosis enlarged

  7. Machine-specific quality assurance procedure for stereotactic treatments with dynamic couch rotations.

    Science.gov (United States)

    Wilson, Byron; Gete, Ermias

    2017-12-01

    We present a method in which the treatment couch's accuracy is measured using the electronic portal imaging device (EPID) and a phantom of our own construction. Using this phantom, we were able to quantify the treatment couch walkout, and the rotation angle accuracy for both static and dynamic couch treatments. These measurements were used to provide an accurate measure of the treatment couch isocenter as well as to verify the couch rotation angle recorded in the trajectory log. The phantom was constructed using a polystyrene slab in which five ball bearings of 4 mm diameter are placed on the same plane at varying radii (0, 2.8, 4.4, 5.6, and 6.7 cm). The couch was rotated through its full extent (-90, 90 degrees) while MV images were acquired continuously. The couch rotational accuracy was calculated using a least squares minimization which fit the locations of the BBs to their expected locations relative to reference setup conditions. Using this approach, rotation angle and isocenter walkout was calculated in three dimensions. These measurements were used to quantify the accuracy of the couch as well as to validate the Varian TrueBeam trajectory logs. Additionally, a method for an EPID-based couch star-shot measurement was developed and compared with the traditional film-based method. The measured couch center of rotation consisted of a cloud of points clustered around the room isocenter within 0.7 mm distance. The trajectory log couch angle values agreed with those recorded in the DICOM header of the EPID images to the third significant digit and the couch rotation angles recorded in the trajectory log and DICOM header agreed with the calculated values to 0.08 degrees. Comparison of couch star-shot measurement developed in this study with film-based star-shot measurements gave an agreement to within 0.2 mm. We have developed a quality assurance method for the treatment couch which is simple, accurate, and enables the user to access a multitude of consistent data

  8. Dynamics of electron scattering in absolutely transparent channels in three-barrier structures in the case of two-photon transitions

    Energy Technology Data Exchange (ETDEWEB)

    Pashkovskii, A. B., E-mail: solidstate10@mail.ru [Shokin Joint-Stock Company ISTOK Research and Production Corporation (Russian Federation)

    2017-04-15

    Solution of the Schrödinger equation, which describes resonant transitions between three quantum levels in large-signal and high-frequency electric fields, is generalized to the case of the detuning of frequencies and energies from those exactly resonant for asymmetric three-barrier resonance-tunneling structures with thin high barriers. The dependence of the shape of the resonance levels on the amplitude and frequency of electric fields is studied. It is shown that the number of regions of absolute transparency can be as large as four depending on the microwave-field amplitude.

  9. Is forced migration a barrier to treatment success? Similar HIV treatment outcomes among refugees and a surrounding host community in Kuala Lumpur, Malaysia.

    Science.gov (United States)

    Mendelsohn, Joshua B; Schilperoord, Marian; Spiegel, Paul; Balasundaram, Susheela; Radhakrishnan, Anuradha; Lee, Christopher K C; Larke, Natasha; Grant, Alison D; Sondorp, Egbert; Ross, David A

    2014-02-01

    In response to an absence of studies among refugees and host communities accessing highly active antiretroviral therapy (HAART) in urban settings, our objective was to compare adherence and virological outcomes among clients attending a public clinic in Kuala Lumpur, Malaysia. A cross-sectional survey was conducted among adult clients (≥18 years). Data sources included a structured questionnaire that measured self-reported adherence, a pharmacy-based measure of HAART prescription refills over the previous 24 months, and HIV viral loads. The primary outcome was unsuppressed viral load (≥40 copies/mL). Among a sample of 153 refugees and 148 host community clients, refugees were younger (median age 35 [interquartile range, IQR 31, 39] vs 40 years [IQR 35, 48], p < 0.001), more likely to be female (36 vs 21 %, p = 0.004), and to have been on HAART for less time (61 [IQR 35, 108] vs 153 weeks [IQR 63, 298]; p < 0.001). Among all clients, similar proportions of refugee and host clients were <95 % adherent to pharmacy refills (26 vs 34 %, p = 0.15). When restricting to clients on treatment for ≥25 weeks, similar proportions from each group were not virologically suppressed (19 % of refugees vs 16 % of host clients, p = 0.54). Refugee status was not independently associated with the outcome (adjusted odds ratio, aOR = 1.28, 95 % CI 0.52, 3.14). Overall, the proportions of refugee and host community clients with unsuppressed viral loads and sub-optimal adherence were similar, supporting the idea that refugees in protracted asylum situations are able to sustain good treatment outcomes and should explicitly be included in the HIV strategic plans of host countries with a view to expanding access in accordance with national guidelines for HAART.

