| 1. |
- Andersson-Sköld, Yvonne, 1957, et al.
(författare)
-
A framework for identification, assessment and prioritization of climate change adaptation measures for roads and railways
- 2021
-
Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 18:23
-
Tidskriftsartikel (refereegranskat)abstract
- Severe accidents and high costs associated with weather-related events already occur in today’s climate. Unless preventive measures are taken, the costs are expected to increase in future due to ongoing climate change. However, the risk reduction measures are costly as well and may result in unwanted impacts. Therefore, it is important to identify, assess and prioritize which measures are necessary to undertake, as well as where and when these are to be undertaken. To be able to make such evaluations, robust (scientifically based), transparent and systematic assessments and valuations are required. This article describes a framework to assess the cause-and-effect relationships and how to estimate the costs and benefits as a basis to assess and prioritize measures for climate adaptation of roads and railways. The framework includes hazard identification, risk analysis and risk assessment, identification, monetary and non-monetary evaluation of possible risk reduction measures and a step regarding distribution-, goal-and sensitivity analyses. The results from applying the framework shall be used to prioritize among potential risk reduction measures as well as when to undertake them.
|
|
| 2. |
- Bellander, Lisa, et al.
(författare)
-
Oral assessment and preventive actions within the swedish quality register senior alert: Impact on frail older adults’ oral health in a longitudinal perspective
- 2021
-
Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 18:24
-
Tidskriftsartikel (refereegranskat)abstract
- Poor oral health is common among older people in nursing homes. To identify and prevent oral health problems among the residents, ROAG-J (Revised Oral Assessment Guide–Jönköping), a risk-assessment instrument, is used by nursing staff routinely, and the outcome is registered in the web-based Swedish quality register Senior Alert. This study aims to investigate the preventive actions registered when oral health problems are identified and the effect of these actions longitudinally. ROAG-J data registered at nursing homes in Sweden during 2011–2016 were obtained from the Senior Alert database. Out of 52,740 residents (≥65 years), 41% had oral health problems, of whom 62% had preventive actions registered. The most common action was “Assistance with cleaning teeth”. Longitudinally, during the five-year observation period, a slight increase in oral health problems assessed with ROAG-J was found. Registered preventive actions, however, led to significant improvement in the subsequent assessment for the ROAG items lips, tongue, and dentures. Standardised risk assessments like ROAG-J provide an opportunity to detect problems early and establish preventive actions. The study, however, indicates a further need for structured education and a continuous follow-up in ROAG-J. Moreover, increased collaboration between nursing and dental care to improve oral health for older residents at nursing homes is needed.
|
|
| 3. |
- Brambilla, Andrea, et al.
(författare)
-
Flexibility during the covid-19 pandemic response: Healthcare facility assessment tools for resilient evaluation
- 2021
-
Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 18:21
-
Tidskriftsartikel (refereegranskat)abstract
- Healthcare facilities are facing huge challenges due to the outbreak of COVID-19. Around the world, national healthcare contingency plans have struggled to cope with the population health impact of COVID-19, with healthcare facilities and critical care systems buckling under the ex-traordinary pressures. COVID-19 has starkly highlighted the lack of reliable operational tools for assessing the level sof flexibility of a hospital building to support strategic and agile decision making. The aim of this study was to modify, improve and test an existing assessment tool for evaluating hospital facilities flexibility and resilience. We followed a five-step process for collecting data by (i) doing a literature review about flexibility principles and strategies, (ii) reviewing healthcare design guidelines, (iii) examining international healthcare facilities case studies, (iv) conducting a critical review and optimization of the existing tool, and (v) assessing the usability of the evaluation tool. The new version of the OFAT framework (Optimized Flexibility Assessment Tool) is composed of nine evaluation parameters and subdivided into measurable variables with scores ranging from 0 to 10. The pilot testing of case studies enabled the assessment and verification the OFAT validity and reliability in support of decision makers in addressing flexibility of hospital design and/or operations. Healthcare buildings need to be designed and built based on principles of flexibility to accommodate current healthcare operations, adapting to time-sensitive physical transformations and responding to contemporary and future public health emergencies.
|
|
| 4. |
- Ek, Kristine, 1975, et al.
