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VOCs or Volatile Organic Compounds are organic chemical compounds that have become vaporised and enter into the atmosphere. Carbon-based molecules like (aldehydes) which are any of a class of highly reactive chemical compounds; used in making resins, dyes, organic acids, and (ketones) which are also any of a class of organic compounds having a carbonyl group linked to a carbon atom in each of two hydrocarbon radicals and other light hydrocarbons are VOCs.

VOCs are sometimes accidentally released into our environment damaging soil and groundwater. Escaping vapours of VOCs into the air contribute to air pollution. VOCs are an important outdoor air pollutant and turns into methane which is an extremely effective greenhouse gas which contributes to enhanced global warming.

There are systems that deal with this type of problem; a VOC Abatement System relies upon the concept of a chemical reaction, and when involving organic hydrocarbons the process is called oxidation. Within this oxidation process, the compounds within the air stream, theses VOCs or Volatile Organic Compounds are broken down from their original composition and reformed into new compounds, and when enough heat and oxygen are added to the hydrocarbons to create the oxidation reaction, this process is called Thermal Oxidation. By breaking the original composition of the VOC Hydrocarbons, carbon and hydrogen, can be regenerate naturally into carbon dioxide and water vapor releasing heat energy. The heat energy is then recouped into the system by use of a heat exchanger, (a device built for efficient heat transfer from one medium to another) while the now clean air stream of carbon dioxide and water is discharged in to the atmosphere.

Needing to find the right systems to answer theses types of environmental issues are not uncommon to the industrial marketplace today. Those within the industry are on the cutting edge of designing systems such as Thermal Oxidizers to help meet this global problem head on. Rest assured that with the new technology in this area of Thermal Oxidizer manufacturing, there are those with an eye finding solutions to this issue.

There are different types of affordable health insurance plans, including affordable individual health insurance, affordable family health insurance, affordable child health insurance, affordable employee health insurance and affordable business health insurance. Full information on affordable insurance schemes can be obtained from the Internet, and if you need further clarifications, you can consult an insurance broker. Customer service departments of health care providers also give information regarding available benefits and coverage.

Child health insurance focuses on children’s general wellness. This health insurance helps parents cover expenses arising from unforeseen circumstances also. Very often, affordable child health insurance plans offer treatment by a group of specialists. They remind parents about the important preventive medicines that are to be administered to their children and also give programs and information to parents on how to manage their children?s health conditions. State-of-the-art technology provided by many affordable child health insurance schemes simplifies the tracking of health benefits. Parents, who want to buy a policy need to do the proper homework and study the benefits and affordability before filing in the application.

Health care is always critical for a child. Health insurance is essential for children who grow up in divorced, separated, or never-married families. It is easy to find affordable child health insurance plans that provide health care services, including preventive care, to ensure childhood immunizations, vision care, hearing and dental care. Lots of child health insurance plans are affordable, providing a wide range of health schemes for children. Hence, it is important to choose a plan that is most suitable.

Jennifer Millis’s coworkers always know when her son suffers a sickle-cell pain crisis. “I lose five pounds just like that,” says Millis. Despite Christopher’s countless crises, Millis says she cannot get used to them. “Every time he has a crisis is like the first time. It’s very hard to watch someone you love go through such intense pain,” she says.

For many sickle-cell patients, a pain crisis can last up to a week or more and is severe enough to require hospitalization for treatment with potent painkillers. The crippling pain described by patients tends to attack the chest, abdomen and joints, but some, like 15-year-old Donna, a Dallas high-school student, say they hurt from head to foot. “I’m talking excruciating pain all over–capitalized, underlined and circled with red!” she says. And for parents of such children, the pain comes from watching helplessly while a child suffers regularly. “There’s so little even the doctors can do,” says Millis.

There’s still no cure for sicklecell disease, an inherited blood disorder that in this country afflicts primarily African-Americans. Pain strikes when the red blood cells of sickle-cell patients stick together and clog small blood vessels. Unlike normal red blood cells that are round and pliable, in patients with the disease the cells are sickle-shaped, like crescent moons, and frequently cannot pass through arteries and capillaries. When the cells jam up blood vessels, oxygen doesn’t get to some of the organs and limbs of the body, which causes pain. This malfunction can also damage major organs, such as the kidneys, heart and liver, or cause a stroke if the vessel that’s blocked leads to the brain.

