Peer Review Panel: A New Zealand approach to regulatory compliance of landfills

New Zealand is increasingly using a Peer Review Panel (PRP) system for regulatory compliance of complex and contentious environmental infrastructure facilities, such as landfills. The PRP is a set of experts who serve as an advisor to the operator and the regulator, and are responsible to both parties for independent assessments. The PRP for the Kate Valley landfill facility is presented as a case study in the motivation for, and operation of, a PRP. The use of the PRP arises partly from the effects-based environmental legislation in New Zealand, which leads to a lack of standardization in construction/operation and unique permit conditions at each site. The PRP meets with operators on a regular basis, conducts site visits, receives relevant documentation, and prepares an annual report for regulatory authorities. The PRP is able to examine and discuss safety, financial, and operational issues with the operators while maintaining confidentiality. This allows for open discussions of these issues where they might impact on environmental performance. The PRP also assists operators by providing them with technical information and experience from outside the operator’s business environment. The PRP is a valuable option for regulatory bodies and project proponents to consider when developing permits for any one-off, complex facility with potentially large environmental impacts, and with great public concern

The relationship between life stress and sporting injuries

This study was designed to investigate the relationship between life stress and sporting injuries, and factors mediating that relationship. Eighty two Soccer players and sixty eight Rugby players had their injuries recorded for a three month period. Subjects were then administered the Social and Athletic Readjustment Rating Scale (Bramwell, Masuda, Wagner, & Holmes, 1975), a measure of life stresses for athletes, along with the Test of Attentional and Interpersonal Style (Nideffer, 1976), and the Sport Competition Anxiety Test. (Martens, 1977). The results indicated a relationship between high life stress and sporting injuries for Rugby players, but not for Soccer players. No significant differences in life stress scores were found for those players categorized as having suffered minor, moderate, or major injuries. Competitive Trait Anxiety, attention, and fatigue were examined as moderator variables in the life stress/sporting injury relationship, and were found to have no significant effects. It was concluded that the differences between Rugby and Soccer players in the life stress/ sporting injury relationship may be due to differences in a number of variables, particularly Trait Anxiety. While partially supporting past research, the findings indicated that further investigation into the life stress/sporting injury relationship is required

National evaluation of the neighbourhood nurseries: integrated report

Report description: The NNI was launched in 2001 to provide high quality childcare in the most disadvantaged neighbourhoods of England, to help parents into employment, reduce child poverty and boost children’s development. By 2005 45,000 new childcare places had been created in approximately 1,400 neighbourhood nurseries. This report brings together the findings of the four individual strands of the National Evaluation of Neighbourhood Nurseries Initiative as shown above and makes a number of recommendations. The report shows the rationale for the government’s strategy in targeting disadvantaged neighbourhoods and in focusing on high quality childcare to provide the link between raising parental employment and income and improving children’s life chances

Spatial variation in automated burst suppression detection in pharmacologically induced coma

Burst suppression is actively studied as a control signal to guide anesthetic dosing in patients undergoing medically induced coma. The ability to automatically identify periods of EEG suppression and compactly summarize the depth of coma using the burst suppression probability (BSP) is crucial to effective and safe monitoring and control of medical coma. Current literature however does not explicitly account for the potential variation in burst suppression parameters across different scalp locations. In this study we analyzed standard 19-channel EEG recordings from 8 patients with refractory status epilepticus who underwent pharmacologically induced burst suppression as medical treatment for refractory seizures. We found that although burst suppression is generally considered a global phenomenon, BSP obtained using a previously validated algorithm varies systematically across different channels. A global representation of information from individual channels is proposed that takes into account the burst suppression characteristics recorded at multiple electrodes. BSP computed from this representative burst suppression pattern may be more resilient to noise and a better representation of the brain state of patients. Multichannel data integration may enhance the reliability of estimates of the depth of medical coma.National Institutes of Health (U.S.) (Grant K23 NS090900)National Institute of Neurological Diseases and Stroke (U.S.) (Grant K23 NS090900)National Institutes of Health (U.S.) (Grant DP2-OD006454)National Institutes of Health (U.S.) (Grant TROI-GMI04948

Variability in pharmacologically-induced coma for treatment of refractory status epilepticus

