Browsing by Author "Zhao, Y."

Now showing 1 - 3 of 3

Solid Waste Source Separation Behavior and it’s Association with Demographic, Socio-Economic, and Local Authority (Involvement Factors at the Household Level in Sri Lanka)
(Department of Social Statistics, Faculty of Social Sciences, University of Kelaniya Sri Lanka, 2022) Diunugala, H. P.; Gamlath, G. R. M.; Zhao, Y.
Effective solid waste source separation behavior at the household level plays a pivotal role in modern societal scenarios. Understanding situational and socio-psychological factors, including knowledge, inconvenience, experience, awareness, attitudes, subjective norms, and perceived behavioral control, is critical in improving practical waste separation practices. This study investigated the relationships between demographic, socio-economic and situational and socio-psychological factors on solid waste source separation behavior among households in Sri Lanka. The study was conducted within the positivist paradigm using the deductive method approach. The data were collected by distributing the structured questionnaire to 428 households selected under the cluster sampling strategy in the Western Province. The study revealed significant connections between situational and sociopsychological factors, such as knowledge, convenience, experience, attitudes, subjective norms, and perceived behavioral control on households’ solid waste source separation behaviors. The study also identified significant associations between situational and socio-psychological factors and demographic and socio-economic factors. The findings implied that space for an integrative effort for households’ solid waste source separation behaviors and its association with demographic, socioeconomic, and local authority engagement is a pre-requisite arrangement for implementing on-bound solid waste management techniques in the country’s development regime. This suggests the need for effective solid waste source separation behavior among households for improving sustainable development policies and strategies, particularly in developing countries like Sri Lanka, which can be achieved through collaborative and participatory approaches. The study provides valuable insights for policymakers, government agencies, and other stakeholders to improve solid waste management practices and promote sustainable development targets.
Solid Waste Source Separation Behavior and it’s Association with Demographic, Socio-Economic, and Local Authority Involvement Factors at the Household Level in Sri Lanka
(Department of Social Statistics, Faculty of Social Sciences, University of Kelaniya Sri Lanka, 2022) Zhao, Y.; Diunugala, H. P.; Gamlath, G. R. M.
Effective solid waste source separation behavior at the household level plays a pivotal role in modern societal scenarios. Understanding situational and socio-psychological factors, including knowledge, inconvenience, experience, awareness, attitudes, subjective norms, and perceived behavioral control, is critical in improving practical waste separation practices. This study investigated the relationships between demographic, socio-economic and situational and socio-psychological factors on solid waste source separation behavior among households in Sri Lanka. The study was conducted within the positivist paradigm using the deductive method approach. The data were collected by distributing the structured questionnaire to 428 households selected under the cluster sampling strategy in the Western Province. The study revealed significant connections between situational and sociopsychological factors, such as knowledge, convenience, experience, attitudes, subjective norms, and perceived behavioral control on households’ solid waste source separation behaviors. The study also identified significant associations between situational and socio-psychological factors and demographic and socio-economic factors. The findings implied that space for an integrative effort for households’ solid waste source separation behaviors and its association with demographic, socioeconomic, and local authority engagement is a pre-requisite arrangement for implementing on-bound solid waste management techniques in the country’s development regime. This suggests the need for effective solid waste source separation behavior among households for improving sustainable development policies and strategies, particularly in developing countries like Sri Lanka, which can be achieved through collaborative and participatory approaches. The study provides valuable insights for policymakers, government agencies, and other stakeholders to improve solid waste management practices and promote sustainable development targets.
