Treatment Practices Research Articles

Safe water treatment practices: A qualitative study on point-of-use chlorination in Nigeria

Safe water treatment practices: A qualitative study on point-of-use chlorination in Nigeria

A quantitative survey of correctional mental health professionals on current healthcare and treatment practices for transgender incarcerated persons.

There is a need for updated survey literature collected from correctional mental health professionals working within prison settings. Up to date research can add to the literature addressing the best practices for mental health treatment of the transgender incarcerated population in order to provide health care professionals and correctional staff with more effective, efficient, and widely understood intervention practices to facilitate the well-being and safety of this population. Guided by three research aims, 50 mental health professionals from 21 states throughout the United States were surveyed in this quantitative survey regarding their work with the transgender incarcerated population. Results are discussed in terms of implications for the type of care and coordination of care provided by correctional mental health professionals.

Best practices for treatment of adolescent SUDs

Best practices for treatment of adolescent SUDs

Advancements in Biopolymer‐Derived Graft Copolymers: A Comprehensive Review on Their Application in Sustainable Wastewater Treatment

ABSTRACTRising concerns over water pollution and the depletion of non‐renewable resources have propelled the exploration of eco‐friendly and sustainable wastewater treatment alternatives. Biopolymer‐derived graft copolymers emerge as a promising solution, offering biodegradability, cost‐effectiveness, versatility, and enhanced functionality. This review provides a comprehensive overview of the latest developments in utilizing these copolymers as eco‐friendly flocculants for wastewater treatment. It covers synthesis methods for functionalized biopolymer‐based flocculants, diverse flocculation mechanisms, and their efficacy in solid–liquid separation. The article explores applications for removing pollutants, emphasizing biodegradability, cost‐effectiveness, and versatility. Special attention is given to the environmental impact, critically analyzing how these copolymers contribute to sustainable water treatment practices. The review also discusses potential future prospects and advancements in addressing global water pollution challenges using biopolymer‐derived graft copolymers.

SATURN: assessing the feasibility of utilising existing registries for real-world evidence data collection to meet patients, regulatory, health technology assessment and payer requirements

BackgroundSATURN (Systematic Accumulation of Treatment practices and Utilisation, Real world evidence, and Natural history data) for the rare condition osteogenesis imperfecta (OI) has the objective to create a common core dataset by utilising existing, well-established data sources to meet the needs of the various stakeholders (physicians, registry/dataset owners, patients and patient associations, OI community leaders, European [EU] policymakers, regulators, health technology assessments [HTA]s, and healthcare systems including payers). This paper describes the steps taken to assess the feasibility of one existing OI registry (i.e., the Registry of OI [ROI]) as a candidate for SATURN. The same methodology will be applied to other existing OI registries in the future and this same concept could be utilised for other rare disease registries.MethodsThe approach to assessing the feasibility of the ROI registry consisted of three steps: (1) an assessment of the registry characteristics using the Registry Evaluation and Quality Standards Tool (REQueST); (2) a gap analysis comparing SATURN required Core Variables to those being captured in the registry’s Case Report Form (CRF); and (3) a compliance check on the data exchange process following the Title 21 of Code of Federal Regulations (CFR) Part 11/EudraLex Annex 11 Compliance Checklist. The first registry that SATURN has assessed is the ROI database at the Istituto Ortopedico Rizzoli (IOR) in Italy.ResultsThe results from the ROI REQueST have demonstrated satisfactory complete responses in terms of methodology, essential standards, interpretability, and interoperability—readiness for data linkage, data sources, and ethics to meet the needs of data customers. However, the ROI data is from a tertiary referral centre which may limit the ability to understand the full patient journey. The gap analysis has revealed that an exact or logical match between SATURN requested variables and the ROI current variables exists for the following items: patient characteristics, treatment of OI (medical and surgical) and treatment of pain (with the exception of frequency of treatment and reasons for discontinuation), fracture history and bone density. However, data on safety was missing. The compliance check has implied that the ROI implemented appropriate controls for the web-based platform (i.e., Genotype–phenotype Data Integration Platform [GeDI]) that is involved in processing the electronic patient data, and GeDI is a validated/compliant application that follows relevant 21 CFR Part 11/EudraLex Annex 11 regulations.ConclusionsThis robust feasibility process highlights potential limitations and opportunities to develop and to refine the collaboration with the ROI as the SATURN programme moves forward. It also ensures that the existing datasets in the rare condition OI are being maximised to respond to the needs of patients, data customers and decision-makers. This feasibility process has allowed SATURN to build a compliant methodology that aligns with the requirements from the European Medicines Agency (EMA) and HTAs. More data variables will continue to be developed and refined along the way with more registries participating in SATURN. As a result, SATURN will become a meaningful and truly collaborative core dataset, which will also contribute to advancing understanding of OI diagnosis, treatment, and care.

