Analysis of PM2.5, black carbon, and trace metals measurements from the kansas city transportation and local-scale air quality study (KC-TRAQS).

Communities near transportation sources can be impacted by higher concentrations of particulate matter (PM) and other air pollutants. Few studies have reported on air quality in complex urban environments with multiple transportation sources. To better understand these environments, the Kansas City Transportation and Local-Scale Air Quality Study (KC-TRAQS) was conducted in three neighborhoods in Southeast Kansas City, Kansas. This area has several emissions sources including transportation (railyards, vehicles, diesel trucks), light industry, commercial facilities, and residential areas. Stationary samples were collected for 1-year (October 24, 2017 to October 312,018) at six sites using traditional sampling methods and lower-cost air sensor packages. This work examines PM less than 2.5 µm in diameter (PM2.5), black carbon (BC), and trace metals data collected during KC-TRAQS. PM2.5 filter samples showed the highest 24-h mean concentrations (9.34 µg/m3) at the sites located within 20-50 m of the railyard. Mean 24-h PM2.5 concentrations, ranging from 7.96 to 9.34 µg/m3, at all sites were lower than that of the nearby regulatory site (9.83µµg/m3). Daily maximum PM2.5 concentrations were higher at the KC-TRAQS sites (ranging from 25.31 to 43.76 µg/m3) compared to the regulatory site (20.50 µg/m3), suggesting short-duration impacts of localized emissions sources. Across the KC-TRAQS sites, 24-h averaged PM2.5 concentrations from the sensor package (p-POD) ranged from 3.24 to 5.69 µg/m3 showing that, out-of-the-box, the PM sensor underestimated the reference concentrations. KC-TRAQS was supplemented by elemental and organic carbon (EC/OC) and trace metal analysis of filter samples. The EC/OC data suggested the presence of secondary organic aerosol formation, with highest mean concentrations observed at the site within 20 m of the railyard. Trace metals data showed daily, monthly, and seasonal variations for iron, copper, zinc, chromium, and nickel, with elevated concentrations occurring during the summer at most of the sites. Implication statement This work reports on findings from a year-long air quality study in Southeast Kansas City, Kansas to understand micro-scale air quality in neighborhoods which are impacted by multiple emissions sources such as transportation sources (including a large railyard operation), light industry, commercial facilities, and residential areas. Fixed-site measurements were collected with traditional samplers and lower-cost air sensors. This work expands on previously published work providing an overview of KC-TRAQS (Chemosensors, 7, 26, 2019, doi:10.3390/chemosensors7020026), and provides further details specifically on PM2.5, EC/OC, and trace metals analysis of the filter samples collected in the study area. While dozens of studies have reported on air quality near roadways, this work will provide more information on air quality near other transportation sources in particular railyards. This work can also inform additional field studies near railyards and promote the use and evaluation of newer technologies such as air sensors to collect data near transportation sources.

Assessment of Chemical Facility Ethylene Oxide Emissions Using Mobile and Multipoint Monitoring.

Ethylene oxide (EtO) is a hazardous air pollutant that can be emitted from a variety of difficult to measure industrial sources, such as fugitive leaks, wastewater handling, and episodic releases. Emerging next generation emission measurement (NGEM) approaches capable of time-resolved, low parts per billion by volume (ppbv) method detection limits (MDLs) can help facilities understand and reduce EtO and other air pollutant emissions from these sources yielding a range of environmental and public health benefits. In October 2021, a first of its kind 4-day observational study was conducted at an EtO chemical facility in the midwestern United States. The study had dual objectives to both improve understanding of EtO emission sources within the facility and advance NGEM methods. Using cavity ring-down spectroscopy (CRDS) instruments, a combination of mobile surveys and stationary multipoint process unit monitoring assessed EtO concentrations in and near facility operations, while testing and comparing measurement methods. The study concluded that four main areas of EtO source emissions existed within the facility, each possessing unique emission characteristics. Episodic EtO emissions from supply railcar switchovers and batch reactor washouts, lasting seconds to minutes in duration, produced EtO concentrations exceeding 500 ppbv inside the process unit in some cases. In one instance, EtO at ~30 ppbv was briefly observed hundreds of meters from the process unit. Lower level but more sustained EtO concentrations were observed near an EtO transfer pump and wastewater tank outfall and drain system. Overall, 4.6% of mobile survey data were above the 1.2 ppbv mobile test MDL while the nine stationary sampling locations ranged from 17.7% to 82.8% of data above the 1.0 ppbv multipoint test MDL. This paper describes the EtO emissions observed in and near the four defined source areas within the facility and provides details of the NGEM method development advances accomplished as part of the study.

