Self-reported alcohol consumption and its association with adherence and outcome of antiretroviral therapy in the Swiss HIV Cohort Study

BACKGROUND: Alcohol consumption leading to morbidity and mortality affects HIV-infected individuals. Here, we aimed to study self-reported alcohol consumption and to determine its association with adherence to antiretroviral therapy (ART) and HIV surrogate markers. METHODS: Cross-sectional data on daily alcohol consumption from August 2005 to August 2007 were analysed and categorized according to the World Health Organization definition (light, moderate or severe health risk). Multivariate logistic regression models and Pearson's chi(2) statistics were used to test the influence of alcohol use on endpoints. RESULTS: Of 6,323 individuals, 52.3% consumed alcohol less than once a week in the past 6 months. Alcohol intake was deemed light in 39.9%, moderate in 5.0% and severe in 2.8%. Higher alcohol consumption was significantly associated with older age, less education, injection drug use, being in a drug maintenance programme, psychiatric treatment, hepatitis C virus coinfection and with a longer time since diagnosis of HIV. Lower alcohol consumption was found in males, non-Caucasians, individuals currently on ART and those with more ART experience. In patients on ART (n=4,519), missed doses and alcohol consumption were positively correlated (P<0.001). Severe alcohol consumers, who were pretreated with ART, were more often off treatment despite having CD4+ T-cell count <200 cells/microl; however, severe alcohol consumption per se did not delay starting ART. In treated individuals, alcohol consumption was not associated with worse HIV surrogate markers. CONCLUSIONS: Higher alcohol consumption in HIV-infected individuals was associated with several psychosocial and demographic factors, non-adherence to ART and, in pretreated individuals, being off treatment despite low CD4+ T-cell counts.

A compact and portable deposition chamber to study nanoparticles in air-exposed tissue

BACKGROUND Epidemiological studies show that elevated levels of particulate matter in ambient air are highly correlated with respiratory and cardiovascular diseases. Atmospheric particles originate from a large number of sources and have a highly complex and variable composition. An assessment of their potential health risks and the identification of the most toxic particle sources would require a large number of investigations. Due to ethical and economic reasons, it is desirable to reduce the number of in vivo studies and to develop suitable in vitro systems for the investigation of cell-particle interactions. METHODS We present the design of a new particle deposition chamber in which aerosol particles are deposited onto cell cultures out of a continuous air flow. The chamber allows for a simultaneous exposure of 12 cell cultures. RESULTS Physiological conditions within the deposition chamber can be sustained constantly at 36-37°C and 90-95% relative humidity. Particle deposition within the chamber and especially on the cell cultures was determined in detail, showing that during a deposition time of 2 hr 8.4% (24% relative standard deviation) of particles with a mean diameter of 50 nm [mass median diameter of 100 nm (geometric standard deviation 1.7)] are deposited on the cell cultures, which is equal to 24-34% of all charged particles. The average well-to-well variability of particles deposited simultaneously in the 12 cell cultures during an experiment is 15.6% (24.7% relative standard deviation). CONCLUSIONS This particle deposition chamber is a new in vitro system to investigate realistic cell-particle interactions at physiological conditions, minimizing stress on the cell cultures other than from deposited particles. A detailed knowledge of particle deposition characteristics on the cell cultures allows evaluating reliable dose-response relationships. The compact and portable design of the deposition chamber allows for measurements at any particle sources of interest.

Design and evaluation of the parent education component of a comprehensive violence prevention project in middle schools

