Search results for: alkaline treatment

Authors: Mende Mensa Sorato, Majid Davari, Abbas Kebriaeezadeh, Nizal Sarrafzadegan, Tamiru Shibru, Behzad Fatemi

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Markov model, like cardiovascular disease (CVD) policy model based simulation, is being used for evaluating the cost-effectiveness of hypertension treatment. Stroke, angina, myocardial infarction (MI), cardiac arrest, and all-cause mortality were included in this model. Hypertension is a risk factor for a number of vascular and cardiac complications and CVD outcomes. Objective: This systematic review was conducted to evaluate the comprehensiveness of this model across different regions globally. Methods: We searched articles written in the English language from PubMed/Medline, Ovid/Medline, Embase, Scopus, Web of Science, and Google scholar with a systematic search query. Results: Thirteen cohort studies involving a total of 2,165,770 (1,666,554 hypertensive adult population and 499,226 adults with treatment-resistant hypertension) were included in this scoping review. Hypertension is clearly associated with coronary heart disease (CHD) and stroke mortality, unstable angina, stable angina, MI, heart failure (HF), sudden cardiac death, transient ischemic attack, ischemic stroke, subarachnoid hemorrhage, intracranial hemorrhage, peripheral arterial disease (PAD), and abdominal aortic aneurism (AAA). Association between HF and hypertension is variable across regions. Treatment resistant hypertension is associated with a higher relative risk of developing major cardiovascular events and all-cause mortality when compared with non-resistant hypertension. However, it is not included in the previous CVD policy model. Conclusion: The CVD policy model used can be used in most regions for the evaluation of the cost-effectiveness of hypertension treatment. However, hypertension is highly associated with HF in Latin America, the Caribbean, Eastern Europe, and Sub-Saharan Africa. Therefore, it is important to consider HF in the CVD policy model for evaluating the cost-effectiveness of hypertension treatment in these regions. We do not suggest the inclusion of PAD and AAA in the CVD policy model for evaluating the cost-effectiveness of hypertension treatment due to a lack of sufficient evidence. Researchers should consider the effect of treatment-resistant hypertension either by including it in the basic model or during setting the model assumptions.

Keywords: cardiovascular disease policy model, cost-effectiveness analysis, hypertension, systematic review, twelve major cardiovascular events

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Authors: Nawal A. Abu-Shady, Ibrahim M. I. Hamoda, Ahmed R. Z. Baghdadi, Mohammed K. Mohamed

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Background: The aim of this work was to investigate the efficacy of Transcranial Magnetic Therapy (TMT) on balance in hemiparetic stroke patients. It was conducted in outpatient clinic and in BIODEX balance system lab in Faculty of Physical Therapy, Cairo University. Subjects and Methods: Thirty hemiparetic stroke patients from both sexes represent the sample of this study. The patients' ages ranged from 45 to 55 years. They were assigned randomly into two equal groups; the study group (GA) and the control group (GB). control group treated by selected therapeutic physical therapy program. GA treated by the same program of treatment as the GB in addition to TMT. The duration of treatment was six weeks, three times weekly.day after day. The different aspects of dynamic balance (overall stability, anteroposterior stability and mediolateral stability indices) were assessed pre and post treatment objectively by Biodex balance system and clinically by Short Form of Berg Balance Scale (SFBBS) in both groups. Results: Comparison of each variable pre and post treatment in each group revealed a significant improvement in all different parameters in both groups ( p < 0.01), however comparison between post results revealed that the GA showed a high significant improvement higher than the GB in all different variables.

Keywords: stroke, TMT, SFBBS, biodex balance system

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Authors: Mohamad Reza Khodabakhsh

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Drug use and addiction are major biological, psychological, and social problems. In drug abuse treatment, it is important to pay attention to personality problems and coping methods of patients. Today, the third-wave treatments in psychotherapy emphasize people's awareness and acceptance of feelings and emotions, cognitions, and behaviors instead of challenging cognitions. For this reason, this research was conducted with the aim of investigating the effectiveness of group therapy based on acceptance and commitment to self-criticism and coping strategies of people with drug use disorder. This research was a quasi-experimental type of research (pre-test-post-test design with an unequal control group), and the statistical population of this research included all men with drug use disorder in Mashhad, 174 of whom among the 75 people eligible for this research, 30 of them were selected by available sampling method and randomly assigned to two experimental and control groups. In this research, Gilbert's self-criticism scale was used to measure self-criticism, and Andler and Barker's coping strategies questionnaire was used to measure coping strategies. Therapeutic intervention (treatment based on acceptance and commitment) was performed on the experimental group for eight sessions of 90 minutes, and then post-tests were taken from both groups, and multivariate analysis of covariance (MANCOVA) was used to analyze the data. The results showed that treatment based on acceptance and commitment significantly reduced self-criticism and improved coping strategies used by patients with drug use disorder (p>0.01). Therefore, treatment based on acceptance and commitment has been effective in reducing self-criticism and improving the coping strategies of patients with drug use disorder due to teaching clients to accept thoughts and conditions.

Keywords: treatment based on acceptance and commitment, self-criticism, coping strategies, addiction

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Authors: M. A. Hashem, I. Jahan

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The experiment was conducted to find out the effect of different levels of Pomegranate (Punica granatum) extract and synthetic antioxidant BHA (Beta Hydroxyl Anisole) on fresh and preserved beef meatballs in order to make functional food. For this purpose, ground beef samples were divided into five treatment groups. They were treated as control group, 0.1% synthetic antioxidant group, 0.1%, 0.2% and 0.3% pomegranate extract group as T1, T2, T3, T4 and T5 respectively. Proximate analysis, sensory tests (color, flavor, tenderness, juiciness, overall acceptability), cooking loss, pH value, free fatty acids (FFA), thiobarbituric acid values (TBARS), peroxide value (POV) and microbiological examination were determined in order to evaluate the effect of pomegranate extract as natural antioxidant and antimicrobial activities compared to BHA (Beta Hydroxyl Anisole) at first day before freezing and for maintaining meatballs qualities on the shelf life of beef meat balls stored for 60 days under frozen condition. Freezing temperature was -20˚C. Days of intervals of experiment were on 0, 15th, 30th and 60th days. Dry matter content of all the treatment groups differ significantly (p<0.05). On the contrary, DM content increased significantly (p<0.05) with the advancement of different days of intervals. CP content of all the treatments were increased significantly (p<0.05) among the different treatment groups. EE and Ash content were decreased significantly (p<0.05) at different treatment levels. FFA values, TBARS, POV were decreased significantly (p<0.05) at different treatment levels. Color, odor, tenderness, juiciness, overall acceptability decreased significantly (p<0.05) at different days of intervals. Raw PH, cooked pH were increased at different treatment levels significantly (p<0.05). The cooking loss (%) at different treatment levels were differ significantly (p<0.05). TVC (logCFU/g), TCC (logCFU/g) and TYMC (logCFU/g) was decreased significantly (p<0.05) at different treatment levels and at different days of intervals comparison to control. Considering CP, tenderness, juiciness, overall acceptability, cooking loss, FFA, POV, TBARS value and microbial analysis it can be concluded that pomegranate extract at 0.1%, 0.2% and 0.3% can be used instead of synthetic antioxidant BHA in beef meatballs. On the basis of sensory evaluation, nutrient quality, physicochemical properties, biochemical analysis and microbial analysis 0.3% Pomegranate extract can be recommended for formulation of value added beef meatball enriched with natural antioxidant.

