Exploring behavioral determinants of handwashing with soap after defecation in an urban setting in Bangladesh: findings from a barrier analysis

Social and behavior change (SBC) has long been recognized as a necessary step in the promotion of handwashing with soap (HHWS), and identifying the barriers and enablers of this behavior are key to increasing its adoption. Based on the health belief model (HBM), the theory of reasoned action (TRA) and other behavioral models, this barrier analysis study was conducted to identify the barriers and enablers of HWWS after defecation in an urban setting in Bangladesh. We conducted interviews with 45 adults who washed their hands with soap after defecation (doers) and compared them to 45 adults who did not (non-doers). The analysis showed that the main barriers of HWWS after defecation were related to perceived self-efficacy, difficulty to remember to buy soap, access to low-cost soap, low perceived severity of diarrhea, and not believing that HWWS would reduce diarrhea. Believing that it is Allah's will when one gets diarrhea was mentioned more frequently by the non-doers, while feeling clean and keeping free from illness were reported as benefits of HWWS significantly by the doers. The results suggest that an SBC strategy that addresses these key barriers and enablers would be more effective in promoting the adoption of HWWS.

The Transposition of Energy Communities into Swedish Regulations: Overview and Critique of Emerging Regulations

One organizational innovation introduced by the clean energy for all Europeans package (CEP) is that of the energy community (EC), including the renewable energy community (REC) and citizen energy community (CEC). The translation of related directives into national legislation is underway in Sweden, and the Swedish Energy Market Inspectorate (Ei) has proposed a new law on ECs, which has been sent for consultation. This article analyzes the Ei proposal and the responses from the 27 referral bodies commenting on the new EC regulations. Positive aspects of the proposal were that it would be a law on ECs and that it would be easy to start and run an EC. Critics were concerned that the law was too vague, the relationship between existing cooperatives and the new ECs was not clear, both CEC and REC are used instead of only using one term, there is a lack of suggestions on supportive measures for ECs, ECs will have less favorable conditions than other micro-producers of electricity, there is a lack of barrier analysis and visions of a future of ECs, and finally, that the situation for marginalized households was not dealt with in the proposal.

11-year workload and barrier analysis for a high-energy linear accelerator

The formalism used for barriers calculations is based on a conservative estimation of workload, use factor, and occupancy factor. IMRT techniques (Intensity Modulated Radiation Therapy) and VMAT (Volumetric Modulated Arc Therapy) are known for being superior to conventional techniques, but costly from the shielding standpoint, as they increase the number of monitor units used to deliver the same dose to the patient, increasing the leakage radiation produced and, consequently, the thickness of the secondary barriers. At InRad (Radiology Institute of HC-FMUSP) a 2100CD LINAC already installed was upgraded to perform IMRT/VMAT techniques, and the existing barrier was reassessed. The present study proposes a methodology for acquiring real workload data from the institution's management software (MOSAIQ®) to replace the initially estimated data and recalculate the thickness of the barriers, assessing the impact of the introduction of these techniques and understanding the profile of the treatments carried out at the institution over the years of 2010 to 2020. Through this methodology, a decrease in the workload of 15 MV was observed as the technique of modulated intensity with 6 MV was introduced, reducing the thicknesses calculated for primary barriers. However, no significant changes were observed in the thicknesses calculated for the secondary barriers, because despite the increase in the leakage workload of 6 MV, the total workload of 15 MV decreased. There was also a trend towards an increase in the number of patients treated with modulated intensity year after year, which went from 5% in 2016 to 67% in 2020.

Towards Safety Barrier Analysis of Hydrogen Powered Maritime Vessels

This paper focuses on the use of safety barrier analysis, during the design phase of a vessel powered by cryogenic hydrogen, to identify possible weaknesses in the architecture. Barrier analysis can be used to evaluate a series of scenarios that have been identified in the industry as critical. The performance evaluation of such barriers in a specific scenario can lead to either the approval of the design, if a safety threshold is met, or the inclusion of additional barriers to mitigate risk even further. By conducting a structured analysis, it is possible to identify key barriers that need to be included in the system, intended both as physical barriers (sensors, cold box) and as administrative barriers (checklist, operator training). The method chosen for this study is the Barrier and Operational Risk Analysis (BORA) method. This method, developed for the analysis of hydrocarbon releases, is described in the paper and adapted for the analysis of cryogenic hydrogen releases. A case study is presented using the BORA method, developing the qualitative barrier analysis. The qualitative section of the method can be easily adapted to vessels of different class and size adopting the same storage solution. The barrier analysis provides a general framework to analyze the system and check that the safety requirements defined by the ship operator and maritime certification societies are met.

Identifying behavioral determinants of handwashing with soap after defecation in an urban setting in Bangladesh: Findings from a Barrier Analysis

Social and Behavioral Change (SBC) has long been considered as core component of hand washing with soap (HWWS) intervention, but identifying barriers and enablers of HWWS from a behavioral perspective is limited. By examining twelve potential behavioral determinants this Barrier Analysis study was conducted to identify the barriers and enablers of HWWS after defecation in urban setting in Bangladesh. We conducted 45 interviews with those who washed their hands with soap after defecation (“Doers”) and another 45 interviews with those who did not (“Non-doers”). Data analysis was performed to identify which beliefs were most highly-associated with hand washing with soap. The analysis showed that two of the main barriers of HWWS after defecation were related to perceived self-efficacy and access, especially availability of soap. Non-doers claimed that access to soap was difficult due to lack of money and unavailability at nearby shops. Other important determinants such as difficulty remembering to buy soap (cues for action)), believing that most people did not approve of HWWS (e.g. perceived social norms), low perceived severity of diarrhea, and not believing that HWWS would work to reduce diarrhea (perceived action efficacy) were significantly correlated with adoption of the behavior. Perceived divine will (believing that it is God’s will when one gets diarrhea) was also a factor among the Non-doers. Other benefits such as feeling clean and keeping free from illness were reported more often by Doers, while Non-doers were more likely to report increased costs as a barrier to HWWS. The results suggest that an integrated behavior change strategy promoting specific beliefs about HWWS using culturally-inclusive messaging and activities to address the different barriers and leverage the different enablers may lead to better adoption of HWWS.