Low parental monitoring is related to youth risk behaviors such as delinquency and aggression. The purpose of this dissertation was to describe the development and evaluation of a parent education intervention to increase parental monitoring in Hispanic parents of middle school children.^ The first study described the process of intervention mapping as used to develop Padres Trabajando por la Paz, a newsletter intervention for parents. Using theory, empirical literature, and information from the target population, performance objectives and determinants for monitoring were defined. Learning objectives were specified and a staged social-cognitive approach was used to develop methods and strategies delivered through newsletters.^ The second study examined the outcomes of a randomized trial of the newsletter intervention. Outcome measures consisted of a general measure of monitoring, parent and child reports of monitoring behaviors targeted by the intervention, and psychosocial determinants of monitoring (self-efficacy, norms, outcome expectancies, knowledge, and beliefs). Seventy-seven parents completed the randomized trial, half of which received four newsletters over an eight-week period. Results revealed a significant interaction effect for baseline and treatment for parent's reports of norms for monitoring (p =.009). Parents in the experimental condition who scored low at baseline reported increased norms for monitoring at follow-up. A significant interaction effect for child reports of parental monitoring behaviors (p =.04) reflected an small increase across baseline levels in the experimental condition and decreases for the control condition at higher baseline scores. Both groups of parents reported increased levels of monitoring at follow-up. No other outcome measures varied significantly by condition.^ The third study examined the relationship between the psychosocial determinants of parental monitoring and parental monitoring behaviors in the study population. Weak evidence for a relationship between outcome expectancies and parental monitoring behaviors suggests further research in the area utilizing stronger empirical models such as longitudinal design and structural equation modeling.^ The low-cost, minimal newsletter intervention showed promise for changing norms among Hispanic parents for parental monitoring. In light of the importance of parental monitoring as a protective factor for youth health risk behaviors, more research needs to be done to develop and evaluate interventions to increase parental monitoring. ^

Variation of genotype and prevalence of Noro virus in U.S. students in Mexico with Traveler's Diarrhea, summer of 2004 and 2005

Noro virus, a positive single stranded RNA virus has been identified as a major etiologic agent in food borne gastroenteritis and diarrheal diseases. The emergence of this organism as a major non-bacterial cause in such outbreaks is partly due to the improved diagnostic tools like Reverse Transcription Polymerase chain reaction (RTPCR) that enable its detection. Noro virus accounts for nearly 96% of non-bacterial gastroenteritis outbreaks in US (1). Travelers' Diarrhea (TD) has remained a constant public health risk in the developed nations for decades and bacteria like Entero toxigenic Escherichia coli, Entero aggregative Escherichia coli have been described as the main etiologic agents for TD (2-4). A possible viral contribution to TD has been discovered in two studies (5, 6). The current study was designed to determine the prevalence of Noro virus in a population of 107 US students with TD acquired in Mexico in 2005 and to compare the prevalence to the prevalence of Noro virus in a similar study done in 2004. This study involved the testing of clinical stool specimens from 107 subjects in 2005 for the presence of Noro virus using RTPCR. The prevalence of Noro virus in 2004 used for comparison to 2005 data was obtained from published data (5). All subjects were recruited as TD subjects in a randomized, double-blinded clinical trial comparing a standard three day dosing of Rifaximin with and without an anti motility drug Loperamide. The prevalence of Noro virus geno group I was similar in both years, but geno group II prevalence differed across the two years (p = 0.003). This study finding suggests that the prevalence of Noro virus geno groups varies with time even within a specific geographic location. This study emphasizes the need for further systematic epidemiologic studies to determine the molecular epidemiology and the prevalence patterns of different geno groups of this virus. These are essential to planning and implementation of public health measures to lessen the burden of TD due to Noro virus infection among US travelers. ^

Evaluation of a solid phase microextraction method for community-based monitoring of 1,3-butadiene and benzene in Houston, Texas

