Environmental performance of industrial companies, sites, installations and production processes

A set of 10 environmental impact indicators is proposed for the evaluation the environmental impact of industrial installations and processes or industrial companies and sites: global warming, destruction of the ozone layer (ozone depletion), acidification, photochemical ozone creation, human toxicity, ecotoxicity, eutrophication, resource consumption (abiotic depletion), water consumption and waste production. These are »weighed« indicators: the individual emissions or discharges of components contributing to a certain theme are multiplied with a weighing factor and aggregated. Eco-efficiency indicators are calculated by dividing the »weighed« indicators by a value related to production. These relative indicators make it possible to quantify the evolution of the environmental performance for a process, company or industrial site and to evaluate which component(s) contribute(s) most to a given theme, thus allowing to set priorities for lowering the environmental impact. Examples illustrate the proposed method. Attention is also given to the emission of persistent organic pollutants (POPs) during the incineration of waste, trying to answer the question: are waste incinerators sinks or sources of POPs? It is shown that for non-carcinogenic effects of POPs, according to the incineration scenario, the weighed input/output ranges from 0.3 to 20,500 when considering the POPs in flue gases and solid residues

Family carer support in home and hospital : a cross-sectional survey of specialised palliative care

Objectives To evaluate: (1) to what extent family carers of people supported by specialised palliative care services felt they had been provided with information, support and aftercare and (2) how this varied by type of palliative care service, length of enrolment and characteristics of deceased. Methods A cross-sectional postal survey was conducted using a structured questionnaire with nine items on information, support and aftercare provided by specialised palliative care services to family carers. Flemish family carers of people who had made use of specialised palliative care services at home or in hospital were contacted. Results Of all primary family carers (response rate of 53.5% resulting in n=1504), 77.7% indicated they were asked frequently by professionals how they were feeling. Around 75% indicated they had been informed about specific end-of-life topics and around 90% felt sufficiently supported before and immediately after the death. Family carers of people who had died in a palliative care unit, compared with other types of specialised palliative care services, indicated having received more information, support and aftercare. Conclusions Family carers evaluate the professional assistance provided more positively when death occurred in a palliative care unit. Policy changes might be needed to reach the same level of care across all specialised palliative care services

On the evolution of “cleaner production” as a concept and a practice

“Cleaner Production“(CP) is about less and more efficient energy and materials use and the substitution of more harmful products (for the environment and health) by less dangerous ones. CP was the reply of the industry to the call for sustainable development as launched by the WCED (1987) and further elaborated in Rio's Agenda 21 (UN, 1992). During the past 25 years, the concept was put in practice. During this period it changed in scope, methods, and application area. This provided a deeper socio-economic impact to an idea that was originally launched to awaken industry on its environmental responsibilities. This paper provides a review of essentials that contributed to the fundamental changes in CP during the most recent quarter of a century. It takes off with a review of CP definitions illustrating the changes of the content. Changes in scope are exemplified with the increasing importance of “Corporate Social Responsibility” (CSR). This includes that post-modern companies have not only responsibilities on their economic performance and the environment, but should also act on issues including human rights and resources, business ethics, and community involvement. The links between CP and green and circular economy are indicated. The CP approach is increasingly applied outside the industry. CP for sustainable tourism is discussed in more detail but is only an example of the wider application in e.g. agriculture or health services

Environmental representativity in marine protected area networks over large and partly unexplored seascapes

Converting assemblages of marine protected areas (MPAs) into functional MPA networks requires political will, multidisciplinary information, coordinated action and time. We developed a new framework to assist planning environmental representativity in a network across the marine space of Portugal, responding to a political commitment to protect 14% of its area by 2020. An aggregate conservation value was estimated for each of the 27 habitats identified, from intertidal waters to the deep sea. This value was based on expert-judgment scoring for environmental properties and features relevant for conservation, chosen to reflect the strategic objectives of the network, thus providing an objective link between conservation commitments and habitat representativity in space. Additionally, habitats' vulnerability to existing anthropogenic pressures and sensitivity to climate change were also scored. The area coverage of each habitat in Portugal and within existing MPAs (regionally and nationally) was assigned to a scale of five orders of magnitude (from 10%) to assess rarity and existing representation. Aggregate conservation value per habitat was negatively correlated with area coverage, positively correlated with vulnerability and was not correlated with sensitivity. The proposed framework offers a multi-dimensional support tool for MPA network development, in particular regarding the prioritization of new habitats to protect, when the goal is to achieve specific targets while ensuring representativity across large areas and complex habitat mosaics. It requires less information and computation effort in comparison to more quantitative approaches, while still providing an objective instrument to scrutinize progress on the implementation of politically set conservation targets.Agência financiadora Número do subsídio Oceanic Observatory of Madeira M1420-01-0145-FEDER-000001-OOM national funds through FCT UID/BIA/00329/2013 UID/Multi/04326/2013 Fundacao para a Ciencia e a Tecnologia SFRH/BPD/95334/2013 CESAM - FCT/MEC through national funds UID/AMB/50017 - POCI-01-0145-FEDER-007638 FEDER FCT SFRH/BPD/94320/2013 MARE - UID/MAR/04292/2019 EU through the Cohesion Fund POSEUR-03-2215-FC-000046 POSEUR-03-2215-FC-000047 FCT national funds ECO/28687/2017info:eu-repo/semantics/publishedVersio

Long‐term safety, efficacy, and quality of life in patients with juvenile idiopathic arthritis treated with intravenous abatacept for up to seven years

