Evaluating the effectiveness of patient tailored treatment for patients with non-specific low back pain: A systematic review.

OBJECTIVE: This systematic review summarizes the relevant literature on the effectiveness of tailored interventions in non-specific low back pain (NSLBP). METHODS: The search strategy has been executed in December 2019 in the electronic databases PubMed, Web of Science and Embase. Study selection, data extraction and quality assessment were done independently by two authors. RESULTS: A total six eligible studies were identified. Five out of six articles used a classification system to subgroup patients. All active patient tailored interventions had similar or better results than the non-patient tailored interventions, most importantly on pain (short- and mid-term, not for long term follow-up). Two motor control interventions revealed sustained or increased effects at 12 months follow-up for disability. For cost-effectiveness, medication use and work absenteeism, results were inconclusive. Global rating of change evaluation confirmed significant between-group results at 10 weeks to 4 months follow-up, but results were not maintained at 12-month evaluation. DISCUSSION & CONCLUSION: Our findings support the preliminary evidence for the use of patient tailored treatment for reductions in pain and disability. However, our results are of very low to moderate quality evidence and the observed effects strongly depend on the subgroups and the chosen interventions. More high-quality RCT's with homogenous designs and larger sample sizes are needed.

Physical-chemical treatment of rainwater runoff in recovery and recycling companies: lab-scale investigation.

Scrap material recovery and recycling companies are producing wastewater in which common pollutants (such as COD, nutrients and suspended solids), toxic metals, polyaromatic hydrocarbons (PAH) and polychlorinated biphenyls (PCB) frequently can exceed the discharge limits. Lab-scale optimisation of different possible physical-chemical treatment techniques was performed on the wastewater originating from three different companies in view of further testing at pilot-scale testing and implementation at full-scale. The lab-scale tests demonstrate that sedimentation or hydrocyclone treatment as stand-alone technique cannot be used for proper treatment of this type of wastewater. Dual bed filtration or coagulation/flocculation proved to be more promising with removal efficiencies of about 71-95% (dual bed filtration) and 61-97% (coagulation/flocculation) for the above-mentioned pollutants (metals, PAH and PCB).

Leaching behaviour of different scrap materials at recovery and recycling companies: full-, pilot- and lab-scale investigation.

Scrap material recovery and recycling companies are confronted with waste water that has a highly fluctuating flow rate and composition. Common pollutants, such as COD, nutrients and suspended solids, potentially toxic metals, polyaromatic hydrocarbons and poly chlorinated biphenyls can exceed the discharge limits. An analysis of the leaching behaviour of different scrap materials and scrap yard sweepings was performed at full-scale, pilot-scale and lab-scale in order to find possible preventive solutions for this waste water problem. The results of these leaching tests (with concentrations that frequently exceeded the Flemish discharge limits) showed the importance of regular sweeping campaigns at the company, leak proof or covered storage of specific scrap materials and oil/water separation on particular leachates. The particulate versus dissolved fraction was also studied for the pollutants. For example, up to 98% of the polyaromatic hydrocarbons, poly chlorinated biphenyls and some metals were in the particulate form. This confirms the (potential) applicability of sedimentation and filtration techniques for the treatment of the majority of the leachates, and as such the rainwater run-off as a whole.

Parameter study on the efficiency of ozonation for biologically treated landfill leachate.

Ozonation was investigated as a potential post-treatment step for biologically treated landfill leachate to enhance the biodegradability and observe the influence of the initial organic matter concentration and pH. Changes in COD, UV absorption at 254 nm (UVA254) and BOD content were measured during and after ozonation, and the ozone utilisation efficiency at different conditions was calculated. The initial COD concentration was found to influence the absolute removal of UVA254 significantly, but especially changes in pH influenced the ozone reactions. Increased pH (pH 10) most probably increased the overall hydroxyl radical production leading to a higher COD removal and a much better ozone utilisation compared to lower pH. This in contrast to initial COD variations which had little influence on the determined ozone utilisation. Regardless of initial COD content or pH, on average 10% of the initial COD content was converted to BOD, next to 10% COD that was removed.

Treatment of rainwater runoff in recovery and recycling companies: Lab and pilot-scale testing.

Wastewater released from the storage and/or processing of recycling and materials recovery can be characterised as rainwater runoff. Recuperation and recycling companies are confronted with wastewater that has a very fluctuating flow rate and composition. The flow rate mainly depends on the amount of rainfall while the composition additionally depends on what is currently stored on site. An analysis of possible physical-chemical treatment (coagulation/flocculation, sand filtration, activated carbon filtration and sedimentation) methods was performed at two different recycling companies in order to find a robust and economical feasible water treatment system that meets the discharge limits at all times. A violation of some measurement values (Cd, Cr, Ni and acenaphthene) after coagulation/flocculation occurred, which could be further reduced by using sand filtration. Good removal is achieved for common parameters as for mono- and poly-aromatic hydrocarbons (MAH and PAH) and polychlorinated biphenyls (PCB). Applying a coupled sand- and activated carbon filtration on runoff resulted in a removal of over 80% of several measurement values (suspended solids, heavy metals). This clearly indicates the applicability of the physical-chemical treatment techniques.