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Sample records for nordheim integral treatment

  1. Theory of electron emission in high fields from atomically sharp emitters: Validity of the Fowler-Nordheim equation

    NASA Astrophysics Data System (ADS)

    Cutler, P. H.; He, Jun; Miller, J.; Miskovsky, N. M.; Weiss, B.; Sullivan, T. E.

    1993-04-01

    Field emission from metallic emitters is generally described by the Fowler-Nordheim [F-N] theory, which is based on a planar model of the tip with a classical image correction. Within the free electron model and the WKB approximation, the planar tip model leads to the well-known Fowler-Nordheim equation, which predicts that a plot of log J/F 2 versus 1/F, where J is the current density and F, the field, should be a straight line within the narrow range of field strengths of typical field emission experiments, 3 - 5V/nm. This has been experimentally confirmed for conventional emitters, (i.e., electrolytically etched tips with radii ⪆50 nm). Field emitters fabricated with today's new techniques are much sharper with radii of curvature of the order of nm's or even the size of a single atom. Hence, the local geometry of the tip may become an important factor in the electron emission process. To investigate the effects of the shape and/or size on emission, the authors, in a recent series of papers, studied the dependence of the current-voltage characteristics on the local geometry of pointed emitters. It was found that the calculated results, plotted as log J/V 2 vs. 1/V, do not exhibit the straight line behavior predicted by the Fowler-Nordheim theory. In addition, there is a dramatic increase in the tunneling current for a fixed external bias, V, relative to the Fowler-Nordheim result for a planar model of the tip with the same bias voltage. Using the exact current integral additional results have been obtained exhibiting the effects of emitter curvature on field electron energy distributions and on electron emission in high fields and temperatures. These results continue to differ with the predictions of the Fowler-Nordheim equation for the same emitter models. Therefore, the adequacy of a β-factor in the conventional planar model Fowler-Nordheim equation to account for emitter curvature is examined. It is demonstrated that even a β-modified Fowler-Nordheim

  2. Fowler-Nordheim characteristics of electron irradiated MOS capacitors

    SciTech Connect

    Candelori, A.; Paccagnella, A.; Cammarata, M.; Ghidini, G.; Fuochi, P.G.

    1998-12-01

    MOS capacitors with 8 nm thick oxides have been irradiated by an 8 MeV LINAC electron beam. C-V and I-V measurements have shown a positive trapped charge, higher for irradiation performed under negative gate bias, as a consequence of preferential charge recombination at the cathodic interface. No saturation of the positive trapped charge is measured up to 20 Mrad(Si). Neutral defects induced by irradiation have been studied, by performing positive and negative Fowler-Nordheim injection. The distribution of neutral defects is similar to that of trapped holes, indicating a correlation between trapped holes and neutral defects. Electrical stresses performed after irradiation have shown that the accumulation kinetics of oxide defects is similar in both unirradiated and irradiated devices.

  3. Fowler-Nordheim theory for a spherical emitting surface.

    PubMed

    Edgcombe, C J

    2003-01-01

    In tests on a field emitter whose dimensions and work function were known, Fowler-Nordheim (F-N) theory as usually stated for a planar emitter was found to give poor agreement with observations. The effect of curvature of the emitting surface has been modelled by including (a) non-linear variation of potential with distance from the surface; (b) the consequent changes in the exponent and pre-exponential terms in the F-N expression for current; and (c) the variation of current density over the surface, modelled by an effective solid angle. Application of the resulting expression to the measured data gives estimates for apex radius which agree much more closely with the measured value than the value from planar theory does. PMID:12535544

  4. 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…

  5. Analysis of the trapping characteristics of silicon dioxide after Fowler-Nordheim degradation

    NASA Astrophysics Data System (ADS)

    Papadas, C.; Morfouli, P.; Ghibaudo, G.; Pananakakis, G.

    1991-12-01

    An analysis of the trapping characteristics of silicon dioxide (SiO 2) subjected to Fowler-Nordheim degradation is presented. Based on the Fowler-Nordheim threshold and flat-band voltage shifts, the total charge trapped in the oxide ( Qox) and the centroid ( overlinex) of the trapped charge distribution is extracted while taking into account the charge stored in the fast Si-SiO 2 interface states as a function of the Fowler-Nordheim injection dose. Using qausi-first-order kinetic equations the capture cross sections ( σi) and densities ( Nti) of the oxide bulk traps are also determined.

  6. 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.

  7. Generalized Fowler-Nordheim Theory of Field Emission of Carbon Nanotubes

    NASA Astrophysics Data System (ADS)

    Liang, Shi-Dong; Chen, Lu

    2008-07-01

    Based on the low-energy band structure of carbon nanotubes (CNs), we develop a generalized Fowler-Nordheim theory of the CN field emission, in which the behavior of the current-voltage (I-V) characteristics depends on the electric field and the diameter of the CNs. This formalism reveals the key differences of field emission between conventional bulk metallic emitters and low-dimensional emitters and gives a clear physical understanding of the non-Fowler-Nordheim feature of the I-V characteristics of the CN field emission.

  8. Generalized Fowler-Nordheim theory of field emission of carbon nanotubes.

    PubMed

    Liang, Shi-Dong; Chen, Lu

    2008-07-11

    Based on the low-energy band structure of carbon nanotubes (CNs), we develop a generalized Fowler-Nordheim theory of the CN field emission, in which the behavior of the current-voltage (I-V) characteristics depends on the electric field and the diameter of the CNs. This formalism reveals the key differences of field emission between conventional bulk metallic emitters and low-dimensional emitters and gives a clear physical understanding of the non-Fowler-Nordheim feature of the I-V characteristics of the CN field emission. PMID:18764229

  9. IMPACT OF TREATMENT INTEGRITY ON INTERVENTION EFFECTIVENESS

    PubMed Central

    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 failures and the efficacy of behavioral interventions. Avenues for future research are provided. PMID:22844155

  10. 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…

  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. 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.

  13. Complementary and integrative treatments: adenotonsillar disease.

    PubMed

    Billings, Kathleen R; Maddalozzo, John

    2013-06-01

    The purpose of this article is to familiarize the otolaryngologist with complementary and integrative treatment options for the management of sore throat and tonsillitis. A review of the available literature will provide insight into available treatment options with these therapies. Current medical and surgical approaches to therapy for adenotonsillar disease will be reviewed.

  14. Integrating spirituality into alcohol treatment.

    PubMed

    Delaney, Harold D; Forcehimes, Alyssa A; Campbell, William P; Smith, Bruce W

    2009-02-01

    Spirituality is presumed by millions of Americans to be directly relevant to problems of alcohol abuse. We summarize findings regarding the role of religion and spirituality in the prevention and treatment of substance abuse and present a case illustration. We also consider mechanisms responsible for these effects. We offer advice about why, by whom, and how religion and spirituality should be discussed with clients with substance use disorders. In a recent clinical trial, therapists trained in a client-centered approach to facilitate exploration of spirituality fostered clients' use of spiritual practices. We suggest that the therapist's ability to skillfully engage clients in a discussion of spirituality is largely determined by how the therapist balances the dual roles of authoritative expert and evocative facilitator.

  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. Integrating Primary Medical Care With Addiction Treatment

    PubMed Central

    Weisner, Constance; Mertens, Jennifer; Parthasarathy, Sujaya; Moore, Charles; Lu, Yun

    2010-01-01

    Context The prevalence of medical disorders is high among substance abuse patients, yet medical services are seldom provided in coordination with substance abuse treatment. Objective To examine differences in treatment outcomes and costs between integrated and independent models of medical and substance abuse care as well as the effect of integrated care in a subgroup of patients with substance abuse–related medical conditions (SAMCs). Design Randomized controlled trial conducted between April 1997 and December 1998. Setting and Patients Adult men and women (n=592) who were admitted to a large health maintenance organization chemical dependency program in Sacramento, Calif. Interventions Patients were randomly assigned to receive treatment through an integrated model, in which primary health care was included within the addiction treatment program (n=285), or an independent treatment-as-usual model, in which primary care and substance abuse treatment were provided separately (n=307). Both programs were group based and lasted 8 weeks, with 10 months of aftercare available. Main Outcome Measures Abstinence outcomes, treatment utilization, and costs 6 months after randomization. Results Both groups showed improvement on all drug and alcohol measures. Overall, there were no differences in total abstinence rates between the integrated care and independent care groups (68% vs 63%, P=.18). For patients without SAMCs, there were also no differences in abstinence rates (integrated care, 66% vs independent care, 73%; P=.23) and there was a slight but nonsignificant trend of higher costs for the integrated care group ($367.96 vs $324.09, P=.19). However, patients with SAMCs (n=341) were more likely to be abstinent in the integrated care group than the independent care group (69% vs 55%, P=.006; odds ratio [OR], 1.90; 95% confidence interval [CI], 1.22-2.97). This was true for both those with medical (OR, 3.38; 95% CI, 1.68-6.80) and psychiatric (OR, 2.10; 95% CI, 1

  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. Modifications of Fowler-Nordheim injection characteristics in {gamma} irradiated MOS devices

    SciTech Connect

    Scarpa, A.; Paccagnella, A.; Montera, F.; Candelori, A.; Ghibaudo, G.; Pananakakis, G.; Fuochi, P.G.

    1998-06-01

    In this work the authors have investigated how gamma irradiation affects the tunneling conduction mechanism of a 20 nm thick oxide in MOS capacitors. The radiation induced positive charge is rapidly compensated by the injected electrons, and does not impact the gate current under positive injection after the first current-voltage measurement. Only a transient stress induced leakage current at low gate bias is observed. Instead, a radiation induced negative charge has been observed near the polysilicon gate, which enhances the gate voltage needed for Fowler-Nordheim conduction at negative gate bias. No time decay of this charge has been observed. Such charges slightly modify the trapping kinetics of negative charge during subsequent electrical stresses performed at constant current condition.

  19. Development of Fowler-Nordheim theory for a spherical field emitter

    NASA Astrophysics Data System (ADS)

    Edgcombe, C. J.

    2005-07-01

    Fowler-Nordheim (F-N) theory has been extended to use a potential distribution approximating that outside a hemisphere supported on a shank, instead of planar field as widely used hitherto. The extended theory includes an effective angle of emission and a supply factor (relative to free-electron supply) that can be calculated when other parameters are known. If single values of the F-N slope and intercept are available, compatible sets of parameters including emitter radius, surface field, solid angle of emission, and supply factor can be deduced. Specific values can be estimated for these parameters when the change of slope over the experimental range is known with sufficient accuracy.

  20. 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.

  1. From waste treatment to integrated resource management.

    PubMed

    Wilsenach, J A; Maurer, M; Larsen, T A; van Loosdrecht, M C M

    2003-01-01

    Wastewater treatment was primarily implemented to enhance urban hygiene. Treatment methods were improved to ensure environmental protection by nutrient removal processes. In this way, energy is consumed and resources like potentially useful minerals and drinking water are disposed of. An integrated management of assets, including drinking water, surface water, energy and nutrients would be required to make wastewater management more sustainable. Exergy analysis provides a good method to quantify different resources, e.g. utilisable energy and nutrients. Dilution is never a solution for pollution. Waste streams should best be managed to prevent dilution of resources. Wastewater and sanitation are not intrinsically linked. Source separation technology seems to be the most promising concept to realise a major breakthrough in wastewater treatment. Research on unit processes, such as struvite recovery and treatment of ammonium rich streams, also shows promising results. In many cases, nutrient removal and recovery can be combined, with possibilities for a gradual change from one system to another.

  2. Integrated odour modelling for sewage treatment works.

    PubMed

    Gostelow, P; Parsons, S A; Lovell, M

    2004-01-01

    Odours from sewage treatment works are a significant source of environmental annoyance. There is a need for tools to assess the degree of annoyance caused, and to assess strategies for mitigation of the problem. This is the role of odour modelling. Four main stages are important in the development of an odour problem. Firstly, the odorous molecules must be formed in the liquid phase. They must then transfer from the liquid to the gaseous phase. They are then transported through the atmosphere to the population surrounding the odour source, and are then perceived and assessed by that population. Odour modelling as currently practised tends to concentrate on the transportation of odorants through the atmosphere, with the other areas receiving less attention. Instead, odour modelling should consider each stage in an integrated manner. This paper describes the development of integrated odour models for annoyance prediction. The models describe the liquid-phase transformations and emission of hydrogen sulphide from sewage treatment processes. Model output is in a form suitable for integration with dispersion models, the predictions of which can in turn be used to indicate the probability of annoyance. The models have been applied to both hypothetical and real sewage treatment works cases. Simulation results have highlighted the potential variability of emission rates from sewage treatment works, resulting from flow, quality and meteorological variations. Emission rate variations can have significant effects on annoyance predictions, which is an important finding, as they are usually considered to be fixed and only meteorological variations are considered in predicting the odour footprint. Areas for further development of integrated odour modelling are discussed, in particular the search for improved links between analytical and sensory measurements, and a better understanding of dose/response relationships for odour annoyance.

  3. [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

  4. 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

  5. Fowler-Nordheim tunnelling current in an Mg/SiO 2/Si MOS structure

    NASA Astrophysics Data System (ADS)

    Sik, On Kong; Chee, Yee Kwok

    1994-01-01

    The Fowler-Nordheim tunnelling current in a Mg/SiO 2/Si structure has been studied. With suitable sintering of the sample at 260°C for 2 h, the Mg/SiO 2 barrier height is reduced from 2.16 to 1.22 eV. This may be the lowest barrier height so far reported on an MOS structure with flat surfaces and a metal layer which is stable in a normal ambient. The tunnelling field at a current density of 1 × 10 -7 A/cm 2 is reduced from 5 to 2.2 MV/cm after sintering. The highest tunnelling current density previously recorded before silicon dioxide breakdown is 1 A/cm 2 and the maximum recorded charge-to-breakdown obtained is 24 C/cm 2. The two figures compare favourably with the results of an Al-MOS or a polysilicon-MOS structures fabricated in the same manner. This work may be applied to the development of new EPROM or EEPROM devices. The reduced field lowers the requirement on the programming voltage and the enhanced tunnelling current density increases the programming speed, while the increment of charge-to-breakdown increases the number of allowable read/write cycles.

  6. 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…

  7. [Reflection on treatment of acquired immunodeficiency syndrome by integrative medicine].

    PubMed

    Wang, Dan-Ni

    2012-02-01

    The current situation of Chinese medicine and Western medicine treatment of acquired immunodeficiency syndrome (AIDS) has made the integrative medicine treatment of AIDS an important treatment strategy. Integrative medicine treatment of AIDS has made certain achievements in clinical research, basic research, and other aspects. It has good mass foundation and curative efficacy, as well as insufficiency. I hope integrative medicine can be brought into full play in the treatment of AIDS and make breakthrough progress.

  8. 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.

  9. 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…

  10. 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.

  11. A Systematic Framework for Addressing Treatment Integrity in School Settings

    ERIC Educational Resources Information Center

    Kupzyk, Sara; Shriver, Mark D.

    2016-01-01

    School psychologists are tasked with ensuring treatment integrity because the level of intervention implementation affects decisions about student progress. Treatment integrity includes multiple dimensions that may impact the effectiveness of an intervention including adherence, dosage, quality, and engagement. Unfortunately, treatment integrity…

  12. 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.

  13. 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

  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. 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…

  16. Complementary and integrative treatments: managing obstructive sleep apnea.

    PubMed

    Billings, Kathleen R; Maddalozzo, John

    2013-06-01

    This article familiarizes the otolaryngologist with potential integrative and complementary treatment options for obstructive sleep apnea syndrome. The authors discuss current medical and surgical regimens, and then provide a review of the current literature on integrative and complementary approaches for treatment of this disorder.

  17. 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,…

  18. 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…

  19. 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.

  20. 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…

  1. Integrated design of sewers and wastewater treatment plants.

    PubMed

    Vollertsen, J; Hvitved-Jacobsen, T; Ujang, Z; Talib, S A

    2002-01-01

    Sewer system design must be integrated with wastewater treatment plant design when moving towards a more sustainable urban wastewater management. This integration allows an optimization of the design of both systems to achieve a better and more cost-effective wastewater management. Hitherto integrated process design has not been an option because the tools to predict in-sewer wastewater transformations have been inadequate. In this study the WATS model--being a new and validated tool for in-sewer microbial process simulations--is presented and its application for integrated sewer and treatment plant design is exemplified. A case study on a Malaysian catchment illustrates this integration. The effects of centralization of wastewater treatment and the subsequently longer transport distances are addressed. The layout of the intercepting sewer is optimized to meet the requirements of different treatment scenarios.

  2. 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…

  3. Analysis of the effects of constant-current Fowler-Nordheim-tunneling injection with charge trapping inside the potential barrier

    NASA Astrophysics Data System (ADS)

    Lopez-Villanueva, J. A.; Jimenez-Tejada, J. A.; Cartujo, P.; Bausells, J.; Carceller, J. E.

    1991-10-01

    Charge trapping and the generation of interface traps in thermally grown SiO2 and its interface with silicon, produced by Fowler-Nordheim tunneling injection at low temperatures from highly doped Si substrates, have been investigated. The results that can be obtained with the constant-current-injection method, when a moderate amount of charge is trapped inside the potential barrier, have been analyzed. This has afforded information about the position of the charge trapped in the oxide. No increase in the interface-trap density has been produced immediately after injection at 77 K, but, as the temperature is raised after injection, the growing of a peak of interface states has been observed. This phenomenon had been reported to be produced as a consequence of a previous hole trapping but, in this case, this intermediate stage of positive-charge building has not been observed. This effect is discussed, taking into account published models.

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

    PubMed

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

    2015-08-01

    Sewage treatment, treated water treatment and sludge treatment are three basic units of an integrated sewage treatment system. This work assessed the influence of reusing or discharge of treated water and sludge landfill or compost on the sustainability of an integrated sewage treatment system using emergy analysis and newly proposed emergy indicators. This system's value included its environmental benefits and the products. Environmental benefits were the differences of the environmental service values before and after sewage treatment. Due to unavailability of data of the exchanged substance and energy in the internal system, products' values were attained by newly proposed substitution values. The results showed that the combination of sewage treatment, treated water reuse and sludge landfill had the strongest competitiveness, while the combination of sewage treatment, treated water reuse and earthworm compost was the most sustainable. Moreover, treated water reuse and earthworm compost were helpful for improving the sustainability of the integrated sewage treatment system. The quality of treated water and local conditions should be also considered when implementing the treated water reuse or discharge. The resources efficiency of earthworm compost unit needed to be further improved. Improved emergy indices were more suitable for integrated sewage treatment systems. PMID:26685613

  5. EFFECTS OF VIDEO MODELING ON TREATMENT INTEGRITY OF BEHAVIORAL INTERVENTIONS

    PubMed Central

    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 treatment integrity to 100% for all participants, and performance was maintained 1 week later. Teachers found video modeling to be more socially acceptable with performance feedback than alone, but rated both positively. PMID:21119903

  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. Integrated plant for treatment of liquid radwaste

    SciTech Connect

    Sen Gupta, S.K.

    1995-05-01

    In the early 1980`s, AECL Research, at its Chalk River Laboratories (CRL) site, built a Waste Treatment Centre for managing low-level radioactive aqueous liquid wastes. At present, two industrial liquid waste streams are being routinely treated. One stream originates from the central Decontamination Centre (DC), where reactor components, protective plastic clothing, and respirators are cleaned. The other Active Drain (AD) stream is produced from a large and diverse number of research laboratories and radioisotope production facilities. The two waste streams, totalling about 2500 m per year (0.66 million US gallons), are volume reduced by a combination of continuous crossflow microfiltration (MF), spiral wound reverse osmosis (SWRO), and tubular reverse osmosis (TRO) membrane technologies; two thin-film evaporators (TFE) are employed for (i) the final volume reduction step, and (ii) the subsequent solidification of evaporator bottom with bitumen for containment of the radioactivity.

  8. 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

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

    SciTech Connect

    Durrani, H.A.; Schmidt, L.J.; Erickson, T.A.; Sondreal, E.A.; Erjavec, J.; Steadman, E.N.; Fabrycky, W.J.; Wilson, J.S.; Musich, M.A.

    1996-07-01

    This report analyzes three systems engineering (SE) studies performed on integrated thermal treatment systems (ITTSs) and integrated nonthermal treatment systems (INTSs) for the remediation of mixed low-level waste (MLLW) stored throughout the US Department of Energy (DOE) weapons complex. The review was performed by an independent team of nine researchers from the Energy and Environmental Research Center (EERC), Science Applications International Corporation (SAIC), the Waste Policy Institute (WPI), and Virginia Tech (VT). The three studies reviewed were as follows: Integrated Thermal Treatment System Study, Phase 1--issued July 1994; Integrated Thermal Treatment System Study, Phase 2--issued February 1996; and Integrated Nonthermal Treatment System Study--drafted March 1996. The purpose of this review was to (1) determine whether the assumptions taken in the studies might bias the resulting economic evaluations of both thermal and nonthermal systems, (2) identify the critical areas of the studies that would benefit from further investigation, and (3) develop a standard template that could be used in future studies to produce sound SE applications.

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

    SciTech Connect

    1996-08-01

    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 three studies reviewed were as follows: Integrated Thermal Treatment System Study, Phase 1--issued July 1994; Integrated Thermal Treatment System Study, Phase 2--issued February 1996; and Integrated Nonthermal Treatment System Study--drafted March 1996. 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.

  11. 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.

  12. 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.

  13. Hanford Site waste treatment/storage/disposal integration

    SciTech Connect

    MCDONALD, K.M.

    1999-02-24

    In 1998 Waste Management Federal Services of Hanford, Inc. began the integration of all low-level waste, mixed waste, and TRU waste-generating activities across the Hanford site. With seven contractors, dozens of generating units, and hundreds of waste streams, integration was necessary to provide acute waste forecasting and planning for future treatment activities. This integration effort provides disposition maps that account for waste from generation, through processing, treatment and final waste disposal. The integration effort covers generating facilities from the present through the life-cycle, including transition and deactivation. The effort is patterned after the very successful DOE Complex EM Integration effort. Although still in the preliminary stages, the comprehensive onsite integration effort has already reaped benefits. These include identifying significant waste streams that had not been forecast, identifying opportunities for consolidating activities and services to accelerate schedule or save money; and identifying waste streams which currently have no path forward in the planning baseline. Consolidation/integration of planned activities may also provide opportunities for pollution prevention and/or avoidance of secondary waste generation. A workshop was held to review the waste disposition maps, and to identify opportunities with potential cost or schedule savings. Another workshop may be held to follow up on some of the long-term integration opportunities. A change to the Hanford waste forecast data call would help to align the Solid Waste Forecast with the new disposition maps.

  14. Use of Millikan-Lauritsen plots, rather than Fowler-Nordheim plots, to analyze field emission current-voltage data

    NASA Astrophysics Data System (ADS)

    Forbes, Richard G.

    2009-06-01

    In the late 1920s, two forms of data plot were used to analyze the current-voltage (i-V) data obtained in experiments on cold field electron emission (CFE). Millikan-Lauritsen (ML) plots have the form [ln{i } versus 1/V]; Fowler-Nordheim (FN) plots have the form [ln{i /V2} versus 1/V]. In both cases common logarithms may be used instead. For historical reasons, it has become customary to use FN plots; but recent mathematical developments in CFE theory made these historical reasons less valid than they formerly were. ML plots are in fact easier to understand and use, and are more flexible when it is wanted to make corrections for all physical sources of voltage dependence in the data, or to estimate uncertainties in derived parameter values when the precise forms of voltage dependences are not known. This paper summarizes historical and recent background and argues that ML plots should now replace FN plots as the basic method of analyzing CFE i-V data (or related data involving current densities and/or fields). A formula for the interpretation of ML plot slopes is presented and discussed, and examples are given of its use.

  15. 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.

  16. 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.

  17. 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…

  18. 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…

  19. A Treatment Integrity Analysis of Function-Based Intervention

    ERIC Educational Resources Information Center

    Wood, Brenna K.; Umbreit, John; Liaupsin, Carl J.; Gresham, Frank M.

    2007-01-01

    This study examined whether direct, interval-by-interval measures of treatment integrity would make it possible to distinguish whether equivocal intervention results could be attributed to the intervention itself, or to poor implementation. Josh, an eight-year-old 3rd grader, performed at or slightly above his peers' academically, yet engaged in…

  20. 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…

  1. An integrated blood volume pulse biofeedback system for migraine treatment.

    PubMed

    Lichstein, K L; Hoelscher, T J; Nickel, R; Hoon, P W

    1983-03-01

    A blood volume pulse (BVP) biofeedback system is described that integrates BVP amplitude to provide a signal appropriate for auditory feedback. In comparison to binary BVP feedback methods, this integrated system offers the advantages of continuous feedback and increased scoring ease. The validity of this system was established by correlating the integrated BVP output with trough-to-peak measurements of the raw BVP signal during unassisted relaxation and temporal BVP biofeedback with eight migraine headache patients. Within-subject correlations of the integrated and raw BVP outputs ranged from .82 to .98 (means = .95). Although the integrated method admits unwanted BVP changes in rate, correlation analyses showed this confound factor to be small. Increments in biofeedback training effects were observed during the treatment course. Substantive migraine relief was achieved by the end of treatment and therapeutic gains were maintained at 1-year follow-up. In conclusion, it appears that this method successfully presents continuous auditory feedback from an integrated BVP signal resulting in therapeutic benefits to migraineurs.

  2. 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

  3. 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.

  4. 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

  5. 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

  6. 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…

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

    PubMed

    Boisvert, Jennifer A; Harrell, W Andrew

    2015-02-01

    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

  8. 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

  9. 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.

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

    PubMed

    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 10(3) and 10(9). 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.

  11. 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).

  12. 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.

  13. 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

  14. Process modeling for the Integrated Thermal Treatment System (ITTS) study

    SciTech Connect

    Liebelt, K.H.; Brown, B.W.; Quapp, W.J.

    1995-09-01

    This report describes the process modeling done in support of the integrated thermal treatment system (ITTS) study, Phases 1 and 2. ITTS consists of an integrated systems engineering approach for uniform comparison of widely varying thermal treatment technologies proposed for treatment of the contact-handled mixed low-level wastes (MLLW) currently stored in the U.S. Department of Energy complex. In the overall study, 19 systems were evaluated. Preconceptual designs were developed that included all of the various subsystems necessary for a complete installation, from waste receiving through to primary and secondary stabilization and disposal of the processed wastes. Each system included the necessary auxiliary treatment subsystems so that all of the waste categories in the complex were fully processed. The objective of the modeling task was to perform mass and energy balances of the major material components in each system. Modeling of trace materials, such as pollutants and radioactive isotopes, were beyond the present scope. The modeling of the main and secondary thermal treatment, air pollution control, and metal melting subsystems was done using the ASPEN PLUS process simulation code, Version 9.1-3. These results were combined with calculations for the remainder of the subsystems to achieve the final results, which included offgas volumes, and mass and volume waste reduction ratios.

  15. 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.

  16. Frontal White Matter Integrity Predictors of Adult Alcohol Treatment Outcome

    PubMed Central

    Sorg, Scott F.; Taylor, Michael J.; Alhassoon, Omar M.; Gongvatana, Assawin; Theilmann, Rebecca J.; Frank, Lawrence R.; Grant, Igor

    2013-01-01

    Background Previous research has associated abnormalities in frontal lobe functioning with alcohol relapse. In this study, we used diffusion tensor imaging to investigate whether frontal white matter integrity measured at the start of treatment differs between persons with alcohol use disorders (AUD) who sustain treatment gains and those who return to heavy use after treatment. Methods Forty-five treatment-seeking AUD inpatients and 30 healthy control subjects were included in the study. Six months after completing treatment, 16 of the AUD participants had resumed heavy use (RHU) and 29 others remained abstinent or drank minimally (treatment sustainers [TS]). Voxel-wise group comparisons (TS vs. RHU) were performed on fractional anisotropy (FA), radial diffusivity (RD), and axial diffusivity maps generated from each subject’s diffusion tensor imaging scan at the start of treatment. Results We found significantly lower FA and significantly higher RD in the frontal lobes of the RHU group, relative to the TS group. The RHU group data are consistent with previous reports of abnormal frontal white matter tract abnormalities in persons with AUD. Conclusions It is possible that the lower FA and higher RD in the RHU group reflect microstructural injury to frontal circuitries, and these may underlie the reduced cognitive control amid heightened reward sensitivity associated with resumption of heavy drinking. PMID:22047719

  17. Treatment integrity in psychotherapy research: analysis of the studies and examination of the associated factors.

    PubMed

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

    2007-12-01

    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 predictors of their implementation. Randomized controlled trials of psychosocial interventions published in 6 influential psychological and psychiatric journals were reviewed and coded for treatment integrity implementation. Results indicate that investigations that systematically addressed treatment integrity procedures are virtually absent in the literature. Treatment integrity was adequately addressed for only 3.50% of the evaluated psychosocial interventions. Journal of publication and treatment approach predicted integrity implementation. Skill-building treatments (e.g., cognitive-behavioral) as compared with non-skill-building interventions (e.g., psychodynamic, nondirective counseling) were implemented with higher attention to integrity procedures. Guidelines for implementation of treatment integrity procedures need to be reevaluated.

  18. Mixed Waste Treatment Project: Computer simulations of integrated flowsheets

    SciTech Connect

    Dietsche, L.J.

    1993-12-01

    The disposal of mixed waste, that is waste containing both hazardous and radioactive components, is a challenging waste management problem of particular concern to DOE sites throughout the United States. Traditional technologies used for the destruction of hazardous wastes need to be re-evaluated for their ability to handle mixed wastes, and in some cases new technologies need to be developed. The Mixed Waste Treatment Project (MWTP) was set up by DOE`s Waste Operations Program (EM30) to provide guidance on mixed waste treatment options. One of MWTP`s charters is to develop flowsheets for prototype integrated mixed waste treatment facilities which can serve as models for sites developing their own treatment strategies. Evaluation of these flowsheets is being facilitated through the use of computer modelling. The objective of the flowsheet simulations is to provide mass and energy balances, product compositions, and equipment sizing (leading to cost) information. The modelled flowsheets need to be easily modified to examine how alternative technologies and varying feed streams effect the overall integrated process. One such commercially available simulation program is ASPEN PLUS. This report contains details of the Aspen Plus program.

  19. 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.

  20. 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

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. Combination and Integration of DPF-SCR After-treatment

    SciTech Connect

    Rappe, Kenneth G.; Lee, Jong H.; Stewart, Mark L.; Devarakonda, Maruthi N.; Maupin, Gary D.

    2012-01-08

    Exhaust after-treatment is considered an enabler for widespread implication of higher fuel efficient diesel engines. In the last decade extensive research has resulted in the development and advancement of many after-treatment technologies. However there are still many unanswered questions that relate to how these technologies can work together synergistically versus in opposition if intimately integrated with one another. It is anticipated that in the future there will be a need to minimize the volume and mass of after-treatment systems on ever increasingly more complex truck platforms. However, to-date research focused on combining technologies into an integrated system has been relatively sparse. With the inevitable need to consider how SCR and DPF technologies will function in synergy to reduce both NOx and PM, as well as how CO and hydrocarbons (HC) need to be managed, an intergraded investigation and approach is essentially mandatory. The determination of important synergies will require study both under steady-state and through transient conditions.

  6. Toward Treatment Integrity: Developing an Approach to Measure the Treatment Integrity of a Dialectical Behavior Therapy Intervention With Homeless Youth in the Community.

    PubMed

    McCay, Elizabeth; Carter, Celina; Aiello, Andria; Quesnel, Susan; Howes, Carol; Johansson, Bjorn

    2016-10-01

    The current paper discusses an approach to measuring treatment integrity of dialectical behavioral therapy (DBT) when implemented within two programs providing services to street-involved youth in the community. Measuring treatment integrity is a critical component of effective implementation of evidence-based interventions in clinical practice, since sound treatment integrity increases confidence in client outcomes and intervention replicability. Despite being an essential part of implementation science, few studies report on treatment integrity, with limited research addressing either measurement tools or maintenance of treatment integrity. To address the lack of available treatment integrity measures, researchers in the current study developed and piloted a treatment integrity measure which pertain to the individual and group components of DBT. A total of 20 recordings were assessed using the treatment integrity measure. Results indicate that the community agency staff (e.g. youth workers, social workers & nurses) implemented the intervention as intended; increasing confidence in the outcome variables, the staffs' training and the replicability of the intervention. This article offers one approach to addressing treatment integrity when implementing evidence-based interventions, such as DBT in a community setting, and discusses the need for effective and feasible integrity measures that can be adopted in order to strengthen mental health practice in community settings. PMID:27654239

  7. Toward Treatment Integrity: Developing an Approach to Measure the Treatment Integrity of a Dialectical Behavior Therapy Intervention With Homeless Youth in the Community.

    PubMed

    McCay, Elizabeth; Carter, Celina; Aiello, Andria; Quesnel, Susan; Howes, Carol; Johansson, Bjorn

    2016-10-01

    The current paper discusses an approach to measuring treatment integrity of dialectical behavioral therapy (DBT) when implemented within two programs providing services to street-involved youth in the community. Measuring treatment integrity is a critical component of effective implementation of evidence-based interventions in clinical practice, since sound treatment integrity increases confidence in client outcomes and intervention replicability. Despite being an essential part of implementation science, few studies report on treatment integrity, with limited research addressing either measurement tools or maintenance of treatment integrity. To address the lack of available treatment integrity measures, researchers in the current study developed and piloted a treatment integrity measure which pertain to the individual and group components of DBT. A total of 20 recordings were assessed using the treatment integrity measure. Results indicate that the community agency staff (e.g. youth workers, social workers & nurses) implemented the intervention as intended; increasing confidence in the outcome variables, the staffs' training and the replicability of the intervention. This article offers one approach to addressing treatment integrity when implementing evidence-based interventions, such as DBT in a community setting, and discusses the need for effective and feasible integrity measures that can be adopted in order to strengthen mental health practice in community settings.

  8. [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

  9. 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).

  10. 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…

  11. 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

  12. 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.

  13. 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

  14. The shared image guiding the treatment process. A precondition for integration of the treatment of schizophrenia.

    PubMed

    Aaltonen, J; Räkköläinen, V

    1994-04-01

    The aim of the study reported here was to develop psychotherapeutic in-patient treatment for acute schizophrenia, following the principles of a need-adapted approach. To improve the integration of experiences which hospital staff have with acutely psychotic patients and their families, systematic supervision sessions were organised. In these sessions, it was possible to achieve shared psychological images through while the whole staff could integrate patients' behaviour and symptoms, both symbolic and non-symbolic. Such an image was called 'the shared image guiding the treatment process' (SIGTP). The process of achieving the SIGTP was interpreted through Peircean semiotics, especially the concepts of indexical, iconic, and symbolical signs. An SIGTP was considered to have been achieved in the early phase of the supervision process in 32 of the 54 cases. For the patients, SIGTP and the need-adaptation connected with it meant achieving a more realistic and more functional ordering of their experiences.

  15. [Familial hypercholesterolemia: why screening, counselling and treatment should be integrated].

    PubMed

    Roeters van Lennep, Jeanine E; Visseren, Frank L J; Jira, Petr E

    2015-01-01

    Familial hypercholesterolemia (FH) is a monogenic autosomal dominant disorder. FH is the most common hereditary cause of raised serum cholesterol levels and is associated with an increased risk of premature cardiovascular disease (CVD). This disorder is known to have a genetic cause, and effective drug therapies exist for patients with FH. Successful cascade screening, within the framework of a national screening programme, gave the Netherlands an international role as model and pioneer as far as FH detection is concerned. With the ending of this screening programme as of 1 January 2014 the care for FH patients, including screening and counselling has had to be incorporated within the basic Dutch healthcare insurance system. It is essential that detection of FH should continue in as efficient and cost-effective a manner as possible. Our proposal is that this detection should be performed and co-ordinated by those treating patients with FH so that FH screening, counselling and treatment are integrated.

  16. A COMPARISON OF SENSORY INTEGRATIVE AND BEHAVIORAL THERAPIES AS TREATMENT FOR PEDIATRIC FEEDING DISORDERS

    PubMed Central

    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 integration for both children. The results are discussed in terms of the challenges of evaluating sensory-integration-based treatments, and the reasons why component analyses of multicomponent treatments like sensory integration are important. PMID:23060661

  17. Integrated chemical-biological treatment of benzo[a]pyrene

    SciTech Connect

    Zeng, Yu; Hong, P.K.A.; Wavrek, D.A.

    2000-03-01

    Benzo[a]pyrene of natural and anthropogenic sources is one of the toxic, mutagenic, polycyclic aromatic hydrocarbons (PAHs) listed as priority pollutants. This study focuses on an integrated treatment of benzo[a]pyrene involving sequential chemical oxidation and biological degradation. The objectives are to (1) provide mechanistic details in the ozone-mediated degradation of benzo[a]pyrene in the aqueous phase, (2) test the biodegradability of resultant intermediates, and (3) test the feasibility for the coupled chemical-biological treatment of the five-ring PAH. Batch and packed column reactors were used to examine the degradation pathways of benzo[a]pyrene subject to ozonation in the aqueous phase. After different ozonation times, samples containing reaction intermediates and byproducts from both reactors were collected, identified for organic contents, and further biologically inoculated to determine their biodegradability. The O{sub 3}-pretreated samples were incubated for 5, 10, 15, and 20 days; afterward biochemical oxygen demand (BOD), chemical oxygen demand (COD), and E. coli toxicity tests were conducted along with qualitative and quantitative determinations of benzo[a]pyrene, intermediates, and reaction products by GC/FID and GC/MS methods. Prevalent intermediates identified at different stages included ring-opened aldehydes, phthalic derivatives, and aliphatics. The degradation of benzo[a]pyrene is primarily initiated via O{sub 3}-mediated ring-opening, followed by O{sub 3} and hydroxyl radical fragmentation, and ultimately brought to complete mineralization primarily via hydroxyl radicals. Intermediates formed during chemical oxidation were biodegradable with a measured first-order rate constant (k{sub 0}) of 0.18 day{sup {minus}1}. The integrated chemical-biological system seems feasible for treating recalcitrant compounds, while pretreatment by chemical oxidation appears useful in promoting soluble intermediates from otherwise highly insoluble

  18. Integration of freshwater environmental policies and wastewater treatment plant management.

    PubMed

    Corominas, Lluís; Acuña, Vicenç; Ginebreda, Antoni; Poch, Manel

    2013-02-15

    In the last decade the political awareness of river water quality issues has grown substantially over the world and legislation is accordingly adapting. In the European Union (EU), two different directives regulate separately the characteristics of the discharged water and the chemical status of the receiving freshwater ecosystem. On the one hand, the characteristics of the urban effluents are regulated by the EU Directive 91/271/EEC, which defines limits on different elements set in the form of both static emission limits and minimum percentage load reductions. On the other hand, the characteristics of the receiving freshwater ecosystems are described in the EU Water Framework Directive (2000/60/EEC), which sets minimum 'good' chemical and ecological status in water bodies that should be achieved by 2015, and aims for an ecosystem-based management. With the support of an example, we show that there is a gap in these EU environmental policies leading to non-integrated management, which may result on adverse environmental and economical consequences. We believe that these policies should be updated and tuned to account for an integrated perspective, allowing a more efficient and sustainable management of wastewater treatment plants, maximizing the ecological, economical and social benefits of the system as a whole.

  19. 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

  20. 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

  1. 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.

  2. 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

  3. 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

  4. 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.

  5. Fowler-Nordheim tunneling and conduction-band discontinuity in GaAs/GaAsAl high electron mobility transistor structures

    NASA Astrophysics Data System (ADS)

    Smoliner, J.; Christanell, R.; Hauser, M.; Gornik, E.; Weimann, G.

    1987-06-01

    Oscillatory structure is observed in the dI/dV characteristics of conventional GaAs/GaAlAs high electron mobility transistor samples at liquid-helium temperature, which can be explained using a Fowler-Nordheim tunneling theory. The position of the oscillations allows a determination of the conduction-band discontinuity, and the depth of the deep donor levels in the GaAlAs for high aluminum concentrations. The fit of the data gives a value of Delta Ec/Delta Eg = 0.61 + or - 0.04 for aluminum concentration 30, 36, and 40 percent. The deep donor level in the GaAlAs was determined to be 130 meV below the conduction band.

  6. 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.

  7. 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.

  8. 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…

  9. 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

  10. 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

  11. 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.

  12. Making a Case for Treatment Integrity as a Psychosocial Treatment Quality Indicator for Youth Mental Health Care

    PubMed Central

    McLeod, Bryce D.; Southam-Gerow, Michael A.; Tully, Carrie B.; Rodríguez, Adriana; Smith, Meghan M.

    2013-01-01

    Measures of treatment integrity are needed to advance clinical research in general and are viewed as particularly relevant for dissemination and implementation research. Although some efforts to develop such measures are underway, a conceptual and methodological framework will help guide these efforts. The purpose of this article is to demonstrate how frameworks adapted from the psychosocial treatment, therapy process, healthcare, and business literatures can be used to address this gap. We propose that components of treatment integrity (i.e., adherence, differentiation, competence, alliance, client involvement) pulled from the treatment technology and process literatures can be used as quality indicators of treatment implementation and thereby guide quality improvement efforts in practice settings. Further, we discuss how treatment integrity indices can be used in feedback systems that utilize benchmarking to expedite the process of translating evidence-based practices to service settings. PMID:23935254

  13. 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.

  14. The perturbative approach to path integrals: A succinct mathematical treatment

    NASA Astrophysics Data System (ADS)

    Nguyen, Timothy

    2016-09-01

    We study finite-dimensional integrals in a way that elucidates the mathematical meaning behind the formal manipulations of path integrals occurring in quantum field theory. This involves a proper understanding of how Wick's theorem allows one to evaluate integrals perturbatively, i.e., as a series expansion in a formal parameter irrespective of convergence properties. We establish invariance properties of such a Wick expansion under coordinate changes and the action of a Lie group of symmetries, and we use this to study essential features of path integral manipulations, including coordinate changes, Ward identities, Schwinger-Dyson equations, Faddeev-Popov gauge-fixing, and eliminating fields by their equation of motion. We also discuss the asymptotic nature of the Wick expansion and the implications this has for defining path integrals perturbatively and nonperturbatively.

  15. 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…

  16. 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…

  17. Exploring the Relationship between Factors of Implementation, Treatment Integrity and Reading Fluency

    ERIC Educational Resources Information Center

    Henninger, Kira Liese

    2010-01-01

    Treatment integrity has always had a presence in research, but now more than ever must become a priority owing to the changes in Special Education Law. The present study intends to explore the relationship between factors of implementation, treatment integrity of intervention implementation, and reading fluency. Participants included students in…

  18. 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…

  19. 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…

  20. A Descriptive Evaluation of Long-Term Treatment Integrity

    ERIC Educational Resources Information Center

    Arkoosh, Maire Kathryn; Derby, K. Mark; Wacker, David P.; Berg, Wendy; McLaughlin, T. F.; Barretto, Anjali

    2007-01-01

    The validity of selecting treatment contingencies on the basis of the results obtained through functional analysis is well documented. However, a number of second-generation questions have emerged: For example, what are the parameters required to achieve desired treatment outcomes? More specifically, what is the degree of treatment integrity…

  1. 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.

  2. 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…

  3. 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

  4. When Timeout Works Some of the Time: The Importance of Treatment Integrity and Functional Assessment.

    ERIC Educational Resources Information Center

    Taylor, Jill; Miller, Michelle

    1997-01-01

    Describes a series of experiments designed to identify why the classroom use of timeouts sometimes failed. Results indicate that both treatment integrity and the function of student behavior problems were related to treatment success and failure. Discusses implications for the function of student behavior problems, treatment selection, and other…

  5. 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…

  6. 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

  7. 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…

  8. Behavioral naltrexone therapy: an integrated treatment for opiate dependence.

    PubMed

    Rothenberg, Jami L; Sullivan, Maria A; Church, Sarah H; Seracini, Angela; Collins, Eric; Kleber, Herbert D; Nunes, Edward V

    2002-12-01

    Treatment of opiate dependence with naltrexone has been limited by poor compliance. Behavioral Naltrexone Therapy (BNT) was developed to promote adherence to naltrexone and lifestyle changes supportive of abstinence, by incorporating components from empirically validated treatments, including Network Therapy with a significant other to monitor medication compliance, the Community Reinforcement Approach, and voucher incentives. An overview is presented of the BNT treatment manual. In an uncontrolled Stage I trial (N = 47), 19% completed the 6-month course of treatment. Retention was especially poor in the subsample of patients who were using methadone at baseline (N = 18; 39% completed 1 month, none completed 6 months), and more encouraging among heroin-dependent patients (N = 29; 65% completed 1 month, 31% completed 6 months). Thus, attrition continues to be a serious problem for naltrexone maintenance, although further efforts to develop interventions such as BNT are warranted. PMID:12495797

  9. 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...

  10. 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.

  11. 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…

  12. 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 ...

  13. 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…

  14. [Comments on treatment of severe acute respiratory syndrome by integrated traditional Chinese and western medicine].

    PubMed

    Wang, Xin-Lu; Zhou, Yong-Hong

    2003-07-01

    There are obvious advantages of the integrated traditional Chinese and western medicine on the treatment of severe acute respiratory syndrome (SARS). Combining the ancient and present literature with the special epidemic patterns, pathological changes and clinical symptoms of SARS, the paper discussed the methods of application of the integrated traditional Chinese and western medicine on the treatment of SARS, and some matters needing attention in clinic.

  15. 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

  16. 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…

  17. 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…

  18. RDX degradation using an integrated Fe(0)-microbial treatment approach.

    PubMed

    Wildman, M J; Alvarez, P J

    2001-01-01

    RDX is a persistent and highly mobile groundwater contaminant that represents a major remediation challenge at numerous munitions manufacturing and load-assemblage-package facilities. This work presents proof of concept that permeable reactive iron barriers might be a viable approach to intercept and degrade RDX plumes. Specifically, RDX was rapidly reduced in aquifier microcosms amended with Fe(0) powder, and in flow-through columns packed with steel wool. The rate and extent of RDX degradation in microcosms was enhanced by anaerobic bacteria that feed on cathodic hydrogen (i.e., H2 produced during anaerobic Fe(0) corrosion by water). Apparently, the hydrogenotrophic consortium that exploits Fe(0) corrosion as a metabolic niche participated in the further degradation of heterocyclic intermediates produced by the reaction of RDX with Fe(0). Reductive treatment of RDX with Fe(0) also reduced its toxicity to microorganisms and enhanced its subsequent biodegradability under either anaerobic or anaerobic conditions. Therefore, a combined or sequential Fe(0)-biological treatment approach might improve treatment efficiency.