(författare)
-
Life Cycle Sustainability Performance Assessment Method for Comparison of Civil Engineering Works Design Concepts: Case Study of a Bridge
- 2020
-
Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 17:21, s. 1-34
-
Tidskriftsartikel (refereegranskat)abstract
- Standardized and transparent life cycle sustainability performance assessment methods are essential for improving the sustainability of civil engineering works. The purpose of this paper is to demonstrate the potential of using a life cycle sustainability assessment method in a road bridge case study. The method is in line with requirements of relevant standards, uses life cycle assessment, life cycle costs and incomes, and environmental externalities, and applies normalization and weighting of indicators. The case study involves a short-span bridge in a design-build infrastructure project, which was selected for its generality. Two bridge design concepts are assessed and compared: a concrete slab frame bridge and a soil-steel composite bridge. Data available in the contractor’s tender phase are used. The two primary aims of this study are (1) to analyse the practical application potential of the method in carrying out transparent sustainability assessments of design concepts in the early planning and design stages, and (2) to examine the results obtained in the case study to identify indicators in different life cycle stages and elements of the civil engineering works project with the largest impacts on sustainability. The results show that the method facilitates comparisons of the life cycle sustainability performance of design concepts at the indicator and construction element levels, enabling better-informed and more impartial design decisions to be made.
|
|
| 5. |
- Fagefors, Carina, 1989, et al.
(författare)
-
Application of portfolio theory to healthcare capacity management
- 2021
-
Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 18:2, s. 1-9
-
Tidskriftsartikel (refereegranskat)abstract
- Healthcare systems worldwide are faced with continuously increasing demand for care, while simultaneously experiencing insufficient capacity and unacceptably long patient waiting times. To improve healthcare access and availability, it is thus necessary to improve capacity utilization and increase the efficiency of existing resource usage. For this, variations in healthcare systems must be managed judiciously, and one solution is to apply a capacity pooling approach. A capacity pool is a general, collaborative capacity that can be allocated to parts of the system where the existing workload and demand for capacity are unusually high. In this study, we investigate how basic mean-variance methodology from portfolio theory can be applied as a capacity pooling approach to healthcare systems. A numerical example based on fictitious data is used to illustrate the theoretical value of using a portfolio approach in a capacity pooling context. The example shows that there are opportunities to use capacity more efficiently and increase service levels, given the same capacity, and that a mean-variance analysis could be performed to theoretically dimension the most efficient pooling organization. The study concludes with a discussion regarding the practical usefulness of this methodology in the healthcare context.
|
|
| 6. |
- Fagefors, Carina, 1989, et al.
(författare)
-
Creating short-term volume flexibility in healthcare capacity management
- 2020
-
Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 17:22, s. 1-18
-
Tidskriftsartikel (refereegranskat)abstract
- It is well-known that unpredictable variations in supply and demand capacity in healthcare systems create the need for flexibility. The main tools used to create short-term volume flexibility in the healthcare system include overtime, temporary staff from internal calling lists, moving staff across units, internal staffing pools, external staffing agencies, queuing patients, and purchasing care from external providers. We study the creation of short-term volume flexibility in healthcare systems to manage short-term capacity losses. A questionnaire was developed and distributed among department managers in the Region Västra Götaland healthcare system. Respondents were asked to what extent they used each tool to create short-term flexibility in capacity. Data were analyzed using multiple regression analysis. Several significant tendencies were found, including that acute units use overtime and internal staffing pools to a larger extent, and patient queues and external providers to a smaller extent than planned units. The prerequisites and required managerial approaches used to manage aggregate capacity in the system efficiently differ substantially between different parts of the system. These differences must be addressed when, for example, capacity pools are considered. These results serve as a steppingstone towards a more thorough understanding of efficient capacity management in healthcare systems.
|
|
| 7. |
- Furberg, Anna, 1990, et al.
(författare)
-
Live and Let Die? Life Cycle Human Health Impacts from the Use of Tire Studs
- 2018
-
Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 15:8
-
Tidskriftsartikel (refereegranskat)abstract
- Studded tires are used in a number of countries during winter in order to prevent accidents. The use of tire studs is controversial and debated because of human health impacts from increased road particle emissions. The aims of this study are to assess whether the use of tire studs in a Scandinavian studded passenger car actually avoids or causes health impacts from a broader life cycle perspective, and to assess the distribution of these impacts over the life cycle. Life cycle assessment is applied and the disability-adjusted life years indicator is used to quantify the following five types of health impacts: (1) impacts saved in the use phase, (2) particle emissions in the use phase, (3) production system emissions, (4) occupational accidents in the production system, and (5) conflict casualties from revenues of cobalt mining. The results show that the health benefits in the use phase in general are outweighed by the negative impacts during the life cycle. The largest contribution to these negative human health impacts are from use phase particle emissions (67–77%) and occupational accidents during artisanal cobalt mining (8–18%). About 23–33% of the negative impacts occur outside Scandinavia, where the benefits occur. The results inform the current debate and highlight the need for research on alternatives to tire studs with a positive net health balance.
|
|
| 8. |
- Hedblom, Marcus, et al.
