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Sample records for nordheim integral treatment

  1. Support Systems for Treatment Integrity

    ERIC Educational Resources Information Center

    Goense, Pauline Brigitta; Boendermaker, Leonieke; van Yperen, Tom

    2016-01-01

    Objective: This systematic review evaluates the content of effective support provided to practitioners of evidence-based interventions in order to establish and maintain treatment integrity. Method: Four articles covering six outcome studies are included in this review, these studies (1) adequately operationalized treatment integrity procedures…

  2. Special features of Fowler-Nordheim stress degradation of SiC-MOSFETs

    NASA Astrophysics Data System (ADS)

    Murakami, Eiichi; Oda, Kazuhiro; Takeshita, Tatsuya

    2016-04-01

    SiC-MOSFETs have been markedly developed, and the main issues remaining are high-temperature stability and gate-oxide integrity. In this paper, we report special features of I ds-V gs and I g-V gs characteristics of commercially available SiC-MOSFETs during high-gate-voltage and high-temperature stress. Moreover, we introduce simple analytical models that reveal the effects of the trapped charges on the characteristics. Interface states around the conduction-band edge are suggested to be the key mechanisms of Fowler-Nordheim stress degradation (FN degradation) as well as negative bias temperature instability (NBTI), which affects both mobility and carrier density. Hole trapping is also important in FN degradation as well as NBTI. Near-interfacial electron trapping and detrapping found in positive bias temperature instability (PBTI) is also observed in FN degradation. A continuous I g increase during FN stress, which is the most specific to SiC-MOSFETs, is related to the observation that near-interfacial electron trapping has little effect on FN tunneling.

  3. Integrated nonthermal treatment system study

    SciTech Connect

    Biagi, C.; Bahar, D.; Teheranian, B.; Vetromile, J.; Quapp, W.J.; Bechtold, T.; Brown, B.; Schwinkendorf, W.; Swartz, G.

    1997-01-01

    This report presents the results of a study of nonthermal treatment technologies. The study consisted of a systematic assessment of five nonthermal treatment alternatives. The treatment alternatives consist of widely varying technologies for safely destroying the hazardous organic components, reducing the volume, and preparing for final disposal of the contact-handled mixed low-level waste (MLLW) currently stored in the US Department of Energy complex. The alternatives considered were innovative nonthermal treatments for organic liquids and sludges, process residue, soil and debris. Vacuum desorption or various washing approaches are considered for treatment of soil, residue and debris. Organic destruction methods include mediated electrochemical oxidation, catalytic wet oxidation, and acid digestion. Other methods studied included stabilization technologies and mercury separation of treatment residues. This study is a companion to the integrated thermal treatment study which examined 19 alternatives for thermal treatment of MLLW waste. The quantities and physical and chemical compositions of the input waste are based on the inventory database developed by the US Department of Energy. The Integrated Nonthermal Treatment Systems (INTS) systems were evaluated using the same waste input (2,927 pounds per hour) as the Integrated Thermal Treatment Systems (ITTS). 48 refs., 68 figs., 37 tabs.

  4. Fowler-Nordheim emission modified by laser pulses in the adiabatic regime

    NASA Astrophysics Data System (ADS)

    Rokhlenko, A.; Lebowitz, J. L.

    2016-06-01

    We investigate enhanced field emission due to a continuous or pulsed oscillating field added to a constant electric field E at the emitter surface. When the frequency of oscillation, field strength, and property of the emitter material satisfy the Keldysh condition γ<1 /2 , one can use the adiabatic approximation for treating the oscillating field, i.e., consider the tunneling through the instantaneous Fowler-Nordheim barrier created by both fields. Due to the great sensitivity of the emission to the field strength, the average tunneling current can be much larger than the current produced by only the constant field. We carry out the computations for arbitrary strong constant electric fields, beyond the commonly used Fowler-Nordheim approximation which exhibit, in particular, an important property of the wave function inside the potential barrier where it is found to be monotonically decreasing without oscillations.

  5. Blow-up rate estimates for the solutions of the bosonic Boltzmann-Nordheim equation

    NASA Astrophysics Data System (ADS)

    Bandyopadhyay, J.; Velázquez, J. J. L.

    2015-06-01

    In this paper, we study the behavior of a class of mild solutions of the homogeneous and isotropic bosonic Boltzmann-Nordheim equation near the blow-up. We obtain some estimates on the blow-up rate of the solutions and prove that, as long as a solution is bounded above by the critical singularity /1 x (the equilibrium solutions behave like this power law near the origin), it remains bounded in the uniform norm. In Sec. III of the paper, we prove a local existence result for a class of measure-valued mild solutions, which is of independent interest and which allows us to solve the Boltzmann-Nordheim equation for some classes of unbounded densities.

  6. Nordheim-Gorter like behavior and one carrier conduction in a quasi-one-dimensional system

    NASA Technical Reports Server (NTRS)

    Datta, T.; Hermann, A. M.; Deck, R. J.; Somoano, R. B.

    1980-01-01

    A linear correlation has been observed between the thermopower and the conductivity in the high-temperature state (T greater than 220 K) of the TTF halide and pseudohalide salts. It is suggested that this correlation indicates conduction by a single type of carrier under two types of scattering and represents the first reported extension of the Nordheim-Gorter behavior to any quasi-one-dimensional conductor.

  7. On the Blow Up and Condensation of Supercritical Solutions of the Nordheim Equation for Bosons

    NASA Astrophysics Data System (ADS)

    Escobedo, M.; Velázquez, J. J. L.

    2014-08-01

    In this paper we prove that the solutions of the isotropic, spatially homogeneous Nordheim equation for bosons with bounded initial data blow up in finite time in the L ∞ norm if the values of the energy and particle density are in the range of values where the corresponding equilibria contain a Dirac mass. We also prove that, in the weak solutions, whose initial data are measures with values of particle and energy densities satisfying the previous condition, a Dirac measure at the origin forms in finite time.

  8. Impact of Treatment Integrity on Intervention Effectiveness

    ERIC Educational Resources Information Center

    Fryling, Mitch J.; Wallace, Michele D.; Yassine, Jordan N.

    2012-01-01

    Treatment integrity has cogent implications for intervention effectiveness. Understanding these implications is an important, but often neglected, undertaking in behavior analysis. This paper reviews current research on treatment integrity in applied behavior analysis. Specifically, we review research evaluating the relation between integrity…

  9. On the Cauchy Problem for the Homogeneous Boltzmann-Nordheim Equation for Bosons: Local Existence, Uniqueness and Creation of Moments

    NASA Astrophysics Data System (ADS)

    Briant, Marc; Einav, Amit

    2016-06-01

    The Boltzmann-Nordheim equation is a modification of the Boltzmann equation, based on physical considerations, that describes the dynamics of the distribution of particles in a quantum gas composed of bosons or fermions. In this work we investigate the Cauchy theory of the spatially homogeneous Boltzmann-Nordheim equation for bosons, in dimension d≥slant 3. We show existence and uniqueness locally in time for any initial data in L^∞ (1+| v| ^s) with finite mass and energy, for a suitable s, as well as the instantaneous creation of moments of all order.

  10. On the Cauchy Problem for the Homogeneous Boltzmann-Nordheim Equation for Bosons: Local Existence, Uniqueness and Creation of Moments

    NASA Astrophysics Data System (ADS)

    Briant, Marc; Einav, Amit

    2016-04-01

    The Boltzmann-Nordheim equation is a modification of the Boltzmann equation, based on physical considerations, that describes the dynamics of the distribution of particles in a quantum gas composed of bosons or fermions. In this work we investigate the Cauchy theory of the spatially homogeneous Boltzmann-Nordheim equation for bosons, in dimension d≥slant 3 . We show existence and uniqueness locally in time for any initial data in L^∞ (1+| v| ^s) with finite mass and energy, for a suitable s, as well as the instantaneous creation of moments of all order.

  11. Advances in Treatment Integrity Research: Multidisciplinary Perspectives on the Conceptualization, Measurement, and Enhancement of Treatment Integrity

    ERIC Educational Resources Information Center

    Schulte, Ann C.; Easton, Julia E.; Parker, Justin

    2009-01-01

    Documenting treatment integrity is an important issue in research and practice in any discipline concerned with prevention and intervention. However, consensus concerning the dimensions of treatment integrity and how they should be measured has yet to emerge. Advances from three areas in which significant treatment integrity work has taken…

  12. Practical Consideration of Both Endurance and Performance for Sub-90 nm Embedded Two Transistor Fowler-Nordheim Tunneling Flash Memory

    NASA Astrophysics Data System (ADS)

    Lee, Yong Kyu; Seo, Boyoung

    2012-02-01

    Practical consideration about performance and endurance of two transistor Fowler-Nordheim tunneling (2T-FN) embedded flash cell has been suggested to expand its application not only for subscriber identity module (SIM) but also new various uses in smart-phone. We present practical 35% improvement on endurance characteristics (ΔVth) without any performance degradation.

  13. A simple method for determination of Fowler-Nordheim tunnelling parameters

    NASA Astrophysics Data System (ADS)

    Casados-Cruz, G.; Reyes-Barranca, M. A.; Moreno-Cadenas, J. A.

    2011-05-01

    A simple technique for extracting the Fowler-Nordheim (FN) tunnelling parameters is proposed. It consists of measuring the Drain-Source current of a floating gate transistor while a linear ramp voltage is applied to a simple injector structure attached to the transistor's floating gate. Such a test device is fabricated using a standard CMOS process. The parameters obtained can be used in a freely available electrical simulator as SPICE3f5 (NGSPICE), but in general it can be easily adapted to other SPICE-like programs. We describe the technique step-by-step and a comparison is made of simulated and measured FN tunnelling parameters, for a floating gate transistor with tunnelling injectors. A good agreement has been found between experimental and simulated data.

  14. INTEGRATED WATER TREATMENT SYSTEM PERFORMANCE EVALUATION

    SciTech Connect

    SEXTON RA; MEEUWSEN WE

    2009-03-12

    This document describes the results of an evaluation of the current Integrated Water Treatment System (IWTS) operation against design performance and a determination of short term and long term actions recommended to sustain IWTS performance.

  15. Waste treatment integration in space

    NASA Technical Reports Server (NTRS)

    Baresi, L.; Kern, R.

    1991-01-01

    The circumstances and criteria for space-based waste treatment bioregenerative life-support systems differ in many ways from those needed in terrestrial applications. In fact, the term "waste" may not even be appropriate in the context of nearly closed, cycling, ecosystems such as those under consideration. Because of these constraints there is a need for innovative approaches to the problem of "materials recycling". Hybrid physico-chemico-biological systems offer advantages over both strictly physico-chemico or biological approaches that would be beneficial to material recycling. To effectively emulate terrestrial cycling, the use of various microbial consortia ("assemblies of interdependent microbes") should be seriously considered for the biological components of such systems. This paper will examine the use of consortia in the context of a hybrid-system for materials recycling in space.

  16. Waste treatment integration in space.

    PubMed

    Baresi, L; Kern, R

    1991-10-01

    The circumstances and criteria for space-based waste treatment bioregenerative life-support systems differ in many ways from those needed in terrestrial applications. In fact, the term "waste" may not even be appropriate in the context of nearly closed, cycling, ecosystems such as those under consideration. Because of these constraints there is a need for innovative approaches to the problem of "materials recycling". Hybrid physico-chemico-biological systems offer advantages over both strictly physico-chemico or biological approaches that would be beneficial to material recycling. To effectively emulate terrestrial cycling, the use of various microbial consortia ("assemblies of interdependent microbes") should be seriously considered for the biological components of such systems. This paper will examine the use of consortia in the context of a hybrid-system for materials recycling in space. PMID:11537702

  17. Treatment Integrity Assessment in the Schools: An Evaluation of the Treatment Integrity Planning Protocol

    ERIC Educational Resources Information Center

    Sanetti, Lisa M. Hagermoser; Kratochwill, Thomas R.

    2009-01-01

    The Treatment Integrity Planning Protocol (TIPP) provides a structured process for collaboratively creating a treatment integrity assessment within a consultation framework. The authors evaluated the effect of the TIPP on the implementation of an intervention designed to improve the consistency of students' mathematics performance. Treatment…

  18. Relationships among the physical parameters required to give a linear relation between slope and intercept of Fowler-Nordheim plots.

    PubMed

    Gotoh, Y; Tsuji, H; Ishikawa, J

    2001-10-01

    For field emitters with a given surface condition, but different apex radii, there exists an empirical linear relationship between the slopes and intercepts of their Fowler-Nordheim plots. This behavior is quite different from that predicted by the theory with the assumption of a smooth surface. We have already characterized the possible reasons for this discrepancy; one possibility is that the emission area rapidly increases with increase in the apex radius. The previous report (Jpn. J. Appl. Phys. Part II 32 (1993) L342), however, showed a curved relation between the slope and the intercept of Fowler-Nordheim plots. In the present article, we try to extract the relationship between the emission area and the apex radius needed in order to give a linear relationship between slope and intercept of the F-N plots. As an additional result of the present analysis, the change in work function of the field emitting surface is demonstrated. PMID:11770752

  19. Barriers to Infertility Treatment: An Integrated Study

    PubMed Central

    Mosalanejad, Leili; Parandavar, Nehle; Abdollahifard, Sareh

    2014-01-01

    Background: Infertility is one of the most important events in life. Despite the negative impact of infertility, a significant number of women struggling to conceive do not consult a physician and do not fallow up infertility treatment. This integrated study aimed to investigate a large amount of factors which influenced discontinuation of infertility treatment. Methods: This integrated study (qualitative – quantitative study) was done on infertile women who had referred to infertility center in Jahrom University of medical sciences using purposive sampling. In the first study, data were collected from a valid questionnaire with 22 questions in a 5-point likert scale about barriers to infertility treatments and in the second study, as a phenomenology approach, data collection was done using deep unstructured interviews and focused groups were aimed to identify deep individual experiences about it. Results: major barriers to infertility treatments included the probability of treatment failure (52.5%), couple’s age and possibility of high risk pregnancy (51.5%), Painfulness of some treatment methods such as laparoscopy (50.5%). Qualitative results led to the identification of three main themes: Nature of treatment, negative thinking, social and cultural factors. Conclusion: As a result, we suggest family education and enrichment of cultural context in the field of infertility; infertile people would be willing to pursue infertility treatments. PMID:24373278

  20. Fowler-Nordheim tunneling induced charge transfer plasmons between nearly touching nanoparticles.

    PubMed

    Wu, Lin; Duan, Huigao; Bai, Ping; Bosman, Michel; Yang, Joel K W; Li, Erping

    2013-01-22

    Reducing the gap between two metal nanoparticles down to atomic dimensions uncovers novel plasmon resonant modes. Of particular interest is a mode known as the charge transfer plasmon (CTP). This mode has been experimentally observed in touching nanoparticles, where charges can shuttle between the nanoparticles via a conductive path. However, the CTP mode for nearly touching nanoparticles has only been predicted theoretically to occur via direct tunneling when the gap is reduced to ~0.4 nm. Because of challenges in fabricating and characterizing gaps at these dimensions, experiments have been unable to provide evidence for this plasmon mode that is supported by tunneling. In this work, we consider an alternative tunneling process, that is, the well-known Fowler-Nordheim (FN) tunneling that occurs at high electric fields, and apply it for the first time in the theoretical investigation of plasmon resonances between nearly touching nanoparticles. This new approach relaxes the requirements on gap dimensions, and intuitively suggests that with a sufficiently high-intensity irradiation, the CTP can be excited via FN tunneling for a range of subnanometer gaps. The unique feature of FN tunneling induced CTP is the ability to turn on and off the charge transfer by varying the intensity of an external light source, and this could inspire the development of novel quantum devices. PMID:23215253

  1. Fowler-Nordheim plot characteristics for ZnO virtual field emitter array

    NASA Astrophysics Data System (ADS)

    Al-Tabbakh, Ahmed A.

    2015-09-01

    Linear and nonlinear Fowler-Nordheim (FN) plots from semiconductors emitters arrays were equally reported by researchers with occasionally inexplicit justification of either behaviour. Interpretation of experimental field emission data depends on explaining the FN plot behaviour from these arrays. The FN plot behaviour was investigated for virtual arrays of ZnO emitters with defined geometries based on fundamental electron tunnelling from semiconductors. The effects of emitters' size distribution, saturation of conduction band (CB) current and contribution of valence band (VB) current on FN plot behaviour were investigated and discussed in detail. Comparison with some experimental results was introduced in support of the discussion. Results showed that saturation of CB current and contribution of VB electrons may not always be manifested as a well-observed deviation from linear characteristic of the FN plot. In addition, the dependence of the CB current on the emitters' geometries was found to affect the FN plot behaviour. The present investigation is thought to be of great importance to field emission community and help for better interpretation of experimental field emission data.

  2. [Integrated multidisciplinary treatment modalities for obesity].

    PubMed

    Yu, Jian-chun

    2010-02-01

    The rapid increase of obesity nationwide and worldwide has threatened human health and caused the increase of metabolic diseases and the changes of disease spectrum. Its co-morbidities, mortality, and relevant socio-economic issues have became global concerns. Integrated multidisciplinary treatment modalities have emerged in recent years. For severely obese patients body mass index (BMI>40 kg/m(2) or obese patients (BMI 35 - 40 kg/m(2)) with co-morbidities such as severe diabetes, obesity-associated cardiac lesions, severe sleep apnea, infertility, and osteoarthritis that affect the daily life, minimally invasive laparoscopic bariatric surgery (such as Lap Banding) can achieve satisfactory results by reducing body weight in long term, treating or preventing the co-morbidities, and ultimately decreasing mortality. Multidisciplinary treatment modalities for tumors, obesity, and other diseases have been widely adopted. This strategy may play increasingly important roles in improving the treatment effectiveness, upgrading healthcare services, and addressing interdisciplinary problems. PMID:20236577

  3. [Integrated treatments of rectal carcinoma (review)].

    PubMed

    Gennari, Leandro; Doci, Roberto; Rossetti, Carlo; Bagnoli, Pietro; Eboli, Marco; Brocchi, Andrea

    2002-01-01

    We have reviewed the international literature regarding the treatment of rectal carcinoma. Over the last decades the evolution of treatment methods has led to a drastic fall in the incidence of local recurrences which has gone from a wide range (15-40%) to a much lower figure (10%). This favourable result has been reached also due to improvement in surgical techniques (total mesorectal excision) and to the use of an association of preoperative radio and chemotherapy. However, the drugs and dosage of these as well as of the RT still have to be defined. In our experience the integrated treatment has brought a downstaging of the T in 60% of cases and of the N in 15%. PMID:12613323

  4. Conceptual and Methodological Issues in Treatment Integrity Measurement

    ERIC Educational Resources Information Center

    McLeod, Bryce D.; Southam-Gerow, Michael A.; Weisz, John R.

    2009-01-01

    This special series focused on treatment integrity in the child mental health and education field is timely. The articles do a laudable job of reviewing (a) the current status of treatment integrity research and measurement, (b) existing conceptual models of treatment integrity, and (c) the limitations of prior research. Overall, this thoughtful…

  5. Enhanced integrated nonthermal treatment system study

    SciTech Connect

    Biagi, C.; Schwinkendorf, B.; Teheranian, B.

    1997-02-01

    The purpose of the Enhanced Nonthermal Treatment Systems (ENTS) study is to evaluate alternative configurations of one of the five systems evaluated in the Integrated Nonthermal Treatment Systems (INTS) study. Five alternative configurations are evaluated. Each is designed to enhance the final waste form performance by replacing grout with improved stabilization technologies, or to improve system performance by improving the destruction efficiency for organic contaminants. AU enhanced systems are alternative configurations of System NT-5, which has the following characteristics: Nonthermal System NT-5: (1) catalytic wet oxidation (CWO) to treat organic material including organic liquids, sludges, and soft (or combustible) debris, (2) thermal desorption of inorganic sludge and process residue, (3) washing of soil and inorganic debris with treatment by CWO of removed organic material, (4) metal decontamination by abrasive blasting, (5) stabilization of treated sludge, soil, debris, and untreated debris with entrained contamination in grout, and (6) stabilization of inorganic sludge, salts and secondary waste in polymer. System NT-5 was chosen because it was designed to treat combustible debris thereby minimizing the final waste form volume, and because it uses grout for primary stabilization. The enhanced nonthermal systems were studied to determine the cost and performance impact of replacing grout (a commonly used stabilization agent in the DOE complex) with improved waste stabilization methods such as vitrification and polymer.

  6. Enhancing Treatment Integrity Maintenance through Fading with Indiscriminable Contingencies

    ERIC Educational Resources Information Center

    Gross, Thomas J.; Duhon, Gary J.; Doerksen-Klopp, Bethany

    2014-01-01

    School psychologists are often asked to develop treatment to remediate students' academic skills or social behavior problems. When teachers implement treatment recommendations with high levels of treatment integrity, students benefit. Treatment integrity has been enhanced by use of direct training, performance feedback, and negative…

  7. Automated radiotherapy treatment plan integrity verification

    SciTech Connect

    Yang Deshan; Moore, Kevin L.

    2012-03-15

    Purpose: In our clinic, physicists spend from 15 to 60 min to verify the physical and dosimetric integrity of radiotherapy plans before presentation to radiation oncology physicians for approval. The purpose of this study was to design and implement a framework to automate as many elements of this quality control (QC) step as possible. Methods: A comprehensive computer application was developed to carry out a majority of these verification tasks in the Philips PINNACLE treatment planning system (TPS). This QC tool functions based on both PINNACLE scripting elements and PERL sub-routines. The core of this technique is the method of dynamic scripting, which involves a PERL programming module that is flexible and powerful for treatment plan data handling. Run-time plan data are collected, saved into temporary files, and analyzed against standard values and predefined logical rules. The results were summarized in a hypertext markup language (HTML) report that is displayed to the user. Results: This tool has been in clinical use for over a year. The occurrence frequency of technical problems, which would cause delays and suboptimal plans, has been reduced since clinical implementation. Conclusions: In addition to drastically reducing the set of human-driven logical comparisons, this QC tool also accomplished some tasks that are otherwise either quite laborious or impractical for humans to verify, e.g., identifying conflicts amongst IMRT optimization objectives.

  8. Integration of Antiretroviral Therapy with Tuberculosis Treatment

    PubMed Central

    Abdool Karim, Salim S.; Naidoo, Kogieleum; Grobler, Anneke; Padayatchi, Nesri; Baxter, Cheryl; Gray, Andrew L.; Gengiah, Tanuja; Gengiah, Santhanalakshmi; Naidoo, Anushka; Jithoo, Niraksha; Nair, Gonasagrie; El-Sadr, Wafaa M.; Friedland, Gerald; Abdool Karim, Quarraisha

    2011-01-01

    Background We previously reported that integrating antiretroviral therapy (ART) with tuberculosis treatment reduces mortality. However, optimal time to initiate ART during tuberculosis treatment remains contentious. Methods To address this, we conducted a 3-arm, open-label randomized controlled trial in South Africa in acid-fast bacilli smear positive patients (n=642) with HIV and CD4+ counts <500 cells/mm3. Findings on the early therapy group (ART initiated within 4 weeks of tuberculosis treatment initiation, n=214) and late therapy group (ART initiated within the first 4 weeks of the continuation phase of tuberculosis treatment, n=215) are presented here. Results Median CD4+ count and viral load at baseline was 150 cells/mm3 and 161000 copies/ml, being similar in both groups. Incidence rate of AIDS or death was 6.9 (18/259.4) and 7.8 (19/244.2) per 100 person-years in the early and late therapy groups respectively (Incidence Rate Ratio (IRR)=0.89; 95%Confidence Interval (95%CI): 0.44,1.79; P=0.73). However, in patients with CD4+ counts <50 cells/mm3, the incidence rates of AIDS or death were 8.5 (early) and 26.3 (late) per 100 person-years (IRR=0.32; 95%CI: 0.07,1.13; P=0.06). Immune reconstitution inflammatory syndrome (IRIS) incidence rates were 20.2 (early) and 7.7 (late) per 100 person-years (IRR=2.62; 95%CI: 1.48,4.82; P<0.001). Adverse events requiring antiretroviral drug switches occurred in 10 (early) and 1 (late) patients (P=0.006). Conclusions The benefits of AIDS-free survival balanced against the risks of IRIS and ART-related adverse events, support early ART initiation in patients with CD4+ counts <50 cells/mm3 and deferred ART initiation to the continuation phase of tuberculosis treatment when CD4+ counts are higher. PMID:22010915

  9. Investigating the Relationship between Training Type and Treatment Integrity.

    ERIC Educational Resources Information Center

    Sterling-Turner, Heather E.; Watson, T. Steuart; Wildmon, Mark; Watkins, Carrie; Little, Elizabeth

    2001-01-01

    Investigates the relationship between three training procedures (didactic, modeling, or rehearsal feedback) and treatment integrity. Results indicate that higher levels of treatment integrity were associated with direct training procedures. Discusses implications for treatment planning and potential ramifications for consultants working in…

  10. RAPID COMMUNICATION: Influence of nitrogen concentration in nitrided oxides on interface trap generation caused by Fowler-Nordheim injection

    NASA Astrophysics Data System (ADS)

    Chen, T. P.; Huang, Jiayi; Tse, M. S.

    2002-11-01

    In this study, a novel technique, i.e. the direct-current current-voltage method is used to quantitatively examine the influence of nitrogen concentration in nitrided oxides on interface trap generation caused by Fowler-Nordheim injection. A power-law stress time dependence of interface trap generation is always observed. As the nitrogen concentration is increased, the exponent of the power law is reduced leading to a significant suppression of interface trap generation. However, no significant polarity dependence from the influence of nitrogen concentration is observed. These experimental findings are used to clarify the two models that have been proposed to explain the reduced degradation of nitrided oxides under electrical stress.

  11. K West integrated water treatment system subproject safety analysis document

    SciTech Connect

    SEMMENS, L.S.

    1999-02-24

    This Accident Analysis evaluates unmitigated accident scenarios, and identifies Safety Significant and Safety Class structures, systems, and components for the K West Integrated Water Treatment System.

  12. Integrated Treatment of Substance Use and Psychiatric Disorders

    PubMed Central

    Kelly, Thomas M.; Daley, Dennis C.

    2013-01-01

    Epidemiological studies find that psychiatric disorders, including mental disorders and substance use disorders, are common among adults and highly comorbid. Integrated treatment refers to the focus of treatment on two or more conditions and to the use of multiple treatments such as the combination of psychotherapy and pharmacotherapy. Integrated treatment for comorbidity has been found to be consistently superior compared to treatment of individual disorders with separate treatment plans. This article focuses on a review of the risks for developing comorbid disorders and the combinations of treatments that appear to be most effective for clients with particular comorbid disorders. PMID:23731427

  13. An Evaluation of the Observer Effect on Treatment Integrity in a Day Treatment Center for Children

    ERIC Educational Resources Information Center

    Howard, Monica R.; Burke, Raymond V.; Allen, Keith D.

    2013-01-01

    Treatment integrity is an important concern in treatment centers but is often overlooked. Performance feedback is a well-established approach to improving treatment integrity, but is underused and undervalued. One way to increase its value to treatment centers may be to expose unrealized benefits on the observer who collects the performance…

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

    ERIC Educational Resources Information Center

    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…

  15. Treatment Integrity in Behavioral Consultation: Measurement, Promotion, and Outcomes

    ERIC Educational Resources Information Center

    Sanetti, Lisa M. Hagermoser; Kratochwill, Thomas R.

    2008-01-01

    The purpose of this article is to provide an overview of the current state of research in the area of treatment integrity as it relates to behavioral consultation. To this end, four primary topics are discussed. First, a rationale for why treatment integrity is an important professional and methodological concern is presented. Second,…

  16. Effects of Verbal and Graphed Feedback on Treatment Integrity

    ERIC Educational Resources Information Center

    Zoder-Martell, Kimberly; Dufrene, Brad; Sterling, Heather; Tingstrom, Daniel; Blaze, John; Duncan, Neelima; Harpole, Lauren

    2013-01-01

    Treatment integrity is the degree to which an intervention is implemented as designed and is critical for concluding whether the intervention is responsible for treatment outcomes. This study aimed to add to the integrity literature by examining graphed performance feedback alone and in conjunction with verbal performance feedback for increasing…

  17. Summary of comparative results integrated nonthermal treatment and integrated thermal treatment systems studies

    SciTech Connect

    1996-12-01

    In July 1994, the Idaho National Engineering Laboratory (INEL), under a contract from U.S. Department of Energy`s (DOE) Environment Management Office of Science and Technology (OST, EM-50) published a report entitled {open_quotes}Integrated Thermal Treatment System Study - Phase 1 Results{close_quotes} (EGG-MS-11211). This report was the culmination of over a year of analysis involving scientists and engineers within the DOE complex and from private industry. The purpose of that study was {open_quotes}to conduct a systematic engineering evaluation of a variety of mixed low level waste (MLLW) treatment system alternatives.{close_quotes} The study also {open_quotes}identified the research and development, demonstrations, and testing and evaluation needed to assure unit operability in the most promising alternative system.{close_quotes} This study evaluated ten primary thermal treatment technologies, organized into complete {open_quotes}cradle-to-grave{close_quotes} systems (including complete engineering flow sheets), to treat DOE MLLW and calculated mass balances and 20-year total life cycle costs (TLCC) for all systems. The waste input used was a representative heterogenous mixture of typical DOE MLLW. An additional study was conducted, and then, based on response to these studies, additional work was started to investigate and evaluate non-thermal treatment options on a footing comparable to the effort devoted to thermal options. This report attempts to present a summary overview of the thermal and non-thermal treatment technologies which were examined in detail in the process of the above mentioned reviews.

  18. Maintaining Cultural Integrity in Residential Treatment

    ERIC Educational Resources Information Center

    Pazaratz, Don

    2005-01-01

    Cross-cultural residential placement of children and adolescents requires careful attention to the youth's culture of origin, so that the delivery of the treatment service is respectful of his or her way of life. Cultural protection in treatment facilities, as a principle, ensures that the traditions, symbols, values, norms, and the worldview, as…

  19. Integrated treatment of multiple subgingival fractures.

    PubMed

    Cheshire, P D

    1991-08-01

    With careful planning an apparently "hopeless case" can be treated successfully and conservatively. The case report of an 18 year old male requiring a combined periodontic, endodontic and prosthodontic approach is presented. With emphasis on treatment planning and emergency cover in the new dental contract, the approach to the treatment plan is discussed. PMID:1813937

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

    ERIC Educational Resources Information Center

    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…

  1. Fowler-Nordheim electron tunneling mechanism in Ni/SiO2/n-4H SiC MOS devices

    NASA Astrophysics Data System (ADS)

    Kodigala, Subba Ramaiah; Chattopadhyay, S.; Overton, C.; Ardoin, I.

    2015-12-01

    The Ni/SiO2/n-type 4H SiC MOS devices have been fabricated for microelectronic device applications. The SiO2 layer employed in the MOS devices is grown by wet thermal oxidation process. The current-field characteristics of Ni/SiO2/n-type 4H SiC MOS devices are quiet interestingly studied by employing Fowler Nordheim (FN) conduction tunneling model, which is verified by theoretical simulation. It is learnt that the tunneling current through the barrier in the MOS devices promptly obeys the FN conduction tunneling mechanism. The simulation results show that the current in the MOS device increases and barrier height decreases with increasing temperature and internal electric field. Therefore, the correction factor for the barrier height of n-type 4H SiC/SiO2 MOS device due to the influence of both the temperature and internal electric field is employed. The barrier height observed by the experiments is apparently smaller than the simulated one of an ideal MOS device. However, after employing all the correction factors to the barrier height, the simulated current-field curves fairly coincide with the experimental results. The reason for obtaining smaller experimental barrier height for MOS devices is substantially explored with the support of current-field (J-F) analysis. On the other hand, this article comprehensively addresses the effects of quantum mechanical, interface trap density and thickness of 4H-SiC on the barrier height.