  19. 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…

  20. 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.…

  1. 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…

  2. Community integration through therapeutic recreation: day-treatment patients compete in a softball league.

    PubMed

    Seilheimer, T; Lee, M

    1986-09-01

    A team of male psychiatric patients drawn from two community mental-health day-treatment centers competed in a community-based softball league. Treatment objectives were twofold: therapeutic recreation and participation in a community activity apart from a traditional psychiatric setting. Points of success, while anecdotal, seem to suggest avenues through which further efforts toward community integration may be achieved.

  3. Integrated treatment of farm effluents in New Zealand's dairy operations.

    PubMed

    Bolan, N S; Laurenson, S; Luo, J; Sukias, J

    2009-11-01

    Maintaining growth through intensification in the New Zealand dairy industry is a challenge for various reasons, in particular sustainably managing the large volumes of effluent. Dairy farm effluents have traditionally been treated using two-pond systems that are effective in the removal of carbon and suspended solids, however limited in their ability to remove nutrients. In the past these nutrient-rich two-pond treated effluents were disposed of in surface waters. Current environmental concerns associated with the direct discharge of these effluents to surface waters has prompted in developing technologies to either minimise the nutrient content of the effluent or apply effluents to land. Here, we discuss various approaches and methods of treatment that enable producers to sustainably manage farm effluents, including advanced pond treatment systems, stripping techniques to reduce nutrient concentration, land application strategies involving nutrient budgeting models to minimise environmental degradation and enhance fodder quality. We also discuss alternative uses of farm effluents to produce energy and animal feed.

  4. 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…

  5. 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

  6. Integrative Complementary Medicine for Treatment of Bariatric Perioperative Symptoms: Patients' Experiences and Staff Evaluations

    PubMed Central

    Attias, Samuel; Ben-Arye, Eran; Shaham, Miri; Grimberg, Ofra; Schiff, Elad

    2013-01-01

    Background A unique integrative complementary medicine (CM) pilot program was launched in a general surgery department at a public teaching hospital in Israel. In addition to standard supportive care, CM treatments are used to support patients undergoing laparoscopic sleeve gastrectomy (LSG) in coping with perioperative distresses. We examined the experiences of patients and how the nursing staff evaluate these treatments. Methods Qualitative semi-structured open-ended interviews were used. Results Most patients reported that the treatments helped them to cope better with preoperative anxiety, and facilitated postoperative breathing and pain relief. Nurses reported that CM treatments enabled them to reduce doses of analgesics. Both patients and nurses suggested that preoperative CM treatment facilitated a better postoperative CM-associated outcome. Conclusions Integrative perioperative CM treatments improved pain and anxiety care in patients undergoing LSG. More research is needed to examine CM efficacy in improving standard LSG perioperative supportive care and to evaluate cost effectiveness. PMID:24761369

  7. Minimizing dioxin emissions from integrated MSW thermal treatment.

    PubMed

    Cheung, Wai Hung; Lee, Vinci K C; McKay, Gordon

    2007-03-15

    The combustion of wastes has very significant benefits in reducing the volume of waste materials and producing energy. However, combustion processes produce emissions, which must be below the Best Practical Means (BPM) specified legislative limits. Several wastes, such as tires and meat meal, have been successfully combusted in cement kilns, up to 20% w/w, while retaining emission standards well below legislative limits. In the case of municipal solid waste (MSW) the introduction of large amounts of MSW into cement kilns is not practical because the additional kiln volume required is too great, the large amounts of ash generated will affect the cement clinker quality, and it would be difficult to sustain the required very high clinkering temperature of 1500 degrees C with large quantities of low calorific value MSW. A completely novel process, termed the Co-Co process, has been developed, integrating MSW combustion in a synergistic fashion with the cement production. This process is based on combining the cement "front-end" calcination reaction and incorporating it with a high temperature, at 1200 degrees C, combustion process, providing a giant acid gas scrubber. A pilot plant was designed, constructed, and operated to demonstrate the benefits of the Co-Co process. The pilot plant achieved emissions minimization: dioxins were typically 0.5-1% of the European BPM limits, HCl, SOx, NOx, and particulates were 15, 10, 20, and 25% of BPM limits, respectively. Heavy metals were typically below 25% of BPM limit values.

  8. 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…

  9. Integration of chemical and biological treatments for textile industry wastewater: a possible zero-discharge system.

    PubMed

    Lee, H H; Chen, G; Yue, P L

    2001-01-01

    Theoretical and experimental studies have established that integrated treatment systems (mostly chemical and biological) for various industrial wastewaters can achieve better quality of treatment and can be cost-effective. In the present study, the objective is to minimize the use of process water in the textile industry by an economical recycle and reuse scheme. The textile wastewater was first characterized in terms of COD, BOD5, salinity and color. In order to recycle such wastewater, the contaminants should be mineralized and/or removed according to the reusable textile water quality standards. Typical results show that this is achievable. An economic analysis has been conducted on the proposed integrated system. The economic analysis shows that the integrated system is economically more attractive than any of the single treatment technologies for achieving the same target of treatment. The information presented in this paper provides a feasible option for the reduction of effluent discharges in the textile industry.

  10. Enhancing the developmental appropriateness of treatment for depression in youth: integrating the family in treatment.

    PubMed

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

    2012-04-01

    Treatment models for youth depression that emphasize interpersonal functioning, particularly family relationships, may be particularly promising. This article first reviews the current state of knowledge on the efficacy of psychosocial treatments for depression in youth, with an emphasis on family involvement in treatment. It then discusses developmental factors that may impact the applicability and structure of family-focused treatment models for preadolescent and adolescent youth. Finally, 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.

  11. Evaluation of an integrated treatment system for MGP site groundwaters

    SciTech Connect

    Scheible, O.K.; Grey, G.M.; Maiello, J.A.

    1995-12-31

    Initially studied at bench scale, process sequences comprising dissolved air flotation (DAF), aerobic biological oxidation, air stripping, filtration, and carbon adsorption were demonstrated at pilot scale at a manufactured gas plant (MGP) site in New Jersey. Benzene, toluene, ethylbenzene, and xylenes (BTEX), and polycyclic aromatic hydrocarbons (PAHs) were the primary organics in the groundwater, ranging from levels of 2 to 8 mg/L and 0.3 to 27 mg/L, respectively; chemical oxygen demand (COD) levels were from 60 to 4,500 mg/L. Significant levels of dense, emulsified, and nonaqueous tars and oils were present in the more highly contaminated waters and were effectively removed by DAF. Carbon-based fluidized-bed biological treatment of the DAF subnatant at COD loadings between 2 and 4 g/L-d yielded effluent-soluble COD levels between 40 and 60 mg/L, with both residual BTEX and PAH concentrations ranging from nondetect levels to 0.1 mg/L. Subsequent polishing by filtration and carbon adsorption resulted in additional COD removal and nondetect levels of volatiles and semivolatiles. Air stripping was effective in lieu of the biological process for both volatile organic compound (VOC) and PAH removal.

  12. 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.

  13. 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.

  14. Review of the integrated thermal and nonthermal treatment system studies. Final report

    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 three studies reviewed were as follows: Integrated Thermal Treatment System Study, Phase 1 -- issued July 1994; Integrated Thermal Treatment System Study, Phase 2 -- issued February 1996; and Integrated Nonthermal Treatment System Study -- drafted March 1996. 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.

  15. 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

  16. 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

  17. 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

  18. 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

  19. The tactical-integration model for the treatment of dissociative identity disorder and allied dissociative disorders.

    PubMed

    Fine, C G

    1999-01-01

    The ebb and flow of the diagnosis of Dissociative Identity Disorder (DID) and other dissociative conditions has led to the evolution of theories and treatment modalities to resolve the fluctuating and ephemerous symptoms of these conditions. This paper summarizes the structured cognitive-behavioral-based treatment of dissociative disorders that will foster not only symptom relief but also an integration of the personalities and/or ego states into one mainstream of consciousness. This model of DID therapy is called the tactical integration model; it promotes proficiency over posttraumatic and dissociative symptoms, is collaborative and exploratory, and conveys a consistent message of empowerment to the patient.

  20. Identity: empirical contribution. Changes in the identity integration of adolescents in treatment for personality disorders.

    PubMed

    Feenstra, Dine J; Hutsebaut, Joost; Verheul, Roel; van Limbeek, Jacques

    2014-02-01

    A renewed interest in identity as one of the core markers of personality disorders has been introduced by the DSM-5 Level of Personality Functioning Scale. However, little is known about the utility of the construct of identity in children and adolescents. This study aimed to broaden the knowledge of identity integration as a core component of personality functioning in adolescents. The authors investigated levels of identity integration, as measured by the Severity Indices of Personality Problems (SIPP-118; Verheul et al., 2008), in adolescents in both normal (n = 406) and clinical populations (n = 285). Furthermore, changes in levels of identity integration during treatment were investigated in a clinical subsample (n = 76). Levels of identity integration were not associated with age. They were, however, associated with the absence or presence of personality pathology. Most adolescents receiving inpatient psychotherapy gradually changed toward more healthy levels of identity integration; a significant number, however, remained at maladaptive levels of identity functioning after intensive psychotherapy.

  1. Path-integral treatment of the Hulthén potential

    NASA Astrophysics Data System (ADS)

    Cai, J. M.; Cai, P. Y.; Inomata, A.

    1986-12-01

    An exact path-integral treatment of the s states for the Hulthén potential is presented. A procedure of the nontrivial change of variable accompanied by the local time rescaling is given in detail. The dimensional extension trick is applied to convert the radial path integral into a path integral in the SU(2) manifold. The exact energy spectrum and the normalized s-state eigenfunctions are obtained from the poles of the Green function and their residues, respectively. The Yukawa and the Coulomb limits are also discussed.

  2. 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

  3. 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…

  4. 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.

  5. 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.

  6. 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.

  7. Integrated Educational and Mental Health Services within a Day Treatment Setting.

    ERIC Educational Resources Information Center

    Francis, Greta; Radka, Dale F.

    This paper discusses the integration of educational and mental health services for children and adolescents within a psychiatric day treatment setting at the Bradley School housed in a private psychiatric hospital affiliated with Brown University in Rhode Island. A full range of mental health services are used, and therapies are delivered in the…

  8. 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.

  9. 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…

  10. 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…

  11. 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…

  12. 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…

  13. 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…

  14. A Formative Program Evaluation of Treatment Integrity Practices, Assessments and Attitudes within a Specialized School Setting

    ERIC Educational Resources Information Center

    Tang, Lin

    2012-01-01

    The purpose of this study, a formative program evaluation, was to provide an overview of treatment integrity rates, attitudes, and assessment methods within a specialized school for children and adolescents with Autism Spectrum Disorder. The study utilized a partnership model whereby the evaluators worked collaboratively with primary stakeholders…

  15. Increasing Treatment Integrity through Negative Reinforcement: Effects on Teacher and Student Behavior

    ERIC Educational Resources Information Center

    DiGennaro, Florence D.; Martens, Brian K.; McIntyre, Laura Lee

    2005-01-01

    The current study examined the extent to which treatment integrity was increased and maintained for 4 teachers in their regular classroom settings as a result of performance feedback and negative reinforcement. Teachers received daily written feedback about their accuracy in implementing an intervention and were able to avoid meeting with a…

  16. 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.

  17. 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…

  18. 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…

  19. 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…

  20. 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…

  1. 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…

  2. 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…

  3. 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…

  4. Perchlorate and nitrate treatment by ion exchange integrated with biological brine treatment.

    PubMed

    Lehman, S Geno; Badruzzaman, Mohammad; Adham, Samer; Roberts, Deborah J; Clifford, Dennis A

    2008-02-01

    Groundwater contaminated with perchlorate and nitrate was treated in a pilot plant using a commercially available ion exchange (IX) resin. Regenerant brine concentrate from the IX process, containing high perchlorate and nitrate, was treated biologically and the treated brine was reused in IX resin regeneration. The nitrate concentration of the feed water determined the exhaustion lifetime (i.e., regeneration frequency) of the resin; and the regeneration condition was determined by the perchlorate elution profile from the exhausted resin. The biological brine treatment system, using a salt-tolerant perchlorate- and nitrate-reducing culture, was housed in a sequencing batch reactor (SBR). The biological process consistently reduced perchlorate and nitrate concentrations in the spent brine to below the treatment goals of 500 microg ClO4(-)/L and 0.5mg NO3(-)-N/L determined by equilibrium multicomponent IX modeling. During 20 cycles of regeneration, the system consistently treated the drinking water to below the MCL of nitrate (10 mgNO3(-)-N/L) and the California Department of Health Services (CDHS) notification level of perchlorate (i.e., 6 microg/L). A conceptual cost analysis of the IX process estimated that perchlorate and nitrate treatment using the IX process with biological brine treatment to be approximately 20% less expensive than using the conventional IX with brine disposal.

  5. The Relationship between Pre-Treatment Clinical Profile and Treatment Outcome in an Integrated Stuttering Program

    ERIC Educational Resources Information Center

    Huinck, Wendy J.; Langevin, Marilyn; Kully, Deborah; Graamans, Kees; Peters, Herman F. M.; Hulstijn, Wouter

    2006-01-01

    A procedure for subtyping individuals who stutter and its relationship to treatment outcome is explored. Twenty-five adult participants of the Comprehensive Stuttering Program (CSP) were classified according to: (1) stuttering severity and (2) severity of negative emotions and cognitions associated with their speech problem. Speech characteristics…

  6. Advantages, Disadvantages, and Trend of Integrative Medicine in the Treatment of Heart Failure.

    PubMed

    Zhang, PeiYing

    2015-06-01

    Integrative medicine therapy using traditional Chinese medicine (TCM) combined with western medicine has shown some advantages in treating heart failure (HF), such as holistic concept; multi-target treatment; dialectical logic; personalized therapy; formulae compatibility; and reduction of side effects of western medicine. However, problems still exist in TCM treatment of HF, including non-uniformed categorization of TCM, lack of standardized syndrome differentiation and lack of an evidence base. The future of treatment of HF seems to be focused on reversing ventricular remodeling, improving cardiac rehabilitation, and accelerating experimental research and drug discovery in TCM.

  7. Giving "Sadness" a Name: The Need for Integrating Depression Treatment into HIV Care in Uganda.

    PubMed

    Odokonyero, Raymond; Wagner, Glenn; Ngo, Victoria; Nakasujja, Noeline; Musisi, Seggane; Akena, Dickens

    2015-01-01

    Depression is common among people living with HIV/AIDS (PLWHA) in sub-Saharan Africa (SSA), and can have significant consequences for HIV disease progression, treatment response and prevention. Yet mental health services are limited in most HIV care programs in this region, in part due to severe shortages of mental health professionals. To address the need for establishing an effective, sustainable model for integrating depression treatment into HIV care in SSA, we have embarked upon a 3-year research project, INDEPTH Uganda (INtegrating DEPression Treatment and in HIV care in Uganda), to evaluate a task-sharing, protocolized approach to providing antidepressant care in ten HIV clinics in Uganda. In this paper we share our experiences with two treated cases identified during the initial days of implementation, which we believe highlight the potential value and policy implications for task shifting depression care models in under-resourced settings. PMID:25376926

  8. Integrated residential treatment for persons with severe and persistent mental illness: lessons in recovery.

    PubMed

    Davis, Kristin E; Devitt, Timothy; Rollins, Angela; O'Neill, Sheila; Pavick, Debra; Harding, Brian

    2006-09-01

    This retrospective study examines 24-month outcomes for 38 participants with histories of chronic homelessness and hospitalizations in an urban, residential integrated treatment (IT) program and compares characteristics of those who stayed in the program 24 months with those who left within their first year of residence. Informed by an Assertive Community Treatment approach, characterized by outreach (or what might better be referred to as inreach), low staff to consumer ratio, and meeting of basic needs, the residential program emphasized harm reduction and motivational interventions. The longitudinal study design was supplemented with a comparative analysis of treatment completers and noncompleters. There were significant differences between the two groups at baseline in terms of engagement with treatment, alcohol use severity, and mental health diagnosis. Additionally, those who stayed with the program showed significant reductions in alcohol and drug use, significant reduction in hospitalizations, and advances in treatment engagement.

  9. Integrated breast cancer surgical treatment: novel aspects of minimally-invasive treatments.

    PubMed

    Franceschini, Gianluca; Sanchez, Alejandro M; DI Leone, Alba; Magno, Stefano; Moschella, Francesca; Accetta, Cristina; Natale, Maria; Masetti, Riccardo

    2016-04-01

    The surgical management of breast cancer has been undergoing continuous and profound changes over the last 40 years. The evolution from aggressive and mutilating treatment to conservative approach has been long but constant, despite the controversies arising every time a new procedure came to light. Today, the esthetic satisfaction of breast cancer patients coupled with oncological safety is the goal of the modern breast surgeon. Breast-conserving surgery with adjuvant radiotherapy is considered the gold standard approach for patients with early stage breast cancer and the recent introduction of "oncoplastic techniques" has furtherly increased the use of breast-conserving procedures. Mastectomy still remains a valid surgical alternative in selected cases and is usually associated with immediate reconstructive procedures. New surgical procedures called "conservative mastectomies" are emerging as techniques that combine oncological safety and esthetic outcome by entirely removing the breast parenchyma sparing the breast skin and nipple-areola complex. Staging of the axilla has also gradually evolved toward less aggressive approaches with the adoption of sentinel node biopsy and new therapeutic strategies are emerging in patients with a pathological positivity in sentinel lymph node biopsy. The present special article will highlight the new surgical treatment options, which are more and more effective and respectful of breast cancer patients.

  10. 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.

  11. [Hot issues on the treatment of severe acute pancreatitis by Integrated Traditional Chinese and Western Medicine].

    PubMed

    Xia, Qing; Deng, Li-Hui

    2013-11-01

    Severe acute pancreatitis (SAP) is recognized as critical refractory disease. The case fatality rate of SAP is as high as 36%-50%. Although significant progress has been achieved on the treatment of severe acute pancreatitis (SAP) by Integrated Traditional Chinese Medicine (TCM) and Western Medicine (WM), there still exist some difficulties hindering the further improvement of therapeutic efficacy. The hot issues includes: unconfirmative curative effects and diverse treatment principles, complicated predictive scoring systems and inaccurate markers for the severity stratification, unproved new therapeutic tools and controversial methods waiting more high qualified evidence, unclarified mechanism of Integrated TCM and WM. In order to overcome the difficulties, we aim to launch the clinical pathway of Integrated TCM and WM, to strengthen the unity of multidisciplinary cooperation. We also need to keep the efforts on screening the markers for early evaluation and prediction of disease severity, improving the diagnosis and treatment, exploring the mechanism of Traditional Chinese Medicine in treating SAP with more high quality basic and clinical research. Based on these efforts, we could provide better treatments and prognosis for SAP patients.

  12. 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

  13. Integrated care for chronic migraine patients: epidemiology, burden, diagnosis and treatment options.

    PubMed

    Diener, Hans-Christoph; Solbach, Kasja; Holle, Dagny; Gaul, Charly

    2015-08-01

    Migraine is a common neurological disorder, characterised by severe headaches. Epidemiological studies in the USA and Europe have identified a subgroup of migraine patients with chronic migraine. Chronic migraine is defined as ≥15 headache days per month for ≥3 months, in which ≥8 days of the month meet criteria for migraine with or without aura, or respond to treatment specifically for migraine. Chronic migraine is associated with a higher burden of disease, more severe psychiatric comorbidity, greater use of healthcare resources, and higher overall costs than episodic migraine (<15 headache days per month). There is a strong need to improve diagnosis and therapeutic treatment of chronic migraine. Primary care physicians, as well as hospital-based physicians, are integral to the identification and treatment of these patients. The latest epidemiological data, as well as treatment options for chronic migraine patients, are reviewed here.

  14. 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

  15. 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

  16. 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.

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

    PubMed

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

    2015-02-21

    While active tuberculosis (TB) is a treatable disease, many complex factors prevent its global elimination. Part of the difficulty in developing optimal therapies is the large design space of antibiotic doses, regimens and combinations. Computational models that capture the spatial and temporal dynamics of antibiotics at the site of infection can aid in reducing the design space of costly and time-consuming animal pre-clinical and human clinical trials. The site of infection in TB is the granuloma, a collection of immune cells and bacteria that form in the lung, and new data suggest that penetration of drugs throughout granulomas is problematic. Here we integrate our computational model of granuloma formation and function with models for plasma pharmacokinetics, lung tissue pharmacokinetics and pharmacodynamics for two first line anti-TB antibiotics. The integrated model is calibrated to animal data. We make four predictions. First, antibiotics are frequently below effective concentrations inside granulomas, leading to bacterial growth between doses and contributing to the long treatment periods required for TB. Second, antibiotic concentration gradients form within granulomas, with lower concentrations toward their centers. Third, during antibiotic treatment, bacterial subpopulations are similar for INH and RIF treatment: mostly intracellular with extracellular bacteria located in areas non-permissive for replication (hypoxic areas), presenting a slowly increasing target population over time. Finally, we find that on an individual granuloma basis, pre-treatment infection severity (including bacterial burden, host cell activation and host cell death) is predictive of treatment outcome.

  18. Progress on integrated Chinese and Western medicine in the treatment of osteoarthritis.

    PubMed

    Wang, He-ming; Liu, Jun-ning; Zhao, Yi

    2010-08-01

    Osteoarthritis (OA) is a chronic degenerative disease of the joints caused by wide variety of factors. factors. This paper provides a review of the clinical and experimental research on integrated Chinese and Western medicine in the treatment of osteoarthritis. Western medicine in the treatment of osteoarthritis. (1) Clinical research: integrated Chinese and Western medicine therapies were used including physiotherapy, medications, acupuncture, functional training, intra-articular injection of sodium hyaluronate therapy, and arthroscopic debridement with Chinese medicine articular iontophoresis therapy. articular iontophoresis therapy. (2) Experimental research: modern methods were used in studying the mechanism of Chinese medicine in slowing down cartilage degeneration, promoting articular cartilage repair, inhibiting synovial inflammation, and blocking cartilage destruction. inflammation, and blocking cartilage destruction. In addition, this article also reviews the advantages, prospects, and problems of the therapies. and problems of the therapies.

  19. Heat Treatment With Beam Integrators Device For CO2 High Power Laser

    NASA Astrophysics Data System (ADS)

    Botticelli, A.; Caneve, L.; Conserva, Dannille; Cruciani, Diego; Garifo, Luciano

    1989-03-01

    Reflective metallic optics for high power CO2 laser are very important in industrial application of laser surface modification processes (cladding, heat treatment, etc.). Copper wirrors fabricated by diamond turning method offer a very high reflectance in the IR spectral region. Usually, metallic mirrors are coated with protective films to preserve the surface from any kind of degradation. In the development of these optics, we have produced a system for heat treatment. Such a system uses a beam integrator convex mirror that divides the CO2 beam laser in several beams with a predetermined spot size. By a concave mirror all spots are overlapped on the surface which must be treated. In this way, it is possible to obtain a uniform intensity, distribution of radiation on the irradiated surface. Using different beam integrator convex mirrors, various spot sizes at the same focal distance can be achieved.

  20. Relationship between genotoxic effects of breast cancer treatments and patient basal DNA integrity.

    PubMed

    Ceballos, María Paula; Funes, Juan Capitaine; Massa, Estefanía; Cipulli, Germán; Gil, Alfonso Benitez; Funes, Carlos Capitaine; Tozzini, Roberto; Ghersevich, Sergio

    2014-01-01

    Radiotherapy and chemotherapy cause genotoxic side effects that are highly variable among patients. In this study, we evaluated DNA integrity using the comet assay in peripheral blood lymphocytes from breast cancer patients before ("pre-treatment patients"; n=47) and after ("post-treatment patients"; n=24) radiotherapy and/or chemotherapy treatment and from healthy donors (n=15). Comet evaluation was made by visual (types 0-4) and digital (percentage of DNA remaining in the comet head=% head DNA) analysis. The association between the level of DNA damage and cancer prognostic factors was assessed. The treatments caused a significant increase in DNA damage registered by both visual (p<0.001) and digital (p<0.001) analyses. No significant associations between the level of DNA damage in pre-treatment patients and cancer prognostic factors were found. A significant correlation between the comet results from each patient before and after treatment (r=0.64, p=0.001) was observed. The % head DNA in post-treatment samples from patients with a high level of DNA damage before treatment (30.3±3.1%, p<0.01) was lower than in post-treatment samples from patients with a low-to-medium level of DNA damage before therapy (49.2±4.4%). These results support the usefulness of the comet assay as a sensitive technique to evaluate basal DNA status and DNA damage caused by cancer treatments. The comet assay could contribute to treatment decisions, especially by taking into account the patient's basal DNA damage before therapy.

  1. A biofilter integrated with gas membrane separation unit for the treatment of fluctuating styrene loads.

    PubMed

    Li, Lin; Lian, Jing; Han, Yunping; Liu, Junxin

    2012-05-01

    Biofiltration for volatile organic compound control in waste gas streams is best operated at steady contaminant loadings. To provide long-term stable operation of a biofilter under adverse contaminant feeding conditions, an integrated bioreactor system with a gas separation membrane module installed after a biofilter was proposed for styrene treatment. Styrene was treated effectively, with average styrene effluent concentrations maintained at less than 50 mg m(-3) and a total removal efficiency of over 96% achieved when the biofiltration column faced fluctuating loads. The maximum elimination capacity of the integrated bioreactor system was 93.8 g m(-3)h(-1), which was higher than that obtained with the biofiltration column alone. The combination of these two processes (microbial and chemical) led to more efficient elimination of styrene and buffering of the fluctuating loads. The factors on gas membrane separation, microbial characteristics in the integrated bioreactor and membrane fouling were also investigated in this study.

  2. [Establishment of diagnosis and treatment patterns of holistic integrated medicine for neuro-ophthalmology].

    PubMed

    Wang, Yanling

    2014-12-01

    Neuro-ophthalmology, as an interdisciplinary, covers at least three disciplines- ophthalmology, neurology and neurosurgery. With limited knowledge in each discipline, doctors often make misdiagnoses for neuro-ophthalmology diseases. Therefore, it is imperative to abandon the distinction between disciplines and combine all the knowledge to diagnose and treat patients in patterns of holistic integrated medicine in order to effectively improve the diagnosis and treatment of neuro-ophthalmology.

  3. An integrated treatment delivery system for CSRS and CSRT and clinical applications.

    PubMed

    Shiu, A; Parker, B; Ye, J-S; Lii, J

    2003-01-01

    An integrated treatment delivery system for conformal stereotactic radiosurgery (CSRS) and radiotherapy (CSRT) has been developed through a collaboration involving Siemens Medical Systems, Inc., Tyco/Radionics, Inc., and The University of Texas M. D. Anderson Cancer Center. The system consists of a 6-MV linear accelerator (LINAC) equipped with a Tyco/Radionics miniature multileaf collimator (mMLC). For the conventional SRS treatment, the circular collimator housing can be attached to the opening window of the mMLC. The treatment delivery system is integrated with a radiotherapy treatment planning system and a record-and-verify system. The purpose of this study is to report the characteristics, performance, benefits, and the clinical applications of this delivery system. The technical specifications of the LINAC and mMLC were tested, and all the specifications were met. The 80% to 20% penumbral width for each mMLC leaf is approximately 3 mm and is nearly independent of the off-axis positions of a leaf. The maximum interleaf leakage is 1.4% (1.1% on average) and the maximum intra-leaf leakage is 1.0% (0.9% on average). The leaf position precision is better than 0.5 mm for all the leaves. The integration of the SRS/SRT treatment planning system, mMLC, and LINAC has been evaluated successfully for transferring the patient treatment data file through radiotherapy treatment planning system to the patient information and treatment record-and-verify server and the mMLC controller. Subsequently, the auto-sequential treatment delivery for SRS, CSRS/CSRT, and the step-and-shoot intensity-modulated radiotherapy has also been tested successfully. The accuracy of dose delivery was evaluated for a 2-cm spherical target in a Radiological Physics Center SRS head phantom with GAFChromic films and TLD. Five non-coplanar arcs, using a 2-cm diameter circular collimator, were used for this simulation treatment. The accuracy to aim the center of the spherical target was within 0.5 mm and

  4. An integrated treatment delivery system for CSRS and CSRT and clinical applications.

    PubMed

    Shiu, A; Parker, B; Ye, J-S; Lii, J

    2003-01-01

    An integrated treatment delivery system for conformal stereotactic radiosurgery (CSRS) and radiotherapy (CSRT) has been developed through a collaboration involving Siemens Medical Systems, Inc., Tyco/Radionics, Inc., and The University of Texas M. D. Anderson Cancer Center. The system consists of a 6-MV linear accelerator (LINAC) equipped with a Tyco/Radionics miniature multileaf collimator (mMLC). For the conventional SRS treatment, the circular collimator housing can be attached to the opening window of the mMLC. The treatment delivery system is integrated with a radiotherapy treatment planning system and a record-and-verify system. The purpose of this study is to report the characteristics, performance, benefits, and the clinical applications of this delivery system. The technical specifications of the LINAC and mMLC were tested, and all the specifications were met. The 80% to 20% penumbral width for each mMLC leaf is approximately 3 mm and is nearly independent of the off-axis positions of a leaf. The maximum interleaf leakage is 1.4% (1.1% on average) and the maximum intra-leaf leakage is 1.0% (0.9% on average). The leaf position precision is better than 0.5 mm for all the leaves. The integration of the SRS/SRT treatment planning system, mMLC, and LINAC has been evaluated successfully for transferring the patient treatment data file through radiotherapy treatment planning system to the patient information and treatment record-and-verify server and the mMLC controller. Subsequently, the auto-sequential treatment delivery for SRS, CSRS/CSRT, and the step-and-shoot intensity-modulated radiotherapy has also been tested successfully. The accuracy of dose delivery was evaluated for a 2-cm spherical target in a Radiological Physics Center SRS head phantom with GAFChromic films and TLD. Five non-coplanar arcs, using a 2-cm diameter circular collimator, were used for this simulation treatment. The accuracy to aim the center of the spherical target was within 0.5 mm and

  5. Successful Integration of Hepatitis C Evaluation and Treatment Services With Methadone Maintenance

    PubMed Central

    Harris, Kenneth A.; Arnsten, Julia H.; Litwin, Alain H.

    2010-01-01

    Objectives Despite high rates of hepatitis C virus (HCV) infection, relatively few current or former injection drug users receive evaluation and treatment for HCV. Here, we demonstrate the feasibility and effectiveness of integrating HCV care and methadone maintenance treatment (MMT). We hypothesized that colocation of these services would result in improved access to and utilization of HCV care. Methods In this retrospective observational study, all patient charts from a single MMT clinic were reviewed 2 years after HCV care and MMT were integrated. Information obtained included screening for and counseling about HCV infection status, on-site HCV treatment and outcomes, and demographic and substance abuse data. Results Two hundred ninety-one patient charts were reviewed. Two hundred eighty-one (99%) patients were screened for HCV antibody (HCV-Ab), and 188 (65%) were positive. Forty-nine (17%) patients were HIV/HCV coinfected. Ninety-eight percent of the HCV-Ab-positive patients received HCV counseling. Hundred fifty-nine (85%) of the HCV-Ab-positive patients were eligible to receive further evaluation and treatment for HCV on site, and 125 (78%) accepted. Hundred eighteen (94%) patients were tested for chronic HCV, and 83 were determined to have chronic HCV. Twenty-five patients received liver biopsy; low-stage disease was found in 7 patients. Twenty-one patients initiated HCV treatment. Sustained viral response was achieved in 8 patients. Seventeen patients had contraindications to HCV treatment. Further workup was prevented or delayed in 45 patients for various reasons, most commonly due to personal choice (29 patients). Conclusions This study demonstrates that current and former injection drug users can be engaged successfully in evaluation and treatment of HCV infection when these services are collocated with MMT. PMID:20485532

  6. 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.

  7. Anticipating clinical integration of genetically tailored tobacco dependence treatment: perspectives of primary care physicians.

    PubMed

    Park, Elyse R; Kleimann, Susan; Pelan, Julie A; Shields, Alexandra E

    2007-02-01

    Emerging research will likely make it possible to tailor pharmacological treatment for individuals with tobacco dependence by genotype. This study explored primary care physicians' attitudes about the strengths of and barriers to using genetic testing to match patients to optimal nicotine replacement therapy. Four focus groups (n=27) were conducted, and data were analyzed using thematic content analysis. Physicians reported how likely they would be to offer patients a genetic test to tailor smoking treatment in response to three different scenarios that described characteristics of the genetic test based on published research. Respondents were on average 36 years of age; 59% were male and 67% were white. Physicians believed genetically tailored treatment may offer new hope to smokers trying to quit, yet they also noted several potential barriers to clinical integration. Barriers included erroneous assumptions by patients regarding the meaning of genetic test results, possible misinterpretation of information regarding racial differences in the prevalence of certain risk alleles, and potential discrimination against patients undergoing testing. Concerns increased dramatically when physicians were told that the same genotypes that would be identified to tailor smoking treatment also have been associated with increased risk of becoming addicted to nicotine, as well as other addictions and psychiatric disorders. Physicians were interested in the possibility of realizing improved smoking cessation outcomes through pharmacogenetic developments, but they also raised many concerns. Primary care physicians will need additional educational inputs and system support prior to integrating genetic testing for a common trait into their routine clinical practice. PMID:17365758

  8. 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.

  9. 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

  10. 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.

  11. 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.

  12. Improved cartilage integration and interfacial strength after enzymatic treatment in a cartilage transplantation model.

    PubMed

    van de Breevaart Bravenboer, Jarno; In der Maur, Caroline D; Bos, P Koen; Feenstra, Louw; Verhaar, Jan A N; Weinans, Harrie; van Osch, Gerjo J V M

    2004-01-01

    The objective of the present study was to investigate whether treatment of articular cartilage with hyaluronidase and collagenase enhances histological and mechanical integration of a cartilage graft into a defect. Discs of 3 mm diameter were taken from 8-mm diameter bovine cartilage explants. Both discs and annulus were either treated for 24 hours with 0.1% hyaluronidase followed by 24 hours with 10 U/ml collagenase or left untreated (controls). Discs and annulus were reassembled and implanted subcutaneously in nude mice for 5 weeks. Integration of disc with surrounding cartilage was assessed histologically and tested biomechanically by performing a push-out test. After 5 weeks a significant increase in viable cell counts was seen in wound edges of the enzyme-treated group as compared with controls. Furthermore, matrix integration (expressed as a percentage of the total interface length that was connected; mean +/- standard error) was 83 +/- 15% in the treated samples versus 44 +/- 40% in the untreated controls. In the enzyme-treated group only, picro-Sirius Red staining revealed collagen crossing the interface perpendicular to the wound surface. Immunohistochemical analyses demonstrated that the interface tissue contained cartilage-specific collagen type II. Collagen type I was found only in a small region of fibrous tissue at the level of the superficial layer, and collagen type III was completely absent in both groups. A significant difference in interfacial strength was found using the push-out test: 1.32 +/- 0.15 MPa in the enzyme-treated group versus 0.84 +/- 0.14 MPa in the untreated controls. The study shows that enzyme treatment of cartilage wounds increases histological integration and improves biomechanical bonding strength. Enzymatic treatment may represent a promising addition to current techniques for articular cartilage repair.

  13. [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

  14. 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

  15. An innovative integrated oxidation ditch with vertical circle (IODVC) for wastewater treatment.

    PubMed

    Xia, Shi-bin; Liu, Jun-xin

    2004-01-01

    The oxidation ditch process is economic and efficient for wastewater treatment, but its application is limited in case where land is costly due to its large land area required. An innovative integrated oxidation ditch with vertical circle (IODVC) system was developed to treat domestic and industrial wastewater aiming to save land area. The new system consists of a single-channel divided into two ditches(the top one and the bottom one by a plate), a brush, and an innovative integral clarifier. Different from the horizontal circle of the conventional oxidation ditch, the flow of IODVC system recycles from the top zone to the bottom zone in the vertical circle as the brush is running, and then the IODVC saved land area required by about 50% compared with a conventional oxidation ditch with an intrachannel clarifier. The innovative integral clarifier is effective for separation of liquid and solids, and is preferably positioned at the opposite end of the brush in the ditch. It does not affect the hydrodynamic characteristics of the mixed liquor in the ditch, and the sludge can automatically return to the down ditch without any pump. In this study, experiments of domestic and dye wastewater treatment were carried out in bench scale and in full scale, respectively. Results clearly showed that the IODVC efficiently removed pollutants in the wastewaters, i.e., the average of COD removals for domestic and dye wastewater treatment were 95% and 90%, respectively, and that the IODVC process may provide a cost effective way for full scale dye wastewater treatment.

  16. Reducing barriers to hepatitis C treatment among drug users: an integrated hepatitis C peer education and support program.

    PubMed

    Roose, Robert J; Cockerham-Colas, Lauren; Soloway, Irene; Batchelder, Abigail; Litwin, Alain H

    2014-05-01

    This report describes an innovative HCV Peer Educator Program that facilitates education, support, and engagement in HCV treatment among patients in an opioid treatment program. Integrating peer educators in a collaborative manner with close supervision holds promise as a model to reduce barriers to HCV treatment among drug users.

  17. 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.…

  18. 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

  19. 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.

  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 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.

  2. 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.

  3. Integrative Therapies in Anxiety Treatment with Special Emphasis on the Gut Microbiome

    PubMed Central

    Schnorr, Stephanie L.; Bachner, Harriet A.

    2016-01-01

    Over the past decade, research has shown that diet and gut health affects symptoms expressed in stress related disorders, depression, and anxiety through changes in the gut microbiota. Psycho-behavioral function and somatic health interaction have often been ignored in health care with resulting deficits in treatment quality and outcomes. While mental health care requires the professional training in counseling, psychotherapy and psychiatry, complimentary therapeutic strategies, such as attention to a nutritional and diverse diet and supplementation of probiotic foods, may be integrated alongside psychotherapy treatment models. Development of these alternative strategies is predicated on experimental evidence and diligent research on the biology of stress, fear, anxiety-related behaviors, and the gut-brain connection. This article provides a brief overview on biological markers of anxiety and the expanding nutritional literature relating to brain health and mental disorders. A case study demonstrates an example of a biopsychosocial approach integrating cognitive psychotherapy, dietary changes, and mindfulness activities, in treating symptoms of anxiety. This case study shows a possible treatment protocol to explore the efficacy of targeting the gut-brain-axis that may be used as an impetus for future controlled studies. PMID:27698624

  4. 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

  5. Integrative Therapies in Anxiety Treatment with Special Emphasis on the Gut Microbiome

    PubMed Central

    Schnorr, Stephanie L.; Bachner, Harriet A.

    2016-01-01

    Over the past decade, research has shown that diet and gut health affects symptoms expressed in stress related disorders, depression, and anxiety through changes in the gut microbiota. Psycho-behavioral function and somatic health interaction have often been ignored in health care with resulting deficits in treatment quality and outcomes. While mental health care requires the professional training in counseling, psychotherapy and psychiatry, complimentary therapeutic strategies, such as attention to a nutritional and diverse diet and supplementation of probiotic foods, may be integrated alongside psychotherapy treatment models. Development of these alternative strategies is predicated on experimental evidence and diligent research on the biology of stress, fear, anxiety-related behaviors, and the gut-brain connection. This article provides a brief overview on biological markers of anxiety and the expanding nutritional literature relating to brain health and mental disorders. A case study demonstrates an example of a biopsychosocial approach integrating cognitive psychotherapy, dietary changes, and mindfulness activities, in treating symptoms of anxiety. This case study shows a possible treatment protocol to explore the efficacy of targeting the gut-brain-axis that may be used as an impetus for future controlled studies.

  6. 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.

  7. [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

  8. 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.

  9. [Practical implementation of an integrated care model in mother-child treatment].

    PubMed

    Kunze, J; Wagner, K; Fittig, E

    2016-09-01

    This article summarizes the specific treatment options in the combined mother-child treatment for women with postpartum psychiatric disorders. The incidence of postpartum mental illness is high, especially for postpartum depression that probably occurs in10-15 % of cases. Mental disorders not only have a negative impact on the mental health of the women affected, such as chronification and suicidal tendencies but can also adversely affect the mother-child relationship as well as the emotional and cognitive development of the child. For these reasons it is important, also under the aspects of a primary prevention with respect to the children of mentally ill mothers, to provide a needs-oriented, timely and disorder-specific interactional therapy, which also considers the long-term aspects of treatment. At the Celenus Klinik Carolabad in Chemnitz an integrated treatment model, the "Carola PLUS", could be established that caters for the particularly high demands of combined care and treatment for both mother and child. PMID:27531206

  10. 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

  11. 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.

  12. Integrated treatment of the severely injured patient with coexistent comorbidities. A case report and literature review.

    PubMed

    Pedrazzini, Alessio; Martelli, Alessandra; Magotti, Maria Grazia; Degli Antoni, Anna Maria; Cervellin, Gianfranco

    2015-01-01

    Major trauma represents a paradigmatic clinical condition, needing multidisciplinary and structured approach. When a patient is affected by significant comorbidities such as diabetes mellitus and other conditions that compromise the immune competence the risk of infections in the presence of exposed fractures is remarkably high. Although usually managed by multidisciplinary teams, these patients often have unfavorable functional outcomes. We describe here the case of a young diabetic and immunosuppressed man, treated for a destroying injury of the left lower limb, with more than 60 centimeters of multiple fractures exposition. The prompt and fast integration of several different competences led to favorable functional outcome, without any severe local or systemic complication. Therefore, in severely injured patients, especially when affected by significant comorbidities, a quick and highly integrated treatment, provided by a polyspecialistic team, is crucial for reducing unfavorable outcomes and improving the recovery rate. PMID:26422438

  13. 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.

  14. 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.

  15. Asynchronous collision integrators: Explicit treatment of unilateral contact with friction and nodal restraints

    PubMed Central

    Wolff, Sebastian; Bucher, Christian

    2013-01-01

    This article presents asynchronous collision integrators and a simple asynchronous method treating nodal restraints. Asynchronous discretizations allow individual time step sizes for each spatial region, improving the efficiency of explicit time stepping for finite element meshes with heterogeneous element sizes. The article first introduces asynchronous variational integration being expressed by drift and kick operators. Linear nodal restraint conditions are solved by a simple projection of the forces that is shown to be equivalent to RATTLE. Unilateral contact is solved by an asynchronous variant of decomposition contact response. Therein, velocities are modified avoiding penetrations. Although decomposition contact response is solving a large system of linear equations (being critical for the numerical efficiency of explicit time stepping schemes) and is needing special treatment regarding overconstraint and linear dependency of the contact constraints (for example from double-sided node-to-surface contact or self-contact), the asynchronous strategy handles these situations efficiently and robust. Only a single constraint involving a very small number of degrees of freedom is considered at once leading to a very efficient solution. The treatment of friction is exemplified for the Coulomb model. Special care needs the contact of nodes that are subject to restraints. Together with the aforementioned projection for restraints, a novel efficient solution scheme can be presented. The collision integrator does not influence the critical time step. Hence, the time step can be chosen independently from the underlying time-stepping scheme. The time step may be fixed or time-adaptive. New demands on global collision detection are discussed exemplified by position codes and node-to-segment integration. Numerical examples illustrate convergence and efficiency of the new contact algorithm. Copyright © 2013 The Authors. International Journal for Numerical Methods in

  16. The integrated continence system: a manual therapy approach to the treatment of stress urinary incontinence.

    PubMed

    Grewar, Heather; McLean, Linda

    2008-10-01

    Stress urinary incontinence (SUI) constitutes a large-scale public health concern. The integrated continence system (ICS) developed by the authors is an evidence-based model that demonstrates how urinary incontinence is maintained through the interaction of three structural systems (intrinsic urethral closure, urethral support and lumbopelvic stability) and three modifiable factors (motor control, musculoskeletal and behavioural). The purpose of the ICS is first, to demonstrate the important role that manual physiotherapists can play in the treatment of SUI and second, to guide clinical practice decisions in order to improve clinical outcomes among women with SUI.

  17. Introduction to the special feature on the integrated treatment of personality disorder.

    PubMed

    Dimaggio, Giancarlo; Livesley, John

    2012-02-01

    The solid evidence that personality disorders can be treated effectively goes side by side with, on the one hand, sparse evidence for disorders other than borderline and for personality disorders co-occurrent with one another, and, on the other hand, with a relative lack of knowledge about the actual effective mechanisms of change that underpin successful psychotherapies. In this introduction we present the rationale for this special feature, advocating for an integrated treatment of personality pathology in which empirically-supported strategies and techniques are selected from different traditions on the basis of the pragmatic principle of what works.

  18. Integrating assertive community treatment and illness management and recovery for consumers with severe mental illness.

    PubMed

    Salyers, Michelle P; McGuire, Alan B; Rollins, Angela L; Bond, Gary R; Mueser, Kim T; Macy, Veronica R

    2010-08-01

    This study examined the integration of two evidence-based practices for adults with severe mental illness: Assertive community treatment (ACT) and illness management and recovery (IMR) with peer specialists as IMR practitioners. Two of four ACT teams were randomly assigned to implement IMR. Over 2 years, the ACT-IMR teams achieved moderate fidelity to the IMR model, but low penetration rates: 47 (25.7%) consumers participated in any IMR sessions and 7 (3.8%) completed the program during the study period. Overall, there were no differences in consumer outcomes at the ACT team level; however, consumers exposed to IMR showed reduced hospital use over time.

  19. 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.

  20. 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

  1. The place of psychodynamic psychotherapy in the integrated treatment of posttraumatic stress disorder and trauma recovery.

    PubMed

    Moss, Eric

    2009-06-01

    Psychodynamic psychotherapists treating posttraumatic stress disorder (PTSD) sufferers can draw on an accumulated body of trauma studies from their own field to guide their work. However, these reports, often based on case studies or conceptual reviews, do not have the same empirical conclusiveness as more recent evidence-based research demonstrating the efficacy of cognitive-behavioral and body-oriented therapies. In this article, a psychodynamic psychotherapist reflects on his treatment of an Israeli man who developed PTSD after enduring 4 terrorist attacks. The author shows how assimilative integration offered him a theory- and research-based model that helped him comfortably combine separate treatment interventions. He also shows how this model helped him locate with some precision the specific contribution of psychodynamic psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

  2. Electrocoagulation-integrated hybrid membrane processes for the treatment of tannery wastewater.

    PubMed

    Keerthi; Vinduja, V; Balasubramanian, N

    2013-10-01

    Three different combinations of treatment techniques, i.e. electrocoagulation combined with microfiltration (EMR), membrane bioreactor (MBR) and electrocoagulation integrated with membrane bioreactor (hybrid MBR, (HMBR)), were analysed and compared for the treatment of tannery wastewater operated for 7 days under the constant trans-membrane pressure of 5 kPa. HMBR was found to be most suitable in performance as well as fouling reduction, with 94 % of chemical oxygen demand (COD) removal, 100 % chromium removal and 8 % improvement in percentage reduction in permeate flux compared to MBR with only 90 % COD removal and 67 % chromium removal. The effect of mixed liquor suspended solids on fouling was also investigated and was found to be insignificant. EMR was capable of elevating the flux but was not as efficient as HMBR and MBR in COD removal. Fouling reduction by HMBR was further confirmed by SEM-EDX and particle size analysis.