Effectiveness of remotely delivered speech therapy in persons with Parkinson's disease – a randomised controlled trial

Increasing evidence supports the merits of speech therapy in Parkinson's disease, but the current practice of multiple in-house treatments is demanding for patients. We therefore assessed the effectiveness of remotely delivered and personalised speech therapy on improving quality of life and speech quality in persons with Parkinson's disease. We performed a single blinded randomised controlled trial (the PERSPECTIVE study), comparing 8 weeks of personalised remote speech therapy to no intervention (waiting list design). Patients with reduced speech intelligibility were included, regardless of disease stage or dysarthria severity. Patients were assigned randomly (1:1) to the intervention or control group. Measurements took place at baseline and after 8 weeks (both groups), and after 32 weeks (intervention group only). Patients were treated remotely by 20 experienced speech therapists. The primary outcome was disease-related quality of life at 8 weeks, assessed with the Parkinson's Disease Questionnaire 39 (PDQ-39). Data were analysed using analysis of covariance based on the intention-to-treat principle. This trial is registered in ClinicalTrials.gov, NCT03963388. Between March 1, 2019, and March 27, 2021, 214 patients were enrolled in the intervention group (n=109) or control group (n=105). At the primary timepoint, the adjusted mean difference in PDQ-39 was-2.0 in favour of the intervention group (95% CI-4.0 to 0.1); p=0.056). The intervention group scored better on the communication index score of the PDQ-39 (post hoc analysis), with an adjusted mean difference of-5.3 (95% CI-9.4 to-1.2; p=0.011). We found no between-group differences on any other PDQ-39 domain. Follow-up measurements showed a significant reduction of the PDQ-39 compared to the primary timepoint with a difference of 2.40 (95%CI 0.77-4.02; p=0.004). Personalised remote speech therapy improved communication-related quality of life, but not overall quality of life. Michael J. Fox Foundation, Gatsby Foundation, and Health∼Holland.

Notalgia Paresthetica Dermatologist Report of Symptom Burden and Treatment: Results from a Physician Survey.

Notalgia paresthetica (NP) is a sensory neuropathy characterized by chronic pruritus, skin pain, and other pathologic sensations affecting the mid-to-upper back. NP may be under-recognized and under-diagnosed, with limited data available on its symptom presentation and treatment patterns. NP-DERM was an internet-based survey of dermatologists (n = 650) from 8 different countries on their perspectives on NP symptoms and current treatment practices. Dermatologists typically treated a median of 12 patients with NP per month. Dermatologists reported that itch (pruritus) was the most common symptom for their patients with NP, followed by hyperpigmentation and sensitive skin. The most burdensome NP symptom was pruritus, followed by burning or hot sensation, and painful or raw skin. The most prescribed treatments included non-medicated skin care, topical corticosteroids, oral antihistamines, medicated topicals, and gabapentin or pregabalin. Physicians reported low satisfaction with available treatments. The most common reason for physicians to discontinue patients' therapy was lack of response.

