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In: Social justice: a journal of crime, conflict and world order, Band 23, Heft 1-2
ISSN: 1043-1578, 0094-7571
Looks at the dynamics of intra-Arab relations and the place the dominant powers of the world economic system assign to the Arab world within that system. Also considers certain aspects of the geography, history, and societal composition of the Arab world.
In: World Marxist review, Band 32, Heft 10, S. 37-40
ISSN: 0266-867X
This paper proposes an overarching review of national municipal waste management systems and waste-to-energy as an important part of it in the context of circular economy in the selected countries in Europe. The growth of population and rising standards of living means that the consumption of goods and energy is increasing. On the one hand, consumption leads to an increase in the generation of waste. On the other hand, the correlation between increased wealth and increased energy consumption is very strong as well. Given that the average heating value of municipal solid waste (MSW) is approximately 10 MJ/kg, it seems logical to use waste as a source of energy. Traditionally, waste-to-energy (WtE) has been associated with incineration. Yet, the term is much broader, embracing various waste treatment processes generating energy (for instance, in the form of electricity and/or heat or producing a waste-derived fuel). Turning waste into energy can be one key to a circular economy enabling the value of products, materials, and resources to be maintained on the market for as long as possible, minimising waste and resource use. As the circular economy is at the top of the EU agenda, all Member States of the EU (including the EEA countries) should move away from the old-fashioned disposal of waste to a more intelligent waste treatment encompassing the circular economy approach in their waste policies. Therefore, the article examines how these EU policies are implemented in practice. Given that WtE traditionally is attached to the MSW management and organisation, the focus of this article is twofold. Firstly, it aims to identify the different practices of municipal waste management employed in selected countries and their approaches in embracing the circular economy and, secondly, the extent to which WtE technologies play any role in this context. The following countries, Estonia, Greece, Italy, Latvia, Lithuania, Norway, Poland, Slovenia, Spain, and the UK were chosen to depict a broad European context. ; publishedVersion
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This paper proposes an overarching review of national municipal waste management systems and waste- to-energy as an important part of it in the context of circular economy in the selected countries in Europe. The growth of population and rising standards of living means that the consumption of goods and energy is increasing. On the one hand, consumption leads to an increase in the generation of waste. On the other hand, the correlation between increased wealth and increased energy consumption is very strong as well. Given that the average heating value of municipal solid waste (MSW) is approximately 10 MJ/kg, it seems logical to use waste as a source of energy. Traditionally, waste-to-energy (WtE) has been associated with incineration. Yet, the term is much broader, embracing various waste treatment processes generating energy (for instance, in the form of electricity and/or heat or producing a waste- derived fuel). Turning waste into energy can be one key to a circular economy enabling the value of products, materials, and resources to be maintained on the market for as long as possible, minimising waste and resource use. As the circular economy is at the top of the EU agenda, all Member States of the EU (including the EEA countries) should move away from the old-fashioned disposal of waste to a more intelligent waste treatment encompassing the circular economy approach in their waste policies. Therefore, the article examines how these EU policies are implemented in practice. Given that WtE traditionally is attached to the MSW management and organisation, the focus of this article is twofold. Firstly, it aims to identify the different practices of municipal waste management employed in selected countries and their approaches in embracing the circular economy and, secondly, the extent to which WtE technologies play any role in this context. The following countries, Estonia, Greece, Italy, Latvia, Lithuania, Norway, Poland, Slovenia, Spain, and the UK were chosen to depict a broad European context.
