Plan básico para la gestión ambiental del distrito de Cartagena de Indias, Colombia = Basic plan for the environmental management of the district of Cartagena, Colombia

Incluye Bibliografía

The management of cover plant residues for cotton cropped in a no-tillage system

The cutting of plant residue in no-tillage systems under certain environmental conditions becomes necessary to adequately establish and grow crops. This study aims to assess the effect on the yield of different methods of managing millet plant residue in cotton plantations. The study was conducted during the agricultural years 2006/07 and 2007/08, and the treatments included no-mechanical-treatment tillage and the use of a rotary shredder, crimper-roller, and mechanical disintegrator for millet plants before sowing the cotton. Evaluations were performed for the residue fragmentation, emergence speed, percent of soil cover during the cycle and yield of the cotton crop. The emergence speed was faster in the management with the rotary shredder. In 2006/07, the no-tillage treatment showed a rate of loss for soil cover that was 46 percent greater than the disintegrator treatment. The rotary shredder and the disintegrator yielded greater soil coverage during the cultivation cycle, and the yield was highly correlated with the soil cover at 75 days after emergence. The management of the millet residue affected the cotton plants for the two-year study period.

Management of Port Solid Waste Framework

One of contemporary environmental issues refers to progressive and diverse generation of solid waste in urban areas or specific, and requires solutions because the traditional methods of treatment and disposal are becoming unviable over the years and, consequently, a significant contingent of these wastes presents final destination inappropriate. The diversity of solid waste generated as a result of human activities must have the appropriate allocation to specific legislation in force, such as landfill, incineration, among other procedures established by the competent bodies. Thus, also the waste generated in port activities or proceeding vessels require classification and segregation for proper disposal later. This article aims at presenting a methodology for the collection, transportation, treatment and disposal of solid waste port and also application of automation technology that makes possible the implementation of the same.

Consensus Document of the International Union of Angiology (IUA)-2013. Current concept on the management of arterio-venous management

Arterio-venous malformations (AVMs) are congenital vascular malformations (CVMs) that result from birth defects involving the vessels of both arterial and venous origins, resulting in direct communications between the different size vessels or a meshwork of primitive reticular networks of dysplastic minute vessels which have failed to mature to become 'capillary' vessels termed "nidus". These lesions are defined by shunting of high velocity, low resistance flow from the arterial vasculature into the venous system in a variety of fistulous conditions. A systematic classification system developed by various groups of experts (Hamburg classification, ISSVA classification, Schobinger classification, angiographic classification of AVMs,) has resulted in a better understanding of the biology and natural history of these lesions and improved management of CVMs and AVMs. The Hamburg classification, based on the embryological differentiation between extratruncular and truncular type of lesions, allows the determination of the potential of progression and recurrence of these lesions. The majority of all AVMs are extra-truncular lesions with persistent proliferative potential, whereas truncular AVM lesions are exceedingly rare. Regardless of the type, AV shunting may ultimately result in significant anatomical, pathophysiological and hemodynamic consequences. Therefore, despite their relative rarity (10-20% of all CVMs), AVMs remain the most challenging and potentially limb or life-threatening form of vascular anomalies. The initial diagnosis and assessment may be facilitated by non- to minimally invasive investigations such as duplex ultrasound, magnetic resonance imaging (MRI), MR angiography (MRA), computerized tomography (CT) and CT angiography (CTA). Arteriography remains the diagnostic gold standard, and is required for planning subsequent treatment. A multidisciplinary team approach should be utilized to integrate surgical and non-surgical interventions for optimum care. Currently available treatments are associated with significant risk of complications and morbidity. However, an early aggressive approach to elimiate the nidus (if present) may be undertaken if the benefits exceed the risks. Trans-arterial coil embolization or ligation of feeding arteries where the nidus is left intact, are incorrect approaches and may result in proliferation of the lesion. Furthermore, such procedures would prevent future endovascular access to the lesions via the arterial route. Surgically inaccessible, infiltrating, extra-truncular AVMs can be treated with endovascular therapy as an independent modality. Among various embolo-sclerotherapy agents, ethanol sclerotherapy produces the best long term outcomes with minimum recurrence. However, this procedure requires extensive training and sufficient experience to minimize complications and associated morbidity. For the surgically accessible lesions, surgical resection may be the treatment of choice with a chance of optimal control. Preoperative sclerotherapy or embolization may supplement the subsequent surgical excision by reducing the morbidity (e.g. operative bleeding) and defining the lesion borders. Such a combined approach may provide an excellent potential for a curative result. Conclusion. AVMs are high flow congenital vascular malformations that may occur in any part of the body. The clinical presentation depends on the extent and size of the lesion and can range from an asymptomatic birthmark to congestive heart failure. Detailed investigations including duplex ultrasound, MRI/MRA and CT/CTA are required to develop an appropriate treatment plan. Appropriate management is best achieved via a multi-disciplinary approach and interventions should be undertaken by appropriately trained physicians.