ClinicalTrials.gov identifier: NCT00095173[Abstract] Objective. The efficacy and safety of abatacept in patients with juvenile idiopathic arthritis (JIA) who experienced an inadequate response to disease‐modifying antirheumatic drugs were previously established in a phase III study that included a 4‐month open‐label lead‐in period, a 6‐month double‐blind withdrawal period, and a long‐term extension (LTE) phase. The aim of this study was to present the safety, efficacy, and patient‐reported outcomes of abatacept treatment (10 mg/kg every 4 weeks) during the LTE phase, for up to 7 years of followup. Methods. Patients enrolled in the phase III trial could enter the open‐label LTE phase if they had not achieved a response to treatment at month 4 or if they had received abatacept or placebo during the double‐blind period. Results. One hundred fifty‐three (80.5%) of 190 patients entered the LTE phase, and 69 patients (36.3%) completed it. The overall incidence rate (events per 100 patient‐years) of adverse events decreased during the LTE phase (433.61 events during the short‐term phase [combined lead‐in and double‐blind periods] versus 132.39 events during the LTE phase). Similar results were observed for serious adverse events (6.82 versus 5.60), serious infections (1.13 versus 1.72), malignancies (1.12 versus 0), and autoimmune events (2.26 versus 1.18). American College of Rheumatology (ACR) Pediatric 30 (Pedi 30) responses, Pedi 70 responses, and clinically inactive disease status were maintained throughout the LTE phase in patients who continued to receive therapy. Improvements in the Child Health Questionnaire physical and psychosocial summary scores were maintained over time. Conclusion. Long‐term abatacept treatment for up to 7 years was associated with consistent safety, sustained efficacy, and quality‐of‐life benefits in patients with JIA

Fluxes of dissolved organic carbon in stand throughfall and percolation water in 12 boreal coniferous stands on mineral soils in Finland

Predictors for glucose intolerance postpartum were evaluated in women with gestational diabetes mellitus (GDM) based on the 2013 World Health Organization (WHO) criteria. 1841 women were tested for GDM in a prospective cohort study. A postpartum 75g oral glucose tolerance test (OGTT) was performed in women with GDM at 14 ± 4.1 weeks. Of all 231 mothers with GDM, 83.1% (192) had a postpartum OGTT of which 18.2% (35) had glucose intolerance. Women with glucose intolerance were more often of Asian origin [15.1% vs. 3.7%, OR 4.64 (1.26–17.12)], had more often a recurrent history of GDM [41.7% vs. 26.7%, OR 3.68 (1.37–9.87)], higher fasting glycaemia (FPG) [5.1 (4.5–5.3) vs. 4.6 (4.3–5.1) mmol/L, OR 1.05 (1.01–1.09)], higher HbA1c [33 (31–36) vs. 32 (30–33) mmol/mol, OR 4.89 (1.61–14.82)], and higher triglycerides [2.2 (1.9–2.8) vs. 2.0 (1.6–2.5) mmol/L, OR 1.00 (1.00–1.01)]. Sensitivity of glucose challenge test (GCT) ≥7.2 mmol/l for glucose intolerance postpartum was 80% (63.1%–91.6%). The area under the curve to predict glucose intolerance was 0.76 (0.65–0.87) for FPG, 0.54 (0.43–0.65) for HbA1c and 0.75 (0.64–0.86) for both combined. In conclusion, nearly one-fifth of women with GDM have glucose intolerance postpartum. A GCT ≥7.2 mmol/L identifies a high risk population for glucose intolerance postpartum

Normal glucose tolerant women with low glycemia during the oral glucose tolerance test have a higher risk to deliver a low birth weight infant

BackgroundData are limited on pregnancy outcomes of normal glucose tolerant (NGT) women with a low glycemic value measured during the 75g oral glucose tolerance test (OGTT). Our aim was to evaluate maternal characteristics and pregnancy outcomes of NGT women with low glycemia measured at fasting, 1-hour or 2-hour OGTT.MethodsThe Belgian Diabetes in Pregnancy-N study was a multicentric prospective cohort study with 1841 pregnant women receiving an OGTT to screen for gestational diabetes (GDM). We compared the characteristics and pregnancy outcomes in NGT women according to different groups [(<3.9mmol/L), (3.9-4.2mmol/L), (4.25-4.4mmol/L) and (>4.4mmol/L)] of lowest glycemia measured during the OGTT. Pregnancy outcomes were adjusted for confounding factors such as body mass index (BMI) and gestational weight gain.ResultsOf all NGT women, 10.7% (172) had low glycemia (<3.9 mmol/L) during the OGTT. Women in the lowest glycemic group (<3.9mmol/L) during the OGTT had compared to women in highest glycemic group (>4.4mmol/L, 29.9%, n=482), a better metabolic profile with a lower BMI, less insulin resistance and better beta-cell function. However, women in the lowest glycemic group had more often inadequate gestational weight gain [51.1% (67) vs. 29.5% (123); p<0.001]. Compared to the highest glycemia group, women in the lowest group had more often a birth weight <2.5Kg [adjusted OR 3.41, 95% CI (1.17-9.92); p=0.025].ConclusionWomen with a glycemic value <3.9 mmol/L during the OGTT have a higher risk for a neonate with birth weight < 2.5Kg, which remained significant after adjustment for BMI and gestational weight gain

Information et sensibilisation à la prévention des infections nosocomiales manuportées (expérience des hôpitaux de Thionville)

NANCY1-SCD Pharmacie-Odontologie (543952101) / SudocSudocFranceF