  2. The Fowler-Nordheim behavior and mechanism of photo-sensitive field from SnS{sub 2} nanosheets

    SciTech Connect

    Suryawanshi, Sachin R.; Chaudhari, Nilima S.; Warule, Sambhaji S.; More, Mahendra A.

    2015-06-24

    Here in, we report photo-sensitive field emission measurements of SnS{sub 2} nanosheets at base pressure of ∼1×10{sup −8} mbar are reported. The nonlinear Fowler-Nordheim (F-N) plot is elucidate according to a (F-N) model of calculation based on shift in a saturation of conduction band current density after light illumination and prevalence of valence band current density at high electric field values. The model of calculation suggests that the slope variation before and after visible light illumination of the F-N plot, in the high-field and low-field regions, does not depend on the magnitude of saturation but also depend on charge carrier (electron) concentration get increased in conduction band. The F-N model of calculation is important for the fundamental understanding of the photo-sensitive field emission mechanism of semiconducting SnS{sub 2}. The replicate F-N plots exhibit similar features to those observed experimentally. The model calculation suggests that the nonlinearity of the F-N plot is a characteristic of the photo-enhanced energy band structure of the photo-sensitive semiconductor material.

  3. Characterization of NiSi nanowires as field emitters and limitations of Fowler-Nordheim model at the nanoscale

    NASA Astrophysics Data System (ADS)

    Belkadi, Amina B.; Gale, E.; Isakovic, A. F.

    2015-03-01

    Nanoscale field emitters are of technological interest because of the anticipated faster turn-on time, better sustainability and compactness. This report focuses on NiSi nanowires as field emitters for two reasons: (a) possible enhancement of field emission in nanoscale field emitters over bulk, and (b) achieving the same field emission properties as in bulk, but at a lower energy cost. To this end, we have grown, fabricated and characterized NiSi nanowires as field emitters. Depending on the geometry of the NiSi nanowires (aspect ratio, shape etc.), the relevant major field emission parameters, such as (1) the turn-on field, (2) the work function, and (3) the field enhancement factor, can be comparable or even superior to other recently explored nanoscale field emitters, such as CdS and ZnO. We also report on a comparative performance of various nanoscale field emitters and on the difficulties in the performance comparison in the light of relatively poor applicability of the standard Folwer-Nordheim model for field emission analysis for the case of the nanoscale field emitters. Proposed modifications are discussed. This work is supported through SRC-ATIC Grant 2011-KJ-2190. We also acknoweldge BNL-CFN and Cornell CNF facilities and staff.

  4. Evaluating Alcoholism Treatment Programs: An Integrated Approach.

    ERIC Educational Resources Information Center

    Cronkite, Ruth C.; Moos, Rudolf H.

    1978-01-01

    Examined variables (social background, intake symptoms, program type, treatment experiences, and perceptions of environment) related to posttreatment functioning of alcoholic patients. Results showed the combined explanatory power of program-related variables was more than expected. Explained variance was shared between patient-related and…

  5. Phosphorus removal from secondary effluents through integrated constructed treatment system.

    PubMed

    Xiong, Jibing; Qin, Yong; Mahmood, Qaisar; Liu, Hanhu; Yang, Dejun

    2011-01-01

    The treatment capacity of an integrated constructed treatment system (CTS) was explored which was designed to reduce phosphorus (P) from secondary effluents. The integrated CTS was combined with vertical-flow constructed wetland, floating bed and sand filter. The vertical wetland was filled from the bottom to the top with gravels, steel slag and peat. Vetiverzizanioides (L.) Nash was selected to grow in the vertical constructed wetland while Coixlacrymajobi L. was grown in floating bed. The results suggested that integrated CTS displayed excellent removal efficiency for chemical oxygen demand (COD), dissolved phosphorus (DP), and total phosphorus (TP). The average COD removal efficiency of the integrated CTS was 90.45% after 40 days of operation, the average DP and TP removal efficiencies of the integrated CTS were 97.43% and 96.40%, respectively. The integrated CTS has good potential in removing COD as well as P from secondary effluents. PMID:21570097

  6. Treatment Integrity: An Essential--But Often Forgotten--Component of School-Based Interventions

    ERIC Educational Resources Information Center

    Lane, Kathleen L.; Bocian, Kathleen M.; MacMillan, Donald L.; Gresham, Frank M.

    2004-01-01

    In this article, the authors introduce the construct of treatment integrity and illustrate the importance of treatment integrity as it relates to school-based intervention. Specifically, the authors address the following questions: What is treatment integrity? Why is it important to assess treatment integrity? How can treatment integrity be…

  7. Spiritually Integrated Treatment of Depression: A Conceptual Framework

    PubMed Central

    Peteet, John R.

    2012-01-01

    Many studies have found an inverse correlation between religious/spiritual involvement and depression. Yet several obstacles impede spiritually integrated treatment of depressed individuals. These include specialization and fragmentation of care, inexperience of clinicians and spiritual care providers, ideological bias, boundary and ethical concerns, and the lack of an accepted conceptual framework for integrated treatment. Here I suggest a framework for approaching these obstacles, constructed from a unified view of human experience (having emotional, existential, and spiritual dimensions); spirituality seen as a response to existential concerns (in domains such as identity, hope, meaning/purpose, morality, and autonomy in relation to authority, which are frequently distorted and amplified in depression); a rationale for locating spiritually oriented approaches within a clinician's assessment, formulation, and treatment plan; and recognition of the challenges and potential pitfalls of integrated treatment. PMID:22577530

  8. Extraction of emission parameters for large-area field emitters, using a technically complete Fowler-Nordheim-type equation

    NASA Astrophysics Data System (ADS)

    Forbes, Richard G.

    2012-03-01

    In papers on cold field electron emission from large-area field emitters (LAFEs), it has become widespread practice to publish a misleading Fowler-Nordheim-type (FN-type) equation. This equation over-predicts the LAFE-average current density by a large highly variable factor thought to usually lie between 103 and 109. This equation, although often referenced to FN’s 1928 paper, is a simplified equation used in undergraduate teaching, does not apply unmodified to LAFEs and does not appear in the 1928 paper. Technological LAFE papers often do not cite any theoretical work more recent than 1928, and often do not comment on the discrepancy between theory and experiment. This usage has occurred widely, in several high-profile American and UK applied-science journals (including Nanotechnology), and in various other places. It does not inhibit practical LAFE development, but can give a misleading impression of potential LAFE performance to non-experts. This paper shows how the misleading equation can be replaced by a conceptually complete FN-type equation that uses three high-level correction factors. One of these, or a combination of two of them, may be useful as an additional measure of LAFE quality; this paper describes a method for estimating factor values using experimental data and discusses when it can be used. Suggestions are made for improved engineering practice in reporting LAFE results. Some of these should help to prevent situations arising whereby an equation appearing in high-profile applied-science journals is used to support statements that an engineering regulatory body might deem to involve professional negligence.

  9. Managing integrated oncology treatment in virtual networks.

    PubMed

    Stanicki, Verena; Becker, Matthias; Böckmann, Britta

    2015-01-01

    Interdisciplinary and intersectoral coordinated healthcare management based on Clinical Practice Guidelines is essential to achieve high quality in oncological networks. The objective of our research project is to create a cookbook, which can be used by oncological networks as a template. The cookbook is based on guideline-compliant care processes. To develop these care processes, the three S3-guidelines breast, colon and prostate carcinoma have been formalized. The thus-obtained platform-independent process fragments were transformed into an underlying metamodel, which is based on HL7 and can be used for modeling clinical pathways. Additional, qualitative guided interviews were chosen to capitalize on the experts' (e.g. chief residents, resident specialists) wide knowledge and experience in oncological health care management. One of these use cases (tumor board scheduling) is developed for a healthcare management platform which is linked to a national electronic case record. The projected result of our approach is a cookbook which shows, how the treatment can be controlled by interdisciplinary and intersectoral care processes in an oncological network. PMID:26063274

  10. Biological treatment and ozone oxidation: Integration or coupling?

    PubMed

    Di Iaconi, Claudio

    2012-02-01

    Wastewaters generated by many economically relevant industrial activities contain recalcitrant organic compounds which pass unaltered through biological stage of the treatment plant making it difficult to meet the discharge limits currently in force. Therefore, an additional treatment is usually required to remove these compounds. In this study, the application of ozonation together with biological treatment was investigated. In particular, the effectiveness of biological degradation followed by or integrated with ozonation for treating the effluents produced by three environmentally relevant activities (i.e., leather and textile processing and municipal waste landfilling) are compared in the present paper. The results show that biological treatment followed by ozonation does not guarantee depurative levels sufficient for discharge for landfill leachates and tannery wastewater. On the contrary, thanks to the synergy between biological degradation and ozonation, integrated treatment significantly improves the process performance for all the investigated wastewaters, thus allowing the discharge limits to be met. PMID:22206914

  11. Process modeling for the Integrated Nonthermal Treatment System (INTS) study

    SciTech Connect

    Brown, B.W.

    1997-04-01

    This report describes the process modeling done in support of the Integrated Nonthermal Treatment System (INTS) study. This study was performed to supplement the Integrated Thermal Treatment System (ITTS) study and comprises five conceptual treatment systems that treat DOE contract-handled mixed low-level wastes (MLLW) at temperatures of less than 350{degrees}F. ASPEN PLUS, a chemical process simulator, was used to model the systems. Nonthermal treatment systems were developed as part of the INTS study and include sufficient processing steps to treat the entire inventory of MLLW. The final result of the modeling is a process flowsheet with a detailed mass and energy balance. In contrast to the ITTS study, which modeled only the main treatment system, the INTS study modeled each of the various processing steps with ASPEN PLUS, release 9.1-1. Trace constituents, such as radionuclides and minor pollutant species, were not included in the calculations.

  12. Treatment of domain integrals in boundary element methods

    SciTech Connect

    Nintcheu Fata, Sylvain

    2012-01-01

    A systematic and rigorous technique to calculate domain integrals without a volume-fitted mesh has been developed and validated in the context of a boundary element approximation. In the proposed approach, a domain integral involving a continuous or weakly-singular integrand is first converted into a surface integral by means of straight-path integrals that intersect the underlying domain. Then, the resulting surface integral is carried out either via analytic integration over boundary elements or by use of standard quadrature rules. This domain-to-boundary integral transformation is derived from an extension of the fundamental theorem of calculus to higher dimension, and the divergence theorem. In establishing the method, it is shown that the higher-dimensional version of the first fundamental theorem of calculus corresponds to the well-known Poincare lemma. The proposed technique can be employed to evaluate integrals defined over simply- or multiply-connected domains with Lipschitz boundaries which are embedded in an Euclidean space of arbitrary but finite dimension. Combined with the singular treatment of surface integrals that is widely available in the literature, this approach can also be utilized to effectively deal with boundary-value problems involving non-homogeneous source terms by way of a collocation or a Galerkin boundary integral equation method using only the prescribed surface discretization. Sample problems associated with the three-dimensional Poisson equation and featuring the Newton potential are successfully solved by a constant element collocation method to validate this study.

  13. Integrating harm reduction therapy and traditional substance abuse treatment.

    PubMed

    Marlatt, G A; Blume, A W; Parks, G A

    2001-01-01

    One-size-fits-all therapy has not worked well for a majority of substance users seeking help. New approaches to substance abuse treatment are desperately needed. Traditional models of service delivery offer little, if any, help to people who may not choose abstinence as a goal. To address this concern, the Bridging the Gap Conference was sponsored by the San Francisco Department of Public Health. The overall goals of the conference were to improve standards of care, develop best practice principles for integrating harm reduction approaches into traditional substance abuse services, and increase the accessibility of quality services to people in need of alcohol and drug treatment. G. Alan Marlatt gave a keynote address on the integration of harm reduction therapy into traditional treatment services, an expanded version of which is presented in this article. Such integration would broaden the scope of services available to a larger group of consumers of substance abuse treatment. Furthermore, harm reduction therapy would infuse traditional treatment practices with scientifically-based pragmatism that pays close attention to individual and community public health needs. Because of its tolerance of treatment goals other than abstinence, harm reduction therapy offers the greatest hope to expand the availability of substance abuse services to people who have not benefited from traditional abstinence-based treatment models. PMID:11332996

  14. Determination of Fowler-Nordheim tunneling parameters in Metal-Oxide-Semiconductor structure including oxide field correction using a vertical optimization method

    NASA Astrophysics Data System (ADS)

    Toumi, S.; Ouennoughi, Z.; Strenger, K. C.; Frey, L.

    2016-08-01

    Current conduction mechanisms through a Metal-Oxide-Semiconductor structure are characterized via Fowler-Nordheim (FN) plots. The extraction of the FN parameters like the electron/hole effective mass in oxide mox and in semiconductor msc, the barrier height at the semiconductor-oxide interface ϕB, and the correction oxide voltage Vcorr for a MOS structure is made using a vertical optimization process on the current density without any assumption about ϕB or mox. An excellent agreement is obtained between the FN plots calculated with the FN parameters extracted using a vertical optimization process with the experimental one.

  15. Strong deviations from Fowler-Nordheim behavior for field emission from individual SiC nanowires due to restricted bulk carrier generation

    NASA Astrophysics Data System (ADS)

    Choueib, M.; Ayari, A.; Vincent, P.; Bechelany, M.; Cornu, D.; Purcell, S. T.

    2009-02-01

    We report here field-emission (FE) studies of individual single-crystal SiC nanowires that showed several distinct I/V regimes including strong saturation resulting in highly nonlinear Fowler-Nordheim plots. The saturation is due to the formation of a depletion layer near the nanowire ends as predicted for FE from semiconductors and appears after in situ control of the surface cleanliness. This work opens the door to improving the uniformity, stability, and photon control of mass-produced planar nanowire FE cathodes and shows how FE can be used for transport measurements on individual semiconducting nanowires.

  16. Improving Treatment Integrity through a Functional Approach to Intervention Support

    ERIC Educational Resources Information Center

    Liaupsin, Carl J.

    2015-01-01

    A functional approach to intervention planning has been shown to be effective in reducing problem behaviors and promoting appropriate behaviors in children and youth with behavior disorders. When function-based intervention plans are not successful, it is often due to issues of treatment integrity in which teachers omit or do not sufficiently…

  17. Effects of Video Modeling on Treatment Integrity of Behavioral Interventions

    ERIC Educational Resources Information Center

    DiGennaro-Reed, Florence D.; Codding, Robin; Catania, Cynthia N.; Maguire, Helena

    2010-01-01

    We examined the effects of individualized video modeling on the accurate implementation of behavioral interventions using a multiple baseline design across 3 teachers. During video modeling, treatment integrity improved above baseline levels; however, teacher performance remained variable. The addition of verbal performance feedback increased…

  18. A Comparison of Treatment Integrity Assessment Methods for Behavioral Intervention

    ERIC Educational Resources Information Center

    Koh, Seong A.

    2010-01-01

    The purpose of this study was to examine the similarity of outcomes from three different treatment integrity (TI) methods, and to identify the method which best corresponded to the assessment of a child's behavior. Six raters were recruited through individual contact via snowball sampling. A modified intervention component list and 19 video clips…

  19. Changing Donor Funding and the Challenges of Integrated HIV Treatment.

    PubMed

    Nattrass, Nicoli; Hodes, Rebecca; Cluver, Lucie

    2016-01-01

    Donor financing for HIV prevention and treatment has shifted from supporting disease-specific ("vertical") programs to health systems strengthening ("horizontal") programs intended to integrate all aspects of care. We examine the consequences of shifting resources from three perspectives: first, through a broad analysis of the changing policy context of health care financing; second, through an account of changing priorities for HIV treatment in South Africa; and third, through a description of some clinical consequences that the authors observed in a research study examining adherence to antiretroviral therapy (ART) and sexual health among adolescents. We note that AIDS responses are neither completely vertical nor horizontal but rather increasingly diagonal, as disease-specific protocols operate alongside integrated supply chain management, human resource development, and preventive screening. We conclude that health care programs are better conceived of as networks of policies requiring different degrees of integration into communities. PMID:27437818

  20. Integrated anaerobic/aerobic biological treatment for intensive swine production.

    PubMed

    Bortone, Giuseppe

    2009-11-01

    Manure processing could help farmers to effectively manage nitrogen (N) surplus load. Many pig farms have to treat wastewater. Piggery wastewater treatment is a complex challenge, due to the high COD and N concentrations and low C/N ratio. Anaerobic digestion (AD) could be a convenient pre-treatment, particularly from the energetic view point and farm income, but this causes further reduction of C/N ratio and makes denitrification difficult. N removal can only be obtained integrating anaerobic/aerobic treatment by taking into account the best use of electron donors. Experiences gained in Italy during development of integrated biological treatment approaches for swine manure, from bench to full scale, are reported in this paper. Solid/liquid separation as pre-treatment of raw manure is an efficient strategy to facilitate liquid fraction treatment without significantly lowering C/N ratio. In Italy, two full scale SBRs showed excellent efficiency and reliability. Current renewable energy policy and incentives makes economically attractive the application of AD to the separated solid fraction using high solid anaerobic digester (HSAD) technology. Economic evaluation showed that energy production can reduce costs up to 60%, making sustainable the overall treatment. PMID:19135363

  1. Treatment provision for gambling disorder in Britain: call for an integrated addictions treatment and commissioning model.

    PubMed

    George, Sanju; Bowden-Jones, Henrietta

    2016-06-01

    Treatment provision for individuals with gambling problems in Britain is at best inadequate. Here we call for gambling treatment provision to be integrated into mainstream drug and alcohol services, and for its commissioning responsibilities to fall under local public health departments. PMID:27280028

  2. An Experimental Examination of the Impact of Choice of Treatment Components on Treatment Integrity

    ERIC Educational Resources Information Center

    Andersen, Melissa; Daly, Edward J., III

    2013-01-01

    Although there is a growing body of research on the use of performance feedback to improve treatment integrity, antecedent interventions have received little attention. Antecedent interventions are simple to use and have a strong research base. This study examined the effects of offering teachers choice of treatment components. A choice condition…

  3. Treatment provision for gambling disorder in Britain: call for an integrated addictions treatment and commissioning model

    PubMed Central

    George, Sanju; Bowden-Jones, Henrietta

    2016-01-01

    Treatment provision for individuals with gambling problems in Britain is at best inadequate. Here we call for gambling treatment provision to be integrated into mainstream drug and alcohol services, and for its commissioning responsibilities to fall under local public health departments. PMID:27280028

  4. The particle production at the event horizon of a black hole as gravitational Fowler-Nordheim emission in uniformly accelerated frame, in the non-relativistic scenario

    NASA Astrophysics Data System (ADS)

    De, Sanchari; Ghosh, Sutapa; Chakrabarty, Somenath

    2015-11-01

    In the conventional scenario, the Hawking radiation is believed to be a tunneling process at the event horizon of the black hole. In the quantum field theoretic approach the Schwinger's mechanism is generally used to give an explanation of this tunneling process. It is the decay of quantum vacuum into particle anti-particle pairs near the black hole surface. However, in a reference frame undergoing a uniform accelerated motion in an otherwise flat Minkowski space-time geometry, in the non-relativistic approximation, the particle production near the event horizon of a black hole may be treated as a kind of Fowler-Nordheim field emission, which is the typical electron emission process from a metal surface under the action of an external electrostatic field. This type of emission from metal surface is allowed even at extremely low temperature. It has been noticed that in one-dimensional scenario, the Schrödinger equation satisfied by the created particle (anti-particle) near the event horizon, can be reduced to a differential form which is exactly identical with that obeyed by an electron immediately after the emission from the metal surface under the action of a strong electrostatic field. The mechanism of particle production near the event horizon of a black hole is therefore identified with Schwinger process in relativistic quantum field theory, whereas in the non-relativistic scenario it may be interpreted as Fowler-Nordheim emission process, when observed from a uniformly accelerated frame.

  5. Integrative Treatment of Pediatric Obesity: Psychological and Spiritual Considerations

    PubMed Central

    Boisvert, Jennifer A.; Harrell, W. Andrew

    2015-01-01

    This article presents an integrative approach to the problem of pediatric obesity, which is a multifaceted medical condition that is epidemic in the United States and elsewhere in the world. In this article, definitions of pediatric obesity are provided, and its prevalence, etiological factors, medical complications, and comorbidities are reviewed. Psychological and spiritual factors associated with pediatric obesity are discussed, together with their importance to integrative treatment. This review suggests that the use of psychological interventions, such as cognitive behavioral therapy (CBT) and animal-assisted therapy (AAT), can be considered in conjunction with medical and educational interventions to treat pediatric obesity successfully. PMID:26770130

  6. Integrated thermal treatment system sudy: Phase 2, Results

    SciTech Connect

    Feizollahi, F.; Quapp, W.J.

    1995-08-01

    This report presents the second phase of a study on thermal treatment technologies. The study consists of a systematic assessment of nineteen thermal treatment alternatives for the contact-handled mixed low-level waste (MLLW) currently stored in the US Department of Energy complex. The treatment alternatives consist of widely varying technologies for safely destroying the hazardous organic components, reducing the volume, and preparing for final disposal of the MLLW. The alternatives considered in Phase 2 were innovative thermal treatments with nine types of primary processing units. Other variations in the study examined the effect of combustion gas, air pollution control system design, and stabilization technology for the treatment residues. The Phase 1 study, the results of which have been published as an interim report, examined ten initial thermal treatment alternatives. The Phase 2 systems were evaluated in essentially the same manner as the Phase 2 systems. The assumptions and methods were the same as for the Phase 1 study. The quantities, and physical and chemical compositions, of the input waste used in he Phase 2 systems differ from those in the Phase 1 systems, which were based on a preliminary waste input database developed at the onset of the Integrated Thermal Treatment System study. The inventory database used in the Phase 2 study incorporates the latest US Department of Energy information. All systems, both primary treatment systems and subsystem inputs, have now been evaluated using the same waste input (2,927 lb/hr).

  7. Integrated thermal treatment systems study. Internal review panel report

    SciTech Connect

    Cudahy, J.; Escarda, T.; Gimpel, R.

    1995-04-01

    The U.S. Department of Energy (DOE) Office of Technology Development (OTD) commissioned two studies to evaluate nineteen thermal treatment technologies for treatment of DOE mixed low-level waste. These studies were called the Integrated Thermal Treatment System (ITTS) Phase I and Phase II. With the help of the DOE Office of Environmental Management (EM) Mixed Waste Focus Group, OTD formed an ITTS Internal Review Panel to review and comment on the ITTS studies. This Panel was composed of scientists and engineers from throughout the DOE complex, the U.S. Environmental Protection Agency, the California EPA, and private experts. The Panel met from November 15-18, 1994 to review the ITTS studies and to make recommendations on the most promising thermal treatment systems for DOE mixed low-level wastes and on research and development necessary to prove the performance of the technologies. This report describes the findings and presents the recommendations of the Panel.

  8. Review of the integrated thermal and nonthermal treatment system studies

    SciTech Connect

    1996-10-01

    This report contains a review and evaluation of three systems analysis studies performed by LITCO on integrated thermal treatment systems and integrated nonthermal treatment systems for the remediation of mixed low-level waste stored throughout the US Department of Energy weapons complex. The review was performed by an independent team of nine researchers from the Energy and Environmental Research Center, Science Applications International Corporation, the Waste Policy Institute, and Virginia Tech. The purpose of this review was to (1) determine whether the assumptions of the studies were adequate to produce an unbiased review of both thermal and nonthermal systems, (2) to identify the critical areas of the studies that would benefit from further investigation, and (3) to develop a standard template that could be used in future studies to assure a sound application of systems engineering.

  9. Clinical Strategies for Integrating Medication Interventions Into Behavioral Treatment for Adolescent ADHD: The Medication Integration Protocol

    PubMed Central

    Hogue, Aaron; Bobek, Molly; Tau, Gregory Z.; Levin, Frances R.

    2014-01-01

    Attention-Deficit/Hyperactivity Disorder (ADHD) is highly prevalent among adolescents enrolled in behavioral health services but remains undertreated in this age group. Also the first-line treatment for adolescent ADHD, stimulant medication, is underutilized in routine practice. This article briefly describes three behavioral interventions designed to promote stronger integration of medication interventions into treatment planning for adolescent ADHD: family ADHD psychoeducation, family-based medication decision-making, and behavior therapist leadership in coordinating medication integration. It then introduces the Medication Integration Protocol (MIP), which incorporates all three interventions into a five-task protocol: ADHD Assessment and Medication Consult; ADHD Psychoeducation and Client Acceptance; ADHD Symptoms and Family Relations; ADHD Medication and Family Decision-Making; and Medication Management and Integration Planning. The article concludes by highlighting what behavior therapists should know about best practices for medication integration across diverse settings and populations: integrating medication interventions into primary care, managing medication priorities and polypharmacy issues for adolescents with multiple diagnoses, providing ADHD medications to adolescent substance users, and the compatibility of MIP intervention strategies with everyday practice conditions. PMID:25505817

  10. Integrated thermal treatment system study: Phase 1 results. Volume 1

    SciTech Connect

    Feizollahi, F.; Quapp, W.J.; Hempill, H.G.; Groffie, F.J.

    1994-07-01

    An integrated systems engineering approach is used for uniform comparison of widely varying thermal treatment technologies proposed for management of contact-handled mixed low-level waste (MLLW) currently stored in the US Department of Energy complex. Ten different systems encompassing several incineration design options are studied. All subsystems, including facilities, equipment, and methods needed for integration of each of the ten systems are identified. Typical subsystems needed for complete treatment of MLLW are incoming waste receiving and preparation (characterization, sorting, sizing, and separation), thermal treatment, air pollution control, primary and secondary stabilization, metal decontamination, metal melting, mercury recovery, lead recovery, and special waste and aqueous waste treatment. The evaluation is performed by developing a preconceptual design package and planning life-cycle cost (PLCC) estimates for each system. As part of the preconceptual design process, functional and operational requirements, flow sheets and mass balances, and conceptual equipment layouts are developed for each system. The PLCC components estimated are technology development, production facility construction, pre-operation, operation and maintenance, and decontamination and decommissioning. Preconceptual design data and other technology information gathered during the study are examined and areas requiring further development, testing, and evaluation are identified and recommended. Using a qualitative method, each of the ten systems are ranked.

  11. Integrating psychotherapy and pharmacotherapy in the treatment of premature ejaculation

    PubMed Central

    Ciocca, Giacomo; Limoncin, Erika; Mollaioli, Daniele; Gravina, Giovanni Luca; Di Sante, Stefania; Carosa, Eleonora; Lenzi, Andrea; Jannini, Emmanuele A.

    2013-01-01

    Objectives To describe the different approaches to the treatment of premature ejaculation (PE), with a final focus on integrated treatment, as conventional theories and therapies for PE are based on an organic or psychogenic dichotomy. Methods We list the principal hypotheses of the causes and therapy of PE on the basis of psychological and medical perspectives, after identifying all relevant studies available on Medline up to 2012. Results The cognitive feedback from PE can lead to a ‘performance anxiety’, which can combine with other conditions to further impair ejaculatory control. For these reasons, a psychological approach is always useful in treating PE, the most useful of which are sex therapy and behavioural therapy. For pharmacological treatment, reports suggest that dapoxetine (60 mg) significantly improves the control of the ejaculatory reflex, and it thus represents the first-line officially approved pharmacotherapy for PE. Conclusions A holistic approach which considers the biological, psychological and relational aspects is the advised treatment for PE. Integrated medical and psycho-sexological therapy requires a mutual understanding of and respect for the different disciplines involved in sexology. In this aspect two very important roles are those of the physician and the psychologist. PMID:26558097

  12. Integrated modeling and heat treatment simulation of austempered ductile iron

    NASA Astrophysics Data System (ADS)

    Hepp, E.; Hurevich, V.; Schäfer, W.

    2012-07-01

    The integrated modeling and simulation of the casting and heat treatment processes for producing austempered ductile iron (ADI) castings is presented. The focus is on describing different models to simulate the austenitization, quenching and austempering steps during ADI heat treatment. The starting point for the heat treatment simulation is the simulated microstructure after solidification and cooling. The austenitization model considers the transformation of the initial ferrite-pearlite matrix into austenite as well as the dissolution of graphite in austenite to attain a uniform carbon distribution. The quenching model is based on measured CCT diagrams. Measurements have been carried out to obtain these diagrams for different alloys with varying Cu, Ni and Mo contents. The austempering model includes nucleation and growth kinetics of the ADI matrix. The model of ADI nucleation is based on experimental measurements made for varied Cu, Ni, Mo contents and austempering temperatures. The ADI kinetic model uses a diffusion controlled approach to model the growth. The models have been integrated in a tool for casting process simulation. Results are shown for the optimization of the heat treatment process of a planetary carrier casting.

  13. Integrated thermal treatment system study -- Phase 2 results. Revision 1

    SciTech Connect

    Feizollahi, F.; Quapp, W.J.

    1996-02-01

    This report presents the second phase of a study on thermal treatment technologies. The study consists of a systematic assessment of nineteen thermal treatment alternatives for the contact-handled mixed low-level waste (MLLW) currently stored in the US Department of Energy complex. The treatment alternatives consist of widely varying technologies for safely destroying the hazardous organic components, reducing the volume, and preparing for final disposal of the MLLW. The alternatives considered in Phase 2 were innovative thermal treatments with nine types of primary processing units. Other variations in the study examined the effect of combustion gas, air pollution control system design, and stabilization technology for the treatment residues. The Phase 1 study examined ten initial thermal treatment alternatives. The Phase 2 systems were evaluated in essentially the same manner as the Phase 1 systems. The alternatives evaluated were: rotary kiln, slagging kiln, plasma furnace, plasma gasification, molten salt oxidation, molten metal waste destruction, steam gasification, Joule-heated vitrification, thermal desorption and mediated electrochemical oxidation, and thermal desorption and supercritical water oxidation. The quantities, and physical and chemical compositions, of the input waste used in the Phase 2 systems differ from those in the Phase 1 systems, which were based on a preliminary waste input database developed at the onset of the Integrated Thermal Treatment System study. The inventory database used in the Phase 2 study incorporates the latest US Department of Energy information. All systems, both primary treatment systems and subsystem inputs, have now been evaluated using the same waste input (2,927 lb/hr). 28 refs., 88 figs., 41 tabs.

