Alternative treatments

Environmental Pollution Control Alternatives Centralized Waste Treatment Alternatives for the Electroplating Industry, Jime 1981 625/5-81-017. 

What nonpharmacologic and pharmacologic treatment alternatives are available for this patient ... 

Electroconvulsive therapy (ECT) is a highly efficacious treatment for MDD. The response rate is about 80% to 90% and even exceeds 50% for patients who have failed pharmacotherapy.16,17 ECT may be particularly beneficial for MDD that is complicated by psychotic features, severe suicidality, refusal to eat, pregnancy, or contraindication/non-response to pharmacotherapy.16,17 ECT is typically a very safe treatment alternative, but various cautions do exist, and the chief side effects are confusion and memory impairment.16... 

Rush, A. J., Fava, M., Wisniewski, S. R. et al. (2004). Sequenced treatment alternatives to relieve depression (STAR D) rationale and design. Controlled Clinical Trials, 25(1), 119-42. 

Precious metal wastes can be treated using the same treatment alternatives as those described for treatment of common metal wastes. However, due to the intrinsic value of precious metals, every effort should be made to recover them. The treatment alternatives recommended for precious metal wastes are the recovery techniques—evaporation, ion exchange, and electrolytic recovery. 

SARA requires that remedial actions meet all applicable or relevant federal standards or any more stringent state standards. Nine criteria that need to be met are set by CERCLA as amended by SARA for a complete assessment of treatment alternatives applicable for a site remedial action12 ... 

To provide sufficient data to allow treatment alternatives to be fully developed and evaluated during the detailed analyses, and to support the remedial design of a selected alternative... 

To reduce cost and performance uncertainties for treatment alternatives to acceptable levels so that a remedy can be selected... 

This determination requires an examination of both an old and a new line of cases. In the new line of cases, plaintiffs have argued—in the therapeutic context—that health care providers have a duty to provide comparative data about the effectiveness not only of various treatment alternatives, but also about the qualifications, competence, and experience of the provider. In the one case in which plaintiffs have so far succeeded in surviving a motion to dismiss, the Wisconsin Supreme Court held that a neurosurgeon had a duty to disclose his level of experience with a procedure and the morbidity and mortality differences between himself and more experienced neurosurgeons (Johnson v. Kokemoor, 1996). The Wisconsin court s ruling has been labeled the "second revolution" of the informed consent doctrine (Twerski and Cohen, 1999 Ketler, 2001). 

In a cost-benefit analysis, both costs and consequences are valued in dollars and the ratio of cost to benefit (or more commonly benefit to cost) is computed. Cost-benefit analysis has been used for many years to assess the value of investing in a number of different opportunities, including investments (or expenditure) for health care services. Cost-effectiveness analysis attempts to overcome (or avoid) the difficulties in cost-benefit analysis of valuing health outcomes in dollars by using nonmonetary outcomes such as life-years saved or percentage change in biomarkers like serum cholesterol levels. Cost-minimization analysis is a special case of cost-effectiveness analysis in which the outcomes are considered to be identical or clinically equivalent. In this case, the analysis defaults to selecting the lowest-cost treatment alternative. Cost-utility analysis is another special case of cost-effectiveness analysis in which the value of the outcome is adjusted for differences in patients preferences (utilities) for the outcomes. Cost-utility analyses are most appropriate when quality of life is a very important consideration in the therapeutic decision. 

Consistently low environmental emission characteristics exhibited by plasma gasification support the idea that it can be used as a waste treatment alternative to other technologies... 

Twenty years ago the dislike of traditional treatment may have presented some real challenges. Today, however, there are many more treatment alternatives to which a client can be referred to if she or he would not match well with a traditional treatment facility. A good referral might be to a psychologist or other therapist who practices cognitive behavioral therapy for individuals. In addition, the advent of the Internet era allows for new and creative treatment alternatives even for people in small communities. 

FIGURE 8.3 Preliminary treatment, cooling towers, and biological treatment (Alternative 1). 

Summary of Total Annual Estimated Cost (in Dollars) for Groundwater Treatment Alternatives... 

Finally, when depressive symptoms persist after treatment with both a mood stabilizer and an antidepressant has been maximized, other treatment alternatives remain. These include the use of electroconvulsive therapy (ECT) or the addition... 

Atypical Antipsychotics. The so-called atypical antipsychotics are not well studied in the treatment of ADHD. However, a few case reports have indicated that risperidone (Risperdal) may reduce the impulsivity and hyperactivity of ADHD. There is also preliminary evidence that risperidone may be effective in treating tics. Although the usefulness of risperidone and other atypical antipsychotics in treating ADHD needs more study, this may prove another viable treatment alternative for patients with ADHD and tics or agitation. 

Other Hypersomnias. Narcolepsy is not the only hypersomnia, but it is by far the most common. Primary hypersomnia shares sleep attacks and excessive daytime sleepiness with narcolepsy but does not feature cataplexy or REM-associated abnormalities. Another rare hypersomnia is Kleine-Levin syndrome (KLS), which most often occurs in teenage boys. KLS consists of intermittent bouts of hypersomnia and bizarre behaviors including compulsive eating and sexual inappropriateness. Distinguishing these hypersomnias from narcolepsy may help clarify the patient s prognosis, but the treatment alternatives are very similar. 

The full complement of anxiety syndromes including panic, generalized anxiety, obsessive-compulsiveness, and post-traumatic stress disorder can arise in the after-math of TBI. In fact, anxiety may be the most common neuropsychiatric complication of TBI. Anxiety appears to be most likely to arise when the injury occurs to the right side of the brain. The treatment alternatives for post-TBl anxiety parallel those used when treating anxiety disorders and include serotonin-boosting antidepressants, buspirone (Buspar), and the benzodiazepines (see Table 12.1). 

Comparison of Ca availability from CCM (tablet form and as a fortificant in juice), CaCOs, and milk Interindividual differences tested, subjects assigned to either treatment alternative in each experiment Double-isotope technique employed to assess serum and urine Ca... 

Selection of appropriate treatment alternatives in a clinical smdy is essential for a useful economic evaluation of a pharmaceutical therapy. This issue is both a clinical and an economic one. Comparators can be the most common alternative therapies for a condition or the lowest possible cost alternatives, even when not frequently used. However, in pharmacoeconomic studies, treatment comparators may be inappropriately selected as much for their relatively high price as for their likely effectiveness. Phase III smdies have special limitations in this regard, because agents will be compared against the... 

TABLE 1 Summary of Costs (in Dollars) Associated with Various Treatment Alternatives at Lawrence Livermore National Laboratory... 

The Biopur system requires little maintenance and has proven to be a cost-effective treatment alternative in Europe. The system is patented in the United States and in Europe, and is marketed in North America by Maple Engineering Services, Inc., Canada. 

TABLE 1 Comparison of Projected Capital Costs for Major Bioreactor Components and of Operating Costs for Three Treatment Alternatives for Benzene-Contaminated Water (Costs in U.S. Dollars, 1995)... 

Treatment Alternative Capital Cost for Modifications Operating Cost ( per day)... 

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