BackgroundAcupuncture has been provided in nurse-led group clinics in St Albans since 2008. It is funded by a commissioning group within the National Health Service, on a trial basis, for patients with knee osteoarthritis who would otherwise be referred to an orthopaedic surgeon.AimTo evaluate the patients seen in the service's first year of operation and their outcome up to the end of 2010.MethodsService evaluation was made of patient data from the referral centre and the acupuncture clinics, including baseline characteristics, attendance data and Measure Yourself Medical Outcome Profile (MYMOP) symptom, function and well-being scores over at least 2 years.Results114 patients were offered acupuncture, of whom 90 patients were assessed in the acupuncture clinics. 41 of these were still attending after 1 year and 31 (34%) after 2 years. MYMOP scores showed clinically significant improvements at 1 month for pain (4.2 (SD 1.2) to 2.9 (SD 1.4)), stiffness (4.1 (SD 1.3) to 2.9 (SD 1.3)) and function (4.5 (SD 1.1) to 3.3 (SD 1.2)) which continued up to 2 years. Well-being scores did not change.ConclusionsThis is the first evaluation of nurse-led group (multibed) acupuncture clinics for patients with knee osteoarthritis to include a 2 year follow-up. It shows the practicability of offering a low-cost acupuncture service as an alternative to knee surgery and the service's success in providing long-term symptom relief in about a third of patients. Using realistic assumptions, the cost consequences for the local commissioning group are an estimated saving of £100 000 a year. Sensitivity analyses are presented using different assumptions.

and numerous other organizations with whom the three-laboratory team has interacted during this project. The project team would also like to acknowledge the Clean Energy States Alliance (CESA) for very close collaboration in implementing its energy policy and regulations database into the Energy Zones Mapping Tool, as well as Navigant Consulting for its contributions related to demand-side resources.

TX 75083-3836 U.S.A., fax 01-972-952-9435. AbstractDrilling waste management practices vary in different parts of the United States and elsewhere in the world. Those practices are governed by regulatory agencies charged with the protection of human health and the environment. Within the United States, regulations vary by state and address the environmental issues by geographic location. Regulations for offshore and international drilling waste management vary, as well. In a project funded by the U.S. Department of Energy, Argonne National Laboratory, in conjunction with Marathon and ChevronTexaco, is developing an interactive website to provide technical, unbiased information about drilling waste management options. The website will include components such as a technology description module to familiarize readers with available options, a regulatory module to summarize existing state and federal regulations governing drilling waste, a case study module to exhibit successful implementations of various technologies, and an interactive technology identification module to help users identify waste management options applicable in their region. This information system will provide operators with easy access to regulations, waste management options, technology, and cost data, thus allowing them to choose the option with the most environmental and economic benefits. Another benefit is that it will provide information to countries currently developing drilling waste regulations so that those regulations include the most economic, environmentally appropriate waste management options, not only options familiar in that country. The paper describes the design of the website and summarizes the data that are being collected to populate it.

fax 01-972-952-9435. AbstractProduced water is the largest volume waste stream generated during oil and gas production. Management of produced water can be costly. The industry can benefit from having readily available and unbiased information on produced water management options and regulatory requirements. This paper describes a new web-based Produced Water Management Information System (PWMIS) being developed by Argonne National Laboratory. PWMIS includes three functional modules:

Emergency responders historically have not been provided with specializedtraining or assistance for spills and fires at oil field sites. This situationhas lead to potential safety hazards for responders, and, in some cases, inappropriate response efforts have been made. Planning for emergency oil fieldincidents has been hampered by the sheer number of individual oil field sites. The Ohio Department of Natural Resources, in conjunction with the Ohio oil andgas industry, conceived a multimedia program to provide training and resourcesto emergency responders for dealing with oil field emergencies and to providebetter resources to response planners. Argonne National Laboratory (Argonne), through funding from the U.S. Department of Energy's National PetroleumTechnology Office, developed an innovative interactive web site that providesonline information to emergency responders and response planners. The web site consists of three modules that allow responders and planners torapidly obtain information about well sites. The "Find a Well" module utilizesmultiple graphical information system (GIS) layers and the Ohio Risk-Based DataManagement System (RBDMS) database to allow users to identify wellowner/operators, and well proximity to roads, streams, schools, and otherimportant features. Using Argonne's Maps and Data (MaD) Java applet, users areable to download and interact with detailed maps by using standard webbrowsers. The web site also includes "Reporting" and "Resources" modules toprovide information to users on the necessary reporting requirements followinga spill or fire, as well as access to many other government and privateresources for additional information. The Ohio web site is considered to be a pilot project and can be modifiedfor use in other states or for other purposes, such as Safe Drinking Water Actsource water protection programs, for example. Depending on a user's needs, additional GIS data layers can be added to the system to provide moreinformation. Introduction Emergency responders face a wide range of situations when they respond toaccidents, fires, spills, and other emergency events. Although many respondersare well trained, few have been given specialized training specific toincidents at oil and gas wells. This unfamiliarity with oil and gas facilities, practices, and hazards can lead to unsafe situations for responders. Onoccasion, it can also result in inappropriate response practices. To overcomethis liability, the Ohio Department of Natural Resources (DNR), in conjunctionwith the Ohio Oil and Gas Association (OOGA) and the Ohio Oil and Gas EnergyEducation Program (OOGEEP), conceived a multimedia program to provide trainingand resources to emergency responders for dealing with oil field emergencies. OOGA and OOGEEP have developed a training manual and plan to complement it witha training video, a CD to train other trainers, a series of permanent trainingfacilities, and a mobile training trailer. This paper describes another component of the emergency response informationsystem (an interactive web site, the Oil and Gas Well Emergency ResponseSystem. The web site contains three main modules, as shown in Figure 1. The"Find a Well" module provides information on individual oil and gas wells, their owners, their locations, and emergency contact persons. The "Reporting"module identifies government agencies that must be contacted following anincident and information that must be provided. The "Resources" module provideslinks to numerous government agencies and other organizations that may play arole in spill or release incidents and offers Material Safety Data Sheets forthousands of chemicals. Funding for this project was provided by the U.S. Department of Energy's(DOE's) Office of Fossil Energy at the request of the Ohio DNR, OOGA, andOOGEEP. Argonne National Laboratory (Argonne) was chosen to develop the website. The resulting site can be viewed at http://web.ead.anl.gov/oil/.