With international concern growing over the sharp increase in alcohol-related physical, psychological and social problems, effort has been directed over the past decade toward arresting the growth of the situation created by alcoholism in western society. Alcoholism is defined and treatment approaches are discussed, along with the methodological problems encountered in evaluating such approaches. An innovative technique, ALCONFRONTATION, is described and examined. Encouraging claims have been made by the author of Alconfrontation in provoking drug dependent persons to choose to become independent of their drug of choice. A study designed to evaluate the impact of the technique in comparison with another treatment approach and a control group of "no treatment" is described. Cases diagnosed alcoholic who were consecutively admitted to a psychiatric admission centre were randomly assigned to the experimental and control groups. Pre-treatment data were collected on all subjects prior to treatment. The groups were followed up six to seven months later and comparisons were made between groups on variables related to life style and sobriety using Chi-square and Federighi's Exact test. Absence of significant differences between groups indicated no evidence of treatment effect. Few subjects were sober on follow-up. It is concluded that Alconfrontation did not positively affect the drinking behaviour and life patterns of alcoholics in this study. Further research is suggested to determine if the technique has any negative impact. Recommendations for alternative management and treatment of chronic alcoholics are made. A two level programme consisting of a community co operative support system and a "Total Push" interdisciplinary team treatment facility is suggested and outlined. / Masters Thesis

<p>Abstract</p><p>Centro Universitaire UNIVATES is located in the town Lajeado that is situated in the most southerly state, Rio Grande Do Sul, in Brazil. The university has 5000 students, teachers and others staff. UNIVATES is not satisfied with their present wastewater situation and wants to improve it by eliminate the smell caused by the wastewater. They would also like to remove the oil that the storm water brings into the wetland. The high amount of particles in the storm water gives rise to a lot of sediments that eventually will fill up the wetland, and something has to be done about this, if the wetland should continue to be in use. Another aspect to consider is the wish of some people at UNIVATES, for the wetland to be a beautiful and recreational place. All these factors had to be considered, which led to the main question: How can the use of the wetland for wastewater treatment be combined with the request for the wetland to be a beautiful place with the wildlife preserved? </p><p>During the course Wetland Technology that we took before our departure to Brazil, we got introduced to the situation at UNIVATES by Professor André Jasper and Odorico Konrad who visited the course several times. They pointed out that the main issue is the smell from the wastewater and later during the field study at UNIVATES, more information were obtained through discussions, meetings and conversations with the people involved. Several visual inspections were carried out by walking around the wetland. We could determine where and how the inlets and outlets to the wetland were and when it was clear which inlets that brought wastewater and which that brought storm water, the water flow of the wastewater was estimated. Water samples from the wetland were collected at five different sites and analyses of pH, BOD, COD, N-Tot, phosphorus and metals were done by the accredited laboratory at UNIVATES. To test some of our theories, we did a smaller practical experiment that got the name Superficial Filtration Bed. </p><p>The results from the water samples showed the highest BOD, COD, N-Tot and Phosphorus levels in the samples from site 2 and 4 and this reveals that it is wastewater. This was also confirmed by the smell that we felt at these sites during the visual inspections. The results also showed that there is no wastewater coming from site 1, 3 and 5. </p><p>Our final proposal is to create a multifunctional wetland with the purpose to take care of both storm water and wastewater and at the same time work as a research and recreational area. The wetland, which would be divided into two parts, will constitute of all the fundamental functions; storm water buffering, sedimentation basin and biological oil separation and treatment. There will also be research sites and hybrid system for wastewater treatment. The hybrid system will consist of two steps where the first is aerobic and the second both aerobic and anaerobic. The first step is a Superficial Filtration Bed (SFB) and the second a FWS wetland. </p><p>The conclusion of this thesis is that more detailed research is needed to be able to dimension the specific functions correctly. With some further investigations the proposal presented is possible to carry through and our feeling when we left UNIVATES was that the people responsible really liked our ideas. They made it clear that they want to make a change and improve the situation and with the help they have gotten from us, they are a few steps closer to solving the problem.</p>

