Analyzing, Mapping, and Managing Environmental Impacts along Supply Chains

This article reports on research toward a pragmatic and credible means for analyzing, mapping, and managing environmental impacts along supply chains. The results of this research include a management tool called "ecological supply chain analysis" (EcoSCAn) that is presented here for the first time. Its structure bears a passing resemblance to that used in some streamlined life-cycle assessments, but its operation and purpose are quite different. The EcoSCAn tool frames a comparative environmental analysis of products capable of performing broadly equivalent functions. The analysis occurs over complete extended supply chains and within defined supply chain stages at a product level and, to some extent, at a site level. The results are mapped with data confidence indicators. A range of tactical and, where data quality is sufficient, strategic supply chain actions are prompted. Actions to mitigate environmental stress are possible in the absence of good quality data across entire product life cycles, although the extent to which management actions are limited is made plain.     

Rethinking Environmental Performance from a Public Health Perspective: A Comparative Industry Analysis

To date the most common measures of environmental performance used to compare industries, and by extension firms or facilities, have been quantity of pollution emitted or hazardous waste generated. Discharge information, however, does not necessarily capture potential health effects. We propose an alternative environmental performance measure that includes the public health risks of toxic air emissions extended to industry supply chains using economic input-output life-cycle assessment. Cancer risk to the U.S. population was determined by applying a damage function to the Toxic Release Inventory (TRI) as modeled by CalTOX, a multimedia multipathway fate and exposure model. Risks were then translated into social costs using cancer willingness to pay. For a baseline emissions year of 1998, 260 excess cancer cases were calculated for 116 TRI chemicals, dominated by ingestion risk from polycyclic aromatic compounds and dioxins emitted by the primary aluminum and cement industries, respectively. The direct emissions of a small number of industry sectors account for most of the U.S. population cancer risk. For the majority of industry sectors, however, cancer risk per $1 million output is associated with supply chain upstream emissions. Ranking industries by total (direct + upstream) supply chain risk per economic output leads to different conclusions about the relative hazards associated with these industries than a conventional ranking based on emissions per economic output.     

Analyzing Economic and Environmental Performance of Switchgrass Biofuel Supply Chains

This study optimized the net present value (NPV) of profit of various switchgrass-based ethanol supply chains and estimated associated greenhouse gas (GHG) emissions in west Tennessee. Three configurations of feedstock harvesting and storage, including a large round baler system, a large square baler system, and a chopping/densification system, were evaluated. A mixed-integer mathematical programming model incorporating high-resolution spatial data was used to determine the optimal locations and capacities of cellulosic ethanol plants and feedstock preprocessing facilities, and associated feedstock-draw areas by maximizing the NPV of profit over 20 years. The optimized outputs were then used to estimate the GHG emissions produced in the biofuel supply chain (BSC) per year. The study shows that BSC configurations have important implications for the economic and environmental performance of the system. The harvest and storage configurations affect the locations of conversion and preprocessing facilities, and associated feedstock-draw areas, hence impacting the cost and emissions of both feedstock and biofuels transportation. The findings suggest the BSC system that harvests feedstock with forage choppers and utilizes stretch-wrap balers to increase feedstock density has the highest NPV of profit. The BSC system that uses large square balers for harvest and storage emits the lowest amount of GHGs per year. In addition, the sensitivity analysis suggests that biofuel price and scaling factor of facility capital was influential to the economics of BSC systems. The breakeven price of biofuel for the three BSCs was around $0.97 L^?1.     

Evaluating Local Crop Residue Biomass Supply: Economic and Environmental Impacts

The increasing interest in energy production from biomass requires a better understanding of potential local production and environmental impacts. This information is needed by local producers, biomass industry, and other stakeholders, and for larger scale analyses. This study models biomass production decisions at the field level using a case example of a biomass gasification facility constructed at the University of Minnesota??Morris (UMM). This institutional-scale application has an anticipated feedstock demand of about 8,000?Mg?year^?1. The model includes spatial impacts due to sub-field variation in soil characteristics and transportation costs. Results show that the amount of biomass producers could profitably supply within a 32.2-km radius of UMM increases as plant-gate biomass price increases from $59 to $84?Mg^?1, with 588,000?Mg annual biomass supply at $84?Mg^?1. Results also show that the most profitable tillage and crop rotation practices shift in response to increasing biomass price with producers shifting from a corn-soybean rotation toward continuous corn. While biomass harvest is conducive to increased soil erosion rates and reduced soil organic carbon levels, changes in crop production practices are shown to at least partially offset these impacts. Transportation costs tend to concentrate and intensify biomass production near the biomass facility, which also tends to concentrate environmental impacts near the facility.     

