Defects and Amendment Suggestions of Human Organ Transplantation Ordinance / 中国医学伦理学

This paper put forward suggestions on the Human Organ Transplantation Ordinance, including: clarify the priority of the protection of the rights and interests of organ owner in Article 1; conditionally increase the range of relatives who can donate cadaver organs; clarify whether relatives can donate cadaver organs of people without full civil capacity and strictly regulate them; allow matured juveniles to donate living organs under strict restrictions; distinguish between donor and organ owner in legal expression.

Análise da aplicabilidade da Portaria 557 do Ministério das Cidades em estudos de viabilidade técnico-econômica para incineração com recuperação energética de resíduo sólido urbano no Brasil / Analysis of the applicability of Ordinance 557 of the Ministry of Cities in technical-economic feasibility studies for incineration with MSW energy recovery in Brazil

RESUMO Os estudos de viabilidade técnico econômica são elementos primordiais para a viabilização de projetos de saneamento, inclusive de incineração de resíduo sólido urbano com recuperação energética. O artigo teve como base os padrões para estudos de viabilidade técnico econômica conforme Portaria n° 557 do Ministério das Cidades, previstos na lei n° 11.445 que estabelece diretrizes nacionais para o saneamento básico. Foram realizadas visitas técnicas em quatro incineradores em operação na Suíça e dois em Portugal, com o objetivo de estabelecer um benchmarking para referenciar a análise da aplicação da Portaria, a identificação dos fatores críticos que dificultam a adoção dessa tecnologia no Brasil, assim como as ações necessárias para a viabilidade técnico-econômica do incinerador. Os principais fatores críticos identificados foram a localização da planta, o efeito Not in My Backyard, a concepção de conflito entre reciclagem e incineração, o elevado investimento inicial, o risco de adoção de tecnologias já superadas, a falta de experiência e mão de obra capacitada local, a variação e sazonalidade na alimentação de resíduo sólido urbano, a volatilidade do preço da energia no mercado, as receitas mínimas para viabilidade financeira, a adequação do arcabouço legal e a seleção de modelo de negócio adequado.

ABSTRACT Technical-economic feasibility studies are essential elements for making sanitation projects feasible, including projects of MSW incinerators with energy recovery. This article is based on the reference standards for technical-economic feasibility studies according to Ordinance No. 557 (2016) of the Ministry of Cities, provided for in Law No. 11.445, which establishes national guidelines for basic sanitation. Technical visits were carried out in four incinerators in Switzerland and two in Portugal in order to establish a benchmark to reference the analysis of the application of the Ordinance, the identification of critical factors that hinder the adoption of this technology in Brazil, as well as the necessary actions for technical-economic feasibility. The objective of this article is to propose an adaptation of the technical-economic feasibility studies model of the Ordinance for a MSW incinerator project with energy recovery, identifying the critical factors and actions related to the financial-economic viability that hinder the adoption of this technology in Brazil. The critical factors identified were the location of the plant, the Not in My Backyard effect, the concept of conflict between recycling and incineration, the high initial investment, the risk of adopting technologies that have already been overcome, the lack of experience and hands of qualified local work, variation and seasonality in MSW supply, volatility in the price of energy in the market, minimum revenues for financial viability, adequacy of the legal framework, and selection of an appropriate business model.

Fitoplâncton da região central do Lago Paranoá (DF): uma abordagem ecológica e sanitária / Phytoplankton in the central region of Paranoá Lake, Federal District of Brazil: an ecological and sanitary approach

RESUMO Este estudo teve como objetivo analisar a estrutura, a dinâmica e a importância sanitária do fitoplâncton em um perfil vertical na região central do Lago Paranoá, Distrito Federal. As amostras foram coletadas mensalmente entre outubro de 2009 e setembro de 2010, na região pelágica, em seis profundidades. Foi possível identificar três fases em relação ao regime de mistura: estratificação (outubro de 2009 a maio de 2010), mistura (junho a agosto de 2010) e transição (setembro de 2010). As concentrações de fósforo total e fósforo solúvel reativo e a biomassa algal foram relativamente baixas, permitindo classificar o Lago Paranoá como um reservatório oligotrófico. Já as concentrações de nitrogênio total e os grupos funcionais do fitoplâncton foram típicos de ambientes mesotróficos. Foram encontrados 94 táxons, distribuídos em dez classes taxonômicas, com predomínio de diatomáceas centrales, clorofíceas e cianobactérias. Foram definidos 13 grupos funcionais fitoplanctônicos, com destaque para os grupos C, J, F, X2, K e S1. Durante os meses de mistura e transição houve aumento na biomassa de diatomáceas (grupo C), mas ao longo do perfil vertical, houve tendência dos grupos K e S1 (cianobactérias) se localizarem nas camadas mais superficiais nos meses quentes. Do ponto de vista sanitário, foram identificados táxons com potencial para promover sabor e odor na água (e.g., diatomáceas, criptofíceas e cianobactérias) ou que poderiam obstruir filtros em sistemas de tratamento (e.g., diatomáceas). Além disso, foram registradas cianobactérias (e.g., Aphanocapsa e Planktolyngbya) em densidades que já apontam a necessidade de intensificação do monitoramento e análise de cianotoxinas, de acordo com a Portaria do Ministério da Saúde nº 2.914/2011.

