The health sector gap in the southern Africa crisis in 2002/2003

The southern Africa crisis represents the first widespread emergency in a region with a mature HIV/AIDS epidemic. It provides a steep learning curve for the international humanitarian system in understanding and responding to the complex interactions between the epidemic and the causes and the effects of this crisis. It also provoked much debate about the severity and causes of this emergency, and the appropriateness of the response by the humanitarian community. The authors argue that the over-emphasis on food aid delivery occurred at the expense of other public health interventions, particularly preventative and curative health services. Health service needs were not sufficiently addressed despite the early recognition that ill-health related to HIV/AIDS was a major vulnerability factor. This neglect occurred because analytical frameworks were too narrowly focused on food security, and large-scale support to health service delivery was seen as a long-term developmental issue that could not easily be dealt with by short-term humanitarian action. Furthermore, there were insufficient countrywide data on acute malnutrition, mortality rates and performance of the public health system to make better-balanced evidence-based decisions. In this crisis, humanitarian organisations providing health services could not assume their traditional roles of short-term assistance in a limited geographical area until the governing authorities resume their responsibilities. However, relegating health service delivery as a long-term developmental issue is not acceptable. Improved multisectoral analytical frameworks that include a multidisciplinary team are needed to ensure all aspects of public health are dealt with in similar future emergencies. Humanitarian organisations must advocate for improved delivery and access to health services in this region. They can target limited geographical areas with high mortality and acute malnutrition rates to deliver their services. Finally, to address the underlying problem of the health sector gap, a long-term strategy to ensure improved and sustainable health sector performance can only be accomplished with truly adequate resources. This will require renewed efforts on part of governments, donors and the international community. Public health interventions, complementing those addressing food insecurity, were and are still needed to reduce the impact of the crisis, and to allow people to re-establish their livelihoods. These will increase the population's resilience to prevent or mitigate future disasters.     

Land Evaluation for Maize Based on Fuzzy Set and Interpolation

The objective of this article is to apply fuzzy set and interpolation techniques for land suitability evaluation for maize in Northern Ghana. Land suitability indices were computed at point observations using the Semantic Import (SI) model, whereas spatial interpolation was carried out by block kriging. Interpolated land suitability shows a high correlation (R2 = 0.87) with observed maize yield at the village level. This indicates that land suitability is closely related to maize yield in the study area. Membership functions were further used to assess the degree of limitation of land characteristics to maize. Sixty percent of the data has membership functions ranging from 0.23 for ECEC to 1.00 for drainage. ECEC, organic C, and clay are the major constraints to maize yield. The use of the fuzzy technique is helpful for land suitability evaluation, especially in applications in which subtle differences in soil quality are of a major interest. Furthermore, the use of kriging that exploits spatial variability of data is useful in producing continuous land suitability maps and in estimating uncertainties associated with predicted land suitability indices.     

Barriers to interlock implementation

This commentary reviews current and past vehicle interlock programs for impaired driving offenders with a focus on the challenges that courts and motor vehicle departments face in attempting to implement mandatory programs as required by current federal legislation. There are few offenders in interlock programs compared to the large number of impaired drivers arrested each year. This suggests that, to increase participation, courts will have to threaten more severe sanctions for those offenders who reject interlock programs. A combination of electronic house arrest with interlock programs is suggested as a method of maximizing interlock use.     

A GIS Model of Subsurface Water Potential for Aquatic Resource Inventory,Assessment, and Environmental Management

Biological, chemical, and physical attributes of aquatic ecosystems are often strongly influenced by groundwater sources. Nonetheless, widespread access to predictions of subsurface contributions to rivers, lakes, and wetlands at a scale useful to environmental managers is generally lacking. In this paper, we describe a neighborhood analysis approach for estimating topographic constraints on spatial patterns of recharge and discharge and discuss how this index has proven useful in research, management, and conservation contexts. The Michigan Rivers Inventory subsurface flux model (MRI-DARCY) used digital elevation and hydraulic conductivity inferred from mapped surficial geology to estimate spatial patterns of hydraulic potential. Model predictions were calculated in units of specific discharge (meters per day) for a 30-m²-cell raster map and interpreted as an index of potential subsurface water flux (shallow groundwater and event through-flow). The model was evaluated by comparison with measurements of groundwater-related attributes at watershed, stream segment, and local spatial scales throughout Lower Michigan (USA). Map-based predictions using MRI-DARCY accounted for 85% of the observed variation in base flow from 128 USGS gauges, 69% of the observed variation in discharge accrual from 48 river segments, and 29% of the residual variation in local groundwater flux from 33 locations as measured by hyporheic temperature profiles after factoring out the effects of climate. Although it does not incorporate any information about the actual water table surface, by quantifying spatial variation of key constraints on groundwater-related attributes, the model provides strata for more intensive study, as well as a useful spatial tool for regional and local conservation planning, fisheries management, wetland characterization, and stream assessment.     