Keywords: antioxidant, pomegranate, BHA, value added meat products

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Authors: Jessy Mattar, Mohamad Turk, Maurice Nonus, Nikolai Lebovka, Henri El Zakhem, Eugene Vorobiev

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The effects of electro-stimulation of S. cerevisiae cells in colloidal suspension by Pulsed Electric Fields ‎‎(PEF) with electric field strength E = 20 – 2000 V.cm-1 and effective PEF treatment time tPEF = 10^−5 – 1 s were ‎investigated. The applied experimental procedure includes variations in the preliminary fermentation time and ‎electro-stimulation by PEF-treatment. Plate counting was performed.‎ At relatively high electric fields (E ≥ 1000 V.cm-1) and moderate PEF treatment time (tPEF > 100 µs), the ‎extraction of ionic components from yeast was observed by conductivity measurements, which can be related to ‎electroporation of cell membranes. Cell counting revealed a dependency of the colonies’ size on the time of ‎preliminary fermentation tf and the power consumption W, however no dependencies were noticeable by varying the initial yeast concentration in the treated suspensions.‎

Keywords: intensification, yeast, fermentation, electroporation, biotechnology

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Authors: Pegah Safavi, Mehdi Zehtabian, Mohammad Amin Mosleh-Shirazi

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Cancer is one of the leading causes of death in the world. Radiation therapy is one of the main choices for cancer treatment. Intensity-modulated radiation therapy is a new type of radiation therapy technique available for vital structures such as the parathyroid glands. It is very important to check the accuracy of the delivered IMRT treatment because any mistake may lead to more complications for the patient. This paper describes an experiment to determine the accuracy of a dose measured by EBT3 film. To test this method, the EBT3 film on the head and neck of the Rando phantom was irradiated by an IMRT device and the irradiation was repeated twice. Finally, the dose designed by the irradiation system was compared with the dose measured by the EBT3 film. Using this criterion, the accuracy of the EBT3 film was evaluated. When using this criterion, a 95% agreement was reached between the planned treatment and the measured values.

Keywords: EBT3, phantom, accuracy, cancer, IMRT

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Authors: Tooba Aslam, Efthalia Chatzisymeon

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UV-assisted irradiation technologies are well-established for water and wastewater treatment. UVC treatments are widely used at large-scale, while UVA irradiation has more often been applied in combination with a catalyst (e.g. TiO₂ or FeSO₄) in smaller-scale systems. A technical issue of these systems is the formation of fouling on the quartz sleeves that houses the lamps. This fouling can prevent complete irradiation, therefore reducing the efficiency of the process. This paper investigates the effects of operational parameters, such as the type of wastewater, irradiation source, H₂O₂ addition, and water pH on fouling formation and, ultimately, the treatment of municipal wastewater. Batch experiments have been performed at lab-scale while monitoring water quality parameters including: COD, TS, TSS, TDS, temperature, pH, hardness, alkalinity, turbidity, TOC, UV transmission, UV₂₅₄ absorbance, and metal concentrations. The residence time of the wastewater in the reactor was 5 days in order to observe any fouling formation on the quartz surface. Over this period, it was observed that chemical oxygen demand (COD) decreased by 30% and 59% during photolysis (Ultraviolet A) and photo-catalysis (UVA/Fe/H₂O₂), respectively. Higher fouling formation was observed with iron-rich and phosphorous-rich wastewater. The highest rate of fouling was developed with phosphorous-rich wastewater, followed by the iron-rich wastewater. Photo-catalysis (UVA/Fe/H₂O₂) had better removal efficiency than photolysis (UVA). This was attributed to the Photo-Fenton reaction, which was initiated under these operational conditions. Scanning electron microscope (SEM) measurements of fouling formed on the quartz sleeves showed that particles vary in size, shape, and structure; some have more distinct structures and are generally larger and have less compact structure than the others. Energy-dispersive X-ray spectroscopy (EDX) results showed that the major metals present in the fouling cake were iron, phosphorous, and calcium. In conclusion, iron-rich wastewaters are more suitable for UV-assisted treatment since fouling formation on quartz sleeves can be minimized by the formation of oxidizing agents during treatment, such as hydroxyl radicals.

Keywords: advanced oxidation processes, photo-fenton treatment, photo-catalysis, wastewater treatment

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Authors: Chih-Yi Ho, Tzu-Fang Chang, Chih-Chia Huang, Chia-Yen Lee

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In dental clinics, the dentists use the periapical radiography image to assess the effectiveness of endodontic treatment of teeth with chronic apical periodontitis. Periapical radiography images are taken at different times to assess alveolar bone variation before and after the root canal treatment, and furthermore to judge whether the treatment was successful. Current clinical assessment of apical tissue recovery relies only on dentist personal experience. It is difficult to have the same standard and objective interpretations due to the dentist or radiologist personal background and knowledge. If periapical radiography images at the different time could be registered well, the endodontic treatment could be evaluated. In the image registration area, it is necessary to assign representative control points to the transformation model for good performances of registration results. However, detection of representative control points (feature points) on periapical radiography images is generally very difficult. Regardless of which traditional detection methods are practiced, sufficient feature points may not be detected due to the low-contrast characteristics of the x-ray image. Barnard detector is an algorithm for feature point detection based on grayscale value gradients, which can obtain sufficient feature points in the case of gray-scale contrast is not obvious. However, the Barnard detector would detect too many feature points, and they would be too clustered. This study uses the local extrema of clustering feature points and the suppression radius to overcome the problem, and compared different feature point detection methods. In the preliminary result, the feature points could be detected as representative control points by the proposed method.