  14. Integrative Treatments to Reduce Risk for Cardiovascular Disease

    PubMed Central

    Bradley, Ryan; Oberg, Erica

    2010-01-01

    Recognizing the contribution and interrelatedness of lipoprotein risk factors is critical to prioritizing treatment strategies for cardiovascular risk reduction. Lipoprotein factors still dominate risk for developing cardiovascular disease, including myocardial infarction. Some emerging risk factors such as C-reactive protein are gaining acceptance due to recent prospective clinical trials demonstrating clinical benefit in reducing these markers. Other emerging risk factors, including lipoprotein particle size, remain to be validated. In this second article of a 2-part series, we will begin with a review of formal risk assessment, discussing the contribution of multiple “risky” and “healthy” components that play a part in overall cardiovascular health. Following risk assessment, we will discuss evidence-based integrative therapies that can be used to modify any risky lipoprotein and inflammatory patient profiles, including medications, functional foods, supplements, and lifestyle approaches. The focus is on low-density lipoproteins, high-density lipoproteins, triglycerides, and C-reactive protein. Understanding the interrelatedness of lipoprotein risk factors, and finding efficient methods of treating multiple risk factors simultaneously, will not only improve the long-term health of patients but will also save on the expenditure of healthcare dollars for unnecessary testing and ineffective treatments. Integrative practitioners who understand the contribution of lifestyle factors, and who have numerous effective treatment options at their disposal, are well positioned to counsel patients on cardiovascular disease prevention. PMID:21461347

  15. Simulation of wastewater treatment plant within integrated urban wastewater models.

    PubMed

    Heusch, S; Kamradt, B; Ostrowski, M

    2010-01-01

    In the federal state of Hesse in Germany the application of an integrated software modelling framework is becoming part of the planning process to attain legal approval for the operation of combined sewer systems. The software allows for parallel simulation of flow and water quality routing in the sewer system and in receiving rivers. It combines existing pollution load model approaches with a simplified version of the River Water Quality Model No. 1 (RWQM1). Comprehensive simulation of the wastewater treatment plant (WWTP) is not considered yet. The paper analyses alternatives for the implementation of a WWTP module to model activated sludge plants. For both primary and secondary clarifiers as well as for the activated sludge process concepts for the integration into the existing software framework were developed. The activated sludge concept which uses a linearized version of the well known ASM1 model is presented in detail. PMID:20453339

  16. Fabrication of reproducible sub-5 nm nanogaps by a focused ion beam and observation of Fowler-Nordheim tunneling

    SciTech Connect

    Li, Hu; Wani, Ishtiaq H.; Hayat, Aqib; Leifer, Klaus; Jafri, S. Hassan M.

    2015-09-07

    Creating a stable high resistance sub-5 nm nanogap in between conductive electrodes is one of the major challenges in the device fabrication of nano-objects. Gap-sizes of 20 nm and above can be fabricated reproducibly by the precise focusing of the ion beam and careful milling of the metallic lines. Here, by tuning ion dosages starting from 4.6 × 10{sup 10} ions/cm and above, reproducible nanogaps with sub-5 nm sizes are milled with focused ion beam. The resistance as a function of gap dimension shows an exponential behavior, and Fowler-Nordheim tunneling effect was observed in nanoelectrodes with sub-5 nm nanogaps. The application of Simmon's model to the milled nanogaps and the electrical analysis indicates that the minimum nanogap size approaches to 2.3 nm.

  17. The consequences of dependence between the formal area efficiency and the macroscopic electric field on linearity behavior in Fowler–Nordheim plots

    NASA Astrophysics Data System (ADS)

    de Assis, Thiago A.; Dall’Agnol, Fernando F.; Andrade, Roberto F. S.

    2016-09-01

    This work presents a theoretical explanation for a crossover in the linear behavior in Fowler–Nordheim (FN) plots based on orthodox cold field electron emission (CFE) experimental data. It is characterized by a clear change in the decay rate of usually single-slope FN plots, and has been reported when non-uniform nano-emitters are subject to high macroscopic electric field F M. We assume that the number of emitting spots, which defines an apparent formal area efficiency of CFE surfaces, depends on the macroscopic electric field. Non-uniformity is described by local enhancement factors ≤ft\\{{γj}\\right\\} , which are randomly assigned to each distinct emitter of a conducting CFE surface, from a discrete probability distribution ρ ≤ft({γj}\\right) , with j  =  1, 2. It is assumed that ρ ≤ft({γ1}\\right)<ρ ≤ft({γ2}\\right) , and that {γ1}>{γ2} . The local current density is evaluated by considering a usual Schottky–Nordheim barrier. The results reproduce the two distinct slope regimes in FN plots when {{F}\\text{M}}\\in [2, 20] V μm‑1 and are analyzed by taking into account the apparent formal area efficiency, the distribution ρ, and the slopes in the corresponding FN plot. Finally, we remark that our results from numerical solution of Laplace’s equation, for an array of conducting nano-emitters with uniform apex radii 50 nm but different local height, supports our theoretical assumptions and could used in orthodox CFE experiments to test our predictions.

  18. [Home treatment--a treatment model of integrated care in Hamburg].

    PubMed

    Schöttle, Daniel; Ruppelt, Friederike; Karow, Anne; Lambert, Martin

    2015-03-01

    Treatment models like "Crisis Resolution and Hometreatment (CRHT)" or "Assertive Community Treatment" (ACT), were found to be effective, enhancing the qualitative level of treatment for patients with severe mental disorders. In Germany, these are implemented only sporadically until today, often as part of a cross-sectoral Integrated Care (IC) treatment system. We will present the implementation of an "Assertive Community Treatment" embedded into an IC-treatment model in Hamburg and discuss the 3-year-outcomes. The IC-treatment model has been designed for severe mentally ill patients with psychotic disorders. Since May 2007 the model is financed by different health insurances as a managed-care "capitation-model" and its effectiveness gets continuously evaluated. The model proved to be effective in earlier studies were compared with standard care low rates of service disengagement were found as well as significantly improved psychopathology, psychosocial functioning, quality of life, satisfaction with care and adherence, while being cost effective. The rates of involuntary admissions declined to 10% in comparison to the years before. In 2011 the model was specified to the indication "first-episode adolescents and young adults in the age of 12-29" in a government-funded study "Integrated Care in Early Psychosis, ICEP Study". In this study an interdisciplinary team of child, adolescent and adult psychiatrists was implemented and since 2012 it is financed by the involved health insurances throughout an expansion of the §140 SGB V agreement. PMID:25485599

  19. Implementing Residential Integrated Treatment for Co-occurring Disorders

    PubMed Central

    McKee, Shari A.; Harris, Grant T.; Cormier, Catherine A.

    2013-01-01

    Objective: Much is now known about effective treatment for co-occurring substance abuse and psychiatric difficulties and many evidence-based practice recommendations have been disseminated. Implementation of these recommended interventions in daily clinical practice has been more of a struggle. This article describes successful implementation of integrated treatment for co-occurring disorders in a small residential program. Methods: A traditional 28-day addiction service was transformed into a 3-month integrated treatment program and 155 individuals with co-occurring disorders agreed to participate in its evaluation. The transformation entailed a completely new manualized service, training in a number of clinical interventions for all program clinicians, ongoing clinical supervision, and formal measurement of clients’ backgrounds, substance abuse, quality of life, mental health symptoms, self-esteem, and satisfaction with the program. We also obtained collateral informants’ reports on participants’ symptoms, substance use, and quality of life. Fidelity to the treatment model was continuously assessed, as were participants’ knowledge and skill acquisition. In addition, impact of the implementation on the program clinicians’ morale and attitudes toward evidence-based practices was assessed, as was staff turnover and per diem costs. Results: Despite very problematic clinical and sociodemographic histories, the 86 participants who completed the program showed clinically significant mental health symptom improvement, acquisition of knowledge and skill, and high self-esteem and satisfaction with the program. Program fidelity, clinician morale, commitment to the program, and attitudes toward evidence-based practice were uniformly high. These successes were achieved while maintaining the lowest per–inpatient day cost of all hospital inpatient units. Conclusions: The findings support the contention that evidence-based integrated treatment can be implemented with

  20. Treatment Integrity in Psychotherapy Research: Analysis of the Studies and Examination of the Associated Factors

    ERIC Educational Resources Information Center

    Perepletchikova, Francheska; Treat, Teresa A.; Kazdin, Alan E.

    2007-01-01

    Treatment integrity refers to the degree to which an intervention is delivered as intended. Two studies evaluated the adequacy of treatment integrity procedures (including establishing, assessing, evaluating, and reporting integrity; therapist treatment adherence; and therapist competence) implemented in psychotherapy research, as well as…

  1. Integrated Waste Treatment Unit GFSI Risk Management Plan

    SciTech Connect

    W. A. Owca

    2007-06-21

    This GFSI Risk Management Plan (RMP) describes the strategy for assessing and managing project risks for the Integrated Waste Treatment Unit (IWTU) that are specifically within the control and purview of the U.S. Department of Energy (DOE), and identifies the risks that formed the basis for the DOE contingency included in the performance baseline. DOE-held contingency is required to cover cost and schedule impacts of DOE activities. Prior to approval of the performance baseline (Critical Decision-2) project cost contingency was evaluated during a joint meeting of the Contractor Management Team and the Integrated Project Team for both contractor and DOE risks to schedule and cost. At that time, the contractor cost and schedule risk value was $41.3M and the DOE cost and schedule risk contingency value is $39.0M. The contractor cost and schedule risk value of $41.3M was retained in the performance baseline as the contractor's management reserve for risk contingency. The DOE cost and schedule risk value of $39.0M has been retained in the performance baseline as the DOE Contingency. The performance baseline for the project was approved in December 2006 (Garman 2006). The project will continue to manage to the performance baseline and change control thresholds identified in PLN-1963, ''Idaho Cleanup Project Sodium-Bearing Waste Treatment Project Execution Plan'' (PEP).

  2. An Integrated System for the Treatment of Coal Conversion Wastewater

    SciTech Connect

    Henry Y. Wang; Keeran R. Srinivasan

    1999-02-25

    Treatment of mixed waste from coal conversion wastewaters involves the degradation of toxic organics and the removal of heavy metals. An integrated and cost-effective treatment scheme that can implement such a process is considered essential to promote continued development and growth of coal conversion processes without any deleterious effects on our ecosystem. We have recently developed a pH-dependent, reversible heavy metal adsorption/desorption process which promises to be a cost-effective alternative to the treatment and disposal options currently in place for these inorganic contaminants. Our work shows that: (1) Polydisperse, industrial-grade surfactants can be used in the development of novel, surfactant-coated smectitic clays containing up to 50% by weight of adsorbed surfactant, (2) Reversible adsorption and resorption of cationic (CU(II) and Cd(II)) and anionic (Cr(VI)) heavy metals from their respective aqueous solutions onto these surfactant-modified smectites can be effected using pH of the medium as a switch, and (3) These surfactant-modified smectites can be repeatedly used (up to 5 times) with only a minimal loss in their adsorption potency and with very little leaching of the adsorbed surfactants.

  3. Integrating electrodermal biofeedback into pharmacologic treatment of grand mal seizures

    PubMed Central

    Scrimali, Tullio; Tomasello, Damiana; Sciuto, Massimo

    2015-01-01

    Electrodermal activity (EDA) and electrodermal biofeedback, when integrated with pharmacologic treatments, indicate promising methods for the treatment of grand mal seizures. They can be used to monitor patient arousal and help patients learn new strategies to better cope with stress and anxiety. Our proposed method can possibly reduce the number of crises for patients who are dependent on pharmacologic therapy and can improve their quality of life. This article describes the scientific background of electrodermal monitoring and electrodermal biofeedback for patients affected by grand mal seizures. In this study, we have reported a clinical case study. The patient was treated for 2 years with electrodermal biofeedback to augment pharmacologic treatments. The trial has been designed in accordance with “n = 1 case study research”. Our results have shown that our methods could achieve a significant reduction in grand mal seizures and sympathetic arousal when applied. The patient under consideration was also relaxed and exhibited greater competency to cope with stress. Additionally, the patient’s sense of mastery and self-efficacy was enhanced. PMID:26029078

  4. Integrating electrodermal biofeedback into pharmacologic treatment of grand mal seizures.

    PubMed

    Scrimali, Tullio; Tomasello, Damiana; Sciuto, Massimo

    2015-01-01

    Electrodermal activity (EDA) and electrodermal biofeedback, when integrated with pharmacologic treatments, indicate promising methods for the treatment of grand mal seizures. They can be used to monitor patient arousal and help patients learn new strategies to better cope with stress and anxiety. Our proposed method can possibly reduce the number of crises for patients who are dependent on pharmacologic therapy and can improve their quality of life. This article describes the scientific background of electrodermal monitoring and electrodermal biofeedback for patients affected by grand mal seizures. In this study, we have reported a clinical case study. The patient was treated for 2 years with electrodermal biofeedback to augment pharmacologic treatments. The trial has been designed in accordance with "n = 1 case study research". Our results have shown that our methods could achieve a significant reduction in grand mal seizures and sympathetic arousal when applied. The patient under consideration was also relaxed and exhibited greater competency to cope with stress. Additionally, the patient's sense of mastery and self-efficacy was enhanced. PMID:26029078

  5. Integrated flue gas treatment condensing heat exchanger for pollution control

    SciTech Connect

    Johnson, D.W.; Warchol, J.J.; Schulze, K.H.; Carrigan, J.F.

    1994-12-31

    Condensing heat exchangers recover both sensible and latent heat from flue gases. Using Teflon{reg_sign} to cover the heat exchanger tubes and inside surfaces that are exposed to the flue gas ensures adequate material lifetime in the corrosive environment encountered when the flue gas temperature drops below the acid dew point. A recent design improvement, called the integrated flue gas treatment (IFGT) concept, offers the ability to remove pollutants from the flue gas, as well as recover waste heat. It has been shown to remove SO{sub 2}, SO{sub 3}, particulates, and trace emissions. Babcock and Wilcox (B and W) is undertaking an extensive program to optimize this technology for a variety of flue gas applications. This paper summarizes the current status of IFGT technology and the development activities that are in progress.

  6. Integrating Multiscale Modeling with Drug Effects for Cancer Treatment

    PubMed Central

    Li, Xiangfang L.; Oduola, Wasiu O.; Qian, Lijun; Dougherty, Edward R.

    2015-01-01

    In this paper, we review multiscale modeling for cancer treatment with the incorporation of drug effects from an applied system’s pharmacology perspective. Both the classical pharmacology and systems biology are inherently quantitative; however, systems biology focuses more on networks and multi factorial controls over biological processes rather than on drugs and targets in isolation, whereas systems pharmacology has a strong focus on studying drugs with regard to the pharmacokinetic (PK) and pharmacodynamic (PD) relations accompanying drug interactions with multiscale physiology as well as the prediction of dosage-exposure responses and economic potentials of drugs. Thus, it requires multiscale methods to address the need for integrating models from the molecular levels to the cellular, tissue, and organism levels. It is a common belief that tumorigenesis and tumor growth can be best understood and tackled by employing and integrating a multifaceted approach that includes in vivo and in vitro experiments, in silico models, multiscale tumor modeling, continuous/discrete modeling, agent-based modeling, and multiscale modeling with PK/PD drug effect inputs. We provide an example application of multiscale modeling employing stochastic hybrid system for a colon cancer cell line HCT-116 with the application of Lapatinib drug. It is observed that the simulation results are similar to those observed from the setup of the wet-lab experiments at the Translational Genomics Research Institute. PMID:26792977

  7. An integrated biological approach for treatment of cyanidation wastewater.

    PubMed

    Mekuto, Lukhanyo; Ntwampe, S K O; Akcil, Ata

    2016-11-15

    The cyanidation process has been, and still remains, a profitable and highly efficient process for the recovery of precious metals from ores. However, this process has contributed to environmental deterioration and potable water reserve contamination due to the discharge of poorly treated, or untreated, cyanide containing wastewater. The process produces numerous cyanide complexes in addition to the gold cyanocomplex. Additionally, the discharge constituents also include hydrogen cyanide (HCN) - metallic complexes with iron, nickel, copper, zinc, cobalt and other metals; thiocyanate (SCN); and cyanate (CNO). The fate of these complexes in the environment dictates the degree to which these species pose a threat to living organisms. This paper reviews the impact that the cyanidation process has on the environment, the ecotoxicology of the cyanidation wastewater and the treatment methods that are currently utilised to treat cyanidation wastewater. Furthermore, this review proposes an integrated biological approach for the treatment of the cyanidation process wastewater using microbial consortia that is insensitive and able to degrade cyanide species, in all stages of the proposed process. PMID:27424119

  8. Integrating Tobacco Use Treatment Into Practice: Billing and Documentation.

    PubMed

    Leone, Frank T; Evers-Casey, Sarah; Mulholland, Mary A; Sachs, David P L

    2016-02-01

    Balancing population-based efforts to modify the social and environmental factors that promote tobacco dependence with efforts to improve the delivery of case-based treatments is necessary for realizing maximum reductions in the cost and consequences of the disease. Public health antismoking campaigns following the 1964 Surgeon General's report on the health risks of smoking have changed social norms, prevented initiation among youth, and promoted abstinence among the addicted. However, the rate of progress enjoyed to date is unlikely to continue into the coming decades, given that current annual unassisted cessation rates among prevalent smokers remains fairly low. With more than 1 billion patient interactions annually, there is an enormous unrealized capacity for health-care systems to have an effect on this problem. Clinicians report a perceived lack of reimbursement as a significant barrier to full integration of tobacco dependence into health care. A more complete understanding of the coding and documentation requirements for successful practice in this critically important area is a prerequisite to increasing engagement. This paper presents several case-based scenarios illustrating important practice management issues related to the treatment of tobacco dependence in health care. PMID:26426215

  9. New treatment approaches: integrating new media in the treatment of war and torture victims.

    PubMed

    Knaevelsrud, Christine; Wagner, Birgit; Karl, Ankel; Mueller, Julia

    2007-01-01

    The diagnostic process and treatment of victims of war and torture is associated with a number of difficulties. This article will provide an overview of three different approaches on how the new media may be integrated into the treatment of survivors of torture and war to face some of the challenges. Illiteracy is a common problem and makes it difficult to apply standardized psychological assessment procedures. Also, the majority of survivors of torture and war do not have access to any psychotherapeutic treatment due to geographical limitations or limitations concerning psychotherapeutic treatment capacity. Furthermore, chronic psychological disorders such as (complex) Posttraumatic Stress Disorder (PTSD) are often seen with comorbid chronic pain disorders, which present a therapeutic challenge. The Treatment Center for Torture Victims, Berlin, in cooperation with the University of Zurich, developed a number of approaches to address these challenges: 1) MultiCASI - to standardize the diagnostic process an audiovisual diagnostic tool was developed which allows illiterate individuals to answer standardized psychological questionnaires whithout the help of interpreters; 2) A virtual treatment center for posttraumatic stress disorder for traumatized patients in Iraq and other Arab speaking postconflict countries; 3) Utility of Biofeedback (BF) in chronic (somatoform) pain and in traumatized patients: to address the chronic pain syndrome presented by most survivors, a biofeedback supported cognitive-behavioral therapy approach was developed and successfully tested in a pilot study. PMID:17728484

  10. Independent peer review panel report on the integrated nonthermal treatment systems study and the comparison of integrated thermal and integrated nonthermal treatment systems for mixed low level waste

    SciTech Connect

    1996-08-01

    The US Department of Energy`s (DOE) Office of Environmental Management (EM) Office of Science and Technology (OST) has conducted studies of integrated thermal treatment systems and integrated nonthermal treatment systems (INTS) for treating contact handled, alpha and non-alpha mixed low level radioactive waste (MLLW). The MLLW in the DOE complex consists of a wide variety of organic and inorganic solids and liquids contaminated with radioactive substances. Treatment systems are needed to destroy organic material and stabilize residues prior to land disposal. In May 1996 the Deputy Assistant Secretary for OST appointed an Independent Peer Review Panel to: (1) review and comment on the INTS Study; (2) make recommendations on the most promising thermal and nonthermal treatment systems; (3) make recommendations on research and development necessary to prove the performance of nonthermal and thermal technologies; and (4) review and comment on the preliminary draft of the ITTS/INTS Comparison Report. This report presents the primary conclusions and recommendations based on the review of the INTS study and the comparison report. System selection, overviews, comparisons, cost estimations and sensitivity analyses, and recommended R and D engineering needs are then described and discussed.

  11. Portal dosimetry for VMAT using integrated images obtained during treatment

    SciTech Connect

    Bedford, James L. Hanson, Ian M.; Hansen, Vibeke Nordmark

    2014-02-15

    Purpose: Portal dosimetry provides an accurate and convenient means of verifying dose delivered to the patient. A simple method for carrying out portal dosimetry for volumetric modulated arc therapy (VMAT) is described, together with phantom measurements demonstrating the validity of the approach. Methods: Portal images were predicted by projecting dose in the isocentric plane through to the portal image plane, with exponential attenuation and convolution with a double-Gaussian scatter function. Appropriate parameters for the projection were selected by fitting the calculation model to portal images measured on an iViewGT portal imager (Elekta AB, Stockholm, Sweden) for a variety of phantom thicknesses and field sizes. This model was then used to predict the portal image resulting from each control point of a VMAT arc. Finally, all these control point images were summed to predict the overall integrated portal image for the whole arc. The calculated and measured integrated portal images were compared for three lung and three esophagus plans delivered to a thorax phantom, and three prostate plans delivered to a homogeneous phantom, using a gamma index for 3% and 3 mm. A 0.6 cm{sup 3} ionization chamber was used to verify the planned isocentric dose. The sensitivity of this method to errors in monitor units, field shaping, gantry angle, and phantom position was also evaluated by means of computer simulations. Results: The calculation model for portal dose prediction was able to accurately compute the portal images due to simple square fields delivered to solid water phantoms. The integrated images of VMAT treatments delivered to phantoms were also correctly predicted by the method. The proportion of the images with a gamma index of less than unity was 93.7% ± 3.0% (1SD) and the difference between isocenter dose calculated by the planning system and measured by the ionization chamber was 0.8% ± 1.0%. The method was highly sensitive to errors in monitor units and

  12. Inpatient Treatment of Community-Acquired Pneumonias with Integrative Medicine

    PubMed Central

    Diederich, Klas; Kusserow, Maria; Laubersheimer, Andreas; Kramer, Klaus

    2013-01-01

    Introduction. The aim of the presented observational case series was to evaluate the experience in treating patients with community-acquired pneumonia (CAP) within integrative medicine, particularly anthroposophic medicine in a well-experienced and specialized unit. Patients and Methods. Patients with proven CAP were evaluated (CAP-study group) based on a retrospective chart review. To estimate the severity of pneumonia, the pneumonia severity index (PSI) was applied. Treatment efficacy was evaluated regarding body temperature, CRP level, leukocytes blood count, the need to be treated on ICU, and mortality. Results were compared with the inpatient data of the Pneumonia PORT Validation Cohort. Results. 15/18 patients of the CAP-study group belonged to risk class groups I–III (low and moderate risk), 2 patients to risk class IV, and one patient to risk class V (severe pneumonia). 16/18 patients were treated with anthroposophic medicine only and 2/18 got additionally antibiotic therapy (both of risk class IV). A significant reduction of body temperature, CRP level, and leukocytes blood count has been obtained by applying anthroposophic medicine, while neither complications nor pneumonia-related death occurred. Compared with the control group there was no significant difference in mortality rate, whereby no patient had to be treated on the ICU, but the duration of hospital stay was significantly longer in the presented series. Conclusion. Inpatient treatment of CAP with anthroposophic medicine without the use of antibiotics may achieve reasonable results in selected cases. Additional larger sized prospective controlled trials should further clarify the role of AM in the treatment of CAP. PMID:23762145

  13. Integrating smoking cessation into substance use disorder treatment for military veterans: measurement and treatment engagement efforts.

    PubMed

    Shealy, Suzanne E; Winn, Jaime L

    2014-02-01

    Military personnel and veterans smoke at higher rates than the general population, compromising physical performance readiness and health (Committee on Smoking Cessation in Military and Veteran Populations & Institute of Medicine, 2009). While efforts are being made within both the Department of Defense and the Veterans' Administration (VA) hospitals to prevent onset, change the smoking culture, and promote smoking cessation; smoking rates are increasing among combat deployed service members, and smoking rates are particularly high among veterans with mental health and other substance use disorders (McFall, 2006). Recent research supports making smoking cessation widely available and integrated with other forms of care (Gierisch et al., 2012; McFall et al., 2010). This paper describes the efforts of one VA substance use disorder (SUD) treatment program to integrate smoking cessation in routine care, including assessment of tobacco use and motivation and intention to quit via the proposed Nic-BAM assessment. Our team was 100% successful in incorporating the Nic-BAM into our regular assessment of treatment program participants. This suggests that staff members are amenable to assessing for tobacco addiction alongside other substance addictions. Although smoking did not decrease according to the Nic-BAM, an increase in the use of nicotine-replacement products suggests that participants are willing to initiate a quit attempt during SUD treatment. The availability of new evidence-based approaches for integration of tobacco cessation with mental health and SUD treatment may help to enhance programmatic efforts. Environmental changes are needed to fully incorporate tobacco recovery into SUD programming, and additional resources may include peer support specialists. PMID:24094921

  14. Evolution of the Treatment Integrity Concept: Current Status and Future Directions

    ERIC Educational Resources Information Center

    Gresham, Frank M.

    2009-01-01

    The concept of treatment integrity cuts across a diversity of fields involved with providing treatments or interventions to individuals. In medical treatments, the concept of "treatment compliance" or "treatment adherence" is an important and problematic issue. In the field of nutrition, the concept of "dietary adherence" is important for…

  15. Treatment integrity in school-wide programs: a review of the literature (1993-2012).

    PubMed

    Bruhn, Allison L; Hirsch, Shanna E; Lloyd, John W

    2015-10-01

    We assessed the reporting of treatment integrity in school-wide prevention programs in K-12 schools. This review was designed to determine (a) the extent to which treatment integrity was reported in school-wide prevention and intervention programs and how the reporting varied by research design, year, and journal; and (b) the procedures (e.g., method, frequency, informant) used to collect treatment integrity data. Results indicated that fewer than half of the studies in the review (n = 36, 45.6 %) measured and reported treatment integrity. Those studies reporting treatment integrity often used multiple methods and informants. Reporting treatment integrity in this body of literature has increased steadily over time. PMID:26319798

  16. The role of Hurst exponent on cold field electron emission from conducting materials: from electric field distribution to Fowler-Nordheim plots

    PubMed Central

    de Assis, T. A.

    2015-01-01

    This work considers the effects of the Hurst exponent (H) on the local electric field distribution and the slope of the Fowler-Nordheim (FN) plot when considering the cold field electron emission properties of rough Large-Area Conducting Field Emitter Surfaces (LACFESs). A LACFES is represented by a self-affine Weierstrass-Mandelbrot function in a given spatial direction. For 0.1 ≤ H < 0.5, the local electric field distribution exhibits two clear exponential regimes. Moreover, a scaling between the macroscopic current density () and the characteristic kernel current density (), , with an H-dependent exponent , has been found. This feature, which is less pronounced (but not absent) in the range where more smooth surfaces have been found (), is a consequence of the dependency between the area efficiency of emission of a LACFES and the macroscopic electric field, which is often neglected in the interpretation of cold field electron emission experiments. Considering the recent developments in orthodox field emission theory, we show that the exponent must be considered when calculating the slope characterization parameter (SCP) and thus provides a relevant method of more precisely extracting the characteristic field enhancement factor from the slope of the FN plot. PMID:26035290

  17. Performance Evaluation of Integrated Constructed Wetland for Domestic Wastewater Treatment.

    PubMed

    Sehar, Shama; Naz, Iffat; Khan, Sumera; Naeem, Sana; Perveen, Irum; Ali, Naeem; Ahmed, Safia

    2016-03-01

    Simple, budget friendly, laboratory-scale integrated constructed wetland (ICW) was designed to assess domestic wastewater treatment performance at a loading rate of 75 mm/d, planted with native plant species: Veronica-angallis aquatica and compared with non-vegetative control system at various residence times of 4, 8, 12, 16, 20, 24, and 28 days. Results revealed that the vegetated ICW demonstrated superior performance over non-vegetated control: 69.12 vs 17.12%, 67.77 vs 16.04%, 68 vs 16.48%, 71.19 vs 6.56%, 71.54 vs 14.80%, and 72.04 vs 11.41% for total dissolved solids, total suspended solids, phosphates (PO4(-)), sulfate (SO4(-)), nitrate (NO3(-)), and nitrite (NO2(-)), respectively, at 20 days residence times. Reduction in bacterial counts (2.79 × 10(4) CFU/mL) and fecal pathogens (345.5 MPN index/100 mL) was observed in V. aquatica at 20 days residence time. Therefore, the present study highlights not only the presence of vegetation but also appropriate residence time in constructed wetlands for better performances. PMID:26931539

  18. Integrative Treatment of Reflux and Functional Dyspepsia in Children

    PubMed Central

    Yeh, Ann Ming; Golianu, Brenda

    2014-01-01

    Gastroesophageal reflux disease (GERD) and functional dyspepsia (FD) are common problems in the pediatric population, with up to 7% of school-age children and up to 8% of adolescents suffering from epigastric pain, heartburn, and regurgitation. Reflux is defined as the passage of stomach contents into the esophagus, while GERD refers to reflux symptoms that are associated with symptoms or complications—such as pain, asthma, aspiration pneumonia, or chronic cough. FD, as defined by the Rome III classification, is a persistent upper abdominal pain or discomfort, not related to bowel movements, and without any organic cause, that is present for at least two months prior to diagnosis. Endoscopic examination is typically negative in FD, whereas patients with GERD may have evidence of esophagitis or gastritis either grossly or microscopically. Up to 70% of children with dyspepsia exhibit delayed gastric emptying. Treatment of GERD and FD requires an integrative approach that may include pharmacologic therapy, treating concurrent constipation, botanicals, mind body techniques, improving sleep hygiene, increasing physical activity, and traditional Chinese medicine and acupuncture. PMID:27417471

  19. An evaluation of programmed treatment-integrity errors during discrete-trial instruction.

    PubMed

    Carroll, Regina A; Kodak, Tiffany; Fisher, Wayne W

    2013-01-01

    This study evaluated the effects of programmed treatment-integrity errors on skill acquisition for children with an autism spectrum disorder (ASD) during discrete-trial instruction (DTI). In Study 1, we identified common treatment-integrity errors that occur during academic instruction in schools. In Study 2, we simultaneously manipulated 3 integrity errors during DTI. In Study 3, we evaluated the effects of each of the 3 integrity errors separately on skill acquisition during DTI. Results showed that participants either demonstrated slower skill acquisition or did not acquire the target skills when instruction included treatment-integrity errors. PMID:24114154

  20. Integration of alternative feedstreams for biomass treatment and utilization

    DOEpatents

    Hennessey, Susan Marie; Friend, Julie; Dunson, Jr., James B.; Tucker, III, Melvin P.; Elander, Richard T.; Hames, Bonnie

    2011-03-22

    The present invention provides a method for treating biomass composed of integrated feedstocks to produce fermentable sugars. One aspect of the methods described herein includes a pretreatment step wherein biomass is integrated with an alternative feedstream and the resulting integrated feedstock, at relatively high concentrations, is treated with a low concentration of ammonia relative to the dry weight of biomass. In another aspect, a high solids concentration of pretreated biomass is integrated with an alternative feedstream for saccharifiaction.

  1. Integrating Surgery Into Treatment Paradigms for Organ Preservation: Tailoring Treatment to Biology Improves Outcomes

    SciTech Connect

    Wolf, Gregory T.

