A Multi Expert Decision Support Tool for the Evaluation of Advanced Wastewater Treatment Trains: A Novel Approach to Improve Urban Sustainability

This is the author accepted manuscript. The final version is available from Elsevier via the DOI in this record.Wastewater Treatment (WWT) for water reuse applications has been accepted as a strategic solution in improving water supplies across the globe; however, there are still various challenges that should be overcome. Selection of practical solutions is then required whilst considering technical, environmental, socio-cultural, and financial factors. In this study, a multi expert decision support tool that considers a variety of evaluation criteria is proposed to provide a ranking system for competing advanced WWT technologies in terms of their performance. Two scenarios of water reuse in the contexts of Brazil and Greece are defined, and evaluation is undertaken based on opinions of water reuse experts. The results prove that the tool would successfully facilitate rigorous and methodical analysis in evaluation of WWT technologies for water reuse applications with potential for use under various sets of evaluation criteria, WWT technologies and contexts

Water resource management for sustainable development

Water resource management is the cornerstone for sustainable development. According to the United Nations world water development report, one-fifth of the world?s population lives in areas characterized by physical water scarcity.info:eu-repo/semantics/publishedVersio

Lifestyle and psychological factors associated with pregnancy intentions: findings from a Longitudinal Cohort Study of Australian women

BACKGROUND:Preconception is a critical time for the establishment of healthy lifestyle behaviours and psychological well-being to reduce adverse maternal and offspring outcomes. This study aimed to explore relationships between preconception lifestyle and psychological factors and prospectively assessed short- (currently trying to conceive) and long-term (future parenthood aspirations) pregnancy intentions. METHODS:Data from Wave 3 (age 25-30 years; n = 7656) and Wave 5 (age 31-36 years; n = 4735) from the Australian Longitudinal Study of Women's Health were used. Pregnancy intentions and parenthood aspirations were evaluated. Logistic regressions explored cross-sectional associations between demographic, lifestyle and psychological factors and pregnancy intentions/parenthood aspirations. RESULTS:In multivariable models, parity and marital status were associated consistently with pregnancy intentions and parenthood aspirations. Few lifestyle behaviours and no psychological factors were associated with pregnancy intentions. Alcohol intake was the only behaviour associated with aspirations to have a first child. Aspirations for a second/subsequent child were associated negatively with physical activity, sitting time, diet quality, lower anxiety and higher stress. CONCLUSIONS:It appears that women are not changing their behaviours when they form a decision to try to conceive. Interventions are needed that address women's preconception needs, to optimise lifestyle and improve health outcomes for women and their families.Briony Hill, Mathew Ling, Gita Mishra, Lisa J. Moran, Helena J. Teede, Lauren Bruce and Helen Skouteri

A conceptual classification of parents’ attributions of the role of food advertising in children’s diets

Background: High levels of child obesity are triggering growing concerns about the prevalence and effects of food advertising targeted at children. Efforts to address this advertising are confounded by the expanding repertoire of media and promotional techniques used to reach and attract children. The present study explored parents’ views on food marketing and the strategies parents employ when attempting to ameliorate its effects. As part of an online survey of Australian parents’ attitudes towards a range of food advertisements, respondents were invited to provide additional comment in an open-ended question. The question was optional and asked “Are there any other comments you would like to make?”. One in five of the survey respondents (18%; n = 235) elected to answer this question by discussing their views on food advertising and children’s diets. The responses were imported into NVivo10 for coding and analysis. A grounded approach was used to draw meaning from the data and develop a proposed conceptual classification of parents’ attributions relating to food advertising and its consequences.Results: The majority of responses related to the negative perceived effects of unhealthy food advertising on children’s diets, with few respondents considering such advertisements to be innocuous. The responses were classified into four conceptual categories reflecting differing attitudes to advertising (negative to neutral) and varying levels of locus of control (low to high). The typical characteristics of parents allocated to the four categories exhibited variation according to weight status, television viewing habits, education level, and family size. The largest number of responses was coded to the category characterized by a negative attitude toward food advertising and a low locus of control. Parents in this category were more likely than others to be overweight/obese and heavy television viewers. Parents in the negative attitude to advertising and high locus of control category nominated a variety of parenting practices that could form the basis of parent education interventions. Conclusions: The results suggest that many Australian parents may feel disempowered in the face of high levels of advertising for unhealthy foods. The current voluntary regulatory code appears to be inadequate in scope and coverage to address this situation

Reliability and Validity of the Multidimensional Scale of Perceived Social Support (MSPSS): Thai Version

This study examines the Thai version of the Multidimensional Scale of Perceived Social Support (MSPSS) for its psychometric properties

Cyclooxygenase-2 overexpression abrogates the antiproliferative effects of TGF-β

The influence of cyclooxygenase-2 (COX-2) overexpression on the development of tumours has been well documented. The underlying mechanism however has still not been completely elucidated. An escape of proliferating cells from the regulatory influence of TGF-β for example in the intestine has been discussed as well as a preponderance or prolongation of growth factor stimulation. The experiments presented here demonstrated that COX-2 transfection of a TGF-β-sensitive cell line abrogates the growth inhibitory effects of TGF-β. However, analysis of the TGF-β/Smad-signalling pathway clearly revealed that COX-2 overexpression did not interfere with that. Neither TGF-receptor expression nor Smad phosphorylation and signal transfer into the nucleus were influenced by COX-2 overexpression. In addition, a TGF-β reporter assay revealed no difference between controls and COX-2-transfected cells. Thus, the proliferation inhibiting effects must have been well compensated by growth-inducing stimuli. Indications for this came from experiments showing an induction of TGF-α expression and secretion with a higher and prolonged stimulation of the ERK 1/2 (p42/44) pathway in COX-2 transfectants. This effect could have been triggered by direct prostaglandin receptor stimulation or changes in intracellular lipid mediators. An increase in PPAR signalling as proven by a reporter assay is indication for the latter. Therefore, inhibiting both COX-2 as well as the PPAR and TGF/EGF pathway could be effective in the inhibition of adenoma or even carcinoma development in the intestine

