Browsing by Author "Ferreira, Vera"
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- Assessing the medical waste management practices and associated risk perceptions in Algarve hospitals, PortugalPublication . Ferreira, Vera; Ribau Teixeira, MargaridaIn the past few years, there has been an increase in public concern about the medical wastes management on a global basis and a significant effort has been directed toward proper and safe management of hazardous medical wastes. However, if there is not a clear understanding of the risks, inadequate management practices are often implemented. The objective of this study was to analyse the medical waste management practice of hospitals in Algarve (Portugal), analyse the risk perception of medical staff (nurses, doctors and housekeepers) and assess the risk for medical staff. This study was carried out in the three hospitals, one public and two private. Field visits and questionnaires survey method was implemented to collect information regarding different medical waste management aspects and the perception of risk associated with medical wastes by the medical staff. The risk assessment was based in real injuries data associated with sharps and needles (estimate of infections) and in inadequate wastes separation, i.e. frequency of errors in separation. There are some problems in the medical waste management in all hospitals due to lack of training and resources. Nurse’s group show slightly higher knowledge about medical wastes separation, with 71.6% correct answers, and doctor’s group lower knowledge, with 64.8% correct answers. Only 26% of doctors participated in training programs and this medical staff group evidences a lower perception of risk associated of the infectious wastes (group IV wastes). The separation about pharmaceuticals, cytotoxic and pathological waste has more errors, which in reality can be reflected in a higher percentage of inadequate treatment and final disposal, and has impacts in medical workers and environment. Most injuries from needlestick/sharp occur during patient care, but there are medical wastes risk associated, mainly linked to the deposition in containers and separation errors of this material. However, only HVB is likely to occur in hospitals, in coming years if the prophylaxis is not 100%. Results indicate the waste management is affected by perception of risk and training programs.
- Avaliação das práticas de gestão de resíduos hospitalares, risco e percepção do risco associado - caso de estudo: Hospitais do AlgarvePublication . Ferreira, Vera; Teixeira, Margarida RibauNos últimos anos tem sido desenvolvido um esforço significativo para uma gestão adequada dos resíduos hospitalares, mas na ausência de clara compreensão dos riscos associados, muitas vezes, existem práticas de gestão inadequadas. O presente estudo teve como objectivos principais, analisar as práticas de gestão de resíduos hospitalares nos hospitais do Algarve, analisar as percepções de risco, verificar diferenças entre grupos de profissionais de saúde e entre hospitais, e avaliar e abordar o risco dos resíduos para a sua saúde e ambiente. Este estudo foi efectuado em três hospitais, um público e dois privados, que correspondem a 50% dos hospitais no Algarve. A principal metodologia utilizada foi a realização de visitas aos hospitais, observação directa, entrevistas e realização de questionários aos profissionais de saúde. A avaliação dos riscos foi baseada em dados reais de ferimentos com material cortante e perfurante (estimativa de infecções) e na análise da triagem inadequada dos resíduos, ou seja, frequência de respostas erradas evidenciadas nos questionários. Verificaram-se alguns problemas na gestão de resíduos em todos os hospitais resultantes da falta de formação e recursos. Os enfermeiros são o grupo de profissionais de saúde que mostra maior conhecimento na separação dos resíduos por grupos e os médicos menor conhecimento, com 71,6% e 64,8% de respostas correctas, respectivamente. Apenas 26% dos médicos participaram em acções de formação, sendo os mesmos que apresentam maiores dúvidas na triagem dos resíduos perigosos do Grupo IV e percepções de risco mais distorcidas relativamente ao estipulado na lei. Constata-se que a gestão dos resíduos hospitalares é influenciada pela percepção de risco e participação em acções de formação. A separação de medicamentos, citostáticos e peças anatómicas não identificáveis é a que sugere mais dúvidas, o que na realidade se pode reflectir numa maior percentagem destes resíduos encaminhados para tratamento e destino final inadequado, que tem impactes negativos na saúde e ambiente. Muitos ferimentos com material cortante e perfurante ocorrem na prestação de cuidados de saúde, mas existe um risco associado a resíduos hospitalares nomeadamente incidentes devido a erros na separação deste material e durante a sua deposição no contentor. Este risco deve ser eliminado ou minimizado através da gestão adequada dos resíduos.
- Predicting soil erosion after land use changes for irrigating agriculture in a large reservoir of southern PortugalPublication . Ferreira, Vera; Panagopoulos, Thomas; Cakula, Anda; Andrade, Rita; Arvela, Andre; Barouchas, PE; Tsirogiannis, YL; Malamos, NThe construction of the Alqueva reservoir in a semi-arid Mediterranean landscape brought new opportunities for irrigated farming. Land use changes and climate change may alter the risk of soil erosion that was not predicted in the initial development plans and decrease the lifetime of the investment. A comprehensive methodology that integrates the Revised Universal Soil Loss Equation (RUSLE) and geographic information system was adopted to study the effect on soil erosion of different land-uses of the Alqueva reservoir region. Analysing the soil erosion of each land-use it was obtained the following land use erosion vulnerability: Olive orchard>Vineyard>Montado>Alfalfa. The strong erosion variances that were observed in the study area show the importance of locating the 'hot spots' of soil erosion. Simulated scenarios for the entire area can be used as a basis for site-specific soil conservation plans, to promote sustainable land management practices and to facilitate localized erosion control practices and environmentally friendly farming. (C) 2015 The Authors. Published by Elsevier B.V.