The Houston region is home to arguably the largest petrochemical and refining complex anywhere. The effluent of this complex includes many potentially hazardous compounds. Study of some of these compounds has led to recognition that a number of known and probable carcinogens are at elevated levels in ambient air. Two of these, benzene and 1,3-butadiene, have been found in concentrations which may pose health risk for residents of Houston.^ Recent popular journalism and publications by local research institutions has increased the interest of the public in Houston's air quality. Much of the literature has been critical of local regulatory agencies' oversight of industrial pollution. A number of citizens in the region have begun to volunteer with air quality advocacy groups in the testing of community air. Inexpensive methods exist for monitoring of ozone, particulate matter and airborne toxic ambient concentrations. This study is an evaluation of a technique that has been successfully applied to airborne toxics.^ This technique, solid phase microextraction (SPME), has been used to measure airborne volatile organic hydrocarbons at community-level concentrations. It is has yielded accurate and rapid concentration estimates at a relatively low cost per sample. Examples of its application to measurement of airborne benzene exist in the literature. None have been found for airborne 1,3-butadiene. These compounds were selected for an evaluation of SPME as a community-deployed technique, to replicate previous application to benzene, to expand application to 1,3-butadiene and due to the salience of these compounds in this community. ^ This study demonstrates that SPME is a useful technique for quantification of 1,3-butadiene at concentrations observed in Houston. Laboratory background levels precluded recommendation of the technique for benzene. One type of SPME fiber, 85 μm Carboxen/PDMS, was found to be a sensitive sampling device for 1,3-butadiene under temperature and humidity conditions common in Houston. This study indicates that these variables affect instrument response. This suggests the necessity of calibration within specific conditions of these variables. While deployment of this technique was less expensive than other methods of quantification of 1,3-butadiene, the complexity of calibration may exclude an SPME method from broad deployment by community groups.^

Doctor-patient communication in the medical interaction: Context, implications, and practice

Effective communication; whether from an interpersonal, mass media, or global perspective, is a critical component in public health. It is an essential conduit in increasing public awareness of available health resources, potential health hazards and related disease prevention strategies, and in delivering better health care. Within this context, available literature asserts doctor-patient communication as central to healthcare delivery. It has been shown to affect patient health outcomes, satisfaction with care, adherence to treatment recommendations, and even understanding of medical information. While research supports the essential imperative of interventions aimed at teaching doctors and patients the communication skills necessary for a successful and meaningful medical interaction, most interventions to date, focus on teaching these communication skills to doctors and seem to rely, largely, on mass media for providing patients with the information needed to increase communication efficacy. This study sought to fill a significant gap in the doctor-patient communication literature by reviewing the context of the doctor-patient exchange in the medical interaction, the implications of this exchange in resulting care of the patient, and the potential improvements to practice through interventions aimed at improving the communication exchange. Closing with an evaluation of a patient-centered communication intervention, the “How to Talk to Your Doctor” (HTTTYD) program that combines previously identified optimal strategies for improving communication between doctors and patients, this study examined the patients’ perspective of their potential as better communicators in the medical interaction. ^ Specific Aims, Hypotheses or Questions (Aim I) To examine the context of health communication within a public health framework and its relation to health care delivery. (Aim II) To review doctor-patient communication as a central focus within health care delivery and the resulting implications to patient care. (Aim III) To assess the utility of interventions to improve doctor-patient communication. Specifically, to evaluate the effectiveness of a patient-centered community education intervention, the “How to Talk to Your Doctor” (HTTTYD) program, aimed at improving patient communication efficacy.^

Selection of body fat distribution indices in adults and associations with plasma lipid metabolism variables

