Highway filter drain waste arisings: a challenge for urban source control management?

Essential maintenance activities on highway BMP drainage controls involve refurbishment of filter (French) drains which can generate substantial amounts of "controlled waste". An innovative procedure for their re-instatement is described which offers a more sustainable option for filter drain/trench management. The quality classification of these waste arisings is problematical and it is difficult to reliably identify the risks posed by such materials and the most effective forms of management and disposal options.

A randomised, prospective study comparing trabeculectomy augmented with antimetabolites with a viscocanalostomy technique for the management of open angle glaucoma uncontrolled by medical therapy.

AIMS: To compare trabeculectomy with viscocanalostomy for the control of intraocular pressure (IOP) in open angle glaucoma (OAG) uncontrolled by medical therapy. METHODS: 48 patients (50 eyes) with uncontrolled OAG were randomised to either trabeculectomy (25 eyes) or a viscocanalostomy technique (25 eyes). Preoperatively, eyes were graded in terms of risk factors for drainage failure. Those undergoing trabeculectomy were given intraoperative antimetabolites (5-fluorouracil 25 mg/ml (5-FU), mitomycin C (MMC) 0.2 mg/ml and 0.4 mg/ml) according to a standard protocol. Antimetabolites were not used intraoperatively in eyes undergoing viscocanalostomy, but they were randomised to the use of viscoelastic (Healonid GV) for intraoperative intracanalicular injection. RESULTS: There were no significant differences between the groups in age, sex, type of OAG, preoperative medications, risk factors for drainage failure, and preoperative IOP. Mean follow up was 19 months (range 6-24 months). It was 12 months or longer in all eyes, except one lost to follow up at 6 months. At 12 months, complete success (IOP <21 mm Hg without antiglaucoma medications) was seen in all eyes undergoing trabeculectomy (100%), but in only 64% of eyes undergoing viscocanalostomy (p<0.001). The mean IOP was lower at 12 months (p<0.001) with trabeculectomy and the number of eyes with IOPs of 15 mm Hg or less was greater (p<0.05). The mean IOP at 12 months was lower in eyes that had undergone viscocanalostomy using intraoperative intracanalicular Healonid GV injection compared to those where only balanced saline solution had been used (p<0.01). However, in terms of complete success there was no difference between the viscocanalostomy groups (p<0.1). With the exception of measurements at 1 week, visual recovery (logMAR acuity) was similar and laser flare and cell values showed little differences between the groups. Corneal topography and keratometry at 12 months were little different from preoperative values. Postoperative interventions (subconjunctival 5-FU and needling procedures) were similar between the groups. Transient complications such as early bleb leak and hyphaema were more common in the trabeculectomy group (p<0.05). Postoperative cataract formation was more common after trabeculectomy (p<0.05). CONCLUSIONS: IOP control appears to be better with trabeculectomy. Viscocanalostomy is associated with fewer postoperative complications, although significant complications permanently impairing vision did not occur with either technique.

Reduced incidence of retinopathy of prematurity.

AIM: To audit the prevalence of retinopathy of prematurity (ROP) in a level 2 status neonatal unit. METHODS: Data were collected prospectively over 9 years from September 1989 to September 1998. Preterm infants were examined according to the Royal College of Ophthalmologists' guidelines and retinopathy graded following the International Classification of ROP. ROP 3-5 was analysed using logistic regression in relation to time, and to gestational age and birth weight. RESULTS: 383 babies were examined. Mean gestational age fell over the 9 year period (p=0.051) as did mean birth weight (p<0.001). There was a decrease in the number of infants with ROP grades 3-5 over the 9 years (p=0.045 and, when adjusted for gestational age and birth weight, the decrease in ROP 3-5 was significant (p=0.03). CONCLUSIONS: This study found a significant reduction in the incidence of ROP during the 9 years of the study period, despite a decrease in mean gestational age of and birth weight. The reduced incidence of ROP is attributed to improvements in ventilation techniques and overall care of the neonate, in particular the use of prenatal steroids and surfactant.

Open-mindedness, rigidity, and the tendency to change inferences among psychiatric nursing staff: a pilot study.

To test the relationship between open- and closed-mindedness, between rigidity and nonrigidity, and the tendency of psychiatric nursing staff to alter inferences when given additional information about a patient, the Dogmatism Scale, Form E, And the Gough-Sanford Rigidity Scale were presented to 120 psychiatric nursing staff members, all employed and working directly with patients. Low-dogmatic subjects changed their inferences regarding patient behavior significantly more than high-dogmatic subjects. Although high-rigid subjects changed their inferences about patient behaviour more than low-rigid subjects, the relationship was not significant.

A spectrofluorometric method for the determination of ajmaline in plasma.

1 Ajmaline was found to have maximum fluorescence at neutral pH with 300 nm excitation and 365 nm emission wavelengths (corrected). 2 The fluorescence intensity had a linear relationship to concentration up to 50 microgram ml-1 and the recovery of ajmaline after extraction from plasma was 92.5 +/- 3%. 3 Extraction of drug-free plasma and of samples containing known concentrations of ajmaline showed that drug levels in the range found clinically could be measured accurately by fluorimetry. 4 Serial plasma ajmaline concentrations were measured in a subject after intravenous injection of ajmaline (50 mg). The rates of plasma clearance of the drug were found to be similar to those obtained in previous studies.

Propulsion (mass movements) in the human colon and its relationship to meals and somatic activity.

Propulsive activity of the human colon was measured with radiopaque markers (shapes), radiotelemetering capsules, Perspex capsules containing (51)Cr, or with free (51)Cr sodium chromate. Propulsive activity can be readily detected by these techniques, none of which requires the use of radiological contrast media. With capsules containing (51)Cr or with free (51)Cr repeated observations can be made in the same patient without recourse to radiography. The patient can remain normally active during the test with encapsulated (51)Cr. Repeated observations may also be made with shapes, if films exposed at low mA are used. It was found that colonic intraluminal pressure activity rises markedly during and after food, but that in the resting patient this increase is rarely associated with propulsive activity. In physically active patients propulsion of colonic contents was significantly increased after meals. When colonic propulsion takes place, it does so by a series of mass movements. These results suggest that somatic activity is an important factor in the control of colonic transit in health or disease.