    2007-10-01

    Purpose: Neoadjuvant chemotherapy was introduced into treatment paradigms for curable head and neck cancer in the early 1970s in an effort to reduce the magnitude of mutilating surgery and to provide a rationale for adjuvant systemic chemotherapy in patients who responded to initial chemotherapy. The large number of trials that followed failed to demonstrate improved survival when neoadjuvant chemotherapy was added to conventional surgery or radiation. Importantly, a consistent observation in these neoadjuvant trials was the significant association of clinical tumor response to neoadjuvant therapy and favorable prognosis. Results: The findings led to development of a new treatment paradigm that was based on the hypothesis that the biology of an individual cancer is more predictive of response to specific therapy and overall outcome than is anatomic tumor site or extent, and on the corollary that matching treatment modality to biology will improve overall survival rates. Conclusions: This report identifies key findings that are important in the design and analysis of organ preservation trials and biologic markers predictive of response and outcomes. Ongoing studies incorporating biomarkers such as p53, Bcl-xL, HPV, EGFR, COX-2, and tumor promoter gene methylation are underway and will identify new targets for molecular manipulation, response monitoring, and tumor imaging that could allow real-time changes in how we integrate the various components of multi-modal therapy.

  2. Effects of Treatment Integrity Failures during Differential Reinforcement of Alternative Behavior: A Translational Model

    ERIC Educational Resources Information Center

    Pipkin, Claire St. Peter; Vollmer, Timothy R.; Sloman, Kimberly N.

    2010-01-01

    Differential reinforcement of alternative behavior (DRA) is used frequently as a treatment for problem behavior. Previous studies on treatment integrity failures during DRA suggest that the intervention is robust, but research has not yet investigated the effects of different types of integrity failures. We examined the effects of two types of…

  3. Does Treatment Integrity Matter in Promoting Learning among Children with Developmental Disabilities?

    ERIC Educational Resources Information Center

    Odluyurt, Serhat; Tekin-Iftar, Elif; Adalioglu, Iclal

    2012-01-01

    The purpose of this study was to compare the effects of simultaneous prompting instruction with high and low treatment integrity on the learning of children with developmental disabilities. Low treatment integrity was defined as not delivering a controlling prompt during 30% of the teaching trials. Three preschool children with autism and…

  4. Treatment Integrity Assessment: How Estimates of Adherence, Quality, and Exposure Influence Interpretation of Implementation

    ERIC Educational Resources Information Center

    Hagermoser Sanetti, Lisa M.; Fallon, Lindsay M.

    2011-01-01

    The assessment of treatment integrity is important for determining the effectiveness of an intervention. Treatment integrity, a multidimensional construct, can be evaluated in two ways: by session or component. In this study, adherence, quality, and exposure data are estimated using permanent product data from implementation of the PAX Good…

  5. An Evaluation of Programmed Treatment-integrity Errors during Discrete-trial Instruction

    ERIC Educational Resources Information Center

    Carroll, Regina A.; Kodak, Tiffany; Fisher, Wayne W.

    2013-01-01

    This study evaluated the effects of programmed treatment-integrity errors on skill acquisition for children with an autism spectrum disorder (ASD) during discrete-trial instruction (DTI). In Study 1, we identified common treatment-integrity errors that occur during academic instruction in schools. In Study 2, we simultaneously manipulated 3…

  6. Treatment Integrity in a Home-Based Pre-Reading Intervention Programme

    ERIC Educational Resources Information Center

    van Otterloo, Sandra G.; van der Leij, Aryan; Veldkamp, Esther

    2006-01-01

    Treatment integrity is an underexposed issue in the phonological awareness intervention research. The current study assessed the integrity of treatment of the families (N = 32) participating in the experimental condition of a home-based pre-reading intervention study. The participating kindergartners were all genetically at risk for developing…

  7. A view from Riggs: treatment resistance and patient authority-IX. Integrative psychodynamic treatment of psychotic disorders.

    PubMed

    Tillman, Jane G

    2008-01-01

    Psychotic spectrum disorders present treatment challenges for patients, families, and clinicians. This article addresses the history of the dualism in the field between biological and psychological approaches to mental disorders, and surveys the contemporary literature about the etiology and treatment of psychotic spectrum disorders. An integrative approach to treatment derived from work at Austen Riggs with previously treatment refractory patients with psychotic spectrum disorders is described that combines individual psycho- dynamic psychotherapy, psychopharmacology, family systems approaches, and intensive psychosocial engagement. Helping patients develop their own authority to join the treatment, use relationships for learning, and understand the meaning of their symptoms is central to the treatment at Austen Riggs. An extended case vignette of a patient diagnosed with a schizoaffective disorder is presented illustrating this integrative psychodynamic treatment approach. PMID:19113964

  8. Integrating Treatment of Posttraumatic Stress Disorder and Substance Use Disorder

    ERIC Educational Resources Information Center

    Ford, Julian D.; Russo, Eileen M.; Mallon, Sharon D.

    2007-01-01

    Historically, administrators and clinicians have been hesitant to address posttraumatic stress disorder (PTSD) in the treatment of substance use disorders (SUDs). However, research shows that SUD treatment recruitment and outcomes may be adversely affected if co-occurring PTSD is left untreated. The authors provide guidelines for screening and…

  9. Self-administered behavior modification to reduce nail biting: incorporating simple technology to ensure treatment integrity.

    PubMed

    Craig, Andrew R

    2010-01-01

    Habitual behaviors, such as problematic nail biting, are a common target for self-managed behavior-modification programs. The current self-experiment used self-monitoring in conjunction with a self-managed differential-reinforcement procedure for the treatment of problematic nail biting. A simple picture-comparison procedure allowed an independent observer to assist in monitoring treatment progress and outcomes and to ensure treatment integrity. Results provide support that the overall treatment package was successful in decreasing the occurrence of nail biting. Moreover, the treatment-integrity procedure enabled full-day monitoring to take place with limited requirement of a secondary observer. PMID:22532892

  10. Integrating Cognitive Behavioral Therapy and Pharmacotherapy in the Treatment of Adolescent Depression

    ERIC Educational Resources Information Center

    Ginsburg, Golda S.; Albano, Anne Marie; Findling, Robert L.; Kratochvil, Christopher; Walkup, John

    2005-01-01

    Recent evidence from the Treatment for Adolescents With Depression Study (TADS) suggests that combining cognitive behavioral and pharmacological treatments holds the most promise for ameliorating depression among adolescents. This article describes lessons learned during the TADS trial about how to integrate these two treatments in the care of…

  11. Policy implications of integrating buprenorphine/naloxone treatment and HIV care.

    PubMed

    Finkelstein, Ruth; Netherland, Julie; Sylla, Laurie; Gourevitch, Marc N; Cajina, Adan; Cheever, Laura

    2011-03-01

    Researchers, practitioners, and policymakers have long recognized the potential benefits of providing integrated substance abuse and medical care services, particularly for special populations such as people living with HIV/AIDS. Buprenorphine, an office-based pharmacological treatment for opioid dependence, offers new opportunities for integrating drug treatment into HIV care settings. However, the historical separation between the drug treatment and medical care systems has resulted in a host of policy barriers. The Buprenorphine and HIV Care Evaluation and Support initiative, a multisite demonstration project to assess the feasibility and effectiveness of integrating buprenorphine/naloxone into HIV care settings, provided an opportunity to evaluate if and how policy barriers affect efforts to integrate HIV care and addiction treatment. We found that financing issues, workforce and training issues, and the operational consequences of some conceptual differences between HIV care and addiction treatment are barriers to the full integration of buprenorphine into HIV care. We recommend changes to financing and reimbursement policies, programs to strengthen the addiction treatment skills of physicians, and cross training between the fields of addiction, medicine, drug treatment, and HIV medicine. By addressing some of the policy barriers to integration, this promising new treatment can help the thousands of people living with HIV/AIDS who are also opioid dependent. PMID:21317602

  12. Integrating emerging treatment options in mantle cell lymphoma.

    PubMed

    Kahl, Brad S; Fowler, Nathan H; Czuczman, Myron S

    2013-12-01

    Mantle cell lymphoma is an uncommon lymphoma subtype that is currently considered incurable and lacks a single standard of care. Choice of treatment is complicated by the disease’s clinical heterogeneity. The course of the disease may be indolent, moderately aggressive, or aggressive. A translocation between chromosomes 11 and 14 is observed in the majority of mantle cell lymphoma patients, and the diseased cells may develop a variety of other genetic aberrations. Although the disease tends to respond well to treatment, patients almost invariably relapse, with many becoming chemotherapy refractory over time. The development of new treatment strategies has improved the prognosis for these patients. Novel approaches include intensive chemotherapy, often in combination with stem cell transplantation; maintenance therapy with extended duration; and new targeted treatments such as ibrutinib, bendamustine, bortezomib, lenalidomide, and idelalisib. Many of these new agents have shown promising activity, both as single agents and in combination regimens. PMID:24893155

  13. Test Driving Interventions to Increase Treatment Integrity and Student Outcomes

    ERIC Educational Resources Information Center

    Dart, Evan H.; Cook, Clayton R.; Collins, Tai A.; Gresham, Frank M.; Chenier, Jeffrey S.

    2012-01-01

    Behavioral consultation has been shown to be an effective way for school psychologists to work with teachers in implementing interventions for student problem behavior. Some teachers are resistant to the behavioral consultation process and thereby fail to implement agreed upon interventions with integrity, which is problematic considering the…

  14. Smoking Cessation: An Integral Part of Lung Cancer Treatment

    PubMed Central

    Cataldo, Janine K.; Dubey, Sarita; Prochaska, Jodi J.

    2010-01-01

    Lung cancer is the leading cause of cancer death in the US. About 50% of lung cancer patients are current smokers at the time of diagnosis and up to 83% continue to smoke after diagnosis. A recent study suggests that people who continue to smoke after a diagnosis of early-stage lung cancer almost double their risk of dying. Despite a growing body of evidence that continued smoking by patients after a lung cancer diagnosis is linked with less effective treatment and a poorer prognosis, the belief prevails that treating tobacco dependence is useless. With improved cancer treatments and survival rates, smoking cessation among lung cancer patients has become increasingly important. There is a pressing need to clarify the role of smoking cessation in the care of lung cancer patients. Objective This paper will report on the benefits of smoking cessation for lung cancer patients and the elements of smoking cessation treatment, with consideration of tailoring to the needs of lung cancer patients. Results Given the significant benefits of smoking cessation and that tobacco dependence remains a challenge for many lung cancer patients, cancer care providers need to offer full support and intensive treatment with a smoking cessation program that is tailored to lung cancer patients’ specific needs. Conclusion A tobacco dependence treatment plan for lung cancer patients is provided. PMID:20699622

  15. Treatment of tobacco dependence: integrating recent progress into practice

    PubMed Central

    Le Foll, Bernard; George, Tony P.

    2007-01-01

    Tobacco use is one of the leading preventable causes of death in developed countries. Adoption of approaches that have demonstrated efficacy to improve the treatment of tobacco dependence are critical to reduce the health consequences of tobacco use. We summarize the latest epidemiologic data on tobacco use, the mechanisms that underlie tobacco dependence, and advances in pharmacotherapy and nonpharmacologic interventions available for the treatment of tobacco dependence. Specifically, we discuss the use of nicotine replacement therapy, bupropion and varenicline in primary care settings. PMID:18025429

  16. Tomorrow`s energy today for cities and counties -- Alternative wastewater treatment: Advanced Integrated Pond systems

    SciTech Connect

    Not Available

    1993-10-01

    This report provides a discussion of the design, construction, operation, and maintenance of the Advanced Integrated Pond System as an alternative for other more costly municipal waste water treatment plants.

  17. Integrated Passive Biological Treatment System/ Mine Waste Technology Program Report #16

    EPA Science Inventory

    This report summarizes the results of the Mine Waste Technology Program (MWTP) Activity III, Project 16, Integrated, Passive Biological Treatment System, funded by the United States Environmental Protection Agency (EPA) and jointly administered by EPA and the United States Depar...

  18. An Evaluation of the "Treatment Integrity Planning Protocol" and Two Schedules of Treatment Integrity Self-Report: Impact on Implementation and Report Accuracy

    ERIC Educational Resources Information Center

    Hagermoser Sanetti, Lisa M.; Kratochwill, Thomas R.

    2011-01-01

    The evidence-based practice movement has focused on identifying, disseminating, and promoting the adoption of evidence-based interventions. Despite advances in this movement, numerous barriers, such as the lack of treatment integrity assessment methods, remain as challenges in implementation. Accurate teacher self-report could be an efficient…

  19. An Integrated Evaluation of Nonspeech Oral Motor Treatments

    ERIC Educational Resources Information Center

    Powell, Thomas W.

    2008-01-01

    Purpose: This article functions as an epilogue to the clinical forum examining the use of nonspeech oral motor treatments (NSOMTs) to remediate speech sound disorders in children. Method: Conclusions to eight clinical questions are formed based on the findings that were reported in the clinical forum. Theoretical and clinical challenges are also…

  20. DEMONSTRATION OF AN INTEGRATED, PASSIVE BIOLOGICAL TREATMENT PROCESS FOR AMD

    EPA Science Inventory

    An innovative, cost-effective, biological treatment process has been designed by MSE Technology Applications, Inc. to treat acid mine drainage (AMD). A pilot-scale demonstration is being conducted under the Mine Waste Technology Program using water flowing from an abandoned mine ...

  1. Integrating Fieldwork into Employment Counseling for Methadone-Treatment Patients

    ERIC Educational Resources Information Center

    Blankertz, Laura; Spinelli, Michael; Magura, Stephen; Bali, Priti; Madison, Elizabeth M.; Staines, Graham L.; Horowitz, Emily; Guarino, Honoria; Grandy, Audrey; Fong, Chunki; Gomez, Augustin; Dimun, Amy; Friedman, Ellen

    2005-01-01

    An innovative employment counseling model, Customized Employment Supports, was developed for methadone-treatment patients, a population with historically low employment rates. The effectiveness of a key component of the model, "vocational fieldwork," the delivery of services in the community rather than only within the clinic, was assessed through…

  2. Integrated Self-Management System for Improved Treatment of Asthma

    PubMed Central

    NGUYEN, Kristen T.; CULJAT, Martin O.; MIERZWA, Andrzej P.; SINGH, Rahul S.; FONG, Benson; VANLANDINGHAM, Rebecca

    2016-01-01

    A mobile, affordable product that provides clinicians and patients with comprehensive asthma assessment is needed to improve asthma control. Our solution is an integrated system consisting of a portable, inexpensive, easy-to-use spirometer and a mobile application that communicates wirelessly with the spirometer. Results demonstrated that the wireless asthma management solution meets recommended American Thoracic Society (ATS) and European Respiratory Society (ERS) standards. The device is expected to empower patients to accurately self-assess their asthma for better self-management at home, work, or leisure. PMID:27046589

  3. Integrated Psychosocial and Opioid-Antagonist Treatment for Alcohol Dependence: A Systematic Review of Controlled Evaluations

    ERIC Educational Resources Information Center

    Vaughn, Michael G.; Howard, Matthew O.

    2004-01-01

    Methodological characteristics and outcomes of 14 controlled clinical investigations of integrated psychosocial and opioid-antagonist alcohol dependence treatment were evaluated. The 14 studies were identified through computerized bibliographic and manual literature searches. Clients receiving integrated psychosocial and opioid-antagonist…

  4. Treatment of Smokers with Co-Occurring Disorders: Emphasis on Integration in Mental Health and Addiction Treatment Settings

    PubMed Central

    Hall, Sharon M.; Prochaska, Judith J.

    2009-01-01

    This article reviews the research on the treatment of cigarette smoking in individuals who have comorbid mental illnesses or non-nicotinic addictions. The prevalence of smoking in mentally ill and substance-abusing populations is presented, as well as reasons for this high prevalence. The historical role of cigarettes and tobacco in mental illness and addiction is reviewed to help the reader better understand the pervasiveness of smoking in these disorders and the relative absence of intervention efforts in mental heath and addiction treatment settings. The article then discusses the several reasons for integrating smoking treatment into mental health and addiction settings. The outcome research for adult and adolescent comorbid smokers is reviewed, and barriers to treatment are discussed. The review closes with a brief discussion of models of integration and thoughts about prevention. PMID:19327035

  5. Melting down the Ice Queen: an integrative treatment of anorexia nervosa

    PubMed Central

    Hartogs, Bregje M A; Eikmans, Kirsten M; Bartels-Velthuis, Agna A

    2013-01-01

    A 23-year-old woman with anorexia nervosa (AN) and a strong need for control was offered an integrative treatment, empowering the patient to be an active participant and advocating shared decision-making. To emphasise this, both the therapist and patient describe their views on the therapy. The integrative treatment resulted in more psychological flexibility and behavioural improvements, as is evident from an increased weight, a decreased dietary restriction and an increased valued action. The strength of this integrative treatment is based on accepting and encouraging patient's self-chosen treatment method, within healthy limits, and thereby creating a flexible, supportive and empowering therapeutic alliance. More research is needed to test the efficacy of combining complementary therapies within conventional treatments of AN. PMID:23531925

  6. Treatment Integrity Assessment of a Daily Report Card Intervention: A Preliminary Evaluation of Two Methods and Frequencies

    ERIC Educational Resources Information Center

    Sanetti, Lisa M. Hagermoser; Chafouleas, Sandra M.; O'Keeffe, Breda V.; Kilgus, Stephen P.

    2013-01-01

    Although intuitively appealing, teacher self-report of treatment integrity is not currently recommended as a method for collecting treatment integrity data. Education researchers have not, however, evaluated features of a treatment integrity self-reporting system that may facilitate accurate self-report. In this preliminary investigation, four…

  7. Integrated treatment to resolve a horizontal root fracture.

    PubMed

    Brandini, Daniela Atili; Poi, Wilson Roberto; Panzarini, Sônia Regina; Sonoda, Celso Koogi; de Castro, José Carlos Monteiro; Luvizuto, Eloá Rodrigues; Leal, Cláudia Resende

    2009-04-01

    Root fractures are defined as those that involve cement, dentin and pulp, comprising from 0.5 to 7% of injuries in permanent dentition. Diagnosis is made through clinical and radiographic exams, the latter frequently being limited by the position of the fracture. Treatment varies according to the displacement and vitality of the fragments. The authors present a clinical case of recurrent trauma of tooth 21 causing a horizontal root fracture in the middle third. After several attempts at endodontic treatment, the option was to remove the apical fragment by surgery. The postoperative period of 4 years shows very satisfactory results with regard to wound repair and tooth mobility, or implantation of the coronal segment. PMID:19290888

  8. Integrated treatment of molasses distillery wastewater using microfiltration (MF).

    PubMed

    Basu, Subhankar; Mukherjee, Sangeeta; Kaushik, Ankita; Batra, Vidya S; Balakrishnan, Malini

    2015-08-01

    To achieve zero-liquid discharge, high pressure reverse osmosis (RO) of effluent is being employed by molasses based alcohol distilleries. Low pressure and thus less energy intensive microfiltration (MF) is well established for particulate separation but is not suitable for removal of dissolved organics and color. This work investigates two schemes incorporating MF for molasses distillery wastewater (a) chemical coagulation followed by treatment in a membrane bioreactor (MBR) using MF and (b) electrocoagulation followed by MF. The performance was assessed in terms of COD and color reduction; the conversion of the generated sludge into a zeolite desiccant was also examined. A comparison of the schemes indicates electrocoagulation followed by MF through a 0.1 μm membrane to be most effective. By hydrothermal treatment, electrocoagulated sludge can be transformed into a porous NaX zeolite with a surface area of 86 m(2)/g, which is comparable to commercial desiccants. PMID:25956444

  9. Assessing treatment integrity in cognitive-behavioral therapy: comparing session segments with entire sessions.

    PubMed

    Weck, Florian; Grikscheit, Florian; Höfling, Volkmar; Stangier, Ulrich

    2014-07-01

    The evaluation of treatment integrity (therapist adherence and competence) is a necessary condition to ensure the internal and external validity of psychotherapy research. However, the evaluation process is associated with high costs, because therapy sessions must be rated by experienced clinicians. It is debatable whether rating session segments is an adequate alternative to rating entire sessions. Four judges evaluated treatment integrity (i.e., therapist adherence and competence) in 84 randomly selected videotapes of cognitive-behavioral therapy for major depressive disorder, social anxiety disorder, and hypochondriasis (from three different treatment outcome studies). In each case, two judges provided ratings based on entire therapy sessions and two on session segments only (i.e., the middle third of the entire sessions). Interrater reliability of adherence and competence evaluations proved satisfactory for ratings based on segments and the level of reliability did not differ from ratings based on entire sessions. Ratings of treatment integrity that were based on entire sessions and session segments were strongly correlated (r=.62 for adherence and r=.73 for competence). The relationship between treatment integrity and outcome was comparable for ratings based on session segments and those based on entire sessions. However, significant relationships between therapist competence and therapy outcome were only found in the treatment of social anxiety disorder. Ratings based on segments proved to be adequate for the evaluation of treatment integrity. The findings demonstrate that session segments are an adequate and cost-effective alternative to entire sessions for the evaluation of therapist adherence and competence. PMID:24912466

  10. Treatment integrity in applied behavior analysis with children.

    PubMed

    Gresham, F M; Gansle, K A; Noell, G H

    1993-01-01

    Functional analysis of behavior depends upon accurate measurement of both independent and dependent variables. Quantifiable and controllable operations that demonstrate these functional relationships are necessary for a science of human behavior. Failure to implement independent variables with integrity threatens the internal and external validity of experiments. A review of all applied behavior analysis studies with children as subjects that have been published in the Journal of Applied Behavior Analysis between 1980 and 1990 found that approximately 16% of these studies measured the accuracy of independent variable implementation. Two thirds of these studies did not operationally define the components of the independent variable. Specific recommendations for improving the accuracy of independent variable implementation and for defining independent variables are discussed. PMID:8331022

  11. Treatment Integrity Enhancement via Performance Feedback Conceptualized as an Exercise in Social Influence

    ERIC Educational Resources Information Center

    Erchul, William P.

    2013-01-01

    This commentary is in response to the article "Effects of Verbal and Written Performance Feedback on Treatment Adherence" (Kaufman, Codding, Markus, Tryon, & Kyse, this issue). The overall recommendation to those who study treatment integrity using performance feedback methods is to incorporate theories and research on social…

  12. The Protected Addiction: Exploring Staff Beliefs toward Integrating Tobacco Dependence into Substance Abuse Treatment Services

    ERIC Educational Resources Information Center

    Teater, Barbra; Hammond, Gretchen Clark

    2009-01-01

    Survey research was used to explore the beliefs of 963 staff members regarding the myths to treating tobacco dependence and the integration of tobacco dependence into substance abuse treatment programs. The staff represented a mixture of residential, outpatient, and prevention-based gender-specific (women only) treatment centers throughout Ohio.…

  13. Primary Prevention Programs at the Elementary Level: Issues of Treatment Integrity, Systematic Screening, and Reinforcement

    ERIC Educational Resources Information Center

    Lane, Kathleen Lynne; Kalberg, Jemma Robertson; Bruhn, Allison Leigh; Mahoney, Michelle E.; Driscoll, Steven A.

    2008-01-01

    This study examined issues of treatment integrity, systematic screenings, and access to reinforcement relative to school-wide positive behavior support programs (SW-PBS) implemented in two rural elementary schools during the first year of program implementation. Results suggested that treatment fidelity, as measured by self-report and direct…

  14. The Effects of Varying Levels of Treatment Integrity on Child Compliance during Treatment with a Three-Step Prompting Procedure

    ERIC Educational Resources Information Center

    Wilder, David A.; Atwell, Julie; Wine, Byron

    2006-01-01

    The effects of three levels of treatment integrity (100%, 50%, and 0%) on child compliance were evaluated in the context of the implementation of a three-step prompting procedure. Two typically developing preschool children participated in the study. After baseline data on compliance to one of three common demands were collected, a therapist…

  15. Does Integrated Trauma-Informed Substance Abuse Treatment Increase Treatment Retention?

    ERIC Educational Resources Information Center

    Amaro, Hortensia; Chernoff, Miriam; Brown, Vivian; Arevalo, Sandra; Gatz, Margaret

    2007-01-01

    This article presents findings from a quasi-experimental, nonrandomized group design study that explored whether trauma-enhanced substance abuse treatment results in longer residential treatment stays and improved outcomes compared with treatment-as-usual. We used a subsample (N = 461) of participants in the Women, Co-Occurring Disorders and…

  16. Integrated Treatment to Achieve Functional Recovery for First-Episode Psychosis

    PubMed Central

    Valencia, Marcelo; Juarez, Francisco; Ortega, Hector

    2012-01-01

    This study describes an integrated treatment approach that was implemented to enhance functional recovery in first-episode psychotic patients. Patients were randomized to two treatment conditions: either to an integrated treatment approach: pharmacotherapy, psychosocial treatment, and psychoeducation (experimental group: N = 39) or to medication alone (control group: N = 34). Patients were evaluated at baseline and after one year of treatment. Functional recovery was assessed according to symptomatic and functional remission. At the end of treatment, experimental patients showed a 94.9% of symptomatic remission compared to 58.8% of the control group. Functional remission was 56.4% for the experimental group and 3.6% for the control group, while 56.4% of the experimental group met both symptomatic and functional remission criteria and were considered recovered compared to 2.9% of the control group. PMID:22970366

  17. Integrity of erythrocytes of hypercholesterolemic rats during spices treatment.

    PubMed

    Kempaiah, R K; Srinivasan, K

    2002-07-01

    In rats rendered hypercholesterolemic by maintaining them on a cholesterol-enriched diet (0.5%) for 8 weeks, inclusion of spice principles--curcumin (0.2%) or capsaicin (0.015%) or the spice--garlic powder (2.0%) in the diet, produced the expected hypolipidemic effect. Plasma cholesterol which was more than 200% that of basal control in hypercholesterolemic rats, was decreased by these dietary spice principles and garlic by 25-39%. Erythrocyte membranes of hypercholesterolemic rats were relatively enriched in cholesterol, which was about 120% of basal control, while membrane phospholipid was unaffected. This resulted in a significant alteration in cholesterol to phospholipid ratio of RBC membranes. Dietary curcumin, capsaicin and garlic were observed to counter this altered lipid profile of erythrocyte membranes in hypercholesterolemic situation by producing a significant 10-14% decrease in membrane cholesterol content. As a result of alteration in membrane structural lipids, the structural integrity of RBCs was also affected. An examination of the osmotic fragility of erythrocytes in various groups, indicated that RBCs of hypercholesterolemic rats were relatively fragile compared to normal controls. Dietary curcumin, capsaicin and garlic appeared to correct this increased fragility of erythrocytes. PMID:12190115

  18. Advances in Applying Treatment Integrity Research for Dissemination and Implementation Science: Introduction to Special Issue

    PubMed Central

    Southam-Gerow, Michael A.; McLeod, Bryce D.

    2013-01-01

    This special series focuses upon the ways in which research on treatment integrity, a multidimensional construct including assessment of the content and quality of a psychosocial treatment delivered to a client as well as relational elements, can inform dissemination and implementation science. The five articles for this special series illustrate how treatment integrity concepts and methods can be applied across different levels of the mental health service system to advance dissemination and implementation science. In this introductory article, we provide an overview of treatment integrity research and describe three broad conceptual models that are relevant to the articles in the series. We conclude with a brief description of each of the five articles in the series. PMID:23970819

  19. A novel, integrated treatment systems for coal wastewaters

    SciTech Connect

    Wang, H.Y.; Srinivasan, K.R.

    1992-01-01

    The aims of this study are to develop, characterize and optimize a novel treatment scheme that would be effective simultaneously against the toxic organics and heavy metals present in coal conversion wastewaters. Hec-CBDA-DT, a modified hectorite containing a mixed bilayer of a cationic (CBDA) and a diamine (DT) type surfactants, was shown to adsorb simultaneously heavy metals such as Cu[sup 2+] and Cd[sup 2+] and toxic organics such as chlorophenols. The pH dependence of the adsorption of chlorophenols on Hec-CBDA-DT suggested hydrophobic partitioning, counterion adsorption and hydrogen-bond interaction of the phenolate ions with the surface diamine groups as the possible mechanisms of sorption. Adsorption of Cu[sup 2+] by Hec-CBDA-DT was shown to be only slightly affected by a large excess of counterions, thus indicating that Cu[sup 2+] adsorbed specifically to the surface. A second type of modified clay, Hec-CBDA-Palmitic Acid (Hec-CBDA-PA) adsorbed both Cu[sup 2+] and Cd[sup 2+] strongly. However, the pH optima for adsorption were 6.0 and 8.0 respectively in the case of Cu[sup 2+] and Cd[sup 2+]. It is inferred that the mechanisms of adsorption of these two metal ions to Hec-CBDA-PA are different, specific and counterion binding respectively in the case of Cu and Cd ions.

  20. A novel integrated treatment system for coal wastewaters

    SciTech Connect

    Wang, H.Y.; Srinivasan, K.R.

    1992-01-01

    The aims of this study are to develop, characterize and optimize a novel treatment scheme that would be effective simultaneously against the toxic organics and heavy metals present in coal conversion wastewaters. To remove and recover heavy metals from wastewaters, four different types of surfactant-clay complexes have been prepared using hectored or montmorillonite as the base clays. The adsorbent is prepared by first coating the clay surface, upto a monolayer, with a cationic surfactant, CBDA, to which an amine, (DT), or a carboxylic acid (Palmitic acid, PA) is anchored using hydrophobic effect to form a mixed bilayer. Such an arrangement is expected to locate the functional groups in metal adsorption at the solid-solution interface. Complexes based on hectored are shown to adsorb Cu{sup 2+} ions more strongly than the ones based on montmorillonite. The rate of adsorption of Cu{sup 2+} ions is quite rapid and the adsorbed amount levels off in less than 2 hrs. The optimum pH for metal adsorption is around 6.5 and the amount of metal adsorbed declines sharply on the lower pH side of the pH optimum, suggesting that removal and recovery of adsorbed metal ions can be effected by a slight pH shift.

  1. A novel, integrated treatment system for coal wastewaters

    SciTech Connect

    Wang, H.Y.; Srinivasan, K.R.

    1992-01-01

    The aims of this study are to develop, characterize and optimize a novel treatment scheme that would be effective simultaneously against the toxic organics and the heavy metals present in coal conversion wastewaters. Hec-CBDA-DT, (HCDT), a modified hectorite containing a mixed bilayer of a cationic (CBDA) and a dismine (DT) type surfactants, has been shown to adsorb Cr (VI) strongly at PH below 5.0. A second kind of a modified clay, montmorillonite-DT, (MONT-DT), in which the protonated form of the diamine is directly attached to the negative sites of clay surface, has also been found to adsorb CR(VI) as strongly as Hec-CBDA-DT at a pH of 4.5. The adsorption of Cr (VI) onto these two modified-clays is strongly inhibited by an increase in the ionic strength of the medium. It is inferred that the main mechanism of adsorption of CR(VI) onto these two clay complexes is of the counterion. Preliminary data on the partitioning of phenanthrene, a three-ringed polyaromatic hydrocarbon (PAH), reveal that organic carbon located on the external surfaces of clay complexes is more effective in partitioning nonionic, toxic organic compounds.

  2. Enhancing the Developmental Appropriateness of Treatment for Depression in Youth: Integrating the Family in Treatment

    PubMed Central

    Tompson, Martha C.; Boger, Kathryn Dingman; Asarnow, Joan R.

