Building energy efficiency for sustainable development in China: challenges and opportunities

Rapid urbanisation in China has resulted in great demands for energy, resources and pressure on the environment. The progress in China's development is considered in the context of energy efficiency in the built environment, including policy, technology and implementation. The key research challenges and opportunities are identified for delivering a low carbon built environment. The barriers include the existing traditional sequential design process, the lack of integrated approaches, and insufficient socio-technical knowledge. A proposed conceptual systemic model of an integrated approach identifies research opportunities. The organisation of research activities should be initiated, operated, and managed in a collaborative way among policy makers, professionals, researchers and stakeholders. More emphasis is needed on integrating social, economic and environmental impacts in the short, medium and long terms. An ideal opportunity exists for China to develop its own expertise, not merely in a technical sense but in terms of vision and intellectual leadership in order to flourish in global collaborations.

Sustainable urban development to 2050: complex transitions in the built environment of cities

The majority of the world’s population now live in cities. This poses great challenges, but also great opportunities in terms of tackling climate change, resource depletion and environmental degradation. Policy agendas have increasingly focused on how to develop and maintain ‘integrated sustainable urban development’, and a number of theoretical conceptualisations of urban transition have been formulated to help our thinking and understanding in both developed and developing countries. Drawing on examples around the world the paper aims to examine the key ‘critical success factors’ that need to be in place for cities to traverse a pathway to a more sustainable future in urban development terms by 2050. The paper explores how important the issues of ‘scale’ is in the context of complexity and fragmentation in the city’s built environment, identifies the lessons that can be learned for future sustainable urban development, and the further research which is needed to address future urban transitions to 2050.

Evaluation of the relationship between education and sustainability in peasant movements: The experience of the National Education Program in Agrarian Reform

Brazil is one of the largest agricultural producers in the world. However, its agrarian composition is based on two markedly different production models, particularly in relation to sustainability: a peasant family agriculture, which plays an important role in food production for domestic consumption and advocates agro-ecological practises; and agribusiness, the politically and economically hegemonic model that produces commodities for export based on monoculture and intensive use of pesticides. Therefore, in order to create the means to develop peasant lands, social movements and peasants have engaged themselves politically and defended an education model grounded in sustainable practises of production and social organisation. Taking this into account, the main purpose of this paper is to analyse and assess the Brazilian experience of integration between education and sustainability, in the National Education Program in Agrarian Reform (PRONERA). To accomplish this aim, a survey with a semi-structured questionnaire was carried out among teachers, students, monitors, and coordinators of the course offered by PRONERA. The surveys showed that the courses are promoting the concepts of sustainability among peasants. However, many adjustments need to be taken into consideration during the planning process for the next courses offered by PRONERA.

Prevalence of hepatitis B virus infection and carriage after nineteen years of vaccination program in the Western Brazilian Amazon

Introduction: Reductions in the prevalence of hepatitis B virus (HBV) infection and carriage, decreases in liver cancer incidence, and changes in patterns of liver dysfunctions are described after hepatitis B vaccination. Methods: We conducted a population-based seroprevalence study aimed at estimating the HBV prevalence and risk of infection in the rural area of Labrea following nineteen years of HBV vaccination. Results: Half of the subjects showed total anti-HBc of 52.1% (95% CI 49.6-54.7). The HBsAg prevalence was 6.2% (95% CI 5.1-7.6). Multivariate analysis showed an inverse association between HBV infection and vaccination (OR 0.62; 95% CI 0.44-0.87). HBsAg remained independently associated with past hepatitis (OR 2.44; 95% CI 1.52-3.89) and inversely to vaccination (OR 0.43; 95% CI 0.27-0.69). The prevalence of HBeAg among HBsAg-positive individuals was 20.4% (95% CI 12.8-30.1), with the positive subjects having a median age of 11 years (1-46) p=0.0003. Conclusions: We demonstrate that HBV infection is still an important public health issue and that HBV vaccination could have had better impact on HBV epidemiology. If we extrapolate these findings to other rural areas in the Brazilian Amazon, we can predict that the sources of chronic infected patients remain a challenge. Future studies are needed regarding clinical aspects, molecular epidemiology, surveillance of acute cases, and risk groups.