Keywords: feature detection, Barnard detector, registration, periapical radiography image, endodontic treatment

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Authors: Suleman Maliha, Suleman Sidra

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Obstructive sleep apnea (OSA) is a sleep disorder that can result in behavioral and psychomotor impairments in children. The classical treatment modalities for OSA have been continuous positive airway pressure and adenotonsillectomy. However, orthodontic intervention through rapid maxillary expansion (RME) has also been commonly used to manage skeletal transverse maxillary discrepancies. Aim and objectives: The aim of this study is to determine the efficacy of rapid maxillary expansion in paediatric patients with obstructive sleep apnea by assessing pre and post-treatment mean apnea-hypopnea index (AHI) and oxygen saturations. Methodology: Literature was identified through a rigorous search of the Embase, Pubmed, and CINAHL databases. Articles published from 2012 onwards were selected. The inclusion criteria consisted of patients aged 18 years and under with no systemic disease, adenotonsillar surgery, or hypertrophy who are undergoing RME with AHI measurements before and after treatment. In total, six suitable papers were identified. Results: Three studies assessed patients pre and post-RME at 12 months. The first study consisted of 15 patients with an average age of 7.5 years. Following treatment, they found that RME resulted in both higher oxygen saturations (+ 5.3%) and improved AHI (- 4.2 events). The second study assessed 11 patients aged 5–8 years and also noted improvements, with mean AHI reduction from 6.1 to 2.4 and oxygen saturations increasing from 93.1% to 96.8%. The third study reviewed 14 patients aged 6–9 years and similarly found an AHI reduction from 5.7 to 4.4 and an oxygen saturation increase from 89.8% to 95.5%. All modifications noted in these studies were statistically significant. A long-term study reviewed 23 patients aged 6–12 years post-RME treatment on an annual basis for 12 years. They found that the mean AHI reduced from 12.2 to 0.4, with improved oxygen saturations from 78.9% to 95.1%. Another study assessed 19 patients aged 9-12 years at two months into RME and four months post-treatment. Improvements were also noted at both stages, with an overall reduction of the mean AHI from 16.3 to 0.8 and an overall increase in oxygen saturations from 77.9% to 95.4%. The final study assessed 26 children aged 7-11 years on completion of individual treatment and found an AHI reduction from 6.9 to 5.3. However, the oxygen saturation remained stagnant at 96.0%, but this was not clinically significant. Conclusion: Overall, the current evidence suggests that RME is a promising treatment option for paediatric patients with OSA. It can provide efficient and conservative treatment; however, early diagnosis is crucial. As there are various factors that could be contributing to OSA, it is important that each case is treated on its individual merits. Going forward, there is a need for more randomized control trials with larger cohorts being studied. Research into the long-term effects of RME and potential relapse amongst cases would also be useful.

Keywords: orthodontics, sleep apnea, maxillary expansion, review

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Authors: Komal Rathore, Aydin Sunol, Gita Iranipour, Luke Mulford

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Advanced wastewater treatment plants have complex biological kinetics, time variant influent flow rates and long processing times. Due to these factors, the modeling and operational control of advanced wastewater treatment plants become complicated. However, development of a robust model for advanced wastewater treatment plants has become necessary in order to increase the efficiency of the plants, reduce energy costs and meet the discharge limits set by the government. A dynamic model was designed using the Envirosim (Canada) platform software called BioWin for several wastewater treatment plants in Hillsborough County, Florida. Proper control strategies for various parameters such as mixed liquor suspended solids, recycle activated sludge and waste activated sludge were developed for models to match the plant performance. The models were tuned using both the influent and effluent data from the plant and their laboratories. The plant SCADA was used to predict the influent wastewater rates and concentration profiles as a function of time. The kinetic parameters were tuned based on sensitivity analysis and trial and error methods. The dynamic models were validated by using experimental data for influent and effluent parameters. The dissolved oxygen measurements were taken to validate the model by coupling them with Computational Fluid Dynamics (CFD) models. The Biowin models were able to exactly mimic the plant performance and predict effluent behavior for extended periods. The models are useful for plant engineers and operators as they can take decisions beforehand by predicting the plant performance with the use of BioWin models. One of the important findings from the model was the effects of recycle and wastage ratios on the mixed liquor suspended solids. The model was also useful in determining the significant kinetic parameters for biological wastewater treatment systems.

Keywords: BioWin, kinetic modeling, flowsheet simulation, dynamic modeling

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Authors: Derwin K. C. Chan, Alfred S. Y. Lee

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The integrated model of self-determination theory and the theory of planned behaviour has been successfully applied to explain individuals’ adherence to health behaviours, including behavioural adherence toward rehabilitation. This study was a randomised controlled trial that examined the effectiveness of an mHealth intervention (i.e., mobile application) developed based on this integrated model in promoting treatment adherence of patients of anterior cruciate ligament rupture during their post-surgery home-based rehabilitation period. Subjects were 67 outpatients (aged between 18 and 60) who undertook anterior cruciate ligament (ACL) reconstruction surgery for less than 2 months for this study. Participants were randomly assigned either into the treatment group (who received the smartphone application; N = 32) and control group (who receive standard treatment only; N = 35), and completed psychological measures relating to the theories (e.g., motivations, social cognitive factors, and behavioural adherence) and clinical outcome measures (e.g., subjective knee function (IKDC), laxity (KT-1000), muscle strength (Biodex)) relating to ACL recovery at baseline, 2-month, and 4-month. Generalise estimating equation showed the interaction between group and time was significant on intention was only significant for intention (Wald x² = 5.23, p = .02), that of perceived behavioural control (Wald x² = 3.19, p = .07), behavioural adherence (Wald x² = 3.08, p = .08, and subjective knee evaluation (Wald x² = 2.97, p = .09) were marginally significant. Post-hoc between-subject analysis showed that control group had significant drop of perceived behavioural control (p < .01), subjective norm (p < .01) and intention (p < .01), behavioural adherence (p < .01) from baseline to 4-month, but such pattern was not observed in the treatment group. The treatment group had a significant decrease of behavioural adherence (p < .05) in the 2-month, but such a decrease was not observed in 4-month (p > .05). Although the subjective knee evaluation in both group significantly improved at 2-month and 4-month from the baseline (p < .05), and the improvements in the control group (mean improvement at 4-month = 40.18) were slightly stronger than the treatment group (mean improvement at 4-month = 34.52). In conclusion, the findings showed that the theory driven mobile application ameliorated the decline of treatment intention of home-based rehabilitation. Patients in the treatment group also reported better muscle strength than control group at 4-month follow-up. Overall, the mobile application has shown promises on tackling the problem of orthopaedics outpatients’ non-adherence to medical treatment.