    2016-01-01

    Youth depression is an impairing and frequently recurrent and persistent disorder that impacts current and later development, resulting in high social and economic costs. Depression and interpersonal stress are frequently transactional, with depression powerfully negatively impacting relationships and relationship stress negatively impacting the course and outcome of depression. In this context, treatment models for youth depression that emphasize interpersonal functioning, particularly family relationships, may be particularly promising. This article has three objectives. It first reviews the current state of knowledge on the efficacy of psychosocial treatments for depression in youth, with an emphasis on the role of family involvement in treatment. Second, it discusses developmental factors that may impact the applicability and structure of family-focused treatment models for preadolescent and adolescent youth. Third, two family-based treatment models that are currently being evaluated in randomized clinical trials are described: one focusing on preadolescent depressed youth and the other on adolescents who have made a recent suicide attempt. PMID:22537731

  3. Uniting adolescent neuroimaging and treatment research: Recommendations in pursuit of improved integration

    PubMed Central

    Feldstein Ewing, Sarah W.; Tapert, Susan F.; Molina, Brooke S.G.

    2016-01-01

    Many clinicians who provide mental health treatment find developmental neuroscience discoveries to be exciting. However, the utility of these findings often seem far removed from everyday clinical care. Thus, the goal of this article is to offer a bridge to connect the fields of applied adolescent treatment and developmental neuroscience investigation. An overview of the relevance of developmental neuroscience in adolescent direct practice and a rationale for how and why this integration could benefit adolescent treatment outcomes is provided. Finally, a series of practical suggestions is generated for enhancing collaborative, interdisciplinary work that ultimately advances treatment response for this important clinical population. PMID:26748378

  4. Interpersonal, cognitive analytic and other integrative therapies versus treatment as usual for depression

    PubMed Central

    Churchill, Rachel; Davies, Philippa; Caldwell, Deborah; Moore, Theresa HM; Jones, Hannah; Lewis, Glyn; Hunot, Vivien

    2014-01-01

    This is the protocol for a review and there is no abstract. The objectives are as follows: To examine the effectiveness and acceptability of all integrative therapies compared with treatment as usual/waiting list/attention placebo control conditions for acute depression.To examine the effectiveness and acceptability of different integrative therapies (IPT, CAT, psychodynamic-interpersonal therapy, cognitive behavioural analysis system of psychotherapy and counselling) compared with treatment as usual/waiting list/attention placebo control conditions for acute depression.To examine the effectiveness and acceptability of all integrative therapies compared with different types of comparator (standard care, no treatment, waiting list, attention placebo) for acute depression. PMID:25411560

  5. Patient perspectives of an integrated program of medical care and substance use treatment.

    PubMed

    Drainoni, Mari-Lynn; Farrell, Caitlin; Sorensen-Alawad, Amy; Palmisano, Joseph N; Chaisson, Christine; Walley, Alexander Y

    2014-02-01

    The benefits of integrating primary care and substance use disorder treatment are well known, yet true integration is difficult. We developed and evaluated a team-based model of integrated care within the primary care setting for HIV-infected substance users and substance users at risk for contracting HIV. Qualitative data were gathered via focus groups and satisfaction surveys to assess patients' views of the program, evaluate key elements for success, and provide recommendations for other programs. Key themes related to preferences for the convenience and efficiency of integrated care; support for a team-based model of care; a feeling that the program requirements offered needed structure; the importance of counseling and education; and how provision of concrete services improved overall well-being and quality of life. For patients who received buprenorphine/naloxone for opioid dependence, this was viewed as a major benefit. Our results support other studies that theorize integrated care could be of significant value for hard-to-reach populations and indicate that having a clinical team dedicated to providing substance use disorder treatment, HIV risk reduction, and case management services integrated into primary care clinics has the potential to greatly enhance the ability to serve a challenging population with unmet treatment needs. PMID:24428768

  6. Patient Perspectives of an Integrated Program of Medical Care and Substance Use Treatment

    PubMed Central

    Farrell, Caitlin; Sorensen-Alawad, Amy; Palmisano, Joseph N.; Chaisson, Christine; Walley, Alexander Y.

    2014-01-01

    Abstract The benefits of integrating primary care and substance use disorder treatment are well known, yet true integration is difficult. We developed and evaluated a team-based model of integrated care within the primary care setting for HIV-infected substance users and substance users at risk for contracting HIV. Qualitative data were gathered via focus groups and satisfaction surveys to assess patients' views of the program, evaluate key elements for success, and provide recommendations for other programs. Key themes related to preferences for the convenience and efficiency of integrated care; support for a team-based model of care; a feeling that the program requirements offered needed structure; the importance of counseling and education; and how provision of concrete services improved overall well-being and quality of life. For patients who received buprenorphine/naloxone for opioid dependence, this was viewed as a major benefit. Our results support other studies that theorize integrated care could be of significant value for hard-to-reach populations and indicate that having a clinical team dedicated to providing substance use disorder treatment, HIV risk reduction, and case management services integrated into primary care clinics has the potential to greatly enhance the ability to serve a challenging population with unmet treatment needs. PMID:24428768

  7. The BRENDA model: integrating psychosocial treatment and pharmacotherapy for the treatment of alcohol use disorders.

    PubMed

    Starosta, Aron N; Leeman, Robert F; Volpicelli, Joseph R

    2006-03-01

    While the U.S. Food and Drug Administration has approved several medications for the treatment of alcohol-related problems, their use has not gained wide acceptance in the United States. Typically, patients with alcohol use disorders are only referred to psychosocial support (e.g., Alcoholics Anonymous). However, the use of pharmacotherapy may complement psychosocial treatments, as evidence shows that pharmacotherapy can improve treatment outcomes. The effectiveness of pharmacotherapy depends on patient compliance with taking the medication and the context in which the medication is administered. BRENDA is a psychosocial program designed specifically to be used by many types of healthcare providers, including primary care clinicians. Designed to enhance medication and treatment compliance, BRENDA is an ideal approach for use in conjunction with pharmacotherapy. The BRENDA approach has 6 components: 1) a biopsychosocial evaluation; 2) a report of findings from the evaluation given to the patient; 3) empathy; 4) addressing patient needs; 5) providing direct advice; and 6) assessing patient reaction to advice and adjusting the treatment plan as needed. This paper describes these components and discusses how the empirical support for each component is linked to the enhancement of medication compliance and the improvement of treatment outcomes. PMID:16728904

  8. The BRENDA Model: Integrating Psychosocial Treatment and Pharmacotherapy for the Treatment of Alcohol Use Disorders

    PubMed Central

    Starosta, Aron N.; Leeman, Robert F.; Volpicelli, Joseph R.

    2009-01-01

    While the U. S. Food and Drug Administration has approved several medications for the treatment of alcohol-related problems, their use has not gained wide acceptance in the United States. Typically, patients with alcohol use disorders are only referred to psychosocial support (e.g., Alcoholics Anonymous). However, the use of pharmacotherapy may complement psychosocial treatments, as evidence shows that pharmacotherapy can improve treatment outcomes. The effectiveness of pharmacotherapy depends on patient compliance with taking the medication and the context in which the medication is administered. BRENDA is a psychosocial program designed specifically to be used by many types of healthcare providers, including primary care clinicians. Designed to enhance medication and treatment compliance, BRENDA is an ideal approach for use in conjunction with pharmacotherapy. The BRENDA approach has 6 components: 1) a biopsychosocial evaluation; 2) a report of findings from the evaluation given to the patient; 3) empathy; 4) addressing patient needs; 5) providing direct advice; and 6) assessing patient reaction to advice and adjusting the treatment plan as needed. This paper describes these components and discusses how the empirical support for each component is linked to the enhancement of medication compliance and the improvement of treatment outcomes. PMID:16728904

  9. The Urgency Of Providing Comprehensive And Integrated Treatment For Substance Abusers With HIV

    PubMed Central

    Volkow, Nora D.; Montaner, Julio

    2011-01-01

    Substance abuse is linked to many new cases of HIV infection. Barriers such as the myth that drug users cannot adhere to HIV/AIDS treatment block progress in curbing the spread of HIV in that population. In this article we explain the need to aggressively seek out high-risk, hard-to-reach substance abusers and to offer them HIV testing, access to treatment, and the necessary support to remain in treatment—both for HIV and for substance abuse. We summarize evidence showing that injection drug users can successfully undergo HIV treatment; that many substance abusers adhere to antiretroviral therapy as well as do people who don’t inject drugs; and that injection drug users who undergo substance abuse treatment are more likely to obtain and stay in treatment for their HIV infection. This evidence makes a strong case for integrating substance abuse treatment with HIV treatment programs and providing substance abusers with universal access to HIV treatment. But an integrated strategy will require changes in the health care system to overcome lingering obstacles that inhibit the merging of substance abuse treatment with HIV programs. PMID:21821558

  10. Integrating Art into Group Treatment for Adults with Post-Traumatic Stress Disorder from Childhood Sexual Abuse: A Pilot Study

    ERIC Educational Resources Information Center

    Becker, Carol-Lynne J.

    2015-01-01

    Current research supports the use of exposure-based treatments for posttraumatic stress disorder (PTSD) and integrated treatments show potential for enhanced symptom reduction. This pilot study developed a manualized group treatment integrating art interventions with exposure, grounding, and narrative therapy for five adults with PTSD who were…

  11. The possible introduction of anti-osteoporosis drugs as an integrated treatment in total hip arthroplasty.

    PubMed

    Marchese, Marcella; Zarattini, Guido; Pazzaglia, Ugo E

    2011-04-01

    The anchorage of cementless total hip arthroplasty relies on a direct bone to implant bonding. Several factors including material properties and surface treatment determine the interfacial response of the host bone to a foreign material. Another factor that must be taken into account is the bone remodeling after the prosthesis introduction. Considering this bone remodeling, in the last few years the possibility of using anti-osteoporotic drugs has been introduced as a supplementary and integrated treatment in total hip replacement. PMID:21970916

  12. [Integration of drug treatment in the management concept of prostate cancer].

    PubMed

    Cathomas, R

    2013-10-01

    The drug treatment of prostate cancer was for many years based on androgen deprivation with luteinizing hormone-releasing hormone (LHRH) analogues.This treatment still represents the standard first line treatment for advanced prostate cancer. In cases of progression to metastatic castration-resistant prostate cancer (mCRPC) further treatment options used to be limited. Only the chemotherapy drug docetaxel could demonstrate a significant overall survival benefit. Within the last few years, however, five new treatments for patients with mCRCP have achieved significant results in large phase III trials. Interestingly they have different mechanisms of action: abiraterone is a testosterone synthesis inhibitor, enzalutamide is a novel antiandrogen, cabazitaxel is a cytotoxic drug, radium-223 is a radionuclide and sipuleucel-T an immunotherapy. Further new drugs are under investigation. The integration of these new treatment options as well as an optimal sequence and combination is the main focus of current research. PMID:23896735

  13. A simple method of independent treatment time verification in gamma knife radiosurgery using integral dose

    SciTech Connect

    Jin Jianyue; Drzymala, Robert; Li Zuofeng

    2004-12-01

    The purpose of this study is to develop a simple independent dose calculation method to verify treatment plans for Leksell Gamma Knife radiosurgery. Our approach uses the total integral dose within the skull as an end point for comparison. The total integral dose is computed using a spreadsheet and is compared to that obtained from Leksell GammaPlan registered . It is calculated as the sum of the integral doses of 201 beams, each passing through a cylindrical volume. The average length of the cylinders is estimated from the Skull-Scaler measurement data taken before treatment. Correction factors are applied to the length of the cylinder depending on the location of a shot in the skull. The radius of the cylinder corresponds to the collimator aperture of the helmet, with a correction factor for the beam penumbra and scattering. We have tested our simple spreadsheet program using treatment plans of 40 patients treated with Gamma Knife registered in our center. These patients differ in geometry, size, lesion locations, collimator helmet, and treatment complexities. Results show that differences between our calculations and treatment planning results are typically within {+-}3%, with a maximum difference of {+-}3.8%. We demonstrate that our spreadsheet program is a convenient and effective independent method to verify treatment planning irradiation times prior to implementation of Gamma Knife radiosurgery.

  14. An Integrated Model for Identifying Linkages Between the Management of Fuel Treatments, Fire and Ecosystem Services

    NASA Astrophysics Data System (ADS)

    Bart, R. R.; Anderson, S.; Moritz, M.; Plantinga, A.; Tague, C.

    2015-12-01

    Vegetation fuel treatments (e.g. thinning, prescribed burning) are a frequent tool for managing fire-prone landscapes. However, predicting how fuel treatments may affect future wildfire risk and associated ecosystem services, such as forest water availability and streamflow, remains a challenge. This challenge is in part due to the large range of conditions under which fuel treatments may be implemented, as response is likely to vary with species type, rates of vegetation regrowth, meteorological conditions and physiographic properties of the treated site. It is also due to insufficient understanding of how social factors such as political pressure, public demands and economic constraints affect fuel management decisions. To examine the feedbacks between ecological and social dimensions of fuel treatments, we present an integrated model that links a biophysical model that simulates vegetation and hydrology (RHESSys), a fire spread model (WMFire) and an empirical fuel treatment model that accounts for agency decision-making. We use this model to investigate how management decisions affect landscape fuel loads, which in turn affect fire severity and ecosystem services, which feedback to management decisions on fuel treatments. We hypothesize that this latter effect will be driven by salience theory, which predicts that fuel treatments are more likely to occur following major wildfire events. The integrated model provides a flexible framework for answering novel questions about fuel treatments that span social and ecological domains, areas that have previously been treated separately.

  15. Family-Based Cognitive-Behavioral Treatments for Suicidal Adolescents and their Integration with Individual Treatment

    ERIC Educational Resources Information Center

    Wells, Karen C.; Heilbron, Nicole

    2012-01-01

    A considerable research base underscores the importance of family functioning in the risk for and treatment of adolescent suicidal thoughts and behaviors. This paper reviews the extant empirical literature documenting associations between features of the family context and adolescent suicidal thoughts and behaviors. A case example is provided to…

  16. Project TEAMS: Integrating Treatment and Education To Improve Outcomes for Delinquent Youth.

    ERIC Educational Resources Information Center

    Huffty, Judy; Fitzsimons-Lovett, Ann

    1999-01-01

    Describes and evaluates a holistic resocialization program used by the Texas Youth Commission that has been integrated into the state's education, treatment, and correctional programs for incarcerated youth. Goals of the program are to help ensure that the youth can generalize the skills they gain through these processes to situations outside the…

  17. K West Basin Integrated Water Treatment System (IWTS) E-F Annular Filter Vessel Accident Calculations

    SciTech Connect

    PIEPHO, M.G.

    2000-01-10

    Four bounding accidents postulated for the K West Basin integrated water treatment system are evaluated against applicable risk evaluation guidelines. The accidents are a spray leak during fuel retrieval, spray leak during backflushing a hydrogen explosion, and a fire breaching filter vessel and enclosure. Event trees and accident probabilities are estimated. In all cases, the unmitigated dose consequences are below the risk evaluation guidelines.

  18. MONITORING INTEGRATED ENERGY SYSTEMS AT A WASTEWATER TREATMENT PLANT IN MAINE

    EPA Science Inventory

    A project was undertaken to monitor the performance of an integrated energy system at the Wilton, Maine, wastewater treatment plant. These systems included active and passive solar heating, effluent heat recovery, digester gas generation, air-to-air heat recovery, and electricity...

  19. Examining the Influence of Treatment Integrity: Accuracy of Daily Report Card Intervention Implementation and Student Outcome

    ERIC Educational Resources Information Center

    Vujnovic, Rebecca Kate

    2010-01-01

    Given the deficits associated with ADHD and the significant prevalence, it is important to explore evidence based treatments for ADHD in the classroom and the efficacy with which the classroom teachers implement such interventions. The current investigation is a secondary analysis to investigate the integrity of a Daily Report Card (DRC)…

  20. Implementation Planning to Promote Parents' Treatment Integrity of Behavioral Interventions for Children with Autism

    ERIC Educational Resources Information Center

    Fallon, Lindsay M.; Collier-Meek, Melissa A.; Sanetti, Lisa M. H.; Feinberg, Adam B.; Kratochwill, Thomas R.

    2016-01-01

    Behavioral interventions delivered across home and school settings can promote positive outcomes for youth with autism spectrum disorders (ASD). Yet, stakeholders who deliver these interventions may struggle to implement interventions as intended. Low levels of treatment integrity can undermine potentially positive intervention outcomes. One way…

  1. Increasing Teacher Treatment Integrity through Performance Feedback Provided by School Personnel

    ERIC Educational Resources Information Center

    Hagermoser Sanetti, Lisa M.; Fallon, Lindsay M.; Collier-Meek, Melissa A.

    2013-01-01

    When implementing behavioral interventions in educational settings, some implementers need support to maintain high levels of treatment integrity. Performance feedback has a large body of research supporting it as a strategy for improving teachers' implementation of classroom interventions. However, in most prior studies, performance feedback has…

  2. Treatment Integrity of Interventions with Children in the School Psychology Literature from 1995 to 2008

    ERIC Educational Resources Information Center

    Sanetti, Lisa M. Hagermoser; Gritter, Katie L.; Dobey, Lisa M.

    2011-01-01

    Increased accountability in education has resulted in a focus on implementing interventions with strong empirical support. Both student outcome and treatment integrity data are needed to draw valid conclusions about intervention effectiveness. Reviews of the literature in other fields (e.g., applied behavior analysis, prevention science) suggest…

  3. Effects of Varied Levels of Treatment Integrity on Appropriate Toy Manipulation in Children with Autism

    ERIC Educational Resources Information Center

    Groskreutz, Nicole C.; Groskreutz, Mark P.; Higbee, Thomas S.

    2011-01-01

    We assessed the effects of varying the treatment integrity of a prompting procedure on appropriate toy manipulation in two preschool-aged children with autism. Following an assessment to identify toys with high levels of inappropriate toy manipulation, each of three toys was associated with implementation of the prompting procedure at a different…

  4. A Randomized, Controlled Trial of Integrated Home-School Behavioral Treatment for ADHD, Predominantly Inattentive Type

    ERIC Educational Resources Information Center

    Pfiffner, Linda J.; Mikami, Amori Yee; Huang-Pollock, Cynthia; Easterlin, Barbara; Zalecki, Christine; McBurnett, Keith

    2007-01-01

    Objective: To evaluate the efficacy of a behavioral psychosocial treatment integrated across home and school (Child Life and Attention Skills Program) with attention-deficit/hyperactivity disorder (ADHD) predominantly inattentive type (ADHD-I). Method: Sixty-nine children ages 7 to 11 years were randomized to the Child Life and Attention Skills…

  5. The Effect of Sensory Integration Treatment on Children with Multiple Disabilities.

    ERIC Educational Resources Information Center

    Din, Feng S.; Lodato, Donna M.

    Six children with multiple disabilities (ages 5 to 8) participated in this evaluation of the effect of sensory integration treatment on sensorimotor function and academic learning. The children had cognitive abilities ranging from sub-average to significantly sub-average, three were non-ambulatory, one had severe behavioral problems, and each…

  6. K West Basin Integrated Water Treatment System (IWTS) E-F Annular Filter Vessel Accident Calculations

    SciTech Connect

    RITTMANN, P.D.

    1999-10-07

    Three bounding accidents postdated for the K West Basin integrated water treatment system are evaluated against applicable risk evaluation guidelines. The accidents are a spray leak during fuel retrieval, spray leak during backflushing, and a hydrogen explosion. Event trees and accident probabilities are estimated. In all cases, the unmitigated dose consequences are below the risk evaluation guidelines.

  7. Preliminary design report for the K basins integrated water treatment system

    SciTech Connect

    Pauly, T.R., Westinghouse Hanford

    1996-08-12

    This Preliminary Design Report (PDR) provides a revised concept for the K Basins Integrated Water Treatment Systems (IWTS). This PDR incorporates the 11 recommendations made in a May 1996 Value Engineering session into the Conceptual Design, and provides new flow diagrams, hazard category assessment, cost estimate, and schedule for the IWTS Subproject.

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

    ERIC Educational Resources Information Center

    Plumb, Jennifer C.; Vilardaga, Roger

    2010-01-01

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

  9. Treatment Integrity: A Review of Intervention Studies Conducted with Children with Autism

    ERIC Educational Resources Information Center

    Wheeler, John J.; Baggett, Bob A.; Fox, James; Blevins, Leia

    2006-01-01

    The purpose of this study was to assess the degree to which behavioral intervention studies conducted with children diagnosed with autism operationally defined the independent variables (IVs) and evaluated treatment integrity (TI). The study replicated the criteria from Gresham, Gansle, and Noell (1993) and focused exclusively on research studies…

  10. A Comparison of Sensory Integrative and Behavioral Therapies as Treatment for Pediatric Feeding Disorders

    ERIC Educational Resources Information Center

    Addison, Laura R.; Piazza, Cathleen C.; Patel, Meeta R.; Bachmeyer, Melanie H.; Rivas, Kristi M.; Milnes, Suzanne M.; Oddo, Jackie

    2012-01-01

    We compared the effects of escape extinction (EE) plus noncontingent reinforcement (NCR) with sensory integration therapy as treatment for the feeding problems of 2 children. Results indicated that EE plus NCR was more effective in increasing acceptance, decreasing inappropriate behavior, and increasing amount consumed relative to sensory…

  11. An Assessment of Treatment Integrity in Behavioral Intervention Studies Conducted with Persons with Mental Retardation

    ERIC Educational Resources Information Center

    Wheeler, John J.; Mayton, Michael R.; Carter, Stacy L.; Chitiyo, Morgan; Menendez, Anthony L.; Huang, Ann

    2009-01-01

    The purpose of this study was to assess the degree to which behavioral intervention studies conducted with persons with mental retardation operationally defined the independent variables and evaluated and reported measures of treatment integrity. The study expands the previous work in this area reported by Gresham, Gansle, and Noell (1993) and…

  12. Integrated trauma treatment in correctional health care and community-based treatment upon reentry.

    PubMed

    Wallace, Barbara C; Conner, Latoya C; Dass-Brailsford, Priscilla

    2011-10-01

    Given the crisis of mass incarceration in the United States and the high prevalence of trauma histories among those incarcerated, it is imperative to improve service delivery to inmates in correctional facilities and to those undergoing reentry in community-based treatment settings. This article provides trauma definitions and categories, describes the sequelae of trauma, reviews research on the high prevalence of incarceration in this nation, and reviews research on the high prevalence of trauma among the incarcerated. This article also provides a menu of evidence-based and promising treatment approaches to address the overlap among trauma, mental illness, substance abuse, and behavioral problems. A synthesis of research via seven points is meant to guide practitioner and policy responses to the national challenge of meeting the needs of those undergoing reentry. PMID:21948808

  13. A Pathway to Personalization of Integrated Treatment: Informatics and Decision Science in Psychiatric Rehabilitation

    PubMed Central

    Spaulding, William; Deogun, Jitender

    2011-01-01

    Personalization of treatment is a current strategic goal for improving health care. Integrated treatment approaches such as psychiatric rehabilitation benefit from personalization because they involve matching diverse arrays of treatment options to individually unique profiles of need. The need for personalization is evident in the heterogeneity of people with severe mental illness and in the findings of experimental psychopathology. One pathway to personalization lies in analysis of the judgments and decision making of human experts and other participants as they respond to complex circumstances in pursuit of treatment and rehabilitation goals. Such analysis is aided by computer simulation of human decision making, which in turn informs development of computerized clinical decision support systems. This inspires a research program involving concurrent development of databases, domain ontology, and problem-solving algorithms, toward the goal of personalizing psychiatric rehabilitation through human collaboration with intelligent cyber systems. The immediate hurdle is to demonstrate that clinical decisions beyond diagnosis really do affect outcome. This can be done by supporting the hypothesis that a human treatment team with access to a reasonably comprehensive clinical database that tracks patient status and treatment response over time achieves better outcome than a treatment team without such access, in a controlled experimental trial. Provided the hypothesis can be supported, the near future will see prototype systems that can construct an integrated assessment, formulation, and rehabilitation plan from clinical assessment data and contextual information. This will lead to advanced systems that collaborate with human decision makers to personalize psychiatric rehabilitation and optimize outcome. PMID:21860042

  14. Human health benefits and burdens of a pharmaceutical treatment: Discussion of a conceptual integrated approach.

    PubMed

    Debaveye, Sam; De Soete, Wouter; De Meester, Steven; Vandijck, Dominique; Heirman, Bert; Kavanagh, Shane; Dewulf, Jo

    2016-01-01

    The effects of a pharmaceutical treatment have until now been evaluated by the field of Health Economics on the patient health benefits, expressed in Quality-Adjusted Life Years (QALYs) versus the monetary costs. However, there is also a Human Health burden associated with this process, resulting from emissions that originate from the pharmaceutical production processes, Use Phase and End of Life (EoL) disposal of the medicine. This Human Health burden is evaluated by the research field of Life Cycle Assessment (LCA) and expressed in Disability-Adjusted Life Years (DALYs), a metric similar to the QALY. The need for a new framework presents itself in which both the positive and negative health effects of a pharmaceutical treatment are integrated into a net Human Health effect. To do so, this article reviews the methodologies of both Health Economics and the area of protection Human Health of the LCA methodology and proposes a conceptual framework on which to base an integration of both health effects. Methodological issues such as the inclusion of future costs and benefits, discounting and age weighting are discussed. It is suggested to use the structure of an LCA as a backbone to cover all methodological challenges involved in the integration. The possibility of monetizing both Human Health benefits and burdens is explored. The suggested approach covers the main methodological aspects that should be considered in an integrated assessment of the health effects of a pharmaceutical treatment. PMID:26544901

  15. Integrated municipal solid waste treatment using a grate furnace incinerator: The Indaver case

    SciTech Connect

    Vandecasteele, C. Wauters, G.; Arickx, S.; Jaspers, M.; Van Gerven, T.

    2007-07-01

    An integrated installation for treatment of municipal solid waste and comparable waste from industrial origin is described. It consists of three grate furnace lines with flue gas treatment by half-wet scrubbing followed by wet scrubbing, and an installation for wet treatment of bottom ash. It is demonstrated that this integrated installation combines high recovery of energy (40.8% net) with high materials recovery. The following fractions were obtained after wet treatment of the bottom ash: ferrous metals, non-ferrous metals, three granulate fractions with different particle sizes, and sludge. The ferrous and non-ferrous metal fractions can both be recycled as high quality raw materials; the two larger particle size particle fractions can be applied as secondary raw materials in building applications; the sand fraction can be used for applications on a landfill; and the sludge is landfilled. For all components of interest, emissions to air are below the limit values. The integrated grate furnace installation is characterised by zero wastewater discharge and high occupational safety. Moreover, with the considered installation, major pollutants, such as PCDD/PCDF, Hg and iodine-136 are to a large extent removed from the environment and concentrated in a small residual waste stream (flue gas cleaning residue), which can be landfilled after stabilisation.

  16. White Matter Integrity and Executive Abilities Following Treatment with Tetrahydrobiopterin (BH4) in Individuals with Phenylketonuria

    PubMed Central

    White, Desirée A.; Antenor-Dorsey, Jo Ann V.; Grange, Dorothy K.; Hershey, Tamara; Rutlin, Jerrel; Shimony, Joshua S.; McKinstry, Robert C.; Christ, Shawn E.

    2013-01-01

    Tetrahydrobiopterin (BH4) lowers blood phenylalanine (Phe) in individuals with PKU who are responders, but its effects on the brain and cognition have not been explored thoroughly. We examined blood Phe, microstructural white matter integrity, and executive abilities in 12 BH4 responders before (i.e., baseline) and after (i.e., follow-up) six months of treatment with BH4. Compared with baseline, Phe in these responders decreased by 51% during a 4 week screening period after initiation of treatment and remained lowered by 37% over the 6 month follow-up period. Significant improvements in white matter integrity, evaluated by mean diffusivity from diffusion tensor imaging, were also found following six months of treatment. Improvements in executive abilities were not identified, although six months may have been a period too brief for changes in cognition to follow changes in brain. To our knowledge, our study is the first to explore relationships among Phe, white matter integrity, executive abilities, and BH4 treatment within a single study. PMID:23928118

  17. White matter integrity and executive abilities following treatment with tetrahydrobiopterin (BH4) in individuals with phenylketonuria.

    PubMed

    White, Desirée A; Antenor-Dorsey, Jo Ann V; Grange, Dorothy K; Hershey, Tamara; Rutlin, Jerrel; Shimony, Joshua S; McKinstry, Robert C; Christ, Shawn E

    2013-11-01

    Tetrahydrobiopterin (BH(4)) lowers blood phenylalanine (Phe) in individuals with PKU who are responders, but its effects on the brain and cognition have not been explored thoroughly. We examined blood Phe, microstructural white matter integrity, and executive abilities in 12 BH(4) responders before (i.e., baseline) and after (i.e., follow-up) six months of treatment with BH(4). Compared with baseline, Phe in these responders decreased by 51% during a 4 week screening period after initiation of treatment and remained lowered by 37% over the 6 month follow-up period. Significant improvements in white matter integrity, evaluated by mean diffusivity from diffusion tensor imaging, were also found following six months of treatment. Improvements in executive abilities were not identified, although six months may have been a period too brief for changes in cognition to follow changes in the brain. To our knowledge, our study is the first to explore relationships among Phe, white matter integrity, executive abilities, and BH(4) treatment within a single study. PMID:23928118

  18. Integrated municipal solid waste treatment using a grate furnace incinerator: the Indaver case.

    PubMed

    Vandecasteele, C; Wauters, G; Arickx, S; Jaspers, M; Van Gerven, T

    2007-01-01

    An integrated installation for treatment of municipal solid waste and comparable waste from industrial origin is described. It consists of three grate furnace lines with flue gas treatment by half-wet scrubbing followed by wet scrubbing, and an installation for wet treatment of bottom ash. It is demonstrated that this integrated installation combines high recovery of energy (40.8% net) with high materials recovery. The following fractions were obtained after wet treatment of the bottom ash: ferrous metals, non-ferrous metals, three granulate fractions with different particle sizes, and sludge. The ferrous and non-ferrous metal fractions can both be recycled as high quality raw materials; the two larger particle size particle fractions can be applied as secondary raw materials in building applications; the sand fraction can be used for applications on a landfill; and the sludge is landfilled. For all components of interest, emissions to air are below the limit values. The integrated grate furnace installation is characterised by zero wastewater discharge and high occupational safety. Moreover, with the considered installation, major pollutants, such as PCDD/PCDF, Hg and iodine-136 are to a large extent removed from the environment and concentrated in a small residual waste stream (flue gas cleaning residue), which can be landfilled after stabilisation. PMID:17049223

  19. Integration of advanced oxidation processes at mild conditions in wet scrubbers for odourous sulphur compounds treatment.