B-vitamins : past, present and future in the study of the coenzymes that built and maintain a habitable planet

Trabajo realizado por Sergio Sañudo-Wilhelmy, Danielle Monteverde and Laura Gomez-Consarnau

An alternative B cell development program

Two major types of B cells, the antibody-producing cells of the immune system, are classically distinguished in the spleen: marginal zone (MZ) and follicular (FO). In addition, FO B cells are subdivided into FO I and FO II cells, based on the amount of surface IgM. MZ B cells, which surround the splenic follicles, rapidly produce IgM in response to blood-borne pathogens without T cell help, while T cell-dependent production of high affinity, isotype-switched antibodies is ascribed to FO I cells. The significance of FO II cells and the mechanism underlying B cell fate choices are unclear. We showed that FO II cells express more Sca1 than FO I cells and originate from a distinct B cell development program, marked by high expression of Sca1. MZ B cells can derive from the “canonical” Sca1lo pathways, as well as from the Sca1hi program, although the Sca1hi program shows a stronger MZ bias than the Sca1lo program, and extensive phenotypic plasticity exists between MZ and FO II, but not between MZ and FO I cells. The Sca1hi program is induced by hematopoietic stress and generates B cells with an Igλ-enriched repertoire. In aged mice, the canonical B cell development pathway is impaired, while the Sca1hi program is increased. Furthermore, we showed that a population of unknown function, defined as Lin-c-kit+Sca1+ (LSK-), contains early lymphoid precursors, with primarily B cell potential in vivo. Our data suggest that LSK- cells may represent a distinct precursor for the Sca1hi program in the bone marrow.

Impact of a nurse vaccination program on hepatitis B immunity in a Swiss HIV clinic

We evaluated the impact of a nurse program for hepatitis B virus vaccination in a center from the Swiss HIV Cohort Study. Immunity (anti-HBs >10 IU/mL) increased from 32% to 76% in the intervention center (n = 238) where vaccine management was endorsed by nurses, but only from 33% to 39% in control centers (n = 2712, P < 0.001) where management remained in charge of physicians. Immunity against HBV in the HIV population is insufficient in Switzerland. Specific nurse vaccination program may efficiently improve health care.

Reducing liver cancer disparities: a community-based hepatitis-B prevention program for Asian-American communities

OBJECTIVES: Several Asian-American groups are at a higher risk of dying of liver diseases attributable to hepatitis-B infection. This culturally diverse community should be well informed of and protected against liver diseases. The present study assesses the knowledge of hepatitis B before and after a hepatitis-B educational program and determines the infection status of an Asian community. METHODS: Nine Asian communities of Montgomery County, MD, enrolled in the hepatitis-B prevention program between 2005 and 2006. They attended culturally tailored lectures on prevention, completed self-administered pre- and posttests, and received blood screening for the disease. RESULTS: More than 800 Asian Americans participated in the study. Knowledge of prevention was improved after educational delivery. The average infection rate was 4.5%, with Cambodian, Thai, Vietnamese, Chinese and Korean groups having higher infection rates. The age group of 36-45 had the highest percentage of carriers (9.1%). CONCLUSION: Many Asian groups, particularly those of a southeast Asian decent, were subject to a higher probability of hepatitis-B infection. At an increased risk are first-generation Asian immigrants, groups with low immunization rates and those aged 36-45. The findings provide potential directions for focusing preventive interventions on at-risk Asian communities to reduce liver cancer disparities.

Process and outcome evaluation of the hepatitis B perinatal vaccination program in Houston, Texas, 1991--1993

