Screening, brief intervention, and referral to treatment (SBIRT) is an important and effective strategy among injury prevention measures aimed at reducing risky alcohol use (). The trauma patient population is at significant risk for alcohol-related trauma recidivism () and is therefore a priority group in which to implement SBIRT. Vancouver General Hospital (VGH) implemented SBIRT on its 2 inpatient trauma units in the fall of 2014. The alcohol use disorders screening test (AUDIT-C) was chosen as the screening tool for nurses to complete with new patients. A brief intervention was conducted by the trauma social workers in the cases where a patient scored positive on the AUDIT-C. To evaluate the implementation and effectiveness of SBIRT on the 2 inpatient trauma units at VGH and to provide recommendations for improvement, a telephone survey of past trauma patients and a review of the screening process were undertaken in May 2016. Patient follow-up was conducted via a telephone survey. Of the 79 patients who met the follow-up criteria, a total of 19 were successfully contacted. Results from the survey showed that the majority of patients did not recall being screened with the AUDIT-C and were either unsure or did not recall receiving a brief intervention by the social worker. Despite these findings, a rescreening with the AUDIT-C tool revealed that 68% of patients who participated in the survey had a lower score than when they were inpatients. Recommendations for improvement include optimizing the timing of SBIRT with trauma inpatients and implementing a follow-up system. The literature suggests that following up with patients to provide an SBIRT "booster" increases the effectiveness of brief interventions (C. ).

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Egyptian Journal of Botany http://ejbo.journals.ekb.eg/ Review 43 E NVIRONMENTAL pollution is exacerbated by the rise in petroleum hydrocarbons due to exploration, production, transportation, and industrialization. This requires immediate remediation. Although crude oil removal using conventional techniques is efficient for cleaning up aquatic and terrestrial ecosystems, it is costly and requires specialized staff and equipment. Despite their negative environmental consequences, chemical compounds such as dispersants, cleansers, emulsifiers, biosurfactants, and soil oxidizers are highly utilized. Phytoremediation and bioremediation have emerged as cost-effective and environmentally friendly technologies. This paper aims to review the impacts of crude oil pollution and the phytoremediation of polluted ecosystems. We have reviewed various phytoremediation/bioremediation mechanisms and environmental factors. Additionally, we have discussed the degradation of crude petroleum, factors affecting petroleum hydrocarbon bioremediation, and the environmental consequences, such as DNA and epigenetic mutations. We have also compared the economics of phytoremediation and restoration of polluted sites with conventional technology. Plants can remediate the environment through phytodegradation, phytostabilization, phytovolatilization, evapotranspiration, and phytoaccumulation. The microbial activities in the plant rhizosphere enhance the degradation and accumulation of the pollutants and modulate their bioavailability, thereby remediating the polluted areas and stabilizing the soil fertility.

Background Phytoremediation is determined as an emerging green technology suitable for the safe remediation and restoration of polluted terrestrial and aquatic environments. In this study, the assessment of an ornamental plant, Vinca rosea L., as a phytoremediator of crude oil in polluted soils was conducted. In an open greenhouse experiment, plants were raised in sandy-clayey soils treated with 1, 3, 5, and 7% oil by weight. The experiment was conducted over 5 months. Results Total petroleum hydrocarbon (TPH) degradation percentage by V. rosea after a 5-month growth period ranged from 86.83 ± 0.44% to 59.05% ± 0.45% in soil treated with 1 and 7%, respectively. Plants raised in polluted soils demonstrated a dramatic reduction in germination rates, in addition to growth inhibition outcomes shown from decreased plant height. An increase in branching was observed with an increase in oil pollution percentages. Moreover, the phytomass allocated to the leaves was higher, while the phytomass witnessed lower values for fine roots, flowering and fruiting when compared to the controls. Apart from the apparent morphological changes, there was a decrease in chlorophyll a/b ratio, which was inversely proportional to the oil pollution level. The contents of carotenoids, tannins, phenolics, flavonoids, and antioxidant capacity were elevated directly with an increase in oil pollution level. The start codon-targeted (SCoT) polymorphisms and inter-simple sequence repeat (ISSR) primers showed the molecular variations between the control and plants raised in polluted soils. The genetic similarity and genomic DNA stability were negatively affected by increased levels of crude oil pollution. Conclusions The ability of V. rosea to degrade TPH and balance the increased or decreased plant functional traits at the macro and micro levels of plant structure in response to crude oil pollution supports the use of the species for phytoremediation of crude oil-polluted sites. The genotoxic effects of crude oil on V. rosea still require further investigation. Further studies are required to demonstrate the mechanism of phenolic, flavonoid, and antioxidant compounds in the protection of plants against crude oil pollution stress. Testing different molecular markers and studying the differentially expressed genes will help understand the behavior of genetic polymorphism and stress-resistant genes in response to crude oil pollution.

