The valuation tool user guide: monetizing Cradle to Cradle®

This User Guide outlines the object, scope and expected deliverables from the Valuation Tool component of the Cradle to Cradle ® C2C BIZZ project. It describes the compendium of subtools that have been developed comprising: i) overview of funding tools; ii) C2C investment appraisal tool; and iii) C2C value indexing tool. The underpinning methodologies, as well as their inherent strengths and limitations are also described. The C2C BIZZ project as a whole aims specifically to promote and enhance the implementation of C2C methods in business site development within North Western Europe (NWE) (PAD, p.14). It is intended to infuse C2C notions into conventional site development, restructuring and management. The primary focus of the project is on planning, building and managing of business sites with C2C credentials (PAD, p.18) using sites in Lille Metropole (La Lainiere), London (London Sustainable Industries Park) and Luxemburg (Ecoparc Windhof) as experimental fields. C2C BIZZ is not concerned with the internal operations and activities of occupiers or users of the developed site. Accordingly, the scope of the valuation tool is confined to the planning, building and management of C2C sites. The deliverable from this component is a compendium of subtools (see Figure 1 below) that may be used to analyse the financial performance of C2C credentials in business sites to aid the making of a business case for such developments and evaluating the financial incentives for particular C2C site development projects. This entire work is premised on the argument that the wider adoption of C2C principles within the built environment depends on the rate of uptake by the private sector. The private sector, being profit driven, are likely to engage in C2C site development if they are convinced of its capacity to contribute to their business goals which ultimately is a return on their investment. The tool development described in this document attempts to provide a framework for collating an evidence base that can assist in articulating the business case for C2C in business site developments

An observational comparative study of intraocular pressure changes in post-operative cataract patients treated with dexamethasone and difluprednate

Background: Cataract is the leading cause of blindness worldwide. Treatment of cataract is surgical. Topical corticosteroids are routinely used in the treatment of post-operative inflammation following cataract surgery. This study aims to compare the intraocular pressure changes caused by topical steroids (dexamethasone and difluprednate) and to detect adverse effects.Methods: All patients operated by phacoemulsification in ophthalmology Department of SMIMER Surat were taken as subjects. Depending on topical steroids prescribed after surgery, subjects were separated into 2 groups, group 1 - difluprednate and group 2 - dexamethasone. Changes in intra-ocular pressure (IOP) of patients were collected from the data available pre-operative, 1st ,2nd ,3rd ,4th week after surgery and were analyzed. Other parameters whose data were collected are-adverse effects and compliance of patients.Results: In group 1 preoperative mean IOP was 15.5. At the end of 1st week, the mean IOP was significantly increased to 15.8. There was equal rise in IOP during 3rd week and 4th week which means that after 3rd week IOP remains stable. In group 2 preoperative mean IOP was 15.4. At the end of 1st, 2nd, 3rd and 4th there was significant increase in IOP as compared to preoperative mean IOP. Adverse effects were reported more in group 2.Conclusions: In group 1 there was a rise in IOP up to three weeks but after 3rd week IOP remained stable. In group 2 rise in IOP was seen throughout 4 weeks of treatment. Adverse effects seen more in group 2. Compliance of patients was better in group 1

Educational intervention to improve knowledge, attitude and practice of pharmacovigilance among nursing staff in tertiary care hospital

Background: The present study was planned to assess the knowledge, attitude and practice among nursing staff and to evaluate the effect of educational intervention.Methods: The questionnaire related with knowledge, attitude and practice (KAP) were given to nursing staff before and after the educational intervention in a tertiary care hospital. The data obtained were subjected to statistical analysis.Results: The training given in different sessions has improved KAP among nursing staff. Ninety six percent of them responded correctly regarding who can report ADR as compared to pre training session (69%). Regarding pharmacovigilance as purpose of safe use of medicines was responded by 71% after training as compared to 54% before training. In questions related to PvPI, 94% of nursing staff responded correctly about the scale to be used for causality assessment in comparison to 79% before training. Majority of them were of opinion that only unknown and serious ADR should be reported whereas after training they answered that all the ADR should be reported. A significant improvement has been noticed in questions related to attitude and practice.Conclusions: The educational intervention to improve KAP among nursing staff has resulted in significant improvement

An observational comparative study of intraocular pressure changes in post-operative cataract patients treated with dexamethasone, difluprednate and prednisolone in a tertiary care centre