Keywords: self-determination theory, theory of planned behaviour, mobile health, orthopaedic patients

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Authors: Sandy Van Vuuren, Lerato Kose, Annah Moteetee

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Lesotho, a country surrounded by South Africa has one of the highest rates of sexually transmitted infections (STI’s) in the world. In fact, the country ranks third highest with respect to infections related to the human immunodeficiency virus (HIV). Despite the high prevalence of STI’s, treatment has been a challenge due to limited accessibility to health facilities. An estimated 77% of the population lives in rural areas and more than 60% of the country is mountainous. Therefore, many villages remain accessible only by foot or horse-back. Thus, the Basotho (indigenous people from Lesotho) have a rich cultural heritage of plant use. The aim of this study was to determine what plant species are used for the treatment of STI’s and which of these have in vitro efficacy against pathogens such as Candida albicans, Gardnerella vaginalis, Oligella ureolytica, and Neisseria gonorrhoeae. A total of 34 medicinal plants were reported by traditional practitioners for the treatment of STI’s. Sixty extracts, both aqueous and organic (mixture of methanol and dichloromethane), from 24 of the recorded plant species were assessed for antimicrobial activity using the minimum inhibition concentration (MIC) micro-titre plate dilution assay. Neisseria gonorrhoeae (ATCC 19424) was found to be the most susceptible among the test pathogens, with the majority of the extracts (21) displaying noteworthy activity (MIC values ≤ 1 mg/ml). Helichrysum caespititium was found to be the most antimicrobially active species (MIC value of 0.01 mg/ml). The results of this study support, to some extent, the traditional medicinal uses of the evaluated plants for the treatment of STI’s, particularly infections related to gonorrhoea.

Keywords: Africa, Candida albicans, Gardnerella vaginalis, Neisseria gonorrhoeae, Oligella urealytica

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Authors: Boriana Karamanova, Svetlana Veleva, Luybomir Soserov, Ana Arenillas, Francesco Lufrano, Antonia Stoyanova

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Supercapacitors have received a lot of research attention and are promising energy storage devices due to their high power and long cycle life. In order to developed an advanced device with significant capacity for storing charge and cheap carbon materials, efforts must focus not only on improving synthesis by controlling the morphology and pore size but also on improving electrode-electrolyte compatibility of the resulting systems. The present study examines the relationship between the surface chemistry of two activated carbon xerogels, the electrolyte type, and the electrochemical properties of supercapacitors. Activated carbon xerogels were prepared by varying the initial pH of the resorcinol-formaldehyde aqueous solution. The materials produced are physicochemical characterized by DTA/TGA, porous characterization, and SEM analysis. The carbon xerogel based electrodes were prepared by spreading over glass plate a slurry containing the carbon gel, graphite, and poly vinylidene difluoride (PVDF) binder. The layer formed was dried consecutively at different temperatures and then detached by water. After, the layer was dried again to improve its mechanical stability. The developed electrode materials and the Aquivion® E87-05S membrane (Solvay Specialty Polymers), socked in Na2SO4 as a polymer electrolyte, were used to assembly the solid-state supercapacitor. Symmetric supercapacitor cells composed by same electrodes and 1 M KOH electrolytes are also assembled and tested for comparison. The supercapacitor performances are verified by different electrochemical methods - cyclic voltammetry, galvanostatic charge/discharge measurements, electrochemical impedance spectroscopy, and long-term durability tests in neutral and alkaline electrolytes. Specific capacitances, energy, and power density, energy efficiencies, and durability were compared into studied supercapacitors. Ex-situ physicochemical analyses on the synthesized materials have also been performed, which provide information about chemical and structural changes in the electrode morphology during charge / discharge durability tests. They are discussed on the basis of electrode-electrolyte interaction. The obtained correlations could be of significance in order to design sustainable solid-state supercapacitors with high power and energy density. Acknowledgement: This research is funded by the Ministry of Education and Science of Bulgaria under the National Program "European Scientific Networks" (Agreement D01-286 / 07.10.2020, D01-78/30.03.2021). Authors gratefully acknowledge.

Keywords: carbon xerogel, electrochemical tests, neutral and alkaline electrolytes, supercapacitors

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Authors: Omer Ibrahim Abdallh Omer

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Cancer patients often face complex medication regimens, leading to challenges in treatment adherence and clinical outcomes. Pharmacist-led medication therapy management (MTM) has emerged as a potential solution to optimize medication use and improve patient outcomes in oncology settings. In this prospective intervention study, we aimed to evaluate the impact of pharmacist-led MTM on treatment adherence and clinical outcomes among cancer patients. Participants were randomized to receive either pharmacist-led MTM or standard care, with assessments conducted at baseline and follow-up visits. Pharmacist interventions included medication reconciliation, adherence counseling, and personalized care plans. Our findings reveal that pharmacist-led MTM significantly improved medication adherence rates and clinical outcomes compared to standard care. Patients receiving pharmacist interventions reported higher satisfaction levels and perceived value in pharmacist involvement in their cancer care. These results underscore the critical role of pharmacists in optimizing medication therapy and enhancing patient-centered care in oncology settings. Integration of pharmacist-led MTM into routine cancer care pathways holds promise for improving treatment outcomes and quality of life for cancer patients.

Keywords: cancer, medications adherence, medication therapy management, pharmacist

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Authors: Vilma Sasyte, Vilma Viliene, Asta Raceviciute-Stupeliene, Agila Dauksiene, Romas Gruzauskas, Virginijus Slausgalvis, Jamal Al-Saifi

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The aim of the present study was to investigate the effect of butyrate, acids, medium-chain fatty acids and plant extract mixture on performance, blood and gastrointestinal tract characteristics of laying hens’. For the period of 8 weeks, 24 Hisex Brown laying hens were randomly assigned to 2 dietary treatments: 1) control wheat-corn-soybean meal based diet (Control group), 2) control diet supplemented with the mixture of butyrate, acids, medium chain fatty acids and plant extract (Lumance®) at the level of 1.5 g/kg of feed (Experimental group). Hens were fed with a crumbled diet at 125 g per day. Housing and feeding conditions were the same for all groups and met the requirements of growth for laying hens of Hisex Brown strain. In the blood serum total protein, bilirubin, cholesterol, DTL- and MTL- cholesterol, triglycerides, glucose, GGT, GOT, GPT, alkaline phosphatase, alpha amylase, contents of c-reactive protein, uric acid, and lipase were analyzed. Development of intestines and internal organs (intestinal length, intestinal weight, the weight of glandular and muscular stomach, pancreas, heart, and liver) were determined. The concentration of short chain fatty acids in caecal content was measured using the method of HPLC. The results of the present study showed that 1.5 g/kg supplementation of feed additive affected egg production and feed conversion ratio for the production of 1 kg of egg mass. Dietary supplementation of analyzed additive in the diets increased the concentration of triglycerides, GOT, alkaline phosphatase and decreased uric acid content compared with the control group (P<0.05). No significant difference for others blood indices in comparison to the control was observed. The addition of feed additives in laying hens’ diets increased intestinal weight by 11% and liver weight by 14% compared with the control group (P<0.05). The short chain fatty acids (propionic, acetic and butyric acids) in the caecum of laying hens in experimental groups decreased compared with the control group. The supplementation of the mixture of butyrate, acids, medium-chain fatty acids and plant extract at the level of 1.5 g/kg in the laying hens’ diets had the effect on the performance, some gastrointestinal tract function and blood parameters of laying hens.