Adults with Severe Psychiatric Symptoms in a Community Partial Hospitalization Program: Characteristics and Predictors of Clinical Response.

Mental health wellbeing is a critical element in the overall wellbeing of an individual. Severe mental health issues are directly connected with the individual's functioning and negatively impacts the quality of life. Inpatient psychiatric hospitalization does help significantly in stabilizing the acute serious mental health problems; however, the utility of community partial hospitalization program (PHP) has not been studied extensively. We undertook this study to assess the usefulness of community partial hospitalization program (PHP) in reducing severity of psychosomatic symptoms of patients; to study the epidemiology of the referred patients; and to elucidate the characteristics and predictors of psychosomatic symptom response. 164 patients were assessed by a baseline Behavioral and Symptom Identification Scale-32 (BASIS-32) at a tertiary healthcare center, out of which 82 patients subsequently followed up and were assessed using the same scale and the data was then stratified and compiled. Out of the initial 164 patients, at a 50% adherence rate, 13 patients showed an improvement greater than 30% with a significant co-relation to the race of the patients. Partial Hospitalization Program proved to be moderately effective in improving psychosomatic symptoms, with better results noticed in the White/Caucasian race. We need to consider several variables before generalizing this finding and more studies are needed in this area. However, we are able to highlight this valuable tool in addressing the severe mental health issues in a community-based populations.

Evaluating mobile monitoring of on-road emission factors by comparing concurrent PEMS measurements.

Many countries have adopted portable emissions measurement system (PEMS) testing in their latest regulations to measure real-world vehicular emissions. However, its fleetwide implementation is severely limited by the high equipment costs and lengthy setup procedures, posing a need to develop more cost-effective, efficient emission measurement methods, such as mobile chasing tests. We conducted conjoint PEMS-chasing experiments for twelve heavy-duty diesel vehicles (HDDTs) to evaluate the accuracy of mobile measurement results. Two data processing approaches were integrated to automate the calculations of fuel consumption-based emission factors of nitrogen oxides (NOX). With a total of 245 plume chasing tests conducted, and then averaged by vehicle and road types, we found that the relative errors of vehicle-specific emission factors using an algorithm developed for this project were within approximately ±20% of the PEMS results for all tested vehicles. Stochastic simulations suggested reasonable results could be obtained using fewer chasing tests per vehicle (e.g., 71% for freeways and 94% for local road, equivalent to two chase tests per vehicle). This study improves the understanding of the accuracy of the mobile chasing method, and provides a practical approach for real-time emission measurements for future scaled-up mobile chasing studies.

Enhancing the local air quality benefits of roadside green infrastructure using low-cost, impermeable, solid structures (LISS).

Communities located in near-road environments face adverse health effects due to elevated exposures to traffic-related air pollution (TRAP). While the use of a combination of solid structures (i.e. sound walls) and vegetation barriers can be an effective TRAP mitigation tool, installing these barriers can also present challenges to local communities. Sound walls are costly, and building these structures often requires the involvement of federal, state, and local permitting agencies. In this paper, we proposed that the use of low-cost, impermeable, solid structures (LISS), e.g., an impermeable thin wooden, plastic or metal fence, combined with vegetation can provide an effective option for local communities to improve near-road air quality due to lower costs and easier implementation. We conducted Large Eddy Simulations (LES) for different design scenarios of LISS and vegetation barriers under various conditions. Our results indicate that (i) combining LISS and vegetation is more effective than either alone, (ii) combining a less dense vegetation and LISS can be as effective as a dense vegetation barrier, (iii) In certain scenarios, depending on wind speed and particle size, vegetation barriers alone might lead to elevated pollutant concentrations; however, combining LISS with vegetation can mitigate those negative impacts, (iv) placing LISS closer to the freeway and in front of the vegetation barrier enhances vertical dispersion of pollutants, and (v) increasing LISS height promotes pollutant concentration reduction. These design recommendations can be used by urban planners, developers, and local community leaders to evaluate and implement green infrastructure to mitigate TRAP.

Identifying air pollution source impacts in urban communities using mobile monitoring.

