Bathing water quality analysis, management and policy: an integrated assessment for Ireland

Every bathing season in Ireland several bathing sites are closing and receiving warnings against bathing. In this report, their water quality status is assessed, and the broader picture of each case is investigated. A database is formed including location-maps, the restrictions they were/are subject to, the official justification, past and current annual water quality status, (sub)catchment where they are located, main water bodies flowing in, the closest WasteWater Treatment Plants with their characteristics and performance based on EU treatment standards, the closest meteorological stations and the rainfall data related with stormwater overflow events (correlation analyses) and the surrounding land cover. For each case, possible causes were discussed; the actions so far and the relevant literature are analyzed to provide key policy recommendations which are useful for the review of the European Bathing Water Directive.

9. Pharmacologic Approaches to Glycemic Treatment: Standards of Medical Care in Diabetes—2022

The American Diabetes Association (ADA) “Standards of Medical Care in Diabetes” includes the ADA’s current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee (https://doi.org/10.2337/dc22-SPPC), are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA’s clinical practice recommendations, please refer to the Standards of Care Introduction (https://doi.org/10.2337/dc22-SINT). Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.

Prevention of ischemic stroke in atrial fibrillation from the point of view of a neurologist. Standards and real clinical practice

The article outlines aspects of the current state of the problem of the priority choice of an oral anticoagulant for indefinite prevention of stroke and systemic thromboembolism in patients with atrial fibrillation. The advantages of direct oral angicoagulants over warfarin are presented, as well as a comparative analysis of the individual characteristics of the main direct oral angicoagulants from the point of view of personification of preventive therapy in accordance with modern treatment standards. The efficacy and safety of oral anticoagulant therapy has been reviewed in terms of the net clinical benefit. Particular attention is paid to the age-related aspects of choosing an anticoagulant for indefinite prophylaxis; an assessment of anticoagulants is presented in accordance with the FORTA concept, which regulates the use of drugs in elderly patients. In conclusion, recommendations are formulated for the choice of an anticoagulant in patients with atrial fibrillation in the most common clinical situations. As a general rule, the choice of a particular drug should be individualized based on risk factors, tolerability, net clinical benefit, patient preference, potential adverse interactions, and other clinical characteristics.

Assessing States’ Intimate Partner Violence Offender Treatment Standards using a Principles of Effective Intervention Framework

Court-ordered treatment programs are a widely used response to intimate partner violence (IPV) and many states have developed standards to guide programs. The current study provides an update to Maiuro and Eberle’s. (2008) review of states’ standards and extends the literature by using the principles of effective intervention (PEIs; i.e., risk, need, responsivity, treatment, and fidelity) as an organizational framework to examine standards. Findings showed that 84% of states had standards in 2020, compared to 88% in 2007, and extensive changes both within and across states’ standards had occurred. Regarding the PEIs, in line with the risk principle most states mandated the use of risk assessments; inconsistent with the needs principle, few states used these assessments to classify clients into risk levels or inform individualized treatment. The majority of standards addressed the treatment principle by outlining a required structure and duration, but few attended to responsivity factors (e.g., identifying treatment modalities, attending to specific client factors). Regarding the fidelity principle, most standards outlined education or training requirements for staff and required periodic program reviews or audits, but few standards were evidenced-based and only about half required that programs collect data to measure effectiveness. Taken together, findings suggest that standards have continued to evolve and that the integration of PEIs into IPV treatment is only just beginning. Standards provide a rich opportunity for future researcher–practitioner partnerships in the field of IPV intervention.

A review on adsorbent parameters for removal of dye products from industrial wastewater

Industrial effluents are usually one of the major industries polluting the environment and surface water. It is estimated that the worldwide production of dyes is about 70 tons/year. To overcome this problem, innovative processes are suggested for the treatment of industrial effluents containing dyes and heavy metals. The goal of the processes is often to reduce the toxicity of these pollutants in order to meet treatment standards. Recently, great attention has been paid to innovative processes for physical and chemical removal techniques such as adsorption on new adsorbents, biomass adsorption, membrane filtration, irradiation, and electrochemical coagulation. In this study, the application of adsorbents in the adsorption process to remove dye pollutants from industrial effluents has been studied. Factors affecting dye adsorption such as pH, temperature, initial dye concentration, and adsorbent amount are also presented. The obtained results revealed that more than 80% of the dye adsorption on the surface of adsorbents are endothermic processes and more than 95% of the processes obey the pseudo-second-order kinetic model.

Non-antibacterial methods for the prevention and treatment of recurrent lower urinary tract infections

Urinary tract infections are widespread throughout the world and occupy one of the leading places among infectious diseases. Antibacterial methods are the basis of modern treatment standards. At the same time, a widespread increase in antibiotic resistance of the main uropathogens is currently observed. In clinical practice, recurrent lower urinary tract infections are increasingly common. Following this, the main task of the doctor is to maximize the recurrence-free interval. Given the obvious negative collateral effect of long-term antibiotic prophylaxis, specialists are increasingly turning to alternative methods. Non-antibacterial preventive measures are aimed at key links in the pathogenesis of the disease, such as counteracting the penetration and adhesion of uropathogens, as well as stimulating the immune system of the macroorganism. The available physicians' toolkit includes pharmacological agents (d-mannose, methenamine hippurate, estrogens, non-steroidal anti-inflammatory drugs, probiotics, intravesical glycosaminoglycans, immunostimulants and vaccines), natural uroantiseptics (medicinal herbs and cranberry products), as well as behavioural therapy. The main advantages of non-antibacterial methods for the treatment and prevention of lower urinary tract infections are environmental friendliness. It is associated with the absence of a negative effect on the commensal flora, as well as a reduction in the risk of developing antibiotic resistance. The current guidelines provide very limited information on the application of this approach to treatment. Published studies indicate the high potential of non-antibacterial methods, some of which are comparable in effectiveness to standard therapy. However, the quality of studies and the lack of drug use standards do not allow including this approach in the existing guidelines. The need for new, high-quality clinical trials is evident.

977 The Role of Telephone Triage in Head and Neck Cancer Care in a Teaching Hospital

Introduction NHS England sets standards to ensure prompt specialist review, diagnosis, and treatment of cancer. Patients with suspected cancer should receive specialist review within 14 days of referral, diagnosis by day 28 and first treatment by day 62. To reduce transmission during the SARS-CoV-2 pandemic, the NHS recommended telephone triage as the first specialist appointment. The effect of telephone triage on head and neck cancer timeframes in an NHS teaching hospital was assessed. Method Four head and neck cancer telephone triage clinics during July 2020 were selected at random. Clinical correspondence and the electronic patient records were reviewed for each patient and cancer pathway timeframes were analysed. Results 31 patients were referred for telephone triage and 100% received specialist review within 14 days. Subsequently 17 (55%) patients were investigated, 12 (71%) of which received a diagnosis within 28 days. 4 patients received a cancer diagnosis, but none received first treatment within 62 days. 24 (77%) patients were seen in a face-to-face clinic after telephone triage on average 7 days after telephone triage. Conclusions In this sample, telephone triage allowed safe initial specialist review by meeting the 14-day standard. However, the 28-day diagnosis and 62-day treatment standards were not adhered to. Telephone triage does not largely reduce overall patient contact, with 77% of patients subsequently reviewed in a patient-facing setting. The addition of telephone triage delayed first clinical examination by a specialist by an average of 7 days, which may be a contributing factor to the delays seen in diagnosis and treatment.