Health and Ecological Impacts of Harmful Algal Blooms: Risk Assessment Needs

The symposium session, Indicators for Effects and Predictions of Harmful Algal Blooms, explored the current state of indicators used to assess the human health and ecological risks caused by harmful algal blooms, and highlighted future needs and impediments that must be overcome in order to provide a complete risk assessment of their impacts. Six recognized human poisoning syndromes resulting from algal toxins (paralytic, neurotoxic, amnesic, diarrhetic shellfish poisonings, ciguatera fish poisoning, and putative estuary associated syndrome) impact human health through consumption of contaminated seafood, direct contact with bloom water, or inhalation of aerosolized toxin. Thorough health risk assessment for the variety of algal toxins is hampered to varying degrees because either the toxin has not been identified or indicators for exposure and effects remain poorly defined. Predicting the occurrence and determining the impacts of harmful algal blooms in coastal ecosystems are the two major ecological risk assessment needs. In the former case, the hazard is the suite of conditions that trigger bloom initiation, magnify bloom intensity or support bloom longevity, whereas in the latter case, the hazard is the algal toxin. In both cases, indicators (of triggering mechanisms, exposure, and effects) are better defined for some HAB species and toxins than others, but are by no means complete.     

Globalization, Health, and the Environment: An Integrated Perspective

Globalization, Health, and the Environment: An Integrated Perspective . Greg Guest, ed. Lanham, MD: Rowman and Littlefield, 2006. 274 pp.     

Ecology,Environmental Impact Statements,and Ecological Risk Assessment: A Brief Historical Perspective

Ecological risk assessment will continue to increase in importance as a conceptual and methodological basis for evaluating environmental impacts as required by the National Environmental Policy Act. Understanding the historical strengths and limitations of more traditional environmental assessments performed in support of the NEPA can facilitate the effective incorporation of ecological risk assessment into the NEPA process. Such integration will also benefit from a knowledge of the historical and continuing development of the ecological risk assessment process, as well as from a recognition of the contri butions from modern quantitative ecology and ecosystem science. Adopting a risk-based approach can improve the NEPA process by providing a framework for consistent and comprehensive ecological assessment and by providing a conceptual and methodological basis for addressing the varied uncertainties attendant to environmental assessments. The primary concern in integrating ecological risk assessment into the NEPA process is that ecological risk assessment not merely become a new name for traditional environmental impact assessments. While the integration of ecological risk assessment into the NEPA process occurs, it is important to begin to outline the next transition in environmental assessment capabilities. Operationally linking ecological risk assessment methods with formal decision models appears as a worthwhile objective in beginning this transition.     

公立医院医养结合养老模式的运行分析及思考

目的 推进公立医院医养结合养老模式更加科学、规范、有序运行。方法 描述性统计法、比较分析法。结果 首家由国家发展与改革委员会批准的公立医院兴办的医养结合养老机构重庆医科大学附属第一医院青杠老年护养中心入住老人人次呈上升趋势,已扭亏为盈,实现“医护养”全面融合,“急慢分治、双向转诊”,护理院医保覆盖,信息化助力养老与安全,逐步形成较为规范的老人综合评估体系。结论 公立医院医养结合养老模式是一种成功的养老模式,其市场需求前景好,但运营成本高、服务收费较高,不能满足大量老人的养老需求,需要政府做好顶层设计、完善相关制度、加大资金投入、分层建设以完善养老服务体系。     

Latent Tuberculosis Infection and Occupational Protection among Health Care Workers in Two Types of Public Hospitals in China

Objective

To determine the impact factors of latent tuberculosis infection (LTBI) and the knowledge of TB prevention and treatment policy among health care workers (HCWs) in different types of hospitals and explore the strategies for improving TB prevention and control in medical institutions in China.

