Healthcare building sustainability assessment tool - Sustainable effective design criteria in the Portuguese context

Tools and methods to improve current practices and quality in the healthcare building sector are necessary to support decision-making at different building life cycle phases. Furthermore, Healthcare Building Sustainability Assessment (HBSA) Methods are based on criteria organised into different levels, such as categories and indicators. These criteria highlight aspects of significant importance when designing and operating a sustainable healthcare building. To bring more objectivity to the sustainability assessments, the standardisation bodies (CEN and ISO) proposed core indicators that should be used in the evaluation of the environmental, societal and economic performances of buildings. Nevertheless, relying on state of the art analysis, it is possible to conclude that there are aspects of major importance for the operation of healthcare buildings that are not considered in the HBSA methods. Thus, the aim of this paper is to discuss the context of sustainability assessment methods in the field of healthcare buildings and to present a proposal for the incorporation of Sustainable-Effective Design (SED) criteria in a new HBSA method. The used research method is innovative since in the development of the list of sustainability criteria it considers the opinion of main healthcare buildings' stakeholders, the existing healthcare assessment methods and the ISO and CEN standardisation works in the field of the methods to assess the sustainability of construction works. As a result, the proposed method is composed of fifty-two sustainability indicators that cover the different dimensions of the sustainability concept to support decision making during the design of a new or retrofitted healthcare building in urban areas.The authors acknowledge the Portuguese Foundation for Science and Technology and POPH/FSE for its financial support for this study (Reference SFRH/BD/77959/2011). A special thank you is also addressed to Donald Ellis for proofreading the English text.info:eu-repo/semantics/publishedVersio

Quantitative risk assessment of hepatitis E virus: modelling the occurrence of viraemic pigs and the presence of the virus in organs of food safety interest

Hepatitis E virus (HEV) is a zoonotic pathogen with consumption of pork and derived products identified in different countries as a risk factor for human exposure to HEV. Great efforts have been made to understand the dynamics of virus transmission within domestic swine populations through modelling. However, from a food safety prospective, it is critical to integrate the parameters involved in the transmission dynamics with those governing the actual presence of HEV in the bloodstream, the liver, gallbladder or faeces. To date, several aspects related to the pathogenesis of the disease are still unknown or characterized by significant levels of uncertainty, making this conjunction challenging. We used published serological data obtained from pigs in a farrow-to-finish farm to implement an Immune-Susceptible-Infected-Recovered (MSIR) model reproducing the on-farm dynamics that lead to the occurrence of viraemic pigs at slaughter. Expert opinion on the length of time infectious HEV can be detected in liver, gallbladder/bile and faeces after recovery from viraemic status were used to inform a stochastic model aimed at estimating the expected proportion of viraemic pigs, pigs with infectious HEV in liver, gallbladder/bile and faeces entering the slaughterhouse. To simulate the potential effect of on-farm mitigation strategies, we estimated the changes in outcomes of interest as a function of variations in the baseline transmission parameters. The model predicted a proportion of viraemic pigs entering the slaughterhouse of 13.8% while the proportions of, and ranged from 13.8% to 94.4%, 13.8% to 94.7% and from 25.3% to 30.8% respectively, due to the uncertainty surrounding the experts’ opinions. Variations in MSIR model’s parameters alert of the need to carefully consider the application of mitigation strategies aimed at delaying the decay of maternal immunity or the peak of the within herd transmission. When the rate of decay of maternal immunity and the transmission rate were decreased between 80% and 5% and 40% and 5% from the baseline values respectively, adverse effects on were observed. The model highlights the relevance of specific aspects in the pathogenesis of the disease from a food safety prospective and it was developed to be easily reproducible and updatable as soon as accurate data becomes available. As presented, the model can be directly connected to existing or future pig-related models to estimate the significance of the identified parameters on the risk of human exposure to HEV through consumption of pork products

Pemetaan Faktor Risiko Lingkungan Leptospirosis dan Penentuan Zona Tingkat Kerawanan Leptospirosis di Kabupaten Demak Menggunakan Remote Sensing Image

Leptosiprosis is a zoonotic disease caused by Leptospira bacteria and transmitted to human by contact through contaminated animal urine and environment contaminated of Leptospirosis. Demak District is an endemic area of Leptospirosis bacteria. The prevalence of Leptospirosis case has increased in the past 2 years. The aim of this research is to map environmental risk factor of Leptospirosis and to determine Leptospirosis vulnerable zone. This research is analyzed in a descriptive using cross sectional design. 42 Leptospirosis cases are mapped with GPS. Leptospirosis case was overlaid with remote sensing (Quickbird image) by using ArcView program. Then interpreted by Spasial Feature and Spasial Analyses.Leptospirosis cases in 2014-2015 was spread out and a bit gouped in Demak Sub District area. More cases are found in male (61,9%), productive age 21-50 years (59,3%), farmer (40,4%). Spasial analyses shows that the leptospirosis cases take place at low plain <47 masl (100%), rainfall ≥220 mm/month (64,7%), clay soil (100%), buffer river <50 m (71,4%), presence of rat (100%), wastewater disposal (100%), waste disposal facilities (97,7%), flood's profile (28,6%), rob's profile (7,1%), vegetation (59,5%). Leptospirosis high risk zone is 37.801,8 ha (41,32%), risk zone is 43.570,23 ha (48,55%), and low risk zone is 9.090,96 ha (10,13%). Densely populated housing, environment condition, and presence of rat with contact of puddle are risk factors of Leptospirosis cases in Demak District

Gambaran Status Kecacatan Kusta Pada Penderita Kusta Di Kabupaten Blora

Leprosy is a communicable disease that can cause permanent physical deformities. According to data from Health Department of Blora District, it was known that Public Health Center of Kunduran and Bogorejo had the highest new cases, with an increasing trend during the last 3 years. Those two PHCs still had 'high' grade 2 disability compared with national target. This research aimed to describe some factors related to the occurrence of disability in leprosy. This research is a descriptive observational with cross sectional design. Population of this research are 83 people affected by leprosy, registered in two PHCs during the last 3 years. These results indicated that the proportion of disability is higher in lepers with non productive age (38,5%), male (32,0%), having low education (36,8%), having good knowledge (55,6%), having no job (55,6%), multibacillary leprosy (36,5%), experiencing lepra reaction (50,0%), having delay of treatment >1 year (44,4%), having nerve impairment (100,0%), doing wound care (100,0%), and without support of family members (33,3%). This research concluded that the proportion of disability found higher in lepers with non productive age, male, having low education, having good knowledge, having no job, having multibacillary leprosy, experiencing lepra reaction, having delay of treatment >1 year, having nerve impairment, doing wound care, and without support of family members. This research suggest to the PHCs to give more counseling and training to the lepers about wound care and provide them tools to do this. Family members are expected to oversee the lepers when consuming MDT and reminds them to complete the treatment

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