Hydrodynamic behavior of freshwater-saltwater mixing zone in the context of subsurface physical barriers.

The seawater intrusion (SWI) process lasts for decades in real world, thus the research on dynamic process of SWI is essential. The freshwater-saltwater mixing zone plays a crucial role in governing the groundwater movement and the solute transport in coastal aquifers. To date, there has been a lack of research on the hydrodynamic behavior of the mixing zone in the presence of subsurface physical barriers. In this work, we employed laboratory experiments and numerical simulations to investigate the dynamics of the mixing zone, comparing scenarios with and without subsurface physical barriers. The findings indicate that the construction of a subsurface physical barrier will not immediately slow down the seawater intrusion velocity and change the salinity distribution of mixing zone. The block effect of subsurface physical barriers with different heights or bottom opening sizes became apparent only when the wedge toe approached the physical barriers. The widening effect of increasing longitudinal dispersivity on the mixing zone width was more pronounced during the dynamic process compared to the steady state. Furthermore, the widening effect of increasing longitudinal dispersivity on the mixing zone was more significant compared to transverse dispersivity in both the SWI and subsurface dam scenarios throughout the intrusion process. However, in the cutoff wall scenarios, the widening effect of increasing transverse dispersivity became more obvious during the later intrusion period. Our conclusions provide a reference for the groundwater management in coastal aquifers. According to the current seawater intrusion situation, the local water bureau can predict the seawater intrusion velocity and the temporal changes of mixing zone after the construction of physical barriers.

A parsimonious approach to predict regions affected by sewer-borne contaminants in urban aquifers.

Leaky urban drainage networks (UDNs) exfiltrating wastewater can contaminate aquifers. Detailed knowledge on spatiotemporal distributions of water-dissolved, sewer-borne contaminants in groundwater is essential to protect urban aquifers and to optimize monitoring systems. We evaluated the effect of UDN layouts on the spreading of sewer-borne contaminants in groundwater using a parsimonious approach. Due to the UDN's long-term leakage behavior and the existence of non-degradable sewer-borne contaminants (equivalent to a conservative and constant contaminant source), we employed a concept of horizontal line sources to mimic the UDN layout. This does not require the consideration of bio-degradation processes or temporal delay and effectively bypasses the vadose zone, thus reducing computational requirements associated with a full simulation of leakages. We used a set of synthetic leakage scenarios which were generated using fractals and are based on a real-world UDN layout. We investigated the effects of typical leakage rates, varying groundwater flow directions, and UDN's layouts on the shape of the contaminant plume, disregarding the resulted concentration. Leakage rates showed minimal effects on the total covered plume area, whereas 89% of the variance of the plume's geometry is explained by both the UDN's layout (e.g., length and level of complexity) and groundwater flow direction. We demonstrated the potential of applying this approach to identify possible locations of groundwater observation wells using a real UDN layout. This straightforward and parsimonious method can serve as an initial step to strategically identify optimal monitoring systems locations within urban aquifers, and to improve sewer asset management at city scale.

Dynamic influence of land reclamation on the nitrate contamination and saltwater redistribution.

Previous research concerning the effect of land reclamation on seawater intrusion mostly focused on the modification of the saltwater wedge and the dynamics of freshwater-saltwater interface after land reclamation, utilizing both analytical and numerical models. So far, the impact of land reclamation on the recharging and accumulation of land-based pollutants such as nitrate has been disregarded. In this work, we are the first to examine the impact of land reclamation on the discharge of nitrate together with the movement of saltwater. The influence of reclamation area and filled soil permeability on nitrate pollution and saltwater redistribution is revealed using a series of field-scale simulations based on numerical models including density flow combined with reactive transport. It was discovered that land reclamation might, on the one hand, result in a substantial redistribution based on the initial saltwater-freshwater interface and, on the other hand, significantly modify the nitrate discharge. This in total would drastically alter the distribution of nitrate in the subsurface. The reclamation area and the permeability of the reclamation material are the two elements that determine the amount of variance. For the cases with hydraulic conductivities increasing from 5 to 50 m/d, the salt mass reduction rate showed a trend of first increased (84.78 %-95.58 %) and then slowly decreased (95.58 %-74.01 %). Meanwhile, the nitrate reduction rate decreased from 80.08 % to 12.93 %, when hydraulic conductivities increased from 5 to 50 m/d. It was also found that coastal nitrate accumulation was always intensified with the enlargement of the reclamation area. Finally, we are able to assist engineers in optimizing their land reclamation strategies by taking into account both the degree of saltwater intrusion and nitrate enrichment.