Petroleum oil pollution is a worldwide problem that results from the continuous exploration, production, and consumption of oil and its products. Petroleum hydrocarbons are produced as a result of natural or anthropogenic practices, and their common source is anthropogenic activities, which impose adverse effects on the ecosystem’s nonliving and living components including humans. Phytoremediation of petroleum hydrocarbon-polluted soils is an evolving, low-cost, and effective alternative technology to most traditional remediation methods. The objective of this study is to evaluate the phytoremediation potentiality of Vinca rosea for crude oil-contaminated soil by understanding its properties and involvement in the enhanced degradation of crude oil. The remediation potentiality was determined by evaluating the total petroleum hydrocarbon degradation percentage (TPH%) and changes in the molecular type composition of saturated and aromatic hydrocarbon fractions. TPH% was estimated gravimetrically, and changes in the molecular type composition of saturated and aromatic fractions were measured using gas chromatography and high-performance liquid chromatography, respectively. Sulfur concentration was measured using X-ray fluorescence. Cadmium and lead quantification was measured using Inductively Coupled Plasma-Atomic Emission Spectrometry (ICP-AES). The results revealed that V. rosea enhanced total petroleum hydrocarbon (TPH) degradation and altered the molecular composition of the crude oil. The saturated hydrocarbons increased and the aromatic hydrocarbons decreased. The saturated hydrocarbon fraction in the crude oil showed a wider spectrum of n-paraffin peaks than the oil extracted from unplanted and V. rosea-planted soils. Polyaromatic hydrocarbon degradation was enhanced in the presence of V. rosea, which was reflected in the increase of monoaromatic and diaromatic constituents. This was parallel to the increased sulfur levels in planted soil. The determination of sulfur and heavy metal content in plant organs indicated that V. rosea can extract and accumulate high amounts from polluted soils. The ability of V. rosea to degrade TPH and alter the composition of crude petroleum oil by decreasing the toxicity of polyaromatic hydrocarbons in soil, as well as its capability to absorb and accumulate sulfur and heavy metals, supports the use of plant species for the phytoremediation of crude oil-polluted sites.

Objective: To explore the literature surrounding pediatric ACP process, documenting and implementing the documentation processes in hopes to inform and support content experts in the creation of a pediatric provincial document for ACP.Introduction: The number of children with serious illness/medical complexity in this province who require ACP and documentation of medical intervention is estimated to be >500 or possibly more. An ongoing data analysis suggests that the number may exceed 1,000 children, greater than the number of children and families consulted to the CPCH program. Currently there is no provincial document for pediatric patients such as the BC Medical Orders for Scope of Treatment form (MOST) as there is in adult care.Inclusion criteria: The review will include studies that focus on documentation, process or implementation in pediatric advance care planning. Child refers to prenatal, neonate, child and youth population (0-19 years), but may also extend into young adulthood in some contexts. These children are defined as at-risk for sudden death and/or expected death prior to reaching adulthood.Methods: We will search MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCOhost), Web of Science Core Collection and Google Scholar, as well as sources of unpublished studies and grey literature. Identified studies will be screened against the eligibility criteria. This review will only consider studies published in English and no date limits will be placed on the search. Relevant data will be extracted from eligible studies and the extracted data will presented in narrative and tabular/charted formats.

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BackgroundIn British Columbia (BC), Canada, fall-related injuries are the leading cause of injury-related deaths among seniors (>65 years). On an average day, 40 seniors are hospitalized from fall-related injuries costing $1.3 million in direct healthcare. The majority of these falls occur in the community setting.ObjectiveDevelop evidence-informed recommendations for prevention of fall-related injuries among seniors living in BC communities.MethodsAn environmental scan was conducted to identify BC programs and initiatives for prevention of falls among seniors. Opportunities, gaps and barriers were identified to assist with direction and planning of falls prevention programming. Falls Prevention Recommendation Working Group, comprising members representing each Health Authority in BC, with extensive experience in the areas of public health, epidemiology, emergency medicine and falls prevention, was formed. The panel conducted a narrative review of literature, including meta-analyses, systematic reviews, randomized controlled trials, cohort studies, program evaluation and grey literature related to falls and injury prevention among community living older adults. Recommendations were developed through a modified Delphi process and focus groups to develop consensus.FindingsAfter review of the environmental scan, provincial polices, practice guidelines, training, education, and capacity across BC, as well as a preliminary feasibility assessment, we developed evidence-informed recommendations that included, promoting community awareness together with a comprehensive approach for multifactorial assessments and interventions for those seniors that are at high risk for falls.ConclusionA multi-disciplinary and multi-agency approach is needed to address complex public health problems such as falls among seniors.Policy implicationsFor addressing a complex regional public health issue, a similar approach can be used that involves a coordinated and collaborative approach. Steps in such an approach include environmental scan, gap analysis, evidence review, and consensus generation.