Keywords: acids, butyrate, laying hens, MCFA, performance, plant extract, psysiological state

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Authors: Z. Honarvar, M. Farhoodi, M. R. Khani, S. Shojaee-Aliabadi

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Recently, edible films and coating have attracted much attention in food industry due to their environmentally friendly nature and safety in direct contact with food. However edible films have relatively weak mechanical properties and high water vapor permeability. Therefore, the aim of the study was to develop bilayer carboxymethyl cellulose (CMC) coated polypropylene (PP) films to increase mechanical properties and water vapor resistance of each pure CMC or PP films. To modify the surface properties of PE for better attachment of CMC coating layer to PP the atmospheric cold plasma treatment was used. Then the PP surface changes were evaluated by contact angle, AFM, and ATR-FTIR. Furthermore, the physical, mechanical, optical and microstructure characteristics of plasma-treated and untreated films were analyzed. ATR-FTIR results showed that plasma treatment created oxygen-containing groups on PP surface leading to an increase in hydrophilic properties of PP surface. Moreover, a decrease in water contact angle (from 88.92° to 52.15°) and an increase of roughness were observed on PP film surface indicating good adhesion between hydrophilic CMC and hydrophobic PP. Furthermore, plasma pre-treatment improved the tensile strength of CMC coated-PP films from 58.19 to 61.82. Water vapor permeability of plasma treated bilayer film was lower in comparison with untreated film. Therefore, cold plasma treatment has potential to improve attachment of CMC coating to PP layer, leading to enhanced water barrier and mechanical properties of CMC coated polypropylene as food packaging in which also CMC is in contact with food.

Keywords: carboxymethyl cellulose film, cold plasma, Polypropylene, surface properties

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Authors: Ravi Prakash

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The effects of Zr addition on kinetics and hydrogen absorption characteristics of BCC alloy 52Ti-12V-36Cr doped with x wt% of Zr (x = 0, 4, 8 & 12) was investigated. The samples have been characterized by X-ray diffraction, and activation study were made at four different temperatures- 100 oC, 200 oC, 300 oC and 400 oC. First hydrogenation kinetics of alloys were studied at 20 bar of hydrogen pressure and room temperature after giving heat treatment at different temperatures for 6 hours. Among the various Zr doped alloys studied, the composition 52Ti-12V-36Cr + 4wt% Zr shows maximum hydrogen storage capacity of 3.6wt%. Small amount of Zr shows advantageous effects on kinetics of alloy. It was also found out that alloys with the higher Zr concentration can be activated by giving heat treatment at lower temperatures. There is reduction in hydrogen storage capacity with increasing Zr content in the alloy primarily due to increasing abundance of secondary phase as established by X-Ray Diffraction and Scanning Electron Microscope results.

Keywords: hydrogen storage, metal hydrides, bcc alloy, heat treatment

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Authors: Akulov M. A., Zaharov V. O., Jurishhev P. E., Tomskij A. A.

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Introduction: Spasticity is a severe consequence of stroke, leading to profound disability, decreased quality of life and decrease of rehabilitation efficacy [4]. Spasticity is often associated with pain syndrome, arising from joint damage of paretic limbs (postural arthropathy) or painful spasm of paretic limb muscles. It is generally accepted that injection of botulinum toxin into a cramped muscle leads to decrease of muscle tone and improves motion range in paretic limb, which is accompanied by pain alleviation. Study aim: To evaluate the change in pain syndrome intensity after incections of botulinum toxin A (Xeomin) in stroke patients with upper limb spasticity. Patients and methods. 21 patients aged 47-74 years were evaluated. Inclusion criteria were: acute stroke 4-7 months before the inclusion into the study, leading to spasticity of wrist and/or finger flexors, elbow flexor or forearm pronator, associated with severe pain syndrome. Patients received Xeomin as monotherapy 90-300 U, according to spasticity pattern. Efficacy evaluation was performed using Ashworth scale, disability assessment scale (DAS), caregiver burden scale and global treatment benefit assessment on weeks 2, 4, 8 and 12. Efficacy criterion was the decrease of pain syndrome by week 4 on PQLS and VAS. Results: The study revealed a significant improvement of measured indices after 4 weeks of treatment, which persisted until the 12 week of treatment. Xeomin is effective in reducing muscle tone of flexors of wrist, fingers and elbow, forearm pronators. By the 4th week of treatment we observed a significant improvement on DAS (р < 0,05), Ashworth scale (1-2 points) in all patients (р < 0,05), caregiver burden scale (р < 0,05). A significant decrease of pain syndrome by the 4th week of treatment on PQLS (р < 0,05) и VAS (р < 0,05) was observed. No adverse effect were registered. Conclusion: Xeomin is an effective treatment of pain syndrome in postural upper limb spasticity after stroke. Xeomin treatment leads to a significant improvement on PQLS and VAS.

Keywords: botulinum toxin, pain syndrome, spasticity, stroke

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Authors: Mohd Amran, Chan Yi Jing, Chong Chien Hwa

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Production of biogas from POME requires anaerobic digestion (AD), thus, anaerobic digester performance in biogas plants is crucial. As POME from different sources have varying characteristics due to different process flows in mills, there is no ideal treatment parameters for POME. Hence, different treatment plants alter different parameters in anaerobic digestion to achieve desired biogas production levels and to meet POME waste discharge limits. The objective of this study is to evaluate the performance of mesophilic anaerobic digestion in four different biogas plants in Malaysia. Aspects of POME pre-treatment efficiency, analysis of treated POME and AD’s bottom sludge characteristics, including several parameters like chemical oxygen demand (COD), biological oxygen demand (BOD), total solid (TS) removal in the effluent, pH and temperature changes, total biogas produced, the composition of biogas including methane (CH₄), carbon dioxide (CO₂), hydrogen sulfide (H₂S) and oxygen (O₂) were investigated. The effect of organic loading rate (OLR) and hydraulic retention time (HRT) on anaerobic digester performance is also evaluated. In pre-treatment, it is observed that BGP B has the lowest average outlet temperature of 40.41°C. All BGP shows a high-temperature fluctuation (36 to 49 0C) and good pH readings (minimum 6.7), leaving the pre-treatment facility before entering the AD.COD removal of POME is considered good, with an average of 78% and maximum removal of 85%. BGP C has the lowest average COD and TS content in treated POME, 13,313 mg/L, and 12,048 mg/L, respectively. However, it is observed that the treated POME leaving all ADs, still contains high-quality organic substances (COD between 12,000 to 19,000 mg/L) that might be able to digest further to produce more biogas. The biogas produced in all four BGPs varies due to different COD loads. BGP B has the highest amount of biogas produced, 378,874.7 Nm³/month, while BGP D has the lowest biogas production of 272,378.5 Nm³/month. Furthermore, the composition of biogas produced in all plants is well within literature values (CH4 between 55 to 65% and CO₂ between 32 to 36%).