Repulsion driven by groundwater level difference around cutoff walls on seawater intrusion in unconfined aquifers.

Cutoff walls have been widely used to prevent seawater intrusion (SWI) in coastal regions. Previous studies generally concluded that the ability of cutoff walls to prevent seawater intrusion depends on the higher flow velocity at the wall opening, which we have shown is not the most critical mechanism. In this work, we implemented numerical simulations to explore the driving force of cutoff walls on the repulsion of SWI in both homogeneous and stratified unconfined aquifers. The results delineated that the inland groundwater level was raised by cutoff walls, which generated a significant groundwater level difference beside two sides of the wall and thus provided a large hydraulic gradient to repel SWI. We further concluded that by increasing inland freshwater influx, the construction of cutoff wall could result in a high inland freshwater hydraulic head and fast freshwater velocity. The high inland freshwater hydraulic head posed a large hydraulic pressure to push the saltwater wedge seawards. Meanwhile, the fast freshwater flow could rapidly carry the salt from the mixing zone to the ocean and induce a narrow mixing zone. This conclusion explained the reason that the cutoff wall can improve the efficiency of SWI prevention through recharging freshwater upstream. With a defined freshwater influx, the mixing zone width and saltwater pollution area mitigated with the increase of the ratio between high and low hydraulic conductivity values (KH/KL) of the two layers. This was because the increase of KH/KL caused a higher freshwater hydraulic head, a faster freshwater velocity in the high-permeability layer, and the prominent change of flow direction at the interface between the two layers. According to the above findings, we deduced that any way to increase the inland hydraulic head upstream of the wall would improve the efficiency of cutoff walls, such as the freshwater recharge, the air injection, and the subsurface dam.

Dynamics of upstream saltwater intrusion driven by tidal river in coastal aquifers.

For the coastal aquifers, recent research have shown that the tidal has a significant effect on saltwater intrusion in the near-shore aquifer. However, it is currently unclear how the tidal river contributes to the groundwater flow and salinity distribution in the upstream aquifer of the estuary. This study examined the effects of a tidal river on the dynamic characteristics of groundwater flow and salt transport in a tidal river-coastal aquifer system using field monitoring data and numerical simulations. It was found that changes in tidal-river level led to the reversal of groundwater flow. For a tidal cycle, the maximum area of seawater intrusion is about 41.16 km2 at the end of the high tide stage. Then the area gradually decreased to 39.02 km2 at the end of the low tide stage. More than 2 km2 area variation can be observed in a tidal cycle. Compared to the low tide stage, the area of SWI increased by 5 % at high tide stage. The SWI region was also spreading landward from the tidal river. In addition, we quantified the water exchange and salt flux between the tidal river and aquifer. When the tidal fell below the level of the riverbed, the water exchange rate was stabilized at about -1.6 m/h. The negative value indicated that the river was recharged by the groundwater. With the increasing of tidal water level, the water exchange rate gradually changes from negative to positive and reached the maximum value of 3.2 m/h at the beginning of the falling tide stage. The presence of a physical river dam can amplify the difference in water level between high and low tides, thereby enhancing the influence of a tidal river on water exchange and salt flux. The findings lay the foundation for gaining a comprehensive understanding of the tidal river on groundwater flow and salt transport in upstream aquifers.

Root grafts matter for inter-tree water exchange - a quantification of water translocation between root grafted mangrove trees using field data and model-based indications.

