Real Reason Research Articles

An Evaluation of Drug-Drug Interaction Alerts Produced by Clinical Decision Support Systems in a Tertiary Hospital.

Introduction Drug-drug interactions (DDIs) have the potential to harm patients. Hence, DDI alerts are meant to prevent harm; as a result, their usefulness is reduced when most alerts displayed to providers are ignored. This study aims to explore the rates and reasons for overriding alerts of DDI. Methods This is a retrospective study of DDI alert overrides that occurred between January 2020 and December 2020 within the inpatient medical records at a tertiary hospital, Medina City, Kingdom of Saudi Arabia. Results A total of 7,098 DDI alerts were generated from inpatient settings, of which 6,551(92.2%) were overridden by the physicians at the point of prescribing. "Will Monitor as Recommended" (33%) was the most common reason for the override, followed by 'Will Adjust the Dose as Recommended (27.1%)," "The Patient Has Already Tolerated the Combination" (25.7%), and "No Overridden Reason Selected" (13.0%). Discussion The DDI alert overriding is still high and is comparable to other studies. However, this study reveals that physicians are ready to deal with the consequences of around 58% of DDI alerts. Additionally, 13% of physicians were not willing to report the reason for overriding. This indicates an urgent need to review and restructure the DDI alert system. Conclusion The DDI alert override rates are high, and this is undesirable. It is recommended to revise the DDI alert system. Future studies should dig deep for real reasons for overriding and seek inputs from all stakeholders, including developing actionable metrics to track and monitor DDI alerting system.

Legal Effectiveness and Legal Functions in Indonesia

Purpose: This study aims to describe the Effectiveness of Law and Legal Functions in Indonesia. Law serves as justice, certainty and expediency. In the practice of law administration in Indonesia, there are times when there is a conflict between legal certainty and justice. This research will examine the effectiveness of law and legal functions in Indonesia, based on the object of research to be studied, and then this research will be based on positive law.Methodology:This research uses a descriptive qualitative approach with library research methods. Legal certainty is concrete and tangible, while justice is abstract. Therefore, in solving a legal problem, the values of justice must be prioritized.Findings: The results of this study show that the effectiveness of law enforcement in Indonesia is influenced by several factors, namely the legal factors themselves, law enforcement factors, factors of facilities or facilities that support law enforcement, and community factors.Implication:The influence of law and the concept of purpose: It can be said that the concept of influence means the attitude of action or behavior associated with the rule of law in reality, a positive effect or effectiveness that depends on the purpose or purpose of the rule of law. A legal purpose is only sometimes identically stated in a rule and is not necessarily the real reason for the rule-maker.

A Study on an Easy-Plane FeSi3.5 Composite with High Permeability and Ultra-Low Loss at the MHz Frequency Band.

An easy-plane FeSi3.5 composite with excellent magnetic properties and loss properties at MHz were proposed. The easy-plane FeSi3.5 composite has ultra-low loss at 10 MHz and 4 mT, about 372.88 kW/m3. In order to explore the reason that the Pcv of easy-plane FeSi3.5 composite is ultra-low, a none easy-plane FeSi3.5 composite, without easy-plane processing as a control group, measured the microstructure, and the magnetic and loss properties. We first found that the real reason why magnetic materials do not work properly at MHz due to overheat is dramatical increase of the excess loss and the easy-plane composite can greatly re-duce the excess loss by loss measurement and separation. The total loss of none easy-plane FeSi3.5 composite is much higher than that of easy-plane FeSi3.5 composite, where the excess loss is a major part in the total loss and even over 80% in the none easy-plane FeSi3.5 composite. The easy-plane FeSi3.5 composite can greatly reduce the total loss compared to the none easy-plane FeSi3.5 composite, from 2785.8 kW/m3 to 500.42 kW/m3 (3 MHz, 8 mT), with the main reduction being the excess loss, from 2435.2 kW/m3 to 204.93 kW/m3 (3 MHz, 8 mT), reduced by 91.58%. Furthermore, the easy-plane FeSi3.5 composite also has excellent magnetic properties, high permeability and ferromagnetic resonance frequencies. This makes the easy-plane FeSi3.5 composite become an excellent soft magnetic composite and it is possible for magnetic devices to operate properly at higher frequencies, especially at the MHz band and above.

