Municipal incinerated bottom ash (MIBA) characteristics and potential for use in road pavements

The characteristics of municipal incinerated bottom ash (MIBA) and its performance in road pavement applications is assessed through systematic analysis and evaluation of the global experimental data. MIBA has been used in unbound, hydraulically and bitumen bound forms. As unbound material, after processing, MIBA exhibits suitable mechanical properties for use as capping, fill and sub-base material, which has been successfully demonstrated in field testing. In hydraulically bound form, MIBA can be a viable aggregate component in subbase and roadbase layers at low to moderate contents, depending on the performance requirements and binder content. As bituminous bound aggregate in roads, the material can be fit for use at low contents, which is reinforced by a number of completed case studies, with the allowable MIBA fraction controlled by the voids contents, abrasion resistance and bitumen content requirements. Keywords: Municipal incinerated bottom ash, Road pavements, Sustainability, Recycled construction material

Feasibility Testing of An Internet-Based Psycho-Educational Game for Children with Juvenile Idiopathic Arthritis and Their Parents

Background/Purpose: Juvenile Idiopathic Arthritis (JIA) is a common chronic illness in childhood. The responsibility of JIA management during the younger years is shared among family members. However, many families do not receive comprehensive JIA education and coping skills training, which can negatively impact health-related quality of life (HRQL). Evidence supports psycho-educational treatments to improve health outcomes in children with JIA but no program has been developed to meet the needs of 7 to 12-year-old children. The aim of this research is to evaluate the feasibility of a bilingual (English and French) interactive, Internet-based psycho-educational game for children with JIA. Methods: A pilot randomized controlled trial (RCT) design with a usual care control group is underway (target n = 120). Recruitment is ongoing at four Canadian pediatric tertiary care centres and three additional centres will start upon completion of study setup. After informed consent is obtained and baseline questionnaires are completed, participants are randomized. Over the 8-week study period, participants in the experimental group are asked to download the game onto a personal device (i.e., computer or iPad) and interact with the game daily. Participants in the control group receive usual care and are offered the program after post-study. Parents of participants in both groups receive access to the ‘JIA Resource Centre’. Post-study questionnaires are completed following 8-weeks. Implementation outcomes are analyzed using descriptive statistics. Results: To date, 57 participant dyads have enrolled in the study. Of these, 30 have completed the study, 24 are currently in progress, and 3 have dropped out. Reasons for dropping out included, failure to download the game due to technical difficulties (1 dyad) or lack of time (2 dyads). On average, dyads have taken 7.8 (SD = 6.5) days to download the game. Additional directions or prompts for families to download the game was required from the team for 61.3% (n = 19) of intervention participants and of these, the team contacted dyads an average of 5.4 (SD = 3.6) times before the download was successful. For 22.6% (n = 7), a change of device type was required for a successful download. On average, participants have gotten through 31.2% of game content at the end of 8-weeks. Participants were contacted at the 2-week mark (40.9%) and 5-week mark (78.9%) during the study period to follow-up on the lower than expected progress in the game. The response to the intervention has been mostly positive, however, some participants indicated that the level of difficulty was either “too easy” or “too hard” and some considered it too repetitive. Participants appreciated that a game had been developed for their disease population. Conclusion: The feasibility of this intervention would benefit from an easier distribution procedure as well as compatibility of the game across more platforms (i.e., older iPad versions). The level of difficulty could be better suited if tailored to the child’s age. Next steps include development of a tutorial to assist younger participants. Upon completion of data collection, preliminary effectiveness outcomes will be analyzed

Growth and weight gain in children with juvenile idiopathic arthritis: results from the ReACCh-Out cohort

Background: With modern treatments, the effect of juvenile idiopathic arthritis (JIA) on growth may be less than previously reported. Our objective was to describe height, weight and body mass index (BMI) development in a contemporary JIA inception cohort. Methods: Canadian children newly-diagnosed with JIA 2005–2010 had weight and height measurements every 6 months for 2 years, then yearly up to 5 years. These measurements were used to calculate mean age- and sex-standardized Z-scores, and estimate prevalence and cumulative incidence of growth impairments, and the impact of disease activity and corticosteroids on growth. Results: One thousand one hundred forty seven children were followed for median 35.5 months. Mean Z-scores, and the point prevalence of short stature (height  95th percentile, 15.8% to 16.4%) remained unchanged in the whole cohort. Thirty-three children (2.9%) developed new-onset short stature, while 27 (2.4%) developed tall stature (>97.5th percentile). Children with systemic arthritis (n = 77) had an estimated 3-year cumulative incidence of 9.3% (95%CI: 4.3–19.7) for new-onset short stature and 34.4% (23–49.4) for obesity. Most children (81.7%) received no systemic corticosteroids, but 1 mg/Kg/day prednisone-equivalent maintained for 6 months corresponded to a drop of 0.64 height Z-scores (0.56–0.82) and an increase of 0.74 BMI Z-scores (0.56–0.92). An increase of 1 in the 10-cm physician global assessment of disease activity maintained for 6 months corresponded to a drop of 0.01 height Z-scores (0–0.02). Conclusions: Most children in this modern JIA cohort grew and gained weight as children in the general population. About 1 in 10 children who had systemic arthritis, uncontrolled disease and/or prolonged corticosteroid use, had increased risk of growth impairment.Medicine, Faculty ofOther UBCNon UBCPediatrics, Department ofReviewedFacult