  3. Integrated coagulation-trickling filter-ultrafiltration processes for domestic wastewater treatment and reclamation.

    PubMed

    Zhao, Qing-Liang; Zhong, Hui-Yuan; Liu, Jin-Li; Liu, Yu

    2012-01-01

    More and more research effort has been put into the development of affordable and high-efficiency wastewater reclamation technology for small communities. In this study, an integrated chemically enhanced primary treatment (CEPT), trickling filter (TF) and ultrafiltration (UF) process was developed with success. Coagulant produced from fly ash was used to enhance primary treatment, while trickling filter packed with coal cinder through four-layer structure without aeration was employed for further removal of COD and ammonium-nitrogen from the CEPT effluent. 95 and 88% removal of COD and ammonium were achieved, while total phosphorus (TP) and suspended solid (SS) were found to be removed completely at a coagulant dosage of 2.5 mL/L in the CEPT-TF-UF system. The product water can meet the standard of Reuse of Recycling Water for Urban Water Quality Standard for Urban Miscellaneous Water Consumption (GB/T 18920-2002, China).

  4. 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.

  5. 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

  6. 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.

  7. Delayed antiretroviral therapy despite integrated treatment for tuberculosis and human immunodeficiency virus

    PubMed Central

    Patel, Monita R.; Nana, Mbonze; Yotebieng, Marcel; Tabala, Martine; Behets, Frieda; Van Rie, Annelies

    2016-01-01

    Setting Five primary health care clinics in Kinshasa, Democratic Republic of Congo. Objective To examine timing and predictors of delayed ART initiation during TB treatment. Design Prospective observational cohort of adult patients receiving integrated TB/HIV treatment, expected to initiate ART at 1 month if CD4 count <100 cells/mm3 or WHO clinical stage 4 for reason other than extrapulmonary TB, at 2 months if CD4 count 100–350 cells/mm3, or at completion of TB treatment if subsequently CD4 count ≤350 cells/mm3 or WHO clinical stage 4. Results Of 492 patients, 235 (47.8%) experienced delayed ART initiation: 171 (72.8%) initiated ART late, after a median delay of 12 days (IQR 4–27) and 64 (27.2%) never initiated ART. Contraindication to any ARV drug (adjOR 2.91, 95% CI 1.22–6.95), lower baseline CD4 count (adjOR 1.20, 95% CI 1.08–1.33 per 100 cells/mm3), TB drug intolerance (adjOR 1.93, 95% CI 1.23–3.02), and non-disclosure of HIV-infection (adjOR 1.50, 95% CI 1.03–2.18) predicted delayed ART initiation. Conclusion Despite fully-integrated treatment, half of all patients experienced delayed ART initiation. Pragmatic approaches to ensure timely ART initiation in those at-risk of delayed ART initiation are needed. PMID:24903941

  8. Sustainable development and migration policies: their treatment within the Latin American economic integration blocks.

    PubMed

    Marmora, L

    1994-01-01

    Without an equal sharing of costs and benefits of natural and human resources worldwide, imbalances and lack of human development lead to migration within and between countries. Economic integration blocks in Latin America provide a context for shared development: in Central America, in the Andean Region, and in the Southern Cone. Over the past 60 years migration policy was based on national protectionism, labor supply, and/or occupation of territory. When economic conditions changed to market economies and world markets, migration policy was redefined. Each of the economic integration blocks has developed its own strategies. The Andean Agreement on Labor Migrations was established to determine the rules for bilateral and multilateral treatment of problems. In the Southern Cone bilateral agreements have been longstanding. Multilateral efforts were recently underway within the Southern Common Market and throughout the region. The Central American Organization for Migrations has spearheaded the adoption of a multilateral strategy. All three regions have made considerable progress in the last three years in constructing multilateral policies for economic integration. Government awareness has been the primary force in these policy changes. Government has come to an understanding that clear domestic and regional migration policies were lacking and that obsolete migration practices of the 1930s did not meet the needs of the 1990s. Migration policy was considered an instrument of development. Movement of economic factors or goods was considered equally with movement of labor. Migration policies must integrate the human rights of migrants into their definitions. Methods of facilitating the movements of populations need to be constructed within the computerization and modernization of the migration administration. Legalization of illegal immigrants has occurred among a number of countries. PROCAM and PRIMCOS were action programs which aimed to integrate migration and

  9. 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

  10. 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

  11. 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.

  12. 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.

  13. 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.

  14. 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

  15. 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.

  16. 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.

  17. 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.

  18. 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

  19. 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

  20. 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.

  1. Plant-integrated measurement of greenhouse gas emissions from a municipal wastewater treatment plant.

    PubMed

    Yoshida, Hiroko; Mønster, Jacob; Scheutz, Charlotte

    2014-09-15

    Wastewater treatment plants (WWTPs) contribute to anthropogenic greenhouse gas (GHG) emissions. Due to its spatial and temporal variation in emissions, whole plant characterization of GHG emissions from WWTPs face a number of obstacles. In this study, a tracer dispersion method was applied to quantify plant-integrated, real-time emissions of methane and nitrous oxides. Two mobile cavity ring-down spectroscopy sampling devices were used to record downwind gas concentrations emitted from a municipal WWTP situated in Copenhagen, Denmark. This plant is equipped to remove biological nitrogen and employs anaerobic digestion for sludge stabilization. Over the course of nine measurement campaigns, a wide range of emissions were detected: methane from 4.99 kg h(-1) up to 92.3 kg h(-1) and nitrous oxide from below the detection limit (0.37 kg h(-1)) up to 10.5 kg h(-1). High emissions were observed during periods experiencing operational problems, such as during foaming events in anaerobic digesters and during sub-optimal operation of biological nitrogen removal in the secondary treatment of wastewater. Methane emissions detected during measurement campaigns corresponded to 2.07-32.7% of the methane generated in the plant. As high as 4.27% of nitrogen entering the WWTP was emitted as nitrous oxide under the sub-optimal operation of biological treatment processes. The study shows that the unit process configuration, as well as the operation of the WWTP, determines the rate of GHG emission. The applied plant-integrated emission measurement method could be used to ease the burden of quantifying GHG emissions from WWTPs for reporting purposes and could contribute to the development of more accurate depictions of environmental performance of WWTPs.

  2. 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.

  3. 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

  4. 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.

  5. 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…

  6. 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

  7. Energy-nutrients-water nexus: integrated resource recovery in municipal wastewater treatment plants.

    PubMed

    Mo, Weiwei; Zhang, Qiong

    2013-09-30

    Wastewater treatment consumes large amounts of energy and materials to comply with discharge standards. At the same time, wastewater contains resources, which can be recovered for secondary uses if treated properly. Hence, the goal of this paper is to review the available resource recovery methods onsite or offsite of municipal wastewater treatment plants. These methods are categorized into three major resource recovery approaches: onsite energy generation, nutrient recycling and water reuse. Under each approach, the review provides the advantages and disadvantages, recovery potentials and current application status of each method, as well as the synthesized results of the life cycle studies for each approach. From a comprehensive literature review, it was found that, in addition to technology improvements, there is also a need to evaluate the applications of the resource recovery methods in wastewater treatment plants from a life cycle perspective. Future research should investigate the integration of the resource recovery methods to explore the combined benefits and potential tradeoffs of these methods under different scales.

  8. 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.

  9. [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.

  10. [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

  11. 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

  12. 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

  13. 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.

  14. NOTE: Tradeoffs of integrating real-time tracking into IGRT for prostate cancer treatment

    NASA Astrophysics Data System (ADS)

    Zhu, X.; Bourland, J. D.; Yuan, Y.; Zhuang, T.; O'Daniel, J.; Thongphiew, D.; Wu, Q. J.; Das, S. K.; Yoo, S.; Yin, F. F.

    2009-09-01

    This study investigated the integration of the Calypso real-time tracking system, based on implanted ferromagnetic transponders and a detector array, into the current process for image-guided radiation treatment (IGRT) of prostate cancer at our institution. The current IGRT process includes magnetic resonance imaging (MRI) for prostate delineation, CT simulation for treatment planning, daily on-board kV and CBCT imaging for target alignment, and MRI/MRS for post-treatment assessment. This study assesses (1) magnetic-field-induced displacement and radio-frequency (RF)-induced heating of transponders during MRI at 1.5 T and 3 T, and (2) image artifacts caused by transponders and the detector array in phantom and patient cases with the different imaging systems. A tissue-equivalent phantom mimicking prostate tissue stiffness was constructed and implanted with three operational transponders prior to phantom solidification. The measurements show that the Calypso system is safe with all the imaging systems. Transponder position displacements due to the MR field are minimal (<1.0 mm) for both 1.5 T and 3 T MRI scanners, and the temperature variation due to MRI RF heating is <0.2 °C. The visibility of transponders and bony anatomy was not affected on the OBI kV and CT images. Image quality degradation caused by the detector antenna array is observed in the CBCT image. Image artifacts are most significant with the gradient echo sequence in the MR images, producing null signals surrounding the transponders with radii ~1.5 cm and length ~4 cm. Thus, Calypso transponders can preclude the use of MRI/MRS in post-treatment assessment. Modifications of the clinical flow are required to accommodate and minimize the substantial MRI artifacts induced by the Calypso transponders.

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

    PubMed

    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.

  16. 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

  17. Evaluation of an integrated continuous stirred microbial electrochemical reactor: Wastewater treatment, energy recovery and microbial community.

    PubMed

    Wang, Haiman; Qu, Youpeng; Li, Da; Zhou, Xiangtong; Feng, Yujie

    2015-11-01

    A continuous stirred microbial electrochemical reactor (CSMER) was developed by integrating anaerobic digestion (AD) and microbial electrochemical system (MES). The system was capable of treating high strength artificial wastewater and simultaneously recovering electric and methane energy. Maximum power density of 583±9, 562±7, 533±10 and 572±6 mW m(-2) were obtained by each cell in a four-independent circuit mode operation at an OLR of 12 kg COD m(-3) d(-1). COD removal and energy recovery efficiency were 87.1% and 32.1%, which were 1.6 and 2.5 times higher than that of a continuous stirred tank reactor (CSTR). Larger amount of Deltaproteobacteria (5.3%) and hydrogenotrophic methanogens (47%) can account for the better performance of CSMER, since syntrophic associations among them provided more degradation pathways compared to the CSTR. Results demonstrate the CSMER holds great promise for efficient wastewater treatment and energy recovery.

  18. 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

  19. An integrated model for prevention and treatment of drug abuse among American Indian youth.

    PubMed

    Beauvais, F

    1992-01-01

    American Indian youth have been shown to be at high risk for drug abuse. Epidemiological studies of Indian school students over the past two decades have revealed rates of use consistently higher than those found for other youth. Socioeconomic and historical factors have led to conditions that put a great deal of stress on the family and other support systems which in part account for the seriousness of the problem. A model is presented which can guide both prevention and treatment efforts addressing drug abuse in Indian communities. Five variable domains, social structure, socialization factors, psychological variables, peer associations and drug use, are related in an integrated structure. By following the progression of the etiological variables, a stepwise plan can be developed to organize interventions. Although the model has immediate utility, a number of further research questions are outlined that will enhance its application.

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

    PubMed

    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

  1. Integrated catalytic wet air oxidation and biological treatment of wastewater from Vitamin B 6 production

    NASA Astrophysics Data System (ADS)

    Kang, Jianxiong; Zhan, Wei; Li, Daosheng; Wang, Xiaocong; Song, Jing; Liu, Dongqi

    This study investigated the feasibility of coupling a catalytic wet air oxidation (CWAO), with CuO/Al 2O 3 as catalyst, and an anaerobic/aerobic biological process to treat wastewater from Vitamin B 6 production. Results showed that the CWAO enhanced the biodegradability (BOD 5/COD) from 0.10 to 0.80. The oxidized effluents with COD of 10,000 mg l -1 was subjected to subsequent continuous anaerobic/aerobic oxidation, and 99.3% of total COD removal was achieved. The quality of the effluent obtained met the discharge standards of water pollutants for pharmaceutical industry Chemical Synthesis Products Category (GB21904-2008), and thereby it implies that the integrated CWAO and anaerobic/aerobic biological treatment may offer a promising process to treat wastewater from Vitamin B 6 production.

  2. Integration of targeted agents in the neo-adjuvant treatment of gastro-esophageal cancers.

    PubMed

    Power, D G; Ilson, D H

    2009-11-01

    Pre- and peri-operative strategies are becoming standard for the management of localized gastro-esophageal cancer. For localized gastric/gastro-esophageal junction (GEJ) cancer there are conflicting data that a peri-operative approach with cisplatin-based chemotherapy improves survival, with the benefits seen in esophageal cancer likely less than a 5-10% incremental improvement. Further trends toward improvement in local control and survival, when combined chemotherapy and radiation therapy are given pre-operatively, are suggested by recent phase III trials. In fit patients, a significant survival benefit with pre-operative chemoradiation is seen in those patients who achieve a pathologic complete response. In esophageal/GEJ cancer, definitive chemoradiation is now considered in medically inoperable patients. In squamous cell carcinoma of the esophagus, surgery after primary chemoradiation is not clearly associated with an improved overall survival, however, local control may be better. In localized gastric/GEJ cancer, the integration of bevacizumab with pre-operative chemotherapy is being explored in large randomized studies, and with chemoradiotherapy in pilot trials. The addition of anti-epidermal growth factor receptor and anti-human epidermal growth factor receptor-2 antibody treatment to pre-operative chemoradiation continues to be explored. Early results show the integration of targeted therapy is feasible. Metabolic imaging can predict early response to pre-operative chemotherapy and biomarkers may further predict response to pre-operative chemo-targeted therapy. A multimodality approach to localized gastro-esophageal cancer has resulted in better outcomes. For T3 or node-positive disease, surgery alone is no longer considered appropriate and neo-adjuvant therapy is recommended. The future of neo-adjuvant strategies in this disease will involve the individualization of therapy with the integration of molecular signatures, targeted therapy, metabolic imaging

  3. 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

  4. An integrated approach for establishing dosing recommendations: paliperidone for the treatment of adolescent schizophrenia.

    PubMed

    Younis, Islam Rasem; Laughren, Thomas P; Wang, Yaning; Mathis, Mitchell; Gobburu, Jogarao V

    2013-04-01

    The Food and Drug Administration recently approved Invega for the treatment of schizophrenia in adolescents 12 to 17 years. If dosing recommendations for this population would have been based only on the results of the single efficacy trial included in this program, paliperidone dosing in adolescents might have been limited to 3 mg/d in adolescents less than 51 kg and to 6 mg/d in adolescents greater than or equal to 51 kg. This article provides an illustration of a more integrated approach to arrive at dosing recommendation that included practical considerations, modeling and simulation of data from the clinical trial, and the totality of evidence for both paliperidone and the parent drug, risperidone. On the basis of this integrated approach, the agency approved a starting dose of 3 mg/d in both adolescent weight groups and subsequent dosing in a range of 3 to 6 mg/d for adolescents less than 51 kg and 3 to 12 mg/d for adolescents greater than 51 kg, although the 3-mg dose was not evaluated in the greater than or equal to 51-kg group. PMID:23422374

  5. Integrated, long term, sustainable, cost effective biosolids management at a large Canadian wastewater treatment facility.

    PubMed

    Leblanc, R J; Allain, C J; Laughton, P J; Henry, J G

    2004-01-01

    The Greater Moncton Sewerage Commission's 115,000 m3/d advanced, chemically assisted primary wastewater treatment facility located in New Brunswick, Canada, has developed an integrated, long term, sustainable, cost effective programme for the management and beneficial utilization of biosolids from lime stabilized raw sludge. The paper overviews biosolids production, lime stabilization, conveyance, and odour control followed by an indepth discussion of the wastewater sludge as a resource programme, namely: composting, mine site reclamation, landfill cover, land application for agricultural use, tree farming, sod farm base as a soil enrichment, topsoil manufacturing. The paper also addresses the issues of metals, pathogens, organic compounds, the quality control program along with the regulatory requirements. Biosolids capital and operating costs are presented. Research results on removal of metals from primary sludge using a unique biological process known as BIOSOL as developed by the University of Toronto, Canada to remove metals and destroy pathogens are presented. The paper also discusses an ongoing cooperative research project with the Université de Moncton where various mixtures of plant biosolids are composted with low quality soil. Integration, approach to sustainability and "cumulative effects" as part of the overall biosolids management strategy are also discussed.

  6. Integrated, long term, sustainable, cost effective biosolids management at a large Canadian wastewater treatment facility.

    PubMed

    Leblanc, R J; Allain, C J; Laughton, P J; Henry, J G

    2004-01-01

    The Greater Moncton Sewerage Commission's 115,000 m3/d advanced, chemically assisted primary wastewater treatment facility located in New Brunswick, Canada, has developed an integrated, long term, sustainable, cost effective programme for the management and beneficial utilization of biosolids from lime stabilized raw sludge. The paper overviews biosolids production, lime stabilization, conveyance, and odour control followed by an indepth discussion of the wastewater sludge as a resource programme, namely: composting, mine site reclamation, landfill cover, land application for agricultural use, tree farming, sod farm base as a soil enrichment, topsoil manufacturing. The paper also addresses the issues of metals, pathogens, organic compounds, the quality control program along with the regulatory requirements. Biosolids capital and operating costs are presented. Research results on removal of metals from primary sludge using a unique biological process known as BIOSOL as developed by the University of Toronto, Canada to remove metals and destroy pathogens are presented. The paper also discusses an ongoing cooperative research project with the Université de Moncton where various mixtures of plant biosolids are composted with low quality soil. Integration, approach to sustainability and "cumulative effects" as part of the overall biosolids management strategy are also discussed. PMID:15259950

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

    PubMed

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

    2009-03-01

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

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

    PubMed

    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

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

    PubMed

    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

    2016-09-06

    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.

  10. Measuring the Integration of Tobacco Policy and Treatment into the Behavioral Health Care Delivery System: How Are We Doing?

    PubMed

    Christiansen, Bruce A; Macmaster, David R; Heiligenstein, Eric L; Glysch, Randal L; Riemer, Donna M; Adsit, Robert T; Hayden, Kristine A; Hollenback, Christopher P; Fiore, Michael C

    2016-01-01

    People with a mental illness and/or drug use disorder have a higher rate of smoking than adults in general. To address this challenge, recommendations include integrating tobacco-free policies and tobacco dependency treatment into the behavioral health care delivery system. Currently, little is known regarding levels of such integration. A 65-item Internet survey measuring integration assessed three areas: a) policies addressing the use of tobacco products; b) provision of evidence-based tobacco dependence treatment; and, c) capacity to help employees/volunteers quit tobacco use. The survey was distributed to representatives of all behavioral health programs in Wisconsin. The survey response rate was 27.1%. Programs, on average, were 40% integrated. A significant proportion of programs (20%) were less than 20% integrated. A few programs (4.3%) exceeded 80% integration. Integration of tobacco policies and treatment into the behavioral health care delivery system remains limited and there is a need for technical assistance and training. PMID:27180692

  11. HIV-K: an integrative knowledge base for semantic integration of AIDS-related malignancy data and treatment outcomes.

    PubMed

    Tirado-Ramos, A; Saltz, Joel; Lechowicz, Mary Jo

    2010-01-01

    Technological innovations such as web services and collaborative Grid platforms like caGrid can create opportunities to converge the worlds of health care and clinical research, by facilitating access and integration of HIV-related malignancy clinical and outcomes data at more sophisticated, semantic levels. At the same time, large numbers of randomized clinical trial and outcomes data on AIDS-defining malignancies (ADM) and non-AIDS-defining malignancies (nADM) have been produced during the last few years. There is still much work to do, though, on obtaining clear conclusions from the integration of such information. This is a white paper on work in progress from Emory University's HIV/AIDS related malignancy data integrative knowledge base project (HIV-K). We are working to increase the understanding of available clinical trial data and outcomes of ADM such as lymphoma, as well as nADM such as anal cancer, Hodgkin lymphoma, or liver cancer. Our hypothesis is that, by creating prototypes of tools for semantics-enabled integrative knowledge bases for HIV/AIDS-related malignancy data, we will facilitate the identification of patterns and potential new overall evidence, as well as the linking of integrated data and results to registries of interest.

  12. A Comparison of Performance Feedback Procedures on Teachers' Treatment Implementation Integrity and Students' Inappropriate Behavior in Special Education Classrooms

    PubMed Central

    DiGennaro, Florence D; Martens, Brian K; Kleinmann, Ava E

    2007-01-01

    This study examined the extent to which treatment integrity of 4 special education teachers was affected by goal setting, performance feedback regarding student or teacher performance, and a meeting cancellation contingency. Teachers were trained to implement function-based treatment packages to address student problem behavior. In one condition, teachers set a goal for student behavior and received daily written feedback about student performance. In a second condition, teachers received daily written feedback about student performance as well as their own accuracy in implementing the intervention and would be able to avoid meeting with a consultant to practice missed steps by implementing the intervention with 100% integrity. This latter package increased treatment integrity the most above baseline levels. Higher levels of treatment integrity were significantly correlated with lower levels of student problem behavior for 3 of the 4 teacher–student dyads. Three of the 4 teachers also rated both feedback procedures as highly acceptable. Implications for increasing and maintaining treatment integrity by teachers via a consultation model are discussed. PMID:17970259

  13. Integration of intensive care treatment and neurorehabilitation in patients with disorders of consciousness: a program description and case report.

    PubMed

    Eifert, Bernd; Maurer-Karattup, Petra; Schorl, Martin

    2013-10-01

    Severe brain injuries frequently result in disorders of consciousness, requiring intensive care unit treatment. We present a rehabilitative system that integrates neurorehabilitation into intensive care treatment. The system will be described using the case report of a young man who was in a vegetative state after a severe traumatic brain injury that resulted in major medical problems and complications. Despite these challenges, interdisciplinary therapies can be applied throughout the rehabilitative process. The patient in our case report showed significant improvements and functional gains during the course of treatment. Additional data from other patients support the feasibility of this system and show that integrating neurorehabilitation into intensive care treatment is possible and can lead to improved outcomes in this patient population. We will discuss the advantages, special features, and limitations of the system. Additional studies are needed to further demonstrate the efficacy of this approach compared with standard treatment.

  14. The impact of an integrated treatment on HIV risk behavior among homeless youth: a randomized controlled trial

    PubMed Central

    Slesnick, Natasha; Kang, Min Ju

    2008-01-01

    While many studies provide useful information on the risk behaviors in which homeless youth engage, few prior studies evaluate Human Immunodeficiency Virus (HIV) risk related reduction strategies. In this study, homeless youth (n = 180) were recruited from a drop-in center and randomly assigned to one of two conditions, either an integrated individual cognitive-behavioral treatment and HIV prevention intervention that focused on skills building and education or to treatment as usual. All youth were assessed at entry into the program and at 3 and 6 month follow-up points. Findings showed an interaction between treatment condition, age and time. In the interaction, youth assigned to the integrated treatment reported greater condom usage than youth assigned to treatment as usual, with younger youth assigned to treatment as usual showing no change in condom use. The number of sexual partners reported by youth in both treatment conditions was also reduced over time. However, youth in both conditions continued to engage in other high-risk behaviors. The integrated treatment findings are promising and suggest that interventions which target both HIV risk behavior in addition to other life areas (substance use, mental health and housing) among homeless youth may be necessary in order to significantly impact high-risk behaviors among this unique group. PMID:17940861

  15. Operator decision support system for integrated wastewater management including wastewater treatment plants and receiving water bodies.

    PubMed

    Kim, Minsoo; Kim, Yejin; Kim, Hyosoo; Piao, Wenhua; Kim, Changwon

    2016-06-01

    An operator decision support system (ODSS) is proposed to support operators of wastewater treatment plants (WWTPs) in making appropriate decisions. This system accounts for water quality (WQ) variations in WWTP influent and effluent and in the receiving water body (RWB). The proposed system is comprised of two diagnosis modules, three prediction modules, and a scenario-based supporting module (SSM). In the diagnosis modules, the WQs of the influent and effluent WWTP and of the RWB are assessed via multivariate analysis. Three prediction modules based on the k-nearest neighbors (k-NN) method, activated sludge model no. 2d (ASM2d) model, and QUAL2E model are used to forecast WQs for 3 days in advance. To compare various operating alternatives, SSM is applied to test various predetermined operating conditions in terms of overall oxygen transfer coefficient (Kla), waste sludge flow rate (Qw), return sludge flow rate (Qr), and internal recycle flow rate (Qir). In the case of unacceptable total phosphorus (TP), SSM provides appropriate information for the chemical treatment. The constructed ODSS was tested using data collected from Geumho River, which was the RWB, and S WWTP in Daegu City, South Korea. The results demonstrate the capability of the proposed ODSS to provide WWTP operators with more objective qualitative and quantitative assessments of WWTP and RWB WQs. Moreover, the current study shows that ODSS, using data collected from the study area, can be used to identify operational alternatives through SSM at an integrated urban wastewater management level.

  16. An Integrated Human/Murine Transcriptome and Pathway Approach To Identify Prenatal Treatments For Down Syndrome

    PubMed Central

    Guedj, Faycal; Pennings, Jeroen LA; Massingham, Lauren J.; Wick, Heather C.; Siegel, Ashley E.; Tantravahi, Umadevi; Bianchi, Diana W.

    2016-01-01

    Anatomical and functional brain abnormalities begin during fetal life in Down syndrome (DS). We hypothesize that novel prenatal treatments can be identified by targeting signaling pathways that are consistently perturbed in cell types/tissues obtained from human fetuses with DS and mouse embryos. We analyzed transcriptome data from fetuses with trisomy 21, age and sex-matched euploid controls, and embryonic day 15.5 forebrains from Ts1Cje, Ts65Dn, and Dp16 mice. The new datasets were compared to other publicly available datasets from humans with DS. We used the human Connectivity Map (CMap) database and created a murine adaptation to identify FDA-approved drugs that can rescue affected pathways. USP16 and TTC3 were dysregulated in all affected human cells and two mouse models. DS-associated pathway abnormalities were either the result of gene dosage specific effects or the consequence of a global cell stress response with activation of compensatory mechanisms. CMap analyses identified 56 molecules with high predictive scores to rescue abnormal gene expression in both species. Our novel integrated human/murine systems biology approach identified commonly dysregulated genes and pathways. This can help to prioritize therapeutic molecules on which to further test safety and efficacy. Additional studies in human cells are ongoing prior to pre-clinical prenatal treatment in mice. PMID:27586445

  17. Operator decision support system for integrated wastewater management including wastewater treatment plants and receiving water bodies.

    PubMed

    Kim, Minsoo; Kim, Yejin; Kim, Hyosoo; Piao, Wenhua; Kim, Changwon

    2016-06-01

    An operator decision support system (ODSS) is proposed to support operators of wastewater treatment plants (WWTPs) in making appropriate decisions. This system accounts for water quality (WQ) variations in WWTP influent and effluent and in the receiving water body (RWB). The proposed system is comprised of two diagnosis modules, three prediction modules, and a scenario-based supporting module (SSM). In the diagnosis modules, the WQs of the influent and effluent WWTP and of the RWB are assessed via multivariate analysis. Three prediction modules based on the k-nearest neighbors (k-NN) method, activated sludge model no. 2d (ASM2d) model, and QUAL2E model are used to forecast WQs for 3 days in advance. To compare various operating alternatives, SSM is applied to test various predetermined operating conditions in terms of overall oxygen transfer coefficient (Kla), waste sludge flow rate (Qw), return sludge flow rate (Qr), and internal recycle flow rate (Qir). In the case of unacceptable total phosphorus (TP), SSM provides appropriate information for the chemical treatment. The constructed ODSS was tested using data collected from Geumho River, which was the RWB, and S WWTP in Daegu City, South Korea. The results demonstrate the capability of the proposed ODSS to provide WWTP operators with more objective qualitative and quantitative assessments of WWTP and RWB WQs. Moreover, the current study shows that ODSS, using data collected from the study area, can be used to identify operational alternatives through SSM at an integrated urban wastewater management level. PMID:26893178

  18. Development of an integrated enzymatic treatment system for phenolic waste streams.

    PubMed

    Mao, X; Buchanan, I D; Stanley, S J

    2006-12-01

    An integrated enzymatic treatment system, which includes Coprinus cinereus peroxidase (CIP) production, processing, and usage in batch or plug flow reactors, is being developed to remove phenolic compounds from the aqueous waste streams. CIP production at bench scale yielded a maximum growth medium activity of approximately 60 U CIP ml(-1). A CIP enzyme solution was prepared for use in treatment by successive filtration steps. This yielded a 4.5-fold increase in enzyme activity, with 87% enzyme activity recovery, and 83% reduction in the solution's Chemical Oxygen Demand. The purity of CIP was observed to have no effect on the ability of the enzyme to remove phenol from the aqueous solutions within the range of enzyme solution purities tested. Contrary to observations reported for phenol removal from buffered solutions, the addition of polyethylene glycol to non-buffered reaction solutions had no positive effect on the phenol removal accomplished at pH 7 in these experiments. The efficiency of enzyme use in a plug flow reactor was improved by step additions of CIP and H2O2.

  19. Integration of photocatalysis and biological treatment for azo dye removal--application to AR183.

    PubMed

    Chebli, Derradji; Fourcade, Florence; Brosillon, Stephan; Nacef, Saci; Amrane, Abdeltif

    2011-04-01

    The feasibility of coupling photocatalysis with biological treatment to treat effluents containing azo dyes was examined in this work. With this aim, the degradation of Acid Red 183 was investigated. The very low biodegradability of AR183 was confirmed beforehand by measuring the biological oxygen demand (BOD5). Photocatalysis experiments were carried out in a closed-loop step photoreactor. The reactor walls were covered by TiO2 catalyst coated on non-woven paper, and the effluent flowed over the photocatalyst as a thin falling film. The removal of the dye was 82.7% after 4 h, and a quasi-complete decolorization (98.5%) was obtained for 10 h of irradiation (initial concentration 100 mg L(-1)). The decrease in concentration followed pseudo-first-order kinetics, with a constant k of 0.47 h(-1). Mineralization and oxidation yields were 80% and 75%, respectively, after 10 h of pretreatment. Therefore, even if target compound oxidation occurs (COD removal), indicating a modification to the chemical structure, the concomitant high mineralization was not in favour of subsequent microbial growth. The BOD5 measurement confirmed the non-biodegradability of the irradiated solution, which remained toxic since the EC50 decreased from 35 to 3 mg L(-1). The proposed integrated process appeared, therefore, to be not relevant for the treatment of AR183. However, this result should be confirmed for other azo dyes.

  20. An Integrated Human/Murine Transcriptome and Pathway Approach To Identify Prenatal Treatments For Down Syndrome.

    PubMed

    Guedj, Faycal; Pennings, Jeroen LA; Massingham, Lauren J; Wick, Heather C; Siegel, Ashley E; Tantravahi, Umadevi; Bianchi, Diana W

    2016-01-01

    Anatomical and functional brain abnormalities begin during fetal life in Down syndrome (DS). We hypothesize that novel prenatal treatments can be identified by targeting signaling pathways that are consistently perturbed in cell types/tissues obtained from human fetuses with DS and mouse embryos. We analyzed transcriptome data from fetuses with trisomy 21, age and sex-matched euploid controls, and embryonic day 15.5 forebrains from Ts1Cje, Ts65Dn, and Dp16 mice. The new datasets were compared to other publicly available datasets from humans with DS. We used the human Connectivity Map (CMap) database and created a murine adaptation to identify FDA-approved drugs that can rescue affected pathways. USP16 and TTC3 were dysregulated in all affected human cells and two mouse models. DS-associated pathway abnormalities were either the result of gene dosage specific effects or the consequence of a global cell stress response with activation of compensatory mechanisms. CMap analyses identified 56 molecules with high predictive scores to rescue abnormal gene expression in both species. Our novel integrated human/murine systems biology approach identified commonly dysregulated genes and pathways. This can help to prioritize therapeutic molecules on which to further test safety and efficacy. Additional studies in human cells are ongoing prior to pre-clinical prenatal treatment in mice. PMID:27586445

  1. Treatment of vegetable oily wastewater using an integrated microfiltration-reverse osmosis system.

    PubMed

    Yu, Xiaoli; Zhong, Zhaoxiang; Xing, Weihong

    2010-01-01

    Vegetable oil processing plants and catering trade often generate a large amount of oil-containing wastewater, which causes serious environmental problems. The objective of this work was to explore the feasibility of vegetable oil wastewater treatment with an integrated microfiltration-reverse osmosis (MF-RO) process. The influence of operational parameters on the separation behaviors were investigated in MF process. In MF continuous process the steady flux was around 90 (L/m(2) h) when the concentrated multiple reached 16, and the oil content in permeate was less than 12 mg/L. In the RO continuous process, antifouling membrane was used to treat permeate from the ceramic membrane process in order to improve the water quality. The RO process had a permeate flux of 24 (L/m(2) h) and water recovery rate of 95%. The permeate from the RO stage was free of oil, and its TOC and conductivity were less than 0.6 mg/L and 50 micros/cm, respectively. The results demonstrated that the two stage membrane process combining MF and RO is highly efficient in the treatment of oil-containing wastewater.

  2. The BraveNet prospective observational study on integrative medicine treatment approaches for pain

    PubMed Central

    2013-01-01

    Background Chronic pain affects nearly 116 million American adults at an estimated cost of up to $635 billion annually and is the No. 1 condition for which patients seek care at integrative medicine clinics. In our Study on Integrative Medicine Treatment Approaches for Pain (SIMTAP), we observed the impact of an integrative approach on chronic pain and a number of other related patient-reported outcome measures. Methods Our prospective, non-randomized, open-label observational evaluation was conducted over six months, at nine clinical sites. Participants received a non-standardized, personalized, multimodal approach to chronic pain. Validated instruments for pain (severity and interference levels), quality of life, mood, stress, sleep, fatigue, sense of control, overall well-being, and work productivity were completed at baseline and at six, 12, and 24 weeks. Blood was collected at baseline and week 12 for analysis of high-sensitivity C-reactive protein and 25-hydroxyvitamin D levels. Repeated-measures analysis was performed on data to assess change from baseline at 24 weeks. Results Of 409 participants initially enrolled, 252 completed all follow-up visits during the 6 month evaluation. Participants were predominantly white (81%) and female (73%), with a mean age of 49.1 years (15.44) and an average of 8.0 (9.26) years of chronic pain. At baseline, 52% of patients reported symptoms consistent with depression. At 24 weeks, significantly decreased pain severity (−23%) and interference (−28%) were seen. Significant improvements in mood, stress, quality of life, fatigue, sleep and well-being were also observed. Mean 25-hydroxyvitamin D levels increased from 33.4 (17.05) ng/mL at baseline to 39.6 (16.68) ng/mL at week 12. Conclusions Among participants completing an integrative medicine program for chronic pain, significant improvements were seen in pain as well as other relevant patient-reported outcome measures. Trial Registration ClinicalTrials.gov, NCT

  3. Verification of Fowler-Nordheim electron tunneling mechanism in Ni/SiO2/n-4H SiC and n+ poly-Si/SiO2/n-4H SiC MOS devices by different models

    NASA Astrophysics Data System (ADS)

    Kodigala, Subba Ramaiah

    2016-11-01

    This article emphasizes verification of Fowler-Nordheim electron tunneling mechanism in the Ni/SiO2/n-4H SiC MOS devices by developing three different kinds of models. The standard semiconductor equations are categorically solved to obtain the change in Fermi energy level of semiconductor with effect of temperature and field that extend support to determine sustainable and accurate tunneling current through the oxide layer. The forward and reverse bias currents with variation of electric field are simulated with help of different models developed by us for MOS devices by applying adequate conditions. The latter is quite different from former in terms of tunneling mechanism in the MOS devices. The variation of barrier height with effect of quantum mechanical, temperature, and fields is considered as effective barrier height for the generation of current-field (J-F) curves under forward and reverse biases but quantum mechanical effect is void in the latter. In addition, the J-F curves are also simulated with variation of carrier concentration in the n-type 4H SiC semiconductor of MOS devices and the relation between them is established.

  4. Towards integration of PET/MR hybrid imaging into radiation therapy treatment planning

    SciTech Connect

    Paulus, Daniel H.; Thorwath, Daniela; Schmidt, Holger; Quick, Harald H.

    2014-07-15

    Purpose: Multimodality imaging has become an important adjunct of state-of-the-art radiation therapy (RT) treatment planning. Recently, simultaneous PET/MR hybrid imaging has become clinically available and may also contribute to target volume delineation and biological individualization in RT planning. For integration of PET/MR hybrid imaging into RT treatment planning, compatible dedicated RT devices are required for accurate patient positioning. In this study, prototype RT positioning devices intended for PET/MR hybrid imaging are introduced and tested toward PET/MR compatibility and image quality. Methods: A prototype flat RT table overlay and two radiofrequency (RF) coil holders that each fix one flexible body matrix RF coil for RT head/neck imaging have been evaluated within this study. MR image quality with the RT head setup was compared to the actual PET/MR setup with a dedicated head RF coil. PET photon attenuation and CT-based attenuation correction (AC) of the hardware components has been quantitatively evaluated by phantom scans. Clinical application of the new RT setup in PET/MR imaging was evaluated in anin vivo study. Results: The RT table overlay and RF coil holders are fully PET/MR compatible. MR phantom and volunteer imaging with the RT head setup revealed high image quality, comparable to images acquired with the dedicated PET/MR head RF coil, albeit with 25% reduced SNR. Repositioning accuracy of the RF coil holders was below 1 mm. PET photon attenuation of the RT table overlay was calculated to be 3.8% and 13.8% for the RF coil holders. With CT-based AC of the devices, the underestimation error was reduced to 0.6% and 0.8%, respectively. Comparable results were found within the patient study. Conclusions: The newly designed RT devices for hybrid PET/MR imaging are PET and MR compatible. The mechanically rigid design and the reproducible positioning allow for straightforward CT-based AC. The systematic evaluation within this study provides the

  5. Simulation of integrated pollutant removal (IPR) water-treatment system using ASPEN Plus

    SciTech Connect

    Harendra, Sivaram; Oryshcyhn, Danylo [U.S. DOE Ochs, Thomas [U.S. DOE Gerdemann, Stephen; Clark, John

    2013-01-01

    Capturing CO2 from fossil fuel combustion provides an opportunity for tapping a significant water source which can be used as service water for a capture-ready power plant and its peripherals. Researchers at the National Energy Technology Laboratory (NETL) have patented a process—Integrated Pollutant Removal (IPR®)—that uses off-the-shelf technology to produce a sequestration ready CO2 stream from an oxy-combustion power plant. Water condensed from oxy-combustion flue gas via the IPR system has been analyzed for composition and an approach for its treatment—for in-process reuse and for release—has been outlined. A computer simulation model in ASPEN Plus has been developed to simulate water treatment of flue gas derived wastewater from IPR systems. At the field installation, water condensed in the IPR process contains fly ash particles, sodium (largely from spray-tower buffering) and sulfur species as well as heavy metals, cations, and anions. An IPR wastewater treatment system was modeled using unit operations such as equalization, coagulation and flocculation, reverse osmosis, lime softening, crystallization, and pH correction. According to the model results, 70% (by mass) of the inlet stream can be treated as pure water, the other 20% yields as saleable products such as gypsum (CaSO4) and salt (NaCl) and the remaining portion is the waste. More than 99% of fly ash particles are removed in the coagulation and flocculation unit and these solids can be used as filler materials in various applications with further treatment. Results discussed relate to a slipstream IPR installation and are verified experimentally in the coagulation/flocculation step.

  6. Implementation and effectiveness of integrated trauma and addiction treatment for incarcerated men

    PubMed Central

    Wolff, Nancy; Huening, Jessica; Shi, Jing; Frueh, B. Christopher; Hoover, Donald R.; McHugo, Gregory

    2015-01-01

    A controlled trial of Seeking Safety (SS) and Male-Trauma Recovery Empowerment Model (M-TREM) examined implementation and effectiveness of integrated group therapy for comorbid post-traumatic stress disorder (PTSD) and substance use disorder (SUD) on PTSD and mental health symptoms plus self-esteem and efficacy for incarcerated men. The study sample (n = 230) was male inmates 18 years or older who were primarily non-white, high school graduates or equivalents, had childhood trauma histories, committed violent crimes, had serious mental illnesses, and resided in a maximum security prison. Incarcerated men, who screened positive for PTSD and SUD, were assigned randomly (n = 142) or by preference (n = 88) to receive SS or M-TREM, with a waitlist group of (n = 93). Manualized interventions were group-administered for 14 weeks. Primary outcomes were PTSD and other mental health symptoms. Secondary outcomes were self-esteem, coping, and self-efficacy. SUD outcomes cannot be measured in a correctional setting. Implementation feasibility was exhibited by the ability to recruit, screen, assign, and retain participants. Effectiveness findings depended on sample, design, and method for analysis. Using a waitlist control group and no follow-up period, we found no aggregate effect of treatment on PTSD symptoms, although, when disaggregated, M-TREM was found to improve PTSD severity and SS improved general mental health symptoms and psychological functioning. Using intent-to-treat and completer analyses, no significant differences were found in the relative performance between SS and M-TREM on primary or secondary outcomes. When longitudinal data were maximized and modeled in ways that reflect the hierarchical nature of the data, we found that SS and M-TREM performed better than no treatment on PTSD severity and secondary outcomes, and that treatment benefits endured. Findings cautiously support implementing either Seeking Safety or M-TREM to treat incarcerated men with co

  7. Abnormal functional integration of thalamic low frequency oscillation in the BOLD signal after acute heroin treatment.

    PubMed

    Denier, Niklaus; Schmidt, André; Gerber, Hana; Vogel, Marc; Huber, Christian G; Lang, Undine E; Riecher-Rossler, Anita; Wiesbeck, Gerhard A; Radue, Ernst-Wilhelm; Walter, Marc; Borgwardt, Stefan

    2015-12-01

    Heroin addiction is a severe relapsing brain disorder associated with impaired cognitive control, including deficits in attention allocation. The thalamus has a high density of opiate receptors and is critically involved in orchestrating cortical activity during cognitive control. However, there have been no studies on how acute heroin treatment modulates thalamic activity. In a cross-over, double-blind, vehicle-controlled study, 29 heroin-maintained outpatients were studied after heroin and placebo administration, while 20 healthy controls were included for the placebo condition only. Resting-state functional magnetic resonance imaging was used to analyze functional integration of the thalamus by three different resting state analysis techniques. Thalamocortical functional connectivity (FC) was analyzed by seed-based correlation, while intrinsic thalamic oscillation was assessed by analysis of regional homogeneity (ReHo) and the fractional amplitude of low frequency fluctuations (fALFF). Relative to the placebo treatment and healthy controls, acute heroin administration reduced thalamocortical FC to cortical regions, including the frontal cortex, while the reductions in FC to the mediofrontal cortex, orbitofrontal cortex, and frontal pole were positively correlated with the plasma level of morphine, the main psychoactive metabolite of heroin. Furthermore, heroin treatment was associated with increased thalamic ReHo and fALFF values, whereas fALFF following heroin exposure correlated negatively with scores of attentional control. The heroin-associated increase in fALFF was mainly dominated by slow-4 (0.027-0.073 Hz) oscillations. Our findings show that there are acute effects of heroin within the thalamocortical system and may shed new light on the role of the thalamus in cognitive control in heroin addiction. Future research is needed to determine the underlying physiological mechanisms and their role in heroin addiction.

  8. Abnormal functional integration of thalamic low frequency oscillation in the BOLD signal after acute heroin treatment.

    PubMed

    Denier, Niklaus; Schmidt, André; Gerber, Hana; Vogel, Marc; Huber, Christian G; Lang, Undine E; Riecher-Rossler, Anita; Wiesbeck, Gerhard A; Radue, Ernst-Wilhelm; Walter, Marc; Borgwardt, Stefan

    2015-12-01

    Heroin addiction is a severe relapsing brain disorder associated with impaired cognitive control, including deficits in attention allocation. The thalamus has a high density of opiate receptors and is critically involved in orchestrating cortical activity during cognitive control. However, there have been no studies on how acute heroin treatment modulates thalamic activity. In a cross-over, double-blind, vehicle-controlled study, 29 heroin-maintained outpatients were studied after heroin and placebo administration, while 20 healthy controls were included for the placebo condition only. Resting-state functional magnetic resonance imaging was used to analyze functional integration of the thalamus by three different resting state analysis techniques. Thalamocortical functional connectivity (FC) was analyzed by seed-based correlation, while intrinsic thalamic oscillation was assessed by analysis of regional homogeneity (ReHo) and the fractional amplitude of low frequency fluctuations (fALFF). Relative to the placebo treatment and healthy controls, acute heroin administration reduced thalamocortical FC to cortical regions, including the frontal cortex, while the reductions in FC to the mediofrontal cortex, orbitofrontal cortex, and frontal pole were positively correlated with the plasma level of morphine, the main psychoactive metabolite of heroin. Furthermore, heroin treatment was associated with increased thalamic ReHo and fALFF values, whereas fALFF following heroin exposure correlated negatively with scores of attentional control. The heroin-associated increase in fALFF was mainly dominated by slow-4 (0.027-0.073 Hz) oscillations. Our findings show that there are acute effects of heroin within the thalamocortical system and may shed new light on the role of the thalamus in cognitive control in heroin addiction. Future research is needed to determine the underlying physiological mechanisms and their role in heroin addiction. PMID:26441146

  9. Integrative Families and Systems Treatment: A Middle Path toward Integrating Common and Specific Factors in Evidence-Based Family Therapy

    ERIC Educational Resources Information Center

    Fraser, J. Scott; Solovey, Andrew D.; Grove, David; Lee, Mo Yee; Greene, Gilbert J.

    2012-01-01

    A moderate common factors approach is proposed as a synthesis or middle path to integrate common and specific factors in evidence-based approaches to high-risk youth and families. The debate in family therapy between common and specific factors camps is reviewed and followed by suggestions from the literature for synthesis and creative flexibility…

  10. Collaborative behavioral management: integration and intensification of parole and outpatient addiction treatment services in the Step'n Out study.

