Breaking the cycle of municipal solid waste management in the United States : a contemporary biotechnic approach

Solid waste management in the United States is one urban practice that provides evidence for, and reinforces Marx’s theory of urban “metabolic rift.” However, urban planners as a field have historically shifted the onus for solid waste issues to engineers and private citizens. By avoiding waste, planners have dismissed a basic portion of their responsibility to the public and violated their own code of ethics. Repairing the metabolic balance of cities is admittedly a colossal undertaking. It will be necessary for planners to once again pay attention to the sub-field that spawned their profession, but this time through an updated frame, or mode of interpreting reality. In the course of this project, I uncover frames that have been employed by planners in the past and the effects these frames have had for solid waste management. Finding that rational positivist, grassroots communitarian, and insurgent radical frames have not adequately addressed the chronic symptoms of our metabolic rift, I analyze and adapt a frame for planning, the biotechnic frame, which is based on Sir Patrick Geddes’ theory of technics and civics. Finally, in order to test an innovative sustainable solid waste management technology that holds promise for repairing the metabolic rift, I evaluate the practice of landfill mining to determine whether or not it fits within a biotechnic frame. This study shows that waste is a frame, or mode of understanding conditions, not an inevitability. Rather than solid waste sitting untouched in landfills, it can be reintegrated into the material and energy flows of the city-region, helping to balance the urban metabolism and “close the loop” on a historically linear waste cycle. With the appropriate frame, planners are especially equipped to facilitate this change.Community and Regional PlanningSustainable Desig

Spatial, sectoral and temporal trends in A8 migration to the UK 2004-2011. Evidence from the worker registration scheme

Since the enlargement of the European Union on 1st May 2004, large numbers of migrants from the A8 countries (Poland, Czech Republic, Latvia, Lithuania, Slovakia, Slovenia, Hungary and Estonia) have joined the UK labour market and East-Central Europe has become one of the principal source regions of migrants to Britain. Nationals from these states now constitute some of the largest foreign-born populations in the country. As part of the transitional arrangements following accession, A8 migrants were required to register under the Worker Registration Scheme (WRS) if they took up employment in the UK for one month or longer. The WRS operated between May 2004 and April 2011. The WRS represents a uniquely detailed source of information on East-Central European labour migration to the UK in terms of the employment taken up by A8 migrants immediately after arrival in the UK. The research presented here analysed administrative data from the WRS in order to shed light on spatial, sectoral and temporal trends in registration flows. The findings in this report can help inform understanding of migration patterns, and responses to them, at the national and local government levels.The volume of labour migration flows from East-Central Europe has been substantial, with 1,133,950 registrations recorded over the lifetime of the WRS (May 2004 – April 2011). These flows have been concentrated in particular segments of the labour market, with most A8 migrants engaging with the hospitality and agricultural sectors and often working through recruitment agencies as opposed to directly for employers. The volume of new arrivals from the A8 countries has decreased since the onset of the recession in 2008 but still remained substantial at the end of the WRS period. The demand for migrant labour has been relatively consistent in agriculture compared to other sectors of the economy during the recession, suggesting that employers in this sector may still require overseas workers as they struggle to source labour regardless of prevailing labour market conditions. In other sectors the requirement for overseas workers had receded to a large extent by 2011. Conceptually this points to A8 migrant labour serving distinct ‘functions’ in the UK labour market

Validity of self-reported smoking status: comparison of patients admitted to hospital with acute coronary syndrome and the general population

Many studies rely on self-reported smoking status. We hypothesized that patients with acute coronary syndrome (ACS), a smoking-related condition, would be more prone to misclassify themselves as ex-smokers, because of pressure to quit. We compared patients admitted with ACS with a general population survey conducted in the same country at a similar time. We determined whether ACS patients who classified themselves as ex-smokers (n = 635) were more likely to have cotinine levels suggestive of smoking deception than self-reported ex-smokers in the general population (n = 289). On univariate analysis, the percentage of smoking deceivers was similar among ACS patients and the general population (11% vs. 12%, p = .530). Following adjustment for age, sex and exposure to environmental tobacco smoke, ACS patients were significantly more likely to misclassify themselves (adjusted OR = 14.06, 95% CI 2.13-93.01, p = .006). There was an interaction with age whereby the probability of misclassification fell significantly with increasing age in the ACS group (adjusted OR = 0.95, 95% CI 0.93-0.97, p<.001), but not in the general population. Overall, smoking deception was more common among ACS patients than the general population. Studies comparing patients with cardiovascular disease and healthy individuals risk introducing bias if they rely solely on self-reported smoking status. Biochemical confirmation should be undertaken in such studies

Ariel - Volume 5 Number 6

Editors J.D. Kanofsky Mark Dembert Entertainment Robert Breckenridge Joe Conti Gary Kaskey Photographer Scot Kastner Overseas Editor Mike Sinason Circulation Jay Amsterdam Humorist Jim McCann Staff Ken Jaffe Bob Sklaroff Janet Welsh Dave Jacoby Phil Nimoityn Frank Chervane

A service improvement ‘tool kit’ for effective heart failure management in primary care