Background: Cataract is opacity of lens which is treated surgically. Topical corticosteroids are routinely used in the treatment of post-operative inflammation following cataract surgery. This study aims to compare the intraocular pressure changes caused by various topical steroids (prednisolone, dexamethasone and difluprednate) in post cataract patients. To compare compliance and to detect any significant adverse effects.Methods: Patients admitted in ophthalmology department for cataract surgery operated by phacoemulsification were taken as subjects. Total number of patients enrolled in the study were 354. Subjects were separated into 3 groups depending on topical steroids which were prescribed after surgery: group 1 - difluprednate, group 2 -dexamethasone and group 3 - prednisolone. Changes in intraocular pressure (IOP) of patients were measured by ophthalmology department preoperatively and postoperatively after 1st, 2nd, 3rd, 4th week of surgery. These data were collected and analysed. Adverse effects, Compliance of patients and number of bottles of drug used after surgery were also noted.Results: On comparing IOP, there was significant variation (p<0.027) between 3 drugs after one week of drug administration. When group 1 was compared with group 2 or group 3 there was no significant difference Average cost of difluprednate is about 3 times higher than the cost of dexamethasone or prednisolone.Conclusions: All the three topical steroids cause a rise in intraocular pressure in post cataract patients. But in group 1 (difluprednate) there was a rise in IOP up to three weeks after surgery but after 3rd week IOP remained stable. Adverse effects were seen more in group 2 and group 3.

Steroid-sparing effect of ciclosporin A 1 mg/mL: 5-year case series of 107 children and young people with vernal keratoconjunctivitis

Background/aims To explore the steroid-sparing and other therapeutic effects of ciclosporin A (CsA) 1 mg/mL in the management of vernal keratoconjunctivitis (VKC). Methods Open retrospective single-group interventional consecutive cohort study (case series) of 107 children and young people (CYP) age 4.4-18 years with severe and/or recurrent VKC who were prescribed CsA 1 mg/mL between November 2015 and May 2021 at one institution. Review of electronic patient records, noting clinical indication for prescribing CsA 1 mg/mL, dosage prescribed at initiation and follow-up, impact on steroid usage before and after commencing CsA as well as adverse events and indications for discontinuation of treatment. Results The median number of inflammatory episodes requiring treatment with topical corticosteroids fell from 3 (IQR 2-4) during the 12 months prior to CsA 1 mg/mL to 1 (IQR 0-3) during the 12 months after, excluding steroid prescriptions with the first CsA 1 mg/mL prescription (Wilcoxon signed ranks test, two tailed, p<0.01). In the 12-month period following initiation of CsA 1 mg/mL with concomitant prescription of topical corticosteroids (n=82), daily dosage of steroids was reduced in 79 (96.3%) and discontinued in 67 (81.7%). The median number of hospital clinic visits fell from 4 (IQR 3-5) to 3 (IQR 2-5) (Wilcoxon p<0.01). Adverse events leading to discontinuation of CsA 1 mg/mL within 12 months of starting included stinging (instillation site pain) (6/107, 5.6%) and skinrash (1/107, 0.9%). Conclusion Commercial preparations of CsA 1 mg/mL, licensed for severe VKC in CYP, significantly reduce the need for concomitant topical corticosteroids and hospital clinic visits. Adverse events which may lead to discontinuation are stinging and skin rash

Hydrobiological studies of an irrigation tank with reference to the culture of large murrel, Channa marulius (Hamilton) and striped murrel Channa striatus (Bloch)

The importance of selection of species for culture according to the ecological niches and fish food organisms is highlighted with respect to the Fox Sagar, an irrigation take. The tank was infested with submerged vegetation as well as minnows and weed fishes, which rendered the tank unsuitable for the culture of Indian major carps. The tank was stocked with 8000 fingerlings of Channa marulius and C. striatus during 1981 by the local fisherman co-operative society. Only partial harvest was possible during 1982 because of high water level. The final harvest was in April-May, 1983. The yield obtained was 3640 kg during the culture period of about 20 months

Incidence and Outcomes of Desmoplastic Small Round Cell Tumor: Results from the Surveillance, Epidemiology, and End Results Database