    PubMed

    Friedmann, Peter D; Rhodes, Anne G; Taxman, Faye S

    2009-09-01

    Integration of community parole and addiction treatment holds promise for optimizing the participation of drug-involved parolees in re-entry services, but intensification of services might yield greater rates of technical violations. Collaborative behavioral management (CBM) integrates the roles of parole officers and treatment counselors to provide role induction counseling, contract for pro-social behavior, and to deliver contingent reinforcement of behaviors consistent with contracted objectives. Attendance at both parole and addiction treatment are specifically reinforced. The Step'n Out study of the Criminal Justice-Drug Abuse Treatment Studies (CJ-DATS) randomly allocated 486 drug-involved parolees to either collaborative behavioral management or traditional parole with 3-month and 9-month follow-up. Bivariate and multivariate regression models found that, in the first 3 months, the CBM group had more parole sessions, face-to-face parole sessions, days on which parole and treatment occurred on the same day, treatment utilization and individual counseling, without an increase in parole violations. We conclude that CBM integrated parole and treatment as planned, and intensified parolees' utilization of these services, without increasing violations.

  11. Path-integral treatment of multi-mode vibronic coupling. II. Correlation expansion of class averages

    NASA Astrophysics Data System (ADS)

    Krempl, Stefan; Winterstetter, Manfred; Domcke, Wolfgang

    1995-04-01

    A path-integral approach to real-time quantum dynamics is presented which is suitable to treat the dynamics of vibronic coupling or spin boson models. In these models the vibrational dynamics is nonseparable as a consequence of the electronic inter-state coupling. The sum over all possible paths in electronic-state space generated by the usual Trotter procedure is expressed in terms of single-mode averages over classes of paths and statistical mode correlations. The averages for classes of a given length can be calculated iteratively from averages over shorter paths. This expansion is formally exact and finite for a finite number of modes. Usually only a limited number of terms has to be evaluated in order to obtain converged results. The scaling of the computational effort with respect to the number of time steps and the number of modes is given by a low-order power law, depending on the chosen class structure and the order of the expansion. The usual time-dependent wave-packet propagation and the full path enumeration, which exhibit an exponential scaling behavior with respect to either the number of modes or the number of time steps, can be considered as opposite limiting cases of the correlation expansion (CE) of the path integral. The convergence of the CE is tested by application to a two-state four-mode model representing S1-S2 vibronic coupling in pyrazine, for which exact references (time-dependent correlation functions) are available. The potential of the CE approximation for the treatment of multi-mode problems is demonstrated by application to an extended 24-mode vibronic-coupling model. This model is suitable to provide a microscopic description of ultrafast optical dephasing processes in large molecules.

  12. Integrating evidence into practice: use of McKenzie-based treatment for mechanical low back pain

    PubMed Central

    Dunsford, Angela; Kumar, Saravana; Clarke, Sarah

    2011-01-01

    Low back pain (LBP) is a major health issue with significant socioeconomic implications in most Western countries. Many forms of treatment have been proposed and investigated in the past, with exercise being a commonly prescribed intervention. Within allied health, in particular physiotherapy, there has been a growing movement that recognizes the role of the McKenzie method in treating LBP. Within the McKenzie framework, directional preference (DP) exercises are one such intervention, with preliminary data demonstrating its effectiveness in the management of LBP. In this paper, we aim to integrate the evidence from current research, identified using a systematic review, and utilize a practical real-life case scenario to outline how evidence from the literature can be implemented in clinical practice. The findings from the systematic review indicate that DP exercises may have positive effects in the management of LBP. While the body of evidence to support this is limited (only four studies) and therefore modest at best, it does provide some emerging evidence to support the use of DP exercises in clinical practice. Despite this, gaps also persist in the literature on DP exercises, and this relates to the exercise parameters and the compliance rates. Recognizing this dichotomy (modest evidence in some areas and evidence gaps in other areas), which is likely to confront health practitioners, using a practical approach with a real-life clinical scenario, we outline how the evidence from the systematic review can be implemented in clinical practice. This approach builds on the philosophy of evidence-based practice of integrating research evidence with clinical expertise and patient values. PMID:22135496

  13. Integration of Three-Dimensional Rotational Angiography in Radiosurgical Treatment Planning of Cerebral Arteriovenous Malformations

    SciTech Connect

    Conti, Alfredo; Pontoriero, Antonio; Farago, Giuseppe; Midili, Federica; Siragusa, Carmelo; Granata, Francesca; Pitrone, Antonio; De Renzis, Costantino; Longo, Marcello; Tomasello, Francesco

    2011-11-01

    Purpose: Accuracy in delineating the target volume is a major issue for successful stereotactic radiosurgery for arteriovenous malformations. The aim of the present study was to describe a method to integrate three-dimensional (3D) rotational angiography ( (3DRA)) into CyberKnife treatment planning and to investigate its potential advantages compared with computed tomography angiography (CTA) and magnetic resonance angiography. Methods and Materials: A total of 20 patients with a diagnosis of cerebral arteriovenous malformation were included in the present study. All patients underwent multislice computed tomography and 3D-volumetric CTA, (3DRA), and 3D magnetic resonance angiography. The contouring of the target and critical volumes was done separately using CTA and thereafter directly using (3DRA). The composite, conjoint, and disjoint volumes were measured. Results: The use of CTA or (3DRA) resulted in significant differences in the target and critical volumes. The target volume averaged 3.49 {+-} 3.01 mL measured using CTA and 3.26 {+-} 2.93 mL measured using (3DRA), for a difference of 8% (p < .05). The conjoint and disjoint volume analysis showed an 88% volume overlap. The qualitative evaluation showed that the excess volume obtained using CTA was mostly tissue surrounding the nidus and venous structures. The mean contoured venous volume was 0.67 mL measured using CTA and 0.88 mL (range, 0.1-2.7) measured using (3DRA) (p < .05). Conclusions: (3DRA) is a volumetric angiographic study that can be integrated into computer-based treatment planning. Although whether (3DRA) provides superior accuracy has not yet been proved, its high spatial resolution is attractive and offers a superior 3D view. This allows a better 3D understanding of the target volume and distribution of the radiation doses within the volume. Additional technical efforts to improve the temporal resolution and the development of software tools aimed at improving the performance of 3D contouring

  14. Integrated Pre-Antiretroviral Therapy Screening and Treatment for Tuberculosis and Cryptococcal Antigenemia

    PubMed Central

    Pac, Lincoln; Horwitz, Mara; Namutebi, Anne Marion; Auerbach, Brandon J.; Semeere, Aggrey; Namulema, Teddy; Schwarz, Miriam; Bbosa, Robert; Muruta, Allan; Meya, David; Manabe, Yukari C.

    2015-01-01

    Objective To demonstrate the feasibility of integrated screening for cryptococcal antigenemia and tuberculosis (TB) prior to antiretroviral therapy (ART) initiation and to assess disease specific and all-cause mortality in the first 6 months of follow-up. Methods We enrolled a cohort of HIV-infected, ART-naïve adults with CD4 counts ≤ 250 cells/µL in rural Uganda who were followed for 6 months after ART initiation. All subjects underwent screening for TB; those with CD4 ≤ 100 cells/µL also had cryptococcal antigen (CrAg) screening. For those who screened positive, standard treatment for TB or preemptive treatment for cryptococcal infection was initiated, followed by ART two weeks later. Results Of 540 participants enrolled, pre-ART screening detected 10.6% (57/540) with prevalent TB and 6.8% (12/177 with CD4 count ≤ 100 cells/µL) with positive serum CrAg. After ART initiation, 13 (2.4%) patients were diagnosed with TB and one patient developed cryptococcal meningitis. Overall 7.2% of participants died (incidence rate 15.6 per 100 person years at risk). Death rates were significantly higher among subjects with TB and cryptococcal antigenemia compared to subjects without these diagnoses. In multivariate analysis, significant risk factors for mortality were male sex, baseline anemia of hemoglobin ≤ 10 mg/dL, wasting defined as body mass index ≤ 15.5 kg/m2, and opportunistic infections (TB, positive serum CrAg). Conclusion Pre-ART screening for opportunistic infections detects many prevalent cases of TB and cryptococcal infection. However, severely immunosuppressed and symptomatic HIV patients continue to experience high mortality after ART initiation. PMID:25761234

  15. Probabilistic evaluation of integrating resource recovery into wastewater treatment to improve environmental sustainability.

    PubMed

    Wang, Xu; McCarty, Perry L; Liu, Junxin; Ren, Nan-Qi; Lee, Duu-Jong; Yu, Han-Qing; Qian, Yi; Qu, Jiuhui

    2015-02-01

    Global expectations for wastewater service infrastructure have evolved over time, and the standard treatment methods used by wastewater treatment plants (WWTPs) are facing issues related to problem shifting due to the current emphasis on sustainability. A transition in WWTPs toward reuse of wastewater-derived resources is recognized as a promising solution for overcoming these obstacles. However, it remains uncertain whether this approach can reduce the environmental footprint of WWTPs. To test this hypothesis, we conducted a net environmental benefit calculation for several scenarios for more than 50 individual countries over a 20-y time frame. For developed countries, the resource recovery approach resulted in ∼154% net increase in the environmental performance of WWTPs compared with the traditional substance elimination approach, whereas this value decreased to ∼60% for developing countries. Subsequently, we conducted a probabilistic analysis integrating these estimates with national values and determined that, if this transition was attempted for WWTPs in developed countries, it would have a ∼65% probability of attaining net environmental benefits. However, this estimate decreased greatly to ∼10% for developing countries, implying a substantial risk of failure. These results suggest that implementation of this transition for WWTPs should be studied carefully in different temporal and spatial contexts. Developing countries should customize their approach to realizing more sustainable WWTPs, rather than attempting to simply replicate the successful models of developed countries. Results derived from the model forecasting highlight the role of bioenergy generation and reduced use of chemicals in improving the sustainability of WWTPs in developing countries. PMID:25605884

  16. TH-A-BRF-09: Integration of High-Resolution MRSI Into Glioblastoma Treatment Planning

    SciTech Connect

    Schreibmann, E; Cordova, J; Shu, H; Crocker, I; Curran, W; Holder, C; Shim, H

    2014-06-15

    Purpose: Identification of a metabolite signature that shows significant tumor cell infiltration into normal brain in regions that do not appear abnormal on standard MRI scans would be extremely useful for radiation oncologists to choose optimal regions of brain to treat, and to quantify response beyond the MacDonald criteria. We report on integration of high-resolution magnetic resonance spectroscopic imaging (HR-MRSI) with radiation dose escalation treatment planning to define and target regions at high risk for recurrence. Methods: We propose to supplement standard MRI with a special technique performed on an MRI scanner to measure the metabolite levels within defined volumes. Metabolite imaging was acquired using an advanced MRSI technique combining 3D echo-planar spectroscopic imaging (EPSI) with parallel acquisition (GRAPPA) using a multichannel head coil that allows acquisition of whole brain metabolite maps with 108 μl resolution in 12 minutes implemented on a 3T MR scanner. Elevation in the ratio of two metabolites, choline (Cho, elevated in proliferating high-grade gliomas) and N-acetyl aspartate (NAA, a normal neuronal metabolite), was used to image infiltrating high-grade glioma cells in vivo. Results: The metabolite images were co-registered with standard contrast-enhanced T1-weighted MR images using in-house registration software and imported into the treatment-planning system. Regions with tumor infiltration are identified on the metabolic images and used to create adaptive IMRT plans that deliver a standard dose of 60 Gy to the standard target volume and an escalated dose of 75 Gy (or higher) to the most suspicious regions, identified as areas with elevated Cho/NAA ratio. Conclusion: We have implemented a state-of-the-art HR-MRSI technology that can generate metabolite maps of the entire brain in a clinically acceptable scan time, coupled with introduction of an imaging co-registration/ analysis program that combines MRSI data with standard imaging

  17. Primary care-mental health integration and treatment retention among Iraq and Afghanistan war veterans.

    PubMed

    Tsan, Jack Y; Zeber, John E; Stock, Eileen M; Sun, Fangfang; Copeland, Laurel A

    2012-11-01

    Despite the high prevalence of posttraumatic stress disorder (PTSD) and medical comorbidity among veterans from Iraq/Afghanistan (OEF/OIF), keeping these patients engaged in health care is challenging. Primary Care-Mental Health Integration (PC-MHI), an initiative in the Veterans Health Administration (VA), sought to improve access to mental health care from within primary care. This study examined the lag between first PC-MHI visit and next mental/medical care visit, if any, and the relationship of PC-MHI with short-term (subsequent year) and long-term (4 years later) use of VA. We identified 2,470 OEF/OIF veterans receiving care during fiscal year 2006 (FY06) in a regional VA health care system. Unconditional survival analysis modeled time to next mental/medical visit and logistic regression modeled short- and long-term care as a function of PC-MHI, demographics, and clinical covariates. Of 181 patients in the PC-MHI program, 60%/18% returned for mental/medical care within 1 month, and 82%/74% within 1 year. Sixty-one percent (1,503) were still using the VA in FY09. Short-term mental care was related to prior-year PC-MHI. Consistent correlates of short- and long-term mental/medical care included physical comorbidity and Priority 1 status. Most patients attended mental health appointments subsequent to PC-MHI, and PC-MHI was correlated with mental health treatment retention in adjusted models for our cohort. Need for treatment, notably VA Priority 1 status and physical comorbidity, were the primary correlates of care-seeking. Developing innovative approaches to engaging new veterans in care remains imperative as multiple options will be necessary to meet the needs of these complex patients.

  18. Probabilistic evaluation of integrating resource recovery into wastewater treatment to improve environmental sustainability

    PubMed Central

    Wang, Xu; McCarty, Perry L.; Liu, Junxin; Ren, Nan-Qi; Lee, Duu-Jong; Yu, Han-Qing; Qian, Yi; Qu, Jiuhui

    2015-01-01

    Global expectations for wastewater service infrastructure have evolved over time, and the standard treatment methods used by wastewater treatment plants (WWTPs) are facing issues related to problem shifting due to the current emphasis on sustainability. A transition in WWTPs toward reuse of wastewater-derived resources is recognized as a promising solution for overcoming these obstacles. However, it remains uncertain whether this approach can reduce the environmental footprint of WWTPs. To test this hypothesis, we conducted a net environmental benefit calculation for several scenarios for more than 50 individual countries over a 20-y time frame. For developed countries, the resource recovery approach resulted in ∼154% net increase in the environmental performance of WWTPs compared with the traditional substance elimination approach, whereas this value decreased to ∼60% for developing countries. Subsequently, we conducted a probabilistic analysis integrating these estimates with national values and determined that, if this transition was attempted for WWTPs in developed countries, it would have a ∼65% probability of attaining net environmental benefits. However, this estimate decreased greatly to ∼10% for developing countries, implying a substantial risk of failure. These results suggest that implementation of this transition for WWTPs should be studied carefully in different temporal and spatial contexts. Developing countries should customize their approach to realizing more sustainable WWTPs, rather than attempting to simply replicate the successful models of developed countries. Results derived from the model forecasting highlight the role of bioenergy generation and reduced use of chemicals in improving the sustainability of WWTPs in developing countries. PMID:25605884

  19. Dosimetric evaluation of integrated IMRT treatment of the chest wall and supraclavicular region for breast cancer after modified radical mastectomy

    SciTech Connect

    Yang, Bo; Wei, Xian-ding; Zhao, Yu-tian; Ma, Chang-Ming

    2014-07-01

    To investigate the dosimetric characteristics of irradiation of the chest wall and supraclavicular region as an integrated volume with intensity-modulated radiation therapy (IMRT) after modified radical mastectomy. This study included 246 patients who received modified radical mastectomy. The patients were scanned with computed tomography, and the chest wall (with or without the internal mammary lymph nodes) and supraclavicular region were delineated. For 143 patients, the chest wall and supraclavicular region were combined as an integrated planning volume and treated with IMRT. For 103 patients, conventional treatments were employed with 2 tangential fields for the chest wall, abutting a mixed field of 6-MV x-rays (16 Gy) and 9-MeV electrons (34 Gy) for the upper supraclavicular region. The common prescription dose was 50 Gy/25 Fx/5 W to 90% of the target volume. The dosimetric characteristics of the chest wall, the supraclavicular region, and normal organs were compared. For the chest wall target, compared with conventional treatments, the integrated IMRT plans lowered the maximum dose, increased the minimum dose, and resulted in better conformity and uniformity of the target volume. There was an increase in minimum, average, and 95% prescription dose for the integrated IMRT plans in the supraclavicular region, and conformity and uniformity were improved. The V{sub 30} of the ipsilateral lung and V{sub 10}, V{sub 30}, and mean dose of the heart on the integrated IMRT plans were lower than those of the conventional plans. The V{sub 5} and V{sub 10} of the ipsilateral lung and V{sub 5} of the heart were higher on the integrated IMRT plans (p < 0.05) than on conventional plans. Without an increase in the radiation dose to organs at risk, the integrated IMRT treatment plans improved the dose distribution of the supraclavicular region and showed better dose conformity and uniformity of the integrated target volume of the chest wall and supraclavicular region.

  20. Dosimetric evaluation of integrated IMRT treatment of the chest wall and supraclavicular region for breast cancer after modified radical mastectomy.

    PubMed

    Yang, Bo; Wei, Xian-Ding; Zhao, Yu-Tian; Ma, Chang-Ming

    2014-01-01

    To investigate the dosimetric characteristics of irradiation of the chest wall and supraclavicular region as an integrated volume with intensity-modulated radiation therapy (IMRT) after modified radical mastectomy. This study included 246 patients who received modified radical mastectomy. The patients were scanned with computed tomography, and the chest wall (with or without the internal mammary lymph nodes) and supraclavicular region were delineated. For 143 patients, the chest wall and supraclavicular region were combined as an integrated planning volume and treated with IMRT. For 103 patients, conventional treatments were employed with 2 tangential fields for the chest wall, abutting a mixed field of 6-MV x-rays (16Gy) and 9-MeV electrons (34Gy) for the upper supraclavicular region. The common prescription dose was 50Gy/25Fx/5W to 90% of the target volume. The dosimetric characteristics of the chest wall, the supraclavicular region, and normal organs were compared. For the chest wall target, compared with conventional treatments, the integrated IMRT plans lowered the maximum dose, increased the minimum dose, and resulted in better conformity and uniformity of the target volume. There was an increase in minimum, average, and 95% prescription dose for the integrated IMRT plans in the supraclavicular region, and conformity and uniformity were improved. The V30 of the ipsilateral lung and V10, V30, and mean dose of the heart on the integrated IMRT plans were lower than those of the conventional plans. The V5 and V10 of the ipsilateral lung and V5 of the heart were higher on the integrated IMRT plans (p < 0.05) than on conventional plans. Without an increase in the radiation dose to organs at risk, the integrated IMRT treatment plans improved the dose distribution of the supraclavicular region and showed better dose conformity and uniformity of the integrated target volume of the chest wall and supraclavicular region.

  1. Integration of Substance Abuse Treatment Organizations into Accountable Care Organizations: Results from a National Survey

    PubMed Central

    D’Aunno, Thomas; Friedmann, Peter D.; Chen, Qixuan; Wilson, Donna M.

    2016-01-01

    To meet their aims of managing population health to improve the quality and cost of health care in the United States, accountable care organizations (ACOs) will need to focus on coordinating care for individuals with substance abuse disorders. The prevalence of these disorders is high, and these individuals often suffer from comorbid chronic medical and social conditions. This article examines the extent to which the nation’s fourteen thousand specialty substance abuse treatment (SAT) organizations, which have a daily census of more than 1 million patients, are contracting with ACOs across the country; we also examine factors associated with SAT organization involvement with ACOs. We draw on data from a recent (2014) nationally representative survey of executive directors and clinical supervisors from 635 SAT organizations. Results show that only 15 percent of these organizations had signed contracts with ACOs. Results from multivariate analyses show that directors’ perceptions of market competition, organizational ownership, and geographic location are significantly related to SATinvolvement with ACOs. We discuss implications for integrating the SAT specialty system with the mainstream health care system. PMID:26124307

  2. Integrity of medial temporal structures may predict better improvement of spatial neglect with prism adaptation treatment

    PubMed Central

    Goedert, Kelly M.; Shah, Priyanka; Foundas, Anne L.; Barrett, A. M.

    2013-01-01

    Prism adaptation treatment (PAT) is a promising rehabilitative method for functional recovery in persons with spatial neglect. Previous research suggests that PAT improves motor-intentional “aiming” deficits that frequently occur with frontal lesions. To test whether presence of frontal lesions predicted better improvement of spatial neglect after PAT, the current study evaluated neglect-specific improvement in functional activities (assessment with the Catherine Bergego Scale) over time in 21 right-brain-damaged stroke survivors with left-sided spatial neglect. The results demonstrated that neglect patients' functional activities improved after two weeks of PAT and continued improving for four weeks. Such functional improvement did not occur equally in all of the participants: Neglect patients with lesions involving the frontal cortex (n=13) experienced significantly better functional improvement than did those without frontal lesions (n=8). More importantly, voxel-based lesion-behavior mapping (VLBM) revealed that in comparison to the group of patients without frontal lesions, the frontal-lesioned neglect patients had intact regions in the medial temporal areas, the superior temporal areas, and the inferior longitudinal fasciculus. The medial cortical and subcortical areas in the temporal lobe were especially distinguished in the “frontal lesion” group. The findings suggest that the integrity of medial temporal structures may play an important role in supporting functional improvement after PAT. PMID:22941243

  3. Integration of Substance Abuse Treatment Organizations into Accountable Care Organizations: Results from a National Survey.

    PubMed

    D'Aunno, Thomas; Friedmann, Peter D; Chen, Qixuan; Wilson, Donna M

    2015-08-01

    To meet their aims of managing population health to improve the quality and cost of health care in the United States, accountable care organizations (ACOs) will need to focus on coordinating care for individuals with substance abuse disorders. The prevalence of these disorders is high, and these individuals often suffer from comorbid chronic medical and social conditions. This article examines the extent to which the nation's fourteen thousand specialty substance abuse treatment (SAT) organizations, which have a daily census of more than 1 million patients, are contracting with ACOs across the country; we also examine factors associated with SAT organization involvement with ACOs. We draw on data from a recent (2014) nationally representative survey of executive directors and clinical supervisors from 635 SAT organizations. Results show that only 15 percent of these organizations had signed contracts with ACOs. Results from multivariate analyses show that directors' perceptions of market competition, organizational ownership, and geographic location are significantly related to SAT involvement with ACOs. We discuss implications for integrating the SAT specialty system with the mainstream health care system. PMID:26124307

  4. Breast Conserving Treatment for Breast Cancer: Dosimetric Comparison of Sequential versus Simultaneous Integrated Photon Boost

    PubMed Central

    Reynders, Truus; Heuninckx, Karina; Verellen, Dirk; Storme, Guy; De Ridder, Mark

    2014-01-01

    Background. Breast conserving surgery followed by whole breast irradiation is widely accepted as standard of care for early breast cancer. Addition of a boost dose to the initial tumor area further reduces local recurrences. We investigated the dosimetric benefits of a simultaneously integrated boost (SIB) compared to a sequential boost to hypofractionate the boost volume, while maintaining normofractionation on the breast. Methods. For 10 patients 4 treatment plans were deployed, 1 with a sequential photon boost, and 3 with different SIB techniques: on a conventional linear accelerator, helical TomoTherapy, and static TomoDirect. Dosimetric comparison was performed. Results. PTV-coverage was good in all techniques. Conformity was better with all SIB techniques compared to sequential boost (P = 0.0001). There was less dose spilling to the ipsilateral breast outside the PTVboost (P = 0.04). The dose to the organs at risk (OAR) was not influenced by SIB compared to sequential boost. Helical TomoTherapy showed a higher mean dose to the contralateral breast, but less than 5 Gy for each patient. Conclusions. SIB showed less dose spilling within the breast and equal dose to OAR compared to sequential boost. Both helical TomoTherapy and the conventional technique delivered acceptable dosimetry. SIB seems a safe alternative and can be implemented in clinical routine. PMID:25162031

  5. Sewage treatment in integrated system of UASB reactor and duckweed pond and reuse for aquaculture.

    PubMed

    Mohapatra, D P; Ghangrekar, M M; Mitra, A; Brar, S K

    2012-06-01

    The performance of a laboratory-scale upflow anaerobic sludge blanket (UASB) reactor and a duckweed pond containing Lemna gibba was investigated for suitability for treating effluent for use in aquaculture. While treating low-strength sewage having a chemical oxygen demand (COD) of typically less than 200 mg/L, with an increase in hydraulic retention time (HRT) from 10.04 to 33.49 h, COD removal efficiency of the UASB reactor decreased owing to a decrease in organic loading rate (OLR) causing poor mixing in the reactor. However, even at the lower OLR (0.475 kg COD/(m3 x d)), the UASB reactor gave a removal efficiency of 68% for COD and 74% for biochemical oxygen demand (BOD). The maximum COD, BOD, ammonia-nitrogen and phosphate removal efficiencies of the duckweed pond were 40.77%, 38.01%, 61.87% and 88.57%, respectively. Decreasing the OLR by increasing the HRT resulted in an increase in efficiency of the duckweed pond for removal of ammonia-nitrogen and phosphate. The OLR of 0.005 kg COD/(m2 x d) and HRT of 108 h in the duckweed pond satisfied aquaculture quality requirements. A specific growth rate of 0.23% was observed for tilapia fish fed with duckweed harvested from the duckweed pond. The economic analysis proved that it was beneficial to use the integrated system of a UASB reactor and a duckweed pond for treatment of sewage.

  6. Sewage treatment in integrated system of UASB reactor and duckweed pond and reuse for aquaculture.

    PubMed

    Mohapatra, D P; Ghangrekar, M M; Mitra, A; Brar, S K

    2012-06-01

    The performance of a laboratory-scale upflow anaerobic sludge blanket (UASB) reactor and a duckweed pond containing Lemna gibba was investigated for suitability for treating effluent for use in aquaculture. While treating low-strength sewage having a chemical oxygen demand (COD) of typically less than 200 mg/L, with an increase in hydraulic retention time (HRT) from 10.04 to 33.49 h, COD removal efficiency of the UASB reactor decreased owing to a decrease in organic loading rate (OLR) causing poor mixing in the reactor. However, even at the lower OLR (0.475 kg COD/(m3 x d)), the UASB reactor gave a removal efficiency of 68% for COD and 74% for biochemical oxygen demand (BOD). The maximum COD, BOD, ammonia-nitrogen and phosphate removal efficiencies of the duckweed pond were 40.77%, 38.01%, 61.87% and 88.57%, respectively. Decreasing the OLR by increasing the HRT resulted in an increase in efficiency of the duckweed pond for removal of ammonia-nitrogen and phosphate. The OLR of 0.005 kg COD/(m2 x d) and HRT of 108 h in the duckweed pond satisfied aquaculture quality requirements. A specific growth rate of 0.23% was observed for tilapia fish fed with duckweed harvested from the duckweed pond. The economic analysis proved that it was beneficial to use the integrated system of a UASB reactor and a duckweed pond for treatment of sewage. PMID:22856320

  7. Integrated physicochemical and biological treatment process for fluoride and phosphorus removal from fertilizer plant wastewater.

    PubMed

    Gouider, Mbarka; Mlaik, Najwa; Feki, Mongi; Sayadi, Sami

    2011-08-01

    The phosphate fertilizer industry produces highly hazardous and acidic wastewaters. This study was undertaken to develop an integrated approach for the treatment of wastewaters from the phosphate industry. Effluent samples were collected from a local phosphate fertilizer producer and were characterized by their high fluoride and phosphate content. First, the samples were pretreated by precipitation of phosphate and fluoride ions using hydrated lime. The resulting low- fluoride and phosphorus effluent was then treated with the enhanced biological phosphorus removal (EBPR) process to monitor the simultaneous removal of carbon, nitrogen, and phosphorus. Phosphorus removal included a two-stage anaerobic/aerobic system operating under continuous flow. Pretreated wastewater was added to the activated sludge and operated for 160 days in the reactor. The operating strategy included increasing the organic loading rate (OLR) from 0.3 to 1.2 g chemical oxygen demand (COD)/L.d. The stable and high removal rates of COD, NH4(+)-N, and PO4(3-)-P were then recorded. The mean concentrations of the influent were approximately 3600 mg COD/L, 60 mg N/L, and 14 mg P/L, which corresponded to removal efficiencies of approximately 98%, 86%, and 92%, respectively. PMID:21905410

  8. Integrated production of polyhydroxyalkanoates (PHAs) with municipal wastewater and sludge treatment at pilot scale.

    PubMed

    Morgan-Sagastume, F; Hjort, M; Cirne, D; Gérardin, F; Lacroix, S; Gaval, G; Karabegovic, L; Alexandersson, T; Johansson, P; Karlsson, A; Bengtsson, S; Arcos-Hernández, M V; Magnusson, P; Werker, A

    2015-04-01

    A pilot-scale process was operated over 22 months at the Brussels North Wastewater Treatment Plant (WWTP) in order to evaluate polyhydroxyalkanoate (PHA) production integration with services of municipal wastewater and sludge management. Activated sludge was produced with PHA accumulation potential (PAP) by applying feast-famine selection while treating the readily biodegradable COD from influent wastewater (average removals of 70% COD, 60% CODsol, 24% nitrogen, and 46% phosphorus). The biomass PAP was evaluated to be in excess of 0.4gPHA/gVSS. Batch fermentation of full-scale WWTP sludge at selected temperatures (35, 42 and 55 °C) produced centrate (6-9.4 gCODVFA/L) of consistent VFA composition, with optimal fermentation performance at 42 °C. Centrate was used to accumulate PHA up to 0.39 gPHA/gVSS. The centrate nutrients are a challenge to the accumulation process but producing a biomass with 0.5 gPHA/gVSS is considered to be realistically achievable within the typically available carbon flows at municipal waste management facilities.

  9. Evaluation of an integrated continuous stirred microbial electrochemical reactor: Wastewater treatment, energy recovery and microbial community.

    PubMed

    Wang, Haiman; Qu, Youpeng; Li, Da; Zhou, Xiangtong; Feng, Yujie

    2015-11-01

    A continuous stirred microbial electrochemical reactor (CSMER) was developed by integrating anaerobic digestion (AD) and microbial electrochemical system (MES). The system was capable of treating high strength artificial wastewater and simultaneously recovering electric and methane energy. Maximum power density of 583±9, 562±7, 533±10 and 572±6 mW m(-2) were obtained by each cell in a four-independent circuit mode operation at an OLR of 12 kg COD m(-3) d(-1). COD removal and energy recovery efficiency were 87.1% and 32.1%, which were 1.6 and 2.5 times higher than that of a continuous stirred tank reactor (CSTR). Larger amount of Deltaproteobacteria (5.3%) and hydrogenotrophic methanogens (47%) can account for the better performance of CSMER, since syntrophic associations among them provided more degradation pathways compared to the CSTR. Results demonstrate the CSMER holds great promise for efficient wastewater treatment and energy recovery. PMID:26094049

  10. An innovative integrated system utilizing solar energy as power for the treatment of decentralized wastewater.

    PubMed

    Han, Changfu; Liu, Junxin; Liang, Hanwen; Guo, Xuesong; Li, Lin

    2013-02-01

    This article reports an innovative integrated system utilizing solar energy as power for decentralized wastewater treatment, which consists of an oxidation ditch with double channels and a photovoltaic (PV) system without a storage battery. Because the system operates without a storage battery, which can reduce the cost of the PV system, the solar radiation intensity affects the amount of power output from the PV system. To ensure that the power output is sufficient in all different weather conditions, the solar radiation intensity of 78 W/m2 with 95% confidence interval was defined as a threshold of power output for the PV system according to the monitoring results in this study, and a step power output mode was used to utilize the solar energy as well as possible. The oxidation ditch driven by the PV system without storage battery ran during the day and stopped at night. Therefore, anaerobic, anoxic and aerobic conditions could periodically appear in the oxidation ditch, which was favorable to nitrogen and phosphate removal from the wastewater. The experimental results showed that the system was efficient, achieving average removal efficiencies of 88% COD, 98% NH4+-N, 70% TN and 83% TP, under the loading rates of 140 mg COD/(g MLSS x day), 32 mg NH4+-N/(g MLSS x day), 44 mg TN/(g MLSS x day) and 5 mg TP/(g MLSS x day).

  11. Integration of Substance Abuse Treatment Organizations into Accountable Care Organizations: Results from a National Survey.

    PubMed

    D'Aunno, Thomas; Friedmann, Peter D; Chen, Qixuan; Wilson, Donna M

    2015-08-01

    To meet their aims of managing population health to improve the quality and cost of health care in the United States, accountable care organizations (ACOs) will need to focus on coordinating care for individuals with substance abuse disorders. The prevalence of these disorders is high, and these individuals often suffer from comorbid chronic medical and social conditions. This article examines the extent to which the nation's fourteen thousand specialty substance abuse treatment (SAT) organizations, which have a daily census of more than 1 million patients, are contracting with ACOs across the country; we also examine factors associated with SAT organization involvement with ACOs. We draw on data from a recent (2014) nationally representative survey of executive directors and clinical supervisors from 635 SAT organizations. Results show that only 15 percent of these organizations had signed contracts with ACOs. Results from multivariate analyses show that directors' perceptions of market competition, organizational ownership, and geographic location are significantly related to SAT involvement with ACOs. We discuss implications for integrating the SAT specialty system with the mainstream health care system.

  12. Integrity of medial temporal structures may predict better improvement of spatial neglect with prism adaptation treatment.

    PubMed

    Chen, Peii; Goedert, Kelly M; Shah, Priyanka; Foundas, Anne L; Barrett, A M

    2014-09-01

    Prism adaptation treatment (PAT) is a promising rehabilitative method for functional recovery in persons with spatial neglect. Previous research suggests that PAT improves motor-intentional "aiming" deficits that frequently occur with frontal lesions. To test whether presence of frontal lesions predicted better improvement of spatial neglect after PAT, the current study evaluated neglect-specific improvement in functional activities (assessment with the Catherine Bergego Scale) over time in 21 right-brain-damaged stroke survivors with left-sided spatial neglect. The results demonstrated that neglect patients' functional activities improved after two weeks of PAT and continued improving for four weeks. Such functional improvement did not occur equally in all of the participants: Neglect patients with lesions involving the frontal cortex (n = 13) experienced significantly better functional improvement than did those without frontal lesions (n = 8). More importantly, voxel-based lesion-behavior mapping (VLBM) revealed that in comparison to the group of patients without frontal lesions, the frontal-lesioned neglect patients had intact regions in the medial temporal areas, the superior temporal areas, and the inferior longitudinal fasciculus. The medial cortical and subcortical areas in the temporal lobe were especially distinguished in the "frontal lesion" group. The findings suggest that the integrity of medial temporal structures may play an important role in supporting functional improvement after PAT.

  13. Combined motor disturbances following severe traumatic brain injury: an integrative long-term treatment approach.

    PubMed

    Keren, O; Reznik, J; Groswasser, Z

    2001-07-01

    Patients surviving severe traumatic brain injury (TBI) often suffer from residual impairments in motor control, communication skills, cognition and social behaviour. These distinctly hamper their capability to return to their 'pre-trauma' activity. Comprehensive and integrated rehabilitation programmes initiate, during the acute phase, a prolonged treatment process which starts at the most sophisticated medical systems. There is no clear end point for the treatment of these patients, since the recovery process and the rehabilitation activity may continue for years, even after patients return home to live with their families. The inherent inability to make a firm early prediction regarding outcome of patients and the late appearance of additional symptoms stress the need for a comprehensive close long-term follow-up. The following presentation concerns the description of the treatment strategy and long-term improvement of a 22-year-old male who suffered from very severe TBI. On admission to the emergency room, he was in the decerebrated position and his Glasgow Coma Scale (GCS) was at the lowest (3). The focus of this presentation is on the recovery of motor function. The initial motor disabilities included weakness in all four limbs, in particular left hemiplegia, and right hemiparesis with severe bilateral ataxic elements and a marked tremor of the right arm. Range of motion was limited in hips, and he suffered from stiff trunk and neck. Goals of physiotherapy were directed towards improving range of motion (ROM) and active movement. Casting, use of orthoses, biofeedback, hydrotherapy, hippotherapy, medication and nerve blocks for reducing spasticity were timely applied during the process. The motor improvement in this very severe TBI patient who is now over 3 years post-injury still continues and has a functional meaning. He has succeeded in being able to stand up by himself from a chair and is able to walk unaided and without orthoses for very short distances

  14. A Guiding Framework for Integrating the Consultation Process and Behavior Analytic Practice in Schools: The Treatment Validation Consultation Model

    ERIC Educational Resources Information Center

    Andersen, Melissa N.; Hofstadter, Kristi L.; Kupzyk, Sara; Daly, Edward J., III; Bleck, Amanda A.; Collaro, Alyssa L.; Jones, Kristin E.; Clure, Lynne F.; Blevins, Carrie A.

    2010-01-01

    Since behavioral consultation (BC) was introduced over 30 years ago, the core procedures and assumptions of the model have remained largely unchanged in spite of its widespread popularity in practice. This article presents the Treatment Validation Consultation (TVC) model, which addresses limitations of BC and integrates recent technological…

  15. The Relationship between Treatment Integrity and Acceptability of Reading Interventions for Children with Attention-Deficit/Hyperactivity Disorder

    ERIC Educational Resources Information Center

    Mautone, Jennifer A.; DuPaul, George J.; Jitendra, Asha K.; Tresco, Katy E.; Junod, Rosemary Vile; Volpe, Robert J.

    2009-01-01

    This study examined the relationship between treatment integrity and acceptability for reading interventions across two consultation models, intensive data-based academic intervention (IDAI) and traditional data-based academic intervention (TDAI). Participants included 83 first- through fourth-grade students who met research criteria for…

  16. The Effect of Performance Feedback on Teachers' Treatment Integrity: A Meta-Analysis of the Single-Case Literature

    ERIC Educational Resources Information Center

    Solomon, Benjamin G.; Klein, Suzanne A.; Politylo, Bethany C.

    2012-01-01

    Performance feedback (PF) has become popular in the school-based literature as a method to increase the treatment integrity of prescribed interventions. The current study extracted and aggregated data from single-case studies that used PF in school settings to increase teachers' use of classroom-based interventions. Results suggest PF is…

  17. Treatment Integrity of Literacy Interventions for Students with Emotional and/or Behavioral Disorders: A Review of Literature

    ERIC Educational Resources Information Center

    Griffith, Annette K.; Hurley, Kristin Duppong; Hagaman, Jessica L.

    2009-01-01

    This review examines the treatment integrity data of literacy interventions for students with emotional and/or behavioral disorders (EBD). Forty-four studies published between 1977 and 2005 were examined. Findings indicate that studies focusing on literacy interventions for students with EBD included clear operational definitions and data on…

  18. The Effects of Self-Monitoring and Performance Feedback on the Treatment Integrity of Behavior Intervention Plan Implementation and Generalization

    ERIC Educational Resources Information Center

    Mouzakitis, Angela; Codding, Robin S.; Tryon, Georgiana

    2015-01-01

    Accurate implementation of individualized behavior intervention plans (BIPs) is a critical aspect of evidence-based practice. Research demonstrates that neither training nor consultation is sufficient to improve and maintain high rates of treatment integrity (TI). Therefore, evaluation of ongoing support strategies is needed. The purpose of this…

  19. Errors of Omission and Commission during Alternative Reinforcement of Compliance: The Effects of Varying Levels of Treatment Integrity

    ERIC Educational Resources Information Center

    Leon, Yanerys; Wilder, David A.; Majdalany, Lina; Myers, Kristin; Saini, Valdeep

    2014-01-01

    We conducted two experiments to evaluate the effects of errors of omission and commission during alternative reinforcement of compliance in young children. In Experiment 1, we evaluated errors of omission by examining two levels of integrity during alternative reinforcement (20 and 60%) for child compliance following no treatment (baseline) versus…

  20. Effect of patient setup errors on simultaneously integrated boost head and neck IMRT treatment plans

    SciTech Connect

    Siebers, Jeffrey V. . E-mail: jsiebers@vcu.edu; Keall, Paul J.; Wu Qiuwen; Williamson, Jeffrey F.; Schmidt-Ullrich, Rupert K.

    2005-10-01

    Purpose: The purpose of this study is to determine dose delivery errors that could result from random and systematic setup errors for head-and-neck patients treated using the simultaneous integrated boost (SIB)-intensity-modulated radiation therapy (IMRT) technique. Methods and Materials: Twenty-four patients who participated in an intramural Phase I/II parotid-sparing IMRT dose-escalation protocol using the SIB treatment technique had their dose distributions reevaluated to assess the impact of random and systematic setup errors. The dosimetric effect of random setup error was simulated by convolving the two-dimensional fluence distribution of each beam with the random setup error probability density distribution. Random setup errors of {sigma} = 1, 3, and 5 mm were simulated. Systematic setup errors were simulated by randomly shifting the patient isocenter along each of the three Cartesian axes, with each shift selected from a normal distribution. Systematic setup error distributions with {sigma} = 1.5 and 3.0 mm along each axis were simulated. Combined systematic and random setup errors were simulated for {sigma} = {sigma} = 1.5 and 3.0 mm along each axis. For each dose calculation, the gross tumor volume (GTV) received by 98% of the volume (D{sub 98}), clinical target volume (CTV) D{sub 90}, nodes D{sub 90}, cord D{sub 2}, and parotid D{sub 50} and parotid mean dose were evaluated with respect to the plan used for treatment for the structure dose and for an effective planning target volume (PTV) with a 3-mm margin. Results: Simultaneous integrated boost-IMRT head-and-neck treatment plans were found to be less sensitive to random setup errors than to systematic setup errors. For random-only errors, errors exceeded 3% only when the random setup error {sigma} exceeded 3 mm. Simulated systematic setup errors with {sigma} = 1.5 mm resulted in approximately 10% of plan having more than a 3% dose error, whereas a {sigma} = 3.0 mm resulted in half of the plans having

  1. How to integrate the good lives model into treatment programs for sexual offending: an introduction and overview.

    PubMed

    Willis, Gwenda M; Yates, Pamela M; Gannon, Theresa A; Ward, Tony

    2013-04-01

    The good lives model (GLM) represents a new theoretical framework informing sex offender treatment programs; however, substantial variation has been observed in terms of how GLM-related ideas and practices have been applied. Integrated appropriately, the GLM offers potential for improving outcomes of programs following a cognitive-behavioral therapy (CBT) approach and operating according to a narrow operationalization of risk, need, responsivity (RNR) principles. Conversely, misguided or otherwise poor integration could increase the very risk practitioners work to prevent and manage. The purpose of this article is to provide an introduction and overview on how to integrate the GLM into treatment using CBT and RNR. The authors describe clinical implications of the GLM as they relate to program aims and orientation, assessment and intervention planning, content, and delivery.

  2. 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.

  3. Challenges in treatment of posttraumatic stress disorder in refugees: towards integration of evidence-based treatments with contextual and culture-sensitive perspectives

    PubMed Central

    Drožđek, Boris

    2015-01-01

    Background Research shows that trauma-focused therapy and multimodal interventions are the two most often used strategies in treatment of refugees suffering from posttraumatic stress disorder (PTSD). While preliminary evidence suggests that trauma-focused approaches may have some efficacy, this could not be established for multimodal interventions. However, it may be that multimodal interventions have been studied in more treatment-resistant refugees with very high levels of psychopathology, disability, and chronicity. In the past decades, various models for understanding of the complex relationship between mental health problems and well-being have emerged. They aim at framing mental health problems in individualized, contextual, epigenetic, and culturally sensitive ways, and may be useful in tailoring content and timing of multimodal interventions. Objective To draw clinicians’ attention to the possibility of using the Integrative Contextual Model for understanding and assessment of posttrauma mental health sequelae while tailoring multimodal interventions; to present a possible way of combining multimodal with evidence-based trauma-focused approaches; and to improve the understanding and treatment of PTSD and other mental health problems in refugee survivors of prolonged and repeated trauma. Method Based on literature, clinical experience, and presentation of a fictional case, the use of the Integrative Contextual Model in tailoring the treatment of severe PTSD in a refugee patient is presented and discussed. Results The Integrative Contextual Model for understanding and assessing factors, which may play a role in causing and maintaining of PTSD and comorbidity in refugees, may help tailoring of multimodal interventions. These interventions can be combined with evidence-based trauma-focused treatments. Conclusion The field of refugee mental health intervention and clinical practice with traumatized refugees may be enriched with the use of contextual and

  4. Integrating services for injection drug users infected with hepatitis C virus with methadone maintenance treatment: challenges and opportunities.

