Industrial symbiosis in European policy: overview of recent progress

The aim of the paper is to explain the cooperation and processes realized within the industrial networks based on the principles of industrial symbiosis in Denmark, Russia and Slovakia. The identified examples can be characterized as best practices in the field of industrial symbiosis that influences importantly the development of regions, where they are localized. Industrial symbiosis as a voluntary cooperation of enterprises with the aim to optimize production costs and improve the environment could influence positively the development of areas where the companies are operating. The paper includes three examples of ‘best practices’ from Denmark, Russia and Slovakia. The examples refer the wide range of benefits that this kind of cooperation brings

Spatially adjusted determinants of Malaria and Anaemia Morbidity among children under age 5 years in Ghana, 2014

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand in partial fulfilment of the requirements for the Degree of Masters in Epidemiology in the field Biostatistics and Epidemiology May, 2018.Background: Malaria and anaemia pose significant public health challenges to most developing countries. Sub-Saharan Africa continues to carry a disproportionately high share of the global malaria burden. Recent WHO (2015) global estimates on disease burden shows the African region accounted for 88% of the 214 million new malaria cases in 2015. This statistic further highlighted that the region accounted for 90% of malaria deaths in 2015. Similarly, anaemia, defined as low hemoglobin concentration, is estimated to globally affect 43% of children under five years of age. Anemia prevalence is very high among Ghanaian children under 5 years of age. The objectives of this study were to determine the prevalence and spatial distribution of malaria morbidity in children under age 5 years in Ghana in 2014, to ascertain the prevalence and spatial distribution of childhood anaemia morbidity in Ghanaian children under age 5 years in 2014, to determine the spatial distribution of factors associated with malaria morbidity in Ghana in 2014, and to determine the spatial distribution of factors associated with anaemia morbidity in Ghana in 2014. Objectives: The aim of the study is to determine spatial distribution and factors associated with malaria and anaemia morbidity among Ghanaian children under 5 years of age in 2014. Methods: This study analysed malaria and anaemia morbidity and prevalence using data from the Ghana 2014 Demographic and Health Survey. These data captured malaria related information on children under 5 years. Survey logistic and ordered logistic multivariable regression was done to determine associations between the singular outcomes malaria and anaemia and several explanatory variables. The regression models were employed and results thereof were used to produce maps illustrating the predicted risk of malaria and anaemia occurrence. The generalized linear mixed model was used to simultaneously identify the risk factors of malaria and anaemia of children under five years and how these are spatially distributed. Multilevel survey adjusted logistic and ordinal logistic regression models with non-spatial random effects were fitted for malaria and anaemia respectively. A Bayesian approach was employed to further adjust for spatial random effects on the convolution models for the two main outcomes. Results: The sample in this study was made up of 2727 children under age 5 years, of which 783 tested positive for malaria and 1873 had anaemia, resulting in an observed malaria and anaemia prevalence of 28.71% and 68.68% respectively. Spatially adjusted significant variables were: Child’s age; type of place of residence; mother’s highest education level, wealth index; child’s altitude adjusted haemoglobin level; cluster altitude; severe anaemia vomiting; severe anaemia extreme weakness. Children from the Western, Central, Greater Accra, Eastern, and Brong Ahafo regions were more likely to have malaria compared to northern region. Malaria was 1.46 times more likely to occur among children residing in rural than urban areas [OR=1.46, (95% CI: 1.02-2.16); p=0.05]. Vomiting as well as extreme weakness were 6.37 [OR=6.37 (95% CI: 2.16- 18.75); p<0.001] and 7.63 [OR=7.63 (95% CI: 3.02-19.22); p<0.001] times more likely to have anaemia than those without these symptoms. Children residing at higher altitude were 0.98 times less likely to have anaemia compared to those at lower altitude [OR=0.98 (95% CI: 0.97-0.99); p=0.01]. Conclusion: Recent reports in Ghana indicate that malaria and anaemia related deaths in children under age 5 years are on the ascendancy. In spite of this, there is a dearth of empirical research that establishes our understanding on the prevalence of malaria and anaemia in the endemic regions of Ghana. Understanding the prevalence of malaria and anaemia in terms of spatial risk factors, will provide more insight and practical guidelines to the formulation of policies aimed at fighting the spread of malaria and anaemia. Hence, directing health interventions to higher risk areas and ensuring nationwide coverage are promising strategies for promoting equity and reducing risk of malaria and anaemia. This study showed that Brong Ahafo, Eastern, Northern, Western, Volta and Upper East regions were the hotspot zones with greatest disease burden. Keywords: Ghana, Anaemia morbidity, Malaria morbidity, Malaria Indicator Survey (MIS), Demographic and Health Survey (DHS), spatial mapping, West Africa.LG201