In the past, these and other complications associated with the disease shortened the lives of sickle-cell patients, many of whom didn’t survive past their early twenties. But now, thanks to recent breakthroughs and aggressive management of the disease (including blood transfusions, bone-marrow transplants and prophylactic penicillin for young children), sickle-cell patients can live long, productive lives if they know how to spot the illness and get help.

Type 1 diabetes can be difficult to control in young children because of variations in food intake and exercise, the difficulty of administrating low doses of insulin, and frequent viral infections. These young children also have increased sensitivity to short-acting insulin and often cannot tell their caregivers when they are having symptoms of hypoglycemia. Pump therapy may be a more effective and safer way to administer insulin therapy in these children. Litton and associates studied the use of pump therapy in nine children younger than four years who had type 1 diabetes and severe hyperglycemia.

Family members received thorough education about hyperglycemia and hypoglycemia and were provided with easy access to staff members for questions or concerns. Dietary information was provided to all, and bedtime snacks were recommended. Initial therapy for all children included multiple doses of insulin during the day using long- and short-acting preparations. Blood glucose measurements were obtained four to 10 times daily along with urine testing for ketones daily and when illness or hyperglycemia occurred. Pump therapy was recommended for use in children who, after at least six months of injection treatment, developed recurrent hypoglycemia, persistent glycosylated hemoglobin (HbA1c) elevation, erratic variations in blood sugar levels, or recurrent ketoacidosis or severe hyperglycemia. Constant adult supervision is required for any child using pump therapy. Caregivers of children starting pump therapy were educated about its use and had to be willing to monitor blood glucose levels at least four times daily. Children had to be able to tolerate and avoid touching the catheter and the pump mechanism.

Acute diarrhea is a common problem in day care centers, especially in centers providing care for children who are not yet toilet trained. Staat and colleagues hypothesized that children first entering day care centers have a greater incidence of diarrhea than children already enrolled in day care centers. The investigators conducted a study to compare the incidence of diarrhea in children who were newly enrolled in day care centers with the incidence in children who had attended the same day care centers for longer periods.

The study included 442 children under two years of age who were enrolled in 13 randomly selected day care centers in Houston. Demographic information was obtained from a standardized questionnaire completed by a parent. The children were monitored over a 14.5-month period for the occurrence of diarrhea. Research nurses visited the day care center twice a week to record episodes of diarrhea and to collect stool specimens.

The overall incidence of diarrhea was 2.8 cases per child-year. However, children were at greatest risk in the first four weeks that they attended a new day care center. During this four-week interval, the incidence was 4.4 cases per child-year. The incidence was higher in boys than in girls. No relatioship was found between the incidence of diarrhea and ethnicity, size of the day care center or season of the year. No difference was found in children who had also attended another day care center. Rotavirus was identified in 18 percent of the cases of diarrhea.

The authors believe that parents considering day care for their children should be aware that children may have diarrhea when they first enter a day care center. Children under one year of age are particularly at risk, but this risk decreases with time. Previous attendance at another day care center may not decrease the risk of diarrhea. Use of appropriate hygienic procedures, including handwashing and environmental cleaning, may be the most effective preventive measures. (Pediatric Infectious Disease Journal, April 1991, vol.10, p.282.)

Practice guidelines from the American Academy of Pediatrics recommend renal ultrasonography and voiding cystourethrography (VCUG) in all children two months to two years of age with a documented first urinary tract infection (UTI). Other authorities have suggested using renal scanning with technetium 99m at the acute infection and later to detect evidence of renal scarring. Hoberman and colleagues conducted a prospective trial to determine if imaging studies in young children with a first UTI altered management or improved outcomes.