    PubMed

    Litwin, Alain H; Soloway, Irene; Gourevitch, Marc N

    2005-04-15

    Despite the high prevalence of hepatitis C virus (HCV) infection among drug users enrolled in methadone maintenance treatment programs, few drug users are being treated with combination therapy. The most significant barrier to treatment is lack of access to comprehensive HCV-related care. We describe a pilot program to integrate care for HCV infection with substance abuse treatment in a setting of maintenance treatment with methadone. This on-site, multidisciplinary model of care includes comprehensive screening and treatment for HCV infection, assessment of eligibility, counseling with regard to substance abuse, psychiatric services, HCV support groups, directly observed therapy, and enhanced linkages to a tertiary care system for diagnostic procedures. Our approach has led to high levels of adherence, with liver biopsy and substantial rates of initiation of antiviral therapy. Two cases illustrate the successful application of this model to patients with HCV infection complicated by active substance abuse and psychiatric comorbidity. PMID:15768345

  5. Maternal substance use and integrated treatment programs for women with substance abuse issues and their children: a meta-analysis

    PubMed Central

    2010-01-01

    Background The rate of women with substance abuse issues is increasing. Women present with a unique constellation of risk factors and presenting needs, which may include specific needs in their role as mothers. Numerous integrated programs (those with substance use treatment and pregnancy, parenting, or child services) have been developed to specifically meet the needs of pregnant and parenting women with substance abuse issues. This synthesis and meta-analysis reviews research in this important and growing area of treatment. Methods We searched PsycINFO, MedLine, PubMed, Web of Science, EMBASE, Proquest Dissertations, Sociological Abstracts, and CINAHL and compiled a database of 21 studies (2 randomized trials, 9 quasi-experimental studies, 10 cohort studies) of integrated programs published between 1990 and 2007 with outcome data on maternal substance use. Data were summarized and where possible, meta-analyses were performed, using standardized mean differences (d) effect size estimates. Results In the two studies comparing integrated programs to no treatment, effect sizes for urine toxicology and percent using substances significantly favored integrated programs and ranged from 0.18 to 1.41. Studies examining changes in maternal substance use from beginning to end of treatment were statistically significant and medium sized. More specifically, in the five studies measuring severity of drug and alcohol use, the average effect sizes were 0.64 and 0.40, respectively. In the four cohort studies of days of use, the average effect size was 0.52. Of studies comparing integrated to non-integrated programs, four studies assessed urine toxicology and two assessed self-reported abstinence. Overall effect sizes for each measure were not statistically significant (d = -0.09 and 0.22, respectively). Conclusions Findings suggest that integrated programs are effective in reducing maternal substance use. However, integrated programs were not significantly more effective than non-integrated

  6. Integration of an innovative biological treatment with physical or chemical disinfection for wastewater reuse.

    PubMed

    De Sanctis, Marco; Del Moro, Guido; Levantesi, Caterina; Luprano, Maria Laura; Di Iaconi, Claudio

    2016-02-01

    In the present paper, the effectiveness of a Sequencing Batch Biofilter Granular Reactor (SBBGR) and its integration with different disinfection strategies (UV irradiation, peracetic acid) for producing an effluent suitable for agricultural use was evaluated. The plant treated raw domestic sewage, and its performances were evaluated in terms of the removal efficiency of a wide group of physical, chemical and microbiological parameters. The SBBGR resulted really efficient in removing suspended solids, COD and nitrogen with an average effluent concentration of 5, 32 and 10 mg/L, respectively. Lower removal efficiency was observed for phosphorus with an average concentration in the effluent of 3 mg/L. Plant effluent was also characterized by an average electrical conductivity and sodium adsorption ratio of 680 μS/cm and 2.9, respectively. Therefore, according to these gross parameters, the SBBGR effluent was conformed to the national standards required in Italy for agricultural reuse. Moreover, disinfection performances of the SBBGR was higher than that of conventional municipal wastewater treatment plants and met the quality criteria suggested by WHO (Escherichia coli<1000 CFU/100 mL) for agricultural reuse. In particular, the biological treatment by SBBGR removed 3.8±0.4 log units of Giardia lamblia, 2.8±0.8 log units of E. coli, 2.5±0.7 log units of total coliforms, 2.0±0.3 log units of Clostridium perfringens, 2.0±0.4 log units of Cryptosporidium parvum and 1.7±0.7 log units of Somatic coliphages. The investigated disinfection processes (UV and peracetic acid) resulted very effective for total coliforms, E. coli and somatic coliphages. In particular, a UV radiation and peracetic acid doses of 40 mJ/cm(2) and 1 mg/L respectively reduced E. coli content in the effluent below the limit for agricultural reuse in Italy (10 CFU/100 mL). Conversely, they were both ineffective on C.perfringens spores.

  7. Integration of an innovative biological treatment with physical or chemical disinfection for wastewater reuse.

    PubMed

    De Sanctis, Marco; Del Moro, Guido; Levantesi, Caterina; Luprano, Maria Laura; Di Iaconi, Claudio

    2016-02-01

    In the present paper, the effectiveness of a Sequencing Batch Biofilter Granular Reactor (SBBGR) and its integration with different disinfection strategies (UV irradiation, peracetic acid) for producing an effluent suitable for agricultural use was evaluated. The plant treated raw domestic sewage, and its performances were evaluated in terms of the removal efficiency of a wide group of physical, chemical and microbiological parameters. The SBBGR resulted really efficient in removing suspended solids, COD and nitrogen with an average effluent concentration of 5, 32 and 10 mg/L, respectively. Lower removal efficiency was observed for phosphorus with an average concentration in the effluent of 3 mg/L. Plant effluent was also characterized by an average electrical conductivity and sodium adsorption ratio of 680 μS/cm and 2.9, respectively. Therefore, according to these gross parameters, the SBBGR effluent was conformed to the national standards required in Italy for agricultural reuse. Moreover, disinfection performances of the SBBGR was higher than that of conventional municipal wastewater treatment plants and met the quality criteria suggested by WHO (Escherichia coli<1000 CFU/100 mL) for agricultural reuse. In particular, the biological treatment by SBBGR removed 3.8±0.4 log units of Giardia lamblia, 2.8±0.8 log units of E. coli, 2.5±0.7 log units of total coliforms, 2.0±0.3 log units of Clostridium perfringens, 2.0±0.4 log units of Cryptosporidium parvum and 1.7±0.7 log units of Somatic coliphages. The investigated disinfection processes (UV and peracetic acid) resulted very effective for total coliforms, E. coli and somatic coliphages. In particular, a UV radiation and peracetic acid doses of 40 mJ/cm(2) and 1 mg/L respectively reduced E. coli content in the effluent below the limit for agricultural reuse in Italy (10 CFU/100 mL). Conversely, they were both ineffective on C.perfringens spores. PMID:26584070

  8. Integration of biotechnological wastewater treatment units in textile finishing factories: from end of the pipe solutions to combined production and wastewater treatment units.

    PubMed

    Feitkenhauer, H; Meyer, U

    2001-08-23

    Increasing costs for water, wastewater and energy put pressure on textile finishing plants to increase the efficiency of wet processing. An improved water management can decrease the use of these resources and is a prerequisite for the integration of an efficient, anaerobic on-site pretreatment of effluents that will further cut wastewater costs. A two-phase anaerobic treatment is proposed, and successful laboratory experiments with model effluents from the cotton finishing industry are reported. The chemical oxygen demand of this wastewater was reduced by over 88% at retention times of 1 day or longer. The next step to boost the efficiency is to combine the production and wastewater treatment. The example of cotton fabric desizing (removing size from the fabric) illustrates how this final step of integration uses the acidic phase bioreactor as a part of the production and allows to close the water cycle of the system.

  9. [Integrated Center for Research and Treatment of Vertigo, Balance and Ocular Motor Disorders].

    PubMed

    Brandt, T; Zwergal, A; Jahn, K; Strupp, M

    2009-08-01

    The German BMBF (German Ministry of Education and Research) has decided to establish an Integrated Center for Research and Treatment of Vertigo, Balance and Ocular Motor Disorders (IFB(LMU)) in Munich in 2010. After funding over a 10-year period, the long-term continuation of the IFB(LMU) by the medical faculty and the hospital is envisioned. Vertigo is one of the most common complaints in medicine. Despite its high prevalence patients with vertigo generally receive either inappropriate or inadequate treatment. This deplorable situation is internationally well known and its causes are multiple: insufficient interdisciplinary cooperation, no standardized diagnostics and therapy, the failure to translate findings of basic science into clinical applications and the scarcity of clinical multicenter studies. The IFB(LMU) will constitute a suitable tool with which these structural, clinical, and scientific deficits can be overcome. It will also make possible the establishment of an international interdisciplinary referral center. Munich has become the site of a unique concentration of leading experts on vertigo, balance and ocular motor disorders, both in the clinical and basic sciences. Academic structures have paved the way for the creation of an interdisciplinary horizontal network that also allows structured, vertical academic career paths via the Bachelor's and Master's degree programs in neuroscience, a Graduate School of Systemic Neurosciences, and the Munich Center for Neuroscience "Brain and Mind". The IFB(LMU) has the following objectives with regard to structure and content: to create an independent patient-oriented clinical research center under the auspices of the Medical Faculty but with autonomic administration and budget; to overcome existing clinical and academic barriers separating the traditional specializations, to establish a standardized interdisciplinary longitudinal and transversal network at one site for the management of patients. This should

  10. Institutional profile: integrated center for research and treatment of vertigo, balance and ocular motor disorders.

    PubMed

    Brandt, Thomas; Zwergal, Andreas; Jahn, Klaus; Strupp, Michael

    2010-01-01

    In 2009 the German BMBF (German Ministry of Education and Research) established an Integrated Center for Research and Treatment (IFB(LMU)) of Vertigo, Balance and Ocular Motor Disorders in Munich. After the 10-year period of funding by the BMBF, it is envisioned that the (IFB(LMU)) will continue over the long term with the joint support of the University Hospital, the Medical Faculty, and the Bavarian State. Vertigo is one of the most common complaints in medicine. Despite its high prevalence, patients with vertigo generally receive either inappropriate or inadequate treatment. This deplorable situation is internationally well known and its causes are multiple: insufficient interdisciplinary cooperation, no standardized diagnostics and therapy, the failure to translate findings of basic science into clinical applications, and the scarcity of clinical multicenter studies. The (IFB(LMU)) will constitute a suitable tool with which these structural, clinical, and scientific deficits can be overcome. It will also make possible the establishment of an international interdisciplinary referral center. Munich has become the site of a unique concentration of leading experts on vertigo, balance and ocular motor disorders, both in the clinical and basic sciences. Academic structures have paved the way for the creation of an interdisciplinary horizontal network that also allows structured, vertical academic career paths via the Bachelor's and Master's degree programs in Neuroscience, a Graduate School of Systemic Neurosciences, and the Munich Center for Neurosciences - Brain and Mind. The (IFB(LMU)) has the following objectives as regards structure and content: to create an independent patient-oriented clinical research center under the auspices of the Medical Faculty but with autonomous administration and budget; to overcome existing clinical and academic barriers separating the traditional specializations; to establish a standardized interdisciplinary longitudinal and

  11. Electrophoretic Behavior in Relation to the Structural Integrity of Codfish Parvalbumin upon Heat Treatment.

    PubMed

    de Jongh, Harmen H J; de los Reyes Jimenez, Marta; Baumert, Joseph L; Taylor, Steve L; Koppelman, Stef J

    2015-05-13

    This work evaluates the impact of heat processing of parvalbumin, a major fish allergen, on the consequences for quantitative analysis of this protein embedded in different matrices during heating (either isolated, in an aqueous extract, or in whole fillets) to assess potential health risks. It is shown that oligomerization of parvalbumin does occur, but only upon heat treatment above 80 °C. This coincides with the ability of the isolated protein to refold up to this temperature in a fully reversible way, as demonstrated by circular dichroism analysis. In autoclaved samples a disintegration of the protein structure is observed. The situation becomes different when parvalbumin is embedded in a matrix with other constituents, as in fish extracts or whole fillets. The electrophoretic analysis of parvalbumin (SDS-PAGE and immunoblotting) is largely determined by complexation with other proteins resulting in insoluble materials caused by the partial unfolding of the parvalbumin at elevated temperatures. This effect is more strongly observed for cod fish extract, compared to whole cod fillets, as in the latter situation the integrity of the tissue hampers this interprotein complexation. Moreover, it is shown by ELISA analysis of heat-treated samples that using blotting procedures where disintegration of complexes may be promoted, restoring some of the IgG-binding propensity, may provide false outcomes. It was concluded that antibody binding to parvalbumin is dominated by the potential to form heat-induced complexes with other proteins. The possibly less-soluble or extractable character of these complexes may provide confusing information regarding potential health risks of fish and fish protein-containing food composites when such heat-treated samples are analyzed by immunochemical assays.

  12. Religiously integrated cognitive behavioral therapy: a new method of treatment for major depression in patients with chronic medical illness.

    PubMed

    Pearce, Michelle J; Koenig, Harold G; Robins, Clive J; Nelson, Bruce; Shaw, Sally F; Cohen, Harvey J; King, Michael B

    2015-03-01

    Intervention studies have found that psychotherapeutic interventions that explicitly integrate clients' spiritual and religious beliefs in therapy are as effective, if not more so, in reducing depression than those that do not for religious clients. However, few empirical studies have examined the effectiveness of religiously (vs. spiritually) integrated psychotherapy, and no manualized mental health intervention had been developed for the medically ill with religious beliefs. To address this gap, we developed and implemented a novel religiously integrated adaptation of cognitive-behavioral therapy (CBT) for the treatment of depression in individuals with chronic medical illness. This article describes the development and implementation of the intervention. First, we provide a brief overview of CBT. Next, we describe how religious beliefs and behaviors can be integrated into a CBT framework. Finally, we describe Religiously Integrated Cognitive Behavioral Therapy (RCBT), a manualized therapeutic approach designed to assist depressed individuals to develop depression-reducing thoughts and behaviors informed by their own religious beliefs, practices, and resources. This treatment approach has been developed for 5 major world religions (Christianity, Judaism, Islam, Buddhism, and Hinduism), increasing its potential to aid the depressed medically ill from a variety of religious backgrounds. PMID:25365155

  13. Religiously Integrated Cognitive Behavioral Therapy: A New Method of Treatment for Major Depression in Patients With Chronic Medical Illness

    PubMed Central

    Pearce, Michelle J.; Koenig, Harold G.; Robins, Clive J.; Nelson, Bruce; Shaw, Sally F.; Cohen, Harvey J.; King, Michael B.

    2015-01-01

    Intervention studies have found that psychotherapeutic interventions that explicitly integrate clients’ spiritual and religious beliefs in therapy are as effective, if not more so, in reducing depression than those that do not for religious clients. However, few empirical studies have examined the effectiveness of religiously (vs. spiritually) integrated psychotherapy, and no manualized mental health intervention had been developed for the medically ill with religious beliefs. To address this gap, we developed and implemented a novel religiously integrated adaptation of cognitive–behavioral therapy (CBT) for the treatment of depression in individuals with chronic medical illness. This article describes the development and implementation of the intervention. First, we provide a brief overview of CBT. Next, we describe how religious beliefs and behaviors can be integrated into a CBT framework. Finally, we describe Religiously Integrated Cognitive Behavioral Therapy (RCBT), a manualized therapeutic approach designed to assist depressed individuals to develop depression-reducing thoughts and behaviors informed by their own religious beliefs, practices, and resources. This treatment approach has been developed for 5 major world religions (Christianity, Judaism, Islam, Buddhism, and Hinduism), increasing its potential to aid the depressed medically ill from a variety of religious backgrounds. PMID:25365155

  14. Nonsurgical Korean Integrative Treatments for Symptomatic Lumbar Spinal Stenosis: A Three-Armed Randomized Controlled Pilot Trial Protocol.

    PubMed

    Kim, Kiok; Shin, Kyung-Min; Lee, Jun-Hwan; Seo, Bok-Nam; Jung, So-Young; Youn, Yousuk; Lee, Sang Ho; Kim, Jaehong; Qu, Wenchun; Kim, Tae-Hun

    2016-01-01

    This is a study protocol for a pilot three-armed randomized controlled trial on nonsurgical integrative Korean medicinal treatment for symptomatic lumbar spinal stenosis (LSS). Thirty-six participants who have been diagnosed with (LSS) and recommended for spinal surgery by neurosurgeons or orthopedics and have had spinal symptoms such as severe low back pain and neurological claudication regardless of at least three months of conservative treatments will be recruited. Participants will be randomly assigned to be one of the three intervention groups, including the Mokhuri treatment program group 1 or 2 or usual care group. All treatments will be administered in inpatient units over a period of 4 weeks. The primary outcomes are 0 to 100 Visual Analogue Scales for low back pain and leg pain and the secondary outcomes are Oswestry Disability Index; EQ-5D; Roland-Morris Disability Questionnaire; Oxford Claudication Score; physical function test, including treadmill test, walking duration, and distance assessment for free leg pain; radiologic testing; and adverse events which will be assessed during the 4-week treatment period as well as after 3 and 6 months of follow-up. Then, we will assess the feasibility of the clinical trial design as well as a nonsurgical integrative treatment program. This trial is registered with CRIS registration number: KCT0001218. PMID:26941823

  15. Integrating Antiretroviral Strategies for Human Immunodeficiency Virus Prevention: Post- and Pre-Exposure Prophylaxis and Early Treatment

    PubMed Central

    Grant, Robert M.; Smith, Dawn K.

    2015-01-01

    Best practices for integrating human immunodeficiency virus (HIV) testing and antiretroviral interventions for prevention and treatment are suggested based on research evidence and existing normative guidance. The goal is to provide high-impact prevention services during periods of substantial risk. Antiretroviral medications are recommended for postexposure prophylaxis (PEP), pre-exposure prophylaxis (PrEP), and treatment of HIV infection. We reviewed research evidence and current normative guidelines to identify best practices for integrating these high-impact prevention strategies. More sensitive HIV tests used for screening enable earlier diagnosis and treatment of HIV infection, more appropriate counseling, and help limit drug resistance. A fully suppressive PEP regimen should be initiated based on exposure history or physical findings when sensitive diagnostic testing is delayed or not available and antibody tests are negative. Transitions from PEP to PrEP are often warranted because HIV exposure events may continue to occur. This algorithmic approach to integrating PEP, PrEP, and early treatment decisions may increase the uptake of these interventions by a greater number and diversity of knowledgeable healthcare providers. PMID:26512356

  16. The BHIVES collaborative: organization and evaluation of a multisite demonstration of integrated buprenorphine/naloxone and HIV treatment.

    PubMed

    Weiss, Linda; Egan, James E; Botsko, Michael; Netherland, Julie; Fiellin, David A; Finkelstein, Ruth

    2011-03-01

    Substance abuse is associated with poor medical and quality-of-life outcomes among HIV-infected individuals. Although drug treatment may reduce these negative consequences, for many patients, options are limited. Buprenorphine/naloxone, an opioid agonist treatment that can be prescribed in the United States in office-based settings, can be used to expand treatment capacity and integrate substance abuse services into HIV care. Recognizing this potential, the US Health Resources and Services Administration funded the development and implementation of demonstration projects that integrated HIV care and buprenorphine/naloxone treatment at 10 sites across the country. An Evaluation and Technical Assistance Center provided programmatic and clinical support as well as oversight for an evaluation that examined the processes for and outcomes of integrated care. The evaluation included patient-level self-report and chart abstractions as well as provider and site level data collected through surveys and in-depth interviews. Although multisite demonstrations pose implementation and evaluation challenges, our experience demonstrates that these can, in part, be addressed through ongoing communication and technical assistance as well as a comprehensive evaluation design that incorporates multiple research methods and data sources. Although limitations to evaluation findings persist, they may be balanced by the scope and "real-world" context of the initiative. PMID:21317598

  17. [The particularity of female coronary heart disease and the thinking way of its diagnosis and treatment by integrative medicine].

    PubMed

    Liang, Dong-Hui

    2014-03-01

    Coronary heart disease (CHD) is a major disease greatly harmful to the health of human beings. The incidence and case fatality rate of female CHD show an increasing tendency due to lack of enough attention. Through analyzing the epidemiology, risk factors, and clinical characteristics of female CHD, we emphasized that it is necessary to pay enough attention to the particularity of female CHD, and put forward the thinking way of diagnosis and treatment of integrative medicine as "integrating Chinese medicine and Western medicine by mutual complement of advantages; combining syndrome typing and disease identification by grasping laws; treating physically and mentally by a wholism concept; spreading health education, preventing and treating comprehensively".

  18. The Impact of Lifetime Drug Use on Hepatitis C Treatment Outcomes in Insured Members of an Integrated Health Care Plan

    PubMed Central

    Pauly, Mary Patricia; Moore, Charles Denton; Chia, Constance; Dorrell, Jennifer Mary; Cunanan, Renee Junko; Witt, Gayle

    2013-01-01

    Background The relation of drug use to HCV treatment outcome in an insured household population has not been previously reported. Methods Lifetime frequencies of marijuana use and non-medical use of stimulants, sedatives, and opioids; hallucinogens; and inhalants were retrospectively assessed in 259 privately insured members of an integrated health care plan treated for chronic hepatitis C virus infection (HCV+) with pegylated interferon alpha and ribavirin and examined with respect to rates of sustained virological response (SVR). Results The majority of patients reported chronic use of multiple illegal drugs; 61.6% reported injection drug use (IDU); 79.5% abstained from drug use during the six months prior to HCV treatment. Total frequency of individual drugs, multiple drugs, and length of abstention from drugs prior to HCV treatment were not related to impaired SVR rates. Sustained viral responses were obtained in 80.2% of patients with HCV genotype 2/3 and 45.1% of patients with genotype 1/4/6. Marijuana use during HCV treatment, reported by 8.5% of patients, was associated with higher treatment adherence (95.5% compared with 78.9%, p=0.045), but lower SVR rates (40.9% compared with 62.5%, p=0.041). In addition, drug use during HCV treatment was associated with significantly higher relapse rates, 18.8% compared with 7.7% (p=.053). Conclusion A history of chronic illegal drug use should not be considered a deterrent to HCV treatment in members of an integrated health care plan who are motivated to seek treatment and closely monitored, but drug use during HCV treatment, including marijuana use, should be discouraged. PMID:24262649

  19. Integrated services plus drug treatment as a system alternative to crime control and parole.

    PubMed

    Danzer, Graham

    2012-01-01

    Integrated services have the potential to facilitate recovery in drug offenders as well as reduce criminal recidivism. This is significant given that prison overcrowding has led many drug offenders to be released from custody into society via the "reentry movement." Offenders incarcerated for many years often return to society with medical, mental health, behavioral, and drug abuse issues. These issues have been found in similar populations, including those with severe mental illness and the homeless, for which integrated services has shown to have a significant impact on improving functioning. Thus the argument of this article is that because integrated services have shown to be effective with somewhat similar populations, integrated services can be effective in treating paroled drug offenders. These benefits are expected to be to a greater degree than that achieved by current system policy regarding paroled drug offenders being supervised by parole officers rather than case managers facilitating integrated services.

  20. Selection of forward osmosis draw solutes for subsequent integration with anaerobic treatment to facilitate resource recovery from wastewater.

    PubMed

    Ansari, Ashley J; Hai, Faisal I; Guo, Wenshan; Ngo, Hao H; Price, William E; Nghiem, Long D

    2015-09-01

    Forward osmosis (FO) can be used to extract clean water and pre-concentrate municipal wastewater to make it amenable to anaerobic treatment. A protocol was developed to assess the suitability of FO draw solutes for pre-concentrating wastewater for potential integration with anaerobic treatment to facilitate resource recovery from wastewater. Draw solutes were evaluated in terms of their ability to induce osmotic pressure, water flux, and reverse solute flux. The compatibility of each draw solute with subsequent anaerobic treatment was assessed by biomethane potential analysis. The effect of each draw solute (at concentrations corresponding to the reverse solute flux at ten-fold pre-concentration of wastewater) on methane production was also evaluated. The results show that ionic organic draw solutes (e.g., sodium acetate) were most suitable for FO application and subsequent anaerobic treatment. On the other hand, the reverse solute flux of inorganic draw solutions could inhibit methane production from FO pre-concentrated wastewater.

  1. The energy trilogy: An integrated sustainability model to bridge wastewater treatment plant energy and emissions gaps

    NASA Astrophysics Data System (ADS)

    Al-Talibi, A. Adhim

    An estimated 4% of national energy consumption is used for drinking water and wastewater services. Despite the awareness and optimization initiatives for energy conservation, energy consumption is on the rise owing to population and urbanization expansion and to commercial and industrial business advancement. The principal concern is since energy consumption grows, the higher will be the energy production demand, leading to an increase in CO2 footprints and the contribution to global warming potential. This research is in the area of energy-water nexus, focusing on wastewater treatment plant (WWTP) energy trilogy -- the group of three related entities, which includes processes: (1) consuming energy, (2) producing energy, and (3) the resulting -- CO2 equivalents. Detailed and measurable energy information is not readily obtained for wastewater facilities, specifically during facility preliminary design phases. These limitations call for data-intensive research approach on GHG emissions quantification, plant efficiencies and source reduction techniques. To achieve these goals, this research introduced a model integrating all plant processes and their pertinent energy sources. In a comprehensive and "Energy Source-to-Effluent Discharge" pattern, this model is capable of bridging the gaps of WWTP energy, facilitating plant designers' decision-making for meeting energy assessment, sustainability and the environmental regulatory compliance. Protocols for estimating common emissions sources are available such as for fuels, whereas, site-specific emissions for other sources have to be developed and are captured in this research. The dissertation objectives were met through an extensive study of the relevant literature, models and tools, originating comprehensive lists of processes and energy sources for WWTPs, locating estimation formulas for each source, identifying site specific emissions factors, and linking the sources in a mathematical model for site specific CO2 e

  2. Integrating precision medicine in the study and clinical treatment of a severely mentally ill person.

    PubMed

    O'Rawe, Jason A; Fang, Han; Rynearson, Shawn; Robison, Reid; Kiruluta, Edward S; Higgins, Gerald; Eilbeck, Karen; Reese, Martin G; Lyon, Gholson J

    2013-01-01

    .Glu429Ala allele in methylenetetrahydrofolate reductase (MTHFR) and the p.Asp7Asn allele in ChAT, encoding choline O-acetyltransferase, with both alleles having been shown to confer an elevated susceptibility to psychoses. We have found thousands of other variants in his genome, including pharmacogenetic and copy number variants. This information has been archived and offered to this person alongside the clinical sequencing data, so that he and others can re-analyze his genome for years to come. Conclusions. To our knowledge, this is the first study in the clinical neurosciences that integrates detailed neuropsychiatric phenotyping, deep brain stimulation for OCD and clinical-grade WGS with management of genetic results in the medical treatment of one person with severe mental illness. We offer this as an example of precision medicine in neuropsychiatry including brain-implantable devices and genomics-guided preventive health care. PMID:24109560

  3. Integrating precision medicine in the study and clinical treatment of a severely mentally ill person

    PubMed Central

    O’Rawe, Jason A.; Fang, Han; Rynearson, Shawn; Robison, Reid; Kiruluta, Edward S.; Higgins, Gerald; Eilbeck, Karen; Reese, Martin G.

    2013-01-01

    .Glu429Ala allele in methylenetetrahydrofolate reductase (MTHFR) and the p.Asp7Asn allele in ChAT, encoding choline O-acetyltransferase, with both alleles having been shown to confer an elevated susceptibility to psychoses. We have found thousands of other variants in his genome, including pharmacogenetic and copy number variants. This information has been archived and offered to this person alongside the clinical sequencing data, so that he and others can re-analyze his genome for years to come. Conclusions. To our knowledge, this is the first study in the clinical neurosciences that integrates detailed neuropsychiatric phenotyping, deep brain stimulation for OCD and clinical-grade WGS with management of genetic results in the medical treatment of one person with severe mental illness. We offer this as an example of precision medicine in neuropsychiatry including brain-implantable devices and genomics-guided preventive health care. PMID:24109560

  4. Integrating Religion and Spirituality into Treatment for Late-Life Anxiety: Three Case Studies

    ERIC Educational Resources Information Center

    Barrera, Terri L.; Zeno, Darrell; Bush, Amber L.; Barber, Catherine R.; Stanley, Melinda A.

    2012-01-01

    Generalized anxiety disorder (GAD) is common in older adults and, although cognitive behavioral therapy (CBT) is an efficacious treatment for late-life GAD, effect sizes are only moderate and attrition rates are high. One way to increase treatment acceptability and enhance current cognitive behavioral treatments for GAD in older adults might be to…

  5. An Integrated, Multidimensional Treatment Model for Individuals Living with HIV, Mental Illness, and Substance Abuse

    ERIC Educational Resources Information Center

    Bouis, Stephanie; Reif, Susan; Whetten, Kathryn; Scovil, Janet; Murray, Andrea; Swartz, Marvin

    2007-01-01

    The challenge of providing effective treatment services for the growing population of HIV-positive individuals who are also dually diagnosed with substance use and mental disorders has only recently been recognized as an important public health concern affecting both HIV treatment and prevention. This article describes a treatment model that was…

  6. Dual Treatments as Starting Point for Integrative Perceptions in Teaching Mathematics

    ERIC Educational Resources Information Center

    Kërënxhi, Svjetllana; Gjoci, Pranvera

    2015-01-01

    In this paper, we recommend mathematical teaching through dual treatments. The dual treatments notion, classified in dual interpretations, dual analyses, dual solutions, and dual formulations, is explained through concrete examples taken from mathematical textbooks of elementary education. Dual treatments provide opportunities for creating…

  7. Integrating screening, brief intervention and referral to treatment (SBIRT) into an abortion clinic: an exploratory study of acceptability.

    PubMed

    Appel, Lindsay; Ramanadhan, Shaalini; Hladky, Katherine; Welsh, Chris; Terplan, Mishka

    2015-04-01

    Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an effective means of identifying problematic substance use. We evaluated the acceptability of SBIRT in an abortion clinic via an anonymous survey of 100 participants. Clients were comfortable being asked about their substance use, receiving counseling, and treatment referral (mean Likert 1.1, 1.5, and 1.6, respectively) and were only minimally embarrassed when asked about substance use (mean Likert 3.6). These findings suggest that integrating SBIRT into an abortion clinic may be feasible. However, future studies are needed to assess the efficacy of abortion clinic SBIRT in reducing risky substance use. PMID:25596511

  8. Central treatment of different emulsion wastewaters by an integrated process of physicochemically enhanced ultrafiltration and anaerobic-aerobic biofilm reactor.

    PubMed

    Zhang, Weijun; Xiao, Ping; Wang, Dongsheng

    2014-05-01

    The feasibility of an integrated process of ultrafiltration (UF) enhanced by combined chemical emulsion breaking with vibratory shear and anaerobic/aerobic biofilm reactor for central treatment of different emulsion wastewaters was investigated. Firstly, it was found that calcium chloride exhibited better performance in oil removal than other inorganic salts. Chemical demulsification pretreatment could efficiently improve oil removal and membrane filtration in emulsion wastewater treatment by VSEP. According to aerobic batch bioassay, UF permeate exhibited good biodegradability and could be further treated with biological process. Additionally, pilot test indicated that anaerobic-aerobic biofilm exhibited an excellent ability against rise in organic loading and overall chemical oxygen demand (COD) removal efficiency of biological system was more than 93% of which 82% corresponded to the anaerobic process and 11% to the aerobic degradation. The final effluent of integrated process could meet the "water quality standards for discharge to municipal sewers" in China.

  9. [Establishing the idea of holistic integrative medicine, optimizing the quality of health care service in prevention and treatment].

    PubMed

    Sun, Xing-guo

    2015-07-01

    Under background of reductionism in the modern science, physiology and medicine are stepwise refined into system, organ, disease, cell and gene etc. Although clinical medicine, only service in whole human object, obviously brought tremendous progress, it also appeared obvious defects and limits at the same time. Professionalized and specialized medicine not only needs to be integrated from basics to clinical fields, but also from prevention, health management, clinical treatment and functional rehabilitation medicine. People are indivisible organic whole. Professionalization, translation and integration must be combined. In order to provide the best quality and optimized medical service for the Chinese people and to lead in the world, we have to strengthen professional and technical knowledge, and have to establish the holistic integrative medical philosophy for physiology and medicine too. PMID:26775496

  10. [Establishing the idea of holistic integrative medicine, optimizing the quality of health care service in prevention and treatment].

    PubMed

    Sun, Xing-guo

    2015-07-01

    Under background of reductionism in the modern science, physiology and medicine are stepwise refined into system, organ, disease, cell and gene etc. Although clinical medicine, only service in whole human object, obviously brought tremendous progress, it also appeared obvious defects and limits at the same time. Professionalized and specialized medicine not only needs to be integrated from basics to clinical fields, but also from prevention, health management, clinical treatment and functional rehabilitation medicine. People are indivisible organic whole. Professionalization, translation and integration must be combined. In order to provide the best quality and optimized medical service for the Chinese people and to lead in the world, we have to strengthen professional and technical knowledge, and have to establish the holistic integrative medical philosophy for physiology and medicine too.

  11. Efficient treatment of phenolic wastewater with high salinity using a novel integrated system of magnetically immobilized cells coupling with electrodes.

    PubMed

    Jiang, Bei; Shi, Shengnan; Song, Lun; Tan, Liang; Li, Meidi; Liu, Jiaxin; Xue, Lanlan

    2016-10-01

    A novel integrated system in which magnetically immobilized cells coupled with a pair of stainless iron meshes-graphite plate electrodes has been designed and operated to enhance the treatment performance of phenolic wastewater under high salinity. With NaCl concentration increased, phenol, o-cresol, m-cresol, p-cresol and COD removal rates by integrated system increased significantly, which were obviously higher than the sum of removal rates by single magnetically immobilized cells and electrode reaction. This integrated system exhibited higher removal rates for all the compounds than that by single magnetically immobilized cells during six cycles for reuse, and it still performed better, even when the voltage was cut off. These results indicated that there was a coupling effect between biodegradation and electrode reaction. The investigation of phenol hydroxylase activity and cells concentration confirmed that electrode reaction played an important role in this coupling effect. PMID:27347805

  12. Efficient treatment of phenolic wastewater with high salinity using a novel integrated system of magnetically immobilized cells coupling with electrodes.

    PubMed

    Jiang, Bei; Shi, Shengnan; Song, Lun; Tan, Liang; Li, Meidi; Liu, Jiaxin; Xue, Lanlan

    2016-10-01

    A novel integrated system in which magnetically immobilized cells coupled with a pair of stainless iron meshes-graphite plate electrodes has been designed and operated to enhance the treatment performance of phenolic wastewater under high salinity. With NaCl concentration increased, phenol, o-cresol, m-cresol, p-cresol and COD removal rates by integrated system increased significantly, which were obviously higher than the sum of removal rates by single magnetically immobilized cells and electrode reaction. This integrated system exhibited higher removal rates for all the compounds than that by single magnetically immobilized cells during six cycles for reuse, and it still performed better, even when the voltage was cut off. These results indicated that there was a coupling effect between biodegradation and electrode reaction. The investigation of phenol hydroxylase activity and cells concentration confirmed that electrode reaction played an important role in this coupling effect.

  13. Intravenous Mistletoe Treatment in Integrative Cancer Care: A Qualitative Study Exploring the Procedures, Concepts, and Observations of Expert Doctors

    PubMed Central

    Kienle, Gunver S.; Mussler, Milena; Fuchs, Dieter; Kiene, Helmut

    2016-01-01

    Background. Mistletoe therapy (MT) is widely used in patient-centered integrative cancer care. The objective of this study was to explore the concepts, procedures, and observations of expert doctors, with a focus on intravenous MT. Method. A qualitative interview study was conducted with 35 highly experienced doctors specialized in integrative and anthroposophic medicine. Structured qualitative content analysis was applied. For triangulation, the results were compared with external evidence that was systematically collected, reviewed, and presented. Results. Doctors perform individualized patient assessments that lead to multimodal treatment approaches. The underlying goal is to help patients to live with and overcome disease. Mistletoe infusions are a means of accomplishing this goal. They are applied to stabilize disease, achieve responsiveness, induce fever, improve quality of life, and improve the tolerability of conventional cancer treatments. The doctors reported long-term disease stability and improvements in patients' general condition, vitality, strength, thermal comfort, appetite, sleep, pain from bone metastases, dyspnea in pulmonary lymphangitis carcinomatosa, fatigue, and cachexia; chemotherapy was better tolerated. Also patients' emotional and mental condition was reported to have improved. Conclusion. Individualized integrative cancer treatment including MT aims to help cancer patients to live well with their disease. Further research should investigate the reported observations. PMID:27239209

  14. Feasibility of laser-integrated high intensity focused ultrasound (HIFU) treatment for bladder tumors: in vitro study (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Nguyen, Van Phuc; Park, Suhyun; Oh, Junghwan; Kang, Hyun Wook

    2016-02-01

    Previous studies have shown that photothemal therapy combined with high intensity focused ultrasound (HIFU) can provide a promising method to achieve rapid thermal coagulation during surgical procedures. The current study investigated the feasibility of the laser-integrated high intensity focused ultrasound (HIFU) application to treat bladder tumors by enhancing thermal effects and therapeutic depth in vitro. To generate thermal coagulation, a single element HIFU transducer with a central frequency of 2.0 MHz was used to transmit acoustic energy to 15 fresh porcine bladders injected with an artificial tumor (100 µl gelatin and hemoglobin solution) in vitro. Simultaneously, an 80-W 532-nm laser system was also implemented to induce thermal necrosis in the targeted tissue. The intensity of 570 W/cm2 at the focus of HIFU and laser energy of 0.9 W were applied to all the samples for 40 s. The temperature rise increased up to about 1.6 or 3 folds (i.e., ΔT=32±3.8 K for laser-integrated HIFU, ΔT=20±6.5 K for HIFU only, and ΔT=11±5.6 K for laser only). The estimated lesion depth also increased by 1.3 and 2 folds during the dual-thermal treatment, in comparison with the treatment by either HIFU or laser. The results indicated that the laser-integrated HIFU treatment can be an efficient hyperthermic method for tumor coagulation.

  15. [Integrated headache care network. Kiel Migraine and Headache Center and German National Headache Treatment Network].

    PubMed

    Göbel, H; Heinze-Kuhn, K; Petersen, I; Göbel, A; Heinze, A

    2013-04-01

    Migraine and other headaches affect 54 million people in Germany. They rank among the ten most severely disabling complaints and the three most expensive neurological disorders. Nevertheless, they are not adequately recognized in the healthcare system with sketchy diagnoses and inadequate treatment. This inadequate care is not primarily due to a lack of medical and scientific knowledge on the development and treatment of headaches but is predominantly due to organizational deficits in the healthcare system and in the implementation of current knowledge. To overcome the organizational barriers the national headache treatment network was initiated in Germany. For the first time it allows national cross-sectoral and multidisciplinary links between inpatient and outpatient care. A hand in hand treatment programme, better education, better information exchange between all partners and combined efforts using clearly defined treatment pathways and goals are the basis for state of the art and efficient treatment results. The treatment network is geared towards the specialized treatment of severely affected patients with chronic headache disorders. A national network of outpatient and inpatient pain therapists in both practices and hospitals works hand in hand to optimally alleviate pain in a comprehensive cross-sectoral and multidisciplinary manner. For therapy refractive disorders, a high-intensive supraregional fully inpatient treatment can be arranged. This concept offers for the first time a nationwide coordinated treatment without limitation by specialization and bureaucratic remuneration sectors.

  16. Fate of As, Se, and Hg in a Passive Integrated System for Treatment of Fossil Plant Wastewater

    SciTech Connect

    Terry Yost; Paul Pier; Gregory Brodie

    2007-12-31

    TVA is collaborating with EPRI and DOE to demonstrate a passive treatment system for removing SCR-derived ammonia and trace elements from a coal-fired power plant wastewater stream. The components of the integrated system consist of trickling filters for ammonia oxidation, reaction cells containing zero-valent iron (ZVI) for trace contaminant removal, a settling basin for storage of iron hydroxide floc, and anaerobic vertical-flow wetlands for biological denitrification. The passive integrated treatment system will treat up to 0.25 million gallons per day (gpd) of flue gas desulfurization (FGD) pond effluent, with a configuration requiring only gravity flow to obviate the need for pumps. The design of the system will enable a comparative evaluation of two parallel treatment trains, with and without the ZVI extraction trench and settling/oxidation basin components. One of the main objectives is to gain a better understanding of the chemical transformations that species of trace elements such as arsenic, selenium, and mercury undergo as they are treated in passive treatment system components with differing environmental conditions. This progress report details the design criteria for the passive integrated system for treating fossil power plant wastewater as well as performance results from the first several months of operation. Engineering work on the project has been completed, and construction took place during the summer of 2005. Monitoring of the passive treatment system was initiated in October 2005 and continued until May 18 2006. The results to date indicate that the treatment system is effective in reducing levels of nitrogen compounds and trace metals. Concentrations of both ammonia and trace metals were lower than expected in the influent FGD water, and additions to increase these concentrations will be done in the future to further test the removal efficiency of the treatment system. In May 2006, the wetland cells were drained of FGD water, refilled with

  17. Development and validation of a novel modeling framework integrating ion exchange and resin regeneration for water treatment.

    PubMed

    Zhang, Jie; Amini, Adib; O'Neal, Jeremy A; Boyer, Treavor H; Zhang, Qiong

    2015-11-01

    Models have been developed to simulate the process of ion exchange for water treatment. However the modeling of resin regeneration process, which can predict regeneration efficiency and residual stream for determining technology sustainability, was not incorporated into previous models. Therefore a model integrating both ion exchange and resin regeneration considering regeneration efficiency is needed for evaluating and improving ion exchange technology. This study developed an integrated model aiming to simulate ion exchange and resin regeneration in different configurations (fixed bed, fluidized bed) for the first time. The integrated model has been validated via comparing model predictions with experimental data. The impacts of dimensionless groups (i.e. the Péclet number, the diffusion modulus, and the Biot number) on ion exchange breakthrough curve have been analyzed using this model. In addition, this integrated model has been used to optimize the regeneration frequency to improve the overall performance of ion exchange. It demonstrated this integrated model could be a useful tool for further studies in ion exchange technology.

  18. Long-term Impact of Integration of Household Water Treatment and Hygiene Promotion with Antenatal Services on Maternal Water Treatment and Hygiene Practices in Malawi

    PubMed Central

    Loharikar, Anagha; Russo, Elizabeth; Sheth, Anandi; Menon, Manoj; Kudzala, Amose; Tauzie, Blessius; Masuku, Humphreys D.; Ayers, Tracy; Hoekstra, Robert M.; Quick, Robert

    2013-01-01

    A clinic-based program to integrate antenatal services with distribution of hygiene kits including safe water storage containers, water treatment solution (brand name WaterGuard), soap, and hygiene education, was implemented in Malawi in 2007 and evaluated in 2010. We surveyed 389 participants at baseline in 2007, and found and surveyed 232 (60%) participants to assess water treatment, test stored drinking water for residual chlorine (an objective measure of treatment), and observe handwashing technique at follow-up in 2010. Program participants were more likely to know correct water treatment procedures (67% versus 36%; P < 0.0001), treat drinking water with WaterGuard (24% versus 2%; P < 0.0001), purchase and use WaterGuard (21% versus 1%; P < 0.001), and demonstrate correct handwashing technique (50% versus 21%; P < 0.001) at the three-year follow-up survey than at baseline. This antenatal-clinic-based program may have contributed to sustained water treatment and proper handwashing technique among program participants. PMID:23243106

  19. Long-term impact of integration of household water treatment and hygiene promotion with antenatal services on maternal water treatment and hygiene practices in Malawi.

    PubMed

    Loharikar, Anagha; Russo, Elizabeth; Sheth, Anandi; Menon, Manoj; Kudzala, Amose; Tauzie, Blessius; Masuku, Humphreys D; Ayers, Tracy; Hoekstra, Robert M; Quick, Robert

    2013-02-01

    A clinic-based program to integrate antenatal services with distribution of hygiene kits including safe water storage containers, water treatment solution (brand name WaterGuard), soap, and hygiene education, was implemented in Malawi in 2007 and evaluated in 2010. We surveyed 389 participants at baseline in 2007, and found and surveyed 232 (60%) participants to assess water treatment, test stored drinking water for residual chlorine (an objective measure of treatment), and observe handwashing technique at follow-up in 2010. Program participants were more likely to know correct water treatment procedures (67% versus 36%; P < 0.0001), treat drinking water with WaterGuard (24% versus 2%; P < 0.0001), purchase and use WaterGuard (21% versus 1%; P < 0.001), and demonstrate correct handwashing technique (50% versus 21%; P < 0.001) at the three-year follow-up survey than at baseline. This antenatal-clinic-based program may have contributed to sustained water treatment and proper handwashing technique among program participants. PMID:23243106

  20. Integrating Antimicrobial Therapy with Host Immunity to Fight Drug-Resistant Infections: Classical vs. Adaptive Treatment

    PubMed Central

    Gjini, Erida; Brito, Patricia H.

    2016-01-01

    Antimicrobial resistance of infectious agents is a growing problem worldwide. To prevent the continuing selection and spread of drug resistance, rational design of antibiotic treatment is needed, and the question of aggressive vs. moderate therapies is currently heatedly debated. Host immunity is an important, but often-overlooked factor in the clearance of drug-resistant infections. In this work, we compare aggressive and moderate antibiotic treatment, accounting for host immunity effects. We use mathematical modelling of within-host infection dynamics to study the interplay between pathogen-dependent host immune responses and antibiotic treatment. We compare classical (fixed dose and duration) and adaptive (coupled to pathogen load) treatment regimes, exploring systematically infection outcomes such as time to clearance, immunopathology, host immunization, and selection of resistant bacteria. Our analysis and simulations uncover effective treatment strategies that promote synergy between the host immune system and the antimicrobial drug in clearing infection. Both in classical and adaptive treatment, we quantify how treatment timing and the strength of the immune response determine the success of moderate therapies. We explain key parameters and dimensions, where an adaptive regime differs from classical treatment, bringing new insight into the ongoing debate of resistance management. Emphasizing the sensitivity of treatment outcomes to the balance between external antibiotic intervention and endogenous natural defenses, our study calls for more empirical attention to host immunity processes. PMID:27078624

  1. Integrating Estimates of the Social and Individual Costs of Caregiving into Dementia Treatment Trials.

    PubMed

    Phillips, Charles D

    2016-01-01

    A variety of new treatments for dementia are awaiting or undergoing randomized clinical trails. These trials focus on outcomes such as changes in cognitive function, physical function, or amyloid plaques. What is quite important and is too often missing from these trials are estimates of the impact of these treatments on the social and individual costs of providing care for those facing dementia. Until outcomes such as family caregiver time and caregiver burden are included in trails of dementia treatments, the picture of how well these treatments work will be distressingly incomplete.

  2. Integrating Antimicrobial Therapy with Host Immunity to Fight Drug-Resistant Infections: Classical vs. Adaptive Treatment.

    PubMed

    Gjini, Erida; Brito, Patricia H

    2016-04-01

    Antimicrobial resistance of infectious agents is a growing problem worldwide. To prevent the continuing selection and spread of drug resistance, rational design of antibiotic treatment is needed, and the question of aggressive vs. moderate therapies is currently heatedly debated. Host immunity is an important, but often-overlooked factor in the clearance of drug-resistant infections. In this work, we compare aggressive and moderate antibiotic treatment, accounting for host immunity effects. We use mathematical modelling of within-host infection dynamics to study the interplay between pathogen-dependent host immune responses and antibiotic treatment. We compare classical (fixed dose and duration) and adaptive (coupled to pathogen load) treatment regimes, exploring systematically infection outcomes such as time to clearance, immunopathology, host immunization, and selection of resistant bacteria. Our analysis and simulations uncover effective treatment strategies that promote synergy between the host immune system and the antimicrobial drug in clearing infection. Both in classical and adaptive treatment, we quantify how treatment timing and the strength of the immune response determine the success of moderate therapies. We explain key parameters and dimensions, where an adaptive regime differs from classical treatment, bringing new insight into the ongoing debate of resistance management. Emphasizing the sensitivity of treatment outcomes to the balance between external antibiotic intervention and endogenous natural defenses, our study calls for more empirical attention to host immunity processes.

  3. Integrating sequencing batch reactor with bio-electrochemical treatment for augmenting remediation efficiency of complex petrochemical wastewater.