(författare)
-
Sounds of Nature in the City: No Evidence of Bird Song Improving Stress Recovery
- 2019
-
Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1660-4601 .- 1661-7827. ; 16:8
-
Tidskriftsartikel (refereegranskat)abstract
- Noise from city traffic is one of the most significant environmental stressors. Natural soundscapes, such as bird songs, have been suggested to potentially mitigate or mask noise. All previous studies on masking noise use self-evaluation data rather than physiological data. In this study, while respondents (n = 117) watched a 360 degrees virtual reality (VR) photograph of a park, they were exposed to different soundscapes and mild electrical shocks. The soundscapesbird song, bird song and traffic noise, and traffic noisewere played during a 10 min recovery period while their skin conductance levels were assessed as a measure of arousal/stress. No significant difference in stress recovery was found between the soundscapes although a tendency for less stress in bird song and more stress in traffic noise was noted. All three soundscapes, however, significantly reduced stress. This result could be attributed to the stress-reducing effect of the visual VR environment, to the noise levels being higher than 47 dBA (a level known to make masking ineffective), or to the respondents finding bird songs stressful. Reduction of stress in cities using masking with natural sounds requires further studies with not only larger samples but also sufficient methods to detect potential sex differences.
|
|
| 9. |
- Li, Guofa, et al.
(författare)
-
Traffic Crash Characteristics in Shenzhen, China from 2014 to 2016
- 2021
-
Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 18:3, s. 1-24
-
Tidskriftsartikel (refereegranskat)abstract
- Road traffic crashes cause fatalities and injuries of both drivers/passengers in vehicles and pedestrians outside, thus challenge public health especially in big cities in developing countries like China. Previous efforts mainly focus on a specific crash type or causation to examine the crash characteristics in China while lacking the characteristics of various crash types, factors, and the interplay between them. This study investigated the crash characteristics in Shenzhen, one of the biggest four cities in China, based on the police-reported crashes from 2014 to 2016. The descriptive characteristics were reported in detail with respect to each of the crash attributes. Based on the recorded crash locations, the land-use pattern was obtained as one of the attributes for each crash. Then, the relationship between the attributes in motor-vehicle-involved crashes was examined using the Bayesian network analysis. We revealed the distinct crash characteristics observed between the examined levels of each attribute, as well the interplay between the attributes. This study provides an insight into the crash characteristics in Shenzhen, which would help understand the driving behavior of Chinese drivers, identify the traffic safety problems, guide the research focuses on advanced driver assistance systems (ADASs) and traffic management countermeasures in China.
|
|
| 10. |
- Meng, Fanyu, et al.
(författare)
-
Influential factors associated with consecutive crash severity: A two-level logistic modeling approach
- 2020
-
Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 17:15, s. 1-16
-
Tidskriftsartikel (refereegranskat)abstract
- A consecutive crash series is composed by a primary crash and one or more subsequent secondary crashes that occur immediately within a certain distance. The crash mechanism of a consecutive crash series is distinctive, as it is different from common primary and secondary crashes mainly caused by queuing effects and chain-reaction crashes that involve multiple collisions in one crash. It commonly affects a large area of road space and possibly causes congestions and significant delays in evacuation and clearance. This study identified the influential factors determining the severity of primary and secondary crashes in a consecutive crash series. Basic, random-effects, random-parameters, and two-level binary logistic regression models were established based on crash data collected on the freeway network of Guizhou Province, China in 2018, of which 349 were identified as consecutive crashes. According to the model performance metrics, the two-level logistic model outperformed the other three models. On the crash level, double-vehicle primary crash had a negative association with the severity of secondary consecutive crashes, and the involvement of trucks in the secondary consecutive crash had a positive contribution to its crash severity. On a road segment level, speed limit, traffic volume, tunnel, and extreme weather conditions such as rainy and cloudy days had positive effects on consecutive crash severity, while the number of lanes was negatively associated with consecutive crash severity. Policy suggestions are made to alleviate the severity of consecutive crashes by reminding the drivers with real-time potential hazards of severe consecutive crashes and providing educative programs to specific groups of drivers.
|
|