О подходах к измерению издержек бездействия

The article attempts to establish general approaches to statistical measurements of effects from a failure to take necessary environmental actions in the medium and long term (or, to use the author’s terminology, estimating the «costs of inaction»). It is emphasized such an assessment is closely related to the «precautionary principle», which implies the rejection of the use of innovative products and technologies due to lack of confidence in their safety for the health of the population and the environment. The paper addresses main problems associated with the practical application of the «precautionary principle», such as risk assessment and management, effective coordination between science and politics, as well as finding a reasonable balance between innovation and potential social and environmental damage.An analysis of today’s most successful attempts to determine the costs of inaction has made it possible to identify methodological shortcomings of the «ethical» approach, which forces us to treat with some caution the estimated costs of future periods that arise in the case of an «insufficiently ambitious» environmental policy.The example of determining the costs of inaction associated with the extraction of shale hydrocarbons by hydraulic fracturing (fracking), shows the present methodological difficulties in assessing the potential risks of environmental pollution and the direction of their solution. The author concludes that under conditions of a high degree of uncertainty at all stages of assessing the negative impact on the environment, the application of the «precautionary principle» can be based on an analysis of the degree of reversibility of the impact of innovative products and technologies.В статье предпринята попытка обоснования самых общих подходов к статистическим измерениям последствий непринятия должных природоохранных мер в среднеи долгосрочной перспепективе (или, по терминологии автора, оценки «издержек бездействия»). Подчеркивается, что такая оценка тесно связана с «принципом предосторожности», предполагающим отказ от применения инновационных продуктов и технологий в случае отсутствия уверенности в их безопасности для здоровья населения и окружающей природной среды. Рассматриваются основные проблемы, связанные с применением «принципа предосторожности» на практике, такие, как оценка рисков и управление ими, эффективная координация взаимодействия науки и политики, а также поиск разумного баланса между инновационной деятельностью и потенциальным социальным и экологическим ущербом.Анализ наиболее удачных на сегодняшний день попыток определения издержек бездействия позволил выявить методологические недостатки «этического» подхода, которые заставляют относиться с некоторой осторожностью к оценкам величины расходов будущих периодов, возникающим в случае «недостаточно амбициозной» экологической политикиНа примере определения издержек бездействия, ассоциируемых с добычей сланцевых углеводородов методом гидравлического разрыва пласта (фрекинга), показаны существующие методологические трудности оценки потенциальных рисков загрязнения окружающей природной среды и направления их решения. Сделан вывод о том, что в условиях высокой степени неопределенности на всех этапах оценки негативного влияния на окружающую среду применение «принципа предосторожности» может основываться на анализе степени обратимости воздействия инновационных продуктов и технологий

Perspectivas teórico-metodológicas do processo de aquisição e desenvolvimento da língua escrita e suas consequências no aprendizado dos estudantes do ensino fundamental anos finais