    PubMed

    Yeruva, Dileep Kumar; Jukuri, Srinivas; Velvizhi, G; Naresh Kumar, A; Swamy, Y V; Venkata Mohan, S

    2015-01-01

    The present study evaluates the sequential integration of two advanced biological treatment methods viz., sequencing batch reactor (SBR) and bioelectrochemical treatment systems (BET) for the treatment of real-field petrochemical wastewater (PCW). Initially two SBR reactors were operated in aerobic (SBR(Ae)) and anoxic (SBR(Ax)) microenvironments with an organic loading rate (OLR) of 9.68 kg COD/m(3)-day. Relatively, SBR(Ax) showed higher substrate degradation (3.34 kg COD/m(3)-day) compared to SBR(Ae) (2.9 kg COD/m(3)-day). To further improve treatment efficiency, the effluents from SBR process were fed to BET reactors. BET(Ax) depicted higher SDR (1.92 kg COD/m(3)-day) with simultaneous power generation (17.12 mW/m(2)) followed by BET(Ae) (1.80 kg COD/m(3)-day; 14.25 mW/m(2)). Integrating both the processes documented significant improvement in COD removal efficiency due to the flexibility of combining multiple microenvironments sequentially. Results were supported with GC-MS and FTIR, which confirmed the increment in biodegradability of wastewater.

  4. Integral dose investigation of non-coplanar treatment beam geometries in radiotherapy

    SciTech Connect

    Nguyen, Dan; Dong, Peng; Ruan, Dan; Low, Daniel A.; Sheng, Ke; Long, Troy; Romeijn, Edwin

    2014-01-15

    Purpose: Automated planning and delivery of non-coplanar plans such as 4π radiotherapy involving a large number of fields have been developed to take advantage of the newly available automated couch and gantry on C-arm gantry linacs. However, there is an increasing concern regarding the potential changes in the integral dose that needs to be investigated. Methods: A digital torso phantom and 22 lung and liver stereotactic body radiation therapy (SBRT) patients were included in the study. The digital phantom was constructed as a water equivalent elliptical cylinder with a major axis length of 35.4 cm and minor axis of 23.6 cm. A 4.5 cm diameter target was positioned at varying depths along the major axis. Integral doses from intensity modulated, non-coplanar beams forming a conical pattern were compared against the equally spaced coplanar beam plans. Integral dose dependence on the phantom geometry and the beam number was also quantified. For the patient plans, the non-coplanar and coplanar beams and fluences were optimized using a column generation and pricing approach and compared against clinical VMAT plans using two full (lung) or partial coplanar arcs (liver) entering at the side proximal to the tumor. Both the average dose to the normal tissue volume and the total volumes receiving greater than 2 Gy (V2) and 5 Gy (V5) were evaluated and compared. Results: The ratio of integral dose from the non-coplanar and coplanar plans depended on the tumor depth for the phantom; for tumors shallower than 10 cm, the non-coplanar integral doses were lower than coplanar integral doses for non-coplanar angles less than 60°. Similar patterns were observed in the patient plans. The smallest non-coplanar integral doses were observed for tumor 6–8 cm deep. For the phantom, the integral dose was independent of the number of beams, consistent with the liver SBRT patients but the lung SBRT patients showed slight increase in the integral dose when more beams were used. Larger

  5. A path-integral Langevin equation treatment of low-temperature doped helium clusters

    NASA Astrophysics Data System (ADS)

    Ing, Christopher; Hinsen, Konrad; Yang, Jing; Zeng, Toby; Li, Hui; Roy, Pierre-Nicholas

    2012-06-01

    We present an implementation of path integral molecular dynamics for sampling low temperature properties of doped helium clusters using Langevin dynamics. The robustness of the path integral Langevin equation and white-noise Langevin equation [M. Ceriotti, M. Parrinello, T. E. Markland, and D. E. Manolopoulos, J. Chem. Phys. 133, 124104 (2010)], 10.1063/1.3489925 sampling methods are considered for those weakly bound systems with comparison to path integral Monte Carlo (PIMC) in terms of efficiency and accuracy. Using these techniques, convergence studies are performed to confirm the systematic error reduction introduced by increasing the number of discretization steps of the path integral. We comment on the structural and energetic evolution of HeN-CO2 clusters from N = 1 to 20. To quantify the importance of both rotations and exchange in our simulations, we present a chemical potential and calculated band origin shifts as a function of cluster size utilizing PIMC sampling that includes these effects. This work also serves to showcase the implementation of path integral simulation techniques within the molecular modelling toolkit [K. Hinsen, J. Comp. Chem. 21, 79 (2000)], 10.1002/(SICI)1096-987X(20000130)21:2<79::AID-JCC1>3.0.CO;2-B, an open-source molecular simulation package.

  6. Integrated Waste Treatment Unit (IWTU) Input Coal Analyses and Off-Gass Filter (OGF) Content Analyses

    SciTech Connect

    Jantzen, Carol M.; Missimer, David M.; Guenther, Chris P.; Shekhawat, Dushyant; VanEssendelft, Dirk T.; Means, Nicholas C.

    2015-04-23

    A full engineering scale Fluidized Bed Steam Reformer (FBSR) system is being used at the Idaho Nuclear Technology and Engineering Center (INTEC) to stabilize acidic Low Activity Waste (LAW) known as Sodium Bearing Waste (SBW). The INTEC facility, known as the Integrated Waste Treatment Unit (IWTU), underwent an Operational Readiness Review (ORR) and a Technology Readiness Assessment (TRA) in March 2014. The IWTU began non-radioactive simulant processing in late 2014 and by January, 2015 ; the IWTU had processed 62,000 gallons of simulant. The facility is currently in a planned outage for inspection of the equipment and will resume processing simulated waste feed before commencing to process 900,000 gallons of radioactive SBW. The SBW acidic waste will be made into a granular FBSR product (carbonate based) for disposal in the Waste Isolation Pilot Plant (WIPP). In the FBSR process calcined coal is used to create a CO2 fugacity to force the waste species to convert to carbonate species. The quality of the coal, which is a feed input, is important because the reactivity, moisture, and volatiles (C,H,N,O, and S) in the coal impact the reactions and control of the mineralizing process in the primary steam reforming vessel, the Denitration and Mineralizing Reformer (DMR). Too much moisture in the coal can require that additional coal be used. However since moisture in the coal is only a small fraction of the moisture from the fluidizing steam this can be self-correcting. If the coal reactivity or heating value is too low then the coal feedrate needs to be adjusted to achieve the desired heat generation. Too little coal and autothermal heat generation in the DMR cannot be sustained and/or the carbon dioxide fugacity will be too low to create the desired carbonate mineral species. Too much coal and excess S and hydroxide species can form. Excess sulfur from coal that (1) is too rich in sulfur or (2) from overfeeding coal can promote wall scale and contribute to corrosion

  7. Treatment of Sexual Disorders in the 1990s: An Integrated Approach.

    ERIC Educational Resources Information Center

    Rosen, Raymond C.; Leiblum, Sandra R.

    1995-01-01

    Reviews existing data regarding the etiology and treatment of male and female sexual dysfunctions. Discusses the use of multidimensional assessment models, especially in the evaluation of erectile dysfunction and sexual pain disorders. Despite the conceptual and technological sophistication of current approaches, treatment outcomes are…

  8. Evaluating the Role of Seed Treatments in Canola/Oilseed Rape Production: Integrated Pest Management, Pollinator Health, and Biodiversity

    PubMed Central

    Sekulic, Gregory; Rempel, Curtis B.

    2016-01-01

    The use patterns and role of insecticide seed treatments, with focus on neonicotinoid insecticides, were examined for canola/oilseed rape production in Canada and the EU. Since nearly all planted canola acres in Western Canada and, historically, a majority of planted oilseed acres in the EU, use seed treatments, it is worth examining whether broad use of insecticidal seed treatments (IST) is compatible with principles of integrated pest management (IPM). The neonicotinoid insecticide (NNI) seed treatment (NNI ST) use pattern has risen due to effective control of several early season insect pests, the most destructive being flea beetles (Phyllotreta sp.). Negative environmental impact and poor efficacy of foliar applied insecticides on flea beetles led growers to look for better alternatives. Due to their biology, predictive models have been difficult to develop for flea beetles, and, therefore, targeted application of seed treatments, as part of an IPM program, has contributed to grower profitability and overall pollinator success for canola production in Western Canada. Early evidence suggests that the recent restriction on NNI may negatively impact grower profitability and does not appear to be having positive impact on pollinator health. Further investigation on impact of NNI on individual bee vs. hive health need to be conducted. Predictive models for flea beetle emergence/feeding activity in canola/oilseed rape need to be developed, as broad acre deployment of NNI seed treatments may not be sustainable due to concerns about resistance/tolerance in flea beetles and other pest species. PMID:27527233

  9. Evaluating the Role of Seed Treatments in Canola/Oilseed Rape Production: Integrated Pest Management, Pollinator Health, and Biodiversity.

    PubMed

    Sekulic, Gregory; Rempel, Curtis B

    2016-01-01

    The use patterns and role of insecticide seed treatments, with focus on neonicotinoid insecticides, were examined for canola/oilseed rape production in Canada and the EU. Since nearly all planted canola acres in Western Canada and, historically, a majority of planted oilseed acres in the EU, use seed treatments, it is worth examining whether broad use of insecticidal seed treatments (IST) is compatible with principles of integrated pest management (IPM). The neonicotinoid insecticide (NNI) seed treatment (NNI ST) use pattern has risen due to effective control of several early season insect pests, the most destructive being flea beetles (Phyllotreta sp.). Negative environmental impact and poor efficacy of foliar applied insecticides on flea beetles led growers to look for better alternatives. Due to their biology, predictive models have been difficult to develop for flea beetles, and, therefore, targeted application of seed treatments, as part of an IPM program, has contributed to grower profitability and overall pollinator success for canola production in Western Canada. Early evidence suggests that the recent restriction on NNI may negatively impact grower profitability and does not appear to be having positive impact on pollinator health. Further investigation on impact of NNI on individual bee vs. hive health need to be conducted. Predictive models for flea beetle emergence/feeding activity in canola/oilseed rape need to be developed, as broad acre deployment of NNI seed treatments may not be sustainable due to concerns about resistance/tolerance in flea beetles and other pest species. PMID:27527233

  10. Co-occurring Hepatitis C, substance use, and psychiatric illness: treatment issues and developing integrated models of care.

    PubMed

    Sylvestre, Diana L; Loftis, Jennifer M; Hauser, Peter; Genser, Sander; Cesari, Helen; Borek, Nicolette; Kresina, Thomas F; Seeff, Leonard; Francis, Henry

    2004-12-01

    Hepatitis C virus (HCV) infection is transmitted by injection drug use and associated with psychiatric conditions. Patients with drug use or significant psychiatric illness have typically been excluded from HCV treatment trials noting the 1997 National Institutes of Health Consensus Statement on HCV that indicated active drug use and major depressive illness were contraindications to treatment of HCV infection. However, the 2002 NIH Consensus Statement recognized that these patients could be effectively treated for HCV infection and recommended that treatment be considered on a case-by-case basis. Treating HCV infection in these patients is challenging, with drug use relapse possibly leading to psychosocial instability, poor adherence, and HCV reinfection. Interferon therapy may exacerbate preexisting psychiatric symptoms. Co-occurring human immunodeficiency virus or hepatitis B virus provide additional challenges, and access to ancillary medical and psychiatric services may be limited. Patients with co-occurring HCV infection, substance use, and psychiatric illness can complete interferon treatment with careful monitoring and aggressive intervention. Clinicians must integrate early interventions for psychiatric conditions and drug use into their treatment algorithm. Few programs or treatment models are designed to manage co-occurring substance use, psychiatric illness, and HCV infection and therapy. The National Institute on Drug Abuse convened a panel of experts to address the current status and the long-range needs through a 2-day workshop, Co-occurring Hepatitis C, Substance Abuse, and Psychiatric Illness: Addressing the Issues and Developing Integrated Models of Care. This conference report summarizes current data, medical management issues, and strategies discussed.

  11. Integrative Psychotherapy for Schizophrenia: Its Potential for a Central Role in Recovery Oriented Treatment.

    PubMed

    Lysaker, Paul H; Roe, David

    2016-02-01

    Research has affirmed that recovery from serious mental illnesses (SMI), such as schizophrenia, is a common outcome and often involves subjective changes in the experience of self, one's identity, and one's sense of agency in the world. Although many different interventions have been developed and validated, efforts to consider how those interventions should be integrated to assist people to direct their own recovery have been limited. This article considers the 5 case reports of psychotherapy presented in this special issue that have sought to integrate scientifically valid approaches within a recovery frame work. Exploring shared themes, this article suggests that a common set of processes exists between these examples of integrative work. These include therapist acceptance of a vulnerable stance in the face of uncertainty, which rejects stigma and remains open to knowing the person. This ultimately allows the kinds of meaning to be made jointly between the therapist and client that promote recovery.

  12. Heat treatment of nuclear reactor pump part in integrated furnace facility

    SciTech Connect

    Not Available

    1983-08-01

    A flexible heat treating system is meeting strict work specifications while accommodating the production flow pattern requirements and floor space needs of Advanced Metal Treating, Inc., Butler, Wis. Modular design and appropriate furnace configurations allow realization of the most efficient heat treat processing and energy use in a relatively small production area. The totally-integrated system (Pacemaker--manufactured by Lindberg, A Unit of General Signal, Chicago) consists of an electric integral-quench furnace with companion draw furnaces, washer unit and a material transfer car. With its one-side, inout configuration, the furnace operates with a minimum of drawing and washing equipment. The integral-quench furnace has a work chamber dimension of 30 by 48 by 30 inches (76.2 x 122 x 76.2 cm). The firm has two of these units, plus three in-out draw furnaces, one washer, one transfer car and two endothermic gas generators.

  13. The treatment of climate science in Integrated Assessment Modelling: integration of climate step function response in an energy system integrated assessment model.

    NASA Astrophysics Data System (ADS)

    Dessens, Olivier

    2016-04-01

    Integrated Assessment Models (IAMs) are used as crucial inputs to policy-making on climate change. These models simulate aspect of the economy and climate system to deliver future projections and to explore the impact of mitigation and adaptation policies. The IAMs' climate representation is extremely important as it can have great influence on future political action. The step-function-response is a simple climate model recently developed by the UK Met Office and is an alternate method of estimating the climate response to an emission trajectory directly from global climate model step simulations. Good et al., (2013) have formulated a method of reconstructing general circulation models (GCMs) climate response to emission trajectories through an idealized experiment. This method is called the "step-response approach" after and is based on an idealized abrupt CO2 step experiment results. TIAM-UCL is a technology-rich model that belongs to the family of, partial-equilibrium, bottom-up models, developed at University College London to represent a wide spectrum of energy systems in 16 regions of the globe (Anandarajah et al. 2011). The model uses optimisation functions to obtain cost-efficient solutions, in meeting an exogenously defined set of energy-service demands, given certain technological and environmental constraints. Furthermore, it employs linear programming techniques making the step function representation of the climate change response adapted to the model mathematical formulation. For the first time, we have introduced the "step-response approach" method developed at the UK Met Office in an IAM, the TIAM-UCL energy system, and we investigate the main consequences of this modification on the results of the model in term of climate and energy system responses. The main advantage of this approach (apart from the low computational cost it entails) is that its results are directly traceable to the GCM involved and closely connected to well-known methods of

  14. Integrated freestanding single-crystal silicon nanowires: conductivity and surface treatment.

    PubMed

    Lee, Chung-Hoon; Ritz, Clark S; Huang, Minghuang; Ziwisky, Michael W; Blise, Robert J; Lagally, Max G

    2011-02-01

    Integrated freestanding single-crystal silicon nanowires with typical dimension of 100 nm × 100 nm × 5 µm are fabricated by conventional 1:1 optical lithography and wet chemical silicon etching. The fabrication procedure can lead to wafer-scale integration of silicon nanowires in arrays. The measured electrical transport characteristics of the silicon nanowires covered with/without SiO(2) support a model of Fermi level pinning near the conduction band. The I-V curves of the nanowires reveal a current carrier polarity reversal depending on Si-SiO(2) and Si-H bonds on the nanowire surfaces.

  15. Integrating Fasciolosis Control in the Dry Cow Management: The Effect of Closantel Treatment on Milk Production

    PubMed Central

    Charlier, Johannes; Hostens, Miel; Jacobs, Jos; Van Ranst, Bonny; Duchateau, Luc; Vercruysse, Jozef

    2012-01-01

    The liver fluke Fasciola hepatica is a parasite of ruminants with a worldwide distribution and an apparent increasing incidence in EU member states. Effective control in dairy cattle is hampered by the lack of flukicides with a zero-withdrawal time for milk, leaving the dry period as the only time that preventive treatment can be applied. Here, we present the results of a blinded, randomized and placebo-controlled trial on 11 dairy herds (402 animals) exposed to F. hepatica to 1) assess the effect of closantel treatment at dry-off (or 80–42 days before calving in first-calving heifers) on milk production parameters and 2) evaluate if a number of easy-to-use animal parameters is related to the milk production response after treatment. Closantel treatment resulted in a noticeable decrease of anti-F. hepatica antibody levels from 3–6 months after treatment onwards, a higher peak production (1.06 kg) and a slightly higher persistence (9%) of the lactation, resulting in a 305-day milk production increase of 303 kg. No effects of anthelmintic treatment were found on the average protein and fat content of the milk. Milk production responses after treatment were poor in meagre animals and clinically relevant higher milk production responses were observed in first-lactation animals and in cows with a high (0.3–0.5 optical density ratio (ODR)), but not a very high (≥0.5 ODR) F. hepatica ELISA result on a milk sample from the previous lactation. We conclude that in dairy herds exposed to F. hepatica, flukicide treatment at dry-off is a useful strategy to reduce levels of exposure and increase milk production in the subsequent lactation. Moreover, the results suggest that treatment approaches that only target selected animals within a herd can be developed based on easy-to-use parameters. PMID:22916226

  16. An integrated treatment approach: a case report for dentinogenesis imperfecta type II.

    PubMed

    Shetty, N; Joseph, M; Basnet, P; Dixit, S

    2007-01-01

    Dentinogenesis imperfecta type II or hereditary opalscent dentin is one of the most common autosomal dominant anomaly of dentin that occurs in both sex affecting approximately 1:8000 persons. Clinically this disorder is characterized by variable blue gray to yellow brown teeth, with fracture of enamel and excessive wear. The treatment strategy is focused towards protecting teeth from further wear and tear and total oral rehabilitation of patient with paramount importance to aesthetics, obtaining an appropriate vertical dimension and providing soft tissue support which will help to return the facial profile to a more normal appearance. A multidisciplinary treatment planning is required for treatment of these individuals.

  17. Comparison of Behavioral Intervention and Sensory-Integration Therapy in the Treatment of Challenging Behavior

    ERIC Educational Resources Information Center

    Devlin, Sarah; Healy, Olive; Leader, Geraldine; Hughes, Brian M.

    2011-01-01

    The objective of the current study was to compare the effects of sensory-integration therapy (SIT) and a behavioral intervention on rates of challenging behavior (including self-injurious behavior) in four children diagnosed with Autism Spectrum Disorder. For each of the participants a functional assessment was conducted to identify the variables…

  18. Issues in the Linkage and Integration of Treatment and Rehabilitation Services for Chronically Mentally Ill Persons.

    ERIC Educational Resources Information Center

    Woy, J. Richard; Dellario, Donald J.

    1985-01-01

    Compares and contrasts characteristics of the mental health system and the Vocational Rehabilitation (VR) service system; examines environmental, intraorganizational, and interorganizational variables as they pertain to potential for linkages between mental health and VR providers; and discusses implications for improved integration of treatment…

  19. Integrating Behavioral and Psychodynamic Therapies: Issues in Training and Treatment. Symposium Papers.

    ERIC Educational Resources Information Center

    Halgin, Richard P.; And Others

    These five symposium papers address the gap between behavioral and psychoanalytic theories. "Teaching the Integration of Different Models to Therapists-in-Training," by Richard P. Halgin, suggests that students should concentrate on a broad-based education, using the best of several approaches to fit individual client needs, rather than choosing…

  20. Violence Survivors with Posttraumatic Stress Disorder: Treatment by Integrating Existential and Narrative Therapies

    ERIC Educational Resources Information Center

    Day, Kristen W.

    2009-01-01

    In this article, the author proposes an integration of existential and narrative therapies with current evidence-supported approaches to treating the aforementioned population. First, she briefly defines interpersonal violence, then provides a history and review of the diagnostic criteria for Posttraumatic Stress Disorder (PTSD), which frequently…

  1. Juvenile Drug Court: Enhancing Outcomes by Integrating Evidence-Based Treatments

    ERIC Educational Resources Information Center

    Henggeler, Scott W.; Halliday-Boykins, Colleen A.; Cunningham, Phillippe B.; Randall, Jeff; Shapiro, Steven B.; Chapman, Jason E.

    2006-01-01

    Evaluated the effectiveness of juvenile drug court for 161 juvenile offenders meeting diagnostic criteria for substance abuse or dependence and determined whether the integration of evidence-based practices enhanced the outcomes of juvenile drug court. Over a 1-year period, a four-condition randomized design evaluated outcomes for family court…

  2. Brief Eclectic Psychotherapy for Traumatic Grief (BEP-TG): toward integrated treatment of symptoms related to traumatic loss

    PubMed Central

    Smid, Geert E.; Kleber, Rolf J.; de la Rie, Simone M.; Bos, Jannetta B. A.; Gersons, Berthold P. R.; Boelen, Paul A.

    2015-01-01

    Background Traumatic events such as disasters, accidents, war, or criminal violence are often accompanied by the loss of loved ones, and may then give rise to traumatic grief. Traumatic grief refers to a clinical diagnosis of persistent complex bereavement disorder (PCBD) with comorbid (symptoms of) posttraumatic stress disorder (PTSD) and/or major depressive disorder (MDD) following confrontation with a traumatic loss. Trauma survivors, who are frequently from different cultural backgrounds, have often experienced multiple losses and ambiguous loss (missing family members or friends). Current evidence-based treatments for PTSD do not focus on traumatic grief. Objective To develop a treatment for traumatic grief combining treatment interventions for PTSD and PCBD that may accommodate cultural aspects of grief. Method To provide a rationale for treatment, we propose a cognitive stress model of traumatic grief. Based on this model and on existing evidence-based treatments for PTSD and complicated grief, we developed Brief Eclectic Psychotherapy for Traumatic Grief (BEP-TG) for the treatment of patients with traumatic grief. The treatment is presented along with a case vignette. Results Processes contributing to traumatic grief include inadequately integrating the memory of the traumatic loss, negative appraisal of the traumatic loss, sensitivity to matching triggers and new stressors, and attempting to avoid distress. BEP-TG targets these processes. The BEP-TG protocol consists of five parts with proven effectiveness in the treatment of PCBD, PTSD, and MDD: information and motivation, grief-focused exposure, memorabilia and writing assignments, finding meaning and activation, and a farewell ritual. Conclusion Tailored to fit the needs of trauma survivors, BEP-TG can be used to address traumatic grief symptoms related to multiple losses and ambiguous loss, as well as cultural aspects of bereavement through its different components. PMID:26154434

  3. An integrated system to remote monitor and control anaerobic wastewater treatment plants through the internet.

    PubMed

    Bernard, O; Chachuat, B; Hélias, A; Le Dantec, B; Sialve, B; Steyer, J-P; Lardon, L; Neveu, P; Lambert, S; Gallop, J; Dixon, M; Ratini, P; Quintabà, A; Frattesi, S; Lema, J M; Roca, E; Ruiz, G; Rodriguez, J; Franco, A; Vanrolleghem, P; Zaher, U; De Pauw, D J W; De Neve, K; Lievens, K; Dochaine, D; Schoefs, O; Fibrianto, H; Farina, R; Alcaraz Gonzalez, V; Gonzalez Alvarez, V; Lemaire, P; Martinez, J A; Esandi, F; Duclaud, O; Lavigne, J F

    2005-01-01

    The TELEMAC project brings new methodologies from the Information and Science Technologies field to the world of water treatment. TELEMAC offers an advanced remote management system which adapts to most of the anaerobic wastewater treatment plants that do not benefit from a local expert in wastewater treatment. The TELEMAC system takes advantage of new sensors to better monitor the process dynamics and to run automatic controllers that stabilise the treatment plant, meet the depollution requirements and provide a biogas quality suitable for cogeneration. If the automatic system detects a failure which cannot be solved automatically or locally by a technician, then an expert from the TELEMAC Control Centre is contacted via the internet and manages the problem. PMID:16180464

  4. Integrated water quality, emergy and economic evaluation of three bioremediation treatment systems for eutrophic water

    EPA Science Inventory

    This study was targeted at finding one or more environmentally efficient, economically feasible and ecologically sustainable bioremediation treatment modes for eutrophic water. Three biological species, i.e. water spinach (Ipomoea aquatica), loach (Misgurus anguillicaudatus) and ...

  5. Integrated Chemical and Toxicological Investigation of UV-Chlorine/Chloramine Drinking Water Treatment

    EPA Science Inventory

    As the use of alternative drinking water treatment increases, it is important to understand potential public health•implications associated with these processes. The objective of this study was to evaluate the formation of disinfection byproducts (DBPs) and cytotoxicity of ...

  6. An integrated system to remote monitor and control anaerobic wastewater treatment plants through the internet.

    PubMed

    Bernard, O; Chachuat, B; Hélias, A; Le Dantec, B; Sialve, B; Steyer, J-P; Lardon, L; Neveu, P; Lambert, S; Gallop, J; Dixon, M; Ratini, P; Quintabà, A; Frattesi, S; Lema, J M; Roca, E; Ruiz, G; Rodriguez, J; Franco, A; Vanrolleghem, P; Zaher, U; De Pauw, D J W; De Neve, K; Lievens, K; Dochaine, D; Schoefs, O; Fibrianto, H; Farina, R; Alcaraz Gonzalez, V; Gonzalez Alvarez, V; Lemaire, P; Martinez, J A; Esandi, F; Duclaud, O; Lavigne, J F

    2005-01-01

    The TELEMAC project brings new methodologies from the Information and Science Technologies field to the world of water treatment. TELEMAC offers an advanced remote management system which adapts to most of the anaerobic wastewater treatment plants that do not benefit from a local expert in wastewater treatment. The TELEMAC system takes advantage of new sensors to better monitor the process dynamics and to run automatic controllers that stabilise the treatment plant, meet the depollution requirements and provide a biogas quality suitable for cogeneration. If the automatic system detects a failure which cannot be solved automatically or locally by a technician, then an expert from the TELEMAC Control Centre is contacted via the internet and manages the problem.

  7. Integrated fungal biomass and activated sludge treatment for textile wastewaters bioremediation.

    PubMed

    Anastasi, Antonella; Spina, Federica; Romagnolo, Alice; Tigini, Valeria; Prigione, Valeria; Varese, Giovanna Cristina

    2012-11-01

    A combined biological process was investigated for effective textile wastewater treatment. The process consisted of a first step performed by selected fungal biomasses, mainly devoted to the effluent decolourisation, and of a subsequent stage by means of activated sludge, in order to reduce the remaining COD and toxicity. In particular, the treatment with Trametes pubescens MUT 2400, selected over nine strains, achieved very good results in respect to all parameters. The final scale-up phase in a moving bed bioreactor with the supported biomass of the fungus allowed to verify the effectiveness of the treatment with high volumes. Despite promising results, further steps must be taken in order to optimize the use of these biomasses for a full exploitation of their oxidative potential in textile wastewater treatment.

  8. An integrative review of attention biases and their contribution to treatment for anxiety disorders

    PubMed Central

    Barry, Tom J.; Vervliet, Bram; Hermans, Dirk

    2015-01-01

    Models of exposure therapy, one of the key components of cognitive behavioral therapy for anxiety disorders, suggest that attention may play an important role in the extinction of fear and anxiety. Evidence from cognitive research suggests that individual differences may play a causal role in the onset and maintenance of anxiety disorders and so it is also likely to influence treatment. We review the evidence concerning attention and treatment outcomes in anxiety disorders. The evidence reviewed here suggests that that attention biases assessed at pre-treatment might actually predict improved response to treatment, and in particular that prolonged engagement with threat as measured in tasks such as the dot probe is associated with greater reductions in anxious symptoms following treatment. We examine this research within a fear learning framework, considering the possible role of individual differences in attention in the extinction of fear during exposure. Theoretical, experimental and clinical implications are discussed, particularly with reference to the potential for attention bias modification programs in augmenting treatment, and also with reference to how existing research in this area might inform best practice for clinicians. PMID:26217284

  9. Sensory integration intervention: historical concepts, treatment strategies and clinical experiences in three patients with succinic semialdehyde dehydrogenase (SSADH) deficiency.

    PubMed

    Kratz, S V

    2009-06-01

    This paper is a review of clinical experiences providing developmental therapy services for three boys diagnosed with paediatric neurotransmitter disease. The clinical presentation of paediatric neurotransmitter diseases might parallel other diagnostic characteristics seen in a typical paediatric therapy clinic (i.e. hypotonia, motor and cognitive delays, coordination, expressive speech, and ocular motor difficulties.) From the clinical perspective of the author, sensory integrative function is but one aspect of a thorough evaluation and treatment plan for all patients. The manifestations of sensory integration dysfunction (SID), also known as sensory processing dysfunction (SPD), can occur alone or be concurrent with a variety of known medical, behavioural and neurological diagnoses. These manifestations of SPD can include, but are not limited to: hypotonia, hyperactivity, irritability, distractibility, attention difficulties, learning difficulties, clumsiness and incoordination, instability, poor motor skills, social-emotional difficulties, and behavioural problems. This paper summarizes the theory and practice applications of sensory integration. The author discusses clinical experiences providing occupational therapy services utilizing sensory integration methods and strategies with clients who were eventually diagnosed with SSADH deficiency.

  10. HIV treatment and reproductive health in the health system in Burkina Faso: resource allocation and the need for integration.

    PubMed

    Windisch, Ricarda; de Savigny, Don; Onadja, Geneviève; Somda, Antoine; Wyss, Kaspar; Sié, Ali; Kouyaté, Bocar

    2011-11-01

    Organizational changes, increased funding and the demands of HIV antiretroviral (ARV) treatment create particular challenges for governance in the health sector. We assess resource allocation, policy making and integration of the national responses to ARV provision and reproductive health in Burkina Faso, using national and district budgets related to disease burden, policy documents, organizational structures, and coordination and implementation processes. ARV provision represents the concept of a "crisis scenario", in which reforms are pushed due to a perception of urgent need, whereas the national reproductive health programme, which is older and more integrated, represents a "politics-as-usual scenario". Findings show that the early years of the national response to HIV and AIDS were characterized by new institutions with overlapping functions, and failure to integrate with and strengthen existing structures. National and district budget allocations for HIV compared to other interventions were disproportionately high when assessed against burden of disease. Strategic documents for ARV provision were relatively less developed and referred to, compared to those of the Ministry of Health Directorates for HIV and for Family Health and district health planning teams for reproductive health services. Imbalances and new structures potentially trigger important adverse effects which are difficult to remedy and likely to increase due to the dynamics they create. It therefore becomes crucial, from the outset, to integrate HIV/AIDS funding and responses into health systems.

  11. Ion implantation: surface treatment for improving the bone integration of titanium and Ti6Al4V dental implants.

    PubMed

    De Maeztu, Miguel A; Alava, J Iñaki; Gay-Escoda, Cosme

    2003-02-01

    Dental implants subjected to surface treatment have shown better bone integration than implants which have only been turned (machined). Three main types of treatment are presently available: the addition of material or coating, the removal of material, and surface modification. Ion implantation corresponds to the third approach. A histomorphometric study is made following the rabbit tibial bone placement of 88 commercial dental implants of pure titanium and Ti6AI4V subjected to surface treatment in the form of different ion implants (C+, CO+, N+, Ne+). Light microscopic, scanning electron microscopic (SEM), electron microsonde (EDS) and X-ray photoelectron spectroscopy (XPS) studies were made. The results indicate improved bone integration (expressed as percentage bone-implant contact) in those specimens subjected to ion implantation versus the non-treated controls, the difference being statistically significant for the groups treated with C+ and CO+. In these groups, XPS showed a Ti-O-C junction (bone-implant interface) involving covalent type bonds, these being stronger and more stable than the ion-type bonds usually established between the titanium oxide and bone.

  12. Optimized matching modes of bioelectrochemical module and anaerobic sludge in the integrated system for azo dye treatment.

    PubMed

    Kong, Fanying; Wang, Aijie; Ren, Hong-Yu

    2015-09-01

    In this work, three matching modes (relative positions, catholyte flow sequences, and flow regimes) of bioelectrochemical module and anaerobic sludge were evaluated and optimized for azo dye treatment in the integrated system with embedding modular bioelectrochemical system into anaerobic sludge reactor. Results showed that it was favorable to operate this integrated system under the condition of 1/4 cathode soaking into sludge with spiral distributor in down-flow direction. Current, electrochemical impedance spectroscopy and pH clearly demonstrated the important role of 1/4 soaking in electron/proton transfer. The down-flow direction flowed through electrode zone and then sludge zone could benefit to the efficient use of cathode and improve AO7 treatment. Furthermore, the positive effect of spiral catholyte distributor might be due to its promoting role in mixing and creating a spiral flow channel around the cathode electrode-microbes-solution interface. These results exhibited great potential for matching modular bioelectrochemical system with anaerobic treatment process.

  13. Feasibility of Typha latifolia for high salinity effluent treatment in constructed wetlands for integration in resource management systems.

    PubMed

    Jesus, J M; Calheiros, C S C; Castro, P M L; Borges, M T

    2014-01-01

    High salinity wastewaters have limited treatment options due to the occurrence of salt inhibition in conventional biological treatments. Using recirculating marine aquaculture effluents as a case study, this work explored the use of Constructed Wetlands as a treatment option for nutrient and salt loads reduction. Three different substrates were tested for nutrient adsorption, of which expanded clay performed better. This substrate adsorbed 0.31 mg kg(-1) of NH4(+)-N and 5.60 mg kg(-1) of PO4(3-)-P and 6.9 mg kg(-1) dissolved salts after 7 days of contact. Microcosms with Typha latifolia planted in expanded clay and irrigated with aquaculture wastewater (salinity 2.4%, 7 days hydraulic retention time, for 4 weeks), were able to remove 94% NH(4+)-N (inlet 0.25 +/- 0.13 mg L(-1)), 78% NO2(-)-N (inlet 0.78 +/- 0.62 mg L(-1)), 46% NO3(-)-N (inlet 18.83 +/- 8.93 mg L(-1)) whereas PO4(3-)-P was not detected (inlet 1.41 +/- 0.21 mg L(-1)). Maximum salinity reductions of 52% were observed. Despite some growth inhibition, plants remained viable, with 94% survival rate. Daily treatment dynamics studies revealed rapid PO4(3-)-P adsorption, unbalancing the N:P ratio and possibly affecting plant development. An integrated treatment approach, coupled with biomass valorization, is suggested to provide optimal resource management possibilities.

  14. Improvement of electrical properties of Cu/SiCOH low-k film integrated system by O2 plasma treatment

    NASA Astrophysics Data System (ADS)

    Qian, Xiao-Mei; Wei, Yong-Xia; Yu, Xiao-Zhu; Ye, Chao; Ning, Zhao-Yuan; Liang, Rong-Qing

    2007-02-01

    This paper investigates the effect of O2 plasma treatment on the electric property of Cu/SiCOH low dielectric constant (low-k) film integrated structure. The results show that the leakage current of Cu/SiCOH low-k integrated structure can be reduced obviously at the expense of a slight increase in dielectric constant k of SiCOH films. By the Fourier transform infrared (FTIR) analysis on the bonding configurations of SiCOH films treated by O2 plasma, it is found that the decrease of leakage current is related to the increase of Si-O cages originating from the linkage of Si dangling bonds through O, which makes the open pores sealed and reduces the diffusion of Cu to pores.

  15. Effectiveness of dairy wastewater treatment in a bioreactor based on the integrated technology of activated sludge and hydrophyte system.

    PubMed

    Debowski, M; Zieliński, M; Krzemieniewski, M; Rokicka, M; Kupczyk, K

    2014-01-01

    The aim of this study was to determine the effectiveness of dairy wastewater treatment in the integrated technology based on the simultaneous use of the activated sludge method (AS) and a hydrophyte system (HS) (AS-HS), in this case, common reed (Phragmites australis) or common cattail (Typha latifolia). Experiments were conducted in an innovative reactor exploited in the fractional-technical scale at the loads of 0.05 mg BOD5/mg.d.m. d (biochemical oxygen demand) and 0.10 mg BOD5/mg.d.m d. The AS--HS enabled improving the removal effectiveness ofbiogenes characterized by concentrations of Ntot., N-NH4 and Ptot. In contrast, the integrated system had no significant reducing effect either on concentrations of organic compounds characterized by BOD5 and chemical oxygen demand parameters or on the structure of AS in the sequencing batch-type reactors. PMID:24701933

  16. Treatment of Posttraumatic Abdominal Autonomic Neuropathy Manifesting as Functional Dyspepsia and Chronic Constipation: An Integrative East-West Approach.

    PubMed

    Shubov, Andrew; Taw, Lawrence

    2015-07-01

    A 52-year-old male with a history of spinal cord injury and cauda equina syndrome resulting in neurogenic bladder presented with chronic constipation and functional dyspepsia that was refractory to medical management. He was treated with an integrative East-West approach including acupuncture, trigger point injections, and Tui Na massage. Both his pain and constipation improved after a series of treatments, and this improvement was largely sustained at 2-year follow-up. This patient's symptoms are consistent with damage to the visceral parasympathetic nervous system. Interestingly, many studies evaluating the mechanisms of acupuncture point to restoration of parasympathetic tone as a mechanism of action. In this article, we describe a case of complex functional gastrointestinal disorders associated with posttraumatic autonomic neuropathy that was refractory to pharmacotherapy and was successfully treated with an integrative East-West approach.

  17. Effectiveness of dairy wastewater treatment in a bioreactor based on the integrated technology of activated sludge and hydrophyte system.

    PubMed

    Debowski, M; Zieliński, M; Krzemieniewski, M; Rokicka, M; Kupczyk, K

    2014-01-01

    The aim of this study was to determine the effectiveness of dairy wastewater treatment in the integrated technology based on the simultaneous use of the activated sludge method (AS) and a hydrophyte system (HS) (AS-HS), in this case, common reed (Phragmites australis) or common cattail (Typha latifolia). Experiments were conducted in an innovative reactor exploited in the fractional-technical scale at the loads of 0.05 mg BOD5/mg.d.m. d (biochemical oxygen demand) and 0.10 mg BOD5/mg.d.m d. The AS--HS enabled improving the removal effectiveness ofbiogenes characterized by concentrations of Ntot., N-NH4 and Ptot. In contrast, the integrated system had no significant reducing effect either on concentrations of organic compounds characterized by BOD5 and chemical oxygen demand parameters or on the structure of AS in the sequencing batch-type reactors.

  18. Treatment of Posttraumatic Abdominal Autonomic Neuropathy Manifesting as Functional Dyspepsia and Chronic Constipation: An Integrative East-West Approach

    PubMed Central

    Taw, Lawrence

    2015-01-01

    A 52-year-old male with a history of spinal cord injury and cauda equina syndrome resulting in neurogenic bladder presented with chronic constipation and functional dyspepsia that was refractory to medical management. He was treated with an integrative East-West approach including acupuncture, trigger point injections, and Tui Na massage. Both his pain and constipation improved after a series of treatments, and this improvement was largely sustained at 2-year follow-up. This patient's symptoms are consistent with damage to the visceral parasympathetic nervous system. Interestingly, many studies evaluating the mechanisms of acupuncture point to restoration of parasympathetic tone as a mechanism of action. In this article, we describe a case of complex functional gastrointestinal disorders associated with posttraumatic autonomic neuropathy that was refractory to pharmacotherapy and was successfully treated with an integrative East-West approach PMID:26331105

  19. Going beyond the BCS level in the superfluid path integral: A consistent treatment of electrodynamics and thermodynamics

    NASA Astrophysics Data System (ADS)

    Anderson, Brandon M.; Boyack, Rufus; Wu, Chien-Te; Levin, K.

    2016-05-01

    In this Rapid Communication we derive the full gauge-invariant electromagnetic response beyond the BCS level using the fermionic superfluid path integral. In the process we identify and redress a failure to satisfy the compressibility sum rule; this shortcoming is associated with the conventional path-integral formulation of BCS-level electrodynamics. The approach in this paper builds on an alternative saddle point scheme. At the mean field level, this leads to the well known gauge-invariant electrodynamics of BCS theory and to the satisfaction of the compressibility sum rule. Moreover, this scheme can be readily extended to address arbitrary higher order fluctuation theories (for example, at the Gaussian level.) At any level this approach will lead to a gauge invariant and compressibility sum rule consistent treatment of electrodynamics and thermodynamics.

  20. An integrated approach for monitoring efficiency and investments of activated sludge-based wastewater treatment plants at large spatial scale.

    PubMed

    De Gisi, Sabino; Sabia, Gianpaolo; Casella, Patrizia; Farina, Roberto

    2015-08-01

    WISE, the Water Information System for Europe, is the web-portal of the European Commission (EU) that disseminates the quality state of the receiving water bodies and the efficiency of the municipal wastewater treatment plants (WWTPs) in order to monitor advances in the application of both the Water Framework Directive (WFD) as well as the Urban Wastewater Treatment Directive (UWWTD). With the intention to develop WISE applications, the aim of the work was to define and apply an integrated approach capable of monitoring the efficiency and investments of activated sludge-based WWTPs located in a large spatial area, providing the following outcomes useful to the decision-makers: (i) the identification of critical facilities and their critical processes by means of a Performance Assessment System (PAS), (ii) the choice of the most suitable upgrading actions, through a scenario analysis. (iii) the assessment of the investment costs to upgrade the critical WWTPs and (iv) the prioritization of the critical facilities by means of a multi-criteria approach which includes the stakeholders involvement, along with the integration of some technical, environmental, economic and health aspects. The implementation of the proposed approach to a high number of municipal WWTPs highlighted how the PAS developed was able to identify critical processes with a particular effectiveness in identifying the critical nutrient removal ones. In addition, a simplified approach that considers the cost related to a basic-configuration and those for the WWTP integration, allowed to link the critical processes identified and the investment costs. Finally, the questionnaire for the acquisition of data such as that provided by the Italian Institute of Statistics, the PAS defined and the database on the costs, if properly adapted, may allow for the extension of the integrated approach on an EU-scale by providing useful information to water utilities as well as institutions.

  1. An integrated approach for monitoring efficiency and investments of activated sludge-based wastewater treatment plants at large spatial scale.

    PubMed

    De Gisi, Sabino; Sabia, Gianpaolo; Casella, Patrizia; Farina, Roberto

    2015-08-01

    WISE, the Water Information System for Europe, is the web-portal of the European Commission (EU) that disseminates the quality state of the receiving water bodies and the efficiency of the municipal wastewater treatment plants (WWTPs) in order to monitor advances in the application of both the Water Framework Directive (WFD) as well as the Urban Wastewater Treatment Directive (UWWTD). With the intention to develop WISE applications, the aim of the work was to define and apply an integrated approach capable of monitoring the efficiency and investments of activated sludge-based WWTPs located in a large spatial area, providing the following outcomes useful to the decision-makers: (i) the identification of critical facilities and their critical processes by means of a Performance Assessment System (PAS), (ii) the choice of the most suitable upgrading actions, through a scenario analysis. (iii) the assessment of the investment costs to upgrade the critical WWTPs and (iv) the prioritization of the critical facilities by means of a multi-criteria approach which includes the stakeholders involvement, along with the integration of some technical, environmental, economic and health aspects. The implementation of the proposed approach to a high number of municipal WWTPs highlighted how the PAS developed was able to identify critical processes with a particular effectiveness in identifying the critical nutrient removal ones. In addition, a simplified approach that considers the cost related to a basic-configuration and those for the WWTP integration, allowed to link the critical processes identified and the investment costs. Finally, the questionnaire for the acquisition of data such as that provided by the Italian Institute of Statistics, the PAS defined and the database on the costs, if properly adapted, may allow for the extension of the integrated approach on an EU-scale by providing useful information to water utilities as well as institutions. PMID:25863511

  2. Effectiveness of individualized, integrative outpatient treatment for females with anorexia nervosa and bulimia nervosa.

    PubMed

    Freudenberg, Cara; Jones, Rebecca A; Livingston, Genvieve; Goetsch, Virginia; Schaffner, Angela; Buchanan, Linda

    2016-01-01

    The effectiveness of an individualized outpatient program was investigated in the treatment of bulimia nervosa (BN) and anorexia nervosa (AN). Participants included 151 females who received outpatient eating disorder treatment in the partial hospitalization program, the intensive outpatient program, or a combination of the two programs. Outcome measures included the Eating Disorder Inventory (EDI-2), Beck Depression Inventory (BDI-II), frequency of binge eating and purging, and mean body weight. Findings included significant increases in weight for the AN group, reductions in binge eating frequency for the BN group, and reductions in EDI-2 and BDI-II scores and purging frequency for both groups. This study provides preliminary support for the efficacy of a multimodal program for the treatment of both anorexia nervosa and bulimia nervosa.

  3. Software Configuration Management Plan for the K West Basin Integrated Water Treatment System (IWTS) Project A.9

    SciTech Connect

    GREEN, J.W.

    2000-05-01

    This document provides a configuration control plan for the software associated with the operation and control of the Integrated Water Treatment System (IWTS). It establishes requirements for ensuring configuration item identification, configuration control, configuration status accounting, defect reporting and resolution of computer software. It is written to comply with HNF-SD-SNF-CM-001, Spent Nuclear Fuel Configuration Management Plan (Forehand 1998) and HNF-PRO-309 Computer Software Quality Assurance Requirements, and applicable sections of administrative procedure CM-6-037-00, SNF Project Process Automation Software and Equipment.

  4. The Substance Abuse Treatment Needs of Prisoners: Implementation of an Integrated Statewide Approach

    ERIC Educational Resources Information Center

    Kubiak, Sheryl Pimlott; Boyd, Carol J.; Slayden, Janie; Young, Amy

    2005-01-01

    Studies have demonstrated that treatment for drug-involved offenders can reduce relapse and recidivism. However, few institutions utilize validated assessments of drug dependence, limiting the ability to determine and prioritize services. Toward this goal, we explain an assessment method implemented statewide using a sample of 22,069 prisoners.…

  5. Policy Issues for Integrating Parenting Interventions and Addiction Treatment for Women.

    ERIC Educational Resources Information Center

    VanBremen, Jane R.; Chasnoff, Ira J.