<p>The purpose of this study was to describe how patients with hemodialysis experience their dialysis treatment. The study was conducted as a qualitative descriptive design. The study is based on six interviews. The interviews were transcribed in their entirety and analyzed according to content analysis inspired by Granheim and Lundman. The result is based on five categories; Stress and requirements, Life-supporting haemodialysis treatment, physical impairments, social constraints and a positive view on haemodialysis. Dialysis Patients experienced different matters from physical symptoms like feeling dizziness, headache and fatigue to feeling that life was limited in time, social interaction and energy. They also reported different experiences regarding their relationships with medical staff and other patients. The results obtained in this study shows that there should be spending more time and understanding on how patients experience their haemodialysis treatment in order to increase understanding and to master the situation by the staff and also to help patients. The study has also revealed that some patients feel persuaded by staff to perform as much of their treatment by themselves as possible. There are a lot of research about the haemodialysis treatment method, but very limited on how patients feel about their treatment and therefore it is needed more research in the experiences of dialysis to improve health care and nursing care.</p> / <p><strong>Sammanfattning</strong></p><p>Syftet med den här studien var att beskriva hur patienter med hemodialys upplever sin dialysbehandling. Studien genomfördes som kvalitativ med beskrivande design. Studien baseras på sex intervjuer. Intervjuerna har transkriberats i sin helhet och analyserats enligt innehållsanalys inspirerad av Granheim och Lundman. Resultatet bygger på fem kategorier som är; Stress och krav, Livsuppehållande hemodialysbehandling, kroppsliga nedsättningar, sociala begränsningar och positiv anblick på hemodialys behandling. Dialyspatienterna upplevde olika saker så som fysiska symptom som att känna yrsel, huvudvärk och trötthet, till att känna att livet blev begränsat i tid, social samvaro och energi. De uppgav också olika upplevelser angående deras relationer med sjukvårdspersonal och övriga patienter. Det resultat som framkommer i denna studie visar att det borde läggas ned mer tid och förståelse för hur patienter med hemodialys upplever sin behandling. För att öka förståelsen och kunna bemästra situationen som personal och även kunna hjälpa patienterna. I studien har det även framkommit att vissa av patienterna känner sig övertalade av personalen att kunna utföra så mycket av sin behandling själv.</p><p>Det sker mycket forskning omkring behandlingsformen hemodialys, men väldigt begränsat om hur patienterna upplever sin behandling och därför behövs mer forskning inom upplevelser inom dialys för att förbättra vården och omvårdnaden.</p>

Increasing costs for wastewater treatment provide incentives to evaluate system alternatives, especially among small communities with limited financial resources. Land treatment systems with hybrid poplar tree plantations are becoming increasingly popular as one such alternative in the Pacific Northwest. Land treatment systems are made up of a complex dual system: the wastewater treatment system and the poplar tree plantation. The complex dual system must account for temporal and spatial variability of natural systems. The goal of the system design is to optimize system parameters, after accounting for system complexity and variability, to maximize economic return without causing adverse effects on the environment and society. This study presents a system optimization model which accounts for the system complexity and natural variability. The model consists of three submodels: nitrogen loading rate estimation submodel, nitrate leaching submodel and total net revenue estimation submodel. The composite model identifies the maximum total net revenue and determines associated system design parameters. An optimization example for a hypothetical community with a population of 5,000 is presented. The optimal system with no time horizon or land area constraints is expected to return a net revenue of $773,659 over a 296-year project lifetime. The wastewater treatment system is characterized by the optimal nitrogen loading rate of 49 kgN/ha and the corresponding estimated leachate nitrate concentration of 8.80 mgN/L. The poplar tree plantation is characterized by the optimal rotation period of 8 years and the optimal total field size of 202 ha. Additional analysis indicates that total net revenue would not be positive if the design system lifetime was shorter than 60 years, or the maximum field size was smaller than 150 ha. Accounting for land depreciation due to wastewater application reduced the optimal nitrogen loading rate by 2 kgN/ha. Costs for an equity loan would reduce system profitability significantly. Sensitivity analysis demonstrated that the model was sensitive to nitrate leaching and poplar tree growth parameters. It was concluded that calibration for site specific nitrate leaching and poplar hybrid specific growth parameters should be evaluated to have more confidence in model performance. / Graduation date: 2004

While research on religion and severe psychopathology is mixed, the majority of evidence suggests that greater religiosity and greater use of religious forms of coping relate to beneficial psychosocial outcomes for both patients with schizophrenia (Huguelet et al., 2006; Moss et al., 2006) and their family members (Pearce et al., 2006; Roff et al., 2004). However, this data is generally cross-sectional. To date, scant research has longitudinally examined how religious beliefs and practices relate to key indicators of psychosocial outcomes for patients with schizophrenia and their relatives. This study used a White and Hispanic sample of 41 patients with schizophrenia and 57 relatives of such patients to examine cross-sectional and longitudinal links between religion and mental health. Results showed that increases in the use of religious forms of coping over time significantly predicted decreases in emotional distress for family members. Results also supported the hypothesis that greater positive and lessor negative forms of religious coping would relate to beneficial outcomes for patients and family members. Lastly, this study found that, for patients, ethnicity appeared to moderate the link between religiosity and outcome. Findings from this study highlight the importance of religion to patients and caregivers coping with schizophrenia. Clinicians treating patients with schizophrenia and their loved ones are cautiously encouraged to explore religion with their clients, with particular attention to its differential influence among patients versus relatives and among Whites versus Hispanics.

