The development of environmental visions and strategies at the municipal level: Case studies from the county of Östergötland in Sweden.

Sweden faces a number of environmental challenges. Municipalities can play an important role in managing these challenges. Using interviews with 13 municipalities in the county of Östergötland, the manner via which environmental visions and strategies were developed and implemented, and the challenges were explored. Differences were found in the effective development and implementation of both environmental visions and strategies due to a range of factors including the range and level of involvement of different stakeholders, variation in what constituted an environmental strategy, and the time horizons employed for the visions. Suggestions for how best to overcome the barriers are outlined.

International governance structures for health-care waste management: a systematic review of scientific literature.

Significant differences exist in the management of health-care waste management, globally. This is particularly so between low, middle and high-income countries. A systematic review of scientific literature on global healthcare waste management spanning the period 2000 - current was undertaken, in order to identify key policies, practices, challenges and best practice. The findings were analysed considering the Gross National Income and the Human Development Index of each country. Effective regulation and operative definitions of waste categories are key-factors requiring improvement at the national level. The economic conditions in the country are an important factor, especially regarding treatment and disposal. Areas for improvement (e.g. the need for improved governance structures, the development of regional clusters, as well as sharps waste segregation) are suggested.

Understanding the perceptions, roles and interactions of stakeholder networks managing health-care waste: A case study of the Gaza Strip.

The sustainable management of waste requires a holistic approach involving a range of stakeholders. What can often be difficult is to understand the manner in which different types of stakeholder networks are composed and work, and how best to enhance their effectiveness. Using social network analysis and stakeholder analysis of healthcare waste management stakeholders in the case study region of the Gaza Strip, this study aimed to understand and examine the manner in which the networks functioned. The Ministry of Health was found to be the most important stakeholder, followed by municipalities and solid waste management councils. Some international agencies were also mentioned, with specific roles, while other local institutions had a limited influence. Finally while health-care facilities had a strong interest in waste management, they were generally poorly informed and had limited links to each other. The manner in which the networks operated was complicated and influenced by differences in perception, sharing of information, access to finance and levels of awareness. The lack of a clear legal framework generated various mistakes about roles and responsibilities in the system, and evidently regulation was not an effective driver for improvement. Finally stakeholders had different priorities according to the waste management issues they were involved with, however segregation at the source was identified as a key requirement by most. Areas for improving the effectiveness of the networks are suggested. The analysis utilized an innovative methodology, which involved a large number of stakeholders. Such an approach served to raise interest and awareness at different levels (public authorities, health providers, supporting actors, others), stimulate the discussion about the adoption of specific policies, and identify the effective way forward.

Evaluating the link between the management of clinical waste in the National Health Service (NHS) and the risk of the spread of infections: A case study of three hospitals in England.

This study aimed to evaluate waste management practices in three case study NHS Trusts in England and the potential risks of the spread of pathogens causing healthcare associated infections (HCAIs). Using a combination of microbiological techniques, interviews and questionnaire surveys, four target microbes were studied, namely: meticillin resistant Staphylococcus aureus (MRSA), meticillin sensitive Staphylococcus aureus (MSSA), Clostridium difficile (C. difficile) and vancomycin-resistant enterococci (VRE). Waste Flow Diagrams (WFDs) were used to map the flow of the waste. While there was a perceived link between the management of the waste and the spread of the microbes by staff, none of the target organisms were isolated. The findings suggest that when the waste is properly contained and managed that it should not pose a significant risk in terms of the spread of the four bacteria tested in this study. In addition, the results demonstrate that there is a need for staff perceptions and beliefs to be addressed in the development of policies and training related to infection control and its link to waste management.

Realising resource efficiency in the management of healthcare waste from the Cornwall National Health Service (NHS) in the UK.

The quantities of waste generated by the healthcare sector in the United Kingdom (UK) have been shown to be amongst the highest in Europe. Based on a case study undertaken within the Cornwall NHS (National Health Service) in the UK, this paper reports on the results of waste minimisation trials. The schemes were able to achieve significant waste reductions in both clinical and domestic waste quantities. Indeed, a reduction in domestic bag waste in the range of 1.6-33.4%, with an average of 14.8% was realised. For clinical waste, the reduction ranged from 1.8% to 38.3%, at an average of 15.7%, with net cost benefits of nearly US$ 25,000 over the period of 1-3 years. The outcomes suggest that significant resource and financial efficiencies can be attained, but due to the many factors involved, there is a need to focus both on containment and logistics, as well as social factors for success.

Healthcare waste management: a case study from the National Health Service in Cornwall, United Kingdom.

This paper looks at steps taken towards the development of a 10-year strategy for the management of healthcare waste from the National Health Service (NHS) in Cornwall, United Kingdom. The major issues and challenges that affect the management of waste by the NHS, including its organisational structure and collection infrastructure, are outlined. The waste flows of the main acute medical site are detailed, using waste audits of domestic and clinical bags, redundant equipment, bulky waste, and special waste. Some of the common barriers to change, such as staff habits and public perceptions, are also identified. Recommendations are made with respect to improvements in the overall organisational infrastructure and increased localised control. The recommendations also centre around the formation of strategic partnerships, within the site, between sites and at the broader level between the NHS and its surrounding community. An important challenge to be overcome is the need to progress from the concept of "waste management", to one of sustainable decision making regarding resource use, including methods of waste minimisation at the source and recycling. Staff training and awareness underpin several of the short and medium/long term solutions suggested to reduce the waste at the source and recover value from that produced. These measures could potentially reduce disposal quantities by as much as 20-30% (wt.) and costs by around 25-35%.

Experimental revealing of polarization waves.

Stationary and traveling waves of the states of optical polarization are considered in the framework of Jones vector formalism. The feasibility of revealing these waves in holographic and interference arrangements is substantiated and demonstrated.

Trabalho da mulher - estagio atual. / Women's work - present status

A capacidade feminina frente ao trabalho, os periodos menstrual e gestacional e as atividades proibidas a mulher sao comentados pela autora, com base em sua vivencia profissional, que se acumula desde a epoca em que ocupou a Secao de Assistencia ao Trabalho da Mulher e de Higiene do Trabalho do extinto Departamento Nacional de Seguranca e Higiene do Trabalho