With increasing population, rapid urbanization, and increased migration to cities, the local impacts of increasing transportation and industrial-related air pollution are of growing concern worldwide. Elevated air pollution concentrations near these types of sources have been linked to adverse health effects including acute and chronic respiratory and cardiovascular diseases. Mobile monitoring has proven to be a useful technique to characterize spatial variability of air pollution in urban areas and pollution concentration gradients from specific sources. A study was conducted in the Kansas City, Kansas (USA) metropolitan area using mobile monitoring to characterize the spatial variability and gradients of air pollutants to identify the contribution of multiple sources on community-level air quality in a complex urban environment. Measurements focused on nitrogen dioxide (NO2), black carbon (BC), and ultrafine particulate matter (UFP). Mobile monitoring showed that median concentrations of these pollutants ranged by up to a factor of three between the communities, with individual measurements ranging over an order of magnitude within the community. Evaluating these air quality measurements with wind direction data highlighted the influence of specific and combinations of air pollution sources on these elevated concentrations, which can provide valuable information to environmental and public health officials in prioritizing and implementing cost-effect air quality management strategies to reduce exposures for urban populations.

Combining Dispersion Modeling and Monitoring Data for Community-Scale Air Quality Characterization.

Spatially and temporally resolved air quality characterization is critical for community-scale exposure studies and for developing future air quality mitigation strategies. Monitoring-based assessments can characterize local air quality when enough monitors are deployed. However, modeling plays a vital role in furthering the understanding of the relative contributions of emissions sources impacting the community. In this study, we combine dispersion modeling and measurements from the Kansas City TRansportation local-scale Air Quality Study (KC-TRAQS) and use data fusion methods to characterize air quality. The KC-TRAQS study produced a rich dataset using both traditional and emerging measurement technologies. We used dispersion modeling to support field study design and analysis. In the study design phase, the presumptive placement of fixed monitoring sites and mobile monitoring routes have been corroborated using a research screening tool C-PORT to assess the spatial and temporal coverage relative to the entire study area extent. In the analysis phase, dispersion modeling was used in combination with observations to help interpret the KC-TRAQS data. We extended this work to use data fusion methods to combine observations from stationary, mobile measurements, and dispersion model estimates.

Rubbertown Next Generation Emissions Measurement Demonstration Project.

Industrial facilities and other sources can emit air pollutants from fugitive leaks, process malfunctions and area sources that can be difficult to understand and to manage. Next generation emissions measurement (NGEM) approaches executed near facilities are enabling new ways to assess these sources and their impacts to nearby populations. This paper describes complementary uses of emerging NGEM systems in a Louisville, KY industrial district (Rubbertown), focusing on an important area air toxic, 1,3-butadiene. Over a one-year deployment starting in September 2017, two-week average passive samplers (PSs) at 11 sites showed both geospatial and temporal trends. At 0.24 ppbv annual average 1,3-butadiene concentration, a group of PSs located near facility fence lines was elevated compared to a PS group located in the community and upwind from facilities (0.07 ppbv average). Two elevated PS periods capturing emission events were examined using time-resolved NGEM approaches as case studies. In one event a 1.18 ppbv PS reading was found to be relatively localized and was caused by a multiday emission from a yet to be identified, non-facility source. In the other event, the airshed was more broadly impacted with PS concentrations ranging from 0.71 ppbv for the near-facility group to 0.46 ppbv for the community group. This case was likely influenced by a known emission event at an industrial facility. For both case studies, air pollutant and wind data from prototype NGEM systems were combined with source location models to inform the emission events. This research illustrates the power of applying NGEM approaches to improve both the understanding of emissions near sources and knowledge of impacts to near-source communities.

The effects of roadside vegetation characteristics on local, near-road air quality.

