Scoping study to identify potential circular economy actions, priority sectors, material flows and value chains

The circular economy is rapidly rising up political and business agendas. In contrast to today’s largely linear, ‘take-make-use-dispose’ economy, a circular economy represents a development strategy that enables economic growth while aiming to optimise the chain of consumption of biological and technical materials. A deep transformation of production chains and consumption patterns is envisaged to keep materials circulating in the economy for longer, re-designing industrial systems and encouraging cascading use of materials and waste. Although there are some elements of circularity such as recycling and composting in the linear economy (see Figure E1) where progress needs to be maintained, a circular economy goes beyond the pursuit of waste prevention and waste reduction to inspire technological, organisational and social innovation across and within value chains (see Figure E2). There are already several policies in place and activities underway that support a circular economy; however there remain a range of untapped opportunities, costs to be avoided and obstacles to be addressed in order to accelerate the move towards a circular economy in the EU. Against this backdrop, the European Commission (DG Environment) launched a Scoping study to identify potential circular economy actions, priority sectors, material flows & value chains. The study was carried out by the Policy Studies Institute (PSI), Institute for European Environmental Policy (IEEP), BIO and Ecologic Institute between November 2013 and July 2014. The aim of the study was to provide an initial scoping assessment of potential priorities and policy options to support the transition to a circular economy in the EU. The study reviewed existing literature, identified potential priority areas for action where accelerating the circular economy would be beneficial and where EU policy has a particular role to play, and developed policy options for consideration across a range of areas

Outcomes following autologous hematopoietic stem cell transplant for patients with relapsed Wilms' tumor: a CIBMTR retrospective analysis.

Despite the marked improvement in the overall survival (OS) for patients diagnosed with Wilms' tumor (WT), the outcomes for those who experience relapse have remained disappointing. We describe the outcomes of 253 patients with relapsed WT who received high-dose chemotherapy (HDT) followed by autologous hematopoietic stem cell transplant (HCT) between 1990 and 2013, and were reported to the Center for International Blood and Marrow Transplantation Research. The 5-year estimates for event-free survival (EFS) and OS were 36% (95% confidence interval (CI); 29-43%) and 45% (95 CI; 38-51%), respectively. Relapse of primary disease was the cause of death in 81% of the population. EFS, OS, relapse and transplant-related mortality showed no significant differences when broken down by disease status at transplant, time from diagnosis to transplant, year of transplant or conditioning regimen. Our data suggest that HDT followed by autologous HCT for relapsed WT is well tolerated and outcomes are similar to those reported in the literature. As attempts to conduct a randomized trial comparing maintenance chemotherapy with consolidation versus HDT followed by stem cell transplant have failed, one should balance the potential benefits with the yet unknown long-term risks. As disease recurrence continues to be the most common cause of death, future research should focus on the development of consolidation therapies for those patients achieving complete response to therapy

“Talk with me”: perspectives on services for men with problem gambling and housing instability

BACKGROUND: Problem gambling and homelessness are recognized as important public health concerns that significantly impact individuals, their friends and families, communities and broader society. We aimed to explore the experiences with health and social services of men who had histories of problem gambling and housing instability in Toronto, Ontario. METHODS: We used a community-based participatory approach with a multi-service agency serving low-income individuals. We conducted qualitative interviews with men (n = 30) who had experienced problem gambling and housing instability. Our interviews employed open-ended questions to elicit men’s perceptions of services related to housing instability, problem gambling and other comorbid conditions (e.g., mental illness, substance use). We reviewed relevant themes related to experiences with services (e.g., Use of and feedback on: health and social services, housing services, justice/legal aid services, substance use services, gambling services; stigma; goals; triggers; physical health; coping strategies; finances; relationships; barriers to services and recommendations for services). RESULTS: The concept of person-centred engagement was identified as a main overarching theme, and seemed to be lacking in most of the men’s experiences of services. Person-centred engagement for these men entailed empowerment and autonomy; empathy, compassion and sincerity; respectful communication; and tailored and holistic life plans. While there was a strong emphasis placed on independence, the men identified the importance of positive therapeutic relationships as being critical aspects of the recovery process. Based on our analyses, several recommendations were identified: 1) Increasing general awareness of services for problem gambling; 2) Delivering integrated services in a one-stop-shop; 3) Addressing mental health with psychotherapy and pharmacotherapy; 4) Providing timely access to prevention and recovery services; and 5) Enhancing life skills with peer support. CONCLUSIONS: Our study highlighted that most of the men we interviewed were not having their health and social needs met. Services need to address the intersection of problem gambling, housing instability, and other comorbidities. Ensuring services are grounded in person-centred engagement appears to be critical for optimal service delivery. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12913-016-1583-3) contains supplementary material, which is available to authorized users

Innovative Makeshift Technique for Removing Ingested Rare Earth Magnets

Swallowing foreign bodies is common in pediatrics. However, ingestion of rare earth magnets, composed of a neodymium alloy with powerful attractive forces, pose unique risks to children. The attraction of the magnets to each other when positioned in separate areas of the intestinal tract can lead to bowel obstruction, perforation, fistula formation, or pressure necrosis. These significant complications have led NASPGHAN to offer guidance for their urgent removal in children. Upon medical presentation and determination of their position on x-ray, ingested magnets should be removed urgently before entering the small intestine to prevent severe adverse events.1,2 However, endoscopic location and removal can be challenging especially if the child has not been in a fasting state. We present a makeshift technique for easily removing magnetic foreign bodies in such a scenario

Changing the Shape of Sickle Cell Disease Treatment: A Hermeneutic Study of a Case that Changed a Family and a Medical Practice

This hermeneutic study analyzes a case of one family who chose to undergo two hematopoietic stem cell transplants for two of their four children affected with sickle cell disease (SCD) with full knowledge of the risks involved with curative therapy. This case had a life-changing impact on the family and on the medical practice of the physician who worked with them. As a result of this family, international treatment of early transplant for SCD has adopted different protocols. In this study, interviewing the mother in the family, the physician, and the transplant nurse, and analyzing the data hermeneutically brings us to a deeper understanding of how change occurs and its profound effect on lives and medical treatment.

