“Green” Technology and Ecologically Unequal Exchange: The Environmental and Social Consequences of Ecological Modernization in the World-System

This paper contributes to understandings of ecologically unequal exchange within the world-systems perspective by offering a series of case studies of ecological modernization in the automobile industry. The case studies demonstrate that “green” technologies developed and instituted in core nations often require specific raw materials that are extracted from the periphery and semi-periphery. Extraction of such natural resources causes significant environmental degradation and often displaces entire communities from their land. Moreover, because states often use violence and repression to facilitate raw material extraction, the widespread commercialization of “green” technologies can result in serious human rights violations. These findings challenge ecological modernization theory, which rests on the assumption that the development and commercialization of more ecologically-efficient technologies is universally beneficial

GSE1 Postgraduate Information Literacy and Communication Skills Training-Project Orientated Delivery

Module presented by the Faculty of Science and Engineering in cooperation with the Subject Librarian from Learning Teaching and Research Development in the Library. Original format was four three hour workshops plus 18 hrs self paced course work using interdisciplinary written and verbal skills training tasks . Translate a peer reviewed Journal paper to communicate it to a interdisciplinary audience and prepare a short presentation. It was enhanced with the introduction of a peer-learning component by dividing participants into four groups of eight. A project orientated and problem based learning (POPBL) approach has been shown to work well in the delivery of educational outcomes and also in the delivery of Information Literac

Sustainable Rundale, Runrig, and Northern English Open-Field Historical Farming Systems: A Comparative Analysis

The wide spatial distribution and the similarity of the agricultural systems in Ireland, Scotland and northern England suggests that they do not emerge from a common stem, but arose out of independent invention in the form of similar responses in comparable environments to the fiscal and rent demands made upon rural communities and the need to manage the land in a sustainable manner. That view also allows that rundale, runrig and the northern English open fields might have emerged at different times as rural groups worked out their solutions to managing the land

The impact of immediate breast reconstruction on the time to delivery of adjuvant therapy: the iBRA-2 study

Background: Immediate breast reconstruction (IBR) is routinely offered to improve quality-of-life for women requiring mastectomy, but there are concerns that more complex surgery may delay adjuvant oncological treatments and compromise long-term outcomes. High-quality evidence is lacking. The iBRA-2 study aimed to investigate the impact of IBR on time to adjuvant therapy. Methods: Consecutive women undergoing mastectomy ± IBR for breast cancer July–December, 2016 were included. Patient demographics, operative, oncological and complication data were collected. Time from last definitive cancer surgery to first adjuvant treatment for patients undergoing mastectomy ± IBR were compared and risk factors associated with delays explored. Results: A total of 2540 patients were recruited from 76 centres; 1008 (39.7%) underwent IBR (implant-only [n = 675, 26.6%]; pedicled flaps [n = 105,4.1%] and free-flaps [n = 228, 8.9%]). Complications requiring re-admission or re-operation were significantly more common in patients undergoing IBR than those receiving mastectomy. Adjuvant chemotherapy or radiotherapy was required by 1235 (48.6%) patients. No clinically significant differences were seen in time to adjuvant therapy between patient groups but major complications irrespective of surgery received were significantly associated with treatment delays. Conclusions: IBR does not result in clinically significant delays to adjuvant therapy, but post-operative complications are associated with treatment delays. Strategies to minimise complications, including careful patient selection, are required to improve outcomes for patients

Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH): a stepped-wedge cluster-randomised trial

