Developing Energy and Environmental Reporting Protocols

In this paper, we concentrate on the reporting and verification of energy and emissions reductions rather than absolute levels. Absolute emissions levels are collected by the US Department of Energy`s (US DOE) Energy Information Administration (EIA) and other agencies, using reporting and verification procedures that are straightforward and build upon previous data collection activities. In contrast, energy savings or reductions cannot be measured directly; instead they must be estimated by subtracting the final energy use from initial energy use. In the meantime, conditions may change, such as economic activity or weather, so that a simple subtraction may yield misleading results. Therefore, estimation, verification, and reporting of energy and emissions savings require considerably more information to ensure that the reductions are due to efficiency improvements rather changes in other conditions. The treatment of this additional information is a major challenge in efforts to report and tabulate energy savings in a consistent manner. This paper identifies several problem areas in reporting programs and some of the mechanisms for dealing with them

Análisis coste-efectividad de la automonitorización de la glucosa sanguínea en diabéticos tipo 2

Objetivo Comparar el coste-efectividad de la práctica de la automonitorización de glucosa en sangre capilar (MGS) frente a su no uso. Métodos Estudio descriptivo y retrospectivo durante el periodo 1995-1997 sobre 597 pacientes diabéticos tipo 2, de los que 286 practican la MGS y 311 no, seguidos ambulatoriamente en siete áreas básicas de salud (ABS) del ámbito territorial de la Dirección de Atención Primaria Tortosa del Institut Català de la Salut. Se cuantificaron los costes directos relacionados con el consumo de tiras reactivas para la práctica de MGS, visitas en su ABS de referencia, derivaciones al especialista, y pruebas complementarias protocolizadas por la European NIDDM Policy Group en la población usuaria de la MGS y la no-usuaria, así como los costes incremental, medio y total para el consumo de tiras reactivas y en el caso de la aplicación de un modelo ideal de cobertura cuantitativa y cualitativa según un consenso clínico, y la razón de coste-efectividad. Resultados Mientras el 78% de los diabéticos cumplen alguna indicación clínica para la prescripción de MGS, sólo la practican el 42,5%. El consumo de tiras pasó del 8% al 15% del gasto médico total de los diabéticos, que en la aplicación del modelo de cobertura ideal la MGS representaría un 30% del coste total. La efectividad lograda, un 27%, no fue significativamente diferente entre los usuarios de la MGS y los no usuarios. El coste-efectividad en los usuarios de la MGS pasó de 210.789 Ptas/año a 213.148 Ptas/año; y en los no usuarios de 162.019 Ptas/año a 162.051 Ptas/año. Si el nivel de efectividad se acercase al de eficacia y se aplicara el modelo ideal de cobertura, el coste-efectividad disminuiría en un 60%, de modo que en los MGS sería de 78.904 Ptas/año y en los no usuarios 54.682 Ptas/año. Conclusiones En las condiciones actuales elegiríamos la opción de no uso de la MGS; la tendencia al mayor coste-efectividad seguirá incrementándose si consideramos que los criterios de control metabólico tienen cada vez valores más bajos y difíciles de lograr; existen evidentes oportunidades para mejorar la gestión y motivar un uso eficiente de una tecnología cuyo consumo está fuertemente asociada a los fallos del mercado sanitario público; el modelo de cobertura ideal debería aplicarse junto a objetivos de mayor efectividad para unificar la eficiencia económica y la clínica.Objective Compare the cost-efectiveness of self-monitoring of blood glucose (MBG) with your non-use. Design Descriptive and retrospective study covering the period 1995-97 in the 597 type-2 diabetes patients: 286 practicing MBG on a stable basis and 311 not doing so. All are registered in seven health districts in the territorial ambit of Tortosa Primary Care. Werw quantified the direct costs in relation to comsumption of reagent strips for the practice of MBG, outpatients visits in your primary care center, derivations to specialist of reference and complementary test according to recomendations of the European NIDDM Policy Group in the population user of MBG and no-user; the annual cost increment, the average annual cost and the total annual cost in the population user of MBG and in the application of a ideal model of quantitative and qualitative cover according to clinical recommendations of the Gedaps; and the cost-effectiveness. Results While the 78% of the total diabetic population satisfy some clinical indication for prescribing MBG, only the 42,5% practice the MBG. The comsumption of reagent strips rising of 8% to 15% of the global cost of the diabetic population. In the aplication of the ideal model of cover, this cost increase up the 30% of global cost. The effectiveness obtained, an 27%, not are significatively different in the population user of MBG and no user. The cost-effectiveness in the user of MBG increased of 210.789 ptes/year to 213.148 ptes/year; and nouser of 162.019 ptes/year to 162.051 ptes/year. The application of ideal model of cover and the gain of an effectiveness near to possible level of efficiencie imply an descent average of cost-effectiveness of approximately 60%: 78.904 ptes/year in user MBG and 54.682 ptes/year in no-user. Conclusions 1. We choose in the presents conditions the option of no-user MBG. 2. The average cost-effectiveness per diabetic patient will increase by the needs of accomodate the therapy to new standards of metabolic control. 3. Are clear oportunity for the improve the management and to motivate an efficient use of tecnology associate to defects of public sanitary market. 4. The model of ideal cover associated to greater effectiveness are necessary for to unify the economic and clinic efficiency