Twelve factors influencing sustainable recycling of municipal solid waste in developing countries

Sustainable management of solid waste is a global concern, as exemplified by the United Nations Millennium Development Goals (MDG) that 191 member states support. The seventh MDG indirectly advocates for municipal solid waste management (MSWM) by aiming to ensure environmental sustainability into countries’ policies and programs and reverse negative environmental impact. Proper MSWM will likely result in relieving poverty, reducing child mortality, improving maternal health, and preventing disease, which are MDG goals one, four, five, and six, respectively (UNMDG, 2005). Solid waste production is increasing worldwide as the global society strives to obtain a decent quality of life. Several means exist in which the amount of solid waste going to a landfill can be reduced, such as incineration with energy production, composting of organic wastes, and material recovery through recycling, which are all considered sustainable methods by which to manage MSW. In the developing world, composting is already a widely-accepted method to reduce waste fated for the landfill, and incineration for energy recovery can be a costly capital investment for most communities. Therefore, this research focuses on recycling as a solution to the municipal solid waste production problem while considering the three dimensions of sustainability environment, society, and economy. First, twenty-three developing country case studies were quantitatively and qualitatively examined for aspects of municipal solid waste management. The municipal solid waste (MSW) generation and recovery rates, as well as the composition were compiled and assessed. The average MSW generation rate was 0.77 kg/person/day, with recovery rates varying from 5 – 40%. The waste streams of nineteen of these case studies consisted of 0 – 70% recyclable material and 17 – 80% organic material. All twenty-three case studies were analyzed qualitatively by identifying any barriers or incentives to recycling, which justified the creation of twelve factors influencing sustainable municipal solid waste management (MSWM) in developing countries. The presence of regulations, enforcement of laws, and use of incentive schemes constitutes the first factor, Government Policy. Cost of MSWM operations, the budget allocated to MSWM by local to national governments, as well as the stability and reliability of funds comprise the Government Finances factor influencing recycling in the third world. Many case studies indicated that understanding features of a waste stream such as the generation and recovery rates and composition is the first measure in determining proper management solutions, which forms the third factor Waste Characterization. The presence and efficiency of waste collection and segregation by scavengers, municipalities, or private contractors was commonly addressed by the case studies, which justified Waste Collection and Segregation as the fourth factor. Having knowledge of MSWM and an understanding of the linkages between human behavior, waste handling, and health/sanitation/environment comprise the Household Education factor. Individuals’ income influencing waste handling behavior (e.g., reuse, recycling, and illegal dumping), presence of waste collection/disposal fees, and willingness to pay by residents were seen as one of the biggest incentives to recycling, which justified them being combined into the Household Economics factor. The MSWM Administration factor was formed following several references to the presence and effectiveness of private and/or public management of waste through collection, recovery, and disposal influencing recycling activity. Although the MSWM Personnel Education factor was only recognized by six of the twenty-two case studies, the lack of trained laborers and skilled professionals in MSWM positions was a barrier to sustainable MSWM in every case but one. The presence and effectiveness of a comprehensive, integrative, long-term MSWM strategy was highly encouraged by every case study that addressed the tenth factor, MSWM Plan. Although seemingly a subset of private MSWM administration, the existence and profitability of market systems relying on recycled-material throughput, involvement of small businesses, middlemen, and large industries/exporters is deserving of the factor Local Recycled-Material Market. Availability and effective use of technology and/or human workforce and the safety considerations of each were recurrent barriers and incentives to recycling to warrant the Technological and Human Resources factor. The Land Availability factor takes into consideration land attributes such as terrain, ownership, and development which can often times dictate MSWM. Understanding the relationships among the twelve factors influencing recycling in developing countries, made apparent the collaborative nature required of sustainable MSWM. Factors requiring the greatest collaborative inputs include waste collection and segregation, MSWM plan, and local recycled-material market. Aligning each factor to the societal, environmental, and economic dimensions of sustainability revealed the motives behind the institutions contributing to each factor. A correlation between stakeholder involvement and sustainability existed, as supported by the fact that the only three factors driven by all three dimensions of sustainability were the same three that required the greatest collaboration with other factors. With increasing urbanization, advocating for improved health for all through the MDG, and changing consumption patterns resulting in increasing and more complex waste streams, the utilization of the collaboration web offered by this research is ever needed in the developing world. Through its use, the institutions associated with each of the twelve factors can achieve a better understanding of the collaboration necessary and beneficial for more sustainable MSWM.