BACKGROUND AND AIMS: Trees interconnected through functional root grafts can exchange resources, but the effect of exchange on trees remains under debate. A mechanistic understanding of resource exchange via functional root grafts will help understand their ecological implications for tree water exchange for individual trees, groups of trees and forest stands. METHODS: To identify the main patterns qualitatively describing the movement of sap between grafted trees, we reviewed the available literature on root grafting in woody plants that focus on tree allometry and resource translocation via root grafts. We then extended the BETTINA model, which simulates mangrove (Avicennia germinans) tree growth on the individual tree scale, to synthesize the available empirical information. Using allometric data from a field study in mangrove stands, we simulated potential water exchange and analysed movement patterns between grafted trees. KEY RESULTS: In the simulations, relative water exchange ranged between -9.17 and 20.3 %, and was driven by gradients of water potential, i.e. differences in tree size and water availability. Moreover, the exchange of water through root grafts alters the water balance of trees and their feedback with the soil: grafted trees that receive water from their neighbours reduce their water uptake. CONCLUSIONS: Our individual-tree modelling study is a first theoretical attempt to quantify root graft-mediated water exchange between trees. Our findings indicate that functional root grafts represent a vector of hydraulic redistribution, helping to maintain the water balance of grafted trees. This non-invasive approach can serve as a basis for designing empirical studies to better understand the role of grafted root interaction networks on a broader scale.

Root grafts matter for inter-tree water exchange - a quantification of water translocation between root grafted mangrove trees using field data and model based indication.

BACKGROUND AND AIMS: Trees interconnected through functional root grafts can exchange resources, but the effect of exchange on trees remains under debate. A mechanistic understanding of resources exchange via functional root grafts will help understand their ecological implications for tree water exchange for individual trees, groups of trees, and forest stands. METHODS: To identify the main patterns qualitatively describing the movement of sap between grafted trees, we reviewed available literature on root grafting in woody plants that focus on tree allometry and resource translocation via root grafts. We then extended the BETTINA model, which simulates mangrove (Avicennia germinans) tree growth on the individual tree scale, in order to synthesize the available empirical information. Using allometric data from a field study in mangrove stands, we simulated potential water exchange and analyzed movement patterns between grafted trees. KEY RESULTS: In the simulations, relative water exchange ranged between -9.17 and 20.3 %, and was driven by gradients of water potential, i.e. differences in tree size and water availability. Moreover, the exchange of water through root grafts alters the water balance of trees and their feedback with the soil: grafted trees that receive water from their neighbors reduce their water uptake. CONCLUSIONS: Our individual-tree modelling study is a first theoretical attempt to quantify root graft-mediated water exchange between trees. Our findings indicate that functional root grafts represent a vector of hydraulic redistribution, helping to maintain the water balance of grafted trees. This non-invasive approach can serve as a fundament for designing empirical studies to better understand the role of grafted root interaction networks on a broader scale.

Nitrate transport behavior behind subsurface dams under varying hydrological conditions.

The construction of subsurface dams for controlling seawater intrusion triggers the accumulation of nitrate upstream of a dam. This is raising the concerns about nitrate contamination in those regions of coastal aquifers that are supposed to be used as a fresh groundwater source behind a subsurface dam. Research on this subject has been mostly restricted to the use of a simplified sea boundary (e.g., static and no slope), ignoring sea level fluctuations driven by tides. In this study, the combined effect of tides and subsurface dams on nitrate pollution in upstream groundwater was examined through laboratory experiments and numerical simulations. The results revealed that the difference in the extent of nitrate contamination under various conditions (i.e., static, tidal, static with a dam, and tidal with a dam) was related to the temporal pollution behavior. In the early stage, nitrate contamination in upstream groundwater was essentially identical for different scenarios. Both tides and subsurface dams were found to increase nitrate contamination in upstream aquifers. The extent of nitrate contamination increased with higher tidal amplitudes, whereas the increment was more evident for a large tidal amplitude. The effects of tides and subsurface dams on nitrate contamination were also regulated by the locations and infiltration rates of the pollution source. Interestingly, under the joint action of tides and subsurface dams, the increment in the extent of nitrate pollution was greater than the sum of their individual effects. The increased pollutions caused by subsurface dams and tides were quantified as 9.47% and 37.22%, respectively, whereas the increased value caused by their joint action was measured as 51.10%. These findings suggest that tidal activity should not be overlooked when assessing nitrate contamination in upstream groundwater.

Effectiveness and comparison of physical barriers on seawater intrusion and nitrate accumulation in upstream aquifers.