Body fat distribution is a cardiovascular health risk factor in adults. Body fat distribution can be measured through various methods including anthropometry. It is not clear which anthropometric index is suitable for epidemiologic studies of fat distribution and cardiovascular disease. The purpose of the present study was to select a measure of body fat distribution from among a series of indices (those traditionally used in the literature and others constructed from the analysis) that is most highly correlated with lipid-related variables and is independent of overall fatness. Subjects were Mexican-American men and women (N = 1004) from a study of gallbladder disease in Starr County, Texas. Multivariate associations were sought between lipid profile measures (lipids, lipoproteins, and apolipoproteins) and two sets of anthropometric variables (4 circumferences and 6 skinfolds). This was done to assess the association between lipid-related measures and the two sets of anthropometric variables and guide the construction of indices.^ Two indices emerged from the analysis that seemed to be highly correlated with lipid profile measures independent of obesity. These indices are: 2*arm circumference-thigh skinfold in pre- and post-menopausal women and arm/thigh circumference ratio in men. Next, using the sum of all skinfolds to represent obesity and the selected body fat distribution indices, the following hypotheses were tested: (1) state of obesity and centrally/upper distributed body fat are equally predictive of lipids, lipoproteins and apolipoproteins, and (2) the correlation among the lipid-related measures is not altered by obesity and body fat distribution.^ With respect to the first hypothesis, the present study found that most lipids, lipoproteins and apolipoproteins were significantly associated with both overall fatness and anatomical location of body fat in both sex and menopausal groups. However, within men and post-menopausal women, certain lipid profile measures (triglyceride and HDLT among post-menopausal women and apos C-II, CIII, and E among men) had substantially higher correlation with body fat distribution as compared with overall fatness.^ With respect to the second hypothesis, both obesity and body fat distribution were found to alter the association among plasma lipid variables in men and women. There was a suggestion from the data that the pattern of correlations among men and post-menopausal women are more comparable. Among men correlations involving apo A-I, HDLT, and HDL$\sb2$ seemed greatly influenced by obesity, and A-II by fat distribution; among post-menopausal women correlations involving apos A-I and A-II were highly affected by the location of body fat.^ Thus, these data point out that not only can obesity and fat distribution affect levels of single measures, they also can markedly influence the pattern of relationship among measures. The fact that such changes are seen for both obesity and fat distribution is significant, since the indices employed were chosen because they were independent of one another. ^

AN INVESTIGATION OF VOLATILE ORGANIC AIR CONTAMINANTS IN THE INDOOR MANUFACTURED HOUSING ENVIRONMENT (TEXAS)

Manufactured housing has been found to have substantial levels of formaldehyde in the indoor air. Because mobile homes are more affordable than conventional housing, there has been a large increase in their use in the U.S. This increase in mobile home use has been substantial in the sunbelt regions such as Texas, where high temperatures and humidities may enhance out-gassing of formaldehyde and other volatile organic compounds from construction and furnishing materials and increase any potential health hazards.^ The influences of environmental, architectural and temporal factors on the presence of indoor formaldehyde and other organic compounds were investigated in conjunction with the Texas Indoor Air Quality Study of manufactured housing. A matched pair of mobile homes, one with electric heating and cooking utilities and the other with propane gas utilities, were used for a series of controlled experiments over a fourteen month period from October, 1982 through November, 1983.^ Over this fourteen month period formaldehyde levels decreased approximately 33%. Daily fluctuations of 20% to 40% were observed even with a constant indoor temperature. An increase in indoor temperature of 8(DEGREES)C doubled the measured formaldehyde concentration. Opening windows resulted in decreases of indoor formaldehyde levels of up to 50%. Studies of the impact of propane as a cooking source showed no increase in formaldehyde levels with stove use.^ The presence and concentration of selected volatile organic compounds is influenced greatest by occupancy. Occupants continually open and close windows and doors, vary the operation and settings (temperature) of air control systems, and vary in their selection of furnishings and use of consumer products, which may act as sources of indoor air contaminants. ^

The success of worksite nutrition and physical activity interventions with environmental modifications A systematic review

Background: As obesity increases among U.S. workers, employers are implementing programs to increase physical activity and improve diets. Although programs to address individual determinants of obesity have been evaluated, less is known about the effects of workplace programs that change environmental factors, because most reviews have not isolated environmental programs; the one that did was published in 2005. ^ Objective: To update the 2005 review to determine the effectiveness of workplace environmental interventions. ^ Methods: The Medline database was searched for published English language reports (2003-2011) of randomized controlled (RCTs) or quasi-experimental trials (NRCTs) that evaluated strategies to modify physical activity opportunities or food services, targeting employees at least 18 years, not including retirees and that provided data for at least one physical activity, dietary, or health risk indicator. Three coders independently extracted study characteristics and scored the quality of study methods. Program effectiveness was determined using the 2005 review's best evidence approach. ^ Results: Seven studies represented in nine reports met eligibility criteria; three focused on diet and the remainder targeted diet and physical activity interventions. All but one study received a high quality score for internal validity. The evidence for the effectiveness of workplace environmental interventions was at best, inconclusive for diet and physical activity and limited for health risk indicators. The outcome constructs were inconsistent across the studies. ^ Conclusions: Limitations in the methods of the 2005 review made it challenging to draw conclusions about findings for this review that include: variation in outcome measures, reliance on distal measures without proximal behavior change measures, no distinction between changes at the workplace versus outside the workplace, and inappropriate analyses of cluster designs that biased findings toward statistical significance. The best evidence approach relied on vote-counting, using statistical significance alone rather than effect size and confidence intervals. Future research should address these limitations and use more rigorous methods; systematic reviews should use methods of meta-analysis to summarize study findings. These recommendations will help employers to better understand how environmental modifications in the workplace can support their efforts to combat the effects of obesity among employees.^

