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- Cachim, Afonso, et al.
(författare)
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Measuring adherence to inhaled control medication in patients with asthma : Comparison among an asthma app, patient self-report and physician assessment
- 2023
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Ingår i: Clinical and Translational Allergy. - : John Wiley & Sons. - 2045-7022 .- 2045-7022. ; 13:2
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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.
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| 2. |
- Cano, Vitor, et al.
(författare)
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Novel bioelectrochemical processes focused on nitrogen in wastewater : Energy generation and resource recovery
- 2023. - 1
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Ingår i: Water Management and Circular Economy. - Amsterdam : Elsevier. - 9780323952804 - 9780323952811 ; , s. 233-272
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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.
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| 3. |
- Cardoso Chrispim, Mariana, Postdoktor, 1990-, et al.
(författare)
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The underrepresented key elements of Circular Economy : A critical review of assessment tools and a guide for action
- 2023
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Ingår i: Sustainable Production and Consumption. - Amsterdam : Elsevier. - 2352-5509. ; 35, s. 539-558
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Tidskriftsartikel (refereegranskat)abstract
- The measurement of progress towards Circular Economy (CE) within a company is crucial for identifying opportunities and designing circular practices. However, most of the existing tools do not consider the systemic view and principles of CE. The aim of this paper is to assess the contributions and limitations of CE assessment tools regarding the key elements: social dimension, stakeholder engagement, R-imperatives and industrial symbiosis. Also, the aim is to offer guidance for improvements towards a CE transition. The methodology was an integrative literature review; then based on the critical assessment of tools a guide was created. Thirty-eight tools were thoroughly analysed and our results show that there is a limited number of multidisciplinary tools (only 10), that is including all CE key elements, and in some cases partly. Social dimension is not fully explored; only 6 tools have indicators related to society, local community, customers, and workers. Recommendations for future tools development include to offer training for possible users of the tools and to develop tools for the service sector. Finally, we conclude that all the key elements of CE are interconnected. The proposed guide-ACTION (Assessing Circular Transition In Organisations Now)- includes the key elements, databases, tools, and indicators, and is aligned with the CE principles to help the assessment. © 2022 The Author(s)
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| 4. |
- Garbellini, Lucas Renan, et al.
(författare)
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(Eco)toxicological impact potential from inorganic substances in biosolids : Real data-based suggestions for regulatory improvements
- 2023
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Ingår i: Environmental Nanotechnology, Monitoring & Management. - Amsterdam : Elsevier. - 2215-1532. ; 20
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Tidskriftsartikel (refereegranskat)abstract
- Sewage sludge (SS) can be applied in soil for its nutrient recycling in agriculture and forestry, but the presence of toxic substances may prompt environmental and human health risks. Brazilian Resolution (CONAMA 498/2020) establishes thresholds for biosolid (i.e., treated sludge) quality for application in soils. We have evaluated the (eco)toxicological impact potential of such practice regarding the mentioned thresholds, and the concentration of inorganic substances in sludge from three different Wastewater Treatment Plants (WWTP) in São Paulo, Brazil. The assessment relied on USEtox®, a model that estimates the potential toxicological impact on humans and ecosystems. According to the evaluation of the regulatory thresholds, Zn are responsible for an ecotoxicological impact potential of 2.33E + 02 PAF.m3.day/kg (potentially affected species), which represents 48.2% of the aggregated impact for the scenario, while Hg potential is of 1.25E-04 cases/kg for non-cancerous diseases in humans – corresponding to 54% of this scenario. The assessment of the SS samples has confirmed to be critical for Zn, Hg, and Cr, and indicated potential ecotoxicological risks for concentrations found of Fe and Al, which do not have regulatory thresholds. Results were discussed along with related literature and international regulation. The study supports sustainable management of sewage in Brazil, and the analytical framework is replicable in other regions. © 2023 Published by Elsevier B.V.
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| 5. |
- Lederman, Judith S., et al.
(författare)
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Completing the progression establishing an international baseline of primary, middle and secondary students’ views of scientific inquiry
- 2023
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Ingår i: International Journal of Science Education. - : Routledge. - 0950-0693 .- 1464-5289.
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Tidskriftsartikel (refereegranskat)abstract
- Knowledge of scientific inquiry (SI) is considered essential to the development of an individual's Scientific Literacy (SL) and therefore, SI is included in many international science education reform documents. Two previous large scale international studies assessed the SI understandings of students entering middle school and secondary students at the end of their formal K-12 science education. The purpose of this international project was to use the VASI-E to collect data on what primary level students have learned about SI in their first few years of school. This study adds to previous research to bridge the landscape of SI understandings now with representation from primary, middle and high school samples. A total of 4,238 students from 35 countries/regions spanning six continents participated in the study. The results show that globally, primary students are not adequately informed about SI for their age group. However, when compared with the students in the previous international studies (grades seven and 12), the primary students' understandings were surprisingly closer to the levels of understanding of SI of the secondary school students than those in the seventh grade study.
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