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Tertiary Treatment (tertiary + treatment)
Selected AbstractsEating disturbance and severe personality disorder: outcome of specialist treatment for severe personality disorderEUROPEAN EATING DISORDERS REVIEW, Issue 2 2006Fiona Warren Abstract Objective To assess the outcome for patients receiving specialist democratic therapeutic community treatment for personality disorder (PD) when they also have eating disturbance. Method Prospective, naturalistic study. Personality psychopathology and disturbed eating attitudes of 135 male and female referrals to tertiary treatment for PD were assessed at referral. Seventy-five referrals were admitted for treatment and 60 were not. Participants were reassessed at 1-year follow-up. Results There was a significant effect of treatment on dieting but not other aspects of eating disturbance. However, patients with eating disturbance were not more likely than those without to terminate treatment early or to have poorer outcome in terms of their personality pathology. Severity of baseline personality pathology did not predict treatment response. Conclusion Clients with comorbidity should be considered for treatment of the personality disorder prior to treatment for the eating disorder. Copyright © 2006 John Wiley & Sons, Ltd and Eating Disorders Association. [source] Effects of sequential depositional basins on lake response to urban and agricultural pollution: a palaeoecological analysis of the Qu'Appelle Valley, Saskatchewan, CanadaFRESHWATER BIOLOGY, Issue 3 2000Aruna S. Dixit 1. Palaeolimnological analyses of fossil diatoms and pigments were conducted in four lakes of the Qu'Appelle Valley, Saskatchewan, Canada, to quantify the effect of upstream depositional basins on lake response to urban and agricultural human activities. Pasqua, Echo, Mission and Katepwa lakes exhibit similar modern limnological characteristics, lie sequentially downstream from urban point sources of growth-limiting nitrogen (N), yet drain similarly large areas of farmland (38,40 × 103 km2). 2. Analyses indicated that all lakes were naturally productive, contained eutrophic diatoms (i.e. Stephanodiscus niagarae, S. hantzchii, S. parvus and Aulacoseira granulata), and supported blooms of colonial (as myxoxanthophyll) and potentially toxic N-fixing cyanobacteria (aphanizophyll), even prior to the onset of European settlement (ca. 1890) and urban development (ca. 1930). 3. The onset of agricultural practices ca. 1890 had only modest effects on algal communities in the Qu'Appelle lakes, with subtle increases in eutrophic diatom species (Pasqua, Mission and Katepwa lakes) and 25,50% increases in pigment-inferred algal abundance (Echo, Mission and Katepwa lakes). 4. Despite naturally high production, total algal abundance (,-carotene) in upstream Pasqua Lake increased by more than 350% after intense urbanization beginning ca. 1930, while eutrophic diatoms became more common and cyanobacteria populations increased ten-fold. Principal components analysis (PCA) explained 64% of diatom variance, and identified three eras corresponding to baseline, pre-agricultural communities (1776,1890), an era of high production (ca. 1925,1960) and recent variable community composition following tertiary treatment of urban sewage (ca. 1977,1990). 5. Analyses of three downstream lakes demonstrated that urban impacts following 1930 remained evident in fossil profiles of ,-carotene and myxoxanthophyll, but that large blooms of N-fixing cyanobacteria were restricted to the past 25 years at downstream Mission and Katepwa lakes. Similarly, PCA showed that fossil diatom assemblages exhibited little directional variation until the 1970s. 6. Together, these analyses support the hypothesis that upstream lakes were effective at reducing the impacts of point-source urban nutrients on downstream lakes. In contrast, diffuse agricultural activities had only limited impacts on water quality and these were less well ameliorated by upstream basins. [source] Diet and Survival After Prostate Cancer DiagnosisNUTRITION REVIEWS, Issue 9 2007Susan E. Berkow PhD Prostate cancer is the most commonly diagnosed non-skin cancer in men in the United States. Among environmental factors, diet may play a particularly important role in its incidence, progression, and clinical outcome. This article reviews the findings of eight observational studies and 17 intervention or laboratory trials on the effect of plant-based diets and plant nutrients on both the progression and clinical outcome of prostate cancer as well as additional studies examining mechanisms that may explain dietary effects. While additional long-term therapeutic clinical trials are needed to further elucidate the role of diet, these early investigations suggest that a