Orientadora : Carmen Sá Brito SigwaltMonografia (especialização) - Universidade Federal do Paraná, Setor de Edcuação, Curso de Especialização em Organização do Trabalho PedagógicoInclui referênciasResumo :Resumo : Este trabalho tem como ponto central de investigação a análise do domínio do sistema gráfico da Língua Portuguesa, em especial as questões relacionadas à capacidade dos alunos do 6º e 9º ano do Ensino Fundamental, em registrar corretamente palavras da Língua Portuguesa que possuam relações biunívocas, cruzadas e arbitrárias. A pesquisa é pautada na análise bibliográfica, documental e empírica. No primeiro capítulo, analisamos e utilizamos os estudos de alguns autores que tratam da concepção Construtivista e o processo de apropriação e desenvolvimento da língua escrita, entre eles Mortatti (2006) (2009) (2010); Sigwalt (2013); Picolli e Camini (2013); Branco (1989); Ferreiro e Teberosky (1999); Ferrari (2011); Dornfeld (2008); Mello (2007); Soares (2004); Grossi (1999); Duarte (2006); Oliveira (2002) (2007); Almeida (2010); Vieira (2014). No segundo capítulo, abordamos o Sistema Gráfico da Língua Portuguesa e suas consequências no ensino e no aprendizado da língua na escola básica. No terceiro capítulo, descrevemos e analisamos os dados obtidos com a investigação empírica. A pesquisa empírica é baseada em um instrumento aplicado pela docente da disciplina aos alunos do 6º ano e do 9º ano do Ensino Fundamental Anos Finais, matriculados em uma escola pública estadual no município de Curitiba.Abstract : This monographic work has as its central point of investigation the analysis of the domain of the graphic system of the Portuguese Language, especially the questions related to the ability of the students of the 6th and 9th grade of Correct Teaching correctly register words of the Portuguese Language that have biunivocas, crossed and arbitrary relations. The research is based on bibliographic, documentary and empirical analysis. In the first chapter we will analyze and use the studies of some authors that deal with the Constructivist conception and the process of appropriation and development of written language, among them Mortatti (2006) (2009) (2010); Sigwalt (2013); Picolli e Camini (2013); Branco (1989); Ferreiro e Teberosky (1999); Ferrari (2011); Dornfeld (2008); Mello (2007); Soares (2004); Grossi (1999); Duarte (2006); Oliveira (2002) (2007); Almeida (2010); Vieira (2014). In the second chapter we will focus on the Portuguese Language Chart System and its consequences on teaching and learning language in basic school. In the third chapter we will describe and analyze the data obtained with the empirical investigation. The empirical research is carried out by means of an instrument applied by the teacher of the educational institution to the students who are enrolled and attending the 6th grade and the 9th grade of the last Years Elementary School in a state public school in the city of Curitiba

New Surgical Approach for Gastric Bezoar: "Hybrid Access Surgery" Combined Intragastric and Single Port Surgery

Regarding the removal of a gastric bezoar, laparoscopic surgery was performed and it was shown that the laparoscopic approach is safe and feasible. However, the laparoscopic method has the risk of intraabdominal contamination, when the gastric bezoar is retrieved from the gastric lumen in the peritoneal cavity. We developed and applied a new procedure for the removal of the gastric bezoar using one surgical glove and two wound retractors as a fashion of intragastric single port surgery. Herein we present this new minimal invasive procedure, so named "hybrid access surgery" which involves the use of existing devices and overcomes the weakness of laparoscopic removal of the gastric bezoar. Our new procedure, combining the concept of intragastric and single port access, is acceptable and feasible to retrieve the gastric bezoar. In the future, this procedure may be one of the alternative procedures for retrieving gastric bezoar even when it is incarcerated in the pylorus

European Guideline on Achalasia - UEG and ESNM recommendations

Altres ajuts: These guidelines have been developed and funded within the United European Gastroenterology.Achalasia is a primary motor disorder of the oesophagus characterised by absence of peristalsis and insufficient lower oesophageal sphincter relaxation. With new advances and developments in achalasia management, there is an increasing demand for comprehensive evidence-based guidelines to assist clinicians in achalasia patient care. Guidelines were established by a working group of representatives from United European Gastroenterology, European Society of Neurogastroenterology and Motility, European Society of Gastrointestinal and Abdominal Radiology, and the European Association of Endoscopic Surgery in accordance with the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. A systematic review of the literature was performed and the certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. Recommendations were voted upon using a nominal group technique. These guidelines focus on the definition of achalasia, treatment aims, diagnostic tests, medical, endoscopic and surgical therapy, management of treatment failure, follow-up and oesophageal cancer risk. These multidisciplinary guidelines provide a comprehensive evidence-based framework with recommendations on the diagnosis, treatment and follow-up of adult achalasia patients