IL GRUPPO EQUESTRE DI OLDRADO DA TRESSENO NEL BROLETTO DI MILANO

equestrian statue depicting Oldrado da Tresseno (1233), ostentatiously placed in a niche in the centre of the southern façade of the 13th-century Palazzo della Ragione in the Broletto in Milan, represents one of the first large equestrian monuments of the mediaeval age and an early inspiration to those of Antiquity. Described and commented on, as early as the 14th century (Galvano Fiamma), as a self-celebratory portrait by a podestà, the relief, as widely acknowledged by critics, especially in the 20th century, undoubtedly presents stylistic features ascribable to the Antelami workshop and indeed at times attributed directly to Benedetto Antelami. This study proposes, also following other interventions by the author, the attribution to a sculptor who worked with Antelami in Parma, and who executed some works at the Cathedral of Reggio Emilia, the Cathedral of Fidenza and the Church of St. Andrew in Vercelli. Having confirmed the stylistic characteristics of the staute and briefly examined the historical figure of Oldrado, this essay intends to indicate, also in the light of the inscription engraved under the aedicule that hosts it, how the real reasons for the creation of this sculptural monument do not lie in the desire for self-assertion of the person depicted, but in the symbolic representation of the role and functions of the foreign official whose task it is to govern the city annually, and in particular the administration of justice. In this, the monument constitutes the figurative counterpart of the theoretical reflection that constituted the subject matter of a wide range of treatises produced around the first half of the 13th century on the subject of city government. The theory of the transposition of imperial prerogatives into the figure of the podestà, especially in matters of justice, finds its place in this doctrinaire strand. Hence the reference to the monarchical institution that must find expression in the conduct of the actions and lifestyle of the podestà and even in the municipal palace, likened to a palace, in the same terms used in the inscription under the statue of Oldrado to describe the Town Hall. The doctrinal literature, as well as part of the inscription itself, also refer to legal terms derived from Roman sources of law. All this clarifies the significance of the presence in the aedicule of the large painted eagle above the equestrian statue, symbolising superior imperial power. This element too, in addition to those mentioned, thus contributes to the recognition of the references to equestrian statuary of Antiquity (the Marcus Aurelius in Rome and the 'Regisole' in Pavia) from which Oldrado’s monument is partly inspired. Finally, the analysis was extended to the numerous traces of polychromy that have been brought to light by the recent restorations to the entire complex, and which make it possible to reconstruct the probable original layout of the sculpted relief, in which the sumptuous robes of the podestà, not of a military nature, reinforce the reference to royalty. Finally, close examination of the sculpture has allowed us to confirm that the podestà originally held an object in his right hand, probably a sword, as a symbol of Justice.

REVIEW OF FINANCIAL CRIMES BY IMPOSTERS AS ARMED FORCES

Online financial crimes are on the rise in the recent past in India. The Reserve Bank of India is taking lot of initiatives in this regard on a continuous basis. Despite the continuous measures and awareness by the topmost banking regulator, the perpetrators are doing their fraudulent activities continuously. The perpetrators use lots of tricks and techniques to win the trust of the public so as to defraud them. The ignorant and innocent public also fall prey to their cunning tricks and get victimised by losing money. Lesser amount of fraud may not seem to be a big threat at the first sight. But if we calculate the aggregate of all the money lost in our country in a particular period, surely it will be an alarm for the policy makers. Also, the duped money may lead to terror funding. The fraudsters become more innovative than the techies. There were considerable number of frauds recorded in the last 2 years in India in which the fraudsters pose themselves as armed forces to win the trust of the public and defraud them. The trust and the sentiments of the public towards the security personnels of the country is misused by the perpetrators for defrauding. This article collects a bunch of real time cases published in various leading newspapers as a sample and analyses the real cause and reason for the online financial crimes by imposters as armed forces and provide suggestions to prevent the same. This article may be the first of its kind to analyse how the people are getting trapped by using the name of armed forces.

Forerunner of Sh. Marjani's work «Nazurat al-Haqq» («Review of the truth»)

The article provides a brief description of an unpublished handwritten work by Mukhammad-Amin al-Bulgari, devoted to the issue of the obligation to perform a night prayer on short summer nights, when the evening dawn does not disappear until the dawn. The work is a dispute in absentia between the author and an opponent representing the camp of those who believed that the obligatory nature of night prayer on the mentioned days of the year subsides due to the absence of a reason for its obligatory nature, which is the disappearance of twilight. The author refutes the condition put forward by the opponent by the fact that the real reason for the obligation to perform a prayer is that a person receives benefits from Almighty Allah, while physical signs serve as nothing more than a guideline for its performance. Coordinating the hadith about the imamship of Jibril (Gabriel), which explains the times of five prayers, and the hadith of Dajjal (The Antichrist), which refers to the need to determine the conditional time of prayer during the day, which will last a year, the author concludes that the first does not imply a physical sign (disappearance of dawn), but the corresponding period of time.