    1994-01-01

    This article addresses the rationale for linking addiction treatment programs and parenting education interventions in substance-abusing families. Specific components of a parenting program for women in recovery are detailed, including parenting classes and support groups, mother-child play groups, and family literacy activities. Program…

  6. Experiential Education as an Integral Part of Day Treatment for Adjudicated Delinquent Youth.

    ERIC Educational Resources Information Center

    Gaus, Charles

    The role of experiential education is the focus of this paper describing the treatment program at De La Salle Vocational, a day vocational high school for adjudicated delinquent youth. The paper begins by discussing the characteristics and needs of the students and describing the Off-Campus Program, a 3-year research model designed to address the…

  7. Evaluation of Family Impairment Following an Integrative Treatment Program for Children with Autism

    ERIC Educational Resources Information Center

    Lambert, Ashley Nehrt

    2012-01-01

    Research has shown that behaviors associated with Autism Spectrum Disorder (ASD) are a consistent source of stress on the family unit. Given the increased amount of stress that families endure and the importance of the family unit to the child with ASD, treatment programs should not only take the child with ASD's needs into account, but also…

  8. Treatment of Childhood and Adolescent Obesity: An Integrative Review of Recent Recommendations from Five Expert Groups

    ERIC Educational Resources Information Center

    Kirschenbaum, Daniel S.; Gierut, Kristen

    2013-01-01

    Objective: To compare and contrast 5 sets of expert recommendations about the treatment of childhood and adolescent obesity. Method: We reviewed 5 sets of recent expert recommendations: 2007 health care organizations' four stage model, 2007 Canadian clinical practice guidelines, 2008 Endocrine Society recommendations, 2009 seven step model, and…

  9. Brief Behavioral Therapy for Pediatric Anxiety and Depression: Piloting an Integrated Treatment Approach

    ERIC Educational Resources Information Center

    Weersing, V. Robin; Gonzalez, Araceli; Campo, John V.; Lucas, Amanda N.

    2008-01-01

    Mood and anxiety disorders in youth are disabling, distressing, and prevalent. Furthermore, depression and anxiety frequently co-exist, may share several etiological factors, and respond to similar interventions. In this paper, we report preliminary results from a treatment adaptation project designed to condense existing cognitive behavioral…

  10. Integrated chemical and toxicological investigation of UV-chlorine/chloramine drinking water treatment.

    PubMed

    Lyon, Bonnie A; Milsk, Rebecca Y; DeAngelo, Anthony B; Simmons, Jane Ellen; Moyer, Mary P; Weinberg, Howard S

    2014-06-17

    As the use of alternative drinking water treatment increases, it is important to understand potential public health implications associated with these processes. The objective of this study was to evaluate the formation of disinfection byproducts (DBPs) and cytotoxicity of natural organic matter (NOM) concentrates treated with chlorine, chloramine, and medium pressure ultraviolet (UV) irradiation followed by chlorine or chloramine, with and without nitrate or iodide spiking. The use of concentrated NOM conserved volatile DBPs and allowed for direct analysis of the treated water. Treatment with UV prior to chlorine in ambient (unspiked) samples did not affect cytotoxicity as measured using an in vitro normal human colon cell (NCM460) assay, compared to chlorination alone when toxicity is expressed on the basis of dissolved organic carbon (DOC). Nitrate-spiked UV+chlorine treatment produced greater cytotoxicity than nitrate-spiked chlorine alone or ambient UV+chlorine samples, on both a DOC and total organic halogen basis. Samples treated with UV+chloramine were more cytotoxic than those treated with only chloramine using either dose metric. This study demonstrated the combination of cytotoxicity and DBP measurements for process evaluation in drinking water treatment. The results highlight the importance of dose metric when considering the relative toxicity of complex DBP mixtures formed under different disinfection scenarios.

  11. Production integrated treatment of textile wastewater by closing raw material cycles.

    PubMed

    Krull, R

    2005-01-01

    A method for the in-house treatment of partial wastewater flows and the recycling of treated process water into the textile finishing process was developed in order to recycle effluents from textile finishing industry and feed them back into the production process. The method is based on a two-stage biological anaerobic-aerobic process to split colouring wastewater agents and to degrade organic substances contained in the water as well as a chemical stage to remove the remaining color of the water with the help of ozone. In the framework of a research and development project a demonstration plant for a treatment capacity of 1440 m3 per working day was installed and started in a textile finishing company. At the plant, a wastewater flow and a recycling flow are treated separately in two different treatment lanes. Approximately 40% of the total wastewater flows, i.e. 576 m3/d are treated in the wastewater lane, and a maximum of 60% of total wastewater, i.e. 864 m3/d are treated in the recycling lane. Thanks to the preliminary treatment of wastewater flows, which are discharged into the municipal sewage works, a reduction of average COD levels in the sewage works effluents could be achieved.

  12. Perspectives--Talking with Practitioners: How to Integrate Best Practices with Evidence-Based Treatment

    ERIC Educational Resources Information Center

    Cohen, Richard

    2012-01-01

    Evidence-based treatments are increasingly important and necessary parts of many disciplines when working with very young children and their families. In using them, it is advantageous to be grounded in the principles and practices that research has shown are critical to children's healthy development, particularly the importance of supporting the…

  13. Integrated and Holistic Treatment Approach to PTSD and SUD: A Synergy

    ERIC Educational Resources Information Center

    Weis, Melanie

    2010-01-01

    Individuals living with posttraumatic stress disorder (PTSD) and addiction experience a complex and dynamic interaction of symptoms from both diagnoses. However, heretofore, each diagnosis has been approached as if it were a separate treatment consideration. Therefore, an individual may be treated for either a substance use disorder (SUD) or PTSD,…

  14. An integrated analysis of the efficacy and safety of desvenlafaxine in the treatment of major depressive disorder.

    PubMed

    Carrasco, José L; Kornstein, Susan G; McIntyre, Roger S; Fayyad, Rana; Prieto, Rita; Salas, Maribel; Mackell, Joan; Boucher, Matthieu

    2016-05-01

    The chronic course of major depressive disorder (MDD) often impedes the ability of patients to achieve full remission. Return of full functioning is a critical goal of antidepressant pharmacotherapy as the presence of residual depressive symptoms is associated with an increased risk of relapse. Treatment guidelines recommend selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, or atypical antidepressants as first-line treatment for moderate to severe MDD. Desvenlafaxine, administered as desvenlafaxine succinate, is an serotonin-norepinephrine reuptake inhibitor approved for the treatment of adults with MDD at the recommended dose of 50 mg/day. The aim of this integrated analysis was to assess the efficacy and safety of desvenlafaxine 50 and 100 mg/day compared with placebo in adult outpatients with MDD. The analysis used data from nine fixed-dose, short-term, placebo-controlled studies in adult outpatients diagnosed with MDD who had depressive symptoms for at least 30 days. Data from 4279 and 4317 patients were pooled for the efficacy and safety analyses, respectively. Statistically significant improvements were observed with desvenlafaxine 50 and 100 mg/day versus placebo for all efficacy endpoints assessed, including improvements in depressive symptoms, response and remission rates, as well as functional and cognitive outcomes. Treatment with desvenlafaxine 50 and 100 mg/day was generally safe and well tolerated. The findings of this integrated analysis of data from a large population of patients with MDD confirmed the antidepressant efficacy of both desvenlafaxine doses and add to previous evidence supporting the efficacy of desvenlafaxine.

  15. Size does matter: an integrative in vivo-in silico approach for the treatment of critical size bone defects.

    PubMed

    Carlier, Aurélie; van Gastel, Nick; Geris, Liesbet; Carmeliet, Geert; Van Oosterwyck, Hans

    2014-11-01

    Although bone has a unique restorative capacity, i.e., it has the potential to heal scarlessly, the conditions for spontaneous bone healing are not always present, leading to a delayed union or a non-union. In this work, we use an integrative in vivo-in silico approach to investigate the occurrence of non-unions, as well as to design possible treatment strategies thereof. The gap size of the domain geometry of a previously published mathematical model was enlarged in order to study the complex interplay of blood vessel formation, oxygen supply, growth factors and cell proliferation on the final healing outcome in large bone defects. The multiscale oxygen model was not only able to capture the essential aspects of in vivo non-unions, it also assisted in understanding the underlying mechanisms of action, i.e., the delayed vascularization of the central callus region resulted in harsh hypoxic conditions, cell death and finally disrupted bone healing. Inspired by the importance of a timely vascularization, as well as by the limited biological potential of the fracture hematoma, the influence of the host environment on the bone healing process in critical size defects was explored further. Moreover, dependent on the host environment, several treatment strategies were designed and tested for effectiveness. A qualitative correspondence between the predicted outcomes of certain treatment strategies and experimental observations was obtained, clearly illustrating the model's potential. In conclusion, the results of this study demonstrate that due to the complex non-linear dynamics of blood vessel formation, oxygen supply, growth factor production and cell proliferation and the interactions thereof with the host environment, an integrative in silico-in vivo approach is a crucial tool to further unravel the occurrence and treatments of challenging critical sized bone defects. PMID:25375821

  16. Integrating first-line treatment options into clinical practice: what's new in advanced melanoma?

    PubMed

    Dummer, Reinhard; Schadendorf, Dirk; Ascierto, Paolo A; Larkin, James; Lebbé, Celeste; Hauschild, Axel

    2015-12-01

    Melanoma remains a serious form of skin cancer in Europe and worldwide. Localized, early-stage melanomas can usually be treated with surgical excision. However, the prognosis is poorer for patients with advanced disease. Before 2011, treatment for advanced melanoma included palliative surgery and/or radiotherapy, and chemotherapy with or without immunotherapy, such as interleukin-2. As none of these treatments had shown survival benefits in patients with advanced melanoma, European guidelines had recommended that patients be entered into clinical trials. The lack of approved first-line options and varying access to clinical trials meant that European clinicians relied on experimental regimens and chemotherapy-based treatments when no other options were available. Since 2011, ipilimumab, an immuno-oncology therapy, and vemurafenib and dabrafenib, targeted agents that inhibit mutant BRAF, have been approved by the European Medicines Agency for the treatment of advanced melanoma. More recently, the MEK inhibitor, trametinib, received European marketing authorization for use in patients with BRAF mutation-positive advanced melanoma. In 2014, the anti-PD-1 antibody nivolumab was approved as a first-line therapy in Japan. Whereas nivolumab and another anti-PD-1 antibody, pembrolizumab, were approved as second-line therapies in the USA, their recent approval in Europe are for first-line use based on new clinical trial data in this setting. Together these agents are changing clinical practice and making therapeutic decisions more complex. Here, we discuss current and emerging therapeutic options for the first-line treatment of advanced melanoma, and how these therapies can be optimized to provide the best possible outcomes for patients. PMID:26426764

  17. Research on soybean protein wastewater treatment by the integrated two-phase anaerobic reactor

    PubMed Central

    Yu, Yaqin

    2015-01-01

    The start-up tests of treating soybean protein wastewater by the integrated two-phase anaerobic reactor were studied. The results showed that the soybean protein wastewater could be successfully processed around 30 days when running under the situation of dosing seed sludge with the influent of approximately 2000 mg/L and an HRT of 40 h. When the start-up was finished, the removal rate of COD by the reactor was about 80%. In the zone I, biogas mainly revealed carbon dioxide (CO2) and hydrogen (H2). Methane was the main component in the zone 2 which ranged from 53% to 59% with an average of 55%. The methane content in biogas increased from the zone I to II. It indicated that the methane-producing capacity of the anaerobic sludge increased. It was found that the uniquely designed two-phase integrated anaerobic reactor played a key role in treating soybean protein wastewater. The acidogenic fermentation bacteria dominated in the zone I, while methanogen became dominant in the zone II. It realized the relatively effective separation of hydrolysis acidification and methanogenesis process in the reactor, which was benefit to promote a more reasonable space distribution of the microbial communities in the reactor. There were some differences between the activities of the sludge in the two reaction zones of the integrated two-phase anaerobic reactor. The activity of protease was higher in the reaction zone I. And the coenzyme F420 in the reaction zone II was twice than that in the reaction zone I, which indicated that the activity of the methanogens was stronger in the reaction zone II. PMID:26288554

  18. Advances in Integrative Nanomedicine for Improving Infectious Disease Treatment in Public Health

    PubMed Central

    Bell, Iris R.; Schwartz, Gary E.; Boyer, Nancy N.; Koithan, Mary; Brooks, Audrey J.

    2012-01-01

    Introduction Infectious diseases present public health challenges worldwide. An emerging integrative approach to treating infectious diseases is using nanoparticle (NP) forms of traditional and alternative medicines. Advantages of nanomedicine delivery methods include better disease targeting, especially for intracellular pathogens, ability to cross membranes and enter cells, longer duration drug action, reduced side effects, and cost savings from lower doses. Methods We searched Pubmed articles in English with keywords related to nanoparticles and nanomedicine. Nanotechnology terms were also combined with keywords for drug delivery, infectious diseases, herbs, antioxidants, homeopathy, and adaptation. Results NPs are very small forms of material substances, measuring 1–100 nanometers along at least one dimension. Compared with bulk forms, NPs’ large ratio of surface-area-to-volume confers increased reactivity and adsorptive capacity, with unique electromagnetic, chemical, biological, and quantum properties. Nanotechnology uses natural botanical agents for green manufacturing of less toxic NPs. Discussion Nanoparticle herbs and nutriceuticals can treat infections via improved bioavailability and antiinflammatory, antioxidant, and immunomodulatory effects. Recent studies demonstrate that homeopathic medicines may contain source and/or silica nanoparticles because of their traditional manufacturing processes. Homeopathy, as a form of nanomedicine, has a promising history of treating epidemic infectious diseases, including malaria, leptospirosis and HIV/AIDS, in addition to acute upper respiratory infections. Adaptive changes in the host’s complex networks underlie effects. Conclusions Nanomedicine is integrative, blending modern technology with natural products to reduce toxicity and support immune function. Nanomedicine using traditional agents from alternative systems of medicine can facilitate progress in integrative public health approaches to infectious

  19. Integrated chemical/biological treatment of paint stripper mixed waste: Metals toxicity and separation

    SciTech Connect

    Vanderberg-Twary, L.; Grumbine, R.K.; Foreman, T.; Hanners, J.L.; Brainard, J.R.; Sauer, N.N.; Unkefer, P.J.

    1995-05-01

    The DOE complex has generated vast quantities of complex heterogeneous mixed wastes. Paint stripper waste (PSW) is a complex waste that arose from decontamination and decommissioning activities. It contains paint stripper, cheesecloth, cellulose-based paints with Pb and Cr, and suspect Pu. Los Alamos National Laboratory has 150--200 barrels of PSW and other national laboratories such as Rocky Flats Plant have many more barrels of heterogeneous waste. Few technologies exist that can treat this complex waste. Our approach to solving this problem is the integration of two established technologies: biodegradation and metals chelation.

  20. Semiclassical treatment of symmetry breaking and bifurcations in a non-integrable potential

    NASA Astrophysics Data System (ADS)

    Koliesnik, M. V.; Krivenko-Emetov, Ya D.; Magner, A. G.; Arita, K.; Brack, M.

    2015-11-01

    We have derived an analytical trace formula for the level density of the Hénon-Heiles potential using the improved stationary phase method, based on extensions of Gutzwiller's semiclassical path integral approach. This trace formula has the correct limit to the standard Gutzwiller trace formula for the isolated periodic orbits far from all (critical) symmetry-breaking points. It continuously joins all critical points at which an enhancement of the semiclassical amplitudes occurs. We found a good agreement between the semiclassical and the quantum oscillating level densities for the gross shell structures and for the energy shell corrections, solving the symmetry breaking problem at small energies.

  1. Time-dependent treatment of scattering. II - Novel integral equation approach to quantum wave packets

    NASA Technical Reports Server (NTRS)

    Sharafeddin, Omar A.; Judson, Richard S.; Kouri, Donald J.; Hoffman, David K.

    1990-01-01

    The novel wave-packet propagation scheme presented is based on the time-dependent form of the Lippman-Schwinger integral equation and does not require extensive matrix inversions, thereby facilitating application to systems in which some degrees of freedom express the potential in a basis expansion. The matrix to be inverted is a function of the kinetic energy operator, and is accordingly diagonal in a Bessel function basis set. Transition amplitudes for various orbital angular momentum quantum numbers are obtainable via either Fourier transform of the amplitude density from the time to the energy domain, or the direct analysis of the scattered wave packet.

  2. Integrating HIV prevention into substance user treatment: current practices and challenges.

    PubMed

    Mitchell, Christopher G; Oltean, Anthony

    2007-01-01

    Despite well-organized prevention efforts, HIV continues to spread in the United States. Injection drug users (IDUs) and other substance users who engage in high-risk behaviors are at particularly high risk for contracting HIV. Substance abuse(dagger) counselors therefore are in a unique position to present HIV prevention messages to their clients. This article reports the results of a study that surveyed counselors in an urban setting (n = 116) to assess their knowledge of HIV, their current HIV prevention practices, and their attitudes about integrating HIV prevention more fully into their work. The article concludes with a discussion of the survey's limitations and its implications for training.

  3. Integration of cognitive and personality-based conceptualization and treatment of psychological trauma.

    PubMed

    Everly, George S; Lating, Jeffrey M

    2005-01-01

    In the wake of the numerous terrorist attacks and horrific natural disasters that have occurred beginning on September 11, 2001, there has been increased interest in the effects of trauma, including posttraumatic stress disorder (PTSD). The purpose of this article is to provide an overview of a synergistic multicomponent approach to therapy that incorporates the integrated use of cognitive and personality-guided approaches to conceptualizing and treating psychological trauma. With Millon's personality classification system serving as a foundation, a case example is provided along with an explanation of the therapeutic stages beginning with establishing the therapeutic alliance to decreasing hyperarousal to restoring assumptive worldviews.

  4. Performance Improvement in Behavioral Health Care: Collateral Effects of Planned Treatment Integrity Observations as an Applied Example of Schedule-Induced Responding

    ERIC Educational Resources Information Center

    Reed, Derek D.; Fienup, Daniel M.; Luiselli, James K.; Pace, Gary M.

    2010-01-01

    With rising interest in the role of treatment integrity on student outcomes, research has primarily focused on isolating the techniques and procedures necessary to improve staff's acquisition and maintenance of adequate levels of integrity. Despite increasing numbers of publications on this topic, there has been little discussion of the variables…

  5. Operation of an integrated algae pond system for the treatment of municipal sewage: a South African case study.

    PubMed

    Mambo, Prudence M; Westensee, Dirk K; Render, David S; Cowan, A Keith

    2014-01-01

    Integrated algae pond systems (IAPS) combine the use of anaerobic and aerobic bioprocesses to effect sewage treatment. In the present work, the performance of IAPS was evaluated to determine the efficiency of this technology for treatment of municipal sewage under South African conditions. Composite samples were analysed over an 8 month period before and after tertiary treatment. Spectrophotometric assays indicated that the treated water from this IAPS was compliant with the discharge limits for phosphate-P, ammonium-N and nitrate/nitrite-N, and mean values were: 5.3, 2.9 and 12.4 mg L(-1), respectively. Chemical oxygen demand (COD), however, fluctuated significantly and was dependent on full function of the IAPS. Mean COD of the final treated water was 72.2 mg L(-1). Although these results suggest that the treated water discharged from this IAPS operating under South African conditions meets the standard for discharge, mean total suspended solids (TSS) was routinely above the limit at 34.5 ± 13 mg L(-1) and faecal coliforms were higher than expected. Tertiary treatment using a maturation pond series (MPS), slow sand filtration (SSF), or a controlled rock filter (CRF) ensured that the final treated water from the IAPS was of a quality suitable for discharge to the environment with CRF > SSF > MPS.

  6. Neuromodulation integrating rTMS and neurofeedback for the treatment of autism spectrum disorder: An exploratory study

    PubMed Central

    Sokhadze, Estate M.; El-Baz, Ayman S.; Tasman, Allan; Sears, Lonnie L.; Wang, Yao; Lamina, Eva V.; Casanova, Manuel F.

    2014-01-01

    Autism spectrum disorder (ASD) is a pervasive developmental disorder characterized by deficits in social interaction, language, stereotyped behaviors, and restricted range of interests. In previous studies low frequency repetitive transcranial magnetic stimulation (rTMS) has been used, with positive behavioral and electrophysiological results, for the experimental treatment in ASD. In this study we combined prefrontal rTMS sessions with electroencephalographic (EEG) neurofeedback (NFB) to prolong and reinforce TMS-induced EEG changes. The pilot trial recruited 42 children with ASD (~14.5 yrs). Outcome measures included behavioral evaluations and reaction time test with event-related potential (ERP) recording. For the main goal of this exploratory study we used rTMS-neurofeedback combination (TMS-NFB, N=20) and waitlist (WTL, N=22) groups to examine effects of 18 sessions of integrated rTMS-NFB treatment or wait period) on behavioral responses, stimulus and response-locked ERPs, and other functional and clinical outcomes. The underlying hypothesis was that combined TMS-NFB will improve executive functions in autistic patients as compared to the waitlist group. Behavioral and ERP outcomes were collected in pre- and post-treatment tests in both groups. Results of the study supported our hypothesis by demonstration of positive effects of combined TMS-NFB neurotherapy in active treatment group as compared to control waitlist group, as the TMS-NFB group showed significant improvements in behavioral and functional outcomes as compared to the waitlist group. PMID:25267414

  7. Neuromodulation integrating rTMS and neurofeedback for the treatment of autism spectrum disorder: an exploratory study.

    PubMed

    Sokhadze, Estate M; El-Baz, Ayman S; Tasman, Allan; Sears, Lonnie L; Wang, Yao; Lamina, Eva V; Casanova, Manuel F

    2014-12-01

    Autism spectrum disorder (ASD) is a pervasive developmental disorder characterized by deficits in social interaction, language, stereotyped behaviors, and restricted range of interests. In previous studies low frequency repetitive transcranial magnetic stimulation (rTMS) has been used, with positive behavioral and electrophysiological results, for the experimental treatment in ASD. In this study we combined prefrontal rTMS sessions with electroencephalographic (EEG) neurofeedback (NFB) to prolong and reinforce TMS-induced EEG changes. The pilot trial recruited 42 children with ASD (~14.5 years). Outcome measures included behavioral evaluations and reaction time test with event-related potential (ERP) recording. For the main goal of this exploratory study we used rTMS-neurofeedback combination (TMS-NFB, N = 20) and waitlist (WTL, N = 22) groups to examine effects of 18 sessions of integrated rTMS-NFB treatment or wait period) on behavioral responses, stimulus and response-locked ERPs, and other functional and clinical outcomes. The underlying hypothesis was that combined TMS-NFB will improve executive functions in autistic patients as compared to the WTL group. Behavioral and ERP outcomes were collected in pre- and post-treatment tests in both groups. Results of the study supported our hypothesis by demonstration of positive effects of combined TMS-NFB neurotherapy in active treatment group as compared to control WTL group, as the TMS-NFB group showed significant improvements in behavioral and functional outcomes as compared to the WTL group.

  8. Operation of an integrated algae pond system for the treatment of municipal sewage: a South African case study.

    PubMed

    Mambo, Prudence M; Westensee, Dirk K; Render, David S; Cowan, A Keith

    2014-01-01

    Integrated algae pond systems (IAPS) combine the use of anaerobic and aerobic bioprocesses to effect sewage treatment. In the present work, the performance of IAPS was evaluated to determine the efficiency of this technology for treatment of municipal sewage under South African conditions. Composite samples were analysed over an 8 month period before and after tertiary treatment. Spectrophotometric assays indicated that the treated water from this IAPS was compliant with the discharge limits for phosphate-P, ammonium-N and nitrate/nitrite-N, and mean values were: 5.3, 2.9 and 12.4 mg L(-1), respectively. Chemical oxygen demand (COD), however, fluctuated significantly and was dependent on full function of the IAPS. Mean COD of the final treated water was 72.2 mg L(-1). Although these results suggest that the treated water discharged from this IAPS operating under South African conditions meets the standard for discharge, mean total suspended solids (TSS) was routinely above the limit at 34.5 ± 13 mg L(-1) and faecal coliforms were higher than expected. Tertiary treatment using a maturation pond series (MPS), slow sand filtration (SSF), or a controlled rock filter (CRF) ensured that the final treated water from the IAPS was of a quality suitable for discharge to the environment with CRF > SSF > MPS. PMID:24960021

  9. Bioelectrochemical treatment of paper and pulp wastewater in comparison with anaerobic process: integrating chemical coagulation with simultaneous power production.

    PubMed

    Krishna, K Vamshi; Sarkar, Omprakash; Venkata Mohan, S

    2014-12-01

    The efficiency of a bioelectrochemical treatment system (BET) to treat complex paper and pulp wastewater at two different pH conditions (6 and 7) in comparison with conventional anaerobic treatment process (AnT) was evaluated. Among the operating conditions, BET showed good treatment efficiency at pH 7 in terms of COD (BET/AnT: 55%/51%), nitrates (33.5%/19.1%), phosphates (33%/19%) and sulfates (58%/41%) in removal. The effluent obtained from BET system was subjected to coagulation for further treatment which showed good COD removal (BET/AnT, 95%/69%) and color (100%/68%). Bioelectrochemical analysis revealed higher catalytic currents in BET than AnT specific to oxidation and reduction. Besides, derivative of cyclic voltammetric scans (DCV) also supported the involvement of various membrane bound electron transferring complexes like FAD(H) bound enzymes, ubiquinone, NADH(+)/H(+) bound enzymes, etc. Experimental results demonstrated that BET system can be a viable platform to treat complex wastewaters with simultaneous energy recovery in integrated approach. PMID:25463793

  10. Potential herb-drug interaction in the prevention of cardiovascular diseases during integrated traditional and Western medicine treatment.

    PubMed

    Wang, Xiao-Long

    2015-01-01

    The combination of herbs and drugs is one of the most important approaches in the prevention and treatment of diseases in the integrated traditional and Western medicine (ITWM). While most medical practices have proved that the combination of herbs and drugs led to a clinical efficacy that was often superior to merely using only one of them; results from some studies have triggered adverse reactions to such an approach. Since few herb-drug interaction studies were carried out during treatments combining herbs and drugs, it really restricts the development of treatment and treatment theory of the combination of herbs and drugs. Given that herb-drug interactions may occur through the main pathway of cytochrome P450 enzymes and transporters; then to exhaustively study the role and impact of herbs in drug metabolism, as well as to establish a corresponding database, is of great significance for guiding the rational combination of herbs and drugs. When the herb-drug interaction information platform is implemented, we would get at ease a reasonable herb-drug prescription to achieve a better outcome, reduce dosage of some expensive drugs preserving the same efficacy, or even reduce some side effects of particular drugs; which might also promote the dynamic combination of Chinese and Western medicine, and accelerate the theory development of ITWM.

  11. Nanotechnology for a safe and sustainable water supply: enabling integrated water treatment and reuse.

    PubMed

    Qu, Xiaolei; Brame, Jonathon; Li, Qilin; Alvarez, Pedro J J

    2013-03-19

    Ensuring reliable access to clean and affordable water is one of the greatest global challenges of this century. As the world's population increases, water pollution becomes more complex and difficult to remove, and global climate change threatens to exacerbate water scarcity in many areas, the magnitude of this challenge is rapidly increasing. Wastewater reuse is becoming a common necessity, even as a source of potable water, but our separate wastewater collection and water supply systems are not designed to accommodate this pressing need. Furthermore, the aging centralized water and wastewater infrastructure in the developed world faces growing demands to produce higher quality water using less energy and with lower treatment costs. In addition, it is impractical to establish such massive systems in developing regions that currently lack water and wastewater infrastructure. These challenges underscore the need for technological innovation to transform the way we treat, distribute, use, and reuse water toward a distributed, differential water treatment and reuse paradigm (i.e., treat water and wastewater locally only to the required level dictated by the intended use). Nanotechnology offers opportunities to develop next-generation water supply systems. This Account reviews promising nanotechnology-enabled water treatment processes and provides a broad view on how they could transform our water supply and wastewater treatment systems. The extraordinary properties of nanomaterials, such as high surface area, photosensitivity, catalytic and antimicrobial activity, electrochemical, optical, and magnetic properties, and tunable pore size and surface chemistry, provide useful features for many applications. These applications include sensors for water quality monitoring, specialty adsorbents, solar disinfection/decontamination, and high performance membranes. More importantly, the modular, multifunctional and high-efficiency processes enabled by nanotechnology provide a

  12. Sperm DNA Integrity Assessment: A New Tool in Diagnosis and Treatment of Fertility

    PubMed Central

    Bungum, Mona

    2012-01-01

    Infertility affects 15% of all couples. Although male infertility factors with reduced semen quality are contributing to about half of all involuntary childlessness, the value of standard semen parameters in prediction of fertility in vivo and choice of proper method for assisted reproduction is limited. In the search for better markers of male fertility, during the last 10 years, assessment of sperm DNA integrity has emerged as a strong new biomarker of semen quality that may have the potential to discriminate between infertile and fertile men. Sperm DNA Fragmentation Index (DFI) as assessed by the flow cytometric Sperm Chromatin Structure Assay (SCSA) can be used for evaluation of sperm chromatin integrity. The biological background for abnormal DFI is not completely known, but clinical data show that DFI above 30% is associated with very low chance for achieving pregnancy in natural way or by insemination, but not in vitro. Already when the DFI is above 20%, the chance of natural pregnancy may be reduced, despite other sperm parameters being normal. Thus this method may explain a significant proportion of cases of unexplained infertility and can be beneficial in counselling involuntary childless couples need of in vitro fertilisation. PMID:22190954

  13. Membrane-integrated physico-chemical treatment of coke-oven wastewater: transport modelling and economic evaluation.

    PubMed

    Kumar, Ramesh; Chakrabortty, Sankha; Pal, Parimal

    2015-04-01

    A modelling and simulation study with economic evaluation was carried out for an advanced membrane-integrated hybrid treatment process that ensures reuse of water with recovery of ammoniacal nitrogen as struvite from coke-oven wastewater. Linearized transport model was developed based on extended Nernst-Plank and concentration polarization modulus equation. Effects of pH, transmembrane pressure and cross-flow rate of interest on membrane charge density, solute rejection and solvent flux were investigated. The membrane module was successful in yielding a pure water flux as high as 120 L m(-2) h(-1) removing more than 95 and 96% of the cyanide and phenol, respectively, while permeating more than 90% NH4 (+)-N at a transmembrane pressure of only 15 × 10(2) KPa and at a pH of 10 for a volumetric cross-flow rate of 800 L h(-1). The Fenton's reagents were used to degrade more than 99% of pollutants present in the concentrated stream. The developed model could successfully predict the plant performance as reflected in the very low relative error (0.01-0.12) and overall high correlation coefficient (R(2) > 0.96). Economic analysis indicated that such a membrane-integrated hybrid system could be quite promising in coke wastewater treatment at low cost i.e. $0.934/m(2) of wastewater.

  14. Membrane-integrated physico-chemical treatment of coke-oven wastewater: transport modelling and economic evaluation.

    PubMed

    Kumar, Ramesh; Chakrabortty, Sankha; Pal, Parimal

    2015-04-01

    A modelling and simulation study with economic evaluation was carried out for an advanced membrane-integrated hybrid treatment process that ensures reuse of water with recovery of ammoniacal nitrogen as struvite from coke-oven wastewater. Linearized transport model was developed based on extended Nernst-Plank and concentration polarization modulus equation. Effects of pH, transmembrane pressure and cross-flow rate of interest on membrane charge density, solute rejection and solvent flux were investigated. The membrane module was successful in yielding a pure water flux as high as 120 L m(-2) h(-1) removing more than 95 and 96% of the cyanide and phenol, respectively, while permeating more than 90% NH4 (+)-N at a transmembrane pressure of only 15 × 10(2) KPa and at a pH of 10 for a volumetric cross-flow rate of 800 L h(-1). The Fenton's reagents were used to degrade more than 99% of pollutants present in the concentrated stream. The developed model could successfully predict the plant performance as reflected in the very low relative error (0.01-0.12) and overall high correlation coefficient (R(2) > 0.96). Economic analysis indicated that such a membrane-integrated hybrid system could be quite promising in coke wastewater treatment at low cost i.e. $0.934/m(2) of wastewater. PMID:25380632

  15. Pollutant removal from municipal wastewater employing baffled subsurface flow and integrated surface flow-floating treatment wetlands.

    PubMed

    Saeed, Tanveer; Al-Muyeed, Abdullah; Afrin, Rumana; Rahman, Habibur; Sun, Guangzhi

    2014-04-01

    This article reports pollutant removal performances of baffled subsurface flow, and integrated surface flow-floating treatment wetland units, when arranged in series for the treatment of municipal wastewater in Bangladesh. The wetland units (of the hybrid system) included organic, inorganic media, and were planted with nineteen types of macrophytes. The wetland train was operated under hydraulic loading fluctuation and seasonal variation. The performance analyses (across the wetland units) illustrated simultaneous denitrification and organics removal rates in the first stage vertical flow wetland, due to organic carbon leaching from the employed organic media. Higher mean organics removal rates (656.0 g COD/(m(2)·day)) did not completely inhibit nitrification in the first stage vertical flow system; such pattern could be linked to effective utilization of the trapped oxygen, as the flow was directed throughout the media by the baffle walls. Second stage horizontal flow wetland showed enhanced biodegradable organics removal, which depleted organic carbon availability for denitrification. The final stage integrated wetland system allowed further nitrogen removal from wastewater, via nutrient uptake by plant roots (along with nitrification), and generation of organic carbon (by the dead macrophytes) to support denitrification. The system achieved higher E. coli mortality through protozoa predation, E. coli oxidation, and destruction by UV radiation. In general, enhanced pollutant removal efficiencies as demonstrated by the structurally modified hybrid wetland system signify the necessity of such modification, when operated under adverse conditions such as: substantial input organics loading, hydraulic loading fluctuation, and seasonal variation.

  16. A Preliminary Study of an Integrated and Culturally Attuned Cognitive Behavioral Group Treatment for Chinese Problem Gamblers in Hong Kong.

    PubMed

    Wong, Daniel Fu Keung; Chung, Catherine Lai Ping; Wu, Janet; Tang, Joe; Lau, Patrick; Wan, Jennie Po Ching

    2015-09-01

    Chinese people may have a higher rate of gambling problems than other cultural groups. However, there are very few clinical outcome studies that have demonstrated the effectiveness of clinical interventions for helping Chinese gamblers. Cognitive behavioural therapy (CBT) has been found to be effective for helping problem gamblers to significantly reduce their gambling problems in western countries. Very few CBT clinical trials have been conducted with the Chinese populations, and the results were masked by methodological limitations. This preliminary study attempted to test the effectiveness of an integrated and culturally attuned CBT group treatment for Chinese problem gamblers in Hong Kong. This study adopted a randomized control design and 38 participants were allocated randomly to the experimental condition (n = 18) and control condition (n = 20). The experimental group received 10 weekly CBT group sessions and individual counseling services while control group only received the individual counseling services. Significant decreases in gambling severity and frequencies of gambling were found in the experimental group. The findings also showed that a change in gambling cognitions predicted the changes in gambling severity and gambling urge while a change in gambling severity was also linked to a change in depression. Preliminary evidence highlights the potential benefits of an integrated and culturally attuned CBT group treatment for Chinese problem gamblers in Hong Kong. However, a more vigorous research design with a larger sample is needed to provide solid evidence of the effectiveness of the model for Chinese problem gamblers.

  17. Community-integrated brain injury rehabilitation: Treatment models and challenges for civilian, military, and veteran populations.

    PubMed

    Trudel, Tina M; Nidiffer, F Don; Barth, Jeffrey T

    2007-01-01

    Traumatic brain injury (TBI) is a major health problem in civilian, military, and veteran populations. Individuals experiencing moderate to severe TBI require a continuum of care involving acute hospitalization and postacute rehabilitation, including community reintegration and, one would hope, a return home to function as a productive member of the community. In the military, the goal is to help individuals with TBI return to active duty or make an optimal return to civilian life if the extent of their injuries necessitates a "medical board" discharge. Whether civilian, military, or veteran with TBI, individuals who move beyond the need to live in a facility must be reintegrated back into the community. This article discusses four treatment models for community reintegration, reviews treatment standardization and outcome issues, and describes a manualized rehabilitation pilot program designed to provide community reintegration and return to duty/work for civilians, veterans, and military personnel with TBI.

  18. AlgaeSim: a model for integrated algal biofuel production and wastewater treatment.

    PubMed

    Drexler, Ivy L C; Joustra, Caryssa; Prieto, Ana; Bair, Robert; Yeh, Daniel H

    2014-02-01

    AlgaeSim, a dynamic multiple-systems (C, N, P) mass balance model, was developed to explore the potential for algae biomass production from wastewater by coupling two photobioreactors into the main treatment train at a municipal wastewater resource recovery facility (WRRF) in Tampa, Florida. The scoping model examined the synergy between algae cultivation and wastewater treatment through algal growth and substrate removal kinetics, as well as through macroeconomic analyses of biomass conversion to bioproducts. Sensitivity analyses showed that biomass production is strongly dependent on Monod variables and harvesting regime, with sensitivity changing with growth phase. Profitability was sensitive to processing costs and market prices of products. Under scenarios based on current market conditions and typical algae production, AlgaeSim shows that a WRRF can potentially generate significant profit if algae are processed for biodiesel, biogas, or fertilizer. Wastewater resource recovery facilities could similarly save on operating costs resulting from the reduction in aeration (for nitrification) and chemicals (for denitrification).

  19. Development of an Integrated Leachate Treatment Solution for the Port Granby Waste Management Facility - 12429

    SciTech Connect

    Conroy, Kevin W.; Vandergaast, Gerald

    2012-07-01

    The Port Granby Project (the Project) is located near the north shore of Lake Ontario in the Municipality of Clarington, Ontario, Canada. The Project consists of relocating approximately 450,000 m{sup 3} of historic Low-Level Radioactive Waste (LLRW) and contaminated soil from the existing Port Granby Waste Management Facility (WMF) to a proposed Long-Term Waste Management Facility (LTWMF) located adjacent to the WMF. The LTWMF will include an engineered waste containment facility, a Wastewater Treatment Plant (WTP), and other ancillary facilities. A series of bench- and pilot-scale test programs have been conducted to identify preferred treatment processes to be incorporated into the WTP to treat wastewater generated during the construction, closure and post-closure periods at the WMF/LTWMF. (authors)

  20. Integral approaches to wastewater treatment plant upgrading for odor prevention: Activated Sludge and Oxidized Ammonium Recycling.

    PubMed

    Estrada, José M; Kraakman, N J R; Lebrero, R; Muñoz, R

    2015-11-01

    Traditional physical/chemical end-of-the-pipe technologies for odor abatement are relatively expensive and present high environmental impacts. On the other hand, biotechnologies have recently emerged as cost-effective and environmentally friendly alternatives but are still limited by their investment costs and land requirements. A more desirable approach to odor control is the prevention of odorant formation before being released to the atmosphere, but limited information is available beyond good design and operational practices of the wastewater treatment process. The present paper reviews two widely applicable and economic alternatives for odor control, Activated Sludge Recycling (ASR) and Oxidized Ammonium Recycling (OAR), by discussing their fundamentals, key operating parameters and experience from the available pilot and field studies. Both technologies present high application potential using readily available plant by-products with a minimum plant upgrading, and low investment and operating costs, contributing to the sustainability and economic efficiency of odor control at wastewater treatment facilities. PMID:26316402

  1. An integrated microfluidic loop-mediated-isothermal-amplification system for rapid sample pre-treatment and detection of viruses.

    PubMed

    Wang, Chih-Hung; Lien, Kang-Yi; Wang, Ting-Yu; Chen, Tzong-Yueh; Lee, Gwo-Bin

    2011-01-15

    This study presents a novel automatic assay for targeted ribonucleic acid (RNA) extraction and a one-step reverse transcription loop-mediated-isothermal-amplification (RT-LAMP) process for the rapid detection of viruses from tissue samples by utilizing an integrated microfluidic system. By utilizing specific probe-conjugated magnetic beads, target RNA samples can be specifically recognized and hybridized onto the surface of the magnetic beads which are mixed with whole tissue lysates, followed by the synthesis of complementary deoxyribonucleic acid (cDNA) and isothermal amplification of target genes simultaneously with the incorporation of two specific primer sets. The nervous necrosis virus (NNV), the most common aquaculture pathogen, with a mortality rate in infected fish ranging from 80% to 100%, has been selected to verify the performance of the developed miniature system. Experimental results showed that the sensitivity of the integrated microfluidic LAMP system is about 100-fold higher when compared to a conventional one-step reverse-transcript polymerase chain reaction (RT-PCR) process. Significantly, the entire protocol from sample pre-treatment to target gene amplification can be completed within 60 min in an automatic manner without cross-reactions with other tested virus, bacteria and eukaryotic cells. Consequently, this integrated microfluidic LAMP system may provide a powerful platform for rapid purification and detection of virus samples.

  2. The integrated melter off-gas treatment systems at the West Valley Demonstration Project

    SciTech Connect

    Vance, R.F.

    1991-12-01

    The West Valley Demonstration project was established by an act of Congress in 1980 to solidify the high level radioactive liquid wastes produced from operation of the Western New York Nuclear Services Center from 1966 to 1972. The waste will be solidified as borosilicate glass. This report describes the functions, the controlling design criteria, and the resulting design of the melter off-gas treatment systems.

  3. Integrating Recent Data in Managing Adverse Events in the Treatment of Hepatocellular Carcinoma

    PubMed Central

    Gish, Robert G.; Abou-Alfa, Ghassan K.; Tong, Myron J.

    2010-01-01

    Hepatocellular carcinoma (HCC) is a major cause of cancer-related morbidity and mortality worldwide. In the United States, HCC is the main cause of death in patients with cirrhosis, and the incidence of this malignancy is on the rise. Because HCC is associated with a particularly poor prognosis, emphasis is placed on surveillance of high-risk patients. Early detection allows a greater chance of diagnosing HCC before it has spread, thus increasing the chances that the patient can be potentially cured with surgical techniques such as resection and transplantation. However, most cases of HCC are not diagnosed until at least some of the cancer has spread or multiple nodules exist. For these patients, treatment options include percutaneous and transarterial ablation, as well as systemic chemotherapy. Systemic therapy is now considered the standard of care for patients with advanced tumors. Traditional treatment was based on cytotoxic chemotherapeutic agents, such as doxorubicin. This approach was associated with minimal benefit and a high rate of toxicity. Recently, targeted agents have proven more effective and safer in this setting. The oral multikinase inhibitor sorafenib is now approved for the treatment of unresectable HCC and is currently the only approved agent for advanced HCC. In order to maximize the benefit of sorafenib and other investigational agents for patients with advanced disease, effective interventions have been designed to mitigate their associated adverse events, such as hand-foot skin reactions and hypertension. PMID:22423222

  4. [Integrated care in pain therapy: innovations and coordinated treatment offers from the "Techniker Krankenkasse"].

    PubMed

    Brunkhorst, J; Schwarz, F; Klein, S

    2013-04-01

    Sectorally segregated healthcare structures are seen as a major reason for deficits in quality and efficiency. With the introduction of §§ 140 a ff. SGB V, the sectoral splitting into outpatient, inpatient and rehabilitative services will be eliminated. This is especially true for the requirements of state-of-the-art multidisciplinary and comprehensive pain therapy. Through this form of contract competition and competition for the best idea, incentives shall be created for economic behaviour of market participants, above all the efficient use of limited resources and allocation of healthcare resources based on need. Selective contracts are essential competition parameters for continued innovative development of the healthcare system. They enable statutory healthcare providers to offer their insurants innovative treatments which are not available in standard care. Agreements can be made concerning higher levels of quality and healthcare services, incentives for economical behaviour and success-based payment models. The key idea is the orientation on the needs of the insurant. The successful realisation of innovation in pain therapy is described using a practical example. Professional contractual partners, high quality information and communication, the taking over of responsibility for treatment and cost effectiveness are factors essential the success of innovative treatment concepts. PMID:23539274

  5. A 12-month controlled trial of methadone medical maintenance integrated into an adaptive treatment model.

    PubMed

    King, Van L; Kidorf, Michael S; Stoller, Kenneth B; Schwartz, Robert; Kolodner, Kenneth; Brooner, Robert K

    2006-12-01

    Methadone medical maintenance (MMM) reduces the reporting schedule for stable and well-functioning methadone maintenance patients to once a month, with counseling provided by medical staff. We report on the 12-month outcomes of 92 highly stable methadone maintenance patients randomly assigned to one of three study conditions: routine care, MMM at the methadone maintenance program, and MMM at a physician's office. Methadone medical maintenance patients received a 28-day supply of methadone, whereas routine care patients received five or six take-home methadone doses each week. All patients performed a medication recall once a month and submitted two urine samples each month. An adaptive stepped-care system of treatment intensification was used for patients who failed recall or who had drug-positive urine specimens. Seventy-seven patients completed the 12-month study period. Dropout was caused primarily by problems with handling methadone and disliking the recall frequency. There were low rates of drug use or failed medication recall. Treatment satisfaction was high in all groups, but the MMM patients initiated more new employment or family/social activities than did routine care patients over the study period. The stepped-care approach was well tolerated and matched patients to an appropriate step of service within a continuum of treatment intensity. PMID:17084792

  6. Process Integrated Heat Treatment of a Microalloyed Medium Carbon Steel: Microstructure and Mechanical Properties

    NASA Astrophysics Data System (ADS)

    Herbst, Sebastian; Schledorn, Mareike; Maier, Hans Jürgen; Milenin, Andrij; Nürnberger, Florian

    2016-04-01

    Air-water spray cooling was employed during a heat treatment to enhance the mechanical properties of microalloyed medium carbon steel test cylinders (38MnVS6, 88 mm diameter). Using appropriate cooling times and intensities, the test cylinders' surfaces could be quenched and subsequently self-tempered by the residual heat of the core. Simultaneously, it was possible to keep the core regions of the cylinders in the bainitic regime and carry out a quasi-isothermal holding. The resulting microstructures consisted of tempered martensite (near-surface) and bainite with pearlite and ferrite (core). Compared to the standard heat treatment (controlled air cooling), the tensile properties (proof stress and ultimate tensile strength) could be improved for both near-surface and core regions with the adapted spray cooling. A hardness profile with 450 HV10 surface hardness and a hardening depth of more than 11 mm could be realized. In addition, an increase of the impact toughness for the core was achieved, resulting in approximately 25 J charpy impact energy. This is a substantial improvement compared to standard heat treatment procedure and values reported in the literature and can be attributed to the reduced pearlite volume fraction and the increased amount of fine bainite.

  7. One System Integrated Project Team: Retrieval And Delivery Of The Hanford Tank Wastes For Vitrification In The Waste Treatment Plant

    SciTech Connect

    Harp, Benton J.; Kacich, Richard M.; Skwarek, Raymond J.