  10. Barrier island facies models and recognition criteria

    Science.gov (United States)

    Mulhern, J.; Johnson, C. L.

    2017-12-01

    Barrier island outcrops record transgressive shoreline motion at geologic timescales, providing integral clues to understanding how coastlines respond to rising sea levels. However, barrier island deposits are difficult to recognize. While significant progress has been made in understanding the modern coastal morphodynamics, this insight is not fully leveraged in existing barrier island facies models. Excellent outcrop exposures of the paralic Upper Cretaceous Straight Cliffs Formation of southern Utah provide an opportunity to revise facies models and recognition criteria for barrier island deposits. Preserved barrier islands are composed of three main architectural elements (shorefaces, tidal inlets, and tidal channels) which occur independently or in combination to create larger-scale barrier island deposits. Barrier island shorefaces record progradation, while barrier island tidal inlets record lateral migration, and barrier island tidal channels record aggradation within the tidal inlet. Four facies associations are used to describe and characterize these barrier island architectural elements. Barrier islands occur in association with backarrier fill and internally contain lower and upper shoreface, high-energy upper shoreface, and tidal channel facies. Barrier islands bound lagoons or estuaries, and are distinguished from other shoreface deposits by their internal facies and geometry, association with backbarrier facies, and position within transgressive successions. Tidal processes, in particular tidal inlet migration and reworking of the upper shoreface, also distinguish barrier island deposits. Existing barrier island models highlight the short term heterogeneous and dynamic nature of barrier island systems, yet overlook processes tied to geologic time scales, such as multi-directional motion, erosion, and reworking, and their expressions in preserved barrier island strata. This study uses characteristic outcrop expressions of barrier island successions to

  11. Smart parking barrier

    KAUST Repository

    Alharbi, Abdulrazaq M.

    2016-01-01

    positioning of the movable parking barrier, and a parking controller configured to initiate movement of the parking barrier, via the barrier drive. The movable parking barrier can be positioned between a first position that restricts access to the parking

  12. Constraint treatment techniques and parallel algorithms for multibody dynamic analysis. Ph.D. Thesis

    Science.gov (United States)

    Chiou, Jin-Chern

    1990-01-01

    Computational procedures for kinematic and dynamic analysis of three-dimensional multibody dynamic (MBD) systems are developed from the differential-algebraic equations (DAE's) viewpoint. Constraint violations during the time integration process are minimized and penalty constraint stabilization techniques and partitioning schemes are developed. The governing equations of motion, a two-stage staggered explicit-implicit numerical algorithm, are treated which takes advantage of a partitioned solution procedure. A robust and parallelizable integration algorithm is developed. This algorithm uses a two-stage staggered central difference algorithm to integrate the translational coordinates and the angular velocities. The angular orientations of bodies in MBD systems are then obtained by using an implicit algorithm via the kinematic relationship between Euler parameters and angular velocities. It is shown that the combination of the present solution procedures yields a computationally more accurate solution. To speed up the computational procedures, parallel implementation of the present constraint treatment techniques, the two-stage staggered explicit-implicit numerical algorithm was efficiently carried out. The DAE's and the constraint treatment techniques were transformed into arrowhead matrices to which Schur complement form was derived. By fully exploiting the sparse matrix structural analysis techniques, a parallel preconditioned conjugate gradient numerical algorithm is used to solve the systems equations written in Schur complement form. A software testbed was designed and implemented in both sequential and parallel computers. This testbed was used to demonstrate the robustness and efficiency of the constraint treatment techniques, the accuracy of the two-stage staggered explicit-implicit numerical algorithm, and the speed up of the Schur-complement-based parallel preconditioned conjugate gradient algorithm on a parallel computer.

