| 1. |
- Cachim, Afonso, et al.
(författare)
-
Measuring adherence to inhaled control medication in patients with asthma : Comparison among an asthma app, patient self-report and physician assessment
- 2023
-
Ingår i: Clinical and Translational Allergy. - : John Wiley & Sons. - 2045-7022 .- 2045-7022. ; 13:2
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundPrevious studies have demonstrated the feasibility of using an asthma app to support medication management and adherence but failed to compare with other measures currently used in clinical practice. However, in a clinical setting, any additional adherence measurement must be evaluated in the context of both the patient and physician perspectives so that it can also help improve the process of shared decision making. Thus, we aimed to compare different measures of adherence to asthma control inhalers in clinical practice, namely through an app, patient self-report and physician assessment.MethodsThis study is a secondary analysis of three prospective multicentre observational studies with patients (≥13 years old) with persistent asthma recruited from 61 primary and secondary care centres in Portugal. Patients were invited to use the InspirerMundi app and register their inhaled medication. Adherence was measured by the app as the number of doses taken divided by the number of doses scheduled each day and two time points were considered for analysis: 1-week and 1-month. At baseline, patients and physicians independently assessed adherence to asthma control inhalers during the previous week using a Visual Analogue Scale (VAS 0–100).ResultsA total of 193 patients (72% female; median [P25–P75] age 28 [19–41] years old) were included in the analysis. Adherence measured by the app was lower (1 week: 31 [0–71]%; 1 month: 18 [0–48]%) than patient self-report (80 [60–95]) and physician assessment (82 [51–94]) (p < 0.001). A negligible non-significant correlation was found between the app and subjective measurements (ρ 0.118–0.156, p > 0.05). There was a moderate correlation between patient self-report and physician assessment (ρ = 0.596, p < 0.001).ConclusionsAdherence measured by the app was lower than that reported by the patient or the physician. This was expected as objective measurements are commonly lower than subjective evaluations, which tend to overestimate adherence. Nevertheless, the low adherence measured by the app may also be influenced by the use of the app itself and this needs to be considered in future studies.
|
|
| 2. |
- Cano, Vitor, et al.
(författare)
-
Novel bioelectrochemical processes focused on nitrogen in wastewater : Energy generation and resource recovery
- 2023. - 1
-
Ingår i: Water Management and Circular Economy. - Amsterdam : Elsevier. - 9780323952804 - 9780323952811 ; , s. 233-272
-
Bokkapitel (refereegranskat)abstract
- The discharge of nitrogen into nature results in environmental degradation and public health problems. Conventional processes applied in wastewater treatment plants (WWTPs) for nitrogen removal have high energy demand and chemical consumption. Hence, this chapter addresses the recent research development about more sustainable approaches involving bioelectrochemical systems (BES) focused on nitrogen. Among the content are novel and meaningful insights towards the main factors controlling nitrogen oxidation, reduction, and separation/recovery; potential applications in WWTP; limiting factors; and contributions towards the circular economy principles. Despite there are limiting factors such as costly materials, lack of knowledge on microbial ecology, and low removal rates, the current generated in autotrophic nitrifying and denitrifying BES ranges from 1.2 to 1175 mA/m2 and 14 to 371 A/m3, respectively. This can potentially increase WWTPs self-sufficiency in terms of energy and external carbon. Alternatively, nitrogen can be recovered in BES (struvite, NH4HCO3 crystals or NH4OH), but improvements in ammonia separation across ion exchange membranes are necessary. © 2023 Elsevier Inc. All rights reserved.
|
|
| 3. |
- Cardoso Chrispim, Mariana, Postdoktor, 1990-, et al.