The real reason why ATP hydrolysis is spontaneous at pH > 7: It's (mostly) the proton concentration!

Common wisdom holds that ATP hydrolysis is spontaneous because of the weakness of its phosphoanhydride bonds, electrostatic repulsion within the polyanionic ATP4- molecule, and resonance stabilization of the inorganic phosphate and ADP products. By examining the pH-dependence of the hydrolysis Gibbs free energy, we show that in fact, above pH 7, ATP hydrolysis is spontaneous due mainly to the low concentration of the H+ that is released as product. Hence, ATP is essentially just an electrophilic target whose attack by H2 O causes the acidity of the water nucleophile to increase dramatically; the spontaneity of the resulting acid ionization supplies much of the released Gibbs free energy. We also find that fermentation lowers pH not due to its organic acid products (e.g., lactic, acetic, formic, or succinic acids), but again, due to the H+ product of ATP hydrolysis.

Machine Learning Based Result Analysis Prediction of Student’s Academic Performance

Abstract: Failure at any phase of education happens frequently. The rise in drop - out rates is a result of numerous reasons. Poor grades are one of the biggest causes of school abandonment. This has an influence on performance because so many students find it difficult to adjust to the institution's learning environment once they get there. Other factors include student participation in extracurricular tasks and politics. Learners' performances frequently tend to be unsatisfactory for these different predictable and unpredictable reasons, which have an impact on development. As a result, it's important to examine undergraduate results to identify the real reasons for students' varied level of performance. The primary goal of our research work is to identify the numerous variables that affect achievement at the under-graduation level. Therefore, the main motivation behind this effort is to help students identify the factors that lead to their performance so that they can take action to change their results. The learners, course teachers, and others will have the opportunity to improve the environment once the major elements have been recognized and assessed. This paper highlights the importance of using student data to drive improvement in education planning. It then presents techniques of how to obtain knowledge from databases such as large arrays of student data from academic Institution databases. To early predict the student’s academic performance, we have proposed deep learning model of Recurrent Neural (RNN) classifier. This proposed methodology is compared with various traditional machines learning classification models and deep learning classifier.

INTRAABDOMINAL PRESSURE CHANGE UNDER ABDOMINAL SURGERY

Abstract. Statement of the problem. Intraabdominal hypertension (IAH) recognized as important consequence of surgery intraabdominal or on abdominal wall.
 For a pity there are no signs to predict the possibility of such a dangerous complication.
 Aim of study: to find out changes of intraabdominal pressure (IAP) corresponding to different kind of abdominal surgeries.
 Material and methods. IAP had been measured in 15 patients before, immediately after, and 1, and 3-4 days since open surgery. Also, IAP had been measured in 5 patients before and after laparoscopic surgeries.
 IAP was measured by urinal bladder way.
 Results and discussion. Before surgery IAP was find at level 10 cm Н2О or higher in 3 patients, but not higher than 15 cm in none of them.
 There was not estimated direct connection between IAP and diagnosis. Of 2 patients with large incisional hernia and abdominal wall defect 243 cm2 and 832 cm2 in size IAP before surgery was stated as 3 and 14 cm Н2О, respectively, while in the latter there were no any little of compression.
 There was no firm interconnection between anesthesia mode and IAP
 Immediately after surgery IAP became equal to 10 cm Н2О or higher in 13 patients, of them in 4 it was 20 cm Н2О or higher. On the next day after surgery IAP leveled to 10 cm Н2О or higher in 7 patients, of them in 3 it was 20 cm Н2О or higher. One of the latter died, all other patients survived.
 In all patients operated in laparoscopic way IAP measured through intrabladder catheter was 7-11 cm Н2О lower than those on insufflator manometer.
 Conclusions. IAP assay via urinary bladder pressure estimating is not the IAP measurement but indicator of urinary bladder tone.
 As high IAP in many cases correspond to patient’s grave condition and even death it is of importance to study the real reason of this indicator.