Editorial: Take Me Home, Down Country Roads

Those of us committed to the tenets of Family Preservation must advocate for increased awareness and attention to the needs of children and their families in rural America. "Country roads" and the rural spaces they traverse have been eulogized by many poets and song writers as ideal places to live. But they may not be ideal for everyone. The past few months, it has become all too evident that rural America is not immune to acts of extreme violence by troubled children. Even though almost 1/3 of American youth live in rural areas, they have been "virtually ignored by mental health service planners and providers"(Cutrona, Halvorson, & Russell, 1996, p. 217). Mental health risk factors such as poverty, parental alcohol abuse, and family instability are on the rise in rural areas, and there has been an increase in suicide attempts, family violence, depression, and alcohol abuse (Cutrona, Halvorson, & Russell, 1996; Petti & Leviton, 1986; National Mental Health Association, 1988). Native Americans are especially concerned about the increases in child abuse and neglect, depression, substance abuse, and suicide in their communities.

The impact of school year work on adolescent *development

In recent decades, work has become an increasingly common feature of adolescent life in the United States. Once assumed to be an inherently positive experience for youth, school year work has recently been associated with several adverse effects, especially as the number of hours of weekly work increases. The purpose of this dissertation was to describe the impact of school year work on adolescent development in a sample of high school students from rural South Texas, an area where economically-disadvantaged and Hispanic students are heavily represented.^ The first study described the prevalence and work circumstances of 3,565 10$\rm\sp{th}$ and 12$\rm\sp{th}$ grade students who responded to anonymous surveys conducted in regular classrooms. The overall prevalence of current work was 53%. Prevalence differed by grade, college-noncollege-bound status, and parent education. Fifty percent of employed students worked to support consumer spending.^ The second study examined the effects of four levels of work intensity on the academic, behavioral, social, mental and physical health of students. The following negative effects of intense work were reported: (1) decreased engagement in school, satisfaction with leisure time, and hours of weeknight and weekend sleep, and (2) increased health risk behaviors and psychological stress. The negative effects of intense work differed by gender, grade, ethnicity, but not by parent education.^ The third study described the prevalence of injury in the study population. A dose response effect was observed where increasing hours of weekly work were significantly related to work-related injury. The likelihood of being injured while employed in restaurant, farm/ranch, and construction work was greater than the probability of being injured while working in factory/office/skilled, yard, or retail work when compared to babysitting. Cuts, shocks/burns and sprains were the most common injuries in working teens.^ Students, parents, educators, health professionals and policymakers should continue to monitor the number of weekly hours that students work during the school year. ^

A design-phase PSA of anuclear-powered hydrogen plant

A probabilistic safety assessment (PSA) is being developed for a steam-methane reforming hydrogenproduction plant linked to a high-temperature gas-cooled nuclear reactor (HTGR). This work is based on the Japan Atomic Energy Research Institute's (JAERI) High Temperature Engineering Test Reactor (HTTR) prototype in Japan. The objective of this paper is to show how the PSA can be used for improving the design of the coupled plants. A simplified HAZOP study was performed to identify initiating events, based on existing studies. The results of the PSA show that the average frequency of an accident at this complex that could affect the population is 7 × 10−8 year−1 which is divided into the various end states. The dominant sequences are those that result in a methane explosion and occur with a frequency of 6.5 × 10−8 year−1, while the other sequences are much less frequent. The health risk presents itself if there are people in the vicinity who could be affected by the explosion. This analysis also demonstrates that an accident in one of the plants has little effect on the other. This is true given the design base distance between the plants, the fact that the reactor is underground, as well as other safety characteristics of the HTGR.

