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Abstract Background For studying the effectiveness of treatment, it is important to check whether a new treatment is performed as originally described in the study-protocol. Objectives To evaluate whether an interdisciplinary graded exposure program, for adolescents with chronic musculoskeletal pain reporting pain-related fear, was performed according to protocol, and whether it is feasible to implement the program in rehabilitation care. Methods A process evaluation where quantitative and qualitative data on participant characteristics (adolescents, parents and therapists), attendance and participants’ opinion on the program were collected, by means of registration forms, questionnaires and group interviews. To evaluate treatment fidelity, audio and video recordings of program sessions were analyzed. Results Thirty adolescents were offered the program, of which 23 started the program. Adolescents attended on average 90% of the sessions. At least one parent per adolescent participated in the program. Analysis of 20 randomly selected recordings of treatment sessions revealed that treatment fidelity was high, since 81% of essential treatment elements were offered to the adolescents. The program was considered client-centered by adolescents and family-centered by parents. Treatment teams wished to continue offering the program in their center. Conclusion The interdisciplinary graded exposure program was performed largely according to protocol, and therapists, adolescents and their parents had a favorable opinion on the program. Implementation of the program in rehabilitation care is considered feasible. Trial registration Clinicaltrials.gov ID: NCT02181725 (7 February 2014).

The paper investigates the sources of mercury (Hg) in municipal/industrial waste and the consequences of the presence of this pollutant for the incineration of this waste. About 1990 the average mercury concentration of the feed stream to incinerators was about 4 mg kg -1. The concentration decreased considerably during the last decade thanks to a considerable reduction of the application of mercury and to the introduction of effective battery return systems. Presently the mercury concentration in municipal SOLID waste is approximately 2 mg kg-1. During incineration mercury passes practically for 100% in the flue gas. The techniques for mercury removal from flue gases are discussed at the hand of practical examples. It is concluded that there are a number of processes which guarantee mercury concentrations of <50 µg Nm-3 in the clean gas, the present emission limit concentration. All mercury control processes produce a new solid or liquid waste stream that contains the mercury removed from the flue gas. This stream has to be disposed of as hazardous waste in a qualified landfill. The flue gas from waste incinerators undergoes very rapid dispersion and dilution after leaving the incinerator stack. It follows that the maximum mercury concentration in the ambient air will remain at least five to six orders of magnitude below the lowest MAC value (=Maximum Admissible Concentration in work spaces) and that public health will not be threatened. [ABSTRACT FROM AUTHOR]