Chapter I presents general information about landfill leachate, characteristics of leachates in Vietnam and review of general leachates treatment situation in the country. In chapter II, a careful bibliographical study on biological processes of nitrification and denitrification is done. In chapter III, existing activated sludge models are briefly reviewed, focusing on ASM1 and ASM3. The ASM3 model then is studied in more detail with focuses on state variables, processes; kinetic and stoichiometric parameters of the model. A careful bibliographical study on sequencing batch reactor (SBR) is done in chapter IV. Chapter V presents materials and methods that will be applied in the experiments in laboratories and modelling processes of this study. In chapter VI, an SBR bench-scale is set up in the laboratory to study partial nitrification process. Chapter VII presents the experimental studies on maximum nitrification and denitrification capability, then determination of kinetic and stoichiometric parameters that will be used for calibration in the next steps. Chapter VIII presents a study on partial nitrification by applying data analysis and experimental planning method. In chapter IX (the key part of the Thesis), the modelling of the partial nitrification and denitrification in SBR is presented. It is hoped that, this study will contribute to the major issue of leachate treatment in Vietnam, especially in the North of the country where leachate characteristics and variations are the same as what was used during our experiments. Partial nitrification seems to be easily achieved in an SBR bench-scale using leachate in Nam Son landfill site. Some important characteristics of the studied leachate, are high alkalinity, high pH leading to high free ammonia concentration in the system. This free ammonia is known as a growth rate inhibitor for nitrite oxidizing bacteria, thus limiting oxidation of nitrite to nitrate and accumulating nitrite during the nitrification period. DO concentration is also known as an important influencing factor in partial nitrification in many previous studies. But in our case, its influence is just significant when the nitrification process is nearly complete: no more ammonium remains in the system, alkalinity concentration is reduced leading to a lower buffer capacity, lower pH, and then nitrite is easily oxidized to nitrate. A sufficiently high DO concentration in this case, expresses its importance in bringing about the best nitrification efficiency, while saving aeration energy. The SBR technique has demonstrated its advantages, especially the flexibility in changing the working volume, and the operating time. Modeling of partial nitrification and denitrification processes for landfill leachate treatment using the SBR technique was the main objective of this study. The simulation software - WEST® program was very useful tool to implement this task. With this program, the available model base for activated sludge model (ASM1, ASM 2, ASM 3 etc,), presented in the Peterson matrix, the variables, kinetic, stoichiometric parameters, processes can be easily modified to another activated sludge model suitable in the scope of our study. In the present case, based on the ASM3, the ASM3_2step was developed and applied, in which nitrification and denitrification are divided into two steps with nitrite as an intermediate product. The modified ASM3_2step has shown its high accuracy during calibration process. It could be use also for the other processes/techniques using activated sludge, by adding more equations and parameters. Calibration and validation were implemented for two cases: Partial nitrification and denitrification with and without carbon addition. Good results were obtained where the simulations fit well the experimental data. The kinetic and stoichiometric parameters found are very important for the other simulations, especially in process optimisation. It also demonstrates that, through process optimisation, general productivity of the SBR system can be increased. Controlling DO, changing operating time cycle mechanisms can improve the total nitrogen removal efficiency, save some aeration energy for nitrification and carbon source for denitrification. As our results are very promising, the next step could be to implement the ANAMMOX process. Key words: Partial nitrification and denitrification, ASM3_2steps, SBR, modeling.