Docosahexaenoic acid (DHA) content of membranes determines molecular activity of the sodium pump: implications for disease states and metabolism

The omega-3 polyunsaturate, docosahexaenoic acid (DHA), plays a number of biologically important roles, particularly in the nervous system, where it is found in very high concentrations in cell membranes. In infants DHA is required for the growth and functional development of the brain, with a deficiency resulting in a variety of learning and cognitive disorders. During adulthood DHA maintains normal brain function and recent evidence suggests that reduced DHA intake in adults is linked with a number of neurological disorders including schizophrenia and depression. Here we report a high positive correlation between the molecular activity (ATP min^–1) of individual Na⁺K⁺ATPase units and the content of DHA in the surrounding membrane bilayer. This represents a fundamental relationship underlying metabolic activity, but may also represent a link between reduced levels of DHA and neurological dysfunction, as up to 60% of energy consumption in the brain is linked to the Na⁺K⁺ATPase enzyme.     

Sediment and porewater geochemistry in a metal contaminated estuary,Dulas Bay,Anglesey

Remobilisation of contaminant metals from sediments can occur by chemical, biological or physical changes. This in turn can lead to contaminant fluxes to the porewaters and ultimately the water column. The aim of the research presented here is to document post-depositional controls on metal mobility and fluxes in a heavily metal-contaminated estuary. This will allow for an improved understanding of the impact of contaminated sediments on water quality from both a short-term and long-term perspective. Dulas Bay is situated on the east coast of Anglesey, North Wales, and receives polluted waters from Parys Mountain. Metals within Dulas Bay sediments show surface enrichment and variations in mineralogical form. Diagenesis clearly plays a role in post-depositional behaviour of the metals, forming sulphides and potentially carbonates. The presence of a dominant exchangeable/carbonate fraction, and elevated porewater metals, in this sulphidic system is significant and could indicate the presence of freshwater diagenesis, or, reflect the high levels of metals in the sediment.     

Coupled abiotic-biotic mineralization of 2,4,6-trinitrotoluene (TNT)

Munitions wastes such as TNT are widespread contaminants in soils and ground waters. We investigated a coupled abiotic-biotic treatment scheme for remediation of aqueous solutions of TNT. Mineralization of aqueous TNT (0.22 mM) was initially optimized with minimum reactant use (Fe3+ and H2O2) in light-assisted and dark, modified Fenton reactions at acidic and neutral pH. Complete TNT degradation occurred under all reaction conditions within 24 h. Using the optimum reactant concentrations, coupled abiotic-biotic reactions showed an increase in TNT mineralization, from 47 to 80%, after biomass addition to the acidic, dark Fenton-like reaction. Comparable increases of TNT mineralization were observed under neutral pH with similar reaction conditions. In light-assisted Fenton-like reactions at neutral pH, no increase in cumulative TNT mineralization (66%) was seen in coupled abiotic-biotic reactions. Abiotic photo-Fenton-like reactions alone, at acidic pH, produced complete TNT mineralization and required no biotic assistance. While light-enhanced Fenton reactions alone can provide high levels of TNT mineralization, the dark abiotic-biotic reaction scheme has perhaps a wider use due to a similar extent of TNT mineralization in the absence of light, leading to possible applications in soil slurry and in situ processes in the subsurface.     