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Background Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction. Methods This international, prospective, cohort study enrolled 20 006 adult (≥18 years) patients from 466 hospitals in 61 countries with 15 cancer types, who had a decision for curative surgery during the COVID-19 pandemic and were followed up until the point of surgery or cessation of follow-up (Aug 31, 2020). Average national Oxford COVID-19 Stringency Index scores were calculated to define the government response to COVID-19 for each patient for the period they awaited surgery, and classified into light restrictions (index 60). The primary outcome was the non-operation rate (defined as the proportion of patients who did not undergo planned surgery). Cox proportional-hazards regression models were used to explore the associations between lockdowns and non-operation. Intervals from diagnosis to surgery were compared across COVID-19 government response index groups. This study was registered at ClinicalTrials.gov, NCT04384926. Findings Of eligible patients awaiting surgery, 2003 (10·0%) of 20 006 did not receive surgery after a median follow-up of 23 weeks (IQR 16–30), all of whom had a COVID-19-related reason given for non-operation. Light restrictions were associated with a 0·6% non-operation rate (26 of 4521), moderate lockdowns with a 5·5% rate (201 of 3646; adjusted hazard ratio [HR] 0·81, 95% CI 0·77–0·84; p<0·0001), and full lockdowns with a 15·0% rate (1775 of 11 827; HR 0·51, 0·50–0·53; p<0·0001). In sensitivity analyses, including adjustment for SARS-CoV-2 case notification rates, moderate lockdowns (HR 0·84, 95% CI 0·80–0·88; p<0·001), and full lockdowns (0·57, 0·54–0·60; p<0·001), remained independently associated with non-operation. Surgery beyond 12 weeks from diagnosis in patients without neoadjuvant therapy increased during lockdowns (374 [9·1%] of 4521 in light restrictions, 317 [10·4%] of 3646 in moderate lockdowns, 2001 [23·8%] of 11 827 in full lockdowns), although there were no differences in resectability rates observed with longer delays. Interpretation Cancer surgery systems worldwide were fragile to lockdowns, with one in seven patients who were in regions with full lockdowns not undergoing planned surgery and experiencing longer preoperative delays. Although short-term oncological outcomes were not compromised in those selected for surgery, delays and non-operations might lead to long-term reductions in survival. During current and future periods of societal restriction, the resilience of elective surgery systems requires strengthening, which might include protected elective surgical pathways and long-term investment in surge capacity for acute care during public health emergencies to protect elective staff and services. Funding National Institute for Health Research Global Health Research Unit, Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, Medtronic, Sarcoma UK, The Urology Foundation, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research.
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Background Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction. Methods This international, prospective, cohort study enrolled 20 006 adult (≥18 years) patients from 466 hospitals in 61 countries with 15 cancer types, who had a decision for curative surgery during the COVID-19 pandemic and were followed up until the point of surgery or cessation of follow-up (Aug 31, 2020). Average national Oxford COVID-19 Stringency Index scores were calculated to define the government response to COVID-19 for each patient for the period they awaited surgery, and classified into light restrictions (index 60). The primary outcome was the non-operation rate (defined as the proportion of patients who did not undergo planned surgery). Cox proportional-hazards regression models were used to explore the associations between lockdowns and non-operation. Intervals from diagnosis to surgery were compared across COVID-19 government response index groups. This study was registered at ClinicalTrials.gov, NCT04384926. Findings Of eligible patients awaiting surgery, 2003 (10·0%) of 20 006 did not receive surgery after a median follow-up of 23 weeks (IQR 16–30), all of whom had a COVID-19-related reason given for non-operation. Light restrictions were associated with a 0·6% non-operation rate (26 of 4521), moderate lockdowns with a 5·5% rate (201 of 3646; adjusted hazard ratio [HR] 0·81, 95% CI 0·77–0·84; p<0·0001), and full lockdowns with a 15·0% rate (1775 of 11 827; HR 0·51, 0·50–0·53; p<0·0001). In sensitivity analyses, including adjustment for SARS-CoV-2 case notification rates, moderate lockdowns (HR 0·84, 95% CI 0·80–0·88; p<0·001), and full lockdowns (0·57, 0·54–0·60; p<0·001), remained independently associated with non-operation. Surgery beyond 12 weeks from diagnosis in patients without neoadjuvant therapy increased during lockdowns (374 [9·1%] of 4521 in light restrictions, 317 [10·4%] of 3646 in moderate lockdowns, 2001 [23·8%] of 11827 in full lockdowns), although there were no differences in resectability rates observed with longer delays. Interpretation Cancer surgery systems worldwide were fragile to lockdowns, with one in seven patients who were in regions with full lockdowns not undergoing planned surgery and experiencing longer preoperative delays. Although short-term oncological outcomes were not compromised in those selected for surgery, delays and non-operations might lead to long-term reductions in survival. During current and future periods of societal restriction, the resilience of elective surgery systems requires strengthening, which might include protected elective surgical pathways and long- term investment in surge capacity for acute care during public health emergencies to protect elective staff and services. Funding National Institute for Health Research Global Health Research Unit, Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, Medtronic, Sarcoma UK, The Urology Foundation, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research.
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