Roadside vegetation has been shown to impact downwind, near-road air quality, with some studies identifying reductions in air pollution concentrations and others indicating increases in pollutant levels when vegetation is present. These widely contradictory results have resulted in confusion regarding the capability of vegetative barriers to mitigate near-road air pollution, which numerous studies have associated with significant adverse human health effects. Roadside vegetation studies have investigated the impact of many different types and conditions of vegetation barriers and urban forests, including preserved, existing vegetation stands usually consisting of mixtures of trees and shrubs or plantings of individual trees. A study was conducted along a highway with differing vegetation characteristics to identify if and how the changing characteristics affected downwind air quality. The results indicated that roadside vegetation needed to be of sufficient height, thickness, and coverage to achieve downwind air pollutant reductions. A vegetation stand which was highly porous and contained large gaps within the stand structure had increased downwind pollutant concentrations. These field study results were consistent with other studies that the roadside vegetation could lead to reductions in average, downwind pollutant concentrations by as much as 50% when this vegetation was thick with no gaps or openings. However, the presence of highly porous vegetation with gaps resulted in similar or sometimes higher concentrations than measured in a clearing with no vegetation. The combination of air quality and meteorological measurements indicated that the vegetation affects downwind pollutant concentrations through attenuation of meteorological and vehicle-induced turbulence as air passes through the vegetation, enhanced mixing as portions of the traffic pollution plume are blocked and forced over the vegetation, and through particulate deposition onto leaf and branch surfaces. Computational fluid dynamic modeling highlighted that density of the vegetation barrier affects pollutant levels, with a leaf area density of 3.0 m2 m-3 or higher needed to ensure downwind pollutant reductions for airborne particulate matter. These results show that roadside bushes and trees can be preserved or planted along highways and other localized pollution sources to mitigate air quality and human health impacts near the source if the planting adheres to important characteristics of height, thickness, and density with full coverage from the ground to the top of the canopy. The results also highlight the importance of planting denser vegetation and maintaining the integrity and structure of these vegetation barriers to achieve pollution reductions and not contribute to unintended increases in downwind air pollutant concentrations.

The Kansas City Transportation and Local-Scale Air Quality Study (KC-TRAQS): Integration of Low-Cost Sensors and Reference Grade Monitoring in a Complex Metropolitan Area. Part 1: Overview of the Project.

Emissions from transportation sources can impact local air quality and contribute to adverse health effects. The Kansas City Transportation and Local-Scale Air Quality Study (KC-TRAQS), conducted over a 1-year period, researched emissions source characterization in the Argentine, Turner, and Armourdale, Kansas (KS) neighborhoods and the broader southeast Kansas City, KS area. This area is characterized as a near-source environment with impacts from large railyard operations, major roadways, and commercial and industrial facilities. The spatial and meteorological effects of particulate matter less than 2.5 µm (PM2.5), and black carbon (BC) pollutants on potential population exposures were evaluated at multiple sites using a combination of regulatory grade methods and instrumentation, low-cost sensors, citizen science, and mobile monitoring. The initial analysis of a subset of these data showed that mean reference grade PM2.5 concentrations (gravimetric) across all sites ranged from 7.92 to 9.34 µg/m3. Mean PM2.5 concentrations from low-cost sensors ranged from 3.30 to 5.94 µg/m3 (raw, uncorrected data). Pollution wind rose plots suggest that the sites are impacted by higher PM2.5 and BC concentrations when the winds originate near known source locations. Initial data analysis indicated that the observed PM2.5 and BC concentrations are driven by multiple air pollutant sources and meteorological effects. The KC-TRAQS overview and preliminary data analysis presented will provide a framework for forthcoming papers that will further characterize emission source attributions and estimate near-source exposures. This information will ultimately inform and clarify the extent and impact of air pollutants in the Kansas City area.

On-Road Chemical Transformation as an Important Mechanism of NO2 Formation.

Nitrogen dioxide (NO2) not only is linked to adverse effects on the respiratory system but also contributes to the formation of ground-level ozone (O3) and fine particulate matter (PM2.5). Our curbside monitoring data analysis in Detroit, MI, and Atlanta, GA, strongly suggests that a large fraction of NO2 is produced during the "tailpipe-to-road" stage. To substantiate this finding, we designed and carried out a field campaign to measure the same exhaust plumes at the tailpipe-level by a portable emissions measurement system (PEMS) and at the on-road level by an electric vehicle-based mobile platform. Furthermore, we employed a turbulent reacting flow model, CTAG, to simulate the on-road chemistry behind a single vehicle. We found that a three-reaction (NO-NO2-O3) system can largely capture the rapid NO to NO2 conversion (with time scale ≈ seconds) observed in the field studies. To distinguish the contributions from different mechanisms to near-road NO2, we clearly defined a set of NO2/NO x ratios at different plume evolution stages, namely tailpipe, on-road, curbside, near-road, and ambient background. Our findings from curbside monitoring, on-road experiments, and simulations imply the on-road oxidation of NO by ambient O3 is a significant, but so far ignored, contributor to curbside and near-road NO2.

