Achieving sustainable sanitation chains through better informed and more systematic improvements: lessons from multi-city research in Sub-Saharan Africa

This paper was accepted for publication in the journal Environmental Science: Water Research Technology and the definitive published version is available at http://dx.doi.org/10.1039/C5EW00255A.This paper presents the synthesised findings of the SPLASH Urban Sanitation research programme through the framework of the sanitation service chain. Urban sanitation service chains are complex and fragmented, involving a multiplicity of service providers and typically resulting in unsustainable or inadequate services. The aggregate data set covers a wide range of research methods including; household surveys, a randomised control trial, a willingness to pay survey prototype testing of technologies, focus group discussions and deliberative forums. Thorough the research, it has been possible to identify situations where incremental improvements are being made with varying degrees of success. Most importantly, it has identified weaknesses to the sanitation service chains where progress is either slow or extremely limited. It is through these weaknesses that key questions affecting the long term sustainability of sanitation service chains need to be answered

Chronic pain among homeless persons: characteristics, treatment, and barriers to management

<p>Abstract</p> <p>Background</p> <p>Little information is available on the problem of chronic pain among homeless individuals. This study aimed to describe the characteristics of and treatments for chronic pain, barriers to pain management, concurrent medical conditions, and substance use among a representative sample of homeless single adult shelter users who experience chronic pain in Toronto, Canada.</p> <p>Methods</p> <p>Participants were randomly selected at shelters for single homeless adults between September 2007 and February 2008 and screened for chronic pain, defined as having pain in the body for ≥ 3 months or receiving treatment for pain that started ≥ 3 months ago. Cross-sectional surveys obtained information on demographic characteristics, characteristics of and treatments for chronic pain, barriers to pain management, concurrent medical conditions, and substance use. Whenever possible, participants' physicians were also interviewed.</p> <p>Results</p> <p>Among 152 homeless participants who experienced chronic pain, 11 (8%) were classified as Chronic Pain Grade I (low disability-low intensity), 47 (32%) as Grade II (low disability-high intensity), 34 (23%) as Grade III (high disability-moderately limiting), and 54 (37%) as Grade IV (high disability-severely limiting). The most common self-reported barriers to pain management were stress of shelter life, inability to afford prescription medications, and poor sleeping conditions. Participants reported using over-the-counter medications (48%), street drugs (46%), prescribed medications (43%), and alcohol (29%) to treat their pain. Of the 61 interviewed physicians, only 51% reported treating the patient's pain. The most common physician-reported difficulties with pain management were reluctance to prescribe narcotics due to the patient's history of substance abuse, psychiatric comorbidities, frequently missed appointments, and difficulty getting the patient to take medications correctly.</p> <p>Conclusions</p> <p>Clinicians who provide healthcare for homeless people should screen for chronic pain and discuss barriers to effective pain management with their patients.</p

Carbon dioxide reduction in the building life cycle: a critical review

The construction industry is known to be a major contributor to environmental pressures due to its high energy consumption and carbon dioxide generation. The growing amount of carbon dioxide emissions over buildings’ life cycles has prompted academics and professionals to initiate various studies relating to this problem. Researchers have been exploring carbon dioxide reduction methods for each phase of the building life cycle – from planning and design, materials production, materials distribution and construction process, maintenance and renovation, deconstruction and disposal, to the material reuse and recycle phase. This paper aims to present the state of the art in carbon dioxide reduction studies relating to the construction industry. Studies of carbon dioxide reduction throughout the building life cycle are reviewed and discussed, including those relating to green building design, innovative low carbon dioxide materials, green construction methods, energy efficiency schemes, life cycle energy analysis, construction waste management, reuse and recycling of materials and the cradle-to-cradle concept. The review provides building practitioners and researchers with a better understanding of carbon dioxide reduction potential and approaches worldwide. Opportunities for carbon dioxide reduction can thereby be maximised over the building life cycle by creating environmentally benign designs and using low carbon dioxide materials

Planning problems of town, city, and region; papers and discussions.

"Twenty years of city planning progress in the United States [by] John Nolen": 19th, p. 1-44.Part of the illustrative material is folded.The proceedings of the 1st conference, 1909, were published in Senate document no. 422, 61st Congress, 2d session."Twenty years of city planning progress in the United States [by] John Nolen": 19th, p. 1-44.Mode of access: Internet.Title varies: 1910-24, Proceedings; 1925-34, Planning problems of town, city and region; papers and discussions (1933, Planning and national recovery; other slight variations)The 25th and 26th conferences were held jointly with the American civic association.The proceedings of the 17th conference, held in New York in 1925 in conjunction with the 9th congress of the International federation for housing and town planning, were issued under the name: International city and regional planning conference.The proceedings of the 2d conference issued under an earlier name: National conference on city planning and the problems of congestion.Vols. 1-18, 1909-26. 1 v.Superseded by the Proceedings of the Joint conference on city, regional, state and national planning (later called National conference on planning)Superseded by the Proceedings of the Joint conference on city, regional, state and national planning (later called National conference on planning

The effects of the indoor environment of residential care homes on dementia suffers in Hong Kong: A critical incident technique approach

Dementia is an irreversible and incurable syndrome that leads to progressive impairment of cognitive functions and behavioural and psychological symptoms such as agitation, depression and psychosis. Appropriate environmental conditions can help delay its onset and progression, and indoor environmental (IE) factors have a major impact. However, there is no firm understanding of the full range of relevant IE factors and their impact levels. This paper describes a preliminary study to investigate the effects of IE on Hong Kong residential care homes (RCH) dementia residents. This involved six purposively selected focus groups, each comprising the main stakeholders of the dementia residents’ caregivers, RCH staff and/or registered nurses, and architects. Using the Critical Incident Technique, the main context and experiences of behavioural problems of dementia residents caused by IE were explored and the key causal RCH IE quality factors identified, together with the associated responses and stress levels involved. The findings indicate that the acoustic environment, lighting and thermal environment are the most important influencing factors. Many of the remedies provided by the focus groups are quite simple to carry out and are summarised in the form of recommendations to current RCHs providers and users. The knowledge acquired in this initial study will help enrich the knowledge of IE design for dementiaspecific residential facilities. It also provides some preliminary insights for healthcare policymakers and practitioners in the building design/facilities management and dementia-care sectors into the IE factors contributing to a more comfortable, healthy and sustainable RCH living environment in Hong Kong