  13. Treatment with the NK1 antagonist emend reduces blood brain barrier dysfunction and edema formation in an experimental model of brain tumors.

    Directory of Open Access Journals (Sweden)

    Elizabeth Harford-Wright

    Full Text Available The neuropeptide substance P (SP has been implicated in the disruption of the blood-brain barrier (BBB and development of cerebral edema in acute brain injury. Cerebral edema accumulates rapidly around brain tumors and has been linked to several tumor-associated deficits. Currently, the standard treatment for peritumoral edema is the corticosteroid dexamethasone, prolonged use of which is associated with a number of deleterious side effects. As SP is reported to increase in many cancer types, this study examined whether SP plays a role in the genesis of brain peritumoral edema. A-375 human melanoma cells were injected into the right striatum of male Balb/c nude mice to induce brain tumor growth, with culture medium injected in animals serving as controls. At 2, 3 or 4 weeks following tumor cell inoculation, non-treated animals were perfusion fixed for immunohistochemical detection of Albumin, SP and NK1 receptor. A further subgroup of animals was treated with a daily injection of the NK1 antagonist Emend (3 mg/kg, dexamethasone (8 mg/kg or saline vehicle at 3 weeks post-inoculation. Animals were sacrificed a week later to determine BBB permeability using Evan's Blue and brain water content. Non-treated animals demonstrated a significant increase in albumin, SP and NK1 receptor immunoreactivity in the peritumoral area as well as increased perivascular staining in the surrounding brain tissue. Brain water content and BBB permeability was significantly increased in tumor-inoculated animals when compared to controls (p<0.05. Treatment with Emend and dexamethasone reduced BBB permeability and brain water content when compared to vehicle-treated tumor-inoculated mice. The increase in peritumoral staining for both SP and the NK1 receptor, coupled with the reduction in brain water content and BBB permeability seen following treatment with the NK1 antagonist Emend, suggests that SP plays a role in the genesis of peritumoral edema, and thus warrants

  14. Clinical comparison of Bio-Oss plus 10% collagen with a bioabsorbable collagen barrier or coronally advanced flap in treatment of mandibular molars class II furcation defects

    Directory of Open Access Journals (Sweden)

    Radafshar G.

    2008-10-01

    Full Text Available "nBackground and Aim: Furcation defects are one of the most challenging problems in periodontal therapy. Regenerative treatment significantly improves the prognosis of the involved teeth. The aim of this study was to compare Bio-Oss plus 10% collagen in combination with either a bioabsorbable collagen barrier (BO/GTR, or coronally advanced flap (BO/CF, in treating human mandibular class II furcation defects. "nMaterials and Methods: This clinical trial included 10 patients with 10 pairs of similar periodontal defects. Each defect was randomly assigned to treatment with BO/CF or BO/GTR. Following basic therapy, baseline measurements were recorded including probing pocket depth (PPD,closed horizontal probing depth (CHPD, clinical attachment level (CAL, and gingival margin position (CEJ-GM, together with plaque and gingival indices. Hard tissue measurements were performed during surgery to determine alveolar crestal height (CEJ-AC, and vertical and horizontal open probing depth (OVPD, OHPD.After 6 months, all sites were re-entered and soft and hard tissue measurements were recorded. "nResults: Both surgical procedures significantly reduced probing depth and improved clinical attachment levels, with no significant difference between groups. Gingival margin position (CEJ-GM, was improved in the BO/CF group (0.66±0.51 mm, p<0.05, but not statistically different from BO/GTR group in which remained relatively constant (0.00±0.81 mm. Vertical defect resolution was significant in each groups (BO/CF:3.17±1.47 mm, BO/GTR:3.33±0.51mm. Horizontal defect resolution was also significant with either procedure (BO/CF:3.67±1.31 mm, BO/GTR:3.80±1.83 mm, with no statistically significant difference between groups. Data were analyzed with wilcoxon and Mann-Whitney tests with p<0.05 as the level of significance. "nConclusion: Based on the results of this study, treatment of mandibular class II furcation defects with both procedures resulted in statistically