The purpose of this study was to describe how patients with hemodialysis experience their dialysis treatment. The study was conducted as a qualitative descriptive design. The study is based on six interviews. The interviews were transcribed in their entirety and analyzed according to content analysis inspired by Granheim and Lundman. The result is based on five categories; Stress and requirements, Life-supporting haemodialysis treatment, physical impairments, social constraints and a positive view on haemodialysis. Dialysis Patients experienced different matters from physical symptoms like feeling dizziness, headache and fatigue to feeling that life was limited in time, social interaction and energy. They also reported different experiences regarding their relationships with medical staff and other patients. The results obtained in this study shows that there should be spending more time and understanding on how patients experience their haemodialysis treatment in order to increase understanding and to master the situation by the staff and also to help patients. The study has also revealed that some patients feel persuaded by staff to perform as much of their treatment by themselves as possible. There are a lot of research about the haemodialysis treatment method, but very limited on how patients feel about their treatment and therefore it is needed more research in the experiences of dialysis to improve health care and nursing care. / Sammanfattning Syftet med den här studien var att beskriva hur patienter med hemodialys upplever sin dialysbehandling. Studien genomfördes som kvalitativ med beskrivande design. Studien baseras på sex intervjuer. Intervjuerna har transkriberats i sin helhet och analyserats enligt innehållsanalys inspirerad av Granheim och Lundman. Resultatet bygger på fem kategorier som är; Stress och krav, Livsuppehållande hemodialysbehandling, kroppsliga nedsättningar, sociala begränsningar och positiv anblick på hemodialys behandling. Dialyspatienterna upplevde olika saker så som fysiska symptom som att känna yrsel, huvudvärk och trötthet, till att känna att livet blev begränsat i tid, social samvaro och energi. De uppgav också olika upplevelser angående deras relationer med sjukvårdspersonal och övriga patienter. Det resultat som framkommer i denna studie visar att det borde läggas ned mer tid och förståelse för hur patienter med hemodialys upplever sin behandling. För att öka förståelsen och kunna bemästra situationen som personal och även kunna hjälpa patienterna. I studien har det även framkommit att vissa av patienterna känner sig övertalade av personalen att kunna utföra så mycket av sin behandling själv. Det sker mycket forskning omkring behandlingsformen hemodialys, men väldigt begränsat om hur patienterna upplever sin behandling och därför behövs mer forskning inom upplevelser inom dialys för att förbättra vården och omvårdnaden.

The purpose of this study was to examine the effect of high and low anxiety on motivation for treatment, length of stay in treatment, and intrapsychic focus of attention in Veterans Administration drug-abuse patients. The dependent variables were measured by the Minnesota Multiphasic Personality Inventory (MMPI), Reasons For Seeking Treatment Inventory (RFST), State Trait Anxiety Inventory (STAI), Psychopathic State Inventory (PSI), and the total number of days each subject participated in the treatment program. The major hypothesis was stated in the null form.The PSI and the STAI were used to measure motivation for seeking treatment. The MMPI and the RFST were used to measure intrapsychic focus of attention.On admission and on day 60, the subjects in the High Stress Treatment Group and the subjects in the Low Stress Treatment Group were not found to he significantly different, as measured by the STAI and the PSI, and intrapsychic focus of attention, as measured by the MMPI and the RFST.This study revealed that the subjects in the High Stress Treatment Group developed a higher level of motivation than the subjects in the Low Stress Treatment Group. The Subjects in the High Stress Treatment Group stayed in treatment longer than the subjects in the Low Stress Treatment Group. Subjects in the High Stress Treatment Group focused more on intrapsychic issues than subjects in the Low Stress Treatment Group.

No description available.

The need for pathogen-free water supplies has spurred investigations into the use of ionizing radiation for the treatment of wastewater effluent and municipal biosolids. The objective of this research was to develop an electron-beam irradiation scenario to effectively eliminate microbial pathogens from municipal biosolids and wastewater effluent. The Monte Carlo N-Particle (MCNP5) radiation transport code was used to simulate the irradiation scenario. Using MCNP5, dual electron-beam sources were modeled as planar surface sources above and below a stainless steel delivery trough containing either effluent water or one of two biosolids material compositions. A dose deposition analysis was performed to assess both the planar dose distribution and 25 depth-dose curves. In addition, a density perturbation study was performed to assess the variance in the dose deposition for different mass solids concentrations. To validate the MCNP5 code for this type of application, a benchmark study was performed. Two municipal biosolids materials and water were irradiated in plastic bags on a conveyor belt using a 10-MeV electron accelerator with the exit window below the material. The experimental configuration was modeled with the MCNP5 radiation transport code. Simplified and detailed models were created and analyzed. Lastly, an economic analysis was performed to assess whether this treatment method is a financially viable alternative to current wastewater treatment methods. Processing capacity was calculated for two accelerator specifications. These capacity rates in conjunction with the operating and capital costs per dry ton to irradiate the material were compared with existing data for electron beam processing of municipal biosolids. The cost breakdown was also compared with quoted costs for existing conventional methods. The models developed showed that the use of 10MeV electron-beam technology for the treatment of wastewater effluent and municipal biosolids is effective and economically feasible. The benchmarking study illustrated the accuracy of Monte Carlo simulation for this type of application. The method development process was shown to be adaptable for various material compositions and irradiation configurations.