Background: Heart failure (HF) is a complex and highly debilitating clinical syndrome. International guidelines identify the optimum clinical management of patients living with HF in primary care but translation of these into practice remains inadequate. The aim of this service evaluation is to measure standards of HF diagnosis and management, before and after the implementation of The Greater Manchester Heart Failure Investigation Tool (GM-HFIT), a facilitated ‘tool kit’ designed to optimise HF care. Methods: The GM-HFIT was developed as a means of assessing and improving care and was implemented as part of a facilitated service improvement and evaluation in primary care using a prospective, pre-test, post-test design. Results: Anonymised pre- and post-audit data were taken from a sample of 1130 cases entered on general practice HF registers. These cases were from two clinical commissioning groups (39 general practices) in the north west of England and were analysed to compare HF management and treatment parameters against clinical guidelines. Implementation of the GM-HFIT tool kit was associated with a reduction in the number of patients inappropriately placed on the HF register (p<0.001), an improvement in the recording and documentation of pulse rate and rhythm (p=0.005) and the proportion of patients receiving the target dose of angiotensin converting enzyme inhibitors and beta-blockers (p<0.001). There was no significant difference in the recording and documentation of blood pressure levels or in documented target blood pressure levels across the time points. Conclusion: The introduction of the GM-HFIT kit was associated with statistically significant improvements in the identification and clinical management of patients diagnosed with HF in primary care

Further results on the in situ anaerobic corrosion of carbon steel and copper in compacted bentonite exposed to natural Opalinus Clay porewater containing native microbial populations

Since 2012, a long‐term in situ corrosion experiment (IC‐A) is being conducted in the Mont Terri Underground Research Laboratory in Switzerland to investigate the corrosion behaviour of candidate canister materials in conditions representative of the Swiss concept for the disposal of high‐level waste and spent nuclear fuel. To date, carbon steel and various types of copper coatings have been retrieved after different exposure periods of up to 3 years, and characterised to establish the composition of the corrosion product, the morphology of the corroded surface, the nature of the interaction between the metal and the surrounding bentonite, and the microbial populations in the bentonite and surrounding porewater. For carbon steel specimens, a complex corrosion product was identified, consisting predominantly of magnetite. Much less alteration on either the metal or the bentonite was observed in the case of copper samples. Low average anaerobic corrosion rates were measured for carbon steel and a very modest amount of alteration was identified on copper. The density and the initial form of the bentonite had a small influence on the rate of corrosion, across all materials. This paper summarises the results of the experimental programme obtained to date and discusses the relationship observed between exposure time and the evolution of the metal–bentonite interface for both carbon steel and copper

Destruction of tumor vasculature and abated tumor growth upon VEGF blockade is driven by proapoptotic protein Bim in endothelial cells

VEGF deprivation induces Bim expression in tumor endothelial cells, and Bim is needed for anti-VEGF–driven endothelial cell death and tumor shrinkage

The anaerobic corrosion of candidate disposal canister materials in compacted bentonite exposed to natural granitic porewater containing native microbial populations

The materials corrosion test (MaCoTe) is a long‐term, multinational in situ corrosion experiment setup at the Grimsel Test Site, Switzerland. The experiment has been operating since 2014 with a focus on the corrosion behaviour of container materials for the disposal of high‐level waste and spent nuclear fuel under conditions representing a granitic deep geological repository. The experiment consists of eight modules containing metal coupons and bentonite. Two of the modules, each with a different bentonite density, have been retrieved after 394 days of exposure and have been analysed using a range of techniques aimed at studying the corrosion behaviour of the metals and the mineralogical evolution of the bentonite. Weight loss measurements show that carbon steel had a relatively low average corrosion rate (~2 µm year−1). Much lower average corrosion rates were measured for the various types of copper (0.13–0.32 µm year−1). No detectable corrosion was measured on stainless steel coupons. To date, no significant differences were observed in the corrosion behaviour and rate of the test metals in bentonite with different dry densities

The face of equipoise - delivering a structured education programme within a randomized controlled trial: qualitative study

Background: In trials of behavioural interventions, the individuals who deliver the intervention are in a position of key influence on the success of the trial. Their fidelity to the intervention is crucial. Yet little is understood about the experiences of this group of trial personnel. This study aimed to investigate the views and experiences of educators who delivered a structured education intervention to people with type 2 diabetes, which incorporated training in self-monitoring of either blood glucose (SMBG) or urine glucose (SMUG) as part of a randomized controlled trial (RCT). Methods: Educators’ views were explored through focus groups before and after training (N = 18) and approximately 1 year into the trial (N = 14), and semi-structured telephone interviews at approximately 2 years (N = 7). Analysis was based on the constant comparative method. Results: Educators held preferences regarding the intervention variants; thus, they were not in individual equipoise. Training raised awareness of preferences and their potential to impact on delivery. Educators were confident in their unbiased delivery, but acknowledged the challenges involved. Concealing their preferences was helped by a sense of professionalism, the patient-centred nature of the intervention, and concessions in the trial protocol (enabling participants to swap monitoring methods if needed). Commitment to unbiased delivery was explained through a desire for evidence-based knowledge in the contentious area of SMBG. Conclusions: The findings provide insight into a previously unexplored group of trial personnel - intervention deliverers in trials of behavioural interventions - which will be useful to those designing and running similar trials. Rather than individual equipoise, it is intervention deliverers’ awareness of personal preferences and their potential impact on the trial outcome that facilitates unbiased delivery. Further, awareness of community equipoise, the need for evidence, and relevance to the individual enhance commitment to the RCT