Assessment of Uinta Basin Oil and Natural Gas Well Pad Pneumatic Controller Emissions.

In the fall of 2016, a field study was conducted in the Uinta Basin Utah to improve information on oil and natural gas well pad pneumatic controllers (PCs). A total of 80 PC systems at five oil sites (supporting six wells) and three gas sites (supporting 12 wells) were surveyed, and emissions data were produced using a combination of measurements and engineering emission estimates. Ninety-six percent of the PCs surveyed were low actuation frequency intermittent vent type. The overall whole gas emission rate for the study was estimated at 0.36 scf/h with the majority of emissions occurring from three continuous vent PCs (1.0 scf/h average) and eleven (14%) malfunctioning intermittent vent PC systems (1.6 scf/h average). Oil sites employed, on average 10.3 PC systems per well compared to 1.5 for gas sites. Oil and gas sites had group average PC emission rates of 0.28 scf/h and 0.67 scf/h, respectively, with this difference due in part to site selection procedures. The PC system types encountered, the engineering emissions estimate approach, and comparisons to measurements are described. Survey methods included identification of malfunctioning PC systems and emission measurements with augmented high volume sampling and installed mass flow meters, each providing a somewhat different picture of emissions that are elucidated through example cases.

Near-port air quality assessment utilizing a mobile measurement approach.

Mobile monitoring is a strategy to characterize spatially and temporally variable air pollution in areas near sources. EPA's Geospatial Measurement of Air Pollution (GMAP) vehicle - an all-electric vehicle is outfitted with a number of measurement devices to record real-time concentrations of particulate matter and gaseous pollutants - was used to map air pollution levels near the Port of Charleston in South Carolina. High-resolution monitoring was performed along driving routes near several port terminals and rail yard facilities, recording geospatial coordinates and concentrations of pollutants including black carbon, size-resolved particle count ranging from ultrafine to coarse (6 nm-20 µm), carbon monoxide, and nitrogen dioxide. Additionally, a portable meteorological station was used to characterize local conditions. The primary objective of this work was to characterize the impact of port facilities on local scale air quality. The study determined that elevated concentration measurements of black carbon and PM correlated to periods of increased port activity and a significant elevation in concentration was observed downwind of ports. However, limitations in study design prevented a more complete analysis of the port effect.

Evaluation and development of tools to quantify the impacts of roadside vegetation barriers on near-road air quality.

Traffic emissions are associated with the elevation of health risks of people living close to highways. Roadside vegetation barriers have the potential of reducing these risks by decreasing near-road air pollution concentrations. However, while we understand the mechanisms that determine the mitigation caused by solid barriers, we still have questions about how vegetative barriers affect dispersion. The US EPA conducted several field experiments to understand the effects of vegetation barriers on dispersion of pollutants near roadways (e.g., 2008 North Carolina study and 2014 California study) that indicate the reduction of near-road pollutant concentrations can be up to 30% due to the barrier effects. The results of these field studies are being used to develop and evaluate dispersion models that account for the effects of near-road vegetative barriers. These models can be used for evaluating the effectiveness of vegetation barriers as a potential mitigation strategy to reduce exposure to traffic-related pollutants and their associated adverse health effects. This paper presents the results of the analysis of the field studies and discusses dispersion models being used to describe the data in order to simulate the effects of near-road barriers and to develop recommendations for model improvements.

Roadside vegetation barrier designs to mitigate near-road air pollution impacts.

With increasing evidence that exposures to air pollution near large roadways increases risks of a number of adverse human health effects, identifying methods to reduce these exposures has become a public health priority. Roadside vegetation barriers have shown the potential to reduce near-road air pollution concentrations; however, the characteristics of these barriers needed to ensure pollution reductions are not well understood. Designing vegetation barriers to mitigate near-road air pollution requires a mechanistic understanding of how barrier configurations affect the transport of traffic-related air pollutants. We first evaluated the performance of the Comprehensive Turbulent Aerosol Dynamics and Gas Chemistry (CTAG) model with Large Eddy Simulation (LES) to capture the effects of vegetation barriers on near-road air quality, compared against field data. Next, CTAG with LES was employed to explore the effects of six conceptual roadside vegetation/solid barrier configurations on near-road size-resolved particle concentrations, governed by dispersion and deposition. Two potentially viable design options are revealed: a) a wide vegetation barrier with high Leaf Area Density (LAD), and b) vegetation-solid barrier combinations, i.e., planting trees next to a solid barrier. Both designs reduce downwind particle concentrations significantly. The findings presented in the study will assist urban planning and forestry organizations with evaluating different green infrastructure design options.