Physical barrier is a coastal engineering widely used to prevent seawater intrusion. However, previous studies have not evaluated the combined influence of type and structure of the physical barrier on nitrate accumulation in upstream aquifers. Furthermore, the mechanisms of nitrate accumulation caused by the physical barriers are still unclear. In this study, numerical simulations were conducted to investigate the mechanisms and influence of the physical barrier on seawater intrusion and NO3- accumulation. The results show that constructing physical barrier can result in the reduction of nitrate discharge to the sea and accumulation of nitrate in upstream aquifers. The accumulation degree is significant if the barrier height is large; the barrier location is near the sea; the nitrate infiltration rate is large; the infiltration nitrate concentration is large; the inflow is weak, and the inflow DOC concentration is low. A cut-off wall is more likely to cause nitrate accumulation than a subsurface dam. It can result in mean nitrate concentration in groundwater upstream increasing by more than 30 %. Because a nitrate accumulation zone is formed behind the cut-off wall where the flow is slow and dissolved oxygen carbon is difficult to be replenished so that the denitrification is weak. Despite the subsurface dam may not result in a significant increase in nitrate concentration, it cannot be applied to the areas where SI has occurred due to the residual seawater problem. The nitrate accumulation in the upstream aquifer is a long-term process that lasts for more than three years to reach a pseudo-steady state. Seasonal variations of inflow and infiltration lead to fluctuation of mean nitrate concentration, thereby the nitrate accumulation rate increased after April and weakened between July and December.

Partial Desalination of Saline Groundwater: Comparison of Nanofiltration, Reverse Osmosis and Membrane Capacitive Deionisation.

Saline groundwater (SGW) is an alternative water resource. However, the concentration of sodium, chloride, sulphate, and nitrate in SGW usually exceeds the recommended guideline values for drinking water and irrigation. In this study, the partial desalination performance of three different concentrated SGWs were examined by pressure-driven membrane desalination technologies: nanofiltration (NF), brackish water reverse osmosis (BWRO), and seawater reverse osmosis (SWRO); in addition to one electrochemical-driven desalination technology: membrane capacitive deionisation (MCDI). The desalination performance was evaluated using the specific energy consumption (SEC) and water recovery, determined by experiments and simulations. The experimental results of this study show that the SEC for the desalination of SGW with a total dissolved solid (TDS) concentration of 1 g/L by MCDI and NF is similar and ranges between 0.2-0.4 kWh/m3 achieving a water recovery value of 35-70%. The lowest SECs for the desalination of SGW with a TDS concentration ≥2 g/L were determined by the use of BWRO and SWRO with 0.4-2.9 kWh/m3 for a water recovery of 40-66%. Even though the MCDI technique cannot compete with pressure-driven membrane desalination technologies at higher raw water salinities, this technology shows a high selectivity for nitrate and a high potential for flexible desalination applications.

Utilization of pit lake on the cleaning process of residual saltwater in unconfined coastal aquifers.

Subsurface dams are widely used to prevent saltwater intrusion. Once a subsurface dam is established, a large amount of residual saltwater (RSW) may trap behind the dam and negatively affect the groundwater exploitation over the long term. Based on monitoring hydrological information and field-scale numerical models, we proposed three kinds of RSW clean-up strategy coupling the applications of a pit lake and wells in a coastal aquifer. We firstly investigated the spontaneous natural removal of RSW in an actual coastal aquifer affected by a pit lake, assessed the impact of pit lake drainage on the removal of RSW, and designed a feasible strategy for reducing residual saltwater utilizing both pit lake and wells. Our results indicated that RSW remediation is a slow process under natural conditions. The area of the RSW decreased from 15.17 to 11.62 km2 after 20 years, and the Cl- concentration of RSW around the pit lake increased to 1750 mg/L. The RSW cleaning efficiency can be significantly enhanced by the pit lake drainage process. With the pit lake drainage rate of 1.6E5 m3/d, the area of the RSW decreased by 10.14 km2 in five years being 17-times larger than that of the natural restoration scheme (0.58 km2). With the combined well-lake drainage system, the total residual saltwater area decreased by more than 90% within five years, and the Cl- concentration of RSW almost reached WHO standards for drinking-water quality (250 mg/L). RSW upstream the subsurface dam was thoroughly cleaned up adopting the well-lake drainage strategy. Therefore, a well-lake drainage strategy can be strongly recommended for removing the RSW in coastal aquifers.

Towards predicting DNAPL source zone formation to improve plume assessment: Using robust laboratory and numerical experiments to evaluate the relevance of retention curve characteristics.