(författare)
-
A framework for resource recovery from wastewater treatment plants in megacities of developing countries
- 2020
-
Ingår i: Environmental Research. - Maryland Heights : Academic Press. - 0013-9351 .- 1096-0953. ; 188
-
Tidskriftsartikel (refereegranskat)abstract
- In developing countries, there is often a lack of a comprehensive data set that supports the development of coherent policies on resource recovery from wastewater treatment. This paper aims to contribute to the elaboration of resource recovery projects by providing accurate and updated data from wastewater treatment plants such as those located in the region of the Macrometropolis of Sao Paulo. The authors discuss possibilities of improvement of resource recovery for this illustrative example. Comprehensive analyses were performed based on data from 143 municipal wastewater treatment plants to understand the situation regarding resource recovery implementation in this region. The results show that just 26% of the plants perform at least one resource recovery practice. The predominant resource recovery practice is internal water reuse, and recovery is concentrated more in large plants than in medium and small ones. The sludge is disposed in landfills except for three plants, which perform sludge recycling for compost. Some plant managers reported interest in recovering energy from biogas, in expanding water reuse and in recovering sludge for fertilizer production or for building materials. Several aspects that have been regarded as relevant to the implementation of resource recovery processes in previous literature are discussed, such as the size of the plant, related legislation as well as treatment technologies and configurations. Finally, the authors propose a generic framework with several steps that can help to achieve resource recovery implementation. Therefore, the results can provide support for planning of resource recovery projects for large cities in developing countries. © 2020 Elsevier Inc.
|
|
| 4. |
- Cardoso Chrispim, Mariana, Postdoktor, 1990-, et al.
(författare)
-
A Framework for Sustainable Planning and Decision-Making on Resource Recovery from Wastewater : Showcase for São Paulo Megacity
- 2020
-
Ingår i: Water. - Basel : MDPI. - 2073-4441. ; 12:12
-
Tidskriftsartikel (refereegranskat)abstract
- Currently, it is important to develop strategic frameworks to support the selection of sustainable resource recovery solutions. This study applies a new framework for planning, implementation, and assessment of resource recovery strategies for a full-scale wastewater treatment plant (WWTP) in São Paulo megacity. The framework comprises several steps based on case study-specific data and information from current literature. Data were collected from various sources: a survey with a wastewater treatment utility, national and regional databases, and review of local regulations and international literature. Treatment configuration, wastewater and by-products composition, potential demand (for water, energy, and phosphorus), stakeholder identification, and local legislation were thoroughly discussed regarding decision-making on resource recovery. Scenario analysis was used to explore suitable nutrient and energy recovery measures based on indicators. Biogas recovery and sewage sludge composting showed more favorable conditions due to similar experiences in the area and robust legislation. The proposed framework is a simplified tool, and its application can support managers to get information on resource recovery and how to plan such initiatives in easier ways to facilitate wiser decision-making, and better operation and management. The results on framework use and refinement can guide potential applications in other contexts and stimulate public policy formulation and further research.
|
|
| 5. |
- Cardoso Chrispim, Mariana, Postdoktor, 1990-, et al.
(författare)
-
Avaliação Comparativa Entre Veículos Elétricos E Veículos Convencionais No Contexto De Mitigação Das Mudanças Climáticas
- 2019
-
Ingår i: Revista Gestão & Sustentabilidade Ambiental. - São Paulo : Universidade Nove de Julho. - 2238-8753 .- 2238-8753. ; 8:1, s. 127-148
-
Tidskriftsartikel (refereegranskat)abstract
- Atualmente, os veículos elétricos (VE) têm sido apontados como tendência futura da indústria automotiva. Dentre as motivações dos países para isto estão: reduzir a dependência de petróleo e seus derivados, promover o uso mais eficiente de energia e causar menores impactos ambientais, em especial os correlatos à emissão de Gases de Efeito Estufa (GEE). Os automóveis híbridos e elétricos não representam uma inovação tecnológica recente, apesar disso os mesmos contam com uma participação marginal na história do automóvel desde a década de 30. Aliás, vale ressaltar que os VE não são isentos de impactos ambientais, sobretudo na etapa de produção dos mesmos. Neste artigo, espera-se contribuir com informações acerca de características do desempenho ambiental de VE em relação aos veículos convencionais movidos à combustão interna (MCI), analisando quais suas vantagens e desvantagens, quais os impactos ambientais causados em todo o ciclo de vida e como essa tecnologia poderia contribuir para a mitigação das mudanças climáticas. Além disso, também se discute quais os impactos da expansão dos VE na demanda de energia final. Para tanto, empreendeu-se revisão da literatura sistêmica com base em pesquisas recentes e naquelas basilares focadas nos VE. Um dos resultados principais indicou que, quanto maior a participação de energias renováveis na oferta de energia elétrica, maior será a redução das emissões de GEE pelos VE, sendo que em alguns casos pode haver um aumento das emissões no balanço total do ciclo de vida desta tecnologia comparada à convencional.
|
|
| 6. |
- Cardoso Chrispim, Mariana, Postdoktor, 1990-, et al.