On the interaction of copper(II) with disulfiram.

In combination with copper(II) ions, disulfiram (DSF) has been reported to be a potentially potent anticancer agent based on in vitro results. The interaction of DSF with copper(II) chloride in solution has been studied using a range of spectroscopic techniques. There is strong evidence for the rapid formation of the bis(N,N-diethyl dithiocarbamato)copper(II) complex in situ. Kinetic experiments were used to determine rate laws for the reaction that give insight into the mechanism of the process which may help to explain the observed in vitro cytotoxicity.

Field assessment of the effects of roadside vegetation on near-road black carbon and particulate matter.

One proposed method for reducing exposure to mobile source air pollution is the construction or preservation of vegetation barriers between major roads and nearby populations. This study combined stationary and mobile monitoring approaches to determine the effects of an existing, mixed-species tree stand on near-road black carbon (BC) and particulate matter concentrations. Results indicated that wind direction and time of day significantly affected pollutant concentrations behind the tree stand. Continuous sampling revealed reductions in BC behind the barrier, relative to a clearing, during downwind (12.4% lower) and parallel (7.8% lower) wind conditions, with maximum reductions of 22% during the late afternoon when winds were from the road. Particle counts in the fine and coarse particle size range (0.5-10 µm aerodynamic diameter) did not show change. Mobile sampling revealed BC concentration attenuation, a result of the natural dilution and mixing that occur with transport from the road, was more gradual behind the vegetation barrier than in unobstructed areas. These findings suggest that a mature tree stand can modestly improve traffic-related air pollution in areas located adjacent to the road; however, the configuration of the tree stand can influence the likelihood and extent of pollutant reductions.

Recommendations for pharmacological management of inpatient aggression in children and adolescents.

Objective. While there has been a great deal of speculation by clinical researchers over the last three decades on effective and safe methods for the pharmacological management of aggression in children and adolescents, it is only in the last decade that there have been well-designed studies available to address this issue. Medication is commonly used to control aggression in children and adolescents in inpatient units. Also, there exists a need for evidence-based guidelines for the use of these different pharmacological agents for managing pediatric aggression on inpatient units. The aims of this article are to provide a systemic review and to provide treatment guidelines based on these limited but currently available studies.Methods. The articles reviewed in this study were obtained through a PubMed search using the key words 'children,' 'adolescents,' 'aggression,' 'inpatient,' 'ziprasidone,' 'lithium,' and 'risperidone.' A total of 499 studies were generated. Only studies focusing on pharmacological management of inpatient pediatric aggression with mean duration less than six weeks and published during January 1980 to August 2009 were included. Only English articles were considered. A total of 13 studies met these criteria, which were included in the review without any further statistical analysis. Recommendations are made on this available evidenced-based literature.Results. There is some evidence for the standing use of oral lithium, haloperidol, olanzapine, and risperidone for aggression related to specific psychiatric diagnoses. Intramuscular ziprasidone and olanzapine administered as needed were found to be effective for the rapid management of moderate to severe aggression. Oral or intramuscular diphenhydramine administered as needed was found to be useful for managing mild aggression due to a placebo effect.Conclusions. Studies are available on managing aggression in children and adolescents in inpatient treatment settings but are limited. Further studies on the use of various psychotropic medications are needed in order to develop comprehensive guidelines for the safe and effective pharmacological management of child and adolescent inpatient aggression.

Inflammatory bowel disease in children: psychological and psychiatric issues.

The overlap between inflammatory bowel disease (IBD) and psychiatric disorders has been studied extensively. We reviewed the limited literature targeting the complex relationship between IBD and psychiatric disorders in children and adolescents. Findings from this review were compared with findings from available studies in adults. Results reflecting an association between IBD and psychiatric illnesses were observed in children and adolescents and were consistent with results in adults. In adults with IBD, many studies have reflected the advantages of psychotherapeutic treatment, including faster recovery, improved quality of life, and reduced health care use. Unfortunately, such studies are scarce in the child and adolescent population. Psychopharmacologic studies also are limited in adult and pediatric populations. At this time, the literature on treatment of the pediatric IBD population remains minimal, and the need to study screening and treatment modalities is critical.