Comparison of pollutant emission control strategies for cadmium and mercury in urban water systems using substance flow analysis

The European Union (EU) Water Framework Directive (WFD) requires Member States to protect inland surface and groundwater bodies but does not directly stipulate how the associated environmental quality standards should be achieved. This paper develops and assesses the performance of a series of urban emission control strategies (ECS) with an emphasis on the scientific and technological benefits which can be achieved. Data from the literature, in combination with expert judgement, have been used to develop two different semi-hypothetical case cities (SHCC), which represent virtual platforms for the evaluation of ECS using substance flow analysis (SFA). The results indicate that the full implementation of existing EU legislation is capable of reducing the total emissions of cadmium (Cd) and mercury (Hg) by between 11% and 20%. The ability to apply voluntary reduction practices is shown to be particularly effective for Cd with the potential to further lower the overall emissions by between 16% and 27%. The most efficient protection of the receiving surface water environment is strongly influenced by the city characteristics with the introduction of stormwater treatment practices being particularly effective for one city (59% reduction of Hg; 39% reduction of Cd) and the other city being most influenced by the presence of efficient advanced wastewater treatment processes (63% reduction of Hg; 43% reduction of Cd). These reductions in receiving water loads are necessarily accompanied by either increases in stormwater sediment loadings (2.6 to 14.9 kg/year or 0.6 to 2.4 kg/year for Hg) or wastewater sludge loadings (45.8 to 57.2 kg/year or 42.0 to 57.4 kg/year for Cd)

Evaluation of alternative pollutant emission control strategies to urban water systems using substance flow analysis

The EU Water Framework Directive (WFD) requires Member States to protect their inland (and coastal) surface and groundwater bodies. However, the way in which WFD requirements can be met, including the associated stringent environmental quality standards, is less clear. This paper presents selected results from the ScorePP project (an EU Framework Programme 6-funded consortium) which developed and assessed the performance of a series of emission control strategies (ECS) at an urban scale. Data from the literature, in combination with expert judgement (where data was not available), have been used to develop semi-hypothetical case cities (SHCCs), which represent virtual platforms for the evaluation of ECSs using substance flow analysis. The results indicate that the full implementation of existing legislation is capable of reducing total emissions of Cd and Hg by between 11% and 20%. Consideration of emissions on a compartment-by-compartment basis indicates that the impact of a particular ECS is sensitive to both pollutant and city-specific characteristics. Whilst reductions in emissions to one compartment are typically associated with an increase in emissions to an alternative compartment, the final compartment is influenced by the type of ECS selected. Limitations of the current approach are discussed

A web-based psycho-educational intervention (Fex-Can) targeting sexual dysfunction and fertility-related distress in young adults with cancer: study protocol of a randomized controlled trial.

BACKGROUND: This study protocol describes the clinical trial of the Fex-Can intervention, a web-based self-help program targeting sexual dysfunction and fertility-related distress. The psycho-educational intervention has been developed in collaboration with young patients with cancer and shown to be feasible. The primary objective is to determine whether the Fex-Can intervention, provided in addition to standard care, is superior to standard care in terms of reduction of sexual dysfunction and fertility-related distress directly after end of the 12-week program. The trial also aims to determine whether the intervention has an effect on the secondary outcomes including health-related quality of life, anxiety, depression, body image, fertility knowledge, and self-efficacy related to sexuality and fertility. METHODS: The trial has an randomized clinical trial (RCT) design with two parallel arms. The active groups receive either the version of the Fex-Can intervention targeting sexual problems or the version targeting fertility-related distress. Control groups receive standard care. Primary outcomes will be sexual function assessed with the Patient-Reported Outcomes Measurement Information System® Sexual Function and Satisfaction measure version 2.0 (SexFS) and fertility-related distress assessed with the Reproductive Concerns After Cancer scale (RCAC). The effect of the intervention will be evaluated directly after end of the program. Primary and secondary outcomes will also be assessed at the short- (12 weeks after end of program) and long-term (20 and 44 months after end of program) follow-up. At least 64 completers will be needed in each arm (total n = 256) to achieve adequate statistical power in the analyses. In order to increase the understanding of how the intervention brings about a possible change, semi-structured interviews will additionally be conducted with a purposeful sample shortly after completion of the intervention. DISCUSSION: If the Fex-Can intervention proves to be efficacious the necessary steps will be taken to implement it in routine care for young adults diagnosed with cancer. Healthcare could thereby be provided with an easily accessible, cost-effective intervention to offer to young adults suffering from fertility-related distress or sexual problems

Darwinian Selection and Non-existence of Nash Equilibria

We study selection acting on phenotype in a collection of agents playing local games lacking Nash equilibria. After each cycle one of the agents losing most games is replaced by a new agent with new random strategy and game partner. The network generated can be considered critical in the sense that the lifetimes of the agents is power law distributed. The longest surviving agents are those with the lowest absolute score per time step. The emergent ecology is characterized by a broad range of behaviors. Nevertheless, the agents tend to be similar to their opponents in terms of performance.Comment: 4 pages, 5 figure

Experiences of a web-based psycho-educational intervention targeting sexual dysfunction and fertility distress in young adults with cancer-A self-determination theory perspective.

