Optimierung der Pharmakotherapie schizophrener Patienten durch objektive Symptomerfassung und Therapeutisches Drug Monitoring

Der Erfolg einer Schizophrenie-Behandlung ist zum größten Teil abhängig vom Ansprechen des Patienten auf seine antipsychotische Medikation. Welches Medikament und welche Dosis bei einem individuellen Patienten wirksam sind, kann derzeit erst nach mehrwöchiger Behandlung beurteilt werden. Ein Grund für variierendes Therapieansprechen sind variable Plasmakonzentrationen der Antipsychotika. Ziel dieser Arbeit war es, zu untersuchen, in wieweit der Therapieerfolg zu einem frühen Zeitpunkt der Behandlung durch objektive Symptomerfassung vorhersagbar ist und welche Faktoren die hohe Variabilität der Antipsychotikaspiegel im Blut beeinflussen. rnEine 18-monatige naturalistische klinische Studie an schizophrenen Patienten wurde durchgeführt, um folgende Fragen zu beantworten: Kann man das Therapieansprechen prädizieren und welche Instrumente sind dafür geeignet? Die Psychopathologie wurde anhand zweier Messskalen (Brief Psychiatric Rating Scale, BPRS und Clinical Global Impressions, CGI) wöchentlich ermittelt, um die Besserung der Krankheitssymptome im Verlauf von 8 Wochen zu bewerten. Therapiebegleitend wurden noch die Serum-Konzentrationen der Antipsychotika gemessen. Objektive Symptomerfassung durch BPRS oder CGI waren als Messinstrumente geeignet, Therapieansprechen vorherzusagen. Bezogen auf den Behandlungsbeginn war eine Verminderung der Symptome hoch prädiktiv für späteres Therapieversagen oder -ansprechen. Eine Verminderung um mehr als 36,5% auf der BPRS Skala in Woche 2 wurde als signifikanter Schwellenwert für Nichtansprechen ermittelt. Patienten, deren Symptombesserung unterhalb des Schwellenwertes lag, hatten eine 11,2-fach höhere Wahrscheinlichkeit, am Ende der Studie nicht auf ihre medikamentöse Therapie anzusprechen als die Patienten, die sich um mindestens 36,5% verbesserten. Andere Faktoren, wie Alter, Geschlecht, Dauer der Erkrankung oder Anzahl der stationären Aufenthalte hatten keinen Einfluss auf die Prädiktion des Therapieansprechens. Therapeutische Antipsychotika-Spiegel übten einen positiven Einfluss auf die Ansprechrate aus. Bei Patienten mit therapeutischen Spiegeln war das Ansprechen rascher und die Ansprechrate größer als unter denjenigen deren Spiegel außerhalb der therapeutisch üblichen Bereiche lag. rnEine wichtige Voraussetzung für den Einsatz von TDM ist das Vorhandensein einer präzisen, reproduzierbaren, zeit- und kostensparenden analytischen Methode zur quantitativen Bestimmung der untersuchten Substanzen. Die Entwicklung und Validierung einer solchen geeigneten Methode wurde für den Nachweis von Haloperidol vorgenommen. Eine HPLC-Methode mit Säulenschaltung erwies sich für TDM geeignet. rnBasierend auf den Ergebnissen der eigenen klinischen Studie zur Response Prädiktion wurde untersucht, welche Faktoren die Variabilität der Pharmakokinetik von Antipsychotika beeinflussen. Die Variabilität der Pharmakokinetik ist ein Grund für fehlendes oder unzureichendes Ansprechen. Es wurde zum einen der Einfluss der galenischen Formulierung auf die Freisetzung und zum anderen der Einfluss von entzündlichen Prozessen auf die Metabolisierung eines Antipsychotikums untersucht. Dazu wurden Patientendaten retrospektiv ausgewertet.rnDie Analyse von 247 Serumspiegeln von Patienten, die mit Paliperidon in OROS®Formulierung, einer neu eingeführten Retardform, behandelt wurden, zeigte, dass die intraindividuelle Variabilität der Talspiegel (Vk) von Paliperidon 35% betrug. Er war damit vergleichbar wie für nicht retardiertes Risperidon 32% (p=n.s.). Die Retardierung hatte demnach keinen Varianz mindernden Effekt auf die Talspiegel des Antipsychotikums. Der Wirkstoff-Konzentrations-Bereich lag bei 21-55 ng/ml und entsprach ebenfalls nahezu dem therapeutischen Bereich von Risperidon (20-60 ng/ml). rnEntzündliche Prozesse können die Metabolisierung von Medikamenten verändern. Dies wurde bisher für Medikamente nachgewiesen, die über CYP1A2 abgebaut werden. Durch die eigene Analyse von 84 Patienten-Serumspiegeln konnte festgestellt werden, dass die Metabolisierung von Quetiapin während eines entzündlichen Prozesses beeinträchtigt war, wahrscheinlich durch Hemmung von CYP3A4. Dies sprach dafür, dass auch Wirkstoffe, die über CYP3A4 abgebaut werden, während eines entzündlichen Prozesses im Körper in ihrer Pharmakokinetik beeinträchtigt sein können. Aus diesem Grund sollte während einer Infektion unter der Therapie mit Quetiapin besonders auf die Nebenwirkungen geachtet werden und der Serumspiegel sollte in dieser Zeit überwacht werden, um den Patienten vor eventuellen Nebenwirkungen oder sogar Intoxikationen zu schützen. rnDie Befunde dieser Arbeit zeigen, dass bei einer Behandlung schizophrener Patienten mit Antipsychotika die Messung der Psychopathologie zur Vorhersage des Therapieansprechens und die Messung der Blutspiegel zur Identifizierung von Faktoren, die die pharmakokinetische Variabilität bedingen, geeignet sind. Objektive Symptomerfassung und Therapeutisches Drug Monitoring sind demnach Instrumente, die für die Steuerung der antipsychotischen Pharmakotherapie genutzt werden sollten.rn