Desmoplastic small round cell tumor (DSRCT) is a rare but highly fatal malignancy. Due to the rarity of this neoplasm, no large population based studies exist. Procedure. This is a retrospective cohort analysis. Incidence rates were calculated based on sex and ethnicity and compared statistically. Gender-, ethnicity-, and treatment-based survival were calculated using the Kaplan-Meier method. Results. A total of 192 cases of DSRCT were identified. Peak incidence age was between 20 and 24 years. Age-adjusted incidence rate for blacks was 0.5 cases/million and for whites was 0.2 cases/million ( = 0.037). There was no statistically significant difference in survival based on gender or ethnicity. When adjusted for age, there was no statistically significant difference in survival amongst patients who received radiation therapy compared to those who did not (HRadj = 0.73; 95% CI 0.49, 1.11). There was a statistically significant survival advantage for patients who received radiation after surgery compared to those who did not (HR 0.49; 95% CI 0.30, 0.79). Conclusion. DSRCT is more common in males and in people of African-American descent. Although overall survival remains poor, radiation therapy following surgery seems to improve outcome in these patients

Self medication among elderly poses challenges in urban settings

Background: Self-medication can be defined as obtaining and consuming one (or more) drug(s) without the advice of a physician. Using over the counter medicine is a common practice in developing countries including India. Studies have shown relatively high rates of self-medication among elderly and suggested awareness programmes among this group. Objectives of current study are to determine the prevalence of self-medication among geriatric population and to educate them about self-medication by an interactive session.Methods This was a cross sectional, questionnaire based study to evaluate the prevalence of self-medication in geriatric population in senior citizen club of Adajan and Ghoddod area of Surat city. Questionnaires were designed and modified from previous studies. Written informed consent was taken from those willing to participate in the study. After filling of pre-questionnaire, an interactive session was arranged and post-questionnaire were given to all participants. Data obtained were subjected to statistical analysis.Results: Number of participants in present study was 100. Self-medication was most common in age group of 65 to 75 years (48%) followed by less than 65 years (33%). 85% participants reported having taken non-prescription drugs. Drugs commonly used for self-medication were analgesics (85) and antacids (80). Side effects due to self-medication were reported by 22 participants. Main reasons for self-medication cited were to save expenses (65) and to save time (62). Post study awareness increased to 98%.Conclusions: Prevalence of self-medication is high in elderly. Interactive session can increase awareness regarding self-medication

Towards a Circular Economy: An Emerging Economies Context

yesCircular Economy (CE) and the adoption of its principles globally are more important than ever to sustain the rate of production of goods and services to meet the ever-increasing consumer demand that is burdening the environment and society. This study investigates the adoption of CE principles amongst emerging economies as the challenges faced by these economies are generally different in terms of resource availability, varying government policies and consumer behaviour from those of developed economies. This research presents an empirically validated CE adoption model using a sample of 183 consumer responses. The study highlights the strong influence of factors such as consumer behaviour on the acceptance of remanufactured products and using products as a service to encourage the adoption of CE practices in emerging economies. This research offers businesses, consumers and policy makers insights into measures that have been taken by emerging economies that are in line with CE principles

National Cancer Institute–National Heart, Lung and Blood Institute/Pediatric Blood and Marrow Transplant Consortium First International Consensus Conference on Late Effects After Pediatric Hematopoietic Cell Transplantation: Long-Term Organ Damage and Dysfunction

Long-term complications after hematopoietic cell transplantation (HCT) have been studied in detail. Although virtually every organ system can be adversely affected after HCT, the underlying pathophysiology of these late effects remain incompletely understood. This article describes our current understanding of the pathophysiology of late effects involving the gastrointestinal, renal, cardiac, and pulmonary systems, and discusses post-HCT metabolic syndrome studies. Underlying diseases, pretransplantation exposures, transplantation conditioning regimens, graft-versus-host disease, and other treatments contribute to these problems. Because organ systems are interdependent, long-term complications with similar pathophysiologic mechanisms often involve multiple organ systems. Current data suggest that post-HCT organ complications result from cellular damage that leads to a cascade of complex events. The interplay between inflammatory processes and dysregulated cellular repair likely contributes to end-organ fibrosis and dysfunction. Although many long-term problems cannot be prevented, appropriate monitoring can enable detection and organ-preserving medical management at earlier stages. Current management strategies are aimed at minimizing symptoms and optimizing function. There remain significant gaps in our knowledge of the pathophysiology of therapy-related organ toxicities disease after HCT. These gaps can be addressed by closely examining disease biology and identifying those patients at greatest risk for adverse outcomes. In addition, strategies are needed for targeted disease prevention and health promotion efforts for individuals deemed at high risk because of their genetic makeup or specific exposure profile