Survey of international pediatric nutritional supportive care practices: a report from the Pediatric Study Group of the Multinational Association of Supportive Care in Cancer (MASCC)

PurposeMalnutrition is common in children with cancer. While multiple validated malnutrition screens exist, there is no universal, standardized approach to screen or diagnose malnutrition. The Multinational Association of Supportive Care in Cancer (MASCC) Pediatric Study Group is focused on oncologic supportive care for children and young adults. This subgroup designed and administered a pilot study to characterize global malnutrition screening, diagnosis, and treatment practices for pediatric patients with cancer after identifying variations in malnutrition practice patterns within its members.MethodsA novel, exploratory survey was iteratively developed and distributed in early 2020 to 45 MASCC Pediatric Study Group members. The survey included multiple questions with standard patient presentations and nutritional scenarios, and the respondents selected the answer that best reflected the care patients would receive at their institution.ResultsA validated screening tool to assess for malnutrition was routinely used by 15 of 26 respondents (58%). No single validated screen was used by more than 24% of responders, and 11 of 26 (42%) reported not having a standard malnutrition treatment screen. When the same patient was presented with the survey using different malnutrition indicators, patient care plans varied greatly. This was particularly true for z-scores compared to weight percentiles.ConclusionsDevelopment of consensus recommendations for screening practices, preferred malnutrition indicators, and treatment guidelines could help reduce the underdiagnosis of malnutrition and subsequent variation in its management and ought to be a focus of the global pediatric cancer supportive care community.

Adjunctive use of mindfulness-based mobile application in depression: randomized controlled study.

Mindfulness-based interventions (MBI) are effective in relapse prevention in Major Depressive Disorder (MDD). Internet-based interventions have been demonstrated to be effective in the treatment of MDD. Consequently, the integration of MBI through mobile applications emerges as a promising supplementary intervention for MDD, contributing to the augmentation of mental health services, particularly within ambulatory care contexts. The current randomized controlled study is designed to evaluate the efficacy of adjunctive MBI delivered via a mobile app in mitigating symptom severity and stress levels. This assessment involves a comparison with standard treatment practices in an ambulatory setting among individuals diagnosed with MDD. A total of 83 patients diagnosed with MDD (depressive episode, recurrent depression or depressive phase of bipolar disorder) were randomly allocated to the intervention (41 patients) or control condition (42 patients). The intervention consisted of the daily use of the mindfulness mobile application "Headspace" for thirty days. The control condition was treatment as usual (TAU) only. The symptom severity has been assessed by the Beck Depression Inventory (BDI-II) as well as the Hamilton Depression Rating Scale (HDRS-17). Blood pressure and resting heart rate have been assessed as secondary outcome. Upon hospital discharge, the mean scores on the Beck Depression Inventory (BDI) and Hamilton Depression Rating Scale (HDRS) signaled partial remission of MDD in both treatment arms. In both groups, a subsequent decrease in both self-reported and expert-rated scores was evident after a 30-day period. However, the decrease in depression severity as measured by HDRS was significantly higher in the MBI group compared to the control group after 30days. For secondary outcomes, systolic blood pressure was lower in the intervention group compared to control group. The total drop-out rate was 29%. Short term mindfulness intervention via mobile application (30days) can be beneficial as adjunctive therapy to treatment as usual in patients with MDD.

Water Treatment Practices and Misperceived Social Norms among Women Living with Young Children in Rural Uganda.

Access to water safe for consumption is critical for health and well-being, yet substantial structural barriers often necessitate household action to make water safer. Social norms about water treatment practices are understudied as a driver of personal water treatment practice. This study assesses reported and perceived water treatment practices among women in a rural, water insecure setting. We used cross-sectional data from a population-based study of women living with children under 5 years old across eight villages in southwest Uganda. Participants reported their typical household water treatment practices and what they perceived to be the common practices among most other women with young children in their own village. Modified multivariable Poisson regression models estimated the association between individual behavior and perceptions. Of 274 participants (78% response rate), 221 (81%) reported boiling water and 228 (83%) reported taking at least one action to make water safer. However, 135 (49%) misperceived most women with young children in their village not to boil their water, and 119 (43%) misperceived most to take no action. Participants who misperceived these norms were less likely to practice safe water treatment (e.g., for boiling water, adjusted relative risk = 0.80; 95% CI 0.69-0.92, P = 0.002), adjusting for other factors. Future research should assess whether making actual descriptive norms about local water treatment practices visible and salient (e.g., with messages such as "most women in this village boil their drinking water") corrects misperceived norms and increases safe water treatment practices by some and supports consistent safe practices by others.