Untersuchung von Einflussfaktoren zur Ortsbruststabilität und Vortriebsgeschwindigkeit beim Tunnelbau im Rheinischen Schiefergebirge

Zusammenfassung Der ca. 1.555 m lange Tunnel Fernthal wurde von 1998 bis 2000 im Zuge der Bundesbahn-Neubaustrecke Köln – Rhein/Main erstellt. Der Tunnel durchquert devonische Schichten des Rechtsrheinischen Schiefergebirges. Die Ton- und Sandsteine sind tiefgründig verwittert, intensiv verfaltet mit wechselnden Vergenzen der Faltenschenkel und zudem stark durch Trennflächen zerlegt. Beim Auffahren des Tunnel Fernthal sind Phänomene in Bezug auf die Wechselwirkung zwischen dem Grundwasser und dem Tunnel sowie dem Fels und dem Tunnel beobachtet worden, die vom Verfasser der vorliegenden Arbeit im Nachgang der Baumaßnahme vertieft ausgewertet und interpretiert werden.Innerhalb von zwanzig strukturgeologischen Homogenbereichen wurden die geotechnisch und strukturgeologisch bestimmenden Einflussfaktoren (z.B. ungünstig zum Hohlraum einfallende Schichtung oder Querklüftung mit hohem Durchtrennungsgrad) im Hinblick auf Ihre Auswirkung auf die Sicherung der Ortsbrust und damit die Vortriebsgeschwindigkeit quantifiziert. Über das Produkt der den Vortrieb bestimmenden Einzelfaktoren wurde für den jeweiligen Homogenbereich ein Gesamteinflussfaktor errechnet.Aus dem neu eingeführten Gesamteinflussfaktors fn gesamt lassen sich dabei Empfehlungen über die notwendigen Sicherungsmaßnahmen im Bereich der Ortsbrust ableiten und Einteilungen in Ausbruchsklassen vornehmen. Über die Bewertungsmatrix und den sich daraus ergebenen Gesamteinflussfaktor können reduzierte Vortriebsgeschwindigkeiten ausgehend von einer 'idealen' Vortriebsgeschwindigkeit näherungsweise errechnet werden. Mithilfe der Bewertungsmatrix lässt sich die bautechnischen Eigenschaften des Gebirges besser bewerten. So zeigt sich im Rahmen dieser Arbeit deutlich, dass es bei einem vergenten Faltengebirge günstiger ist, den Tunnel gegen die Vergenz von Faltenschenkeln aufzufahren. Somit können schon im Vorfeld einer Tunnelbaumaßnahme verschiedene Vortriebsschemata durchrechnet werden. Neben der besseren Prognose von notwendigen Sicherungsmaßnahmen kann durch den Zeitgewinn auch ein finanzieller Vorteil für die Beteiligten entstehen.