Dynamic analysis using finite elements to calculate the critical wear section of the contact wire in suburban railway overhead conductor rails

The purpose of this study is to determine the critical wear levels of the contact wire of the catenary on metropolitan lines. The study has focussed on the zones of contact wire where localised wear is produced, normally associated with the appearance of electric arcs. To this end, a finite element model has been developed to study the dynamics of pantograph-catenary interaction. The model includes a zone of localised wear and a singularity in the contact wire in order to simulate the worst case scenario from the point of view of stresses. In order to consider the different stages in the wire wear process, different depths and widths of the localised wear zone were defined. The results of the dynamic simulations performed for each stage of wear let the area of the minimum resistant section of the contact wire be determined for which stresses are greater than the allowable stress. The maximum tensile stress reached in the contact wire shows a clear sensitivity to the size of the local wear zone, defined by its width and depth. In this way, if the wear measurements taken with an overhead line recording vehicle are analysed, it will be possible to calculate the potential breakage risk of the wire. A strong dependence of the tensile forces of the contact wire has also been observed. These results will allow priorities to be set for replacing the most critical sections of wire, thereby making maintenance much more efficient. The results obtained show that the wire replacement criteria currently borne in mind have turned out to be appropriate, although in some wear scenarios these criteria could be adjusted even more, and so prolong the life cycle of the contact wire.

A simplified Probabilistic Safety Assesment of a Steam-Methane Reforming Hydrogen Production Plant coupled to a High-Temperature Gas Cooled Nuclear Reactor

A Probabilistic Safety Assessment (PSA) is being developed for a steam-methane reforming hydrogen production plant linked to a High-Temperature Gas Cooled Nuclear Reactor (HTGR). This work is based on the Japan Atomic Energy Research Institute’s (JAERI) High Temperature Test Reactor (HTTR) prototype in Japan. This study has two major objectives: calculate the risk to onsite and offsite individuals, and calculate the frequency of different types of damage to the complex. A simplified HAZOP study was performed to identify initiating events, based on existing studies. The initiating events presented here are methane pipe break, helium pipe break, and PPWC heat exchanger pipe break. Generic data was used for the fault tree analysis and the initiating event frequency. Saphire was used for the PSA analysis. The results show that the average frequency of an accident at this complex is 2.5E-06, which is divided into the various end states. The dominant sequences result in graphite oxidation which does not pose a health risk to the population. The dominant sequences that could affect the population are those that result in a methane explosion and occur 6.6E-8/year, while the other sequences are much less frequent. The health risk presents itself if there are people in the vicinity who could be affected by the explosion. This analysis also demonstrates that an accident in one of the plants has little effect on the other. This is true given the design base distance between the plants, the fact that the reactor is underground, as well as other safety characteristics of the HTGR. Sensitivity studies are being performed in order to determine where additional and improved data is needed.

Investigación técnica y económica sobre desinfección de aguas residuales por sistemas de oxidación

