The impact on life cycle carbon footprint of converting from disposable to reusable sharps containers in a large US hospital geographically distant from manufacturing and processing facilities

Background Sustainable purchasing can reduce greenhouse gas (GHG) emissions at healthcare facilities (HCF). A previous study found that converting from disposable to reusable sharps containers (DSC, RSC) reduced sharps waste stream GHG by 84% but found transport distances impacted significantly on GHG outcomes and recommended further studies where transport distances are large. This case-study examines the impact on GHG of nation-wide transport distances when a large US health system converted from DSC to RSC. Methods The study’s scope was to examine life cycle GHG emissions during 12 months of facility-wide use of DSC and RSC at Loma Linda University Health (LLUH). The facility is an 1100-bed US, 5-hospital system where: the source of polymer was distant from the RSC manufacturing plant; both manufacturing plants were over 3,000 km from the HCF; and the RSC processing plant was considerably further from the HCF than was the DSC disposal plant. Using a “cradle to grave” life cycle GHG tool we calculated the annual GHG emissions of CO2, CH4 and N2O expressed in metric tonnes of carbon dioxide equivalents (MTCO2eq) for each container system. Primary energy input data was used wherever possible and region-specific energy-impact conversions were used to calculate GHG of each unit process over a 12-month period. The scope included Manufacture, Transport, Washing, and Treatment & disposal. GHG emissions from all unit process within these four life cycle stages were summed to estimate each container-system’s carbon footprint. Emission totals were workload-normalized and analysed using CHI2test with P ≤ 0.05 and rate ratios at 95% CL. Results Converting to RSC, LLUH reduced its annual GHG by 162.4 MTCO2eq (−65.3%; p < 0.001; RR 2.27–3.71), and annually eliminated 50.2 tonnes of plastic DSC and 8.1 tonnes of cardboard from the sharps waste stream. Of the plastic eliminated, 31.8 tonnes were diverted from landfill and 18.4 from incineration. Discussion Unlike GHG reduction strategies dependent on changes in staff behavior (waste segregation, recycling, turning off lights, car-pooling, etc), purchasing strategies can enable immediate, sustainable and institution-wide GHG reductions to be achieved. This study confirmed that large transport distances between polymer manufacturer, container manufacturer, user and processing facilities, can significantly impact the carbon footprint of sharps containment systems. However, even with large transport distances, we found that a large university health system significantly reduced the carbon footprint of their sharps waste stream by converting from DSC to RSC

Extending NASA Research Results to Benefit Society: Rapid Prototyping for Coastal Applications

The mission of the NASA Applied Sciences Program is to expand and accelerate the use of NASA research results to benefit society in 12 application areas of national priority. ONe of the program's major challenges is to perform a quick, efficient, and detailed review (i.e., prototyping) of the large number of combinations of NASA observations and results from Earth system models that may be used by a wide range of decision support tools. A Rapid Prototyping Capacity (RPC) is being developed to accelerate the use of NASA research results. Here, we present the conceptual framework of the Rapid Prototyping Capacity within the context of quickly assessing the efficacy of NASA research results and technologies to support the Coastal Management application. An initial RPC project designed to quickly evaluate the utility of moderate-resolution MODIS products for calibrating/validating coastal sediment transport models is also presented

Verification and Validation of NASA-Supported Enhancements to the Near Real Time Harmful Algal Blooms Observing System (HABSOS)

This report discusses verification and validation (V&V) assessment of Moderate Resolution Imaging Spectroradiometer (MODIS) ocean data products contributed by the Naval Research Laboratory (NRL) and Applied Coherent Technologies (ACT) Corporation to National Oceanic Atmospheric Administration s (NOAA) Near Real Time (NRT) Harmful Algal Blooms Observing System (HABSOS). HABSOS is a maturing decision support tool (DST) used by NOAA and its partners involved with coastal and public health management

Dietary modification for women after breast cancer treatment: a narrative review

Diet is thought to account for about 25% of cancers in developed countries. It is well documented that the risks associated with both the breast cancer itself and its treatments are important for women previously treated for breast cancer. Women are at risk of recurrence of the primary disease and prone to develop treatment-induced co-morbidities, some of which are thought to be modified by diet. With a view to making dietary recommendations for the breast cancer patients we encounter in our clinical nursing research, we mined the literature to scope the most current robust evidence concerning the role of the diet in protecting women against the recurrence of breast cancer and its potential to ameliorate some of the longer-term morbidities associated with the disease. We found that the evidence about the role of the diet in breast cancer recurrence is largely inconclusive. However, drawing on international guidelines enabled us to make three definitive recommendations. Women at risk of breast cancer recurrence, or who experience co-morbidities as a result of treatment, should limit their exposure to alcohol, moderate their nutritional intake so it does not contribute to postmenopausal weight gain, and should adhere to a balanced diet. Nursing education planned for breast cancer patients about dietary issues should ideally be individually tailored, based on a good understanding of the international recommendations and the evidence underpinning the

Perfectionism and achievement goals in young Finnish ice-hockey players aspiring to make the Under-16 national team