Keywords: palm oil mill effluent, in-ground lagoon anaerobic digester, anaerobic digestion, biogas

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Authors: Dina Magdy Abdo, Ayat N. El-Shazly, E. A. Abdel-Aal

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Forward osmosis (FO) is one of the important processes during the wastewater treatment system for environmental remediation and fresh water regeneration. Both Egypt and China are troubled by over millions of tons of wastewater every year, including domestic and industrial wastewater. However, the traditional FO process in wastewater treatment usually suffers low efficiency and high energy consumption because of the continuously diluted draw solution. An additional concentration process is necessary to keep running of FO separation, causing energy waste. Based on the previous study on photothermal membrane, a sun-driven evaporation process is integrated into the draw solution side of FO system. During the sun-driven evaporation, not only the draw solution can be concentrated to maintain a stable and sustainable FO system, but fresh water can be directly separated for regeneration. Solar energy is the ultimate energy source of everything we have on Earth and is, without any doubt, the most renewable and sustainable energy source available to us. Additionally, the FO membrane process is rationally designed to limit the concentration polarization and fouling. The FO membrane’s structure and surface property will be further optimized by the adjustment of doping ratio of controllable nano-materials, membrane formation conditions, and selection of functional groups. A novel kind of nano-composite functional separation membrane with bi-interception layers and high hydrophilicity will be developed for the application in wastewater treatment. So, herein we aim to design a new wastewater treatment system include forward osmosis with high-efficiency energy recovery via the integration of photothermal membrane.

Keywords: forward osmosis, membrane, solar, water treatement

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Authors: Tatjana Rakcejeva, Jelena Zagorska, Elina Zvezdina

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The aim of the current research was to investigate the gassy ozone effect on quality parameters of flaxes made form whole biologically activated wheat grains. The research was accomplished on in year 2012 harvested wheat grains variety ′Zentos′. Grains were washed, wetted; grain biological activation was performed in the climatic chamber up to 24 hours. After biological activation grains was compressed; than flaxes was dried in convective drier till constant moisture content 9±1%. For grain treatment gassy ozone concentration as 0.0002% and treatment time – 6 min was used. In the processed flaxes the content of A and G tocopherol decrease by 23% and by 9%; content of B2 and B6 vitamins – by 11% and by 10%; elaidic acid – by 46%, oleic acid – by 29%; arginine (by 80%), glutamine (by 74%), asparagine and serine (by 68%), valine (by 62%), cysteine (by 54%) and tyrosine (by 47%).

Keywords: gassy ozone, flaxes, biologically activated grains, quality parameters, treatment

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Authors: Rajiv Ratan Singh, Sachin Kumar Tripathi, Pradeep Kumar Yadav

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The timely evaluation, diagnosis, and treatment of people who have been exposed to toxic chemicals is a crucial component of emergency poison management in the medical field. The various substances that can poison include chemicals, medications, and naturally occurring poisons. The toxicology of the particular drug involved, as well as the symptoms and indicators of poisoning, must be thoroughly understood to handle poisoning emergencies effectively. One of the most important aspects of emergency poison management in medicine is the prompt examination, diagnosis, and treatment of persons who have been exposed to dangerous substances. To properly manage poisoning crises, one must have a good understanding of the toxicology of the particular medication concerned, as well as the signs and indicators of poisoning. Emergency management of poisoning includes not only prompt medical attention but also patient education, follow-up care, and monitoring for any long-term consequences. To achieve the greatest results for patients, the management of poisoning is a complicated and dynamic process that calls for collaboration between medical professionals, first responders, and toxicologists. All poisoned patients who present to the emergency room are assessed and diagnosed based on a collection of symptoms and a biochemical diagnosis, and they are then provided targeted, specialized treatment for the toxin identified. This article focuses on the loxodromic strategy as the primary method of treatment for poisoned patients. The authors of this article conclude that mortality and morbidity can be reduced if patients visit the emergency room promptly and receive targeted treatment.

Keywords: antidotes, blood poisoning, emergency medicine, gastric lavage, medico-legal aspects, patient care

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Authors: Anika Zafiah M. Rus, S. Shafizah

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This study was developed to compare the behavior and the ability of polymer foam composites towards sound absorption test of Shorea leprosula wood (SL) of acid hydrolysis treatment with particle size < 355µm. Three different weight ratio of polyol to wood particle has been selected which are 10wt%, 15wt%, and 20wt%. The acid hydrolysis treatment is to optimize the surface interaction of a wood particle with polymer foam matrix. In addition, the acoustic characteristic of sound absorption coefficient (Į) was determined. Further treatment is to expose the polymer composite in UV irradiation by using UV-Weatherometer. Polymer foam composite of untreated shorea leprosula particle (SL-B) with respective percentage loading shows uniform pore structure as compared with treated wood particle (SL-A). As the filler percentage loading in polymer foam increases, the Į value approaching 1 for both samples. Furthermore, SL-A shows better Į value at 3500-4500 frequency absorption level(Hz), meanwhile Į value for SL-B is maximum at 4000-5000 Hz. The frequencies absorption level for both SL-B and SL-A after UV exposure was increased with the increasing of exposure time from 0-1000 hours. It is, therefore, concluded that the Į for each sound absorbing material, with or without acid hydrolysis treatment of wood particles and it’s percentages loading in polymer matrix effect the sound absorption behavior.

Keywords: polymer foam composite, sound absorption coefficient, UV-irradiation, wood

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Authors: Noshin Mehrabian, Mohammad Reza Abedi, Hassan Ali Zamani

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A highly selective poly(vinyl chloride)-based membrane sensor produced by using 1,2-Diaminopropane-N,N,N',N'-tetraacetic acid (DAPTA) as active material is described. The electrode displays Nernstian behavior over the concentration range 1.0×10⁻⁶ to 1.0×10⁻² M. The detection limit of the electrode is 7.2×10⁻⁷ M. The best performance was obtained with the membrane containing 30% polyvinyl chloride (PVC), 65% nitrobenzene (NB), 2% sodium tetra phenyl borate (Na TPB), 3% DAPTA. The potentiometric response of the proposed electrode is pH independent in the range of 2.5–‎‎9.1. ‎The proposed sensor displays a fast response time 'less than 10s'. The electrode shows a good selectivity for Eu (III) ion with respect to most common cations including alkali, alkaline earth, transition, and heavy metal ions. It was used as an indicator electrode in potentiometric ‎titration of 25 mL of a 1.0×10⁻⁴ M Eu (III) solution with a 1.0×10⁻² M EDTA solution.