Perioperative anaesthetic management of mediastinal mass in adults

Mediastinal mass syndrome remains an anaesthetic challenge that cannot be underestimated. Depending on the localization and the size of the mediastinal tumour, the clinical presentation is variable ranging from a complete lack of symptoms to severe cardiorespiratory problems. The administration of general anaesthesia can be associated with acute intraoperative or postoperative cardiorespiratory decompensation that may result in death due to tumour-related compression syndromes. The role of the anaesthesiologist, as a part of the interdisciplinary treatment team, is to ensure a safe perioperative period. However, there is still no structured protocol available for perioperative anaesthesiological procedure. The aim of this article is to summarize the genesis of and the diagnostic options for mediastinal mass syndrome and to provide a solid detailed methodology for its safe perioperative management based on a review of the latest literature and our own clinical experiences. Proper anaesthetic management of patients with mediastinal mass syndrome begins with an assessment of the preoperative status, directed foremost at establishing the localization of the tumour and on the basis of the clinical and radiological findings, discerning whether any vital mediastinal structures are affected. We have found it helpful to assign 'severity grade' (using a three-grade clinical classification scale: 'safe', 'uncertain', 'unsafe'), whereby each stage triggers appropriate action in terms of staffing and apparatus, such as the provision of alternatives for airway management, cardiopulmonary bypass and additional specialists. During the preoperative period, we are guided by a 12-point plan that also takes into account the special features of transportation into the operating theatre and patient monitoring. Tumour compression on the airways or the great vessels may create a critical respiratory and/or haemodynamic situation, and therefore the standard of intraoperative management includes induction of anaesthesia in the operating theatre on an adjustable surgical table, the use of short-acting anaesthetics, avoidance of muscle relaxants and maintenance of spontaneous respiration. In the case of severe clinical symptoms and large mediastinal tumours, we consider it absolutely essential to cannulate the femoral vessels preoperatively under local anaesthesia and to provide for the availability of cardiopulmonary bypass in the operating theatre, should extracorporeal circulation become necessary. The benefits of establishing vascular access under local anaesthesia clearly outweigh any associated degree of patient discomfort. In the case of patients classified as 'safe' or 'uncertain', a preoperative consensus with the surgeons should be reached as to the anaesthetic approach and the management of possible complications.