This multicenter trial initially enrolled 421 children who were one to 24 months of age and had a fever and pyuria or bacteriuria in a catheterized urine specimen. Final study results were calculated for 309 children (73 percent), after excluding those with negative urine cultures, declined consent, or other logistical barriers to participation. Each child received renal ultrasonography and technetium 99m renal scanning within 48 hours of the initial diagnosis of UTI. VCUG was performed in 98 percent of the subjects one month after the infection, and follow-up renal scanning was performed in 89 percent of the subjects six months after diagnosis to detect any renal scarring. Children with at least grade II vesicoureteral reflux received either trimethoprim-sulfamethoxazole (TMP-SMX) or nitrofurantoin once daily for 11 months or until the reflux was classified as grade I or less.

The initial renal sonogram was normal in 88 percent of the children with UTI. The presence of hydroureter on ultrasonography was not a sensitive screen for urine reflux, identifying only 10 percent of children who had reflux that was later confirmed by VCUG. No child had a change in clinical management based on renal sonography.

Nuclear medicine renal scanning identified acute pyelonephritis in 61 percent of children with UTI. At six months of follow-up, repeat renal scanning identified scarring in 9.5 percent of children. Scarring was more likely in the subgroups of patients with initial evidence of vesicoureteral reflux (15 percent scar rate) than in those without vesicoureteral reflux (6 percent scar rate). No child with an initially normal renal scan had scarring on the six-month follow-up scan.

The child and dependent care credit is available for certain child and dependent care expenses that enable parents to work. The credit may be as much

as $720 in the case of one qualifying individual or $1,440 for more than one qualifying individual. The credit is designed to help ease the tax burden of persons who must work and who also have the responsibility for the care of children or disabled dependents and spouses.

A person claiming this credit must pay someone to care for a qualifying individual so that the claimant can work or look for work. The person must also have earned income from work during the year and must have maintained a home for himself or herself and the qualifying individual.

Tests

To claim the credit, a person must meet all of the following tests.

Qualifying person. Child and dependent care expenses must be for the care of one or more household members who are qualifying persons. A qualifying person is: * A dependent who was under 13

when the care was provided and

for whom an exemption can be

claimed; * A spouse who was physically or

mentally not able to care for himself

or herself; or * Any person who was not able to

care for himself or herself and for

whom exemption can be claimed

(or for whom an exemption could

be claimed, if the person had less

than $2,300 gross income).

Maintenance of a home. To claim the credit, a claimant (and the claimant’s spouse, if married) must keep up a home the claimant lives in with one or more qualifying persons. A home is being kept up when more than half the cost of running it is paid by the claimant.

The term “home” means the main home for both the claimant and the qualifying person. A home can be the main home even if the qualifying person does not five there all year because of birth, death or certain types of temporary absence.

Earned income. To claim the credit, a claimant (and the claimant’s spouse, if married) must have earned income during the year. Earned income includes wages, salaries, tips, other employee compensation, and net earnings from self-employment. Earned income does not include pensions or annuities, Social Security payments, workers’ compensation, interest, dividends, or unemployment compensation.

A special rule covers a student-spouse or spouse not capable of self-care. A spouse is treated as having earned income for any month that he or she is either a full-time student, or physically or mentally not capable of self-care.

The majority of seizures in children younger than five years are febrile seizures, and children with a positive family history have a higher incidence. A febrile seizure is defined as any seizure occurring in a child who is six months to five years of age accompanied by a current or recent fever (at least 38[degrees]C [100.4[degrees]F]) and without previous seizure or neurologic events. Febrile seizures can be classified as simple or complex. Simple febrile seizures are characteristically generalized, usually last less than 15 minutes, and occur only once in a 24-hour period. Complex febrile seizures may have focal features, last longer than 15 minutes, and recur within a 24-hour period. Fever and seizure can occur at the same time and be unrelated, such as in patients with underlying seizure disorder, patients who are out of the febrile seizure age range, or patients who have a central nervous system infection.

Warden and associates searched the clinical literature to review the evaluation and management of febrile seizures in children. Viral infections are often present with febrile seizures, with human herpes virus 6 and 7 and influenza A and B being important pathogens. There also is a significant increased risk of febrile seizures within 24 hours of receiving vaccination for diphtheria and tetanus toxoids and whole-cell pertussis, and within eight to 14 days of receiving a measles, mumps, and rubella vaccination. The risk of recurrent febrile seizures is increased in patients whose initial febrile seizure occurred at less than 12 months of age, patients with a lower rectal temperature at first seizure (less than 40[degrees]C [104[degrees]F]), patients with shorter duration of fever before their first seizure (less than 24 hours), patients with a family history of febrile seizures, and patients with complex features with the first febrile seizure. The risk of development of epilepsy is slightly increased among persons having simple febrile seizures but is significantly increased among those who have one or more complex febrile seizures.