Neoproterozoic cap carbonates: a critical appraisal of existing models and the plumeworld hypothesis

Evidence for glaciation during the mid-late Neoproterozoic is widespread on Earth, reflecting three or more ice ages between 730 Ma and 580 Ma. Of these, the late Neoproterozoic Marinoan glaciation of approximately 635 Ma stands out because of its ubiquitous association with a characteristic, microcrystalline cap dolostone that drapes glacially influenced rock units worldwide. The Marinoan glaciation is also peculiar in that evidence for low altitude glaciation at equatorial latitudes is compelling. Three models have been proposed linking abrupt deglaciation with this global carbonate precipitation event: (i) overturn of an anoxic deep ocean; (ii) catastrophically accelerated rates of chemical weathering because of supergreenhouse conditions following global glaciation (Snowball Earth Hypothesis); and (iii) massive release of carbonate alkalinity from destabilized methane clathrates. All three models invoke extreme alkalinity fluxes into seawater during deglaciation but none explains how such alkalinity excess from point sources could be distributed homogeneously around the globe. In addition, none explains the consistent sequence of precipitation events observed within cap carbonate successions, specifically: (i) the global blanketing of carbonate powder in shallow marine environments during deglaciation; (ii) widespread and disruptive precipitation of dolomite cement; followed by (iii) localized barite precipitation and seafloor cementation by aragonite. The conceptual model presented here proposes that low latitude deglaciation was so massive and abrupt that the resultant meltwater plume could extend worldwide, physically separating the surface and deep ocean reservoirs for ≥103 years. It is proposed that cap dolostones formed primarily by microbially mediated precipitation of carbonate whitings during algal blooms within this low salinity plumeworld rather than by abiotic precipitation from normal salinity seawater. Many of the disruption features that are characteristic of cap dolostones can be explained by microbially mediated, early diagenetic dolomitization and cementation. The re-initiation of whole ocean circulation degassed CO2 into the atmosphere in areas of upwelling, triggering localized, abiotic CaCO3 precipitation in the form of aragonite fans that overlie cap dolostones in NW Canada and Namibia. The highly oxygenated shallow marine environments of the glacial and post-glacial Neoproterozoic world provided consistently favourable conditions for the evolutionary development of animals and other oxygenophiles

How ‘bad apples’ spoil the bunch: Faultlines, emotional levers and exclusion in the workplace

Just as a rotten apple makes other apples around it begin to decay, so too can people influence others within their vicinity, particularly in terms of destructive emotions and behaviors. Trevino and Youngblood (1990) adopted the term ‘bad apples’ to describe individuals who engage in unethical behaviors and who also influence others to behave in a similar manner. In this chapter, the ‘bad apple’ metaphor is adopted to describe the employee whose actions and interactions create and maintain destructive faultlines and unethical exclusion behaviors that negatively impact the emotional well-being and effective and ethical performance of the team. In particular, the chapter examines the way in which ‘bad apples’ use destructive emotion management skills through the manipulation of emotional levers of others, what motivates them to do so and the implications it may have on management