PET-CT-guided interventions in the management of FDG-positive lesions in patients suffering from solid malignancies: initial experiences

Positron emission tomography-computed tomography (PET-CT) has gained widespread acceptance as a staging investigation in the diagnostic workup of malignant tumours and may be used to visualize metabolic changes before the evolution of morphological changes. To make histology of PET findings without distinctive structural changes available for treatment decisions, we developed a protocol for multimodal image-guided interventions using an integrated PET-CT machine. We report our first experience in 12 patients admitted for staging and restaging of breast cancer, non-small cell lung cancer, cervical cancer, soft tissue sarcoma, and osteosarcoma. Patients were repositioned according to the findings in PET-CT and intervention was planned based on a subsequent single-bed PET-CT acquisition of the region concerned. The needle was introduced under CT guidance in a step-by-step technique and correct needle position in the centre of the FDG avid lesion was assured by repetition of a single-bed PET-CT acquisition before sampling. The metabolically active part of lesions was accurately targeted in all patients and representative samples were obtained in 92%. No major adverse effects occurred. We conclude that PET-CT guidance for interventions is feasible and may be promising to optimize the diagnostic yield of CT-guided interventions and to make metabolically active lesions without morphological correlate accessible to percutaneous interventions.

Impact of a value chain approach on the sustainability of solid waste management in Mukuru Kwa njenga informal settlements Nairobi, Kenya

En un mundo altamente urbanizado, la gestión de residuos sólidos es un problema primordial en toda ciudad. Las ciudades de paises en desarrollo deben además afrontar retos que no afectan a las ciudades de paises desarrollados. En los paises en desarrollo muchas municipalidades sufren un crecimiento descontrolado de los asentamientos informales sin planificación urbana que hace muy complicada una adecuada gestión de los residuos sólidos urbanos, situación que se agrava al no contar estas con suficientes recursos económicos para llevar a cabo su responsabilidad en cuanto a provisión del sevicio básico de recogida de residuos. La provisión de servicio de recogida de residuos por parte de SHGs (grupos de ayuda comunitarios) en estos asentamientos informales puede ayudar a resolver algunos de estos problemas. Para que esta oportunidad sea completamente explotada, los ingresos de estos grupos deben ser garantizados, teniendo en cuenta que la sostenibilidad de estos grupos depende enteramente de ello. Este estudio pretende averiguar cómo un enfoque de cadena de valor puede mejorar la sostenibilidad de la gestión de residuos sólidos, permitiendo asegurar los ingresos de los recolectores informales de residuos. El estudio propondrá después de analizado el actual sistema, mejoras que permitan desarrollar un medio ambiente saludable en los asentamientos informales donde se desarrolla el estudio. Para alcanzar este objetivo, se ha desarrollado una investigación específica en Nairobi (Kenia) en el asentamiento precario de Mukuru Kwa Njenga, analizando los distintos aspectos relevantes que tienen influencia en una gestión integrada de residuos sólidos y las relaciones entre los distintos actores que tienen influencia en la misma.

Desert tortoise habitat conservation : hearing before the Subcommittee on Forests and Public Land Management of the Committee on Energy and Natural Resources, United States Senate, One Hundred Seventh Congress, first session, on H.R. 880, to provide for the acquisition of property in Washington County, Utah, for implementation of a desert tortoise habitat conservation plan, May 10, 2001.

Shipping list no.: 2001-0272-P.

Summaries of solid waste management contracts : July 1, 1970-March 31, 1975 /

EPA/5301/SW-5.4.

A systems study of solid waste management in the Fresno area; final report on a solid waste management demonstration.

Mode of access: Internet.

Implementation plan for the Department of Energy programmatic spent nuclear fuel management and Idaho National Engineering Laboratory environmental restoration and waste management programs environmental impact statement : October 29, 1993.

Mode of access: Internet.

Amendment to the October 29, 1993 implementation plan for the Department of Energy programmatic spent nuclear fuel management and Idaho National Engineering Laboratory environmental restoration and waste management programs environmental impact statement : May 9, 1994.

Mode of access: Internet.

Report for the directors of the Town's Hospital of Glasgow on the management of the city poor, the suppression of mendicity, and the principles of the plan for the new hospital.

Includes tables.