- Relevance of ecosystem services and disservices from green infrastructure perceived by the inhabitants of two portuguese cities dealing with climate change: implications for environmental and intersectional justicePublication . Barreira, Ana; Andraz, Jorge; Ferreira, Vera; Panagopoulos, ThomasGreen infrastructure provides ecosystem services (ESs) and disservices (EDSs), although EDSs are understudied. By considering both, this study contributes to the literature. The inhabitants' perception of the importance of ESs/EDSs is assessed through a survey in two Portuguese cities facing extreme climatic events. "Heat reduction" and "contact with nature" are the most perceived ESs while "risk of fire" and "excessive water consumption" are the most perceived EDSs, respectively, in Elvas and Faro. Using rank-ordered logistic regression models, this study finds that the relevance of ESs/EDSs is perceived differently throughout the different areas of the cities, with Elvas revealing the highest signs of environmental injustice, since the importance of ESs is perceived differently by the inhabitants, specifically those inhabiting impoverished areas. The inhabitants perceiving heatwaves acknowledge less relevance to some ESs and more relevance to several EDSs. Gender, age, and income affect the perceived relevance of some ESs/EDSs, signalling intersectional injustice.
- Soil erosion vulnerability under scenarios of climate land-use changes after the development of a large reservoir in a semi-arid areaPublication . Ferreira, Vera; Samora-Arvela, André; Panagopoulos, ThomasClimate and land-use/cover changes (LUCC) influence soil erosion vulnerability in the semi-arid region of Alqueva, threatening the reservoir storage capacity and sustainability of the landscape. Considering the effect of these changes in the future, the purpose of this study was to investigate soil erosion scenarios using the Revised Universal Soil Loss Equation (RUSLE) model. A multi-agent system combining Markov cellular automata with multi-criteria evaluation was used to investigate LUCC scenarios according to delineated regional strategies. Forecasting scenarios indicated that the intensive agricultural area as well as the sparse and xerophytic vegetation and rainfall-runoff erosivity would increase, consequently causing the soil erosion to rise from 1.78 Mg ha(-1) to 3.65 Mg ha(-1) by 2100. A backcasting scenario was investigated by considering the application of soil conservation practices that would decrease the soil erosion considerably to an average of 2.27 Mg ha(-1). A decision support system can assist stakeholders in defining restrictive practices and developing conservation plans, contributing to control the reservoir's siltation.
- Stakeholders’ perceptions of appropriate nature-based solutions in the urban contextPublication . Ferreira, Vera; Barreira, Ana; Loures, Luís; Antunes, Dulce; Panagopoulos, ThomasThe concept of nature-based solutions (NBSs) has become increasingly popular among urban policymakers and planners to help them tackle the urban challenges arising from urban expansion and climate change. Stakeholders' involvement is a fundamental step, and stakeholders' perceptions and preferences can affect the development of NBS projects. This study aims to identify stakeholders' perceptions of the most critical urban challenges, the priority interventions, the preferred NBSs and the benefits of the NBSs, and to identify the determinants of these perceptions. A survey was administered to assess stakeholders' perceptions and views on implementing NBSs in two Portuguese cities with distinct urban, geographical, and socio-economic contexts. A binary logistic regression model was used to understand the determinants of the likelihood of the stakeholders' answers. According to the stakeholders, climate change is one of the main concerns in the urban context. It is usually associated with the incidence of heatwaves and water scarcity. Additionally, stakeholders are concerned about the low quantity and poor management of green spaces (GSs). They believe that it will be necessary to increase the GS, to recover some degraded areas, and to increase mobility. The preferred NBSs were planting more urban trees, making green shaded areas, and rehabilitating riverbanks. The main expected benefits were benefits for leisure and relaxation, reductions in air temperature, purer air, and improvements in public health. The results showed mostly coherent connections between the main concerns/priorities of the stakeholders and the perceived NBS benefits; however, some stakeholders did not present coherent connections, indicating low awareness of the current policy for implementing NBSs to overcome existing and future urban challenges.
- Understanding attitudes towards the adoption of nature-based solutions and policy priorities shaped by stakeholders’ awareness of climate changePublication . Ferreira, Vera; Barreira, Ana; Pinto, Patrícia; Panagopoulos, ThomasClimate change is affecting cities worldwide. Accordingly, cities are required to find sustainable solutions to tackle climate change's effects, designing bottom-up policies to enhance their success. The involvement of stakeholders plays a central role in the definition of appropriate policies to tackle the challenges posed to cities by climate change. Nature-based solutions (NBS) are increasingly proposed to adapt to and mitigate the adverse effects of climate change. This study aims to assess the coherence of the policies emerging from stakeholders' perceptions of urban climate challenges and their preferred NBS to tackle them. Indeed, it considers whether departing from different urban climate challenges, stakeholders' choices present a coherent articulation between priority interventions, proposed solutions and expected benefits. Using a survey applied to two Portuguese cities and the chi-squared automatic interaction detector (CHAID) algorithm, we analyse the answers provided by stakeholders. The stakeholders' perceptions and preferences were not significantly influenced by their hierarchical position in their institutions, their city's location and socioeconomic setting. Heatwaves and temperature rise together with drought and water scarcity are identified as future urban challenges in Portugal. Priority interventions, as well as preferred NBS and their expected benefits, are addressed. The results show that stakeholders may make decisions that form a coherent policy, in which acknowledgment of climate change's effects interconnects with related priority interventions, suitable NBS and their benefits.