Methods

A cross-sectional study was carried out to evaluate the risk of TB infection and personnel occupational protection among HCWs who directly engage in medical duties in one of two public hospitals. Each potential participant completed a structured questionnaire and performed a tuberculin skin test (TST). Factors associated with LTBI were identified by logistic regression analysis.

Results

Seven hundred twelve HCWs completed questionnaires and 74.3% (n = 529) took the TST or had previous positive results. The TST-positive prevalence was 58.0% (n = 127) in the infectious disease hospital and 33.9% (n = 105) in the non-TB hospital. The duration of employment in the healthcare profession (6–10 years vs. ≤5 years [OR = 1.89; 95% CI = 1.10, 3.25] and>10 vs. ≤5[OR = 1.80; 95% CI = 1.20, 2.68]), type of hospital (OR = 2.40; 95% CI = 1.59, 3.62), and ever-employment in a HIV clinic or ward (OR = 1.87; 95% CI = 1.08, 3.26)were significantly associated with LTBI. The main reasons for an unwillingness to accept TST were previous positive TST results (70.2%) and concerns about skin reaction (31.9%).

Conclusion

A high prevalence of TB infections was observed among HCWs working in high-risk settings and with long professional experiences in Henan Province in China. Comprehensive guidelines should be developed for different types of medical institutions to reduce TB transmission and ensure the health of HCWs.     

浅论与实验动物相关的职业健康安全与人畜共患病

道义上的责任或是法律法规都要求公司或单位提供一个安全和健康的工作环境,以保障员工免受不必要的危害。职业健康与安全（OHS）规程的目的就是预防职业伤害和疾病,它不仅需要满足法规的要求,更重要的是控制危害和减少风险。本文描述了实验动物相关OHS规程的重要性及一些关键要素,如管理措施、设施的设计与运行、控制与危险物的接触、教育和培训、职业健康专业化服务、仪器设备的性能、信息管理、应急措施及对规程的评估和完善。本文还简要地介绍了常见的实验非人灵长类动物相关的人畜共患疾病,以及如何安全地从事实验动物相关工作。     

Medical Education and Research: The Foundations of Quality Health Care

In May 1964 the Royal Commission on Health Services declared that “health research is essential to health progress”. However, since that time the means of providing adequate health care have received far less attention than have methods of payment for physicians'' services. Because medical education and research is the source from which all other health benefits flow, urgent attention must be paid to the adequate support of teacher-scientists, as set forth in the Woods, Gordon (Gundy) report. It is the numbers and quality of these men and women, more than any other factor, that will determine the shape of medical science and, hence, medical practice in Canada in the future. Expensive as it is, Canadian medicine and Canadian medical scientists must have generous support if medical care in this country is to be of high quality.     

From Reef to Table: Social and Ecological Factors Affecting Coral Reef Fisheries,Artisanal Seafood Supply Chains,and Seafood Security

Ocean and coastal ecosystems provide critical fisheries, coastal protection, and cultural benefits to communities worldwide, but these services are diminishing due to local and global threats. In response, place-based strategies involve communities and resource users in management have proliferated. Here, we present a transferable community-based approach to assess the social and ecological factors affecting resource sustainability and food security in a small-scale, coral reef fishery. Our results show that this small-scale fishery provides large-scale benefits to communities, including 7,353 ± 1547 kg yr^-1 (mean ± SE) of seafood per year, equating to >30,000 meals with an economic value of $78,432. The vast majority of the catch is used for subsistence, contributing to community food security: 58% is kept, 33.5% is given away, and 8.5% is sold. Our spatial analysis assesses the geographic distribution of community beneficiaries from the fishery (the “food shed” for the fishery), and we document that 20% of seafood procured from the fishery is used for sociocultural events that are important for social cohesion. This approach provides a method for assessing social, economic, and cultural values provided by small-scale food systems, as well as important contributions to food security, with significant implications for conservation and management. This interdisciplinary effort aims to demonstrate a transferable participatory research approach useful for resource-dependent communities as they cope with socioeconomic, cultural, and environmental change.