Holocene salt-marsh sedimentary infilling and relative sea-level changes in West Brittany (France) using foraminifera-based transfer functions

International audienceIn order to reconstruct the former sea-levels and to better characterize the history of Holocene salt-marsh sedimentary infillings in West Brittany (western France), local foraminifera-based transfer functions were developed using Weighted-Average-Partial-Least-Squares (WA-PLS) regression, based on a modern dataset of 26 and 51 surface samples obtained from salt-marshes in both the bay of Tressseny and the bay of Brest. Fifty cores were retrieved from Tresseny, Porzguen, Troaon and Arun salt-marshes, which were litho- and biostratigraphicaly analyzed in order to reconstruct palaeoenvironmental changes. A total of 26 AMS 14C age determinations were performed within the sediment successions. The Holocene evolution of salt-marsh environments can be subdivided into four stages: (1) a development of brackish to freshwater marshes (from c. 6400 to 4500 cal. a BP); (2) salt-marsh formation behind gravel barriers in the bay of Brest (from 4500 to 2900 cal. a BP); (3) salt-marsh erosion and rapid changes of infilling dynamics due to the destruction of coastal barriers by storm events (c. 2900-2700 cal. a BP); (4) renewed salt-marsh deposition and small environmental changes (from 2700 cal. a BP to present). From the application of transfer functions to fossil assemblages, 14 new sea-level index points were obtained indicating a mean relative sea-level rise around 0.90±0.12 mm a-1 since 6300 cal. a BP

Detection and Localization of Traffic Signals with GPS Floating Car Data and Random Forest

As Floating Car Data are becoming increasingly available, in recent years many research works focused on leveraging them to infer road map geometry, topology and attributes. In this paper, we present an algorithm, relying on supervised learning to detect and localize traffic signals based on the spatial distribution of vehicle stop points. Our main contribution is to provide a single framework to address both problems. The proposed method has been experimented with a one-month dataset of real-world GPS traces, collected on the road network of Mitaka (Japan). The results show that this method provides accurate results in terms of localization and performs advantageously compared to the OpenStreetMap database in exhaustivity. Among many potential applications, the output predictions may be used as a prior map and/or combined with other sources of data to guide autonomous vehicles

Determinants of research use in clinical decision making among physical therapists providing services post-stroke: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Despite evidence of the benefits of research use in post-acute stroke rehabilitation where compliance with clinical practice guidelines has been associated with functional recovery and patient satisfaction, the rate of reliance on the research literature in clinical decision making among physical therapists is low. More research examining factors that motivate physical therapists to consider research findings in neurological practice is needed to inform efforts to intervene. The objective of this study was to identify practitioner, organizational, and research characteristics associated with research use among physical therapists providing services post-stroke.</p> <p>Methods</p> <p>A cross-sectional mail survey of physical therapists providing services to people with stroke in Ontario, Canada was conducted. The survey questionnaire contained items to evaluate practitioner and organizational characteristics and perceptions of research considered to influence evidence-based practice (EBP), as well as the frequency of using research evidence in clinical decision making in a typical month. Ordinal regression was used to identify factors associated with research use.</p> <p>Results</p> <p>The percentage of respondents reporting research use in clinical decision making 0 to 1, 2 to 5, or 6+ times in a typical month was 33.8%, 52.9%, and 13.3%, respectively (n = 263). Academic preparation in the principles of EBP, research participation, service as a clinical instructor, self-efficacy to implement EBP, a positive attitude towards research, perceived organizational support of research use, and Internet access to bibliographic databases at work were each associated with research use and placed in the final regression model. In the final model (n = 244), academic preparation in EBP, EBP self-efficacy, agreement that research findings are useful, and research participation each remained significantly associated with research use after adjusting for the effects of the other variables in the model.</p> <p>Conclusions</p> <p>A third of therapists rarely use research evidence in clinical decision making. Education in the principles of EBP, EBP self-efficacy, a positive attitude towards research, and involvement in research at work may promote research use in neurological physical therapy practice. Future research is needed to confirm these findings and to determine the type of research participation that may promote research use.</p

Advances in the development of a new cartesian explicit solver for hydrodynamics

In order to efficiently address complex problems in hydrodynamics, the advances in the dev lopment of a new method are presented here. This new CFD solver aims at obtaining a good compromise in terms of accuracy, computational efficiency, and easy handling of complex geometries. The chosen method is an Explicit Cartesian Finite Volume method for Hydrodynamics (ECFVH) based on a compressible (hyperbolic) solver, with an embedded method for interfaces and geometry handling. The solver's explicit nature is obtained through a weakly-compressible approach chosen to simulate nearly-incompressible flows. The explicit cell-centered resolution allows for an efficient solving of very large simulations together with a straightforward handling of multi-physics. The use of an embedded Cartesian grid ensures accuracy and efficiency, but also implies the need for a specific treatment of complex solid geometries, such as the cut-cell method in the fixed or moving body frame. Robustness of the cut-cell method is ensured by specific procedures to circumvent small cell volume numerical errors. A characteristic flux method for solving the hyperbolic part of the Navier-Stokes equations is used and introduces numerical viscosity. This viscosity is evaluated prior to modeling viscous and turbulent effects. In a first approach presented here viscous effects are computed via a finite difference Laplacian operator introduced as a source term. This solver is validated on 2-D test cases