Distributing participation in design: Addressing challenges of a global pandemic.

Participatory Design (PD) - whose inclusive benefits are broadly recognised in design - can be very challenging, especially when involving children. The recent COVID-19 pandemic has given rise to further barriers to PD with such groups. One key barrier is the advent of social distancing and government-imposed social restrictions due to the additional risks posed for e.g. children and families vulnerable to COVID-19. This disrupts traditional in-person PD (which involves close socio-emotional and often physical collaboration between participants and researchers). However, alongside such barriers, we have identified opportunities for new and augmented approaches to PD across distributed geographies, backgrounds, ages and abilities. We examine Distributed Participatory Design (DPD) as a solution for overcoming these new barriers, during and after COVID-19. We offer new ways to think about DPD, and unpick some of its ambiguities. We do this through an examination of the results from an online Interaction Design and Children (IDC) 2020 workshop. The workshop included 24 researchers with experience in PD, in a range of forms, in the context of children. Initially designed to take place in-person and to include a design session with children in a school in London, the workshop was adjusted to an online format in response to the COVID-19 pandemic. Despite the adverse circumstances, we discovered that the unexpected change of the workshop style from in-person to online was an opportunity and an impetus for us to address the new PD challenges of the global pandemic. In this article we contribute seven themes which were revealed during our IDC workshop, providing guidance on important areas for consideration when planning and conducting PD in the context of a global pandemic. With a focus on the term 'distributed', we offer insights on how DPD can be applied and explored in these circumstances with child participants. We conclude with a number of lessons learned, highlighting the opportunities and challenges DPD offers to enable continued co-design during a global pandemic. In particular, DPD provides greater access for some populations to be involved in PD, but technical and social challenges must be addressed.

Generation of nano- and micro-sized organic pollutant emulsions in simulated road runoff.

A wide range of organic pollutants (OPs) are emitted from the road and traffic environment and transported with road runoff to receiving waters. To provide an understanding of the transport routes of OPs in the environment, an investigation was carried out with the aim to determine whether OPs are transported with nano- and microparticles in the form of emulsions. Tests were performed on simulated road runoff, using laboratory prepared mixtures of ultrapure water and specific polycyclic aromatic hydrocarbons (PAHs), alkylphenols (APs) and their ethoxylates (APEOs), phthalates, diesel oil (aliphatic hydrocarbons), with and without addition of humic acid (HA) and iron (Fe) colloids. The samples were analysed directly after mixing and after a few days of stabilisation for particle size distribution (PSD) and concentrations of particles in the size range 10 nm-100 µm, and zeta potential > ±â€¯500 mV. Further, after long-term storage to achieve stabilisation, selected samples were investigated for the PSD and particle concentrations in the ranges 10 nm-2 µm, to determine whether stable emulsions had formed. The following simulation mixtures, both mixed and stabilised, were identified as potential emulsions: diesel, APs and APEOs, diesel with APs and APEOS, phthalates, and a mixture of all OPs with and without colloids. Measurements with the Zetasizer and Nanosight instruments imply that the majority of particles in the samples were found in the nano-range of 30-660 nm respectively, and a smaller portion of particles < 28% also measured with Coulter Counter were found to be micro-sized. Higher concentrations of the smallest nanoparticles were found in the mixture of all OPs without colloids added, than in the OP mixture with colloids added. The results indicate that the addition of colloids favours the formation of larger micro-sized emulsions that may break down with time into nano-sized particles. In the mixed samples, the number of micro-sized particles decreased, while the number of nanoparticles increased; this process may also occur in road runoff transportation systems during heavy rain events. This is the first study to indicate that emulsions of OPs may be formed in road runoff, and that emulsions may act as carriers of OPs in urban stormwater.

Use of bibloc and monobloc oral appliances in obstructive sleep apnoea: a multicentre, randomized, blinded, parallel-group equivalence trial.