Objective To characterize the amount of EEG suppression achieved in refractory status epilepticus (RSE) patients treated with pharmacologically-induced coma (PIC). Methods We analyzed EEG recordings from 35 RSE patients between 21–84 years-old who received PIC that target burst suppression and quantified the amount of EEG suppression using the burst suppression probability (BSP). Then we measured the variability of BSPs with respect to a reference level of BSP 0.8 ± 0.15. Finally, we also measured the variability of BSPs with respect to the amount of intravenous anesthetic drugs (IVADs) received by the patients. Results Patients remained in the reference BSP range for only 8% (median, interquartile range IQR [0, 29] %) of the total time under treatment. The median time with BSP below the reference range was 84% (IQR [37, 100] %). BSPs in some patients drifted significantly over time despite constant infusion rates of IVADs. Similar weight-normalized infusion rates of IVADs in different patients nearly always resulted in distinct BSPs (probability 0.93 (IQR [0.82, 1.0]). Conclusion This study quantitatively identified high variability in the amount of EEG suppression achieved in clinical practice when treating RSE patients. While some of this variability may arise from clinicians purposefully deviating from clinical practice guidelines, our results show that the high variability also arises in part from significant inter- and intra- individual pharmacokinetic/pharmacodynamic variation. Our results indicate that the delicate balance between maintaining sufficient EEG suppression in RSE patients and minimizing IVAD exposure in clinical practice is challenging to achieve. This may affect patient outcomes and confound studies seeking to determine an optimal amount of EEG suppression for treatment of RSE. Therefore, our analysis points to the need for developing an alternative paradigm, such as vigilant anesthetic management as happens in operating rooms, or closed-loop anesthesia delivery, for investigating and providing induced-coma therapy to RSE patients

When does economic development promote mitigation and why?

Is economic development compatible with mitigation? On the one hand, development should promote effective climate policy by enhancing states’ capacities for mitigation. On the other hand, economic growth creates more demand for production, thereby inhibiting emissions reduction. These arguments are often reconciled in the environmental Kuznets curve (EKC) thesis. According to this approach, development initially increases emissions in poor economies, but begins to lower emissions after a country has attained a certain level of development. The aim of this article is to determine empirically whether the EKC hypothesis seems plausible in light of emissions trends over the birth and implementation of the Kyoto Protocol. Drawing on data from the World Bank World Development Indicators and World Resources Institute Climate Data Explorer, it conducts a large-N investigation of the emissions behaviour of 120 countries from 1990 to 2012. While several quantitative studies have found that economic factors influence emissions activity, this article goes beyond existing research by employing a more sophisticated – multilevel – research design to determine whether economic development: (a) continues to be a significant driver once country-level clustering is accounted for and (b) has different effects on different countries. The results of this article indicate that, even after we account for country-level clustering and hold constant the other main putative drivers of emissions activity, economic development tends to inhibit emissions reduction. They also provide strong evidence that emissions trends resemble the EKC, with development significantly constraining emissions reduction in the South and promoting it in the North

An enhanced cerebral recovery index for coma prognostication following cardiac arrest

Prognostication of coma outcomes following cardiac arrest is both qualitative and poorly understood in current practice. Existing quantitative metrics are powerful, but lack rigorous approaches to classification. This is due, in part, to a lack of available data on the population of interest. In this paper we describe a novel retrospective data set of 167 cardiac arrest patients (spanning three institutions) who received electroencephalography (EEG) monitoring. We utilized a subset of the collected data to generate features that measured the connectivity, complexity and category of EEG activity. A subset of these features was included in a logistic regression model to estimate a dichotomized cerebral performance category score at discharge. We compared the predictive performance of our method against an established EEG-based alternative, the Cerebral Recovery Index (CRI) and show that our approach more reliably classifies patient outcomes, with an average increase in AUC of 0.27

The human burst suppression electroencephalogram of deep hypothermia

Objective: Deep hypothermia induces 'burst suppression' (BS), an electroencephalogram pattern with low-voltage 'suppressions' alternating with high-voltage 'bursts'. Current understanding of BS comes mainly from anesthesia studies, while hypothermia-induced BS has received little study. We set out to investigate the electroencephalogram changes induced by cooling the human brain through increasing depths of BS through isoelectricity. Methods: We recorded scalp electroencephalograms from eleven patients undergoing deep hypothermia during cardiac surgery with complete circulatory arrest, and analyzed these using methods of spectral analysis. Results: Within patients, the depth of BS systematically depends on the depth of hypothermia, though responses vary between patients except at temperature extremes. With decreasing temperature, burst lengths increase, and burst amplitudes and lengths decrease, while the spectral content of bursts remains constant. Conclusions: These findings support an existing theoretical model in which the common mechanism of burst suppression across diverse etiologies is the cyclical diffuse depletion of metabolic resources, and suggest the new hypothesis of local micro-network dropout to explain decreasing burst amplitudes at lower temperatures. Significance: These results pave the way for accurate noninvasive tracking of brain metabolic state during surgical procedures under deep hypothermia, and suggest new testable predictions about the network mechanisms underlying burst suppression.National Institutes of Health (U.S.) (Grant DP2-OD006454)National Institutes of Health (U.S.) (Grant DP1-OD003646)National Institutes of Health (U.S.) (Grant TR01-GM104948