INTRODUCTION: Sexual and reproductive health are significant aspects of quality of life. Healthcare often fails to provide adequate support for young cancer survivors in this area, hence the need to develop more effective interventions. The present study aimed to describe experiences of participating in a web-based psycho-educational intervention focusing on sexual dysfunction and fertility distress after cancer, and to explore these experiences within the theoretical frame of the basic psychological needs for competence, relatedness and autonomy according to self-determination theory. METHODS: Individual semi-structured interviews with 24 women and 4 men, age 19-40, were abductively analyzed using the Framework approach for qualitative content analysis. RESULTS: Participant experiences corresponded well with the three main deductive themes competence, relatedness and autonomy, divided into a total of nine subthemes illustrating varying degrees of basic need satisfaction with considerable nuance but not without ambiguity. While satisfaction of the need for competence could be linked to the amount of information in relation to participants' cognitive capacity, satisfaction of the need for relatedness seemed to be of special importance for these young adults with cancer experience. Invitation to the program meant a chance at alleviating loneliness and normalizing problems, symptoms and concerns. Participants' descriptions of perceived autonomy support were more challenging and ambiguous, because of the many contradictions in participants' responses to their variable situations. CONCLUSION: Basic psychological needs were confirmed as flexible positions along a continuum rather than discrete and mutually exclusive qualities. Understanding the variety of basic need satisfaction may enhance the design of future web-based interventions to be even more inclusive, tailorable and autonomy-supportive. Further research is warranted to determine the role of basic need satisfaction as a possible mediator for web-based psychoeducational interventions in cancer survivorship care

Content Analysis of Online Focus Group Discussions are a Valid and Feasible Mode When Investigating Sensitive Topics Among Young Persons With a Cancer Experience

BACKGROUND: Clinical research often lacks participants of young age. Adding to the small amount of scientific studies that focus on the population entering adulthood, there are also difficulties to recruit them. To overcome this, there is a need to develop and scientifically evaluate modes for data collection that are suitable for adolescents and young adults. With this in mind we performed 39 online focus group discussions among young survivors of childhood cancer to explore thoughts and experiences around dating, being intimate with someone, and having children. OBJECTIVE: The aim of the study was to evaluate online focus group discussions as a mode for data collection on sensitive issues among young persons with a cancer experience. METHODS: One hundred thirty-three young persons (16-25 years) previously diagnosed with cancer, participated in 39 synchronous online focus group discussions (response rate 134/369, 36%). The mode of administration was evaluated by analyzing participant characteristics and interactions during discussions, as well as group members' evaluations of the discussions. RESULTS: Persons diagnosed with central nervous tumors (n=30, 27%) participated to a lower extent than those with other cancer types (n=103, 39%; χ 2= 4.89, P=.03). The participants described various health impairments that correspond to what would be expected among cancer survivors including neuropsychiatric conditions and writing disabilities. Even though participants were interested in others' experiences, sexual issues needed more probing by the moderators than did fertility-related issues. Group evaluations revealed that participants appreciated communicating on the suggested topics and thought that it was easier to discuss sex when it was possible to be anonymous toward other group members. CONCLUSIONS: Online focus group discussions, with anonymous participation, are suggested to be a feasible and valid mode for collecting sensitive data among young persons with a cancer experience

Flat Dielectric Grating Reflectors with High Focusing Power

Sub-wavelength dielectric gratings (SWG) have emerged recently as a promising alternative to distributed-Bragg-reflection (DBR) dielectric stacks for broadband, high-reflectivity filtering applications. A SWG structure composed of a single dielectric layer with the appropriate patterning can sometimes perform as well as thirty or forty dielectric DBR layers, while providing new functionalities such as polarization control and near-field amplification. In this paper, we introduce a remarkable property of grating mirrors that cannot be realized by their DBR counterpart: we show that a non-periodic patterning of the grating surface can give full control over the phase front of reflected light while maintaining a high reflectivity. This new feature of dielectric gratings could have a substantial impact on a number of applications that depend on low-cost, compact optical components, from laser cavities to CD/DVD read/write heads.Comment: submitted to Nature Photonic

Meeting the future through bio-behavioral healthcare sciences; Innovations for Healthcare Science

The call for the establishment of an endowed chair in innovative care was motivated by a need to address a multitude of challenges, including the aging population with increasing chronic diseases and multiple comorbidities; continuing breakthroughs in biomedical and medtech research which change care strategies and needs; and the increasing provision of care outside hospital environments. Meeting these challenges calls for investment in healthcare science research, education, and innovation. To meet these challenges, Investor AB donated SEK 10 million in 2013 to the establishment of an endowed Chair in Innovative Care at Karolinska Institutet. This competitive position, which integrates health and social care research, was awarded to Professor Carol Tishelman in October 2014 and is based at the Department of Learning, Informatics, Management and Ethics (LIME) where she leads the Innovative Care research group (ki.se/en/lime/innovative-care) with Assoc. Prof Lars E. Eriksson. Tishelman has a joint position with Karolinska University Hospital, Center for Innovation, as University nurse with responsibility for strategic healthcare innovation