(författare)
-
Biogas recovery for sustainable cities : A critical review of enhancement techniques and key local conditions for implementation
- 2021
-
Ingår i: Sustainable cities and society. - Amsterdam : Elsevier. - 2210-6707. ; 72
-
Forskningsöversikt (refereegranskat)abstract
- There is great potential to apply energy recovery from municipal wastewater treatment plants (WWTP) to achieve better energy efficiency and greenhouse gas emissions abatement. However, in most of the wastewater treatment plants that produce biogas through sludge digestion, there is no thermal energy recovery or electricity generation, and the biogas is flared and wasted, particularly in developing countries. This paper discusses the recent technological advances related to biogas recovery from wastewater treatment besides identifying research gaps and local conditions, which affect implementation. Techniques for enhancement of biogas production such as co-digestion and microalgae systems for energy recovery were reviewed in terms of performance and context for application. This paper provides an assessment of how local conditions promote or hinder biogas recovery from WWTP in megacities of developing countries. The lack of government subsidies and a biogas market that is not well developed and regulated hinder biogas recovery implementation in the studied megacities. Infrastructure and electricity prices are also discussed. Strategies to promote energy recovery are recommended based on successful examples of energy self-sufficient WWTP. The findings may not only support planning on energy recovery but also guide technological development and research on this topic, aligned with the sustainable development goals.
|
|
| 7. |
- Cardoso Chrispim, Mariana, Postdoktor, 1990-
(författare)
-
Evaluation of decentralized approaches to wastewater treatment systems as alternative to environmental impacts and indication of sustainable solution for water conservation in cities
- 2017. - 1
-
Ingår i: Proceedings of the Regional Workshop Wastewater Treatment and Reuse for Metropolitan Regions and Small Cities in Developing Countries. - Göttingen : Cuvillier Verlag. - 9783736994546 ; , s. 28-37
-
Konferensbidrag (refereegranskat)abstract
- The Millennium Development Goals aim to achieve the sustainable development and to contribute improving access to water supply, sanitation, and energy, and to reduce hunger in the world. Energy and water are essential resources for food production, however, are becoming scarce. In this context an integration of the complete water management cycle includes water conservation and reclamation, storage of reclaimed water and rainwater, and wastewater treatment mainly in decentralized models. Wastewater treatment systems can generate products such as: renewable energy, fertilizers and water. This study focuses on the relations between wastewater treatment systems and its environmental impacts, besides to indicate potential solutions. In addition, it is also presented results from an experimental greywater treatment system operated at the university. The objective of this study was to address some Brazilian experiences of centralized wastewater treatment plant (large scale) and decentralized wastewater treatment plant (small scale). We expect that the results of this study can offer a review of strategies of wastewater treatment to implement in urban areas in Brazil, and to create subsidies for the planning of new wastewater treatment plants with low environmental impacts, including sustainable solutions (e.g., water reuse).
|
|
| 8. |
- Cardoso Chrispim, Mariana, Postdoktor, 1990-, et al.
(författare)
-
Greywater treatment using a moving bed biofilm reactor at a university campus in Brazil
- 2017
-
Ingår i: Journal of Cleaner Production. - Amsterdam : Elsevier. - 0959-6526 .- 1879-1786. ; 142:Part 1, s. 290-296
-
Tidskriftsartikel (refereegranskat)abstract
- Water reuse can contribute as an important approach and practice to the reduction of the pressures on water resources lowering the demand for potable water for purposes that do not require water's high quality. However the greywater reuse has been rarely applied in Brazil. Therefore, the main objective of this study was to evaluate a greywater collection and treatment system from lavatories, showers and washing machine aiming the non-potable reuse. The objectives were to characterize the quality and quantity of greywater from different sources, to monitor a pilot system for synthetic greywater treatment and to analyze the quality of the effluent after treatment. The pilot system implemented in a building at University of Sao Paulo allowed to segregate greywater collection and characterization. To evaluate the greywater production water flow meters were installed in the water inlet of each greywater source. The treatment system included a moving bed biofilm reactor and a settling tank at pilot scale. The evaluation of greywater treatment was conducted based on the monitoring of physicochemical and microbiological water quality parameters during the operation of the experimental system. Based on the results, amongst the three greywater sources, the water from showers had the highest E. coli concentration while the lavatories water had the highest total coliforms concentration. The removal efficiencies of BOD and COD were 59% e 70% respectively. The phosphorus removal during the experimental period was low. Nevertheless the water quality produced is viable to be applied for outdoor purposes - landscape and garden irrigation in household, commercial and institutional buildings and the results were satisfactory according to Brazilian standard. The treatment showed stability and reliability ensuring the potential for a safe reuse if appropriate operation and monitoring of the treatment system is performed.