Comparison of performance and patient satisfaction of two types of ERG electrodes

BACKGROUND: An age-controlled comparison concerning patient satisfaction and electrical performance of microfibres (DTL) and rigid contact lens (Henkes) corneal ERG electrodes was carried out. METHODS: 36 test persons underwent complete ophthalmological examination and were equally distributed into 3 age groups. Electroretinograms were recorded according to ISCEV standards. Randomly, in one eye a Henkes electrode was used and in the other eye a DTL electrode. Amplitudes of a- and b-waves and implicit times were measured and compared for the two electrode types. RESULTS: 34 of 36 test persons preferred DTL electrodes. Electrical performance concerning b-wave amplitudes was comparable. Statistically significant differences were detected only for scotopic combined cone-rod stimulation in the age groups 20 - 40 and 41 - 60 years between the different electrodes. Other recordings did not show differences. A statistically significant reduction of signal amplitudes with age was detected for scotopic isolated rod signals and combined cone-rod signals. Significance level was p < 0.05. No conjunctival or corneal erosions were found after ERG recordings for either electrode. CONCLUSIONS: Electrical performance is comparable between electrodes. For scotopic stimulations age was a significant influencing factor for signal amplitude and should be respected for normative values. DTL electrodes were preferred by the vast majority of patients. No adverse clinical effects were observed for either electrode. DTL electrodes should be preferred due to hygienic reasons (single use) and patient comfort.

Femoral head injuries: Which treatment strategy can be recommended?

Despite different operative and non-operative treatment regimens, the outcome after femoral head fractures has changed little over the past decades. The initial trauma itself as well as secondary changes such as posttraumatic osteoarthritis, avascular necrosis or heterotopic ossification is often responsible for severe loss of function of the afflicted hip joint. Anatomic reduction of all fracture fragments seems to be a major influencing factor in determining the outcome quality. Eight years ago we inaugurated a new surgical approach for better access and visualisation for the treatment of femoral head fractures, using the "trochanteric flip" (digastric) osteotomy. Thus inspection of the entire hip joint and accurate fragment reduction under direct visual control are possible. After good initial experiences with this operative procedure we changed our standard treatment regimen to this approach in an attempt to achieve the most accurate anatomic reduction of the femoral head in every affected patient. Between 1998 and 2006 we operated on 12 patients with femoral head fractures associated with posterior hip dislocation, using the new surgical approach. Patients were followed for 2-96 months and outcome was documented with the Merle d'Aubigne and Postel score as well as the Thompson and Epstein score. The posttraumatic formation of heterotopic bone was documented with the Brooker score. Retrospective analysis of these 12 patients showed good or excellent results in 10 patients (83.3%). The two patients with poor outcome developed an avascular necrosis of the femoral head and underwent total hip arthroplasty. Periarticular heterotopic ossification was seen in five patients. In four patients this caused a significantly reduced range of motion and was therefore considered as a posttraumatic complication. The two patients with the most severe heterotopic bone formation (Brooker III and IV) had initially sustained multiple injuries including brain injury. Comparing our results with earlier published series including our own before changing the treatment protocol, the data suggest a favorable outcome in patients with trochanteric flip (digastric) osteotomy for the treatment of femoral head fractures.

Prevalence of halitosis in young male adults: a study in swiss army recruits comparing self-reported and clinical data