Research on perfectionism suggests that is it useful to differentiate between perfectionistic strivings and perfectionistic concerns. Regarding the 2 x 2 achievement goal framework, the usefulness of this differentiation was recently demonstrated in a study with university student athletes (Stoeber, Stoll, Pescheck, & Otto, 2008, Study 2), in which it was found that perfectionistic strivings were associated with mastery-approach and performance-approach goals and perfectionistic concerns with mastery-avoidance, performance-approach, and performance-avoidance goals. Because the study was largely exploratory and only used non-elite athletes, the aim of the present research was to replicate and extend these findings by investigating a sample of 138 young, elite ice-hockey players, while adding further measures of perfectionism and using structural equation modelling (SEM) to confirm the relationships between perfectionistic strivings, perfectionistic concerns,and the 2 x 2 achievement goals. The SEM results showed that, in elite athletes also, perfectionistic strivings are associated with mastery-approach and performance-approach goals, whereas perfectionistic concerns are associated with masteryavoidance, performance-approach, and performance-avoidance goals. Our findings corroborate the importance of differentiating between perfectionistic strivings and perfectionistic concerns when studying perfectionism in sports, because only perfectionistic concerns (and not perfectionistic strivings) are associated with maladaptive patterns of achievement goals

Design as a catalyst for engaging students in creative problem solving

This project addressed an identified need to support academics in the design and redevelopment of curricula in which creativity is embedded and serves as a catalyst for engaging students in the creative problem solving process (CPS). Project aims The project aimed to achieve this through the design and development of a CPS framework and open source online CPS tools (Ingenium) to act as a scaffold for academics in the development and redevelopment of courses (Ingenium Teacher's Tool) and a CPS tool for students (Ingenium Student's Tool) to guide them through the creative problem solving process in their coursework. The project also aimed to develop guidelines for academics and students, trials of the use of CPS in courses across a range of disciplinary fields and a suite of resources available via the project site. Through an engaged dissemination approach, the project sought to have an impact on the wider higher education sector. Research approach A design-based research (DBR) approach was adopted to develop a CPS framework and open source suite of CPS tools for academics, students and researchers. The DBR approach involved an iterative approach incorporating design of the CPS tools, trialling the tools in courses, evaluating the academic and student experience in those courses and then redesigning the tools based on the formative feedback. The CPS tools were developed as open source applications to enable them to be adapted to different institutional contexts and to ensure long term sustainability through further developments by the open source community. Formative feedback was obtained from academics and students via an anonymous online survey identifying the benefits and challenges in following the creative problem solving approach as well as the usability of the tools developed for teachers and students (see Appendix A for copy of research instruments). The research method included interviews with academics who trialled the tools and resources at the conclusion of the project to identify guidelines to assist other academics wishing to embed CPS in their curriculum. These guidelines were also informed by analysis of the trials developed through the trials and the findings from focus groups conducted at an employers' forum facilitated by the Career Services Team from the Learning and Teaching Unit at the University of South Australia. The primary methods for evaluation of Ingenium were online and paper-based anonymous surveys for both the teachers and students participating in the trials, as well as teacher reflections on the experiences of their students and semi-structured interviews conducted with academics at the completion of the trials. The project website and CPS tools were also subjected to auditing for accessibility against the World Wide Web Consortium's (W3C) Web Content Accessibility Guidelines to ensure compliance at Double AA standards. An independent summative evaluation was undertaken by Ms Deanne Gannaway, Manager of the Evaluation Unit, at The University of Queensland. This summative evaluation included review of the project site and deliverables, review of project documentation and communication and interviews conducted with project team members and academics participating in the trials. Ms Gannaway's recommendations have been incorporated into the recommendations section of this report

Amphetamine-evoked c- fos mRNA expression in the caudate-putamen: the effects of DA and NMDA receptor antagonists vary as a function of neuronal phenotype and environmental context

Dopamine (DA) and glutamate neurotransmission is thought to be critical for psychostimulant drugs to induce immediate early genes (IEGs) in the caudate-putamen (CPu). We report here, however, that the ability of DA and glutamate NMDA receptor antagonists to attenuate amphetamine-evoked c- fos mRNA expression in the CPu depends on environmental context. When given in the home cage, amphetamine induced c- fos mRNA expression predominately in preprodynorphin and preprotachykinin mRNA-containing neurons (Dyn-SP+ cells) in the CPu. In this condition, all of the D1R, D2R and NMDAR antagonists tested dose-dependently decreased c- fos expression in Dyn-SP+ cells. When given in a novel environment, amphetamine induced c- fos mRNA in both Dyn-SP+ and preproenkephalin mRNA-containing neurons (Enk+ cells). In this condition, D1R and non-selective NMDAR antagonists dose-dependently decreased c- fos expression in Dyn-SP+ cells, but neither D2R nor NR2B-selective NMDAR antagonists had no effect. Furthermore, amphetamine-evoked c- fos expression in Enk+ cells was most sensitive to DAR and NMDAR antagonism; the lowest dose of every antagonist tested significantly decreased c- fos expression only in these cells. Finally, novelty-stress also induced c- fos expression in both Dyn-SP+ and Enk+ cells, and this was relatively resistant to all but D1R antagonists. We suggest that the mechanism(s) by which amphetamine evokes c- fos expression in the CPu varies depending on the stimulus (amphetamine vs. stress), the striatal cell population engaged (Dyn-SP+ vs. Enk+ cells), and environmental context (home vs. novel cage).Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66272/1/j.1471-4159.2003.01815.x.pd

Patients with chronic three-vessel disease in a 15-year follow-up study: genetic and non-genetic predictors of survival.