    2012-12-20

    The One System Integrated Project Team (IPT) was formed in late 2011 as a way for improving the efficiency of delivery and treatment of highly radioactive waste stored in underground tanks at the U.S. Department of Energy's (DOE's) 586-square-mile Hanford Site in southeastern Washington State. The purpose of the One System IPT is to improve coordination and integration between the Hanford's Waste Treatment Plant (WTP) contractor and the Tank Operations Contractor (TOC). The vision statement is: One System is a WTP and TOC safety conscious team that, through integrated management and implementation of risk-informed decision and mission-based solutions, will enable the earliest start of safe and efficient treatment of Hanford's tank waste, to protect the Columbia River, environment and public. The IPT is a formal collaboration between Bechtel National, Inc. (BNI), which manages design and construction of the WTP for the U.S. Department of Energy's Office of River Protection (DOEORP), and Washington River Protection Solutions (WRPS), which manages the TOC for ORP. More than fifty-six (56) million gallons of highly radioactive liquid waste are stored in one hundred seventy-seven (177) aging, underground tanks. Most of Hanford's waste tanks - one hundred forty-nine (149) of them - are of an old single-shell tank (SST) design built between 1944 and 1964. More than sixty (60) of these tanks have leaked in the past, releasing an estimated one million gallons of waste into the soil and threatening the nearby Columbia River. There are another twenty-eight (28) new double-shelled tanks (DSTs), built from 1968 to 1986, that provide greater protection to the environment. In 1989, DOE, the U.S. Environmental Protection Agency (EPA), and the Washington State Department of Ecology (Ecology) signed a landmark agreement that required Hanford to comply with federal and state environmental standards. It also paved the way for agreements that set deadlines for retrieving the tank

  8. One System Integrated Project Team: Retrieval and Delivery of Hanford Tank Wastes for Vitrification in the Waste Treatment Plant - 13234

    SciTech Connect

    Harp, Benton J.; Kacich, Richard M.; Skwarek, Raymond J.

    2013-07-01

    The One System Integrated Project Team (IPT) was formed in late 2011 as a way for improving the efficiency of delivery and treatment of highly radioactive waste stored in underground tanks at the U.S. Department of Energy's (DOE's) 586-square-mile Hanford Site in southeastern Washington State. The purpose of the One System IPT is to improve coordination and integration between the Hanford's Waste Treatment Plant (WTP) contractor and the Tank Operations Contractor (TOC). The vision statement is: One System is a WTP and TOC safety-conscious team that, through integrated management and implementation of risk-informed decision and mission-based solutions, will enable the earliest start of safe and efficient treatment of Hanford's tank waste, to protect the Columbia River, environment and public. The IPT is a formal collaboration between Bechtel National, Inc. (BNI), which manages design and construction of the WTP for the U.S. Department of Energy's Office of River Protection (DOEORP), and Washington River Protection Solutions (WRPS), which manages the TOC for ORP. More than fifty-six (56) million gallons of highly radioactive liquid waste are stored in one hundred seventy-seven (177) aging, underground tanks. Most of Hanford's waste tanks - one hundred forty-nine (149) of them - are of an old single-shell tank (SST) design built between 1944 and 1964. More than sixty (60) of these tanks have leaked in the past, releasing an estimated one million gallons of waste into the soil and threatening the nearby Columbia River. There are another twenty-eight (28) new double-shelled tanks (DSTs), built from 1968 to 1986, that provide greater protection to the environment. In 1989, DOE, the U.S. Environmental Protection Agency (EPA), and the Washington State Department of Ecology (Ecology) signed a landmark agreement that required Hanford to comply with federal and state environmental standards. It also paved the way for agreements that set deadlines for retrieving the tank

  9. The Positive Impact of Integrative Medicine in the Treatment of Recalcitrant Chronic daily Headache: A Series of Case Reports

    PubMed Central

    Amoils, Sandi; Lester, Tiffany; Woolford, Liz; Gallagher, Lisa

    2014-01-01

    People who suffer from recalcitrant chronic daily headache (CDH)—a primary, episodic headache occurring at least 15 days per month, and lasting four or more hours per day for at least three consecutive months1—have generally tried many pain relief medications with few positive results. These patients often continue to add more and more medications and travel from clinician to clinician seeking help, without relief. Patients with recalcitrant CDH are often caught in a vicious cycle of increasing pain which results in a substantial impact from their disease on productivity and quality of life. Studies in the United States and Europe indicate that four to five percent of the general population has recalcitrant CDH,2 which encompasses transformed migraine and chronic tension-type headache.3 The disability associated with recalcitrant CDH is substantial, as patients have a significantly diminished quality of life and mental health, as well as impaired physical, social, and occupational functioning.4,5 Research shows that CDH may not be treated effectively with conventional medicine (CM). Integrative medicine (IM) offers a complex, personalized intervention necessary to treat CDH. Many integrative therapies have shown benefit, effectiveness, cost effectiveness and low side effect profile in patients with both chronic headache and chronic pain.6-17 Yet even within the IM community, clinicians often struggle with the balance between providing evidence-based therapy and patient-centered, complex, personalized integrative approaches, which may use popular but unproven therapies. In this article, we present a series of cases comprising patients with CDH who had previously been recalcitrant to CM approaches. In each case, employing a five-pronged treatment algorithm resulted in the successful IM treatment of CDH. By using this five-pronged approach, clinicians can offer the standardized protocols and scientific rationale they are accustomed to when employing CM options

  10. Definition and compositions of standard wastestreams for evaluation of Buried Waste Integrated Demonstration treatment technologies

    SciTech Connect

    Bates, S.O.

    1993-06-01

    The Buried Waste Integrated Demonstration (BWID) Project was organized at the Idaho National Engineering Laboratory to support research, development, demonstration, testing, and evaluation of emerging technologies that offer promising solutions to remediation of buried waste. BWID will identify emerging technologies, screen them for applicability to the identified needs, select technologies for demonstration, and then evaluate the technologies based on prescribed performance objectives. The technical objective of the project is to establish solutions to Environmental Restoration and Waste Management`s technological deficiencies and improve baseline remediation systems. This report establishes a set of standard wastestream compositions that will be used by BWID to evaluate the emerging technologies. Five wastestreams are proposed that use four types of waste and a nominal case that is a homogenized combination of the four wastes. The five wastestreams will provide data on the compositional extremes and indicate the technologies` effectiveness over the complete range of expected wastestream compositions.

  11. [Cognitive behavioral treatment in the integral management of obesity in adolescents].

    PubMed

    Rodríguez-Morán, Martha; Mendoza-Ávila, Eduardo; Cumplido-Fuentes, Agustín; Simental-Mendía, Luis E; Rodríguez-Ramírez, Gabriela; Sánchez-Lazcano, Gloria Janeth; Ramírez-Bonilla, Paulina; Cumplido-González, Guadalupe; Ortiz-Martínez, Guadalupe; Pinedo-Rodríguez, Gustavo Alan; Meza-Villa, Ángel; Ortiz-Ramos, Alma Fátima; Puerta-Mota, Gerardo; Guerrero-Romero, Fernando

    2014-01-01

    INTRODUCTIÓN: la obesidad en niños y adolescentes y la morbilidad que se le asocia se han incrementado significativamente, lo cual se ha convertido en un problema de salud pública. El objetivo de este estudio fue evaluar la eficacia de la terapia cognitivo-conductual (TCC) en el manejo integral de la obesidad en adolescentes. MÉTODOS: estudio de intervención, aleatorio, doble ciego, controlado, de cuatro meses de seguimiento, al que se integraron 115 adolescentes obesos de 12 a 16 años de edad. El grupo de intervención recibió TCC como terapia coadyuvante, así como indicaciones de dieta y apoyo para el desarrollo de ejercicio. El grupo control solo recibió indicaciones de dieta y apoyo para el desarrollo de ejercicio.

  12. INTEGRATED OPTICAL TOOLS FOR MINIMALLY INVASIVE DIAGNOSIS AND TREATMENT AT GASTROINTESTINAL ENDOSCOPY.

    PubMed

    Rodriguez-Diaz, Eladio; Bigio, Irving J; Singh, Satish K

    2011-04-01

    Over the past two decades, the bulk of gastrointestinal (GI) endoscopic procedures has shifted away from diagnostic and therapeutic interventions for symptomatic disease toward cancer prevention in asymptomatic patients. This shift has resulted largely from a decrease in the incidence of peptic ulcer disease in the era of antisecretory medications coupled with emerging evidence for the efficacy of endoscopic detection and eradication of dysplasia, a histopathological biomarker widely accepted as a precursor to cancer. This shift has been accompanied by a drive toward minimally-invasive, in situ optical diagnostic technologies that help assess the mucosa for cellular changes that relate to dysplasia. Two competing but complementary approaches have been pursued. The first approach is based on broad-view targeting of "areas of interest" or "red flags." These broad-view technologies include standard white light endoscopy (WLE), high-definition endoscopy (HD), and "electronic" chromoendoscopy (narrow-band-type imaging). The second approach is based on multiple small area or point-source (meso/micro) measurements, which can be either machine (spectroscopy) or human-interpreted (endomicroscopy, magnification endoscopy), much as histopatholgy slides are. In this paper we present our experience with the development and testing of a set of familiar but "smarter" standard tissue-sampling tools that can be routinely employed during screening/surveillance endoscopy. These tools have been designed to incorporate fiberoptic probes that can mediate spectroscopy or endomicroscopy. We demonstrate the value of such tools by assessing their preliminary performance from several ongoing clinical studies. Our results have shown promise for a new generation of integrated optical tools for a variety of screening/surveillance applications during GI endoscopy. Integrated devices should prove invaluable for dysplasia surveillance strategies that currently result in large numbers of benign

  13. Integrated treatment and recycling of stormwater: a review of Australian practice.

    PubMed

    Hatt, Belinda E; Deletic, Ana; Fletcher, Tim D

    2006-04-01

    With the use of water approaching, and in some cases exceeding, the limits of sustainability in many locations, there is an increasing recognition of the need to utilise stormwater for non-potable requirements, thus reducing the demand on potable sources. This paper presents a review of Australian stormwater treatment and recycling practices as well as a discussion of key lessons and identified knowledge gaps. Where possible, recommendations for overcoming these knowledge gaps are given. The review of existing stormwater recycling systems focussed primarily on the recycling of general urban runoff (runoff generated from all urban surfaces) for non-potable purposes. Regulations and guidelines specific to stormwater recycling need to be developed to facilitate effective design of such systems, and to minimise risks of failure. There is a clear need for the development of innovative techniques for the collection, treatment and storage of stormwater. Existing stormwater recycling practice is far ahead of research, in that there are no technologies designed specifically for stormwater recycling. Instead, technologies designed for general stormwater pollution control are frequently utilised, which do not guarantee the necessary reliability of treatment. Performance modelling for evaluation purposes also needs further research, so that industry can objectively assess alternative approaches. Just as many aspects of these issues may have impeded adoption of stormwater, another impediment to adoption has been the lack of a practical and widely accepted method for assessing the many financial, social and ecological costs and benefits of stormwater recycling projects against traditional alternatives. Such triple-bottom-line assessment methodologies need to be trialled on stormwater recycling projects. If the costs and benefits of recycling systems can be shown to compare favourably with the costs and benefits of conventional practices this will provide an incentive to overcome

  14. Optimizing control of acromegaly: integrating a growth hormone receptor antagonist into the treatment algorithm.

    PubMed

    Clemmons, David R; Chihara, Kazuo; Freda, Pamela U; Ho, Ken K Y; Klibanski, Anne; Melmed, Shlomo; Shalet, Stephen M; Strasburger, Christian J; Trainer, Peter J; Thorner, Michael O

    2003-10-01

    Acromegaly is associated with significant morbidities and a 2- to 3-fold increase in mortality because of the excessive metabolic action of GH and IGF-I, a marker of GH output. Reductions in morbidity correspond with decreases in IGF-I, and mortality is lowered following normalization of IGF-I or GH levels. Therefore, this has become an important end point. Current guidelines for the treatment of acromegaly have not considered recent advances in medical therapy, in particular, the place of pegvisomant, a GH receptor antagonist. Treatment goals include normalizing biochemical markers, controlling tumor mass, preserving pituitary function, and relieving signs and symptoms. Surgery reduces tumor volume and is considered first-line therapy. Radiation reduces tumor volume and GH and IGF-I levels, but the onset of action is slow and hypopituitarism typically develops. Therefore, pharmacotherapy is often used following surgery or as first-line therapy for nonresectable tumors. Dopamine agonists can be considered in patients exhibiting minimal disease or those with GH-prolactin-cosecreting tumors but will not achieve hormone normalization in most patients. Somatostatin analogs effectively suppress GH and IGF-I in most patients, but intolerance (e.g. diarrhea, cramping, gallstones) can occur. Pegvisomant, the newest therapeutic option, blocks GH action at peripheral receptors, normalizes IGF-I levels, reduces signs and symptoms, and corrects metabolic defects. Pegvisomant does not appear to affect tumor size and has few adverse effects. Pegvisomant is the most effective drug treatment for acromegaly in normalizing IGF-I and producing a clinical response; it is the preferred agent in patients resistant to or intolerant of somatostatin analogs.

  15. Prevention of hepatotoxicity due to anti tuberculosis treatment: A novel integrative approach

    PubMed Central

    Adhvaryu, Meghna R; Reddy, Narsimha M; Vakharia, Bhasker C

    2008-01-01

    AIM: To evaluate the ability of Curcuma longa (CL) and Tinospora cordifolia (TC) formulation to prevent anti-tuberculosis (TB) treatment (ATT) induced hepatotoxicity. METHODS: Patients with active TB diagnosis were randomized to a drug control group and a trial group on drugs plus an herbal formulation. Isoniazid, rifampicin, pyrazinamide and ethambutol for first 2 mo followed by continuation phase therapy excluding Pyrazinamide for 4 mo comprised the anti-tuberculous treatment. Curcumin enriched (25%) CL and a hydro-ethanolic extract enriched (50%) TC 1 g each divided in two doses comprised the herbal adjuvant. Hemogram, bilirubin and liver enzymes were tested initially and monthly till the end of study to evaluate the result. RESULTS: Incidence and severity of hepatotoxicity was significantly lower in trial group (incidence: 27/192 vs 2/316, P < 0.0001). Mean aspartate transaminase (AST) (195.93 ± 108.74 vs 85 ± 4.24, P < 0.0001), alanine transaminase (ALT) (75.74 ± 26.54 vs 41 ± 1.41, P < 0.0001) and serum bilirubin (5.4 ± 3.38 vs 1.5 ± 0.42, P < 0.0001). A lesser sputum positivity ratio at the end of 4 wk (10/67 vs 4/137, P = 0.0068) and decreased incidence of poorly resolved parenchymal lesion at the end of the treatment (9/152 vs 2/278, P = 0.0037) was observed. Improved patient compliance was indicated by nil drop-out in trial vs 10/192 in control group (P < 0.0001). CONCLUSION: The herbal formulation prevented hepatotoxicity significantly and improved the disease outcome as well as patient compliance without any toxicity or side effects. PMID:18720535

  16. Integrated gasification and plasma cleaning for waste treatment: A life cycle perspective

    SciTech Connect

    Evangelisti, Sara; Tagliaferri, Carla; Clift, Roland; Lettieri, Paola; Taylor, Richard; Chapman, Chris

    2015-09-15

    Highlights: • A life cycle assessment of an advanced two-stage process is undertaken. • A comparison of the impacts of the process when fed with 7 feedstock is presented. • Sensitivity analysis on the system is performed. • The treatment of RDF shows the lowest impact in terms of both GWP and AP. • The plasma shows a small contribution to the overall impact of the plant. - Abstract: In the past, almost all residual municipal waste in the UK was landfilled without treatment. Recent European waste management directives have promoted the uptake of more sustainable treatment technologies, especially for biodegradable waste. Local authorities have started considering other options for dealing with residual waste. In this study, a life cycle assessment of a future 20 MWe plant using an advanced two-stage gasification and plasma technology is undertaken. This plant can thermally treat waste feedstocks with different composition and heating value to produce electricity, steam and a vitrified product. The objective of the study is to analyse the environmental impacts of the process when fed with seven different feedstocks (including municipal solid waste, solid refuse fuel, reuse-derived fuel, wood biomass and commercial & industrial waste) and identify the process steps which contribute more to the environmental burden. A scenario analysis on key processes, such as oxygen production technology, metal recovery and the appropriate choice for the secondary market aggregate material, is performed. The influence of accounting for the biogenic carbon content in the waste from the calculations of the global warming potential is also shown. Results show that the treatment of the refuse-derived fuel has the lowest impact in terms of both global warming potential and acidification potential because of its high heating value. For all the other impact categories analysed, the two-stage gasification and plasma process shows a negative impact for all the waste streams

  17. Integrating forward osmosis into microbial fuel cells for wastewater treatment, water extraction and bioelectricity generation.

    PubMed

    Zhang, Fei; Brastad, Kristen S; He, Zhen

    2011-08-01

    A novel osmotic microbial fuel cell (OsMFC) was developed by using a forward osmosis (FO) membrane as a separator. The performance of the OsMFC was examined with either NaCl solution or artificial seawater as a catholyte (draw solution). A conventional MFC with a cation exchange membrane was also operated in parallel for comparison. It was found that the OsMFC produced more electricity than the MFC in both batch operation (NaCl solution) and continuous operation (seawater), likely due to better proton transport with water flux through the FO membrane. Water flux from the anode into the cathode was clearly observed with the OsMFC but not in the MFC. The solute concentration of the catholyte affected both electricity generation and water flux. These results provide a proof of concept that an OsMFC can simultaneously accomplish wastewater treatment, water extraction (from the wastewater), and electricity generation. The potential applications of the OsMFC are proposed for either water reuse (linking to reverse osmosis for reconcentration of draw solution) or seawater desalination (connecting with microbial desalination cells for further wastewater treatment and desalination). PMID:21751820

  18. Integrated nitrogen removal biofilter system with ceramic membrane for advanced post-treatment of municipal wastewater.

    PubMed

    Son, Dong-Jin; Yun, Chan-Young; Kim, Woo-Yeol; Zhang, Xing-Ya; Kim, Dae-Gun; Chang, Duk; Sunwoo, Young; Hong, Ki-Ho

    2016-12-01

    The pre-denitrification biofilm process for nitrogen removal was combined with ceramic membrane with pore sizes of 0.05-0.1 µm as a system for advanced post-treatment of municipal wastewater. The system was operated under an empty bed hydraulic retention time of 7.8 h, recirculation ratio of 3, and transmembrane pressure of 0.47 bar. The system showed average removals of organics, total nitrogen, and solids as high as 93%, 80%, and 100%, respectively. Rapid nitrification could be achieved and denitrification was performed in the anoxic filter without external carbon supplements. The residual particulate organics and nitrogen in effluent from biofilm process could be also removed successfully through membrane filtration and the removal of total coliform was noticeably improved after membrane filtration. Thus, a system composed of the pre-denitrification biofilm process with ceramic membrane would be a compact and flexible option for advanced post-treatment of municipal wastewater. PMID:27108849

  19. System-Level Effects of Integrating a Promising Treatment into JDCs

    PubMed Central

    McCart, Michael R.; Henggeler, Scott W.; Chapman, Jason E.; Cunningham, Phillippe B.

    2011-01-01

    This study examined the system-level effects of implementing a promising treatment for adolescent substance abuse in juvenile drug courts (JDCs). Six JDCs were randomized to receive training in the experimental intervention (contingency management-family engagement, CM-FAM) or to continue their usual services (US). Participants were 104 families served by the courts, 51 therapists, and 74 JDC stakeholders (e.g., judges, prosecutors, defense attorneys). Assessments included repeated measurements of CM-FAM implementation by therapists as well as therapist and stakeholder perceptions of incentive-based interventions and organizational characteristics. Results revealed greater use of CM and family engagement techniques among CM-FAM relative to US therapists. In addition, therapists and stakeholders in the CM-FAM condition reported more favorable attitudes toward the use of incentives and greater improvement on several domains of organizational functioning relative to US counterparts. Taken together, these findings suggest that JDC professionals’ are amenable to the adoption and implementation of a treatment model that holds promise for improving youth outcomes. PMID:22154039

  20. Cancer treatment as a game: integrating evolutionary game theory into the optimal control of chemotherapy.

    PubMed

    Orlando, Paul A; Gatenby, Robert A; Brown, Joel S

    2012-12-01

    Chemotherapy for metastatic cancer commonly fails due to evolution of drug resistance in tumor cells. Here, we view cancer treatment as a game in which the oncologists choose a therapy and tumors 'choose' an adaptive strategy. We propose the oncologist can gain an upper hand in the game by choosing treatment strategies that anticipate the adaptations of the tumor. In particular, we examine the potential benefit of exploiting evolutionary tradeoffs in tumor adaptations to therapy. We analyze a math model where cancer cells face tradeoffs in allocation of resistance to two drugs. The tumor 'chooses' its strategy by natural selection and the oncologist chooses her strategy by solving a control problem. We find that when tumor cells perform best by investing resources to maximize response to one drug the optimal therapy is a time-invariant delivery of both drugs simultaneously. However, if cancer cells perform better using a generalist strategy allowing resistance to both drugs simultaneously, then the optimal protocol is a time varying solution in which the two drug concentrations negatively covary. However, drug interactions can significantly alter these results. We conclude that knowledge of both evolutionary tradeoffs and drug interactions is crucial in planning optimal chemotherapy schedules for individual patients.

  1. Integrating forward osmosis into microbial fuel cells for wastewater treatment, water extraction and bioelectricity generation.

    PubMed

    Zhang, Fei; Brastad, Kristen S; He, Zhen

    2011-08-01

    A novel osmotic microbial fuel cell (OsMFC) was developed by using a forward osmosis (FO) membrane as a separator. The performance of the OsMFC was examined with either NaCl solution or artificial seawater as a catholyte (draw solution). A conventional MFC with a cation exchange membrane was also operated in parallel for comparison. It was found that the OsMFC produced more electricity than the MFC in both batch operation (NaCl solution) and continuous operation (seawater), likely due to better proton transport with water flux through the FO membrane. Water flux from the anode into the cathode was clearly observed with the OsMFC but not in the MFC. The solute concentration of the catholyte affected both electricity generation and water flux. These results provide a proof of concept that an OsMFC can simultaneously accomplish wastewater treatment, water extraction (from the wastewater), and electricity generation. The potential applications of the OsMFC are proposed for either water reuse (linking to reverse osmosis for reconcentration of draw solution) or seawater desalination (connecting with microbial desalination cells for further wastewater treatment and desalination).

  2. INTEGRATED OPTICAL TOOLS FOR MINIMALLY INVASIVE DIAGNOSIS AND TREATMENT AT GASTROINTESTINAL ENDOSCOPY

    PubMed Central

    Rodriguez-Diaz, Eladio; Bigio, Irving J.; Singh, Satish K.

    2010-01-01

    Over the past two decades, the bulk of gastrointestinal (GI) endoscopic procedures has shifted away from diagnostic and therapeutic interventions for symptomatic disease toward cancer prevention in asymptomatic patients. This shift has resulted largely from a decrease in the incidence of peptic ulcer disease in the era of antisecretory medications coupled with emerging evidence for the efficacy of endoscopic detection and eradication of dysplasia, a histopathological biomarker widely accepted as a precursor to cancer. This shift has been accompanied by a drive toward minimally-invasive, in situ optical diagnostic technologies that help assess the mucosa for cellular changes that relate to dysplasia. Two competing but complementary approaches have been pursued. The first approach is based on broad-view targeting of “areas of interest” or “red flags.” These broad-view technologies include standard white light endoscopy (WLE), high-definition endoscopy (HD), and “electronic” chromoendoscopy (narrow-band-type imaging). The second approach is based on multiple small area or point-source (meso/micro) measurements, which can be either machine (spectroscopy) or human-interpreted (endomicroscopy, magnification endoscopy), much as histopatholgy slides are. In this paper we present our experience with the development and testing of a set of familiar but “smarter” standard tissue-sampling tools that can be routinely employed during screening/surveillance endoscopy. These tools have been designed to incorporate fiberoptic probes that can mediate spectroscopy or endomicroscopy. We demonstrate the value of such tools by assessing their preliminary performance from several ongoing clinical studies. Our results have shown promise for a new generation of integrated optical tools for a variety of screening/surveillance applications during GI endoscopy. Integrated devices should prove invaluable for dysplasia surveillance strategies that currently result in large

  3. The use of mindfulness in obsessive compulsive disorder: suggestions for its application and integration in existing treatment.

    PubMed

    Fairfax, Hamilton

    2008-01-01

    Treatment for obsessive-compulsive disorder (OCD) is a standard activity of psychologists, particularly those in Community Mental Health Teams (CMHT). In 2005, NICE published guidelines recommending Cognitive Behavioural Therapy (CBT) with Exposure and Response Prevention (ER-P) as the evidence-based psychological treatments of choice. In recent years there have been significant developments within cognitive behavioural theory, including what has been referred to as the 'Third Wave'. This paper explores the contribution of mindfulness; a practice that has previously been integrated into other CBT models of treatment, to cognitive interventions in OCD, suggesting that in complements both CBT and ER-However it had previously been suggested by Freeston that mindfulness may prevent successful ER-P by becoming a neutralising technique. Examples of the application of a mindfulness-based approach are explored (MOCD), including reference to an OCD group run by the author, and areas of potential overlap are identified, in particular thought-action Fusion. It is concluded that if applied properly, mindfulness not only complements traditional CBT interventions, but could also increase their efficacy and perhaps prevent relapse.

  4. Integrated hot-compressed water and laccase-mediator treatments of Eucalyptus grandis fibers: structural changes of fiber and lignin.

    PubMed

    Wu, Jian-Quan; Wen, Jia-Long; Yuan, Tong-Qi; Sun, Run-Cang

    2015-02-18

    Eucalyptus grandis fibers were treated with hot-compressed water (HCW) and laccase mediator to enhance the fiber characteristics and to produce an active lignin substrate for binderless fiberboard production. The composition, morphology, and crystallinity index (CrI) analysis of fibers showed that the HCW treatment increased the CrI and lignin content of the treated fibers through partial removal of hemicelluloses. Simultaneously, the HCW treatment produced some granules and holes on the surface of the fibers, which possibly facilitated the accessibility of the laccase mediator. Milled wood lignins and enzymatic hydrolysis lignins isolated from the control and treated fibers were comparatively characterized. A reduction of molecular weight was observed, which indicated that a preferential degradation of lignin occurred after exposure to the laccase mediator. Quantitative (13)C, 2D-HSQC and (31)P NMR characterization revealed that the integrated treatment resulted in the cleavage of β-O-4' linkages, removal of G' (oxidized α-ketone) substructures, and an increase in the S/G ratio and free phenolic hydroxyls.

  5. Patient Satisfaction with Methadone Maintenance Treatment in Vietnam: A Comparison of Different Integrative-Service Delivery Models

    PubMed Central

    Tran, Bach Xuan; Nguyen, Long Hoang; Phan, Huong Thu Thi; Latkin, Carl A.

    2015-01-01

    Background Patient satisfaction is an important component of quality in healthcare delivery. To inform the expansion of Methadone Maintenance Treatment (MMT) services in Vietnam, we examined the satisfaction of patients with regards to different services delivery models and identified its associated factors. Methods We interviewed 1,016 MMT patients at 5 clinics in Hanoi and Nam Dinh province. The modified SATIS instrument, a 10-item scale, was used to measure three dimensions: “Services quality and convenience”, “Health workers’ capacity and responsiveness” and “Inter-professional care”. Results The average score was high across three SATIS dimensions. However, only one third of patients completely satisfied with general health services and treatment outcomes. Older age, higher education, having any problem in self-care and anxiety/depression were negatively associated with patient’s satisfaction. Meanwhile, patients receiving MMT at clinics, where more comprehensive HIV and general health care services were available, were more likely to report a complete satisfaction. Conclusion Patients were highly satisfied with MMT services in Vietnam. However, treatment for drug users should go beyond methadone maintenance to address complicated health demands of drug users. Integrating MMT with comprehensive HIV and general health services together with improving the capacity of health workers and efficiency of services organisation to provide interconnected health care for drug users are critical for improving the outcomes of the MMT program. PMID:26556036

  6. Integrated hot-compressed water and laccase-mediator treatments of Eucalyptus grandis fibers: structural changes of fiber and lignin.

    PubMed

    Wu, Jian-Quan; Wen, Jia-Long; Yuan, Tong-Qi; Sun, Run-Cang

    2015-02-18

    Eucalyptus grandis fibers were treated with hot-compressed water (HCW) and laccase mediator to enhance the fiber characteristics and to produce an active lignin substrate for binderless fiberboard production. The composition, morphology, and crystallinity index (CrI) analysis of fibers showed that the HCW treatment increased the CrI and lignin content of the treated fibers through partial removal of hemicelluloses. Simultaneously, the HCW treatment produced some granules and holes on the surface of the fibers, which possibly facilitated the accessibility of the laccase mediator. Milled wood lignins and enzymatic hydrolysis lignins isolated from the control and treated fibers were comparatively characterized. A reduction of molecular weight was observed, which indicated that a preferential degradation of lignin occurred after exposure to the laccase mediator. Quantitative (13)C, 2D-HSQC and (31)P NMR characterization revealed that the integrated treatment resulted in the cleavage of β-O-4' linkages, removal of G' (oxidized α-ketone) substructures, and an increase in the S/G ratio and free phenolic hydroxyls. PMID:25639522

  7. Treatment Efficacy of Integrative Family and Systems Treatment (I-FAST) With and Without Consultation: The Role of Model Training in the Sustainability of Evidence-Based Family Treatments.

    PubMed

    Lee, Mo Yee; Hsu, Kai-Shyang; Liu, Chang; Greene, Gilbert J; Fraser, J Scott; Grove, David; Solovey, Andy; Edwards, Shivani G; Scott, Pam

    2016-07-01

    This study examined the efficacy of the Integrative Family and Systems Treatment (I-FAST) training model that seeks to support development of model expertise within the agency in the context of facilitating the sustainability of evidence-based family treatment within community mental health settings. A quasi-experimental design was used to examine treatment outcomes of I-FAST among agencies that received ongoing Consultation and agencies that received No Consultation upon completion of I-FAST training. χ (2) analyses and independent samples t test analyses showed that there were no significant differences between the two groups on clients who had achieved reliable change on Problem Severity and Functioning based on parents' assessments. Significance of this study is discussed in the context of the role of evidence-based family therapy (EBFT) training in facilitating its sustainability in community mental health settings.

  8. Integrated gasification and plasma cleaning for waste treatment: A life cycle perspective.

    PubMed

    Evangelisti, Sara; Tagliaferri, Carla; Clift, Roland; Lettieri, Paola; Taylor, Richard; Chapman, Chris

    2015-09-01

    In the past, almost all residual municipal waste in the UK was landfilled without treatment. Recent European waste management directives have promoted the uptake of more sustainable treatment technologies, especially for biodegradable waste. Local authorities have started considering other options for dealing with residual waste. In this study, a life cycle assessment of a future 20MWe plant using an advanced two-stage gasification and plasma technology is undertaken. This plant can thermally treat waste feedstocks with different composition and heating value to produce electricity, steam and a vitrified product. The objective of the study is to analyse the environmental impacts of the process when fed with seven different feedstocks (including municipal solid waste, solid refuse fuel, reuse-derived fuel, wood biomass and commercial & industrial waste) and identify the process steps which contribute more to the environmental burden. A scenario analysis on key processes, such as oxygen production technology, metal recovery and the appropriate choice for the secondary market aggregate material, is performed. The influence of accounting for the biogenic carbon content in the waste from the calculations of the global warming potential is also shown. Results show that the treatment of the refuse-derived fuel has the lowest impact in terms of both global warming potential and acidification potential because of its high heating value. For all the other impact categories analysed, the two-stage gasification and plasma process shows a negative impact for all the waste streams considered, mainly due to the avoided burdens associated with the production of electricity from the plant. The plasma convertor, key characteristic of the thermal process investigated, although utilising electricity shows a relatively small contribution to the overall environmental impact of the plant. The results do not significantly vary in the scenario analysis. Accounting for biogenic carbon

  9. Integrated gasification and plasma cleaning for waste treatment: A life cycle perspective.

    PubMed

    Evangelisti, Sara; Tagliaferri, Carla; Clift, Roland; Lettieri, Paola; Taylor, Richard; Chapman, Chris

    2015-09-01

    In the past, almost all residual municipal waste in the UK was landfilled without treatment. Recent European waste management directives have promoted the uptake of more sustainable treatment technologies, especially for biodegradable waste. Local authorities have started considering other options for dealing with residual waste. In this study, a life cycle assessment of a future 20MWe plant using an advanced two-stage gasification and plasma technology is undertaken. This plant can thermally treat waste feedstocks with different composition and heating value to produce electricity, steam and a vitrified product. The objective of the study is to analyse the environmental impacts of the process when fed with seven different feedstocks (including municipal solid waste, solid refuse fuel, reuse-derived fuel, wood biomass and commercial & industrial waste) and identify the process steps which contribute more to the environmental burden. A scenario analysis on key processes, such as oxygen production technology, metal recovery and the appropriate choice for the secondary market aggregate material, is performed. The influence of accounting for the biogenic carbon content in the waste from the calculations of the global warming potential is also shown. Results show that the treatment of the refuse-derived fuel has the lowest impact in terms of both global warming potential and acidification potential because of its high heating value. For all the other impact categories analysed, the two-stage gasification and plasma process shows a negative impact for all the waste streams considered, mainly due to the avoided burdens associated with the production of electricity from the plant. The plasma convertor, key characteristic of the thermal process investigated, although utilising electricity shows a relatively small contribution to the overall environmental impact of the plant. The results do not significantly vary in the scenario analysis. Accounting for biogenic carbon

  10. Integrated treatment of municipal sewage sludge by deep dewatering and anaerobic fermentation for biohydrogen production.

    PubMed

    Yu, Li; Yu, Yang; Jiang, Wentian; Wei, Huangzhao; Sun, Chenglin

    2015-02-01

    The increasing sludge generated in wastewater treatment plants poses a threat to the environment. Based on the traditional processes, sludge dewatered by usual methods was further dewatered by hydraulic compression and the filtrate released was treated by anaerobic fermentation. The difficulties in sludge dewatering were associated with the existence of sludge flocs or colloidal materials. A suitable CaO dosage of 125 mg/g dry sludge (DS) could further decrease the moisture content of sludge from 82.4 to 50.9 %. The filtrate from the dewatering procedure was a potential substrate for biohydrogen production. Adding zero-valent iron (ZVI) into the anaerobic system improved the biohydrogen yield by 20 %, and the COD removal rate was lifted by 10 % as well. Meanwhile, the sludge morphology and microbial community were altered. The novel method could greatly reduce the sludge volume and successfully treated filtrate along with the conversion of organics into biohydrogen. PMID:25192669

  11. Integrated nanofiltration and upflow anaerobic sludge blanket treatment of textile wastewater for in-plant reuse.

    PubMed

    Gomes, Arlindo Canigo; Gonçalves, Isolina Cabral; de Pinho, Maria Norberta; Porter, John Jefferson

    2007-05-01

    The filtration characteristics of simulated dyeing effluents containing Acid Orange 7, sodium sulfate, and a pH buffer made of acetic acid and sodium acetate is described using a commercially available nanofiltration membrane. The original membrane filtration properties were characterized with deionized water to provide a baseline of membrane performance. At high volumetric concentration of the test solutions, greater than 98% rejection of dye and sodium sulfate were obtained. Rejection of buffering chemicals was approximately 50% in all experiments, giving a permeate water not suitable for reuse in most dyeing operations. The final composite concentrate had a chemical oxygen demand (COD) value > 2000 mg/L. No problems were encountered with anaerobic treatment of the concentrate obtained from the dyeing wastewater. Adjusting the sulfate concentration to give COD-to-sulfate ratios to 2.9, 5.4, and 18.2 in the reactor feed had no significant alterations in the performance of the upflow anaerobic sludge blanket reactor.

  12. Integrated treatment of municipal sewage sludge by deep dewatering and anaerobic fermentation for biohydrogen production.

    PubMed

    Yu, Li; Yu, Yang; Jiang, Wentian; Wei, Huangzhao; Sun, Chenglin

    2015-02-01

    The increasing sludge generated in wastewater treatment plants poses a threat to the environment. Based on the traditional processes, sludge dewatered by usual methods was further dewatered by hydraulic compression and the filtrate released was treated by anaerobic fermentation. The difficulties in sludge dewatering were associated with the existence of sludge flocs or colloidal materials. A suitable CaO dosage of 125 mg/g dry sludge (DS) could further decrease the moisture content of sludge from 82.4 to 50.9 %. The filtrate from the dewatering procedure was a potential substrate for biohydrogen production. Adding zero-valent iron (ZVI) into the anaerobic system improved the biohydrogen yield by 20 %, and the COD removal rate was lifted by 10 % as well. Meanwhile, the sludge morphology and microbial community were altered. The novel method could greatly reduce the sludge volume and successfully treated filtrate along with the conversion of organics into biohydrogen.

  13. An integrative analysis of treatment, outcomes and prognostic factors for primary spinal anaplastic ependymomas.

    PubMed

    Chen, Peiqin; Sui, Mingxing; Ye, Jingliang; Wan, Zhiping; Chen, Feng; Luo, Chun

    2015-06-01

    The aim of this study was to elucidate the role of treatment modalities in primary spinal anaplastic ependymomas (PSAE) and identify promising prognostic factors. PSAE are rare tumors of the central nervous system with poorly understood clinical characteristics and treatment outcomes. We reviewed the literature in PubMed, Web of Science and Scopus databases to identify patients with PSAE. Multivariate Cox proportional hazards analysis and univariate Kaplan-Meier analysis were performed on the PSAE patients and overall survival (OS) and progression-free survival (PFS) were assessed to evaluate the clinical outcomes. Of the 40 patients with PSAE, the tumors were mostly intramedullary (n=19; 47.5%) and frequently involved the thoracic cord (n=25; 62.5%). Eighteen patients suffered recurrence during the follow-up with a median PFS of 24 months. The 1, 2, and 5year OS rates of the PSAE patients were 91.5%, 82.1%, and 63.1%, respectively. Gross total resection (GTR) was independently associated with prolonged PFS (hazard ratio [HR] 0.11; p=0.004) and OS (HR 0.11; p=0.003) in the multivariate analysis. Adjuvant radiotherapy also conferred improved PFS (HR 0.15; p=0.008) and OS (HR 0.16; p=0.022). Age, sex, tumor location and chemotherapy did not influence the outcomes in this group. The results of our study suggest that GTR and adjuvant radiotherapy are strong prognostic indicators in patients with PSAE and the role of chemotherapy is yet to be defined. PMID:25769252

  14. INtegration of DEPression Treatment into HIV Care in Uganda (INDEPTH-Uganda): study protocol for a randomized controlled trial

    PubMed Central

    2014-01-01

    Background Despite 10 to% of persons living with HIV in sub-Saharan Africa having clinical depression, and the consequences of depression for key public health outcomes (HIV treatment adherence and condom use), depression treatment is rarely integrated into HIV care programs. Task-shifting, protocolized approaches to depression care have been used to overcome severe shortages of mental health specialists in developing countries, but not in sub-Saharan Africa and not with HIV clients. The aims of this trial are to evaluate the implementation outcomes and cost-effectiveness of a task-shifting, protocolized model of antidepressant care for HIV clinics in Uganda. Methods/Design INDEPTH-Uganda is a cluster randomized controlled trial that compares two task-shifting models of depression care - a protocolized model versus a model that relies on the clinical acumen of trained providers to provide depression care in ten public health HIV clinics in Uganda. In addition to data abstracted from routine data collection mechanisms and supervision logs, survey data will be collected from patient and provider longitudinal cohorts; at each site, a random sample of 150 medically stable patients who are depressed according to the PHQ-2 screening will be followed for 12 months, and providers involved in depression care implementation will be followed over 24 months. These data will be used to assess whether the two models differ on implementation outcomes (proportion screened, diagnosed, treated; provider fidelity to model of care), provider adoption of treatment care knowledge and practices, and depression alleviation. A cost-effectiveness analysis will be conducted to compare the relative use of resources by each model. Discussion If effective and resource-efficient, the task-shifting, protocolized model will provide an approach to building the capacity for sustainable integration of depression treatment in HIV care settings across sub-Saharan Africa and improving key public

  15. Integrating Social Determinants of Health With Treatment and Prevention: A New Tool to Assess Local Area Deprivation.

    PubMed

    Maroko, Andrew R; Doan, Thao M; Arno, Peter S; Hubel, Megan; Yi, Shirley; Viola, Deborah

    2016-01-01

    We assessed the appropriate geographic scale to apply an area deprivation index (ADI), which reflects a geographic area's level of socioeconomic deprivation and is associated with health outcomes, to identify and screen patients for social determinants of health. We estimated the relative strength of the association between the ADI at various geographic levels and a range of hospitalization rates by using age-adjusted odds ratios in an 8-county region of New York State. The 10-km local ADI estimates had the strongest associations with all hospitalization rates (higher odds ratios) followed by estimates at 20 km, 30 km, and the regional scale. A locally sensitive ADI is an ideal measure to identify and screen for the health care and social services needs and to advance the integration of social determinants of health with clinical treatment and disease prevention. PMID:27634778

  16. Press fluid pre-treatment optimisation of the integrated generation of solid fuel and biogas from biomass (IFBB) process approach.

    PubMed

    Corton, John; Toop, Trisha; Walker, Jonathan; Donnison, Iain S; Fraser, Mariecia D

    2014-10-01

    The integrated generation of solid fuel and biogas from biomass (IFBB) system is an innovative approach to maximising energy conversion from low input high diversity (LIHD) biomass. In this system water pre-treated and ensiled LIHD biomass is pressed. The press fluid is anaerobically digested to produce methane that is used to power the process. The fibrous fraction is densified and then sold as a combustion fuel. Two process options designed to concentrate the press fluid were assessed to ascertain their influence on productivity in an IFBB like system: sedimentation and the omission of pre-treatment water. By concentrating press fluid and not adding water during processing, energy production from methane was increased by 75% per unit time and solid fuel productivity increased by 80% per unit of fluid produced. The additional energy requirements for pressing more biomass in order to generate equal volumes of feedstock were accounted for in these calculations.

  17. Integrating Social Determinants of Health With Treatment and Prevention: A New Tool to Assess Local Area Deprivation

    PubMed Central

    Doan, Thao M.; Arno, Peter S.; Hubel, Megan; Yi, Shirley; Viola, Deborah

    2016-01-01

    We assessed the appropriate geographic scale to apply an area deprivation index (ADI), which reflects a geographic area’s level of socioeconomic deprivation and is associated with health outcomes, to identify and screen patients for social determinants of health. We estimated the relative strength of the association between the ADI at various geographic levels and a range of hospitalization rates by using age-adjusted odds ratios in an 8-county region of New York State. The 10-km local ADI estimates had the strongest associations with all hospitalization rates (higher odds ratios) followed by estimates at 20 km, 30 km, and the regional scale. A locally sensitive ADI is an ideal measure to identify and screen for the health care and social services needs and to advance the integration of social determinants of health with clinical treatment and disease prevention. PMID:27634778

  18. Integrating the selection of PHA storing biomass and nitrogen removal via nitrite in the main wastewater treatment line.

    PubMed

    Basset, N; Katsou, E; Frison, N; Malamis, S; Dosta, J; Fatone, F

    2016-01-01

    A novel scheme was developed for the treatment of municipal wastewater integrating nitritation/denitritation with the selection of polyhydroxyalkanoates (PHA) storing biomass under an aerobic/anoxic, feast/famine regime. The process took place in a sequencing batch reactor (SBR) and the subsequent PHA accumulation in a batch reactor. The carbon source added during the selection and accumulation steps consisted of fermentation liquid from the organic fraction of municipal solids waste (OFMSW FL) (Period I) and OFMSW and primary sludge fermentation liquid (Period II). Selection of PHA storing biomass was successful and denitritation was driven by internally stored PHA during the famine phase. Under optimum conditions of SBR operation ammonia removal was 93%, reaching a maximum nitrite removal of 98%. The treated effluent met the nitrogen limits, while PHA-storing biomass was successfully selected. The maximum accumulation of PHA was 10.6% (wt.) since the nutrients present in the carbon source promoted bacterial growth. PMID:26587791

  19. Development of Site-Specific Soil Design Basis Earthquake (DBE) Parameters for the Integrated Waste Treatment Unit (IWTU)

    SciTech Connect

    Payne, Suzette

    2008-08-01

    Horizontal and vertical PC 3 (2,500 yr) Soil Design Basis Earthquake (DBE) 5% damped spectra, corresponding time histories, and strain-compatible soil properties were developed for the Integrated Waste Treatment Unit (IWTU). The IWTU is located at the Idaho Nuclear Technology and Engineering Center (INTEC) at the Idaho National Laboratory (INL). Mean and 84th percentile horizontal DBE spectra derived from site-specific site response analyses were evaluated for the IWTU. The horizontal and vertical PC 3 (2,500 yr) Soil DBE 5% damped spectra at the 84th percentile were selected for Soil Structure Interaction (SSI) analyses at IWTU. The site response analyses were performed consistent with applicable Department of Energy (DOE) Standards, recommended guidance of the Nuclear Regulatory Commission (NRC), American Society of Civil Engineers (ASCE) Standards, and recommendations of the Blue Ribbon Panel (BRP) and Defense Nuclear Facilities Safety Board (DNFSB).

  20. Combining urban wastewater treatment with biohydrogen production--an integrated microalgae-based approach.

    PubMed

    Batista, Ana Paula; Ambrosano, Lucas; Graça, Sofia; Sousa, Catarina; Marques, Paula A S S; Ribeiro, Belina; Botrel, Elberis P; Castro Neto, Pedro; Gouveia, Luisa

    2015-05-01

    The aim of the present work was the simultaneous treatment of urban wastewater using microalgae and the energetic valorization of the obtained biomass. Chlorella vulgaris (Cv), Scenedesmus obliquus (Sc) and a naturally occurring algal Consortium C (ConsC) were grown in an urban wastewater. The nutrient removals were quite high and the treated water fits the legislation (PT Dec-Lei 236/98) in what concerns the parameters analysed (N, P, COD). After nutrient depletion the microalgae remained two more weeks in the photobioreactor (PBR) under nutritional stress conditions, to induce sugar accumulation (22-43%). The stressed biomass was converted into biohydrogen (bioH2), a clean energy carrier, through dark fermentation by a strain of the bacteria Enterobacter aerogenes. The fermentation kinetics were monitored and fitted to a modified Gompertz model. The highest bioH2 production yield was obtained for S. obliquus (56.8 mL H2/gVS) which was very similar when using the same algae grown in synthetic media.