Background
Nutritional Risk Screening 2002 is recommended as a screening tool to identify patients at risk of undernutrition for all patients in hospitals by the European Society of Clinical ...Nutrition and Metabolism. Nutritional risk is associated with increased morbidity and mortality in patients, and it is common among patients on haemodialysis. Factors associated with nutritional risk that could facilitate the screening/diagnostic procedures are warranted.
Objectives
Identification of factors that are associated with nutritional risk in patients with end‐stage renal disease treated with haemodialysis.
Design and Participants
Single‐centre, cross‐sectional study in patients receiving haemodialysis (n = 53) were screened for nutritional risk using Nutritional Risk Screening 2002. Associations were made with data on dietary intake by 24‐h dietary recall, and measurement of body composition, anthropometric measurements and biochemical variables.
Results
Nutritional risk was common among patients on haemodialysis (26%), and was associated with low energy and protein intake, and low pre‐albumin concentrations also after adjustments for age and sex. Nutritional risk was neither associated with diabetes nor duration of dialysis treatment.
Conclusion
Measurement of pre‐albumin and dietary assessment using a 24‐h dietary recall can support the identification of patients receiving haemodialysis at nutritional risk.
•A method to couple circularity and environmental assessments is presented.•Urban agriculture as a case study to exemplify urban metabolism flows.•Material Circularity Indicator (MCI) shows ...limitations at system-level.•Combining the Linear Flow Index and LCA to reach the lowest possible value.•Further research is required to detect limitations in sector-specific assessments.
Local food production through urban agriculture (UA) is promoted as a means to make cities more sustainable. However, UA does not come free of environmental impacts. In this sense, optimizing urban resources through circular economy principles offers the opportunity to close loops and improve production systems, but an assessment of these systems through a combination of circularity and environmental tools is missing from the literature. The goal of our study is to analyse the environmental and circularity performance of applying circular strategies in UA systems. We use Life Cycle Assessment (LCA) and the Material Circularity Indicator (MCI) to assess the baseline scenario of a Mediterranean rooftop greenhouse and the application of 13 circular strategies. The results show that the MCI score for all strategies was biased by overweighting of the water subsystem in the mass balance. Based on this finding, we propose a series of modifications to the circularity assessment, calculating specific MCI scores for every subsystem before coupling them with environmental life cycle indicators. The outcome is a set of indicators that use the Linear Flow Index (LFI), where decreasing the values as much as possible will correspond to a decrease both in environmental impact and linearity of the system (the inverse of circularity). The use of these indicators provides a simple understanding of the circular and environmental performance of these systems while being fully adaptable. With these indicators, the uses of nutrient recirculation, struvite fertilizer or recycled materials were the best strategies to improve urban agriculture.
A paradigm shift is needed in wastewater treatment plants (WWTPs) to progress from traditional pollutant removal to resource recovery. However, whether this transformation produces overall ...environmental benefits will depend on the efficient and sustainable use of resources by emerging technologies. Given that many of these technologies are still being tested at the pilot scale, there is a lack of environmental assessments quantifying their impacts and benefits. In particular, an integrated approach to energy and nutrient recovery can elucidate the potential configurations for WWTPs. In this study, we conduct a life cycle assessment (LCA) of emergent wastewater treatment technologies aimed at increasing resource circularity in WWTPs. We focus on increasing energy self-sufficiency through biogas upgrades and a more radical circular approach aimed at nutrient recovery. Based on a case-study WWTP, we compare its current configuration with (1) implementing autotrophic nitrogen removal in the mainstream and deriving most of the organic matter for biogas production, which increases the quality and quantity of biogas available for energy production; (2) implementing struvite recovery through enhanced biological phosphorus removal (EBPR) as a radical approach to phosphorus management, offering an alternative to mineral fertilizer; and (3) a combination of both approaches. The results show that incremental changes in biogas production are insufficient for compensating for the environmental investment in infrastructure, although autotrophic nitrogen removal is beneficial for increasing the quality of the effluent. Combined phosphorus and energy recovery reduce the environmental impacts from the avoided use of fertilizers and phosphorus and the nitrogen release into water bodies. An integrated approach to resource management in WWTPs is thus desirable and creates new opportunities toward the implementation of circular strategies with low environmental impact in cities.
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•Rethinking wastewater treatment is key to recover energy and resources in cities.•Increased biogas production, nitrogen removal and struvite recovery are studied.•Radical upgrades through nutrient recovery decrease the plant's environmental impacts.
In spring 2022, the inaugural cohort of Genetic and Genomic Counseling MSc students graduated from the Medical University of Innsbruck, representing a significant milestone for the establishment of ...the genetic counselor (GC) profession in the German-speaking countries. A pivotal component of their education was a 15-week clinical training period. The placement experiences of both students and supervisors offered valuable insights into the attitudes of medical geneticists toward the profession. To share the knowledge gained by these pioneers and offer guidance to potential placement institutions, the MSc program team organized an online workshop on the education and training of GCs in German-speaking countries in October 2022. The first part of the workshop focused on the training program and professional profile of GCs in the German-speaking countries. It covered educational aspects, such as the structure of the MSc degree program and specific communication training. Additionally, it addressed challenges arising from the integration of GCs into existing genetics centers. The second part of the workshop delved into first-hand experiences of genetic counseling students and placement providers during clinical training. Featuring insights from supervisors, this session facilitated a discussion about the roles of GCs within interprofessional genetics teams. The workshop participants agreed on a growing demand for GCs and highlighted positive experiences, as well as challenges within participating institutes that had hosted a student. In this article we summarize suggestions for the education and training of GCs in the German-speaking countries where the profession is newly established.
EPDF and EPUB available Open Access under CC-BY-NC-ND licence. Policymakers throughout Europe are enacting policies to support youth labour market integration. However, many young people continue to ...face unemployment, job insecurity, and the subsequent consequences. Adopting a mixed-method and multilevel perspective, this book provides a comprehensive investigation into the multifaceted consequences of social exclusion. Drawing on rich pan-European comparative and quantitative data, and interviews with young people from across Europe, this text gives a platform to the unheard voices of young people. Contributors derive crucial new policy recommendations and offer fresh insights into areas including youth well-being, health, poverty, leaving the parental home, and qualifying for social security.EPDF and EPUB available Open Access under CC-BY-NC-ND licence. Policymakers throughout Europe are enacting policies to support youth labour market integration. However, many young people continue to face unemployment, job insecurity, and the subsequent consequences. Adopting a mixed-method and multilevel perspective, this book provides a comprehensive investigation into the multifaceted consequences of social exclusion. Drawing on rich pan-European comparative and quantitative data, and interviews with young people from across Europe, this text gives a platform to the unheard voices of young people. Contributors derive crucial new policy recommendations and offer fresh insights into areas including youth well-being, health, poverty, leaving the parental home, and qualifying for social security.
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