Genetic and non-genetic predictors of 15-year survival in patients with chronic three-vessel disease (3VD) were investigated. Coronary angiography was performed on 810 subjects with symptoms of stable ischemic heart disease in 1998. The patients with 3VD were genotyped for 23 candidate polymorphisms covering the PPAR-RXR pathway, matrix metalloproteinase-2, renin-angiotensin-aldosterone system, endothelin-1, cytokine genes, MTHFR and APO E variants. Fifteen-year survival data were obtained from the national insurance registry. All data were available in the case of 150 patients with 3VD. Statistical analysis used stepwise Cox regression with dominant, recessive, or additive mode of genetic expression. Involved variables included age, sex, BMI, blood pressure, diabetes, ejection fraction, left main stenosis, previously diagnosed coronary stenosis, myocardial infarction in personal history, and coronary bypass along with polymorphisms pre-selected by log-rank tests. Out of the 23 polymorphisms, four were included in the model construction. SNP in the IL-6 gene rs1800795 (-174 G/C) has been found to be a significant predictor of survival. This SNP was in a linkage disequilibrium with rs1800797 (-597 G/A) in the same gene (D=1.0), which was also found to constitute a significant predictor of survival when rs1800795 was not included in the model construction. Age, increased BMI, diabetes, low EF, and left main stenosis were also significant predictors in all models. Age, increased BMI, diabetes, low ejection fraction, left main stenosis, and genetic variation in the IL-6 promoter were established as significant independent risk factors for the survival of patients with three-vessel disease.Genetic and non-genetic predictors of 15-year survival in patients with chronic three-vessel disease (3VD) were investigated. Coronary angiography was performed on 810 subjects with symptoms of stable ischemic heart disease in 1998. The patients with 3VD were genotyped for 23 candidate polymorphisms covering the PPAR-RXR pathway, matrix metalloproteinase-2, renin-angiotensin-aldosterone system, endothelin-1, cytokine genes, MTHFR and APO E variants. Fifteen-year survival data were obtained from the national insurance registry. All data were available in the case of 150 patients with 3VD. Statistical analysis used stepwise Cox regression with dominant, recessive, or additive mode of genetic expression. Involved variables included age, sex, BMI, blood pressure, diabetes, ejection fraction, left main stenosis, previously diagnosed coronary stenosis, myocardial infarction in personal history, and coronary bypass along with polymorphisms pre-selected by log-rank tests. Out of the 23 polymorphisms, four were included in the model construction. SNP in the IL-6 gene rs1800795 (-174 G/C) has been found to be a significant predictor of survival. This SNP was in a linkage disequilibrium with rs1800797 (-597 G/A) in the same gene (D=1.0), which was also found to constitute a significant predictor of survival when rs1800795 was not included in the model construction. Age, increased BMI, diabetes, low EF, and left main stenosis were also significant predictors in all models. Age, increased BMI, diabetes, low ejection fraction, left main stenosis, and genetic variation in the IL-6 promoter were established as significant independent risk factors for the survival of patients with three-vessel disease

Active and passive smoking and the risk of breast cancer in women aged 36–45 years: a population based case–control study in the UK

Active smoking has little or no effect on breast cancer risk but some investigators have suggested that passive smoking and its interaction with active smoking may be associated with an increased risk. In a population based case–control study of breast cancer in women aged 36–45 years at diagnosis, information on active smoking, passive smoking in the home, and other factors, was collected at interview from 639 cases and 640 controls. Women were categorised jointly by their active and passive smoking exposure. Among never smoking controls, women who also reported no passive smoking exposure were significantly more likely to be nulliparous and to be recent users of oral contraceptives. Among those never exposed to passive smoking, there was no significant association between active smoking and breast cancer, relative risk (RR) of 1.12 (95% confidence interval (CI) 0.72–1.73) for past smokers and RR of 1.19 (95% CI 0.72–1.95) for current smokers, nor was there an association with age started, duration or intensity of active smoking. Compared with women who were never active nor passive smokers, there was no significant association between passive smoking in the home and breast cancer risk in never smokers, RR of 0.89 (95% CI 0.64–1.25), in past smokers, RR of 1.09 (95% CI 0.75–1.56), or in current smokers, RR of 0.93 (95% CI 0.67–1.30). There was no trend with increasing duration of passive smoking and there was no heterogeneity among any of the subgroups examined. In this study, there was no evidence of an association between either active smoking or passive smoking in the home and risk of breast cancer