BACKGROUND: Sound epidemiologic data on halitosis are rare. We evaluated the prevalence of halitosis in a young male adult population in Switzerland using a standardized questionnaire and clinical examination. METHODS: Six hundred twenty-six Swiss Army recruits aged 18 to 25 years (mean: 20.3 years) were selected as study subjects. First, a standardized questionnaire focusing on dental hygiene, self-reported halitosis, smoking, and alcohol consumption was filled out by all participants. In the clinical examination, objective values for the presence of halitosis were gathered through an organoleptic assessment of the breath odor and the measurement of volatile sulfur compounds (VSCs). Additionally, tongue coating, plaque index, and probing depths were evaluated for each recruit. RESULTS: The questionnaire revealed that only 17% of all included recruits had never experienced halitosis. The organoleptic evaluation (grades 0 to 3) identified eight persons with grade 3, 148 persons with grade 2, and 424 persons with grade 1 or 0. The calculation of the Pearson correlation coefficient to evaluate the relationship among the three methods of assessing halitosis revealed little to no correlation. The organoleptic score showed high reproducibility (kappa = 0.79). Tongue coating was the only influencing factor found to contribute to higher organoleptic scores and higher VSC values. CONCLUSIONS: Oral malodor seemed to pose an oral health problem for about one-fifth of 20-year-old Swiss males questioned. No correlation between self-reported halitosis and organoleptic or VSC measurements could be detected. Although the organoleptic method described here offers a high reproducibility, the lack of correlation between VSC values and organoleptic scores has to be critically addressed. For further studies assessing new organoleptic scores, a validated index should always be included as a direct control.

A quantitative analysis of microcirculation in sore-prone pressure areas on conventional and pressure relief hospital mattresses using laser Doppler flowmetry and tissue spectrophotometry

BACKGROUND Pressure ulcers are associated with severe impairment for the patients and high economic load. With this study we wanted to gain more insight to the skin perfusion dynamics due to external loading. Furthermore, we evaluated the effect of different types of pressure relief mattresses. METHODS A total of 25 healthy volunteers were enrolled in the study. Perfusion dynamics of the sacral and the heel area were assessed using the O2C-device, which combines a laser light, to determine blood flow, and white light to determine the relative amount of hemoglobin. Three mattresses were evaluated compared to a hard surface: a standard hospital foam mattress bed, a visco-elastic foam mattress, and an air-fluidized bed. RESULTS In the heel area, only the air-fluidized bed was able to maintain the blood circulation (mean blood flow of 13.6 ± 6 versus 3.9 ± 3 AU and mean relative amount of hemoglobin of 44.0 ± 14 versus 32.7 ± 12 AU.) In the sacral area, all used mattresses revealed an improvement of blood circulation compared to the hard surface. CONCLUSION The results of this study form a more precise pattern of perfusion changes due to external loading on various pressure relief mattresses. This knowledge may reduce the incidence of pressure ulcers and may be an influencing factor in pressure relief mattress selection.

A comparative analysis of hospital -based physician monitoring systems

The purpose of the multiple case-study was to determine how hospital subsystems (such as physician monitoring and credentialing; quality assurance; risk management; and peer review) were supporting the monitoring of physicians? Three large metropolitan hospitals in Texas were studied and designated as hospitals #1, #2, and #3. Realizing that hospital subsystems are a unique entity and part of a larger system, conclusions were made on the premises of a quality control system, in relation to the tools of government (particularly the Health Care Quality Improvement Act (HCQIA)), and in relation to itself as a tool of a hospital.^ Three major analytical assessments were performed. First, the subsystems were analyzed as to their "completeness"; secondly, the subsystems were analyzed for "performance"; and thirdly, the subsystems were analyzed in reference to the interaction of completeness and performance.^ The physician credentialing and monitoring and the peer review subsystems as quality control systems were most complete, efficient, and effective in hospitals #1 and #3. The HCQIA did not seem to be an influencing factor in the completeness of the subsystem in hospital #1. The quality assurance and risk management subsystem in hospital #2 was not representative of completeness and performance and the HCQIA was not an influencing factor in the completeness of the Q.A. or R.M. systems in any hospital. The efficiency (computerization) of the physician credentialing, quality assurance and peer review subsystems in hospitals #1 and #3 seemed to contribute to their effectiveness (system-wide effect).^ The results indicated that the more complete, effective, and efficient subsystems were characterized by (1) all defined activities being met, (2) the HCQIA being an influencing factor, (3) a decentralized administrative structure, (4) computerization an important element, and (5) staff was sophisticated in subsystem operations. However, other variables were identified which deserve further research as to their effect on completeness and performance of subsystems. They include (1) medical staff affiliations, (2) system funding levels, (3) the system's administrative structure, and (4) the physician staff "cultural" characteristics. Perhaps by understanding other influencing factors, health care administrators may plan subsystems that will be compatible with legislative requirements and administrative objectives. ^

MCT1 T1470A polymorphism influences adherence to strength training in overweight and obese men following a weight loss program

The monocarboxylate transporter (MCT) family member MCT1 transports lactate into and out of myocytes. Oxidative cells import lactate through MCT1 as a substrate, being the role of MCT1 in glycolysis-derived lactate efflux less clear. MCT1 T1470A polymorphism (rs1049434), which has been related with lactate metabolism and sports specialty 1, 2, could be an influencing factor for exercise adherence. Therefore the aim of this study was to relate the adherence to different training modalities with the T1470A MCT1 polymorphism in overweight and obese men following a weight loss program (WLP).