Background: The clinical benefit of bibloc over monobloc appliances in treating obstructive sleep apnoea (OSA) has not been evaluated in randomized trials. We hypothesized that the two types of appliances are equally effective in treating OSA. Objective: To compare the efficacy of monobloc versus bibloc appliances in a short-term perspective. Patients and methods: In this multicentre, randomized, blinded, controlled, parallel-group equivalence trial, patients with OSA were randomly assigned to use either a bibloc or a monobloc appliance. One-night respiratory polygraphy without respiratory support was performed at baseline, and participants were re-examined with the appliance in place at short-term follow-up. The primary outcome was the change in the apnoea-hypopnea index (AHI). An independent person prepared a randomization list and sealed envelopes. Evaluating dentist and the biomedical analysts who evaluated the polygraphy were blinded to the choice of therapy. Results: Of 302 patients, 146 were randomly assigned to use the bibloc and 156 the monobloc device; 123 and 139 patients, respectively, were analysed as per protocol. The mean changes in AHI were -13.8 (95% confidence interval -16.1 to -11.5) in the bibloc group and -12.5 (-14.8 to -10.3) in the monobloc group. The difference of -1.3 (-4.5 to 1.9) was significant within the equivalence interval (P = 0.011; the greater of the two P values) and was confirmed by the intention-to-treat analysis (P = 0.001). The adverse events were of mild character and were experienced by similar percentages of patients in both groups (39 and 40 per cent for the bibloc and monobloc group, respectively). Limitations: The study shows short-term results with a median time from commencing treatment to the evaluation visit of 56 days and long-term data on efficacy and harm are needed to be fully conclusive. Conclusion: In a short-term perspective, both appliances were equivalent in terms of their positive effects for treating OSA and caused adverse events of similar magnitude. Trial registration: Registered with ClinicalTrials.gov (#NCT02148510).

Family Health Conversations at a Pediatric Oncology Center - A Way for Families to Rebalance the Situation.

PURPOSE: The study aimed to describe and understand adult family members' experiences of participating in a Family Health Conversation (FamHC) when a child is diagnosed with cancer. DESIGN AND METHODS: Twelve individual interviews were performed with adult family members who had participated in a FamHC. During the interviews each interviewee was a spokesman for his or her respective family. Thereby the family was included as a system. The interviews were analyzed using a hermeneutic approach. RESULTS: The analysis resulted in four themes: "To unburden the burden," "Seeing things in a new light," "To be seen the way you are," and "Talking to someone who is both within and alongside." Finally an overarching theme evolved, "To rebalance the situation" revealing the meaning of taking part in the FamHC. CONCLUSION: All participants considered the FamHC to be valuable. It was surprising that such a relatively small investment of two family conversations and a closing letter could have such significance for the families in their difficult situation. PRACTICE IMPLICATIONS: With training, clinical nurses can use a well-established structured interview process such as the Family Health Conversation to help family members to gain insight into each other's experiences, which increase their ability to cope and regain control.

Emissions of organic pollutants from traffic and roads: Priority pollutants selection and substance flow analysis.

A large number of organic pollutants (OPs) emitted from vehicles and traffic-related activities exhibit environmental persistence and a tendency to bioaccumulate, and may have detrimental long-term effects on aquatic life. The aim of the study was to establish a list of significant sources of OPs occurring in road runoff, identify the OPs emitted from these sources, select a number of priority pollutants (PP), and estimate the quantity of PPs emitted in a road environment case study using substance flow analysis (SFA). The priority pollutants included in the SFA were selected from a list of approximately 1100 compounds found after comprehensive screening, including literature and database searches, expert judgments, the Ranking and Identification of Chemical Hazards method, and chemical analysis of sediments. The results showed the following priority order: polycyclic aromatic hydrocarbons (PAHs)>alkanes C20-C40>alkylphenols>phthalates>aldehydes>phenolic antioxidants>bisphenol A>oxygenated-PAHs>naphtha C5-C12>amides>amines. Among these, PAHs were chosen for a SFA, which was performed for a highway case study area in Gothenburg (Sweden). The SFA showed that the main sources of PAHs emitted in the area were vehicle exhaust gases, followed by tyre wear, motor lubricant oils, road surface wear, and brake linings. Only 2-6% of the total 5.8-29kg annually emitted PAHs/ha ended up in the stormwater sewer system. The measured PAH loads were found in much smaller amounts than the calculated loads and the outflow to stormwater contained much more of the hazardous PAHs than the total loads emitted in the catchment area.

