A method and tool for 'cradle to grave' embodied carbon and energy impacts of UK buildings in compliance with the new TC350 standards

As operational impacts from buildings are reduced, embodied impacts are increasing. However, the latter are seldom calculated in the UK; when they are, they tend to be calculated after the building has been constructed, or are underestimated by considering only the initial materials stage. In 2010, the UK Government recommended that a standard methodology for calculating embodied impacts of buildings be developed for early stage design decisions. This was followed in 2011-12 by the publication of the European TC350 standards defining the 'cradle to grave' impact of buildings and products through a process Life Cycle Analysis. This paper describes a new whole life embodied carbon and energy of buildings (ECEB) tool, designed as a usable empirical-based approach for early stage design decisions for UK buildings. The tool complies where possible with the TC350 standards. Initial results for a simple masonry construction dwelling are given in terms of the percentage contribution of each life cycle stage. The main difficulty in obtaining these results is found to be the lack of data, and the paper suggests that the construction and manufacturing industries now have a responsibility to develop new data in order to support this task. © 2013 The Authors. Published by Elsevier B.V. All rights reserved.

Transducer and base compliance alter the in situ 6 dof force measured from muscle during an isometric contraction in a multi-joint limb.

Although musculoskeletal models are commonly used, validating the muscle actions predicted by such models is often difficult. In situ isometric measurements are a possible solution. The base of the skeleton is immobilized and the endpoint of the limb is rigidly attached to a 6-axis force transducer. Individual muscles are stimulated and the resulting forces and moments recorded. Such analyses generally assume idealized conditions. In this study we have developed an analysis taking into account the compliances due to imperfect fixation of the skeleton, imperfect attachment of the force transducer, and extra degrees of freedom (dof) in the joints that sometimes become necessary in fixed end contractions. We use simulations of the rat hindlimb to illustrate the consequences of such compliances. We show that when the limb is overconstrained, i.e., when there are fewer dof within the limb than are restrained by the skeletal fixation, the compliances of the skeletal fixation and of the transducer attachment can significantly affect measured forces and moments. When the limb dofs and restrained dofs are matched, however, the measured forces and moments are independent of these compliances. We also show that this framework can be used to model limb dofs, so that rather than simply omitting dofs in which a limb does not move (e.g., abduction at the knee), the limited motion of the limb in these dofs can be more realistically modeled as a very low compliance. Finally, we discuss the practical implications of these results to experimental measurements of muscle actions.

Complexity and Conundrums in Pollution Control:Improving Effectiveness in Regulatory Compliance

The last century has witnessed a dramatic increase in the wealth of European nations and the well being of their inhabitants. The focus has, however, largely been upon economic growth to the detriment of people and the environment. It is only in recent years that governments have taken cognisance of the impacts of our actions and there is a growing realisation that the causal factors must be identified and addressed as a matter of urgency. One of the key problem areas is pollution and as such environmental protection has become increasingly important as a mechanism for safeguarding the quality of air, water and land. This involves a range of activities from setting standards to monitoring and reporting on discharges and emissions, through to the enforcement of legislation. In theory, this is a simple challenge, in practice, it has proven to be an extremely complex equation that might only begin to be addressed through research. In this context it is strange, and alarming, to find that while it is an axiom of good practice that policy is informed by research there has been a dearth of investigation in this field. The purpose of this paper is, therefore, to consider the issue of pollution, how it impacts on the environment, what measures have been established in pursuit of reducing the number of incidences and, most significantly, which strategies might be employed to avoid or ameliorate detrimental impacts.

Decreased respiratory system compliance on the sixth day of mechanical ventilation is a predictor of death in patients with established acute lung injury

Background: Multiple studies have identified single variables or composite scores that help risk stratify patients at the time of acute lung injury (ALI) diagnosis. However, few studies have addressed the important question of how changes in pulmonary physiologic variables might predict mortality in patients during the subacute or chronic phases of ALI. We studied pulmonary physiologic variables, including respiratory system compliance, P/F ratio and oxygenation index, in a cohort of patients with ALI who survived more than 6 days of mechanical ventilation to see if changes in these variables were predictive of death and whether they are informative about the pathophysiology of subacute ALI.

Availability of stage at diagnosis, cancer treatment delay and compliance with cancer guidelines as cancer registry indicators for cancer care in Europe:Results of EUROCHIP-3 survey

EUROCHIP (European Cancer Health Indicators Project) focuses on understanding inequalities in the cancer burden, care and survival by the indicators "stage at diagnosis," "cancer treatment delay" and "compliance with cancer guidelines" as the most important indicators. Our study aims at providing insight in whether cancer registries collect well-defined variables to determine these indicators in a comparative way. Eighty-six general European population-based cancer registries (PBCR) from 32 countries responded to the questionnaire, which was developed by EUROCHIP in collaboration with ENCR (European Network of Cancer Registries) and EUROCOURSE. Only 15% of all the PBCR in EU had all three indicators available. The indicator "stage at diagnosis" was gathered for at least one cancer site by 81% (using TNM in 39%). Variables for the indicator "cancer treatment delay" were collected by 37%. Availability of type of treatment (30%), surgery date (36%), starting date of radiotherapy (26%) and starting date of chemotherapy (23%) resulted in 15% of the PBCRs to be able to gather the indicator "compliance to guidelines". Lack of data source access and qualified staff were the major reasons for not collecting all the variables. In conclusion, based on self-reporting, a few of the participating PBCRs had data available which could be used for clinical audits, evaluation of cancer care projects, survival and for monitoring national cancer control strategies. Extra efforts should be made to improve this very efficient tool to compare cancer burden and the effects of the national cancer plans over Europe and to learn from each other. © 2012 UICC.

Compliance with recommendations in a geriatric outreach assessment service

Objectives: to measure the extent to which the recommendations of a geriatric outreach assessment service were being followed, and to determine what patient-related factors were associated with compliance with assessment recommendations. Methods: eighty-one eligible patients or caregivers who had an assessment in a geriatric outreach service participated in a telephone interview. The interview focused on the use of health services and compliance with assessment recomendations. Patient-related variables obtained from charts included demographics, caregiver support and stability, health status and assessment recommendations. Results: overall compliance with recommendations from the geriatric outreach assessment service was 65%. Patients were less likely comply fully with recommendations if they had a high number of recommendations [odds ratio (OR) = 0.23; 95% confidence interval (CI) = 0.12-0.46; P = 0.0001], inadequate caregiver support (OR) = 0.212; 95% CI = 0.04 to 1.02; P = 0.0523), or the ability to transfer themselves independently (OR = 0.12; 95% CI = 0.02-0.63; P = 0.0124). They were more likely to have full compliance if they had normal vision (OR = 6.67; 95% CI = 1.22- 36.46; P = 0.0284). Conclusion: it is important to focus on key issues when developing service recommendations and on the role of the informal caregiver in facilitating compliance with them. Good communication between the patient or caregiver and the family physician and geriatric services can help to identify strategies which might improve acceptance of recommendations.