Los usuarios ante los alimentos genéticamente modificados y su información en el etiquetado

OBJETIVO: Analizar la opinión que los usuarios tienen sobre alimentos genéticamente modificados y su información en el etiquetado. MÉTODOS: Realizada revisión sistemática de la literatura científica sobre los alimentos transgénicos y el etiquetado a partir de la consulta de las bases de datos bibliográficas: Medline (vía PubMed), EMBASE, ISIWeb of Knowledge, Cochrane Library Plus, FSTA, LILACS, CINAHL y AGRICOLA. Los descriptores seleccionados fueron: «organisms, genetically modified» y «food labeling». La búsqueda se realizó desde la primera fecha disponible hasta junio de 2012, seleccionando los artículos pertinentes escritos en inglés, portugués y castellano. RESULTADOS: Se seleccionaron 40 artículos. En todos ellos, se debía haber realizado una intervención poblacional enfocada al conocimiento de los consumidores sobre los alimentos genéticamente modificados y su necesidad, o no, de incluir información en el etiquetado. El consumidor expresa su preferencia por el producto no-genéticamente modificado, y apunta que está dispuesto a pagar algo más por él, pero, en definitiva compra el artículo que está a mejor precio en un mercado que acoge las nuevas tecnologías. En 18 artículos la población se mostraba favorable a su etiquetado obligatorio y seis al etiquetado voluntario; siete trabajos demostraban el poco conocimiento de la población sobre los transgénicos y, en tres, la población subestimó la cantidad que consumía. En todo caso, se observó la influencia del precio del producto genéticamente modificado. CONCLUSIONES: La etiqueta debe ser homogénea y aclarar el grado de tolerancia en humanos de alimentos genéticamente modificados en comparación con los no modificados. Asimismo, debe dejar claro su composición, o no, de alimento genéticamente modificado y la forma de producción de estos artículos de consumo. La etiqueta también debe ir acompañada de un sello de certificación de una agencia del estado y datos para contacto. El consumidor expresa su preferencia por el producto no-genéticamente modificado pero señaló que acaba comprando el artículo que está a mejor precio en un mercado que acoge las nuevas tecnologías.

Direct restorative materials use in Australia in 2002

Background: This study aimed to determine the reasons for dentists' choice of materials, in particular amalgam and resin composite, in Australia. Method: A questionnaire was developed to elicit this information. The names and addresses of 1000 dentists in Australia were selected at random. The questionnaire was mailed to these dentists with an explanatory letter and reply-paid envelope. Results: A total of 560 replies were received. Regarding choice of material, 99 per cent of respondents cited clinical indication as an influencing factor, although patients' aesthetic demands (99 per cent), patients' financial situation (82 per cent), and lecturers' suggestions (72 per cent) were also reported to influence respondents' choice of materials. Twelve per cent of respondents used composite 'always', 29 per cent 'often', 32 per cent 'sometimes', 23 per cent 'seldom' and 4 per cent 'never' in extensive load-bearing cavities in molar teeth. For composite restorations in posterior teeth, 84 per cent 'always', 'often' or 'sometimes' used the total etch technique, 84 per cent used a thick glass-ionomer layer and 36 per cent never used rubber dam. Fifty-nine per cent of respondents reported a decreased use of amalgam over the previous five years. Sixty-eight per cent of respondents agreed with the statement 'discontinuation of amalgam restricts a dentist's ability to adequately treat patients'. Seventy-five per cent considered that the growth in the use of composites increased the total cost of oral health care. Conclusions: Of the respondents from Australia 73 per cent place large composite restorations in molar teeth and their choice of material is influenced greatly by clinical indications, and patients' aesthetic demands.