Sex-dependent differences in behavioral and immunological responses to antibiotic and bacteriophage administration in mice.

The problem of antibiotic resistance is a global one, involving many industries and entailing huge financial outlays. Therefore, the search for alternative methods to combat drug-resistant bacteria has a priority status. Great potential is seen in bacteriophages which have the natural ability to kill bacterial cells. Bacteriophages also have several advantages over antibiotics. Firstly, they are considered ecologically safe (harmless to humans, plants and animals). Secondly, bacteriophages preparations are readily producible and easy to apply. However, before bacteriophages can be authorized for medical and veterinary use, they must be accurately characterized in vitro and in vivo to determinate safety. Therefore, the aim of this study was to verify for the first time the behavioral and immunological responses of both male and female mice (C57BL/6J) to bacteriophage cocktail, composed of two bacteriophages, and to two commonly used antibiotics, enrofloxacin and tetracycline. Animal behavior, the percentage of lymphocyte populations and subpopulations, cytokine concentrations, blood hematological parameters, gastrointestinal microbiome analysis and the size of internal organs, were evaluated. Unexpectedly, we observed a sex-dependent, negative effect of antibiotic therapy, which not only involved the functioning of the immune system, but could also significantly impaired the activity of the central nervous system, as manifested by disruption of the behavioral pattern, especially exacerbated in females. In contrast to antibiotics, complex behavioral and immunological analyses confirmed the lack of adverse effects during the bacteriophage cocktail administration. The mechanism of the differences between males and females in appearance of adverse effects, related to the behavioral and immune functions, in the response to antibiotic treatment remains to be elucidated. One might imagine that differences in hormones and/or different permeability of the blood-brain barrier can be important factors, however, extensive studies are required to find the real reason(s).

How do new energy vehicle companies deal with ambiguous product harm crises? Scenario simulation based on three communication strategies

AbstractIn the face of some product harm crises of new energy vehicles, which are difficult to find out the real reasons, it is highly significant for new energy vehicle companies to choose appropriate communication strategies. This study examines the impact of three communication tactics on consumer trust and purchase willingness using two rounds of scenario simulation experiments based on stimulus–organism–response theory. The results show that, when compared with deny and rebuild method, the diminish strategy is the most effective in reducing the influence of ambiguous product harm crises on consumer behaviours. Simultaneously, brand reputation has a moderating effect. For new energy vehicle companies with high brand reputation, the communication effect of diminish strategy is the best. Only a higher‐cost rebuild strategy can be viable for automotive businesses with a poor brand reputation. Thus, when dealing with ambiguous product harm crises, new energy vehicle companies should focus on efficient and low‐cost diminish strategy. Meanwhile, to take the initiative in dealing with an ambiguous product harm crisis, we must improve the technical maturity of products as well as improve the after‐sales service system to continuously enhance the brand reputation.

Analysis of Short Film from the Perspective of Filmmakers and Audiences

With the rapid expansion of the Internet and media in the present era, an increasing number of individuals like to relax by viewing a movie in their leisure time. People prefer to watch short videos rather than long movies, thanks to the rapid increase of short videos and self-media. This study investigates the motivators that drive short filmmakers to create each short film, as well as the real reasons why directors choose to make short films. Exploring the stories behind short films is critical for the future of short films. As they move forward, filmmakers should discover the core of existence from the past, rather than filming for the sake of shooting. In addition to exploring filmmakers, this paper conducts some audience research while viewing short films in order to explore the impact of audience behavior on the development of the entire short film business.

Functioning of Visual Narratives of Russian Propaganda in the Conditions of Armed War Against Ukraine