ABSTRACT This study aimed at analyzing the dynamic, the structure and the sanitary importance of phytoplankton in a vertical profile at Paranoá Lake central region, Federal District, Brazil. Sampling was carried out monthly from October 2009 to September 2010, in six depths. Three distinct phases were identified, concerning mixing pattern: stratification (October 2009 to May 2010), mixing in (June to September 2010), transition (September 2010). Total phosphorus and soluble reactive phosphorus concentrations and algal biomass were relatively low, classifying Paranoá Lake as an oligotrophic reservoir. In opposite, total nitrogen nd functional groups were typical of mesotrophic environments. Altogether, 94 phytoplanktonic taxa were found, among 10 taxonomic classes, especially centrales diatoms, chlorophyceans and cyanobacteria. Thirteen functional groups were identified, with emphasis on C, J, F, X2, K and S1. During mixing and transition months there was an increase in diatom biomass (group C). On the vertical profile, there was a trend of K and S1 groups to locate at surface layers during warmer months. Considering the sanitary approach, this study reported algal taxa that can potentially promote odor and taste in the water (e.g., diatoms, cryptophytes, cyanobacteria) or cause filter clogging at water treatment plants (e.g., diatoms). Moreover, cyanobacterial taxa (e.g., Aphanocapsa and Planktolyngbya) were reported under densities that already point out the need of monitoring intensification and cyanotoxin analysis, according to the MS Ordinance number 2,914/2011.

The effect of community-level smoke-free ordinances on smoking rates in men based on Community Health Surveys / 한국역학회지

OBJECTIVES: As one of smoke-free policies, communities have established the smoke-free ordinances since August 2010. Thus, this study aimed to evaluate the effects of community-level smoke-free ordinances (SFO) on smoking rates in men using multiyear Community Health Survey (CHS) data. METHODS: Data on community-level SFO were collected from a website on Enhanced Local Laws and Regulation Information System. Regional smoking-related data were obtained from CHS data from 2008 to 2012 and the age-standardized rates of current smoking in men, attempts to quit smoking, and smoke-free campaign experiences including the mean number of cigarettes smoked (smoking amount) were calculated. Repeated measures analysis of variance was performed to evaluate the effects of regional implementation of SFO and the duration on change of smoking rates. RESULTS: Overall current smoking rates and daily mean cigarettes smoked were lower in community where SFO had been implemented compared to those without implementation, and there was a significant difference in smoking rates between 2010 and 2008. Cross-sectional analysis of the effects of regional SFO revealed clear difference in rate of current smoking, but longitudinal analysis showed no significant differences. Stratifying by age groups, however, showed that groups less than 30 years of age had low smoking rates in community with ordinance compared to those without SFO since 2010. Yearly surveys measuring the number of cigarettes smoked, attempts to quit smoking, and experiences of smoke-free campaigns showed regional differences in the duration of implementation, but these differences were not significant in longitudinal analysis. Furthermore, there was a difference in regional socioeconomic characteristics between community with and without SFO implementation. CONCLUSIONS: For effective smoking control, it is necessary to evaluate current policies and develop indices to evaluate the practical implementation of ordinances. As more communities to pass the SFO, long-term observation and assessments required.

Ambientes libres de humo de tabaco. Impacto de una ordenanza municipal en docentes de escuelas de Puerto Madryn / Tobacco smoke-free environments. Impact of a municipal ordinance on school teachers in Puerto Madryn

El tabaquismo es una adicción de altísima morbimortalidad en el mundo dándose la particularidad de que el inicio de la misma ocurre, en general, en jóvenes, muchos de ellos escolarizados. Las legislaciones restrictivas respecto del consumo en espacios públicos tienen como objetivo disminuir la exposición al humo de segunda mano pero también hacen que los fumadores, que desarrollan sus actividades en estas áreas, disminuyan o cesen en su consumo. En este trabajo analizamos el impacto de una ordenanza municipal sobre ambientes 100% libres de humo de tabaco seguida de un importante trabajo de divulgación, en docentes en contacto directo con jóvenes, comparando una encuesta realizada dosaños antes y otra similar dos años después de promulgada la ordenanza. Se observó disminución del consumo de tabaco dentro del ámbito escolar (del 60.7 al 17.9%), se revirtió la extensión de zonas “permitidas” para fumar dentro de los establecimientos escolares (del 49% al 6,6%) y disminuyó o cesó el hábito de fumar en un elevado porcentaje de docentes (70,5%), lo que sin duda refleja el cambio en la visión de los alumnos sobre esta adicción.Concluimos que las legislaciones restrictivas (ambientes 100% libres de humo de tabaco) asociadas a trabajo de difusión y esclarecimiento sobre el tema, tienen un importante impacto en la lucha contra el tabaquismo.