Tympanometric norms for Chinese schoolchildren

Current tympanometric norms have acknowledged the relevance of age as,in influencing factor. However, little attention has been afforded to other potentialities such its the non-pathological effects of gender, ear asymmetry, and racial heritage. This study aimed to examine normative tympanometric findings in a large sample of Chinese schoolchildren. Using a Madsen 901 Middle Ear Analyzer, data was collected from 269 children (538 ears), ranging in age from 6.2-12.7 years (mean = 9.4 years, SD = 1.7), in Jiangsu province. Descriptive statistics were calculated for the parameters of equivalent car canal volume (chi = 1.03, SD = 0.25, 90% = 0.68-1.46), peak compensated static acoustic admittance (chi = 0.58, SD = 0.34, 90% = 0.26-1.13), tympanometric width (chi = 112, SD=36, 90% = 62-156), and peak pressure (chi = -25, SD = 30, 90% = -85-+10). Statistically significant car asymmetry and grade/age effects were estabished, although differences found were minor. In comparison with past studies in Caucasian paediatric populations, the Chinese normative data displayed minimal disparities.

The development and stability analysis of a nonlinear growth model for microorganisms

A nonlinear dynamic model of microbial growth is established based on the theories of the diffusion response of thermodynamics and the chemotactic response of biology. Except for the two traditional variables, i.e. the density of bacteria and the concentration of attractant, the pH value, a crucial influencing factor to the microbial growth, is also considered in this model. The pH effect on the microbial growth is taken as a Gaussian function G0e-(f- fc)2/G1, where G0, G1 and fc are constants, f represents the pH value and fc represents the critical pH value that best fits for microbial growth. To study the effects of the reproduction rate of the bacteria and the pH value on the stability of the system, three parameters a, G0 and G1 are studied in detail, where a denotes the reproduction rate of the bacteria, G0 denotes the impacting intensity of the pH value to microbial growth and G1 denotes the bacterial adaptability to the pH value. When the effect of the pH value of the solution which microorganisms live in is ignored in the governing equations of the model, the microbial system is more stable with larger a. When the effect of the bacterial chemotaxis is ignored, the microbial system is more stable with the larger G1 and more unstable with the larger G0 for f0 > fc. However, the stability of the microbial system is almost unaffected by the variation G0 and G1 and it is always stable for f0 < fc under the assumed conditions in this paper. In the whole system model, it is more unstable with larger G1 and more stable with larger G0 for f0 < fc. The system is more stable with larger G1 and more unstable with larger G0 for f0 > fc. However, the system is more unstable with larger a for f0 < fc and the stability of the system is almost unaffected by a for f0 > fc. The results obtained in this study provide a biophysical insight into the understanding of the growth and stability behavior of microorganisms.

Achievement motivation attributes of international students attending a *postsecondary institution

The purpose of this study was to identify and compare the causal attributes of achievement motivation for academic success possessed by international students to those causal attributes of achievement motivation by other legal immigrant student groups attending a postsecondary institution. In this study, F-1 international students have obtained permission from the federal Department of Immigration and Naturalization Services to attend Miami-Dade Community College in Miami, Florida. There were two additional groups of students selected to participate in this study: Permanent Resident students and Others comprised of asylees, refugees and paroles, which are specific categories of legal immigrant students.^ From the observations of the investigator, international students were more successful at the institution as compared to the other two student groups as measured by such variables as Grade Point Average, Number of Credits Earned and Honors Day awards. By identifying these attributes of achievement motivation, additional curricula, support services and activities can be developed to meet the needs of these highly motivated students.^ Incorporating the theories of McClelland and Weiner in the theoretical framework of the study, both quantitative and qualitative data were collected from 150 subjects using the Measurement of Achievement Motivation Questionnaire and the Guided Biography Interview as data collection instruments. Statistical analyses on the data collected from the three groups of foreign born students at the institution indicated differences in these identified attributes and their effects on academic success.^ Results indicated that F-1 international students at Miami-Dade Community College were highly motivated to achieve, possessed different causal attributes of achievement motivation and displayed their need for achievement in different activities and in different ways as compared to the Permanent Resident and Other student groups. Further investigation on the importance of residency status as an influencing factor of achievement motivation is suggested. ^

Radiation fluxes, soil heat flux, air temperature, soil temperature, soil moisture and vegetation at dwarf shrubs and wet sedges in Kytalyk, NE Siberia