Molecular epidemiology and the evolution of human coxsackievirus A6.

Coxsackievirus A6 (CV-A6) is a major aetiologic agent for hand, foot and mouth disease (HFMD) in recent years. HFMD outbreaks associated with CV-A6 resulted from the evolutionary dynamics of CV-A6 and the appearance of novel recombinant forms (RFs). To examine this, 151 variants collected in 2013 and 2014 from Germany, Spain, Sweden, Denmark and Thailand were genotyped for the VP1 capsid and 3Dpol genes. Analysis of the VP1 gene showed an increasing correspondence between CV-A6 genome recombination and sequence divergence (estimated substitution rate of 8.1×10-3 substitutions site-1 year-1 and RF half-life of 3.1 years). Bayesian phylogenetic analysis showed that recent recombination groups (RF-E, -F, -H, -J and -K) shared a common ancestor (RF-A). Thirty-nine full-length genomes of different RFs revealed recombination breakpoints between the 2A-2C and the 5' UTRs. The emergence of new CV-A6 recombination groups has become widespread in Europe and Asia within the last 8 years.

Particle phase distribution of polycyclic aromatic hydrocarbons in stormwater--Using humic acid and iron nano-sized colloids as test particles.

The distribution of polycyclic aromatic hydrocarbons (PAHs) in different particulate fractions in stormwater: Total, Particulate, Filtrated, Colloidal and Dissolved fractions, were examined and compared to synthetic suspensions of humic acid colloids and iron nano-sized particles. The distribution of low-molecular weight PAHs (LMW PAHs), middle-molecular weight PAHs (MMW PAHs) and high-molecular weight PAHs (HMW PAHs) among the fractions was also evaluated. The results from the synthetic suspensions showed that the highest concentrations of the PAHs were found in the Filtrated fractions and, surprisingly, high loads were found in the Dissolved fractions. The PAHs identified in stormwater in the Particulate fractions and Dissolved fractions follow their hydrophobic properties. In most samples >50% of the HMW PAHs were found in the Particulate fractions, while the LMW and MMW PAHs were found to a higher extent in the Filtrated fractions. The highest concentrations of PAHs were present in the stormwater with the highest total suspended solids (TSS); the relative amount of the HMW PAHs was highest in the Particulate fractions (particles>0.7 µm). The highest concentration of PAHs in the Colloidal fraction was found in the sample with occurrence of small nano-sized particles (<10nm). The results show the importance of developing technologies that both can manage particulate matter and effectively remove PAHs present in the Colloidal and Dissolved fractions in stormwater.

Waste paper for recycling: Overview and identification of potentially critical substances.

Paper product manufacturing involves a variety of chemicals used either directly in paper and pulp production or in the conversion processes (i.e. printing, gluing) that follow. Due to economic and environmental initiatives, paper recycling rates continue to rise. In Europe, recycling has increased by nearly 20% within the last decade or so, reaching a level of almost 72% in 2012. With increasing recycling rates, lower quality paper fractions may be included. This may potentially lead to accumulation or un-intended spreading of chemical substances contained in paper, e.g. by introducing chemicals contained in waste paper into the recycling loop. This study provides an overview of chemicals potentially present in paper and applies a sequential hazard screening procedure based on the intrinsic hazard, physical-chemical and biodegradability characteristics of the substances. Based on the results, 51 substances were identified as potentially critical (selected mineral oils, phthalates, phenols, parabens, as well as other groups of chemicals) in relation to paper recycling. It is recommended that these substances receive more attention in waste paper.

A prospective 10-year follow-up polygraphic study of patients treated with a mandibular protruding device.