We conducted multiple laboratory trials in a robust and repeatable experimental layout to study dense non-aqueous phase liquid (DNAPL) source zone formation. We extended an image processing and analysis framework to derive DNAPL saturation distributions from reflective optical imaging data, with volume balance deviations < 5.07%. We used a multiphase flow model to simulate source zone formation in a Monte Carlo approach, where the parameter space was defined by the variation of retention curve parameters. Integral and geometric measures were used to characterize the source zones and implemented into a multi-criteria objective function. The latter showed good agreement between observation data and simulation results for effective DNAPL saturation values > 0.04, especially for early stages of DNAPL migration. The common hypothesis that parameters defining the DNAPL-water retention curves are constant over time was not confirmed. Once DNAPL pooling started, the optimal fit in the parameter space was significantly different compared to the earlier DNAPL migration stages. We suspect more complex processes (e.g., capillary hysteresis, adsorption) to become relevant during pool formation. Our results reveal deficits in the grayscale-DNAPL saturation relationship definition and laboratory estimation of DNAPL-water retention curve parameters to overcome current limitations to describe DNAPL source zone formation.

Potential of mixed hydraulic barriers to remediate seawater intrusion.

Remediation measures are crucial to prevent or reverse seawater intrusion deteriorating coastal fresh groundwater resources. The mixed hydraulic barrier approach, as a combination of positive and negative hydraulic barriers, holds promising advantages especially for arid areas because extracted water provides a resource for injection after treatment. However, transient remediation mechanisms and impact of parameters are still unsatisfyingly understood. Therefore, the feasibility and optimal management of mixed hydraulic barriers as well as a comparison to single positive and negative barriers are explored with a synthetic 2D variable-density model of an already salinated, unconfined coastal aquifer using SEAWAT and FloPy. The hydraulic conductivity, porosity, injection and extraction rate, barrier locations, injection salt concentration, and reduction of pumping stress are varied jointly to determine the parameters' impact and interdependencies. The hydraulic conductivity controls the overall remediation potential as a hydrogeological component. Reduced inland abstractions of supply wells and the injection rates of the positive barrier show the largest remediation effects. However, locating the positive barrier within the salt wedge poses the risk of trapping salt landside. A sole negative barrier did not improve remediation substantially. This study thus shows that remediation with mixed hydraulic barriers can be feasible if implemented according to local conditions.

The fate of DNAPL contaminants in non-consolidated subsurface systems - Discussion on the relevance of effective source zone geometries for plume propagation.

Dense non-aqueous phase liquids, i.e., DNAPLs and the evolving contaminant plumes in aquifers provide significant potential to pose hazards affecting both environment and human health. Therefore, a proper assessment of contaminant spreading within the subsurface is critical. This includes a sufficient characterization of governing parameters describing both the subsurface and the contaminant itself. Thereby, knowledge on the contaminant source zone and especially the source zone geometry, i.e., SZG is critically required, yet very uncertain. This study identifies current limitations and open research questions in the formation and shape determination of source zone geometry, as well as its relevance for contaminant plumes. Our literature review reveals that existing characterization methods are subject to data interpretation uncertainties, while the application of these methods on field scale is limited by technical demands and accompanied efforts. In a next step, methods to implement increased source zone information into calculation methods are discussed. By means of an exemplary application of selected assessment tools, i.e., plume response models, results clearly proof the relevance of SZGs for site assessment. However, existing plume response models consider over-simplified geometries that may compromise their suitability. Our findings identify the demand for improved characterization of complex SZGs and the need to better evaluate the dependency of DNAPL migration on system properties and external influences. With emphasized knowledge on the most relevant SZG features, the delineation of "effective" SZGs allowing for straightforward implementation into plume response models and an adaption of the latter to incorporate more information on SZGs should be possible.

Occurrence, fate and environmental risk assessment of the organic microcontaminants included in the Watch Lists set by EU Decisions 2015/495 and 2018/840 in the groundwater of Spain.