Vegetation changes, such as shrub encroachment and wetland expansion, have been observed in many Arctic tundra regions. These changes feed back to permafrost and climate. Permafrost can be protected by soil shading through vegetation as it reduces the amount of solar energy available for thawing. Regional climate can be affected by a reduction in surface albedo as more energy is available for atmospheric and soil heating. Here, we compared the shortwave radiation budget of two common Arctic tundra vegetation types dominated by dwarf shrubs (Betula nana) and wet sedges (Eriophorum angustifolium) in North-East Siberia. We measured time series of the shortwave and longwave radiation budget above the canopy and transmitted radiation below the canopy. Additionally, we quantified soil temperature and heat flux as well as active layer thickness. The mean growing season albedo of dwarf shrubs was 0.15 ± 0.01, for sedges it was higher (0.17 ± 0.02). Dwarf shrub transmittance was 0.36 ± 0.07 on average, and sedge transmittance was 0.28 ± 0.08. The standing dead leaves contributed strongly to the soil shading of wet sedges. Despite a lower albedo and less soil shading, the soil below dwarf shrubs conducted less heat resulting in a 17 cm shallower active layer as compared to sedges. This result was supported by additional, spatially distributed measurements of both vegetation types. Clouds were a major influencing factor for albedo and transmittance, particularly in sedge vegetation. Cloud cover reduced the albedo by 0.01 in dwarf shrubs and by 0.03 in sedges, while transmittance was increased by 0.08 and 0.10 in dwarf shrubs and sedges, respectively. Our results suggest that the observed deeper active layer below wet sedges is not primarily a result of the summer canopy radiation budget. Soil properties, such as soil albedo, moisture, and thermal conductivity, may be more influential, at least in our comparison between dwarf shrub vegetation on relatively dry patches and sedge vegetation with higher soil moisture.

Development of a transitioning approach to reduce surface water volumes in combined sewer systems

The overarching goal of this research is to establish a successful forum for a transition from the existing paradigm of managing wastewater infrastructure to a more sustainable paradigm that achieves a more efficient utilisation of wastewater assets. A transitioning approach to support a more efficient utilisation of surface water and wastewater assets and infrastructure is proposed and developed. The determined transitioning approach possesses key stages namely developing the arena, developing the agenda, case study, and monitoring. The case study stage investigates a drainage utility identifying their improvement drivers, the removal of surface water through detailed drainage modelling and the financial examination of the costs incurred under the various scenarios conducted. Understanding the implications of removing/attenuating surface water from the network is improved through obtaining data by detailed drainage modelling. Infoworks software is used to investigate and assess the current and future operational scenarios of a wastewater system operating over one calendar year. Modelling scenarios were conducted removing surface water from selected areas focusing on the volumes requiring pumping and durations of pumping station(s) operation prior to treatment during storm conditions. The financial implication of removing surface water in combined sewer systems is examined in three main components. Firstly the costs of electricity incurred at the single sewage pumping station (SPS) investigated during the various scenarios modelled require to be addressed. Secondly the costs to retrofit sustainable urban drainage system (SUDS) solutions needs to be identified. Thirdly the implications of removing surface water for the drainage utility at the national level and the potential saving for householder’s committing to a surface water disconnection rebate scheme. When addressed at the macro level i.e., with over 2,100 pumping stations, some operating in sequence and contained within one drainage utility annually treating 315,360 megalitres the significance of the same multiple quantifiable and intangible benefits becomes amplified. The research aims, objectives and findings are presented to the identified and convened stakeholders. The transitioning approach developed encourages positive discourse between stakeholders. The level of success of the transitioning approach determined is then tested using a quantitative methodology through the completion of questionnaires. From the questionnaires completed the respondents unanimously agreed that surface water flows should be removed as well as reduced from the combined sewer system. The respondents agreed that the removal of surface water from a typical combined sewer system is justified by applying a transitioning approach focusing on the energy consumption required to pump increased volumes during storm events. This response is significant based upon the economic evidence and is contrary to the respondents previous position that finance was their most influencing factor. When provided with other potentially available benefits the respondents were even more supportive of the justification to remove surface water from the combined sewer system. The combined findings of the work presented in this thesis provide further justification that the transitioning approach applied to the removal of surface water from a typical combined sewer system, as determined in this research has been successful.