The purpose of the article is to study the functioning of visual narratives of Russian propaganda in the conditions of Russia’s armed war against Ukraine and consider the phenomenon in the context of postmodern theories. The research methodology is based on the application of the postmodern method of deconstruction, systematically applied to the visual texts of Russian propaganda in order to reveal hidden meanings. The novelty of the research consists in revealing the peculiarities of the functioning of the visual narratives of Russian propaganda, which, in fact, made it possible to simulate the reasons for the large-scale armed invasion of the Russian Federation in Ukraine, as well as to create masking of the real reasons for the war, which are related to the crisis phenomena of power institutions with imperial determinants that are not appropriate for modern times. Among such mechanisms the repetition of the visual narrative in various modifications and contexts was found; hiding a detail or masking it; manipulation of images (mother and homeland, motives of the collapse and resurrection of the empire-Russia-USSR, etc.). One of the non-obvious techniques was the discovery of this type of visual constructions which enter the viewer’s field of vision unnoticed and begin to work automatically at the right moment, disguising themselves as structures of axiomatic knowledge. We called this technique “inversion of automatic writing”. Conclusions. As a result of the research, we come to the conclusion that the effectiveness of Russian propaganda is ensured not so much by the quality of visual information, but by its quantity and intrusiveness, commensurate with the displacement of any other informational “noise”, as well as by the aggressiveness, emotional colour and appeallessness of the presentation. However, technological means are present. Systematic repetition of the same figurative messages in different combinations and contexts allows to bind together ideologically different topics, ranging from political and geopolitical to elementary everyday issues (store windows, American jeans, American dollars, etc.). The article also traces the stages of formation of the “enemy” image by means of propaganda, namely through the use of techniques of dehumanization and desubjectivization of the image of Ukrainians, and further – militarization and glorification of war as the sacred mission of imperial Russia. Examining the phenomenon in the context of postmodern theories testifies to a deep crisis of the power institutions of the Russian Federation, which, in the language of postmodernism, reflects the stage of a simulacrum self-reproduction. The latter makes it possible to make encouraging predictions, since the specified stage is called by postmodern theorists the last in the functioning of the system, which precedes its inevitable disintegration.

Integritas Guru Pak Dalam Membentuk Karakter Rohani Peserta Didik

In writing this article the author discusses the integrity of PAK teachers in shaping the spiritual character of students. In this case the author will briefly explain the problems that occur for PAK students and teachers. There are still PAK teachers who have not been able to emulate Jesus' attitude, so they are unable to be role models for students. The integrity of an PAK teacher should be, namely directing the behavior of students so that they are successful in following lessons in a definite knowledge environment. In writing this article the author also provides implications for PAK teachers, namely: 1) maintaining the sanctity of his life as God's partner in educating and directing his students to become students like him; 2) realizing that he is a servant of God, the task of teaching is God's call, which must be taken seriously. Christian religious teachers must prepare lessons as well as possible; 3) Christian religious teachers must be role models and have integrity for students and be friendly to students in the context of building student character. Also the author uses a qualitative method of library research methods which is research that is synonymous with text analysis or lectures, where an event occurs either in the form of an activity or writing, which is examined to find out the real facts (to find out the real reasons etc.

Intrinsic factors behind long‐COVID: I. Prevalence of the extracellular vesicles

It can be argued that the severity of COVID-19 has decreased in many countries. This could be a result of the broad coverage of the population by vaccination campaigns, which often reached an almost compulsory status in many places. Furthermore, significant roles were played by the multiple mutations in the body of the virus, which led to the emergence of several new SARS-CoV-2 variants with enhanced infectivity but dramatically reduced pathogenicity. However, the challenges associated with the development of various side effects and their persistence for long periods exceeding 20 months as a result of the SARS-CoV-2 infection, or taking available vaccines against it, are spreading horizontally and vertically in number and repercussions. For example, the World Health Organization announced that there are more than 17 million registered cases of long-COVID (also known as post-COVID syndrome) in the European Union countries alone. Furthermore, by using the PubMed search engine, one can find that more than 10 000 articles have been published focusing exclusively on long-COVID. In light of these enormous and ever-increasing numbers of cases and published articles, most of which are descriptive of the various long-COVID symptoms, the need to know the reasons behind this phenomenon raises several important questions. Is long-COVID caused by the continued presence of the virus or one/several of its components in the recovering individual body for long periods of time, which urges the body to respond in a way that leads to long-COVID development? Or are there some latent and limited reasons related to the recovering patients themselves? Or is it a sum of both? Many observations support a positive answer to the first question, whereas others back the second question but typically without releasing a fundamental reason/signal behind it. Whatever the answer is, it seems that the real reasons behind this widespread phenomenon remain unclear. This report opens a series of articles, in which we will try to shed light on the underlying causes that could be behind the long-COVID phenomenon.

For Land and Liberty: Black Struggles in Rural Brazil

For Land and Liberty: Black Struggles in Rural Brazil

Why Turkish Parents Refuse Childhood Vaccination? A Qualitative Study.