PURPOSE: This 10-year follow-up prospective study aimed to evaluate the effects of treatment with a mandibular protruding device (MPD) on respiratory parameters and subjective symptoms in patients with obstructive sleep apnea (OSA) or snoring. METHODS: Seventy-seven consecutive patients diagnosed with OSA or snoring were treated with an MPD. At baseline and the 10-year follow-up, a polygraphic examination and questionnaires on sleep quality were administrated and weight, and neck size was measured. RESULTS: At the 10-year follow-up, we examined 64 of the 77 patients and recorded their current treatment (45 MPD, 9 continuous positive airway pressure (CPAP), and 10 no treatment). For MPD patients, 89 % reported MPD use every night and 9 % several nights a week. Compared to baseline, MPD users with OSA had a significantly decreased oxygen desaturation index (ODI) (p = 0.006) and increased lowest arterial oxygen saturation, SaO2 nadir (p = 0.007) after 10 years. MPD treatment was successful for 70 % of OSA patients, yet 89 % subjectively considered themselves cured, indicating overestimation of the treatment effect. OSA patients who responded to treatment maintained baseline weight and neck size, while these increased for non-responders. Of the baseline snorers still using an MPD, 93 % maintained an ODI value of <5. All CPAP users had an ODI value of <5. Both OSA and snorers using an MPD had significantly fewer self- and relative reports of snoring, apnea, daytime tiredness, and poor night sleep quality (p < 0.001). CONCLUSIONS: MPD treatment is well tolerated and effective in a long-term, 10-year perspective. Weight gain may jeopardize MPD effects. Both patients and relatives reported significantly less snoring and fewer periods of apnea.

Biocides in urban wastewater treatment plant influent at dry and wet weather: concentrations, mass flows and possible sources.

In recent years, exterior thermal insulation systems became more and more important leading to an increasing amount of houses equipped with biocide-containing organic façade coatings or fungicide treated wood. It is known that these biocides, e.g. terbutryn, carbendazim, and diuron, as well as wood preservatives as propiconazole, leach out of the material through contact with wind driven rain. Hence, they are present in combined sewage during rain events in concentrations up to several hundred ng L(-1). The present study focused on the occurrence of these biocides in five wastewater treatment plants in Denmark and Sweden during dry and wet weather. It was discovered, that biocides are detectable not only during wet weather but also during dry weather when leaching from façade coatings can be excluded as source. In most cases, the concentrations during dry weather were in the same range as during wet weather (up to 100 ng L(-1)); however, for propiconazole noteworthy high concentrations were detected in one catchment (4.5 µg L(-1)). Time resolved sampling (12 × 2 h) enabled assessments about possible sources. The highest mass loads during wet weather were detected when the rain was heaviest (e.g. up to 116 mg h(-1) carbendazim or 73 mg h(-1) mecoprop) supporting the hypothesis that the biocides were washed off by wind driven rain. Contrary, the biocide emissions during dry weather were rather related to household activities than with emissions from buildings, i.e., emissions were highest during morning and evening hours (up to 50 mg h(-1)). Emissions during night were significantly lower than during daytime. Only for propiconazole a different emission behaviour during dry weather was observed: the mass load peaked in the late afternoon (3 g h(-1)) and declined slowly afterwards. Most likely this emission was caused by a point source, possibly from inappropriate cleaning of spray equipment for agriculture or gardening.

A source classification framework supporting pollutant source mapping, pollutant release prediction, transport and load forecasting, and source control planning for urban environments.

PURPOSE: Implementation of current European environmental legislation such as the Water Framework Directive requires access to comprehensive, well-structured pollutant source and release inventories. The aim of this work was to develop a Source Classification Framework (SCF) ideally suited for this purpose. METHODS: Existing source classification systems were examined by a multidisciplinary research team, and an optimised SCF was developed. The performance and usability of the SCF were tested using a selection of 25 chemicals listed as priority pollutants in Europe. RESULTS: The SCF is structured in the form of a relational database and incorporates both qualitative and quantitative source classification and release data. The system supports a wide range of pollution monitoring and management applications. The SCF functioned well in the performance test, which also revealed important gaps in priority pollutant release data. CONCLUSIONS: The SCF provides a well-structured approach for European pollutant source and release classification and management. With further optimisation and demonstration testing, the SCF has the potential to be fully implemented throughout Europe.

Modelling the fate of organic micropollutants in stormwater ponds.