  15. Identifying social and economic barriers to regular care and treatment for Black men who have sex with men and women (BMSMW) and who are living with HIV: a qualitative study from the Bruthas cohort.

    Science.gov (United States)

    Arnold, Emily A; Weeks, John; Benjamin, Michael; Stewart, William R; Pollack, Lance M; Kegeles, Susan M; Operario, Don

    2017-01-28

    There is little research regarding the ability of Black men who have sex with men and women (BMSMW) to access and maintain HIV-related health care and treatment adherence. This population, who often insist on secrecy about their same-sex desire, may experience unique barriers to seeking regular care and treatment. From March 2011-April 2014, we recruited 396 BMSMW in the San Francisco Bay Area to be enrolled in our randomized controlled trial. At baseline we administered a behavioral survey assessing: demographics, homelessness, employment, history of incarceration, HIV status and disclosure practices, care and treatment adherence. 64 men reported living with HIV at intake. To learn more about their experiences, we recruited N = 25 to participate in qualitative interviews, which were conducted April-December 2014. Topics included: current living situation, diagnosis story, disclosure practices, experiences of accessing and maintaining care and treatment, and HIV-related stigma. Recordings were transcribed and coded for major themes. Despite being located in an area where treatment is plentiful, men faced social and economic barriers to maintaining regular care and treatment adherence. Several findings emerged to shed light on this quandary: (1) Competing needs particularly around attaining stable housing, food security, and money created barriers to treatment and care; (2) Side effects of HIV medications discouraged men from adhering to treatment; (3) Provider and Institutional level characteristics influenced care engagement; (4) Disclosure and social support made a difference in care and treatment behaviors; and (5) Participants expressed a desire for group-based intervention activities to support treatment and care among HIV+ BMSMW. Inadequate engagement in the continuum of care for HIV was born out in the quantitative data where 28% of participants did not know their Viral Load. A holistic approach to HIV health for BMSMW would appear to translate to better

  16. Barriers against psychosocial communication: oncologists' perceptions.

    Science.gov (United States)

    Fagerlind, Hanna; Kettis, Åsa; Glimelius, Bengt; Ring, Lena

    2013-10-20

    To explore oncologists' psychosocial attitudes and beliefs and their perceptions regarding barriers against psychosocial communication. A questionnaire was distributed to oncologists in Sweden (n = 537). Questions covered demography, the Physician Psychosocial Beliefs Scale (PPBS), and barriers against psychosocial communication. Stepwise multiple regression was used to determine what factors contribute the most to the PPBS score and the total number of barriers and barriers affecting clinical practice, respectively. Spearman rank-order correlation was used to determine correlation between PPBS score and number of barriers. Questionnaire response rate was 64%. Mean PPBS value was 85.5 (range, 49 to 123; SD, 13.0). Most oncologists (93%) perceived one or more barriers in communicating psychosocial aspects with patients. On average, five different communication barriers were perceived, of which most were perceived to affect clinical practice. These barriers included insufficient consultation time, lack of resources for taking care of problems discovered, and lack of methods to evaluate patients' psychosocial health in clinical practice. There was a positive correlation (rs = 0.490; P barriers (ie, less psychosocially oriented oncologists perceived more barriers). Oncologists with supplementary education with a psychosocial focus perceived fewer barriers/barriers affecting clinical practice (P barriers affecting psychosocial communication in clinical practice. Interventions aiming to improve psychosocial communication must therefore be multifaceted and individualized to clinics and individual oncologists. It is important to minimize barriers to facilitate optimal care and treatment of patients with cancer.