The third intensive care bundle with blood pressure reduction in acute cerebral haemorrhage trial (INTERACT3): an international, stepped wedge cluster randomised controlled trial
(Elsevier, 2023) Ma, L.; Hu, X.; Song, L.; Chen, X.; Ouyang, M.; Billot, L.; Li, Q.; Malavera, A.; Li, X.; Muñoz-Venturelli, P.; de Silva, A.; Thang, N.H.; Wahab, K.W.; Pandian, J.D.; Wasay, M.; Pontes-Neto, O.M.; Abanto, C.; Arauz, A.; Shi, H.; Tang, G.; Zhu, S.; She, X.; Liu, L.; Sakamoto, Y.; You, S.; Han, Q.; Crutzen, B.; Cheung, E.; Li, Y.; Wang, X.; Chen, C.; Liu, F.; Zhao, Y.; Li, H.; Liu, Y.; Jiang, Y.; Chen, L.; Wu, B.; Liu, M.; Xu, J.; You, C.; Anderson, C.S.; INTERACT3 Investigators
BACKGROUND: Early control of elevated blood pressure is the most promising treatment for acute intracerebral haemorrhage. We aimed to establish whether implementing a goal-directed care bundle incorporating protocols for early intensive blood pressure lowering and management algorithms for hyperglycaemia, pyrexia, and abnormal anticoagulation, implemented in a hospital setting, could improve outcomes for patients with acute spontaneous intracerebral haemorrhage. METHODS: We performed a pragmatic, international, multicentre, blinded endpoint, stepped wedge cluster randomised controlled trial at hospitals in nine low-income and middle-income countries (Brazil, China, India, Mexico, Nigeria, Pakistan, Peru, Sri Lanka, and Viet Nam) and one high-income country (Chile). Hospitals were eligible if they had no or inconsistent relevant, disease-specific protocols, and were willing to implement the care bundle to consecutive patients (aged ≥18 years) with imaging-confirmed spontaneous intracerebral haemorrhage presenting within 6 h of the onset of symptoms, had a local champion, and could provide the required study data. Hospitals were centrally randomly allocated using permuted blocks to three sequences of implementation, stratified by country and the projected number of patients to be recruited over the 12 months of the study period. These sequences had four periods that dictated the order in which the hospitals were to switch from the control usual care procedure to the intervention implementation of the care bundle procedure to different clusters of patients in a stepped manner. To avoid contamination, details of the intervention, sequence, and allocation periods were concealed from sites until they had completed the usual care control periods. The care bundle protocol included the early intensive lowering of systolic blood pressure (target <140 mm Hg), strict glucose control (target 6·1-7·8 mmol/L in those without diabetes and 7·8-10·0 mmol/L in those with diabetes), antipyrexia treatment (target body temperature ≤37·5°C), and rapid reversal of warfarin-related anticoagulation (target international normalised ratio <1·5) within 1 h of treatment, in patients where these variables were abnormal. Analyses were performed according to a modified intention-to-treat population with available outcome data (ie, excluding sites that withdrew during the study). The primary outcome was functional recovery, measured with the modified Rankin scale (mRS; range 0 [no symptoms] to 6 [death]) at 6 months by masked research staff, analysed using proportional ordinal logistic regression to assess the distribution in scores on the mRS, with adjustments for cluster (hospital site), group assignment of cluster per period, and time (6-month periods from Dec 12, 2017). This trial is registered at Clinicaltrials.gov (NCT03209258) and the Chinese Clinical Trial Registry (ChiCTR-IOC-17011787) and is completed. FINDINGS: Between May 27, 2017, and July 8, 2021, 206 hospitals were assessed for eligibility, of which 144 hospitals in ten countries agreed to join and were randomly assigned in the trial, but 22 hospitals withdrew before starting to enrol patients and another hospital was withdrawn and their data on enrolled patients was deleted because regulatory approval was not obtained. Between Dec 12, 2017, and Dec 31, 2021, 10 857 patients were screened but 3821 were excluded. Overall, the modified intention-to-treat population included 7036 patients enrolled at 121 hospitals, with 3221 assigned to the care bundle group and 3815 to the usual care group, with primary outcome data available in 2892 patients in the care bundle group and 3363 patients in the usual care group. The likelihood of a poor functional outcome was lower in the care bundle group (common odds ratio 0·86; 95% CI 0·76-0·97; p=0·015). The favourable shift in mRS scores in the care bundle group was generally consistent across a range of sensitivity analyses that included additional adjustments for country and patient variables (0·84; 0·73-0·97; p=0·017), and with different approaches to the use of multiple imputations for missing data. Patients in the care bundle group had fewer serious adverse events than those in the usual care group (16·0% vs 20·1%; p=0·0098). INTERPRETATION: Implementation of a care bundle protocol for intensive blood pressure lowering and other management algorithms for physiological control within several hours of the onset of symptoms resulted in improved functional outcome for patients with acute intracerebral haemorrhage. Hospitals should incorporate this approach into clinical practice as part of active management for this serious condition. FUNDING: Joint Global Health Trials scheme from the Department of Health and Social Care, the Foreign, Commonwealth & Development Office, and the Medical Research Council and Wellcome Trust; West China Hospital; the National Health and Medical Research Council of Australia; Sichuan Credit Pharmaceutic and Takeda China.