recommendation for individual patients to shift their diets toward plant foods may serve as an important component of the tertiary treatment of prostate cancer. [source] Sources and bioavailability of phosphorus fractions in freshwaters: a British perspectiveBIOLOGICAL REVIEWS, Issue 1 2001C. S. REYNOLDS ABSTRACT This paper seeks a perspective on the forms of phosphorus which promote aquatic eutrophication, with the particular quest of establishing their sources. A short background traces the development of understanding of nutrient enrichment and the suppositions about the relative contributions of agriculture, sewage and detergent residues. Most aquatic systems, and their primary producers, are naturally deficient in biologically-available phosphorus. Aquatic plants have evolved very efficient phosphorus uptake mechanisms. The biomass responses to an increase in the supply of phosphorus are stoichiometrically predictable. The most bioavailable forms of phosphorus are in solution, as orthophosphate ions, or are readily soluble or elutable from loose combinations. Ready bioavailability coincides well with what is measurable as molybdate-reactive (MRP) or soluble-reactive phosphorus (SRP). Most other forms, including phosphates of the alkaline earth metals, aluminium and iron are scarcely available at all. Orthophosphate ions sorbed to metal oxides and hydroxides are normally not biologically available either, except through weak dissociation (,desorption'). The production of alkaline phosphatase provides organisms with an additional mechanism for accelerating the sequestration of phosphate from organic compounds. Bioavailable phosphate is liberated when redox- or alkali-sensitive metal hydroxides dissolve but these processes are minor contributors to the biological responses to nutrient enrichment. Most of the familiar eutrophication is attributable to the widespread application of secondary sewage treatment methods to the wastes emanating from a burgeoning and increasingly urbanised human population. The use of polyphosphate-based detergents, now in decline, has contributed to the problem. In aquatic systems, the additional phosphorus raises the biological supportive capacity, sometimes to the capacity of the next limiting factor (carbon, light, hydraulic retention or of another nutrient). At high orthophosphate loadings, the straight stoichiometric yield relationship between biomass yield and phosphorus availability is lost. Movements of phosphorus and its recycling within aquatic systems do not prevent the slow gravitation of phosphorus to the bottom substrata. The phosphorus retentivity of sediments depends upon their chemical composition. While oxide-hydroxide binding capacity in the surface sediments persists, they act as a sink for phosphorus and a control on further cycling. Iron-rich and clay-rich sediments perform best in these conditions; calcareous sediments least so. Eutrophication may lead to the exhaustion of sediment P-binding capacity. Non-sorbed phosphate is readily recyclable if primary producers have access to it. Recycling is most rapid in shallow waters (where sediment disturbance, by flow, by wind action and through bioturbation, is frequent) and least in deep ventilated sediments. The contributions of phosphorus from catchments are assessed. The slow rate of weathering of (mostly apatitic) minerals, the role of chemical binding in soils and the incorporation and retentivity by forested terrestrial ecosystems each contribute to the minimisation of phosphorus leakage to drainage waters. Palaeolimnological and experimental evidence confirms that clearance of land and ploughing its surface weakens the phosphorus retentivity of catchments. The phosphorus transferred from arable land to drainage remains dominated by sorbed fractions which are scarcely bioavailable. Some forms of intensive market gardening or concentrated stock rearing may mobilise phosphates to drainage but it is deduced that drainage from agricultural land is not commonly a major source of readily bioavailable phosphorus in water. Careful budgeting of the phosphates in run-off from over-fertilised soils may nevertheless show that a proportionately small loss of bioavailable phosphorus can still be highly significant in promoting aquatic plant production. The bioavailable-phosphorus (BAP) load achieving the OECD threshold of lake eutrophy (35 mg P m,3) is calculated to be equivalent to a terrestrial loss rate of approximately 17.5 kg BAP km,2 year,1), or only 1,2% of a typical fertiliser application. The output is shown to be comparable with the P yield from secondary treatment of the sewage produced by a resident population of 30,44 persons km,2. With tertiary treatment, the equivalence is with approximately 200 persons km,2. [source] | ||||||||||