Factors affecting the performance of stormwater treatment wetlands.

Data from 35 studies on 49 wetland systems used to treat stormwater runoff or runoff-impacted surface waters were examined and compared in order to identify any obvious trends that may aid future stormwater treatment wetland design efforts. Despite the intermittent nature of hydrologic and pollutant inputs from stormwater runoff, our analysis demonstrates that steady-state first-order plug-flow models commonly used to analyze wastewater treatment wetlands can be adapted for use with stormwater wetlands. Long-term pollutant removals are analyzed as functions of long-term mean hydraulic loading rate and nominal detention time. First-order removal rate constants for total phosphorus, ammonia, and nitrate generated in this fashion are demonstrated to be similar to values reported in the literature for wastewater treatment wetlands. Constituent removals are also demonstrated via regression analyses to be functions of the ratio of wetland area to watershed area. Resulting equations between these variables can be used as preliminary design tools in the absence of more site-specific details, with the understanding that they should be employed cautiously.

Adult immunizations: recommendations for practice.

Each year in the United States, 50,000 to 90,000 adults die of pneumococcal disease, influenza, and hepatitis infections. These figures vastly exceed mortality due to vaccine-preventable diseases in children. In addition, adult immunizations are cost-effective and lifesaving measures. Nonetheless, surveys reveal that both physicians and patients underuse adult immunizations as an effective means of disease prevention. The goal of achieving higher adult immunization rates is critically dependent on improving the attitudes and practices of health-care providers. In this article, we review several vaccines routinely used in the practice of adult medicine.