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

Motor competence assessments for children with intellectual disabilities and/or autism: a systematic review.

Objective: Gross motor competence is essential for daily life functioning and participation in physical activities. Prevalence of gross motor competence in children with intellectual disabilities (ID) and/or autism is unclear. This systematic review aimed to identify appropriate assessments for children with ID and/or autism. Design & data sources: An electronic literature search was conducted using the EBSCOhost platform searching MEDLINE, Education Research Complete, ERIC, CINAHL Plus and SPORTDiscus databases. Eligibility criteria: Included studies sampled children with ID and/or autism aged between 1 and 18 yrs, used field-based gross motor competence assessments, reported measurement properties, and were published in English. The utility of assessments were appraised for validity, reliability, responsiveness and feasibility. Results: The initial search produced 3182 results, with 291 full text articles screened. 13 articles including 10 assessments of motor competence were included in this systematic review. There was limited reporting across measurement properties, mostly for responsiveness and some aspects of validity. The Bruininks-Oseretsky Test of Motor Proficiency-2 followed by The Test of Gross Motor Development-2 demonstrated the greatest levels of evidence for validity and reliability. Feasibility results were varied, most instruments required little additional equipment (n=8) and were suitable for a school setting, but, additional training (n=7) was needed to score and interpret the results. Conclusion: This review found the BOT-2 followed by the TGMD-2 to be the most psychometrically appropriate motor competency assessments for children with ID and/or autism in field-based settings. Motor competence assessment research is limited for these cohorts and more research is needed

Predictors of Segmented School Day Physical Activity and Sedentary Time in Children from A Northwest England Low-income Community

Background: Schools have been identified as important settings for health promotion through physical activity participation, particularly as children are insufficiently active for health. The aim of this study was to investigate the child and school-level influences on children′s physical activity levels and sedentary time during school hours in a sample of children from a low-income community; Methods: One hundred and eighty-six children (110 boys) aged 9–10 years wore accelerometers for 7 days, with 169 meeting the inclusion criteria of 16 h∙day−1 for a minimum of three week days. Multilevel prediction models were constructed to identify significant predictors of sedentary time, light, and moderate to vigorous physical activity during school hour segments. Child-level predictors(sex, weight status, maturity offset, cardiorespiratory fitness, physical activity self-efficacy, physical activity enjoyment) and school-level predictors (number on roll, playground area, provision score) were entered into the models; Results: Maturity offset, fitness, weight status, waist circumference-to-height ratio, sedentary time, moderate to vigorous physical activity, number of children on roll and playground area significantly predicted physical activity and sedentary time; Conclusions: Research should move towards considering context-specific physical activity and its correlates to better inform intervention strategies

Associations between motor competence and physical activity levels of children with intellectual disabilities and/or autism spectrum disorder: Movement matters

Motor competence is important for lifelong physical activity (PA). The current study aimed to examine associations between PA and motor competence. In total, 43 children aged 7–12 years with intellectual disabilities and/or autism spectrum disorder completed anthropometric measures, the Bruininks-Oseretsky Test of Motor Proficiency-2, and wore a wrist accelerometer to capture total PA, moderate-to-vigorous PA (MVPA), average acceleration, and intensity gradient. No significant associations were found between PA outcomes and motor competence. Motor competence performance was commonly ‘below average’ or ‘average’. The weakest subtests were upper limb coordination and strength. The strongest subtest was running speed and agility. Total weekly MVPA was 336.1 ± 150.3 min, higher than UK recommendations of 120-180 per week for disabled children and young people. Larger scale studies are needed to better understand the relationship between PA and motor competence. Future research should also consider the influence of environmental factors on PA in this group

The management of acute venous thromboembolism in clinical practice. Results from the European PREFER in VTE Registry