Urban water managers need to estimate the potential removal of organic micropollutants (MP) in stormwater treatment systems to support MP pollution control strategies. This study documents how the potential removal of organic MP in stormwater treatment systems can be quantified by using multimedia models. The fate of four different MP in a stormwater retention pond was simulated by applying two steady-state multimedia fate models (EPI Suite and SimpleBox) commonly applied in chemical risk assessment and a dynamic multimedia fate model (Stormwater Treatment Unit Model for Micro Pollutants--STUMP). The four simulated organic stormwater MP (iodopropynyl butylcarbamate--IPBC, benzene, glyphosate and pyrene) were selected according to their different urban sources and environmental fate. This ensures that the results can be extended to other relevant stormwater pollutants. All three models use substance inherent properties to calculate MP fate but differ in their ability to represent the small physical scale and high temporal variability of stormwater treatment systems. Therefore the three models generate different results. A Global Sensitivity Analysis (GSA) highlighted that settling/resuspension of particulate matter was the most sensitive process for the dynamic model. The uncertainty of the estimated MP fluxes can be reduced by calibrating the dynamic model against total suspended solids data. This reduction in uncertainty was more significant for the substances with strong tendency to sorb, i.e. glyphosate and pyrene and less significant for substances with a smaller tendency to sorb, i.e. IPBC and benzene. The results provide support to the elaboration of MP pollution control strategies by limiting the need for extensive and complex monitoring campaigns targeting the wide range of specific organic MP found in stormwater runoff.

The implications of household greywater treatment and reuse for municipal wastewater flows and micropollutant loads.

An increasing worldwide interest in water recycling technologies such as greywater treatment and reuse suggests that additional research to elucidate the fate of xenobiotics during such practices would be beneficial. In this paper, scenario analyses supported by empirical data are used for highlighting the potential fate of a selection of xenobiotic micropollutants in decentralised greywater treatment systems, and for investigation of the possible implications of greywater recycling for the wider urban water cycle. Potential potable water savings of up to 43% are predicted for greywater recycling based on Danish water use statistics and priority substance monitoring at a greywater treatment plant in Denmark. Adsorption represents an important mechanism for the removal of cadmium, nickel, lead and nonylphenol from influent greywater and therefore the disposal route adopted for the generated sludge can exert a major impact on the overall efficiency and environmental sustainability of greywater treatment.

Environmental benefits and risks of zero-valent iron nanoparticles (nZVI) for in situ remediation: risk mitigation or trade-off?

The use of nanoscaled zero-valent iron particles (nZVI) to remediate contaminated soil and groundwater has received increasing amounts of attention within the last decade, primarily due to its potential for broader application, higher reactivity, and cost-effectiveness compared to conventional zero-valent iron applications and other in situ methods. However, the potential environmental risks of nZVI in in situ field scale applications are largely unknown at the present and traditional environmental risk assessment approaches are not yet able to be completed. Therefore, it may not yet be fully clear how to consider the environmental benefits and risks of nZVI for in situ applications. This analysis therefore addresses the challenges of comprehensively considering and weighing the expected environmental benefits and potential risks of this emerging environmentally-beneficial nanotechnology, particularly relevant for environmental engineers, scientists, and decision makers. We find that most of the benefits of using nZVI are based on near-term considerations, and large data gaps currently exist within almost all aspects of environmental exposure and effect assessments. We also find that while a wide range of decision support tools and frameworks alternative to risk assessment are currently available, a thorough evaluation of these should be undertaken in the near future to assess their full relevancy for nZVI at specific sites. Due to the absence of data in environmental risk evaluations, we apply a 'best' and 'worst' case scenario evaluation as a first step to qualitatively evaluate the current state-of-knowledge regarding the potential environmental risks of nZVI. The result of this preliminary qualitative evaluation indicates that at present, there are no significant grounds on which to form the basis that nZVI currently poses a significant, apparent risk to the environment, although the majority of the most serious criteria (i.e. potential for persistency, bioaccumulation, toxicity) are generally unknown. We recommend that in cases where nZVI may be chosen as the 'best' treatment option, short and long-term environmental monitoring is actively employed at these sites. We furthermore recommend the continued development of responsible nZVI innovation and better facilitated information exchange between nZVI developers, nano-risk researchers, remediation industry, and decision makers.