Iatrogenic pediatric unilateral vocal cord paralysis after cardiac surgery: a review.

Unilateral vocal cord paralysis (UVCP) is a growing area of research in pediatrics as it spans across many specialties including otolaryngology, cardiology, general surgery, respirology, and speech language pathology. Iatrogenic injury is the most common cause of UVCP, however there is a wide range of data reporting the prevalence, symptom burden, and best treatment practice for this condition. The literature included systematic reviews and meta-analyses, retrospective studies and limited prospective studies. Overall, the literature lacked consistency in the diagnosis, treatment, and long-term outcomes of patients with UVCP. Many articles conflated bilateral vocal cord paralysis (BVCP) with UVCP and had limited data on the natural history of the condition. There was no consensus on objective and subjective measurements to evaluate the condition or best indications for requiring surgical intervention. Thyroplasty, injection medialization (IM) and recurrent laryngeal nerve reinnervation (RLNR) were the reported surgical interventions used to treat UVCP, however there was limited data on short and long-term surgical outcomes in children. More research is needed to determine the true prevalence, natural history, indications for surgical intervention and long-term outcomes for pediatric patients with this condition.

Utilization of Traditional Healing Practices for Cancer Treatment: Benefits, Risks, and Integration with Modern Medicine

Traditional healing practices in Africa, characterized by the use of locally available plants, minerals, and spiritual rituals, have historically played a significant role in managing diseases, including cancer. Despite the overshadowing effect of Western medicine during the colonial period, traditional practices continue to be integral to many communities, providing culturally relevant and accessible treatments. This review explores the utilization of traditional healing practices in cancer treatment, focusing on the benefits, risks, and integration with modern medicine. Traditional cancer treatments, including herbal remedies, spiritual interventions, and physical therapies, offer potential benefits like improved symptom management and emotional support. However, challenges like lack of standardization, scientific validation, and potential interactions with conventional treatments pose significant risks. The integration of traditional and modern medical approaches is emerging as a trend, aiming to improve treatment outcomes and patient quality of life. This requires careful consideration of safety, efficacy, and standardization. Effective integration involves developing collaborative care models, regulatory frameworks, and interdisciplinary partnerships. Future directions include advancing research to understand traditional remedies’ mechanisms, improving quality control, and exploring hybrid therapies. By fostering collaboration between traditional healers, researchers, and modern healthcare professionals, and addressing ethical and safety concerns, traditional practices can be harnessed while enhancing overall cancer care. Keywords: Traditional Healing, Cancer Treatment, Benefits, Risks, Modern Medicine

Building Clinical Care Capacity for Patients With Special Pathogens in Advance of the Next Outbreak.

In response to the growing number of outbreaks of emerging infectious diseases, the US Administration for Strategic Preparedness and Response (ASPR) has embarked on a plan to improve and expand special pathogen patient care capabilities. To achieve this, ASPR is developing a coordinated network of Regional Emerging Special Pathogen Treatment Centers (RESPTCs) to serve as state-of-the-art facilities staffed by a highly trained workforce to care for and manage special pathogen patients across the lifespan. The RESPTC network represents the operational arm of a broader US National Special Pathogen System of care to prevent and prepare for the next infectious disease outbreak. RESPTCs are strategically located in every region across the country and form a network linking local and regional healthcare partners to enhance national preparedness through training in best practices for detection, isolation, and treatment of individuals suspected of or known to be infected with a special pathogen. This local, regional, and national network is also designed to lead a coordinated response that includes the dissemination of accurate and trustworthy information to responders and the public. The overarching goal of the RESPTCs is to serve as a valuable resource for clinical care, training, and material support to meet current and future major infectious diseases challenges. In this case study, 2 new RESPTCs, MedStar Washington Hospital Center and the University of North Carolina, describe their experiences related to designing a biocontainment unit, creating clinical teams, building staff resiliency, receiving mentoring from regional RESPTC partners, and developing opportunities for innovation.

