An overview of the corrective action management unit and temporary unit regulations

In February 1993, the US Environmental Protection Agency (EPA) promulgated the corrective action management unit (CAMU) and temporary unit (TU) regulations as 40 CFR Part 264, Subpart S. These regulations are intended to foster the selection of protective and cost-effective remedies for the restoration of sites contaminated by hazardous substances, hazardous wastes, and hazardous waste constituents by removing certain regulatory impediments to implementing those remedies, most notably those of the land disposal restrictions (LDRs). This paper provides a brief overview of the CAMU and TU regulations

Vitrification of underground storage tanks: Technology development, regulatory issues, and cost analysis

In situ vitrification (ISV), developed by the Pacific Northwest Laboratory (PNL) for the US Department of Energy (DOE), is a thermal treatment process for the remediation of hazardous, radioactive, or mixed waste sites. The process has been broadly patented both domestically and abroad. Since the inception of ISV in 1980, developmental activities have been focused on applications to contaminated soils, and more recently the potential for application to buried wastes and underground structures (tanks). Research performed to date on the more advanced ISV applications (i.e., application to buried wastes and underground tanks) shows that significant technical and economic potential exists for using ISV to treat buried wastes and underground structures containing radionuclides and/or hazardous constituents. Present ISV applications are directed to the treatment of contaminated soils; the likelihood of using ISV to treat underground tanks depends on the resolution of significant technical and institutional issues related to this advanced application. This paper describes the ISV process and summarizes the technical progress of underground tank vitrification (UTV), discusses pertinent regulatory issues facing the use of UTV, and presents the potential cost of UTV relative to other remedial action alternatives

ISPAD Clinical Practice Consensus Guidelines 2022: The delivery of ambulatory diabetes care to children and adolescents with diabetes

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Transition From Pediatric to Adult Care for Youth Diagnosed With Type 1 Diabetes in Adolescence

Youth with type 1 diabetes mellitus are at risk for poor glycemic control as they age into adulthood. The aim of this study was to describe sociodemographic and clinical correlates of poor glycemic control associated with the transfer of care from pediatric to adult diabetes providers among a cohort of youth with type 1 diabetes diagnosed in adolescence

Resolution of regulatory issues facing the DOE in situ vitrification program

In situ vitrification (ISV) is being developed by researchers at the Pacific Northwest Laboratory (PNL), Idaho National Engineering Laboratory (INEL), and Oak Ridge National Laboratory (ORNL) as a technology for remediating soils, underground storage tank residuals, and buried materials that have been contaminated with hazardous, radioactive, and mixed wastes (i.e., wastes containing both radioactive and hazardous wastes) at US Department of Energy (DOE) facilities. The goal of the DOE ISV technology development program (i.e., the ISV Integrated Program) is to ensure that ISV is a workable technology for environmental restoration applications for DOE and other agencies. A DOE complex-wide plan was prepared during Fiscal Year 1991 to coordinate all levels of activities associated with the deployment of ISV. As part of this plan, a programmatic regulatory strategy was developed which focused on the federal environmental, health, safety, and nuclear regulations, including the US Environmental Protection Agency (EPA) and DOE regulations, believed to have the most significant near-term impact on the use of ISV as a remediation technology. The portion of the programmatic regulatory strategy addressing compliance with the Comprehensive Environmental Response, Compensation and Liability Act, as amended, and the Resource Conservation and Recovery Act, as amended, is presented in this paper

Vitrification of underground storage tanks: Technology development, regulatory issues, and cost analysis

In situ vitrification (ISV), developed by the Pacific Northwest Laboratory (PNL) for the US Department of Energy (DOE), is a thermal treatment process for the remediation of hazardous, radioactive, or mixed waste sites. The process has been broadly patented both domestically and abroad. Since the inception of ISV in 1980, developmental activities have been focused on applications to contaminated soils, and more recently the potential for application to buried wastes and underground structures (tanks). Research performed to date on the more advanced ISV applications (i.e., application to buried wastes and underground tanks) shows that significant technical and economic potential exists for using ISV to treat buried wastes and underground structures containing radionuclides and/or hazardous constituents. Present ISV applications are directed to the treatment of contaminated soils; the likelihood of using ISV to treat underground tanks depends on the resolution of significant technical and institutional issues related to this advanced application. This paper describes the ISV process and summarizes the technical progress of underground tank vitrification (UTV), discusses pertinent regulatory issues facing the use of UTV, and presents the potential cost of UTV relative to other remedial action alternatives

Transition From Pediatric to Adult Care for Youth Diagnosed With Type 1 Diabetes in Adolescence

OBJECTIVE: Youth with type 1 diabetes mellitus are at risk for poor glycemic control as they age into adulthood. The aim of this study was to describe sociodemographic and clinical correlates of poor glycemic control associated with the transfer of care from pediatric to adult diabetes providers among a cohort of youth with type 1 diabetes diagnosed in adolescence. METHODS: Analyses included 185 adolescent participants with recently diagnosed type 1 diabetes in the SEARCH for Diabetes in Youth Study with pediatric care at baseline who were age ≥18 years at follow-up. Demographic and clinical factors were measured by survey and laboratory results. Survival analysis was used to estimate the age of transition. Logistic regression analysis assessed the association of demographic and clinical factors with the transition of care and poor glycemic control at follow-up. RESULTS: Fifty-seven percent of participants had transitioned to adult diabetes care providers by the follow-up visit. The estimated median age of transition of care was 20.1 years (95% confidence interval 19.8–20.4). Older age, lower baseline glycosylated hemoglobin, and less parental education were independently associated with increased odds of transition. The odds of poor glycemic control at follow-up were 2.5 times higher for participants who transitioned to adult care compared with those who remained in pediatric care. CONCLUSIONS: Transferring from pediatric to adult care, experienced by more than half the sample, was associated with an increased risk of poor glycemic control at follow-up. These findings suggest that young adults need additional support when moving to adult care

PedsQL 3.2 Diabetes Module for Children, Adolescents, and Young Adults: Reliability and Validity in Type 1 Diabetes

ObjectiveThe objective of the study was to report on the measurement properties of the revised and updated Pediatric Quality of Life Inventory (PedsQL) 3.2 Diabetes Module for children, adolescents, and young adults with type 1 diabetes.Research design and methodsThe 33-item PedsQL 3.2 Diabetes Module and PedsQL Generic Core Scales were completed in a 10-site national field test study by 656 families of patients ages 2-25 years with type 1 diabetes.ResultsThe 15-item Diabetes Symptoms Summary Score and 18-item Diabetes Management Summary Score were derived from the factor analysis of the items. The Diabetes Symptoms and Diabetes Management Summary Scores evidenced excellent reliability (patient self-report α = 0.88-0.90; parent proxy report α = 0.89-0.90). The Diabetes Symptoms and Diabetes Management Summary Scores demonstrated construct validity through medium to large effect size correlations with the Generic Core Scales Total Scale Score (r = 0.43-0.67, P < 0.001). HbA1c was significantly correlated with the Diabetes Symptoms and Diabetes Management Summary Scores (r = -0.21 to -0.29, P < 0.001). Minimal clinically important difference scores ranged from 5.05 to 5.55.ConclusionsThe PedsQL 3.2 Diabetes Module Diabetes Symptoms and Diabetes Management Summary Scores demonstrated excellent measurement properties and may be useful as standardized patient-reported outcomes of diabetes symptoms and diabetes management in clinical research, clinical trials, and practice in children, adolescents, and young adults with type 1 diabetes