This paper aims to review the existing occurrence data in Spanish groundwater (GW) for the emerging organic contaminants (EOCs) defined in the surface water Watch Lists of Decisions 2015/495/EU and 2018/840/EU since these contaminants are likely to reach GW bodies because surface waters show close interaction with GW. These two lists include 20 substances: 9 pesticides (5 neonicotinoids, 2 carbamates, 1 oxadiazole and 1 semicarbazone), 6 pharmaceuticals (diclofenac and 5 antibiotics), 3 estrogens, 1 UV filter (2-ethylhexyl-4-methoxycinnamate, EHMC) and 1 antioxidant (2,6-di-tert-butyl-4-methylphenol, BHT). Most of these substances are usually detected at low ng/L concentration range or not detected in the GW bodies of Spain. However, eventually they are reported at concentrations>100ng/L (e.g., imidacloprid, methiocarb, diclofenac, macrolide antibiotics, ciprofloxacin, EHMC and BHT). Consequently, it is required to set up drinking water standards, and/or GW threshold quality values because GW is a valuable water resource worldwide. Overall, GW is less contaminated than other water bodies, such as rivers, suggesting that aquifers possess a natural attenuation capacity and/or are less vulnerable than rivers to contamination. Nevertheless, the natural hydrogeochemical processes that control the fate and transformation of these substances during infiltration and in the aquifer have been barely investigated so far. The concentrations of the target EOCs are used to calculate hazard quotients (HQs) in the Spanish GW bodies as an estimation of their ecotoxicity and in order to compare somehow their chemical quality with respect to those of surface water. Due to the limited ecotoxicity data for most EOCs, HQs can only be calculated for few substances. The results pointed out the risk posed by the anti-inflammatory diclofenac towards Ceriodaphnia dubia (HQ=21) and the medium risk associated to the antibiotic erythromycin for Brachionus calyciflorus (HQ=0.46).

An index system constructed for ecological stress assessment of the coastal zone: A case study of Shandong, China.

Coastal zones, which have high ecological value and environmental function and play a key role in human development, face intense ecological stress from human activities. This study constructed an assessment index system for coastal zones and proposed a coastal ecological stress index (CESI) model. This method was then applied to the Shandong coastal zone. The results showed an increase in ecological stress from 2001 to 2016 and implied a further growth trend. The stress caused by terrigenous pollution was the most prominent, with the ecological stress index showing significant spatial difference. Qingdao exerted the highest ecological stress on the population and economy, while Yantai showed the highest stress on the coastal index. The CESI model effectively reflects the temporal and spatial characteristics of the coastal ecological stress and provides a theoretical basis for the management of different regions.

Description and verification of a novel flow and transport model for silicate-gel emplacement.

We present a novel approach for the numerical simulation of the gelation of silicate solutions under density-dependent flow conditions. The method utilizes an auxiliary, not density-dependent solute that is subject to a linear decay function to provide temporal information that is used to describe the viscosity change of the fluid. By comparing the modeling results to experimental data, we are able to simulate the behavior and the gelation process of the injected solute for three different compositions, including long-term stability of the gelated area, and non-gelation of low concentrations due to hydro-dynamic dispersion. This approach can also be used for other types of solutes with this gelling property and is useful in a variety of applications in geological, civil and environmental engineering.

[Impact of a training in brief intervention. Differences in the hospital approach of tobacco and alcohol consumption]. / Impacto de la formación en intervención breve. Diferencias en el abordaje hospitalario del consumo de tabaco y alcohol.

OBJECTIVE: To evaluate th e impact of a training intervention To evaluate the impact of a training intervention for health care professionals on inpatients' smoking and alcohol consumption and to compare the hospital intervention for the two substances. METHODS: Through two parallel studies, we compared, using auto-administered questionnaires, the referred clinical behaviour on smoking of 66 health care professionals and the intervention received by 169 patients, with the clinical behaviour on hazardous drinking of other 38 professionals and other 118 patients from different hospital wards before and after attending a training in brief intervention on smoking cessation and hazardous alcohol drinking respectively. RESULTS: We only found slight differences between alcohol and tobacco concerning professionals' behaviour. Professionals declared to assist more often patients with alcohol risk consumption than smoking (36.4% vs 10.9% [p<.0001]) although with patients those differences haven't been confirmed. They just told to have been asked more often about alcohol consumption than about smoking (43.6% vs 30.8% [p<.05]). There were no differences after the training sessions. DISCUSSION: Before and after training, health professionals hardly intervene in patients with alcohol or tobacco consumption even we observed higher detection and assist for alcohol risk consumption. It is necessary to examine other barriers to the application of the knowledge gained.