Un incremento de la demanda del agua, junto con el aumento de la contaminación, ha provocado que hoy en día la reutilización de las aguas depuradas sea necesaria, pero la reutilización de aguas debe garantizar y minimizar los posibles riesgos sanitarios y medioambientales que su práctica pueda provocar. En España estos parámetros se encuentran regulados por el RD 1620/2007 relativo al régimen jurídico de la reutilización de las aguas depuradas. Las aguas regeneradas son aguas que ya han sido sometidas a un tratamiento de depuración, y a las cuales se aplica un posterior tratamiento adicional o complementario que permita adecuar su calidad al uso al que vaya a destinarse. Siendo requeridos para los distintos reúsos procesos de desinfección, uno de los principales sistemas utilizados es el cloro, debido a su sencilla aplicación y costos bajos, sin tomar en cuenta la posible formación de compuestos organohalogenados potencialmente cancerígenos. Es por esto que surge la necesidad de aplicar distintos sistemas de oxidación objeto de estudio en esta tesis, como el dióxido de cloro estabilizado, ozono y los procesos avanzados de oxidación (Advanced Oxidation Processes, AOP), ozono/peróxido y uv/peróxido. En esta tesis se investiga los rendimientos que pueden alcanzar estos sistemas en la eliminación de los ácidos húmicos y los fenoles, siendo las principales sustancias formadoras de subproductos de la desinfección, así mismo, se considera necesario garantizar la desinfección del agua a través del estudio de tres grupos de microrganismos, los coliformes totales, e. coli y enterococos, siendo un punto importante el posible recrecimiento microbiológico debido a una desinfección escasa, por la permanencia en el agua de los compuestos antes mencionados, o por alguna fuente de alimento que pudieran encontrar en el sistema de distribución. Lo más importante será la calidad que se pueda alcanzar con estos desinfectantes, con el fin de obtener agua para los distintos reúsos que existen en la actualidad. Y así no limitar los alcances que puede tener la reutilización de las aguas residuales. Basándose en lo antes mencionado se procedió a realizar la caracterización del agua del rio Manzanares, con el fin de determinar la cantidad de ácidos húmicos disueltos y fenoles, obteniendo valores bajos, se decidió incorporar a las muestras de rio 5 mg/L de estos compuestos, con el fin de observar de que manera podrían interferir en la desinfección de esta agua. De esta forma se logran obtener resultados óptimos de los sistemas de desinfección estudiados, siendo el Ozono un oxidante eficiente en la desinfección de los microrganismos y en la eliminación de ácidos húmicos y fenoles con tiempos de contacto cortos, mostrando deficiencias al permitir el recrecimiento de los coliformes totales. Del sistema de oxidación avanzada UV/Peróxido se determino como un eficiente desinfectante para garantizar la inexistencia de rebrotes, al paso del tiempo. Así mismo se concluye que tiene buenos rendimientos en la eliminación del ácido húmico y los fenoles. An increase in water demand, coupled with increasing pollution, has caused today reuse of treated water is necessary, but must ensure water reuse and minimize potential health and environmental risks that their practice is cause. In Spain these parameters are regulated by Royal Decree 1620/2007 on the legal regime of the reuse of treated water. The reclaimed water is water that has already been subjected to a depuration treatment, which is applied as a subsequent further treatment that will bring quality to the use to which is to be delivered. As required for various reuses disinfection processes, one of the main systems used is chlorine, due to its simple implementation and low costs, without taking into account the possible formation of potentially carcinogenic halogenated organic compounds. That is why there is a need to apply different oxidation systems studied in this thesis, as stabilized chlorine dioxide, ozone and advanced oxidation processes (AOP), ozone/peroxide and UV/peroxide. This thesis investigates the rates can reach these systems in removing humic acids and phenols, the main substances forming disinfection byproducts, likewise, it is considered necessary to ensure water disinfection through the study of three groups of microorganisms, total coliform, e. coli and enterococci, the important point being a possible regrowth due to microbiological disinfection scarce, the water remaining on the aforementioned compounds, or a food source which may be found in the distribution system. The most important quality is that achievable with these disinfectants, with the water to obtain various reuses that exist today. And thus not limit the scope that can be reuse of wastewater. Based on the above we proceeded to perform characterization Manzanares river water, in order to determine the quantity of dissolved humic acids and phenols, obtaining low values, it was decided to incorporate river samples 5 mg / L of these compounds, in order to observe how they might interfere with the disinfection of the water. Thus optimum results are achieved for disinfection systems studied, being efficient ozone oxidant in the disinfection of microorganisms and the removal of humic acids and phenols with short contact times, showing gaps to allow regrowth total coliforms. Advanced oxidation system UV / peroxide were determined as an efficient disinfectant to ensure the absence of volunteers, the passage of time. Also it is concluded that has good yields in removing humic acid and phenols.