Research progress on the timing and implementation of early rehabilitation for critically ill patient

Critical care rehabilitation is an essential component of treating critically ill patients. Implementing early rehabilitation is safe and feasible, with benefits and early rehabilitation is both safe and feasible, with benefits far outweighing potential risks. An individualized rehabilitation plan is necessary for initiating early rehabilitation treatment. This includes identifying the rehabilitation needs of critically ill patients, timely seizing opportunities for rehabilitation intervention, and implementing safe rehabilitation measures through position training, exercise training, respiratory training, and monitoring the rehabilitation process. There remains considerable heterogeneity in the clinical practice of early rehabilitation treatment for critically ill patients. This article provides an updated overview of evidence-based medicine for early rehabilitation treatment of critically ill patients, aiming to offer a reference for clinical medical staff in formulating critical care rehabilitation treatment strategies for these patients.

Technology-driven carbon-neutral pathway analysis for Urban Wastewater Treatment Plants

Carbon-neutral pathways for China's wastewater sector is of great significance, but technical carbon reduction pathways for single wastewater treatment plant (WWTP) are not yet clear. This study develops a framework to design technology-driven carbon-neutral pathways at plant-level up to 2050 through four steps. Results shows that the average greenhouse gas (GHG) intensity was assessed at about 0.29 kgCO2eq/m3 from 2011 to 2021. Techno-economic analyses of various low-carbon technologies reveal Sharon-anammox as an effective option for carbon reduction. Additionally, the sensitivity of GHG reduction potential to changes in electricity emission factors highlights the importance of the power sector's clean energy transition. Scenario simulations suggest that approximately 39% of the carbon-neutral target by 2050 will require technological advancements, achievable with a 0.37 $/kgCO2eq investment. This study presents an analysis of the carbon-neutral pathways for a single WWTP system, providing insights into sustainable wastewater treatment practices.

Physiotherapists' attitudes and beliefs in the management of low back pain: Protocol for a systematic review.

Low back pain (LBP) poses a significant global health burden where a biopsychosocial model of care has been recommended. Physiotherapists (PTs) play a crucial role in LBP management; however, their attitudes and beliefs towards LBP were not reviewed in detail. This systematic review aims to summarise the attitudes and beliefs of PTs towards LBP and the factors influencing them. The review protocol and methods adhere to the PRISMA-P and Meta Analyses and Systematic Reviews for Observational Studies in Epidemiology (MOOSE) guidelines. A comprehensive search of PubMed, Scopus, CINAHL, Web of Science, PEDro and Ovid databases will be conducted to search for cross-sectional studies evaluating PTs' attitudes and beliefs towards LBP. Two reviewers will independently screen the articles, conduct data extraction and assess methodological quality using the Joanna Briggs Institute's critical appraisal tool for prevalence studies. Data synthesis will involve a narrative synthesis of study characteristics, attitudes, beliefs, and methodological quality. If feasible, a meta-analysis will be performed to quantify the pooled effects. Despite the emphasis on biopsychosocial approaches for managing LBP, the adoption of such approaches in physiotherapy practice is still suboptimal, with attitudes and beliefs of PTs being considered an important factor influencing treatment practices. Our review will summarise the literature on attitudes and beliefs of PTs towards LBP. Such knowledge would inform the need for development of additional interventions addressing the attitudes and beliefs that would eventually enhance the update of the biopsychosocial model of care in physiotherapy management of LBP.

