Geochemistry of As-, F- and B-bearing waters in and around San Antonio de los Cobres, Argentina, and implications for drinking and irrigation water quality

Spring, stream and tap waters from in and around San Antonio de los Cobres, Salta, Argentina, were sampled to characterize their geochemical signatures, and to determine whether they pose a threat to human health and crops. The spring waters are typical of geothermal areas world-wide, in that they are Na-Cl waters with high concentrations of Astot, As(III), Li, B, HCO3, F and SiO2 (up to 9.49, 8.92, 13.1, 56.6, 1250, 7.30 and 57.2 mg L-1, respectively), and result from mixing of deep Na-Cl brines and meteoric HCO3-rich waters. Springs close to the town of San Antonio have higher concentrations of all elements, and are generally cooler, than springs in the Baños de Agua Caliente. Spring water chemistry is a result of mixing of deep Na-Cl brines and meteoric HCO3 waters. Stream waters are also Na-Cl type, and receive large inputs of all elements from the springs near San Antonio, but concentrations decrease downstream through the town of San Antonio due to mineral precipitation. The spring that is used as a drinking water source, and other springs in the area, have As, F and B concentrations in excess of WHO and Argentinian drinking water guidelines. Evaluation of the waters for irrigation purposes suggests that their high salinities and B concentrations may adversely affect crops. The waters may be improved for drinking and irrigation by dilution with cleaner meteoric waters, mineral precipitation or by use of commercial filters. Such recommendations could also be followed by other settlements that draw drinking and irrigation waters from geothermal sources

Estimated Risk of HIV Acquisition and Practice for Preventing Occupational Exposure: A Study of Healthcare Workers at Tumbi and Dodoma Hospitals, Tanzania.

Health care workers (HCWs) are at risk of acquiring human immuno-deficiency virus (HIV) and other infections via exposure to infectious patients' blood and body fluids. The main objective of this study was to estimate the risk of HIV transmission and examine the practices for preventing occupational exposures among HCWs at Tumbi and Dodoma Hospitals in Tanzania. This study was carried out in two hospitals, namely, Tumbi in Coast Region and Dodoma in Dodoma Region. In each facility, hospital records of occupational exposure to HIV infection and its management were reviewed. In addition, practices to prevent occupational exposure to HIV infection among HCWs were observed. The estimated risk of HIV transmission due to needle stick injuries was calculated to be 7 cases per 1,000,000 HCWs-years. Over half of the observed hospital departments did not have guidelines for prevention and management of occupational exposure to HIV infections and lacked well displayed health and safety instructions. Approximately, one-fifth of the hospital departments visited failed to adhere to the instructions pertaining to correlation between waste materials and the corresponding colour coded bag/container/safety box. Seventy four percent of the hospital departments observed did not display instructions for handling infectious materials. Inappropriate use of gloves, lack of health and safety instructions, and lack of use of eye protective glasses were more frequently observed at Dodoma Hospital than at Tumbi Hospital. The poor quality of the hospital records at the two hospitals hampered our effort to characterise the risk of HIV infection acquisition by HCWs. Greater data completeness in hospital records is needed to allow the determination of the actual risk of HIV transmission for HCWs. To further reduce the risk of HIV infection due to occupational exposure, hospitals should be equipped with sufficient personal protective equipment (PPE) and HCWs should be reminded of the importance of adhering to universal precautions

Defining an epidemic:The body mass index in British and American obesity research 1960-2000

Between the 1970s and the mid‐1990s the body mass index (BMI) became the standard means of assessing obesity both in populations and in individuals, replacing previously diverse and contested definitions of excess body weight. This article draws on theoretical approaches from the sociology of standards and science and technology studies to describe the development of this important new standard and the ways in which its adoption facilitated the development of obesity science, that is, knowledge about the causes, health effects and treatments of excess body weight. Using an analysis of policy and healthcare literatures, I argue that the adoption of the BMI, along with associated standard cut‐off points defining overweight and obesity, was crucial in the framing of obesity as an epidemic. This is because, I suggest, these measures enabled, firstly, the creation of large data sets tracking population‐level changes in average body weight, and, secondly, the construction of visual representations of these changes. The production of these two new techniques of representation made it possible for researchers in this field, and others such as policymakers, to argue credibly that obesity should be described as an epidemic

Primary Care Staff's Views and Experiences Related to Routinely Advising Patients about Physical Activity. A Questionnaire Survey