    PubMed

    Vega, Esther; Martin, Maria J; Gonzalez-Olmos, Rafael

    2014-08-01

    The effectiveness of different advanced oxidation processes on the treatment of a multicomponent aqueous solution containing ethyl mercaptan, dimethyl sulphide and dimethyl disulphide (0.5 mg L(-1) of each sulphur compound) was investigated with the objective to assess which one is the most suitable treatment to be coupled in wet scrubbers used in odour treatment facilities. UV/H2O2, Fenton, photo-Fenton and ozone treatments were tested at mild conditions and the oxidation efficiency obtained was compared. The oxidation tests were carried out in magnetically stirred cylindrical quartz reactors using the same molar concentration of oxidants (hydrogen peroxide or ozone). The results show that ozone and photo-Fenton are the most efficient treatments, achieving up to 95% of sulphur compounds oxidation and a mineralisation degree around 70% in 10 min. Furthermore, the total costs of the treatments taking into account the capital and operational costs were also estimated for a comparative purpose. The economic analysis revealed that the Fenton treatment is the most economical option to be integrated in a wet scrubber to remove volatile organic sulphur compounds, as long as there are no space constraints to install the required reactor volume. In the case of reactor volume limitation or retrofitting complexities, the ozone and photo-Fenton treatments should be considered as viable alternatives. PMID:24873715

  20. Complementary Therapies for Significant Dysfunction from Tinnitus: Treatment Review and Potential for Integrative Medicine

    PubMed Central

    Wolever, Ruth Q.; Price, Rebecca; Hazelton, A. Garrett; Dmitrieva, Natalia O.; Bechard, Elizabeth M.; Shaffer, Janet K.; Tucci, Debara L.

    2015-01-01

    Tinnitus is a prevalent and costly chronic condition; no universally effective treatment exists. Only 20% of patients who report tinnitus actually seek treatment, and when treated, most patients commonly receive sound-based and educational (SBE) therapy. Additional treatment options are necessary, however, for nonauditory aspects of tinnitus (e.g., anxiety, depression, and significant interference with daily life) and when SBE therapy is inefficacious or inappropriate. This paper provides a comprehensive review of (1) conventional tinnitus treatments and (2) promising complementary therapies that have demonstrated some benefit for severe dysfunction from tinnitus. While there has been no systematic study of the benefits of an Integrative Medicine approach for severe tinnitus, the current paper reviews emerging evidence suggesting that synergistic combinations of complementary therapies provided within a whole-person framework may augment SBE therapy and empower patients to exert control over their tinnitus symptoms without the use of medications, expensive devices, or extended programs. PMID:26457113

  1. Using Enhanced and Integrated Services to Improve Response to Standard Methadone Treatment: Changing the Clinical Infrastructure of Treatment Networks

    PubMed Central

    Neufeld, Karin; Kidorf, Michael; King, Van; Stoller, Ken; Clark, Michael; Peirce, Jessica; Brooner, Robert K.

    2009-01-01

    Outcomes are presented from opioid-dependent outpatients (N = 81) participating in a new community-based initiative designed to improve access to enhanced substance abuse and psychiatric services in the publicly-supported methadone maintenance treatment network in Baltimore, Maryland. The initiative, entitled Community Access to Specialized Treatment (CAST), is located at the Addiction Treatment Services (ATS), a program within this network. Network programs referred patients engaged in unremitting drug use and at risk for discharge to CAST, where they received methadone substitution, individual and group counseling within an adaptive platform, behavioral contingencies to reinforce adherence, and on-site psychiatric evaluation and care. Patients returned to their referring program after producing at least two consecutive weeks of drug-negative urine samples and full counseling adherence. CAST was well-utilized by the community. Patients had high rates of adherence to scheduled individual and group counseling services (93% and 73%, respectively); 43% of referrals successfully completed the program in an average of 101 days. This community-wide service delivery approach is a novel alternative to integrating intensive substance abuse and psychiatric care at each program within a treatment network. PMID:19717272

  2. A Two-site Randomized Clinical Trial of Integrated Psychosocial Treatment for ADHD-Inattentive Type

    PubMed Central

    Pfiffner, Linda J.; Hinshaw, Stephen P.; Owens, Elizabeth; Zalecki, Christine; Kaiser, Nina M.; Villodas, Miguel; McBurnett, Keith

    2014-01-01

    Objective This study evaluated the efficacy of the Child Life and Attention Skills (CLAS) program, a behavioral psychosocial treatment integrated across home and school, for youth with Attention Deficit Hyperactivity Disorder-Inattentive Type (ADHD-I). Method In a two-site randomized controlled trial, 199 children (ages 7-11) were randomized to CLAS (N=74), parent-focused treatment (PFT, N=74), or treatment as usual (TAU, N=51). We compared groups on parent and teacher ratings of inattention symptoms, organizational skills, social skills, and global improvement at post-treatment, and also at follow-up during the subsequent school year. Results CLAS resulted in greater improvements in teacher-reported inattention, organizational skills, social skills, and global functioning relative to both PFT and TAU at post-treatment. Parents of children in CLAS reported greater improvement in organizational skills than PFT and greater improvements on all outcomes relative to TAU at post-treatment. Differences between CLAS and TAU were maintained at follow-up for most parent-reported measures but were not significant for teacher-reported outcomes. Conclusions These findings extend support for CLAS across two study sites, revealing that integrating parent, teacher, and child treatment components, specifically adapted for ADHD-I, is superior to parent training alone and to usual care. Direct involvement of teachers and children in CLAS appears to amplify effects at school and home and underscores the importance of coordinating parent, teacher, and child treatment components for cross-setting effects on symptoms and impairment associated with ADHD-I. PMID:24865871

  3. A computational tool integrating host immunity with antibiotic dynamics to study tuberculosis treatment

    PubMed Central

    Pienaar, Elsje; Cilfone, Nicholas A.; Lin, Philana Ling; Dartois, Véronique; Mattila, Joshua T.; Butler, Russ; Flynn, JoAnne L.; Kirschner, Denise E.; Linderman, Jennifer J.

    2014-01-01

    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. PMID:25497475

  4. Integrated constructed wetland systems: design, operation, and performance of low-cost decentralized wastewater treatment systems.

    PubMed

    Behrends, L L; Bailey, E; Jansen, P; Houke, L; Smith, S

    2007-01-01

    Several different types of constructed wetland systems are being used as decentralized treatment systems including surface-flow, subsurface-flow, vertical-flow, and hybrid systems. Archetypical wetland systems have design strengths and weaknesses, and therefore it should be possible to design combined (integrated) systems to optimize a number of important treatment processes. This study provides comparative efficacy data for two integrated wetland treatment systems (IWTS) designed to enhance treatment of medium strength wastewater generated from a pilot-scale intensive fish farm. Results from the twenty eight months study included consistently high removal of COD (84% +) and ammonia nitrogen (93%) in both systems. Initially, phosphorus removal was also high (>90%) in both systems, but removal efficacy declined significantly over time. Nitrate removal was significantly better in the system that provided sequential aerobic and anoxic environments. Short hydraulic retention times coupled with sustained removal of COD and ammonia indicate that the ReCip components could be a least-cost wastewater treatment technology in the decentralized market sector. PMID:17506433

  5. Two Models of Integrating Buprenorphine Treatment and Medical Staff within Formerly "Drug-Free" Outpatient Programs.

    PubMed

    Monico, Laura; Schwartz, Robert P; Gryczynski, Jan; O'Grady, Kevin E; Mitchell, Shannon Gwin

    2016-01-01

    "Drug-free" outpatient programs deliver treatment to the largest number of patients of all treatment modalities in the U.S., providing a significant opportunity to expand access to medication treatments for substance use disorders. This analysis examined staff perceptions of organizational dynamics associated with the delivery of buprenorphine maintenance within three formerly "drug-free" outpatient treatment programs. Semi-structured interviews (N = 15) were conducted with counseling and medical staff, and respondents were predominantly African American (n = 11) and female (n = 12). Themes and concepts related to medical staff integration emerged through an inductive and iterative coding process using Atlas.ti qualitative analysis software. Two treatment clinics incorporated buprenorphine maintenance into their programs using a co-located model of care. Their staff generally reported greater intra-organizational discord regarding the best ways to combine medication and counseling compared to the clinic using an integrated model of care. Co-located program staff reported less communication between medical and clinical staff, which contributed to some uncertainty about proper dosing and concerns about the potential for medication diversion. Clinics that shift from "drug-free" to incorporating buprenorphine maintenance should consider which model of care they wish to adapt and how to train staff and structure staff communication. PMID:26940870

  6. Oral antioxidant treatment partly improves integrity of human sperm DNA in infertile grade I varicocele patients.

    PubMed

    Gual-Frau, Josep; Abad, Carlos; Amengual, María J; Hannaoui, Naim; Checa, Miguel A; Ribas-Maynou, Jordi; Lozano, Iris; Nikolaou, Alexandros; Benet, Jordi; García-Peiró, Agustín; Prats, Juan

    2015-09-01

    Infertile males with varicocele have the highest percentage of sperm cells with damaged DNA, compared to other infertile groups. Antioxidant treatment is known to enhance the integrity of sperm DNA; however, there are no data on the effects in varicocele patients. We thus investigated the potential benefits of antioxidant treatment specifically in grade I varicocele males. Twenty infertile patients with grade I varicocele were given multivitamins (1500 mg L-Carnitine, 60 mg vitamin C, 20 mg coenzyme Q10, 10 mg vitamin E, 200 μg vitamin B9, 1 μg vitamin B12, 10 mg zinc, 50 μg selenium) daily for three months. Semen parameters including total sperm count, concentration, progressive motility, vitality, and morphology were determined before and after treatment. In addition, sperm DNA fragmentation and the amount of highly degraded sperm cells were analyzed by Sperm Chromatin Dispersion. After treatment, patients showed an average relative reduction of 22.1% in sperm DNA fragmentation (p = 0.02) and had 31.3% fewer highly degraded sperm cells (p = 0.07). Total numbers of sperm cells were increased (p = 0.04), but other semen parameters were unaffected. These data suggest that sperm DNA integrity in grade I varicocele patients may be improved by oral antioxidant treatment. PMID:26090928

  7. An integrated prediction and optimization model of biogas production system at a wastewater treatment facility.

    PubMed

    Akbaş, Halil; Bilgen, Bilge; Turhan, Aykut Melih

    2015-11-01

    This study proposes an integrated prediction and optimization model by using multi-layer perceptron neural network and particle swarm optimization techniques. Three different objective functions are formulated. The first one is the maximization of methane percentage with single output. The second one is the maximization of biogas production with single output. The last one is the maximization of biogas quality and biogas production with two outputs. Methane percentage, carbon dioxide percentage, and other contents' percentage are used as the biogas quality criteria. Based on the formulated models and data from a wastewater treatment facility, optimal values of input variables and their corresponding maximum output values are found out for each model. It is expected that the application of the integrated prediction and optimization models increases the biogas production and biogas quality, and contributes to the quantity of electricity production at the wastewater treatment facility. PMID:26295443

  8. Epidermal growth factor treatment decreases mortality and is associated with improved gut integrity in sepsis

    PubMed Central

    Clark, Jessica A.; Clark, Andrew T.; Hotchkiss, Richard S.; Buchman, Timothy G.; Coopersmith, Craig M.

    2007-01-01

    Epidermal growth factor (EGF) is a cytoprotective peptide that has healing effects on the intestinal mucosa. We sought to determine whether systemic administration of EGF following the onset of sepsis improved intestinal integrity and decreased mortality. FVB/N mice were subjected to either sham laparotomy or 2×23 cecal ligation and puncture (CLP). Septic mice were further randomized to receive intraperitoneal injection of either 150 μg/kg/day EGF or 0.9% saline. Circulating EGF levels were decreased following CLP compared to sham animals but were unaffected by giving exogenous EGF treatment. In contrast, intestinal EGF levels increased following CLP, and were further augmented by exogenous EGF treatment. Intestinal EGF-receptor (EGF-R) was increased following CLP whether assayed by immunohistochemistry, real-time PCR or western blot, and exogenous EGF treatment decreased intestinal EGF-R. Villus length decreased 2-fold between sham and septic animals, and EGF treatment resulted in near total restitution of villus length. Sepsis decreased intestinal proliferation and increased intestinal apoptosis. This was accompanied by increased expression of the pro-apoptotic proteins Bid and FADD, as well as the cyclin-dependent kinase inhibitor p21cip1/waf. EGF treatment after the onset of sepsis restored both proliferation and apoptosis to levels seen in sham animals and normalized expression of Bid, FADD, and p21cip1/waf. To determine whether improvements in gut homeostasis were associated with a decrease in sepsis-induced mortality, septic mice with or without EGF treatment after CLP were followed seven days for survival. Mortality decreased from 60% to 30% in mice treated with EGF after the onset of sepsis (p<0.05). EGF may thus be a potential therapeutic agent for the treatment of sepsis, in part due to its ability to protect intestinal integrity. PMID:18004230

  9. Epidermal growth factor treatment decreases mortality and is associated with improved gut integrity in sepsis.

    PubMed

    Clark, Jessica A; Clark, Andrew T; Hotchkiss, Richard S; Buchman, Timothy G; Coopersmith, Craig M

    2008-07-01

    Epidermal growth factor (EGF) is a cytoprotective peptide that has healing effects on the intestinal mucosa. We sought to determine whether systemic administration of EGF after the onset of sepsis improved intestinal integrity and decreased mortality. FVB/N mice were subjected to either sham laparotomy or 2 x 23 cecal ligation and puncture (CLP). Septic mice were further randomized to receive injection of either 150 microg kg(-1) d(-1) (i.p.) EGF or 0.9% saline (i.p.). Circulating EGF levels were decreased after CLP compared with sham animals but were unaffected by giving exogenous EGF treatment. In contrast, intestinal EGF levels increased after CLP and were further augmented by exogenous EGF treatment. Intestinal EGF receptor was increased after CLP, whether assayed by immunohistochemistry, real-time polymerase chain reaction, or Western blot, and exogenous EGF treatment decreased intestinal EGF receptor. Villus length decreased 2-fold between sham and septic animals, and EGF treatment resulted in near total restitution of villus length. Sepsis decreased intestinal proliferation and increased intestinal apoptosis. This was accompanied by increased expression of the proapoptotic proteins Bid and Fas-associated death domain, as well as the cyclin-dependent kinase inhibitor p21 cip1/waf Epidermal growth factor treatment after the onset of sepsis restored both proliferation and apoptosis to levels seen in sham animals and normalized expression of Bid, Fas-associated death domain, and p21 cip1/waf . To determine whether improvements in gut homeostasis were associated with a decrease in sepsis-induced mortality, septic mice with or without EGF treatment after CLP were followed 7 days for survival. Mortality decreased from 60% to 30% in mice treated with EGF after the onset of sepsis (P < 0.05). Thus, EGF may be a potential therapeutic agent for the treatment of sepsis in part due to its ability to protect intestinal integrity. PMID:18004230

  10. Integrated demonstration of molten salt oxidation with salt recycle for mixed waste treatment

    SciTech Connect

    Hsu, P.C.

    1997-11-01

    Molten Salt Oxidation (MSO) is a thermal, nonflame process that has the inherent capability of completely destroying organic constituents of mixed wastes, hazardous wastes, and energetic materials while retaining inorganic and radioactive constituents in the salt. For this reason, MSO is considered a promising alternative to incineration for the treatment of a variety of organic wastes. Lawrence Livermore National Laboratory (LLNL) has prepared a facility and constructed an integrated pilot-scale MSO treatment system in which tests and demonstrations are performed under carefully controlled (experimental) conditions. The system consists of a MSO processor with dedicated off-gas treatment, a salt recycle system, feed preparation equipment, and equipment for preparing ceramic final waste forms. This integrated system was designed and engineered based on laboratory experience with a smaller engineering-scale reactor unit and extensive laboratory development on salt recycle and final forms preparation. In this paper we present design and engineering details of the system and discuss its capabilities as well as preliminary process demonstration data. A primary purpose of these demonstrations is identification of the most suitable waste streams and waste types for MSO treatment.

  11. An integrated anaerobic digestion and UV photocatalytic treatment of distillery wastewater.

    PubMed

    Apollo, Seth; Onyango, Maurice S; Ochieng, Aoyi

    2013-10-15

    Anaerobic up-flow fixed bed reactor and annular photocatalytic reactor were used to study the efficiency of integrated anaerobic digestion (AD) and ultraviolet (UV) photodegradation of real distillery effluent and raw molasses wastewater (MWW). It was found that UV photodegradation as a stand-alone technique achieved colour removal of 54% and 69% for the distillery and MWW, respectively, with a COD reduction of <20% and a negligible BOD reduction. On the other hand, AD as a single treatment technique was found to be effective in COD and BOD reduction with efficiencies of above 75% and 85%, respectively, for both wastewater samples. However, the AD achieved low colour removal efficiency, with an increase in colour intensity of 13% recorded when treating MWW while a colour removal of 51% was achieved for the distillery effluent. The application of UV photodegradation as a pre-treatment method to the AD process reduced the COD removal and biogas production efficiency. However, an integration in which UV photodegradation was employed as a post-treatment to the AD process achieved high COD removal of above 85% for both wastewater samples, and colour removal of 88% for the distillery effluent. Thus, photodegradation can be employed as a post-treatment technique to an AD system treating distillery effluent for complete removal of the biorecalcitrant and colour imparting compounds. PMID:23974530

  12. Integrated radwaste treatment system lessons learned from 2{1/2} years of operation

    SciTech Connect

    Baker, M.N.; Fussner, R.J.

    1997-05-01

    The Integrated Radwaste Treatment System (IRTS) at the West Valley Demonstration Project (WVDP) is a pretreatment scheme to reduce the amount of salts in the high-level radioactive waste (vitrification) stream. Following removal of cesium-137 (Cs-137) by ion-exchange in the Supernatant Treatment System (STS), the radioactive waste liquid is volume-reduced by evaporation. Trace amounts of Cs-137 in the resulting distillate are removed by ion-exchange, then the distillate is discharged to the existing plant water treatment system. The concentrated product, 37 to 41 percent solids by weight, is encapsulated in cement producing a stable, low-level waste form. The Integrated Radwaste Treatment System (IRTS) operated in this mode from May 1988 through November 1990, decontaminating 450,000 gallons of high-level waste liquid; evaporating and encapsulating the resulting concentrates into 10,393 71-gallon square drums. A number of process changes and variations from the original operating plan were required to increase the system flow rate and minimize waste volumes. This report provides a summary of work performed to operate the IRTS, including system descriptions, process highlights, and lessons learned.

  13. Service Utilization Patterns as Predictors of Response to Trauma-Informed Integrated Treatment for Women With Co-occurring Disorders.

    PubMed

    Gilbert, Allison R; Morrissey, Joseph P; Domino, Marisa E

    2011-07-01

    OBJECTIVE: The current study examined whether clinical responses to an integrated treatment intervention among women with co-occurring disorders and histories of abuse varied according to their service use patterns at baseline. METHODS: Data were from a national, multi-site, integrated treatment intervention study in 1998-2003. Analyses included 999 study participants assigned to the integrated treatment group and who were symptomatic at baseline. Participants' baseline service use activity was characterized according to five distinct baseline service use clusters. Logistic regression models estimated study participants' odds of good clinical responses to integrated treatment at 12 months across the five service clusters. RESULTS: Participants with high levels of psychotropic medication and medical care use at baseline had significantly lower odds than low-intensity service users of having a good response to integrated treatment at 12 months on mental health, alcohol addiction, and posttraumatic stress measures. A majority of women in this group had serious medical illness or disability and were more likely than their counterparts with other service use patterns to have used homeless or domestic violence shelters. CONCLUSIONS: Women who used high levels of medication and medical services appear to have faced especially difficult barriers in responding well to integrated treatment. Careful assessments of their mental health, trauma, and medical treatment needs may be required as part of integrated treatment in an effort to improve their response to integrated treatment, clinical outcomes and well-being. This information can also be used to target integrated treatment to women who are likely to respond positively and achieve meaningful improvements in their functioning. PMID:22368532

  14. Integrated Thermal Treatment Systems study: US Department of Energy Internal Review Panel report

    SciTech Connect

    Cudahy, J.; Escarda, T.; Gimpel, R.

    1995-04-01

    The U.S. Department of Energy`s (DOE) Office of Technology Development (OTD) commissioned two studies to uniformly evaluate nineteen thermal treatment technologies. These studies were called the Integrated Thermal Treatment System (ITTS) Phase I and Phase II. With the advice and guidance of the DOE Office of Environmental Management`s (EM`s) Mixed Waste Focus Group, OTD formed an ITTS Internal Review Panel, composed of scientists and engineers from throughout the DOE complex, the U.S. Environmental Protection Agency (EPA), the California EPA, and private experts. The Panel met from November 15-18, 1994, to review and comment on the ITTS studies, to make recommendations on the most promising thermal treatment systems for DOE mixed low level wastes (MLLW), and to make recommendations on research and development necessary to prove the performance of the technologies on MLLW.

  15. Integrated Next-Generation Sequencing and Avatar Mouse Models for Personalized Cancer Treatment

    PubMed Central

    Garralda, Elena; Paz, Keren; López-Casas, Pedro P.; Jones, Siân; Katz, Amanda; Kann, Lisa M.; López-Rios, Fernando; Sarno, Francesca; Al-Shahrour, Fátima; Vasquez, David; Bruckheimer, Elizabeth; Angiuoli, Samuel V.; Calles, Antonio; Diaz, Luis A.; Velculescu, Victor E.; Valencia, Alfonso; Sidransky, David; Hidalgo, Manuel

    2015-01-01

    Background Current technology permits an unbiased massive analysis of somatic genetic alterations from tumor DNA as well as the generation of individualized mouse xenografts (Avatar models). This work aimed to evaluate our experience integrating these two strategies to personalize the treatment of patients with cancer. Methods We performed whole-exome sequencing analysis of 25 patients with advanced solid tumors to identify putatively actionable tumor-specific genomic alterations. Avatar models were used as an in vivo platform to test proposed treatment strategies. Results Successful exome sequencing analyses have been obtained for 23 patients. Tumor-specific mutations and copy-number variations were identified. All samples profiled contained relevant genomic alterations. Tumor was implanted to create an Avatar model from 14 patients and 10 succeeded. Occasionally, actionable alterations such as mutations in NF1, PI3KA, and DDR2 failed to provide any benefit when a targeted drug was tested in the Avatar and, accordingly, treatment of the patients with these drugs was not effective. To date, 13 patients have received a personalized treatment and 6 achieved durable partial remissions. Prior testing of candidate treatments in Avatar models correlated with clinical response and helped to select empirical treatments in some patients with no actionable mutations. Conclusion The use of full genomic analysis for cancer care is encouraging but presents important challenges that will need to be solved for broad clinical application. Avatar models are a promising investigational platform for therapeutic decision making. While limitations still exist, this strategy should be further tested. PMID:24634382

  16. [Training model for integral treatment of patients with eating disorders resistant to change].

    PubMed

    Calvo Sagardoy, R; Gallego Morales, L T; García de Lorenzo y Mateos, A

    2012-01-01

    The need to find effective treatments for patients with Anorexia or Bulimia nervosa has led to the professionals who care for them to develop new forms of treatment that take into account the variables that cause resistance to change. Patients in this study (2006-2009) have the following characteristics: 340 patients who have 7 or more years of evolution and/or have tried numerous previous treatments without having succeeded in starting and / or maintaining the desired changes, that allowed them to recover steadily. As the proposed treatment, the patient-treatment team is based on the principles of the training model. It considers the patient holistically, it informs and provides him with resources to increase its commitment to change. Teaches the patient to take care physically and mentally as a way to regain their health and leave the disorder in a stable way. Includes family members as essential support in the recovery of their closest. Therapists require extensive experience in the treatment of ED, flexibility, ability to integrate with other team members even if they use different theoretical models, skills for group sessions, ability to handle negative emotions and frustration tolerance. Finally, the model presented below has been implemented, recovered patients whose stay in the disorder exceeded 15 years of development and led to permanent occupational disability. PMID:23114941

  17. The outcome of treatment of chronic osteomyelitis according to an integrated approach.

    PubMed

    Marais, Leonard C; Ferreira, Nando; Aldous, Colleen; Le Roux, Theo L B

    2016-08-01

    Previous classification systems of chronic osteomyelitis have failed to provide objective and pragmatic guidelines for selection of the appropriate treatment strategy. In this study, we assessed the short-term treatment outcome in adult patients with long-bone chronic osteomyelitis prospectively where a modified host classification system was integrated with treatment strategy selection through a novel management algorithm. Twenty-six of the 28 enrolled patients were available for follow-up at a minimum of 12 months. The median patient age of was 36.5 years (range 18-72 years). Fourteen patients (54 %) were managed palliatively, and 11 patients (42 %) were managed through the implementation of a curative treatment strategy. One patient required alternative treatment in the form of an amputation. The overall success rate was 96.2 % (95 % CI 80.4-99.9 %) at a minimum of 12-months follow-up. Remission was achieved in all [11/11] patients treated curatively (one-sided 95 % CI 73.5-100.0 %). Palliative treatment was successful in 92.9 % [13/14] of cases (95 % CI 66.1-99.9 %). In patients with lower limb involvement, there was a statistically significant improvement of 28.3 (95 % CI 21.0-35.7; SD 17.0) in the AAOS Lower Limb Outcomes Instrument score (p value < 0.001). The integrated approach proposed in this study appears a useful guideline to the management of chronic osteomyelitis of long bones in adult patients in the developing world. Further investigation is required to validate the approach, and additional development of the algorithm may be required in order to render it useful in other clinical environments. PMID:27369868

  18. Evaluating integrated strategies for robust treatment of high saline piggery wastewater.

    PubMed

    Kim, Hyun-Chul; Choi, Wook Jin; Chae, A Na; Park, Joonhong; Kim, Hyung Joo; Song, Kyung Guen

    2016-02-01

    In this study, we integrated physicochemical and biological strategies for the robust treatment of piggery effluent in which high levels of organic constituents, inorganic nutrients, color, and salts remained. Piggery effluent that was stabilized in an anaerobic digester was sequentially coagulated, micro-filtered, and air-stripped prior to biological treatment with mixotrophic algal species that showed tolerance to high salinity (up to 4.8% as Cl(-)). The algae treatment was conducted with continuous O2 supplementation instead of using the combination of high lighting and CO2 injection. The microalga Scenedesmus quadricauda employed as a bio-agent was capable of assimilating both nitrogen (222 mg N g cell(-1) d(-1)) and phosphorus (9.3 mg P g cell(-1) d(-1)) and utilizing dissolved organics (2053 mg COD g cell(-1) d(-1)) as a carbon source in a single treatment process under the heterotrophic growth conditions. The heterotrophic growth of S. quadricauda proceeded rapidly by directly incorporating organic substrate in the oxidative assimilation process, which coincided with the high productivity of algal biomass, accounting for 2.4 g cell L(-1) d(-1). The algae-treated wastewater was subsequently ozonated to comply with discharge permits that limit color in the effluent, which also resulted in improved biodegradability of residual organics. The integrated treatment scheme proposed in this study also achieved 89% removal of COD, 88% removal of TN, and 60% removal of TP. The advantage of using the hybrid configuration suggests that this would be a promising strategy in full-scale treatment facilities for piggery effluent. PMID:26689659

  19. Integrating Motivational Interviewing and Cognitive Behavioral Therapy in the Treatment of Eating Disorders: Tailoring Interventions to Patient Readiness for Change

    ERIC Educational Resources Information Center

    Geller, Josie; Dunn, Erin C.

    2011-01-01

    This paper focuses on the integration of Motivational Interviewing (MI) and cognitive behavioral therapy (CBT) in the treatment of eating disorders. Although CBT is regarded as the treatment of choice in this population, it nevertheless has limitations: some patients fail to engage, drop out from treatment prematurely, or simply do not improve.…

  20. Integrated omics for the identification of key functionalities in biological wastewater treatment microbial communities

    PubMed Central

    Narayanasamy, Shaman; Muller, Emilie E L; Sheik, Abdul R; Wilmes, Paul

    2015-01-01

    Biological wastewater treatment plants harbour diverse and complex microbial communities which prominently serve as models for microbial ecology and mixed culture biotechnological processes. Integrated omic analyses (combined metagenomics, metatranscriptomics, metaproteomics and metabolomics) are currently gaining momentum towards providing enhanced understanding of community structure, function and dynamics in situ as well as offering the potential to discover novel biological functionalities within the framework of Eco-Systems Biology. The integration of information from genome to metabolome allows the establishment of associations between genetic potential and final phenotype, a feature not realizable by only considering single ‘omes’. Therefore, in our opinion, integrated omics will become the future standard for large-scale characterization of microbial consortia including those underpinning biological wastewater treatment processes. Systematically obtained time and space-resolved omic datasets will allow deconvolution of structure–function relationships by identifying key members and functions. Such knowledge will form the foundation for discovering novel genes on a much larger scale compared with previous efforts. In general, these insights will allow us to optimize microbial biotechnological processes either through better control of mixed culture processes or by use of more efficient enzymes in bioengineering applications. PMID:25678254

  1. Integrated forward osmosis-membrane distillation process for human urine treatment.

    PubMed

    Liu, Qianliang; Liu, Caihong; Zhao, Lei; Ma, Weichao; Liu, Huiling; Ma, Jun

    2016-03-15

    This study demonstrated a forward osmosis-membrane distillation (FO-MD) hybrid system for real human urine treatment. A series of NaCl solutions at different concentrations were adopted for draw solutions in FO process, which were also the feed solutions of MD process. To establish a stable and continuous integrated FO-MD system, individual FO process with different NaCl concentrations and individual direct contact membrane distillation (DCMD) process with different feed temperatures were firstly investigated separately. Four stable equilibrium conditions were obtained from matching the water transfer rates of individual FO and MD processes. It was found that the integrated system is stable and sustainable when the water transfer rate of FO subsystem is equal to that of MD subsystem. The rejections to main contaminants in human urine were also investigated. Although individual FO process had relatively high rejection to Total Organic Carbon (TOC), Total Nitrogen (TN) and Ammonium Nitrogen (NH4(+)-N) in human urine, these contaminants could also accumulate in draw solution after long term performance. The MD process provided an effective rejection to contaminants in draw solution after FO process and the integrated system revealed nearly complete rejection to TOC, TN and NH4(+)-N. This work provided a potential treatment process for human urine in some fields such as water regeneration in space station and water or nutrient recovery from source-separated urine. PMID:26773483

  2. [Integration of burn treatment and rehabilitation for a child with extremely severe burn].