Background: Emergency abdominal surgery is associated with poor patient outcomes. We studied the effectiveness of a national quality improvement (QI) programme to implement a care pathway to improve survival for these patients. Methods: We did a stepped-wedge cluster-randomised trial of patients aged 40 years or older undergoing emergency open major abdominal surgery. Eligible UK National Health Service (NHS) hospitals (those that had an emergency general surgical service, a substantial volume of emergency abdominal surgery cases, and contributed data to the National Emergency Laparotomy Audit) were organised into 15 geographical clusters and commenced the QI programme in a random order, based on a computer-generated random sequence, over an 85-week period with one geographical cluster commencing the intervention every 5 weeks from the second to the 16th time period. Patients were masked to the study group, but it was not possible to mask hospital staff or investigators. The primary outcome measure was mortality within 90 days of surgery. Analyses were done on an intention-to-treat basis. This study is registered with the ISRCTN registry, number ISRCTN80682973. Findings: Treatment took place between March 3, 2014, and Oct 19, 2015. 22 754 patients were assessed for elegibility. Of 15 873 eligible patients from 93 NHS hospitals, primary outcome data were analysed for 8482 patients in the usual care group and 7374 in the QI group. Eight patients in the usual care group and nine patients in the QI group were not included in the analysis because of missing primary outcome data. The primary outcome of 90-day mortality occurred in 1210 (16%) patients in the QI group compared with 1393 (16%) patients in the usual care group (HR 1·11, 0·96–1·28). Interpretation: No survival benefit was observed from this QI programme to implement a care pathway for patients undergoing emergency abdominal surgery. Future QI programmes should ensure that teams have both the time and resources needed to improve patient care. Funding: National Institute for Health Research Health Services and Delivery Research Programme

Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH): a stepped-wedge cluster-randomised trial

BACKGROUND: Emergency abdominal surgery is associated with poor patient outcomes. We studied the effectiveness of a national quality improvement (QI) programme to implement a care pathway to improve survival for these patients. METHODS: We did a stepped-wedge cluster-randomised trial of patients aged 40 years or older undergoing emergency open major abdominal surgery. Eligible UK National Health Service (NHS) hospitals (those that had an emergency general surgical service, a substantial volume of emergency abdominal surgery cases, and contributed data to the National Emergency Laparotomy Audit) were organised into 15 geographical clusters and commenced the QI programme in a random order, based on a computer-generated random sequence, over an 85-week period with one geographical cluster commencing the intervention every 5 weeks from the second to the 16th time period. Patients were masked to the study group, but it was not possible to mask hospital staff or investigators. The primary outcome measure was mortality within 90 days of surgery. Analyses were done on an intention-to-treat basis. This study is registered with the ISRCTN registry, number ISRCTN80682973. FINDINGS: Treatment took place between March 3, 2014, and Oct 19, 2015. 22 754 patients were assessed for elegibility. Of 15 873 eligible patients from 93 NHS hospitals, primary outcome data were analysed for 8482 patients in the usual care group and 7374 in the QI group. Eight patients in the usual care group and nine patients in the QI group were not included in the analysis because of missing primary outcome data. The primary outcome of 90-day mortality occurred in 1210 (16%) patients in the QI group compared with 1393 (16%) patients in the usual care group (HR 1·11, 0·96-1·28). INTERPRETATION: No survival benefit was observed from this QI programme to implement a care pathway for patients undergoing emergency abdominal surgery. Future QI programmes should ensure that teams have both the time and resources needed to improve patient care. FUNDING: National Institute for Health Research Health Services and Delivery Research Programme

Environmental inequality: Race, income, and industrial pollution in Detroit

Over the last ten to fifteen years, an expanding body of research has sought to ascertain whether environmental hazards are distributed equitably according to race and income. While much attention has been paid to the relative ability of each of these variables to predict increased hazard levels, little attention has been paid to the forces giving rise to environmental inequality. This dissertation fills this gap by examining the forces giving rise to the current distribution of industrial pollution in the Detroit metropolitan area. The dissertation addresses three basic questions. First, is there a positive association between manufacturing facility presence and race in the Detroit area? In other words, are blacks more likely than whites to live near potentially hazardous manufacturing facilities? Second, has the distribution of whites and blacks around regional manufacturing facilities changed over time? Third, since it turns out that there is a positive association between facility presence and race in Detroit, why is this the case? Is the racially inequitable distribution of manufacturing facilities in Detroit due to (a) differences in black/white income levels, (b) racist siting practices, or (c) the biased operation of institutional arenas such as the housing market? It turns out that the racially inequitable distribution of manufacturing facilities in the Detroit metropolitan area is not the result of black/white income inequality or racist siting practices. Instead, the distribution of blacks and whites around the region's manufacturing facilities is shaped by residential segregation. Thus, racial status and racism are important determinants of environmental stratification in the Detroit metropolitan area

Implications of the environmental justice movement for environmental education

Master of ScienceNatural Resources and EnvironmentUniversity of Michiganhttp://deepblue.lib.umich.edu/bitstream/2027.42/101549/1/39015032597836.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/101549/2/39015032597836.pd