Constipation in children accounts for approximately 3 percent of outpatient visits to general clinics for children per year. Treatment can include dietary and behavior modifications, counseling, and the use of various laxatives and stool softeners. Polyethylene glycol 3350 (PEG) is an osmotic laxative that currently is being used to cleanse the gastrointestinal tract before diagnostic or surgical procedures in children. PEG is a nontoxic and highly soluble compound that is not absorbed in the gastrointestinal tract. This compound, without electrolytes, comes as a powder that is palatable when dissolved in water or juice. PEG has proved to be effective in the short-term treatment of constipation in children, but there currently are no published studies of long-term safety. Pashankar and colleagues evaluated the clinical and biochemical safety of long-term PEG therapy in children with chronic constipation. They also examined acceptance of this therapy in young children.

The trial was a prospective observational study of children with chronic constipation, which was defined as at least three months of at least two of the following symptoms: hard stools, encopresis, painful defecation, or fewer than three bowel movements per week. After enrollment in the study, patients received PEG therapy at 0.8 g per kg per day, and use of other laxatives was stopped. Parents were instructed to dissolve 17 g of PEG powder in 240 mL of water and give the appropriate amount of the liquid in two divided doses. Parents could adjust the dosage until the child starting having two soft, painless stools per day.

Parents were allowed to taper the dosage over time, based on the child’s response to therapy. Follow-up after the initiation of therapy was performed by giving parents a standard questionnaire that reviewed the dosage of PEG given, medication compliance, the beverage used to prepare PEG, ease of mixing, overall improvement in bowel movements, and any adverse effects. The children were asked whether they liked the medication and if they preferred it to other laxatives. Blood was obtained at the follow-up appointment to evaluate the biochemical effect of PEG therapy.

Today the membership rolls of health-maintenance organizations (HMOs) top 67 million–more than of all people insured. But as the managed-care industry grows, so do patients’ complaints: A 1996 Consumer Reports investigation revealed that 10 percent of readers feel their HMO has discouraged them from seeking certain treatments, and 18 percent have gone outside their plan to get the care they need.

Consumers don’t have to take this medicine lying down. If you’re considering or already belong to an HMO:

Know the plan. “Read everything you can about the HMO’s scope of coverage and referrals and reimbursement policies,” says Liza Greenberg, medical affairs director of the American Association of Health Plans. Familiarize yourself with the membership booklet and the rules for services such as obstetric and gynecological care, emergency treatment and preventive care.

Ask about point-of-service (POS) plans. Some HMOs and employers , offer this insurance option, which lets patients seek care outside the network for an additional out-of-pocket fee.

Work the doctor-patient relationship. Talk frankly with your primary-care physician about your health concerns, says Trudy Lieberman, a senior investigative editor for Consumer Reports. Ask, for example, if she’ll refer you to specialists if necessary. Jointly develop strategies to make the system work for you.

Be a squeaky wheel. If you’re refused a referral or reimbursement, first try to negotiate through the HMO’s formal grievance process, suggests Lieberman. Then contact your state insurance commissioner s office to complain. Keep records of receipts, correspondence and phone calls, and ask your benefits administrator for help.

Always put your health first. Don’t hesitate to get the care you want and need. Some HMOs will reimburse as much as 80 percent of out-of-network costs.

For more managed-care strategies, read The HMO Health Care Companion by Alan Raymond (HarperCollins, $10).

Q I left my physically abusive husband of 11 years. He wants us to get back together and is seeking himself and for us, but I’m afraid to take any chances. What should I do?

A Do not allow your husband to coerce you in any way, and always maintain self-protective behavior. If you fear reconciliation, encourage him to seek help on his own, and ask his personal counselor to advise you of any progress. Only indepth therapy can determine whether your husband has learned how to control his violent outbursts.