Background: United Kingdom public health policy has recently re-emphasised the role of primary health care professionals in tackling increasing levels of physical inactivity within the general population. However, little is known about the impact that this has had in practice. This study explores Scottish primary care staff's knowledge, attitudes and experiences associated with advising patients about physical activity during routine consultations. Methods: A cross-sectional questionnaire survey of general practitioners (or family physicians), practice nurses and health visitors based in four health regions was conducted during 2004. The main outcome measures included: i) health professionals' knowledge of the current physical activity recommendations; (ii) practice related to routine physical activity advising; and (iii) associated attitudes. Results: Questionnaires were returned by 757 primary care staff (response rate 54%). Confidence and enthusiasm for giving advice was generally high, but knowledge of current physical activity recommendations was low. In general, respondents indicated that they routinely discuss and advise patients about physical activity regardless of the presenting condition. Health visitors and practice nurses were more likely than general practitioners to offer routine advice. Lack of time and resources were more likely to be reported as barriers to routine advising by general practitioners than other professional groups. However, health visitors and practice nurses were also more likely than general practitioners to believe that patients would follow their physical activity advice giving. Conclusion: If primary health care staff are to be fully motivated and effective in encouraging and supporting the general population to become more physically active, policymakers and health professionals need to engage in efforts to: (1) improve knowledge of current physical activity recommendations and population trends amongst frontline primary care staff; and (2) consider the development of tools to support individual assessment and advice giving to suit individual circumstances. Despite the fact that this study found that system barriers to routine advising were less of a problem than other previous research has indicated, this issue still remains a challenge

Guidelines for the Diagnosis, Treatment and Prevention of Leprosy

The development of these guidelines was coordinated by Laura Gillini, Medical Officer, Global Leprosy Programme (GLP) and supervised by Erwin Cooreman, GLP Team Leader. The GLP would like to thank members of the Guidelines Development Group (GDG), members of the External Review Group (ERG), and World Health Organization (WHO) staff who contributed to the development of these guidelines as part of the Steering Group or as peer reviewers. The GLP appreciates the input provided by the national leprosy programmes of the following countries: Colombia, the Democratic Republic of the Congo, India, Morocco and the Philippines. The GLP is particularly grateful to the persons affected by leprosy who participated in focus group discussions in Colombia, Ghana, India and Nepal on diagnosis, treatment and contact screening. The guidelines for the diagnosis, treatment and prevention of leprosy were developed with full funding support from The Nippon Foundation.Publisher PD

Scientific Opinion on Exploring options for providing advice about possible human health risks based on the concept of Threshold of Toxicological Concern (TTC)

<p>Synthetic and naturally occurring substances present in food and feed, together with their possible breakdown or reaction products, represent a large number of substances, many of which require risk assessment. EFSA’s Scientific Committee was requested to evaluate the threshold of toxicological concern (TTC) approach as a tool for providing scientific advice about possible human health risks from low level exposures, its applicability to EFSA’s work, and to advise on any additional data that might be needed to strengthen the underlying basis of the TTC approach. The Scientific Committee examined the published literature on the TTC approach, undertook its own analyses and commissioned an <em>in silico </em>investigation of the databases underpinning the TTC approach. The Scientific Committee concluded that the TTC approach can be recommended as a useful screening tool either for priority setting or for deciding whether exposure to a substance is so low that the probability of adverse health effects is low and that no further data are necessary. The following human exposure threshold values are sufficiently conservative to be used in EFSA’s work; 0.15 μg/person per day for substances with a structural alert for genotoxicity, 18 μg/person per day for organophosphate and carbamate substances with anti-cholinesterase activity, 90 μg/person per day for Cramer Class III and Cramer Class II substances, and 1800 μg/person per day for Cramer Class I substances, but for application to all groups in the population, these values should be expressed in terms of body weight, i.e. 0.0025, 0.3, 1.5 and 30 μg/kg body weight per day, respectively. Use of the TTC approach for infants under the age of 6 months, with immature metabolic and excretory systems, should be considered on a case-by-case basis. The Committee defined a number of exclusion categories of substances for which the TTC approach would not be used.</p&gt

