Audit report on the Pocahontas County Solid Waste Commission for the year ended June 30, 2012

Audit report on the Pocahontas County Solid Waste Commission for the year ended June 30, 2012

Audit report on the Wayne-Ringgold-Decatur County Solid Waste Management Commission for the year ended June 30, 2012

Audit report on the Wayne-Ringgold-Decatur County Solid Waste Management Commission for the year ended June 30, 2012

Audit report on the Crawford County Area Solid Waste Agency Commission for the year ended June 30, 2012

Audit report on the Crawford County Area Solid Waste Agency Commission for the year ended June 30, 2012

Audit report on the Delaware County Solid Waste Disposal Commission for the year ended June 30, 2012

Audit report on the Delaware County Solid Waste Disposal Commission for the year ended June 30, 2012

Audit report on the Great River Regional Waste Authority for the year ended June 30, 2012

Audit report on the Great River Regional Waste Authority for the year ended June 30, 2012

Waste Authority of Jackson County (formerly known as the Jackson County Sanitary Disposal Agency) independent auditor's reports, basic financial statements, required supplementary information, schedule of findings, June 30, 2012

Audit report on the Waste Authority of Jackson County (formerly known as the Jackson County Sanitary Disposal Agency) for the year ended June 30, 2012

Audit report on the Rathbun Area Solid Waste Commission for the year ended June 30, 2013

Audit report on the Rathbun Area Solid Waste Commission for the year ended June 30, 2013

Reaudit report on the North Central Iowa Regional Solid Waste Agency for the period July 1, 2011 through June 30, 2012

Reaudit report on the North Central Iowa Regional Solid Waste Agency for the period July 1, 2011 through June 30, 2012

Treatment of ruptured abdominal aortic aneurysm, a permanent challenge or a waste of resources? Prediction of outcome using a multi-organ-dysfunction score.

OBJECTIVES: in a retrospective study, attempts have been made to identify individual organ-dysfunction risk profiles influencing the outcome after surgery for ruptured abdominal aortic aneurysms. METHODS: out of 235 patients undergoing graft replacement for abdominal aortic aneurysms, 57 (53 men, four women, mean age 72 years [s.d. 8.8]) were treated for ruptured aneurysms in a 3-year period. Forty-eight preoperative, 13 intraoperative and 34 postoperative variables were evaluated statistically. A simple multi-organ dysfunction (MOD) score was adopted. RESULTS: the perioperative mortality was 32%. Three patients died intraoperatively, four within 48 h and 11 died later. A significant influence for pre-existing risk factors was identified only for cardiovascular diseases. Multiple linear-regression analysis indicated that a haemoglobin <90 g/l, systolic blood pressure <80 mmHg and ECG signs of ischaemia at admission were highly significant risk factors. The cause of death for patients, who died more than 48 h postoperatively, was mainly MOD. All patients with a MOD score >/=4 died (n=7). These patients required 27% of the intensive-care unit (ICU) days of all patients and 72% of the ICU days of the non-survivors. CONCLUSION: patients with ruptured aortic aneurysms from treatment should not be excluded. However, a physiological scoring system after 48 h appears justifiable in order to decide on the appropriateness of continual ICU support.

A regional Industrial Symbiosis methodology and its implementation in Geneva, Switzerland

The Agenda 21 for the Geneva region is the results from a broad consultation process including all local actors. The article 12 stipulates that « the State facilitates possible synergies between economic activities in order to minimize their environmental impacts » thus opening the way for Industrial Ecology (IE) and Industrial Symbiosis (IS). An Advisory Board for Industrial Ecology and Industrial Symbiosis implementation was established in 2002 involving relevant government agencies. Regulatory and technical conditions for IS are studied in the Swiss context. Results reveal that the Swiss law on waste does not hinder by-product exchanges. Methodology and technical factors including geographic, qualitative, quantitative and economical aspects are detailed. The competition with waste operators in a highly developed recycling system is also tackled.The IS project develops an empirical and systematic method for detecting and implementing by-products synergies between industrial actors disseminated throughout the Geneva region. Database management tool for the treatment of input-output analysis data and GIS tools for detecting potentials industrial partners are constantly improved. Potential symbioses for 17 flows (including energy, water and material flows) are currently studied for implementation.

Audit report on the Crawford County Area Solid Waste Agency Commission for the year ended June 30, 2013

Audit report on the Crawford County Area Solid Waste Agency Commission for the year ended June 30, 2013

Audit report on the Shelby County Area Solid Waste Agency for the year ended June 30, 2013

Audit report on the Shelby County Area Solid Waste Agency for the year ended June 30, 2013

Audit report on the Wayne-Ringgold-Decatur County Solid Waste Management Commission for the year ended June 30, 2013

Audit report on the Wayne-Ringgold-Decatur County Solid Waste Management Commission for the year ended June 30, 2013

Audit report on the Pocahontas County Solid Waste Commission for the year ended June 30, 2013

Audit report on the Pocahontas County Solid Waste Commission for the year ended June 30, 2013

Audit report on the Butler County Solid Waste Commission for the year ended June 30, 2013

Audit report on the Butler County Solid Waste Commission for the year ended June 30, 2013