Resilience, Emotional Intelligence, and Occupational Performance in Family Members Who Are the Caretakers of Patients with Dementia in Spain: A Cross-Sectional, Analytical, and Descriptive Study.

BACKGROUND: The concern in the scientific community for the study of people with dementia and their families is comprehensible, especially the importance of knowing the effects that caring for the patient has on their family dynamic, paying special attention to the main caregiver. The objective of this study was to analyze the relationship of resilience and emotional intelligence with functional performance in the main caregivers of people with dementia in Spain according to the phase of the disease. METHODS: A cross-sectional, descriptive, and analytical study was carried out. A total of 144 primary family caregivers of patients with dementia in Spain were included in the study. The following variables were measured: sociodemographic, psychosocial, and occupational, as well as resilience and emotional intelligence. RESULTS: The caregivers obtained a low moderate resilience (mean = 64.01 ± 14.5), an emotional intelligence bordering between moderate and high (mean = 78.48 ± 14.82), and a 61.8% self-care categorized as somewhat and quite a bit. The presence of higher levels of resilience in family caregivers of people with dementia were positively related to the time spent on self-care (r = 0.227; p = 0.033) and leisure (r = 0.262; p = 0.014), especially in the moderate phase of the disease, while in the severe phase, this relationship appeared with productivity (r = 0.355; p = 0.034). The higher levels of emotional intelligence were positively related to a greater time dedicated to self-care (r = 0.233, p = 0.005), as well as the data observed in the moderate and severe phase (r = 0.214; p = 0.046 and r = 0.398; p = 0.016 respectively). CONCLUSIONS: The primary caregivers of relatives with dementia who have higher levels of resilience and emotional intelligence spend more time on self-care and leisure activities, especially in the moderate phase of the disease.

Eco-efficiency assessment of municipal solid waste services: Influence of exogenous variables.

Improving the eco-efficiency of municipalities in the provision of municipal solid waste (MSW) services is fundamental in the context of a circular economy. This study evaluates the eco-efficiency of a sample of Spanish municipalities, integrating the total cost as input, recyclable waste as desirable output, and unsorted waste as undesirable output. Following a pioneering approach, the weighted Russell directional distance model (a non-radial data envelopment analysis model) was employed, which allowed us to obtain a global inefficiency score and individual inefficiency scores for each variable integrated in the model. In the second stage of analysis, the potential factors affecting the previously computed inefficiency scores were investigated. The results indicated that one third of the municipalities evaluated were eco-efficient in the provision of MSW services with the total cost being the variable in which the municipalities exhibited the best performance. Moreover, the size of the municipalities, population served, population density, tourism, and availability of containers for separative collection of paper, glass, and plastic significantly affect the eco-efficiency of the municipalities. The findings of this study provide detailed information to support decision-making for the policy makers to improve the eco-efficiency of the municipalities in managing MSW.

Measuring the eco-efficiency of wastewater treatment plants under data uncertainty.

Eco-efficiency assessment is a useful tool for improving the sustainability of wastewater treatment plants (WWTPs). However, it is a complex task that requires the integration of several performance indicators into a single index. Data envelopment analysis (DEA) is established as a highly effective methodology for achieving this as it permits the integration of the service value, resource consumption and environmental impact variables as the desirable outputs, inputs and undesirable outputs, respectively. However, traditional DEA models omit uncertainties in the data that are likely to result in biased conclusions. This study pioneers the assessment of the eco-efficiency of WWTPs while accounting for the data uncertainty and integrating the greenhouse gas emissions as an undesirable output. The DEA-tolerance model was applied to compute the eco-efficiency scores for 729 scenarios for each facility tested for identifying the best- and worst-case scenarios. The WWTPs were also ranked based on their eco-efficiency scores. The results demonstrated the importance of integrating data uncertainty in eco-efficiency assessments; the performances of the WWTPs change notably based on the evaluated set of scenarios. The proposed methodological approach provides a reliable and robust framework for supporting decision-making processes.

Assessment of wastewater treatment alternatives for small communities: An analytic network process approach.

The selection of the most appropriate wastewater treatment (WWT) technology is a complex problem since many alternatives are available and many criteria are involved in the decision-making process. To deal with this challenge, the analytic network process (ANP) is applied for the first time to rank a set of seven WWT technology set-ups for secondary treatment in small communities. A major advantage of ANP is that it incorporates interdependent relationships between elements. Results illustrated that extensive technologies, constructed wetlands and pond systems are the most preferred alternatives by WWT experts. The sensitivity analysis performed verified that the ranking of WWT alternatives is very stable since constructed wetlands are almost always placed in the first position. This paper showed that ANP analysis is suitable to deal with complex decision-making problems, such as the selection of the most appropriate WWT system contributing to better understand the multiple interdependences among elements involved in the assessment.

Assessing the sustainability of small wastewater treatment systems: a composite indicator approach.

The assessment of the sustainability of wastewater treatment (WWT) systems has gained interest in recent years. However, most previous studies have focused on environmental and/or economic dimensions ignoring social aspects. Moreover, they tend to be based on sets of indicators rather than providing a holistic assessment. To overcome this limitation, this paper proposes an innovative methodology to assess the sustainability of WWT systems based on the development of a composite indicator embracing economic, environmental and social issues. Subsequently, the global sustainability of seven WWT technologies for secondary treatment in small communities is compared. The joint application of the analytical hierarchical process (AHP) to assign weights to each indicator allows the incorporation of the preferences of experts. Initially, the global sustainability of the WWT technologies evaluated is quite similar. However, a scenario analysis illustrates that constructed wetlands technology is the most sustainable in five out of the seven scenarios evaluated. Moreover, extended aeration and rotating biological contactors are identified as the technologies with the lowest variability in their sustainability. Hence, in an uncertain context, they might be considered the preferred options. The proposed approach contributes to ease of interpretation of a complex problem such as the selection of the most sustainable WWT alternative.

Scedosporium apiospermum keratitis.

A case of Scedosporium apiospermum keratitis is reported in a 65-year-old farmer referred for treatment of an extensive corneal ulcer in the left eye. Direct examination of scrapes revealed abundant filamentous septate hyphae; all cultures were consistently positive for the same fungus, identified later as Scedosporium apiospermum. The patient successfully responded to treatment with amphotericin B.