Landscape metrics and estuarine sediment contamination in the mid-Atlantic and southern New England regions

In a previously published study, quantitative relationships were developed between landscape metrics and sediment contamination for 25 small estuarine systems within Chesapeake Bay. These analyses have been extended to include 75 small estuarine systems across the mid-Atlantic and southern New England regions of the USA. Because of the different characteristics and dynamics of the estuaries across these regions, adjustment for differing hydrology, sediment characteristics, and sediment origins were included in the analysis. Multiple linear regression with stepwise selection was used to develop statistical models for sediment metals, organics, and total polycyclic aromatic hydrocarbons (PAHs). The landscape metrics important for explaining the variation in sediment metals levels (R2 = 0.72) were the percent area of nonforested wetlands (negative contribution), percent area of urban land, and point source effluent volume and metals input (positive contributions). The metrics important for sediment organics levels (R2 = 0.5) and total PAHs (R2 = 0.46) were percent area of urban land (positive contribution) and percent area of nonforested wetlands (negative contribution). These models included silt-clay content (metals) or total organic C (organics, total PAHs) of sediments and grouping by estuarine hydrology, suggesting the importance of sediment characteristics and hydrology in mitigating the influence of the landscape metrics on sediment contamination levels. The overall results from this study are indicative of how statistical models can be developed relating landscape metrics to estuarine sediment contamination for distributions of land cover and point source discharges.     

PM2.5 assessment in 21 European study centers of ECRHS II: Method and first winter results

The follow-up of a cohort of adults from 29 European centers of the former European Community Respiratory Health Survey (ECRHS) I (1989-1992) will examine the long-term effects of exposure to ambient air pollution on the incidence, course, and prognosis of respiratory diseases, in particular asthma and decline in lung function. The purpose of this article is to describe the methodology and the European-wide quality control program for the collection of particles with 50% cut-off size of 2.5 microm aerodynamic diameter (PM2.5) in the ECRHS II and to present the PM2.5 results from the winter period 2000-2001. Because PM2.5 is not routinely monitored in Europe, we measured PM2.5 mass concentrations in 21 participating centers to estimate background exposure in these cities. A standardized protocol was developed using identical equipment in each center (U.S. Environmental Protection Agency Well Impactor Ninety-Six [WINS] and PQ167 from BGI, Inc.). Filters were weighed in a single central laboratory. Sampling was conducted for 7 days per month for a year. Winter mean PM2.5 mass concentrations (November 2000-February 2001) varied substantially, with Iceland reporting the lowest value (5 microg/m3) and northern Italy the highest (69 microg/m3). A standardized procedure appropriate for PM2.5 exposure assessment in a multicenter study was developed. We expect ECRHS II to have sufficient variation in exposure to assess long-term effects of air pollution in this cohort. Any bias caused by variation in the characteristics of the chosen monitoring location (e.g., proximity to traffic sources) will be addressed in later analyses. Given the homogenous spatial distribution of PM2.5, however, concentrations measured near traffic are not expected to differ substantially from those measured at urban background sites.     

The distribution of octachlorostyrene (OCS) in environmental samples from Europe

Although octachlorostyrene (OCS) was never used as a commercial product, it may be produced during incineration and combustion processes involving chlorinated compounds. Its environmental spreading was evaluated through the analysis of several representative samples. OCS could not be measured in soil samples collected from urban and rural areas or sediments, but was present (up to 5.41 ng/g dry weight) in industrial soil collected near chemically polluted areas. For aquatic biota samples, the OCS concentrations in freshwater mussels ranged from <0.01 ng/g wet weight (ww) to 0.18 ng/g ww (mean 0.06 ng/g ww) and similar levels could be measured in 11 freshwater fish species from Belgium and Romania. A higher OCS contamination level was found in shrimps (mean 0.08 ng/g ww) compared to marine fish (mean 0.02 ng/g ww for bib and 0.01 ng/g ww for sole and whiting, respectively). OCS could also be measured in 19 harbour porpoise (Phocoena phocoena) liver samples with a mean value of 1.90 ng/g ww. According to these data, it could be computed that the biomagnification factor for OCS was one order of magnitude lower than that of HCB in the fish-porpoise food chain. The mean OCS concentrations in blue tits (Parus caeruleus) eggs and great tits (Parus major) adipose tissue were 1.24 ng/g ww and 3.24 ng/g ww, respectively. OCS could be measured in different tissues of hedgehog (Erinaceus europaeus), with the highest concentrations found in adipose tissue (mean 0.34 ng/g ww) and liver (mean 0.39 ng/g ww). In contrast, only low concentrations of OCS could be measured in human adipose tissue (up to 0.38 ng/g ww) and liver (up to 0.05 ng/g ww), while it could not be detected in human brain or lung. The relationship between the concentrations of OCS and HCB was also discussed for each species.