A retrospective cohort study was designed to evaluate the compliance of vaccination dose schedules and vaccination effectiveness at 12 months of age among a total of 226 high-risk infants born to HBsAg-positive pregnant women who participated in the HBV Perinatal Vaccination Program in Houston, Texas, 1991-1993.^ The seroprevalence of HBsAg-positivity was 0.5% among pregnant women who attended prenatal clinics in Houston, Texas, 1991-1993. The Asian women had the highest seroprevalence rate (5.9%), followed by black (1.9%), white (0.7%), and Hispanic women (0.3%). The seroprevalence of HBsAg increased with age (p =.02); the highest seroprevalence rate found among the $>$40 group (5.4%), followed by the 20-40 age group, and the $<$20 age. A steady increase was observed in the number of infants, from 45 in 1991, to 103 in 1993. The majority of these infants were black (58.0%), followed by Hispanic (28.8%), Asian (8.4%), and white infants (4.0%). Significant increases were observed from 1991 to 1993 in the number of infants who initiated vaccination (86.7% to 98.1%, p =.02) and in those infants who were post-tested at 12 months of age (24.4% to 44.7%, p =.04). During the same period an increase was also observed in the number of infants who completed the vaccination dose schedules (62.2% to 72.8%, p =.37). The compliance rates were not statistically significant regarding gender, race or ethnicity, health service area, medical referral source, and residential geographic areas. About 56.0% of the reasons cited for non-compliance among the 144 infants who neither completed the vaccination dose schedules nor received the 12-month post-test were "moved," and "no response/not at home." A total of 82 infants completed the vaccination dose schedules and were post-tested at 12 months of age for anti-HBs-positivity, and 96.3% of these infants seroconverted. A race-specific statistically significant seroconversion difference was found among infants who received all vaccination doses and were post-tested at 12 months of age (100% for the black and the white, 96.3% for the Hispanic, and 80.0% for the Asians infants, p =.05).^ From a public health perspective, the HBV Perinatal Vaccination Program improved during its first three years (1991-1993). It was effective in preventing perinatal HBV infection in almost 97.0% of infants who were vaccinated and post-tested. To increase the efficiency and efficacy of the program, the following recommendations are proposed: (1) Increase the vaccination compliance rate by educating and improving the tracking, communication and coordination channels with those individuals involved in the process and by increasing staff resources. (2) Reduce the post-test vaccination non-compliance by post-testing infants simultaneously with third vaccination dose at 6 months of age, and only post-test those infants who are anti-HBs-negative at 9-12 months of age. (Abstract shortened by UMI.) ^

Community health workers: The critical link to sustainable, healthy societies in low-resource settings---A model for the Baylor Shoulder to Shoulder Foundation

Community health workers (CHWs) can serve as a bridge between healthcare providers and communities to positively impact social determinants of health and, thus, the overall health of the population. The potential to effect lasting change is particularly significant within resource-poor settings with limited access to formally trained health care providers such as the small, rural village of Santa Ana Intibucá, Honduras and surrounding areas—located on the geographically and politically isolated border of Honduras and El Salvador. The Baylor Shoulder to Shoulder Foundation (BSTS) works in conjunction with Santa Ana's volunteer health committee to bring a health brigade that has provided health care and public health projects to the area at least twice a year since 2001. They have also hired a full-time Honduran physician, a Honduran in-country administrative director, and built a clinic; yet, no community health worker program exists. This CHW program model is the response to a clear need for a CHW program within the area served by BSTS and presents a CHW program model specific to Santa Ana Intibucá and surrounding areas to be implemented by BSTS. Methods used to develop this model include reviewing the literature for recommendations from leading authorities as well as successfully implemented CHW programs in comparable regions. This information was incorporated into existing knowledge and materials currently being used in the area. Using the CHW model proposed here, each brigade, in conjunction with the communities served, can help develop new modules to respond to the specific health priorities of the region at that time, incorporating consistent modes of contact with the local physician and the CHWs to provide refresher courses, training in new topics of interest, and to be reminded of the importance of community health workers' role as the critical link to healthy societies. With cooperation, effort, and support, the brigade can continue to help integrate a sustainable CHW system in which communities may be able to maximize the care they receive while also learning to care for their own health and the future of their communities.^

SERBA: a B.I.E. program with linear elements for 2-D elastostatics analysis

The great developments that have occurred during the last few years in the finite element method and its applications has kept hidden other options for computation. The boundary integral element method now appears as a valid alternative and, in certain cases, has significant advantages. This method deals only with the boundary of the domain, while the F.E.M. analyses the whole domain. This has the following advantages: the dimensions of the problem to be studied are reduced by one, consequently simplifying the system of equations and preparation of input data. It is also possible to analyse infinite domains without discretization errors. These simplifications have the drawbacks of having to solve a full and non-symmetric matrix and some difficulties are incurred in the imposition of boundary conditions when complicated variations of the function over the boundary are assumed. In this paper a practical treatment of these problems, in particular boundary conditions imposition, has been carried out using the computer program shown below. Program SERBA solves general elastostatics problems in 2-dimensional continua using the boundary integral equation method. The boundary of the domain is discretized by line or elements over which the functions are assumed to vary linearly. Data (stresses and/or displacements) are introduced in the local co-ordinate system (element co-ordinates). Resulting stresses are obtained in local co-ordinates and displacements in a general system. The program has been written in Fortran ASCII and implemented on a 1108 Univac Computer. For 100 elements the core requirements are about 40 Kwords. Also available is a Fortran IV version (3 segments)implemented on a 21 MX Hewlett-Packard computer,using 15 Kwords.