Anti-vaccination is spreading among parents. In 2017, 23000 families in Turkey refused vaccinations for their children. Meanwhile an increase in infectious diseases was observed, which might be caused by vaccination rejection. The reasons why families do not vaccinate their children may be very different, such as side effects, or advocation for "healthy life" by gurus. However, the real reasons for vaccine refusal are unknown. Our aim is to determine the reasons for anti-vaccination in Turkey. In order to reveal the real reasons for not taking the vaccine, we planned to conduct interviews with the representatives of the vaccine rejection group using qualitative research methodology with the "grounded theory" method. We searched some anti-vaccination blogs to find candidates for interviews. Within the scope of our study, parental concerns about vaccinations were classified by analyzing the data obtained from semi-structured questions and interviews recorded with voice recorders in face-to-face interviews with 21 parents in 13 cities of Turkey. The obtained findings were classified under the headings of ''mistrust'', ''vaccine efficacy-importance'', ''decision-making processes - bases'', and ''law-ethics''. Mistrust was the main theme, almost singularly, as the most important reason for vaccine rejection. The salient reasons for mistrusts were: Companies which produce vaccines especially international companies because of conspiratory beliefs; health authorities, because of the belief about non-transparency in epidemiologic data, immunization council etc. and healthcare professionals, because of their non-communicative and non-concerned attitude. Mistrust is hard to overcome. The beliefs of the patients cannot be easily changed. As a result of our study, we made some recommendations for health authorities, healthcare professionals, companies and other related stakeholders.

Times Series Analysis on Inflation in the U.S. under COVID-19 Pandemic

The COVID-19 pandemic has affected the economic environment in the U.S, particularly in inflation, which is experiencing its highest levels in decades. The reasons for this high inflation might be change in supply relations and consumer habits, logistics bottlenecks and policy reasons. The Fed has raised interest rates several times in hopes of a quick return to pre-pandemic inflation rate, but it is still in a high level around 0.08. Given the complex international situation, it is obvious that high domestic inflation and prices will significantly drag down GDP and economic growth. However, if reducing the current situation of high inflation in a short period, it is obviously not only by raising interest rates. The correct path is to find the real causes of inflation and solve these. Unfortunately, the exogenous shocks not only frequently affect the stability of price and inflation but fuzz the real reasons behind inflation, which leading to a difficult process of finding the causes.

Enhanced catalytic stability of non-stoichiometric Cu–Al spinel catalysts for dimethyl ether synthesis from syngas: Effect of coordination structure

Cu–Al spinel catalysts were synthesized by various preparation methods, and its CO hydrogenation performance was evaluated. Characterization results showed that different preparation methods can effectively regulate the coordination distribution of cations in surface spinel structure. The sustained release property of Cu–Al spinel was related to its coordination structure. The catalyst containing a large amount of octahedral spinel Cu2+ ions was capable of delaying the reduction of copper, and small Cu nanoparticles (Cu NPs) were produced and highly dispersed on the defective spinel surface, which may be that the vacancy derived on the surface of defective spinel anchored small Cu NPs, which was the key to improve catalytic stability. We also discussed the real reason for poor catalytic stability, and this was due to that the easily-reducible spinel possessed extensive tetrahedral spinel Cu2+, which accelerated the reduction and release of copper, resulting in that the formed copper was unstable and aggregated readily. The Cu–Al spinel catalyst prepared by the solid phase method included octahedral coordination Cu2+ ratio as high as 59%, and the corresponding average size of Cu particles produced from spinel was measured as about 11.3 nm by N2O titration method, exhibiting enhanced stability and excellent catalytic performance.

Why are decentralised urban water solutions still rare given all the claimed benefits, and how could that be changed?

Numerous innovative decentralised urban water solutions have been described over many years, yet their application in practice is still not common at all. While many proposed solutions may have some techno-economic advantages over current systems, the real reasons for the slow uptake have more to do with system-wide inertia and technology ‘lock-in’ where existing solutions are preferred for simplicity and familiarity. A key factor is also the inadequate assessments in project decision making processes that should consider all relevant social, environmental and economic benefits and values. This paper highlights some key barriers and how to address them in a more holistic way. It also identifies opportunities where more integrated, hybrid solutions could offer significant benefits over current technologies. It calls on all key partners in this sector to foster broad and strong collaborations, and on water service providers to be empowered to take an inclusive leadership role in creating such innovative solutions that help address our growing challenges driven by rapid urbanisation and climate change.