Person-centred care in interventions to limit weight gain in pregnant women with obesity - a systematic review

Background Person-centred care, asserting that individuals are partners in their care, has been associated with care satisfaction but the value of using it to support women with obesity during pregnancy is unknown. Excessive gestational weight gain is associated with increased risks for both mother and baby and weight gain therefore is an important intervention target. The aims of this review was to 1) explore to what extent and in what manner interventions assessing weight in pregnant women with obesity use person-centred care and 2) assess if interventions including aspects of person-centred care are more effective at limiting weight gain than interventions not employing person-centred care. Methods Ten databases were systematically searched in January 2014. Studies had to report an intervention offered to pregnant women with obesity and measure gestational weight gain to be included. All included studies were independently double coded to identify to what extent they included three defined aspects of person-centred care: 1) “initiate a partnership” including identifying the person’s circumstances and motivation; 2) “working the partnership” through sharing the decision-making regarding the planned action and 3) “safeguarding the partnership through documentation” of care preferences. Information on gestational weight gain, study quality and characteristics were also extracted. Results Ten studies were included in the review, of which five were randomised controlled trials (RCT), and the remaining observational studies. Four interventions included aspects of person-centred care; two observational studies included both “initiating the partnership”, and “working the partnership”. One observational study included “initiating the partnership” and one RCT included “working the partnership”. No interventions included “safeguarding the partnership through documentation”. Whilst all studies with person-centred care aspects showed promising findings regarding limiting gestational weight gain, so did the interventions not including person-centred care aspects. Conclusions The use of an identified person-centred care approach is presently limited in interventions targeting gestational weight gain in pregnant women with obesity. Hence to what extent person-centred care may improve health outcomes and care satisfaction in this population is currently unknown and more research is needed. That said, our findings suggest that use of routines incorporating person-centredness are feasible to include within these interventions

Australian women's use of complementary and alternative medicines to enhance fertility: exploring the experiences of women and practitioners

<p>Abstract</p> <p>Background</p> <p>Studies exploring the use of complementary and alternative medicine (CAM) to enhance fertility are limited. While Australian trends indicate that women are using CAM during pregnancy, little is known about women's use of CAM for fertility enhancement. With the rising age of women at first birth, couples are increasingly seeking assisted reproductive technologies (ART) to achieve parenthood. It is likely that CAM use for fertility enhancement will also increase, however this is not known. This paper reports on an exploratory study of women's use of CAM for fertility enhancement.</p> <p>Methods</p> <p>Three focus groups were conducted in Melbourne, Australia in 2007; two with women who used CAM to enhance their fertility and one with CAM practitioners. Participants were recruited from five metropolitan Melbourne CAM practices that specialise in women's health. Women were asked to discuss their views and experiences of both CAM and ART, and practitioners were asked about their perceptions of why women consult them for fertility enhancement. Groups were digitally recorded (audio) and transcribed verbatim. The data were analysed thematically.</p> <p>Results</p> <p>Focus groups included eight CAM practitioners and seven women. Practitioners reported increasing numbers of women consulting them for fertility enhancement whilst also using ART. Women combined CAM with ART to maintain wellbeing and assist with fertility enhancement. Global themes emerging from the women's focus groups were: women being willing to 'try anything' to achieve a pregnancy; women's negative experiences of ART and a reluctance to inform their medical specialist of their CAM use; and conversely, women's experiences with CAM being affirming and empowering.</p> <p>Conclusions</p> <p>The women in our study used CAM to optimise their chances of achieving a pregnancy. Emerging themes suggest the positive relationships achieved with CAM practitioners are not always attained with orthodox medical providers. Women's views and experiences need to be considered in the provision of fertility services, and strategies developed to enhance communication between women, medical practitioners and CAM practitioners. Further research is needed to investigate the extent of CAM use for fertility enhancement in Australia, and to explore the efficacy and safety of CAM use to enhance fertility, in isolation or with ART.</p

Use of complementary and alternative medicines by a sample of Turkish women for infertility enhancement: a descriptive study

<p>Abstract</p> <p>Background</p> <p>Infertility patients are a vulnerable group that often seeks a non-medical solution for their failure to conceive. World-wide, women use CAM for productive health, but only a limited number of studies report on CAM use to enhance fertility. Little is known about traditional and religious forms of therapies that are used in relation to conventional medicine in Turkey. We investigated the prevalence and types of complementary and alternative medicine (CAM) used by infertile Turkish women for fertility enhancement.</p> <p>Methods</p> <p>A face-to-face questionnaire inquiring demographic information and types of CAM used for fertility enhancement were completed by hundred infertility patients admitted to a primary care family planning centre in Van, Turkey between January and July 2009.</p> <p>Results</p> <p>The vast majority of infertile women had used CAM at least once for infertility. CAM use included religious interventions, herbal products and recommendations of traditional "hodja's" (faith healers). Of these women, 87.8% were abused in the last 12 months, 36.6% felt not being supported by her partner and 80.5% had never spoken with a physician about CAM.</p> <p>Conclusions</p> <p>Infertile Turkish women use complementary medicine frequently for fertility enhancement and are in need of information about CAM. Religious and traditional therapies are used as an adjunct to, rather than a substitute for, conventional medical therapy. Physicians need to approach fertility patients with sensitivity and should be able to council their patients about CAM accordingly.</p