Cytotoxic chemotherapy for incurable colorectal cancer: living with a PICC-line

<b>Aims.</b> (i) To determine which aspects of living with a peripherally inserted central catheter (PICC) line cause Modified de Gramont (MdG) patients most difficulty. (ii) To explore MdG patients' views of the PICC-line experience. (iii) To determine if patients view PICC-lines as a benefit or a burden when receiving ambulatory MdG chemotherapy. <b>Design.</b> A two-stage, descriptive study. <b>Methods.</b> Phase 1 comprised semi-structured interviews. Phase 2 surveyed the MdG population. Phase 1 interview data informed the Phase 2 questionnaire. The setting was a West of Scotland Cancer Care Centre and the sample was: Phase 1, a convenience sample of 10 MdG patients; Phase 2, 62 consecutive patients. <b>Results.</b> A response rate of 93·9% for Phase 2. The majority of PICC-line patients held favourable views towards having a PICC-line and adapted well with minimal disruption to daily life. Concerns were evident regarding coping at home with a PICC-line, chemotherapy spillage, dealing with complex information and the responsibility of patients/carers regarding PICC-line management. Patients preferred ambulatory chemotherapy to in-patient treatment. <b>Conclusions.</b> PICC-lines should be considered for more chemotherapy patients but service development is necessary to ensure individual needs are addressed. <b>Relevance to clinical practice.</b> Contributes to the PICC-line literature by providing a national patient perspective on a range of daily living activities (DLAs). PICC-line patients prefer out-patient ambulatory chemotherapy rather than in-patient treatment. The longer a patient has a PICC-line, the more able they are to manage activities such as dressing. Concerns remain over chemotherapy spillage, partner/carer responsibility for PICC-line maintenance and the proper balance between required information and what the patient wants to know

Effective vaccination against rabies in puppies in rabies endemic regions.

In rabies endemic regions, a proportionally higher incidence of rabies is often reported in dogs younger than 12 months of age, which includes puppies less than 3 months of age; this presents a serious risk to public health. The higher incidence of rabies in young dogs may be the effect of low vaccination coverage in this age class, partly as a result of the perception that immature immune systems and maternal antibodies inhibit seroconversion to rabies vaccine in puppies less than three months of age. Therefore, to test this perception, the authors report the virus neutralising antibody titres from 27 dogs that were vaccinated with high quality, inactivated rabies vaccine aged three months of age and under as part of larger serological studies undertaken in Gauteng Province, South Africa, and the Serengeti District, Tanzania. All of these dogs seroconverted to a single dose of vaccine with no adverse reactions reported and with postvaccinal peak titres ranging from 2.0 IU/ml to 90.5 IU/ml. In light of these results, and the risk of human beings contracting rabies from close contact with puppies, the authors recommend that all dogs in rabies endemic regions, including those less than three months of age, are vaccinated with high quality, inactivated vaccine.Funding for the study in Zenzele was provided by the International Fund for Animal Welfare (IFAW) and World Animal Protection (WAP). Funding for the study in Tanzania was provided by the RCVS Small Grant Programme and the University of Edinburgh Small Grant Scholarship Program. Dog vaccines for the Serengeti study were donated by MSD Animal Health. Partial funding for the APHA was provided by the UK Department for Environment and Rural Affairs (Project SV3500). JW receives support from the Alborada Trust and the Research and Policy for Infectious Disease Dynamics Program of the Science and Technology Directorate, Department of Homeland Security, Fogarty International Centre, National Institute of Health.This is the author accepted manuscript. The final version is available from BMJ Group via http://dx.doi.org/10.1136/vr.10297

Stormwater harvesting for irrigation purposes: An investigation of chemical quality of water recycled in pervious pavement system

Most available water resources in the world are used for agricultural irrigation. Whilst this level of water use is expected to increase due to rising world population and land use, available water resources are expected to become limited due to climate change and uneven rainfall distribution. Recycled stormwater has the potential to be used as an alternative source of irrigation water and part of sustainable water management strategy. This paper reports on a study to investigate whether a sustainable urban drainage system (SUDS) technique, known as the pervious pavements system (PPS) has the capability to recycle water that meets irrigation water quality standard. Furthermore, the experiment provided information on the impact of hydrocarbon (which was applied to simulate oil dripping from parked vehicles onto PPS), leaching of nutrients from different layers of the PPS and effects of nutrients (applied to enhance bioremediation) on the stormwater recycling efficiency of the PPS. A weekly dose of 6.23×10-3L of lubricating oil and single dose of 17.06g of polymer coated controlled-release fertilizer granules were applied to the series of 710mm×360mm model pervious pavement structure except the controls. Rainfall intensity of 7.4mm/h was applied to the test models at the rate of 3 events per week. Analysis of the recycled water showed that PPS has the capability to recycle stormwater to a quality that meets the chemical standards for use in agricultural irrigation irrespective of the type of sub-base used. There is a potential benefit of nutrient availability in recycled water for plants, but care should be taken not to dispose of this water in natural water courses as it might result in eutrophication problems. © 2014 Elsevier Ltd

Younger adult type 2 diabetic patients have poorer glycaemic control: A cross-sectional study in a primary care setting in Singapore

10.1186/1472-6823-13-18BMC Endocrine Disorders13-BEDM