A Comparison of Treatment Practices for Newborn Seizure Management Across Level II and III Neonatal Intensive Care Units in the United States

BackgroundNeonatal seizures (NS) represent an important clinical manifestation among critically ill infants and are often the first sign of underlying brain injury. Early recognition and treatment are essential to reduce morbidity and mortality. The present study investigated the NS management and treatment approaches employed by level II/III neonatal intensive care units (NICUs) across the United States to identify areas of consensus and variability. MethodsPersonnel associated with level II/III NICUs were directly surveyed with an electronic questionnaire. Access to neurology specialists, on-site electroencephalography (EEG) monitoring, and use of antiseizure medications was directly queried. A total of 51 NICUs participated in this survey. ResultsTwenty-five percent of the surveyed NICUs reported having an established clinical practice pathway available for treating NS. Twenty-four percent endorsed having written guidelines that provided a formal definition for the concept of “neonatal seizures.” Although the majority of NICUs reported having phenobarbital available for rapid seizure management, most NICUs lacked access to additional antiseizure medications for treatment escalation. Twenty-four percent of the surveyed NICUs had no access to EEG monitoring available to them on-site. Daytime and overnight access to neurology consultants was limited and variable. ConclusionsFindings were consistent with a lack of equitable access for NS treatment. Areas of potential improvement include development and implementation of a protocol for rapidly treating NS that emphasizes enhanced access to EEG and rapid neurology consultation, acknowledging and improving upon resource limitations. These developments may eventually provide earlier detection, evaluation, and treatment of seizures in newborns, contributing to improved long-term outcomes.

Effect of sintering temperature on magnetic, catalytic and photocatalytic properties of Cu-Co-Mn ferrite catalyst

Wastewater pollution is a pressing environmental issue, necessitating effective remediation strategies to mitigate its impact. This study investigates the use of an efficient catalyst for degrading nitrophenols by converting them into useful aromatic amines, which are crucial building blocks for many pharma industries, and photodegradation of various dyes in their unitary solution as well as in mixture. The Cu-Co-Mn ferrite was synthesized using the sol-gel process and sintered at different temperatures. Structural analysis using XRD and Rietveld refinement revealed a crystal structure corresponding to the Fd3‾m space group having high purity in all the samples. Additionally, the impact of sintering temperature on the magnetic features of the phases were also studied and the findings suggest that all the phases exhibit ferromagnetic behaviour, which means they can be easily separated from reaction mixtures using an external magnetic field. It was also found that higher sintering temperatures lead to a rise in saturation magnetization and magnetic moment with decrease in coercivity (Hc). Further, it was observed that Curie temperature (Tc) increases with increase in sintering temperature with the exception of CFM400. The catalytic performance of all the catalysts, including CFM400, CFM500, CFM600, CFM800, and CFM1000, was evaluated and the results indicate that CFM400 exhibits the highest catalytic activity for nitrophenols reduction and photodegradation of dyes, which could be accredited to its larger BET surface area and lower PL intensity. Overall, the structural and magnetic features of the catalyst’s sheds light on the underlying mechanisms governing their catalytic activity. These insights offer valuable guidance in the designing and development of effective catalysts for sustainable wastewater treatment practices, emphasizing the importance of considering both structural and magnetic features in catalyst design.

52916 Keratosis Pilaris: Treatment practices of board-certified dermatologists

52916 Keratosis Pilaris: Treatment practices of board-certified dermatologists

What I was thinking/what I would do differently: Clinical research.

At the 2023 International Society for Traumatic Stress Studies annual meeting, a panel of three distinguished investigators and clinicians convened to reflect on their careers, their contributions to the field of traumatic stress disorders, and the lessons learned over the years. Dr. Terence M. Keane has guided the development and deployment of evidence-based care, shaping evaluation guidelines and best treatment practices for traumatic stress pathology. Dr. Sheila Rauch, a pioneer in the development of prolonged exposure therapy, has significantly contributed to the treatment of posttraumatic stress disorder (PTSD) and other traumatic stress disorders. Dr. Richard Bryant has developed targeted psychological treatments for traumatic stress and prolonged grief, adapting to the diverse needs, mechanisms, and cultural contexts of patients. These individuals' collective experiences span from the establishment of the PTSD diagnosis to the current proliferation of scientific knowledge on its epidemiology, assessment, and treatment. Their unique yet overlapping contributions have provided invaluable guidelines for the next generation of clinicians and investigators. This panel discussion offers a retrospective look at their careers and a forward-looking perspective on the future of traumatic stress treatment.