|
|
| 9. |
- Cardoso Chrispim, Mariana, Postdoktor, 1990-, et al.
(författare)
-
Phosphorus recovery from municipal wastewater treatment : Critical review of challenges and opportunities for developing countries
- 2019
-
Ingår i: Journal of Environmental Management. - Amsterdam : Elsevier. - 0301-4797 .- 1095-8630. ; 248
-
Forskningsöversikt (refereegranskat)abstract
- The aim of this paper is to provide guidance in selecting phosphorus recovery options within the municipal wastewater treatment sector regarding developing countries. This critical review includes a brief contextualization of the resource-oriented sanitation paradigm, the discussion of processes for phosphorus recovery based on methods at full-scale, pilot-scale and laboratory-scale, and a concise discussion of the environmental impacts and benefits associated with phosphorus recovery strategies. Finally, the main challenges related to the implementation of resource recovery strategies, especially for phosphorous, were identified and discussed. According to the results, some of the main drivers for phosphorus recovery are the limited availability of phosphorus, increasing cost of phosphate fertilizers and reduction of maintenance costs. Currently, most of the operational processes are based on crystallization or precipitation from the digester supernatant. Struvite is the most common recovered product. The recovery rate of phosphorus from the liquid phase is lower (10–60% from wastewater treatment plant influent), than from sludge (35–70%) and from sludge ashes (70–98%). Phosphorus recovery remains challenging, and some barriers identified were the integration between stakeholders and institutions, public policies and regulations as well as public acceptance and economic feasibility. In developing countries, the implementation of nutrient recovery systems is challenging, because the main concern is on the expansion of sanitation coverage. Resource recovery approaches can provide benefits beyond the wastewater treatment sector, not only improving the sustainability of wastewater treatment operations, but generating revenue for the utility provider.
|
|
| 10. |
- Cardoso Chrispim, Mariana
(författare)
-
Resource recovery from wastewater treatment: challenges, opportunities and guidance for planning and implementation
- 2021
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Considering the current resources scarcity, Wastewater Treatment Plants (WWTP) should be adapted to become more sustainable. For example, it is possible to recover resources present in municipal wastewater. However, regional studies about integration of resource recovery processes at different scales or about the main barriers to implementation in developing countries are missing in the literature. Also, there is a need for planning methodologies to identify the most sustainable solution in each context. Understanding the current situation is an essential step to support planning and accelerate resource recovery implementation. To address these issues this thesis aims to guide planning, technology and policy development towards resource recovery from municipal WWTP in large cities of developing countries. This thesis presents a comprehensive knowledge base for wastewater treatment plant managers and decision-makers leading to a better understanding of resource recovery solutions and the actions needed to facilitate implementation. The methodology comprised critical literature reviews and two case studies. Secondary data from literature and primary data (obtained through questionnaires) were collected and analysed. Megacities in developing countries are analysed in the papers, with the focus on the Macrometropolis of Sao Paulo, which is the most populous area in the Southern Hemisphere. The current situation shows a low implementation of resource recovery practices in the region, and local conditions affect the implementation of water reuse, and nutrients and energy recovery. A framework consisting of eleven steps is proposed to support planning and decision-making on resource recovery from wastewater. This new tool was tested and can be applied by decision-makers in wastewater sector for better operation and management. Market, legislation, local economic development, and cooperation with stakeholders are relevant aspects covered in the analysis. There is a great potential to expand wastewater treatment integrated with nutrient and energy recovery strategies in developing countries. Potentials for phosphorus and energy recovery were estimated and some recovery scenarios are recommended. In conclusion, the findings can help planning and elaboration of resource recovery projects in wastewater treatment in urban areas and stimulate creation of public policies. The main research gaps identified in this thesis can guide further research and technological development in this field.
|
|