Building institutions for an effective health system: lessons from China's experience with rural health reform

This paper is concerned with the management of health system changes aimed at substantially increasing the access to safe and effective health services. It argues that an effective health sector relies on trust-based relationships between users, providers and funders of health services, and that one of the major challenges governments face is to construct institutional arrangements within which these relationships can be embedded. It presents the case of China, which is implementing an ambitious health reform, drawing on a series of visits to rural counties by the author over a 10-year period. It illustrates how the development of reform strategies has been a response both to the challenges arising from the transition to a market economy and the result of actions by different actors, which have led to the gradual creation of increasingly complex institutions. The overall direction of change has been strongly influenced by the efforts made by the political leadership to manage a transition to a modern economy which provides at least some basic benefits to all. The paper concludes that the key lessons for other countries from China’s experience with health system reform are less about the detailed design of specific interventions than about its approach to the management of institution-building in a context of complexity and rapid change.ESR

Retroviral Expression of Transforming Growth Factor-Alpha Does Not Transform Fibroblasts or Keratinocytes

Transforming growth factor α (TGFα) is a peptide so named because it helps to impart anchorage-independent growth to normal rat kidney (NRK) cells in vitro and is secreted by many rodent and human tumor cells. To directly investigate the transforming properties of this factor, we constructed a replication-defective murine retrovirus that expresses the human sequence coding for TGFα. infection of NIH/3T3 cells with the TGFα retrovirus led to the integration of a transcriptionally active provirus and overexpression of biologically active TGFα, but failed to induce morphologic transformation. Similarly, the TGFα retrovirus failed to induce morphologic transformation of five other types of rodent fibroblasts.We also investigated the effect of TGFα expression on the growth of BALB/MK mouse keratinocytes, which require epidermal growth factor (EGF) for proliferation. We show that exogenously added TGFα is an extremely potent mitogen for BALB/MK cells. However, retroviral expression of TGFa in BALB/MK cells failed to relieve dependence on exogenously added EGF (or TGFα) for cell growth. These results suggest that overexpression of TGFα does not, by itself, transform rodent fibroblasts or keratinocytes

2-Octyl-cyanoacrylate for wound closure in cervical and lumbar spinal surgery

It is claimed that wound closure with 2-octyl-cyanoacrylate has the advantages that band-aids are not needed in the postoperative period, that the wound can get in contact with water and that removal of stitches is not required. This would substantially enhance patient comfort, especially in times of reduced in-hospital stays. Postoperative wound infection is a well-known complication in spinal surgery. The reported infection rates range between 0% and 12.7%. The question arises if the advantages of wound closure with 2-octyl-cyanoacrylate in spinal surgery are not surpassed by an increase in infection rate. This study has been conducted to identify the infection rate of spinal surgery if wound closure was done with 2-octyl-cyanoacrylate. A total of 235 patients with one- or two-level surgery at the cervical or lumbar spine were included in this prospective study. Their pre- and postoperative course was evaluated. Analysis included age, sex, body mass index, duration and level of operation, blood examinations, 6-week follow-up and analysis of preoperative risk factors. The data were compared to infection rates of similar surgeries found in a literature research and to a historical group of 503 patients who underwent wound closure with standard skin sutures after spine surgery. With the use of 2-octyl-cyanoacrylate, only one patient suffered from postoperative wound infection which accounts for a total infection rate of 0.43%. In the literature addressing infection rate after spine surgery, an average rate of 3.2% is reported. Infection rate was 2.2% in the historical control group. No risk factor could be identified which limited the usage of 2-octyl-cyanoacrylate. 2-Octyl-cyanoacrylate provides sufficient wound closure in spinal surgery and is associated with a low risk of postoperative wound infection