Life cycle assessment of municipal biowaste management - a Czech case study.

As part of coming targets to transition to a sustainable society and actively set a circular economy, one of the EU objectives is to decrease the amount of municipal solid waste and initiate the separation of its organic fraction, i.e., biowaste. Consequently, the question of how to best manage biowaste at the municipal level is of high importance, and previous research has shown the strong influence of local factors on the most sustainable treatment option. Life Cycle Assessment is a valuable tool for comparison of waste management impacts and was used to assess environmental impacts of the current biowaste management in Prague and give insight for improvements. Different scenarios were created regarding EU and Czech biowaste targets for separated collection. Results show the significant influence of the source of energy that is substituted. Consequently, in the current situation of an energy mix highly based on fossil fuels, incineration is the most sustainable option in most impact categories. However, community composting was found to have a better potential to reduce ecotoxicity and resource use of minerals and metals. Furthermore, it could supply a significant proportion of the minerals need of the region while increasing the autonomy of the Czech Republic regarding mineral fertilisers. To meet targets of EU directives for separated collection of biowaste, a combination of anaerobic digestion, to avoid use of fossil fuels, and composting, to increase circular economy, is most likely the best option. The outputs of this project would be of great significance for municipalities.

Impact of a Serious Videogame Designed for Flexible Insulin Therapy on the Knowledge and Behaviors of Children with Type 1 Diabetes: The LUDIDIAB Pilot Study.

BACKGROUND: Flexible (or functional) insulin therapy method is a self-management education approach for intensive insulin therapy in patients with type 1 diabetes. The serious game (or applied game) "L'Affaire Birman" ("Mr. Birman's File") (available at www.gluciweb.com ) was specifically designed as an educational tool for the flexible insulin therapy method. Its educational impact was evaluated in children with type 1 diabetes. MATERIALS AND METHODS: This prospective multicenter pilot study evaluated the effect of this videogame on the therapeutic knowledge and behavior of children with type 1 diabetes. PedCarbQuiz (PCQ) and Diabetes Self-Management Profile (DSMP) questionnaires were used before (T0), immediately after (T1), and 6 months after (T2) the unstructured use of the videogame. RESULTS: The 38 children enrolled in the study were 42% boys and 58% girls; they had a mean age of 13.7 ± 2.1 years old, a diabetes duration of 6.0 ± 3.8 years, and hemoglobin A1c (HbA1c) levels of 8.5 ± 1.4% (69.4 ± 9.4 mmol/mol). The children connected to the game 3.3 ± 2.8 times during this 6-month study. Their PCQ score increased from 31.6 ± 4.9 at T0 to 36.0 ± 4.0 at T2 (P < 0.05). Two PCQ subscores also increased significantly: the insulin titration score at T1 and T2 and the carbohydrate quantification score at T2. Conversely, the DSMP score was not different at T0, T1, and T2 (59.1 ± 9.9, 60.2 ± 9.8, and 60.0 ± 10.0, respectively), and HbA1c levels also remained stable throughout the study (8.4 ± 1.3%, 8.4 ± 1.2%, and 8.5 ± 1.5% at T0, T1, and T2, respectively). Subgroup analysis found a greater impact of the game in children with poor glycemic control and low knowledge at baseline. Adherence to the game was rather low (half of the children played less than 2.5 bouts), but no criterion was found to be predictive of this low attractiveness. CONCLUSIONS: Nonsupervised usage of the serious game "L'Affaire Birman" was able to improve insulin titration and carbohydrate quantification in children with type 1 diabetes.