Keywords: potentiometry, PVC membrane, sensor, ion-selective electrode

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Authors: Wighens Ngoie Ilunga, Pamela J. Welz, Olewaseun O. Oyekola, Daniel Ikhu-Omoregbe

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Currently, most sludge from the wastewater treatment plants of edible oil factories is disposed to landfills, but landfill sites are finite and potential sources of environmental pollution. Production of biodiesel from wastewater sludge can contribute to energy production and waste minimization. However, conventional biodiesel production is energy and waste intensive. Generally, biodiesel is produced from the transesterification reaction of oils with alcohol (i.e., Methanol, ethanol) in the presence of a catalyst. Homogeneously catalysed transesterification is the conventional approach for large-scale production of biodiesel as reaction times are relatively short. Nevertheless, homogenous catalysis presents several challenges such as high probability of soap. The current study aimed to reuse wastewater sludge from the edible oil industry as a novel feedstock for both monounsaturated fats and bioethanol for the production of biodiesel. Preliminary results have shown that the fatty acid profile of the oilseed wastewater sludge is favourable for biodiesel production with 48% (w/w) monounsaturated fats and that the residue left after the extraction of fats from the sludge contains sufficient fermentable sugars after steam explosion followed by an enzymatic hydrolysis for the successful production of bioethanol [29% (w/w)] using a commercial strain of Saccharomyces cerevisiae. A novel nano-magnetic catalyst was synthesised from mineral processing alkaline tailings, mainly containing dolomite originating from cupriferous ores using a modified sol-gel. The catalyst elemental chemical compositions and structural properties were characterised by X-ray diffraction (XRD), scanning electron microscopy (SEM), Fourier transform infra-red (FTIR) and the BET for the surface area with 14.3 m²/g and 34.1 nm average pore diameter. The mass magnetization of the nano-magnetic catalyst was 170 emu/g. Both the catalytic properties and reusability of the catalyst were investigated. A maximum biodiesel yield of 78% was obtained, which dropped to 52% after the fourth transesterification reaction cycle. The proposed approach has the potential to reduce material costs, energy consumption and water usage associated with conventional biodiesel production technologies. It may also mitigate the impact of conventional biodiesel production on food and land security, while simultaneously reducing waste.

Keywords: biodiesel, bioethanol, edible oil wastewater sludge, nano-magnetism

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Authors: Onyekachi Ogbonnaya Iroanya, Taiye Abdullahi Gegele, Frank Tochukwu Egwuatu

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Introduction: Forensic taphonomy is a multifaceted area that incorporates decomposition, chemical and biological cadaver exposure in post-mortem event chronology and reconstruction to predict the Post Mortem Interval (PMI). The aim of this study was to evaluate the integrity of DNA extracted from the remains of embalmed decomposed Sus domesticus tissues buried in different soil types. Method: A total of 12 limbs of Sus domesticus weighing between 0.7-1.4 kg were used. Each of the samples across the groups was treated with 10% formaldehyde, absolute methanol and 50% Pine oil for 24 hours before burial except the control samples, which were buried immediately. All samples were buried in shallow simulated Clay, Sandy and Loamy soil graves for 12 months. The DNA for each sample was extracted and quantified with Nanodrop Spectrophotometer (6305 JENWAY spectrometers). The rate of decomposition was examined through the modified qualitative decomposition analysis. Extracted DNA was amplified through PCR and bands visualized via gel electrophoresis. A biochemical enzyme assay was done for each burial grave soil. Result: The limbs in all burial groups had lost weight over the burial period. There was a significant increase in the soil urease level in the samples preserved in formaldehyde across the 3 soil type groups (p≤0.01). Also, the control grave soils recorded significantly higher alkaline phosphatase, dehydrogenase and calcium carbonate values compared to experimental grave soils (p≤0.01). The experimental samples showed a significant decrease in DNA concentration and purity when compared to the control groups (p≤0.01). Obtained findings of the soil biochemical analysis showed the embalming treatment altered the relationship between organic matter decomposition and soil biochemical properties as observed in the fluctuations that were recorded in the soil biochemical parameters. The PCR amplified DNA showed no bands on the gel electrophoresis plates. Conclusion: In criminal investigations, factors such as burial grave soil, grave soil biochemical properties, antemortem exposure to embalming chemicals should be considered in post-mortem interval (PMI) determination.

Keywords: forensic taphonomy, post-mortem interval (PMI), embalmment, decomposition, grave soil

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Authors: Vinu Viswanath, Lawrence Dsouza, Ugo Ravon

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Syngas typically and intermediary gas product has a wide range of application of producing various chemical products, such as mixed alcohols, hydrogen, ammonia, Fischer-Tropsch products methanol, ethanol, aldehydes, alcohols, etc. There are several technologies available for the syngas production. An alternative to the conventional processes an attractive route of utilizing carbon dioxide and methane in equimolar ratio to generate syngas of ratio close to one has been developed which is also termed as Dry Reforming of Methane technology. It also gives the privilege to utilize the greenhouse gases like CO2 and CH4. The dry reforming process is highly endothermic, and indeed, ΔG becomes negative if the temperature is higher than 900K and practically, the reaction occurs at 1000-1100K. At this temperature, the sintering of the metal particle is happening that deactivate the catalyst. However, by using this strategy, the methane is just partially oxidized, and some cokes deposition occurs that causing the catalyst deactivation. The current research work was focused to mitigate the main challenges of dry reforming process such coke deposition, and metal sintering at high temperature.To achieve these objectives, we employed three different strategies of catalyst development. 1) Use of bulk catalysts such as olivine and pyrochlore type materials. 2) Use of metal doped support materials, like spinel and clay type material. 3) Use of core-shell model catalyst. In this approach, a thin layer (shell) of redox metal oxide is deposited over the MgAl2O4 /Al2O3 based support material (core). For the core-shell approach, an active metal is been deposited on the surface of the shell. The shell structure formed is a doped metal oxide that can undergo reduction and oxidation reactions (redox), and the core is an alkaline earth aluminate having a high affinity towards carbon dioxide. In the case of metal-doped support catalyst, the enhanced redox properties of doped CeO2 oxide and CO2 affinity property of alkaline earth aluminates collectively helps to overcome coke formation. For all of the mentioned three strategies, a systematic screening of the metals is carried out to optimize the efficiency of the catalyst. To evaluate the performance of them, the activity and stability test were carried out under reaction conditions of temperature ranging from 650 to 850 ̊C and an operating pressure ranging from 1 to 20 bar. The result generated infers that the core-shell model catalyst showed high activity and better stable DR catalysts under atmospheric as well as high-pressure conditions. In this presentation, we will show the results related to the strategy.