    PubMed

    Li, Hongming; Zhang, Jiaping; Chen, Jian; Song, Huapei; Liu, Qiushi; Fan, Xin; Peng, Yizhi; Wu, Jun

    2015-04-01

    This article reports the successful experience of integration of burn treatment and rehabilitation for a child suffering from 91% TBSA flame burn injury (with 60% TBSA full-thickness injury, 30% TBSA deep partial-thickness injury, and 1% TBSA superficial partial-thickness injury), severe inhalation injury, severe burn shock, stress ulcer, gastrointestinal bleeding and atelectasis of the right upper lung. The patient was given effective fluid infusion against shock, treatment for gastrointestinal bleeding, and other effective supportive treatment for functions of various organs after being admitted to our burn ward. When vital signs became stable at 30 hours post injury, bedside rehabilitation was begun. On post injury day (PID) 4, escharectomy was performed for both lower limbs, followed by microskin grafting and allogeneic skin covering. On PID 10, invasive infection of multi-drug resistant bacteria was found with accompanied high fever, and at the same time allograft began to disintegrate, with dissolution of large area of eschar, leading to a raw surface reaching 86% TBSA. Following debridement, dressing, application of compound polymyxin B ointment, temporary covering of wounds with porcine acellular dermal matrix, adjustment of antibiotics, patient's condition was finally stabilized. From PID 28 on, split-thickness skin grafting was conducted 7 times, and the raw surface of 75% TBSA involving the upper and lower limbs and trunk was successfully covered. At the same time, our rehabilitation team launched comprehensive rehabilitation measures comprising active exercise, occupational therapy, prevention of scar formation, organ function training and psychological intervention. Finally, the patient was able to walk unaided and fed herself when the wounds were almost entirely healed in 3 months after injury. Oriented forwards functional rehabilitation, strong cooperation between team members, and synchronous effective implementation of burn treatment and

  3. Quality of life and BMI changes in youth participating in an integrated pediatric obesity treatment program

    PubMed Central

    2013-01-01

    Background Changes in Quality of Life (QOL) measures over time with treatment of obesity have not previously been described for youth. We describe the changes from baseline through two follow up visits in youth QOL (assessed by the Pediatric Quality Life Inventory, PedsQL4.0), teen depression (assessed by the Patient Health Questionnaire, PHQ9A), Body Mass Index (BMI) and BMI z-score. We also report caregiver proxy ratings of youth QOL. Methods A sample of 267 pairs of youth and caregiver participants were recruited at their first visit to an outpatient weight-treatment clinic that provides care integrated between a physician, dietician, and mental health provider; of the 267, 113 attended a visit two (V2) follow-up appointment, and 48 attended visit three (V3). We investigated multiple factors longitudinally experienced by youth who are overweight and their caregivers across up to three different integrated care visits. We determined relationships at baseline in QOL, PHQ9A, and BMI z-score, as well as changes in variables over time using linear mixed models with time as a covariate. Results Overall across three visits the results indicate that youth had slight declines in relative BMI, significant increases in their QOL and improvements in depression. Conclusions We encourage clinicians and researchers to track youth longitudinally throughout treatment to investigate not only youth’s BMI changes, but also psychosocial changes including QOL. PMID:23837620

  4. Integrated basic treatment of activated carbon for enhanced CO2 selectivity

    NASA Astrophysics Data System (ADS)

    Adelodun, Adedeji Adebukola; Jo, Young-Min

    2013-12-01

    We attempted the use of three chemical agents viz nitric acid (HN), calcium nitrate (CaN) and calcium ethanoate (CaEt) to achieve enhanced CO2 selective adsorption by activated carbon (AC). In dry phase treatment, microporous coconut shell-based carbon (CS) exhibits higher CO2 capacity than coal-based. However, upon wet-phase pre-treatment, modified CS samples showed lesser CO2 adsorption efficiency. Surface characterization with X-ray photoelectron spectroscopy confirms the presence of calcium and amine species on the samples with integrated treatment (A-CaN). These samples recorded the highest low-level CO2 capture despite calcinated CaEt-doped samples (C-CaEt) showing the highest value for pure and high level CO2 adsorption capacities. The slope and linearity values of isobaric desorption were used to estimate the proportion of CO2 chemisorbed and heterogeneity of the adsorbents’ surfaces respectively. Consequently, integrated basic impregnation provides the most efficient adsorbents for selective adsorption of both indoor and outdoor CO2 levels.

  5. Integrated process control for recirculating cooling water treatment in the coal chemical industry.

    PubMed

    Pei, Y S; Guo, W; Yang, Z F

    2011-01-01

    This work focused on the integrated process of the recirculating cooling water (RCW) treatment to achieve approximate zero emission in the coal chemical industry. The benefits of fractional and comprehensive RCW treatment were quantified and qualified by using a water and mass balance approach. Limits of cycle of concentrations and some encountered bottlenecks were used to ascertain set target limits for different water sources. Makeup water was mixed with water produced from reverse osmosis (RO) in the proportion of 6:4, which notably reduced salts discharge. Side infiltration, which settled down suspended solids, can reduce energy consumption by over 40%. An automated on-line monitoring organic phosphorus inhibitor feed maintains the RCW system stability in comparison to the manual feed. Two-step electrosorb technology (EST) instead of an acid feed can lead cycle of concentration of water to reach 7.0. The wastewater from RO, EST and filter was transferred into a concentration treatment system where metallic ions were adsorbed by permanent magnetic materials. Separation of water and salts was completed by using a magnetic disc separator. Applying the integrated process in a coal chemical industry, a benefit of 1.60 million Yuan annually in 2 years was gained and approximate zero emission was achieved. Moreover, both technical and economic feasibility were demonstrated in detail. PMID:21977648

  6. How Does Scale of Implementation Impact the Environmental Sustainability of Wastewater Treatment Integrated with Resource Recovery?

    PubMed

    Cornejo, Pablo K; Zhang, Qiong; Mihelcic, James R

    2016-07-01

    Energy and resource consumptions required to treat and transport wastewater have led to efforts to improve the environmental sustainability of wastewater treatment plants (WWTPs). Resource recovery can reduce the environmental impact of these systems; however, limited research has considered how the scale of implementation impacts the sustainability of WWTPs integrated with resource recovery. Accordingly, this research uses life cycle assessment (LCA) to evaluate how the scale of implementation impacts the environmental sustainability of wastewater treatment integrated with water reuse, energy recovery, and nutrient recycling. Three systems were selected: a septic tank with aerobic treatment at the household scale, an advanced water reclamation facility at the community scale, and an advanced water reclamation facility at the city scale. Three sustainability indicators were considered: embodied energy, carbon footprint, and eutrophication potential. This study determined that as with economies of scale, there are benefits to centralization of WWTPs with resource recovery in terms of embodied energy and carbon footprint; however, the community scale was shown to have the lowest eutrophication potential. Additionally, technology selection, nutrient control practices, system layout, and topographical conditions may have a larger impact on environmental sustainability than the implementation scale in some cases. PMID:27001077

  7. A membrane-integrated advanced scheme for treatment of industrial wastewater: dynamic modeling towards scale up.

    PubMed

    Kumar, Ramesh; Pal, Parimal

    2013-08-01

    Modeling and simulation was carried out for an advanced membrane-integrated hybrid treatment process that ensures reuse of water with conversion and recovery of ammoniacal nitrogen as value-added struvite fertilizer from coke wastewater. While toxic cyanide was largely removed in a pre-chemical treatment unit using Fenton's reagents under optimized conditions, more than 95% of NH4(+)-N could be recovered as a valuable by-product called struvite through addition of appropriate doses of magnesium and phosphate salts. Water could be turned reusable through a polishing treatment by nanofiltration membranes in a largely fouling free membrane module following a biodegradation step. Mathematical modeling of such an integrated process was done with Haldane-Andrew approach for the associated microbial degradation of phenol by Pseudomonas putida. Residual NH4(+) was degraded by nitrification and denitrification following the modified Monod kinetics. The model could successfully predict the plant performance as reflected in reasonably low relative error (0.03-0.18) and high Willmott d-index (>0.98). PMID:23735488

  8. Personalized psychotherapy: a treatment approach based on Theodore Millon's integrated model of clinical science.

    PubMed

    Strack, Stephen; Millon, Theodore

    2013-12-01

    In this article we present personalized psychotherapy, a treatment approach for people with a wide range of personality problems and clinical syndromes that is a central part of Theodore Millon's unified clinical science model of personality and psychopathology. Because the intervention strategy is fully integrated with an evolutionary perspective on human development, we offer it in this context. We begin with a historical overview of Millon's model and its relationship to the Diagnostic and Statistical Manual of Mental Disorders (DSM). We then present his basic theoretical principles and personality taxonomy, and discuss variations in personality functioning across the normal-abnormal continuum. We move on to describe assessment measures that were developed to operationalize his concepts and ideas, and which are used as the basis for creating treatment plans. The premises and principles of personalized psychotherapy are described to show how the intervention model is squarely focused on the integrated unity of the person. We look at presenting problems of all kinds from the point of view of how they emanate from, and are related to, the individual's unique combination of temperament, traits, preferences, behavioral patterns, and coping strategies. We then specify multimodal interventions (e.g., a combination of pharmacologic, cognitive, behavioral, phenomenological, interpersonal, and/or intrapsychic treatments) and apply them in a particular sequence to maximize their impact, not only on the target symptoms, but on the underlying personality elements believed to be their primary cause. PMID:23072423

  9. Inhibitors of HIV-1 entry and integration: recent developments and impact on treatment.

    PubMed

    Sharma, Anil K; George, Varghese; Valiathan, Ranjini; Pilakka-Kanthikeel, Sudheesh; Pallikkuth, Suresh

    2013-05-01

    Advances in the drug development against HIV-1 have lead to the identification of new compounds which could be used to target cellular entry and nuclear integration of virus in addition to drugs that commonly target reverse transcriptase and protease. These additional targets have added a new dimension to fight against HIV. Cellular entry of HIV is a multistep procedure involving a range of cellular and molecular interactions between virus envelope protein and receptors expressed on the surface of the target cells, thus providing many opportunities to block infection. Some of these entry inhibitors are currently being used in the clinic and more compounds are under various stages of development. Integration of the HIV-1 DNA is required and essential to maintain the viral DNA in the infected cell. The design and discovery of integrase inhibitors were first focused at targeting the catalytic site of integrase that selectively acting on strand transfer and thus inhibits integration of virus DNA with host cell genome. Thus, entry and integrase inhibitors present a real added value in combined treatment against HIV infection. This review discusses the recent development in the discovery of inhibitors of HIV entry and integration along with some of recent patents in the field. PMID:23578097

  10. Integrated process analysis of treatment systems for mixed low level waste

    SciTech Connect

    Cooley, C.R.; Schwinkendorf, W.E. |; Bechtold, T.E.

    1997-10-01

    Selection of technologies to be developed for treatment of DOE`s mixed low level waste (MLLW) requires knowledge and understanding of the expected costs, schedules, risks, performance, and reliability of the total engineered systems that use these technologies. Thus, an integrated process analysis program was undertaken to identify the characteristics and needs of several thermal and nonthermal systems. For purposes of comparison, all systems were conceptually designed for a single facility processing the same amount of waste at the same rate. Thirty treatment systems were evaluated ranging from standard incineration to innovative thermal systems and innovative nonthermal chemical treatment. Treating 236 million pounds of waste in 20 years through a central treatment was found to be the least costly option with total life cycle cost ranging from $2.1 billion for a metal melting system to $3.9 billion for a nonthermal acid digestion system. Little cost difference exists among nonthermal systems or among thermal systems. Significant cost savings could be achieved by working towards maximum on line treatment time per year; vitrifying the final waste residue; decreasing front end characterization segregation and sizing requirements; using contaminated soil as the vitrifying agent; and delisting the final vitrified waste form from Resource Conservation and Recovery Act (RCRA) Land Disposal Restriction (LDR) requirements.

  11. Hybrid Processing: the Impact of Mechanical and Surface Thermal Treatment Integration onto the Machine Parts Quality

    NASA Astrophysics Data System (ADS)

    Skeeba, V. Yu; Ivancivsky, V. V.; Kutyshkin, A. V.; Parts, K. A.

    2016-04-01

    The comparative analysis of the two hybrid process technologies, which are based on the integration of mechanical treatment (abrasive grinding or turning) and a surface heat strengthening by high frequency current on the same processing equipment, is given in the paper. The acquired results demonstrate that the suggested integrating approach allows carrying out the processing on the one technological base, which leads to the increase in the quality of the machine parts surface layer. The conducted experimental research proves that a minor stock allowance value for the final mechanical processing (sparking out or diamond smoothing) ensures the absence of defects such as local abatement zones and provides strain hardening of the work piece surface. This leads to the formation of the work-hardened layer of 0.01 - 0.03 mm, increase in microhardness value by 12 - 17% and the level of residual compressive stress in the surface layer by 10 - 21 % respectively.

  12. Patient-centered care in cancer treatment programs: the future of integrative oncology through psychoeducation.

    PubMed

    Garchinski, Christina M; DiBiase, Ann-Marie; Wong, Raimond K; Sagar, Stephen M

    2014-12-01

    The reciprocal relationship between the mind and body has been a neglected process for improving the psychosocial care of cancer patients. Emotions form an important link between the mind and body. They play a fundamental role in the cognitive functions of decision-making and symptom control. Recognizing this relationship is important for integrative oncology. We define psychoeducation as the teaching of self-evaluation and self-regulation of the mind-body process. A gap exists between research evidence and implementation into clinical practice. The patients' search for self-empowerment through the pursuit of complementary therapies may be a surrogate for inadequate psychoeducation. Integrative oncology programs should implement psychoeducation that helps patients to improve both emotional and cognitive intelligence, enabling them to better negotiate cancer treatment systems. PMID:25531048

  13. An Integrated Water Treatment Technology Solution for Sustainable Water Resource Management in the Marcellus Shale

    SciTech Connect

    Matthew Bruff; Ned Godshall; Karen Evans

    2011-04-30

    This Final Scientific/ Technical Report submitted with respect to Project DE-FE0000833 titled 'An Integrated Water Treatment Technology Solution for Sustainable Water Resource Management in the Marcellus Shale' in support of final reporting requirements. This final report contains a compilation of previous reports with the most current data in order to produce one final complete document. The goal of this research was to provide an integrated approach aimed at addressing the increasing water resource challenges between natural gas production and other water stakeholders in shale gas basins. The objective was to demonstrate that the AltelaRain{reg_sign} technology could be successfully deployed in the Marcellus Shale Basin to treat frac flow-back water. That objective has been successfully met.

  14. Integrated Biomarker Responses of Effluents from Municipal Sewage Treatment Works in Goldfish

    NASA Astrophysics Data System (ADS)

    Lu, G. H.; Xia, J.; Zhang, H. Z.; Wang, C.

    2010-11-01

    The organic toxicants were extracted from the effluents from municipal sewage treatment works (STWs) in Nanjing (Chengbei, Suojincun and Jiangxinzhou STWs) by using solid phase extraction. AChE, GST, EROD, GPx and Na+/K+-ATPase activities in goldfish (Carassius auratus) were determmed after exposure of the extracted components. The extracts of water samples from the three STWs induced AChE, GST, EROD and Na+/K+-ATPase activities. The responses of enzymatic activities were mostly significant for those exposures of intermediate polar components, weakly polar components and/or nonpolar hexane extracts. Integrated biomarker response (IBR) index were calculated and used to evaluate an integrated impact of organic toxicants from different sampling sites. The order of negative biological effects of the three STWs was Jiangxinzhou>Chengbei>Suojincun.

  15. Coke oven gas treatment and by-product plant of Magnitogorsk Integrated Iron and Steel Works

    SciTech Connect

    Egorov, V.N.; Anikin, G.J.; Gross, M.

    1995-12-01

    Magnitogorsk Integrated Iron and Steel Works, Russia, decided to erect a new coke oven gas treatment and by-product plant to replace the existing obsolete units and to improve the environmental conditions of the area. The paper deals with the technological concept and the design requirements. Commissioning is scheduled at the beginning of 1996. The paper describes H{sub 2}S and NH{sub 3} removal, sulfur recovery and ammonia destruction, primary gas cooling and electrostatic tar precipitation, and the distributed control system that will be installed.

  16. Integrated ozonation and biomethanization treatments of vinasse derived from ethanol manufacturing.

    PubMed

    Siles, J A; García-García, I; Martín, A; Martín, M A

    2011-04-15

    Anaerobic digestion of vinasse derived from bioethanol manufacturing, in which total COD was found to be 68.56 ± 8.17 g/L, was studied in batch laboratory-scale reactors at mesophilic temperature (35 °C). The vinasse was subjected to a short ozonation pre-treatment (15 min) in which more than 50% reduction of phenols was observed, although the total organic carbon concentration remained approximately stable, indicating that the phenols were transformed into other simpler forms. The anaerobic biodegradability of raw and pre-treated vinasse was similar, reaching values close to 80% (COD). However, the methane yield coefficient and methane production rate enhanced by around 13.6% and 41.16%, respectively, when the ozonized vinasse was fed. These results indicate that the integration of chemical-biological treatments could be a viable option for the purification of this hazardous wastewater. PMID:21330053

  17. Integrating addiction treatment into primary care using mobile health technology: protocol for an implementation research study

    PubMed Central

    2014-01-01

    Background Healthcare reform in the United States is encouraging Federally Qualified Health Centers and other primary-care practices to integrate treatment for addiction and other behavioral health conditions into their practices. The potential of mobile health technologies to manage addiction and comorbidities such as HIV in these settings is substantial but largely untested. This paper describes a protocol to evaluate the implementation of an E-Health integrated communication technology delivered via mobile phones, called Seva, into primary-care settings. Seva is an evidence-based system of addiction treatment and recovery support for patients and real-time caseload monitoring for clinicians. Methods/Design Our implementation strategy uses three models of organizational change: the Program Planning Model to promote acceptance and sustainability, the NIATx quality improvement model to create a welcoming environment for change, and Rogers’s diffusion of innovations research, which facilitates adaptations of innovations to maximize their adoption potential. We will implement Seva and conduct an intensive, mixed-methods assessment at three diverse Federally Qualified Healthcare Centers in the United States. Our non-concurrent multiple-baseline design includes three periods — pretest (ending in four months of implementation preparation), active Seva implementation, and maintenance — with implementation staggered at six-month intervals across sites. The first site will serve as a pilot clinic. We will track the timing of intervention elements and assess study outcomes within each dimension of the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework, including effects on clinicians, patients, and practices. Our mixed-methods approach will include quantitative (e.g., interrupted time-series analysis of treatment attendance, with clinics as the unit of analysis) and qualitative (e.g., staff interviews regarding adaptations to implementation

  18. Potential integration of wetland wastewater treatment with space life support systems.

    PubMed

    Nelson, M; Alling, A; Dempster, W F; Van Thillo, M; Allen, J P

    2002-01-01

    Subsurface-flow constructed wetlands for wastewater treatment and nutrient recycling have a number of advantages in planetary exploration scenarios: they are odorless, relatively low labor and low energy, assist in purification of water and recycling of atmospheric CO2, and can directly grow some food crops. This article presents calculations for integration of wetland wastewater treatment with a prototype ground-based experimental facility ("Mars on Earth") supporting four people showing that an area of 4-6 m2 may be sufficient to accomplish wastewater treatment and recycling. Discharge water from the wetland system can be used as irrigation water for the agricultural crop area, thus ensuring complete reclamation and utilization of nutrients within the bioregenerative life support system. Because the primary requirements for wetland treatment systems are warm temperatures and lighting, such bioregenerative systems can be integrated into space life support systems because heat from the lights may be used for temperature maintenance in the human living environment. Subsurface-flow wetlands can be modified for space habitats to lower space and mass requirements. Many of its construction requirements can eventually be met with use of in situ materials, such as gravel from the Mars surface. Because the technology does not depend on machinery and chemicals, and relies more on natural ecological mechanisms (microbial and plant metabolism), maintenance requirements (e.g., pumps, aerators, and chemicals) are minimized, and systems may have long operating lifetimes. Research needs include suitability of Martian soil and gravel for wetland systems, system sealing and liner options in a Mars base, and determination of wetland water quality efficiency under varying temperature and light regimes. PMID:12481806

  19. Integrating membrane filtration into bioelectrochemical systems as next generation energy-efficient wastewater treatment technologies for water reclamation: A review.

    PubMed

    Yuan, Heyang; He, Zhen

    2015-11-01

    Bioelectrochemical systems (BES) represent an energy-efficient approach for wastewater treatment, but the effluent still requires further treatment for direct discharge or reuse. Integrating membrane filtration in BES can achieve high-quality effluents with additional benefits. Three types of filtration membranes, dynamic membrane, ultrafiltration membrane and forward osmosis membrane that are grouped based on pore size, have been studied for integration in BES. The integration can be accomplished either in an internal or an external configuration. In an internal configuration, membranes can act as a separator between the electrodes, or be immersed in the anode/cathode chamber as a filtration component. The external configuration allows BES and membrane module to be operated independently. Given much progress and interest in the integration of membrane filtration into BES, this paper has reviewed the past studies, described various integration methods, discussed the advantages and limitations of each integration, and presented challenges for future development. PMID:26026232

  20. Cost Analysis of Integrative Inpatient Treatment Based on DRG Data: The Example of Anthroposophic Medicine

    PubMed Central

    Heinz, Jürgen; Fiori, Wolfgang; Heusser, Peter

    2013-01-01

    Background. Much work has been done to evaluate the outcome of integrative inpatient treatment but scarcely the costs. This paper evaluates the costs for inpatient treatment in three anthroposophic hospitals (AHs). Material and Methods. Cost and performance data from a total of 23,180 cases were analyzed and compared to national reference data. Subgroup analysis was performed between the cases with and without anthroposophic medical complex (AMC) treatment. Results. Costs and length of stay in the cases without AMC displayed no relevant differences compared to the national reference data. In contrast the inlier cases with AMC caused an average of € 1,394 more costs. However costs per diem were not higher than those in the national reference data. Hence, the delivery of AMC was associated with a prolonged length of stay. 46.6% of the cases with AMC were high outliers. Only 10.6% of the inlier cases with AMC were discharged before reaching the mean length of stay of each DRG. Discussion. Treatment in an AH is not generally associated with an increased use of resources. However, the provision of AMC leads to a prolonged length of stay and cannot be adequately reimbursed by the current G-DRG system. Due to the heterogeneity of the patient population, an additional payment should be negotiated individually. PMID:23431346

  1. An integrated Monte Carlo dosimetric verification system for radiotherapy treatment planning

    NASA Astrophysics Data System (ADS)

    Yamamoto, T.; Mizowaki, T.; Miyabe, Y.; Takegawa, H.; Narita, Y.; Yano, S.; Nagata, Y.; Teshima, T.; Hiraoka, M.

    2007-04-01

    An integrated Monte Carlo (MC) dose calculation system, MCRTV (Monte Carlo for radiotherapy treatment plan verification), has been developed for clinical treatment plan verification, especially for routine quality assurance (QA) of intensity-modulated radiotherapy (IMRT) plans. The MCRTV system consists of the EGS4/PRESTA MC codes originally written for particle transport through the accelerator, the multileaf collimator (MLC), and the patient/phantom, which run on a 28-CPU Linux cluster, and the associated software developed for the clinical implementation. MCRTV has an interface with a commercial treatment planning system (TPS) (Eclipse, Varian Medical Systems, Palo Alto, CA, USA) and reads the information needed for MC computation transferred in DICOM-RT format. The key features of MCRTV have been presented in detail in this paper. The phase-space data of our 15 MV photon beam from a Varian Clinac 2300C/D have been developed and several benchmarks have been performed under homogeneous and several inhomogeneous conditions (including water, aluminium, lung and bone media). The MC results agreed with the ionization chamber measurements to within 1% and 2% for homogeneous and inhomogeneous conditions, respectively. The MC calculation for a clinical prostate IMRT treatment plan validated the implementation of the beams and the patient/phantom configuration in MCRTV.

  2. Why clinicians do not implement integrated treatment for comorbid substance use disorder and posttraumatic stress disorder: a qualitative study

    PubMed Central

    Gielen, Nele; Krumeich, Anja; Havermans, Remco C.; Smeets, Feikje; Jansen, Anita

    2014-01-01

    Background Healthcare providers working in addiction facilities do not often implement integrated treatment of comorbid substance use disorder (SUD) and posttraumatic stress disorder (PTSD) while there is empirical evidence to do so. Objective This study aims to get insight into the views of clinicians with regard to the diagnosis and treatment of PTSD in SUD patients. Method A qualitative research method was chosen. Fourteen treatment staff members of different wards of an addiction care facility were interviewed by an independent interviewer. Results Despite acknowledging adverse consequences of trauma exposure on SUD, severe underdiagnosis of PTSD was mentioned and treatment of PTSD during SUD treatment was not supported. Obstacles related to the underestimation of PTSD among SUD patients and to the perceptions of SUD clinicians concerning the treatment of comorbid SUD/PTSD were reported. Conclusions It is concluded that SUD facilities should train their clinicians to enable them to provide for integrated treatment of SUD/PTSD. PMID:24511368

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

    PubMed

    Mena-Ulecia, Karel; Hernández, Heykel Hernández

    2015-01-01

    Selection of treatment technologies without considering the environmental, economic and social factors associated with each geographical context risks the occurrence of negative impacts that were not properly foreseen, working against the sustainable performance of the technology. The principal aim of this study was to evaluate 12 technologies for decentralized treatment of domestic wastewater applicable to peri-urban communities using sustainability approaches and, at the same time, continuing a discussion about how to address a more integrated assessment of overall sustainability. For this, a set of 13 indicators that embody the environmental, economic and social approach for the overall sustainability assessment were used by means of a target plot diagram as a tool for integrating indicators that represent a holistic analysis of the technologies. The obtained results put forward different degrees of sustainability, which led to the selection of: septic tank+land infiltration; up-flow anaerobic reactor+high rate trickling filter and septic tank+anaerobic filter as the most sustainable and attractive technologies to be applied in peri-urban communities, according to the employed indicators. PMID:26177403

  4. An integrated system for the online monitoring of particle therapy treatment accuracy

    NASA Astrophysics Data System (ADS)

    Fiorina, E.

    2016-07-01

    Quality assurance in hadrontherapy remains an open issue that can be addressed with reliable monitoring of treatment accuracy. The INSIDE (INnovative SolutIons for DosimEtry in hadrontherapy) project aims to develop an integrated online monitoring system based on two dedicated PET panels and a tracking system, called Dose Profiler. The proposed solution is designed to operate in-beam and provide an immediate feedback on the particle range acquiring both photons produced by β+ decays and prompt secondary particle signals. Monte Carlo simulations cover an important role both in the system development, by confirming the design feasibility, and in the system operation, by understanding data. A FLUKA-based integrated simulation was developed taking into account the hadron beam structure, the phantom/patient features and the PET detector and Dose Profiler specifications. In addition, to reduce simulation time in signal generation on PET detectors, a two-step technique has been implemented and validated. The first PET modules were tested in May 2015 at the Centro Nazionale Adroterapia Oncologica (CNAO) in Pavia (Italy) with very satisfactory results: in-spill, inter-spill and post-treatment PET images were reconstructed and a quantitative agreement between data and simulation was found.

  5. Effectiveness of a Novel Integrative Online Treatment for Depression (Deprexis): Randomized Controlled Trial

    PubMed Central

    Berger, Thomas; Caspar, Franz; Beevers, Christopher G; Andersson, Gerhard; Weiss, Mario

    2009-01-01

    Background Depression is associated with immense suffering and costs, and many patients receive inadequate care, often because of the limited availability of treatment. Web-based treatments may play an increasingly important role in closing this gap between demand and supply. We developed the integrative, Web-based program Deprexis, which covers therapeutic approaches such as behavioral activation, cognitive restructuring, mindfulness/acceptance exercises, and social skills training. Objective To evaluate the effectiveness of the Web-based intervention in a randomized controlled trial. Methods There were 396 adults recruited via Internet depression forums in Germany, and they were randomly assigned in an 80:20 weighted randomization sequence to either 9 weeks of immediate-program-access as an add-on to treatment-as-usual (N = 320), or to a 9-week delayed-access plus treatment-as-usual condition (N = 76). At pre- and post-treatment and 6-month follow-up, we measured depression (Beck Depression Inventory) as the primary outcome measure and social functioning (Work and Social Adjustment Scale) as the secondary outcome measure. Completer analyses and intention-to-treat analyses were performed. Results Of 396 participants, 216 (55%) completed the post-measurement 9 weeks later. Available case analyses revealed a significant reduction in depression severity (BDI), Cohen’s d = .64 (CI 95% = 0.33 - 0.94), and significant improvement in social functioning (WSA), Cohen’s d = .64, 95% (CI 95% = 0.33 - 0.95). These improvements were maintained at 6-month follow-up. Intention-to-treat analyses confirmed significant effects on depression and social functioning improvements (BDI: Cohen’s d = .30, CI 95% = 0.05 - 0.55; WSA: Cohen’s d = .36, CI 95% = 0.10 - 0.61). Moreover, a much higher percentage of patients in the intervention group experienced a significant reduction of depression symptoms (BDI: odds ratio [OR] = 6.8, CI 95% = 2.90 - 18.19) and recovered more often (OR

  6. Integrating Field Spectra and Worldview-2 Data for Grapevine Productivity in Different Irrigation Treatments

    NASA Astrophysics Data System (ADS)

    Maimaitiyiming, M.; Bozzolo, A.; Wulamu, A.; Wilkins, J. L.

    2015-12-01

    Precision farming requires high spectral, spatial and temporal resolution remote sensing data to detect plant physiological changes. The higher spatial resolution is particularly as important as the spectral resolution for crop monitoring. It is important to develop data integration techniques between field or airborne hyperspectral data with spaceborne broad band multispectral images for plant productivity monitoring. To investigate varying rootstock and irrigation interactions, different irrigation treatments are implemented in a vineyard experimental site either i) unirrigated ii) full replacement of evapotranspiration (ET) iii) irrigated at 50 % of the potential ET. In summer 2014, we collected leaf and canopy spectra of the vineyard using field spectroscopy along with other plant physiological and nutritional variables. In this contribution, we integrate the field spectra and the spectral wavelengths of WorldView-2 to develop a predictive model for plant productivity,i.e., fruit quality and yield. First, we upscale field and canopy spectra to WorldView-2 spectral bands using radiative transfer simulations (e.g., MODTRAN). Then we develop remote sensing techniques to quantify plant productivity in different scenarios water stress by identifying the most effective and sensitive wavelengths, and indices that are capable of early detection of plant health and estimation of crop nutrient status. Finally we present predictive models developed from partial least square regression (PLSR) for plant productivity using spectral wavelengths and indices derived from integrated field and satellite remote sensing data.

  7. Integration of microalgae systems at municipal wastewater treatment plants: implications for energy and emission balances.

    PubMed

    Menger-Krug, Eve; Niederste-Hollenberg, Jutta; Hillenbrand, Thomas; Hiessl, Harald

    2012-11-01

    Integrating microalgae systems (MAS) at municipal wastewater treatment plants (WWTPs) to produce of bioenergy offers many potential synergies. Improved energy balances provide a strong incentive for WWTPs to integrate MAS, but it is crucial that WWTPs maintain their barrier function to protect water resources. We perform a prospective analysis of energy and emission balances of a WWTP with integrated MAS, based on a substance flow analysis of the elements carbon (C), nitrogen (N), and phosphorus (P). These elements are the main ingredients of wastewater, and the key nutrients for algae growth. We propose a process design which relies solely on resources from wastewater with no external input of water, fertilizer or CO(2). The whole process chain, from cultivation to production of bioelectricity, takes place at the WWTP. Our results show that MAS can considerably improve energy balances of WWTPs without any external resource input. With optimistic assumptions, they can turn WWTPs into net energy producers. While intensive C recycling in MAS considerably improves the energy balance, we show that it also impacts on effluent quality. We discuss the importance of nonharvested biomass for effluent quality and highlight harvesting efficiency as key factor for energy and emission balances of MAS at WWTP. PMID:23050661

  8. Structural elucidation of sorghum lignins from an integrated biorefinery process based on hydrothermal and alkaline treatments.