Impacto de la formación en intervención breve. Diferencias en el abordaje hospitalario del consumo de tabaco y alcohol / Impact of a training in brief intervention. Differences in the hospital approach of tobacco and alcohol consumption

Objetivo: Evaluar el impacto de una intervención formativa para profesionales sanitarios sobre consumo de alcohol y tabaco en pacientes hospitalizados y comparar la intervención hospitalaria de dichas sustancias. Métodos: A través de dos estudios paralelos se compara, mediante cuestionarios autoadministrados, la conducta clínica declarada de 66 profesionales sanitarios frente al consumo de tabaco de sus pacientes y la intervención recibida de 169 pacientes por parte de estos profesionales, con la conducta clínica de otros 38 profesionales frente al consumo de alcohol de sus pacientes y otros 118 pacientes de diferentes unidades de hospitalización antes y después de una formación en intervención breve en tabaquismo y consumo de riesgo de alcohol respectivamente. Resultados: Se observan pocas diferencias en la conducta de los profesionales ante las dos sustancias. Los profesionales dicen prestar más ayuda en el caso del alcohol (36,4% vs 10,9% [p<0.0001]) si bien, según la intervención recibida declarada por los pacientes, no se observan estas diferencias aunque sí se les ha preguntado más por el consumo de alcohol (43,6% vs 30,8% [p<0.05]). Después de la formación no se observan cambios significativos. Discusión: En estos dos estudios, la frecuencia de intervención de los profesionales sanitarios sobre el consumo de tabaco y alcohol es baja, tanto previa como posteriormente a la formación recibida, aunque se observa una mayor detección y ayuda en el caso del alcohol. Es necesario analizar otras barreras que frenan la aplicación de los conocimientos adquiridos (AU)

Objective: To evaluate the impact of a training intervention the for health care professionals on inpatients’ smoking and alcohol consumption and to compare the hospital intervention for the two substances. Methods: Through two parallel studies, we compared, using auto-administered questionnaires, the referred clinical behaviour on smoking of 66 health care professionals and the intervention received by 169 patients, with the clinical behaviour on hazardous drinking of other 38 professionals and other 118 patients from different hospital wards before and after attending a training in brief intervention on smoking cessation and hazardous alcohol drinking respectively. Results: We only found slight differences between alcohol and tobacco concerning professionals’ behaviour. Professionals declared to assist more often patients with alcohol risk consumption than smoking (36,4% vs 10,9% [p<.0001]) although with patients those differences haven’t been confirmed. They just told to have been asked more often about alcohol consumption than about smoking (43,6% vs 30,8%[p<.05]). There were no differences after the training sessions. Discussion: Before and after training, health professionals hardly intervene in patients with alcohol or tobacco consumption even we observed higher detection and assist for alcohol risk consumption. It is necessary to examine other barriers to the application of the knowledge gained (AU)

[Evaluation of a training programme for health professionals on smoking cessation in hospitalized patients]. / Evaluacion de un programa de formacion de profesionales sanitarios sobre abordaje del tabaquismo en pacientes hospitalizados.

INTRODUCTION: The promotion of smoking cessation in hospital settings is uncommon. One of the main barriers to such promotion is lack of knowledge on how to proceed. The objective of this study is to assess changes in professionals' knowledge, attitudes and actions after having received training in brief intervention. PARTICIPANTS AND METHOD: Self-perceived knowledge, actions and status in relation to smoking status were assessed in 66 healthcare professionals before and after training. Furthermore, we compared the actions carried out by these professionals with 170 inpatients before the professionals' training and with another 170 after the training (patient's report), to corroborate professionals' self-reported actions. RESULTS: Brief intervention training significantly increased professionals' knowledge of psychological skills (by 23.3%) and of pharmacological resources (by 27.1%). Nevertheless, changes were not observed in the extent to which professionals: ask (30.8% vs. 38.2%, before and after the training, respectively); register patients' smoking status (73.4% vs. 65.9%); assess willingness to quit (25% vs 12.5%); or advise patients to quit (21.9% vs. 20.8%), according to the information provided by patients, which is consistent with that provided by the professionals. CONCLUSIONS: It is necessary to examine other barriers to the application of the knowledge gained.