  17. The dynamics of histamine level in patients with chronic urticaria under the influence of different methods of treatment.

    Directory of Open Access Journals (Sweden)

    Dytyatkovska Ye.M.

    2014-11-01

    Full Text Available There was studied the efficiency of different methods of chronic urticaria treatment. All patients were divided into 2 groups depending on treatment scteme. The paper shows the dynamics of histamine level in blood plasma, intestine disbiosis in patients with chronic urticaria under the influence of different treatment complexes. It was proved that there exists the correlation between the serum histamine level and method of treatment. Intro¬ducing bionorm into the treatment allows to decrease histamine level and correspondingly to significantly improve clinical effect and patients’ life quality.

  18. WE-AB-209-06: Dynamic Collimator Trajectory Algorithm for Use in VMAT Treatment Deliveries

    Energy Technology Data Exchange (ETDEWEB)

    MacDonald, L [Department of Medical Physics, Dalhousie University, Halifax, Nova Scotia, CA (Canada); Thomas, C; Syme, A [Department of Medical Physics, Dalhousie University, Halifax, Nova Scotia, CA (Canada); Department of Radiation Oncology, Dalhousie University, Halifax, Nova Scotia (Canada); Medical Physics, Nova Scotia Cancer Centre, Halifax, Nova Scotia (Canada)

    2016-06-15

    Purpose: To develop advanced dynamic collimator positioning algorithms for optimal beam’s-eye-view (BEV) fitting of targets in VMAT procedures, including multiple metastases stereotactic radiosurgery procedures. Methods: A trajectory algorithm was developed, which can dynamically modify the angle of the collimator as a function of VMAT control point to provide optimized collimation of target volume(s). Central to this algorithm is a concept denoted “whitespace”, defined as area within the jaw-defined BEV field, outside of the PTV, and not shielded by the MLC when fit to the PTV. Calculating whitespace at all collimator angles and every control point, a two-dimensional topographical map depicting the tightness-of-fit of the MLC was generated. A variety of novel searching algorithms identified a number of candidate trajectories of continuous collimator motion. Ranking these candidate trajectories according to their accrued whitespace value produced an optimal solution for navigation of this map. Results: All trajectories were normalized to minimum possible (i.e. calculated without consideration of collimator motion constraints) accrued whitespace. On an acoustic neuroma case, a random walk algorithm generated a trajectory with 151% whitespace; random walk including a mandatory anchor point improved this to 148%; gradient search produced a trajectory with 137%; and bi-directional gradient search generated a trajectory with 130% whitespace. For comparison, a fixed collimator angle of 30° and 330° accumulated 272% and 228% of whitespace, respectively. The algorithm was tested on a clinical case with two metastases (single isocentre) and identified collimator angles that allow for simultaneous irradiation of the PTVs while minimizing normal tissue irradiation. Conclusion: Dynamic collimator trajectories have the potential to improve VMAT deliveries through increased efficiency and reduced normal tissue dose, especially in treatment of multiple cranial metastases

  19. WE-AB-209-06: Dynamic Collimator Trajectory Algorithm for Use in VMAT Treatment Deliveries

    International Nuclear Information System (INIS)

    MacDonald, L; Thomas, C; Syme, A

    2016-01-01

    Purpose: To develop advanced dynamic collimator positioning algorithms for optimal beam’s-eye-view (BEV) fitting of targets in VMAT procedures, including multiple metastases stereotactic radiosurgery procedures. Methods: A trajectory algorithm was developed, which can dynamically modify the angle of the collimator as a function of VMAT control point to provide optimized collimation of target volume(s). Central to this algorithm is