    PubMed

    Sun, Shao-Long; Wen, Jia-Long; Ma, Ming-Guo; Sun, Run-Cang

    2014-08-13

    An integrated process based on hydrothermal pretreatment (HTP) (i.e., 110-230 °C, 0.5-2.0 h) and alkaline post-treatment (2% NaOH at 90 °C for 2.0 h) has been performed for the production of xylooligosaccharide, lignin, and digestible substrate from sweet sorghum stems. The yield, purity, dissociation mechanisms, structural features, and structural transformations of alkali lignins obtained from the integrated process were investigated. It was found that the HTP process facilitated the subsequent alkaline delignification, releasing lignin with the highest yield (79.3%) and purity from the HTP residue obtained at 190 °C for 0.5 h. All of the results indicated that the cleavage of the β-O-4 linkages and degradation of β-β and β-5 linkages occurred under the harsh HTP conditions. Depolymerization and condensation reactions simultaneously occurred at higher temperatures (≥ 170 °C). Moreover, the thermostability of lignin was positively related to its molecular weight, but was also affected by the inherent structures, such as β-O-4 linkages and condensed units. These findings will enhance the understanding of structural transformations of the lignins during the integrated process and maximize the potential utilizations of the lignins in a current biorefinery process. PMID:25090032

  9. An integrated approach to energy recovery from biomass and waste: Anaerobic digestion-gasification-water treatment.

    PubMed

    Milani, M; Montorsi, L; Stefani, M

    2014-07-01

    The article investigates the performance of an integrated system for the energy recovery from biomass and waste based on anaerobic digestion, gasification and water treatment. In the proposed system, the organic fraction of waste of the digestible biomass is fed into an anaerobic digester, while a part of the combustible fraction of the municipal solid waste is gasified. Thus, the obtained biogas and syngas are used as a fuel for running a cogeneration system based on an internal combustion engine to produce electric and thermal power. The waste water produced by the integrated plant is recovered by means of both forward and inverse osmosis. The different processes, as well as the main components of the system, are modelled by means of a lumped and distributed parameter approach and the main outputs of the integrated plant such as the electric and thermal power and the amount of purified water are calculated. Finally, the implementation of the proposed system is evaluated for urban areas with a different number of inhabitants and the relating performance is estimated in terms of the main outputs of the system. PMID:24946772

  10. One System Integrated Project Team Progress in Coordinating Hanford Tank Farms and the Waste Treatment Plant

    SciTech Connect

    Skwarek, Raymond J.; Harp, Ben J.; Duncan, Garth M.

    2013-12-18

    The One System Integrated Project Team (IPT) was formed at the Hanford Site in late 2011 as a way to improve coordination and itegration between the Hanford Tank Waste Treatment and Immobilization Plant (WTP) and the Tank Operations Contractor (TOC) on interfaces between the two projects, and to eliminate duplication and exploit opportunities for synergy. The IPT is composed of jointly staffed groups that work on technical issues of mutal interest, front-end design and project definition, nuclear safety, plant engineering system integration, commissioning, planning and scheduling, and environmental, safety, health and quality (ESH&Q) areas. In the past year important progress has been made in a number of areas as the organization has matured and additional opportunities have been identified. Areas covered in this paper include: Support for development of the Office of Envirnmental Management (EM) framework document to progress the Office of River Protection's (ORP) River Protection Project (RPP) mission; Stewardship of the RPP flowsheet; Collaboration with Savannah River Site (SRS), Savannah River National Laboratory (SRNL), and Pacific Northwest National Laboratory (PNNL); Operations programs integration; and, Further development of the waste acceptance criteria.

  11. Integrated Treatment and Storage Solutions for Solid Radioactive Waste at the Russian Shipyard Near Polyarny

    SciTech Connect

    Griffith, A.; Engoy, T.; Endregard, M.; Busmundrud, O.; Schwab, P.; Nazarian, A.; Krumrine, P.; Backe, S.; Gorin, S.; Evans, B.

    2002-02-27

    Russian Navy Yard No. 10 (Shkval), near the city of Murmansk, has been designated as the recipient for Solid Radioactive Waste (SRW) pretreatment and storage facilities under the Arctic Military Environmental Cooperation (AMEC) Program. This shipyard serves the Northern Fleet by servicing, repairing, and dismantling naval vessels. Specifically, seven nuclear submarines of the first and second generation and Victor class are laid up at this shipyard, awaiting defueling and dismantlement. One first generation nuclear submarine has already been dismantled there, but recently progress on dismantlement has slowed because all the available storage space is full. SRW has been placed in metal storage containers, which have been moved outside of the actual storage site, which increases the environmental risks. AMEC is a cooperative effort between the Russian Federation, Kingdom of Norway and the United States. AMEC Projects 1.3 and 1.4 specifically address waste treatment and storage issues. Various waste treatment options have been assessed, technologies selected, and now integrated facilities are being designed and constructed to address these problems. Treatment technologies that are being designed and constructed include a mobile pretreatment facility comprising waste assay, segregation, size reduction, compaction and repackaging operations. Waste storage technologies include metal and concrete containers, and lightweight modular storage buildings. This paper focuses on the problems and challenges that are and will be faced at the Polyarninsky Shipyard. Specifically, discussion of the waste quantities, types, and conditions and various site considerations versus the various technologies that are to be employed will be provided. A systems approach at the site is being proposed by the Russian partners, therefore integration with other ongoing and planned operations at the site will also be discussed.

  12. Integrating HIV care and treatment into primary healthcare: Are clinics equipped?

    PubMed Central

    Stellenberg, Ethelwynn L.

    2014-01-01

    Abstract Background The demand for HIV care and treatment services is increasing rapidly and strategies to sustain long-term care should be employed. The decentralisation and integration of HIV care and treatment services into primary healthcare (PHC) is vitally important in order to ensure optimal access to life-saving antiretroviral therapy and ongoing chronic care. Conversely, the PHC system is fraught with the current burden of disease. Setting The study was conducted in PHC clinics in the uMgungundlovu district, Kwa-Zulu Natal. Aim The objectives of the study were to assess whether PHC clinics were equipped to deliver integrated HIV services and to evaluate the availability of resources as well as support systems for HIV care and treatment in PHC clinics. Methods A quantitative, cross-sectional descriptive study was undertaken in 20 randomly-selected, eligible clinics in the uMgungundlovu district, KwaZulu-Natal, South Africa. An evaluation instrument was completed through observations and review of the clinic data records. Criteria were based on the World Health Organization's guide to indicators for antiretroviral programmes as well as South African HIV standards for PHC facilities. Results None of the clinics were equipped adequately. Clinics with a higher patient load had poorer scores, whilst clinics providing antiretroviral therapy were better equipped in terms of human resources and infrastructure. Conclusion HIV services are an essential part of primary healthcare and clinics need to be equipped adequately in order to render this service. It is unlikely that the over-burdened health system would be able to cope with an increased number of patients on antiretroviral therapy in the long term, whilst maintaining quality of services, without support being given to PHC clinics. PMID:26245407

  13. Nutrient removal and biogas upgrading by integrating freshwater algae cultivation with piggery anaerobic digestate liquid treatment.

    PubMed

    Xu, Jie; Zhao, Yongjun; Zhao, Guohua; Zhang, Hui

    2015-08-01

    An integrated approach that combined freshwater microalgae Scenedesmus obliquus (FACHB-31) cultivation with piggery anaerobic digestate liquid treatment was investigated in this study. The characteristics of algal growth, biogas production, and nutrient removal were examined using photobioreactor bags (PBRbs) to cultivate S. obliquus (FACHB-31) in digestate with various digestate dilutions (the concentration levels of 3200, 2200, 1600, 1200, 800, and 400 mg L(-1) chemical oxygen demand (COD)) during 7-day period. The effects of the level of pollutants on nutrient removal efficiency and CO2 removal process were investigated to select the optimum system for effectively upgrade biogas and simultaneously reduce the nutrient content in digestate. The treatment performance displayed that average removal rates of COD, total nitrogen (TN), total phosphorous (TP), and CO2 were 61.58-75.29, 58.39-74.63, 70.09-88.79, and 54.26-73.81 %, respectively. All the strains grew well under any the dilution treatments. With increased initial nutrient concentration to a certain range, the CO4 content (v/v) of raw biogas increased. Differences in the biogas enrichment of S. obliquus (FACHB-31) in all treatments mainly resulted from variations in biomass productivity and CO2 uptake. Notably, the diluted digestate sample of 1600 mg L(-1) COD provided an optimal nutrient concentration for S. obliquus (FACHB-31) cultivation, where the advantageous nutrient and CO2 removals, as well as the highest productivities of biomass and biogas upgrading, were revealed. Results showed that microalgal biomass production offered real opportunities to address issues such as CO2 sequestration, wastewater treatment, and biogas production. PMID:25808519

  14. Integrated chemical treatment of municipal wastewater using waste hydrogen peroxide and ultraviolet light

    NASA Astrophysics Data System (ADS)

    Bhatti, Zulfiqar Ahmed; Mahmood, Qaisar; Raja, Iftikhar Ahmad; Malik, Amir Haider; Rashid, Naim; Wu, Donglei

    Dilemmas like water shortage, rapid industrialization, growing human population and related issues have seriously affected human health and environmental sustainability. For conservation and sustainable use of our water resources, innovative methods for wastewater treatment are continuously being explored. Advance Oxidation Processes (AOPs) show a promising approach to meet specific objectives of municipal wastewater treatment (MWW). The MWW samples were pretreated with Al 2(SO 4) 4·8H 2O (Alum) at different doses 4, 8, 12-50 mg/L to enhance the sedimentation. The maximum COD removal was observed at alum treatments in range of 28-32 mg/L without increasing total dissolved solids (TDS). TDS were found to increase when the alum dose was increased from 32-40 mg/L. In the present study, the optimum alum dose of 30 mg/L for 3 h of sedimentation and subsequent integrated H 2O 2/UV treatment was applied (using 2.5 mL/L of 40% waste H 2O 2 and 35% fresh H 2O 2 separately). Organic and inorganic pollutants, contributing towards chemical oxygen demand (COD), biological oxygen demand (BOD), turbidity and total dissolved solids were degraded by H 2O 2/UV. About 93% COD, 90% BOD and 83% turbidity reduction occurred when 40% waste H 2O 2 was used. When using fresh H 2O 2, 63% COD, 68% BOD and 86% turbidity reduction was detected. Complete disinfection of coliform bacteria occurred by using 40% H 2O 2/UV. The most interesting part of this research was to compare the effectiveness of waste H 2O 2 with fresh H 2O 2. Waste H 2O 2 generated from an industrial process of disinfection was found more effective in the treatment of MWW than fresh 35% H 2O 2.

  15. Integrating Theory and Research: The Development of a Research-Based Treatment Program for Juvenile Male Sex Offenders

    ERIC Educational Resources Information Center

    Calley, Nancy G.

    2007-01-01

    A research-based treatment model designed to effectively address identified factors related to juvenile sexual offending behaviors is presented. Current research, theory, and national standards related to juvenile sexual offending are each explored with the treatment model reflecting an integration of these 3 components. The use of counseling…

  16. Integrated system for the treatment of oxides of nitrogen from flue gases

    SciTech Connect

    Sanjoy Barman; Ligy Philip

    2006-02-01

    A novel and effective system was developed for the complete treatment of NOx from flue gases. The system consisted of photocatalytic or ozone oxidation of NOx, followed by scrubbing and biological denitrification. Maximum photocatalytic oxidation of NOx was achieved while using powdered TiO{sub 2} at a catalytic loading rate of 10 g/h, relative humidity of 50%, and a space time of 10 s. The used catalyst was regenerated and reused. A total of 72% of oxidized NO was recovered as HNO{sub 3}/HNO{sub 2} in the regeneration process. Stoichiometrically, 10% excess ozone was able to affect 100% oxidation of NO to NO{sub 2}. Presence of SO{sub 2} adversely influenced the oxidation of NO by ozone. The scrubbing of NO was effective with distilled water. Heterotrophic denitrifiers were able to denitrify the leachate with an efficiency of 90%, using sewage (COD 450 mg/L) as electron donor. The new integrated treatment system seems to be a promising alternative for complete treatment of NOx from flue gases. 29 refs., 7 figs., 2 tabs.

  17. Performance evaluation of vinasse treatment plant integrated with physico-chemical methods.

    PubMed

    Ojha, Sanjay Kumar; Mishra, Snehasish; Kumar, Satish; Mohanty, Shakti Shankar; Sarkar, Biplab; Singh, Monika; Chaudhury, Gautam Roy

    2015-11-01

    With an objective to assess environmental management criteria of a vinasse treatment plant (VTP) and to evaluate the critical environmental parameters, a study was undertaken in a multi-product (packaged apple juice, distillery, brewery, packaged drinking water) brewery-cum-distillery unit. The facility with a volumetric loading rate of 11-15 kg COD m(-3).day, 3.6-4.5 h hydraulic retention time and 20 g l(-1) VSS had a scientifically managed technically sound effluent treatment system. While the water quality parameters were found within the acceptable limits, there was 99.07% reduction in BOD, from 43140.0 to 398.0 mg l(-1) and 98.61% reduction in COD from 98003.0 to 1357.0 mg l(-1). There was appreciable improvement in mixed liquor suspended solids (MLSS), mixed liquorvolatile suspended solids (MLVSS) and sludge volume index (SVI). A striking feature was the integrated aerobic-anaerobic highly efficient Up-flow Anaerobic Sludge Blanket (UASB) treatment for biodegradation and energy production that reduced energy and space needs, producing utilisable end-products and net savings on the operational cost. The end-point waste management included terminal products such as fertile sludge, cattle feed supplement, recyclable water and biogas. Vast lagoons with combined aerobic-anaerobic approaches, biogasification unit, sludge recovery, remediated irrigable water were the notable attributes. PMID:26688960

  18. [Research on integrated application of tumor magnetic induction hyperthermia treatment planning system and modern medical information systems].

    PubMed

    Zhuo, Zihan; Zhai, Weiming; Cai, Dongyang; Wang, Jie; Zhang, Xiaodong; Tang, Jintian

    2014-02-01

    Magnetic induction hyperthermia becomes a very important tumor treatment method at present. In order to ensure a successful operation, doctors should make hyperthermia treatment planning before surgery. Based on Integration Healthcare Enterprise (IHE) framework and Digital Imaging and Communications in Medcine (DICOM) standard, we proposed and carried out a network workflow integrated with modern medical information systems for the dissemination of information in magnetic induction hyperthermia like accurate accessing patient information and radiology image data, storing processed images, sharing and verifying hyperthermia reports. The results proved that our system could not only improve the efficiency of magnetic induction hyperthermia treatment planning, but also save medical resources and reduce labor costs. PMID:24804509

  19. Integrated monitoring technologies for the management of a Soil-Aquifer-Treatment (SAT) system

    NASA Astrophysics Data System (ADS)

    Kallioras, Andreas; Kofakis, Petros; Bumberger, Jan; Athanasiou, Georgios; Schimdt, Felix; Apostolopoulos, Georgios; Uzunoglou, Nikolaos; Dietrich, Peter; Schuth, Christoph

    2015-04-01

    Artificial recharge of groundwater has an important role to play in water reuse as treated wastewater effluent can be infiltrated into the ground for aquifer recharge. As the effluent moves through the soil and the aquifer, it undergoes significant quality improvements through physical, chemical, and biological processes in the underground environment. Collectively, these processes and the water quality improvement obtained are called soil-aquifer-treatment (SAT) or geopurification. The pilot site of Lavrion Technological & Cultural Park (LTCP) of the National Technical University of Athens (NTUA), involves the employment of plot infiltration basins at experimental scale, which will be using waters of impaired quality as a recharge source, and hence acting as a Soil-Aquifer-Treatment, SAT, system. Τhe LTCP site will be employed as a pilot SAT system complemented by new technological developments, which will be providing continuous monitoring of the quantitative and qualitative characteristics of infiltrating groundwater through all hydrologic zones (i.e. surface, unsaturated and saturated zone). This will be achieved by the development and installation of an integrated system of prototype sensing technologies, installed on-site, and offering a continuous evaluation of the performance of the SAT system. An integrated approach of the performance evaluation of any operating SAT system should aim at parallel monitoring of all hydrologic zones, proving the sustainability of all involved water quality treatment processes within unsaturated and saturated zone. Hence a prototype system of Time and Frequency Domain Reflectometry (TDR & FDR) sensors is developed and will be installed, in order to achieve continuous quantitative monitoring of the unsaturated zone through the entire soil column down to significant depths below the SAT basin. Additionally, the system contains two different radar-based sensing systems that will be offering (i) identification of preferential

  20. Integrated monitoring technologies for the management of a Soil-Aquifer-Treatment (SAT) system.

    NASA Astrophysics Data System (ADS)

    Papadopoulos, Alexandros; Kallioras, Andreas; Kofakis, Petros; Bumberger, Jan; Schmidt, Felix; Athanasiou, Georgios; Uzunoglou, Nikolaos; Amditis, Angelos; Dietrich, Peter

    2016-04-01

    Artificial recharge of groundwater has an important role to play in water reuse as treated wastewater effluent can be infiltrated into the ground for aquifer recharge. As the effluent moves through the soil and the aquifer, it undergoes significant quality improvements through physical, chemical, and biological processes in the underground environment. Collectively, these processes and the water quality improvement obtained are called soil-aquifer-treatment (SAT) or geopurification. The pilot site of Lavrion Technological & Cultural Park (LTCP) of the National Technical University of Athens (NTUA), involves the employment of plot infiltration basins at experimental scale, which will be using waters of impaired quality as a recharge source, and hence acting as a Soil-Aquifer-Treatment, SAT, system. Τhe LTCP site will be employed as a pilot SAT system complemented by new technological developments, which will be providing continuous monitoring of the quantitative and qualitative characteristics of infiltrating groundwater through all hydrologic zones (i.e. surface, unsaturated and saturated zone). This will be achieved by the development and installation of an integrated system of prototype sensing technologies, installed on-site, and offering a continuous evaluation of the performance of the SAT system. An integrated approach of the performance evaluation of any operating SAT system should aim at parallel monitoring of all hydrologic zones, proving the sustainability of all involved water quality treatment processes within unsaturated and saturated zone. Hence a prototype system of Time and Frequency Domain Reflectometry (TDR & FDR) sensors is developed and will be installed, in order to achieve continuous quantitative monitoring of the unsaturated zone through the entire soil column down to significant depths below the SAT basin. Additionally, the system contains two different radar-based sensing systems that will be offering (i) identification of preferential

  1. Hole injection and dielectric breakdown in 6H-SiC and 4H-SiC metal-oxide-semiconductor structures during substrate electron injection via Fowler-Nordheim tunneling

    NASA Astrophysics Data System (ADS)

    Samanta, Piyas; Mandal, Krishna C.

    2015-12-01

    Hole injection into silicon dioxide (SiO2) films (8-40 nm thick) is investigated for the first time during substrate electron injection via Fowler-Nordheim (FN) tunneling in n-type 4H- and 6H-SiC (silicon carbide) based metal-oxide-semiconductor (MOS) structures at a wide range of temperatures (T) between 298 and 598 K and oxide electric fields Eox from 6 to 10 MV/cm. Holes are generated in heavily doped n-type polycrystalline silicon (n+ -polySi) gate serving as the anode as well as in the bulk silicon dioxide (SiO2) film via hot-electron initiated band-to-band ionization (BTBI). In absence of oxide trapped charges, it is shown that at a given temperature, the hole injection rates from either of the above two mechanisms are higher in n-4H-SiC MOS devices than those in n-6H-SiC MOS structures when compared at a given Eox and SiO2 thickness (tox). On the other hand, relative to n-4H-SiC devices, n-6H-SiC structures exhibit higher hole injection rates for a given tox during substrate electron injection at a given FN current density je,FN throughout the temperature range studied here. These two observations clearly reveal that the substrate material (n-6H-SiC and n-4H-SiC) dependencies on time-to-breakdown (tBD) or injected charge (electron) to breakdown (QBD) of the SiO2 film depend on the mode of FN injections (constant field/voltage and current) from the substrate which is further verified from the rigorous device simulation as well.

  2. Integrated modelling of transitions in mechanical conditions during casting and heat treatment

    NASA Astrophysics Data System (ADS)

    Thorborg, J.; Klinkhammer, J.; Heitzer, M.

    2015-06-01

    The mechanical material behaviour of a cast component changes significantly during casting and heat treatment. The big difference in temperature levels during the different process steps causes different deformation mechanisms to be active. The thermal gradients promote transient stresses that can lead to inelastic deformations, residual stresses and in some cases to defects in the final part. It is a big challenge to make a reasonable transition in the mechanical model, and hence material data, when modelling several different coupled process steps. It is important to use an integrated approach where the transition is included in the full load history of the part. When industrial examples are considered, the sequence of process steps typically also changes the thermal and mechanical boundary conditions significantly e.g. going from being mechanically constrained during casting to being supported point-wise during the heat treatment process. This change includes mapping of results and obtaining equilibrium in a new global system, where the further reaction forces from the supports must be handled with contact conditions to e.g. predict deformations due to gravity during solution heat treatment. The work presented in this paper is focused on modelling the mechanical fields, taking into account the changes in the mechanical material model at different temperature levels, and the transition in mechanical behaviour when the microstructure is changing during the different steps of the heat treatment process. The approach used is based on a unified model where creep effects are considered at high temperature and rate effects are included in general during cooling. Proposals are made to include cooling rate sensitivity, annealing and precipitation hardening via modification of mechanical properties in the different process steps.

  3. An endoscope with integrated transparent bioelectronics and theranostic nanoparticles for colon cancer treatment

    PubMed Central

    Lee, Hyunjae; Lee, Youngsik; Song, Changyeong; Cho, Hye Rim; Ghaffari, Roozbeh; Choi, Tae Kyu; Kim, Kyung Hoon; Lee, Young Bum; Ling, Daishun; Lee, Hyuk; Yu, Su Jong; Choi, Seung Hong; Hyeon, Taeghwan; Kim, Dae-Hyeong

    2015-01-01

    The gastrointestinal tract is a challenging anatomical target for diagnostic and therapeutic procedures for bleeding, polyps and cancerous growths. Advanced endoscopes that combine imaging and therapies within the gastrointestinal tract provide an advantage over stand-alone diagnostic or therapeutic devices. However, current multimodal endoscopes lack the spatial resolution necessary to detect and treat small cancers and other abnormalities. Here we present a multifunctional endoscope-based interventional system that integrates transparent bioelectronics with theranostic nanoparticles, which are photoactivated within highly localized space near tumours or benign growths. These advanced electronics and nanoparticles collectively enable optical fluorescence-based mapping, electrical impedance and pH sensing, contact/temperature monitoring, radio frequency ablation and localized photo/chemotherapy, as the basis of a closed-loop solution for colon cancer treatment. In vitro, ex vivo and in vivo experiments highlight the utility of this technology for accurate detection, delineation and rapid targeted therapy of colon cancer or precancerous lesions. PMID:26616435

  4. Designing a concept for an IT-infrastructure for an integrated research and treatment center.

    PubMed

    Stäubert, Sebastian; Winter, Alfred; Speer, Ronald; Löffler, Markus

    2010-01-01

    Healthcare and medical research in Germany are heading to more interconnected systems. New initiatives are funded by the German government to encourage the development of Integrated Research and Treatment Centers (IFB). Within an IFB new organizational structures and infrastructures for interdisciplinary, translational and trans-sectoral working relationship between existing rigid separated sectors are intended and needed. This paper describes how an IT-infrastructure of an IFB could look like, what major challenges have to be solved and what methods can be used to plan such a complex IT-infrastructure in the field of healthcare. By means of project management, system analyses, process models, 3LGM2-models and resource plans an appropriate concept with different views is created. This concept supports the information management in its enterprise architecture planning activities and implies a first step of implementing a connected healthcare and medical research platform. PMID:20841898

  5. Integrated bacterial process for the treatment of a spent nickel catalyst.

    PubMed

    Bosio, V; Viera, M; Donati, E

    2008-06-15

    Integrated biological processes involving the dissolution and subsequent precipitation have been used for the treatment of the spent material from the hydrogenation of vegetable oil containing a high-level of nickel. Our results show that nickel was successfully leached using Acidithiobacillus thiooxidans. The percentages of nickel leached using A. thiooxidans were higher than those obtained with dilute sulphuric acid solutions. Due to the physical characteristics of the residue, the best results were obtained when the leaching process was carried out using sulphuric acid biogenerated by an A. thiooxidans biofilm. The recovery of nickel from the leachates was performed at room temperature by precipitating with sulphide generated by Desulfovibrio cells. Indirect precipitation using sulphide generated in Desulfovibrio sp. cultures allowed the recovery of nickel as the very insoluble nickel sulphide. PMID:18079054

  6. Integrated surgical protocol for the treatment of the infected diabetic foot.

    PubMed

    Caravaggi, C

    2012-02-01

    Diabetes is a chronic disease with a worldwide increasing trend. Feet complication, closely related to neuropathy and obstructive peripheral vascular disease, are responsible for more than 1 million of leg amputations every year. Foot infection can dramatically improve the risk of amputation. Although many ulcer classification systems have been proposed to stratify the severity of infectious process the problem of the definition of a correct therapeutic approach to different clinical pictures still remains unresolved. A diabetic foot triage and an integrated surgical protocol are proposed to try identifying a diagnostic flowchart and a step-by-step surgical protocol that can be applied in the treatment of diabetic foot infection. Goals and technical aspects of emergent and elective surgical procedures in diabetic foot are analysed to evaluate critical aspects and to suggest proper surgical choices. PMID:22231526

  7. Tracing pharmaceuticals in a municipal plant for integrated wastewater and organic solid waste treatment.

    PubMed

    Jelic, Aleksandra; Fatone, Francesco; Di Fabio, Silvia; Petrovic, Mira; Cecchi, Franco; Barcelo, Damia

    2012-09-01

    The occurrence and removal of 42 pharmaceuticals, belonging to different therapeutic groups (analgesics and anti-inflammatory drugs, anti-ulcer agent, psychiatric drugs, antiepileptic drug, antibiotics, ß-blockers, diuretics, lipid regulator and cholesterol lowering statin drugs and anti-histamines), were studied in the wastewater and sewage sludge trains of a full scale integrated treatment plant. The plant employs a biological nutrient removal (BNR) process for the treatment of municipal wastewater, and a single-stage mesophilic anaerobic co-digestion for the treatment of wasted activated sludge mixed with the organic fraction of municipal solid waste (OFMSW), followed by a short-cut nitrification-denitrification of the anaerobic supernatant in a sequential batch reactor. Influent and effluent wastewater, as well as thickened, digested and treated sludge were sampled and analyzed for the selected pharmaceuticals in order to study their presence and fate during the treatment. Twenty three compounds were detected in influent and effluent wastewater and eleven in sludge. Infiltration of groundwater in the sewer system led to a dilution of raw sewage, resulting in lower concentrations in wastewater (up to 0.7 μg/L in influent) and sludge (70 ng/g d.w.). Due to the dilution, overall risk quotient for the mixture of pharmaceuticals detected in effluent wastewater was less than one, indicating no direct risk for the aquatic environment. A wide range of removal efficiencies during the treatment was observed, i.e. <20% to 90%. The influent concentrations of the target pharmaceuticals, as polar compounds, were undoubtedly mostly affected by BNR process in the wastewater train, and less by anaerobic-co-digestion. Mass balance calculations showed that less than 2% of the total mass load of the studied pharmaceuticals was removed by sorption. Experimentally estimated distribution coefficients (<500 L/kg) also indicated that the selected pharmaceuticals preferably remain in

  8. Acupuncture in Uganda: A Research Letter on the Integration of Acupuncture With Conventional Biomedical Treatments

    PubMed Central

    Kirschner, Kathia; Mandell, Richard; Knowlton, Janelle; Romeo, Melissa J.

    2014-01-01

    The PanAfrican Acupuncture Project (PAAP) was created in 2001 and is a volunteer-based not-for-profit training organization. It encourages community empowerment and wellness through training local healthcare providers how to use simple, effective acupuncture protocols to treat the symptoms of HIV/ AIDS, malaria, tuberculosis, and other chronic conditions. A manual explains the theory of acupuncture and the techniques associated with it in clear and simple terms with specific acupuncture protocols associated with the signs and symptoms of illnesses commonly seen in Uganda. PAAP maintains contact with the trainees to provide ongoing support through: (1) three week-long meetings per year, (2) ongoing contact with the PAAP local coordinator, and (3) electronic communications including email, text messaging, and Facebook communication. A primary focus is to help integrate acupuncture into the local context and current public-health system. This is accomplished by working with local governmental and nongovernmental agencies and healthcare facilities to improve access to and effectiveness of care through collaboration with Western and traditional healthcare modalities. The integration of acupuncture and other traditional complementary and alternative medicines (TCAMs) in the international public health sector at the level of local health workers can increase access to treatment in a sustainable manner while also building the confidence and self-worth of the public health-care practitioners. PMID:25105080

  9. Acupuncture in Uganda: a research letter on the integration of acupuncture with conventional biomedical treatments.

    PubMed

    Kirschner, Kathia; Mandell, Richard; Knowlton, Janelle; Romeo, Melissa J; Conboy, Lisa

    2014-07-01

    The PanAfrican Acupuncture Project (PAAP) was created in 2001 and is a volunteer-based not-for-profit training organization. It encourages community empowerment and wellness through training local healthcare providers how to use simple, effective acupuncture protocols to treat the symptoms of HIV/ AIDS, malaria, tuberculosis, and other chronic conditions. A manual explains the theory of acupuncture and the techniques associated with it in clear and simple terms with specific acupuncture protocols associated with the signs and symptoms of illnesses commonly seen in Uganda. PAAP maintains contact with the trainees to provide ongoing support through: (1) three week-long meetings per year, (2) ongoing contact with the PAAP local coordinator, and (3) electronic communications including email, text messaging, and Facebook communication. A primary focus is to help integrate acupuncture into the local context and current public-health system. This is accomplished by working with local governmental and nongovernmental agencies and healthcare facilities to improve access to and effectiveness of care through collaboration with Western and traditional healthcare modalities. The integration of acupuncture and other traditional complementary and alternative medicines (TCAMs) in the international public health sector at the level of local health workers can increase access to treatment in a sustainable manner while also building the confidence and self-worth of the public health-care practitioners. PMID:25105080

  10. Systems Pharmacology Dissection of the Integrated Treatment for Cardiovascular and Gastrointestinal Disorders by Traditional Chinese Medicine

    PubMed Central

    Zhang, Wenjuan; Tao, Qin; Guo, Zihu; Fu, Yingxue; Chen, Xuetong; Shar, Piar Ali; Shahen, Mohamed; Zhu, Jinglin; Xue, Jun; Bai, Yaofei; Wu, Ziyin; Wang, Zhenzhong; Xiao, Wei; Wang, Yonghua

    2016-01-01

    Though cardiovascular diseases (CVDs) and gastrointestinal disorders (GIDs) are different diseases associated with different organs, they are highly correlated clinically. Importantly, in Traditional Chinese Medicine (TCM), similar treatment strategies have been applied in both diseases. However, the etiological mechanisms underlying them remain unclear. Here, an integrated systems pharmacology approach is presented for illustrating the molecular correlations between CVDs and GIDs. Firstly, we identified pairs of genes that are associated with CVDs and GIDs and found that these genes are functionally related. Then, the association between 115 heart meridian (HM) herbs and 163 stomach meridian (SM) herbs and their combination application in Chinese patent medicine was investigated, implying that both CVDs and GIDs can be treated by the same strategy. Exemplified by a classical formula Sanhe Decoration (SHD) treating chronic gastritis, we applied systems-based analysis to introduce a drug-target-pathway-organ network that clarifies mechanisms of different diseases being treated by the same strategy. The results indicate that SHD regulated several pathological processes involved in both CVDs and GIDs. We experimentally confirmed the predictions implied by the effect of SHD for myocardial ischemia. The systems pharmacology suggests a novel integrated strategy for rational drug development for complex associated diseases. PMID:27597117