Venous thromboembolism (VTE) is a significant cause of morbidity and mortality in Europe. Data from real-world registries are necessary, as clinical trials do not represent the full spectrum of VTE patients seen in clinical practice. We aimed to document the epidemiology, management and outcomes of VTE using data from a large, observational database. PREFER in VTE was an international, non-interventional disease registry conducted between January 2013 and July 2015 in primary and secondary care across seven European countries. Consecutive patients with acute VTE were documented and followed up over 12 months. PREFER in VTE included 3,455 patients with a mean age of 60.8 ± 17.0 years. Overall, 53.0 % were male. The majority of patients were assessed in the hospital setting as inpatients or outpatients (78.5 %). The diagnosis was deep-vein thrombosis (DVT) in 59.5 % and pulmonary embolism (PE) in 40.5 %. The most common comorbidities were the various types of cardiovascular disease (excluding hypertension; 45.5 %), hypertension (42.3 %) and dyslipidaemia (21.1 %). Following the index VTE, a large proportion of patients received initial therapy with heparin (73.2 %), almost half received a vitamin K antagonist (48.7 %) and nearly a quarter received a DOAC (24.5 %). Almost a quarter of all presentations were for recurrent VTE, with >80 % of previous episodes having occurred more than 12 months prior to baseline. In conclusion, PREFER in VTE has provided contemporary insights into VTE patients and their real-world management, including their baseline characteristics, risk factors, disease history, symptoms and signs, initial therapy and outcomes

Impacts of urbanisation on hydrological and water quality dynamics, and urban water management: a review

As urban space continues to expand to accommodate a growing global population, there remains a real need to quantify and qualify the impacts of urban space on natural processes. The expansion of global urban areas has resulted in marked alterations to natural processes, environmental quality and natural resource consumption. The urban landscape influences infiltration and evapotranspiration, complicating our capacity to quantify their dynamics across a heterogeneous landscape at contrasting scales. Impervious surfaces exacerbate runoff processes, whereas runoff from pervious areas remains uncertain owing to variable infiltration dynamics. Increasingly, the link between the natural hydrological cycle and engineered water cycle has been made, realising the contributions from leaky infrastructure to recharge and runoff rates. Urban landscapes are host to a suite of contaminants that impact on water quality, where novel contaminants continue to pose new challenges to monitoring and treatment regimes. This review seeks to assess the major advances and remaining challenges that remain within the growing field of urban hydrology

Seasonal salinity variations in a coastal wetland induced by complex interactions between sea, river and evapoconcentration processes

Deltaic coastal areas are often formed by a piecemeal of transitional wetland environments. These environments consist of wetland-aquifer systems, which commonly react rapidly to climate changes. Direct evaporation from surface water bodies like lakes, wetlands and lagoons will increase due to temperature increase leading to salt accumulation. To understand the hydrological exchanges between the transitional coastal wetlands of the Variconi oasis, the unconfined aquifer of the Volturno River Delta and the Tyrrenian Sea, the contributions of various processes were monitored and assessed. Physical-chemical parameters like salinity, pH, Eh and temperature were monitored during the hydrological year 2016-2017 on a monthly basis. Moreover, the use of groundwater and surface water equivalent freshwater heads, along with hydraulic conductivity tests and the geological architecture, permitted to connect the salinity variations in the wetlands with the degree of the hydraulic connection between the wetlands, the Volturno River, the Tyrrenian Sea and the coastal aquifer. The results show that the permanent wetlands fed by both the Volturno River and the Tyrrenian Sea, show a smoothed salinity peak during the summer season; while the ephemeral wetlands hydraulically disconnected from the aquifer show high salinity peaks during the summer season due to evapoconcentration processes. Spatial mapping of salinity and other measured parameters, highlighted an elevated heterogeneity of environments (from saline to freshwater environments) enclosed in the Variconi oasis. This in turn, induced a large biodiversity of both autochthonous and migratory species. Despite of this, the projected increase in salinity of these wetlands due to coastal erosion, augmented evapotranspiration rates and sea level rise, could be of serious concern for the above-mentioned biodiversity, thus monitoring and management strategies are urgently required to preserve this and other oasis in the Mediterranean area that are key sites employed as stop-over along migratory routes