Smoking is an addiction associated to high morbidity and mortality worldwide with the peculiarity that the smoking habit starts in young people during the school years. Restrictive laws on tobacco consumption in public spaces aim to reduce exposure to second-handsmoke but also to induce smokers to reduce or stop their consumption in these spaces. This paper analyzes the impact of a municipal ordinance on 100% tobacco smoke-free environments, followed by an important communication program, on teachers in direct contact with young people, comparing a survey two years before and a similar survey two years after the enactment of the ordinance. Tobacco consumption decreased in the school settings (from 60.7 to 17.9%), the availability of smoking areas diminished (from 49% to 6.6%) and the smoking habit was reduced or stopped in a significant percent of teachers (70.5%), which undoubtedly reflects a change in the view of the students about this addiction. We conclude that restrictive laws (environments 100% free of tobacco smoke) associated with communication activities have an important impact in the fight against smoking.

Opinions on the Recent No-Smoking Policy in Daejeon Metropolitan City: a Focus on the Differences of Opinions Between Smokers and Non-Smokers

BACKGROUND: The anti-smoking policy in Korea has been recently focusing on reducing the harmful effects of tobacco smoke pollution by establishing smoking bans or restrictions. The purpose of this study was to investigate the differences in opinions between smokers and non-smokers regarding this current policy. METHODS: A telephone survey was conducted by Gallup Korea involving 1,200 adult residents (older than 19 years) of the Daejeon Metropolitan Area. The number of respondents included in the assessment was 1,013 people (sampling error: +/-3.1% in 95% confidence interval). The questionnaire consisted of 4 main categories-general characteristics, knowledge and attitude of tobacco smoke pollution, agreement on non-smoking area designation of 9 public facilities, and opinions for imposing smoking fines. We conducted the Pearson's chi-square test to identify the different opinions between smokers and non-smokers. All statistical assessments were performed using the SPSS 18.0K. RESULTS: There was no statistically significant difference in the level of knowledge regarding the risks of tobacco smoke pollution between the two groups. However, smokers (79.0%) were less likely to recognize the seriousness of tobacco smoke pollution than non-smokers (94.7%) (P<0.001). In regard to their opinions for designating outdoor non-smoking areas, both groups agreed that designating non-smoking zones for children is the most important. Lastly, regarding the imposing of smoking fines, smokers were less supportive (58.3%) of the policy than non-smokers (92.2%) (P<0.001). CONCLUSIONS: According to the results of our survey, establishing non-smoking zones for children is the top priority of all non-smoking public areas, followed by restaurants, bus stops, and parks. For a successful non-smoking policy in public facilities, the cooperation and participation of smokers is required. Therefore, we should make every effort to educate smokers focusing on public relations to reduce the harmful effects of tobacco smoke pollution.

Opinions on the Recent No-Smoking Policy in Daejeon Metropolitan City: a Focus on the Differences of Opinions Between Smokers and Non-Smokers

BACKGROUND: The anti-smoking policy in Korea has been recently focusing on reducing the harmful effects of tobacco smoke pollution by establishing smoking bans or restrictions. The purpose of this study was to investigate the differences in opinions between smokers and non-smokers regarding this current policy. METHODS: A telephone survey was conducted by Gallup Korea involving 1,200 adult residents (older than 19 years) of the Daejeon Metropolitan Area. The number of respondents included in the assessment was 1,013 people (sampling error: +/-3.1% in 95% confidence interval). The questionnaire consisted of 4 main categories-general characteristics, knowledge and attitude of tobacco smoke pollution, agreement on non-smoking area designation of 9 public facilities, and opinions for imposing smoking fines. We conducted the Pearson's chi-square test to identify the different opinions between smokers and non-smokers. All statistical assessments were performed using the SPSS 18.0K. RESULTS: There was no statistically significant difference in the level of knowledge regarding the risks of tobacco smoke pollution between the two groups. However, smokers (79.0%) were less likely to recognize the seriousness of tobacco smoke pollution than non-smokers (94.7%) (P<0.001). In regard to their opinions for designating outdoor non-smoking areas, both groups agreed that designating non-smoking zones for children is the most important. Lastly, regarding the imposing of smoking fines, smokers were less supportive (58.3%) of the policy than non-smokers (92.2%) (P<0.001). CONCLUSIONS: According to the results of our survey, establishing non-smoking zones for children is the top priority of all non-smoking public areas, followed by restaurants, bus stops, and parks. For a successful non-smoking policy in public facilities, the cooperation and participation of smokers is required. Therefore, we should make every effort to educate smokers focusing on public relations to reduce the harmful effects of tobacco smoke pollution.