Keywords: carbon dioxide, dry reforming, supports, core shell catalyst

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Authors: Teresa Sarmento de Beires, Sofia Padilha, Pedro Arantes, Joana Ribeiro, Andreia Eiras

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Background: Trichotillomania is a psychiatric condition that is very challenging to treat, with no first-line medications approved by any medical agency. It is defined as a recurrent compulsive habit of pulling out one's own hair, usually from the scalp and eyebrows area, but it can also affect eyelashes or any other hair-bearing area. N-acetylcysteine, a glutamate modulator, has been studied as a possible treatment for several psychiatric and neurological disorders, considering its role in attenuating pathophysiological processes responsible for compulsive behaviors and, therefore, trichotillomania. Objective: This study aims to determine the efficacy of N-acetylcysteine in the treatment of adults with trichotillomania. Methodology: The authors researched guidelines, standards of clinical guidance, systematic reviews, meta-analyses, and randomized clinical trials, published in the last 20 years using the MeSH terms: "Trichotillomania” and “N-acetylcysteine” in the following databases: PubMed, Cochrane library, National Guideline Clearing House, National Institute of Health and Care Excellence (NICE), Canadian Medical Association Practice Guidelines and Database of Abstracts of Reviews of Effectiveness (DARE). The Strength of Recommendation Taxonomy (SORT) Scale, from the American Family Physician, was used to evaluate the level of evidence and assign the strength of recommendation. Results: The research found fifteen articles, among which only three were eligible according to the inclusion criteria: 1. systematic review and 2. meta-analyses. There was evidence of a probable beneficial effect of N-acetylcysteine on treatment response and reduction of trichotillomania symptom severity in adults, with moderate certainty in the effect estimate. There was no evidence of effectiveness with the use of inositol, antioxidants, naltrexone, or selective serotonin reuptake inhibitors (SSRIs) in the treatment of adults with trichotillomania. Clomipramine and Olanzapine showed potential treatment benefits, with low certainty. N-acetylcysteine had the least severe side effect profile in adults compared with the other potentially beneficial pharmacological treatments. Conclusion: Evidence points towards the effectiveness of N-acetylcysteine in the treatment of adults with trichotillomania, which exhibits a good tolerability profile with minimal adverse effects. Therefore, the authors attribute a level of evidence 2, the strength of recommendation B, to the prescription of N-acetylcysteine in the treatment of adults suffering from trichotillomania (SORT analysis). Further investigation is needed in order to extract high-quality conclusions from the meta-analysis.

Keywords: trichotillomania, hair pulling, treatment, n-acetylcysteine

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Authors: Tony Ngoy Mbodi, Christophe Muanda

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Textile industry is considered as one of the most polluting sectors in terms of effluent volume of discharge and wastewater composition, such as dye, which represents an environmental hazard when discharged without any proper treatment. A study was conducted to investigate the capability of the use of recycled alum sludge (RAS) as an alternative treatment for the reduction of colour, chemical oxygen demand (COD), total dissolved solids (TDS) and pH adjustment from dye based synthetic textile industry wastewater. The coagulation/flocculation process was studied for coagulants of Alum:RAS ratio of, 1:1, 2:1, 1:2 and 0:1. Experiments on treating the synthetic wastewater using membrane filtration and adsorption with corn cobs were also conducted. Results from the coagulation experiment were compared to those from adsorption with corn cobs and membrane filtration experiments conducted on the same synthetic wastewater. The results of the RAS experiments were also evaluated against standard guidelines for industrial effluents treated for discharge purposes in order to establish its level of compliance. Based on current results, it can be concluded that reusing the alum sludge as a low-cost material pretreatment method into the coagulation/flocculation process can offer some advantages such as high removal efficiency for disperse dye and economic savings on overall treatment of the industry wastewater.

Keywords: alum, coagulation/flocculation, dye, recycled alum sludge, textile wastewater

Procedia PDF Downloads 343

Authors: Melissa K. Hord, Stephen P. Whiteside

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With lifetime prevalence rates ranging from 6% to 15%, anxiety disorders are among the most common childhood mental health diagnoses. Anxiety disorders diagnosed in childhood generally show an unremitting course, lead to additional psychopathology and interfere with social, emotional, and academic development. Effective evidence-based treatments include cognitive-behavioral therapy (CBT) and selective serotonin reuptake inhibitors (SSRI’s). However, if anxious children receive any treatment, it is usually through primary care, typically consists of medication, and very rarely includes evidence-based psychotherapy. Despite the high prevalence of anxiety disorders, there have only been two independent research labs that have investigated long-term results for CBT treatment for all childhood anxiety disorders and two for specific anxiety disorders. Generally, the studies indicate that the majority of youth maintain gains up to 7.4 years after treatment. These studies have not been replicated. In addition, little is known about the additional mental health care received by these patients in the intervening years after anxiety treatment, which seems likely to influence maintenance of gains for anxiety symptoms as well as the development of additional psychopathology during the subsequent years. The original sample consisted of 335 children ages 7 to 17 years (mean 13.09, 53% female) diagnosed with an anxiety disorder in 2010. Medical record review included provider billing records for mental health appointments during the five years after anxiety treatment. The subsample for this study was classified into three groups: 64 children who received CBT in an anxiety disorders clinic, 56 who received treatment from a psychiatrist, and 10 who were seen in a primary care setting. Chi-square analyses resulted in significant differences in mental health care utilization across the five years after treatment. Youth receiving treatment in primary care averaged less than one appointment each year and the appointments continued at the same rate across time. Children treated by a psychiatrist averaged approximately 3 appointments in the first two years and 2 in the subsequent three years. Importantly, youth treated in the anxiety clinic demonstrated a gradual decrease in mental health appointments across time. The nuanced differences will be presented in greater detail. The results of the current study have important implications for developing dissemination materials to help guide parents when they are selecting treatment for their children. By including all mental health appointments, this study recognizes that anxiety is often comorbid with additional diagnoses and that receiving evidence-based treatment may have long-term benefits that are associated with improvements in broader mental health. One important caveat might be that the acuity of mental health influenced the level of care sought by patients included in this study; however, taking this possibility into account, it seems those seeking care in a primary care setting continued to require similar care at the end of the study, indicating little improvement in symptoms was experienced.

Keywords: anxiety, children, mental health, outcomes

Procedia PDF Downloads 263